Herald of Almaty State Institute of Advanced Medical Education

6-15

Authors: Nurakhmedova I.S., Nurbekova A.A.

General diabetic complications are diabetic retinopathy, nephropathy, and peripheral neuropathy patients. In addition to this, patients often may have another complication - the autonomic nervous system. In particular - cardiac autonomic neuropathy. This complication is caused by metabolic disorders in the sinus node and nerves that regulate the work of the heart and the tone of the bloodvessels. Fundamental factors in the development of cardiac autonomic neuropathy are chronic hyperglycemia and variability of glycemia. In order to identify this complication, five Ewing cardiovascular tests are used. Besides, the disturbance of the sinus node is indicated by changes in the variability of the heart rate according to the daily monitoring of the ECG. Often cardiac autonomic neuropathy remains undiagnosed, although the presence of this complication is prognostically unfavorable and associated with a high risk of death.

21-25

Authors: Berdiyarova G.S., Anockhina S.G., Abentaeva B.A., Dzhumabekov T.A.

The article introduces the results of critical conditions monitoring in the neonatal period. The analysis of the critical children cards at the age from 0 to 28 days of life with a body weight of 1500 gr and more, located in the NICU for the Republic, for 2017. Have been identified the main nosological structures, statistical analysis has been carried out between the number of newborns with a weight of 1500 grams and more for the given period. Revealed accompanying and background pathologies and average timing of the transmission of children according to the critical report. The nosological structure on the first place are states of the perinatal period. Congenital malformations ranked second place, then congenital heart disease, which does not correspond to data on the structure of infant mortality, where the congenital heart disease is larger. The infectious diseases in newborns, including intrauterine infections of unclear etiology, tend to grow and are in third place. The high incidence of intrauterine growth retardation is 40% of cases, it is an unfavorable indicator of maternal health. Monitoring of critical conditions allows timely response to problems in remote regions related to the provision of medical care to newborns: problems in the transportation of a newborn, diagnosis (lack of equipment or specialist, limited range of laboratory studies), therapy (lack of medicines, resuscitation equipment, narrow specialists) its timely and full-fledged submission of necessary information indicating the existing problems. If, according to the critical report, the newborn continues to remain in the critical ranks for 3 days, then the appropriate measures for the provision of medical care should be taken by higher-level hierarchies and by the principle of regionalization: tele-consultations, transfer the newborn at the appropriate levels of regionalization, which will improve the situation morbidity and mortality. Reserves to reduce the mortality of newborns is the resolution of issues of staffing and equipment, improving the quality of prenatal screenings and prenatal consultations in the regions.

31-37

Authors: Aliev M.A., Zhaylaubayeva A.S., Mustafinov D.B., Karavayev V.S., Aglakov B.M., Suleymanova G.E.

Intraoperative neuromonitoring represents an opportunity to observe the state of the the nervous system structures during surgical intervention and to define, reduce and prevent neurological deficits prior to the surgery. Intraoperative neuromonitoring remains important, as the surgeon has no neuronavigation information during the operation to remove tumors/ Moreover, constantly changing structures can reduce the quality of the manipulations performed. Therefore, the neurophysiologist who also participates during the operations on the spinal cord "co-work" with the neurosurgeon closely in order to establish the physiological limits of resection, to prevent mechanical damage to the spinal cord and its ganglia: overstretch, rupture, trauma, detection of damage to the vessels in proper time and thereby preventing potential iatrogenic lesions. 41 operations were performed using Nim Eclipse intraoperative neuromonitoring by Medtronic at the Almaty City Clinical Hospital No. 7, This article describes neuromonitoring methods and good results confirming an obtained effectiveness. A total intravenous anesthesia without myorelaxants was performed according to the international standards of anesthesiologists. A close interaction of neurophysiologists, neurosurgeons, anesthesiologists is required in order to improve postoperative results and reduce the risks of neurologic lesions:

43-46

Authors: Sinyavsky Y. A., Berdygaliyev A. B.

Objective: to assess cognitive or emotional disorders using questionnaires accepted in clinical practice for 100 employees of a lead processing enterprise. Methods: Cognitive or emotional impairment was assessed using the Montreal Cognitive Assessment Scale (MoCA) developed for rapid screening of cognitive impairment in the adult population. The survey was conducted with information consent (in Kazakh and Russian) for an interview. Brief description of the work and the results of the work: As a result of the conducted studies, it was found that 30.1% of employees of enterprises located in the Almaty and Karaganda regions had various psychological and emotional disorders, the reasons for which needed to be studied in more detail, identifying the main hematological indicators and lead content in blood serum. All identified violations require the provision of nutritional support among employees to increase the resistance of their bodies to the unfavorable factor of the working environment.

51-55

Authors: Dosmatova K.R., Temirbayev M.A., Mansurov Z.A., Daulbaev CH.B.

Today, it is important to search for various biocompatible materials of organic origin for using them in medical purposes. Development of such materials actively develops and solves many problems in the field of medicine: Materials for endoprostheses in traumatology and orthopedics, filling materials in dentistry, implants in maxillofacial surgery, medical and cosmetic means in cosmetology and pharmacology. An important direction is the creation of biomaterials based on hydroxyapatite to replace damaged bone tissue, since hydroxyapatite is the main inorganic component of bone and dental tissue in humans and animals. The use of chemically synthesized nanocrystalline hydroxyapatite opens up wide opportunities in case of various tissue defects of bones, as it helps rapid reparative regeneration of the surrounding tissue. This study is devoted to the improvement of existing osteoplastic materials and to a comparative analysis of domestic nanocrystalline hydroxyapatite and its analogues of various origin.

67-75

Authors: Shamsutdinova A.G., Turdalieva B.S., Beltenova A.G., Shalabekova M.T., Kudaibergenova Т.А.

themselves. The calculation of mortality-to-incidence index expands the possibilities for analysis. This index is an indirect indicator for the quality of oncological care, including early diagnosis of diseases, i.e. screening programs. Using the GLOBOCAN 2012 data on incidence and mortality of breast, cervical and prostate cancers, we calculated the r mortality- to-incidence index for a number of countries with different economic development. Ranked incidence and mortality of these cancer types were taken from Global Burden of Cancer 2013. Screening data were extrapolated from various sources of the PubMed database by key words and tabulated for further analysis of the impact of reproductive cancer screening in countries with different income level. The analysis confirmed that in countries where population-based screening is used, the mortality-to-incidence index is low. In Kazakhstan, incidence and mortality of breast, cervical and prostate cancers are in global trend but ranking is closer to developing countries than to the developed ones. The mortality-to-incidence index for breast, cervical and prostate cancers is high Kazakhstan.