Drunk driving is an important risk factor significantly contributing to traffic accidents and their associated lethality. This meta-analysis of observational studies aims to provide the estimates of drunk driving prevalence in non-lethally injured motor vehicle drivers in relation to the world region, blood alcohol concentration (BAC), and quality of the primary study. A systematic search for observational studies that examined the prevalence of drunk driving in injured drivers was performed, and 17 studies comprising 232,198 drivers were included in the pooled analysis. The pooled prevalence of drunk driving in injured drivers was found to be 16.6% (95% CI: 12.8–20.3%; I2 = 99.87%, p < 0.001). In addition, the prevalence of alcohol use ranged from 5.5% (95% CI: 0.8–10.1%) in the Middle East, North Africa, and Greater Arabia region to 30.6% (95% CI: 24.6–36.5%) in the Asia region. As for the subgroups with different thresholds of BAC, the maximum value of 34.4% (95% CI: 28.5–40.3%) was found for a dose of 0.3 g/L. The prevalence of alcohol use reported by high-quality studies was 15.7% (95% CI: 11.1–20.3%), compared to 17.7% (95% CI: 11.3–24.2%) reported by studies of moderate quality. These findings could inform law enforcement efforts to promote road safety.

Background Vitiligo is one of the most common hypomelanoses, in which the destruction of functioning melanocytes causes depigmentation of the skin, hair and mucous membranes. The genes encrypting brain-derived neurotrophic factor (BDNF) and corticotropin releasing hormone (CRH) might be the conceivable contributors to the development of vitiligo. This study was aimed at investigation of the serum levels of BDNF and CRH as well as their selected single nucleotide polymorphisms (SNPs) in vitiligo patients in comparison with the healthy controls. Methods The cross-sectional study was carried out between October 2020 and June 2021 in 93 vitiligo patients (age range from 23 to 48 years) and 132 healthy controls (age range from 24 to 52 years). The psychological status of study participants was evaluated using the Generalized Anxiety Disorder-7 (GAD-7) scale. Serum levels of BDNF and CRH were measured with the help of a commercially available sandwich enzyme-linked immunosorbent assay (ELISA) kit. Genotyping for the rs11030094 polymorphism of the BDNF gene and for the rs242924 polymorphism of the corticotropin releasing hormone receptor 1 (CRH-R1) gene was performed by a real-time polymerase chain reaction (PCR). Results There was a significant relationship between the CRH-R1 rs242924 and BDNF rs11030094 polymorphisms and vitiligo. Moreover, serum levels of neurotransmitters differed significantly between vitiligo and control groups and were associated with the CRH-R1 rs242924 and BDNF rs11030094 SNPs. Conclusions Our findings demonstrated the association between CRH-R1 rs242924 and BDNF rs11030094 polymorphisms and vitiligo. Further studies need to be carried out in vitiligo patients to confirm the results observed.

Background: Epidemiology of male reproductive cancers (MRC) is relatively well studied in developed world nations, but little is known about Central Asian states. We aimed to analyze the changing trends for incidence, mortality and 5-year survival MRC across provinces of the Republic of Kazakhstan. Methods: This was a retrospective cohort study based on data obtained from the Kazakhstan Cancer Registry, which serves as a nationwide database for all histologically confirmed cancer cases. From this, information on all male patients with prostate (PCa) and testicular cancers (TCa) was retrieved for the period from 2010 to 2019. The statistical analysis of official data on incidence, survival, and mortality rates was performed for both the whole country and its provinces. Results: There was a substantial instability of PCa incidence rates, attributed to the execution of screening program from 2013 to 2017. Still, there was a lack of variations in TCa incidence rates. However, PCa screening program had no influence on reduction of mortality rates, which remained relatively stable. There is much heterogeneity between country’s provinces in incidence and mortality rates. TCa patients were younger than PCa patients and had better 5-year survival. Conclusion: As compared with many other countries, Kazakhstani men with PCa and TCa have poorer five-year survival, which requires further investigation. Moreover, a careful analysis of diagnostic and treatment strategies utilized at different hospitals across the country would be highly desirable.

Introduction. Coronavirus infection is a risk factor for vascular thrombosis. This is of particular importance for patients undergoing myocardial revascularization since this infection can be a trigger for the formation of restenosis in the area of a previously implanted coronary stent. Understanding the risk factors for stent thrombosis and restenosis is of particular importance in individuals at risk for adverse outcomes. The rarity of such situations makes the present study unique. Objective. Studying the peculiarities of restenosis and thrombosis of the coronary arteries in patients after coronavirus infection. Methods. The study was performed in the Department of Cardiovascular Surgery of Emergency Hospital, Semey City, in 2021. We have examined the medical records of 10 consecutive patients with restenosis of coronary arteries after coronavirus infection and 10 matched-by-age patients with similar restenosis of coronary arteries who did not have coronavirus infection as a comparison group. To determine statistically significant differences between independent samples, we calculated the Mann–Whitney U test. Results. The average age of patients was 65.7 years. Only one case was classified as early restenosis (within 8 days of previous revascularization), two cases represented late restenosis, and seven cases were very late restenoses. In 70% of cases, restenosis was localized in the left anterior descending artery, in 30% of cases, it was in the right coronary artery, and in 40% of cases, it was in the left circumflex artery. In comparison with patients who did not have a coronavirus infection, there were statistically significant differences regarding IgG ( P < 0.001 ) and fibrinogen ( P = 0.019 ). Conclusion. Patients with myocardial revascularization in the past have a higher risk of stent restenosis against the background of coronavirus infection due to excessive neointimal hyperplasia, hypercoagulability, increased inflammatory response, and endothelial dysfunction.

BACKGROUND: Patients with heart failure (HF) and implanted heart devices constitute a vulnerable category during the coronavirus disease –2019 (COVID-19) pandemic. The remote monitoring function allows the physician to detect atrial fibrillation (AF) in these patients and to prevent thromboembolic complications by prescribing anticoagulants. Under quarantine conditions, such patients can receive fully remote consultation and treatment, which will protect them from the risk of infection, and also reduce the burden on medical institutions. CASE REPORT: A 56-year-old man presented to the clinic with shortness of breath when climbing the second floor, moderate non-specific fatigue, general weakness, and a decrease in exercise tolerance. The patient received standard treatment for HF for at least 3 months (ACEI, beta blockers, MR antagonists, and loop diuretics) in individually selected adequate doses. ECG on admission showed a QRS of 150 ms, left bundle branch block (LBBB). Echo showed dilatation of all heart chambers, diffuse hypokinesis of the walls with akinesis of the apical, middle anterior LV segments, as well as hypokinesis of the basal, middle apical, and anterior septal segment of the LV. The ejection fraction was reduced to 35%. RV function is reduced. After a detailed discussion with the team, it was decided to do implantation of a cardioverter-defibrillator with resynchronization function, equipped with remote monitoring (Biotronik, and Home monitoring). Date of implantation is June 19, 2014. Due to the fact that the patient was connected to the remote monitoring system, May 5, 2020, he was diagnosed with asymptomatic AF. The episode lasted 1 min 22 s. On the following days of monitoring, episodes of AF were also recorded. The duration of the episodes ranged from a few seconds to 12 h/day. The patient received a doctor’s consultation through phone call, his risk of stroke was four when assessed using the CHA2DS2VASc scale. In treatment, it was recommended to add antiarrhythmic drugs (amiodarone 600 mg a day) and oral anticoagulants (rivaroxaban 20 mg × 1 time/day). Later, periodic IEGM showed absence of AF. CONCLUSION: In the context of the COVID-19 pandemic, health-care providers should rethink their approach to managing patients with implanted heart devices. Modern cardiovascular implantable electronic devices allow the physician to monitor the status of patients and immediately respond to situations requiring a change in treatment. Consultations can be carried out completely online.