Herald of Almaty State Institute of Advanced Medical Education

13-19

Authors: M.D. Sikhimbayev, T.E. Khusainov, A. O. Zatybekov, A.A. Korolkov, D.H. Karamamud-oglu

At the varikotsel long stagnation of a venous blood leads to ischemia, development of sclerous changes in a small egg, disturbance of spermatogenic function and damage of a gematotestikulyarny barrier, these reasons lead to development of male infertility. Operation for treatment to a varikotsela: it considerably to block outflow of blood on a pathological way, to thereby create conditions for forming of new ways of dumping of blood from a small egg. Elimination to a varikotsela, at patients concerning infertility with not obstructive azoospermism, results in positive dynamics in indicators of a spermogram and within the first year approach of spontaneous pregnancy was observed.

32-38

Authors: M.V. Prilutskaya, A.S. Rakisheva, R.S. Kuliev

The main indicator of the effectiveness of the treatment of narcological disorders is patient retention in rehabilitation programs. The emergence of new dependencies on the group of synthetic psychoactive substances justifies the need to assess the treatment attrition in the corresponding category of patients. The aim was to assess the risks of early termination of treatment in patients with dependence on new psychoactive substances. A retrospective assessment was conducted among 1038 patients, among which 80 cases with dependence on new drugs. The socio-demographic characteristics of new psychoactive substances’ consumers are determined: Russian ethnicity, a younger age, and experience in the use of opioids. It was revealed that dependence on new drugs determined a twofold increase in the risk of early termination of the program compared with patients suffering from traditional addiction. The worst retention rates were in patients with a combined dependence on opioids and new drugs. These findings emphasize the need for a detailed study of the psychopathological symptoms of dependence on new psychoactive substances and the development of more effective treatment and diagnostic recommendations.

45-56

Authors: B.T. Kamelzhanova, V.P. Seledtsov, A.Sh. Zetov A.M. Mukatova

The article provides a literature review of studies of sputum, bronhoalveolar lavage and brush biopsy in the diagnosis of respiratory pathology. The research results and the diagnostic significance of each of these methods are provided. All these methods are reflected in clinical protocols, nevertheless, the authors emphasize the need to study these methods in a comparative aspect in order to develop tactics for various respiratory diseases.

62-67

Authors: А.А. Khozhayev, А.К. Dzhakipbaeva, B.K. Kaidarov, N.A. Amanbekov, A.M.Musagulova, Sh.T. Makhsetova

The Kazakh National Medical University of S.D.Asfendiyarov, Almaty, Republic of Kazakhstan. The paper presents modern data on the study of quality of life in cancer patients with advanced forms of malignant tumors using the international questionnaire EORTC QLQ-C15-PAL. According to international standards, the language and cultural adaptation of the EORTC QLQ-C15-PAL questionnaire was carried out taking into account the ethno-linguistic characteristics of the population, the tool was validated and a russian-language version of the EORTC QLQ-C15-PAL questionnaire was created, equivalent to the original. The created version is characterized by high psychometric properties.

74-79

Authors: B.S. Turdaliyeva, F.A. Bagiyarova, B.S. Kassiyeva

The actual medical and social problem in our country and abroad is the use of psychoactive substances among adolescents. This problem is comprehensive, and the best way of solving is on well-coordinated interagency cooperation. The formation of a syndrome of dependence on surfactants inevitably leads to a breakdown in a person’s relationship with a healthy social environment and to a loss of social status. It is also important that the problem of dependence affects not only to the consumers of surfactants themselves, but also their immediate environment, especially the family, whose members form co - dependent behavior.

82-87

Authors: D.A. Son, B.S. Turdaliyeva, G.E. Aimbetova

In the framework of the implementation of the State Program "Digital Kazakhstan" for 2017-2020, the level of digitalization of medicine allows the introduction of IT systems and mobile applications in many hospitals and organizations of primary health care in Kazakhstan. The article describes the most popular mobile applications aimed at maintaining and improving the health of patients. An analysis of mobile applications showed that electronics focuses on certain average values and the use of the obtained data may not help but also harm. Therefore, before you start using certain applications, you should consulting a doctor.

13-18

Authors: Hasanov Z.B., Nurgaliev N.S., Zhylkaidarova A.ZH., Ishkinin E.I.,Fakhradiyev I.R.

Patients who inherit the BRCA2 and BRCA1 pathogenic mutations and have a positive family history are undoubtedly at increased risk of developing aggressive prostate cancer. These facts are clinically important, but there are no specific recommendations on treatment strategies for men at increased risk due to mutations or a positive family history of aggressive prostate cancer. In our review, we analyze the genetic risk factors for prostate cancer and the current impact of screening research. Ongoing and future research will be critical to optimizing prostate cancer screening for men with the highest risk of developing aggressive prostate cancer. In the meantime, we offer a practical approach to screening prostate cancer in patients with a BRCA1 / 2 mutation and / or in patients with a positive family history.

26-30

Authors: Jumabekov B.N., Ismailov Zh.K., Jumabekov A.T., Zhao A.V., Sarsenbayev E.Zh., Fakhradiev I.P.

To date, scientific progress has given the surgeon new tools that are designed to improve the quality of operations and reduce the percentage of complications. Before the era of laparoscopic surgery, there was a limited set of tools for connecting tissues, but then various stapling machines and staplers began to appear. This review was originally conducted in order to find the advantages of a mechanical suture. A systematic review of the literature was performed. The search included published meta-analyzes, randomized clinical trials and comparative studies. Keywords for the initial search were: surgical anastomosis, stapler, manual anastomosis. There were no language limitations. Most of the available articles related to resection of the stomach, colon and rectum. We also found data on the use of manual and mechanical suture during resection of the esophagus. From the literature data it is clear that the imposition of a hardware anastomosis takes less operating time, but also cost more than the imposition of the anastomosis manually. With regard to complications and mortality when using a particular method, stapled anastomoses give similar or better results compared with manual technique. However, proper stapler handling and experience remain critical issues.

36-43

Authors: Parmankulova T.N., Kelimkhanova S.E., Nurmanbetova T.M.

One of the most important sources for the production of domestically produced medicinal plants is medicinal plant materials (MPM). Mandatory conditions for the use of MPM (cultivated and wild) are its compliance with regulatory requirements and proven pharmacological activity. The State Pharmacopoeia (MF RK) in the Republic of Kazakhstan regulates the quality of DHP, agreed with the European Pharmacopoeia (EF), and has its own national requirements for individual medicinal raw materials in individual monographs. In the XII editions of the USSR and the Soviet Union, standardization of raw materials, its quality indicators, control methods, regulation of quantitative indicators, etc., is sometimes provided. Different approaches. These types of raw materials include the bark of butterflies, which has long been used in medicine and has become popular among Kazakhstanis. In accordance with the Concept of development and implementation of DP monographs, mulberry grass in the Ministry of Finance of the Republic of Kazakhstan, the XII edition of the XF edition of the Ministry of Agriculture of the Republic of Kazakhstan belongs to the DTP chain, which is not described in the USSR Ministry of Finance, which is also not in the pharmacopoeia of near and far abroad. Therefore, its study, the development of the national pharmacopoeia article is an urgent problem. At the same time, the global practice of this DHS study must be taken into account. Of course, this is primarily the requirement of the WHO (World Health Organization) Pharmacopoeia [10] and the requirements of the European Pharmacopoeia. Therefore the former state standard was used as the basis for the development of pharmacopoeia articles for bone raspberry of old editions.

51-58

Authors: Issayeva A., Heikkilä J., Ospanova D.

Cardiovascular diseases are the leading cause of death worldwide. Every year the number of patients on the waiting list for open heart surgery is increasing. The socio-economic development of countries depends on the state of health of the population, since cardiovascular pathologies are mainly affected by the most efficient part of population. Due to the high level of requirements for professional, scientific, technical, and organizational support, modern cardiac surgery is the basis of the progress of healthcare. In many developed countries, the lack of medical staff is common. The economic crisis has affected the labor force, led to a pay cut, and a reduction in the number of medical personnel. For this reason, it is important to focus on developing new competencies for nurses in cardiac surgery. The role of nurses can to be expanded, and it is effective from an economic point of view. Many countries are undertaking nursing education reforms through which, nurses are delegated some of the traditional tasks of doctors - to independently carry out manipulations and to make appointments that do not require serious intervention. In medicine, there are functions for which the presence of a doctor has been identified not necessary, one of which is the Registered Nurse First Assistant (RNFA). The RNFA is a perioperative registered nurse who works in collaboration with the surgeon and other health care team members to achieve optimal patient outcomes. This in turn gives the motivation that the nurse will have new functions, career opportunities, and the opportunity to continue his or her scientific career. Also, the data shows that shifting tasks not only leads to equivalent or improving the quality of medical care, but also efficiency from an economic point of view.

65-71

Authors: Abdrazakova G., Hanna Hopia, Ospanova D.

Objective: analysis of literature data on international experience in studying the attitude and expectations of nurses in relation to clinical nursing guidelines Relevance of the topic. Clinical practice guidelines are new quality improvement tools that are designed to maintain quality, minimize costs, and improve medical care. Clinical practice guidelines integrate treatment protocols, patient care plans and relevant medical professionals into a single care plan that clearly defines the patient’s expected progress and results throughout their stay in hospital. Search strategy: an analysis of 20 English language publications from the Cinahl, Google Scholar, PubMed, eLibrary databases for the last 10 years, from January 2008 to December 2018, was conducted. Inclusion criteria: publications that contain a tool for analyzing the state of attitude and expectation of nurses to new clinical nursing guidelines. The following search queries were used for the search: “Nursing guideline”, “Nursery guidelines”, “clinical practice guideline”, “nursing recommendation”, and clinical nursing guideline. Results: the published studies found contained various information about the attitude of nurses in relation to new clinical nursing manuals. This literature review helped describe the attitudes of nurses in relation to clinical nursing guidelines. Evidence-based clinical nursing guidelines will be accepted as a reliable source of patient care guidelines in primary care. Conclusions: Implementation measures improve attitudes towards guidelines and increase the use of guidelines. These interventions also improve familiarity with clinical nursing guides, which will also be associated with the use of clinical nursing guides.

75-85

Authors: Tashenov A.D., Ospanovа D.A., Kozhakhmetov A.N., Guryanov V.A.

The article emphasizes the role of adaptation processes and the functional state of the autonomic nervous system of the body in providing homeokinesis in laparoscopic operations with high stressor properties. It is noted that the failure of homeokinesis and distress develop in the vast majority of patients. Intraoperative circulatory disorders can lead to ischemic-reperfusion complications associated with carboxyperitoneum.

92-96

Authors: Nadyrov K.T., Ospanovа D.A., Nurbakyt A.N., Darmen N.Zh.

This article examines public opinion on the changes taking place in the healthcare system of a megacity, which serves as an additional argument in clarifying the directions and priorities of investment and innovation development programs.

14-25

Authors: Zhetpisbaeva N.K. , Tashenova G.T. , Myrzabekova G.T.

In this article, the research proves that the existing problem of iron deficiency anemia in young children remains relevant and remains a subject of research interest. Studies have been conducted to study the factors of iron deficiency, which are not only medical but also social. The issues of diagnosis and treatment, including different methods of solving the problem. Prevention of iron deficiency anemia includes activities in different periods of development of the child: from intrauterine life of the fetus to the age of 3 years. At the same time, an important role is given to drug therapy, correction of nutrition with iron- containing products and a healthy lifestyle. According to statistics, the share of IDA remains high in the Republic of Kazakhstan. So in 2017, there were only cases of iron deficiency anemia in 1805 per 100 thousand population, and in 2016 – 1812.6. Among children from 0 to 5 years old, who fell ill with IDA in 2016 and 2017, intensive indicators were 73.8 and 72.6 per 1000 children. Almaty takes the 11th place with an indicator of 83.3 per 1000 children from 0 to 5 years, which is higher than the national indicator by 110%. These figures indicate the urgency of the problem of iron deficiency anemia and the need for a detailed study of the prevalence of IDA among young children in Almaty in 2018, which was the basis for this study.

40-48

Authors: Kaidaulov M.K., Turdaliyeva B.S., Aimbetova G.E., Meirmanov S.K.

The article presents an analysis of the results of studies of samples of blood serum of patients by enzyme immunoassay (ELISA) for sexually transmitted infections (STIs), performed in the first half of 2018 in the clinical diagnostic laboratory of the SANA Medical Center. Since sexually transmitted infections belong to the category of socially significant and socially- related diseases and represent one of the most important public health problems. The social significance of STIs is determined by the fact that these diseases lead to a decrease in the labor and reproductive potential of the nation. STIs are among the five major categories of diseases for which adults seek medical care, and can lead to acute symptoms, the development of chronic infections and serious long-term consequences, such as infertility, ectopic pregnancy, cervical cancer and premature death of babies and adults. Since the problem of diagnosing an STI is relevant, it is important to emphasize that the ELISA method is a leader among the methods used for screening studies, and can be successfully used to recognize STIs.

59-69

Authors: Kaidaulov M.K., Turdaliyeva B.S., Aimbetova G.E., Meirmanov S.K.

The availability and quality of medical care largely depend on efficiently organized activities of physicians and nurses. Regulations play a key role in organizing activities of general practitioners and nurses. Therefore, purpose of the study was review of regulatory acts regarding general practitioners and nurse’s activity in order to determine changes or tendency on regulatory acts. As well as analyzed changes in workload of general practitioners and nurses. This study was conducted through reviewing changes and additions in legal acts regulating activities of general practitioners and nurses. Overall, 25 regulatory documentations and scientific publications were analyzed. Sources of legal acts and scientific publications were website www.zakon.kz, Republican Center for Healthcare Development. The results of the study showed that there are many legal acts that govern activities of general practitioners and nurses. During content analysis of legal acts were identified inequality of physicians and nurses. For example, general practitioners belong to highly qualified specialists, while nurses to specialists of secondary qualification, although in recent years in the national health care system have been trained nurses with higher education. In addition, nurses belong to B3 unit, while general practitioners are categorized as B2. These facts reduce the status of nurses. Healthcare development programs giving priority on development of primary care, increasing number of general practitioners, improving status of general practitioners and nurses. As well as there is a downsizing of general practitioners’ district, and a gradual reduction in workload of general practitioners. For example, in 2018 according to legislatives 1700 population comes to 1 general practitioner. Changes in order on preventive medical examination and target groups shows that workload of general practitioners and nurses still remain higher comparing with 2011. This is because target groups for cervical and breast cancer in 2017, were expanded compared with 2011. The results of research shows, those functional duties of nurses are expanding. For instance nowadays nurses can individually accept patients on medical organization and may delegate home visits. According to results, general practitioners acquire skills in following areas: obstetrician- gynecology, internal diseases, pediatrics, therapy, nephrology, etc. Nurses acquire skills in following areas: propaedeutic of internal diseases, nursing in pediatrics, nursing in surgery, nursing in obstetrics and gynecology, nursing in epidemiology, clinical pharmacology, nursing in neurology and general practice nurse. The analysis shows that domestic nurses acquire skills for admitting and consultation of patients with chronic diseases.

79-86

Authors: A.B. Kumar, L.K. Kosherbaeva, K.K. Kurakbayev, S.B. Kalmakhanov, A.K. Izekenova, A.K. Abikulova

Meeting the needs of helping people living with multiple or even one chronic disease is a challenge for society. The costs of health care and the costs of social benefits for people with chronic diseases are high, so managing chronic diseases requires better coordination of patientcare. The quality of treatment of patients with chronic diseases can improved by adopting a more systematic and structured approach to care and increasing the patient’s ability to self-manage, meet their own needs and manage their chronic condition. All interventions, such as ranking people according to their risk, multidisciplinary team services, and self-government support, have the potential only if the public health aspects are takes into account.

93-100

Authors: Shmygaleva A. , Johanna Heikkilа, Ospanova D.

Intensive Care Unit (ICU) and Emergency Department (ED) nurses are first in line to recognize and witness a patient’s cardiac arrest. They are closer to the patient than the physician or emergency doctor. In addition, ICU and ED nurses are responsible for initiation of cardio- pulmonary resuscitation (CPR) as well as post-cardiac arrestmanagement. The patient’s successful recovery after in-hospital cardiac arrest is directly dependent on the nurses’ competency. ED and ICU nurses provide care and monitoring for patients in critical condition, which requires sufficient theoretical knowledge, excellent practical skills, awareness of actual modern protocols of emergency conditions, and confidence in their actions. The lack of knowledge and proficient skills among nurses put patients at risk for adverse outcomes. The aim of this literature review is to explore the status of ICU and ED nurses’ education in advanced life support (ALS) in worldwide literature in order to determine main trends in improving nurses’ ability to perform high-quality CPR. The literature review was conducted through searches from several databases such as CINAHL, PubMed, and Google scholar. 14 peer-reviewed English language articles published between 2012 and 2019 were chosen for the review. As a result of the study, it can be stated that in-situ mock code simulation is a progressive and effective method of education for all health care providers (physicians, nurses, paramedics). Usage of high-fidelity manikins for ALS training is proven to enhance skills performance at course conclusion worldwide. In-situ simulation (ISS) with high-fidelity manikins should be implemented in each medical facility. The training should be conducted according to a comprehensive schedule to increase nurses’ confidence and practical skills in CPR.

108-114

Authors: D.I. Kupensheeva, D.Ospanovа

Relevance: In many foreign and European countries, nursing staff form the basis of primary health care. For example, in the Swedish health care system, nurses play an increasing role, providing highly skilled care to patients with chronic and complex conditions (such as diabetes, bronchial asthma, heart failure, mental illness); they are also granted a limited right to prescribe medicines. In Swedish medical centers, a patient is first examined by a nurse with a higher education who can then refer the patient to a general practitioner or hospital.

120-129

Authors: Basics of a multidisciplinary approach in preparing a pregnant woman for childbirth at the clinic level.

This article presents a literature review of the Medline, Pubmed, Cochrane databases and through a regular browser search in Russian and English. We have found 180 articles, 62 of which have been in the last 8 years. The purpose of the review was to understand the essence, goals and objectives of a multidisciplinary approach in preparing a pregnant woman for childbirth. And also to determine the benefits for both women and specialists in this model of organization. Basics of a multidisciplinary approach in preparing a pregnant woman for childbirth at the primary health care level.