02. Master's Thesis
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Item Restricted EFFECT OF MULTI-DIRECTIONAL PERTURBATION TRAINING IN COMBINATION WITH RAGT ON HUMAN GAIT, BALANCE, AND PELVIC MUSCLE ACTIVATION IN CEREBRAL PALSY CHILDREN(Nazarbayev University School of Medicine, 2024) Khawaja, Amna RiazCerebralِ Palsyِ (CP)ِ isِ aِ neurologicalِ disorderِ characterizedِ byِ motorِ impairmentsِ affectingِ gait,ِ balance,ِ andِ pelvicِ muscleِ activation.ِ Thisِ pilotِ studyِ aimsِ toِ investigateِ theِ effectsِ ofِ multi-directionalِ perturbationِ trainingِ combinedِ withِ robotic-assistedِ gaitِ trainingِ (RAGT)ِ onِ gaitِ parameters,ِ balanceِ control,ِ andِ pelvicِ muscleِ activationِ inِ childrenِ withِ CP.ِ Aِ totalِ ofِ 3ِ subjectsِ diagnosedِ withِ twoِ differentِ typesِ ofِ CPِ includingِ Spasticِ Diplegicِ andِ Spasticِ Dyskineticِ wereِ includedِ inِ thisِ study.ِ Theseِ participantsِ areِ undergoingِ aِ comprehensiveِ interventionِ comprisingِ 2-3ِ sessionsِ overِ aِ 4-weekِ period.ِ Eachِ sessionِ integratesِ multi-directionalِ perturbationِ trainingِ andِ RAGTِ techniques.ِ Objectiveِ measuresِ andِ standardizedِ assessmentsِ areِ employedِ toِ evaluateِ gaitِ parameters,ِ balanceِ controlِ andِ pelvicِ muscleِ activation.ِ Earlyِ findingsِ suggestِ thatِ theseِ childrenِ haveِ gaitِ instabilityِ andِ lackِ ofِ equalِ activationِ ofِ musclesِ ofِ pelvisِ andِ presentsِ withِ balanceِ problemsِ indicatedِ byِ lowِ scores.ِ Theِ interventionِ aimsِ toِ addressِ theseِ problemsِ byِ targetingِ theseِ deficits.ِ However,ِ smallِ sampleِ sizeِ andِ shortِ durationِ ofِ theِ studyِ willِ limitِ theِ generalizabilityِ ofِ theِ results.ِ Furtherِ research,ِ withِ largerِ sampleِ sizeِ andِ longerِ follow-upِ periodsِ isِ warrantedِ toِ validateِ theseِ findingsِ andِ elucidateِ theِ underlyingِ mechanismsِ ofِ improvement.ِ Overall,ِ thisِ pilotِ studyِ willِ provideِ evidenceِ supportingِ theِ feasibilityِ andِ potentialِ ofِ incorporatingِ multi- directionalِ perturbationِ trainingِ withِ RAGTِ intoِ rehabilitationِ programsِ forِ childrenِ withِ CP.ِ Byِ targetingِ multipleِ aspectsِ ofِ motorِ functionِ simultaneously,ِ thisِ integratedِ approachِ willِ haveِ potentialِ toِ improveِ gait,ِ balance,ِ andِ pelvicِ muscleِ activation,ِ ultimatelyِ enhancingِ theِ functionalِ mobilityِ andِ qualityِ ofِ lifeِ ofِ childrenِ withِ CP.Item Restricted LSP PROJECT REPORT DEVELOPMENT OF HEPG CELL LINE WITH HUMAN NTCP GENE(Nazarbayev University School of Medicine, 2024) Irgaliyev, AbdyrakhmanHepatitis B virus (HBV) is one of the most common viral infections of the liver. There are 296 million people around the world with chronic hepatitis B and 1.5 million new cases emerge each year (WHO on Hepatitis B, 2021). Also, complications of hepatitis B virus such as liver cirrhosis and hepatocellular carcinoma were the cause of 820 000 deaths in 2019. It creates a significant economic and social burden, especially in developing countries. Until the 2010s the proper mechanism of viral internalization of hepatitis B virus was not properly understood. However, discovery of Na+-taurocholate cotransporting polypeptide (NTCP) protein allowed better understanding of the process as well as new possibilities in treatment. Common anti-HBV treatment is usually antiretroviral utilizing its usage of reverse transcriptase. The discovery of a specific viral entry point may allow development of new treatment options. However, expression of NTCP is downregulated in in vitro hepatocytes. This poses an obstacle in creating a testing field for medication options. Sadly, during this research the results were not achieved due to shortage of time and difficulties with competent cells.Item Restricted “EFFECT OF TAI-CHI ON MENTAL HEALTH INCLUDING: ANXIETY, DEPRESSION AND PSYCHOLOGICAL WELL-BEING”- SYSTEMATIC REVIEW OF META-ANALYSIS(Nazarbayev University School of Medicine, 2024) Yelubay, MagzhanBackground: Tai Chi can improve mental health outcomes without the use of medications. This systematic review investigates the effects of Tai Chi therapy on mental health by doing a comprehensive search of meta-analyses published up to December 2023.. Methods: Using PRISMA criteria, we searched resources such as PubMed, Embase, PsycINFO, and The Cochrane Database of Systematic Reviews for relevant meta-analyses. The inclusion criteria were studies that examined the effects of Tai Chi therapy on various mental health outcomes in different demographics. Results: This systematic review included 24 meta-analyses from 405 studies, including individual RCTs. The research discovered that Tai Chi therapies had a significant favorable influence on mental health outcomes, such as decreased depressive symptoms and anxiety levels, as well as increased overall mental well-being. Tai Chi has been proven to help a variety of conditions and people, including fibromyalgia, Parkinson's disease, heart disease, and sleeplessness. When paired with mental health therapies, Tai Chi has the potential to improve quality of life and general well-being. To best integrate Tai Chi into mental health care, more study is needed to characterize the practice's therapeutic mechanisms and eradicate methodological errors. Conclusion: Tai Chi exhibits potential as a comprehensive treatment approach to enhance mental health outcomes across a range of demographics. Current evidence supports its use as a supplemental therapy in mental health interventions, while more high-quality research is necessary.Item Restricted EFFECTS OF MINI-TRAMPOLINE TRAINING ON FOOT MOBILITY, PLANTAR PRESSURE, AND MUSCLE ELECTRICAL ACTIVITY IN INDIVIDUALS WITH TYPE 2 DIABETES MELLITUS(Nazarbayev University School of Medicine, 2024) Aldanova, AigulObjective: This study aimed to evaluate the possible effects of mini-trampoline exercise on foot mobility, plantar pressure, and muscle electrical activity in persons diagnosed with diabetic neuropathy foot. Methods: Within the study pre-intervention assessment stage, two people with diabetic neuropathy in their feet underwent a full variety of objective tests, such as electromyography (EMG), plantar pressure measurements with smart insoles, and gait analysis with inertial measurement unit (IMU) 3D sensors. The people took part in a set of exercises on both hard and soft surfaces to find out how their muscles were activated and how the heel pressure was distributed. Results: The pre-intervention data showed that muscle activation patterns were very different when workouts were done on different surfaces. Individuals showed higher levels of muscle activity when exercising on the mini-trampoline compared to firm surfaces. This suggests that the unstable nature of the soft surface made the muscles work harder. However, it was hard to keep their balance and keep their muscles working on the mini-trampoline while doing single-leg balance exercises. This suggests that they might not have good proprioception or motor control. Conclusion: This study gives some basic ideas about how mini-trampoline exercise might help people with diabetic neuropathy foot.Item Restricted IMPACT OF MINI-TRAMPOLINE TRAINING COUPLED WITH DIETARY ADVICE ON INSULIN RESISTANCE OF TYPE 2 DIABETES PATIENTS(Nazarbayev University School of Medicine, 2024) Bolegenova, BalnurBackground Mini-trampoline exercise coupled with dietary advice is an ideal combination for diabetes management, but due to absence of awareness and time insufficiency patients with diabetes are unable to engage. Objective: Tо іnvеstіgаtе thе impact of mini-trampoline training coupled with dietary advice on insulin resistance among patients with type 2 diabetes Methods: Two subjects who have had Diabetes Mellitus type 2 with foot neuropathy participated. Bio impedance Analysis was conducted at the beginning of the session and during each third session. Apart from this, hematological parameters like glycated hemoglobin, fasting plasma glucose would be measured at the initial and last sessions. Three questionnaires such as Michigan Neuropathy Screening instrument, Short Form 36 and General Physical Activity Questionnaires were filled by each participant. Dietary recommendations were given for each participant. For calculation of caloric food intake, an account on the Nutri steppe app was created. Evaluation of dietary advice influence coupled with mini-trampoline training on insulin resistance were conducted. The impact on insulin resistance was measured by evaluating the dynamics of change in the levels of glycated hemoglobin and fasting plasma glucose. Results: The influence of Mini-trampoline coupled withth dietary advice on fasting plasma glucose, body mass index and glycated hemoglobin were noted when compared with initial measurements. Conclusion Regular training on mini-trampoline coupled with dietary advice normalizes insulin resistance of type 2 diabetes patients with neuropathic foot.Item Restricted THE EFFECT OF TAI CHI ON COGNITIVE FUNCTION - SYSTEMATIC REVIEW OF META-ANALYSIS(Nazarbayev University School of Medicine, 2024) Serik, MukiyevBackground: Tai Chi shows promise as a target for intervention functions. There are numerous studies about beneficial effect of Tai Chi intervention on cognitive function; however, more systematic research needs to be conducted. Methods: A systematic search up to December 2023 was conducted using PubMed, Google Scholar, and Cochrane. Articles were selected if a meta-analysis of randomized controlled trials was conducted to investigate the effect of Tai Chi therapies on cognitive performance in the general and sick populations. The quality of the included meta-analyses was assessed using AMSTAR 2. Results: This systematic review, based on 21 meta-analyses of 349 included individual RCTs, gives the most thorough overview to date of Tai Chi's usefulness in enhancing cognitive performance in the elderly population. Nonetheless, the results of this study imply that Tai Chi improves cognitive abilities (attention, global cognitive function, visual-spatial ability, cognitive processing speed, and short-term memory). The disparities in research quality and interventions are most likely explained by heterogeneity. Conclusions: This study's findings imply that Tai Chi therapies improve cognitive performance in both the general and ill populations across a wide age range.Item Restricted THE PREVALENCE OF PAIN IN KAZAKHSTANI BIATHLETES(Nazarbayev University School of Medicine, 2024) Sokolskaya, AnastassiyaIntroduction: The prevalence of pain among elite athletes presents great concerns as the consequences of chronic or untreated pain may be severe ranging from the mental health changes to the loss of physical health and professional career. The current research was carried out to investigate the prevalence of pain among elite biathletes of Kazakhstan, together with possible physiological and sensory characteristics of pain. Methods: This study was conducted on 17 elite biathlon athletes from Kazakhstan Federation of Biathlon. Data were collected by a survey based on a valid and reliable questionnaire (Pain Detect), consisting of two sections: Demographic information and questions regarding the intensity of pain, its main localizations, sensory and physiological characteristics. Collected data set was descriptively analyzed. Results: In total, all 17 participants were found to experience persistent pain at the moment of the study. The main area of pain was found to be the lower back with 56% prevalence (9 athletes). The average pain intensity at the current moment was reported to be 2.38 out of 10, and the mean of the strongest pain was 4.2 out of 10. The main sensory characteristics found were burning (9 reports), tingling (9 reports) sensations and numbness (8 reports), while the main physiological characteristic was pain caused by slight pressure (8 reports). Conclusion: The results suggest that the pain is prevalent among Kazakhstani biathletes, with the main localization of pain in the lower back region. The intensity of pain at the moment of the research is not intense, and is mainly caused by slight pressure, while the main sensory characteristics are burning and tingling sensations.Item Restricted PAIN PREVALENCE IN KAZAKHSTANI TRIATHLETES(Nazarbayev University School of Medicine, 2024) Syrymbet, AssemPain is a widespread phenomena in the sports field, commencing from the athletic activities such as yoga, jogging or archery to professional, elite type of sports. The presence of pain is explained by multiple reasons, overloading, training regime, injuries and so on. In terms of the mechanism of pain pathophysiology, it is generally induced by the traumatization of the musculoskeletal system, release of pain mediators and individual characteristics of the body. The intensity as well as duration of the ache varies depending on the causes, anatomical and physiological features of the body, as well as timely addressing for medical assistance. Triathlon is a multidisciplinary endurance sport, consisting of 3 consecutive parts: swimming, cycling and running, provides significant challenges to athletes, including the coping with pain during training and/or competition. This master’s thesis explores the prevalence of pain syndrome by triathletes, with the objective to find out the frequency of pain, its character and duration as well as the location of mostly affected body parts and abnormal sensations in the area chosen. According to the existing literature, the physiological, psychological and biomechanical aspects contributing to torment in triathletes around the world were reviewed. It explores that the pain is pretty common in this type of sport, however the nature of it differs across the training phases, athletes’ experience levels and the reasons. Furthermore, this study investigated the influence of pain on training compliance, competition outcomes and athletes’ quality of life. The methodological approach involves quantitative technique, utilized to find out the frequency of pain, its character and duration as well as the location of mostly affected body parts and abnormal sensations in the area chosen through the combination of two international validated surveys. The findings from this research give a light on the condition of triathletes in a county-scale, highlighting their experience of pain, which was found to be highly prevalent. Regarding the nature of the pain, it was found that it is usually persistent or absent with medium-intensity pain attacks in knees and back. In addition, the sensory abnormalities are not common as the participant mainly reported no presence of any tingling, burning or radiation of the pain to other body parts.Item Restricted ARTIFICIAL INTELLIGENCE-BASED CIRCUIT TRAINING’S EFFECT ON FUNCTIONAL AND PHYSIOLOGIC PARAMETERS OF PATIENTS WITH TYPE 2 DIABETES MELLITUS(Nazarbayev University School of Medicine, 2024) Tukayev, MerekeThe study evaluates the effectiveness of using full circular exercises using artificial intelligence to improve health in people over the age of 18 with diagnosed type 2 diabetes. For 8 weeks, the participants participate in full circuit training program that include artificial intelligence that used to individualize the training program, taking into account the characteristics of each participant, and exercises specially adapted to their health and physical fitness. The technique included measuring anthropometric, functional and physiological parameters with surface electromyography as indicators before and after the training program. We hypothesize that results will lead to significant improvement in the participants' physical condition. We anticipate that full circular exercises adapted to the control of artificial intelligence represent a promising method for managing the second type of diabetes in adults. This study highlights the importance of an individualized approach to physical activity for people with diabetes and shows the potential of artificial intelligence in the field of healthcare. Further research is required to confirm these results in a wider sample and to assess the long-term effects of such training programs.Item Restricted EVALUATION OF FETAL AND NEONATAL OUTCOMES IN PATIENTS WITH GLUCOSE METABOLISM DISORDERS IN PREGNANCY(Nazarbayev University School of Medicine, 2024) Muratova, AidaBackground. Glucose metabolism disorders, encompassing gestational diabetes mellitus (GDM) and pregestational (PGDM) Type 1 and Type 2 diabetes, represent significant health challenges during pregnancy. The interplay between altered maternal glucose regulation and fetal development can lead to various fetal, neonatal, and long-term adverse outcomes, including stillbirth, premature delivery, macrosomia, congenital defects, babies born with hypoglycemia, respiratory distress syndrome, type 2 diabetes, or cardiomyopathy. This study aims to investigate the associations of fetal and neonatal outcomes with glucose metabolism disorders during pregnancy. Methods. The data gathered from the medical records of 281 women who delivered at the Department of Obstetrics and Gynaecology, University Medical Centre, National Research Centre for Mother and Child Health in Nur-Sultan, Kazakhstan, in the period between 2013 and 2017 were analyzed. The study included the records of 281 pregnant women with glucose metabolism disorders and birth at or after 24 gestational weeks of a fetus weighing >500 grams. The participants were divided into 4 groups depending on the type of diabetes: PGDM Type 1, PGDM Type 2, GDM with insulin, and GDM without insulin. The data were examined by applying descriptive, bivariable, and multivariable analyses. Results. Out of 281 women who participated in the study 55 (19.6%) had PGDM Type 1, 36 (12.8%) had PGDM Type 2, 57 (20.3%) had GDM treated with insulin, and 133 (47.3%) had GDM without insulin. There were significant differences between the groups in the frequency of outcomes like birth before 37 weeks, birth weight more than 4000 g, presence of pathologic CTG, and other diseases of the newborn. The occurrence of preterm birth was highest in PGDM Type 1 34.6% (OR 4.18 [1.77-9.92]) compared to the other types. The frequency of macrosomia (birthweight >4000 g) was highest in GDM with insulin 50.9% (OR 2.02 [1.12-3.63]). The percentage of pathologic CTG was greatest in PGDM Type 1 34.5% (OR 3.13 [1.39-7.03]). The prevalence of other diseases of the newborn was highest in PGDM Type 1 33.3% (OR 2.72 [1.16-6.39]). Conclusion. The results of this study illustrate that the vast majority of participants were diagnosed with gestational diabetes mellitus. The occurrence of prematurity, pathological CTG, and other diseases of the newborn were higher in PGDM Type 1, while macrosomia (birthweight >4000 g) was predominant in GDM with insulin and PGDM Type 2 diabetes groups.Item Restricted TRANSFECTION OF THE HEPG CELL LINE WITH THE MOUSE NTCP GENE-CONTAINING VECTOR AND CONFIRMATION OF NTCP EXPRESSION USING WESTERN BLOT.(Nazarbayev University School of Medicine, 2024) Yessekenov, AbylayHepatitis B virus (HBV) is a liver infection that can lead to potentially life-threatening conditions such as liver cirrhosis and hepatocellular carcinoma. In order to study the method of inhibition of HBV viral entry and proliferation in hepatocytes, we should investigate the hepatocytes infected by HBV. In order to gather infected hepatocytes, firstly, healthy hepatocytes (HepG2) have to be infected and most importantly stay infected in vitro. In order to efficiently infect the hepatocyte, these cells have to express Na+-taurocholate cotransporting polypeptide (NTCP) on their surfaces. NTCP is proven to significantly contribute to HBV entry into the cells. However, these cell lines are not able to express NTCP protein continuously in vitro which makes them insusceptible to viral infection. Thus, preparing the cell lines which are constantly expressing the NTCP, would provide an opportunity to be continuously infected by HBV HepG2 cell line which is optimal for longitudinal research on the topic of potential treatment of Hepatitis B Virus infection.Item Restricted CHARACTERIZING THE ROLE OF CTHRC 1 AS A BIOMARKER FOR SYNOVIAL FLUID IN RHEUMATOID ARTHRITIS AND ITS POTENTIAL IMPLICATIONS IN DISEASE PATHOGENESIS(Nazarbayev University School of Medicine, 2024) Issatay, AigerimRheumatoid arthritis (RA) is a complex autoimmune disease characterized by multifactorial etiology, which includes environmental, genetic, and immunological factors. Early RA detection and assessing its activity remains a challenging issue due to the diverse nature of the disease. Currently, available diagnostic protocols include measurement of rheumatoid factor (RF) and anti-cyclic citrullinated protein( ACCP). However, their effectiveness is hindered due to their moderate sensitivity and specificity. Moreover, they are not detected in the early disease course, leading to complications and substantial health burden. This paper explores the potential of Collagen Triple Helix Repeat Containing 1 (CTHRC1) as a novel biomarker for RA. We measured plasma CTHRC 1 in the plasma of RA (n=30) and OA (n=29) patients and identified statistical differences. Plasma of CTHRC 1 is significantly elevated in RA patients as compared to OA. Immunofluorescence was done to observe the expression of different markers involved in the pathogenesis of RA disease. Additionally, potential biomarkers, such as Periostin and Cartilage oligomeric matrix protein (COMP) were also evaluated in this study, their expression and role in differentiation between RA and OA patients. The results of the study may play a significant role in future diagnosis of RA since CTHRC 1 is an easy-to-measure and available diagnostic tool.Item Open Access SPORTS INJURY PREVENTION AND REHABILITATION: A BIBLIOMETRIC MAPPING OF THE RESEARCH LITERATURE(Nazarbayev University School of Medicine, 2024) Urazayev, MaratIntroduction: In the realm of sport, injuries cause an inherent risk with serious public health implications, including disability, missed sporting events and significant financial burden. This need is emphasized by the global drive to improve sporting performance while managing the rising costs of treatment and rehabilitation. In this paper, bibliometric analysis aimed to examine historical trends and inform future strategies in the field of sports injury prevention and rehabilitation. Methods and Analysis: The bibliometric method was applied using the Scopus database. Metadata were stored in two separate files titled "Sports Injury Prevention" and "Sports Injury Rehabilitation". The study period was from 1949 to 2022. Analysis and bibliometric mapping was performed in Biblioshiny app. Results: A total of 8,242 articles were retrieved, of which 5,269 (63.9%) focused on injury prevention in athletes and 2,973 (36.1%) focused on sports rehabilitation. Among the top ten articles on injury prevention, the most cited article was Hewett's article, which was cited 2,365 times. The most cited article on rehabilitation was the Shelbourne & Nitz article with 971 citations. A total of 5,269 articles were published in 893 journals related to sports injury prevention. In rehabilitation, 2,973 articles were distributed among 618 journals. A total of 14,752 individual authors in the field of sports injury prevention and 9,470 authors in the field of sports injury rehabilitation produced 5,269 and 2,973 publications, respectively. A total of 3,566 institutions participated in the study. The majority of articles were produced by the University of Calgary (Canada) with 301 articles in the prevention category and the University of Delaware (USA) with 108 articles in the rehabilitation group. The term "soccer" was the most frequently used keyword in the context of injury prevention, occurring 240 times, while "knee" was the dominant keyword in rehabilitation. Conclusion: The United States has been a leader in sports injury prevention research, with the University of Delaware, University of La Trobe, and University of Kentucky leading the way in rehabilitation research. Key researchers such as Finch and Snyder-Mackler have made significant contributions to these fields, especially in the study of ACL injuries and concussions. The differences in research focus across sports highlight the need for more attention to prevention strategies in baseball and ankle injuries, and point to opportunities for future research and development in these areas.Item Restricted OMICS-GUIDED IDENTIFICATION OF NOVEL NON-INVASIVE BIOMARKERS OF SPORTS-RELATED CONCUSSIONS(Nazarbayev University School of Medicine, 2024) Muratbekov, AlisherBackground. Sports-related concussion is a traumatic brain injury caused by a direct blow to the head, neck, or body, resulting in the transmission of impulsive force to the brain, which occurs during sports and exercise-related activities. It is a widely spread injury in the sports world that needs to be taken seriously. Late-diagnosed or under-treated concussions might decrease the performance of an athlete or even lead to another injury. Nevertheless, the diagnosis of concussion is still a topic of concern. A new potential and convenient method of screening for concussion may be the determination of saliva biomarkers. Since saliva collection does not require the presence of medical personnel and can be carried out on the sideline during the game. Objective. The objective of the study is to perform OMICS-guided identification of novel non-invasive biomarkers of sport-associated concussions. Methods. Potential concussion-related genes were identified after an analysis of the Traumatic Brain Injury-associated transcriptomic dataset. Ten people from University Kickboxing and Brazilian Jiu-Jitsu clubs were recruited. After the application of the Balance Error Scoring System and King-Devick test, two participants were presumed as concussed and 4 saliva samples (2 Cases vs. 2 Controls) were collected to perform RNA extraction followed by cDNA conversion and qPCR. Results. 7 potential genes were identified for concussion screening, namely: HOXA5, TSPAN2, FAM174B, DAAM2, CLCF1, GABRE, and TIMELESS. The possibility of utilization of selected genes as diagnostic biomarkers for sports-related concussions is yet to be discovered. Limitations. Limitations include a small sample size and limited cohort variety (gender, age, race, etc.) which makes it impossible to generalize study results. Conclusion. Our study shows a possible new approach for OMICS-dedicated studies, as the used methodology can fit other topics of interest related to gene expression profiles.Item Restricted ANALYSIS OF PERIPHERAL BLOOD AND MUCOSAL EOSINOPHILS IN CHILDREN WITH CHRONIC INFLAMMATORY BOWEL DISEASES(Nazarbayev University School of Medicine, 2024) Ayazbekova, AkbotaInflammatory bowel diseases (IBDs) comprises Crohn’s disease (CD) and Ulcerative colitis (UC), both of which pathogenesis is still under research. There were several studies investigating the role of eosinophil cell activity in the peripheral blood as well as gastrointestinal mucosa in adults, but there has been limited study in the pediatric population. This study aims to assess eosinophil activity in peripheral blood and mucosa, and also assess the correlation in clinical and pathological aspects. The study recruits 96 patients diagnosed with IBDs during the period from January 1, 2018 till December 31, 2022. Patients' eosinophil counts were compared at the first presentation. From selected patients 27 were diagnosed with CD and 69 were diagnosed with UC. Patient’s mean age was 12.4 and 13.1 years, with male to female ratio of 1.25 and 1.3, respectively. Patients groups divided by PBE median to ‘low’ and ‘high’ group, showed statistical difference in mucosal eosinophils (p-value < 0.05). However, groups divided by clinical and inflammatory parameters did not show statistically significant differences (p-value > 0.05). Overall, the study concludes that there is a correlation between eosinophil count in peripheral blood and colonic mucosa in IBDs diagnosed pediatric patients.Item Restricted EPIDEMIOLOGY OF PATIENTS WITH HYPERTHYROIDISM IN KAZAKHSTAN BASED ON DATA FROM NATIONAL REGISTRY COLLECTED BETWEEN 2013 AND 2019.(Nazarbayev University School of Medicine, 2024) Ibrayeva, ZhanelThe excessive secretion and production of thyroid hormone leads to hyperthyroidism, which can be caused by various factors related to function of gland itself, to regulatory part and due to extra-thyroidal factors. The number one cause of hyperthyroidism is body’s self-induced overproduction of thyroid hormone, which is known as the Graves’ disease. Moreover, iodine is an essential component of thyroid hormone, therefore, the imbalance in its concentration in body may cause either hyperthyroidism or hypothyroidism. Kazakhstan is the country in Central Asia, which has various degrees of iodine deficiency across the country, despite government’s effort to solve this problem by adding iodine into the table salt. As the thyroid disorders are serious conditions, the proper study on its epidemiology is required. There is a lack of information on the epidemiological situation in Kazakhstan related to hyperthyroidism. Thus, the objective of this paper is to analyze the data from the nationwide large-pool registry, which was collected from 2013 to 2019. The statistical analysis on prevalence, incidence, all-cause mortality, survival rates and co-morbidities will be performed on the following study using statistical analysis. It is expected that women are more likely to have hyperthyroidism.Item Restricted RETROSPECTIVE ANALYSIS OF MATERNAL, NEONATAL AND EARLY-LIFE FACTORS IN CHILDREN AFFECTED WITH DIABETES MELLITUS TYPE I(Nazarbayev University School of Medicine, 2024) Saniya, KuanThere is a rapid growth in the incidence of Type 1 Diabetes Mellitus (T1DM) in recent years. Several types of environmental factors related to maternal, neonatal and early life may play a role as triggering factors that lead to emergence of the disease in the genetically susceptible individuals. Current evidence demonstrates conflicting results on the factors that can lead to T1DM. The main aim of this study to analyze the effect of factors, such as birthweight for gestational age, mode of delivery, type of feeding and place of residence on developing T1DM. This is case-control study of the patients that were admitted to Somatic Department of Mother and Child hospital at Astana, Kazakhstan. Patients’ guardians were asked to answer questionaries, and medical records were extracted. There were 52 patients with Type 1 Diabetes Mellitus that were listed as cases and 50 patients that were included as controls. Descriptive data include date of birth, sex, place of residence, birthweight, height at birth, week of birth, type of feeding, birth type, allergies, family history and parity. The association between risk factors and T1DM was assessed by logistic regression analysis by calculation of the odds ratios(ORs) and 95% confidence intervals (CIs). In the multivariate analysis length at birth revealed a significant association with T1DM risk in children born taller (Adjusted OR 1.30, p-value 0.036). Weight, gender, birth timing, residency, feeding methods, and delivery mode resulted in no significant association with T1DM risk.Item Restricted EVALUATION OF OPTIMAL TIME AND PREGNANCY TERMINATION MODALITIES IN PATIENTS WITH DIABETES MELLITUS(Nazarbayev University School of Medicine, 2024) Gabbassova, SaniyaBackground: The poor management of diabetes mellitus (DM) type 1, type 2, and gestational diabetes in pregnant patients is associated with higher risk of adverse outcomes affecting both maternal and neonatal health. Therefore, to reduce the risk of adverse pregnancy outcomes, it is important to determine appropriate time and mode of delivery in patients with DM. Methods: This retrospective cohort study included 281 patients with diabetes mellitus delivered between 2013-2017. Patients were divided into five groups based on the weeks of gestation at delivery: <37w, 37-37(+6)w, 38-38(+6)w, 39-39(+6)w, and 40-41 weeks. Additionally, based on the mode of delivery: vaginal delivery, cesarean section, induced vaginal delivery, and emergency cesarean section. Results: Out of 281 patients 49 (17.44%) delivered < 37 weeks and at 37-37(+6)weeks, 63 (22.42%) patients delivered at 38-38(+6)weeks, 82 (29.18%) patients at 39-39(+6)weeks, and 38 (13.52%) patients delivered at 40-41weeks of gestation. According to the mode of delivery, 62 (22.78%) patients had vaginal delivery, 145 (51.60%) had planned cesarean section, 45 (16.01%) patients had induced vaginal delivery, and 27 (9.61%) patients had undergone emergency cesarean section. Patients with preeclampsia (OR 10.73[4.90, 23.55]), chronic hypertension (OR 2.25 [1.17, 4.32]), diabetic nephropathy (OR 4.06 [2.02, 8.18]), and pathologic CTG (OR 5.06 [2.61, 9.80]) were more likely to deliver before 37 weeks. In neonates born preterm the odds of Apgar score < 7 at 5 min (OR 5.06 [1.22, 21.00]), resuscitation (OR 7.84 [3.62, 16.96]), intubation of the lung (OR 4.67 [1.61, 13.56]), use of oxygen mask (OR 7.84 [3.62, 16.95]), broncho-pulmonary disease (OR 4.83 [1.76, 13.26]), and other diseases (OR 3.44 [1.71, 6.93]) were higher. The macrosomia was 2.38 times more likely in babies born at 40-41 weeks. Neonates born at 38-38(+6)w and 39-39(+6)w groups were less likely to have resuscitation (OR 0.13 [0.03, 0.56]), use of oxygen mask (OR 0.06 [0.01, 0.46]). In terms of mode of delivery, in DM type 2 the odds of having emergency CS were 2.68 times higher. The PROM was associated with vaginal delivery, and pathologic CTG with emergency CS (OR 2.50 [0.16, 5.36] and OR 2.76 [1.21, 6.32], respectively). The use of oxygen mask was less likely in babies born by vaginal delivery (OR 0.19 [0.04, 0.80]). Conclusion: The delivery at 39th week of gestation was common. Participants mostly delivered by cesarean section. Patients with obstetric complications had higher rates of preterm delivery. Neonates born before 37th week were more likely to develop complications. Macrosomia was more common in babies born at 40-41 weeks. Among neonates born at 38th and 39th week resuscitation was less common. Patients with type 2 DM had higher rates of emergency CS. Except for the use of oxygen mask, there was no association between neonatal complications and mode of delivery. Recommendations: Based on results of the study, for achieving favorable neonatal outcomes the delivery at 38-38(+6) weeks or 39-39(+6) weeks of gestation is recommended.Item Restricted ANALYSIS OF IMMUNIZATION COVERAGE AND INSIGHTS INTO VACCINE ACCEPTANCE IN PARENTS OF CHILDREN AFFECTED WITH CHRONIC DISEASES (FOCUS ON ONCOLOGICAL AND NEUROLOGICAL PATIENTS)(Nazarbayev University School of Medicine, 2024) Khalimzhanova, ShakhnozaObjectives: Although vaccination can be considered as one of the most successful public health interventions to prevent infectious diseases, there are many people who remain vaccine hesitant. Children affected with chronic diseases have increased risk of infectious disease complications compared to healthy children, therefore their vaccine coverage should be optimal. Our aim was to measure vaccination coverage among children with chronic diseases admitted to NRCMCH pediatric Neurology and Oncology departments. Also, we aimed to study parental beliefs and determinants of vaccine hesitancy among parents. Methods: This prospective cross-sectional paper-based study was conducted between April 2022 to July 2023. Results: Overall, 59 participants were recruited to participate in our study to answer the paper-based questionnaire about their demographic information, their child’s vaccine coverage and their attitude towards vaccination. All the participants were 100% were female participants and the highest percentage of parents (45.8%) were between the ages 30-39. We found out that vaccination coverage in two departments was similar with a mean score of 0.81 and 0.77 in Neurology and Oncology, respectively. However, parents in neurology department were more vaccine hesitant compared to parents in oncology department with a mean score of 2.9 and 3.35 in Neurology and Oncology respectively.Item Restricted THE EFFECTS OF EARLY AND LATE INTERMITTENT FASTING ON THE INFLAMMATION IN MEN AND WOMEN(Nazarbayev University School of Medicine, 2024) Zhorabek, IliyasAlthough studies show the effectiveness of time-restricted feeding (TRF) regimen for weight loss, there is limited data to suggest if an early or late eating window is more effective. The objective of this case-crossover study was to compare the effects of early TRF and late TRF on body parameters, lipid profile, and inflammatory markers. Young, healthy individuals with body mass index (BMI) no more than 29.9 were recruited. They were randomly assigned into two groups, which practiced TRF for 4 weeks starting with either an early or late eating window. After 4 weeks, the participants returned to their regular eating time for two weeks, after which they switched their eating time. Body measurements and blood tests for lipid profile and inflammatory markers were conducted before and after each fasting period. 44 participants were recruited and divided in a 1:1 ratio into two groups. Early TRF regimen was shown to be more effective in lowering BMI compared to late TRF, with mean difference in change of 0.484±0.60 kg/m2 (p-value < 0.05). There was no statistically significant difference in changes in total cholesterol, LDL, HDL, triglycerides, CRP, and homocysteine. The results of this study suggest that early TRF regimen is more effective for weight-loss than late TRF, while the lipid profile and inflammatory markers are not significantly affected.