CURRENT ISSUE

ABSTRACT: Situs inversus totalis is a rare congenital anomaly characterized by the complete transposition of the thoracic and abdominal organs. We report the case of a previously healthy 21-year-old patient who was incidentally diagnosed with the condition at age 19, following an abdominal ultrasound requested on her own initiative due to a prior suspicion of an anatomical variation. The patient had a history of dextrocardia identified in childhood, without further investigation at the time. The diagnosis was confirmed by ultrasound, which showed complete inversion of the abdominal organs. This case reinforces the importance of early identification of congenital anatomical anomalies and their clinical relevance in diagnostic and surgical contexts.

ABSTRACT: Obesity is a chronic condition  driven in part by disrupted appetite control and changes in gastrointestinal function, both of which contribute to excessive energy intake and progressive weight gain. Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has been shown to produce meaningful weight loss in non-diabetic adults. Despite its growing clinical use, the physiological processes through which semaglutide influences appetite and gastric emptying have not been clearly brought together. This systematic review explored how semaglutide affects appetite regulation and gastric emptying, and how these effects relate to weight reduction.
A systematic search was conducted in PubMed, Google Scholar, and Dimensions for studies published between 2021 and 2026, in line with PRISMA 2020 guidelines. Study screening, data extraction, and risk-of-bias assessment were carried out using Covidence by two independent reviewers, with a third reviewer resolving any disagreements. Four studies met the inclusion criteria, consisting of randomized controlled trials and one retrospective cohort study.
Across randomized trials, semaglutide was consistently associated with greater improvements in appetite-related outcomes compared with placebo, including reductions in hunger scores and overall energy intake. Studies that assessed gastric physiology reported a notable delay in gastric emptying with semaglutide, particularly during the early stages of treatment. These physiological changes occurred alongside greater weight loss in semaglutide-treated participants compared with control groups. Longer-term findings suggested that appetite suppression was maintained over time and accompanied by clinically meaningful weight reduction, while observational data supported the effectiveness of semaglutide in routine clinical practice.
Overall, the findings suggest that the weight-reducing effects of semaglutide in non-diabetic adults with obesity are closely tied to its ability to suppress appetite and slow gastric emptying. These mechanisms appear to play a central role in its therapeutic benefits and help explain the sustained weight loss observed with treatment.

ABSTRACT: The growing pace of antimicrobial resistance (AMR) is a serious threat to modern infectious disease control as it has significantly undermined the clinical value of the traditional antibiotics. Traditional antimicrobial agents, which act by preventing the growth of bacteria or causing cell death, place a lot of selection pressure on the microbial population, therefore, promoting the rapid emergence and spread of resistance determinants. Besides spurring the evolution of resistance, such strategies often destabilize commensal microbiota and help transfer resistance genes between different bacteria of various species. These restrictions have shown that there is an urgent need to establish alternative treatment measures capable of reducing infections and reducing evolutionary pressures that promote resistance. Anti-virulence therapy (AVT) has developed as an exciting paradigm which has sought to lay emphasis on the molecular aspects of bacterial pathogenicity, as opposed to microbial viability. AVTs are designed to disrupt virulence-related processes such as quorum sensing, toxin secretion, host adhesion, immune evasion, and nutrient acquisition by selectively interrupting virulence in endotoxin-producing bacteria with the aim of attenuating virulence and promoting host-mediated clearance without necessarily endangering the survival of bacteria. It is theorized that this mechanistic difference will decrease the selective advantage provided to resistant variants, which may retard the tempo of resistance emergence and dissemination in bacterial populations. In this case, we will analyze the mechanistic foundations of bacterial virulence and will compare the existing anti-virulence therapies used as therapeutic approaches and their application in an evolutionary context. We also evaluate the new preclinical and clinical findings under the effectiveness of AVTs, along with the most important translational obstacles in terms of pharmacological optimization, target specificity, and regulatory validation. Together, these observations provide support to anti-virulence interventions as complementary or alternative therapies to conventional antibiotics in the treatment of multidrug-resistant infections, and highlight the necessity of interdisciplinary collaboration in order to support the adoption of such interventions into new-generation antimicrobial treatment programs.

ABSTRACT: Multiple system atrophy (MSA) remains one of the most challenging neurodegenerative disorders to diagnose, clinically characterized by various combinations of levodopa-resistant parkinsonism, cerebellar, autonomic, and pyramidal dysfunction. Early diagnosis of this disease is challenging, with post-mortem studies showing that the accuracy of diagnosis is only 62-79%. Late diagnosis is common, with an average of 3-4 years from the onset of the first symptoms to diagnosis. Given that the average survival is about 7-9 years, early diagnosis is crucial for the patient's quality of life and effective treatment.
This article provides a comprehensive analysis of three distinct clinical cases (MSA-P, MSA-C, and Mixed phenotype), highlighting the critical role of the 2022 Movement Disorder Society (MDS) diagnostic criteria in refining clinical accuracy, offers a practical framework for clinicians to improve early detection and symptomatic management of MSA, ultimately aiming to enhance patient quality of life in the absence of a curative therapy.

ABSTRACT: In March 2026, Kazakhstan approved a new national Healthcare Development Concept for 2026–2029. This editorial provides a rapid critical analysis of the document, comparing it with its 2022–2026 predecessor. We identify genuine advances, including expanded indicator architecture, health technology assessment tools, digital health ambitions, and an explicit adolescent health agenda alongside persistent structural weaknesses: the absence of a theory of change, limited economic evaluation, no comprehensive human resources for health strategy, and a thin monitoring and evaluation framework. We also raise a chronic governance concern: the Concept was adopted without meaningful consultation with the professional and academic health community, in tension with President of Kazakhstan Tokayev's stated commitment to a hearing state.