Vol. 1 No. 1 (2016): VESTNIK of KSMA

Resume. The paper describes little-known facts of the Kyrgyz period of work of the founder of the Kyrgyz sanitary-bacteriological institution (now – NGO “Preventive Medicine”) and Kyrgyz State Medical Institution (now - Kyrgyz State Medical Academy named after I.K. Akhunbaev), outstanding microbiologist, talented educator and researcher, Professor Elbert Boris yakovlevich (1890-1963). He made exceptionally important contribution into development of the medical science and medical education in Kyrgyzstan.

Пути становления и  перспективы развития гематологической cлужбы в  Кыргызской Республике

Resume. In this article results of Monitoring and estimation of immunoprevention against measles in Kyrgyz Republic in period of outbreak as objective indicator of immunization measure’s quality are given. From 11790 respondents (mothers of children 1 to 6 years old age, students of universities and colleges and non-organized population till 20 years old age) 95% responded, that they are immunized against measles. This dates indices that percentage (96.1%) of immunization in result of National campaign of immunization is true.

Resume. Aim. Considering highly prevalent use of mobile communication, the aim of the study was to assess the effect of patient education programme with the telephone follow-up to improve the clinical and ventilation parameters in outpatient chronic obstructive pulmonary disease (COPD) comorbid with essential hypertension (EH).
Materials and methods. 50 outpatients with comorbid COPD and EH (mean age 59.3±1.2 years) were subjected to clinical and instrumental (spirometry) examinations, after which they were divided into the intervention (N=25) and control (N=25) groups. Intervention group patients were exposed to a structured educational programme with the telephone follow-up. Six months later patients of both groups were examined again.
Results. Educational intervention entailed spirometric improvement (FEV1 increased from 63.2±3.1 to 82.5±5.1% predicted), blood pressure (BP) reduction (systolic BP from 155.0±4.1 to 120.0±1.6 mm Hg; diastolic BP from 98.0±2.2 to 76.0±1.3 mm Hg). Hospitalizations for COPD also reduced from 0.32±0.11 to 0.16±0.07, whereas number of COPD exacerbations also dropped from 1.24±0.21 to 0.68±0.13. There were no associated change in control group.
Conclusions. Patient education programme for patients with COPD comorbid with EH is an effective tool to adjunct basic treatment, leading to significant reduction of workload of primary healthcare facilities as a result of distant patients’ management.

Resume. In a review the data of modern literature which concern the urgent problems of physical development is reflected. The influence of anthropogenic, technogenic, law, middle and high altitude climate-geographical factors on the level, growth, harmonious development of the child first, second childhood, adolescents and young adults living in different social conditions. Territorial , ethnic, children’s and adolescents age-sex population of the CIS countries is studied. The data of negative influence of the ecological environment on formation of health of the young generation is presented.

Resume. The increasing emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) is a major threat to effective control of TB. Drug resistance in Mycobacterium tuberculosis arises from spontaneous chromosomal mutations at low frequency. A great deal of progress has been made in our understanding of the molecular basis of drug action and resistance in M. tuberculosis. Understanding the mechanisms of drug resistance in M. tuberculosis would enable the development of rapid molecular diagnostic tools and furnish possible insights into new drug development for the treatment of TB.

Resume. Objective: the study a prevalence and risk factors of missed abortion.
Materials and methods: this article presents results of a retrospective analysis of 2294 medical cards of women with missed abortion, whose live in the different regions of Kyrgyz Republic. Uterine factor as a cause of missed abortion is 36,6%. Histologically, chronic endometritis detected in 15,3% of cases, acute endometritis was verified in 3,8%.
Conclusion: chronic endometritis is the leading cause of missed abortion.

Resume. Diagnostic algorithm was tested using positional cervicomerty to identify cervical incompetence between 43 pregnant women with risk of preterm delivery. Рessaries were inserted to study the effectiveness of noninvasive cerclage for the management of cervical incompetence.

Resume. This article presents the results of benchmarking laser - fluorescence diagnostics (LFD) of extrapulmonary tuberculosis as tuberculous pleurisy and tuberculous abdominal serositis. Studies were conducted using the “Spektrolyuks” (Russia). The study involved 77 patients with tuberculous ascites and 38 people with tuberculous pleurisy. The clinical diagnosis according to the patient has been exposed on the basis of X-ray examination of the chest, the biochemical analysis of the pleural fluid, ascites, bacteriological methods: Hein test crops on the environment Livenshteyn, molecular methods Gen Xpert, diagnostic thoracoscopy with biopsy of the pleura, ultrasound pleural cavities, organs abdominal cavity. Laser fluorescence diagnosis may have some information content and usefulness in the diagnosis of tuberculosis serozity.

Resume. The intrathecal neurolysis is a well-documented technique that can provide excellent and prolonged pain relief. In this study included twenty-five patients with cervical cancer, who suffered severe leg pain, resistant to opioids. Observation was enrolled during 8 weeks after intrathecal neurolysis. Patients were divided into 2 groups: group I included the patients who received intrathecal neurolysis, group II included patients who used morphine continuously. The pain score, performance status and morphine consumption were recorded regular at a week intervals. Pain scores were strongly reduced in group I after the intrathecal neurolysis (P≤0.05), and these patients used significantly less daily doses of morphine (P≤0.001). In group II pain score was stable, and patients continued to receive high doses of opioids with inadequate pain control and side effects of opioids. Physical performance improved within patients group I, in contrast, performance was decreased in group II (P≤0.001).
The intrathecal neurolysis is the effective method for palliation of severe intractable leg pain of patients with cervical cancer.

Resume. We provided cross-sectional study within 170 patients with cancer, hospitalized in hospices of Mongolia and conducted evaluation of pain and its treatment by WHO recommendation. Mongolian hospices used mild opioids more (55.5%), than severe opioids (24.7%), and NSAIDs (19.8%). 91% of patients used oral pain medicine. In Mongolian hospices 81.8% of patients had no pain after treatment according the WHO recommendation, and just 16.5% of patients still had mild pain and 1.7% of patients had moderate pain. We found out that Mongolian hospices manage the pain appropriately to the WHO recommendation.

Resume. Aortic dissection is the most common catastrophe of the aorta. Although the disease is uncommon, its outcome is frequently fatal, and many patients with aortic dissection die before presentation to the hospital or prior to diagnosis. When left untreated, about 33% of patients die within the first 24 hours, and 50% die within 48 hours. The 2-week mortality rate approaches 75% in patients with undiagnosed ascending aortic dissection.
Pain is the most common symptom of aortic dissection. Physical findings may be absent or, if present, could be suggestive of a diverse range of other conditions. CT scanning, MRI, and transesophageal echocardiography are all fairly accurate modalities that are used to diagnose aortic dissection, but each is fraught with certain limitations. The management of aortic dissection has consisted of aggressive antihypertensive treatment, when associated with systemic hypertension, and surgery.

Resume. This paper analyzes the treatment of 1460 patients with various focal lesions of the brain. The largest group (87.3%) consisted of patients with brain tumors and intracranial hematomas of different genesis. A comparative analysis of the dynamics and development of brain and focal symptoms was held. All patients were put to surgical treatment; mortality in this case amounted to 7.8% of the main group.

Resume. There are results of polypropylent mesh using in plasty of abdominal wall of 56 patients with recurrens postoperative ventral hernias. There was only one complication (pneumonia), it consist 0,84%, without fatal outcome.

Resume. The results of treatment of purulent wounds in 38 patients with the use of ozonated solutions and dekasan are shown. The control group consisted of 50 patients who under went conventional treatment of purulentran. Comparison of the results in. The treatment group showed more rapid healing of wounds.

Rezume. The independent predictors of compression syndrome were presence of large effusion, presence of cardiac chamber collapse and high NyHA class. This model, including 3 variables\ allow to correctly predict cases with cardiac compression in 91.4% of patients.

Rezume. We aimed to study clinical, electrocardiographic, X-Ray, echocardiographic and perioperative data of patients with pericardial disease undergoing surgical treatment and define predictors of syndrome of heart compression (tamponade or constriction).

Resume. Currently there are various methods of diagnosis of urolithiasis, but many of them are, applied in the presence of concretions formed in the urinary tract or the presence of clinical symptoms. Modern methods of diagnosis requires detection of disease before the appearance of clinical symptoms and contribute to conduct timely prevention.
In this article the analysis of 120 patients with urolithiasis, examined by “Litos-system”, 20 people consist in the control group. 120 patients were divided into 3 groups according to the clinical manifestations of urolithiasis. Then the obtained findings that a study by “Litos system” allows you to define: the presence of the process and the degree of activity in the kidney stone formation,type of salts forming stones.

Resume. In this report the analysis of literature is conducted to the devoted stenosis of vertebral channel of department of backbone, where the clear over are brought МРТ and КТ criteria.

Resume. This article presents the tactics of operative treatment of pseudoarthrosis of long bones of the low extremity limbs using our developed method. This developed method recovery anatomic length of bones and also allows early loading limb and rehabilitation of joints. The proposed method used in 24 patients with pseudoarthrosis of long bones of the extremity limb in the period from 2012 to 2014 years, 16 men, 8 women. Results of surgical treatment were studied in the period from 6 months to 1 year. To evaluate the results of surgical treatment we used 100 point system SDI-1 (standardized assessment of outcomes author: Mironov SP 2008). Good results obtained 18 (75%) patients, satisfactory result - 6 (25%), unsatisfactory results and no complications occurred.

Resume. We have analyzed the results of operated patients with isolated fracture of the acromial end of the clavicle with the new method proposed in BNICITO for 2014. The total number amounted to 16 patients.

Resume. This article highlights the modern trends of treatment techniques (osteosynthesis) in the world and in our country. There are historically important stages in the development of technologies in traumatology and orthopedics, have influenced the development of medicine in general. Also describes the history of trauma in the Kyrgyz Republic, given the currently available modern methods of osteosynthesis used in our Republic, as well as methods of data appliances are illustrated in pictures and drawings.

Resume. This article focuses on perioperative antibiotic prophylaxis in the knee arthroplasty. Given the results of smears from the pharynx in patients planned to replace the knee joint. In the preoperative period with the aim of preoperative antibiotic prophylaxis (PAP) was administered the drug, taking into account smear tests for sensitivity to antibiotics. Early and delayed infectious complications were observed.

Resume. Bishkek scientific centre of traumatology and orthopeady.Microsurgical method technique of removal of hernia intervertebral disk hernia is shightly traumatic and high – efficient method according this method removal of disk hernia is peformed with minimal traumatization of anatomical structures of spinal column allowing to recover work capacity for a short period.Microsurgical method of removal of intervertebral disk hernia was put into practice in 1999 in Kyrgyzstan, and at present it is successfully used in clinical work BSCTO.

Resume. This study presents surgery treatment tactics fractures rear edge of the tibia using the developed method. Results were studied by SAO-1. We detected good and satisfactory results in all follow up groups. The age range of patients is between 16-64 years, male – 19, female - 5

Resume. This article deals with modern methods of assessment of treatment (osteosynthesis) fractures of the upper extremities and the clavicle. Using tables and scales of assessment data can monitor the effectiveness of the surgical treatment as well as to judge the short- and long-term results. The method is the summation of points, which will depend on the function of the operated limb. Using these methods of estimation were examined, patients who are hospitalized in the traumatology department of the Bishkek Research Center of Traumatology and Orthopedics and Jalal-Abad Regional Hospital.

Resume. Presents an analysis of 37 patients with rheumatic disease, subjected to operations on the hip joints from 2011 - 2014. in Bishkek Research Center of Traumatology and Orthopedics. Gives some details of the operative technique arthroplasty using razrabotannym device that allows you to perform external rotation of the femur without dissection of the surrounding tissues and economical resection of the neck of the femur. The immediate and remote results of treatment were studied by the method of the Central Institute of traumatology and orthopedics named after N. N. Priorov (SОI-3).

Resume. The purpose of this investigation is the analysis of the results of operative treatment of vertebral canal stenosis on srenovertebral level of spinal column. There are given a short characteristic of vertebral canal stenosis the main etiological factors, pathogenesis 422 patients clinical material is given.lCatamnestic observation was performed for 4 years.

Resume. This article summarizes the experience of the treatment of inflammatory healing after osteosynthesis of bones of the skeleton of patients were hospitalized in the bone-purulent department of the Bishkek Research Center of Traumatology and Orthopedics. There are also historical data of osteosynthesis in traumatology and orthopedics. The article listed the most common errors that we encounter in our clinic. Collated clinical examples and suggested solutions to problems on reduction of inflammatory complications of technological genesis.

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