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Aiymkul Ashimkhanova,1,* Dmitriy Syssoyev,1,* Arnur Gusmanov,1 Kakharman Yesmembetov,2 Arina Yespotayeva,3 Anara Abbay,1 Aiymzhan Nurpeissova,4 Antonio Sarria-Santamera,1 Abduzhappar Gaipov1 1Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan; 2Department of Medicine III, University Medical Center Aachen, Aachen, Germany; 3Al-Farabi University, Faculty of Medicine and Healthcare, Almaty, Kazakhstan; 4Department of Medical Information Analysis of Outpatient and Polyclinic Care, Republican Center of Electronic Healthcare, Nur-Sultan, Kazakhstan*These authors contributed equally to this workCorrespondence: Abduzhappar Gaipov, Department of Medicine, Nazarbayev University School of Medicine, Kerey and Zhanibek Khans Street 5/1, Nur-Sultan, 010000, Kazakhstan, Tel +7 7172 706 297, Email abduzhappar.gaipov@nu.edu.kzBackground: Viral hepatitis is the leading cause of hepatic cirrhosis and liver-related mortality, yet there are no countrywide epidemiological studies available to date in Kazakhstan. The aim of the study was to perform an estimation of mortality, prevalence and incidence of Hepatitis B and C infections and liver-related complications.Methods: Using centralized healthcare data from the Unified National Electronic Health System (UNEHS) for the period 2014– 2019, a total of 82,700 registered patients with chronic viral hepatitis B (HBV), C (HCV) and D (HDV) have been extracted based on ICD − 10 codes. Crude rates of incidence, prevalence and mortality, as well as age-, sex- and year-specific rates of incidence and mortality per 100,000 population were estimated. Unadjusted and adjusted hazard ratios were estimated using Cox proportional hazards regression modeling.Results: For the total number of 82,700 patients, 56.6% were represented by chronic HCV infection and 43.4% by HBV infection. The prevalence of coinfection was 10% for HBV+HDV and 3.5% for HBV+HCV. Both HBV and HCV were more prevalent among female patients (56%) and among Kazakh ethnic group (64.8%). Males with HBV had a higher probability of death than females; this trend was stronger among male patients with HCV. Russian ethnic groups infected with HBV had a higher risk of death compared to Kazakh and other ethnic groups. Whereas in HCV-infected patients, Russian ethnic group and other ethnic group had similar risk for death, but higher compared to Kazakhs.Conclusion: During the 2014– 2019 period, prevalence, incidence and mortality from chronic HBV and HCV infections increased. Despite the disproportionately higher infection rate among females with chronic viral hepatitis, all-cause mortality was more than two-fold higher among males. Higher death rates in Russian ethnic group compared to other ethnicities need to be evaluated in further studies for other confounding factors and associated comorbidities in this group.Keywords: HBV, HCV, mortality, incidence, prevalence, survival

BACKGROUND AND AIMS Hemodialysis patients are more likely than the general population to contract hepatitis B virus and hepatitis C virus. In Kazakhstan, there is no research on HBV and HCV in this population. The major goal of this study is to find out how common HBV and HCV infections are among hemodialysis patients in Kazakhstan, as well as their risk factors, the impact of hepatitis on the survival of patients with ESRD undergoing hemodialysis survival analysis was conducted using Kaplan–Meier method and Cox proportional hazards regression modelling. Data from the Unified National Electronic Health System (UNEHS) for the period of 2014–9 were used to study the epidemiology of viral hepatitis in patients with ESRD receiving hemodialysis in Kazakhstan. METHOD The study population consisted of 9310 patients with ESRD undergoing hemodialysis, whose individual records were obtained from the ‘Registry of Chronic Kidney Disease’ (RCKD) within UNEHS for the period of 2014–8. This cohort was cross-referenced with a cohort of hepatitis patients based on population registry number (RPN) for the purpose of identifying ESRD patients undergoing hemodialysis who had been diagnosed with hepatitis before the end of 2018. Utilizing one-to-one closest neighbor propensity score matching, a control group from among the dialysis patients with no diagnosed hepatitis was derived with sufficient bias reduction based on age, gender, education, region and ethnicity. Crude survival analysis was conducted using Kaplan–Meier method to compare the survivability of dialysis patients based on the presence of hepatitis and relative time of hepatitis diagnosis. Hepatitis diagnoses that took place in the 120 days since dialysis initiation were classified as prior hepatitis. Any later hepatitis diagnoses were considered as infection developed after the start of dialysis. All statistical analyses were conducted using STATA 15 MP/IC Version (STATA Corporation, College Station, TX). The study was approved by the Institutional Review Ethics Committee (NU-IREC 203/29 112 019), with exemption from informed consent. RESULTS Among the dialysis patients, 500 were diagnosed with hepatitis in 2014–8 or earlier. Propensity score matching resulted in a loss of two cases due to lack of appropriate controls, resulting in a final cohort of 996 patients with 498 cases and 498 controls. Within this cohort, survival analysis was conducted. Figure 1 illustrates the Kaplan–Meier survival probability curves, where a consistently and significantly lower survivability is apparent among dialysis patients without hepatitis, as compared with those with hepatitis. Figure 2 shows the comparison of survival probabilities of patients diagnosed with prior or consequent hepatitis infection, relative to the time of dialysis initiation. A significantly lower survivability is visible among patients with prior hepatitis infection, as compared with those with consequent hepatitis infection. Both graphs are limited to 5 years of follow-up, with dates of patients’ dialysis initiation as the start points of individual follow-up periods. Both graphs contain the P-values of log-rank significance tests of the difference between the survival curves. CONCLUSION Viral hepatitis continues to be a serious complication in patients with HD, with HCV being the most common. Internationally, HCV infection is almost never treated in patients on HD. Our data inform in incident (

The article first discusses translation peculiarities of culture-specific items in the famous poem Alystaǵy baýyryma (To my brother in distance) of great Kazakh poet Magzhan Zhumabaev in parallel to the Turkish and English languages. Turkish is a related language, and this poem is well-known in Turkey, even has been translated several times by poets (poetic translation) and scholars (prose translation). But it was recently translated into English, that is, in 2018 for the 125th anniversary of the poet's birth by a professor at the University of Michigan, Timur Kocaoglu. This poem message to the fraternal Turkish people contains several culture-bounded words. And we considered their reflection in translation to the related and non-related languages through comparative analyses, and focused how translators coped with the task of rendering of cultural words. Since this has been and still remains as one of the most discussable and relevant aspects of literary translation. Fortunately, we were given a rare opportunity to speak with the translators, and some moments have been accompanied by comments from the translators themselves.

This clinical case demonstrates a history of 40-year old male with decompensated liver cirrhosis due to hepatitis C (genotype 1). The patient was started on direct acting antiviral therapy with sofosbuvir and simeprevir in order to decrease rate of disease progression. Treatment was associated with marked improvement of patient’s condition and resolving of ascites. Negative viremia was achieved after week 8 of antiviral therapy and the treatment was completed on week 12. However, evaluation on post-treatment week 12 has demonstrated recurrence of hepatitis C virus with sharp increase of liver transaminases of higher than 20 times upper limit normal. Second round of direct acting antiviral agents including ombitasvir, paritaprevir, dasabuvir and ritonavir was started. Negative viremia was achieved on week 4 with consequent demonstration of end of treatment and sustained virological response at 12 weeks post-treatment. This clinical case demonstrates need for personalized approach to antiviral therapy in each patient with modification of the treatment regimen by prolongation or implementing additional antiviral agent, if needed.

The clinical-functional research has allowed to identify the functional state of respiratory organs of production workers. The pathology is formed through stages (healthy –unhealthy individuals).

Peculiarities of the Infinitive are investigated in this article. Peculiar features of the English Infinitive are analyzed in comparison with Kazakh Infinitive

A 40-year-old man, diagnosed with decompensated liver cirrhosis because of hepatitis C virus, was on the wait list for a liver transplant when he began treatment with the direct-acting antivirals simeprevir 150 mg and sofosbuvir 400 mg. The patient demonstrated end of treatment virologic response at week 12, normal bilirubin, and alanine aminotransferase levels, resolution of ascites, with downgrading to subcompensated liver cirrhosis, and was removed from the liver transplant wait list. However, the patient did not comply with the recommended duration of the antiviral treatment of at least 16 weeks, which resulted in hepatitis C virus relapse at posttreatment week 12. Later, the patient started an alternative regimen that included a combination of ombitasvir 12.5 mg, paritaprevir 75 mg, ritonavir 50 mg, and dasabuvir 250 mg for 24 weeks and achieved a sustained virologic response. However, despite undetectable hepatitis C virus, the patient began to deteriorate again and was again put on the liver transplant wait list. This first described clinical case in Kazakhstan of successful antiviral therapy with 2 consecutive directacting agents demonstrates the importance of virus eradication of pretransplant survival extension and delaying the need for liver transplant.

На основе эмпирических данных рассматриваются проблемы профессиональной ориентации молодежи в Республике Казахстан. In this paper discussed problem of professional orientation of young people in the Republic of Kazakhstan. It presents an analysis of empirical data on the subject.

Kazakhstan is experiencing a high demand for liver transplants. More than 1000 patients have end-stage liver disease in the country, and liver transplant is the only viable option for their treatment.Liver transplant patients, treated from February 2013 to December 2014, were included in this retrospective analysis.From February 2013 to December 2014, seven patients received a liver transplant in our center (1 pediatric patient was excluded). Deceased liver recipients' (n = 3) median age was 52 years and median Model for End-Stage Liver Disease score 9. The indication for transplant was uncontrolled portal hypertension due to autoimmune liver disease. Cadaveric donors' median age was 45 years. Recipients' intensive care unit stay was5 days, time on inotropic support was3 days. Mean cold ischemic time was6 hours, and secondary ischemic time was 67 minutes. One patient in the deceased donor transplant group died during postoperative week 1 from hepatic artery thrombosis. Living donor liver recipients' (n = 3) median age was 47 years (43-48 y) and median Model for End-Stage Liver Disease score was 17 (range 14-20). Liver disease was hepatitis virus related (hepatitis C virus in 1 patient and hepatitis B and D virus in 2 patients). Mean cold ischemic time was 0.43 hours, and mean secondary ischemic time was 64 minutes. One recipient in the living donor liver group died early in the postoperative period from hemorrhage.Our experience was insufficient to adequately assess morbidity and survival rates in patients for whom the longest follow-up was 25 months. However, no episodes of rejection were observed. Survival rates between living and deceased donor recipients were equivalent, although cadaveric-donor liver conditions were imperfect. This analysis demonstrates the necessity for timely diagnosis of surgical complications, which accounted for all mortality incidence in our series.

The paper contains the analysis of the modern youth's installations towards labour in the Republic of Kazakhstan. The focus is on the following aspects: youth's goals in work, factors influencing the youth's career choice, youth's ideas of occupational prestige, youth's requirements to an ideal profession, factors influencing the emergence of unemployed youth with no educational background and the youth's opinion on the level of threat from this phenomenon to the society. The basis of the paper is formed by the data of sociological research 2016 conducted in Kazakhstan. The basic method of the sociological research was the mass survey with the application of the accidental representative sample of 2000 people. The Kazakhstani youth's values were analysed through the lens of such socio-demographic indicators as gender, age, region of living, profession, level of income, sphere of employment, and level of education.