Karaganda State Medical University

Aim Evaluation of epicardial fat thickness (EFT) and concentrations of biochemical markers in overweight patients after coronary artery bypass grafting (CABG) at different stages of the rehabilitation period.Material and methods The study included 155 patients aged 35 to 65 years with left main coronary artery disease who underwent CABG. Patients were divided into 3 groups. The main group (Group 1) consisted of 85 overweight (OW) patients (48 men and 37 women) after CABG (CABG+OW+) with body mass index (BMI) 28.0 ± 0.9 kg/m2). Group 2 included 70 patients (39 men and 31 women) with normal body weight (BMI 23.3 ± 1.1 kg/m2) after CABG (CABG+OW-). The control group (Group 3) consisted of 30 healthy age-matched volunteers without acute or chronic disease (BMI 20.4±0.7 kg/m2).Results A trend toward increased EFT and concentrations of acid-soluble blood fraction (ASBF) and deoxyribonucleic acid (DNA) in blood was observed in Group 1 at the third stage of rehabilitation. Concentrations of neutrophil extracellular traps (NETs) were significantly (p<0.05) higher in Group 1 at all stages of rehabilitation, with a trend toward an increase at the third stage of rehabilitation compared to Group 2.Conclusion In OW patients after CABG, the EFT and the DNA concentration were significantly increased 1.8 times (p<0.05), the ASFB was 2.1 times higher, and the NET concentration was 1.9 times higher than in patients with normal body weight. In OW patients after CABG, the EFT and the concentrations of cell-free nucleic acids (ASBF, DNA) and NETs were significantly increased (p<0.05) at the third stage of rehabilitation compared to patients with normal body weight. Strong direct correlations were found between EFT and ASBF (r=0.705; p<0.001) at the second stage of rehabilitation and between EFT and DNA (r=0.825; p<0.001) at the third stage of rehabilitation.

Relevance: Contrast spectral mammography (CSM) is an innovative technology that combines the principles of traditional digital mammography with intravenous administration of an iodine-containing contrast agent. This makes it possible to obtain images reflecting angiogenesis and vascularization of pathological foci, which potentially increases the sensitivity and specificity of breast cancer (BC) diagnosis. BС occupies the first place in the structure of cancer morbidity and mortality from cancer among the female population worldwide and remains an urgent problem today. Despite promising research results, many aspects of the clinical application of CSM require further study. In particular, it is relevant to compare the diagnostic value of CSM with other radiation imaging meth-ods such as digital mammography (DM) and magnetic resonance imaging (MRI) of the mammary glands. The study aimed to explore the diagnostic capacity of contrast spectral mammography in breast cancer detection compared to other radiation methods. Methods: A search and selection of articles in the databases PubMed, Web of Science, Scopus, and Google Scholar from 2015 to 2025, devoted to the diagnosis of breast cancer. To write this review, 107 literary sources were found for all resources, of which 30 were included in the presented review. Results: The results showed that CSM is easily performed and well tolerated by patients. The meth-od is superior to DM because it provides information about the presence of pathological neoangiogenesis of the tumor. Compared to MRI, CSM is similar in sensitivity and specificity. Therefore, CSM can be used as an alternative method of breast imaging due to its higher accessibility and usability in patients with contraindications for MRI. Conclusion: CSM exceeds the capacity of conventional DM, regardless of breast density. As a result, this method can reduce the number of false positive results and limit the number of unwanted invasive interventions. Early detection of BC significantly increases the chances of successful treat-ment, reduces the risk of metastasis, and improves overall and disease-free survival.

Background:E-learning, including platforms like Google Classroom and Moodle, has become integral to nursing education, offering flexibility and adapting to the changing educational system. Despite varied student responses, the COVID-19 pandemic accelerated the shift to online nursing education at Karaganda Medical University, prompting an evaluation of platforms like Zoom, WebEx, Google Classroom, and Moodle for their quality and convenience. This study, based on the students’ perspective, contributes to ongoing efforts to optimize online platforms for nursing education at Karaganda Medical University.Materials and Methods:This cross-sectional study was conducted by a group of lecturers in December 2023 at Karaganda Medical University, Kazakhstan. The study adopted a quantitative approach, employing a survey methodology administered to 154 second-year students enrolled in the academic bachelor’s degree program in Nursing. Participants were chosen through convenience sampling, and they were tasked with rating educational platforms and programs based on predefined criteria, utilizing a 5-point scale. Data analysis was carried out using descriptive statistics, calculating relative values for comparative analysis.Results:Comparative analysis was conducted on two prominent educational platforms—Google Classroom and Moodle—and two programs designed for online consultations and classes—WebEx and Zoom. All obtained data is presented in tables for clarity.Conclusions:An analysis of the preferences of second-year undergraduate students regarding educational platforms and online programs identified the main criteria important for the learning process. This research can be used to further improve educational platforms and enhance the quality of education.

IntroductionThis clinical report describes the management of a 32-year-old patient with a long-standing history of drug-resistant epilepsy. It uniquely illustrates how stereoelectroencephalography (SEEG) played a significant role in the presurgical evaluation of a multifocal epileptic disorder which, despite a long history of no changes on MRI, was ultimately found to be associated with bilateral hippocampal sclerosis. This is one of the first documented cases of SEEG application in Kazakhstan, where the method was introduced in 2024.Clinical presentation and diagnostic findingsThe patient suffered from debilitating seizures (4–6 times/week, often in series of 3-4/day) refractory to combined antiepileptic therapy. Scalp EEG revealed the first originating from the right frontotemporal leads with subsequent diffuse, predominantly right-sided, propagation. The second seizure, however, showed onset from the left temporal leads; notably, only left-onset seizures culminated in bilateral synchronization. Financial constraints precluding PET-CT and the diagnostic ambiguity of routine methods necessitated invasive SEEG.SEEG results and therapeutic strategySEEG monitoring unequivocally identified three independent epileptogenic foci: in the right hippocampus, left hippocampus, and left orbitofrontal region. Such multifocal pathology significantly reduces the likelihood of successful focal resection. Despite this inherent complexity, a crucial clinical outcome was achieved: the patient has remained completely seizure-free for 7 months following the ANT-DBS procedure.ConclusionThis report underscores the critical role of SEEG in the precise localization and characterization of complex, multifocal epileptogenic networks, often elusive to non-invasive modalities. It convincingly demonstrates that a comprehensive invasive approach can lead to successful seizure control even in cases previously considered inoperable. It also reflects the challenges and advancements in developing high-tech epileptological care in regions where advanced methods like SEEG have only recently been introduced.

Introduction: Nosocomial infections or hospital-acquired infections (HAIs) are contracted in hospitals or other health-care facilities. The immune response of the host against these infections may cause sepsis. The sepsis due to HAI is also called nosocomial sepsis or hospital-acquired sepsis (HAS). Sepsis may be associated with organ dysfunction, longer stays in hospitals, morbidity, and mortality. HAS is now considered a global critical health concern, and this condition is worsening due to the development of antimicrobial resistance among microorganisms. Furthermore, implementing infection prevention and control strategies does not reduce the prevalence of hospital-acquired infections, probably due to the presence of endogenous pathogens. The main objective of this study is to provide a piece of information related to nosocomial infections and sepsis. This study focused on associated microorganisms, epidemiology, risk factors, pathophysiology, and associated adverse effects of HAS. Additionally, management strategies for HAS are also discussed. This information can be useful in clinical practice. Methods: For this study, online literature was accessed from various sources like Google Scholar, Science Direct, PubMed, Scopus, and Web of Science. Including this, websites of different agencies were also accessed. Authors used different keywords such as: hospital-acquired infections, sepsis, epidemiology, risk factors, symptoms, pathophysiology, management approaches for HAS, etc., to search the relevant information. Results: The dysregulated immune response to hospital-acquired infections causes nosocomial sepsis that may lead to morbidity, organ dysfunction, and death. Epidemiological data highlighted that sepsis is associated with about 11 million worldwide deaths. Both Gram-positive and Gram-negative bacteria cause infection in hospitalized patients, but Staphylococci, Pseudomonas, and Escherichia coli (E. coli) are found as primary pathogens. Furthermore, antimicrobial-resistant microbes are creating challenges for the antimicrobial-based treatment. Within healthcare facilities, intensive care settings are suggested as key hotspots for antibiotic-resistant microorganisms. Discussion: HAS remains a major public health challenge, causing millions of deaths worldwide every year. It is associated with multiple risk factors such as old age, weakened immune systems, lack of adequate hygiene practices in healthcare settings, and clinical and surgical interventions. Although the prevalence of nosocomial sepsis is observed both in developed and underdeveloped countries, lowand middle-income countries possess a higher risk. The management approaches for nosocomial infections and nosocomial sepsis depend on the type and severity of the infection. These include early detection, use of antibiotics and fluids, etc. Further management approaches include controlling the transmission of infections, antibiotic stewardship, identification of sepsis biomarkers, etc. Conclusion: HAS is a critical health concern. More patients are exposed to infections during hospital stays rather than outpatient visits. Staphylococci, Pseudomonas, and E. coli are identified as key pathogens. It is a treatable and manageable clinical condition. Although early detection plays a key role in managing the HAS using antibiotics, rising incidences of antimicrobial resistance among microorganisms are limiting the antibiotic-based treatment options. Nowadays, researchers are also focusing on the identification of alternative antimicrobial agents, such as antimicrobial peptides, to manage infections caused by antibiotic-resistant microorganisms.

Aim . The main idea of the study is to assess the impact of night shift work on the quality of life of nurses. Materials and methods. The quality of life of 175 nurses working in shifts at the Multidisciplinary regional children's hospital PUE was studied. The study involved 31 (17.7%) male nurses and 144 (82.3%) female nurses. Using descriptive statistics from the WHOQOL-BREF questionnaire, the average values and standard deviations of the assessment of the quality of life of nurses of the regional children's clinical hospital were calculated and presented by age, gender, length of service and the indicators of fashion, median, minimum and maximum were calculated. Results and discussion. The average indicator of general physical health is 54.22, which is an average indicator of quality of life. Mental health – 63.47; social relations – 68.61; environment – 65.37. This shows that the quality of life of nurses is above average in these three areas. Conclusions. The quality of life of nurses working the night shift at the multidisciplinary regional children's hospital shows a level from average to above average. Working the night shift has a significant impact on nurses' quality of life, including sleep, rest, pain and ability to work, as well as the ability to perform their daily duties.

Abstract: The Semipalatinsk Nuclear Test Site (SNTS) in Kazakhstan was the site of extensive nuclear testing during the Soviet era, leading to long-term environmental contamination and potential health effects for exposed populations. Aim: Analysis of existing studies on radiation dosimetry and health effects of radiation exposure in the affected regions. Search strategy: Relevant literature was identified through searches in PubMed, Scopus, and Web of Science databases. The search covered studies published up to January 2025 using the following key terms: “Semipalatinsk nuclear test site”, “radiation exposure”, “biodosimetry”, “transgenerational effects”, and “radiation-induced mutations”. No date or language restrictions were applied at the search stage. A total of 74 records were initially retrieved. After duplicate removal, 70 articles were screened based on title and abstract. The full text of 45 articles was reviewed for eligibility, and 39 publications were selected based on their relevance to the objectives of this review. Results: The article discusses key biodosimetric methods, including electron paramagnetic resonance (EPR), fluorescence in situ hybridization (FISH), and glycophorin A (GPA) assays, which have been used to estimate radiation exposure. Studies indicate increased mutation rates, potential transgenerational effects, and a heightened risk of oncological diseases among exposed populations. Despite decades of research, uncertainties remain regarding radiation exposure's long-term genetic and epigenetic consequences. Conclusions: This review highlights the necessity for further investigations using advanced molecular techniques to clarify the impact of radiation on future generations and improve radioprotection strategies. Введение:Семипалатинский ядерный полигон (СЯП) в Казахстане был местом обширных ядерных испытаний в советский период, что привело к длительному загрязнению окружающей среды и потенциальным последствиям для здоровья подвергшихся облучению групп населения. Цель.Анализ существующих исследований по радиационной дозиметрии и последствиям облучения для здоровья в затронутых регионах. Стратегия поиска:Актуальная литература была найдена посредством поиска в базах данных PubMed, Scopus и WebofScience. Поиск охватывал публикации до января 2025 года с использованием ключевых слов: «Семипалатинский ядерный полигон», «воздействие радиации», «биодозиметрия», «трансгенерационные эффекты», «мутации, вызванные радиацией». На этапе поиска ограничения по дате и языку не применялись. Всего было отобрано 74 публикации. После удаления дубликатов было проанализировано 70 статей по названию и аннотации. Полный текст 45 публикаций был рассмотрен на предмет соответствия критериям включения, и в итоге 39 статей были включены в обзор. Результаты:В статье рассматриваются ключевые методы биодозиметрии, такие как электронный парамагнитный резонанс (ЭПР), флуоресцентная гибридизация insitu (FISH) и анализ по гликофорину А (GPA), применяемые для оценки уровня радиационного воздействия. Исследования указывают на повышенный уровень мутаций, возможные трансгенерационные эффекты и увеличенный риск онкологических заболеваний у подвергшихся облучению групп населения. Несмотря на десятилетия исследований, остаются нерешённые вопросы о долгосрочных генетических и эпигенетических последствиях радиационного воздействия. Выводы: Настоящий обзор подчеркивает необходимость дальнейших исследований с применением современных молекулярных методов для уточнения влияния радиации на будущие поколения и усовершенствования стратегий радиационной защиты. Кіріспе:Семей ядролық сынақполигоны (СЯСП) —КеңесдәуіріндеҚазақстанаумағындаорналасқанядролықсынақтардыңауқымдыаймағыболып, қоршағанортаныңұзақмерзімділастануынажәнехалықтыңденсаулығынаәсеретуқаупінеалыпкелді. Зерттеудіңмақсаты:зардапшеккенаймақтардағырадиациялықдозиметрияжәнеденсаулыққаәсеріжөніндегіғылымизерттеулердіталдайды. Іздеу стратегиясы:Қатыстыәдебиеттер PubMed, Scopus және Web of Science дерекқорларындаізделді. Іздеу 2025 жылдыңқаңтарынадейінжарияланғанеңбектердіқамтыды. Қолданылғаннегізгісөздер: «Семейядролықсынақполигоны», «радиацияәсері», «биодозиметрия», «ұрпаққаберілетінәсерлер», «радиацияменшақырылғанмутациялар». Іздеубарысындажарияланғануақытыментілібойыншашектеуқолданылғанжоқ. Барлығы 74 мақалатабылып, қайталанатындарыалыныптасталғансоң 70 мақалатақырыбыменаңдатпасыбойыншасарапталды. Толықмәтіндішолунәтижесінде 45 мақалақаралып, 39 мақалаосышолуғаенгізілді. Нәтижелер:Мақаладарадиациялықәсердібағалауғаарналғаннегізгібиодозиметриялықәдістер—электрондықпарамагниттікрезонанс (ЭПР), флуоресцентті in situ гибридизациясы (FISH), жәнегликофорин A (GPA) сынақтарыталданады. Зерттеулермутацияжиілігініңжоғарылауы, ықтималұрпақаралықәсерлержәнеонкологиялықауруларқаупініңартқанынкөрсетеді. Ондағанжылдарғасозылғанзерттеулергеқарамастан, радиацияныңұзақмерзімдігенетикалықжәнеэпигенетикалықәсерлерітуралысұрақтарашықкүйіндеқалыпотыр. Қорытынды:Бұлшолурадиацияныңболашақұрпаққаәсеріннақтылаужәнерадиациялыққауіпсіздікстратегияларынжетілдіруүшінзаманауимолекулалықәдістерменқосымшазерттеулержүргізудіңөзектілігінкөрсетеді.

While child morbidity in Kazakhstan is studied, existing research often prioritizes mortality or infectious diseases over non-communicable conditions. This study fills this gap by examining socioeconomic, demographic, and healthcare factors linked to respiratory diseases, asthma, and nervous system disorders among children aged 0-14 years across Kazakhstan from 2010 to 2019 highlighting regional context. Panel data from 14 regions were analyzed using linear mixed models with autoregressive covariance to address regional and temporal heterogeneity. Log-transformed incidence rates of respiratory diseases (J00-J99), asthma (J45), and nervous system diseases (G00-G99) were modeled against predictors including GRP per capita, unemployment, population density, Gini coefficient, pediatrician density, and hospital resources. Other variables with variance inflation factors ≥5 were excluded to mitigate multicollinearity. Respiratory diseases showed the highest mean incidence (57,329.86 per 100,000), with significant regional variation. Aqtöbe, Atyrau, and South Kazakhstan had 12-25% lower incidence compared to Zhambyl (reference), while Pavlodar and North Kazakhstan had 35-61% higher rates. A 1% increase in population density correlated with a 1.05% decrease in respiratory disease incidence (p = 0.008), whereas unemployment was linked to a 0.41% rise (p = 0.029). Asthma incidence increased by 140% over the decade, with higher rates in regions with greater income inequality (0.26% increase per 1% rise in low-income households, p = 0.032). Nervous system disorders showed limited associations, with unemployment as the sole predictor (0.69% increase per 1% rise, p = 0.040). Temporal trends revealed declines in most diseases, but neoplasms, diabetes, and asthma increased significantly. The study addresses the lack of localized socioeconomic and healthcare analyses for respiratory diseases, asthma, and nervous system disorders among children, providing evidence for region-specific policy interventions. Respiratory diseases and asthma among Kazakhstani children 0-14 years had associations with the regional economic conditions, healthcare utilization, and inequality. Population density and income inequality were consistent predictors, while nervous system disorders showed fewer clear associations. Our findings show distinct regional patterns in pediatric morbidity, linking health outcomes to localized socioeconomic and healthcare conditions.

The study of thermal developments of heavy oil feedstock, vacuum residue in particular, is a relevant factor for the development of technologies for the processing and production of petroleum products. This paper investigates the process of thermal decomposition of the vacuum residue in the manufacturing of catalyst and polymer material using thermal analysis methods, including thermogravimetric analysis (TGA) in isothermal and dynamic modes. Particular attention is paid to the measurement of kinetic parameters of thermolysis using model and non-model methods, which allows us to assess the output power and other kinetic characteristics of decomposition. The results obtained can be used for the development of new oil refining technologies for significantly increasing the efficiency and safety of processes. During the course of this study, experimental and theoretical activation energy values were obtained for the vacuum residue without a catalyst (experimentally: 91.54 kJ mol−1/theoretically: 91.35 kJ mol−1) and a sample with the presence of a catalyst (experimentally: 89.68 kJ mol−1/theoretically: 90.87 kJ mol−1). The reduction in activation energy in the presence of the catalyst confirms its catalytic activity and potential for processing heavy hydrocarbon feedstock.

Abstract Background Aesthetic body surgeries are increasingly performed worldwide, often driven by social media, shifting beauty standards, and medical tourism. Despite being elective procedures, they carry significant risk for complications and medico-legal disputes. This systematic review explores litigation trends, common complications, and legal outcomes in body aesthetic surgeries. Methods A systematic review was conducted per PRISMA guidelines, with registration on PROSPERO (ID: CRD420251043585). Forty-one studies published since 1 January 2020 were included, sourced from 7 databases, 2 trial registries, and grey literature. Eligible studies reported on adult patients undergoing body aesthetic surgeries and subsequent medico-legal claims. Data were extracted regarding surgical procedures, complications, legal allegations, and verdicts. Risk of bias was assessed using JBI and ROBINS-I tools. Results Liposuction, abdominoplasty, gluteoplasty, and breast augmentation were the most litigated procedures. Fat embolism, infection, and implant rupture were the most common complications cited in claims. Allegations frequently involved inadequate informed consent (over 50%), procedural errors, and insufficient follow-up. Plaintiff success rates ranged from 20–40%, especially when complications were severe or documentation was poor. Surgeon-favorable outcomes were more likely when thorough documentation and informed consent were evident. Conclusion Litigation in aesthetic body surgery is largely preventable and frequently associated with poor communication, inadequate consent, and procedural missteps. Standardizing informed consent, restricting high-risk procedures to certified specialists, and improving postoperative care may reduce litigation and improve patient safety.