CURRENT ISSUE

ABSTRACT: Welcome editorial from Editor in Chief

ABSTRACT: Cervical cancer remains a major public health concern in Kazakhstan despite ongoing prevention efforts. Although incidence has declined in many high-income countries due to effective screening and human papillomavirus vaccination programs, Kazakhstan continues to report relatively high incidence and still considerable mortality rates compared with many developed regions. This narrative review summarizes the current epidemiological trends, screening practices, and prevention strategies for cervical cancer in Kazakhstan. National screening programs based on cytology have been implemented since 2008 and have improved early detection; however, screening coverage remains below the World Health Organization target of 70%, with participation particularly low in rural areas due to limited awareness, access barriers, and logistical challenges. The prevalence of human papillomavirus infection among women in Kazakhstan is relatively high, with high-risk types contributing significantly to disease burden. The reintroduction of the national HPV vaccination program targeting adolescents represents an important step toward long-term cervical cancer prevention. In addition, emerging screening approaches such as HPV self-sampling offer promising opportunities to increase screening uptake, especially among under-screened populations. Integrating vaccination programs with innovative and accessible screening strategies, alongside improved awareness, follow-up systems, and health system support, could significantly enhance cervical cancer prevention efforts. Strengthening these interventions will be essential for Kazakhstan to reduce cervical cancer burden and move toward achieving the World Health Organization goal of cervical cancer elimination.

ABSTRACT: Central precocious puberty is an uncommon but important paediatrics endocrine condition that requires timely recognition and evaluation to prevent adverse auxological and psychosocial outcomes. We present the case of a 6-year-old girl with a 10-month history of progressive breast enlargement and pubic and axillary hair development. Clinical examination revealed markedly advanced secondary sexual characteristics, consistent with Tanner stage IV maturation. Endocrine evaluation demonstrated pubertal-range gonadotropin concentrations, and dynamic testing with a gonadotropin-releasing hormone agonist showed a pubertal luteinizing hormone response, supporting activation of the hypothalamic-pituitary-gonadal axis. Bone age assessment demonstrated advancement beyond chronological age, while pelvic ultrasonography showed pubertal uterine morphology. Brain magnetic resonance imaging revealed no hypothalamic-pituitary or other intracranial lesion. Following clinical, biochemical, radiological, and imaging assessment, a diagnosis of idiopathic central precocious puberty was made. The patient’s parents were counselled on the diagnosis, treatment options, expected benefits, and need for follow-up, and treatment with a gonadotropin-releasing hormone analogue was commenced. This case underscores the importance of a structured approach to children presenting with early progressive pubertal development, including careful clinical assessment, bone age evaluation, endocrine testing, pelvic imaging, and neuroimaging where indicated.

ABSTRACT: Background: In India, pregnant women and their families face considerable challenges when trying to access expert-level maternity care, primarily due to the inadequately rendered services within poorly managed healthcare facilities. Among these challenges, one of the most profound discouragements is the documented evidence of disrespect and mistreatment of women during childbirth within healthcare facilities. This type of mistreatment undermines the dignity and the psychological wellness of mothers and discourages them from pursuing prompt care within the facility. While it is of significant relevance, the disrespect and mistreatment of women during the childbirth process remain poorly documented, thus limiting the understanding of the phenomenon's size. This paper could be the first of its kind to document the ubiquity of discourtesy and mistreatment in maternity care in the context of facility childbirth in Uttarakhand, India, and to contribute to the understanding of disrespect and mistreatment in maternity care across the healthcare continuum.
Methods: A cross-sectional facility-based study was conducted from March 2021 to October 2021. In total, 120 women were selected using a total enumeration technique. A standardized tool (Women's Perception of Respectful Maternity Care) was used to retrieve the data. Data were entered into SPSS version 22.0 for analysis. Significant statistics were confirmed at a P-value of < 0.05.
Results: From 120 women’s data, 83% of them received respectful maternity care. The mean whole respectful maternity care score was 86.4 with a range of 19 to 95. Subsequently, after adjusting for sociodemographic and obstetric features, the correlation between respectful maternity care and the mode of delivery (P=0.96), age (P=0.77), and gravida (P=0.79) was not significant.
Conclusions: Respectful maternity care is clearly practiced in Rishikesh's designated public wellness services. Positive experiences with perinatal care can increase use of parental care services. A more intensive study is needed to better recognise appropriate local factors, social norms, and patient-provider interactions.