Vol. 1 No. 1(1) (2015): VESTNIK of KSMA

The analysis of the existing system of the organization of postdegree education of doctors of primary medical care in Ukraine is carried out. Ways and the priority directions of a state policy of support of health care to branch in general and increases of prestige of profession of the doctor of family medicine in particular are designated.

This article discussed the main health and social issues on the organization and modernization of hemophilic service in the country, ranging from the relevance of the disease, methods of diagnosis, treatment, and to carry out rehabilitation activities aimed at improving the quality of life and skilled care for patients with hemophilia. Also noted that for a full understanding of the problems associated with hemophilia, you can interact with other hematologist’s narrow professionals - dentists, surgeons, physiotherapists, orthopedic traumatology, psychologists, and social workers. Also requires the support of modern politics and the public health.

This article presents an analysis of the current state of the provision of orthodontic care to the population in the conditions of medical institutions of private ownership. Also presents data on the prevalence of dental anomalies, as well as the latest technology in the treatment of pathologies of abnormalities of dentition. In a comparative perspective shows data about the technical equipment of state and private clinics with special tools to work with no removable and removable orthodontic appliances.

This article presents an analysis of the effectiveness of the transition state dental clinics on the level of automated medical information systems and their prospects. Marked the path of improvement and development of the national dental health an example of this model informatization. For comparison provides an analysis of the CIS countries in the transition to the level of information technology.

Сlinical approach to the treatment of neurological patients nowadays (subject lecture)

Within the framework of the realization of the national project «Health» it was carried out the investigation of spreading IHD and risk factors of its development in 418 women arid 522 men, working population of Khanty- Mansiysk at the age 20-59. There are detected gender differences in lipid metabolism abnormalities among the residents of Khanty-Mansiysk, decrease of XC LPBN 53,6% was the characterictic for women, for men 46,7%. The increase of the indice TR/LPBP was registered in 8,53% patients, more often in women than in men (11,1% against 7,1% correspondingly p<0,01). The spreading of IHD in women according to strict criteria was 12%, in men 3,9%, IHD was observed in women 3 times more often than in men, and category of possible IHD prevailed 2.3 times more often in women, in comparison with men.

The content of heavy metals in soils and sediments sampled in the area of Haidarkan mercury plant (Kyrgyzstan) was studied in this paper. The average levels of Pb, Cd, Cu, Cr, As, Zn, Ni and Hg in soils and sediments of the study area exceeded their translocational MPC from 1,3 to 41,0 times. Total pollution index of the soil of the study area is 1083 relative units. The territory along of the Osh-Batken road near Haidarkan mercury plant is classified as extremely dangerous and cannot be used by people for agricultural and other purposes.

In work the issue of features of epidemic process of the virus hepatitises B (HB). Measurement of incidence and assessment of risk factors in development of an epidemic situation is carried out. Ways of decrease and approach in the organization and carrying out preventive actions on the basis of the international recommendations are offered.

Presented data of scientific literature shows a significant impact of medical and social factors on general and reproductive health of migrant women. There are negative trends in the health state of this group of female population. All this requires a complex and dynamic assessment of reproductive health of women in this category by using international criteria and standards with the aim of developing measures of preservation.

There were carried out screaming ECG and echocardiography investigation and USI of thyroid gland in 2 teenagers of both sex living in Khanty-Mansiysk at the age 14 years. Investigation was simultaneously conducted. Investigation result showed that spreading of rhythm and cardial conduction disturbance in children at the age of 14 of the population of Khanty-Mansiysk was 19,9%. Cardiac arrhythmia is marked more often in boys in comparison with girls of the same age. It defected that frequency of non-specific changes of S-T segment and final part of ventricular complex (code 5-2) according to Minnesota code (codes 4-2) was 3,9% according to strict criteria and non strict criteria (codes 4-3. 5-3)-2,7.
Category of non-specific changes S-T segment and final part of ventricular complex in teenagers was marked 4,5 time more often in boys than in girls, the frequency was considerably 10,6-2,3%. Predictors of rhythmic and cardiac conduction disturbance in teenagers without organic cardiac pathologies are, PMK, LHLZH, thickening of MZHP or ZSZH> 9 and 10 men, increase of ZP sizes>30 mm. In teenagers with cardiac rate disturbances there are focal and diffuse changes of thyroid gland, and it is necessary to take into consideration while making up plan of examination of teenagers with cardiac rate disturbances. High spreading of heart arrhythmia and myocardial hypertrophy of right and left ventricular in children population of Khanty-Mansiysk requires special epidemiological studies and additional investigation methods (Halter ECJ veloergometry and other) and working out therapeutic and rehabilitation measures.

Results of the study on the commitment to and effectiveness of HIV antiretroviral therapy in women and children in Kyrgyz Republic are presented. Out of 1283 women with HIV, only every fourth woman (25.4%) and every other (56.9%) child with HIV received antiretroviral therapy.

The analysis of the literary data of 54 children sick of a chicken pox is carried out. Clinical-epidemiological features of a clinical course at children in different age groups are revealed. Mikst-infections of a chicken pox with other diseases are described. Complications of a chicken pox and their influence on a current of the basic disease are presented. The basic methods of treatment of a chicken pox at children are considered.

The review of the studies devoted to study of the clinical particularities of the acute viral hepatitis «А» in children at the last is presented. Features of diagnostics ВГА, currents of heavy forms and outcomes of the verified hepatitis «A» at children are not studied enough. Reasons of formation of the prolonged duration are not studied completely.

Postoperative infectious complications after endoprothesis of knee jointare developed in 1/5-2/5% of cases from the general number of all operations on substitution of joints of different localization but according to its course it represents the states treated with great difficulty and requires maximal strength and forces of orthopedics and also the specialist in surgical infection field and clinical pharmacologist in mobilization of all possible methods of conservative treatment to maintain endoprothesis. In majorty of cases there is figt not for maintanceofendoprothesis but for the life of patients. That is why in same caes it is necessary to remove constructions. This review represents the results of som microbial investigations and prevention of endoprothesiscomplicacion.

The paper presents a tactics of surgical treatment for complex intra-articular fractures of the distal metaepiphysis humerus. There is suggested a new method of osteotomy of the ulnar process, which promotes early activation and rehabilitation of patients in postoperative period. This method of osteotomy was introduced in Bishkek Scientific Research Center of Traumatology and Orthopedics in traumatology departments №1,2,3,4. 27 patients were studied and operated by this methodics . The article also displays a detailed description of the surgical operation and the materials used. Results of the research demonstrate the effectiveness of this method of osteotomy, and is recommended for treatment of patients with fractures of the distal section of humerus.

We were studied dynamic of clinical manifestation and parameters of iron metabolism (hemoglobin, erythrocytes, colour index, reticulocytes, serum iron, serum ferritin) in patients with iron deficiency conditions. Patients, with mild form of iron deficiency anemia, were usedtreningprogramm. Obtained results shows the effectiveness of treningprogrammin iron deficiency condinions.

We analyzed peculiarities of spreading of cancer cervix, in selected three regions of Kazakhstan for during 2009- 2011 years. These regions located in mountain regions (Jambyl, 1200 m. altitude), in plain region (Kostanay, 500 m. altitude) and low-lying region (Atyrau , low 110m. altitude). In the specified areas the volume of the oncological help rather identical were rendered to patients with cancer cervix. Age features of a cancer cervixwith peak of growth of 40-49 years of inhabitants low and flat districts are revealed, and in mountain regions – the age peak is established among persons of 50-59 years. Thus high incidence of a cancer cervixis established in low and flat zones, in comparison with mountain regions of Kazakhstan among Kazakh women and the Russian women. These distinctions are probably caused by a mountain hypoxia which changes depending on accommodation height above sea level, and also demographic factors, etc.

In work the assessment of surgical treatment of 76 patients with nefroptozy and from them 44 by an advanced tech- nique of a nefropeksiya is given, which transferred expeditious treatment in urological offices in Republican scientific center of urology at National hospital of Ministry of Health to the Kyrgyz Republic from 2004 for 2013.For diagnosing of a nefroptoz along with kliniko-laboratory researches were carried out X-ray urological (survey and excretory and costing to urography in a prone position) and ultrasonic Doppler researches of kidneys. The comparative characteristic of methods of a nefropeksiya is carried out. The new way of a nefropeksiya at a nefroptoz which created a reliable effective nefropeksiya is developed and keeps physiological mobility of the operated kidney.

In work results of haemodynamic research of kidneys of 59 patients suffering the nefroptozy are yielded.Patients were examined in Republican scientific center of urology and andrology at National hospital of Ministry of Health of the Kyrgyz Republic from 2008 for 2012. All patient conducted all-clinical, biochemical, ultrasonic Doppler trials of kidneys, X-ray urological inspections (survey and excretory and costing to urography in a prone position). The special attention was paid to ultrasonic Doppler research of kidneys with simultaneous application of the V-mode, color Doppler mapping and the pulse Doppler mode (a method of tripleksny scanning). Doppler sonography of kidney vessels was estimated in the position mode i.e. horizontal, vertical (at rest) and after physical activity (knee-bends of 15 times), also in horizontal and vertical situation.

Retrospective analysis of 249 cases with hypertensive intracerebral hemorrhage, trustworthiness of ICH Score in the prognosis of disease outcome was tested using Glasgow Outcome Scale. Comparative analysis of data showed that increasing marks by ICH Score was correlating with worsening of disease outcome. Also comparative analysis of results of the surgery and conservative treatment methods is conducted. The data showed that patients with 0 point marked by ICH Score should be treated using conservative method, for patients with ICH 1 and 2 points necessary urgent surgery for extracting intracerebral hemorrhage in the early period of the disease.

Within the period of 2010-2013 the BRCTO specialists had carried out an ACLS surgery on 37 patients diagnosed with fresh and old injuries of the anterior cruciate ligament of knee. All these patients underwent an autoplasty of the anterior cruciate ligament of knee using a tendon of the thigh semitendinosus muscle as a plastic transplant material. The results of treatment were evaluated in accordance with the International Knee Documentation Committee (IKDC) requirements.

This article the authors provides an overview and the possibilities of functional endoscopic rhinosinusosurgery (FESS), as well as the possibilities of combined applying with other benign techniques of minimally invasive surgery such as: , laser surgery, electrosurgery, radiowave surgery, ultrasonic surgery, shaver surgery, cold plasma (coblationned), cryosurgery.

The scientific analysis of indicators of prevalence with studying of risk factors of developing of glaucoma among adult population of Ukraine and approaches to the organization of rendering primary medical care to patients with an oftalmogipertenziya is carried out. Expediency of the accounting of modern risk factors of glaucoma in practice of the family doctor at the level of whom measures of prevention and timely detection of glaucoma at primary level of delivery of health care have to be formed is proved.

During the period from 2010 to 2013 at the offices of joint pathology and trauma №1,2,3,4 BNITSTO operated on 42 patients with fractures of the femoral neck. All of these patients underwent bipolar hip arthroplasty. Results of surgical treatment were studied in the period from 6 months to 1 year. To evaluate the results of surgical treatment we used the SDI-1 (standardized assessment of outcomes author: Mironov SP et al. 2008). All patients received good and satisfactory results. Primary bipolar endoprosthesis hip replacement joint is the method of choice when fracture neck and adjacent area of the femur in elderly and senile age.

In this work there was made an analysis of mistakes in the treatment of extremity fractures of 106 patients, great amount of them came from district and regional hospitals. reasons which led to various complications, we devided into three groups: diagnostic, medical treatment and rehabilitation mistakes. each types of these complications are described in this article. It is necessary to mention that osteosynthesis was made by surgeons who had not necessary equipment and appropriate conditions to make traumatologic operations. The principal issues to overcome medical mistakes are identified there.

Analysis of the morbidity of plague in the world, the state of activity of natural focuses of plague in the CIS countries, indicate a high risk of plague disease among the people in the Kyrgyz Republic, which requires urgent measures for epidemiological surveillance of plague in the country.

The article discusses the features of airway management and anesthesia in patients with maxillofacial pathology. Endotracheal general anesthesia provides not only anti-stress protection of the patient during surgery, but also secure the airway. It is very important to the operations in the maxillofacial region in which the airways are often in close proximity to the operating wound. Results of the study revealed that the use of laryngeal mask airway (LMA) for short operations in the maxillofacial region allow for an alternative method to limit the indications for endotracheal general anesthesia method.

To identify the actual benefits and persisting problems in management of vestibular schwannomas by the suboccipital retrosigmoid approach. The results and complications in a consecutive series of 120 tumours surgically treated were analysed and compared with experience involving other treatment modalities.
Methods: Pre-and postoperative clinical statuses were determined, radiological and surgical findings were collected and evaluated a database for 120 patients undergoing 125 vestibular schwannoma operations.
Results: By the suboccipital retrosigmoid approach, 109 tumours were completely removed; in 16 cases, deliberate partial removal was performed either in severely ill patients for decompression of the brain stem or in an attempt to preserve hearing in the last hearing ear. Surgical complications included hematomas in 2.2% of the cases, cerebrospinal fluid fistulas in 9.2%, hydrocephalus in 2.3%, bacterial meningitis in 1.2%, and wound revisions in 1.1 %.
Conclusion: The current treatment options of complete tumour resection with ongoing reduction morbidity are well fulfilled by the suboccipital retrosigmoid approach.

We have analyzed 444 clinical records about patients with cleft lip and palate, for the presence of concomitant diseases of ENT organs. The results were 26 (5.8%) children with otitis. Treatment of inflammatory disorders of the middle ear of children with cleft lip and palate, needs a high attention from parents as well as medical workers’ side during the rehabilitation and treatment. Qualified care of ENT doctor further will help to avoid complications, such as hearing loss and deafness.

An article about the rationale for the use in postoperative surgical patients multimodal approach analgesia. The fact that at equal efficacy of analgesia and the same need for narcotic analgesics after surgery warning opioid analgesia can be either Ketorol or Рaracetamol, depending on whether the patient contraindications to the use of non-steroidal anti-inflammatory drugs.

We studied the efficacy of “Betaleukin” in 82 patients with purulent diseases of the paranasal sinuses by evaluating the functional activity of neutrophil inflammatory focus. Was conducted cytology cell washings maxillary sinuses. Also investigated the functional patency of the upper respiratory tract by rinomanometrii and analyze the dynamics of reducing the volume of fluid in the puncture of maxillary sinuses.

Physico - chemical properties of powdered materials , as medicinal powders have studied their crystallographic structure.
This article presents the results of experiments on the crystallographic characteristics and technological indexes of Jerusalem artichoke powder.

One of the main quality indicators of modern medicinal preparations are biopharmaceutical indicators, i.e. “Dissolving” the test - for solid dosage forms. In this article are given the results of researches on working out the “Dissolving” test for enteric soluble capsules of Diclofenac sodium and paracetamol which have been elaborated in the Tashkent Pharmaceutical Institute. On the results of the conducted researches have been chosen the following conditions of determination the bioavailability of the analyzed capsules by the in vitro method: for determination the dissolving profile are used two dissolving mediums – 0,1 M of hydrochloric acid solution (capsules must not be dissolved during 60 min) and phosphate buffer solution with pH 7,4 (du-ring 45 min must be isolated no more than 75 % of active substances), medium volume – 1000 ml, punnet speed rotation – 100 v/min, temperature – 37±10С.

At the expressed forms of a stenosis shown by expansion of a stomach and infringement of its impellent function, vagotomy in combination with drainage operations is inexpedient. A choice method at treatment of ulcer processes in pyloro-duodenal areas we consider a stomach resection on a way as Bilrot-II or Bilrot-I. As a rule, resect off not less 2/3 stomach.

This article discusses the epidemiology, classification, clinical types, methods of research, diagnosis and results of surgical treatment arteriovenous fistulas. The article about posttraumatic arteriovenous fistulas do not have specific clinical manifestations. Preventive measure of posttraumatic AVF is a thorough revision of the wound with primary surgical treatment. In everyday medical practice endovascular interventions are an important treatment for arteriovenous fistulas.

The article provides a brief summary of the myotonic dystrophy Rossolimo – Kurshmann – Steinert – Batten. Describes a clinical case of a patient, the diagnostic criteria for the disease.

The formal training in doing research is lacking in most of the medical training programs. Incorporation of the “doing research” subject into curricula varies considerably among countries, and also among universities within countries. The very beginning of the postgraduate clinical career is in “internship” or “residency” training; characterized+- by gaining practical knowledge, following clinical guidelines and compliance with the “the best clinical practice” that is a healthcare quality indicator. It was shown that students’ involvement in research during medical school is associated with not only postgraduate research involvement, but more effective medicine practice based on evidence-based medicine.
However, the need for training “how to do research” is frequently either not sufficiently recognized, or there is no adequate/ sufficient space in overloaded under- or postgraduate medical curricula.
It was also an experience in the editorial office of the journals. During the peer-review process, many rejected papers had creative ideas and potentially interesting/ applicable results; however their design did not achieve the requirements for proper academic writing. Recognizing this problem, the Journal of Electrocardiology commenced an initiative of the International Scientific Summer Schools and implemented the interactive method of research training .
We describe in this paper the interactive method on how to prepare project and how to do research and share our experience with implementation of scientific summer school.