According to Globocan, in 2022, the highest incidence of hepatocellular carcinoma (HCC) was observed in Asia, which accounted for 75% of the global burden of liver cancer 1. In the Republic of Kazakhstan in 2022, the incidence of liver cancer was 5.1 per 100,000 population, with a mortality rate of 2.9, respectively. For the period 2014-2022, HCC had the lowest five-year survival rate among all malignant neoplasms in Kazakhstan2,3. The treatment of HCC across various stages involves a range of clinical strategies4. Sorafenib is currently the primary drug in the treatment of HCC 4,5 and doxorubicin is used in transarterial hepatic artery chemoembolization (TACE)8. However, their use results in cardiotoxicity leading to cancer therapeutics-related cardiac dysfunction (CTRCD)9. CRTCD manifests as cardiovascular disease symptoms in patients with HCC, reflecting irreversible structural changes in the myocardium10. BJMS, Vol. 24 No. 04 October’25 Page : 1189-1196

Background/Objectives: Emergency medical care is a critical component of the healthcare system. The aim of the study was to forecast the number of general practitioner and paramedic teams, the number of ambulance stations, and the number of calls per 1000 population in Kazakhstan until 2030. Methods: We conducted a retrospective longitudinal ecological time-series study of the staffing and structure of the emergency medical service in Kazakhstan for 2000–2023. Data were provided by emergency medical stations in 16 regions of Kazakhstan. We also used data from the statistical digest “Health of the Population of the Republic of Kazakhstan and the Activities of Healthcare Organizations”. Results: A progressive decrease in the absolute number of emergency medical system (EMS) stations by an average of 4.19% (95% CI: [−5.00%, −3.37%]) was found. In the period from 2000 to 2023, a relative average annual decrease was found in the number of medical teams by 7.94% [CI −10.14%, 5.69%] and pediatric teams by 7.73% [CI −10.36%, 5.02%]. An analysis showed an average annual growth rate of paramedic teams of 1.62% [CI 0.19%, 3.46%]. The construction of a predictive model for the number of medical and pediatric teams and EMS stations in the country for the coming years demonstrates a further gradual decrease in their number. Conclusions: A predictive model for the number of physician teams predicts a further decline through 2030, while the forecast for the number of paramedic teams remains relatively stable.

Background Hypertension is a risk factor for cardiovascular disease and premature mortality worldwide. Effective management of this condition requires the integration of structured interventions, such as disease management programs, which have proven clinically significant in increasing treatment adherence and improving patient outcomes. Objective To evaluate the effectiveness of a disease management program in achieving target blood pressure in primary care. Materials and methods A retrospective random sampling method was used to include 200 medical cards (form 025/u) of patients with arterial hypertension registered for dispensary care in 4 city polyclinics of Astana, Kazakhstan, for 2023-2024. Patients were divided into two groups depending on whether they achieved the target BP level (<140/90 mmHg). Clinical and laboratory parameters, including age, lipid profile, glucose level, and systolic/diastolic BP, were analyzed. The completeness of the disease management program implementation was also assessed using a criterion scale. Results Of the total number of patients, 170 (85%) successfully achieved the target blood pressure level, and 30 (15%) did not. Individuals with uncontrolled arterial hypertension were characterized by a significantly higher mean age (71.17 ± 10.87 vs. 66.08 ± 10.14 years; p < 0.05) and elevated levels of low-density lipoprotein cholesterol (LDL-C) (4.86 ± 1.75 vs. 3.53 ± 1.32 mmol/L; p < 0.05). Mean systolic and diastolic BP were also significantly higher in this group (142.83 ± 12.98/87.00 ± 5.63 mmHg vs 133.34 ± 12.41/82.43 ± 6.80 mmHg; p < 0.05). Full compliance with the Disease Management Program was associated with good clinical outcomes, with the group that achieved target blood pressure levels and fully complied with the program scoring significantly higher on the program implementation scores (8.2 ± 0.7 vs 5.6 ± 1.1; p < 0.001). Conclusion Full implementation of the disease management program significantly improves lipid profile and BP control in the primary care. The study also demonstrated the importance of regular follow-up, patient monitoring, and lifestyle interventions as key components of effective hypertension management. BJMS, Vol. 24 No. 04 October’25 Page : 1181-1188