Herald of Almaty State Institute of Advanced Medical Education

17-21

Authors: Ahmetova L.M.

This article presents a brief history of bronchial asthma, statistical data on the incidence in different countries, particularly bronchial asthma in children population of Almaty. Elucidated and the main factors of the above nosology. Statistical data on the incidence, prevalence and epidemiology of the disease, provide an analysis of the incidence of asthma among children in Almaty (0-14) and find out the main factors that influence the occurrence of this disease in allergic diseases of high incidence structure identified in Almaty. Over the past 5 years in Kazakhstan has been an increase in patients with bronchial asthma by 18.9%. Treatment of asthma in the Republic of Kazakhstan is conducted in accordance with international recommendations and national RC programs. Patients with bronchial asthma in the Republic of Kazakhstan in accordance with the order of Ministry of Health of the Republic of Kazakhstan № 786 of 04.11. 2011, amended in 2012 by order of the Ministry of Health of the Republic of Kazakhstan №347 from 18.05.2012 of the year, provided the necessary drugs. Bronchial asthma is an urgent problem in the service of Pediatrics. In most cases of asthmaasthma, effects persist for many years. The most severe forms of asthma significantly affect the quality of life of the patient and his family. About 15-20% of cases hereinafter tends to the formation of chronic obstructive pulmonary disease and subsequent disability. There is a high increase in asthma, especially among children. Today, in developed countries, the disease becomes an epidemic. According to WHO, in the world suffer from asthma around 300 million people. According to official statistics in the Republic of Kazakhstan for the past 5 years, the first place on the prevalence of diseases of the respiratory organs, which include diseases such as pneumonia, chronic bronchitis and unspecified emphysema, bronchial asthma. Of particular importance in all consensus documents in the management of patients with allergic diseases is attached to prevention system. Under the prevention of asthma is understood as a warning of disease occurrence (primary prevention) and prevention of relapse in those who already suffer from asthma (secondary prevention).

28-31

Authors: Ahan R.A., Umeshow A.

Relevance of a problem of strokes of a brain at children of early age gains extreme sharpness in connection with the increasing frequency of developing of this pathology, a suspense of many questions of diagnostics and treatment. Sharp violations of brain blood circulation on hemorrhagic type is a prerogative only of people of advanced age, but the statistics notes considerable rejuvenation of this pathological state and increase in its cases at children of early age. In this paper - levels of prevalence of a hemorrhagic stroke, the main mechanisms of pathogenesis, feature of a clinical current and outcomes of a stroke at children of early age of Almaty are studied. The analysis with use of medical documentation of the Center of children's emergency medical service in made.

38-46

Authors: Lepessova M.M., Ushakova T.S., Myrzaliyeva B.D.

Spinal muscular amyotrophy type 1 (SMA), Werdnig-Hoffmann infantile spinal amyotrophy) is inherited in an autosomal - recessive manner. Responsible for the development of the disease genes are localized in the region of chromosome 5q12.2-q13.3. There are 4 gene in this zone, damage of which causes the development of the disease or determines its severity. The most common SMN gene mutation, a deletion introduced in the 7th or 8th exon in the homozygous state. SMA type 1 is one of many diseases, causing the symptom «floppy baby». «Gold standard» diagnosis of SMA is a genetic method. Genetic diagnosis is to determine the deletion of exons 7 and / or 8 SMN1 gene. Among the methods used electrophysiological methods such as needle electromyography. Children with this disorder may keep their head, but never turn over or sit. The first in the pathological process involved the proximal muscles of the lower extremities, the process has spread upward. SMA type 1 must be differentiated from other diseases that cause a syndrome «floppy baby»: structural myopathies, neonatal myasthenia gravis, metabolic myopathy, storage disorders, atonic form of cerebral palsy, Marfan syndrome. This article provides a brief overview on the topic. Discussion on the clinical case of a child with genetically unconfirmed diagnosis of spinal muscular amyotrophy, but with the presence of characteristic clinical picture and pathognomonic for the SMA results of additional methods. During examination of the child was carried out differential diagnosis of SMA type 1 with other diseases that give similar clinical picture.

53-56

Authors: Lepessova M.M., Fedyanina Y.A., Akhmetova D.A.

Difficulties in the diagnosis of tuberous sclerosis complex associated with the polymorphism of clinical manifestations specific to this disease. We presented the article on the example of clinical case raised an important question about the diagnostic criteria for tuberous sclerosis complex, required for correct clinical diagnosis, and modern views on the subject. We present the definition of new data on the mechanisms of pathogenesis of tuberous sclerosis and major mutations in genes TSC1 and the TSC2, localized in the chromosomes 9 and 16, respectively, underlying the disease. Dysfunction of genes TSC1 and TSC2 leads to morphological changes of neurons and neurotransmitter disorders, which are also described in the article. We also examined the functions of proteins and hamartintuberin, as part of the natural antitumor systems. Here are described the controversial issues of the reliability criteria of tuberous sclerosis complex given the variety of clinical manifestations. It is noted that the classical triad of signs in the form of seizures, mental retardation, and «adenoma sebaceum», is today considered obsolete. It was revealed that diagnosis of epilepsy, mental retardation and autism should not be exhibited as major diagnosis and related diagnosis. For clarity, the clinical signs of tuberous sclerosis complex presented in the form of a table. There was presented clinical case of the patient Т., five-year-old boy with a diagnosis of tuberous sclerosis complex. There was displayed the data history, somatic and neurological status, indicating the considered nosology. It was carried out a genetic screening and identified family history of tuberous sclerosis in the family. This article contains information instrumental methods (electroencephalography, echocardiography, computed tomography and magnetic resonance imaging of the brain). It has been clearly presented morphological changes in the brain in the form of cortical Tuber on the example of magnetic resonance imaging, patient T. In conclusion, summarizes the clinical and diagnostic criteria to establish a definite diagnosis of tuberous sclerosis.

61-63

Authors: Rakhimbekova D.K., Duisen A.T.

In the article presented the dynamic of the main indicators of the polyclinic help organization on the example of one policlinic in the conditions of stage-by-stage realization of the Republic of Kazakhstan state programs in the health protection field.

69-72

Authors: Aknazarov A.S., Amidova M.B., Dusekova T.P., Kononbayeva S.N., Rashitova N.A., Sultanova A.K., Hamzina A.N., Amankulova Z.S.

The aim of the article is to reveal the most significant risk factors that lead to suicidal thinking in children. The objects of study are the pupils of the school number 30 in Almaty. One of the first aims of the work were create questionnaires for children in two age categories, together with the school psychologist. During the development of the questionnaires reviewed and processed for a better understanding of each question for the child, but at the same time excluded those that some way could hint at the main essence of this article. Age category of pupils divided into 5-8 and 9-11 according to the education system. Key words: suicides, suicidalbehavior.

78-83

Authors: Khussainova K.N.

In this article results of introduction of the new, progressive technologies reducing environmental pollution are brightly shown. On the oil and gas field studied by us introduction of new, nature protection technologies, such as "A super green torch", progressive technology for collecting excess gas, methanol regeneration installation, the compressor of gases of aeration, system of intra-field pipelines, the return pumping excess and sour gases has begun. Also data of monitoring researches of quality of atmospheric air are provided in article. By the conducted researches it is established that the periods of increase of pollution of the air basin of settlements, adjacent to the field, have two peaks which are connected with an intensification of production of hydrocarbonic raw materials. However these negative ecological moments significantly differ. In 1990. in connection with sharp increase in production of hydrocarbonic raw materials, and also low efficiency of gas-cleaning device, air pollution has considerably increased. And the second period was characterized by slight increase of concentration of dioxide of nitrogen only in two next settlements, and concentration of other chemicals, in the atmosphere of the studied settlements didn't exceed limits of the corresponding sanitary standards, despite essential increase in volume of extraction of gas condensate any more. Results of studying of incidence of local population are given in article. In general true incidence of the population of the region of inspection in 1995 in comparison with 1991 has increased by 1,31 times. In 1998 there was a decrease in the general incidence of the population by 1,1 times in comparison with 1995. In 2002 on some classes there was an incidence lowering of the level. Results of the comparative analysis of incidence of the population of the region studied by us give the chance to come to a conclusion that decrease in concentration of the polluting substances for the studied period, can lead to decrease in indicators of incidence on some classes, for example - respiratory organs, eyes and its appendages, and also skin and hypodermic

92-95

Authors: Mahambetova G.T., Shaimardanova R.R.

The given article discusses the importance of teaching Professional English within the framework of postgraduate medical continuing education. Language competency is an essential element of profile training of high-qualified specialists. Methods and materials of the investigation are an interview, sociological observation of 97 undergraduates and residents of Kazakh Medical University of continuing education. Most residents and undergraduates see a practical necessity of learning English and treat it seriously. However, the majority of them have difficulties in learning Professional English, as there are some reasons of objective and subjective character: the lack of time and a low level of basic knowledge of the language.