Search

Relevance: According to modern literature, over the past decade, there has been no tendency in the world to reduce maternal mortality from postpartum hemorrhage (PPH). In Kazakhstan, evidence-based medicine clinical recommendations on prevention and algorithm of action for obstetric bleeding have been developed and recommended for use since 2010. We conducted a literary search for existing innovative methods of PPH prevention and treatment based on the study of clinical recommendations of many developed countries, WHO, FIGO, and scientific publications. There exist separate algorithms for managing PPH during vaginal delivery or cesarean section.The study aimed to explore the existing innovative methods of preventing and treating postpartum hemorrhage to determine the most effective medical care for postpartum hemorrhage.Materials and methods: The literature search included papers published on PubMed in English from January 1, 2018, to November 31, 2022. The search was done by keywords including “pregnancy,” “PPH,” “pregnancy complication,” “pregnancy outcomes,” and “tranexamic acid,” “guideline.” Results: Today, there are separate algorithms for managing PPH during vaginal delivery or cesarean section. Fibrin preparations and fibrinogen concentrate are recommended for use. When PPH occurs, it is important to communicate with family members to further inform them about the patient’s condition. The routine use of the Allgower shock index for accurate calculation of the volume of blood loss is proposed. It is proposed to use antifibrinolytic drugs not only for therapeutic purposes but also for prophylactic purposes. It is important to carry out adequate infusion-transfusion therapy to prevent iatrogenic coagulopathy. Conclusion: Introducing the above modern technologies into practical healthcare does not require high economic costs and can be used in obstetric institutions at all levels of medical care for PPH.

For the first time, the general properties of degenerate related hypergeometric systems such as Horn, Whittaker, Bessel and Laguerre are investigated together. The joint research allowed to reveal their various common properties and to establish a number of new degenerate related systems. They are all private cases of the common system offered by the authors for consideration. For the full study, it is important to classify its regular and irregular special curves and to identify the types of corresponding solutions. In this paper, they are implemented using simple rules. Special attention is paid to the construction of normal and regular solutions, because the solutions of all related degenerate systems such as Horn, Whittaker, Bessel and Laguerre near the irregular singularity on infinity relate to this species. Peculiarities of building normal-regular solutions by the Frobenius-Latysheva method are shown. All constructed normal-regular solutions are expressed through the function of Humbert  variables, which is the solution of degenerate hypergeometric system of Horn type. As an example, the cases  where, along with the application of the Frobenius-Latysheva method, the possibility of outputting new degenerate related systems is demonstrated.

BACKGROUND: Over the past few decades, the cesarean section frequency has increased significantly in many countries around the world, especially in the countries with high and medium income. The World Health Organization recommends 10–15% as the optimum cesarean section frequency. In Kazakhstan, the frequency of operative delivery in 2018 was 23.5%. AIM: The article is aimed at analyzing the caesarean section frequency following the Robson classification in Kazakhstan at Level II and III obstetric institutions, identifying the groups that make the greatest contribution to the overall cesarean section frequency, studying the clinical reasons in these groups, and identifying the ways to reduce unneeded cesarean sections. METHODS: A prospective study was performed at the Level II and III obstetric facilities in Almaty. On admission for delivery, all women were assigned following the Robson classification. The indices of cesarean section in each of 10 groups and the absolute and relative contribution to the overall cesarean section frequency were calculated. The patient data were prospectively entered into a computer application and processed in MS Excel and Statistica version 23. The results were presented using the Robson classification. The odds ratios were calculated with a confidence interval of 95%. RESULTS: For the period from January 1, 2019, to December 31, 2019, 12,395 women parturiated at Level II and III obstetric facilities. The main contributors to the overall cesarean section frequency at Level II and III obstetric facilities were Group 5 (multiparous women with uterine scars) – 46.3% (Level II facility) and 37.5% (Level III facility), Group 2 (12.4%) and (12.4%), Group 1 (12%) and (9.6%), and Group 10 (11.4%) at the Level III facility. CONCLUSION: The Robson classification has been used for the 1st time in Kazakhstan which has made it possible to identify the reasons that make the greatest contribution to the overall cesarean section frequency. The use of monitoring for analyzing the cesarean section frequency will make it possible to compare the Kazakhstan data with the foreign data and determine the organizational measures aimed at reducing the frequency of operative delivery. The strategies to reduce unneeded cesarean section should focus on reducing the cesarean section frequency in nulliparous women. In the absence of contraindications, natural delivery should be advised to the women with uterine scars.

This paper examines public policy towards small and medium-sized enterprises in the Central Asian countries during the COVID-19 pandemic. A study of analytical surveys for 2020 and 2021 pro-duced by international organizations (such as the World Bank, the Asian Development Bank, KPMG, and the Organization for Economic Cooperation and Development), as well as of legal and regulatory docu-ments and strategic programs adopted in the countries of Central Asia during the coronavirus pandemic, has made it possible to identify the advantages and disad-vantages of government decisions regarding business and to analyze public strategies for supporting small and medium-sized enterprises. This analysis leads to the conclusion that the potential for economic recovery in the Central Asian countries is directly de-pendent on the measures taken by their governments to maintain and support the business sector. In particular, the study results show that the main business support tools during the coronavirus pandemic are mechanisms such as tax holidays for businesses, soft loans, loan restructuring and refinancing, and administrative support measures. © 2021, CA and C Press AB. All rights reserved.

A retrospective analysis was carried out according to the archival material of the center of perinatology and pediatric cardiac surgery in Almaty for 2017-2018. The analysis was carried out in 2 groups: the main group - 250 histories of women giving birth after IVF and the comparative group - 250 histories of women giving birth to spontaneous pregnancy. The condition of the feto-placental complex was assessed by studying the data of ultrasound, Dopplerometry, CTG, histological examination. The study shows that in women after the use of ART, the absence of pronounced blood flow disorders in the mother-placenta-fetus system according to Dopple-rometry is important and significant, which contributes to the favorable course of pregnancy and the state of the fetus, as well as the presence of morphological signs of placental insufficiency in 68% of cases inflammatory changes in the placenta in 57% of cases of varying severity.

Introduction: Cerebral palsy is the most common childhood disability Aims: Analyze and determine the main risk factors for the development of cerebral palsy in the population of Kazakhstan Materials and methods: Retrospective, analytical "case" - "control". Core group "case" - medical records of 100 pregnant women whose children at different ages has been diagnosed with cere-bral palsy Results: Thus, a retrospective analysis revealed the following features and complications in the perinatal period, which could promote the formation of cerebral palsy in children. Analytical results of the study are set significant results in cerebral palsy development Conclusion: Premature birth and urinary tract infections turned out to be the largest contribu-tors to the development of cerebral palsy, however, according to statistics, the rate of preterm birth, as well as the detection of infections, stably remains at the same level, while the number of cerebral palsy has been steadily growing since the early 1990s in Kazakhstan.

It is necessary to select the optimization criterion in order to determine operation parameters of transport and warehouse complexes. We developed a procedure for determining the optimal parameters for operation of the complexes. It includes methods of calculating the optimal amount of loading and unloading mechanisms and stations. The research findings show that when calculating the optimal amount of loading and unloading mechanisms and stations it is advisable to take into account the ratio of intervals of the rolling stock arrival for loading and unloading and the standard duration of one unloading mechanism operation. In order to determine the optimal amount of loading and unloading mechanisms and stations in warehouse complexes, we propose a cost-based criterion in the form of minimum aggregate costs for loading and unloading operations incurred by transport and warehouse complexes and the downtime of rolling stock in the course of loading and unloading operations incurred by shipping organizations. It has been found that the saving of the total costs and losses incurred by carriers and the terminal to organize the unloading of vehicles using two loaders at one unloading station is 23 % as compared to the unloading at two unloading stations.

Background: The clinical aspect of cerebral tumor is a headache, a sign of a growing tumor is nausea, turning into vomiting, frequent dizziness, weakness, drowsiness, mental disorders such as reduced concentration, lack of appetite, a slight increase in body temperature, irritability, aggression. Pregnant women often do not attach importance to these symptoms, since they are often signs of ordinary toxicosis. We report a case of uncomplicated pregnancy, the birth of a healthy mature baby in a patient with a giant tumor of both frontal lobes of the brain, and a case of maternal mortality in the postoperative period. Aim: Aim of the article was to present a rare clinical situation - a case of maternal mortality in a 21-year-old Asian patient with uncomplicated pregnancy which had a planned cesarean section operation due to the presence of a scar on the uterus under epidural anesthesia. On the 2nd postoperative day according to MRT newly diagnosed inoperable giant tumor of both frontal lobes of the brain with a dislocation, which caused the death of the puerpera. Results: probability of the physiological course of pregnancy and the birth of a healthy newborn in the presence of a giant meningioma of the brain (anterior frontal lobe). Case presentation: A case of maternal mortality in a 21-year-old Asian patient with uncomplicated pregnancy which had a planned cesarean section operation due to the presence of a scar on the uterus under epidural anesthesia. On the 2nd day of the postoperative period, an inoperable giant tumor of both frontal lobes of the brain with dislocation was diagnosed according to MRT data. Conclusion: The combination of pregnancy and cerebral tumor is rare, in this case, it is reported about the asymptomatic course of an inoperable cerebral tumor of gigantic size. The diagnosis was confirmed by non-invasive diagnostic methods (MRT). Knowledge of this rare brain disease in pregnant women is important in the differential diagnosis of patients with mental and neurological conditions in the postpartum period.

Peculiar characteristics of cytotoxic endometrial cells' response depending on the clinical aspects (frequency, gestational age, form of miscarriage, hysteroscopic pattern) have been studied. Patients with pregnancy loss in their past medical history demonstrate a decreased level of CD8 + lymphocytes, and the decrease is exacerbated as the incidence of miscarriages increases and in the presence of endometrial hypoplasia. The content of CD16 + lymphocytes increases in comparison with the control group, however, there is a reducing trend of this phenotype of killers as the incidence of miscarriages increases and in the presence of endometrial hypoplasia. Reduction of CD56 + lymphocytes progresses with repeated pregnancy loss and endometrial hyperplasia.

In June of 2015, we investigated the distribution of biogenic elements, heavy metals, and pesticides in the waters of the Shardara Reservoir. The average content of ammonium, nitrates, nitrites and phosphates in the water did not exceed the limit values ??set for the fishery water bodies. Zinc concentration in the water averaged 0.121, copper – 0.040, cadmium – 0.003, lead – 0.034 mgdm-3, isomers of hexachlorcyclohexane (HCCH) – 0.0041 mg dm-3. Wafer plots were built in order to identify the distribution correlation of hydro-chemical and toxic variables with the sources of pollution in Shardara reservoir, and statistical methods were used as well (correlation, multiple regression analysis methods, canonical correspondence analysis, and ecological mapping with the Statistica 12.0 Program). It was found that copper, nitrates, and isomers of HCCH enter the reservoir mainly with the drainage water discharged from irrigated fields along the southern bank. The source of mineral phosphorus, polyphosphates, nitrites and zinc is the river runs off rom the east. High concentration of heavy metals in the water could also be related to natural causes, as the water reservoir and its tributaries are located in a metallogenic province.

A molecular genetic study of DNA in 98 pregnant women with mycoplasma infection and 100 healthy pregnant women was carried out. The results of the study revealed that the presence of the homozygous mutant genotype AA increases the risk of pro-inflammatory processes in the body by 6.7 times, and the carriage of GA genotypic variants increases the risk of its occurrence by 2.6 times.

The purpose of the study was to discover an effect of the composition on the basis of heterocyclic series containing derivatives of oxone FGSK-2, 2 (dinitrophenylhydrazine 2, 2-dimethyltetrahydropyran-4-one) with a concentration of 0.00001%, in different proportions with 20% raw carbon mineral on the growth and development of the spring wheat under laboratory conditions. The standard techniques of seeds’ germination and plant culture were used in this study. Observations on germination, plant growth and thickness, as well as the photopigments’ content were recorded. It was observed that plants in treatment with such composition grew up very well and contained a large amount of chlorophyll. Thus, it showed the rising productivity of plant culture. We observed a stimulating effect of the 20%-concentrated shungite on seed germination of spring wheat. The results of the study showed a decrease in linearity of a bark of the axial bodies and increase in a thickness of plant stems after treatment in a 1: 1 ratio by means of the compositions of dinitrophenylhydrazine 2, 2-dimethyltetrahydropyran-4-one and shungite. Furthermore, wheat leaves had the rich dark-green colour due to chlorophyll content in wheat plant leaves of all kinds of treatment that was higher in comparison with control plants. Plants in treatment by means of composition in a 2: 1 ratio had the highest chlorophyll content. On the basis of these results, it was concluded that the treatment of spring wheat seeds by means of composition derived from oxone FGSK-2, 2 (dinitrophenylhydrazone 2, 2-dimethyltetrahydropyran-4-one) and 20%-concentrated shungite of 1: 1, 2: 1 and 1: 2 ratios showed germination. The aqueous solution of shungite in the vegetative phase of wheat had an inhibitory effect on the plant height. There was found the stimulating effect of the composition of dinitrophenylhydrazone 2, 2dimethyltetrahydropyran-4-one and carbon mineral of 1: 1, 2: 1 and 1: 2 ratios on the plant stem thickness.

UDC: 618.14-002 The study of the endometrium and the development of new methods of rehabilitation therapy for women with reproductive disorders is important issue in modern obstetrics. Violations of the proliferative activity of the endometrium, the presence of persistent infection and changes in local immunity are the main causes of obstetric and perinatal complications (Adamian and Kulakov, 1997; Donders, Van Bulek, Caudron et al., 2000; Vikhlyaeva, 2002). The aim of this work was studying the hysteroscopic endometrium and its integrated study (immunological, histological, bacteriological and PCR) of 84 patients with a violation of the reproductive function to determine the role of persistent mycoplasma infection. Endoscopic exploration of the uterine cavity was carried out using the “KARL STORZ” (Germany). We used saline solution as the liquid medium. After removing the polyps, polypoid formations and doing endometrial sampling for the immunological, histological, bacteriological and PCR study, we carried out a hysteroscopic control research, which made it possible to evaluate the effectiveness of the operation. A visual study of the uterus showed that the endometrium had no pathology and corresponded to the phase of the menstrual cycle in 26.2% of cases and other 73.8% revealed various pathologies of the endometrium. Herewith, the most common pathology of endometrium were various hyperplastic processes (in 70.9% of cases - glandular and glandular-fibrous hyperplasia, various types of polyps). We noticed the endoscopic differences between the fibrous and glandular polyps, which were appearing in different sizes and shapes of polyps localization. With hysteroscopy, fibrous polyps were often determined as a single pale formation of round or oval shape, with a small size (0.5 cm). Most polyps were located in the bottom of the uterus, near the ostium of the uterine tubes. Glandular polyps, in contrast to fibrous were larger in size (0.5 to 5-6 cm) and in most cases were multiple. The colors of the polyps were pale-pink and gray-pink; the tip of the polyp - a dark purple or blue-purple color. We spotted vessels in the shape of capillary net on the surface of the polyp. The symptoms of chronic endometritis were characterized by increased vascular pattern, edema and focal hyperemia of the endometrium, which were noted in 19.04% of cases. In about the same percentage of cases we revealed endometriosis of the uterus - 2.4% and intrauterine adhesions - 2.4%. With adenomyosis, the endoscopy took form of the “eyes” of dark-purple color on the background of relief of the uterine walls. Upon detection of intrauterine synechia: the uterus is divided by vertical spikes of whitish color, the volume of the cavity is reduced.

The aim of this Bachelor's Thesis is to analyze selected personnel activities in the company Orion Minerals. Furthermore, to evaluate these activities and suggest their optimization. The theoretical part includes basic concepts and description of certain personnel activities. In order to write the theoretical part I used technical literature and my own knowledge gained by studying at university. The practical part describes how personnel activities are under way in the company. Required information has been identified on the basis of interviews with the management and personnel manager, studying internal documents and observation the personnel officers' work during my practical work. In the final part of the thesis I described the advantages and disadvantages of the company from my point of view, then a number of recommendations were suggested. Also were compared ascertained facts with theoretical knowledge.