Vol. 1 No. 1 (2019): VESTNIK of KSMA

The paper presents the results of a psychological survey of pupils of the 10 graden of the lyceum at the Kyrgyz State Medical Academy named after. IK Akhunbaev. 80 people at the age of 16-17 were examined. To determine the level of situational and personal anxiety of students, the self-rating scale of anxiety by Spielberg, Yu.L. Khanin (1983) was used. This test is a reliable and informative way to assess the level of anxiety. As a result of the psychological studies conducted of the 10th grade respondents was dis­covered, that girls reactive anxiety indicators are comparatively dominant, whereas the pa­rameters of moderate personal anxiety in 53% of young men and 28% of girls, which indicates high personal activity of young men. At the end of the school year, 5% of girls found low personal anxiety, moderate - in 48% of boys and 20% of girls, high - in 52% of boys and 75%
of girls. High personal anxiety was found in 52% of young men and 75% of girls. Based on the psychological studies conducted, it was found that the girls have relatively high rates of anxiety. This may be due to the adaptation process, the training load and the individual char­acteristics of the girls.

The analysis of drug supply with narcotic analgesics of oncological patients for the purpose of relieving chromic pain syndrome on the terminal stage of the disease at the outpatient level is carried out in the article. Concern of incurable cancer patients with narcotic analgesics in the Kyrgyz Republic averaged 0.25 %, of the reasons for this indicator is the low physical and economic accessibility to this group of drugs.

A market study of the drugs used in the treatment of gastric ulcer and duodenal ulcer in the Kyrgyz Republic was conducted, which results showed that there are 285 drugs on the pharmaceutical market of the republic. A segmentation of the pharmaceutical market of products of this group by manufacturer, composition, and dosage forms was carried out. The main indicators and development trends of the pharmaceutical range of drugs used in gastric ulcer and duodenal ulcer are established.

Considering the increase in the number of patients with DM 2, high mortality from CVD, the lack of active preventive measures to identify diabetes mellitus and its risk factor, the study of the characteristics of the risk of developing diabetes mellitus among the indigenous people of the high mountainous region of Kyrgyzstan is justified. The peculiarities of the 10-year risk of diabetes 2 among the indigenous people of the high-altitude Aksai of the Naryn region of Kyrgyzstan are: the prevalence of irregular intake of vegetables and fruits, abdominal obesity, a sedentary lifestyle and BMI, regardless of gender.The moderate and high risks of stratification of the 10-year risk of developing DM 2 are also due to the irregular intake of vegetables and fruits, overweight and obesity, a sedentary lifestyle; although among the surveyed prevails the proportion of low risk.

The article is devoted to the analysis of current literature data on the study of the features of the course of coronary heart disease in type 2 diabetes mellitus in the elderly. The literature data shows prevalence and growth of the number of elderly persons, features of diabetes mellitus (DM) type 2 and coronary heart disease (CHD) in the elderly, prevalence and mortality from CHD in type 2 diabetes are given. Large randomized research on the study of the features of clinical and functional manifestations of CHD in type 2 diabetes in the elderly have not been found.

Resume: Studies have shown significant effectiveness of the integrated drug treatment  with Kyrgyz traditional massage to nerve and the electro-acupuncture therapy in which the rehabilitation period decreased in 2 times.

Summary: The article presents an assessment of the use of simulation technologies on the example of training using automatic external defibrillators from clinical residents of KSMIRandIQ, general practitioners, nursing staff.

Aim: a comparative analysis of the effectiveness of the use of a sample with a recombinant tuberculosis allergen (ATP) and a Mantoux test with 2 TE in a mass screening for tuberculosis in children of primary school age in Bishkek. Materials and methods: A comparative analysis of immunological diagnostic methods was carried out: Mantoux tests with 2 TE and ATP tests in 1873 children aged 7-10 years.
Results: The obtained data showed that the number of positively responding to the Mantoux test with 2 TE was 31.6%, and when placing the sample with ATP - 12.3% of cases. In 9 children with suspected active tuberculosis of the intrathoracic lymph nodes, a local process was excluded in 6 (0.3%). Along with the breakdown of the ATP, he performed a CT scan of the chest organs. If, according to the Mantoux test with 2 TE, 243 (13%) children should have been under observation, then carrying out the ATP sample reduced the number of children to be monitored to 95 (5%) people (P = 0.000).
Conclusion: The results of the study among children of primary school age (7-10 years old) suggests that the ATP test eliminates false positive results and shows true infection. A sample with ATP can be recommended for the differential diagnosis of post-vaccination and infectious allergies and used as an additional test when registering for monitoring and conducting preventive treatment of latent tuberculosis infection (LTBI). 

Summary: This article presents clinical observation and experience in the treatment of anaerobic non-clostridial infection of the upper and lower extremities, lateral surfaces of the chest and abdomen complicated by sepsis.The anatomical localization of anaerobic phlegmon and the route of spread of the infection in anatomical cases in 17 patients was studied. In 12 patients, an infected wound of the upper limb, in 1 lower limb, and in 4th patients acute paraproctitis complicated by anaerobic phlegmon. All patients were urgently operated and surgical treatment of anaerobic non clostridial phlegmon was performed.

Summary: goal- is to evaluate the results of treatment of pleuropulmonary complications after liver resection for alveloar echinococcosis. 84 patients were operated with alveolar echinococcosis of liver: radical operations were performed in 58 and palliative in 26. In the postoperative period, pleuritis was detected in 23 (27.3%). There was no mortality.

Resume: the Aim of the study was to determine the frequency of postoperative complications of emergency abdominal surgery and submit the effectiveness of measures to prevent them. There are results in two groups of patients: the first - 93 operated in which, preventive measures included antibiotics, their intramuscular or intravenous administration, complications were 20.4%. The Second group of 105 patients with the use of prophylaxis measures: the preoperative administration of antibiotics, the moment of operations- irrigation of the abdominal cavity and the surgical wound ozonized solution of sodium chloride with ozone concentration of 8-10 ^gk/ml or 0.02% solution of dekasan, reducing the time of application retractors and use of infrared laser radiation after surgery on the area of the wound (5-6 sessions). In this group, complications after operations were 9.7%.

Summary: today, the issues of diagnosis, treatment of thyroid nodules remain topical. The study included 80 patients with various nodules who underwent operative treatment methods. The most informative and necessary in the diagnosis and differential diagnosis of thyroid nodules is ultrasound and fine needle aspiration biopsy. The effectiveness of the latter is reduced in case of multinodular lesions.

Summary: aim - to assess prophylactic measures for complications in patients with gallstone disease. Operated 76 patients with mechanical jaundice on the basis of gallstone disease. For the prophylaxis of complications in 8 patients used percutaneous cholangiostoma, in 4 - endoscopic papillosphincterotomy. External drainage performed in 47 and in 29 performed internal drainage. At postoperation period performed regional lymphostimaulation by ligamentum teres of the liver. Complications were in 6 (7.9%), mortality 1 (1.3%). 

Resume. The paper presents an analysis of the experience of treating 50 patients with intraarticular fractures of the proximal tibial bone using various methods of ostheosynthesis. The analysis showed the best option for ostheosynthesis of intraarticular fractures of the proximal tibia using counter-compression screws on the external plate.

Summary. 146 patients with lateral femur fractures (type A) in the period from 2013 to 2017, patients are divided into three groups: 1 osteosynthesis with an external plate with spongy screws (n-56). 11 - dynamic femoral screw (DHS) (n-45). III hemiarthroplasty of the hip joint - one and bipolar hemiprosthesis (n-45). In group I, good results were obtained in 20 (35.8%) patients, satisfactory results were observed in 30 (53.6%) cases, but in 6 (10.8%) cases we received unsatisfactory results.   In group II, good results were obtained in 23 (51.1%) patients, satisfactory results were observed in 20 (44.4%) cases and in 2 (4.4%) cases we received unsatisfactory results. In group III (n-45), unsatisfactory results were not possible, but satisfactoiy results were obtained in 26 (57.8%) cases and good results were observed in 19 (42.2%) patients.

In this article, we conducted a brief review of the current literature on the treatment of fractures of the proximal femur in the Kyrgyz Republic over the past 20 years.

Resume. This article presents an analysis of the survey of students of the 4th year of the dental faculty, through anonymous questionnaires, about training in simulation classes. On the need to practice practical skills in the classroom using simulators and phantoms, as this is a modern requirement for the level of training of a dentist.

Summary. In 2017, a number of legislative and regulatory documents were adopted, among which the Criminal Procedure Code of the Kyrgyz Republic, in which individual chapters and articles are devoted to the organization of the purpose and production of examinations, the concepts of terms of expertise, expert opinion, etc., defender’s rights are defined, in particular the possibility of assigning examinations on a contractual basis by applying to the investigating judge, the rights of the participants in the process (victims, suspects and other persons), and very importantly, the rights of experts to defense at the State level. At the same time, the sub-paragraphs of individual articles raise questions that need to be specified.

Summary: This article notes the achievements and successes of the department of phthisiology, dedicated to the 80th anniversary of the Kyrgyz State Medical Academy named after I.K. Akhunbaev.