Journal of Clinical Medicine of Kazakhstan

J Clin Med Kaz 2016; 2(40):6-13 doi:10.23950/1812-2892-2016-2-6-13

Authors: Nailya Sheveleva, Larissa Minbayeva

The article provides literature review that reflect a modern view on the problem of articular pathology treatment and rehabilitation. Step-by-step osteoarthritis management schemes, published in the leading recommendations (NICE, OARSI, HKOA) are presented. The results of modern clinical trials, systematic reviews and meta-analyzes on the use of various methods of physical therapy for joints diseases treatment from the standpoint of evidence-based medicine are analyzed. Etiopathogenetic and clinical substantiation for inclusion of physiotherapy measures in rehabilitation programs were given to help maximizing the impact on all links of the pathological process chain. The use of different methods and techniques of physical therapy for osteoarthritis is currently debated, because of the contradictory literature data. Low level of evidence does not allow including physical therapy in the leading guidelines of osteoarthritis management. The reasons for low level of evidence might be small samples and insufficient degree of randomization in the majority of studies. Different sensitivity of patients to physical therapy and presence of associated diseases necessitate individualization of rehabilitation program that makes further large-scale assessment of impact of the physical factors difficult. However, considering physical therapy infinite possibilities, scientists continue to actively explore, constantly improve and implement a lot of new, highly effective methods of physiotherapy in rehabilitation process of osteoarthritis, proving the prospects of this type of conservative therapy.

J Clin Med Kaz 2016; 2(40):22-26 doi:10.23950/1812-2892-2016-2-22-26

Authors: Samat Kozhakhmetov, Almagul Kushugulova, Akbota Kakimova, Talgat Nurgozhin, Zhaksybay Zhumadilov

Statins widely used in clinical practice in decreasing the level of lipids in blood plasma. Difference of response for therapy may be associated with structural changes in genes of metabolism of drugs. Main polymorphisms of genes of metabolism which impact on effectiveness and security of rosuvastatin are studied in review.

J Clin Med Kaz 2016; 2(40):31-35 doi:10.23950/1812-2892-10.23950/1812-2892-2016-2-31-35

Authors: Yevgen Lisovskyy, Kenzhe Kussainova

Research objective was the evaluation of effectiveness of the dynamic proprioceptive correction in complex rehabilitation of patients with Children Cerebral Palsy. Methods. The results of diagnostics and treatment of 80 patients at age from 4 to 7 years with Children’s Cerebral Palsy, diplegical form, level of severity II-IV according to GMFCS, were analyzed. 55 children of study group were treated with complex rehabilitation program included dynamic proprioceptive correction; 25 children of control group were treated with standard complex rehabilitation program. The state of muscular tone were estimate in patient of both groups according to Ashworth scale, dynamics of motor function according to GMFCS with calculation program GMAE, indicators of bioelectrical brain activity with computer complex Nihon-Kohden EEG-1100К. Results. The analysis of our date demonstrates that patients treated with rehabilitation program included dynamic proprioceptive correction have statistically significant advantage over patients of control group in the gaining of new motor skills. Investigation of EEG-indicators shows that the correction of pathological afferentation makes activate influence on the brain cortex and decrease pathological influence of subcortical and thalamus structures on the cortical electrogenesis. Conclusions. The data of conducted investigation confirm the effectiveness of the method of dynamic proprioceptive correction in the treating of patients with Children Cerebral Palsy.

J Clin Med Kaz 2016; 2(40): 43-49 doi:10.23950/1812-2892-2016-2-43-49

Authors: Galiya Orazova, Leonid Karp, Gulnar Rakhimbekova, Anargul Nogayeva

Objective. Create a mathematical model and forecast esophageal and stomach cancer case rate in Kazakhstan up to the year 2020. Methods: It is retrospective, descriptive-analytical study. Primary information sources during performance of this work were indicators of oncological service of the Republic of Kazakhstan for 1990-2014. Forecasting on the level of esophageal and stomach cancer case rate was performed through the development of time-series model and their extrapolation. The length of the forecast period was identified by the length of actual data series. Total forecast in the country up to the year 2020 was made on the basis of data for 1990-2014. Unfortunately, due to the insufficiency of data in archives, we failed to obtain the required volume of data across the country regions for the specified period. Comparatively short regional database, which covers the period from 1999 to 2014, allowed to extrapolate the obtained models for 2-3 years in advance, in our case - up to 2017. Considering the dynamics peculiarities of esophageal and stomach cancer case rate among the country population, the most relevant method for forecasting is the logarithmic function. Results. According to the results of forecasting, there was some tendency to the growth of esophageal and stomach cancer case rate among the population of Akmola (from 8,900/0000 to 9,650/0000), Almaty (from 5,740/0000 to 6,130/0000) and Kostanay (from 9,450/0000 to 10,590/0000) regions. Based on the forecast of stomach cancer case rate in Zhambyl region, there is a possibility of the growth from 15,00/0000 to 16,00/0000 till the year 2017. In all other regions there was a common tendency to stabilization and decrease in stomach cancer case rate. Nationwide, there is a tendency to the decrease in esophageal cancer (7,90/0000) and stomach cancer (17,00/0000) case rate to the year 2020. Conclusion. In connection with the identification of esophageal and stomach cancer case rate growth in a certain regions of Kazakhstan during mathematical forecasting, there is a viability of further investigations on the detailed study of possible cause and effect relationships of this phenomenon.

J Clin Med Kaz 2016; 2(40):57-59 doi:10.23950/1812-2892-2016-2-57-59

Authors: Akzhunus Orekeshova, Oral Ospanov

The purpose of the study: to evaluate the efficacy of laparoscopic greater curvature gastric plication in the treatment of type 2 diabetes. Methods. The study involved 32 patients suffering from type 2 diabetes and obesity on average 6.87 ± 1.9 years. Results. Participants in a year lost an average weight of 25 kg. Fasting glucose levels dropped significantly within six months after the operation, which correlates with the trend in the weight loss during this period. The average HbA1c for the cohort gradually decreased during the study period from 9.8% to 5.6%. Much of this change occurred during the first six months. Diabetes Remission was achieved in 92% of patients. In patients with remission, hypoglycemic agents were canceled after 4-22 weeks after surgery. Conclusions. Laparoscopic greater curvature gastric plication lowest altering the physiology of the gastrointestinal tract, lowers blood glucose levels in patients suffering from type 2 diabetes and obesity.