Clinical work

The Department has 4 clinical sites: “CCIH named after Zhekenova” (main), “Municipal clinic №5, “City polyclinic №3, “Municipal students ‘polyclinic” – extra, which has created good conditions for the learning process. Responsible for clinical work assistant Umeshova L. A.

Clinical work of the Department staff is carried out at a high professional level (scientific degree is 60%, work experience more than 10 years – 100%, the highest qualification category have 81,1% of teaching staff).

Professors and associate professors provide emergency advice in basic clinics on weekends and holidays.

Professor Duisenova A.K. is the Chairman of the pathology conference in the basic clinic.

Professor Dmitrovskiy A.M. is a freelance trainer of the training seminar of the Central Asian office of CDC “Standard definitions of extremely dangerous infections”, consultant on extremely dangerous infections.

Fig. 1 Prof. Dmitrovskiy A.M. conducts training with the cadets of the training course of the Central Asian office of the CDC ” Standard case definitions of extremely dangerous infections.”

 

Professor Kurmanova K.B., Docent Sadykova S. S. are certified experts.

The staff of the Department is involved in the development of clinical protocols of the Ministry of health and RK on specialty “Infectious diseases”, which indicates the recognition of high professionalism of the Department staff:

  1. Clinical Protocol of diagnosis and treatment «Tropical malaria», protocol №9 December 12, 2014, Prof. Duisenova A.K.
  2. Clinical Protocol of diagnosis and treatment «Acute brucellosis», protocol №16 November 20, 2015, Prof. Duisenova A.K.
  3. Clinical Protocol of diagnosis and treatment «Meningococcal disease in adults», protocol №9 September 15,2015, Prof.Duisenova A.K, Prof. Shopayeva G.A.
  4. Clinical Protocol of diagnosis and treatment «Encephalitis», protocol №9, August 16, 2016, Prof. Yegemberdiyeva R.A., Prof. Duisenova A.K.
  5. Clinical Protocol of diagnosis and treatment «Dengue Fever», protocol №9, August 16, 2016, Prof. Yegemberdiyeva R.A., Prof. Duisenova A.K.
  6. Clinical Protocol of diagnosis and treatment «Infectious Mononucleosis», protocol №9, August 16, 2016, Prof. Shopayeva G.A., Prof. Duisenova A.K.
  7. Clinical Protocol of diagnosis and treatment «Cholera», protocol №9, August 16, 2016, prof. Duisenova A.K.
  8. Clinical Protocol of diagnosis and treatment «Cystic echinococcosis (liver) in adults», protocol №9, August 16, 2016, Prof. Duisenova A.K., prof Shopayeva G.A., Doc. Bayekeeva K.T.
  9. Clinical Protocol of diagnosis and treatment of «Anthrax in adults», protocol №11, September 29, 2016, Prof. Duisenova A.K.
  10. Clinical Protocol of diagnosis and treatment «Tularemia», protocol №22, May 12, 2017, Prof. Duisenova A.K., Dmitrovskiy A.M.
  11. Clinical Protocol of diagnosis and treatment «Pseudotuberculosis», protocol №22, May 12, 2017, Prof. Duisenova A.K., Dmitrovskiy A.M.
  12. Clinical Protocol of diagnosis and treatment «Yersiniosis», protocol №22, May 12, 2017, Prof. Duisenova A.K., Dmitrovskiy A.M.

 

Conducted monthly training seminars for doctors in the framework of the «School infectious diseases». At the meetings of the school according to the plan, lectures on topical nosologies, analysis of clinical cases, determination of tactics of management at the outpatient and inpatient level, current regulations, reports of clinics for infectious diseases service to discuss problems and solutions, exchange of experience.

Head of department, prof. Duysenova AK, holds a meeting of the “School of Infectious Diseases”

 

In the summer of  2015, Prof. Yegemberdiyeva R.A., ass. Baykhozhayeva R. Zh. and Shokolakova A.K., Kashim Zh. K. provided advice and in the villages affected by mudslides.  Together with doctors examined 1138 residents of the affected area.

The participation of the teaching staff of the department in the courtyard bypasses of the residents of the village affected by the mudflow, 2015

In order to optimize the organizational, methodological and medical advice, preventive work on the infectious service, as well as to improve the work of the infectious diseases cabinets of Almaty organizations PMSC Department employees conducted training seminars on topical issues of infectious diseases:

– in February 2016 on the basis of 6 Almaty RMO (Zhetysu, Bostandyk, Auezov, Almaly, Turksib, Alatau) Head of Infectious and Tropical Diseases Department, KazNMU n.a. S. Asfendiyarov – Prof. Duisenova, A.K. and Almaty DOH Chief Infectiologist Bayekeyeva K.T. conducted training seminars «Influenza and ARVI. Tactics of the doctor of primary health care».

– In August-September 2016 in 30 Almaty MO (Zhetysu, Bostandyk, Auezov, Almaly, Turksib, Alatau) the staff of the Department conducted training seminars on “Anthrax. Clinic, diagnosis, treatment. Algorithm of response to the case of EDID”. A survey of medical workers with an assessment of the initial level of knowledge of Anthrax and the final level after the seminar. A total of 2275 participants attended. At the initial level testing, 45.3% of the students scored less than 50%, and when testing the effectiveness of lecture material, only 14.3% scored 50% or less.

– In October 2018, 8 DMO in Almaty (Zhetysuysky, Bostandyksky, Auezovsky, Medeu, Almaly, Turksib, Alatau, Nauryzba,) head of the department prof. Duysenova A.K. and the head of the freelance infectious disease specialist of the ultrasound department of Almaty, Bayekeeva K.T. training seminars “Flu and other ARVI. Epidemic season 2017-2018 and preparation for the epidemic season

2018-2019. ”

– In November 2018, in connection with the registration of measles cases in Almaty, seminars are held in 8 DMO and 12 emergency medical substations on the topic: “Measles. Diagnosis, treatment, prevention. ”

Teaching staff of the department give lectures and interviews in the media (head of department prof. Duysenova A.K., prof. Dmitrovsky A.M., prof. Egemberdieva R.A., associate professor Seydulaeva LB, assistant professor Sadykov A .M.), Participate in briefings by the UZ in Almaty and the Ministry of Health of the Republic of Kazakhstan on the urgent problems of the infectious disease service (head of department. Prof. Duysenova A.K.).

During the rise in the incidence of meningococcal infection in Almaty in May-June 2018, the department staff advised patients according to the schedule in the evening, night and weekend.

The staff of the department in order to optimize the organizational, methodological and medical-advisory assistance, preventive work in the infectious diseases service, as well as to improve the work of the infectious disease rooms of primary health care organizations in Almaty, carried out the following activities:

In 2018-2019 13 seminars were held, including 1 seminar with international participation “Actual issues of parasitic and vector-borne diseases”, 5 city seminars within the framework of the “School of Infectious Diseases”.

According to a comprehensive plan for clinical work on the basis of the CCIH named after I.Zhekenova” citywide conferences, seminars in infectious disease.

Employees of the Department of industrial necessity working part-time in the CCIH: as a doctor-resident at 0.5 rates (ass.Umeshova L.A., Ergalieva A.A.).

Annually the staff of the Department conduct the Open Days in consultation with patients (Prof. Duisenova A.K., Prof. Yegemberdiyeva R.A., Prof. Shopayeva G.A., Doc. Bayekeyeva K.T., Doc. Ermukhanova N.T., Doc. Saydullayeva L.B., Doc. Ospanbekova N.K., Doc. Sadykova S. S., Doc. Sadykova A. M.).

In 2015, an information resource was created-mail for infectious disease doctors [email protected] where doctors can get acquainted with the current regulations of the Republic of Kazakhstan on infectious and parasitic diseases (orders, clinical protocols, etc.), presentations of teachers at clinical conferences.

Professor Duisenova A.K. was awarded by the badge “Excellent Health” (2014), Docent Ospanbekova N.K. and Docent Ermuhanova N.T., awarded the breastplate «Денсаулық ісіне қосқан үлесі үшін» (2015). Prof, Shopayeva G.A., Docent Saydullayeva L.B., Docent Sadykova A.M. noted the letter of thanks of the Minister of Health of Kazakhstan, as well as “CCIH n.a. I.Zhekenova” (2016). Professor Duisenova A. K., Professor, Dmitrovskiy A.M., Docent Bayekeyeva K. T., Docent Sadykova A.M. a letter of thanks from the health Department of Almaty (2017), assistant Umeshova L.A. awarded the “Gratitude” for clinical work 2019г.

According to the comprehensive plan for clinical work on the basis of the PCG, the citywide conferences and seminars on infectious diseases are being held at the SKB named after I. Zhekenova.

In 2016, the staff of the Department were direct participants of the city scientific and practical conference dedicated to the 100th anniversary of I. S. Zhekenova ” experience and prospects of development of the infectious service of Almaty».

Employees of the Department at the city scientific-practical conference dedicated to the 100th anniversary of I. S. Zhekenova “Experience and prospects of development of infectious service of the Almaty city”(Almaty, 2016).

 

In may 2017 the teaching staff of the Department participated in the scientific-practical conference dedicated to the days of the University “School of General practitioner». Within the framework of this conference, a master class “Algorithm of measures for identifying a patient with a particularly dangerous infection” was held with a demonstration of boxes and suits for biological protection and an author’s video.

Employees of the Department at the scientific-practical conference dedicated to the days of the University “School of General practitioner”. (Almaty, 2017).

 

In preparation for the 28th world winter Universiade 2017, the teaching staff of the Department of infectious and tropical diseases together with the Almaty DOH in December 2016 conducted trainings «Algorithm of actions in identifying a patient with dangerous infectious disease» 281 employees of medical organizations (doctors and nurses of polyclinics, PMSC, reception and Advisory departments of multi-profile and single-profile hospitals).

June 7, 2017 professors of the Department Duisenova A.K., Dmitrovskiy A.M., Yegemberdiyeva R.A. on the basis of Astana Pediatric Infectious Hospital held training ” Algorithm of actions in identifying the patient with a dangerous infectious disease” in preparation for EXPO 2018.

In September 2017 Professors of the Department made a reports at the international scientific-practical conference “Actual infections of the Central Asia: management of infectious diseases in primary health care” in Astana.

The staff of the Department and the Chief physician of the CCID n.a. I.S. Zhekenova at the international scientific and practical conference “Actual infections of Central Asia: management of infectious diseases at the stage of primary health care” (Astana, September 2017).

 

For 2017-2018 employees of the Department introduced 15 acts for use in practical health care:

  1. Clinical Protocol of diagnosis and treatment «Tularemia»
  2. Clinical Protocol for diagnosis and treatment «Giardiasis»
  3. Clinical Protocol of diagnosis and treatment «Pseudotuberculosis»
  4. Clinical Protocol of diagnosis and treatment «Enterovirus infection»
  5. The use of bactistatin for the prevention of dysbiotic changes in antibacterial treatment of infectious diseases
  6. Clinical Protocol of diagnosis and treatment «Yersiniosis»
  7. The use of bactistatin (3-component complex enterosorbent, pre – and probiotics) in complex therapy of acute intestinal infections moderate and severe.
  8. The use of bactistatin (3-component complex enterosorbent, pre – and probiotics) in complex therapy of acute intestinal infections light and medium flow.
  9. «Algorithm of diagnosis and treatment of HIV infection at the inpatient stage».
  10. Express diagnosis of enterovirus infection of intestinal form (immunochromatographic method of fecal examination).
  11. Rapid diagnosis of enterovirus infection (meningitis) using the immunochromatographic method of the study of cerebrospinal fluid
  12. Algorithm of diagnosis and treatment of hepatic cystic echinococcosis
  13. WHO ultrasound classification of hepatic cystic echinococcosis
  14. Monotherapy with albendazole of hepatic cystic echinococcosis.
  15. The use of tenofovir in the fulminate course of acute hepatitis B.

 

In 2018-2019, the department employees introduced 4 acts in practical health care:

1) The use of Amizon in the complex treatment of ARVI

2) The effectiveness of recombinant interferon alfa-2b in the complex treatment of measles

3) Diagnosis and treatment of sepsis (Clinical protocol “Sepsis”)

4) Diagnosis and treatment of septic shock (Clinical protocol “Sepsis”).

The introduction of tenofovir in the fulminant course of viral hepatitis prevented 75% of fatal cases. So, in March 2016, maternal mortality was prevented for patient C., 1980 with a Final diagnosis: Acute viral hepatitis B, severe course (HBsAg +, antiHBcoreIgM +, antiHBcoretotal +, HBeAg +, HBV DNA – positive (BH-21304 IU / ml).

Complications: Acute hepatic encephalopathy 3 tbsp. (March 29, 2016) DIC-syndrome of the 3rd stage (March 29, 2016). Cerebral edema (March 30, 2016). Bilateral bacterial pneumonia. Respiratory failure (03/30/2016). AKI (ARF) prerenal form, 1 tbsp. by riple. (April 6, 2016).

Associated: Complete spontaneous late miscarriage in the period of 19-20 weeks (03/31/2016). Operation curettage of the uterine cavity (04/04/2016) Tracheostomy (04/05/2016). Iron deficiency anemia 2 tbsp. Small residual effects of the post-tuberculosis process.

In January 2018, timely diagnosis, the choice of the right treatment tactics and successful transplantation of a related liver (at the N.T. Syzganov Scientific Center for Surgery under the guidance of Prof. B. Baimakhanov) prevented the mortality of a young girl of 21 years old with acute toxic hepatitis of a fulminant course.

Clinical cases were reported at the international conference “Almaty Hepatology-2018) and published in the journal“ Medicine ”.

Employees of the department publish articles together with practitioners of public health.

In order to optimize organizational and methodical and medical Advisory assistance in infectious service, as well as to improve the performance of infectious diseases cabinets of PHC organizations of Almaty and continuity Department of infectious diseases with the course dermatovenerology clinics with the city in September and November 2018 at the bases 8 of the MO Almaty Professor Duisenova A.K., Docent and Almaty DOH chief infectiologist Bayekeyeva K.T. jointly with the DOH epi chief specialist, Ibragimova E. I. held training seminars on the topic: “Influenza and ARVI. The results of the 2017-2018 and preparation for 2018-2019 epidemiological season.

The teaching staff of the department participate in consultations of severe and diagnostically complex patients on telemedicine at the republic level (head of department, prof. Duysenova AK, prof. Egemberdieva R.A., associate professor. Seydulaeva L.B.) (Kustanay, Atyrau, Taraz, Turkestan).

The faculty of the department provide advisory assistance in the field of sanitation (Atyrau, 10.24.2016, 2.1.2016 – head of the department prof. Duysenova A.K., Aktau – prof. Kurmanova KB, .Atyrau, Kyzylorda – Prof. R. Egemberdiev). For contribution to saving the lives of pregnant women prof. Duysenova was awarded the Medal of the National Chamber of Health of the Republic of Kazakhstan “For professional merit, selfless work, dedication and love of medicine in Kazakhstan.”

Awarding Head of Department prof. Duysenov A.K. Medal of the National Chamber of Health of the Republic of Kazakhstan “For professional services, selfless work, dedication and love of medicine in Kazakhstan.”

 

The faculty of the Department of Infectious and Tropical Diseases gained access to the resources of BMJ – the British Medical Journal. Project Name: BMJ Best practice – Clinical Decision Support Training Initiative (RCC). The memorandum of cooperation was signed by the Minister of Health of the Republic of Kazakhstan and the leadership of BMJ.

BMJ is a global provider of constantly updated medical knowledge based on evidence-based medicine and one of the best clinical decision support tools for healthcare professionals worldwide.

The teaching staff of the department carry out clinical work on the basis of Kazakhstani protocols of diagnosis and treatment and modern international recommendations, conduct “Open Days”, inviting for consultation the most difficult patients in the diagnostic and treatment plan of the city, region and Republic.