International Medical Journal

Abstract :

За период с 2009 по 2018 год в Шымкенте зарегистрировано 1664 случая суточной смертности больных острым инфарктом миокарда (ОИМ) со снижением с 227 случаев в 2009 году до 63 в 2018 году. Мужчины по сравнению с женщинами более подвержены риску смерти в молодом возрасте (18-44 года), среднем (45-59 лет) и пожилом (60-74 года). На зимний сезон приходится 26,4% смертей, весенний -26,1% и осенний -25,7%, низкая смертность наблюдается летом 21,8%. В холодный период года (ноябрь-март) смертей на 10,0% меньше, чем в теплый период (апрель-октябрь). Однако при пересчете этих показателей на каждые 1000 случаев смерти смертность от ОИМ в холодный период года на 76 случаев выше, чем в теплый. Во все сезоны года показатели смертности повышаются с увеличением возраста больных и преобладанием мужчин в первых трех возрастных группах, особенно в молодой (в 5,7 раза) и средней (в 5 раз). В старческом возрасте смертность от ОИМ заметно снижается и чаще встречается у женщин (в 1,7 раза). Анализ особенностей годовой динамики смертности от ОИМ у взрослого населения г. Шымкента за период с 2009 по 2018 год с использованием индекса сезонности (Си), рассчитанного для каждого месяца и сезона с учетом пола и возраста больных, показал, что высокий риск смертности от ОИМ примерно эквивалентен для трех сезонов года (зима, весна, осень), при некоторой распространенности смертности у мужчин зимой и у женщин весной и осенью. Летом риск развития ОИМ значительно меньше у мужчин и женщин. Существует очень высокий риск увеличения смертности, вызванной ОИМ, во все сезоны года у пациентов в возрасте 45 лет и старше, особенно у пожилых людей. Для всех возрастных групп наибольший риск наблюдается в октябре-декабре. Кроме того, существует высокий риск для молодых людей в июле, средний - в январе, пожилого и старческого возраста в марте.

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Abstract : The purpose of the study was to investigate the structure of cardiovascular comorbid states, their frequency dynamic within the study period, as well as predictors of new-onsets events in end-stage renal disease (ESRD) patients and its incidence rate depending on dialysis modality. The prospective observational cohort study involved 326 ESRD patients, 223 of whom were treated with hemodialysis (HD) and 103 with peritoneal dialysis (PD), between 2012 and 2019. Average duration of prospective observation was 42.2 ± 26.4 months. Оf particular interest were new-onset cardiovascular diseases (CVD). Within the observational timeframe the portion of CVD patients increased by 25.6% and 20.3%, when treated with HD and PD respectively (p=0.2978). The incidence of coronary artery disease was significantly higher in HD compared to PD patients. (23.8% to 8.8%, р = 0.0014; RR 2.7200; 95% СІ: 1.3961 – 5.2992). However, the incidence of heart failure was higher in PD compared to HD patients (20.4% to 5.5%, р < 0.0001; RR 3.7888; 95% СІ: 1.9393 – 7.4023). The independent predictors of new-onset CVD in studied cohort were: diabetes mellitus (HR 2.3116, 95% СІ: 1.5664 – 1.5664), history of MRSA carried (HR 2.1535, 95% СІ: 1.3578 – 3.4156), age (HR 1.0323, 95% СІ: 1.0183 – 1.0465), PD treatment (HR 1.8205, 95% СІ: 1.1259 – 2.9435), serum albumin levels (HR 0.9532, 95% СІ: 0.9122 – 0.9961). The observed results demonstrate an over-time significant increase in frequency of CVDs in those suffering from ESRD. A difference was established in the structure of new-onset CVD events, as well as their predictors, between PD and HD groups.
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Abstract : Consumption of vegetables and fruit in obese adolescents is still very low. One of the efforts to improve it is by providing nutrition education. This study aims to compare the effectiveness of leaflets and short message service (SMS) in changing the pattern of vegetable and fruit consumption among obese adolescents. The research design was an experimental study with a non-randomized pre-post test design. This research was conducted for 5 months in which respondents were given intervention for 1 month. The method of selecting subjects using purposive sampling method, the number of samples of each group of 20 people. The Wilcoxon test was used with a significance level of p <0.05. The results showed that the mean score of the group educated with leaflets and SMS had a significant increase (p = 001 and p = 0.002). Where education with leaflets increases the knowledge score by 2.2 points and education via SMS increases the knowledge score by 2.35 points. Education with leaflets and SMS can significantly increase the frequency of vegetable consumption (p = 0.002 and p = 0.005). Where leaflets increased the frequency of vegetable consumption by 1.13 times per day and SMS increased the frequency of vegetable consumption by 1.37 times per day. Nutrition education using sms media can be an alternative to increase the consumption of vegetables and fruit in obese students. It is recommended to use other types of media to conduct nutrition education, such as social media which are now so familiar and loved by students. Consumption of vegetables and fruit in obese adolescents is still very low. One of the efforts to improve it is by providing nutrition education. This study aims to compare the effectiveness of leaflets and short message service (SMS) in changing the pattern of vegetable and fruit consumption among obese adolescents. The research design was an experimental study with a non-randomized pre-post test design. This research was conducted for 5 months in which respondents were given intervention for 1 month. The method of selecting subjects using purposive sampling method, the number of samples of each group of 20 people. The Wilcoxon test was used with a significance level of p <0.05. The results showed that the mean score of the group educated with leaflets and SMS had a significant increase (p = 001 and p = 0.002). Where education with leaflets increases the knowledge score by 2.2 points and education via SMS increases the knowledge score by 2.35 points. Education with leaflets and SMS can significantly increase the frequency of vegetable consumption (p = 0.002 and p = 0.005). Where leaflets increased the frequency of vegetable consumption by 1.13 times per day and SMS increased the frequency of vegetable consumption by 1.37 times per day. Nutrition education using sms media can be an alternative to increase the consumption of vegetables and fruit in obese students. It is recommended to use other types of media to conduct nutrition education, such as social media which are now so familiar and loved by students.
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Abstract : Measurement of ventricular size is important in pediatric patients with hydrocephalus, especially those who are being followed with CSF shunts. 56 computed tomography (CT) and magnetic resonance imaging (MRI) scans from children aged 1 month to 1 year with hydrocephalus (HC), before and after treatment, were measured. Before measurement of thalamo-occipital distance (TOD) was performed only by ultrasound. We suggest implementation of TOD to other imaging modalities such as CT and MRI. Measurements were made in 56 patients with HC and 30 healthy children to determine the normal values and classify its severity. TOD was compared with Evans index and head circumference. We used the Pearson's correlation coefficients and correlations were further differentiated using a t-test statistic. The normal TOD is less than 3 cm. Distance between 3.0-3.7 cm is considered as mild, 3,71-4.4 cm moderate, more than 4,41 cm as severe degree of HC. The TOD measurement is a simple method of evaluating ventricular size in pediatric HC patients. The TOD showed high sensitivity (96%) and specificity (93%) in the diagnosis of HC in children.
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Abstract : Inguinal hernia is a common surgical disease. Giant inguinoscrotal hernias are more unusual and impose significant impact on quality of life including difficulty with mobility, scrotal skin ulceration and bowel obstruction. Besides it is more challenging in terms of surgical management. Diagnosis of giant inguinoscrotal hernia is straight forward on clinical examination. Nevertheless, with the advent of CT scan, pre-operative contrast-enhanced CT scan is useful for ascertaining the hernia contents, its configuration and measuring the neck of hernia. We report a case of a patient with extremely huge irreducible right giant inguinoscrotal hernias.
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