Vol. 5 No. 5 (2022): VESTNIK of KSMA

Abstract. The frequency of kidney disease depends on prevention measures that prevent acute kidney injury, screening to identify risk groups. We have identified morbidity trends contributing to the development of chronic kidney disease and mortality based on data from the State Statistics Committee of Azerbaijan and the Republican Clinical Urological Hospital named after Academician M. Javad-zade. An analysis of the total incidence of the population of Azerbaijan showed its decrease in 2018 compared to 2014 by 1.9%. Diseases of the circulatory organs occupied - V, genitourinary system - VIII, endocrine system - XIII in 2014, XII rank - from 2015 to 2018. An analysis of the total mortality rate of the Azerbaijani population showed a decrease of 1.4% (visibility indicator - 98.6%). Diseases of the circulatory organs took first place, diseases of the genitourinary system - IX in 2014. 2016 and 2017, X in 2015 and VIII in 2018, diseases of the endocrine system - VIII in 2015, VII in 2016, VI in 2017 and 2018. The trend of an increase in the incidence of the genitourinary system was observed only in 2016 by + 9.4%. An increase in the circulation rate of patients with urolithiasis, bladder and prostate diseases was revealed. The outcome of chronic kidney disease in most cases is diseases of the circulatory, genitourinary and endocrine systems. Therefore, it is necessary to identify risk factors at the primary level of medical services and an interdisciplinary approach of doctors of various specialties. 

Abstract. The problem of prehospital care for victims with vascular trauma was studied based on the analysis of 246 case histories of victims with vascular trauma operated in the districts by vascular surgeons of the Osh Interregional Joint Clinical Hospital for 2011- 2020. It was found out that 97.2% of the victims did not receive any assistance before the arrival of a medical worker or their delivery to a medical institution. 320 citizens from various strata of the population and the city of Osh and the Osh region were surveyed. It was found out that the absolute majority of the population will not master the knowledge and skills of first aid, and most importantly, they believe that providing first aid in case of injury is not their civic duty, it should be carried out exclusively by emergency medical personnel or other medical workers. Organizational and tactical proposals are given to improve the results of pre-hospital care for victims.

Abstract. The characteristics of therapeutic and diagnostic measures for vascular trauma in primary and secondary healthcare organizations are given based on the analysis of diagnosis and treatment of 574 patients with vascular trauma treated in the vascular department of the Osh Interregional Joint Clinical Hospital and the departments of surgery and traumatology of the Osh City Clinical Hospital for the period 2011-2020. The scope and nature of providing assistance to victims with vascular trauma at the place of injury, in primary and secondary health care facilities have been clarified. It was revealed that the absolute majority of victims are not provided with the full volume of first aid at the place of injury, and therefore there is a need to teach a wide segment of the population the rules of first aid. The tactics of diagnosis and treatment of vascular injury in secondary health care hospitals have been developed, it is also indicated that it is necessary to develop a clinical protocol for providing assistance to victims with vascular injury at all stages of the medical service.

Abstract. The article presents modern classifications of fractures of the trochanteric region of the proximal femur. The values of classification of injuries for the successful implementation of the activities of a traumatologist-orthopedist in accordance with the professional standard are shown. A modern classification system for trochanteric fracturesto describe fracture patterns should be simple, reliable, easily reproducible, and clinically useful for determining further patient management. Possession of modern classifications of fractures is the basis for choosing an adequate tactics for treating fractures, choosing orthopedic implants depending on the type of fractures and predicting the consequences of damage.

Abstract. This article presents an analysis of the primary incidence of malignant neoplasms of the cervix over time, the ranking of mortality to 1 year by region from 2013 to 2021 according to the Center for Electronic Health of the Ministry of Health of the Kyrgyz Republic. Significantly high rates of primary incidence of malignant neoplasms of the cervix with a positive increase in the republic in 2015 (17,8±0,70/0000), 2018 (15,3±0,60/0000) and 2021 (12,8±0,60/0000) have been established, by year an increase was mainly detected in the Naryn, Jalal-Abad, Talas regions and Bishkek. The largest number of cases of deaths up to 1 year from malignant neoplasms of the cervix occurred in the Jalal-Abad, Osh, Chui and Issyk-Kul regions by year. Despite the smaller female population in the Issyk-Kul region, deaths from cervical cancer occupy leading places in rank. This is due to the late circulation of the population, low availability of cancer care in the regions. This is due to the late circulation of the population, low availability of cancer care in the regions. Reducing the increase in morbidity, mortality in the first year from cervical cancer is possible by increasing the literacy of the population about the symptoms and measures to prevent the disease, as well as by increasing the oncological alertness of doctors at the primary health level.

Abstract. The article presents the results of a study of the blood and fascicular zone of the adrenal cortex of the corpses of persons who died from mechanical asphyxia (hanging) -suicidal death. It was found that cortisol in the blood serum ranged from 200 to 1200 nmol/l, which indicates an increased content of the hormone cortisol. A morphological study revealed the loading of adrenocorticocytes located in the fascicular zone with lipids. With an increase in blood supply to the fascicular zone, the degree of saturation with lipids decreases. There is a blurring of boundaries between the zones, especially between the beam and reticular zones.

Abstract. The article provides an analysis of the frequency and structure of cases of violent death according to the data of the Republican Center for Emergencies of the Ministry of Health of the Kyrgyz Republic. It was found that out of 3956 examined corpses for 2019-2021. as a result of violent death, 855 people died. The largest number of cases of violent death is observed in 2021 and amounted to 345 cases (22.9%), then in 2019 - 323 cases (22.3%), in 2020 - 187 cases (18.6%). Among the dead, the largest number (83.2%) of deaths occurs among men. This figure is especially high in 2021 - 287 cases (83.2%). Of the total number of victims of violent death, the overwhelming majority were males - 686 (80.3%), and females 169 (19.7%). The analysis showed that the greatest number of deaths occurs among people of young and working age from 21 to 61 years (67.1%). It was also found that during this period, most often deaths were accompanied by signs of mechanical asphyxia - 274 cases (32.1%).

Abstract. In order to identify the peculiarities of the formation of injuries in cyclists in the conditions of collisions of moving bicycles with each other and with stationary obstacles, the authors analyzed the results of the conclusions of forensic medical examinations, in relation to cyclists who have suffered various degrees of injury with these types of bicycle injuries. The cyclists were males aged 46 to 81 years, did not have a helmet and other protective equipment, and were in seasonal clothing. It has been established that the diagnosis of injuries in cyclists affected by collisions of moving bicycles with each other can be based on the nature and localization of the structure of the head, taking into account the peculiarities of skin damage. In the conditions of collisions of moving bicycles with stationary vehicles, cyclists may experience damage to the skin in the form of multiple abrasions and bruises in the head, face and limbs, as well as severe fractures of the bones of the forearms and lower ribs. At the same time, there may be no damage to the structure of the head, lower limbs or internal organs, which are more often observed in other types of bicycle injuries.

Abstract. The article presents the results of monitoring and assessing the state of prison health care during the COVID-19 pandemic in order to prevent the decline of COVID-19 cases. The monitoring was carried out in penitentiary institutions (IVS, pre-trial detention center, correctional colony and educational colony for male minors). The monitoring and evaluation methodology was based on interviewing persons held in these institutions and interviewing representatives of these institutions.
The main prison health problems are:
­ -low personnel potential;
­- insufficient funding for penitentiary health care;
­ -insufficient development of the system of continuous medical education, advanced training;
­ -insufficient organization of the quality system of medical care;
­- low material and technical base and level of medical equipment;
­ -irrational use of budgetary funds without providing a calculation of needs and an analysis of strategic directions;
­- lack of a system of interdepartmental interaction.

Abstract. A retrospective comparative analysis of commission forensic medical examinations on professional offenses of medical workers for 2019-2020 found that in 2019-2020, out of 184 commission examinations conducted, 73 cases related to the professional activities of obstetrician-gynecologists and 37 cases to surgeons. There is a tendency to increase the number of examinations in relation to orthopedic traumatologists, oculists, resuscitators. Among the accused were a urologist, a cardiologist, a neurosurgeon, a proctologist and a laboratory assistant.

Abstract. The article contains a report on morphological changes in regional lymph nodes of the lungs in case of lethal outcomes from Covid-19. The criteria for inclusion in the study group were 25 cases of death from CoVID-19 in the hospital setting, confirmed by PCR. The objects of the study were peribronchial lymph nodes subjected to histotreatment and morphological examination by hematoxylin and eosin staining. It was found that lymphocytes, plasma cells, macrophage cells, deposits of fibrin and fibrin-like masses, erythrocyte sludge and thrombi in vessels prevailed in the cellular composition of lymph nodes. The changes are also characteristic of exudative and proliferative phases of changes in the lungs during death from CoVID-19.

Abstract. The article presents the data of a retrospective study of children with acquired aplastic anemia who were on inpatient examination and treatment in the Department of Hematology of the National Center for Maternal and Child Health for the period 2015-2022. The analysis of the medical history was carried out, which included the data of anamnesis, objective examination, clinical, laboratory and instrumental research methods.

Abstract. Alport syndrome (AS) or hereditary nephritis is a hereditary disease, which is most characterized by kidney damage caused by abnormalities of the α3, α4 or α5 chains in type IV collagen. Boys suffer from this hereditary pathology more often than girls. AS is more severe in males, up to a condition requiring kidney transplantation. This article describes the prevalence of this genetic disease, modern classification, and also presents 2 clinical cases of AS, in a boy and a girl from the same family.

Abstract. Pathological jaundice in newborns is the leading cause of neonatal morbidity and mortality. The purpose of our study was to identify and rank risk factors and clinical and laboratory features of the course of prolonged neonatal pathological jaundice in premature infants. The object of the study were newborns with pathological hyperbilirubinemia: premature newborns (198 children) and full-term newborns (205 children). The severity of the condition was assessed by the level of indirect hyperbilirubinemia, clinical manifestations and assessments on the Kramer, AVPU and Glasgow scales. It has been established that there are many evidently significant risk factors for the development of prolonged neonatal pathological hyperbilirubinemia, more pronounced in premature infants. Premature infants have an atypical clinical picture, a more severe prolonged course with high indirect hyperbilirubinemia (p<0.05).

Abstract. This article presents the results of the study of 139 newborn children who were on artificial lung ventilation (ALV) carried out on the basis of neonatology intensive care unit of the State Children's Clinical Hospital of Bishkek. The original modified method (patent KR №2227 dd 30.10.2020) of sterile taking of tracheal aspirate by vacuum collection without taking the endotracheal tube, traumatization and anesthesia is presented and the obtained data are discussed in comparison with taking tracheal aspirate by the traditional method. To prevent ventilator-associated pneumonia in newborns, irrigation of the oral and nasal mucosa with 0.05% chlorhexidine aqueous solution is suggested.

Abstract. The article highlights the factors determining the high risk of death in children with CHD. Heart failure with subsequent development of multiple organ failure was the most frequent cause of severe clinical condition and lethal outcome in patients with congenital heart disease.

Abstract. This article presents the results of a retrospective study of the efficacy and safety of rituximab in 48 children with SLE. Rituximab was administered to patients with a highly active course of the disease with renal and CNS damage, as well as in case of a resistant or relapsing course, the presence of signs of corticosteroid toxicity. The dose of administered drug was 375 mg/m2 weekly, not more than 500 mg per infusion (2-4 infusions) with repeated courses every 6-12 months, depending on the degree of disease activity, the severity of B-cell depletion, the level of hypoimmunoglobulinemia IgG. Rituximab has been shown to treat children with systemic lupus erythematosus more effectively and safely.

Abstract. The article presents data from a study of children with erosive-ulcerative and functional lesions of the digestive system in children for the presence of small intestinal bacterial overgrowth (SIBO)syndrome. It was revealed that SIBO in children with various diseases of the gastrointestinal tract was found in 29%. Of these, SIBO was in 9.61% of patients with functional disorders of the gastrointestinal tract and in 19.23% of children with erosive and ulcerative lesions of the gastrointestinal tract.

Abstract. This article discusses the results of a retrospective study of the medical records of 68 children aged 1 month to 3 years hospitalized in the City Children's Clinical Emergency Hospital (CCEMH) of Bishkek from 2017 to 2018 with the diagnosis: acute bronchiolitis (AB) and acute obstructive bronchitis (OAB). It is noted that despite the frequency of bronchiolitis in patients of the first year of life (68%), severe forms of the disease were also registered in children aged 1-3 years (23.8%). Patients older than 2 years reliably more often had an infection in a moderate form (p<0.05), with less severe bronchial obstruction and absence of respiratory failure in 66.6% of cases. In 70.5% (n=48) of examined patients mild form of SBS was diagnosed, in 29.5% (n=20) - severe form. Chest x-ray of the chest organs revealed OB and CPB in 86.7% of cases. In 57.3% (n=39) of patients with moderate and severe forms of SLE a significant increase in leukocyte count and sedimentation rate was detected.

Absrtact. An analysis of the clinical and epidemiological features of enteroviral exanthema in children was carried out on the basis of the Republican Clinical Infectious Diseases Hospital of the Kyrgyz Republic. The criteria for the severity of the disease were determined, and the features of the diagnosis of enterovirus infection using rapid tests were presented.