Impact of the SARS-CoV-2 Outbreak on the Epidemiology and Treatment Outcomes of Fractures of the Proximal Femur in Kazakhstan

The study aimed to assess the impact of isolation and quarantine on the frequency of registration and the treatment of fractures of the proximal femur in Kazakhstan in the context of the COVID-19 pandemic in 2020 (compared to the pre-pandemic period). This retrospective observational comparative study included all primary patients with injuries (the code S72) in the period 2019-2020 according to the national register.In 2020, the number of S72 fractures was 6.6 % higher compared to 2019. In comparison with 2019, in 2020 the number of beddays of patients was reduced to 7.1±3.8 days (p≤0.001). Both in 2019 and in 2020, the number of women predominated among all patients (p ≤ 0.05). The frequency of conservative treatment in 2020 compared to 2019 was increased from 26.6% to 35.6%, while the surgical procedure for internal fixation was reduced to 34.2% in 2020. In 2020, the highest number of cases among women with S72 fractures cases were recorded in the age groups 60-74 years and 75-90 years. In 2019 in female patients (42%) with S72 cases were registered in the age group 75-90 years.The incidence of fractures of the proximal femur did not change significantly in 2020 compared to 2019. However, the number of conservative treatment methods has increased along with the decrease in the frequency of surgical interventions. We observed the growth of the frequency of non-surgical treatment methods in 2020 that might impose the possible risks of mortality of these patients in the long term after conservative treatment. [ FROM AUTHOR]

The Recent Advances of Mobile Healthcare in Cardiology Practice.

Background: Digitalization of healthcare led to the optimization of monitoring, diagnostics, and treatment of the range of disorders. Taking into account recent situation with COVID-19 pandemics, digital technologies allowed to improve management of viral infections via remote monitoring and diagnostics of infected patients. Up to date, various mobile health applications (apps) have been proposed, including apps for the patients diagnosed with cardiovascular pathologies. Objective: The presented review aimed at the analyses of a range of mHealth solutions used to improve primary cardiac care. In addition, we studied the factors driving and hindering the wide introduction of mHealth services in the clinics. Methods: The work was based on the guidelines of the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. The publication search was carried out using PubMed, Web of Science, Cochrane Library, Scopus, and Google Scholar databases. Studies published during the period from 2014 until January 2022 were selected for the analysis. The evaluation of risk of bias for the included studies was conducted using the Cochrane Collaboration Risk of Bias tool. Results and Discussion: An overall 5513 studies were assessed for eligibility after which 39 studies were included.. The main trend in the mobile health for cardiological applications is the use of different types of wearable devices and Artificial Intelligence-platforms. In fact, mobile technology allows remotely to monitor, interpret, and analyze biomedical data collected from the patient. Conclusion: The results of this literature search demonstrated that patients diagnosed with cardiovascular disorders can potentially benefit from the application of mHealth in cardiology. However, despite the proven advantages of mHealth for cardiology, there are many challenges and concerns regarding effectiveness, safety, reliability and the lack of official regulation and guidelines from official organizations. Such issues require solutions and further work towards a wide implementation of mHealth technologies in cardiac practice.

The Study of the Outbreak of Coronavirus Infection in a General Hospital in Almaty.

The study aimed to identify the possible causes of COVID-19 outbreak and its development in a general hospital in Almaty (from April 11 to May 6, 2020), where 682 persons were identified with a COVID-19. 546 were hospital employees (48.9%), including doctors (57.8%), nurses (53.4%), junior medical personnel (54.4%) and other personnel (23.3%), and also among 136 patients. The attack rate among women was 50.0%, and incidence rate was higher amongst young employees < 30 years old (57.0%). The analysis showed that there was a failure of the management of the medical personnel in such critical situation.

Sero-prevalence of SARS-CoV-2 in certain cities of Kazakhstan.

Background and Aims: Seroprevalence studies are needed to determine the cumulative prevalence of SARS-CoV-2 infection and to develop pandemic mitigation strategies. Despite the constant monitoring and surveillance, the true level of infection in the population of Kazakhstan remains unknown. The aim of this study was to determine the sero-prevalence of SARS-CoV-2 in the main cities of Kazakhstan. Methods: The research was conducted as a cluster-randomized cross-sectional national household study in three cities of Kazakhstan. The study covered the period: from October 24, 2020, to January 11, 2021. A total of 5739 people took part in the study. All participants agreed to be tested for antibodies to IgM/IgG. Demographic characteristics were analyzed. The presence of symptoms of respiratory diseases and the results of polymerase chain reaction (PCR) testing were determined. The antibodies to the SARS-CoV-2 virus were detected using the method of enzyme-linked immunosorbent assay (ELISA). Results: There was significant geographic variability with a higher prevalence of IgG/IgM antibodies to SARS-CoV-2 in Almaty 57.0%, in Oskemen 60.7% than in Kostanay 39.4%. There were no significant differences in prevalence between men and women (p ≥ 0.05). In Almaty, only 19% of participants with antibodies reported the presence of respiratory symptoms during a pandemic. At the same time, the percentage of patients with antibodies who had respiratory symptoms was 36% in Oskemen and 27% in Kostanay. Conclusion: The findings indicate that despite reasonable level of seroprevalence, the country has not yet reached the baseline minimum of herd immunity scores. The prevalence estimates for asymptomatic or subclinical forms of the disease ranged from 64% to 81%. Thus, given that almost half of the population of Kazakhstan remains vulnerable, the importance of preventive strategies such as social distancing, the use of medical masks, and vaccination to protect the population from the transmission of SARS-CoV-2 is highly critical.

Analysis of COVID-19 pandemics in Kazakhstan.

BACKGROUND: This study aimed to analyze the demographic and epidemiological features of identified COVID-19 cases in Kazakhstan. STUDY DESIGN: A cross-sectional study. METHODS: This cross-sectional study aimed to analyze COVID-19 cases (n=5116) collected from March 13 to June 6, 2020, in Kazakhstan. The data were obtained from a state official medical electronic database. The study investigated the geographic and demographic data of patients as well as the association of COVID-19 cases with gender and age. The prevalence of symptoms, the presence of comorbidities, complications, and COVID-19 mortality were determined for all patients. RESULTS: The mean±SD age of the patients in this study was 34.8±17.6 years, and the majority (55.7%) of COVID-19 cases were male and residents of cities (79.6%). In total, 80% of the cases had the asymptomatic/mild form of the disease. Cough (20.8 %) and sore throat (17.1%) were the most common symptoms among patients, and pneumonia was diagnosed in 1 out of 5 cases. Acute respiratory distress syndrome (ARDS) was recorded in 1.2% of the patients. The fatality rate was 1% in the study population and lethality was 2.6 times higher in males compared to females.  Each additional year in age increased the probability of COVID-19 infection by 1.06 times. The presence of cardiovascular, diabetes, respiratory, and kidney diseases affected the rate of mortality (P<0.05). CONCLUSION: The results demonstrated a high proportion (40%) of the asymptomatic type of coronavirus infection in the Kazakhstan population. The severity of COVID-19 symptoms and lethality were directly related to the age of patients and the presence of comorbidities.

The Recent Progress and Applications of Digital Technologies in Healthcare: A Review.

BACKGROUND: The implementation of medical digital technologies can provide better accessibility and flexibility of healthcare for the public. It encompasses the availability of open information on the health, treatment, complications, and recent progress on biomedical research. At present, even in low-income countries, diagnostic and medical services are becoming more accessible and available. However, many issues related to digital health technologies remain unmet, including the reliability, safety, testing, and ethical aspects. PURPOSE: The aim of the review is to discuss and analyze the recent progress on the application of big data, artificial intelligence, telemedicine, block-chain platforms, smart devices in healthcare, and medical education. Basic Design. The publication search was carried out using Google Scholar, PubMed, Web of Sciences, Medline, Wiley Online Library, and CrossRef databases. The review highlights the applications of artificial intelligence, "big data," telemedicine and block-chain technologies, and smart devices (internet of things) for solving the real problems in healthcare and medical education. Major Findings. We identified 252 papers related to the digital health area. However, the number of papers discussed in the review was limited to 152 due to the exclusion criteria. The literature search demonstrated that digital health technologies became highly sought due to recent pandemics, including COVID-19. The disastrous dissemination of COVID-19 through all continents triggered the need for fast and effective solutions to localize, manage, and treat the viral infection. In this regard, the use of telemedicine and other e-health technologies might help to lessen the pressure on healthcare systems. Summary. Digital platforms can help optimize diagnosis, consulting, and treatment of patients. However, due to the lack of official regulations and recommendations, the stakeholders, including private and governmental organizations, are facing the problem with adequate validation and approbation of novel digital health technologies. In this regard, proper scientific research is required before a digital product is deployed for the healthcare sector.

COVID-19 in the paediatric population of Kazakhstan.

Background: To date, there have been no studies of COVID-19 infection in children in Central Asia, particularly the Republic of Kazakhstan. This report analyses the epidemiological data on COVID-19 infection in children in Kazakhstan.Methods: The study included 650 paediatric patients diagnosed with COVID-19. Demographic and epidemiological data and the symptoms and radiological evidence of complications were collected and analysed. Children were sub-divided into four groups: neonates/infants, young children, older children and adolescents.Results: All of the 650 children were under 19 years of age, 56.3% of whom were male, and 122 (18.8%) were newborns and infants. The majority of cases (n = 558, 85.8%) were asymptomatic and only four cases were severe (0.6%). The symptoms were as follows in descending order: cough (14.8%), sore throat (12.8%), fever (9.1%) and rhinorrhoea (5.5%). Diarrhoea (2%), dyspnoea (1.8%) and muscle pain were rare (1.1%). Only three children required intensive care, including invasive ventilation. One patient had acute respiratory distress syndrome. There were no deaths.Conclusion: Most cases of COVID-19 infection in children in Kazakhstan were asymptomatic or the symptoms were mild. Only three patients required intensive care.