ISJM

ISJM

MAIN REASONS FOR DETERIORATION OF WORK OF THE CHEMIST'S ORGANIZATION

AND METHODS OF THEIR DECISION

Idrissova D. S. (E-mail: [email protected]), Shopabayeva A.R., Himenko S. V.

S. D. Asfendiyarov Kazakh National University, Almaty, Kazakhstan

Research objective

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.

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 %;

• lack of a demanded preparation – 26 %;

• mistake in professional activity of the

personnel – 37 %;

• 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.

8 Issue 01 / July 2013 isjm.kaznmu.kz

mailto:[email protected]

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


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.


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 wound-

healing effect.

The presented new formulation - "gel with

extract of camel thorn" could be proposed

for further study.

isjm.kaznmu.kz Issue 01 / July 2013 9 .

ISJM

RESULTS OF THE CLINICAL EXAMINATION OF THE CHILDREN WITH SPINAL

HERNIAS

Yerbolat Saruarov, Ilham Annaorazov

E-mail: [email protected]

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

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 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.


Materials for research

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].

Methods of examination

In children with congenital spinal hernias

performed physical and neurological

examination, and a endoscopic methods of

diagnostics. Pluricausal, exceptional



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%).


ISJM

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 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.

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

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.

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,

promote of uretrohydronephrosis, vesico-

ureteral reflux and the most common

cause of severe renal disease (chronic

kidney disease, reflux nephropathy, etc.)

at a later age [7].



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 neuro-

orthopedic 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

«closing» 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.


ISJM

Spinal hernia; 56,70%Fixed spinal

cord syndrome;

20,00%

Lipoma; 13,30%

Dermal sinus; 5,30%

Dyastematomyelya; 4,70%

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

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; 446-

449.

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



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



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

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

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.



COMPUTER VISION SYNDROME AMONG MEDICAL STUDENTS: A CROSS-SECTIONAL

STUDY

Jillian May T. Tomboc ([email protected]), Myla H. Alcan ([email protected]), Kathleen Anne R. Boniol

([email protected]), Lean Alfonso A. Cervantes ([email protected]), Cielo Mar S. Perez ([email protected]),

ChristzelR. Rebudal ([email protected]), Francis S. Soriano ([email protected]), Wilkeen Flerika S. Tajonera

([email protected]), Krystin O. Wenceslao ([email protected])

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 health-

related 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].











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].

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].

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

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.

Methods

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.



Flow Diagram

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


1st to 3

rd year medical students

of Saint Louis University

n=470

Questionnaires were floated on

respective classrooms

n=470

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

Assessment of questionnaires

Questionnaires included in the

study

n=417

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

Not included in the data:

1. Unanswered questionnaires

2. Questionnaires with

incomplete data or

unanswered items

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

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.



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

Sex

Male 168 40.3 %

Female 249 59.7 %

TOTAL 417 100 %

Year Level

1st year 141 33.8 %

2nd year 139 33.3 %

3rd year 137 32.9 %

TOTAL 417 100 %


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 %



Figure 1. A standardized questionnaire used

to gather the needed data adapted from

Central Phoenix Eyecare[23].

References

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.e-

mfp.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/JHE-

28-1-000-09-Abst-PDF/JHE-28-01-067-09-1900-Charpe-N-A/JHE-28-01-067-

09-1900-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

[Internet]. [cited 2012, Nov 13]. Available from: http://www.aoa.org/x5253.xml

9. Gangamma, M.P., Poonam and Rajagopola, Manjusha.A

clinical study on “Computer vision syndrome” and its management with Triphala eye

drops and SaptamritaLauha. Ayu [Internet]. 2010 Apr-Jun; 31(2): 236–239. Available

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:


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 from:

https://www.aamc.org/newsroom/newsreleases/1999/95352/991026a.html

17. SmitaAgarwal, DishanterGoel, Anshu Sharma.Evaluation of the factors which

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=0973-

709x&year=2013&month=February&volume=7&issue=2&page=331-335&id=2760

18. 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. 2005 [cited 2013 Mar 12]; 50: 253–262. Available from:


21. 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


22. 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


http://www.e-mfp.org/2008v3n3/pdf/computer_vision_syndrome.pdf

http://www.e-mfp.org/2008v3n3/pdf/computer_vision_syndrome.pdf



http://www.aoa.org/x5253.xml

http://thescipub.com/pdf/10.3844/amjsp.2012.33.36


http://www.bioline.org.br/request?oe05017

https://www.aamc.org/newsroom/newsreleases/1999/95352/991026a.html

http://www.ncbi.nlm.nih.gov/pubmed/8757544?dopt=ExternalLink

http://www.ncbi.nlm.nih.gov/pubmed?term=Uchino%20M%5BAuthor%5D&cauthor=true&cauthor_uid=18708259

http://www.ncbi.nlm.nih.gov/pubmed?term=Schaumberg%20DA%5BAuthor%5D&cauthor=true&cauthor_uid=18708259

http://www.ncbi.nlm.nih.gov/pubmed?term=Dogru%20M%5BAuthor%5D&cauthor=true&cauthor_uid=18708259

http://www.ncbi.nlm.nih.gov/pubmed?term=Uchino%20Y%5BAuthor%5D&cauthor=true&cauthor_uid=18708259

http://www.ncbi.nlm.nih.gov/pubmed?term=Fukagawa%20K%5BAuthor%5D&cauthor=true&cauthor_uid=18708259

http://www.ncbi.nlm.nih.gov/pubmed?term=Shimmura%20S%5BAuthor%5D&cauthor=true&cauthor_uid=18708259

http://www.ncbi.nlm.nih.gov/pubmed?term=Shimmura%20S%5BAuthor%5D&cauthor=true&cauthor_uid=18708259

http://www.ncbi.nlm.nih.gov/pubmed?term=Satoh%20T%5BAuthor%5D&cauthor=true&cauthor_uid=18708259

http://www.ncbi.nlm.nih.gov/pubmed?term=Takebayashi%20T%5BAuthor%5D&cauthor=true&cauthor_uid=18708259

http://www.ncbi.nlm.nih.gov/pubmed?term=Tsubota%20K%5BAuthor%5D&cauthor=true&cauthor_uid=18708259

ISJM

ASSESSMENT OF STUDENTS’ AWARENESS ABOUT HARM OF KALIAN SMOKING

Myrzabayeva Zhansaya

Scientific adviser: Darmen N.Zh., MD, Department of Public Health



Kalian is a means of tabacco smocking like

cigarettes.

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

1) Analysis of information about kalian;

2) Compilation of inquiry among students for

the purpose of evaluation of their awareness

of this subject;

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;



- the most common reasons of kalian

smoking are “socially” (61%) and because

of clouds of smoke (48%);

- 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%).

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.

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


http://shymkent.otyrar.kz/2013/02/%D2%9Bor%D2%9Bordy%D2%A3-kalyan-densauly%D2%9B%D2%9Ba-keltirer-ziyany/

http://shymkent.otyrar.kz/2013/02/%D2%9Bor%D2%9Bordy%D2%A3-kalyan-densauly%D2%9B%D2%9Ba-keltirer-ziyany/

ISJM

MEDICAL AND SOCIAL CHARASTERISTICS OF HEALTH NURSE

Abdilda Gabit Alimuly

Scientific adviser: Kozhekenova Zh.A.,PhD, Assistant Professor, Department of Public Health



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

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.



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%.

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.

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.

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.

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.

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


ISJM

INVESTIGATION OF STOMATITIS CAUSES AMONG THE STUDENTS AND

DEVELOPMENT OF "PHYTOMEDICATION" FOR THE PREVENTION AND TREATMENT

D. Sharipov ([email protected])

Scientific adviser: G.Pichhadze ([email protected]), PhD, professor, Department of Pharmacology


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.


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

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.




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

"Phytostom» № 23948).


ISJM

DRUGS, USED IN COMBINED INJURIES

Eismont V. V.MussinaA. M.

Scientific advisers: doc. Kim I. I., prof. Kadirova D.M., Department of Pharmacology


Introduction

According to different authors from 17-

23% prescribed by doctors combinations

of drugs are potentially dangerous. Only 6-

8% 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

(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 above-

mentioned 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).


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.



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:

• help to improve care at the stage of SMP

• reduce the time the rehabilitation of

victims

• to reduce disability and mortality.


ISJM

THE DYNAMICS OF THE SYSTEM OF GUARANTEED FREE MEDICAL CARE (GFMC) IN

REPUBLIC OF KAZAKHSTAN

Kozina A.B. ([email protected]), Sabirova V.K., Shopabaeva A.R., Khimenko S.V.


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.


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

(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"




ANTIOXIDANTS IN STRESSFUL SITUATIONS

Balmukhanova Altynay ([email protected])


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.


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.



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 ([email protected])

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

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.





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.

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.

Conclusion

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.

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.

isjm.kaznmu.kz Issue 01 / July 2013 35

S.D.Asfendiyarov Kazakh National Medical University

International Students Journal of Medicine (ISJM)


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