Kuat Abzaliev

Department of Clinical Disciplines, National  Al Farabi University of Kazakhstan, Almaty,  Kazakhstan

Various structures of case report from practice are represented in internet.  Based on  their experience and  such  messages,   doctors can transfer   to other medical specialists  interesting cases from the practice, so they  use it to  improve not only for their knowledge, but also  motivate  practitioners to express their opinions in professional activities they dedicated to.

Case report   is considered to be relatively weak evidence-based medicine plan.   New  scientific  information in  clinical case for medical specialists  is practically absent and is written easily and does not require confirmation.

The case is easy and  is quickly described by  practitioners and  is more profitable compared to the procedure of preparing for the publication of  any  many years  clinical  trials on testing drugs or surgical techniques, or  publication of the results of a meta-analysis.   

The disadvantages of this type of publication  include single  experience in the practice of particular clinic or doctors  who present such case. Technologies and modern medical equipment make it possible to perform a number of interventions much faster and with better quality, so  authors of  submitting an article should understand how much they lag behind modern medicine.  

In introduction (a brief literature review) the authors must show the relevance of this case, the publication of which will benefit both practical  medicine  and medical science (2).   And if a  researcher is interested in analyzing casuistic cases, he can ask the authors of articles for certain parameters and    to give a scientific basis for their occurrence and offer their treatment methods  like this happened in 1961 at the birth of children without limbs in Germany (3).

 Global practical and scientific  experience   give  enormous  medical knowledge  and allow  to continue to develop medicine and the medical industry.   Therefore, we as a medical clinical journal use  recommendations of CARE Guideline  for describing clinical cases based on Consensus  (http://www.care-statement.org/) aimed   to restore the tradition of writing effective cases (4, 5).

   Each  submitted  manuscript or clinical case report  are peer-reviewed by independent experts.    Publication template (format)   must  comply with the rules  of "Heart, Vessels  and  Transplantation``  and contain  main   sections  to represent  clinical case report.

Title of the article

 You should very carefully consider the formulation of  title  of the clinical  case,  which would fully reflect the content and conclusions of report.   That  is ,   title  of case   should clearly reflect  not only  the content of  and the meaning of  publication , but also  to be attractive.   It is preferable to limit title of  article  to be not   more than 10 words.  You should not  use  numbers,  abbreviations,  codes  in the title  and   should include type of the article : ``Case report``   so  readers could understand what this article is  about.

Abstract 

This section, in approximately of 100-150 words, summarizes the content of the clinical case and the main difficulties, ways to solve them and have a brief conclusion.   Abstract  must have the main   information  from   sections of  article  and  factor  of   motivation  and  interest,  addressed to readers to attract their attention  to the full the  text of this  case report.    

The following components of the abstract must be given:  rationale

• rationale for the need to describe this clinical case, its uniqueness; 

• key characteristics of the case in terms of the main purpose of the study; 

• key findings and information for healthcare practitioners to consider. 

Structured abstract  contains headings that usually correspond to the main sections of the article ( relevance,  purpose,  summary  discussion  with conclusion ).

 Key words

 In the modern world, searches for the necessary information based on key  questions, offers and  words.   Therefore,   one should indicate 4 to 8 keywords or two-syllable phrases.   You can include the name of the disease, syndrome  and    terminological reference books and  various  versions. To facilitate  selection of keywords   one  should  use   a reference book of medical terms created and published by the US National Library of Medicine   United  States  National Library  of   Medicine  (NLM) (https://www.ncbi.nlm.nih.gov/mesh).  (NLM),  used in many databases and libraries for classifying and indexing medical information - also the  MeSH  rubricator (https:// (www.ncbi.nlm.nih.gov/  mesh  ).

Introduction

A mandatory section describes common actual problem disease denoted in a patient. Provide a brief thematic review of the literature, which shows unexplored issues on this problem.  Then smoothly move on to the purpose of the case report, which  should be stated  in  one sentence.

 The introduction includes the following aspects: 

-General information about the disease or disorder noted in patient, and the rationale for the analysis of the given case. It is necessary to formulate which category the case belongs to:

 •rare pathology, unusual course of a known disease;

 • clinical situation,  is typical for any nosology. 

 • manifestation of adverse effects of the drug.

 • medical intervention with a description of its advantages, novelty or its negative consequences. 

-  A brief thematic review of the literature on the disease with links to the most significant publications.

 -  The goal is formulated in one sentence and shows what results the author achieves.

 -  Written informed consent of the  patient ( guardian) for the publication of the case of his illness (6, 7). 

Ethical aspect

"Informed consent of patient", which patient signs upon admission to the clinic, should include a question about the possibility of using his/her data in  publication of the case about his/her  disease. 

Description  of clinical case  should be considered only after patient has signed the form.   If the incident occurs like  an undesirable event or complication,  then informed consent must be obtained from his/her immediate  relative or spouse. If  as a result of medical procedures  patient - child  becomes incapacitated,  then  form must be signed by a  parent or  guardian. When publishing  photographs of a patient's  face, measures should be taken in advance to preserve his anonymity (8, 9).

Case description 

When describing a case, all necessary information about when the incident occurred and in which medical institution should be described.    Presentation of the clinical case itself should consist of the following information:

-main complaints,   description of symptoms and manifestations of the disease;

-results of diagnostic studies and procedures;

-presentation of diagnostic results and imaging studies;

-preliminary diagnosis, dynamics of its changes;  

 -treatment;   

-any other interference; outcome, number of days of treatment (in a hospital, clinic, etc.), medical rehabilitation, etc. (2, 3, 7, 9-12).  

Discussion 

Required section.   It should include additional information and explanation of the originality of the case, as well as why the treating physicians chose a particular method of management, diagnosis and treatment. It is recommended to describe the differential diagnostic search algorithm and the process of forming a diagnosis of the disease, diagnostic problems and their discussion, including differential diagnosis, prognostic characteristics, and applicability in clinical practice. It is necessary to emphasize not only the positive results of patient management, but also the shortcomings of the medical care provided. It is necessary to highlight new and important aspects of the above observation and compare them with data from other studies, if any. 

Each statement, with the exception of those containing well-known facts, must be accompanied by links to sources of information. Do not repeat information from previous sections.  

In discussion, distinguishing between strengths and limitations in your approach to the case is recommended. Their reasoning must be weighed against a discussion of the relevant medical literature.

Conclusion 

The conclusion indicates the novelty of the presented case, the conclusions that can be drawn from this description, the importance of the particular case for practitioners and medical science. It should also indicate ways to overcome the difficulties that the specialist encountered in the process of working with the patient (13).

 Patient perspective

This section is optional and can be added at the request of the  authors and/or patient.  If the article becomes more interesting from the perspective of the patient’s opinion, then  can be added at the request of the authors and (or) the patient. This section can be written by  as  by  patient  and by the authors based on the patient's story , and it should leave a description of the diseases, their changes over time; how the procedure or treatment affected the patient and what he thinks about the outcome. At the same time, the  author must comment on the information,   feelings, opinions,  stated by the patient.

Conflict of interest  

Recommended section.   This section indicates whether a conflict of interest exists when reporting a particular clinical case. It should be noted that a conflict of interest arises in a situation where the publication or interpretation of a clinical case may affect the financial or personal relationships of the author with other people or an organization.

If this is not the case, the following must be written: “The authors declare that they have no conflicting interests.”

If the publication is supported or carried out under a grant, then this should be stated and the project number indicated (14).

Acknowledgments

This is not a mandatory  section. The authors of a clinical case can  thank all specialists who participated in the treatment of the patient or  specialists of the laboratory-  diagnostic unit, as well as the heads of departments or departments for providing support and reviewing cases.  

 Information about the authors

 Required section.    This section recommends introduce to readers the first author of the  article and  identify the

 contribution of each of the authors in the literature review, presentation of reliable information, photo documentation of case.    The author is considered to be a person who has made a serious intellectual contribution to this case,  he discovered the uniqueness of this case , will once again remind the medical community that this is possible in practice, as well as he provides  its  vision,  interpretation and description of the case.   Co-authors also  contribute   to   description  of case and interpretation of diagnostic   data  (ECG, X-ray, CT, MSCT etc.)  and treatment.

Authors contributions are denoted in the Authorship form and all authors must sign the form and submit along with the manuscript.

References 

Bibliographic references should not be deeper than 10 years. They should be in brackets, numbered in order  of appearance references  in text, table, photo, diagram, etc.

Bibliographic list of  literature  is drawn up according to the Instructions for the  authors of the journal and style should  in the NLM format (see  PubMed).   It is advisable not  to use self-citation, with the exception of  important  cases when it   is deemed necessary.     

Peer-review: Internal

Conflict of interest: None to declare

Authorship:  K.A.

Acknowledgements and funding: None to declare

Statement on A.I.-assisted technologies use: We declare that we did not use AI-assisted technologies in preparation of this manuscript