Herald of Almaty State Institute of Advanced Medical Education

6-10

Authors: Djalairova A.Sh. Likhacheva N.E., Lepesova M.M.

The article describes main etiological and risk factors of psycho-speech delays in children. Several classifications scales of psychoverbal delays that are used by child neurologists, speech therapists and psychologists are also outlined, which in turn reflect major stages of speech development in a child, associated with different age periods. There are different psychological scales to assess the child's intellectual areas specified here: adaptive behaviour, social and emotional areas, cognitive, and speech and communications, starting from the age of three, which help in the psychoverbal delays diagnostics. Special attention is given to the correctional work of experts, without which the isolated drug therapy is not efficient. At present, the screening methods have become more important, which enable to diagnose a psychoverbal delay in children before the age of four, thus consequently allow applying correctional methods in combination with the drug therapy at early stages. Main tools used for early diagnostics are also discussed in this review.

17-19

Authors: Kugizbekova A.B., Smagulova I.B., Varushkin E.G.

The paper presents the results of the prevalence of chronic gastroduodenitis among children of different ages. The structure and frequency of concomitant diseases from the gastrointestinal tract was studied. Leading amnestic data: age and sex characteristics, family characteristics and place of residence. The clinical picture and the results of instrumental methods are described.

24-29

Authors: Usupbayev A.Ch., Kurbanaliyev R.M., Kuzebayev R.E.

Actually, the treatment of hypospadias is one of the most complex and unresolved problems in constructive surgery. According to domestic and foreign authors, the frequency of complications in the postoperative period 50% and more. Materials and methods. The work is based on an analysis of the results of the survey and the surgical treatment of 195 patients aged 3 - 31 years for the period 2004 - 2017. Inclusion criterias: boys with a stem, a stem-scrotal and a scrotal form of hypospadias of the urethra. Depending on the choice of plastic material and the type of performed surgery, patients were divided into three groups. In the postoperative period, glumen instillation by the antiseptic solute in the main group of patients was perfomed by the catheter, specially developed by us. Results: In the analysis of complications in these three groups of patients established: in the main group complications occurred 10%; in the second group of patients operated by the Duptay method complications reached 28,5%; in the group of patients operated by the method of Landerer complications reached 24,6%. Conclusion: The operation of buccal urethroplasty with the use of a continuous screw-in suture and the developed neo-urethral instillation catheter allowed us to achieve a positive result of up to 90% in comparison with the method of Duplay (success up to 71,5%) and Landerer (success up to 75,4%).

35-40

Authors: EnsebayevE.Zh., Sharipova K.K., Baigaskinov Zh.K., Sholokh P.I., Abdrakhmanova A.A. Zhanbyrbekuly U.Zh., Ainayev T.M.

This article presents the results studies patients of womens the different age groups with disorders of urination and basic diagnostic methods, taking into account clinical and urodynamic parameters. One of the informative and objective research methods to clarify the behavior of the bladder in the phases of filling and emptying is urodynamic research that allows to simultaneously studying intravesical, intra-abdominal and detrusor pressure. Obstruction of the urination determined by the ratio of pressure and flow reflects detrusor contractility and urethral resistance, but does not allow determining which of the factors is impaired. The clinical significance of urodynamic examination of patients in diagnosis is undeniable. At the heart of urinary dysfunction in women lies a different degree of sphincter insufficiency, therefore the conducted studies of domestic and foreign colleagues showed the objectivity of existing significant differences in the study of the urethral pressure profile in urgent and stressful forms, in particular, the functional length and intraurethral pressure at stress [1, 2]. Purpose of the study: Indices ratio of changes in the volume of filling the bladder to a change in intravesical pressure in the dynamics of the development of "urinary incontinence" and the identification of the relationship and significance of urodynamic indicators in the mechanism of development of this pathology. Materials and methods of research. 81 women aged 18 to 85 years were examined. According to the urodynamic parameters and the clinical picture of the disease, the patients are divided into 4 groups. Women were examined in stages: filling the diaries of urination, a questionnaire was conducted (they were introduced into the study of the questionnaire recommended by the European Association: UDI-6, ICIQ-UI, QOL). The physiological volume of filling the bladder was determined, the extensibility of the bladder wall to a change in the intravesical pressure. Results and discussion: The results obtained allow us to say that the measurement inside the abdominal, detrusor, urethral pressure for various types of incontinence is mandatory; the parameters of the pressure parameters may change with uncoordinated detrusor cuts often manifested by symptoms of the imperative type urinary incontinence. Conclusion Given that detrusor activity may be normal (stable bladder), abnormal (hyperactive urinary bladder disease), urinary incontinence can occur with a decrease in urethral pressure and no detrusor cuts. The correct interpretation of the profile of the uriureurethral pressure depends on the correctness of the performance and measurement of detrusor pressure. If there is a manifestation of instability of the urethra, which is detected with a decrease in urethral pressure, the absence of detrusor reduction should be taken into account that uncoordinated reductions "detrusor hyperactivity" is manifested by increased intra¬abdominal pressure, while the capacity of the bladder does not change.

46-50

Authors: Ramazanova R.M., Begaliyev B.A., Sultangaziev G.Zh., Zholdasova R.Zh.

In this paper, the efficacy of the VD scheme use in patients with newly diagnosed multiple myeloma for the period 2012¬2017, in the department of hemoblastoses of Kazakh Institute of oncology and radiology was evaluated. The effectiveness of treatment was assessed after 4-6 cycles of VD. Objective: To evaluate the efficacy of the VD regimen (bortezomib + dexamethasone) in the first line of multiple myeloma therapy. Methods. The study included 40 patients with newly diagnosed MM who received treatment according to the VD scheme in the department of hemoblastoses of of Kazakh Institute of oncology and radiology from 2012 to 2017. The median age was 59 years (40-81 years). Results. Using the VD scheme in patients with newly diagnosed MM, the overall response rate was 75%. 40.6% of patients complete remission was achieved, in 16.6% of patients was very good partial remission, in 43.3% of patients - partial remission. Progression of the disease on the therapy background according to the VD scheme occurred in 25% of patients. The median time to achieve complete remission was 4 months. The overall survival of patients was 28 months. The transferability of treatment according to the VD scheme was satisfactory regardless of the age of the patients. Among the side effects anemia (42.5), peripheral neuropathy (35.5%), asthenic syndrome (25%), dyspepsia syndrome (22.5%) were observed. The conclusion. The VD scheme has a manageable and predictable toxic profile, is effective and plays an important role in MM therapy as a first line, and leads to a significant increase in the overall survival of patients compared to treatment methods without the use of proteasome inhibitors.

63-69

Authors: Shamsutdinova A.G., Kasymzhanova M.K., Juszkiewicz K.

The diagnosis of a mental disorder bears in itself a social and ethical burden, which is not present in any other clinical medical field. For psychiatric patients, this often results in a decrease in public confidence, infringement of dignity, violation of rights and somatization that significantly affects the quality of patient's life and causes less appeal to psychiatrists, followed by a negative effect on the course and prognosis of the disease. The application of the paternalistic approach in patient-physician relation has its testimony. However, an introduction of a new model of partnership based on patient's right is becoming popular. Taken into consideration a polyprofessional and partnership approaches for the provision of psychiatric care, ethical and moral principles should also be followed by non-medical specialists. The aim of the article is to reveal challenges in psychiatric practice that require separate analysis and conversion into a broad field of scientific research.