Herald of Almaty State Institute of Advanced Medical Education

6-13

Authors: Trusheva K.S., Toktarbayeva A.A., Baybolova M.K., Aytkulov M.S.

THE DATA ON THE POSSIBILITY OF ELECTRICAL CARDIOVERSION IN PATIENTS WITH ATRIAL FIBRILLATION. IN THIS ARTICLE THE POROKSIZMALNOY OF ATRIAL FIBRILLATION AS WELL AS EFFICIENCY AND FEATURE NON-DRUG TREATMENT OF ATRIAL FIBRILLATION. THE AMERICAN ASSOCIATION OF CARDIOLOGISTS, THE COMMITTEE OF EXPERTS ON THE TREATMENT OF PATIENTS WITH ATRIAL FIBRILLATION, RECOMMENDS THE CLASSIFICATION OF ATRIAL FIBRILLATION IN THREE MODELS: PAROXYSMAL ATRIAL FIBRILLATION, PERMANENT ATRIAL FIBRILLATION, PERMANENT ATRIAL FIBRILLATION, WHICH PERSISTS FOR ONE YEAR. DIFFERENT MODELS OF ATRIAL FIBRILLATION REQUIRE DIFFERENT TREATMENT TACTICS.ELECTRICAL CARDIOVERSION IS AN ELECTRIC DISCHARGE WITH DIRECT CURRENT, SYNCHRONIZED WITH THE ACTIVITY OF THE HEART. THE RISK OF ELECTRICAL CARDIOVERSION IS LOWER THAN THE RISK OF MEDICAL CARDIOVERSION. SURGICAL METHODS IN THE TREATMENT OF AF ARE NOT OFTEN USED. SUCH AS, OPERATIONS OF SURGICAL ISOLATION OF THE ATRIA. PACING IS SHOWN IN BRADY AND TACHY-BRADY FORMS OF AF (IE SSSU AND WITH AV BLOCKADES). THE LAST 20 YEARS CAN BE CALLED AN ELECTROPHYSIOLOGICAL PERIOD IN CLINICAL ARRHYTHMOLOGY. RADIOFREQUENCY CATHETER DESTRUCTION (ABLATION) - THE EXCITATION IS INTERRUPTED BY A "VICIOUS CIRCLE". THE METHOD DOES NOT DIFFER FROM THE "LABYRINTH" METHOD, BUT IT IS MORE ACCESSIBLE, THEREFORE IT IS GIVEN PREFERENCE IN RECENT YEARS. INTERVENTIONAL METHODS IN THE TREATMENT OF AF (TRANSVENOUS CATHETER RADIOFREQUENCY ABLATION) ARE NOW FINDING MORE AND MORE SUPPORTERS. THIS PROCEDURE IS HIGHLY EFFECTIVE, BUT IT IS VERY COMPLICATED TECHNICALLY AND LABORIOUSLY.

22-28

Authors: Satubaldyeva A.D., Bazagazukuzu G., Nasurbekova D.K.

ARTERIAL HYPERTENSION IS ONE OF THE MOST COMMON DISEASES AMONG THE ELDERLY. RISE IN BLOOD PRESSURE AT ANY AGE, ESPECIALLY IN THE ELDERLY TARGET ORGANISMS HEART, BRAIN, HEART, BLOOD VESSELS, KIDNEYS AND BODY DAMAGE IS A RISK FACTOR. THE MAJORITY OF PATIENTS WITH ARTERIAL HYPERTENSION KARD?OMEGAL?YA, BRAIN CIRCULATORY DISORDERS, COMPLICATIONS SUCH AS KIDNEY FAILURE DEVELOPS. 74 FROM 65 ARTERIAL HYPERTENSION CARDIOVASCULAR DEATH AMONG MEN BETWEEN THE AGES OF 4 TIMES, 2 TIMES HIGHER AMONG WOMEN. HYPERTENSION IN THE ELDERLY, A PANEL OF LEADING ACADEMIC PHYSICIANS COMPREHENSIVELY REVIEWS ALL ASPECTS OF THIS PROBLEM USING THE MOST CURRENT CLINICAL DATA. THEREFORE, THESE PATIENTS REQUIRE SPECIAL KNOWLEDGE AND TAKING INTO ACCOUNT ADDITIONAL DISEASES, DRUG THERAPY SHOULD BE VERY CAREFUL. THIS ARTICLE FEATURES A VARIETY OF HYPERTENSION IN OLDER AGE. HYPERTENSION IN THE ELDERLY AND THOSE SPECIFIC DIAGNOSIS, TREATMENT AND COMPLICATIONS SHOULD BE FOCUSING ON THE MOST.

33-37

Authors: Shakirov S.S., Mambetov Zh. S., Kolesnishenko I. V.

In this article it is considered an echomorphological verification of changes in a prostate gland at patients with chronic prostatitis at ultrasonography. The purpose of work was the comparative research and studying of ultrasonic parameters of a prostate gland at patients with various clinical forms of chronic prostatitis. Examination is conducted to 360 patients of able-bodied and reproductive age, suffering from infiltrative and proliferative, kongestivny, kalkulezny forms of chronic prostatitis. It is revealed that depending on localization an echo -pathological process in a prostate gland various clinical symptoms are revealed. At localization of concrements in a periuretralny zone dizurichesky frustration, in the central area - an anogenitalny syndrome, in a peripheral zone - a syndrome of pelvic pain prevailed, at the mixed pathology clinical symptoms were polymorphic. The overwhelming nature of sexual violations took place at all forms of chronic prostatitis and was characterized by frustration of a potentiality in the form of fear of failures of sexual intercourse, weakness of an erection and an orgasm that in 76% of cases caused psychostressful reaction of the sexual partner to sexual intercourse. And, even for men of 20-40 years it was expressed by psychomotor reaction of the sexual partner that fixed an oppressed depression of the patient before sexual intercourse. We consider that it is clinically expedient to consider ultrasonic signs taking into account the working classification of chronic prostatitises developed in clinic to which infiltrative and proliferative, stagnant changes and existence of kaltsinat in a prostate gland parenchyma are peculiar, for the purpose of more exact an echo - morphological verification of pathological process in a prostate gland. Timely ultrasonic diagnostics taking into account clinical forms of a disease as the main low-invasive method of a research gains the medical and social importance in view of decline in quality of life because of sexual frustration and stressful reactions from men. Ultrasonography gives essential help in identification of pathological changes in a prostate gland and in dynamic control of the carried-out conservative treatment at chronic prostatitises.

47-52

Authors: Baymuratova M.A., Tyessova-Berdalina R.A., Abdusalamova Z.S., Zhakanova G.A., Ibraimova A.A.

The purpose of our research was studying of a specific variety of microflora mucous vaginas of pregnant women and women after the delivery. Object of a research were smears with mucous the cervical channel. The research was conducted by well-known techniques, we also studied an antibiotikogramma, the list 6 the disks taken in hand entered: drugs of half-yen group and also drugs of azolum group. The analysis of our three-year researches taped that the leading role of an etiopatogenum of a candidosis infection belongs C.albicans - 58,8 % as originators of urogenital infections in both categories surveyed (among pregnant women, women after the delivery) that allows to think of current situation of high risk of disturbance of genesial health of women in general. And also allowed to draw conclusions that use of a mycologic method in SOP (Standard of the operational procedure), allows to standardize microbiological researches among pregnant women and women after the delivery, providing thereby the early diagnostics referred on well-timed correction and conservation of health of women. Studying of etiological structure of a candidosis infection allowed to tap the leading gynecologic strain of Candida albicans. It is necessary to notice that clinical isolates of yeast-like mushrooms of the sort Candida spp. concerning half-yen group (Nistatinum and Amphotericinum) of antimicotic drugs showed the high level of sensitivity to Nistatinum of 97,8% and Amphotericinum In 90,1 %. At the same time for practical health care very important observation is the sensitivity found by us to Clotrimazolum in 75,8 % (n=69), a ketakenazol - 50,5 % (n=46) which will allow clinicians to use these drugs in obstetrical institutions, without ignoring, obligatory statement of an antimikotikogramma concerning originators of a candidosis infection among women of genesial age.

58-65

Authors: Kusainova F.A., Zhusupova N.S., Nurumbetova Zh.Zh., Alyeva Zh.S., Davletbayeva A.P.

THE ARTICLE PRESENTS THE RESULTS OF HYSTOLOGIC INVESTIGATION OF ENDOMETRIUM EVACUATED AND REMOVAL OF FOCI OF HYPERPLASIA AND AIMING REMOVAL UNDER HYSTEROSCOPIC CONTROL FROM 55 WOMEN AGED 22-57 (AVERAGE 39.5), FOR THE PERIOD FROM JANUARY 2015 TO SEPTEMBER 2015 BASES OF OPERATIVE GYNECOLOGY IRM.WHEN CARRYING OUT ULTRASOUND IN ALL PATIENTS WERE FOUND TO HAVE SONOGRAPHIC SIGNS OF ENDOMETRIAL HYPERPLASTIC PROCESSES. DIFFUSE ENDOMETRIAL HYPERPLASIA - 31 (56,3 %), FOCAL ENDOMETRIAL HYPERPLASIA - 20 (36,3), POLOVIP HYPERPLASIA - 2 (3.6 PERCENT).HAVING IDENTIFIED HYSTEROSCOPIC RESEARCH OF ENDOMETRIAL HYPERPLASTIC PROCESSES IT WAS COMPARE WITH HISTOLOGICAL FINDING: CHRONIC ENDOMETRITIS - 3 (5,4 %), FOCAL ENDOMETRIAL HYPERPLASIA WITH CHRONIC ENDOMETRITIS - 5 (9,09%), DIFFUSE ENDOMETRIAL HYPERPLASIA WITH CHRONIC ENDOMETRITIS - 14 (25,45%), GLANDS POLIP ENDOMETRIAL HYPERPLASIA WITH CHRONIC ENDOMETRITIS - 14 (16,36%), SIMPLE ENDOMETRIAL HYPERPLASTIC - 10(18,18%), COMPLICATED WITH ATYPICAL ENDOMETRIAL HYPERPLASTIC - 1 (1,8%), FIBROSIS POLIP ENDOMETRIAL HYPERPLASTIC WITH CHRONIC ENDOMETRITIS - 2 (12,7%). ON THE BASIS OF THE DATA OBTAINED FROM HYSTEROSCOPIC RESEARCH WITH HISTOLOGICAL RESULTS NOT CONFIRMED 3,85%, WERE CONFIRMED 96,1 %.

72-76

Authors: Tulebaeva A, Mullen A., Sharipova M.

INVOLVEMENT IN THE PATHOLOGICAL PROCESS OF THE CARDIOVASCULAR SYSTEM IS DESCRIBED FOR ALL TYPES OF MPS.TO CONDUCT A STUDY OF THE AORTIC ROOT IN CHILDREN WITH MPS TYPESL, II, IVA AND VI.TRANSTHORACIC ECHOCARDIOGRAPHY ASSESSMENT OF THE MORPHOLOGY OF THE HEART AND GREAT ARTERIES.RESULTS:AMONG THE CHILDREN WE OBSERVED, THERE WERE 8 CHILDREN WITH MPS I TYPE (25 %), 14 BOYS WITH MPS TYPE II (43.7 %), 4 CHILDREN WITH MPS TYPE IVA (12.5 %) AND 6 CHILDREN WITH MPS TYPE VI (18.7 %). ACCORDING TO THE DATA OF THE ECHOCARDIOGRAM, THE MEAN VALUE OF THE AORTIC ROOT WAS 16.7±6.4 MM. THE SIGNIFICANT DILATION OF THE AORTIC VALVE (Z-SCORE 3.0 AND 3.6) AND ESPECIALLY THE VALSALVA SINUS (Z-SCORE 3.2 AND 4.3) IS A SPECIFIC FEATURE IN BOTH CLINICAL CASES. WITH A CAREFUL EXAMINATION OF THE SINUS VALSALVA MORPHOLOGY IN THE FIRST PATIENT, WE FOUND AN ANEURYSM OF THE RIGHT CORONARY SINUS, WHICH IS A RARE CONGENITAL PATHOLOGY. IN THE SECOND PATIENT, THE SINUS OF VALSALVA WAS SIGNIFICANTLY ENLARGED, BUT WITHOUT AN ANEURYSMAL COMPONENT. MILD AORTIC REGURGITATION WITH DOPPLER ECHOCARDIOGRAPHY (PHT 720 MSEC) WAS REGISTERED IN-PATIENT M. IN-PATIENT P., REGURGITATION WAS MODERATE, WHICH WAS INDICATED BY THE PHT INDEX OF 460 MSEC. IN ADDITION, THE PEAK PRESSURE GRADIENT ON THE AORTIC VALVE WAS 27.8 MM HG, INDICATING A MILD STENOTIC COMPONENT. WE NOTE A LOW INCIDENCE OF AORTIC ROOT DAMAGE IN CHILDREN WITH MPS IN THE REPUBLIC OF KAZAKHSTAN. HOWEVER, IT IS NECESSARY TO TAKE INTO ACCOUNT THE INTERNATIONAL EXPERIENCE OF MAINTAINING THIS CATEGORY OF PATIENTS AND THE EXTREME UNPREDICTABILITY OF THE COURSE OF AN ANEURYSM OF THE SINUS OF VALSALVA IN CONDITIONS OF ACCUMULATION DISEASE.

83-85

Authors: Aksakalova S.K.

IN THE COMPLEX REHABILITATION IN A SPECIAL CATEGORY OF PATIENTS, THE USE OF PHYSICAL THERAPY AND SPA TREATMENTS IN CERTAIN SCHEMES COMBINATIONS ALLOWED TO DETERMINE THE EFFECTIVENESS OF THIS TECHNIQUE. IMPLEMENTATION CERTAIN COMBINATIONS OF ELECTROTHERAPY IN CONJUNCTION WITH WATER PROCEDURES IN PATIENTS IN THE PRESENCE OF THE MAIN AND CONCOMITANT DISEASES WITH A POSITIVE BOTTOM LINE.

96-99

Authors: Smailova F.K., Berdygul M., Tashaev AA., Bekbatyrov S., Egemberdy A., Kaltai N., Sultan A., Tanashkyzy A.

THE ARTICLE INCLUDES THE METHODS OF INTERNSHIP TRAINING IN INTERNAL DISEASES, WHICH FORMS AND CONSOLIDATES THEORETICAL KNOWLEDGE, PRACTICAL SKILLS AND INTERESTS IN MAKING RESEARCHES OF INTERNS. THE INNOVATIONAL METHODS ARE DIRECTED TO COMPETENCE-ORIENTED EDUCATION OF INTERNS-THERAPISTS, AND ACCORDING TO THE STUDENTS CONSIDERATION THOSE METHODS GIVE DEEPER COMPREHENSION IN ABSORPTION STUDYING MATERIALS. THIS IS VERY IMPORTANTE FOR MEDICAL SPECIALISTS, WHO ARE REQUIRED TO IMPROVE THEIR PROFESSIONAL LEVEL IN ACCORDANCE WITH MODERN TECHNOLOGIES AND INNOVATIONS.