Cervical cancer trend in the Republic of Kazakhstan and attitudes towards cervical cancer screening in urban and rural areas.

Cervical cancer (CC) continues to be a significant global health issue, which in part can be attributed to disparities in access to CC screening services. This study aims to conduct a trend of CC in Kazakhstan and to compare attitudes towards the screening program between women living in urban and rural areas. In the first stage, we conducted a trend study of CC indicators in Kazakhstan using official statistics. In the second stage, a cross-sectional study was conducted using a structured questionnaire to assess adherence to screening. The trend study reveals a decline in cervical cancer mortality rates (from 7.15 to 5.93 per 100,000 female inhabitants) over the period studied, while the incidence remains stable (from 18.51 to 19.38 per 100,000 female inhabitants). Regional variations in Period Prevalence rates were observed. Significant differences were found in screening participation rates between urban n = 41 (74%) and rural n = 23 (38%) women, p < 0.001, as well as awareness of the screening program (urban: n = 15 (27%), rural: n = 35 (58%), p < 0.001). The trend study highlights a decrease in cervical cancer mortality rates over the specified period, accompanied by a consistent incidence rate. Additionally, regional disparities in period prevalence rates of cervical cancer were observed. The primary factor contributing to the low adherence of rural women to screening was found to be a lack of awareness regarding the screening program. Therefore, increasing awareness about the importance of screening is crucial for improving adherence rates among rural women in Kazakhstan.

Predictors associated with night sleep disturbance among breastfeeding women.

OBJECTIVE: The aim of this study was to investigate the incidence of somnological disorders among Kazakhstani women who breastfeed and to assess the association of this phenomenon with some medical and social characteristics. METHODS: The authors used the standardized questionnaire of A.M. Vein and Y.I. Levin to assess nocturnal sleep among 1101 breastfeeding women in the Republic of Kazakhstan, applied Pearson's chi-square test to study the correlation between sleep disturbances and duration of breastfeeding, and multiple logistic regression to assess the influence of various medical and social factors on somnological disorders. Data collection occurred in February 2023. RESULTS: On average, 80% of breastfeeding women (ranging from 79% to 85.9%) experienced some form of nocturnal sleep disorders, with no significant association found between these disorders and breastfeeding duration (p = 0.234), while urban residence, history of operative delivery, child's health issues, and low satisfaction levels with various aspects were associated with over twofold increased odds of experiencing sleep disorders (p ≤ 0.05). CONCLUSIONS: The elevated prevalence of nocturnal sleep disorders among breastfeeding Kazakhstani women serves as a risk indicator for adverse health outcomes, with predictors including place of residence, obstetric complications, child health issues, and satisfaction levels with social conditions and personal expression opportunities.

Cervical Cancer Prevention in Rural Areas.

Objective: Globally, cervical cancer (CC) incidence is higher in rural areas than in urban areas that could be explained by the influence of many factors, including inequity in accessibility of the CC prevention measures. This review aimed to identify and analyze factors associated with a lack of cervical cancer screening and HPV vaccination programs in people living in rural areas and to outline strategies to mitigate these factors. Methods: The literature search encompassed two focal domains: cervical cancer screening and HPV vaccination among populations residing in rural areas, covering publications between January 1, 2004 to December 31, 2021 in the PubMed, Google Scholar, Scopus, and Cyberleninka databases, available in both English and Russian languages. Result: A literature review identified 22 sources on cervical cancer screening and HPV vaccination in rural and remote areas. These sources revealed similar obstacles to screening and vaccination in both high and low-income countries, such as low awareness and knowledge about CC, screening, and HPV vaccination among rural residents; limited accessibility due to remoteness and dearth of medical facilities and practitioners, associated with a decrease in recommendations from them, and financial constraints, necessitating out-of-pocket expenses. The reviewed sources analyzed strategies to mitigate the outlined challenges. Possible solutions include the introduction of tailored screening and vaccination campaigns designed for residents of rural and remote locations. New screening and vaccination sites have been proposed to overcome geographic barriers. Integrating HPV testing-based CC screening is suggested to counter the lack of healthcare personnel. HPV vaccination is essential for primary cervical cancer prevention, especially in rural and remote areas, as it requires less medical infrastructure. Conclusion: Certain measures can be proposed to improve the uptake of CC screening and HPV vaccination programs among rural residents, which are needed to address the higher prevalence of CC in rural areas. Further investigation into cervical cancer prevention in rural and remote contexts is necessary to ascertain the optimal strategies that promote health equity.

Pregnancy after in vitro fertilization in an elderly primigravida with Shereshevsky-Turner Syndrome: A case report.

Background: Shereshevsky-Turner Syndrome is a chromosomal condition that affects females owing to full or partial missing of X-monosomy in all or part of the body's cells. Shereshevsky-Turner Syndrome is characterized by severe hormonal disorders and defects of the cardiovascular and urinary systems. With the advent of assisted reproductive technology (ART), pregnancy has become more accessible for this group of cases, often with donor eggs. In the available literature, it was not possible to find exact information during the time of selection of progestogen support, the duration of the appointment, and the term of withdrawal. Case presentation: This is the case of a 36-yr-old primigravid woman suffering from STs, mosaic karyotype comprising of 3 clones: 45X (69), 46XX (23), 47XXX (8), and 1000 interphase nuclei. In this case, we left high-maintenance doses of progesterone due to the application of ART and concomitant extragenital pathology, leading to a decrease in all functions of the placenta, including the endocrine. The woman was monitored before, during, and after the pregnancy. She was delivered at 37 wk and 6 days of gestation. Conclusion: ART increases the possibility of having a pregnancy and gestation in cases with a wide variety of genital and extragenital pathologies.