Journal of Clinical Medicine of Kazakhstan

J Clin Med Kaz 2017; 1(43):11-14 doi:10.23950/1812-2892-JCMK-00388

Authors: Aliya Konysbekova

Chronic hepatitis D- severe and rapidly progressing form of viral hepatitis, leading to the liver cirrhosis in 70% of cases within 5-10 years. HDV RNA replicates only in the presence of viral hepatitis B. Introduction to the calendar of immunization vaccination in the Republic of Kazakhstan led to a reduction in the incidence of hepatitis B is almost 40 times. However, despite the ongoing effective measures, the amount of detectable virus mixed in with the delta agent is increased and is now at a global map of Kazakhstan refers to medium-endemic countries. Against the background of rapid progress in the treatment of hepatitis C, hepatitis B treatment of existing schemes in the delta agent ineffective, allowing HDV considered as one of the most virulent and dangerous hepatotropic virus.

J Clin Med Kaz 2017; 1(43):20-23 doi:10.23950/1812-2892-JCMK-00427

Authors: Tuba Tülay Koca, Filiz Özdemir, Rabia Baykara

Aim: Fibromyalgia syndrome (FS) is characterized with diffuse pain and sensitivity at specifc anatomical points and occurs together with mood, sleep and cognitive disorders. Life quality of the patients was destroyed and this situation creates an important economical issue in the medical care system. According to different antigens placed on the surface of red blood cells, there are four different blood type groups such as A, B, O and AB. To give nutritional recommendations for different blood types became one of the most popular topics in last decades. In this study, we investigated the link between FS and ABO blood types. Methods: In this study, we included 200 female patients with FS diagnosis (according to American College of Rheumatology, 2010 criteria) who visited our Physical Medicine and Rehabilitation Clinic between July 2015 and December 2015. The patients’ age, blood group, Rh antigen system were saved. Control group was also formed from 185 volunteer healthy female patients. P<0.05 was evaluated as statistically signifcant. Results: In our study, age distribution of FS group (N=200) was 40.6±10.8 and for control group (N=185), it was 43.0±14.8. In the control group, 58 people was A type (%31,4), 29 people was B type (%15.7), 23 people was AB type (%12.4) and 75 people (40.5%) was O type blood group according to ABO classifcation system. In the FS group, 60 people was A type (%30), 21 people was B type (%10.5), 10 people was AB type (%5) and 109 people (54.5%) was O type blood group according to ABO classifcation system. In both groups, a statistically signifcant difference was observed (p=0.03). There were more O type blood group carrying patients were detected in FS group. Conclusion: Most of the treatments used for FS are not effective. In order to decrease oxidative stress, weight management, nutritional condition, diet and nutrition supplement are important in these patients. To see more O type carrying people in FS group will guide us for etiopathogenesis, monitoring, clinical follow and treatment.

J Clin Med Kaz 2017; 1(43):30-33 doi:10.23950/1812-2892-JCMK-00383

Authors: Mariya Prilutskaya, Sergey Molchanov

Aim of research: assessment of needs in improvement of clinical competences on the topic of novel psychoactive substances (NPS) among specialists of narcological branch. Methods: cross-sectional study is conducted by means of questionnaire survey of 84 specialists from 3 narcological institutions. Results: Persons, who have problems with usage of NPS were represented in common structure of patients, who are suffering from substance addictions with frequency of 9,3%. Considering the regular curation of this patients’ group the low level of clinical competences of the third part of respondents is noted on the topic of NPS. Also, incompetent level of knowledge is detected regarding main classes of NPS. Half of respondents (54,8%) are aware of group of synthetic cannabinoids only. Lacked opportunities of education, rare usage of specialized literature, reported by respondents are combined with high demand on new education programs, which include usage of modern information and communication technology: distance education, system of electronic notifcation and information by means of newsletters and letters for private e-mail. Conclusions: topicality of improvement of competences on topic of NPS is marked, main content of educational programs is determined; forms of continuous information regarding clinical management of cases of NPS abuse are defned.

J Clin Med Kaz 2017; 1(43):42-47 doi:10.23950/1812-2892-JCMK-00376

Authors: Anar Kystaubayeva, Gulyash Tanysheva, Yuliya Semenova, Ion Bologan, Zhanar Kaliyeva, Meruert Sharipova

Aim: To evaluate the effects of body mass index on fundal height charts. Methods: Design: Cross-sectional study. The study complies with the principles of the Helsinki Declaration. Approved by the Ethics Committee of The Semey State Medical University protocol No.2 of 14.11.2014. Study was conducted in Semey and in the region within January-December, 2014. We identifed 2387 cases of uncomplicated pregnancy ended in childbirth of full-term fetus in cephalic presentation, with a weight between 2,500 and 4,000 grams. Depending on the body mass index, the cases were divided into 3 groups. The frst group included pregnant women with a body mass index of less than 18.5. The second group included cases with body mass index of 18.5-24.9 while the third group included pregnant women with an index greater than 24, which corresponds to overweight and obesity. Statistical analysis was performed with SPSS package, version 20. We used descriptive statistics and nonparametric tests for unpaired samples (Kruskal Wallis and Mann-Whitney). Results: Statistically signifcant differences were identifed between the average fundal height indexes in all stages of gestation (p = 0.001), except for 22 weeks (p = 0347) and 28 weeks (p = 0.14). Pairwise comparisons with MannWhitney test between “defcit weight – normal weight” and “defcit weight – overweight, obesity” and “normal weight – overweight, obesity” groups showed no statistically signifcant difference in fundal height of pregnant women with underweight and normal weight at pregnancy terms of 24, 25, 34, and 35 weeks. At 26 and 31 weeks of pregnancy there were no statistically signifcant difference in pregnant women with normal weight and overweight. In other cases, the differences between study groups in fundal height were statistically signifcant. Conclusions: Body mass index is a variable that affects the character of fundal height curve. To enable high-quality antenatal carem we need to use the curves tailored to anthropometric indicators.

J Clin Med Kaz 2017; 1(43):56-58 doi:10.23950/1812-2892-JCMK-00372

Authors: Akylbek Tusupkaliyev, Svetlana Tuitebayeva, Abai Nurken, Zhanargul Eshimbayeva, Leila Sarsembayeva

Hysteromyoma is one of the most common gynecological disease that occupies an important place among the pathologies of the reproductive system. One of the main objectives of conservative surgery is to preserve the reproductive function. Long-term consequences of the removal of myoma needs to be assessed in relation to pregnancy and childbirth. In classic case complications of uterine rupture disruption is internal bleeding and antenatal fetal death. We found a uterine rupture during pregnancy after laparoscopic myomectomy scar accompanied by bleeding and impaired fetal life. Description of the case, we would like to note to the possibility of uterine rupture disruption during pregnancy in women after conservative myomectomy by laparoscopic access, more careful outpatient observation and individual approach to the issue of the timing of delivery.