Vol. 4 No. 4 (2016): VESTNIK of KSMA

Resume.The article describes the experience of PHC Center based on Asfendiyarov KazNMU to provide outpatient care to students and the population of Almaty within the guaranteed volume of free medical care (GVFMC). The data show the effectiveness and prospects of this PHC model.

Resume. During the sociological research in Almaty city (1440 respondents) and Almaty region (1592 respondents) satisfaction of elderly people of the quality health care has been studied.
It was found that “bad” health is more common in Almaty (12.4%) than in rural areas (6.4%). In most cases, 55.6% and 59.4% of respondents said that their health condition is “satisfactory” and only 1/3 of the respondents is “good” and “excellent.”
Not satisfied with the quality of medical care in the last year were 51.8% of the urban population and 24.4% of the rural population. In thstructure of the main reasons for dissatisfaction: negligence of medical staff (26.6% and 19.8%), long queues (37.4% and 33.8%), rude medical staff (17.1% and 6.8%, respectively).
The authors concluded that the distribution of gerontological and geriatric care to the population - is a cross-sectoral and interdisciplinary problem requiring comprehensive solutions not only in the field of prevention, diagnosis, treatment and rehabilitation of elderly persons as well as social and psychological support.

Resume. The aim of the study was to identify the knowledge of allergists, pediatricians, therapists and family physicians working in Osh Interregional United Clinical Hospital and Family Medicine Centers №1 and 2 of Osh, about modern approaches to the diagnosis of chronic urticaria (CU). A total of 112 physicians participated in the study. 23.7% of surveyed doctors were familiar with Russian and only 1.9% with foreign clinical guidelines for the diagnosis of CU. Awareness of therapists was lower than allergists 4.5 times (9.5% vs. 42.8%) than pediatricians - 2.6 times (16.6% vs. 42.8%) and than the family doctors - 1.6 times (25.9% vs. 42.8%). Increase awareness of the doctors is possible through allergoschools, round tables, master classes, lectures, as well as through the popularization of online training.

The study established the macroscopic parameters lymphangions forming efferent lymph vessels of the lymph nodes located in the lungs of the gate.The most important function of the lymphangoins of bronchopulmonary lymph nodes is their motor function that is inextricably linked to the distribution in their wall of myocytes. It is revealed local peculiarities in the amount and spatial orientation of the myocytes. The number of myocyters calculated in three parts of the lymphangions, it is determind their orientation. It is revelaed that the myocytes in the wall of the lymphatic vessels are more oblquotransverse, less- longitudinally, transverse, and obliquolongotudinally orientation of myocytes is intermediate position. As the age of the person there are observed changes in the numerical strength of the smooth muscle cells.

The received new information about the structure and the number of myocytes in the capsule of the lymph nodes located in the lungs gate confirms the findings of other researchers on the active role of the contractile activity of the capsule of the lymph node in the lymphatic transport. Bronchopulmonary lymph nodes have an active influence on the lymph flow through the motor capsules and trabeculae, as evidenced by the presence of myocytes. Is is determind the relatioship of muscle elements of the lymph vessels with myocytes of capsules lymph nodes.

Resume. The article presents the morphometry of the femoral artery wall after the experiment associated with physical activity. The main components of tissue reaction of femoral artery walls in response to hyperkinesia was expressed in the inner and middle shells.

Resume. The concept of pathogenic heterogeneity of cerebral ischemia using the example of hypertensive discirculatory encephalopathy is revealed in article. Concept is based on contemporary instrumental examination data (ultrasound rheoencephalography and neuroimaging)

Resume. It is carried out a randomized comparative clinical study of the effect of koumiss and beverage Aktyk on motor function of the intestine in women with metabolic syndrome. It is marked the aggravation of bowel motor function, assessed by a computer fonoenterography, as well as reducing weight and body mass index in the treatment of natural medicinal drink.

Resume. Presented clinical case shows a combination of dextrocardia and transposition of internal organs with arrhythmias, namely supraventricular extrasystole and ectopic atrial pacemaker rhythm in young age patient.

Resume. This article treatment the main treatment in complex rehabilitation of neurosensory hearing loss. Is given in this atricle offered article shows the efficiency of a combination of medicamentous therapy and physiotherapeutic influence for improvement of function of the conductive ways of the acoustic analyzer that allows to carry out rehabilitation of patients with this pathology.

It has been done the analysis of the incidence of purulent bacterial meningitis among preschool children in the Kyrgyz Republic. The study of etiological structure showed that the leading etiological agents of purulent bacterial meningitis in children of preschool age are N. meningitidis, S.pneumoniae and representatives of genus Staphylococcus.

The purpose of this study: determination of risk factors of diabetic retinopathy (DR) in children with diabetes mellitus (DM), type 1 according to methods for administering insulin. Materials and methods. The analysis of 223 outpatients dispensary children with type 1 diabetes. Results of the study. We compared the indices of diabetes duration, HbA1c levels and the proportion of patients with DR groups using continuous subcutaneous infusion (CSII) group 1 -38 children and using multiple subcutaneous injections (MPII) 185 Children: 1 HbA1c group - 6,5 ± 1,3 % patients with DR are not found. Group 2: HbA1c 9,2 ± 2,4%, in 2 children nonproliferative DR. Conclusion: The use of CSII and regular self-monitoring of the disease allows due to the normalization of blood glucose levels to avoid the development of diabetic pathology of vision in children with type 1 diabetes.

The article presents the changes in number of micronuclei in buccal cells of petrol station workers which are expressed in the increased detection rate of micronuclei in cells being the signs of DNA damage and cytogenetıc violation.

An experimental and laboratory study were carried out on 18 animals to detect safety of drug “Decamethoxin” 0,02% on the hepatic tissue. There are 143 results of operated patients with hydated disease of liver. For disinfection of echinococcosis’s elements it was used “Decamethoxin”0,02%. Also for the prevention of disease’s recurrence 40 patients were inserted “Decamethoxin” 0,02% into perycapsular tissue of a liver.

There are given the results of treatment of lightning gangrene of scrotum (illness, Fournier) identified in 6 patients aged 53 to 61 years. Of these, a limited form of the disease was in 4 patients, a common form of the disease in 2 patients. The disease development was preceded by minor injuries, scrapes the skin, infected with disease pathogens Streptococcus and non clostridial anaerobic infection. Active management of the treatment of the disease Fournier includes early necroectomy, a system of local treatment with copious irrigation of wounds ozonized solution with ozone concentration of 8-10 mcg / mL or 3% solution of hydrogen peroxide with the imposition of bandages with 0.02% decametoxine to complete cleansing of wounds correction of violations of water electrolyte balance, can improve treatment outcomes. The analysis of the severity of the condition and the results of patients treatment was carried out.

The authors present the data of the endoscopic low-invasive rhinosinusitis surgery used for the first time in Kyrgyzstan and also the results of the Sheiver plastics application for hypertrophic rhinitis in comparison with the control group with Chitozan gel application.

For the first ever time in Kyrgyzstan the authors present their data concerning the application of the method of the endoscopic low- invasive radio-frequency tonsillectomy in chronic tonsillitis as compared to the conventional methods.

The main purpose of our work was to increase efficiency of results of curing patients with inguinal hernia by developing methodology of Liechtenstein. In total 48 patients had a surgery related to inguinal hernia, in 12 cases classical methodology of Liechtenstein was used, and the rest used the modified version. Most of the patients were men-45 of them, there were 3 women, and 33 of working age. All patients had surgery in planned row. Disease prescription was from 2 month to 11 years. Hernia carriers were 11 of patients, which contacted the hospital after detecting incorrigibility hernia sac- 1, pinching – 10. We paid much meaning to early activation of patients, especially those of elderly ages. After the surgery 1 of them had infiltrate, other complications were not noticed. All patients were discharched in satisfactory state. In 6-18 mouths after the monitoring of patients relapse was not detected.

There were 579 newborns children during 2013-2016 years in the Children Emergancy Hospital of Bishkek with Pus-inflamatory deseases, from them: 21(4%) -with sepsis, 38 (7%) epiphiseal osteomyelitis, 16(3%)-necrotic flegmone , 57(9%) pseudophurincu lesis, 28(5%) - pyodermitis, 26(8%) abscesses, 137(24%)–pus puppulaes, 46(8%) otitis, 111(19%) –pus paraproctitis, 25(4%) –pus mastitis, 74(13%) ompholitis.

This article presents clinical observation and treatment of patients with anaerobic non-clostridial infection (fulminant form) soft tissue upper limb with rapid progression purulent-necrotic lesion and extensive cellulitis. Sepsis. Septical (bacterial) shock. Multi- organ failure. The main treatment is early surgical treatment with complete removal of pathologically changed soft tissue (subcutaneous tissue, muscle, fascia). In determining bacteriological sowing it is revealed Staphylococcus aureus and sensitivity to antibiotics.

The influence of laparoscopic and open cholecystectomy on the quality of life in patients is studied comparing their post-operative states. More than 50 patients, getting hospital treatment in the National Surgery Center between the 1st of January and the 1st of March 2016, were involved in the study. The patients were grouped according to gender, age and the disease severity, similar to distribution of pathology. The material used in the study was the questionnaire for early post-operative surgery patients. It is proved that physical, emotional and mental states of laparoscopic cholecystectomy patients are better than the open cholecystectomy method group.

This article presented analysis of population injuries Jalal-Abad region, including patients with fractures of the clavicle in the last five years (2010-2014 yy.). And results of the study of patients with fractures of the clavicle with the proposed method of osteosynthesis.

There was done comparative analysis of different methods of diagnostics of old damages of anterior cruciate ligament at 46 patients. It is established that the old damages of anterior cruciate ligament of the knee joint in 35 (76, 1%) cases are combined with damaged meniscuses. The damage o f the last were established by clinical data correctly only in 32, 6% observation; and with the help of MRI – in 82, 1%. The efficiency of the diagnostics of old damages of anterior cruciate ligament by clinical tests was 71, 7%; with the help of functional roentgenogram were 76, 5%; using MRI were 88, 6%. The use of diagnostic arthroscopy in combination with above mentioned methods of research assisted to increase the efficiency of diagnostic up to 100, 0%.

There were analyzed data of 46 patients with old damages of anterior cruciate ligament treated with developed by authors the low invasive xenolavsanplastic with and without use of videoarthroscopic technique. The use of offered approaches, the key section of which is the use of low invasive technology of lavsanplastic, and use of modern technology of preparation of xenolavsanplastic by 0, 05% solution of formaldehyde with addition of 0, 01% flavonoid and antibiotics allowed in nearest period to decrease the frequency of post operation hemarthrosis is up to 19, 6%; the frequency of synovitis by 10, 1%; and at distant period the specific weight of unacceptable results is up to 6, 5%. The performance of operation on low invasive technology allowed to reduce the term of rehabilitation of patients in post operation period on average by two months.

The medical and ethnographic research of traditional medicine and use of information obtained from the ethnic culture, as well as from scientific researches, is aimed to improve women and girls reproductive health. Accumulated by past cultural creativity of the people tested, and mapped in practice by many generations of people positive empirical knowledge is of great interest for modern obstetrics.

The analysis of reproductive function of the women who underwent organ-preserving operations in massive obstetric bleedings in childbirth and early postnatal the periods is carried out. It is noted that organ-preserving uterus operations are the most modern method of expeditious treatment in obstetric bleedings as according to the obtained data nearly more than a half of women were childbearing age and they were more often nulliparous.

There are stadied medical and biological factors, socio-hygienic characteristics and peculiarities of pregnancy. It is examined 30 patients who died with the CDF (congenital malformations) of newborn in IUI. The findings showed the presence of many of modifying risk factors for the disease: Extra - urogenital disease mothers burdened obstetrical history, pathological course of pregnancy and childbirth.

A review of the literature on the possible mechanisms that explain the cause of intrauterine disorders of the capillary bed in menopause, with the subsequent development of uterine bleeding . It is discussed the questions issues of ultrasonic diagnosis , assessment causes of the violation of uterine blood flow in women with age-related changes in the later reproductive years .

In women of Kyrgyzstan with pathological climacteric syndrome, it is observed the significant disturbances in humoral immunity component: increase of Ig M level showing systemic disturbances of eliminations of antigen complexes and development of predisposition to auto – immune aggression, decrease of immunoglobulin A, and suppression of local immunity of mucous membranes.

This paper shows the results of fetal echocardiographic diagnosis of congenital heart disease and the evaluation of its admissibility. Of the 148 surveyed pregnant women in 7 fetuses it is revealed complex congenital heart disease. Our experience of fetal echocardiography indicates the possibility of rationally and optimally develop further tactics in the surgical treatment of critical heart defects.

There were analyzed the results of 120 operations coronary artery bypass grafting in patients with coronary heart disease, performed in cardiopulmonary bypass. The main group consisted of 56 patients during an operation it is carried out controlled reperfusion of the myocardium according to our methodology. The control group included 64 patients who underwent surgical myocardial revascularization with conventional myocardial protection. Myocardial revascularization index groups was respectively 3.0 ± 1.0 and 2.7 ± 0.8. Perioperative myocardial infarction and hospital mortality were not in the main group.

This article is devoted to the study of chromosomal aberrations in oncological patients using the micronucleus test. The growth of cancer disease requires a comprehensive analysis. The article provides a method for studying the buccal epithelial cells and provides comparative characteristics of primary and control group of patients.

Among investigated students S. aureus bearing was confirmed in 65,2% of causes. Spreading of bearing among students depends on curriculum. Number of carriers at senior course was in 2 times above approximately, than on younger.

The study of personal data of 600 medical students KazNMU them. S. D. Asfendiyarov from the 1st to the 6th courses. When processing the questionnaire data revealed that among students there are the following nosological forms: angina (27%), sinusitis (13.3 percent), tonsillitis (12%), chronic rhinitis (10.0 per cent). It was further studied the microflora of the nasopharynx. Microbiological examination of this group of students revealed that of the 463 students from different courses in 300 students it is identified staphylococcal carriage.

In this article, an etiological structure of infections in surgical hospitals of Almaty (Kazakhstan) is described, 130 clinical isolates of bacteria were examined. The proportion of isolates of Enterobacteriaceae family among all agents of surgical infections was 38,46% (n=130), of isolates non-fermenting Gram-negative bacteria – 13,85%. The most common species among Gram-negative microorganisms (n=71) were Escherichia coli – 49,3% %; Pseudomonas aeruginosa – 7,0%; Acinetobacter baumannii – 7,0%; Klebsiella pneumonia – 5,6%. The antibiotic resistance of the isolated strains of Gram-negative microorganisms and phenotypic detection of ESBL production was studied. Resistance to cephalosporins III-IV generation rates 49,3%, to carbapenems –11,27%. 18 of resistance isolated of enterobacteria were found to produce ESBL.

It has been analyzed the situation with the incidence of Haemophilus influenzae in the republic on the example of the Bishkek city. It was used the statistical data of the Department of Sanitary Inspection of the Kyrgyz Republic and the results of bacteriological and PCR research of the laboratories in Bishkek, It is shown that Hib-infection is most common in the structure of morbidity of purulent bacterial meningitis, pneumonia, bronchitis and ears – nose – throat pathology.

We have previously shown an association between the initial stage of the immune response in experimental animals (rabbits) immunized with live plague vaccine, which is assessed to identify lymphocyte receptors to antigens Y. pestis, and the antibody response to the same antigens (effector phase of the immune response ). At this stage, it is-there are assessed the initial stages of the immune response - the emergence of lymphocyte receptors (Lfr) in re-vaccinated people Living plague vaccine dry (ZHCHS) and eliminating them before than in people first vaccinated with the vaccine.

Analysis of suicidal death by strangulation asphyxia, hanging, found that in 2014. 61.68% in the 2015 year to 88.23% of the deceased committed suicide. At the same time the vast majority of the victims were people of working age (16 to 55 years old), and 50.59% of those killed in 2014 and 41.88% of victims in 2015 were intoxicated by varying degrees.

Purpose: to assess therapeutic efficacy of complex treatment patients with myopia and pathology of cervical spinal colomn.
Methods: The study included 96 patients (192eyes) with myopia of different degrees: low myopia- 36 (72eyes), mild – 29 (58eyes), high myopia –31(62eyes).
According to the changes of cervical spine patients were divided into three groups: I – with “string” symptom- 20, II- spondilolistesis – 10,III osteochondrosis -13.

All patients accepted standard treatment and additional target treatment: electrophoresis with papaverin 1%, massage of cervical zone, laser therapy on cervical zone. All patients underwent standard ophthalmological examination and additionall ultrasound dopplerography of a. ophthalmica and vertebral before and after treatment, analysis of index of peripheral resistance, and papillary responses.

The main purpose is to study the traditional treatment of the Kyrgyz people in the late XIX - early XX centuries. In the epic “Manas” it is clearly reflected the people’s surgery. Traditional bone setters carried out various operations on the open fractures, sprains, imposed “plaster”. In the epic “Manas” it is referred to such folk instruments as’ shak-shak “,” Ashtar “,” tintүүr “,” shimshүүr “.

In spite of the modern high-tech medicine, important and significant are the moral values in the behavior of the doctor.