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.

6-20

Authors: Nussipov E.E., Askarova G.K.

The review of publications on dermatophytosiswith inguinal localization (tinea cruris) for studying of prevalence and a prevalence of an etiological agent of this pathology was executed. Frequency of occurrence of adermatomycosis with inguinal localization on regions and climatic zones of the world is considered. In article the range and a share of mushrooms of dermatophytes, which meets in various regions and climatic zones,is revealed. It was established that the dermatophytosiswith inguinal localization is everywhere widespread and varies ranging from 9 to 18% on regions and from 12 to 18% on climatic zones. Contrary to opinion tha dermatophytes are widespread in the countries with tropical and subtropical climate, it was revealed according to publications that these infections are found in subequatorial and moderate climatic zones of the planet more often.

28-31

Authors: Abdurazakov U.A., Abdurazakov A.U., Yuldashev A.Zh.

Given external signs of the asymmetry of the human body and their mutual influence on the development of various diseases of the musculoskeletal system and ways of their correction with the use of orthosis foot FormthoticsWith the aim of restoring of body balance, eliminate distortion of the pelvis, curvature of the spine and shortening the length of the leg patients were used orthosis for the correction stop medical system Formthotics. Orthosis of the foot system Formthotics contribute to the restoration of leg length, balance, body, elimination of distortion and the elimination of lateral curvature and freedom from pain and optimal gait in these patients, improving quality of life.

39-42

Authors: Abzaliev K.B., Baimbetov A.K., Abzalieva S.A., Amit Soni

Comparison between endovascular and surgical correction of interatrial septal defects. In conclusion, degree of reduction systolic blood pressure in the right ventricle is same between children who underwent surgical correction of lASDand endovascular closure of interatrial septal defects. However, endovascular correction of interatrial septal defects is less traumatic surgery, is not accompanied with dysfunction of cardiac rhythm and conduction, and does not reduce the contractile function indicatorsof right ventricle.

50-54

Authors: Bozshagulov T.T., Tuleutaev R.M., Urazbekov D.O., Sydykov E.N.

All 17 patients performed the operation Bentall-De Bono modification Kouchoukos NT. (Kouchoukos NT., 1986). The method consists in the implantation of KSK full dissection aneurysmal aortic wall, the mobilization of the mouths of the coronary arteries with subsequent reimplantation in KCK. Summing up the results of analysis, it should be noted the high mortality curve due to neglect of the underlying pathology in conjunction with the accompanying severe chronic disease that leads the development of degenerative processes in the target organs is not a positive trend towards 99% index of postoperative survival. That in turn requires a thorough analysis of each case with an individual approach in the conduct of the pre and postoperative period and the choice of surgical treatment strategy.

59-65

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

In this article epidemiological features of urogenital candidiasis, from a position of improvement of microbiological diagnostics are considered that the drozhzhepodobnykh of mushrooms of the sort Candida.spp will allow to expand ideas of need of introduction of modifications of identification. 400/336 samples of urine, dabs with mucous vaginas from pregnant women and women after the delivery - the Center of perinatology and a children's heart surgery of Almaty, also the patients who are on out-patient observation in policlinics were surveyed: No. 2, 3, 4, 6, 8, 11, 16, 17 of Almaty and samples of the environment objects (EO) of the Center of perinatology and children's surgery: washouts from the hospital environment, air, surgical tools and material on sterility (the operational field and hands of surgeons) - 1707 tests. The microbiological research was conducted for the period 2012g-2014gg on laboratory bases of the Kazakh medical university of continuous education: bacteriological laboratory of infectious diseases hospital of I. Zhekenova of Almaty and kliniko-bacteriological laboratory of the Center of perinatology. True incidence (I), cumulative incidence, a prevalentnost (P) were defined. The etiologichesky structure with definition of specific accessory was studied. In etiologichesky structure of a kandidozny infection prevalence of a look - C.albicans is established - pregnant women and women have 83,9% after the delivery. It is revealed that the most struck kandidozny infection among pregnant women are faces aged from 20-29 years - 34,5 %; and among women after the delivery faces at the age of 20-24 years - 34,2 % were such vulnerable group. Epidemiologo-mikrobiologichesky monitoring revealed that at every 5th pregnant woman and the 6th woman in childbirth kandidozny defeat is established by drozhzhepodobny mushrooms of the sort Candida spp. lower department of a sexual path of women. Incidence level among pregnant women made - 18,6 %, respectively among women in childbirth - 15,4 %.

71-74

Authors: Baizhigitov N.B., Nurzhanova G.A., Edenbayeva S.S.

During open-heart surgery it is possible to disturbance of the barrier function and the appearance of inflammation in the systemic circulation of inflammatory mediators and pro-inflammatory cytokines, which is realized in the systemic inflammatory response syndrome (SIRS). To prevent the development of the condition, or to reduce the severity of its complications method of mechanical removal of inflammatory mediators and cytokines from the blood of the patient is the most efficient. At the moment, the problem of implementation of the systemic inflammatory response syndrome after surgery using cardiopulmonary bypass quite relevant because of the high frequency of its manifestations and adverse effects [1,8]. This explains the large number of studies aimed at both the study of the pathogenesis of systemic inflammatory response syndrome and the development of new methods to combat this phenomenon and the improvement of systemic inflammatory response syndrome, but special attention is given to the study of methods of modified ultrafiltration and hemofiltration. Further study of the application of ultrafiltration on patients undergoing cardiac surgery heart surgery with the use of bypass is necessary for understanding of the physiology and pathophysiology of systemic inflammatory response syndrome induced by the conduct of bypass, as well as for the subsequent formulation of clinical guidelines for use in cardiac surgery practice. In this article we have tried to consider the most significant results of such studies. A statistical effectiveness analysis of ultrafiltration and modified ultrafiltration methods on fluid balance during surgery with cardiopulmonary bypass was conducted. Statistical analysis shows the effectiveness of ultrafiltration and modified ultrafiltration to remove excess fluid from the bloodstream.

80-83

Authors: Isabayev D.K., Temirbayev M.A., Samenov Zh.K., Isabayev A.D., Bukenbayev N.Zh.

The article describes the orthopedic alignment of patients with a false form anteroclusion dentition, mesial occlusion.A brief analysis of the literature was conducted on the disorder occlusal-articulation interaction is complicated by the occlusion of the dentition reduced of occlusal vertical dimension.Clinical examples of consequences of the mistakes made at treatment false theanteroclusion (a mandatorydentitionanteroclusion) and results of treatment which were carried out by authors of article are presented.

87-91

Authors: Mirmanova G.K.

In article some working methods with texts on classes in the professional oriented foreign language are considered. The integration processes which are intensively developing in the last decades, growth of professional and academic exchanges, deepening of international cooperation stimulated forward development of foreign-language education. Foreign-language competence became an important component of training of highly qualified, competitive specialists. The modern concept of teaching and a learning of foreign language at an advanced stage assumes personally and active - the oriented approach. One of competences which any professionally successful person shall own today is ability to work with texts of different type and format. The task of enhancement of skills of reading authentic texts remains urgent as use the Internet of resources became an integral part of modern reality. Text materials thematically represent a wide range of scientific areas which can appear in the sphere of professional interests of the medical specialist. In work on texts various types of pretext, text and posttext exercises for enhancement of the foreign-language professional orienting competence of students are used. Pretext exercises are provided for removal of semantic and language difficulties. In text tasks installation by sight of reading is given and certain informative and communicative tasks are set. Posttext exercises serve for check of the understanding read of enhancement of speech skills. In the course of work on texts the professional orienting foreign-language competences which are directly connected with future professional activity of students are developed and enhanced.

6-13

Authors: Zetov A.Sh., Erimbetov K.D.

The situation on tuberculosis in the state is a serious problem therefore actions were offered, making the National Program of fight against tuberculosis in the Republic of Kazakhstan. There are features aggravating a situation about the country: the big tank of the ТВ patients with multiple medicinal stability who are difficult giving in to drug treatment that is bound to inexact coverage and poor quality of a cultural research of a sputum on a micobacterium of tuberculosis with definition of medicinal stability, incorrect selection of patients on treatment in the DOTS-plus mode. The number of ТВ patients with multiple medicinal stability in the Republic of Kazakhstan in 2008 made 1562 persons - the testimony of the menacing nature of spread of tuberculosis, its negative influence on health of the population of the Republic of Kazakhstan in the present and future. 48% of cases among again revealed patients make tubercular processes with existence of destructions and selection of bacteria. Besides progressive body height of the contingent of patients with multi is observed - and weed resistance of МВТ to himiopreparats, at these patients sometimes it is not possible to stabilize process. In such cases and justified the surgical method of treatment is the most acceptable. Scientists of the countries of Europe, America, Asia hold the opinion indicating direct indications to use of surgical treatment at a multirefractory pulmonary tuberculosis and its complications. Drug resistant tuberculosis became a problem, because of low effectiveness of drug treatment the patients with refractory tuberculosis allocating drug resistant МВТ, long time remain selection of bacteria and can infect surrounding with the refractory activator. The refractory pulmonary tuberculosis at the patient has clinical, epidemiological and economic value.

19-24

Authors: Benberin V.V., Tnabayeva G.Z., Aimahanova G.T., Smailova F.K., Nurgaiieva G.K., Ahmentayeva D.A.

In article the analysis of a compliance (commitment to treatment) warmly - vascular diseases at the persons receiving single treatment within the guaranteed volume free medical in the Central hospital of Medical control center of affairs of the president is carried out. For comparison the group of persons from among city dwellers receiving constant dynamic observation and treatment is chosen. In these groupsmultivascular damage of coronary arteries is revealed that was the reason of the address to a cardiac surgery department. In group of city dwellers more composite combinations of defeat of vessels, ischemic heart disease complications, a decompensation of metabolic violations were more often noted. These processes were formed against the background of a smaller compliance to the carried-out therapy, than in group of comparison. A conclusion of this article is need of more close check and dynamic overseeing by patients at the level of primary medical link.

29-32

Authors: Beinikova I.V., Nurgaliyeva A.S., Demidchik L.A., Hendrikson V.

We studied the possibility of the formation of neutrophil extracellular traps in patients with chronic kidney disease different stages. The object of the study: whole blood of 63 patients with chronic kidney disease distributed in five groups depending on the degree of destruction of renal parenchyma. Formation of net-like structures during NETosis of neutrophil, called neutrophil extracellular traps, having in its composition of DNA, histones, defensins and enzymes (elastase, myeloperoxidase, gelatinase, lactoferrin and lysozyme), was triggered by interaction with lipopolysaccharide substances of exogenous (bacteria) and autologous origin (products of oxidative metabolism), which act through the Ғсү-receptors and activate NADPH-oxidase complex. The results of our study revealed the following picture of the detection of neutrophil extracellular traps: neutrophil extracellular traps were detected in 33% of patients with chronic kidney disease 1 stage; amount was in the range from 4 to 10 in 100 neutrophils, in the group with 2 stage - in 5% of patients; amount - 4 in 100 neutrophils, with 3 stage - in 25% of patients; amount was in the range from 1 to 7 in 100 neutrophils, with 4 stage - in 33% of patients in an amount from 2 to 12 in 100 neutrophils, in the group with 5 stage - in 35% of patients in an amount from 2 to 14 in 100 neutrophils. Thus, the highest frequency of detection and the maximum amount of neutrophil extracellular traps was noted in the groups of patients with chronic kidney disease 1, 4 and 5 stages. Some features in morphology of neutrophil extracellular traps different types have been found. Distinctive feature of the first type of neutrophil extracellular traps was hypertrophy of core segments with the concentration of the pellets inside the net-like DNA. Distinctive feature of the second type of neutrophil extracellular traps was rupture of membrane structures of organelles and plasmolemma of neutrophils. The appearance of neutrophil extracellular traps is an unfavorable factor that provokes the activation of procoagulant mechanism of the hemostatic system.

37-41

Authors: Akimov O.Ye., Kovalyova I.A., Kostenko V.A.

The article considers the influence of different classes of sorbents on the metabolism of L-arginine, the processes of lipid peroxidation (LPO), the state of antioxidant systems (AO) in the blood of rats under chronic combined intoxication by sodium nitrate and sodium fluoride. Suspension of nanosized silica, suspension of hydrolysed lignin and activated carbon («Karbolayn») were used as enterosorbents. The experiment was conducted on 62 white Wistar rats for 30 days. Chronic intoxication reproduced by administration solution into the stomach, containing sodium nitrate and sodium fluoride at the dosage of 500 mg/kg and 10mg/kg, respectively. Metabolism of L-arginine was evaluated by determining the total activity of NO-synthases and total arginases activity. LPO processes were assessed by spectrophotometric determination of the products that react with thiobarbituric acid, and their increase after the 1.5 hour incubation in the iron-ascorbate, prooxidant buffer. Status of enzymatic AO systems was evaluated by determining the activity of superoxide dismutase and catalase. Analyzing the results of the study, it was found out that the suspension of nanosized silica more effectively restores function of AO systems and reduces lipid peroxidation indicators. Effect of studied sorbents on L-arginine metabolism under chronic combined intoxication by sodium nitrate and sodium fluoride suggests different sorption capacity of mentioned sorbents for fluoride ions, and nitrate ions.

46-50

Authors: Nijuzov B.S., Dinlosan O.P., Nijazova S.B., Eraaliev B.A., Aitimov G.I., Sabitov A.

This article presents the results of comparative studies of the healing of purulent wounds, in the treatment of wounds with ointment «Levomekol» during the period of deadaptation on the highlands after 3 and 30 day staying on the pass TuyaAshu in experiment. Established the best index of healing in a group of animals after 3-days stay at the altitude 3200 meters and the worst index in the group after 30-days staying on the high altitude. The feedback is based on the results of the dynamics of general and local clinical pictures, quantitative and qualitative microbiological tests, cytology of wound prints and planimetric studies.

58-66

Authors: Pozdnyakova A.P., Ashirbekov G.K., Adilgireyula Z., Kabdulin S.S.

The comparative analysis of incidence, according to official statistics, adult population of the village of Kuandariya and the village of Komekbayev of Karmakshynsky district adjacent to the area of accident of MBR RS-20 in 2006 in the Kyzylorda region, villages of comparison of Turmagambet, a rural population of the Kyzylorda region and the Republic of Kazakhstan is carried out. The certain statistical regularity of dynamics of incidence, connected with accident, are determined: rise in frequency of negotiability behind medical care in a year of accident, return to background level in 3-4 years. The elicited facts of increase of incidence in a year of accident, in the absence of chemical pollution of the habitat heptyl and products of its transformation, allowed to assume that the psychoemotional stress, connected with accident, could make negative impact. Serves as confirmation to it higher rates of a surplus, in comparison with data on a rural population of RK, indicators of those classes of diseases where the percent of psychosomatic pathology is high.

72-78

Authors: Yenin Ye.A., Khilko A.V.

Aim of research is practical application of the given classification of a pathology closely related kidneys allotransplantate and revealing the value of a complex of morphological researches in dynamics. Materials and Methods: was performed retrospective descriptive study, the depth of 5 years from January 2012 till February 2016. Sample - solid. Exclusion criteria - cadaver kidney transplantation. The work was conducted in the archive of pathomorphologic laboratory of National Scientific Surgery Center named after A.N.Syzganov. Results and discussion: it was about 48 cases of kidney transplantation. 64,58% (n-31) cases is related transplantations. According to Banff-07 classification they have been divided into groups by investigated signs. Diagnostic categories of Banff-07 classification renal allograft biopsias was following: the norm - 51,61 % (n-16), antibody associated rejection - 3,22% (n-1), boundary changes - 9,67% (n-3), acute rejection - 9,67% (n-3), chronic nephropathy of transplantate - 25,80 % (n-8), with inherent morphological signs. Conclusion: future advances in analysis of renal allograft biopsies can already be predicted, and the classification and grading of acute/active rejection will continue to evolve. The significance of specific morphologic findings-including glomerulitis, arteriolitis, and infiltrates with unusual cellular features-for acute and chronic allograft dysfunction and outcome will continue to be investigated. Emphasis in biopsy assessment will shift from diagnosis to prediction of later allograft function and outcome, potentially enabling early intervention. Results of research have shown that lifetime morphological research of kidney transplant biopsies allows to give full representation about dynamics of a current, a stage of pathological process, a qualitative and quantitative estimation.

6-12

Authors: Zhumabayev R.Zh.

This article provides an overview of the literature on the issue of treatment of otitis media with effusion. Otitis media with effusion - polietiologic inflammatory disease of the middle ear, in its etiopathogenesis a key role is played by dysfunction of the auditory tube. Pathomorphological substrate of ОМЕ is chronic catarrhal inflammation of the mucosa predominantly of meso-, hypotympanum and auditory tube, and clinical evidence - the presence of exudate in the tympanic cavity, no evidence of acute inflammation, and defects of the tympanic membrane. The most common cause of otitis media with effusion is respiratory viral infections, the second reason - acute otitis media. The prevalence of ОМЕ depends on the age and, according to different authors, percentage of ОМЕ of 1 year children - up to 35 %; 3-5 years - 10-30 %; 6-7 years - 3-10 %; 9-10 years - 1-3%. Otitis media with effusion is the most common cause of hearing loss at children aged 2 to 7 years old - during the mass examinations of children 30.2% of cases of hearing loss are found. Studies of foreign authors confirm the resolution of most cases of exudative otitis media, otherwise the patients are in need of treatment. Given the clinical course of the disease, the main complaint is of hearing loss, which affects patients' life quality. Modern medicine considers many options of ОМЕ treatment, including the alternative use of hearing aids to patients with a contraindication use of other types of treatment. In the CIS countries patients with otitis media with effusion are given medical or surgical treatment without active observation, which goes against the delaying tactic used in most European countries and the United States. Based on the above study of different treatment options for this disease is important and actual in the Republic of Kazakhstan and all over the world.

16-19

Authors: Nurlanbaeva A.E., Otman H.M., Toktabekova G.E., Smailov G.A.

Structural changes in the outflow pathways of varying severity, developing in the zone of surgical intervention in all patients with refractory glaucoma, testify to the importance of a comprehensive dynamic monitoring of patients using ultrasound biomicroscopy. The most significant results of the height of intrascleral cavity was a combination of p-blockers with inhibitors of carbonic anhydrase.

25-28

Authors: Lepessova M.M., Otegenova D.T., Kurmantay A.M.

This article discusses the clinical case a girl of 10 months, where there is not a classic manifestation of Edwards syndrome phenotype, causing doubt in the diagnosis. Edwards Syndrome syndrome or trisomy 18 - is a common chromosomal disorder caused by the presence in all cells of the body added hromosomy18. These children are born with intrauterine growth retardation. Clinical symptoms of the disease: gipognotiya expressed delayed mental and motor development, multiple congenital anomalies: the musculoskeletal, cardiovascular, gastrointestinal and central nervous systems. Just marked changes in the organs of vision: corneal clouding membranes, cataract, ptosis, microphthalmia. Distinguishing features: clenched fists with overlapping toes, short sternum, skin pattern in the form of arcs on most fingers. For example, the clinical case described in the article, there is a polymorphism of Edwards syndrome: from the child no changes typical of the musculoskeletal system. Only with the help of genetic research could set the patient chromosomal disorder such as Edwards syndrome.

33-37

Authors: Shaimerdinov O.B.

In article data on application of low-frequency ultrasound of the device "Tonzilor - MM" for complex treatment of 98 patients with an adenoid disease aged from 6 till 15 years are provided in an endoscopic otorhinolaryngologist's office of the City hospital No. 5, from 2014-2015g.g. Tonzillor-MM showed high performance of a conservative method of treatment at children with an adenoid disease, palatine tonsils as the body of immunity allowing to keep. Before treatment in fences of dabs for bacteriological researches from a surface of palatine tonsils and in lacunas of palatine tonsils were found in a microflora of a mucosa of tonsils at different forms of an adenoid disease not only pathogenic (S.aureus, S. pyogenes, S. Haemoliticus), but also it is conditional - pathogenic microorganisms (S. viridans, S. epidermidis, N.subflavia). After carrying out a course of treatment decrease or disappearance of number of colonies of a pathogenic microflora and decrease of colonies of an opportunistic microflora is revealed. Thus, the ultrasonic device "Tonzillor" and the corresponding techniques of treatment are highly effective both at conservative, and at surgical treatment of diseases of otorhinolaryng organs at the expense of a combination of influence of energy of low-frequency ultrasound and medicinal substances on the struck or defective biological body tissues. Under the influence of ultrasound the trophicity, blood supply of fabrics, a metabolism improves, process of a formation of a collagen decreasesand of cicatricial fabric decreases.

44-47

Authors: Dussekeyeva G.M., Kozhakanova N.T., Isakhanova A.B., Bimagambetova G.S.

Metabolic syndrome one of the most widespread disturbances among cardiologic patients. Chronic kidneys disease, one of the components of a metabolic syndrome, often defines the forecast, and also quality of life of cardiologic patients with a metabolic syndrome. Identification of early markers of chronic kidneys disease at these patients will allow to stop its further development. The objective of this research to estimate presence of an imbalance of a vegetative nervous system at cardiologic patients with a metabolic syndrome and its values at development of chronic kidneys disease. The retrospective analysis of case histories of 35 patients corresponding to the diagnosis of a metabolic syndrome according to criteria of consensus of the International federation of Diabetum of 2005, being on hospitalization in The Scientific Research Institute of Cardiology and Internal Disease, Almaty city from 2009 to 2015 was carried out. To all patients daily monitoring of an ECG byHolter was carried out. As a result of the research all patients were divided into the following groups: 1) a normofiltration without microalbuminuria 2) a normofiltration and a microalbuminuria 3) a giperfilration 4) a hypofiltration. The analysis of a condition of a vegetative nervous system in these groups according to daily monitoring of an ECG by Holterwas carried out. After we have analyzed indicators of variability of a daily rhythm we defined that, in group with a hyperfiltration prevailed a sympathetic influense over parasympathetic. At patients with safe function of kidneys predilection to depression of influences of a sympathetic nervous system with increase of parasympathetic influenseis taped. At patients with a hypofiltration the expressed activation of sympathetic influences with parallel increase of parasympathetic influences is defined. Results of our research indicate great value of a hyperactivity of sympathetic nervous system in advance of chronic kidneys disease. Determination of activity of a sympathetic nervous system according to daily monitoring of an ECG by Holter is the useful accessory instrument estimating extent of blocking of pathological sympathetic influences at these patients.

55-59

Authors: Lepessova M.M., Tankayeva Sh.A.

This article deals with issues of management of children with seizures at the stage of pre-hospital care.The aim of our work was to study uptake with seizures in children to control emergency medical care, as an example of mbulance Station Substation № 2 - the largest ambulance substation in Almaty.The method of continuous selection were analyzed in all 750 emergency calling card with the reason «62D - convulsions in the child» for the period 2013-2015. From the total number of 424 cards (57%) ended in setting a diagnosis of «convulsions». Of these, 275 (65 %) boys, 149 (35%) girls different age groups. In the structure of age groups dominated by a group of 1-3 g, reaching 183 cases (43%). For the main nosological forms, manifesting convulsions, febrile seizures predominate, with a weight of 36 %, followed by epilepsy, in which seizures are the main manifestation of the disease - 20%, symptomatic epilepsy with cerebral palsy - 17%. In 15% of cases of convulsive status coded as «R56.8 Other and unspecified convulsions*.In this paper also identified the prevalence of seizures at the stage of EMSs in the city of Almaty for 2013-2015, which was 5.2 per 1000 child population.

65-70

Authors: Iskakova S.A., Beltenova A.G., Tokbalanova L.T., Andirzhanova G.B.

The article discusses the current status of the Kazakh national medical university. S.D.Asfendiyarov putting indicators on materials research and innovation activities of the university for the period from 2011 to 2013. Analysis of key indicators research university identified key results and prospects of further development of university science.

77-81

Authors: Iskakova S.A., Tanbayeva G.Z., Benberin V.V., Dudnik V.Y.

In article, results of inspections of 179 people aged from 50 years are discussed and are more senior, living in the city of Almaty. Data of age, body height, weight, index of body weight, heart rate, systolic and diastolic arterial pressure of persons of advanced and senile age are submitted, it is revealed that practically all examined persons have age structurally functional features of cardiovascular system which are generally depending on gender influence and environmental factors. Statistical processing of the received results was carried out on the personal computer by means of a software package of «SPSS Statistics 17,0 for Windows* with a conclusion of «box» charts with high degree of statistical reliability.

6-16

Authors: Kim Y.A.

Arterial hypertension (АН) is both a cause and a consequence of chronic kidney disease. Numerous clinical studies have shown the importance of blood pressure control. However, it remains unclear how significant blood pressure control in patients with chronic kidney disease (CKD). In many studies on the treatment and management of patients with AH cases with concomitant CKD were excluded. In addition, chronic kidney disease includes a large group of clinical disorders with various a etiology and pathogenesis. In this article were current available data on the management and treatment of CKD in combination with hypertension, as well as highlighted the current challenges of this disease. Treatment of hypertension in patients with CKD should be prescribed based on the etiology of renal disease. In patients with diabetic nephropathy and proteinuria in renal pathology it is observed best BP control at <130/80 mm Hg during the treatment with ACE inhibitors or angiotensin receptor blockers. Targeted blood pressure <140/80 mm Hg is acceptable in the majority of patients with various forms of CKD. Double or triple block of renin-angiotensin system should be avoided. After analyzing of literature and data from clinical studies, it can be stated that chronic renal failure (CRF) is an outcome of various kidney diseases, while hypertension is both a cause and a consequence of CKD. Considering the significant prevalence of combination of these two conditions it is required further study of the problem in view of the existing gaps in the study of this issue, as well as the development of prevention and improving the organization of specialized care.

22-27

Authors: Grigorova A.A.

On the basis of studying of frequency and nature of changes of cerebral haemo dynamic and neuro and reflex adaptation reactions at stages of treatment of patients with inflammatory diseases and damages of maxillofacial area classification types of neuro and reflex and cerebral haemo dynamic reactions are defined.

32-37

Authors: Baidauletova A.I., Shavlovskaya O.A.

The purpose of the study. This article presents a clinical case of a patient with psychogenic movement disorder by type of fixed dystonia without pain support.The materials and methods. Male 46 years with the only complaint for permanent pinch of the right hand in a fist at rest, worse when performing any motor task; pains in the brush not. Ill for about 5 years.The results of the study. As a result, clinical analysis, it was decided to put the diagnosis of psychogenic dystonia. On examination: in the neurological status without focal symptoms, hand function of normal, the hand no atrophy, tone in the muscles of the hand are sufficient, symmetrical reflexes, sensitivity is not broken.The conclusion. Presented clinical case is complex not only in terms of treatment of musculoskeletal manifestations of the phenomenon as a whole, but also in terms of depth immersing the patient in his own problem.

47-52

Authors: Issbekova A.A., Mergenbayeva M.T., Toktarbayeva A.M.

Acute viral encephalitis is a rare but devastating complication of common virus infections. The most frequent causes of primary encephalitis worldwide are viruses, which comprise different families of viruses distributed according to geography and seasonality. The disease can occur both in the light and in a very severe form of death. The acute encephalomyelitis totally dependent on its severity and on the timely treatment. This article is a rare clinical case of acute meningoencephalomyelitis - viral (possibly cytomegalovirus) etiology of the child, who had been transferred from the children's city clinical infectious hospital № 1 in the department of neurology older children Children's City Clinical Hospital № 2 of Almaty with clinical signs of vascular dystonia mixed type, with crisis course. However, within three days, the child develops a clinical picture of acute disorders of cerebral circulation on ischemic type, in connection with which a child in serious condition, with disturbance of consciousness, with signs of cerebral edema transferred to intensive care unit, which is about one month in stable grave condition. During this period, the child develops the neurological symptoms of acute meningoencephalitis, with further involvement of the spinal cord in the process. The diagnosis of «acute meningoencephalomyelitis virus (possibly cytomegalovirus) etiology» was put up on the basis of medical history, data of physical and instrumental studies, the definition of the virus in laboratory studies (positive enzyme immunoassay blood test for cytomegalovirus antibodies, a positive polymerase chain reaction of the blood on cytomegalovirus infection), blood, although the study of cerebrospinal fluid on cytomegalovirus infection has not given positive results.

57-59

Authors: Amankulova G.S.

The purpose of this work - To show that cryolysis treatment method can find a wide variety of applications in modern medicine, but should be carried out in compliance with reasonable care. It is necessary to know and understand what complications can be caused by the slightest irregularities in the liquid nitrogen. Cryolysis can cause unnecessary tissue damage around the treatment area. It is especially important for clinics where the method is put on aerosol stream. The problem of benign tumors of the skin in modern conditions is constantly growing. Increasingly for the treatment of these diseases we are using the cryolysis method. As benign tumours don't generally pose a threat, diseased patients are considered as a cosmetic defect, particularly if they are located on the visible areas. They will first present to a dermatologist, on whose shoulders lay the diagnosis and determination of the best treatment strategy in a particular case. Plantar warts - warts are caused by the human papilloma virus. Their localisation is only the side of the foot, heel and toes. Dermatologists believe that the disease is the most common occurrence, due to the highly contagious nature of the virus. It is able to survive outside the body for a month. We have considered the case of the use of cryolysis in the treatment of small plantar warts. The manual method of applying liquid nitrogen is with a wooden applicator tipped with a wool bud. Because of the pain expressed lidocaine was introduced with a waiting period of at least 10 minutes before cryosurgery. To long an application of liquid nitrogen and to soon after administering anaesthetic increased the frostbite area and affected and healthy tissue. This case leads to the conclusion that the method of cryolysis liquid nitrogen without the use of special equipment does not allow to monitor sufficiently damaged tissue area, especially in non-compliance to the use of anesthetics, in our case, cryosurgery carried out not after 10 minutes, and immediately after injection of the anesthetic, which greatly increased the frostbite area and cause localised complications.

64-68

Authors: Nuftieva A.I., Yeshmanova A.K., Madibraimov K.M., Abikulova A.K., Makeeva Z.I.

The analysis of trained resources of gerontological description in Almaty city. The current state of normative security, methodology and methods of monitoring's trained resources of geriatric description in Almaty city on the basis of statistics Policlinic of World War II Veterans was studied and theirs the analysis was carried.lt is underdevelopment of geriatric service and small number of geriatric rooms. The available normative security for service population of elderly patients it is necessary to cardinal re-examine and have to expand taking into account modern tendencies and needs of elderly organism. The supporting system of trained resources of geriatric description in Kazakhstan be in need of perfection and modernization. It is necessary to develop effective trained policy of description wich will provide elderly population with qualitative benefits. For creation of competitive gerontological service it is necessary combination of innovation, skilled medical staff and technical equipment.

73-77

Authors: Khussainova K.N.

In this article during the conducted researches it is established that the main sources of pollution of soils in the Atyrau region are the industrial wastes of the enterprises of oil production and oil processes including chemical reagents, drilling mud fluid, boring slime, sewage boring, oil slimes and crude oil. Besides, one of the main reasons for an adverse ecological situation of the studied area remains impurity of the city and its vicinities industrial unauthorized household and other wastes. The actual question for the region is the cleaning of the territory of the large inhabited places of municipal solid waste which is carried out unsatisfactorily. There is an acute shortage of special transport, garbage containers and container platforms. At the same time, the condition of a radiation situation in the studied region demands systematic monitoring. Because of potential dangers of distribution of radionuclides from abnormal sites of pollution in environment, and also radioactive infection of underground waters and an emission of radionuclides from underground cavities on a land surface. The huge territory is polluted by the stiffened sulfur and toxic agents - products of burning of the open fountain of gas and oil. Also there is a pollution by sulfur dioxide - one of the most toxic components of industrial pollution of the environment. Moreover, high concentration of such heavy metals as lead, zinc, copper and iron are characteristic of this region. High impurity oil and oil products leads to a degradation of a soil cover, violation of a geochemical structure of the soil, destruction of a biogeocoenosis. Also in article interrelations between the content of oil products and concentration in them heavy metals in system the soil and the soil plant are considered. At the same time sources of literature have noted positive correlation between accumulation of heavy metals in the soil and receipt them in plants. Genetic consequences of impact of the heavy metals on a human body which are contained in oil and oil products such as lead, zinc, copper and iron are especially dangerous.

84-91

Authors: Ibragimova M.A.

History of the study listeriosis infection has more than a hundred years. In recent years, the cases of the diagnosis of listeriosis in humans. The bacteria Listeria genus are widespread in the environment and are able to lead a saprophytic or parasitic way of life. This is due to the fact that Listeria has a number of features that improve their adaptation, and thereby increase the ability to reproduce and survive in different conditions and at different temperatures. Until the 80-ht listeriosis is not a serious concern in epidemiology, since the frequency of registration of cases of disease in different countries ranged from 0.1-0.5 per 100 thousand people. But the situation has changed dramatically in the late 20-th century, began to be recorded outbreak of listeriosis food, with mortality rates of 24-40 %. The reasons for such a sharp rise in incidence are not fully clarified, perhaps matters long-term storage of food at low temperatures, when the Listeria create a favorable environment for reproduction, given the weak initial contamination of the product. Until the mid-twentieth century, listeriosis was regarded as a veterinary problem. Official registration of the disease in animals is carried out since 1956. In consequence it became clear that a person becomes infected not only by direct contact with infected animals (in the care of sick animals), but also the nutritional way. Because the problem should not be seen as a zoonotic infection, but as anthropozoonosis (food zoonotic infection). The most common form of polymorphic clinical manifestations of listeriosis: CNS symptoms (meningoencephalitis, encephalitis), the defeat of the genital organs (habitual abortions, urogenital pathology), septicemia, tonsillitis, sepsis in newborns, as well as the kind of bacteria asymptomatic.