Vol. 1 No. 1 (2022): VESTNIK of KSMA

Summary. To determine rehabilitation time of young age men there was carried a study in
which 40 students and 40 athletes from the football federation jf Kyrgyz republic participated
voluntarily. During the performance of physical activity with a power of 50, 75, 100 watts
the homeostasis indicators of the participants were measured on a bicycle ergometer. When
carrying out the physical activity with intensity 100 watts, the saturation level of students who
were ill with COVID-19 was SP02=94.4±1.53 and in students who were not ill with COVID
19 it was SP02=97.7±0.30 (p<0.05), the saturation level of athletes who were ill with COVID
19 - SP02=97.4±0.40, in athletes who were not ill with COVID-19 it was SPO2=98,l±0.21
(p>0.05). With such a physical activity, there was no difference in saturation level in athletes
ill and not ill with COVID-19. According to the indicators of homeostasis, the period
exercise performance recovery in ill students was 10 minutes and in non-ill students -
minutes, in athletes who were ill - 5 minutes and in athletes who were not ill - 3 minutes.

Abstract. The article discusses the problem of adhesive small intestinal obstruction (ASIO):
epidemiology, classification and prevention. Several classifications have been described, on
the basis of which not only the severity is determined, but also the peritoneal adhesion index
is determined, which determines the strength of adhesions and stratification of the risk of the
need for surgical intervention. Despite the fact that many specialists all over the world are
working on the problem of combating the formation of adhesions and the development of
adhesive small bowel obstruction, the question remains open, relevant and requires further
study.

Material and methods. The data of 198 patients with isolated traumatic brain injury were
studied and analyzed. For the study, patients with acute and subacute isolated traumatic
intracranial hematomas (epidural, subdural, intracerebral) or their various combinations were
selected by the continuous sampling method. There were 130 (65.7%) men and 68 (34.31%)
women in the study. The average age of the patients was 48.2±4.3 years, ranging from 15
years to 81 years.
Results. Traumatic intracranial hemorrhages in many cases occurred in transport (74 cases -
37.4%) and domestic (69 cases - 34.8%) injuries. 110 patients (55.6%) were delivered by
ambulance. In 34 (17.1%) patients, the injury was received in a state of alcoholic intoxication.
It was most often a domestic injury.
It is proved that the optimal timing and methods of surgical interventions and conservative
treatment are based on the location of traumatic intracranial hemorrhages, the volume and
level of compensation of neurological functions of the patient.
Conclusion. It was revealed that the negative factors affecting the results of surgical and
conservative methods of treatment of traumatic intracranial hemorrhages are the rough phase
of decompensation in the acute period, intracerebral location and location in the dominant
hemisphere.

Abstract. In the study 170 patients with pituitary adenomas have been investigated. There
are 72 (42.4%) males among examined and 98 (57.6%) females. Age of patients ranged from
14 to 74 years.
For the first time, a statistically significant dependence of neuro-ophthalmological symptoms
in patients with pituitary adenoma on localization, predominant growth, and the size of the
volume formation was revealed on significant clinical material. For the first time, the
dynamics of neuro-ophthalmological symptoms after removal of endosuprasellar pituitary
adenoma by various surgical approaches in identical groups of patients was compared. The
dependence of the dynamics of visual functions after surgical removal of the tumor on the
nature and severity of visual disorders before surgery, as well as on the stage of visual
disorders, is analyzed. The factors causing deterioration of visual functions in the early and
long-term postoperative period were determined.

There are 109 males (85.8%) among examined and 18 females (14.2%) in this study. Age of
injured patients ranged from 17 to 82 years. Median age was 42.4±5.6 years. Eight patients
out of 127 died after surgery. General mortality was 6.3%.

Introduction. Due to the new opportunities that have opened up thans to the advent of
computed tomography (CT) and magnetic resonance imaging (MRI) in the arsenal of diagnostic tools. With the introduction of CT and MRI, the reliability of information increased
to 82-93%.
The aim of the study: To improve the diagnosis and increase the effectiveness of surgical
treatment of patients with disc hernias in the lumbar spine by studying the relationship of
clinical manifestations and the results of the applied research and treatment methods.
Materials and methods: The work includes the results of data analysis of a complex of
clinical, diagnostic examinations and surgical treatment of 139 patients with neurological
complications of herniated lumbar intervertebral discs and received inpatient (operative - 116
(83.5%) and conservative – 23 (16.5%) patients) in neurosurgery departments. The age of the
patients ranged from 19 to 72 years.
Results. By using a highly informative MRI method, the dependence of the severity of pain
syndrome and sensitive disorders on the number of levels of disc damage, their localization
in the diameter of the spinal canal and their size was determined. The severity of pain and
sensory disorders depended on the number of prolapsed discs.
Conclusion: The optimal algorithm for examining patients before deciding on neurosurgical
intervention for herniated lumbar intervertebral discs includes radiography of the lumbar
spine, MRI of the spinal cord and spinal column, and, if indicated, magnetic resonance
myelography. 

The implementation of antimicrobial rationalization programs is a cost-effective, time and
relevant activity for healthcare organizations under budget constraints. The article analyses
and systematizes the results of scientific research on the improvement of antimicrobial drugs
in surgical urology published in the PubMed, ScienceDirect, and eLibrary databases.
Key strategic approaches to control and containment of antibiotic resistance have now been
identified and are relevant to all states, regardless of their level of development. The main
approach to curbing antimicrobial resistance is to prevent infectious diseases and to prevent
the spread of antimicrobial resistance. Monitoring antibiotic-resistant strains and
antimicrobial-resistant infections is also a priority in curbing antimicrobial resistance, both
locally and nationally. Countries united under the WHO umbrella follow the third principle
in the fight against antibiotic resistance "management of rational prescribing of the
antimycobacterial agent in clinical practice". The development of new antibiotics and
diagnostic tests to determine sensitivity is the most pressing and difficult to achieve for the
current state of the pharmaceutical industry.
In urological surgery departments, regular research is needed to identify the incidence of
postoperative infectious complications and their risk factors, to study the use of
antimicrobials, and optimize stereotypes in their use. The local data obtained are needed to
optimize measures for the prevention of postoperative infectious complications, thus reducing
the length of hospitalization of operated patients and the cost of their treatment, and
consequently improving the quality of the health care services provided.
In-depth research into the rationalization of the use of antimicrobials in urological surgery is
an urgent and much needed intervention to ensure quality and safe medical care for the
population and the state as a whole.

The increase in life expectancy in the world is accompanied by an increase in the prevalence
of age-related pathological conditions. According to WHO, by 2030, about 1.2 billion women
will be in the postmenopausal period, which is accompanied by the development of urogenital
disorders. Diagnosis and treatment of women with cystitis in the postmenopausal period is
not only a medical, but also a socially significant problem that entails both physical and
psychological maladaptation. The aim of the study was to analyze and systematize the results
of modern scientific research on the diagnosis and treatment of cystitis in postmenopausal
women. The studied published data of 50 literary sources published over the past 10 years in
international databases on the problem of diagnosing and managing cystitis in
postmenopausal women. Estrogen deficiency is the main predictor of the development of
cystitis in postmenopausal women, which is accompanied by various urogenital disorders
with the development of atrophic and dystrophic processes in the estrogen-dependent organs
of the lower third of the urinary tract. In modern conditions, the standardization of the clinical
manifestations of cystitis in postmenopausal women is particularly relevant and is the best
tool for monitoring the quality of treatment and assessing the quality of life.

Abstract. This article discusses the clinical experience of surgical treatment of dislocation of
the acromial extremity of the clavicle. Despite the development of modern implants, the
improvement of surgical techniques, the number of unsatisfactory results today remains high
and requires additional study of the problem. The aim of this study is to improve the results
of the treatment of injuries of the acromioclavicular joint by reconstructing the
coracoclavicular ligament under the control of an image intensifier tube. All 13 patients in the
study groups were operated on for a clavicle fracture in a secondary hospital. The authors
proposed a technique for minimally invasive restoration of the coraco-acromial ligament by
inserting a biodegradable screw through the acromial and coracoid processes using the control
of an electro-optical device. To assess the effectiveness of the proposed method, the Constant
scale was used, and the visual analogue scale (VAS) was used to determine pain. The result
in the studied groups showed the high efficiency of the proposed method due to the early
activation of the patient, 4 days reduction of the length of hospital stay, early rehabilitation
and full recovery. The proposed method serves as a guideline for the traumatological and
orthopedic service in our country.

For many years, research on various components of blood, the cardiovascular system, and
pulmonary pathology in mountainous conditions has occupied one of the leading places in
medical science. In recent years, due to the development of the mining sector, the
development of tourism and the growth of the population, we have seen an increase in
migration to mountainous areas, which prompts us to study in detail various pathologies in
terms of the influence of mountain conditions. Purpose of the study: to determine the
characteristics of coagulogram parameters in patients with gastric ulcer and duodenal ulcer
complicated by bleeding, in persons living in mountainous conditions of the Kyrgyz Republic.
Materials and methods: the development included 65 patients with gastric and duodenal ulcer
complicated by bleeding, living in the Naryn region (high mountainous conditions) and the
city of Bishkek (low mountainous conditions), who were hospitalized in surgical departments.
The study used anamnesis data, the results of objective and endoscopic studies, laboratory
data and indicators of the state of the hemostasis system. Results: as a result of the study, it
was found that in high mountainous conditions there are higher levels of hemoglobin (by
8.2%), erythrocytes (by 6.5%), platelets (by 17.6%), thrombocrit (by 28%). In high
mountainous conditions, the activity of the external hemostasis system is higher than in the
group of patients in the low-mountain group (by 17.8%). In high mountainous conditions, the
activity of the internal hemostasis system is higher than in the group of patients in the low-
mountain group (by 26%).

Summary. Clinical and epidemiological characteristics of coronavirus diarrhea in 44 young
children who were treated at the Republican Clinical Infectious Diseases Hospital for the
period 2020-2021. In the age structure of children with coronavirus diarrhea, children over 1
year of age dominated 59.1%, children in the first year of life accounted for 40.9%. Of the
remaining hospitals, 56.8% were children who were diagnosed with an acute intestinal
infection. Coronavirus diarrhea in the examined children in 59.0% was combined with viral-
bacterial pneumonia. The diagnosis of coronavirus infection was confirmed by the detection
of SARS-CoV-2 RNA in swabs from the oropharynx and nasopharynx by polymerase chain
reaction (PCR). Quantitative determination of blood procalcitonin (PCT) was determined in
79.5% of patients with secretory diarrhea. As a result, the test showed that 11 (25.0%) children
had a course of coronavirus infection without bacterial complications. The disease generally
proceeded in a moderate form with a favorable outcome. As a result, it was found that
secretory diarrhea is one of the symptoms of coronavirus infection, and the severity of the
condition of patients with diarrhea is due to the frequent combination of viral-bacterial
pneumonia.

Summary. The novel coronavirus infection COVID-19 in children in most cases is milder
than in adult patients, however, in combination with other acute infectious diseases,
background pathology and impaired immune reactivity, it can pose a particular threat.
According to the literature, the incidence of COVID-19 in children is 1–11%. Neurological
disorders in COVID-19 may be due to the “cytokine storm”, hypoxemia, neurotropism and
neurovirulence of SARS-CoV-2. An analysis of numerous publications on the new
coronavirus infection using the PubMed, Scopus, and Google Scholar databases indicates that
the meninges, vessels, and brain parenchyma may be involved in the pathological process.
This determines the need for a multidisciplinary approach to the treatment of COVID-19 and
its complications in children. The article describes a clinical case of severe COVID-19 caused
by SARS-CoV-2 with damage to the nervous system in a teenager.

Resume. The etiostructure of ventilator-associated pneumonia (VAP) and antibiotic resistance of pneumotropic pathogens in sick children of the first two months of life were
studied.

Materials and methods of research. The object of the study was 98 children with VAP. The
collection of biomaterial from the endotracheal tube was carried out by a protected technique
developed by us through a vacuum aspirator, eliminating the risk of contamination. The
following nutrient media were used in the microbiological study: 5% blood agar, chocolate
agar, yolk-salt agar, Saburo medium, Endo medium. Results: in the etiostructure of ventilator-
associated pneumonia, gram-negative flora prevails (53.42% vs. 31.96%, p<0.05) in almost
equal proportions in both full-term and premature infants (p>0.05). The high resistance of the
pneumopathogenic gram-positive microflora to all antibiotics widely used in neonatology was
revealed: penicillins, cephalosporins of the 2nd and 3rd generation, macrolides of the 1st
generation. Gram-negative pneumophilogenic microflora is resistant to almost all antibiotics
used in neonatology practice.

Summary: An analysis of the incidence of vaccine-preventable infections over the past 20
years in Kyrgyzstan was carried out on the basis of annual WHO reports and data from the
Department of State Sanitary and Epidemiological Surveillance (DSES) and the Republican
Clinical Infectious Diseases Hospital (RCCH) of the Kyrgyz Republic. The dynamics of
morbidity and features of the course of such infections as measles, rubella, diphtheria,
whooping cough, mumps infection are presented.

Resume. Language competence is an integral element of the medical specialists training.
Knowledge of a foreign language is a prerequisite for the successful professional activity of a doctor. The integration of education and science into the global space poses the task of a
modern specialist of fluency in English.

Resume. The way a doctor communicates with a patient demonstrates not only his education,
but also his level of breeding, inner generosity and kindness. Sensitive and attentive attitude
to the patient indicates mercy. A doctor needs to follow speech etiquette, i.e. know word forms
of courtesy and politeness. What are these forms? How and in what conditions they should
be used? What can lead to misunderstandings and cause mistrust of a patient when
communicating with a doctor? These and other questions are going to be discussed in this article.

КАФЕДРЕ «ДЕТСКИХ ИНФЕКЦИОННЫХ БОЛЕЗНЕЙ» ИСПОЛНИЛОСЬ 50 ЛЕТ!

ВКЛАД СУЛАЙМАНА ИМАНБАЕВА В РАЗВИТИЕ СИСТЕМЫ ЗДРАВООХРАНЕНИЯ КЫРГЫЗСКОЙ РЕСПУБЛИКИ