Background/Objectives. A cardiovascular complication of type 2 diabetes mellitus like coronary artery disease is influenced by a complex interplay between environmental, phenotypic, and genetic factors. The genetic mechanisms in the development of this pathology are not established. This study aims to evaluate the association of polymorphisms rs1011970, rs62560775, and rs564398 from the 9p21.3 locus with coronary artery disease in diabetic patients of the Kazakh population. Methods. A total of 343 people participated in the case-control study: the control group consisted of 109 people with type 2 diabetes and coronary artery disease, while the control group included 234 people. Genotyping was performed using real-time PCR. Statistical analysis was carried out using Chi-square methods and calculating odds ratios (OR) with 95% confidence intervals (CI). Results. According to the results, only the rs564398 polymorphism of the ANRIL gene was associated with coronary artery disease (p = 0.04). The CC genotype increased the risk of developing coronary artery disease by more than 1.5 times (1.62 (1.02–2.56)), whereas the TT genotype reduced the risk of coronary artery disease (0.39 (0.17–0.91)). The remaining polymorphisms, rs1011970 and rs62560775, were not associated with coronary artery disease. Conclusions. Thus, this research further elicits the association of the ANRIL gene with cardiometabolic disease.

Photodynamic therapy is a curative treatment of human papillomavirus-associated diseases that provides a selective effect leading to the destruction of pathological cells containing the virus. The retrospective study aimed to determine the role of systemic inflammatory reaction induced by photodynamic stimulation in low- and high-squamous intraepithelial lesion treatment. 143 patients with confirmed human papillomavirus-associated cervical intraepithelial neoplasia underwent photodynamic therapy with Photolon and activation in the range of 662 nm. All patients underwent colposcopy, histologic study, HPV DNA analysis, CBC, and immunogram. The chi-square criterion was used to evaluate differences before, 5 days post, and 3 months after PDT; a P value <0.05 was considered significant. A complete regression in patients with low-squamous intraepithelial lesion (n=117) was achieved 3 months after PDT in 89.7% of cases (105/117) while it persisted in 12 patients. Complete regression in patients with high-squamous intraepithelial lesion (n=26) was achieved in 92.3% (24/26), one patient retained with the lesion, and another one had partial regression in the form of lower grade lesion. On the 5th day post-PDT, the formation of dense fibrin in photodynamic effect was noted on colposcopy, and changes in CBC, accompanied by statistically significant neutrocytosis, increased ESR and other indicators of reactive inflammation were recorded. Patients noted increased body temperature up to 37.8±0.5°C in 88% of cases. One of the mechanisms of PDT`s antitumor and antiviral action is the development of acute inflammation in response to cytotoxic action on cells and vascular response in the form of pathological area devascularization. Such reactive inflammation activates all parts of the immune system. Changes on day 5 post-PDT in inflammatory parameters in CBC and IL-1, IL-6 and TNF-α markers correlate with the clinical picture of the post-photodynamic effect.

The absence of an early diagnosis of cardiac autonomic neuropathy might increase the risk of the disease, progressing to an irreversible stage. Therefore, this study aims to investigate the APOE gene isoforms in patients with cardiac autonomic neuropathy to identify early markers for predicting this disease in the Kazakh population. A total of 147 patients with cardiac neuropathy and 153 controls were examined in this case–control study. Patients were genotyped for two polymorphisms of the APOE gene using real-time PCR. Statistical calculations were performed using binary logistic regression. As a result of our study, we found that there was no statistically significant difference in the frequency of any APOE gene isoforms (APOE (ε2/ε2), APOE (ε2/ε3), APOE (ε2/ε4), APOE (ε3/ε3), or APOE (ε4/ε4)) between the patient group and the control group (p = 0.69, p = 0.64, p = 0.19, p = 0.22, p = 0.97, respectively). Thus, cardiac autonomic neuropathy is not associated with APOE gene isoforms in the Kazakh population.

Cognitive impairment is a common comorbidity in epilepsy, negatively affecting patients' quality of life. Although various treatments-antiepileptic drugs (AEDs), vagus nerve stimulation (VNS), and surgery-may influence cognition, comparative data on their effects on executive functions and memory remain limited. This systematic review aimed to evaluate studies assessing the impact of these treatments on executive functions and memory using the EpiTrack cognitive screening tool. A systematic search identified 1,008 publications, of which 35 full-text articles were reviewed. After applying inclusion criteria, seven studies were included, examining cognitive changes in patients undergoing various treatments. Perampanel and Cenobamate exhibited a neutral cognitive profile, with scores stable at "moderate impairment" (29.67-30.04). Lamotrigine and Levetiracetam demonstrated persistent severe impairment. Brivaracetam improved from severe to moderate impairment (not clinically significant). Only Topiramate showed a clinically significant decline (30.0 to 26.6). VNS therapy led to slight improvement over five years (severe to moderate impairment), while combined VNS + 1-2AEDs produced clinically meaningful gains. In contrast, VNS with 3-4 AEDs maintained severe impairment. This review underscores the importance of accurate cognitive assessment in epilepsy management, with a monitoring frequency of no more than every six months for patients receiving AED therapy.

In clinical practice, heart rate variability (HRV) has not been considered an indicator for the preventive assessment of cardiovascular autonomic neuropathy (CAN). The paper studies HRV in a large, randomly selected group. A cross-sectional study included a representative sample of 5707 Kazakhs aged 20 years and older from a total population of 25,454 attached to an urban clinic in the capital of Kazakhstan. The sample was drawn from individuals who visited the clinic for a preventive examination. CAN diagnosis was confirmed using data from questionnaires, electronic medical records, HRV, and heart rate measurements. Mean values of the standard deviation of normal sinus RR intervals (SDNN) and the root mean square of successive RR interval differences (RMSSDs) from a 24 h electrocardiogram recording were assessed. CAN was identified in 17.19% of the study participants, with a ratio of the subclinical to clinical phase of 1:0.24. Diabetes mellitus was present in 30.99% of patients with CAN. The prevalence of CAN varied by sex and age, aligning with the prevalence trajectory of diabetes. It was concluded that the SDNN and RMSSD parameters in electrocardiographic studies can be used for preventive measures in the context of limited healthcare resources.

Background/Objectives: Effective management represents a real opportunity to reduce the economic burden of focal epilepsy, which leads to the withdrawal of at least 0.7% of the working-age population from the labor force. The aim of this retrospective observational cross-sectional study is to identify barriers that limit access to surgical treatment for epilepsy among patients with focal epilepsy in Kazakh population. Methods: Medical reports from epileptologists on 3112 patients of the Epilepsy Center (Astana) in 2024 were reviewed. The study included original information on 1361 patients with a confirmed diagnosis of focal epilepsy, in accordance with ICD-10 codes G40.0–G40.2. Results: Timely detection of focal epilepsy was not associated with socio-demographic or regional factors in our sample. Logistic regression analysis showed that sex and social status did not affect whether patients underwent surgery. However, marital status, employment, and region were significant factors. Married and employed patients had higher odds of remaining non-operated. Among candidates for surgical treatment, 38.68% underwent surgery. Conclusions: The markedly higher odds of remaining non-operated outside Astana point to gaps in referral pathways and service availability, emphasizing the need for a comprehensive approach to managing focal epilepsy in countries undergoing rapid technological development.