Background: We aimed to evaluate the impact of national health programs implemented in Kazakhstan from 2011 on CVD incidence and mortality. Methods: Incidence and mortality rates from CVD were studied in Kazakhstan from 2004 to 2017. The official data obtained from “Medinform” company were analyzed based on the annual population statistics. Results: There was an increase in the incidence of cardiovascular disease among the population of Kazakhstan from 1845.4 per 100,000 in 2004 to 2597.5 per 100,000 in 2017. This might be attributed to the implementation of the national health programs, which improved early CVD identification. Incidence of ischemic heart disease (IHD) was grown almost in all provinces of Kazakhstan during the study period. The mortality from cardiovascular disease had a considerable decline over the study period, in particular after 2010, it might be influenced by early diagnosis and provision of timely treatment. Conclusion: The experience of Kazakhstan national health programs shows improved identification of CVD and IHD and timely treatment for cardiovascular disease. A significant variation in incidence and mortality rates of cardiovascular disease was observed between the country provinces.
BACKGROUND: Early detection of cognitive impairments (CIs) has been identified as one of the most important factors for the treatment of the disease. The World Alzheimer report 2011 states that the earlier a diagnosis is known, the better patients can be treated medically, patients and their family members can adapt to the development and learn to deal with the disease. Early diagnosis also leads to higher cost-effectivity, which will further improve, when treatments and social care interventions become more effective in future. It is the first-contact doctor who becomes the main figure in identifying the patient’s cognitive disorders. AIM: This study aimed to research the awareness of medical workers with early diagnosis of cognitive disorders at the PHC level in Kazakhstan. METHODS: It was a cross-sectional study. A survey of primary healthcare workers was conducted to study the early diagnosis of CI in the elderly in the period from December 2019 to March 2020. The questionnaire was developed independently according to international finding and experiences and passed the validation process. The questionnaire included questions such as age, gender, nationality, education, specialty, work experience, conduct early diagnosis of CI or not, what methods respondents know, time available for admission for early diagnosis, desire to learn early diagnosis methods, and the region of residence. RESULTS: The total number of respondents was 823. To the question, “Do you check older patients for early cognitive impairment?” 335 (40.7%) answered “no.” To the question “Do you have time to use methods for the early diagnosis of cognitive impairment in the elderly during admission?” “no” – 354 (43%). To the question “Would you like to learn methods for the early diagnosis of cognitive impairment in the elderly?” The answer was “yes” 759 (92.2%) of respondents. This study reveals that the presence of time during admission, the region of residence, and the desire to study affect whether elder people check for early CI or not, in turn, specialty, education, gender, nationality, age, and work experience do not affect. We have identified a relationship of age, region of residence with the availability of time during admission to use methods for early diagnosis of CI, while it was absent with work experience. The region of residence, the availability of time during admission, and education influenced the respondents’ desire to learn early diagnosis methods, while age and work experience did not. CONCLUSION: The problem of early diagnosis of CI in the elderly at the PHC level is relevant and not fully understood. Early detection of CI at the PHC level is a key element in the fight against such a serious condition as dementia.
The purpose of this study was to identify cognitive disorders in older people by conducting a survey of their relatives (close people) by the Arizona Questionnaire.Material and methods: The study involved people who had relatives (close ones) aged 60-74 years old. Three hundred and eighty respondents took part in the survey.Results: Summing up all the points obtained during the survey of relatives 4-13 points 78.7% (n=299), which may indicate the presence of moderate cognitive disorders that are better not to be ignored (suggests going to the doctor) and above 13 points 6% (n=23) indicates a fairly high probability of dementia (urgent need to seek medical help). Our study revealed that family status (p<0.001), employment (p=0.014), and recitation of namaz (p=0.009) act as protective factors that promote social participation and build cognitive reserve. Social isolation, on the other hand, can lead to apathy, withdrawal, depression, and a greater likelihood of cognitive impairment. We also found that place of residence (p<0.001) and living conditions (p=0.002), may also influence the early formation of cognitive dysfunctions. Arizona Questionnaire has high sensitivity and specificity in detecting both mild cognitive impairments and Alzheimer's disease and allows clinicians to quickly and accurately assess people with reported cognitive problems. Conclusion:As a result of survey informants, it was revealed that most of the olders, whose relatives have been surveyed, may be at risk of cognitive impairment and further testing is needed.
BACKGROUND: The prevalence of hemophilia B in the global population is approximately 1:60,000. Undifferentiated systemic mesenchymal dysplasia (uSMD) is diagnosed rather frequently, about 1:5, according to Russian authors; no data on uSMD prevalence in other countries are available. The combination of hemophilia and uSMD has grouped under the term hematomesenchymal dysplasia (HMD). This combination significantly worsens the clinical picture, prognosis, and quality of life of the patient. AIM: In this article, we present a rare clinical case of a child with a combination of hemophilia B and HMD. CASE REPORT: A clinical case of a male patient, 5 years old with hemophilia B, severe form combined with HMD, complicated by hemothorax, abscessed pulmonary lobe hematoma has presented. The presence of HMD and the above complications had an unfavorable effect on the severity of the clinical picture and the abnormal response to treatment. The main diagnostic procedures were the assessment of the phenotypic signs of HMD in combination with laboratory and instrumental examination methods such as ultrasound, computed tomography (CT) scan, and echocardiography. Vital treatment is factor IX replacement therapy and supportive one. CONCLUSION: This clinical example highlights the importance of clinical alertness to hereditary coagulopathies, which often lead to life threatening, sometimes disabling complications that significantly reduce the quality of life of children with hemophilia. Consequently, full-scale epidemiological studies of the prevalence of HMD in the population are an urgent task for the near future.
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