Introduction:Psychological distress refers to a set of painful mental and physical symptoms of anxiety and depression, which often coexist and coincide with common somatic complaints and chronic conditions. In Kazakhstan, mental disorders are the second leading cause of years lived with disability. Currently, medical education in Kazakhstan is undergoing comprehensive reform, which creates an additional burden on faculty, fostering mental health concerns. Methods:A quantitative observational cross-sectional study was conducted in 6 large medical universities in Kazakhstan. Data were obtained from 715 faculty academics by using an online self-reported DASS-21. Statistical analysis was performed using the SPSS version 20.0. Bivariate and multivariate logistic regression analyses were applied to evaluate the relationship between predictor and outcome variables. Results:The total prevalence of depression, anxiety, and stress was 40.6%, 41.3%, and 53.0%, respectively. Younger age (p = 0.002), female gender (p = 0.001), being single (p = 0.044) or in a relationship (p = 0.001), having chronic diseases (p < 0.001), holding Master (p = 0.036) or PhD degree (p = 0.040), employment status (p = 0.034), and being involved in additional activities (p = 0.049) were significantly associated with different dimensions of distress. Conclusions:Nearly half of the study population reported symptoms of depression, anxiety, and stress. Due to the higher prevalence of psychological distress amongst academic medicine faculty, determined risk factors must be taken into consideration in developing policies for mental issues prevention.

Introduction. Coronavirus infection is a risk factor for vascular thrombosis. This is of particular importance for patients undergoing myocardial revascularization since this infection can be a trigger for the formation of restenosis in the area of a previously implanted coronary stent. Understanding the risk factors for stent thrombosis and restenosis is of particular importance in individuals at risk for adverse outcomes. The rarity of such situations makes the present study unique. Objective. Studying the peculiarities of restenosis and thrombosis of the coronary arteries in patients after coronavirus infection. Methods. The study was performed in the Department of Cardiovascular Surgery of Emergency Hospital, Semey City, in 2021. We have examined the medical records of 10 consecutive patients with restenosis of coronary arteries after coronavirus infection and 10 matched-by-age patients with similar restenosis of coronary arteries who did not have coronavirus infection as a comparison group. To determine statistically significant differences between independent samples, we calculated the Mann–Whitney U test. Results. The average age of patients was 65.7 years. Only one case was classified as early restenosis (within 8 days of previous revascularization), two cases represented late restenosis, and seven cases were very late restenoses. In 70% of cases, restenosis was localized in the left anterior descending artery, in 30% of cases, it was in the right coronary artery, and in 40% of cases, it was in the left circumflex artery. In comparison with patients who did not have a coronavirus infection, there were statistically significant differences regarding IgG (P<0.001) and fibrinogen (P=0.019). Conclusion. Patients with myocardial revascularization in the past have a higher risk of stent restenosis against the background of coronavirus infection due to excessive neointimal hyperplasia, hypercoagulability, increased inflammatory response, and endothelial dysfunction.

Aim: The present study aimed to perform validation and assessment of psychometric indicators of the Kazakh version of the Brief Index of Affective Job Satisfaction on the academic faculty staff. Material and methods: The translation of the Brief Index of Affective Job Satisfaction was performed following the World Health Organization guidelines on the translation and adaptation of research instruments. 715 medical educators of Kazakhstani medical universities represented the study population. Preliminary statistical analysis included Cronbach’s alpha calculation. The psychometric properties of the instrument were examined using exploratory and confirmatory factor analysis. Results: Cronbach’s alpha obtained 0.83. The Kaiser-Meyer-Olkin index reached 0.830, which indicated meritorious sample adequacy. CFA identified good factorial validity of the scale: all model fit indices exceeded the threshold values. The inter-item correlation index varied between r=0.616 and r=0.716, designating an acceptable correlation between variables. The total job satisfaction level was moderate (3.15±0.78). Women reported lower rates of job satisfaction, although the difference was not statistically significant (p<0.284). Conclusion: Our findings provide support to the psychometric properties of the Kazakh version of the BIAJS as an instrument for the assessment of job satisfaction. The major advantages of the BIAJS are that it is optimally brief, highly affective, and has good internal validity.

Background Vitiligo is one of the most common hypomelanoses, in which the destruction of functioning melanocytes causes depigmentation of the skin, hair and mucous membranes. The genes encrypting brain-derived neurotrophic factor (BDNF) and corticotropin releasing hormone (CRH) might be the conceivable contributors to the development of vitiligo. This study was aimed at investigation of the serum levels of BDNF and CRH as well as their selected single nucleotide polymorphisms (SNPs) in vitiligo patients in comparison with the healthy controls. Methods The cross-sectional study was carried out between October 2020 and June 2021 in 93 vitiligo patients (age range from 23 to 48 years) and 132 healthy controls (age range from 24 to 52 years). The psychological status of study participants was evaluated using the Generalized Anxiety Disorder-7 (GAD-7) scale. Serum levels of BDNF and CRH were measured with the help of a commercially available sandwich enzyme-linked immunosorbent assay (ELISA) kit. Genotyping for the rs11030094 polymorphism of the BDNF gene and for the rs242924 polymorphism of the corticotropin releasing hormone receptor 1 (CRH-R1) gene was performed by a real-time polymerase chain reaction (PCR). Results There was a significant relationship between the CRH-R1 rs242924 and BDNF rs11030094 polymorphisms and vitiligo. Moreover, serum levels of neurotransmitters differed significantly between vitiligo and control groups and were associated with the CRH-R1 rs242924 and BDNF rs11030094 SNPs. Conclusions Our findings demonstrated the association between CRH-R1 rs242924 and BDNF rs11030094 polymorphisms and vitiligo. Further studies need to be carried out in vitiligo patients to confirm the results observed.

Vitiligo is clinically characterized by the appearance of non-symptomatic depigmented macules, but the disorder is highly correlated with a wide range of psychiatric disorders and psychological problems. The aim of our study was to investigate serum brain-derived neurotrophic factor (BDNF) and corticotropin releasing hormone (CRH) levels in vitiligo patients and healthy controls in relation to the observed symptoms of depression and anxiety disorders. This study comprised 96 vitiligo patients and 96 healthy controls who filled out the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales. Serum levels of BDNF and CRH were measured using enzyme-linked immunosorbent assay (ELISA) technique. There was a significant increase of depression and anxiety scores in vitiligo patients as compared with healthy controls (P < 0.05). The serum levels of BDNF were significantly lower in vitiligo patients than in healthy individuals (Z = 4.002; P < 0.001), while the serum levels of CRH were markedly higher in cases than those in controls (Z = 3.764; P < 0.001). The significant positive correlations between serum CRH levels and GAD-7, PHQ-9 scores were observed. However, the aforementioned psychometric scales did not correlate significantly with serum BDNF level. Vitiligo is associated with the depression and is closely linked with lower BDNF levels.

Dystonia is a motor disorder characterized by sustained muscle contractions producing twisting, repetitive, and patterned movements or abnormal postures. Dystonia is among the most commonly observed motor disorders in clinical practice in children. Unlike dystonia in adults that typically remains focal or spreads only to nearby muscle groups, childhood dystonia often generalizes. Classification of dystonia has direct implications for narrowing down the differential diagnosis, choosing the diagnostic work-up, predicting the prognosis, and choosing treatment options. The etiology of pediatric dystonia is quite heterogeneous. The etiological classification distinguishes primary dystonia with no identifiable exogenous cause or evidence of neurodegeneration and secondary syndromes. Dystonia can be secondary to any pathological process that affects the basal ganglia. The treatment options of childhood dystonia include several oral pharmaceutical agents, botulinum toxin injections, and deep brain stimulation therapy. Botulinum toxin treatment is the first choice treatment for most types of focal dystonia. In children it is less used because dystonic forms are mainly generalized, but it might also be helpful in controlling the most disabling symptoms of segmental or generalized dystonia. Long-term electrical stimulation of the globus pallidum internum is now established as an effective treatment for various types of movement disorders including dystonia. However, this method has not yet found its application in Russia due to the difficulty of implementation and the lack of patient routing. To increase the effectiveness of complex therapy of dystonia in children, new pathogenetic methods of treatment of common forms of primary dystonia and dystonic syndromes in the structure of degenerative diseases of the central nervous system are needed, as well as the development of optimal algorithms for the diagnosis and treatment of these patients.

The authors present the results of their own clinical study of the nutritional status of cerebral palsy (CP) children. The chemical composition of the diet of the observed patients and the body composition of patients were analyzed with bioimpedance analysis. The results of the dynamic control of the analyzed indices after the nutritive correction are presented. Aim of the study. To study the nutritional status of CP patients and evaluation of its dynamic changes with the help of bioimpendancemetry after carrying out remedial measures. Material and methods. We observed 27 CP children aged from 5 to 11 years, who were diagnosed with a protein-energy deficiency. Examination of patients included physical examination, the assessment of anthropometric indices using the “WHO Anthro+” and a body composition analysis using bioimpendancemetry. Evaluation of the actual nutrition included the study of the diet, the calculation of the chemical composition of the diet, the state of appetite and the nature of the feces. All studies were conducted in CP children twice: at the time of admission to the hospital and in the following-up period after the correction of the diet and the appointment of treatment with metabolic and vitamin preparations for 2 months. Results and conclusion. The protein-energy deficiency in CP children being associated with a disorder of the diet, decreased appetite, lack of basic macronutrients, needs the nutritive correction, including the introduction of the supplemental nutrition in their diet. The study showed that against the background of the basic drug therapy and nutritional correction there is a positive dynamics in the form of increasing Z-score body weight, Z-score ratio of body weight to age, normalization of appetite, which correlates with the normalization of the main study using bioimpedance analysis of body composition.

The review of actual directions of optimization of surgical treatment of locomotor disorders in spastic forms of infantile cerebral palsy is presented. When choosing the tactics of the treatment for this category of patients, the following criteria should be taken into account: the degree of disturbances in motor activity associated with muscle tone disorders, the spasticity pattern, the presence of joint contractures, limb deformities, the level of intellectual development, the presence and severity of perceptual disorders. The implementation of simultaneous operations allows reducing the period of immobilization of the child and the period of temporary incapacity for work of parents and recommended for the treatment of patients with cerebral palsy at all levels of the Gross Motor Function Classification System (GMFCS). There are considered modern methods of surgical treatment of spastic instability of the hip when the choice of the method of correction of the acetabular component of instability depends on the degree of abnormalities of the anatomy of the acetabulum, mainly from the deficit of the bone covering of the head of the femur and the «slanting» of the roof of the acetabulum. In the treatment of contractures of knee joints in order to prevent сrush syndrome, the elongation of the medial group of tibial flexors is advisable to be used in conjunction with tonus-enhancing operations in the anterior group of femur muscles with their secondary weakness. When treating axial deformities of the knee joints and unequal length of the legs, it is important to observe the timeliness principle (during the active growth of the skeleton) with the use of minimally invasive surgical interventions - hemi and epiphysiodesis - to avoid the need for more traumatic interventions.

There are presented own data of comprehensive clinical and instrumental examination of cerebral palsy (CP) patients. The study included 313 patients (183 boys and 130 girls) aged from 1 year to 18 years, with the established diagnosis of CP (ICD 10 code - G80). In addition, spastic CP (G80.0) was diagnosed in 103 patients, spastic diplegia (G80.1) in 98 patients, pediatric hemiplegia (G80.2) in 46 children, another type of CP (G80.8) - in 66 patients. The data of a comparative analysis of clinical symptoms and results of instrumental examinations of patients with various forms of CP are presented.

Analysis of the literature data on the surgical treatment of feet deformities in children with cerebral palsy allowed determining of the first key pathogenesis aspects and management of surgical treatment. The main types of changes occurring in the feet under the influence of spastic disorders and the optimal methods of progressive deformities of feet surgical treatment were studied. The treatment management preference depends on intrapatient habits, age, the pattern of rescue, deformation gravity and mobility, level of the gross motor function (GMFCS). Various «soft tissue surgery» forms are effective provided sufficient deformation mobility for younger children group patients. The bone-cutting feet surgical measures are justified provided rigid deformations in more older children. A differentiated neurogenic feet deformities surgical treatment approach provides obtaining both early and long-term satisfactory treatment results.

The purpose of the study was to determine the structure, compliance to antihypertensive pharmacotherapy in patients with arterial hypertension of the third degree in the conditions of Semey and the frequency of achieving target BP. The study included 618 patients with hypertension III degree. The age of patients ranged from 38 to 77 years (mean age - 61,2 ± 2,7 years). Among the surveyed men was -353, women - 265. Carried out an analysis of medical records and patient survey to determine the structure of antihypertensive therapy, compliance to it and the existing violations preparations reception mode. Was revealed prevalence in the appointment’s structure the combinations of antihypertensive drugs (46.0%) and fixed combinations (29.0%). Monotherapy performed more frequently with beta-blockers and calcium channel antagonists. It revealed the greatest compliance to the use of fixed combinations of drugs and most high clinical efficacy of antihypertensive therapy options.

We sought to identify the features of endothelial function in rectal cancer patients who were exposed to chronic ionizing radiation from a nuclear test site in Kazakhstan. We examined 146 individuals, 76 of whom were rectal cancer patients. The existence of a complex of disturbances of the endothelium and hemostasis systems in patients vs non-patients was revealed. Endothelial dysfunction was expressed as an increase of nitric oxide (NO) production along with decreases in vasodilatation function, and increased levels of von Willebrand factor in blood, along with an increase in the number of circulating endotheliocytes. Significant correlations between indicators of endothelial function and vascular-platelet hemostasis were observed. These changes and their interrelations were expressed more strongly in the patients who lived in the contaminated area around the nuclear test site. Such patients could have an increased risk of thrombosis and other complications after the treatment of a malignant neoplasm.

The aim of this research is to determine the characteristics of endothelial factors and the hemostatic system conditions with malignant neoplasms patients, which were exposed to ionizing radiation. Total number of examined people is 223, 153 of them are patients with gastrointestinal tract oncopathology. The article presents the results of the analysis of numerical indicators of endothelial condition and platelet hemostasis of patients, who had cancer. They lived in the regions of Kazakhstan, subjected to contamination of radionuclides as a result of nuclear weapons tests, which took place in this region from 1949 to 1989. These results then were compared to cancer patients and healthy individuals with no radiation risk. The study revealed the presence of higher levels of endothelial dysfunction and following trigger of the hemostatic system in patients with malignant tumors of the gastrointestinal tract. In particular, the defined high degree of endothelial dysfunction include endothelium- dependent vasodilation, content desquamated endothelial cells in peripheral blood and von Willebrand factor. These indicators have a clear correlation with the degree of disorder of studied parameters of the hemostasis, which can cause the development of thrombotic complications.

Introduction: The Great East Japan Earthquake struck in March 2011 and caused an accident at the nuclear power plant in Fukushima Prefecture. The resulting incident became a major topic of discussion around the world. The lives and living situations of some people are still being impacted by that earthquake. In addition, residents of the area near where the accident occurred still have various concerns. Materials and Methods: The current study examined the aftermath of the Chernobyl accident. This report also considered the direction that measures to deal with radiation and the incident should take in Fukushima Prefecture and Japan as a whole over the coming decades. Results and Conclusion: This report examined potential carcinogenesis and mental symptoms following the Chernobyl accident from various perspectives. We identified studies on health problems following the Chernobyl accident and they will conduct a joint international study to examine the mental and physical state of residents living near the Semipalatinsk Nuclear Test Site and workers at the site as well as environmental conditions. We hope to formulate guidelines for the care of people affected by that incident. We also hope to devise measures to deal with radiation and radiation exposure in Fukushima Prefecture and Japan as a whole over the coming decades. Moreover, we hope to devise care for people affected by the incident in Japan.