Vol. 5 No. 5-6 (2021): VESTNIK of KSMA

Enterobiasis is the most common type of helminthiasis. Almost every person in our country has suffered from this disease at least once in his life. Most often, enterobiasis is observed in children, because children more often than adults neglect hygiene rules. Most often asymptomatic. The main symptom is itching around the anus, especially at night, often causing insomnia. Sometimes, decreased appetite, irritability, secondary bacterial infections of the skin around the anus. Pinworms can cause appendicitis or invade the female genitals and cause inflammation. In the Kyrgyz Republic, enterobiasis with a contact mechanism of transmission of invasion is widespread, which depends little on environmental conditions.

According to the WHO, epilepsy accounts for approximately 1% of the world’s total disease burden, and is fourth on the list of neuropsychiatric disorders, following depression, alcoholism, and cerebrovascular disease, with similar impact to the burden of breast and lung cancer. It affects over 70 million people worldwide and it's characterized by a lasting predisposition to generate spontaneous epileptic seizures and has numerous neurobiological, cognitive, and psychosocial consequences.
Aim. To study the trends of epilepsy incidence in Kazakhstan.
Material and methods: The research material was compiled summary reporting form number 12 of Ministry of Health of the Republic of Kazakhstan on new cases of epilepsy (ICD-10 – G40), established for the first time. A retrospective study was used as the main method for studying the incidence of epilepsy. According to generally accepted methods of biomedical statistics, extensive, intensive and equalized indicators of the incidence of epilepsy were calculated.
Results. For 2009-2018 78,429 new cases of epilepsy were registered in the republic, of which were in children – 47.6%, teenagers – 7.5% and adults –44.8%. The average annual incidence rate of epilepsy in the entire population of Kazakhstan was 45.6±3.0⁰/₀₀₀₀ (95% CI=39.7-51.4⁰/₀₀₀₀), and for population groups having been studied was: in children – 83.2±4.0⁰/₀₀₀₀ (95%CI=75.4-91.0⁰/₀₀₀₀), among teenagers – 84.6±6.5⁰/₀₀₀₀ (95% CI=71.9-97.3⁰/₀₀₀₀) and the adult population 29.3±2.6⁰/₀₀₀₀ (95% CI=24.3-34.3⁰/₀₀₀₀). The difference in incidence between groups was statistically significant. Disease tended to increase in all age groups: in children (Т=+5.7%), in adolescents (T=+9.8%) and in the adult population (Т=+9.8%).

Conclusion. According to the dynamics, epilepsy incidence in Kazakhstan has a increased tendency. The results obtained are recommended to be taken into account by health authorities when making managerial decisions. 

Among the many problems of modern obstetrics, one of the most urgent is the reduction of perinatal morbidity and mortality.
A number of researchers consider “silent” ischemia to be a poor prognostic sign, since its presence is associated with an increased risk of developing unstable angina pectoris, myocardial infarction and sudden death. Since “silent” ischemia does not manifest any discomfort in the region of the heart, its importance is often underestimated.

Colorectal cancer is the third most common cancer worldwide: 1.93 million people were diagnosed with it in 2020. The prognosis of colorectal cancer is better with an earlier diagnosis. CRC is the only cancer for which screening has been proven to reduce cancer deaths in medium-risk women and medium-risk men. The diagnosis of precancerous diseases, as well as the detection of cancers in the early stages, is significantly important for reducing the burden of the disease due to early detection, since the prognosis for such patients is much more favorable.
The aim of the study was to evaluate some indicators of the oncological service at the CRC in Kazakhstan for 2010-2019.
The research material was data from the Ministry of Health of the Republic of Kazakhstan – annual form No. 7 and 35 regarding CRC (ICD 10 – C18-21) for 2010-2019 – incidence, mortality, early diagnosis, neglect, morphological verification. A retrospective study using descriptive and analytical methods of biomedical statistics was used as the main method. For 2010-2019, 28,950 new cases of CRC were registered in the republic for the first time and 15,161 people died from this disease. The average annual crude incidence rate of CRC was 17.1±0.30/0000 (95% CI=16.5-17.8) and increased in dynamics from 15.7±0.30/0000 (2010) to 18.0±0.30/0000 in 2019, the difference was statistically significant (t=5.42 and p=0.000). In dynamics, mortality rates from CRC tended to statistically significant (t=7.07 and p=0.000) decrease from 9.5±0.20/0000 (2010) to 7.5±0.20/0000 in 2019, and the average annual crude mortality rate from CRC was 8.7±0.20/0000 (95% CI=8.3-9.2). The research of  the study period reveals a trend: early diagnosis indicators (specific weight of patients with I-II stage) improved from 42.2% (2010) to 64.3% in 2019, and accordingly the specific weight of neglected patients significantly decreased with stage III (from 40.4% to 23.1%) and with stage IV (from 17.2% to 12.0%). The morphological verification indicators for CRC improved by almost 10%, from 88.1% and 96.3%, respectively, in 2010 and 2019. An analysis of the indicators of the oncological service in CRC revealed an improvement in morphological verification and early diagnosis, a decrease in neglect and mortality rates, which is undoubtedly associated with regular anti-cancer activities in Kazakhstan, in particular screening of CRC. 

The problem of postoperative infectious complications is still relevant for surgeons of various fields, representing a medical, social and economic problem on a global scale. The maximum frequency of postoperative infectious complications (up to 30%) is observed during urological operations, while in Kyrgyzstan this problem has not been studied enough. The aim of the study was to study the frequency, structure and course of postoperative infectious complications in urology.
Materials and methods. A retrospective study of 2256 urological patients was conducted, with the study of treatment outcomes, the structure and nature of postoperative infectious complications using the standard case definition developed by the CDC (Center of disease control and prevention).
Results. The frequency of postoperative infectious complications for all types of urological operations was 19.6%, and varied from 5.8 to 46.7% depending on the type of operations. In the structure of postoperative infectious complications SSI - 55%, catheter-associated urinary tract infections - 24% of cases, acute pyelonephritis - 13%, acute orchiepididymitis - 8% of cases. The occurrence of infections lengthens the hospital stay from 3.4 bed-days for varicocele surgery to 10.1 bed-days for prostate surgery. The data obtained indicate the need for further study of the problem of the development of infectious complications in urology and the development of measures for their prediction and prevention.

The review provides information on the problem of the development of postoperative infectious complications in surgery, the growth of resistant strains of nosocomial infection pathogens, and strategic approaches to control and containment of the growth of antibiotic resistance. The main components of this strategy are the prevention of infectious diseases and the prevention of resistance, the monitoring of resistance and resistant infections, the improvement of antibiotic prescribing practices, and the development of new antimicrobial drugs. The introduction of antibiotic resistance control programs ultimately leads to a decrease in the incidence of postoperative infectious complications, optimization of the cost of antimicrobial agents, a reduction in the length of hospital stay, and treatment of postoperative infectious complications. For healthcare organizations in conditions of budget deficit, the introduction of control programs for the use of antimicrobial drugs is a timely and relevant measure. 

Purpose of the study. Evaluation of the frequency and severity of nosocomial pneumonia associated with artificial lung ventilation in patients in the intensive care unit with and without specialized means for oral care and sanitation of the tracheobronchial tree.
Methods: 60 ICU pts were included in RCT. The reason of invasive mechanical ventilation was the depression of consciousness due to stroke or head injury. The pts were randomized to VAP prophylaxis bundle group 1 or to standard care group 2. In first group we used bundle including filter and HME, disposable breathing circuits for ventilators. The oral care performed 3 time per 24 hours with visual inspection, 0,05% chlorhexidine solution washing, dental and gun cleaning, only closed system aspiration.
Results: Nosocomial pneumonia (NP) prophylaxis bundle decrease early onset NP - 6.6 and 33% in 1 and 2 groups respectively (p = 0.00167), increase VAP free-day - 7.5 ± 4.6 day in 1 group and 5.3 ± 6.5 day, (p = 0.00182) in group 2; decrease severity of NP - CPIS on day 7 was 5.96 ± 3.2 and 7.2 ± 2.43 in 1 and 2 groups (p = 0.046), P/F on day 7 - 304.84 ± 22 and 255.9 ± 43 in 1 and 2 groups (p = 0.001).
Microbiology data show decrease of CFU colonization Klebsiella pneumoniae from 106 to 104 (p < 0.001), Streptococcus pneumoniae from 107 to 103 (p < 0.001), MRSA from 105 to 103 (p < 0.001), Proteus mirabilis from 107 to 103 (p < 0.001). 

Conclusions: VAP prophylaxis bundle decrease “early onset” VAP, severity of VAP,increase VAP free day.

Testicular position abnormalities account for up to 5% of all malformations in mature newborns, and up to 30% in prematurity, causing spermatogenic and hormonal dysfunction, leading to infertility in 60% of men with unilateral, and 80% to 100% in bilateral forms of cryptorchidism. A retrospective analysis of 987 operated on patients with cryptorchidism from 2016 to 2021 was carried out. The prevailing age composition of operated patients of senior preschool and primary school age from 4 to 7 years - 44.3% and children from 1 to 3 years - 34.1% older than 4 years indicates insufficient educational and outpatient diagnostic work at the level of primary health care. In 12.5% of patients with cryptorchidism have been found to have concomitant congenital malformations. To prevent male infertility and improve the early diagnosis of cryptorchidism, further research and improvement of primary health care with the active implementation of in-depth preventive examinations among the child population in polyclinics using modern research methods is necessary. 

According to the International Agency for Research on Cancer, about 906 thousand new cases of liver cancer (LC) are registered annually in the world and in 2040 about 1.4 million are predicted and about 1.3 million are expected to die from this pathology.
Aim of the study: to evaluate some indicators of the oncological service for RP in Kazakhstan for 2010-2019.
The research material was the data of the Ministry of Health of the Republic of Kazakhstan  - annual form 35, concerning RP (ICD 10-C22) for 2010-2019 - morbidity, mortality, early diagnosis, neglect, morphological verification. A retrospective study using descriptive and analytical methods of biomedical statistics was used as the main method.
For 2010-2019 For the first time, 8,335 new cases of LC and 6,037 deaths from this pathology were registered in the republic. The average annual rough indicator of the incidence of LC was 4.8±0.10/0000 (95% CI=4.6-5.0) and in dynamics had a not pronounced tendency to increase from 4.9±0.20/0000 in 2010 to 5.0±0.20/0000 in 2019, the difference was statistically insignificant (p> 0.05). In dynamics, mortality rates from RP tended to bestatistically significant (t=7.95 and p=0.000) decrease from 4.8±0.20/0000 in 2010 to 3.5±0.10/0000 in 2019, and the average annual gross mortality rate from LC was 3.9±0.20/0000 (95% CI=3.5-4.2). Indicators of early diagnosis (the proportion of patients with stages I-II) improved from 8.7% in 2010 to 19.3% in 2019, while the proportion of patients with stage IV decreased (from 31.8% to 17.2 %), and the proportion of patients with stage III increased (from 59.5% to 63.3%) over the years studied, i.e. neglect rates are generally declining. Indicators of morphological verification in LC over the years under study tended to improve
from 38.3% to 64.2%.
As a result of the analysis of the indicators of the oncological service in LC, an improvement in the indicators of morphological verification and early diagnosis, a decrease in the neglect of the process and mortality rates were established, which is undoubtedly associated with the ongoing anti-cancer measures in Kazakhstan. 

Corpus uteri cancer is the sixth most common cancer worldwide. Approximately 417,367 new cases and 97,370 deaths of endometrial cancer occur annually worldwide. Moreover, in many countries such as Europe, the United States, Russia, and Canada, carcinoma of the corpus uteri (endometrial carcinoma) has now surpassed cervical carcinoma as the most common form of malignancy affecting the female genital tract.
The aim of the study was to evaluate some indicators of the oncological service in CUC in Kazakhstan in the period from 2009 to 2018.
The research material was data from the Ministry of Health of the Republic of Kazakhstan – annual form No. 7 and 35 regarding CUC (ICD 10 – C54) for 2009-2018 – incidence, mortality, early diagnosis, neglect, morphological verification. A retrospective study using descriptive and analytical methods of biomedical statistics was used as the main method. For 2009-2018, 10,522 new cases of CUC were registered in the republic for the first time and 2,774 women died from this disease. The average annual crude incidence rate of CUC was 11.9±0.30/0000 (95% CI=11.3-12.5) and increased in dynamics from 10.7±0.40/0000 (2009) to 11.6±0.40/0000 in 2018, the difference was statistically significant (t=1.59 and p=0.112). In dynamics, mortality rates from CUC tended to statistically significant (t=3.89 and p=0.000) decrease from 3.6±0.20/0000 (2009) to 2.5±0.20/0000 in 2018, and the average annual crude mortality rate from corpus uteri cancer was 3.2±0.20/0000 (95% CI=2.9-3.5). The research of the study period reveals a trend: early diagnosis indicators (specific weight of patients with I-II stage) improved from 82.0% (2009) to 88.6% in 2018, and accordingly the specific weight of neglected patients significantly decreased with stage III (from 12.0% to 8.5%) and with stage IV (from 4.7% to 2.8%). The morphological verification indicators for CUC remained virtually unchanged, remaining fairly high 98.6% and 98.8%,respectively, in 2009 and 2018.
Conclusion. An analysis of the indicators of the oncological service in CUC revealed an improvement in morphological verification and early diagnosis, a decrease in neglect and mortality rates, which is undoubtedly associated with regular anti-cancer activities in Kazakhstan. 

The article discusses the method of placing artificial teeth in full removable dentures in a medium-anatomical articulator in compliance with all the rules of medium-anatomical placing. This method greatly facilitates work of the dental technician and allows accurate placing of artificial teeth. The technique is based on using of the Arcon articulator and two additional devices designed by N. Pinnecker. One of which is called ArH, used to fix the models in the articulator according to the average anatomical parameters of ratio of the jaws. The second device is AfH, which is used to place the lower anterior teeth. This technique of placing artificial teeth is very easy to use, with the correct articulation of the models into the articulator, placing of the teeth will be performed correctly.

The article reflects the data of the Department of Legal Statistics and Accounting of the General Prosecutor's Office of the Kyrgyz Republic on crimes against minors for 2016, 2017 and 2018, indicating an increase in the number of crimes in 2017 by 28.4% and in 2018 by 23.5%. At the same time, the largest increase in the number of crimes in 2018 was registered in Bishkek (61.9%), Talas and Osh regions, respectively, 60% and 43.7%.
The most frequent crimes against minors were intentional infliction of light and less serious bodily harm, sexual intercourse with a person under the age of 16, and lecherous acts.