Background/Objectives: This study aims to analyze antibiotic consumption trends from 2014 to 2023 in Kazakhstan, Kyrgyzstan, Tajikistan, and Russia; forecast future trends up to 2030; and identify key social and economic factors influencing antibiotic use. Methods: Data on antibiotic consumption were obtained from the World Health Organization Regional Office for Europe Antimicrobial Consumption Network. Social and economic indicators were sourced from the World Bank DataBank. Of the 86 factors initially considered, 35 were included in the analyses. The forecast modeling of antibiotic consumption trends until 2030 and linear regression analysis to assess associations between antibiotic consumption and its predictors were conducted via SPSS. Results: The lowest antibiotic consumption rates were observed in Kazakhstan and Russia, whereas Kyrgyzstan and Tajikistan presented higher rates. The projected antibiotic consumption rates are expected to decline only in Kazakhstan, with other countries remaining stable. Birth and death rates, as well as under-five mortality rates, were significant determinants of antibiotic consumption in Kazakhstan and Tajikistan. In Russia, per capita GDP was a key determinant, whereas in Kazakhstan, inflation in consumer prices played a significant role. Additionally, cereal production was significantly associated with antibiotic consumption in Kazakhstan. In Kyrgyzstan and Russia, measles immunization rates were important determinants, whereas in Kyrgyzstan, access to clean fuels and technologies for cooking was significantly associated with antibiotic consumption. Conclusions: The findings of this study provide valuable insights for strengthening antimicrobial stewardship programs by addressing key social and economic determinants of antibiotic use.

Background/Objectives: This study aimed to analyze the consumption of systemic antibacterials (WHO ATC J01) in primary care in Kazakhstan from 2017 to 2024 and to estimate the potential contribution of different primary care providers to the use of “Watch” and “Reserve” antibiotics. Methods: The Global Antimicrobial Resistance and Use Surveillance System methodology was applied to calculate defined daily doses per 1000 inhabitants per day (DID) for ATC J01 overall, as well as at ATC levels 3 and 5. Forecast modeling was performed using ARIMA (0,1,0), ARIMA (0,0,0), and Simple models to project trends through 2030. Pearson’s correlation was computed for each category of primary healthcare provider and each chemical agent belonging to the “Watch” and “Reserve” groups. Results: Antibiotic consumption increased by approximately 1.5 times in 2024 after remaining relatively stable from 2017 to 2023. The forecasts suggest that the share of “Access” group antibiotics will continue to decline, reaching 33.71% by 2030, whereas the share of “Watch” group antibiotics is expected to increase proportionally, reaching 65.73% by 2030. The per capita densities of primary care providers correlate with the consumption of certain “Watch” and “Reserve” group antibiotics. Conclusions: This study demonstrates that the primary care sector in Kazakhstan is characterized by a disproportionately high and increasing use of “Watch” antibiotics, a rising trend in “Reserve” antibiotic consumption, and a declining share of “Access” antibiotics. These findings highlight a need to prioritize stewardship interventions that target the reduction in “Watch” and “Reserve” antibiotics, while promoting the use of “Access” antibiotics.

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 ( ) and fibrinogen ( ). 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.

Background: In-stent restenosis of coronary arteries is a significant problem in interventional cardiology. Inflammatory processes in the arterial intima play a key role among the well-known risk factors for restenosis. The COVID-19 pandemic has contributed to the development of inflammation and the activation of the coagulation system. The aim of this study was to assess the risk factors for coronary artery restenosis and patient survival during the COVID-19 pandemic. Materials and Methods: We performed a cross-sectional study on a targeted sample of patients with coronary artery disease who underwent repeat myocardial revascularization (931 patients). The main study group, consisting of patients with coronary artery stent restenosis, included 420 patients (38.5% had previous COVID-19). The control group included 511 patients without stent restenosis (20.9% had COVID-19). Results: The results of multiple logistic regression analysis showed that the odds ratio (OR) for COVID-19 was 2.29 (95% CI 2.78–3.19) (p < 0.001), and the OR for C-reactive protein (CRP) was 1.08 (95% CI 1.002–1.013). The average hospital survival time for subjects with prior COVID-19 (N = 269) was 9.53 ± 0.106 days (95% CI 9.32–9.74), while for those without COVID-19 (N = 662), it was 9.89 ± 0.032 days (95% CI 9.83–9.96) (p < 0.001). The one-year survival time was 316.7 ± 6.982 days (95% CI 303.0–330.4) for the COVID-19 group and 340.14 ± 3.243 days (95% CI 333.8–346.5) for the non-COVID-19 group (p < 0.001). Conclusions: The main risk factors for in-stent restenosis were COVID-19 and elevated CRP levels. The average survival time in the group with prior COVID-19 was statistically significantly lower than in patients without COVID-19, both during the hospital stay and within one year after repeated revascularization.

Background: Drug-resistant epilepsy (DRE) remains a serious clinical challenge, especially in settings with limited access to specialized care. A significant proportion of patients in Kazakhstan do not receive timely diagnosis or referral to specialized centers. Objective: The aim of this study is to identify, using the example of the Epilepsy center’s work, the barriers that limit access to specialized treatment, particularly the timely establishment of a diagnosis of drug-resistant epilepsy. Materials and methods: This retrospective observational study included 560 Kazakh patients with DRE who presented to the Center between 2017 and 2023. Clinical and demographic data, social status, place of residence, and access to specialized care were analyzed. Statistical processing was performed using non-parametric methods and the χ² test, with a significance level of p < 0.05. Results: In the overall patient group, delayed identification of drug resistance was associated with marital status and region of residence. Among patients whose diagnosis was first established at the Epilepsy center, unmarried individuals predominated (p < 0.006). A statistically significant predominance of individuals from Astana who received specialized care was observed (p < 0.0001). Examination of the association between DRE diagnosis and different epilepsy duration groups revealed no significant relationship in any group. Analysis of factors contributing to delayed DRE diagnosis in patients with disease duration over 20 years showed that men were almost 1.5 times more likely to experience delayed diagnosis compared to women (OR, 95% CI: 1.12 (1.02–1.31), p = 0.02), and lack of social protection reduced the likelihood of receiving specialized care (OR, 95% CI: 0.65 (0.54–0.79), p < 0.0001). Conclusions: Timeliness of DRE diagnosis in Kazakhstan is determined by a combination of sociodemographic and regional factors. Patients from Astana and those with social support have better access to specialized care. Systemic measures are needed to improve patient referral pathways, reduce regional disparities, and combat stigmatization. Введение. Фармакорезистентная эпилепсия (ФРЭ) остаётся серьёзной клинической проблемой, особенно в условиях ограниченного доступа к специализированной помощи. Значительная часть пациентов в Казахстане не получает своевременную диагностику и направление в специализированные центры. Целью данного исследования является на примере работы Центра выявить барьеры, ограничивающие доступ к специализированному лечению, в частности своевременное установление диагноза фармакорезистентной эпилепсии. Материалы и методы. Ретроспективное наблюдательное исследование включало 560 пациентов казахской национальности с ФРЭ, обратившихся в Центр с 2017 по 2023 гг. Анализировались клинико-демографические данные, социальный статус, место проживания и доступ к специализированной помощи. Статистическая обработка данных проводилась с использованием непараметрических методов и χ²-теста, уровень значимости p < 0,05. Результаты. В общей группе пациентов с несвоевременным выявлением фармакорезистентности были связаны семейное положение и регион проживания пациента. Среди пациентов, у которых диагноз впервые установлен в Центре эпилепсии, преобладали неженатые/незамужние (р<0,006). Наблюдается статистически значимое преобладание лиц в Астане, получивших специализированную помощь (р<0,0001). Изучение ассоциации с диагнозом фармакорезистентности в разных группах в зависимости от продолжительности эпилепсии не показала значимой связи ни в одной из групп. Анализ факторов несвоевременной постановки диагноза фармакорезистентности в группе пациентов с длительностью заболевания более 20 лет показал, что среди мужчин почти в 1,5 раза была вероятность несвоевременного диагностирования по сравнению с женщинами (OR, 95% CI: 1,12 (1,02-1,31), р=0,02) и отсутствие социальной защиты уменьшает шансы на получение специализированной помощи (OR, 95% CI: 0,65 (0,54-0,79), р<0,0001). Выводы. Своевременность диагностики ФРЭ в Казахстане определяется сочетанием социально-демографических и региональных факторов. Пациенты из Астаны и социально защищённые лица обладают более высокой доступностью специализированной помощи....

Objective. To assess the level of stigmatization toward people with epilepsy among different population groups using the Russian version of the Stigma Scale of Epilepsy (SSE). Materials and Methods. A cross-sectional observational study was conducted involving 63 participants aged 18 years or older. Participants were divided into three groups: individuals with no direct association with epilepsy (n = 27), healthcare professionals and relatives of patients with epilepsy (n = 14), and patients with an established diagnosis of epilepsy (n = 22). A survey was conducted using the Russian version of the SSE. The survey was administered anonymously via the Google Forms platform. Statistical analysis was performed using IBM SPSS Statistics version 26.0, applying non-parametric statistical methods. Results. No statistically significant differences in the total SSE score were found among the study groups (p = 0.33). The median total SSE score was 55.0 (35.0–55.0) in the group with no direct association with epilepsy, 43.0 (35.0–51.0) among healthcare professionals and relatives of patients, and 47.0 (38.0–59.0) among patients with epilepsy. Analysis of individual SSE items revealed statistically significant differences in emotional reaction to an epileptic seizure: participants with no direct association with epilepsy were more likely to experience shock (p = 0.001) and fear (p = 0.024). No statistically significant intergroup differences were observed for the remaining SSE items. Conclusion. The findings of the present study did not demonstrate pronounced stigmatization, as no statistically significant differences in the overall SSE scores were observed among the study groups. However, significant differences were identified in emotional reactions to epileptic seizures, particularly shock and fear. Цель. Оценить уровень стигматизации в отношении людей с эпилепсией среди различных категорий населения с использованием русскоязычной версии шкалы Stigma Scale of Epilepsy(SSE). Материалы и методы. Проведено одномоментное поперечное наблюдательное исследование среди 63 участников старше 18 лет. Участники были распределены на три группы: лица, не имеющие непосредственного отношения к эпилепсии (n = 27), медицинские работники и родственники пациентов с эпилепсией (n = 14), а также пациенты с установленным диагнозом эпилепсии (n = 22). Был проведен опрос с применением русскоязычной версии SSE. Анкетирование проводилось анонимно с использованием платформы Google Forms. Статистическая обработка данных выполнялась в программе IBM SPSS Statistics 26.0 с использованием непараметрических методов анализа. Результаты. Статистически значимых различий по общему баллу SSE между исследуемыми группами выявлено не было (p = 0,33). Медианный общий балл SSE составил 55,0 (35,0–55,0) в группе лиц, не имеющих отношения к эпилепсии, 43,0 (35,0–51,0) среди медицинских работников и родственников пациентов и 47,0 (38,0–59,0) у пациентов с эпилепсией. При анализе отдельных вопросов шкалы выявлены статистически значимые различия по эмоциональным реакциям на эпилептический приступ: участники, не имеющие отношения к эпилепсии, чаще испытывали шок (p = 0,001) и страх (p = 0,024). По остальным показателям SSE достоверных межгрупповых различий не выявлено. Заключение. Результаты исследования не выявили выраженной стигматизации, так как отсутствовали статистически значимые различия по общему баллу шкалы SSE между исследуемыми группами. Однако имеются значимые эмоциональные различия по реакции на эпилептический приступ в виде шока и страха. Зерттеудің мақсаты. Stigma Scale of Epilepsy (SSE) шкаласының орыс тіліндегі нұсқасын пайдалана отырып, халықтың әртүрлі санаттары арасында эпилепсиямен ауыратын адамдарға қатысты стигматизация деңгейін бағалау. Материалдар мен әдістер. 18 жастан асқан 63 қатысушы арасында бір мезгілде көлденең бақылау зерттеуі жүргізілді. Қатысушылар үш топқа бөлінді: эпилепсияға тікелей қатысы жоқ адамдар (n = 27), медицина қызметкерлері және эпилепсиямен ауыратын пациенттердің туыстары (n = 14) және эпилепсия диагнозы қойылған пациенттер (n = 22). Сауалнама SSE орыс тіліндегі нұсқасын қолдана отырып жүзеге асырылды. Сауалнама Google...