How the arrival of Polina Monroe, a famous neurologist from the UK, contributed to the opening of the first stroke center in Shymkent

On April 27-28, 2023, the international scientific and practical conference "Stroke: an interdisciplinary problem" was held, dedicated to the opening of the first stroke center in the southern region of Kazakhstan, on the basis of the South Kazakhstan Medical Academy. The speakers of the forum were well-known scientists from Moscow, Kazan, St. Petersburg, Almaty, Astana, the main freelance neurologists of Kazakhstan in charge of stroke services in the regions, neuropathologists, cardiologists, resuscitators, rehabilitation specialists, neurosurgeons, residents also took part in the conference. The main event of the conference was a welcoming speech via video link by a well-known neurologist from the UK, Pauline Monroe, who celebrated her 90th birthday that day.
The topics of presentations concerned not only the diagnosis and treatment of stroke patients, but also the provision of first specialized medical care. At the same time, the speakers relied on practical results, such as:
E. Adilbekov - Deputy Chairman of the Board of the National Coordinating Center for Emergency Medicine of Kazakhstan, Director of the Republican Coordinating Center for Stroke Problems JSC "National Center for Neurosurgery", drew the attention of those present to the organization of a stroke service in the Republic of Kazakhstan, to stenosing carotid atherosclerosis, as well as to a review of recommendations from clinical guidelines rehabilitation after a stroke;
A. Seydanova, head of the neurorehabilitation department of City Clinical Hospital No. 1, chief freelance rehabilitologist of Almaty, spoke about the state and prospects for the development of neurorehabilitation in the Republic of Kazakhstan, emphasized the importance of pain control as a factor in successful rehabilitation;
N. Zharkinbekova, Head of the Department of Neurology, Psychiatry, Rehabilitology and Neurosurgery of the SKMA, Professor, Chief Freelance Neurologist of the Turkestan Region, N. Zharkinbekova, made a presentation on “Organization of a stroke service in the southern region of Kazakhstan: past, present and future”. She, in particular, emphasized the arrival of Pauline Monroe on November 15, 2011 for the medical community of the region. Republican newspapers and TV channels were full of headlines that doctors from Great Britain and Russia had come to the seminar on the treatment and rehabilitation of stroke patients. At that time, the regional clinical hospital was headed by Mukan Kenesbekovich Egizbaev, who explained that the creation of a single center would allow patients to receive not only more qualified medical and surgical care, but also significantly improve rehabilitation processes.
Indeed, in those years, about 20% of stroke patients died, and about 70% remained disabled. The creation of the center made it possible to carry out rehabilitation in order to become able-bodied and socially significant for society a few years later.
Today, South Kazakhstanis no longer run around in search of doctors, medical institutions, but undergo treatment and rehabilitation where they live, that is, in South Kazakhstan and in the southern regions. Colleagues from the regions come to us for experience and to participate in international scientific and practical conferences, master classes. We invite and will invite scientists, leading specialists of scientific centers, medical clinics from Russia, Ukraine, Astana, Almaty, so that simple neuropathologists have an incentive, so that there is motivation to acquire new knowledge, and thereby the stroke service develops.
N. Zharkinbekova noted in her report the neurologists who contributed to the development of the service. In the 1960s of the last century, Anna Ivanovna Volokhova, PhD, Honored Doctor of the Kazakh SSR, a doctor of the highest category, headed the neurological departments in Kentau, Turkestan, Sairam, Saryagash, Zhetysay districts on her initiative. Since 1980, the neurological department in the regional hospital and the neurological service of the South Kazakhstan region were headed by Imanali Ospanovich Baydaulet, with his arrival to this position, neurological departments were opened in Tolebiysky, Tyulkubassky, Kirovsky districts.
From 1988 to 1992, Abdumazhit Mustapaevich Mustapaev, who simultaneously headed the neurological service of the region, was appointed to the post of head of the department of the Regional Clinical Hospital. From 1992 to 2011, Ibragim Nurzhanovich Ermekbaev, a doctor of the highest category, became the head of the neurological department of the Regional Clinical Hospital and a freelance neurologist of the Regional Health Department.
Along with this, a neurological department for 90 beds functioned in the city in the medical association No. 2 under the leadership of Ablasan Shadinovich Shadinov. In 1985, the 90-bed department moved to the Phosphorus Medical Unit, but priority was already given to neurovascular diseases, where 60 beds are allocated, and general neurological diseases - 30 beds. This department from 1987 to 1994. the neuropathologist of the highest category Kazavchuk Svetlana Viktorovna was in charge, the difficulty in the work was the lack of resuscitation beds. The only advantage was the duration of inpatient treatment of more than 21 days, because at present the bed-days are reduced due to the shortage of "acute" beds.
V. Paal was appointed head of the neurological department of the Phosphorus medical unit (1994-1995). Since February 1995, the stroke department of the BSMP, the stroke center of GB No. 1, and to this day, is headed by Mamyr Tolembaevich Dairbekov.
Professor Dushchanova Gulsum Abdrakhmanovna occupies a separate page in the neurological service of the South Kazakhstan region, including stroke. With this parish, the stage of the scientific direction of the neurological school in the Southern region of Kazakhstan began. From 1994 to 2018, she was the head of the Department of Neurology, Psychiatry and Psychology of the South Kazakhstan Medical Academy. A valuable contribution of the professor to the development of medical education and medical science in Kazakhstan.
Since 2011, 14 stroke centers have been operating in the region: 3 ICs in the city of Shymkent and 11 ICs in the Turkestan region, of which 2 ICs III are in the city, and 1 center in the region.
Over the past five years, the material and technical support of stroke centers in Shymkent has improved. Thus, in 2021, 2 computed tomography devices were purchased for GB #2 and GB #3, and then the IC was opened. In March 2021, GB No. 2 was equipped with an angiograph device, which allowed it to be developed as a level III stroke center. In August 2022, a new angiograph device was installed in GKB No. 1 and began to function as an IC of III level. Since 2019, the "situational center" for stroke problems has been operating in GKB No. 1 to monitor medical care in the hospital and in outpatient settings.
Today, there are 11 stroke centers in the Turkestan region, the last two were opened in February of this year in the Centers for Disease Control and Prevention of Baidibek and Ordabasin districts. An angiograph was installed in the regional clinical hospital in 2017, and since then it has been functioning as a III-level IC. In December 2017, the angioneurological office opened its doors for the first time on the basis of OKB. Viktor Aleksandrovich Sorokoumov, MD, Professor of the Department of Neurology of the First St. Petersburg Medical University named after Pavlov, takes an active part in his discovery. Since 2011, V. Sorokoumov has been teaching doctors in Shymkent and Turkestan region principles of early rehabilitation of stroke patients.
With the opening of stroke centers, certain results have been achieved, the mortality rate has decreased, neurosurgical activity has increased, the indicators of performing thrombolysis for patients have improved, as well as the indicators of dispensation. And in this, the team of doctors of the Republican Coordination Center for the Problem of Stroke, under the leadership of the Chairman of the Board of JSC "National Center of Neurosurgery" S.K. Akshulakov and the Director of the National Center for Neurosurgery, E. B. Adilbekov, who coordinate the work of the stroke service in all of Kazakhstan, is a great merit.
Twelve years have passed since the opening of the first stroke center in Shymkent. The international scientific-practical conference dedicated to this memorable date allows gathering not only scientists, but also cardiologists twice a year on the square of the South Kazakhstan Medical Academy.
The following speakers also spoke at the conference:
G. Alipova, deputy chairman of the Board of the "Heart Center - Shymkent", chief freelance cardiologist of the Shymkent Health Department, presented the analysis and perspectives of development of support for BSC in the southern region of Kazakhstan;
E.Nurguzhaev, Professor of the Department of Neurology of KazNMU named after Asfendiyarov, MD spoke about imbalances in stroke patients; E. Medetov, Head of the Neurostroke Service of City Hospital No. 1 in Shymkent, clearly outlined cerebral aneurysms, as well as modern methods of neurosurgical treatment;
Yu.Kobelyatsky, Head of the Department of Anesthesiology and Intensive Care of the Dnepropetrovsk Medical University, Doctor of Medical Sciences, Professor, Dnipro, Ukraine, dwelled on the ways of correcting intracranial hypertension in patients in the acute period of cerebral stroke.
The first day of the conference ended with a meeting of the Republican Coordinating Center for Stroke Problems JSC "National Center for Neurosurgery" in Astana with leading freelance neurologists from all over Kazakhstan.