04. MD Thesis

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    TARGETED DELIVERY OF FACTORS AND CELLS FOR IMPROVING CARDIAC TISSUE REGENERATION AND HEART FUNCTION FOLLOWING MYOCARDIAL INFARCTION
    (Nazarbayev University School of Medicine, 2025-03-01) Nurkesh, Ayan
    Cardiovascular diseases (CVDs), including myocardial infarction (MI) and coronary artey disease, are the leading causes for global mortality. MI arises from the rupture of atherosclerotic plaques, triggering thrombosis, ischemia, and subsequent cardiomyocyte death. Heart has limitations to regenerate the tissue, fibrotic tissue replaces damaged myocardium, impairing cardiac function. While interventions like percutaneous coronary intervention reduce mortality, they do not regenerate tissue, underscoring the need for innovative therapies. Mesenchymal stem cells (MSCs) hold potential for cardiac repair, but their survival in ischemic environments remains suboptimal. Hydrogels, particularly chitosan-based cryogels, may enhance MSC retention and efficacy. This study investigates the combined delivery of MSCs and bioactive factors (IL-10, VEGF-A, FGF-2) via cryogels in a murine MI model. Results indicate reduced inflammation, enhanced angiogenesis, and improved cardiac regeneration, suggesting a novel strategy to mitigate post-MI fibrosis and advance cell- based therapies for CVDs.
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    PREVALENCE, INCIDENCE AND MORTALITY OF THYROID CANCER IN KAZAKHSTAN: DATA FROM UNIFIED NATIONAL ELECTRONIC HEALTH SYSTEM 2014-2021
    (Nazarbayev University School of Medicine, 2025-04-22) Abdymananova, Ramina
    Although a rare type of cancer overall, thyroid cancer is one of the most common endocrine malignancies. According to global studies, its prevalence has been increasing worldwide and continues to grow. Although there are global epidemiological studies on thyroid cancer that involved many regions, there is limited data on the epidemiology of thyroid cancer in Central Asian countries, including Kazakhstan. This project was done to provide information on demographic characteristics of diagnosed patients, determine prevalence, incidence and mortality rates of thyroid cancer in Kazakhstan and conduct survival analysis for such patients. According to the data provided from the Unified National Electronic Health System, in total, 4,877 cases of thyroid cancer have been identified during the period from 2014 to 2021 in Kazakhstan. Based on the results, most of the diagnosed patients throughout the given period were females. The highest incidence and prevalence rates were found in the age group of 51-70 years old while the highest mortality rate was among patients older than 70. Increasing age and male sex were reported as the major predictors of mortality among thyroid cancer patients.
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    CT ANGIOGRAPHIC STUDY OF ANATOMICAL VARIATIONS OF INFERIOR PHRENIC ARTERIES
    (Nazarbayev University School of Medicine, 2025-04-22) Kairatova, Dina
    Introduction: Inferior phrenic arteries (IPA) mostly originate from the abdominal aorta or celiac artery. However, they can originate from renal arteries, splenic arteries, and other sources. Knowledge of existing variations is paramount in surgery and radiology, as right IPAs can be a cause of postoperative bleeding in liver transplantation, and left IPA can be a cause of bleeding in gastroesophageal hemorrhage. The variations in the origins of IPAs in the Kazakh population were investigated in this study. Methods: CT angiographies of 155 patients were retrospectively analyzed. The origins of IPAs were detected using 3D and multiplanar reconstructions. Results: 48 patients had right and left IPAs originating together from either the celiac trunk or the abdominal aorta. 107 cases had separate origins. The most prevalent origins of the right IPA were the celiac artery (42.99%), the abdominal aorta (37.38%), and the right renal artery (15.89%). The most prevalent origins of left IPA were the celiac trunk (61.68%) and the abdominal aorta (32.71%). Overall, 12 combinations of artery origins were noted. Conclusion: The study presents the variations in origins of IPAs which is important in planning surgical and radiological interventions and should increase awareness among surgeons and radiologists during different procedures.
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    SOLUBLE FRAGMENT OF THE RECEPTOR TYROSINE KINASE AXL AS A LIQUID BIOPSY BIOMARKER IN BLADDER CANCER
    (Nazarbayev University School of Medicine, 2025-04-22) Islam, Nazia
    Aim of the study: The study compared urinary levels of soluble Axl between bladder cancer patients and controls, with the goal of studying its potential as a biomarker for bladder cancer. In addition to that, the expression of Axl in bladder cancer tissue and the impact of urine treatment on the migration of bladder cancer cells were assessed. Background: Axl has been investigated as a biomarker in serum for various cancers. However, little research has been conducted on its potential as a biomarker in urine, particularly for bladder cancer. Methodology: Urine was collected from adult bladder cancer patients and controls. Axl levels in urine were detected using Western blot, and its concentrations were measured by ELISA. Immunohistochemistry was performed to assess Axl expression in bladder cancer tissue obtained from patients. Migration assays were conducted with treatment of wounds using urine to assess its biological activity on bladder cancer cells. Results and Conclusion: While no significant difference was observed in sAxl levels between patients and controls, a positive correlation was noted in Axl staining of bladder cancer tissue with sAxl levels in the urine of patients. Recombinant Axl did not exhibit any effect on the migration of cells for wound closure.
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    PREVALENCE OF HIGH-RISK HUMAN PAPILLOMAVIRUS INFECTION AMONG KAZAKHSTANI WOMEN WITH ABNORMAL CERVICAL CYTOLOGY
    (Nazarbayev University School of Medicine, 2025-05-22) Makhmetova, Nurgul
    Aim: This study aims to determine prevalence of HR-HPV in Kazakhstani women with abnormal cervical cytology results. The hypothesis is that HR-HPV prevalence will be high among these women. Methods: An anonymous patient database (de-identified patient records) will be used for data analysis. Statistical analysis will be carried out with STATA 16. Results: Women with abnormal cytology were slightly older (mean age: 36.8) than those with no abnormal cytology (mean age: 36.0). The most prevalent age group in both categories was 25-34. Overall frequency of HPV was higher among women with abnormal cytology (81.6%) compared to those with no abnormal cytology (39.5%). HPV16 was the most frequent type, observed in 28.4% of women with abnormal cytology and 9.2% of women with no abnormal cytology. Multiple HPV infections were more frequent in women with abnormal cytology, particularly co-infections of HPV16 and HPV18. Conclusion: This study highlights the high prevalence of HPV infection in Kazakhstani women with abnormal cervical cytology, with HPV 16 and HPV 18 being the most prevalent types. The findings support the need for targeted HPV vaccination and enhanced screening programs to prevent cervical cancer in Kazakhstan.