Relevance. In the Republic of Tuva for the period 2015-2022, a decrease in birth rate, mortality and natural increase was noted, higher primary morbidity rates in adolescents in the age group of 15-17 years, higher morbidity in some infectious and parasitic diseases, blood diseases, endocrine system, skin and subcutaneous fatty tissue were noted. Differences in primary morbidity rates reflect different levels of organization and accessibility of medical care in different kojuuns of the republic and require study and development of management decisions at the regional level.
The aim of the study is to investigate medical and demographic indicators and to conduct a comparative analysis of morbidity, birth rate, mortality and natural increase in the Republic of Tuva, SFD and RF for the period 2015-2022 for the development and adoption of management decisions at the federal, regional and municipal levels.
Materials and methods. The materials of official state statistics of the Ministry of Health of the Russian Federation, Rosstat and the Republic of Tuva compilation «Statistical indicators of the state of health care of the Republic of Tuva, population health and activities of institutions» 2015-2022, compilation of Russian Institute of Research 2016-2022) were used in the work. Analytical and statistical methods of research were applied.
Results. The main tendencies of modern development of demographic situation, morbidity and mortality rates in the Republic of Tuva are revealed.
Conclusion. In the Republic of Tuva for the period from 2015 to 2022 there is a decrease in birth rate, mortality and natural population growth. The frequency of primary morbidity is less than the level of indicators for the Russian Federation and SFD, which is associated with low availability of doctors in rural areas, as well as inaccessibility of some areas of the Republic. The primary morbidity is high in adolescents aged 15-17 years, which suggests the development of a program to improve the health of the child population of the republic.
Relevance. In the Republic of Tyva, despite the ongoing anti-tuberculosis measures, the epidemiological situation of tuberculosis remains unfavorable. Socio-psychological assistance in the rehabilitation of tuberculosis patients significantly increases the medical effectiveness of chemotherapy and, in this regard, the study of the «social portrait» of a tuberculosis patient is an urgent task.
The goal of the research: to identify the «social portrait» of a patient with a recurrence of tuberculosis receiving treatment at the State Budgetary Healthcare Institution of the Republic of Tyva «Tuberculosis Dispensary» during the 1st half of 2022.
Materials and methods: for retrospective analysis, materials from outpatient records and medical histories of patients taken to the dispensary of an antitubercular dispensary with a recurrence of the tuberculosis process were used for 6 months of 2022. In the analysis of gender and age composition, social status, place of residence and clinical structure.
Results. Based on a retrospective analysis of data on the gender and age composition, social status, place of residence of 61 tuberculosis patients, from the materials of outpatient charts and patient histories using statistical and sociological research methods, a «social portrait» of a patient with a relapse of tuberculosis treated in the Tuberculosis Dispensary of the Republic of Tyva during the 1st half of 2022 was compiled: this is a man 49-50 years old, not working, having no concomitant diseases, mostly living in rural areas. Тhis patient does not pass fluorographic examination two years or more, mostly in the anamnesis who had tuberculosis of the lungs. Тhis patient with multidrug-resistant pathogen, this patient has the disease was detected an active method of detection (radiological or fluorographic method) when conducting preventive examinations.
Conclusion. Тhe main clinical form when taking on dispensary registration this is infiltrative pulmonary tuberculosis in the decay phase and in the decay phase. Mostly such patients receive treatment in the conditions of an antitubercular dispensary.
Background. Female alcoholism development features, cognitive impairments, cooccurring with alcohol dependence, have varying degrees of severity in different ethno-cultural conditions, in particular for the Tuvan and Russian ethnic groups. The study of these differences in female alcoholism has not still been conducted.
Objective: To study alcohol dependence development features and cognitive impairments in women of Tuvan and Russian ethnicity.
Material and Methods. The study sample included two groups of women suffering from alcoholism. Group 1 included 78 women of Tuvan ethnicity (mean age 41.6 ± 9.9 years) who were treated at the State Budgetary Institution of Health “Republican Narcological Dispensary” of the Republic of Tyva. Group 2 included 66 women of Russian ethnicity (mean age 41.6 ± 9.0 years) who were treated at the Addictive States Department of Mental Health Research Institute of Tomsk NRMC. Clinical-psychopathological, psychological, mathematical-statistical methods were used.
Results. In women of Tuvan ethnicity, the formation of alcohol dependence (from the first signs to the development of a withdrawal syndrome) occurs progressively; alcoholic psychosis develops later (after 14-15 years of alcohol dependence). In 16.7% of Tuvan women, psychosis tended to recur frequently. When experiencing the alcoholic psychosis, a severe typical stereotypy in pictograms is associated. Excessive typical stereotypy was found in pictograms in 50% of Tuvan patients and 30.4% of Russian patients without a history of alcoholic psychosis; in subgroups of patients who experienced alcoholic psychosis, this feature was found in 72.41% of Tuvan and in 66% of Russian women.
Conclusion. The revealed clinical and psychopathological symptoms indicate the malignant (progressive) development of alcohol dependence in women of Tuvan ethnicity. In their cognitive functioning, they exhibit uniformity in associative connections, a decrease in the accessible level of generalization and the volume of working memory, while memory productivity does not reveal differences associated with ethnicity.
The article considers the history of the formation and development of the neonatology service of the Republic of Tuva: from the first doctors - microphysicians to the creation of paediatric service in the State budget health institution of the Republic of Tuva «Perinatal Center» with intensive care and neonatal intensive care, where newborn babies receive high-tech care.
Relevance. In recent decades, there has been an increase in the number of children and adolescents with overweight and obesity worldwide. In this regard, it is relevant to monitor the physical development indicators of children of various age groups living in difficult environmental conditions.
The aim of study - to identify the frequency of obesity among pupils of preparatory groups of preschool educational institutions in St. Petersburg.
Material and methods. A survey of 857 children (412 boys and 445 girls) was carried out. The reference values of individual indicators of the mass-height index of WHO standards “WHO Growth Reference 2007” was used for the assessment of the ratio of weight and body length of children. Obesity was registered when the child’s body mass index exceeded the 95th percentile of the age-sex scale.
Results. In the general cohort of preschool children examined, obesity was registered in 10.9% [95% CI: 10.4–11.4] children. In the boys group, the prevalence of obesity was 12.5 [95%CI: 11.7–13.3%]. In girls, the incidence of obesity was 9.5% [95%CI: 8.8–10.2]. The prevalence of obesity in boys is higher than in girls (p = 0.0058), which coincides with the data of most domestic and foreign authors.
Conclusion. Consequently, we have identified a high prevalence of obesity in future first-graders, which requires both additional examination of children and justifies an in-depth analysis of the nutrition of preschool children, including in children’s educational organizations of the metropolis.
Relevance. The progressive growth of pathological Internet use in adolescent populations, associated with impaired neuropsychic and somatic health of Internet-dependent users, is currently an urgent medical and social problem that requires an immediate solution.
Goal of research. To study the age, gender and ethnic characteristics of the structure of online behavior among adolescents in Kyzyl (Republic of Tyva).
Material and methods. Random samples of 216 adolescents aged 12-18 years – students of general education institutions in the city of Kyzyl (Tuva Republic) – were examined. The prevalence of types of online behavior was assessed: adaptive (AIU), non-adaptive (MIU) and pathological (PIU) Internet use. Indicators were compared in groups by age (12-14 and 15-18 years), gender (boys, girls) and ethnicity (Russians, Tuvans), using the program “Statistica 12 for Windows” (StatSoft Inc., USA).
Results. It has been established that adolescents in the younger age group are characterized by a tendency towards a more frequent occurrence of MIU and PIU, among them there is a higher number of people with maladaptive (MIU+PIU) Internet use. Gender-specific characteristics of online behavior include a higher frequency of occurrence of MIU, a tendency towards a higher prevalence of PIU and maladaptive Internet use in girls. Ethnic differences in online behavior include a higher prevalence of PIU and maladaptive Internet use among Tuvan teenagers compared to Russian peers.
Conclusion. Our results indicate the need for further research aimed at solving an urgent medical and social problem - timely diagnosis of Internet addictive behavior among the adolescent population of Tuva and prevention of somatic and neuropsychic health disorders associated with PIU in this population.
Relevance. One of the most important tasks of each medical organization is to provide the population with high-quality medical care and accessible to every patient, which is ensured by the implementation of state, departmental and internal quality and safety control of medical activities. Internal quality control and safety of medical activities is a tool for self-control, can be ensured by implementing a quality management system that promotes the continuous development and improvement of a medical organization and is focused on continuous improvement of activities, taking into account the needs of all stakeholders.
Aim. The article examines the analysis of the implementation of a quality management system for the quality of medical care provided to the population.
Results. Based on the conducted research, it was revealed that the organization of internal quality control through the introduction of a quality management system in the State Medical Institution of the Republic of Tyva «Republican Children’s Hospital» has the following advantages.
The article discusses the personnel shortage of specialists with higher education in the field of healthcare of the Republic of Tyva. The analysis of the most important indicators of staff outflow is also given, revealing the problems of its development.
Relevance. Thrombolytic therapy is the most effective technology for differentiated treatment of ischemic stroke.
Objective. To evaluate the functional outcomes of the acute period of ischemic stroke in patients who underwent thrombolytic therapy.
Material and methods. We retrospectively analyzed a cohort of 54 patients with IS and TLT, recruited from 2017 to 2018, who, upon admission to the hospital, met the criteria for TLT. To carry out a comparative analysis among the discharged patients, a group was formed retrospectively, consisting of 57 patients who did not undergo TLT.
Discussion. After the treatment in the vascular center, the percentage of patients with unexpressed neurological deficit increased by 33%.
Conclusions. The analysis performed demonstrated the safety and efficacy of TLT in ischemic stroke in real clinical practice at a regional vascular center.
Relevance. Preserving the health of the younger generation of indigenous and small peoples of Siberia is a priority social task.
Goal of research. To identify the characteristics of growth and puberty of school boys of the titular nationality in the Republic of Tyva.
Material and methods. A survey of boys and young men studying in educational institutions of Kyzyl was carried out. A total of 554 students aged from 11 to 18 years old were examined. The survey included somatometry (body length and weight, chest circumference), calculation of body surface area using the Dubua formula; assessment of sexual development by J. Tanner and M.V. Maximova.
Results. The dynamics of indicators of the main somatometric indicators indicates that the pubertal growth spurt occurs at the age from 13 to 15 years. The initiation of sexual development by all signs is observed in the surveyed schoolchildren from the age of 12, with an average body surface area of 1.24 m2. The average age of pubic hair onset was 13.9 ± 0.5 years; voice mutations - 14.9 ± 0.4 years; growth of the thyroid cartilage - 14.8 ± 0.5 years, respectively. Facial hair growth appears on average at the age of 15.0 ± 0.3 years and is ahead of the appearance of hair growth in the armpits (15.4 ± 0.5 years). The correspondence of the level of sexual development to the passport age was noted in 65.5% ± 2.6% of the surveyed schoolchildren. Among the disharmonious variants of biological development, delayed puberty prevailed: in 29.2 ± 2.5% of students.
Conclusion. Currently, schoolchildren of the indigenous population of Tyva have a number of biological development features that can adversely affect the implementation of reproductive function.
The article reflects the legal means, the stages of implementation of legal regulation in the field of health-improving areas and resorts in the territory of the Republic of Tyva. In particular, federal laws, laws of the Republic of Tyva, resolutions of the Government of the Russian Federation, resolutions of the Government of the Republic of Tyva, regulatory legal acts regulating legal relations in this area, explanations (step-by-step instructions) on the implementation of the Procedure for recognizing territories as therapeutic areas and resorts of the Republic of Tyva are given.
Relevance. Malnutrition, which contributes to abnormalities in the growth and development of children, remains a pressing problem throughout the world. Malnutrition can manifest itself in both an acute form (underweight) and a chronic form (longitudinal growth retardation). Monitoring deviations in the physical development of children of early and preschool age makes it possible to timely identify negative trends and develop regional programs.
The aim of study: to determine the frequency of malnutrition among pupils of preparatory groups of preschool educational institutions in St. Petersburg.
Material and methods. A survey of 857 children (412 boys and 445 girls) was carried out. The standards “WHO Growth Reference 2007” was used for assessment of the correspondence of longitudinal growth to age and the ratio of weight and body length of children. Low growth was recorded when the child’s body length was less than “–” 2.1SD; exhaustion – when the body mass index is below the 5th percentile according to the age-sex scale of WHO standards.
Results. In the general cohort of examined preschoolers, low longitudinal growth was determined in 1.2% of children. There were more children with short stature in the group of boys (1.5%) than among girls (1.0%). There were 3.6% of children with body mass index values below the 5th percentile; among boys it is more 3.8% than among girls 3.4%.
Conclusion. We have identified a group of children with somatometric markers of malnutrition, who were recommended for in-depth research in specialized medical institutions.
Relevance. The annual tendency of growth in the number of persons with reduced functional health reserves among school students, especially among high school students, entails a subsequent decline in health in all age groups and further affects the quality of labor resources, reproduction of generations. Therefore, one of the most important indicators of the health of the younger generation in the doctrine of the educational system of the Republic of Tyva is the preservation of students’ health in high school.
The aim of the present study was to investigate the functional capabilities of the organism of adolescents of titular nationality in the Republic of Tyva.
Materials and Methods. High school students of indigenous nationality in the Republic of Tyva were examined. The hand dynamometer was used to determine the indices of hand muscle strength, blood pressure, and heart rate were recorded in the state of relative rest. Statistical processing was performed using the programs «Statistica v. 7.0 © Statsoft, USA» using the χ2 criterion modified by Pearson.
Results. Heart rate is one of the most important indicators of the circulatory system. We did not find any difference in heart rate indicators in boys and girls. Assessment of the vegetative tone of schoolchildren (according to the Kerdo index) revealed sympathicotonia in most adolescents, eitonia was observed in 32.7 ±2.1% of boys and 31.4±1.9% of girls. Less often, the surveyed schoolchildren have vagotonia. Low reserves of the functional state of the cardiovascular system according to the Roufier index were recorded in half of the adolescents. The number of boys and girls with high reserves of the functional state of the cardiovascular system was almost the same as with an average level of reserves.
Conclusions. The obtained results of the study show that it is necessary to analyze the ratio of educational and physical load at school and at home, rationalization of nutrition and optimization of the regime for students.
The article considers the problems of gender roles, relationships between parents and children, changes of family values in the tuvan society. Ten years ago, were studied changes of social roles, the main fears and difficulties in the gender groups and the causes of deviant behavior of teenager. At the present the tendency these problems are continuing. Character these problems to get difficult. Alcoholism, unemployment, death rate of young people, feminization of tuvan woman transform contacts between the gender sexes, family members.
The article deals with issues related to the problem of targeted admission and training of students in medical educational institutions from the Republic of Tyva as one of the actual guarantees of providing the region with top-level medical personnel.
The article deals with the issues of formation and development of medical science in the Republic of Tuva: personalities on scientific medical personnel, creation of the first scientific medical institutions of Tuva and their main scientific directions and achievements, problems of further development of medical science in Tuva and possible ways of their solution.
The article considers the main directions of personalized medicine in the Russian Federation and the Republic of Tuva: the creation of scientific centers of personalized medicine, the problems of personalized medicine in the health care system and the possible ways of introducing personalized medicine in the practical health care of the Republic of Tuva.
Relevance. The ongoing growth of Internet addiction among adolescents in recent years indicates the scale of this problem and indicates the need to conduct large-scale epidemiological studies to study the prevalence, structural features and prevention of this type of addiction among adolescents.
Goal of research. To study the age-sex and ethnic features of the structure of online behavior patterns among adolescents in Kyzyl (Tuva Republic).
Material and methods. Random samples of adolescents 12-18 years old – students of secondary schools in the city of Kyzyl (Republic of Tyva) in the amount of 216 people were examined. The structure of online behavior patterns was assessed: adaptive (API), maladaptive (NPI) and pathological (PPI) Internet use using the scales of the Chen questionnaire: Com scale (compulsiveness), Wit (withdrawal symptoms), Tol (tolerance), IH (intrapersonal problems and health problems), TM (problems with time management), as well as integral characteristics: KSIZ (key symptoms of Internet addiction) and PSID (problems associated with Internet addiction). Indicators were compared in groups by age (12-14 and 15-18 years), gender (boys, girls) and ethnicity (Russians, Tuvans), using the program “Statistica 12 for Windows” (StatSoft Inc., USA).
Results. According to the results of the study, no age-related differences were identified for all patterns of online behavior. Gender differences in the pattern of maladaptive online behavior in girls included the Wit (withdrawal symptoms), IH (intrapersonal and health problems) and KSIZ (core symptoms of Internet addiction) scales. According to the compulsivity scale (Com), the scale of interpersonal problems and health problems (IH), Tuvan adolescents were distinguished by a higher frequency of pathological Internet use, i.e. presence of Internet addiction.
Conclusion. The study demonstrated the feasibility of using the Chen questionnaire as an informative psychodiagnostic tool for identifying adolescents at risk of developing Internet addictive behavior and individuals with an already formed pattern of pathological Internet use, i.e. Internet addicted teenagers. Adolescents at risk and Internet addicts identified using the CIAS scale of the Chen questionnaire need a set of measures aimed at leveling this type of addiction and preventing associated problems with the somatic and neuropsychic health of the younger generation.
