Infertility is a problem that affects millions of couples worldwide and has a significant impact on their quality of life. The recently introduced “Fertility Quality of Life Questionnaire (FertiQoL)” quickly became a gold standard for evaluation of the quality of life of patients suffering from infertility. The aim of this study was to determine the quality of life of Kazakhstani women coping with infertility problems by FertiQoL and assess the validity of the questionnaire. This cross-sectional study involved women of reproductive age undergoing an in vitro fertilization (IVF) cycle at a large IVF center in Kazakhstan in the period from 1 September 2020 to 31 September 2021. A total of 453 women out of 500 agreed to participate in the study, and the response rate was 90.6%. The overall Core FertiQoL was 56.95 ± 14.05, and the Treatment FertiQoL was 66.18 ± 11.13 points. Respondents with secondary infertility had statistically significantly higher Emotional (p < 0.001), Mind–body (p = 0.03), Social (p < 0.001), Environment (p = 0.02), and Treatment (p < 0.001) domains of FertiQoL than women with primary infertility. Respondents with a low income had the lowest levels of Total FertiQoL (56.72 ± 11.65). The longer duration of infertility of women undergoing IVF treatment presented the worse scale of Treatment and Total FertiQoL. Cronbach’s alpha revealed good internal reliability for all FertiQoL subscales on the Kazakhstan women’s questionnaire and averaged 0.8, which is an indicator of a high degree of reliability. The Total FertiQoL of Kazakhstan women undergoing IVF treatment was 59.6 ± 11.5, which is considerably lower than European countries. We identified statistically significant differences across medical and demographic groups. As this questionnaire had validity in Kazakhstan survey it possibly be used for both medical counseling and future investigation in our country.

Background and Objectives: The study aimed at identification and analysis of adverse COVID-19 outcomes (admission to intensive care units due to COVID-19, acute respiratory distress syndrome, mechanical ventilation, and death) among hospitalized pregnant and nonpregnant women, which are critical for informed decision-making in obstetric diagnostics and healthcare. Materials and Methods: This was a retrospective observational study conducted on a series of inpatient pregnant women comparatively followed up with nonpregnant women hospitalized between 15 July 2020 to 20 January 2022 across multidisciplinary hospitals in three cities of Kazakhstan. Following group matching with propensity score for COVID-19 disease severity, residence status, and age, the study ultimately included 156 participants, of whom 50% were pregnant, from an initial sample of 314 female inpatients diagnosed with COVID-19. All findings were considered statistically significant at a p-value < 0.05. Results: Laboratory investigations revealed significantly elevated levels of erythrocyte sedimentation rate, creatinine, neutrophils, platelet count, alanine aminotransferase, aspartate aminotransferase, lymphocyte count, and C-reactive protein in pregnant inpatients compared to nonpregnant inpatients. Furthermore, pregnant women exhibited significantly higher levels of D-dimer (2402.97 ng/mL vs. 793.91 ng/mL) and procalcitonin (0.398 ng/mL vs. 0.134 ng/mL) compared to their nonpregnant counterparts. Overall, 16.88% of the pregnant women were admitted to the intensive care unit, whereas among the nonpregnant women, only 2.6% were hospitalized. The most lethal outcomes (8.3%) occurred among pregnant women, while for nonpregnant women, there were two cases (1.3%). Conclusions: Pregnant women diagnosed with COVID-19 may exhibit more severe clinical symptoms and encounter more adverse outcomes compared to their nonpregnant counterparts. Future research should incorporate larger matched samples to comprehensively explore the association between additional factors and clinical conditions.

Background and aims: Chronic viral hepatitis, including Hepatitis B (HBV) and Hepatitis C (HCV), remains a major health concern among hemodialysis patients. This study analyzes the prevalence and characteristics of HBV and HCV infections in hemodialysis patients treated at a single center in Almaty, focusing on comorbidities such as diabetes, hypertension, and cirrhosis. This study aims to determine the prevalence of these infections among hemodialysis patients in Kazakhstan and assess their associated comorbidities, complications, and overall impact on patient health. Methods: Data from the Almaty Center of Hepatology (2016–2023) served as the basis for the study cohort. Inclusion criteria included CKD stage 5, hemodialysis dependence, ESRD, and confirmed HBV, HCV, or both. The study consists of 164 patients diagnosed with HBV, HCV, or mixed infections, with data collected on demographic distribution, viral genotype prevalence, fibrosis staging, and associated conditions. Results: The findings highlight a substantial prevalence of comorbid conditions in hemodialysis patients with viral hepatitis. The study population includes 95 males (57.9%) and 69 females (42,1%), with a slight male predominance. HCV was the most common infection (76.8%), followed by HBV (14%) and mixed HCV+HBV (9.2%). The high percentage of an unspecified genotype (36.4%) suggests that enhanced diagnostic strategies are needed. Cirrhosis was observed in nearly 90% of the cohort, and 92.7% exhibited ascites. Fibrosis progression was significant, with 25.5% of patients in stage 1, 24.2% in stage 2, and 18.8% in stage 3. The prevalence of hypertension (53.9% with high-risk stage 3 hypertension), diabetes (14.5% with type 2 diabetes), and cirrhosis (89.7%) was assessed. Additionally, hepatitis genotypes were identified, with HCV genotype three being the most common (18.2%) and genotype 1 (17.6%). Conclusions: The results of this study demonstrate that patients on hemodialysis with viral hepatitis represent a particularly vulnerable group with a high incidence of severe liver damage and multiple comorbidities. The high rates of advanced fibrosis, cirrhosis, and associated conditions such as hypertension and diabetes underscore the need for timely diagnosis and complex, patient-centered care

Background: Patients with end-stage renal disease (ESRD) undergoing hemodialysis represent a high-risk group for chronic viral hepatitis and its complications. The development of pangenotypic direct-acting antivirals (DAAs) has significantly improved the prognosis of hepatitis C virus (HCV) infection in this population. However, local data from Central Asia, particularly Kazakhstan, remain limited. Aim: To evaluate the efficacy and safety of antiviral therapy in a subgroup of 12 patients with chronic hepatitis B and/or C receiving maintenance hemodialysis at the Hepato Center in Almaty. Methods: From a larger cohort of 164 hemodialysis patients with confirmed viral hepatitis, 12 patients received antiviral treatment between 2021 and 2023. Treatment regimens included pangenotypic DAAs for HCV (Sofosbuvir/Velpatasvir) and nucleos(t)ide analogs for HBV (entecavir or tenofovir). Sustained virological response (SVR12 and SVR24), liver function parameters, fibrosis regression (assessed via FibroScan), and adverse events were recorded. Results: Of the 12 patients, 9 were HCV-positive (genotypes 1, 1b, or 3), 2 had HBV, and 1 had mixed HBV+HCV infection. All HCV patients were treated with SOF/VEL for 8–12 weeks. SVR12 and SVR24 were achieved in 100% of HCV-treated patients. The two HBV patients showed complete viral suppression after 24 weeks of treatment. One mixed-infection patient achieved full suppression of both viruses. FibroScan results showed fibrosis improvement in 7 of 10 patients re-evaluated post-treatment. Liver enzymes normalized in 11 patients. No severe adverse events occurred; two patients reported mild pruritus, and no anemia-related complications were observed. Conclusion: Antiviral therapy with pangenotypic DAAs and nucleos(t)ide analogs was highly effective and well tolerated in hemodialysis patients with chronic hepatitis B and C. These findings demonstrate the feasibility and clinical benefit of integrating antiviral treatment into routine nephrology care for dialysis-dependent patients in Kazakhstan. Актуальность: Пациенты с терминальной стадией хронической болезни почек (ХБП), получающие лечение программным гемодиализом, относятся к группе высокого риска по хроническим вирусным гепатитам и связанным с ними осложнениям. Разработка пангенотипных противовирусных препаратов прямого действия (ПППД) значительно улучшила прогноз у пациентов с инфекцией вируса гепатита C (ВГС) в данной популяции. Однако локальные данные по Центральной Азии, особенно по Казахстану, остаются ограниченными. Цель: оценить эффективность и безопасность противовирусной терапии у подгруппы из 12 пациентов с хроническим гепатитом B и/или C, получающих программный гемодиализ в Гепатоцентре Алматы. Методы: из общей когорты из 164 пациентов на гемодиализе с подтвержденным вирусным гепатитом 12 человек прошли противовирусное лечение в период с 2021 по 2023 год. Схемы терапии включали пангенотипные ПППД для ВГС (софосбувир + велпатасвир) и аналоговые нуклеозиды/нуклеотиды для ВГВ (энтековир или тенофовир). Оценивались устойчивый вирусологический ответ (УВО12 и УВО24), показатели функции печени, регресс фиброза (по данным ФиброСкана) и нежелательные явления. Результаты: Из 12 пациентов у 9 был диагностирован ВГС (генотипы 1, 1b или 3), у 2 - ВГВ, и у 1 пациента – смешан-ная инфекция ВГВ+ВГС. Все пациенты с ВГС получали софосбувир /велпатасвир в течение 8–12 недель. УВО12 и УВО24 были достигнуты у 100% пациентов с ВГС. У двух пациентов с ВГВ через 24 недели терапии была достигнута полная супрессия вируса. Пациент со смешанной инфекцией достиг полной супрессии обоих вирусов. По данным ФиброСкана улучшение фиброза было зафиксировано у 7 из 10 пациентов, проходивших повторное обследование. Нормализация печеночных ферментов (АЛТ/АСТ) произошла у 11 пациентов. Серьезных нежелательных явлений не зарегистрировано; два пациента жаловались на умеренный кожный зуд, анемия или связанные с ней осложнения не наблюдались. Вывод: Противовирусная терапия пангенотипными ПППД и аналогами нуклеозидов/нуклеотидов оказалась высокоэффективной и хорошо переносимой у пациентов на гемодиализе с хроническими гепатитами B и C. Полученные результаты подтверждают целесообразность и клиническую...