ISJM MAIN REASONS FOR DETERIORATION OF WORK OF THE CHEMIST'S ORGANIZATION AND METHODS OF THEIR DECISION Idrissova D. S. (E-mail: dana.idrissova@mail.ru), Shopabayeva A.R., Himenko S. V. S. D. Asfendiyarov Kazakh National University, Almaty, Kazakhstan
Research objective
• lack of a demanded preparation – 26 %;
Level of rendering of the pharmaceutical help to the population depends on many factors: economic, social, psychological and other character. In professional activity of pharmacists it is necessary to reveal, analyze and consider their influence, and, respectively to correct actions of workers of a drugstore, first of all in the sphere of communication with visitors of the chemist's organizations.
• mistake in professional activity of the personnel – 37 %;
Materials and methods The conflicts are one of the main reasons for decrease in overall performance of a drugstore. For the purpose of their identification we carried out questioning of visitors of a number of drugstores of the city of Almaty. Questions reflected psychological characteristics of communication, the possible reasons of emergence of conflict situations. Criteria of efficiency performance of drugstores were defined. Results The main reasons for emergence of conflict situations are as a result established: • return of the bought goods – 84 %;
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• queue existence – 24 %; • violation of ethical principles – 54 %; • inexperience of the personnel – 4 %;
The main directions for optimization of work of a drugstore are established, namely: improvement of appearance of a drugstore and interior of a drugstore, skill level of the personnel, range of a drugstore, appearance of the pharmacist. Conclusions Methods on increase of level of rendering of the pharmaceutical help are offered the population, competitiveness of a drugstore and a role of vocational training of pharmacists, and also a method of check of efficiency of correcting actions. Ways of the prevention and permission of conflict situations are offered.
Issue 01 / July 2013 ACUTE TOXICITY STUDY AND THE PHARMACOLOGICAL ACTIVITY OF NEW DOSAGE FORMS Vansinvina Madina, Beknazarova Kuralai Scientific advisor: Amirkulova M.K., Department of Pharmacology S. D. Asfendiyarov Kazakh National University, Almaty, Kazakhstan
The purpose and objectives of the study To study the acute toxicity, skin irritant and wound-healing effect of a new dosage form gel with extract of camel thorn. Materials and methods To study the general toxicity of used healthy mature animals - mice of both sexes, passed quarantine for at least 10-14 days, grown in a vivarium KazNMU. Number of animals - 6 mice in each group, weight - 18,0-22, 0. The solvent extract of camel thorn used purified water in the ratio of 1:10. The substance was administered into the stomach of animals via a special probe via syringe. The injection volume did not exceed 1 ml. Before administration of the substance and thereafter animals were fed for 2-3 hours. The value of poisoning was calculated using statistical methods. Wound healing effect was investigated in guinea pigs weighing 500,0-700,0. The animals were divided into 2 groups experimental and control (compared with calendula ointment). Area of skin on the back cut out a 2x2 cm moment wounding animals were under general ether anesthesia. Skin wounds of animals of group 1 lubricating gel. Wounds 2 groups of animals with calendula ointment was applied. Test agents were applied 1 time a day in the form of application without the use of dressings and tampons, after cleaning the wounds from necrotic tissues and treatment of damaged surfaces 3% solution of hydrogen peroxide. The study was conducted skin irritation in guinea pigs (weight 250.0 - 300.0). Number of guinea pigs in the group - 6 animals. One day before the experiment
animal hair carefully cut out a laterally symmetrical sites, one of which serves as a control. Treated skin area was 5-8% of the animal body. The study of skin irritation on the skin was performed with daily applications of finished dosage forms - gel for 2 weeks. When applying a gel studied for 4 hours exposure the animals were kept in a fixed state. The gel was applied to the right side every day, open way. Results The experimental results showed no pathological changes in the nature of the overall performance for the entire study period. Animals in all groups remained active, there was not a single case of death or intoxication, is not fixed change of the respiratory, cardiovascular and central nervous systems. Condition of hair, mucous membranes intact. Feed consumption and water in the same mode. Body weight of the animals remained at the original figures. Thus, the test substance is administered in enteral had no general toxic effect in animals and developed means is harmless. Conclusions Thus, the experimental data allowed us to refer gel with extract of camel thorn to the practical non-toxic drug that belongs to the class V toxicity. In this case, the gel has a local effect, and has the potential woundhealing effect. The presented new formulation - "gel with extract of camel thorn" could be proposed for further study.
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ISJM RESULTS OF THE CLINICAL EXAMINATION OF THE CHILDREN WITH SPINAL HERNIAS Yerbolat Saruarov, Ilham Annaorazov E-mail: ereke.0991@mail.ru Scientific supervisor: Dr. Elikbaev Galimzhan International Kazakh-Turkish University by Ahmet Yesevi, Faculty of Medicine, Turkestan, Kazakhstan
Abstract Spinal hernias are one of the more difficult and poorly understood defect of the central nervous system. The problem of diagnosis and surgical treatment of spinal hernias attracts attention of pediatric surgeons, neurosurgeons, urologists, orthopedists, neurologists and other specialists, is far from the solution. Introduction
Materials for research
Spinal hernias are one of the more difficult and poorly understood defect of the central nervous system. The problem of diagnosis and surgical treatment of spinal hernias attracts attention of pediatric surgeons, neurosurgeons, urologists, orthopedists, neurologists and other specialists, is far from the solution [1, 2].
The results of clinical examination of 130 children up to 1 year with spinal hernias, being treated in the department neurotraumatology regional children’s hospital in Shymkent, South Kazakhstan region for 2009-2012 years. Age of the patients ranged from 1 day 2 to 1 year. Of which there were 52 boys and 78 girls. Children from birth to 1 month were – 74 (56,9%), from 1 month to 3 months – 35 (26,9%), from 3 months to 6 months – 13 (10,0%), from 6 months to 1 year – 8 (6,2%). Among patient with spinal hernias most were children with meningomyeloradikulocele (63,8%). Patients with meningocele was 18 (13,8), with meningoradikulocele 13 (10,0%), with rahishizis – 13 (10,0%) and 3 children with terminal mielocystocele (2,3%). By clinical and X-ray studies were allocated and studied mainly meningocele, meningoradikulocele and meningomyelocele. These forms were represent of great interest and more promising in terms of post-operative recovery and rehabilitation [7].
The relatively high detection of spinal hernia, clinical severity and poor treatment outcomes for a number of its forms make the problem of diagnosis and treatment to date and today [3, 4]. Polymorphism in the form of lesions deformations, deformation of different, often a majority, spine, lack of segmental and conductive apparatus of the spinal cord, motor, sensory, autonomic spinal nerve roots determine the clinical manifestations of the disease. The combination of various malformations introduce significant changes in the course of the diseases and transform clinical manifestations of spinal hernia, but the origin of these combined, their clinical significance requires further studies [5, 6]. The purpose of the research Examine the main clinical symptom of spinal hernias with different variants of their localization, shapes and combination of defects.
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Methods of examination In children with congenital spinal hernias performed physical and neurological examination, and a endoscopic methods of diagnostics. Pluricausal, exceptional
Issue 01 / July 2013 complexity of the pathogenesis and clinical severity of malformations are places demands on the diagnostic measures [8, 9]. Clinical examination in children with spinal hernias include: identification of complaints, collection of anamnesis and external examination of the patient, data of neurological examination, evaluation of the research results of the musculoskeletal and urinary systems. The correct diagnosis had to be good to collect anamnesis. Inspection of local changes, largely determine the degree of urgency of the operation, the need for a toilet, disinfection and treatment of surface rupture. Facial expression, body posture and the nature of the movement is in itself important diagnostic indication. Skin pigmentation, hypertrichosis, nevus were indicated to meningocele or the presence of other malformations. A very important point is the correct assessment of head size and rate of growth, and the state of physiological development. Neurological examination in children differ from adults in connection with the anatomical and physiological characteristics of the growing organism. Direct study of the nervous system is composed of the study of reflex activity, cranial nerves, motor activity and sensitivity. Neurological examination was preceded by a general inspection of the child and the study of its physical development. Identifying disparities parts of the body, changes in the size and shape of the skull, the detection of congenital anomalies indicative of past or current disease of the nervous system. The study of the musculoskeletal system consisted of evaluation of motor deficits,
identification of spinal deformities, limb, clinical factors contracture and deformities. Instrumental methods. In the practice of child neurotraumalogical department was introduced various methods of radiodiagnosis of pathology of spinal cord and spinal column: ultrasound, spondilography (general and functional), CT and MRT. Results and discussion Visually the spinal hernia was represented tumor bulging, round or oval in shape and dorsal midline. The hernias often had a wide base and a leg, so that they hung down and were like hanging (73,1%) (fig. 1). A number of children with spinal hernia herniation at the periphery within a healthy skin was observed pilosity and vascular pattern (50%). Skin markers are present at the open neural tube defects [10]. Half of patients with spinal bifida occulta found some form of dermal embryopathy [11]. These symptoms are often the key to the recognition of spinal dizraphysm. In this connection it is necessary to evince great caution when examination of the baby, who was found lipoms, skin stigma, dermal sinus and hemangioma on the average line, hypertrichosis and asymmetric folds buttocks [12, 13]. As the child’s size the herniation is increased. And this process were in some children slowly (16), others more rapidly (114). Fast growing hernia are usually stiff and combined with hydrocephalus (93,3%).
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Fig. 1 – The visual aspect of spinal hernias.
The dimensions herniation were very different. The large size was reached spinal herniation of the lumbar spine (36,6%). The consistency of protrusions were depended on the contents of the hernia sac and previous inflammation, after which there were scars in the wall hernia (20%). As a result of the bone defect back on the spinal canal under the influence were increased pressure of the cerebrospinal fluid in the subarachnoid space of the spinal cord with the roots and shells stick out, forming a mass lesion, partially or completely covered with leather. The movement disorders were ranged from flaccid paralysis to subtle disturbances. With involvement of the spinal cord and its roots in the hernial sac was arose paralysis of the lower limbs. The basis of neurological disorders were violation on innervation of the lower limbs and the mechanisms are considered as the severe underdevelopment of the spinal More than 70% of patients with myelomeningocele were arose combined incontinence urine and faces. The violations of urodynamics of the lower urinary tract which arose at an early age,
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The integuments of herniation in 93,3% of cases were thin as tissue paper and had a tendency to break. Sometimes there was a maceration of the skin due to constant friction of clothing, to joined an inflammatory changes (26,6%). Especially were difficult the infected spinal lumbar herniation, lumbar-sacral and sacral localization. The lower localized hernia, the most happening inflammation of the skin, they maceration and create more conditions for breaking the hernia sac with the subsequent formation of cerebrospinal fluid fistula. cord (myelodisplasia). But not completely understood mechanisms to responsible for the progressive neurological disorder in patients with spinal hernias [14, 15]. In our study the lower flaccid paraparesis were occurred in 63,3% of cases, and paraplegia were occurred in 16,6% of cases. promote of uretrohydronephrosis, vesicoureteral reflux and the most common cause of severe renal disease (chronic kidney disease, reflux nephropathy, etc.) at a later age [7].
Issue 01 / July 2013 The obstructive uropathy (vesico-ureteral reflux, idroureteronephrosis, pyeloectasia) are observed in 30-50% of patients with spinal hernias [16, 17]. We are observed a combination of functional disturbance of the spinal cord with other anomalies and malformations. In this case were revealed an exotropia (3), two-sided clubfoot (9), congenital dislocation of the hip joint (4). The neuroorthopedic syndrome was manifested by bone deformities and muscle atrophy in the lower extremities, unsteady gait, pain in the limbs and scoliosis [18, 19]. Anomalies of the spine occur in patients with spinal hernias are include: spina bifida, floor vertebra, sacral aplasia, segmentation disorders and can be detected in 75-95% of children [20, 21, 22]. The spinal hernia, especially in children under one year, often combined with liquor circulation disorders, which result in hydrocephalus (93,3%). In the postoperative period in these patients in 60% of cases, there is an increase hydrocephalic syndrome, was occurred cerebrospinal fluid fistula, liquorrhea, divergence of the cranial sutures with the accession of inflammatory complications. The success of treatment combinations the spinal hernias with hydrocephalus is largely dependent on the nature of the anatomical and functional impairment, and early diagnosis of liquorshunt operation. The hydrocephalus is one of the constituent elements of classical congenital spinal hernias complex syndrome (impaired function of the lower extremities, pelvic disorders, orthopedic manifestations). The hydrocephalus was occurred mostly in open forms disraphy (spina bifida aperta) and before the introduction of liquorshunt operations are
the leading cause of death and low intellectual development of these children [23]. The surgical correction (liquorshunt operation) is require 80-95% of patients with spina bifida aperta [24, 25]. According Tulipan N. et al. (2003), the frequency liquorshunt operations within a year of life of these patients is 93% of cases [26]. We have conducted 39 operations for progressive hydrocephalus after resection of spinal hernia. Our study showed that infants with severe and progressive hydrocephalus requiring emergency surgical care, while moderately severe ventriculo dilatation and pronounced signs of increased intracranial pressure to delay intervention or even postpone it. In primary bypass operations efficiency was quite low (30%), corresponding to world literature [27]. This is due mainly to the anatomical features of the III ventricle with meningomyelocele-ventricle less expanded, its floor more dense and elastic. So in urgent interventions we did not use the tactics of simultaneous or prior liquorshunt operations. On the one hand, we sought to minimize the duration of the operation, on the other hand, there was no severe intracranial hypertension if liquorrhea. The postpartum hydrocephalus were ascertained approximately 15-25% of cases of children with meningomyelocele [23, 28]. Therefore, the congenital hydrocephalus in congenital spinal hernias diagnosed infrequently. Hydrocephalus often develops after ÂŤclosingÂť the spinal defect. The need for interventions liquorshunt emerged in 26 of 35 infants (74,2%), non-elective surgery for indications, the operations were carried out in 1-3 months after the first intervention.
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ISJM Dermal sinus; 5,30% Lipoma; 13,30% Fixed spinal cord syndrome; 20,00%
Conclusions 1. The clinical picture of the spinal hernia is diverse and complex. 2. The features clinical picture of the disease in children with spinal hernias were depends on the location, and the progression of the depth of the lesion of the spinal cord and roots, on the presence and severity of associated malformations, the child’s age. 3. In children younger than 1 year at the spinal hernias were observed neurologic lower extremities (paraparesis – 63,3%, paraplegia – 16,6%), pelvic disorders (70,5%) and the combination with other anomalies and malformations (hydrocephalus – 93,3%, bilateral clubfoot – 30,0%, congenital dislocation of the hip – 13,3%, exotropia – 10,0%). 4. The disability of the patients with spinal hernia is mainly determined by the degree of involvement in the pathological process of the spinal cord and its roots (meningomyeloradikulocele – 63,8%). 5. The hydrocephalus is a common and life-threatening brain damage when combined congenital malformations of the central nervous system. 6. The improved results of treatment of hydrocephalus has been the determining
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Dyastematomy elya; 4,70% Spinal hernia; 56,70%
factor of long-term positive results of treatment of spinal hernias in children. REFERENCES 1. Khachatryan V. A., Orlov Y. O., OsipovI. B.,Elikbaev G.M.`The spinal dizrafies: neurological and neurosurgical aspects`. St. Petersburg. "Ten".2009; 304. 2. ZozulyaU. A., OrlovU. A. `Malformation of spine and spinal cord`. The ukrainian medical newspaper. 2003; 16: 7-13. 3. Anthony J. Raimondi. Pediatric Neurosurgery Theoretic principles art of surgical techniques.Springer-Verlag.1987; 446449. 4. Sin A.H., Mahmoud Rashidi M., Caldito G., Nanda A. `Surgical treatment of myelomeningocele: year 2000 hospitalization, outcome, and cost analysis in the US`. Childs Nerv.Syst. 2007; 23: 1125–1127. 5. McLone D., Naidich T. Myelomeningocele: Outcome and late complication in McLaurin R, Schut L, Venes J, Epstein F (eds): Pediatric Neurosurgery: Surgery of the Developing Nervous System, ed 2. Philadelphia, Saunders. 1989; 53-70. 6. Dias M.S. Myelomeningocele. In: Choux M., Di Rocco C., Hockley A., Walker M. (eds.) Pediatric neurosurgery. Churchill Livingstone. 1999; 33-59. 7. McGuire E. J., Bloom D. A., Ritchey M. L. Myelodysplasia. Prob. Urol. 1993; 7: 7-11. 8. Vogl D., Ring-Mrozik E., Baierl P. et al. Magnetic resonance imaging in children suffering spina bifida. Z. Kinderchir. 1987; 42(I): 60-64. 9. Barilyak I., Orlov Y.`Spina hernia`.Johannesburg, 2003; 99. 10. Humpreys R.P. `Clinical evaluation of cutaneous lesions of the back: spinal signatures that do not go away`. Clin.Neurosurg.1996; 43: 175-187. 11. Kumar Raj, SinghalNamit. `Spinal dysraphism: trends in Northern India`. Pediatr.Neurosurg.2003; 38: 133-145. 12. Drolet B.A., Boudreau C. `When good is not good enough: the predictive value of cutaneous lesions of the lumbosacral region for occult spinal dysraphism`. Arch. Dermatol. 2004; 140: 1153-1155
Issue 01 / July 2013 WOUND HEALING EFFECT OF THE NEW COMBINED ANTI-BACTERIAL GEL ON COLLAGEN-BASED Kantureeva A.M., Tleuberlin T.K. Scientific advisor: Satbaeva.E.M, MD Associate Professor, Department of Pharmacology S. D. Asfendiyarov Kazakh National University, Almaty, Kazakhstan
The purpose and objectives of the study To study the wound healing antibacterial gel with cefuroxime and metronidazole-based collagen Methods We determined the effect of the combined antibacterial wound-healing gel based on collagen-containing cefuroxime and metronidazole, a common method used by the Guidelines for the experimental and pre-clinical studies of new pharmacological agents (ed. Prof. Habrieva RW). Used guinea pigs of either sex in 6 animals in the experimental and control groups. The comparison was performed with levomikol ointment. Test agents were applied to skin wounds once a day, in the form of application without the use of dressings and tampons, after cleaning the wounds from necrotic tissues and treatment of damaged surfaces 3% solution of hydrogen peroxide. Dynamics of the healing process was monitored by measuring the diameter of a skin wound. The general condition of the animals, the severity of the inflammatory reaction, the timing of the appearance of granulation tissue, epithelialization, wound. The results of objective studies compared the groups. Collection of material for histological examination was made on the 8th day. The animals were cut from the edges of the wound size pieces 1h1sm. For histological examination of tissue fixed in 10% neutral formalin. Processing of tissues followed by pouring in paraffin was performed by the standard technique (GA
Merkulov course patogislogicheskoy technology. - L: Medicine, 1969. - S.423). On the paraffin sections, 5-6 microns thick were used hematoxylin and eosin staining. Results The results showed that the application of the gel test 100% of the experimental wound healing was noted at 11-12 days, provided that the earlier period of healing compared with levomekolevoy ointment, which when applied to the wound occurred 12-13 days. In this evaluation study wound healing gels number 1 and number 2 was conducted on a formula calculating the percentage reduction in the size of the wound area in dynamics during treatment in all phases of wound healing. Histological examination of the first group (metronidazole with cefuroxime) epidermis places had tortuosity marked hyperkeratosis. The epidermis was more widely, consisted of 6 layers of cells, sweat glands were mostly cystic dilated, the gaps identified in their pink homogeneous mass. In the dermis, there were many newly formed capillaries and scattered cell infiltration of single leukocytes, macrophages, eosinophils, fibroblasts. In the second group (ointment levomikol) epidermis with multiple defects, consisted of 2-3 layers of cells, irregular acanthosis, expressed keratosis, cystic glands were enlarged, many scattered in the dermis and focal infiltrates of lymphocytes, white blood cells, fibroblasts. The glands are arranged in groups. In the stroma of the dermis are seen multiple infiltration of leukocytes. isjm.kaznmu.kz Issue 01 / July 2013
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ISJM Conclusions Thus, the study gel caused a pronounced healing effect. Histological examination shows that the regeneration processes were accelerated and structure of epidermis and dermis were restored with the application of gel-based antibacterial agents collagen process more complete
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than in the control group. Perhaps this was due to the collagen framework, able to stimulate the formation of granulation tissue and accelerate wound epithelialization. This gives grounds to recommend the test gel for further clinical studies.
Issue 01 / July 2013 COMPUTER VISION SYNDROME AMONG MEDICAL STUDENTS: A CROSS-SECTIONAL STUDY Jillian May T. Tomboc (tombocjm@yahoo.com), Myla H. Alcan (angel_youth17@yahoo.com), Kathleen Anne R. Boniol (kathleen_boniol@yahoo.com), Lean Alfonso A. Cervantes (leancervantes@yahoo.com), Cielo Mar S. Perez (marcielo_86@yahoo.com), ChristzelR. Rebudal (zel_rebudal@yahoo.com), Francis S. Soriano (soriano_kiko@yahoo.com), Wilkeen Flerika S. Tajonera (wilkeen_25@yahoo.com.ph), Krystin O. Wenceslao (tin2rh7@gmail.com) Saint Louis University School of Medicine, Baguio city, Philippines
Abstract Background: The computer has become a common item in today's society as it has revolutionized easy access to information especially in medical education. However, the use of computers was proven to be associated with health problems, specifically visual problems. Objectives: This study aims to determine the prevalence of CVS among medical students of Saint Louis University along with the association of CVS with their year level, sex, the distance between the monitor and the subject, brightness of the screen, length of time spent using the computer and kind of lighting used when the subject is using the computer. Design: Cross-Sectional study. Setting: The study was conducted in Saint Louis University School of Medicine, Baguio City, Philippines. Study Population: First year to third year medical students currently enrolled in Saint Louis University School of Medicine for the School Year 2012-2013. Measurements: A standardized questionnaire was used to gather the needed data. The prevalence of CVS was measured using an issued inclusion criteria for CVS. Chi square was used to identify the relationship between the various variables. A P value of <0.05 was considered significant. Results: A total of 472 questionnaires were floated but only 417 were retrieved and subjected for data analysis. The study included 168 (40.3%) males and 249 (59.7%) females, with 141 (33.8%) firstyears, 139 (33.3%) second years and 137 (32.9%) third years. A total of 269 (64.5%) medical students have CVS. Eye strain was the most frequent symptom (83.6%) experienced by the medical students who were considered to have CVS. Conclusion: There is a high prevalence of Computer Vision Syndrome among the medicals students of Saint Louis University with the length of time spent by the subject in front of the computer being the most likely related factor for the occurrence of this condition. Introduction With the increasingly complex and vast amount of information presented in medical education today, handheld computers have proven to be a valuable resource for medical students, residents, and faculty physicians[1]. The introduction of the computer no doubt has revolutionized and benefited the society; however it does associate with healthrelated problems[2].Visual effort is greater when looking at the computer screen as
compared to that when looking at paper[3]. Computer use has been associated with both a reduced rate of blinking and a high number of incomplete blinks when compared with viewing hard copy materials[4]. The blinking of eyes is 22 times per minute when looking at a paper which is reduced to 7 blinks per minute while looking at a computer screen. This leads to dry eyes. Thus when using a computer, the eyes strain as they attempt to maintain focus, or may be incapable of obtaining focus at all[3].
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ISJM A study found that complaints of dry eye, eye strain, eye pain, headache and blurring of vision were common among computer users who had to look at the computer screen for more than 6 hours per day[5]. Also, red eye is typically caused by fatigue and eye strain such as reading in poor light and lack of sleep which the medical students are vulnerable to[6].
students of Saint Louis University. The objective of this study is to determine the association of Computer Vision Syndrome and the following symptoms: year level, sex, distance between the monitor and the subject, brightness of the screen, length of time spent using the computer per day and the kind of lighting used while using the computer.
Computers have become a permanent part of our lives. Yet this convenience has not come without a price to our health and general comfort level. Carpal tunnel syndrome has become a universally known term. Not so widely known is computer vision syndrome, or CVS, which in fact is far more widespread[7]. The American Optometric Association describes Computer Vision Syndrome (CVS) as a group of eye and vision related problems which results from prolonged computer use [8,9].The most common symptoms associated with CVS were eye strain, headaches, blurred vision, dry eyes and neck and shoulder pain which are known to be caused by poor lighting, glare on the computer screen, improper viewing distances, poor seating posture, uncorrected vision problems or a combination of these factors [10].
Methods
This topic was chosen to recognize the prevalence and the development of visual problems such as CVS of our fellow medical students as computer and other electronic gadgets became a vital part in daily study routine as well as to determine factors that worsen these conditions. In addition, no reports have been published regarding this topic. The purpose of this study is to determine the prevalence of Computer Vision Syndrome (CVS) among the medical
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Study design This study is a descriptive study and used a cross-sectional design to measure the outcomes and exposure status. These were measured simultaneously from a given population which was comprised of first year to third year level medical students of Saint Louis University, Baguio City, Philippines. The main exposure of the study was computer usage, and the outcome was the percentage of medical students who had signs and symptoms of computer vision syndrome (CVS). Setting The study was conducted in the School of Medicine Saint Louis University, Baguio City, Philippines. Questionnaires were floated during the month of December 2012 to the students involved in their respective classrooms per year level. Data was collected and tallied from December 2012 to January 2013. Participants The participants of the study were 165 first year, 155 second year and 150 third year medical students of Saint Louis University, totalling to 470 participants excluding the researchers. Only 417 participants responded from the total number of participants.
Issue 01 / July 2013 Flow Diagram 1st to 3rd year medical students of Saint Louis University n=470 Questionnaires were floated on respective classrooms n=470 Assessment of questionnaires
Questionnaires included in the study n=417
Excluded are 1. 4th year medical students 2. Absent students during the floating of questionnaires 3. Students who refused to participate 4. Members of the research group
Not included in the data: 1. Unanswered questionnaires 2. Questionnaires with incomplete data or unanswered items
Data available for analysis 1. Demographics (gender, year level) 2. Brightness of the screen 3. Distance between the monitor and the subject 4. kind of lighting used 5. Duration of computer use 6. Length of time spent in front of the monitor Variables The outcome was the presence of Computer Vision Syndrome or CVSin relation to the following variables or exposures such as year level, sex, lighting, length of exposure, distance from the monitor, symptoms experienced and time spent in front of the computer. The diagnostic criteria for CVS are as follows: those having minimum three symptoms of CVS (medical students complaining of complaining of eye strain, dry eyes,
blurred vision, redness, burning eyes, excessive tears, double vision, headache, glare sensitivity, fatigue, neck, shoulder and back pain); a minimum 1 hour exposure to any type of VDT like desktop, laptop or both; and a minimum of 1 year exposure to any type of above-mentioned VDTs[9]. Data Sources or Measurements
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ISJM The source of the data gathered was taken from the questionnaires floated and the response of the respondents. From the total number of 470 floated questionnaires, only 452 were retrieved back and from the 452 questionnaires, only 417 were utilized after the exclusion of incomplete questionnaires due missing responses. The data from each questionnaire was tallied using Microsoft Excel and was recorded by using frequencies and percentages. Chi square was used and subsequent P-values were recorded for the variables related to the outcome (CVS) such as year level, sex, lighting, length of exposure, distance from the monitor, symptoms experienced and time spent in front of the computer. Bias Potential bias could come from the filling in of missing data by the researchers which could influence the prevalence of CVS among medical students so this was avoided. The names of the respondents were not required in the questionnaire therefore maintaining confidentiality. Questionnaires with missing data were also excluded from the study. Study size The number of first to third year students enrolled in the School of Medicine in Saint Louis University determined the sample size with the exemption of the members of the research group. Quantitative variables It was decided that the best method to adopt for this investigation was the criteria for CVS used by Gangamma and colleagues [9]. Computer users complaining
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of at least a minimum of three symptoms such as: eye strain, dry eyes, blurred vision, redness, burning eyes, excessive tears, double vision, headache, glare sensitivity, fatigue, neck, shoulder and back pain, a minimum of one hour exposure to any type of Video Display Terminal (VDT) like a desktop computer, laptop or both and a minimum of one year exposure to any type of above-mentioned VDTs. Statistical methods The prevalence rate was calculated using Chi-square (Mann-Whitney), for the evaluation of the incidence of CVS and its relationship to year level, sex, lighting, length of exposure, the distance from the monitor, symptoms experienced and time spent in front of VDT daily. The P value was computed using Epi Info 7 and a p value of <0.05 was considered as significant. Results Table 1 (Distribution of medical students according to socio-demographic characteristics) showed that regarding demographic characteristics, a total of 417 medical students participated in the study. The majority of the respondents were female with a percentage of 59.7 and 40.3% of the population were males. The year levels included were from the first year to third year medical students of Saint Louis University and of the study population, 33.3 % were first year medical students, 33.3% were second year medical students and 32.9% were third year medical students. Majority of the participants (64.5%) were found to have CVS.
Issue 01 / July 2013 Two-hundred sixty nine respondents were found to have CVS out of the total 417 students who participated in the study as shown in Table 2(Prevalence of Computer Vision Syndrome Among Medical Students of Saint Louis University).Table 3 (Frequency of Symptoms of those with Computer Vision Syndrome)showed that the three most common associated symptom of CVS were eye strain (83.6%), followed by neck pain (81.0%) then head ache (62.5%). Using the Chi square test (Mann-Whitney test), it can be seen from
Table 4(Association of CVS to Specific Variables)that none of the variables were statistically significant except for Length of time spent using the computer in a day with a p value of 0.0412. The p values using Chi-square test were insignificant for the following variables: Year level with 0.2911, Sex with 0.3620, Distance between the monitor and subject with a p value of 0.6029, brightness of the screen with a p value of 0.3795 and kind of lighting with a p value of 0.7348.
Table 1: Distribution of medical students according to socio-demographic characteristics. VARIABLE
FREQUENCY
PERCENTAGE
Male
168
40.3 %
Female
249
59.7 %
TOTAL
417
100 %
1st year
141
33.8 %
2nd year
139
33.3 %
3rd year
137
32.9 %
417
100 %
Sex
Year Level
TOTAL
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ISJM Table 2: Prevalence of Computer Vision Syndrome Among Medical Students of Saint Louis University PREVALENCE OF CVS
FREQUENCY
PERCENTAGE
WITH Computer Vision Syndrome
269
64.5 %
WITHOUT Computer Vision Syndrome
148
35.5 %
TOTAL
417
100 %
Table 3: Frequency of Symptoms of those with Computer Vision Syndrome SYMPTOMS
FREQUENCY
PERCENTAGE
Eye Strain
225
83.6 %
Neck Pain
218
81.0 %
Head Ache
168
62.5 %
Blurred Vision
152
56.5 %
Fatigue
107
39.8 %
Dry Eyes
91
33.8 %
Glare Sensitivity
81
30.1 %
Red Eyes
58
21.6 %
Tears
48
17.8 %
Burning
43
16.0 %
Double Vision
37
13.8 %
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Issue 01 / July 2013 drops and SaptamritaLauha. Ayu [Internet]. 2010 Apr-Jun; 31(2): 236–239. Available
Figure 1. A standardized questionnaire used to gather the needed data adapted from Central Phoenix Eyecare[23].
from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215371/. 10.
Richardson, S., Sen, A. A Study of Computer-related Upper Limbs
Discomfort and Computer Vision Syndrome. J Human Ergol [Internet]. 2007; 36,45-50. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18572794 11.
Zairina, A.R., Atiya, A.S..Prevalence of Work-Related Upper Limbs
(WRULS) Among Office Workers. Asia-Pacific Journal of Public Health [Internet]. 2009; 21(3), 252-58. Available from: http://thescipub.com/pdf/10.3844/amjsp.2012.33.36 12.
Zairina A.R., Suhaila S.Computer User: Demographic and Computer Related
Factors that Predispose Userto Get Computer Vision Syndrome.International Journal of Business, Humanities and Technology [Internet]. 2011 Sep; Vol. 1 No. 2. Available from: http://www.ijbhtnet.com/journals/Vol_1_No_2_September_2011/11.pdf 13.
Subratty, A.H., Korumtolee, F. Occupational Overuse Syndrome Among
Keyboard Users in Mauritius. Indian Journal of Occupational and Environmantal Medicine
[Internet].
2005;
9(2),
71-75.
Available
from:
http://www.bioline.org.br/pdf?oe05017 14.
Iwakiri, K., Mori, L., Sotoyama, M., Horiguchi, K., Ochiai, T., Jonai, H., Saito,
S.Survey on Visual and Musculoskeletal Symptoms in VDT Workers. Journal of Occupational Health
[Internet].
2004;
46(6),
201-12.
Available
from:
http://www.ncbi.nlm.nih.gov/pubmed/15656081
15. Green, R.A., Briggs, C.A. Prevalence of Overuse Injury among KeyboardOperators;
Characteristics ofThe Job, Operator And The Work Environment. J OccupHealth Safety Aust New-Zealand. 2009; 6,109-18. Available from: www.bioline.org.br/request?oe05017 16. American Association of Medical Schools:AAMC Data Show Women Students Are The
Majority Among Entrants to 40 Medical Schools [Internet]. 1999 [cited 2013 Mar 12]Available
References
17. SmitaAgarwal, DishanterGoel, Anshu Sharma.Evaluation of the factors which
1.
Kho, Anna, Henderson, Laura, Dressier, Daniel, and Kripalani Sunil Use of Handheld Computers in Medical Education: A Systematic Review.Journal of General Internal Medicine [Internet]. 2006 [cited 2013 Mar 12]; 21: 531-537. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16704405 2. Yin, LohKeng.Understanding and Preventing Computer Vision Syndrome. Malaysian Family Physician [Internet].2008 [cited 2013 Mar 12];3(3):128-130. Available from: http://www.emfp.org/2008v3n3/pdf/computer_vision_syndrome.pdf 3. Charpe, NamrataArora and Kaushik, Vandana. Computer Vision Syndrome (CVS):Recognition and Control in Software Professionals. J Hum Ecol [Internet]. 2009 [cited 2013 Mar 12]; 28(1): 67-69. Available from: http://www.krepublishers.com/02-Journals/JHE/JHE-28-0-000-09-Web/JHE28-1-000-09-Abst-PDF/JHE-28-01-067-09-1900-Charpe-N-A/JHE-28-01-06709-1900-Charpe-N-A-Tt.pdf 4. Rosenfield M. Computer Vision Syndrome: a Review of Ocular Causes and Potential Treatments. Ophthalmic and Physiological Optics [Internet]. 2011; 31: 502-515. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21480937 5. Izquierdo JC, Garcia M, Buxo C and Izquierdo NJ. Factors leading to the Computer Vision Syndrome: an issue at the Contemporary Workplace. Bol Asoc Med P R. 2007 Jan-Mar;99(1):21-8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17616042 6. Shroff, Anand.Common Eye Problems amongst Older College Students[Internet]. 2007 Oct 18 [cited 2013 Feb 25]. Available from: http://www.whereinthecity.com/medical/topic/eye-and-vision/articles/256.htm 7. Torrey, Jon. Understanding Computer Vision Syndrome.Employment Relations Today
Spring.
2003:
45-51.
Available
from:
http://www.prio.com/consumers/understanding_cvs.cfm 8.
American Optometric Association: Computer Vision Syndrome
contribute to the ocular complaints in computer users. Journal of Clinical and Diagnostic
Research [Internet]. 2013 February [cited: 2013 Mar 11]; 7:331-335. Available from http://www.jcdr.net/back_issues.asp?issn=0973709x&year=2013&month=February&volume=7&issue=2&page=331-335&id=2760
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F.R. Sanchez-Román, C. Pérez-Lucio, C. JuárezRuiz, N.M. Vélez-Zamora and M. Jiménez-Villarruel. Risk factors for asthenopia among computer terminal operators.SaludPública de México 38 [Internet]. 1996 [cited 2013 Mar 12]; 189-196. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8757544?dopt=ExternalLink
19.
Uchino M, Schaumberg DA, Dogru M, Uchino Y, Fukagawa K, Shimmura S, Satoh T, Takebayashi T, Tsubota K.Prevalence ofdry eye disease among Japanese visual display terminalusers. Ophthalmology [Internet]. 2008; 115: 1982–1998 [cited 2013 Mar 12]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18708259
20. Blehm C, Vishnu S, KhattakA et al. Computer visionsyndrome: a review. SurvOphthalmol.
21.
clinical study on “Computer vision syndrome” and its management with Triphala eye
[cited
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Mar
12];
50:
253–262.
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Salibello, C, and Nilsen, E. Is there a typical VDT patient? A demographic analysis. J. Am.
Optom. Assoc [Internet]. 1995 Aug [cited 2013 Mar 20]: 66: (8) 479-483. Available from http://www.ncbi.nlm.nih.gov/pubmed/7494082 22.
Gangamma, M.P., Poonam and Rajagopola, Manjusha.A
2005
http://www.ncbi.nlm.nih.gov/pubmed/15850814
[Internet]. [cited 2012, Nov 13]. Available from: http://www.aoa.org/x5253.xml 9.
from:
https://www.aamc.org/newsroom/newsreleases/1999/95352/991026a.html
American Optometric Association: The Relationship of Computer Vision
Syndrome to Musculoskeletal Disorders [Internet]. 1997 [cited 2013 Mar 20]. Available from http://www.aoa.org/x5378.xml
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ISJM ASSESSMENT OF STUDENTS’ AWARENESS ABOUT HARM OF KALIAN SMOKING Myrzabayeva Zhansaya Scientific adviser: Darmen N.Zh., MD, Department of Public Health S. D. Asfendiyarov Kazakh National University, Almaty, Kazakhstan
The purpose and objectives of the study
1) Analysis of information about kalian;
Kalian is a means of tabacco smocking like cigarettes.
2) Compilation of inquiry among students for the purpose of evaluation of their awareness of this subject;
Number of people smocking kalian every day is 100 million of people. Nowadays increasingly larger number of young people is involve in kalian smoking being an integral part of pleasant pastime. The most frightful thing is the fact that kalian is becoming the element of good living. Ministry of Health has warned that smoking of kalian is dangerous for health. 90 percents of people using this type of tobacco smoking at least three times a week run into dependence on kalian smoking. According to specialists, a person smoking kalian during one hour inhales 100-200 more much smoke than during cigarette smoking. Besides, people sitting next to the smoker run even higher risk than the smoker itself [1]. Nicotine contained in it poisons body filling lungs with asphixing gas. And kalian aperture serves as a spawn of such contagious diseases as hepatitis, herpes, tuberculosis etc. [2,3]. Besides, the body of a kalian smoker absorbs benzapyrene, recognized to be a toxical substance. Also it is factor having a high impact on human’s genes disturbance. Kalian smoking results in saturation of hemoglobin with carbon dioxide more than with oxygen. Therefore, hypoxia (oxygen deprivation) is very common among kalian smokers. As a result cells of brain, heart, liver, kidneys, muscles etc. suffer [4]. Work objectives
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3) Drawing up of diagram based on the results of inquiry and research work; 4) Compilation of evidences concerning harm of kalian for health and appropriate recommendations.
70 students of 3-5 courses were engaged in the study. The inquiry consisted of 13 questions. Methods In connection with the abovementioned information, a research work was carried out in Kazakh National Medical University named after Asfendiyarov with the purpose of finding occurrence of kalian smoking and valuation of students’ awareness of kalian smoking hazards. Results Based on the results of the study it has become clear that: - kalian smoking among students is encountered 2 times more frequently than cigarette smoking, among young girls alone kalian smoking index is 3 times more than cigarette smoking index. Besides, it has been found that 62%-66% of students do not know about the harm of kalian or consider it to be not detrimental to health;
Issue 01 / July 2013 - the most common reasons of kalian smoking are “socially” (61%) and because of clouds of smoke (48%);
Conclusion In summary we would like to know that young people do not understand and do not feel the harm caused to body by kalian smoking, and if they know, they prefer to keep their mind off this for the sake of instant gratification. Nevertheless, kalian lovers should know that kalian kills faster than cigarettes do.
- in respect of kalian smoking frequency it has become clear that kalian smoking “once a month” is the most commonly encountered and duration of one smoke is up to half an hour, dependence on kalian has not been detedted; - it has also become clear that students use kalian together with alcohol (39%); - it is important to note that in spite of awareness of kalian smoking harm (38%55%), kalian smoking is wide spread, moreover, harmful consequence from its smoking is considered to be less than from cigarette smoking (52%).
References 1.
«Қорқор тартып, қор болма, құрбым!» (article, Agiba Mustazhapkyzy, provincial broadsheet “Atyrau”).
2.
Қорқордан сақтаныңыз! Ashykbayeva Shattyk.
3.
«Қорқордың (кальян) денсаулыққа келтірер зияны» article, Makhabbat Abdeshova, shymkent.otyrar.kzshymkent.otyrar.kz
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ISJM MEDICAL AND SOCIAL CHARASTERISTICS OF HEALTH NURSE Abdilda Gabit Alimuly Scientific adviser: Kozhekenova Zh.A.,PhD, Assistant Professor, Department of Public Health S. D. Asfendiyarov Kazakh National University, Almaty, Kazakhstan
The purpose and objectives of the study to evaluate Health Nurse’s medical and social characteristics. To research nurse’s social characteristic working in hospitals №18, №13, №5, №2,№8, and offer better ways to develop it. Tasks assigned to achieve the result: 1. To analyze scientific literature about health nurse’s labor and health conditions 2. Analysis of results of nurse’s health conditions, medical activity and medical healthcare shown to them 3. To find out the impact of labor factors to the nurse’s health based on special research materials and classify them. 4. Making a proposal for a healthy lifestyle of nurse’s and making recommendation for a better health Methods The difference between nurse’s work and their salary is too big. The salary ranges of nurses occupy last place among all Healthcare system employees. According to the nurses their salaries can’t provide the average standard of living. Nurse’s offer is to provide social benefits of their families, motivate them to work and meet their financial needs. Amount of nurses working less than 1 year - 5,9%, working 4 -9 years - 19,6%, working 10-14 years 21,6%. The amount of nurses with work experience 15 – 19 years - 3,9%. Amount of nurses working 20-24 years – 9,8%. The nurses who working more than 25 years – 11,8%. A group of nurses with 1-3
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years of work experience is the largest, because they are young specialists. Results Analyzing nurses’ health and their healthcare we see that their work conditions causing problems in family, conflict situations in collective, and bad habit consumptions. Talking about the living conditions of nurses 25% of them live in rented apartments. 5,9% of nurses lives in dormitory, friends and acquaintances. 17,6 % of nurses lives in their own apartments. The biggest percent of nurses (45,1%) lives in a houses. 29,4% of respondents said that the harmful factors causing health problems it is the psychological and emotional instability and 27,5% of nurses answered “wrong time feeding”, because it may cause serious health problems. The reasons which cause bad habits is the competition among them, answered 3,9% of respondents. Furthermore, the reasons which causing health problems are low social level of life, extra job during holidays, lack of recreational sports facilities answered 17,6%. Nowadays, problems of occupational diseases are given special attention. First of all they are chemical, physical and toxic substances of biological origin, radiation and infections. Emotional factors or stresses became not the main theme of research. Those harmful factors and mostly occupational stresses cause diseases such as neurotically syndrome and psychosomatic conditions. 3,9% of respondents are in sports this is a very low figure.
Issue 01 / July 2013 27,5% of nurses engaged in physical medical culture. The amount of nurses who not in spots, but want to be are 60,8%, and percent who not in sports and do not want 7,8%.
3. The harmful agreement factors of nurses negatively impacts on their health. Working with ill people (patients pathologically changed psychology), emotional overload, super infections and stress during emergency cases all this conditions impacts on agreement. Find out dependence of harmful factors, healthcare system should pay attention on nurse’s housing-living conditions, and lead to normal emotional burden.
Conclusion Analyzing health nurses labor condition we see that nurses do not have opportunity to take care of their own health because of endless problems in private and professional life. In order to solve health problems, employers should develop healthcare mechanisms and the optimal ratio of work and rest, prevention of diseases and develop quality of medical services, all this arrangements should be science based.
4. Specialized clinics should provide differential salary payment for the effort, in other words to lead material motivation. “Sport is the guarantor of health”, but nurses who do not want to be in sport and who do not, this is because of lack of time on it, this type of nurse’s percentage is high. Another type of nurses who totally does not want to be in sports, explains it by extra job during holidays and psycho-emotional stresses. Through aiming to recovery (body activity, intensive self-cultivation, rational feeding etc) form a healthy lifestyle of nurses.
Practical recommendations 1. To create system of differentiation of salary pay based on qualification, labor conditions, volume and quality of medical service provided by employee. Making comparison with other healthcare system specialists and provide necessary recourses. 2. Using mechanisms of Kazakhstan healthcare system create Conception of Health Nurses which provides benefits for the nurses; consequently make citizens Republic of Kazakhstan healthier.
References 1.
Modern problems of a personnel imbalance in system of sisterly service of the region//Natural sciences and humanity: modern world, nature and person – 2007. №5. Р-65
2.
Methodical approaches to studying and an assessment of a state of health of average medical workers //Social and hygienic monitoring of health of the population. Materials of the 11th republican scientific and practical conference with the international participation – Ryazan, 2007, - Р 123-126
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ISJM INVESTIGATION OF STOMATITIS CAUSES AMONG THE STUDENTS AND DEVELOPMENT OF "PHYTOMEDICATION" FOR THE PREVENTION AND TREATMENT D. Sharipov (DShK1@mail.ru) Scientific adviser: G.Pichhadze (guram@yandex.ru), PhD, professor, Department of Pharmacology S. D. Asfendiyarov Kazakh National University, Almaty, Kazakhstan
Introduction In the Republic of Kazakhstan among the children aged from 6 months to 16 years who applied to the dental clinic, the cases of stomatitis 90%, with 80% of acute herpetic stomatitis. Therefore, the development of effective pharmacon for the prevention and treatment of stomatitis is an urgent. Purpose The aim of this work is to investigate the causes of stomatitis among students and its influence on their attendance and performance, as well as to provide them an effective "Phytomedication" for the prevention and treatment, handy in using and in mobile formulation. Materials and methods Designed composition comprises a substance derived from medicinal plants, which have a wide range of pharmacological effects, and applicatory no side effects. The compositions include extracts of chamomile flower, which has an antibacterial, anti-inflammatory, soothing and recovering effect. Glycyram water-soluble salt of monoammonium of glycyrrhizic acid, a derivative of licorice root which has an anti-inflammatory, antiviral activity and has a sweet taste, also serves as a flavoring component. An extract of oak bark, contains tannin, used as an astringent. Peppermint oil was introduced to impart a pleasant odor, as well as all essential oils have antiseptic activity. Rosehip extract and oil is
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used in the treatment of ulcers and fissures in the oral cavity, to promote healing. At the laboratory of Santo, Member of Polpharma Group received extractive substance and extracts from plant material, select the rational structure of auxiliary substances and developed the technology of the "Phytostom" drug. The new pharmacon is designed in optimal dosage form for students: in granular form which packed in sachets and in the plates. The main advantages of the granular formulation and plates are high bioavailability, rapid onset of therapeutic effect, portability, an accuracy of dosing, storage stability and the possibility of correction of unpleasant sensory properties of drugs. Results The results showed that the cause factor of stomatitis is various: mechanical trauma, infections, allergies, etc., but always stomatitis causes pain, discomfort and suffering. Also revealed that one of the common reasons for the development of stomatitis and recrudescence in adolescents feedings in the times of recreation, caused no personal hygiene, lack of capability to neutralize food particles and their degradation products, leading subsequently to pathological disorders of the gastrointestinal tract.
Issue 01 / July 2013 Conclusion In summary, as a result of the study: - ostended the basic reasons for the development of stomatitis among students and its negative impact on their academic performance and attendance;
- derived biologically active substances from endemic medicinal plants; - developed the technology of the new domestic pharmacon of oral using for the prevention and treatment of stomatitis (obtained the Innovation patent of the Republic of Kazakhstan for the drug "PhytostomÂť â&#x201E;&#x2013; 23948).
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ISJM DRUGS, USED IN COMBINED INJURIES Eismont V. V.MussinaA. M. Scientific advisers: doc. Kim I. I., prof. Kadirova D.M., Department of Pharmacology S. D. Asfendiyarov Kazakh National University, Almaty, Kazakhstan
Introduction According to different authors from 1723% prescribed by doctors combinations of drugs are potentially dangerous. Only 68% of patients receiving potentially dangerous combinations of drugs that are developed adverse drug reactions. At the same time, according to the statistics of adverse drug reactions die each year a huge number of patients, causes of death, a third of them are drug interactions are usually associated with the use of potentially dangerous combinations of drugs. Adverse drug reactions (ADRs) in the application of a potentially dangerous combination, as well, are a serious economic problem because cost for their treatment is one half of the cost of drug therapy of complications. In respect of associated injuries prescription drugs is complicated by the lack of a certain standard and protocol for concomitant injuries, there are only records for a single injury, the choice of drugs involves the allocation of lead damage, which can also cause some problems. So may experience side effects from adverse drug interactions, as an attempt to relieve complications of a single fault can lead to the inability to accurately diagnose damage to other anatomical areas. In the structure of combined injuries (CI), the most frequently encountered in the city of Almaty patients with CI unpadded damage and damage to the CI with the leading two or more cavities, are also frequent victims with leading brain injury
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(LBI), and with the leading musculoskeletal injury off the motor system. Associated injuries are accompanied by severe complications as massive blood loss, acute respiratory failure (shock lung), acute renal failure (shock kidney), brain coma and fat embolism. Accordingly drug therapy aimed at eliminating the abovementioned complications. In addition to the importance of the severity of the injury action presents drugs on the following factors: the age of the victims, sex, and physiological condition of the body (the presence of alcohol or drugs). Materials and methods In our study examined three groups of patients with combined injuries: CI unpadded damage CI leading musculoskeletal injury damage, leading to a brain injury. Besides all affected divided into three ages up to 14, 15 to 59, from 60 and above. 1) Combined injury unpadded damage (multiple trauma) is 42% of the total number of people affected with combined injuries. This group is the most promising with respect to the life prediction and rehabilitation. Casualties included in the study 288 people, including 20 children aged man suffered from 16 to 59 - 246, 60 to 91 - 22 people. In this group, all violations of the pathophysiological expressed moderately and relatively easy to correct.
Issue 01 / July 2013 The main complication of this group suffered a traumatic shock (45% of the victims were in a state of shock), respectively, in all of this group, the most frequently used blood replacement drugs and narcotic analgesics. The first aged moreover applied antihypoxants, glucocorticosteroids, calcium channel blockers. We have found that dosing of opioids does not reflect the patient's age and the severity of his condition. In the third age group, and in rare cases prescribed non-narcotic analgesics. The study met some drug interactions, which were divided into favorable and unfavorable. Adverse are allocated following "tandems" drugs: a) promedol+fentanyl increase intracranial pressure and can lead to CNS depression, hypotension and inhibition of respiratory center; b) promedol+ nifedipine, increased neuromuscular blockade due to the neurotoxic effects of promedol; c) glucose + prednisolone, as they potentiate the effect of each other and may lead to hyperglycaemia. A favorable interaction tramadol + ketonal was attributed, as they potentiate the analgesic effect of each other. 2) Associated with the leading brain injury is only 6% of the total number of injuries, but it is necessary to mention that the brain injury with varying degrees of severity are included in the other groups combined injuries. Under CI leading to death is concomitant 44% and 32% of CI two or more cavities, while within this group in 96% of one of the leading damage was BCI. From these data it can be concluded that a major cause of death in 72% of a severe head injury. The most
frequent and severe complication in this group are brain coma and traumatic shock. In this group, the most commonly used drugs blood replacement drugs as well as in the previous group for narcotic analgesics are not taken into account in relation to the dosage of gravity of the injury and the age of the patient. Second age group was also found that the purpose of morphine is known to unacceptable because morphine subsequent diagnosis difficult and can lead to brain edema. In the third age group were appointed as adrenergic agents victim, who was in Grade 3 shock 3) Associated with trauma injury leading musculoskeletal injury. 10% of the total number of victims is with associated trauma. The main pathophysiological manifestation: a classic traumatic shock, fat embolism, and may cause cerebral coma, massive blood loss. In the future, patients often develop acute renal failure. In this group, the most commonly used narcotic analgesics (37% of the total number of prescribed narcotic analgesics), and as in the other groups in the appointment of dosage is not taken into account the severity of injury and the age of the patient. Also, we have revealed the appointment of narcotic analgesics victim was in a state of intoxication, which can lead to increased intracranial pressure, brain depression, hypotension and respiratory center. Conclusion The use of pre-hospital supportive "tandem", the exclusion of negative side effects and undesired combinations of the above, it may: â&#x20AC;˘ help to improve care at the stage of SMP â&#x20AC;˘ reduce the time the rehabilitation of victims â&#x20AC;˘ to reduce disability and mortality.
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ISJM THE DYNAMICS OF THE SYSTEM OF GUARANTEED FREE MEDICAL CARE (GFMC) IN REPUBLIC OF KAZAKHSTAN Kozina A.B. (Kutya_kz@mail.ru), Sabirova V.K., Shopabaeva A.R., Khimenko S.V. S. D. Asfendiyarov Kazakh National University, Almaty, Kazakhstan
Introduction In the Republic of Kazakhstan is increasing every year the amount of drug assistance to outpatients and inpatients at the expense of the state within the state benefit package that has great social significance for the health of the Kazakh people, and improve the quality of life of the population of Kazakhstan. Purpose To analyze the state of free drug supply in the Republic of Kazakhstan, as well as the results of the state program "Salamatty Kazakhstan 2011-2015" at the beginning of 2013. We used the statistics of the program, government regulations, reference literature, proceedings of the conference, professional news publications, etc. Materials and methods For research methods were used: a meta analysis, statistical and comparative analysis. Found that during the period 2010 - 2013 years number of items of drugs dispensed for the guaranteed volume of free medical care (GVFMA) increased from 179 to 276 positions i.e. by 44%. To the list of drugs in a free vacation were additionally included drugs in the following pharmacotherapeutic groups: antihypertensive drugs (22preparata), anticancer drugs (20), antidepressants
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(16), antidiabetic agents (11), antimicrobial agents (3), and the remaining seven pharmaceutical groups are a total of 25 agents. Expanded range of diseases that are subject to free drugs, from 46 to 54 diseases, to include systemic lupus, erythematosus, Gaucher's disease, chronic obstructive bronchitis, osteoarthritis, hepatitis B and C, cystic fibrosis, and autoimmune disease mucopolysaccharidosis amount annually purchase drugs for free drugs, was redistributed for the study period from 77 to 72 billion. At the expense of reducing the burden on hospitals and increasing the share of financing outpatient drug coverage to 25 billion. Conclusion Marked redistribution of budgetary resources from the hospital sector to outpatient. Expanding the range of diseases in the system of GVFMC. Since 2012, the category of grace reclassified as free dispensing of medicines for the treatment of diseases of 7. Increased the number of positions of drugs in the system of free drug coverage from 179 to 276 drugs. Optimized the process of getting free drugs for outpatients at the expense of drug release data from hospital pharmacies. Established sufficient dynamics of the state program "Salamatty Kazakhstan 2011-2015"
Issue 01 / July 2013 ANTIOXIDANTS IN STRESSFUL SITUATIONS Balmukhanova Altynay (goldmoon91@mail.ru) S. D. Asfendiyarov Kazakh National University, Almaty, Kazakhstan
Keywords: antioxidant, stressful situation, adaptogenic properties. Background The free-radical mechanisms involved in the pathogenesis of different diseases. The development of the peroxide oxidation might be terminated by inhibitors. In the clinic practice the most widely used are natural non-enzymatic antioxidants due to their adequate efficiency and lack of the side-effects. Therefore, the aim of this study was investigation of adaptogenic properties of the antioxidant mixtures 1 and 2. Materials and methods Adaptogenic properties of the mixtures №1 and №2 were studied on 54 mice. The mixture №1 is a complex of vitamins C, E, A in doses of 100,2 mg/kg, 20,4mg/kg, 10,2mg/kg approximately, and glucose of 100,2 mg/kg. The mixture №2 - vitamins at the same doses with addition of microelements (copper, zinc, selenium). The mixtures were introduced into the stomach through the esophageal probe every day for two weeks. Then the animals were exposed to stress. The models of extreme situations were normobaric and
hemic hypoxia and tests for endless swimming. In all cases we recorded the lifespan of animals. Results When is used the mixture №1 the lifespan in the normobaric hypoxia was statistically significant higher than the appropriate index of the control group in 1.5 times, and when is used the mixture №2 - in 1.6 times, approximately. In the second series of experiments (hemic hypoxia) the tendency to increase of the lifespan of mice treated with the mixtures is also noticed. The results of the third series of experiments show statistically significant increase of the lifespan of mice treated with the mixture №1 in 1,3 times, and especially with the mixture № 2- in 1,5 times. Conclusion The antioxidant complex is an adaptogen for organisms exposed to a stressful situation. The efficiency of the mixture №2 is higher than №1, due to the fact that it consists of vitamins and microelements.
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ISJM ANALYSIS OF THE RESULTS OF X-RAY CONTRAST OBSTRUCTION OF LACRIMAL APPARATUS OF THE EYE O.G Uldanov, V.A.Dudkov, V.A.Nurakhunova (venera.med@mail.ru) S. D. Asfendiyarov Kazakh National University, Kazakh Research Institute of Eye Diseases, Almaty, Kazakhstan
Abstract The article highlights the issues of frequency of occurrence of various departments obstruction of lacrimal apparatus of the eye. The analysis of the presence of this disease according to the X-ray laboratory of the KSRIED. Keywords: lacrimal apparatus of the eye, obstruction, rinsing, the frequency of occurrence. Introduction The article highlights the issues of frequency of occurrence of various departments of obstruction of lacrimal apparatus of the eye. The analysis of the presence of this disease according roentgen lab of KazNIIGB. Pathology of the lacrimal apparatus still remains one of the most pressing problems in ophthalmology and rhinology. Diseases of the lacrimal are widespread. Structural features of the lacrimal are such that they are predisposed to narrowing or occlusion of the lumen, even from a small swelling of the mucous membrane (injuries, diseases of upper respiratory tract). The persistent tearing that occurs in chronic dakritsistite or stenosis of lacrimal apparatus of the eye, not only causes discomfort (blurred vision, skin maceration and a high probability of joining a secondary infection), but also reduces the ability to work. Persons suffering from watery eyes, unfit for duty in a number of occupations that require a high vision. Lacrimation is an aesthetic flaw. Joining a secondary infection can lead to complications such as dacryocystitis, lacrimal sac abscess, which
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pose a direct threat to the eye and is an absolute contraindication for elective surgery on the eyeball. According to the literature lacrimal disease found in 10% of outpatients and more than 7% of patients with ocular stationary. In the case of patients with obstruction of the data sent to the Xray contrasting lacrimal system to determine treatment strategy. However, data on the incidence of diseases of various departments of the lacrimal apparatus of the eye in the literature we found. The causes lacrimation, diverse. They may be to pathological changes in any part of the outflow of tears. More than half of patients admitted to hospital with watery eyes, have chronic suppurative dacryocystitis, obstruction of the nasolacrimal duct or recurrence of watery eyes due to overgrown rinostomy after dacryocystorhinostomy. Prevention of relapse of chronic suppurative dacryocystitis after surgery DTSRS to date is relevant and significant social problem. The aim of the study To investigate the frequency of obstruction of lacrimal apparatus of the eye.
Issue 01 / July 2013 Materials and methods
Conclusion
The 1501 X-ray images lacrimal with the introduction of X-ray contrast media in 1039 patients who underwent X-ray examination in the laboratory KazNIIGB in 2010-2012. The study of the frequency of occurrence of various types of obstruction.
1. The most frequently encountered up to 65% complete obstruction lacrimalis apparatus of the eye, where because of the duration of the process is not possible to pin point the affected department.
In the period from 2010 to 2012 KazNIIGB in 1039 patients (1501 eyes) were conducted radiography lacrimal apparatus of the eye with the introduction of X-ray contrast agents in age from 15 to 85 years. Results In 568 patients (816 eyes - 54.4%) were diagnosed with an absolute obstruction of the nasal lacrimal duct with a sharp increase in the lacrimal sac. These patients were sent to surgery. Partial obstruction in the nasal lacrimal duct was reported in 409 patients (574 eyes - 38.2%). The narrowing of anastomosis tear ducts with the lacrimal sac was noted 40 patients (75 eyes - 5%). As a result of X-ray contrast in 22 patients (36 eyes - 2.4%) was achieved complete patency of lacrimal apparatus.
2. The defeat of the naso-lacrimal duct 38% of cases indicates a mandatory consultation ENT physician in cases of surgical treatment indicates the need for endonasal surgical approach. 3. Narrowing of anastomosis Lachrymal with lacrimal sac, as well as partial obstruction requires the development of more effective pharmacological treatments. 4. Rentgenkontrastirovanie is not only accurate diagnostic study, but in 2.4% allows you to fully restore patency of the lacrimal apparatus of the eye and avoid surgery. References 1. Astakhov YS, Ryabov, MA, Kuznetsov N., Derain KA Modern methods of diagnosis and treatment of lacrimal organs. - M., 2005.-S. 41-45. 2. Beloglasov VG Atkov EL, Malaeva LV, Chinenov IM Modern technologies of diagnostics and treatment in oftalmologii.-Makhachkala, 2004. - P.82-84. 3. V.V.Volkov, M.Yu.Sultanov "External dacryocystorhinostomy." Leningrad, "Medicine", 1975.
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S.D.Asfendiyarov Kazakh National Medical University International Students Journal of Medicine (ISJM) Issue 01 / July 2013 http://www.isjm.kaznmu.kz Editorial Board is not responsible for the content of publications. Authors of the works are responsible for the content of the articles.