Drug-Resistant Tuberculosis, Georgia, Kazakhstan, Kyrgyzstan, Moldova, and Ukraine, 2017-2022.

In 2021, the World Health Organization recommended new extensively drug-resistant (XDR) and pre-XDR tuberculosis (TB) definitions. In a recent cohort of TB patients in Eastern Europe, we show that XDR TB as currently defined is associated with exceptionally poor treatment outcomes, considerably worse than for the former definition (31% vs. 54% treatment success).

Menopausal Status Impact on the Quality of Life in Kazakhstani Healthcare Workers: A Cross-sectional Study.

BACKGROUND: Menopausal quality of life (MenQoL) is a common concern that primary healthcare workers often encounter. Menopause has a significant impact on women's health, but studies examining its effect on the MenQoL of menopausal healthcare employees have produced conflicting results. OBJECTIVE: The aim of this study was to compare the quality of life related to menopausal status (pre-, peri-, or postmenopausal) in healthcare workers from various clinical settings in Kazakhstan. DESIGN: This was a cross-sectional study. PARTICIPANTS: In total, 222 menopausal healthcare workers (physicians, nurses/midwives, administrative staff, and cleaners) were enrolled from hospitals affiliated with the University Medical Center (UMC) in Kazakhstan. MAIN MEASURES: The outcome variable was assessed using the Menopausal Quality of Life Questionnaire (MENQOL), which evaluates MenQoL across four domains of menopausal symptoms: physical, psychological, vasomotor, and sexual. KEY RESULTS: The most frequently reported menopausal symptoms were physical ones, such as feeling tired or worn out (70.7%), followed by feeling a lack of energy (65.3%) and dry skin (64.1%). The postmenopause group had the highest mean MenQoL score in the vasomotor domain (mean 3.46 ± 1.84). There was a borderline statistical significance when comparing postmenopause and perimenopause groups in the physical domain. The pairwise comparison of mean sexual scores revealed that postmenopause women had the highest average score (3.3 ± 2.36) compared to both premenopause (mean 2.3 ± 1.82) and perimenopause (mean 2.22 ± 1.58) groups (p < 0.05). CONCLUSIONS: Menopausal status has influence on the MenQoL of healthcare workers. The study findings could have important implications for policymakers as they provide insight into the factors influencing the quality of life of menopausal healthcare employees. Creating a more menopause-friendly work environment may not only enhance the well-being of healthcare personnel but also improve their overall job satisfaction and performance.

Polycladomyces zharkentensis sp. nov., a novel thermophilic cellulose- and starch-degrading member of the Bacillota from a geothermal aquifer in Kazakhstan.

A thermophilic, aerobic and heterotrophic filamentous bacterium, designated strain ZKZ2T, was isolated from a pipeline producing hydrothermal water originating from a >2.3 km deep subsurface geothermal source in Zharkent, Almaty region, Kazakhstan. The isolate was Gram-stain-positive, non-motile, heat-resistant and capable of producing a variety of extracellular hydrolases. Growth occurred at temperatures between 55 and 75 °C, with an optimum around 70 °C, and at pH values between 5.5 and 9.0, with an optimum at pH 7.0-7.5 with the formation of aerial mycelia; endospores were produced along the aerial mycelium. The isolate was able to utilize the following substrates for growth: glycerol, l-arabinose, ribose, d-xylose, d-glucose, d-fructose, d-mannose, rhamnose, d-mannitol, methyl-d-glucopyranoside, aesculin, salicin, cellobiose, maltose, melibiose, sucrose, trehalose, melezitose, raffinose, starch, turanose and 5-keto-gluconate. Furthermore, it was able to hydrolyse carboxymethylcellulose, starch, skimmed milk, Tween 60 and Tween 80. The major cellular fatty acids were iso-C15 : 0, iso-C17 : 0, iso-C16 : 0 and C16 : 0. Our 16S rRNA gene sequence analysis placed ZKZ2T within the genus Polycladomyces, family Thermoactinomycetaceae, with the highest similarity to the type species Polycladomyces abyssicola JIR-001T (99.18 % sequence identity). Our draft genome sequence analysis revealed a genome size of 3.3 Mbp with a G+C value of 52.5 mol%. The orthologous average nucleotide identity value as compared to that of its closest relative, P. abyssicola JIR-001T, was 90.23 %, with an in silico DNA-DNA hybridization value of 40.7 %, indicating that ZKZ2T represents a separate genome species. Based on the phenotypic and genome sequence differences from the other two Polycladomyces species, we propose that strain ZKZ2T represents a novel species, for which we propose the name Polycladomyces zharkentensis sp. nov. The type strain is ZKZ2T (=CECT 30708T=KCTC 43421T).

Serum calcium and magnesium levels and quality of life in environmentally exposed populations in Kazakhstan.

The relationship between the levels of essential elements and various aspects of well-being in environmentally exposed populations still needs to be better understood. The present study aims to investigate the potential connections between serum concentrations of calcium (Ca), magnesium (Mg), and quality of life (QoL) in environmentally exposed populations in Kazakhstan. The present study involved 1881 nominally healthy individuals aged 18-52 years who were permanent residents of Abay, Borodulikha, Ust-Kamenogorsk, Kurchum, Uralsk, Aksay, and Berezovka settlements. These settlements were selected to represent different types of environmental exposure: radioactive fallout from the Semipalatinsk Nuclear Test Site (SNTS), non-ferrous metallurgy, and the condensate gas field, compared to environmentally unexposed territories. The Russian version of the SF-36 questionnaire was used to assess the participants' quality of life. Serum Ca levels were measured using colorimetry with O-cresolphthalein, and serum Mg concentrations were measured using colorimetry with xylidyl blue. Both elevated and decreased serum Ca levels were more frequently observed in the environmentally exposed populations. The prevalence of hypermagnesemia was highest among residents near the condensate gas field. Environmentally exposed populations residing near the SNTS and in Ust-Kamenogorsk exhibited lower scores in some QoL domains. In contrast, people near the condensate gas field showed comparable or even higher QoL scores than the control population. Only serum Mg demonstrated a significant association with the average QoL scores, while Ca did not show such an association. These findings have important implications for public health interventions.

The impact of incentive scheme on rural healthcare workforce availability: a case study of Kazakhstan.

BACKGROUND: During the 1990-2000, Kazakhstan experienced a decline in the number of healthcare professionals working in rural areas. Since 2009, the national government has been implementing financial incentives to encourage healthcare professionals to relocate to rural areas. This study aims to investigate the temporal and spatial patterns in the distribution of the rural healthcare workforce and evaluate the impact of this incentive scheme. METHODS: Interrupted Time Series Analysis using ARIMA models and Difference in Differences analyzes were conducted to examine the impact of the incentive scheme on the density of different categories of the healthcare workforce in rural Kazakhstan in the period from 2009 to 2020. RESULTS: There was a significant increase in the number of rural healthcare professionals from 2009 to 2020 in comparison to the period from 1998 to 2008. However, this increase was less pronounced in per capita terms. Moreover, a decline in the density of internists and pediatricians was observed. There is substantial variation in the density of rural nurses and physicians across different regions of Kazakhstan. The incentive scheme introduced in 2009 by the government of Kazakhstan included a one-time allowance and housing incentive. This scheme was found to have contributed insignificantly to the observed increase in the number of rural healthcare professionals. CONCLUSION: Future research should be undertaken to examine the impact made by the incentive scheme on other medical subspecialties, particularly primary practitioners. Addressing the shortage of healthcare workers in rural areas is a complex issue that requires a multifaceted approach. Aside from financial incentives, other policies could be considered to increase relocation and improve the retention of healthcare professionals in rural areas.

Trends and gender disparities in the incidence of rheumatic diseases: a regional study from 2018 to 2021.

Rheumatic diseases encompass a range of entities affecting the musculoskeletal system and connective tissue due to immune dysregulation. These entities include rheumatoid arthritis, systemic lupus erythematosus, and ankylosing spondylitis that present significant medical and social challenges by impacting individuals' quality of life and working capacity. In developing countries, where healthcare access is limited, the burden of these diseases is particularly severe. Analyzing the regional epidemiological characteristics of rheumatic diseases may enhance our understanding of risk factors and aid in developing targeted preventive measures. This study utilized data from the Republican Centre for Health Development in Kazakhstan from 2018 to 2021. The incidence of various rheumatic diseases was examined in the adult population of Shymkent, Kazakhstan, including rheumatoid arthritis, gout, osteoarthritis, systemic lupus erythematosus, dermatomyositis, scleroderma, and ankylosing spondylitis. Shymkent's total number of rheumatic disease cases rose from 52,617 in 2018 to 52,781 in 2021. Primary morbidity increased from 18,381 to 21,677 cases. Incidence rates for systemic lupus erythematosus, systemic scleroderma, and ankylosing spondylitis increased, while cases of rheumatoid arthritis and osteoarthritis showed fluctuation. Gender distribution analysis revealed that women were more frequently affected by rheumatoid arthritis and systemic lupus erythematosus whereas men were more prone to ankylosing spondylitis. The results underscore the need to tailor diagnostic and treatment approaches to account for age-and gender-specific differences in rheumatic diseases. The increased incidence of some diseases calls for new prevention and treatment strategies. This study highlights the significant burden of rheumatic diseases in Shymkent, Kazakhstan and emphasizes the importance of local epidemiological research in adapting medical practices to regional specifics.

Estimating the Real Impact of the COVID-19 Pandemic in Kazakhstan: Factors Associated with Detection of the "True Infections".

The COVID-19 pandemic is ongoing worldwide, and various case and death numbers are being reported to track its spread. However, the number of actual cases is uncertain due to under-reporting. Using mortality data as a more reliable indicator, this study in Kazakhstan evaluated the extent of under-reporting and under-detection of COVID-19 cases from March 2020 to September 2022 using back-casting and capture-recapture methods. The results indicate that official case reporting in Kazakhstan significantly underestimates the number of infections by at least 50%. The study also suggests that improved testing capabilities may have led to a decrease in the percentage of unreported cases, however, early in the pandemic, Kazakhstan faced significant testing shortages. The study presents a mathematical model based on mortality data that highlights the severe under-reporting of COVID-19 cases in Kazakhstan and argues that understanding the true estimate of actual cases could aid in making informed decisions to end the pandemic.

The activity of 210Pb in cigarette smoked in Kazakhstan.

The radon decay product 210Pb is a known component of tobacco. In this study, the activity concentration of 210Pb in the most popular cigarette brands (six samples) for Kazakhstan consumers was determined by beta spectrometry. The activity levels of 210Pb ranged between 2.69 ± 0.27 and 27.42 ± 2.74 mBq per cigarette. Higher activity concentrations for 210Pb were found in Sample No.4 and showed an excess of the world average by 1.8 times. The average activity concentrations of 210Pb in cigarette tobacco were 10.42 ± 1.04 mBq cig-1. The daily activities inhaled in the lungs of a smoker, and the resulting effective doses due to cigarette smoking were calculated. Effective doses per year due to cigarette smoking were calculated assuming that 42.13% of the 210Pb in tobacco were retained in the lungs of the smokers. It is concluded that for a smoker in Kazakhstan, the average effective dose ranges from 9.1 ± 0.9 µSv/year to 92.8 ± 9.3 µSv/year for a cigarette consumption of one pack of cigarettes per day. The results indicate that the annual effective doses from inhalation of 210Pb due to smoking one pack of cigarettes per day are from 7 to 58 times (for different types of cigarettes) greater than the annual effective doses from ingestion of radionuclides via the diet.

Perspectives of healthcare practitioners on environmental sustainability in healthcare: A qualitative study.

AIM: To explore the perspectives of Kazakhstani healthcare professionals on environmental sustainability in healthcare. DESIGN: An exploratory qualitative design. METHODS: Four focus group discussions (FGDs) on environmental sustainability in healthcare were conducted among healthcare professionals (nurses, physicians, midwives and physical therapists) from June to August 2023 in three cities of Kazakhstan. Each FGD consisted of at least 6 to 11 participants and lasted between 60 and 90 minutes. The collected data were analysed using the thematic analysis. RESULTS: A total of 137 initial codes were identified and further organized into 22 sub-themes based on similarities in codes and meanings, and then 5 significant themes were identified. The five main themes are 'Environmental Sustainability Practices in Healthcare', 'Purposes of Environmental Sustainability in Healthcare', 'Impact of Environmental Sustainability in Healthcare in Patients', 'Challenges in Implementing Environmental Sustainability in Healthcare' and 'The Role of Healthcare Leadership in Improving Environmental Sustainability in Healthcare'. CONCLUSIONS: The findings highlighted the perceptions and practices of healthcare professionals on environmental sustainability's purposes in healthcare, its impacts on patients and its implementation challenges. The study also underscored the critical role of strong and active leadership in ensuring a sustainable implementation of green policies in healthcare facilities and achieving successful results of environmentally conscious healthcare practices. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The findings provide invaluable information that can be used by policymakers and healthcare organization leaders to create a sustainable healthcare system. Implementing environmental sustainability practices in healthcare should be widespread, intentional, and sustainable, entailing strong leadership and unwavering personal and organizational commitment. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. REPORTING METHOD: We adhered to relevant EQUATOR guidelines, specifically the Consolidated Criteria for Reporting Qualitative Research.

Application of DNA barcodes in the genetic diversity of hard ticks (Acari: Ixodidae) in Kazakhstan.

Forty-five tick species have been recorded in Kazakhstan. However, their genetic diversity and evolutionary relationships, particularly when compared to ticks in neighbouring countries, remain unclear. In the present study, 148 mitochondrial cytochrome c oxidase subunit I (COI) sequence data from our laboratory and NCBI (National Center for Biotechnology Information; https://www.ncbi.nlm.nih.gov/ ) data were used to address this knowledge gap. Phylogenetic analyses showed that i) Hyalomma anatolicum anatolicum (Koch, 1844) ticks from Jambyl Oblast (southeastern Kazakhstan) and Gansu Province (northwestern China) constituted a newly deviated clade; and ii) Dermacentor reticulatus (Fabricius, 1974) ticks from South Kazakhstan Oblast were closer to those in Romania and Turkey. The network diagram of haplotypes showed that i) the H-1 and H-2 haplotypes of Dermacentor marginatus (Sulzer, 1776) ticks from Zhetisu and Almaty were all newly evolved; and ii) the H-3 haplotypes of Haemaphysalis erinacei (Pavesi, 1884) from Almaty Oblast and Xinjiang Uygur Autonomous Region (northwestern China) were evolved from the H-1 haplotype from Italy. In the future, more COI data from different tick species, especially from Kazakhstan and neighbouring countries, should be employed in the field of tick DNA barcoding.

Aral Sea environmental disasters area population's physical activity level assessment - the first step for targeted health promotion.

OBJECTIVE: Aim: We aimed to assess the physical activity and sedentary behavior of the population living in the Aral Sea area using the Global Physical Activity Questionnaire. PATIENTS AND METHODS: Materials: Data was collected from seven out-patient settings involving 445 participants (47.6% females, 52.4% males). The age of 33.6% of respondents was over 65. RESULTS: Results: Nearly a quarter (23.5%) of the participants did not meet World Health Organization physical activity recommendations. The Median Time spent on physical activity in recreation in all dispensaries among males (Md=34.29, IQR=66.43) was signif i cantly higher (Z=-4.78, p<0.001) than females (Md=12.86, IQR=51.43). A signif i cant association was observed between transport-related physical activity and gender (χ2= 5.60, p=0.018). The average percentage that comes from recreation-related activities among males (M=43.69, SD=26.90) was more signif i cant (MD=6.27, 95% CI: 0.46, 12.07) as compared to that of females (M=37.43, SD=31.66). A signif i cant association was observed between engagement in vigorous activity and gender (χ2= 30.77, p<0.001). CONCLUSION: Conclusions: Environmental, economic, demographic, and cultural peculiarities of the Aral Sea area should be considered in elaborating specif i c health promotion programs to shift health-harming ambient into health-improving environment.

Genetic polymorphism of Y-chromosome in Kazakh populations from Southern Kazakhstan.

BACKGROUND: The Kazakhs are one of the biggest Turkic-speaking ethnic groups, controlling vast swaths of land from the Altai to the Caspian Sea. In terms of area, Kazakhstan is ranked ninth in the world. Northern, Eastern, and Western Kazakhstan have already been studied in relation to genetic polymorphism 27 Y-STR. However, current information on the genetic polymorphism of the Y-chromosome of Southern Kazakhstan is limited only by 17 Y-STR and no geographical study of other regions has been studied at this variation. RESULTS: The Kazakhstan Y-chromosome Haplotype Reference Database was expanded with 468 Kazakh males from the Zhambyl and Turkestan regions of South Kazakhstan by having their 27 Y-STR loci and 23 Y-SNP markers analyzed. Discrimination capacity (DC = 91.23%), haplotype match probability (HPM = 0.0029) and haplotype diversity (HD = 0.9992) are defined. Most of this Y-chromosome variability is attributed to haplogroups C2a1a1b1-F1756 (2.1%), C2a1a2-M48 (7.3%), C2a1a3-F1918 (33.3%) and C2b1a1a1a-M407 (6%). Median-joining network analysis was applied to understand the relationship between the haplotypes of the three regions. In three genetic layer can be described the position of the populations of the Southern region of Kazakhstan-the geographic Kazakh populations of Kazakhstan, the Kazakh tribal groups, and the people of bordering Asia. CONCLUSION: The Kazakhstan Y-chromosome Haplotype Reference Database was formed for 27 Y-STR loci with a total sample of 1796 samples of Kazakhs from 16 regions of Kazakhstan. The variability of the Y-chromosome of the Kazakhs in a geographical context can be divided into four main clusters-south, north, east, west. At the same time, in the genetic space of tribal groups, the population of southern Kazakhs clusters with tribes from the same region, and genetic proximity is determined with the populations of the Hazaras of Afghanistan and the Mongols of China.

SARS-CoV-2 Infection in Wrestlers after International Tournaments, April 2021.

Epidemiologic and genomic investigation of SARS-CoV-2 infections in members of Japan's national wrestling team after participation in international tournaments in 2021 revealed multiple lineages of SARS-CoV-2 not reported in Japan. The attack rate among wrestlers was high. Results suggest possible transmission during matches. We recommend early case detection and response practices.

Compounding vulnerabilities: victimization and discrimination is associated with COVID-19 disruptions to HIV-related care among gay, bisexual, and other men and transgender and nonbinary people who have sex with men in Kazakhstan.

Gay, bisexual, and other men and transgender and nonbinary people who have sex with men (MSM and TSM) are disproportionately impacted by the HIV epidemic in Kazakhstan. MSM and TSM in Kazakhstan also face high levels of discrimination and victimization, known barriers to engagement in HIV prevention and care. We examined data from surveys with 455 MSM and TSM collected May -- October 2020 to determine whether access to HIV testing and treatment was disproportionately limited among those exposed to victimization and discrimination during the early COVID-19 pandemic. Odds of reporting COVID-19 disruptions to HIV-related care access were significantly higher (OR: 1.96; 95% CI: 1.25-3.06; P = .003) among those who experienced recent sexual or gender-based victimization, and recent discrimination (OR: 2.93; 95% CI: 1.65-5.23; P < .001), compared to those who did not experience victimization or discrimination, respectively. Odds of reporting disruptions among those who experienced both victimization and discrimination were significantly higher (OR: 3.59; 95% CI: 1.88-6.86; P < .001) compared to those who experienced neither . Associations remained significant after adjustment for potentially confounding factors. Findings suggest the COVID-19 pandemic is compounding vulnerability among MSM and TSM in Kazakhstan - highlighting need for intervention efforts targeting the most marginalized groups.

Trends in the incidence of musculoskeletal diseases in Kazakhstan in 2011-2020: an information-analytical study.

According to the World Health Organization, there is an increase in the incidence of musculoskeletal diseases worldwide. The problem of this group of diseases is that they are associated with the onset of temporary and permanent disability. A number of studies have demonstrated an increase in the incidence of musculoskeletal diseases in the US, Canada, Australia, and European countries. The current informational and analytical study was aimed to reflect on related morbidity trends in Kazakhstan. We analyzed data on the incidence of diseases of the musculoskeletal system in 2011-2020. Ten annual statistical yearbooks of the Ministry of Health of Kazakhstan were used to obtain data. The results showed an increase in the total incidence of musculoskeletal diseases of 304,492 cases between 2011 and 2020. Primary incidence of musculoskeletal disorders in the whole population increased by a factor of 1.5. The incidence rate of musculoskeletal diseases increased in the age group over 18 years and in the 0-14 years' child group. A comparative analysis of morbidity figures for rural and urban populations was also presented. An increase in the incidence of musculoskeletal diseases in both populations was observed. Finally, comparative data analysis on morbidity across Central Asian countries was provided. This information-analytical study shows that the incidence of musculoskeletal disorders is steadily increasing in Kazakhstan. The scientific community should pay attention to this trend to prevent further increases in the incidence of musculoskeletal disorders.

Structure, demography, and medico-social characteristics of articular syndrome in rheumatic diseases: a retrospective monocentric analysis of 2019-2021 data.

Rheumatic diseases encompass a wide range of conditions characterised by joint inflammation and pain, significantly impacting individuals' quality of life. Articular syndrome, manifested through joint-related symptoms such as pain, swelling, and reduced mobility, is a common feature of rheumatic diseases. This study aimed to analyze articular syndrome's structure, demography, and medico-social characteristics in rheumatic diseases.  We retrieved case notes of 370 patients examined in 2019-2021 at the Rheumatology Department of the Regional Clinical Hospital, Shymkent, Kazakhstan. We processed data on gender, age, place of residence, social status, clinical diagnosis, comorbid conditions, complications, and delays. The material was counted by frequency analysis. Statistical and mathematical data processing was performed using the SPSS application software package version 26.0 (IBM).  The identified rheumatic diseases among the patients included rheumatoid arthritis (183), systemic lupus erythematosus (47), osteoarthritis (42), ankylosing spondylitis (31), systemic scleroderma (30), reactive arthritis (18), gouty arthritis (14), psoriatic arthritis (3), and dermatomyositis (2). The distribution of patients with articular syndrome varied across the study years, with 102 patients in 2019, 216 patients in 2020, and 52 patients in 2021. The study revealed the age distribution of patients, with an average age of 46 at the time of examination and an average age of disease onset at 39. The study further investigated the distribution of rheumatic diseases categorized by gender, place of residence (urban or rural), and disease duration. Additionally, the study examined the prevalence of comorbid conditions and complications related to the underlying rheumatic disease.  By examining the structure, demography, and medico-social characteristics of the articular syndrome in patients with rheumatic diseases, this retrospective analysis provides valuable insights into the epidemiological aspects of these conditions. The findings may contribute to a better understanding of the burden of rheumatic diseases on individuals and society. Such knowledge can aid in developing targeted interventions, improving healthcare delivery, and enhancing patients' overall well-being.

Characteristics of Retracted Publications From Kazakhstan: An Analysis Using the Retraction Watch Database.

BACKGROUND: Retraction is a correction process for the scientific literature that acts as a barrier to the dissemination of articles that have serious faults or misleading data. The purpose of this study was to investigate the characteristics of retracted papers from Kazakhstan. METHODS: Utilizing data from Retraction Watch, this cross-sectional descriptive analysis documented all retracted papers from Kazakhstan without regard to publication dates. The following data were recorded: publication title, DOI number, number of authors, publication date, retraction date, source, publication type, subject category of publication, collaborating country, and retraction reason. Source index status, Scopus citation value, and Altmetric Attention Score were obtained. RESULTS: Following the search, a total of 92 retracted papers were discovered. One duplicate article was excluded, leaving 91 publications for analysis. Most articles were retracted in 2022 (n = 22) and 2018 (n = 19). Among the identified publications, 49 (53.9%) were research articles, 39 (42.9%) were conference papers, 2 (2.2%) were review articles, and 1 (1.1%) was a book chapter. Russia (n = 24) and China (n = 5) were the most collaborative countries in the retracted publications. Fake-biased peer review (n = 38), plagiarism (n = 25), and duplication (n = 14) were the leading causes of retraction. CONCLUSION: The vast majority of the publications were research articles and conference papers. Russia was the leading collaborative country. The most prominent retraction reasons were fake-biased peer review, plagiarism, and duplication. Efforts to raise researchers' understanding of the grounds for retraction and ethical research techniques are required in Kazakhstan.

"Who Else If Not Us": An Exploratory-Descriptive Qualitative Study of Kazakhstani Frontline Professionals' Experience and Perceptions During the Coronavirus Disease 2019 Pandemic.

Little is known about the experiences of frontline professionals in Kazakhstan. Although studies of frontline workers have been conducted worldwide, it is imperative that caution should be exercised when extrapolating findings from disparate societies and generalizing them to Central Asian countries. As such, the purpose of this study was to explore and describe the firsthand experiences, perceptions, and knowledge gained from the experience of Kazakh frontline physicians and nurses during the COVID-19 pandemic. An exploratory-descriptive qualitative (EDQ) study was conducted over the course of a year in COVID-19 hospitals in Kazakhstan, with physicians (n = 23) and nurses (n = 7). Each participant was interviewed three times between May 2021 and May 2022. Braun and Clarke's six-step method was used for the thematic analysis. Three overarching themes and subthemes were identified: (1) Longitudinal Journey ("Nobody knew, nobody understood, nobody was ready"; "It's just life"); (2) Facets of Professionalism ("In my lifetime this is something unique"; "Who else if not us"; "We survived the war and the enemy"); and (3) Facets of Resilience ("God's providence"; "A good word heals too"). In light of the lack of research that has previously been conducted in Kazakhstan, the results of this study offer important new insight into the experiences of medical professionals during the COVID-19 epidemic.

Phytochemical Profile and Antimicrobial Potential of Propolis Samples from Kazakhstan.

In the current paper, we present the results of Kazakh propolis investigations. Due to limited data about propolis from this country, research was focused mainly on phytochemical analysis and evaluation of propolis antimicrobial activity. uHPLC-DAD (ultra-high-pressure-liquid chromatography coupled with diode array detection, UV/VIS) and uHPLC-MS/MS (ultra-high-pressure-liquid chromatography coupled with tandem mass spectrometry) were used to phytochemical characteristics while antimicrobial activity was evaluated in the serial dilution method (MIC, minimal inhibitory concentration, and MBC/MFC, minimal bactericidal/fungicidal concentration measurements). In the study, Kazakh propolis exhibited a strong presence of markers characteristic of poplar-type propolis-flavonoid aglycones (pinocembrin, galangin, pinobanksin and pinobanskin-3-O-acetate) and hydroxycinnamic acid monoesters (mainly caffeic acid phenethyl ester and different isomers of caffeic acid prenyl ester). The second plant precursor of Kazakh propolis was aspen-poplar with 2-acetyl-1,3-di-p-coumaroyl glycerol as the main marker. Regarding antimicrobial activity, Kazakh propolis revealed stronger activity against reference Gram-positive strains (MIC from 31.3 to above 4000 mg/L) and yeasts (MIC from 62.5 to 1000 mg/L) than against reference Gram-negative strains (MIC ≥ 4000 mg/L). Moreover, Kazakh propolis showed good anti-Helicobacter pylori activity (MIC and MBC were from 31.3 to 62.5 mg/L). All propolis samples were also tested for H. pylori urease inhibitory activity (IC50, half-maximal inhibitory concentration, ranged from 440.73 to 11,177.24 µg/mL). In summary Kazakh propolis are potent antimicrobial agents and may be considered as a medicament in the future.

Medicinal Plants of the Flora of Kazakhstan Used in the Treatment of Skin Diseases.

The skin shows the physiological condition of the body's organs and systems that prevent infections and physical damage. Throughout the ages, in folk medicine, phytotherapy was considered a primary form of treatment in all countries, including Kazakhstan, due to the abundance and availability of plant-based remedies. This paper discusses several medicinal plants that are traditionally used in the treatment of skin diseases in the Republic of Kazakhstan. The chemical composition of these plants was analyzed, with a particular focus on the biologically active basic compounds responsible for their therapeutic efficiency in treating skin ailments.