A MULTIPLEX PCR ASSAY FOR THE DIFFERENTIAL DETECTION OF OPISTHORCHIS FELINEUS AND METORCHIS BILIS.

Opisthorchis felineus and Metorchis bilis are two common small worms that parasitize in the gallbladder and bile ducts of the liver of humans and carnivores. These parasites have a severe impact on health and are considered pathogens of serious diseases worldwide, such as cholangiocarcinoma. However, there are still no commercially available molecular diagnostic kits capable of simultaneously detecting these parasites in humans. Therefore, the study aimed to develop a multiplex PCR analysis that will differentially determine these two opisthorchiasis infections in one reaction. Two specific primer pairs for a multiplex polymerase chain reaction (PCR) were designed based on corresponding mitochondrial genome sequences. The multiplex assay detection limit was assessed by serial dilutions of the genomic DNAs of trematode worms examined. Naturally, infected samples of human bile and feces were tested using the developed assay. A multiplex PCR assay was developed based on mitochondrial DNA that accurately and simultaneously identifies two trematode species in one reaction using specific fragment sizes of 307 and 252 bp for O. felineus and M. bilis, respectively. The optimal reaction conditions, specificity, and sensitivity of the multiplex PCR assay were investigated. The lowest DNA concentration detected was 100 pg for M. bilis and O. felineus in a 25µl reaction system. This study provides an efficient tool for the simultaneous detection of O. felineus and M. bilis. The proposed multiplex PCR assay will be potentially useful in epidemiological studies, diagnosis, and treatment of this mixed opisthorchiasis infection.

[HIGH-DENSITY MAPPING OF ATYPICAL ATRIAL FLUTTER USING A PENTARAY].

This article describes clinical cases with complex cardiac arrhythmias after previous interventions. The aim of this article is to provide the first experience of using the PentaRay high-density mapping catheter in Kazakhstan (Biosense Webster, California, USA). Two clinical cases with the presence of several types of cardiac arrhythmias in each patient are described. The article describes two clinical cases with multiple atrial arrhythmias after previously performed interventional procedures on the left atrium. Both patients underwent radiofrequency isolation of the pulmonary veins, which was performed to treat atrial fibrillation, but was unsuccessful. An additional radiofrequency ablation in the atria was performed to treat continuously recurrent atrial arrhythmias. Patients were 56 and 70 years old. In the first case, atrial fibrillation and ventricular tachycardia occurred after previous severe myocarditis. In the second case, the primary occurrence of atrial fibrillation is associated with age-related atrial myocardial fibrosis and the presence of concomitant pathology such as arterial hypertension. In both cases, Carto3 navigation system (Biosense Webster, California, USA) and PentaRay high-density mapping catheter were used. A distinctive feature of the PentaRay high-density mapping catheter is the presence of 20 electrodes, which are located on five branches while the ThermoCool SmartTouch standard ablation-mapping catheter has only four mapping electrodes. In this regard, the advantage of the PentaRay high-density mapping catheter is the ability to quickly, accurately, safely create a map of target arrhythmia in any part of the heart. In this article a PentaRay high-density mapping catheter is used to map atrial arrhythmias. Thus, at least three mechanisms of the development of atrial arrhythmias were revealed in each patient, including the presence of fractionated electrograms. The CLOSE protocol was used to perform radiofrequency ablation, which is more effective and avoid complications.

[IMPACT OF ARRHYTHMIAS ON PREGNANCY COURSE AND OUTCOMES IN WOMEN WITHOUT STRUCTURAL HEART DISEASE].

The aim of the study was to observe the influence of different type of arrhythmias on pregnancy course and outcomes in women without structural heart disease. 72 pregnant women without structural heart disease with different type of cardiac arrhythmias had been studied. The most common types of arrhythmias were supraventricular tachycardia (44%, the 1st group) and premature contractions (40%, the 2nd group). Less frequently diagnosed ventricular tachycardia (6%, the 3dgroupe) and bradyarrhythmia (10%, the 4th group). A more unfavorable course of pregnancy was in the 4th group: myometrial hypertonici (29%, p=0,001), the only artery of the fetal mbilical cord (14%, p=0,036). Median pregnancy duration was 39 (38;39,5) in all groups. Vaginal delivery was in 54 (75%) cases, Cesarean delivery - in 18 (25%) cases. Birth weight and 5 minute Apgar's score were 3378 (3023;3917,5) and 8,9 (7,8;9) in the 1st group, 3460 (3016,5;4020) and 8,9 (7,8;8,9) - in the 2nd group, 3430 (3300;3650) and 8,9 (8,9;8,9) - in the 3dgroupe, 3334 (2870;3530) and 8,9 (7,9;9) - in the 4th group (p>0,05). There were no maternal and neonatal death. The most common type of arrhythmias in pregnant women without structural heart disease were supraventricular tachycardia (44%) and premature beats (40%). It is associated by good pregnancy course and outcomes in cases qualified manadgment.

[LASER CORRECTION OF MYOPIC ASTIGMATISM USING FEMTO LASIK AND RELEX SMILE TECHNOLOGIES - EFFICIENCY AND SAFETY].

The purpose of the study is a comparative analysis of the efficacy and safety of the Femto LASIK and ReLEx SMILE technologies in correcting myopic astigmatism. Materials and methods: The study included 1212 results of interventions in patients with myopic astigmatism, incl. 721 (59.5%) using ReLEx SMILE technology and 491 (40.5%) Femto LASIK technology. Visionometry and refraction investigation were performed at the time of 3, 6, 9, 12 months after the operation, as well as an analysis of the incidence of complications. Results of the study: As a result of the study, it was determined that in patients with myopic astigmatism, laser correction of refractive error using ReLEx SMILE technology gives similar results to Femto LASIK in the presence of a combination of moderate myopia and mild astigmatism. With medium-level astigmatism, the clinical results of Femto LASIK decrease (the difference in this category of patients after 1 week was 12.7% (p=0.04), they were also significant after 3 months (11.9%, p=0.042) and 9 months (8.9%, p=0.048)), which, nevertheless, remain quite satisfactory. The use of the ReLEx SMILE technique provides a significant reduction in the number of complications of laser correction of refractive errors, with both light astigmatism (3.2 times) and more pronounced violations (2.6 times). Significant differences were revealed in the frequency of dry eye syndrome (4.7 times, χ2=23.22, p=0.001), hypercorrection 14.3 times (χ2 = 34.52, p <0.001) in favor of the ReLEx SMILE technique.

PLACENTAL GROWTH FACTOR AND MATERNAL CHARACTERISTICS IN THE FIRST TRIMESTER AMONG PREGNANT WOMEN OF KAZAKH NATIONALITY.

The impact of ethnicity and maternal anamnesis data at the PLGF level is determined. The aim of our study was to estimate changes at PIGF level in the first trimester of pregnancy, depending on the maternal anamnesis data among women of Kazakh ethnicity. 63 pregnant women at 12 weeks of gestation were included into the study. All of them were examined with the maternal anamnesis data selection and a pre-gravid body mass index (BMI) was calculated. At the gestational age of 12 weeks, one sample of blood was taken to determine PlGF among tested pregnant women. The level of placental growth factor among the pregnant women under the study ranged from 0.01 to 107.4 pg/ml at 12 weeks, approximately 80% of the pregnant women had a PlGF level below 25 pg/ml. We identified no differences in PlGF level depending on age, weight, pre-gravid BMI, nulliparity, multiparity. We revealed that pregnant women with more than 4,000 grams childbirth in anamnesis had a higher concentration of PlGF (Me= 27.5 pg/ml Q1-17 Q3-63.5), compared with women whose the given factor was absent in the anamnesis (Me=14.9 pg/ml Q1-9.7 Q3-23), U=101.5, Z =-2.068, p=0.039. We assume that a low concentration of PlGF among pregnant Kazakhs can be determined by ethnic characteristics, as well as by a decrease in the adaptive capacity of adrenal hormones. We recommend that the study on the ethnic variation of PlGF among pregnant women of Kazakh nationality should be conducted completely.