O.T. Ibekenov

https://orcid.org/0000-0001-6605-6435

Articles found: 4

  • Results of gastrointestinal bleeding treatment in the republic of kazakhstan over 10 years (Issue № 3, 2024)

    O.T. Ibekenov, A. E. Ayupov, A.N. Zhuraeva, B.B. Baimakhanov, S.А. Kaniyev, M.O. Doskhanov, A.O. Ibekenova, A. Ibekenova
    2024-09-30
    10–18
    Abstract

    Gastrointestinal bleeding (GIB) remains a significant cause of hospitalization and mortality worldwide, including in Kazakhstan. This retrospective study analyzes the incidence, treatment outcomes, and mortality of GIB in the Republic of Kazakhstan over a 10-year period (2014–2023) using data from 101,703 patients across 254 medical institutions. The study differentiates between non-variceal and variceal GIB, highlighting a 24.5% increase in non-variceal cases and a 45.1% increase in variceal cases due to higher rates of acute ulcerative lesions and liver cirrhosis, respectively. Men were disproportionately affected, accounting for 69.3% of cases, with the highest incidence in the 18-59 age group. Despite a 27.8% increase in GIB cases, overall mortality decreased from 7.8% in 2014 to 5.0% in 2023, largely due to advances in endoscopic hemostasis and critical care management. The mortality rate for non-variceal GIB decreased to 3.0%, while variceal GIB decreased from 23.8% to 13.6%. The results underscore the need for improved prevention, especially in high-risk populations using NSAIDs and anticoagulants, and in those with chronic conditions such as liver disease.

    Keywords

    gastrointestinal bleeding, incidence, mortality

  • Stepwise application of aortic wall autoplasty (Issue № 4, 2024)

    K.N. Kuatbekov, A.E. Tugambaev, A.V. Mishin, A.M. Nurbekov
    2024-12-31
    12–18
    Abstract

    This paper describes the effective management of successive early postoperative complications, using aortic wall autoplasty, VAC-system, with completion of combined sterno-osteosynthesis in one cardiac surgical patient. The paper presents a clinical case of management of postoperative complications in a 67-year-old patient after aortic valve replacement and three-vessel myocardial revascularization by applying a combined and step-by-step approach for each complication: 1. In case of surgical bleeding - formation of flap plasty of the damaged aortic wall with autopericardium by in situ fixation method; 2. In case of profuse bleeding - application of VAC-system; 3. In case of high risk of sternum divergence - its closure by preferential rheosteosynthesis with tie-fixation devices. The described methods of control, carried an individual approach and the choice of the optimal method of their application, which requires knowledge of the entire arsenal of relevant and effective ways of emergency elimination of complications. In our case, unfortunately, against the background of successful one-stage treatment of all complications, the outcome was unfavorable, due to the exhaustion of compensatory mechanisms of the body against the background of severe combined acquired cardiac pathology. Autopericardium plasty by the method of fixation on the stem created additional protection of the aortic bleeding zone, and further installation of the VAC-system successfully stopped the uncontrollable non-surgical bleeding that was festering. Clamp-buckle osteosynthesis, which we applied as a standard in reoperations, contributed to more active intensive care in intensive care with improved repair of the sternum.

    Keywords

    bleeding, vacuum system, thoracoplasty, case report, cardiac surgery

  • Diagnosis and modern treatment methods for hepatic hemangioma (literature review) (Issue № 4, 2023)

    B.B. Baimakhanov, G. Oryngali, Zh.S. Suiindik, A.K. Kydyrbaeva., Y. Y. Barakhan, D.S. Abilkaiyr, Sh.A. Narynbay, А.М. Tolegenova, O.T. Ibekenov, Sh.А. Kaniyev
    2023-12-22
    Abstract

    Background. Hepatic hemangioma is the most common form among benign liver tumors. The vast majority is asymptomatic, usually detected accidentally during screening. A thorough study is required to distinguish it from other local liver pathologies, therefore, in the review paper below we have analyzed important issues during the diagnosis and treatment of liver hemangioma in international experience. The aim of this study differentiation of modern methods of diagnosis and treatment of liver hemangioma in clinical practice..

    Material and methods. In the review work, a literature review of randomized, meta-analyses, clinical trials and international clinical recommendations in English and Russian, published only from January 2010 to August 2023 in bibliographic and other electronic medical databases such as PubMed, Scopus, Web of Science, GoogleScholarship, Springer, rare clinical cases were carried out. Criteria for inclusion in the study: 1) full-text research published in the database; 2) research in English or Russian; 3) research carried out or published in the last 2010-2023 years. Conclusions. As the most common benign liver tumor, the incidence of hepatic hemangioma during autopsy is from 0.4 to 20%. Most hepatic hemangiomas are asymptomatic, small-sized forms do not require intervention. Liver hemangioma can be easily diagnosed using ultrasound, or cop phase spiral contrast computer tomography. An indication for surgical resection is a feeling of progressive pain in the abdomen and a size of more than 5 cm. Some patients also have giant hemangiomas with minimal symptomatic. Giant hemangiomas (>10cm) are most often manifested by symptoms and require mandatory surgical intervention. The most commonly used method for the treatment of hemangiomas today is transaortic embolization, surgical resection. But to date, there is no consensus on the best treatment for patients with symptomatic and/or large hemangiomas.

    Keywords

    hepatic hemangioma, embolization of hepatic arteries, benign tumor, radiofrequency ablation

  • WHAT SCALES SHOULD THE CARDIOLOGIST USE IN PATIENTS WITH ATRIAL FIBRILLATION? WHAT IS NEW? (Issue № 2, 2024)

    K.A. Bizhanov, A.K. Baimbetov, B.B. Baimakhanov, Sh.A. Kaniev, O.T. Ibekenov, A.B. Sarsenbaeva, G.N. Ismailova
    2024-06-28
    61–77
    Abstract

    The current treatment algorithm for patients with non-valvular atrial fibrillation (AF) includes anticoagulation to prevent stroke and systemic embolism, improvement of AF symptom control by heart rate reduction or restoration and maintenance of sinus rhythm, and treatment of cardiovascular and other comorbidities. The evaluation of patients with AF should be structured and include assessment of stroke risk, symptom severity, severity of the AF burden (type of arrhythmia, number and duration of episodes, etc.) and predisposing condition. The use of the CHA2DS2-VASc (risk of stroke), HAS-BLED (risk of bleeding), EHRA (severity of AF symptoms), and 2MACE (risk of cardiovascular outcomes) scales is important to help assess the likelihood of adverse outcomes and select the optimal treatment to protect not only against stroke but also against cardiovascular events. It should be noted that the HAS-BLED scale is primarily necessary for identification of bleeding risk factors, the modification of which allows to increase the safety of anticoagulant therapy, and a high index value according to this scale can’t serve as a reason to refuse anticoagulation in a patient with AF. New scales of stroke and hemorrhagic complications risk assessment in patients with AF on the basis of clinical parameters and laboratory biomarkers have been proposed, but their possible advantages over the existing indices need to be confirmed in special studies.

    Keywords

    Atrial fibrillation, stroke, bleeding, scales, direct oral anyicoagulants, myocardial infarction, interventional arrhythmology, cardiology