Public Health Services

107 treatment-and-prevention institutions of Nizhny Novgorod: 36 hospitals, 34 polyclinics, 5 maternity hospitals, 5 antenatal clinics, 9 dispensaries, 11 stomatological polyclinics, 3 sanatoriums, 3 medical centers, 1 medicosanitary unit, - render medical assistance to the population of the city.

The following institutions function on the basis of the municipal establishments:

1. the regional perinatal center on the basis of the obstetric in-patient department of hospital №40;
2. the municipal department of preventive health care and miscarriage treatment on the basis of antenatal clinic №5;
3. the family planning and reproduction municipal center on the basis of antenatal clinic №20;
4. the glaucomatous municipal center on the basis of hospital №35;
5. the neurosurgical municipal center on the basis of hospital №39;
6. the arrhythmological and surgical department on the basis of the emergency hospital;
7. the rheumatalogical municipal center;
8. the toxicological center on the basis of hospital №33;
9. the advisory and diagnostic municipal center dealing with children and adolescents mental health protection;
10. the young girls reproductive health protection on the basis of hospitals №42, 40 and maternity hospital №5;
11. the gastroenterological inter-district center on the basis of children's hospital №27;
12. the nephrisiological municipal center on the basis of hospital №34;
13. the medicosocial assistance department on the basis of polyclinic №6;
14. the municipal room "Diabetical Foot" on the basis of polyclinic №37;
15. the center of professional medical consultation and students and entrants orientation on the basis of polyclinic №5;
16. the antiepileptic children's municipal center on the basis of children's municipal hospital №1;
17. the inter-district center of children's and adolescents' eyesight protection on the basis of hospital №42;
18. the adolescents' inpatient department on the basis of hospital №42.

5260 doctors, 9772 paramedical workers, 3545 people of junior medical personnel work in the health authorities of the city. At present 87% of doctors have specialists' certificates; 23% - were given the highest level qualification category; 26% of doctors were certified to the 1^st qualification category; 74% of paramedical workers have specialists' certificates, 30% - were given the highest level qualification category, 31% - the 1^st qualification category.

106 emergency teams assigned to 9 substations render acute care twenty-four hours a day.

Program "Urgent measures of tuberculosis control in Nizhny Novgorod in 2000-2004". The basic health activities are: capital development and reconstruction of dispensaries, capital repairs, equipment and antituberculous medicine acquisition.

Program "Pancreatic Diabetes in Nizhny Novgorod" for 2000 - 2002-2005. Specialists carry out the work connected with pancreatic diabetes register development, 6 pancreatic diabetes schools function actively; endocrinologists have all necessary sedatives for qualified performance of their duties; suger-lowering drugs of high-quality only are used for patients treatment.

Program "Healthy Child" for 2001-2005. The program aims at increase of newborns survivability and improvement of their health rates. Integrated measures for improvement of antenatal care are realized, polyvitamins nutrition grants for pregnant women have been introduced into practice, specialized care of newborns is being improved.

Program "Improvement of Emergency in Nizhny Novgorod" for 2002-2006. The program aims at development of the perspective model of emergency at pre-admission and hospital stages.

In 2002 some new technologies have been introduced into practice in treatment-and-prevention institutions:

1. In the sphere of rendering treatment to the grown-up population:

• treatment of spinal column diseases using Julin's apparatus (municipal hospital №30);
• rapid diagnostics of CHD on the basis of biochemical blood and saliva indications and comparison with a dobutamine test (municipal hospital №33);
• reflexogenic zones and bioactive poits SWF-therapy with "Amfis-0,2/10-0,1" apparatus in case of community-acquired pneumonia (municipal hospital №10);
• a temporary pacemaker setting in ward-intensive therapy cases (municipal hospital №12);
• intra-articular introduction of osteonil, aflutop in degenerative arthropathy cases (Nizhny Novgorod emergency hospital);
• polymer-chain reaction when diagnosing the chelibacterial infection of the gastrointestinal tract (municipal hospital №33);
• application of large doses of methotrexate in atrophic arthritis cases (Nizhny Novgorod emergency hospital);
• application of warfarin in coagulopathy cases (Nizhny Novgorod emergency hospital);
• chelicobacter antibodies research (municipal hospital №12);
• external respiration research using rechallenge and bronchodilation methods (municipal hospital №10);
• antibiotic prophylaxis in emergency operative intervention in abdominal cavity organs (Nizhny Novgorod surgical clinics);
• prevention of thromboembolism aftereffects using low-molecular heparin (treatment-and-prevention institutions of Nizhny Novgorod);
• application of ECG-tests with physical activity and medicamentous ECG-tests to outpatient practice;
• application of Holter electrocardiographic monitoring to outpatient practice;
• daily monitoring of ABP.

3. In the sphere of pediatrics:

During the previous year municipal target program "Healthy Child" continued its work. Within its bounds maternity hospitals have acquired the equipment for rendering first aid to newborns.

The following treatment-and-prevention institutions are the most "interesting" among Nizhny Novgorod public health services:

The multifield treatment-and-diagnostic institution renders 630 beds to its patients. The hospital provides medical care including first aid and reanimation. Patients undergo medical treatment of different profiles: therapy, cardiology, neurology, general surgery, contaminated surgery, cardiovascular surgery. Doctors practice low-traumatic abdominal wall organs operations (intramural gallstones disease, stomach ulcer, abdominal hernias, tumors) and chest surgery (lungs, heart and pleural cavity operations).

In this clinic specialists examine and treat patients with cardiovascular diseases using surgical methods - implantation, abdominal aorta operations, aortic-femoral, iliofemoral and popliteal-femoral shunting. Doctors take intensive care of patients with severe forms of connected tissue diffuse diseases and systemic angiitises; in joints-disease cases they carry out the combination therapy adjusting some basis therapy, with the intra-articular introduction of drugs, the complex of adjustment measures and the patients preparation for hip joint and knee joint prosthetics. There are 4 Nizhny Novgorod State Medical Academy chairs functioning on the basis of this hospital.

It is a multifield in-patient hospital with 282 beds and a polyclinic. Highly skilled doctors of the hospital render treatment to therapeutic, cardiologic, pulmonologic and neurologic patients. Specialists of the surgical department have mastered the sparing laparoscopic operations. There is a city colorectal center functioning in the same department. The regional lithotripsy center (lithotripsy of renal and ureteral calculuses) works on the basis of the hospital. The modern US modes, echocardioscopy, fibrous gastroduadennoscopy, colonoscopy, bronchoscopy, computer spirography, rheovasography, electroecephalography, computer ECG, tredmil, Holter monitoring are used in diagnostics. All up-dated modes of bronchopulmonary, cardiovascular and digestive apparatus diagnostics are applied in roentgenology.

The physiotherapy department including the balneary, the valeology cabinet and the halochamber functions on the basis of the polyclinic.

Obstetric clinic, municipal treatment-and-prevention institution "City hospital №40" (a perinatal center).

Within the bounds of WHO/Willstrat International program the clinic has got into status "Hospital benevolent to a child". WHO program "10 steps to successful breast feeding" (breast-feading started soon after birth, rooming-in, infant's feeding on demand, breast-feeding only, absence of nipples)is realized in the perinatal center. For the first time in the city following the advice of WHO, specialists of Nizhny Novgorod perinatal center started delivering a child with a parturient woman in the vertical position that is more physiologically correct for a parturient woman and gives a fetus maximum of comfort for going through maternal passages.

The following new treatment modes are used in this treatment-and-prevention institution: dermatension of a crus wound without application of Ilizarov's external fixator, lavsanoplastics in intercondylar eminence of a shin bone avulsion cases with elbow joint refacing. The functional epicentre has been established on the basis of the neurologic department.

Besides receptions of patients by obstetrician-gynecologists there are day in-patient hospital and specialized multifields receptions in the institution on: gynecological endocrinology, climacteric syndrome, neck of uterus pathology, noncarrying of pregnancy, male and female sterility treatment, family and contraception planning, hirudotherapy. A therapeutist, an oculist, a stomatologist, an ENT, a psycologist carry on receptions of patients.

In their work medical specialists widely use such up-dated diagnostics modes as patient examination for detection of infections transmissible by sexual channels, toxoplasmosis, listeriosis, immune, coagulative and anticoagulative systems research, total hormonic status, US with making a videocassette-recording, truzy, endoscopic examination, HLA-typing. All the above-mentioned modes extend possibilities for making out a precise diagnosis.

While curing a revealed pathology medical specialists of the institution widely use such up-dated diagnostics modes as: SCANER-therapy, hirudotherapy, laser therapy, ozonotherapy, vacuum therapy, gynecological massage, intraurethral electrostimulation, artificial insemination. Treatment-and-diagnostic procedures are carried on under intravenous narcosis of acute medication. The program for future parents including psychological training and exercise therapy has been devised in this institution and is widely used in preparing parents for delivery.

Municipal treatment-and-prevention institution "Children's medical rehabilitation center" has up-dated diagnostic and rehabilitation equipment allowing a large number of latest diagnostic and treatment modes and technologies usage. Every year over 2000 children from all city districts get medical treatment in the center; 93% of them - with psychoneurological pathology. Patients get recommendations from highly skilled medical specialists: a neurologist, a psychiatrist, a psychotherapist, an orthopedist, a physiotherapist, a reflexotherapist, a pediatrician, an ophthalmologist, an otolaryngologist, a homeopath; doctors of different fields: exercise therapy, manual therapy, functional diagnostics, a pedagogue, a psychiatrist, a logopedist. The center renders correction of family relations. Using the newest equipment of the institution the stuff carries out: diagnostic research of brain functions and vessels, diagnostics of musculoskeletal and nervous systems abnormalities, of vestibular and visual apparatuses. The center renders medical treatment according to the latest methods with application of new developments and non-drug therapy: all kinds of physioprocedures, reflexotherapy, biological feedback, all types of massage (including underwater massage), treatment-rehabilitation exercises, hydrokinesotherapy (in the swimming pool), sauna therapy, proprioceptive correction mode with "Adel's" costume, mechanotherapy with Dickul's, Yulin's, Pete's and Tiss's trainers. The specialists of the center carry out psychologic and pedagogic rehabilitation. There is "Young Parents' School" dealing with questions of toddlers upbringing functioning in the center. The latter goes in for rehabilitation treatment of children with the affected central nervous system from the 1^st month of life. It prevents diseases severe forms leading to disability.