Publishing House of Ivano-Frankivsk National Medical University
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International Medical Consensus Documents and Guidelines as the Basis for Getting Knowledge of Clinical Disciplines by Students
Get PDFThe latest data on the diagnosis and treatment of patients with specific diseases are primarily accumulated in the international consensus documents and guidelines according to scientific evidence. In Ukraine, these documents are used mainly by the scientists who present the results of their clinical trials at various congresses and professional association meetings. As for Ukrainian students, the textbooks remain the main source of their knowledge; due to a long process of their preparing and publishing, they do not keep pace with rapid changes in the international documents. One way to solve the problem described is to reorient the methodology of training students. The fundamental postulates of such training should be as follows: the study of each disease semiotics should be based on the universally accepted criteria for its diagnosis described in the latest consensus documents, and the study of treatment methods for each disease should be based on the most important international guidelines according to scientific evidence. The tasks mentioned above can be implemented through teachers’ focusing on information taken from the international guidelines and consensus documents, introducing references to these documents in the methodological materials for students, increasing students’ English proficiency, creating database for the exams on the basis of the international guidelines and consensus documents, and clear agreement of Ukrainian and international medical terminology. The implementation of all the above mentioned is not an easy task, as the introduction of any changes requires appropriate funding including labor compensation for those who provide this introduction. However, without an operative system of acquainting students with the latest achievements in medical science supported by consensus documents of the universally recognized international medical organizations, Ukrainian medicine will not be able to keep pace with global medicine, and medical graduates, at the start of their career, will lag behind their colleagues abroad
Color Vision Deficiency in Medical Students in Jammu & Kashmir, India
Get PDFNon recognition of any of the three colors is known as color blindness. Color blindness is the commonly used term for deficiency of color vision. Word color blindness is a misnomer as anyone labeled as it, is extremely rare to be totally color blind hence more correctly called color vision deficiencies (CVD). Color vision is a function of three types of cone pigments present in retina. The incidence of Color vision deficiency is common in medical profession and affects the diagnosis and treatment of patients but still it remains the most neglected aspect of vision. Color is very important sign used in medical profession, but there is no effective screening for Color Vision Deficiency (CVD) at any level of medical profession. The present study was undertaken to find out CVD in medical students of Government medical college Srinagar.
Material and Method: A total of 300 medical students (MBBS, BDS, NURSING) including 154 males and 146 females between 18-20 years of age were examined for CVD in Medical College using Ishihara pseudoisochromatic plates. After taking history on structured proforma the students were shown Ishihara’s test plates under day light at normal reading distance.
Results: Among 154 males, 11 were color deficient (7.14%), and among 146 females, 1 (0.68%) had color vision deficiency. Deutranomalia (41.6%) was the most common type of CVD followed by Protanomalia (25%) then Protanopia (16.7%) and Deutranopia (16.7%), respectively.
Conclusions: With this high incidence of color vision deficiency, students with CVD may feel difficulty in day-today practice in medical field. So, screening for CVD in medical students at the time of admission is very important which may help in early management of CVD and with timely counseling proper adaptive strategies can be adopted
Patterns of Changes in the Psycho-emotional Background in Patients with Stable Coronary Heart Disease, Complicated By Atrial Fibrillation
Get PDFThe objective is to investigate the influence of stress on the clinical and pathogenetic peculiarities of the course of stable coronary heart disease (SIHD) in conjunction with atrial fibrillation (AF).
Materials and methods. The analysis of psychodiagnostic tests, labolatory and instrumental research methods in patients with and without AF has been performed. Patients were divided into three groups: group 1 – patients with stable ischemic heart disease (SIHD) with a constant form of AF (15 patients were examined), group 2 – patients with SIHD with paroxysmal form of AF (16 patients were examined), group 3 – patients with SIHD without AF (15 patients were examined).
Results. According to the analysis of the data obtained, low level of stress was found in 6 (37.50%) patients with a permanent form of AF, whereas in patients without AF, it was observed in 1 (6.67%) person (p1<0.05) (p1 – the reliability of the differences in indicators relative to patients without AF). Moderate somatic disorder in women with paroxysmal AF was significantly higher than in the group of patients with a constant form of AF (p2<0.05) (p2 – the reliability of the differences in the indicators relative to patients with a constant form of AF). It is confirmed in patients with AF there are signs of the average stress level on the perceived stress level-10 (p2<0.05). Among the social factors that may have an impact on health are the influence of the media, the use of alcohol by relatives, the threat of unemployment for relatives and friends. These indicators were most often found in the group of patients with AF rather than without it (p2<0.05). Changes of ECG and echocardiographic parameters in all groups of patients were revealed.
Conclusion. The association of stress with stable ischemic heart disease combined with atrial fibrillation has shown that stress disorders are associated with an increased risk of atrial fibrillation and may worsen their course and predict the risk of developing paroxysm. The dependence between the severity of clinical manifestations, psychodiagnostic tests, laboratory methods, ECG and echocardiographic parameters of the heart on the course of atrial fibrillation is proved
Death due to Acute Massive Pulmonary Thromboembolism Associated with Risperidone
Get PDFThe antipsychotic drug risperidone, which is extensively used, has also many side effects, as increased risk of stroke, thrombosis, and pulmonary embolism have been reported. We present a case of a 38 year-old-woman with psychiatric disorder who got worse in her home and died in the hospital. Throughout autopsy, during the internal examination, multiple thrombi in the pulmonary artery branches were observed; however, there were no pathology findings in the lower extremity veins. Blood chemistry test revealed 4 ng/ml of risperidone, 37 ng/ml of quetiapine and atropine; chemical examination of urine detected atropine, quetiapine, risperidone. Death occurred due to acute massive pulmonary thromboembolism. We aimed to discuss this case with autopsy and histopathologic findings, laboratory results in medico-legal literature.  
Possible Mechanism of Aframomum Sceptrum Extracts Mediated Modulation of Renal Function after Monosodium Glutamate Exposure
Get PDFThe objective of the research was to explain the possible mechanism of an earlier reported role of Aframomum sceptrum extract in the modulation of renal function parameters in monosodium glutamate-induced toxicity.
Materials and Methods. Similar experimental methods previously reported by us in Ogbeke et al., (2016) were maintained.
Results. Monosodium glutamate administration led to a significant elevation of levels of serum and kidney lipid peroxidation due to decrease in the levels of serum and kidney antioxidant enzyme, super oxide dismutase, catalase, gluthathione peroxidase and gluthathione. There was observed increase in oxidative enzyme, aldehyde oxidase, sulphite oxidase, xanthine oxidase and monoamine oxidase activities in serum and kidney after monosodium glutamate consumption. Aframomum sceptrum treatment significantly regulated all altered indices.
Conclusions. The study concluded that the ability of Aframomum sceptrum extract to modulate renal function parameters in monosodium glutamate-induced toxicity is dependent on its efficacy in the induction and mobilization of antioxidant defense armory via the increased synthesis of tissue and serum enzymatic and non-enzymatic antioxidants, as well as improved oxidative enzyme activities that mediates the quenching of rising aldehydes and sulfoxides, N-oxides and aromatic oxides within the kidney
Effeciency of Initial-I Stage Generalized Periodontitis Treatment Among Medical University Students According to Indicators of Oral Cavity Prooxidant-antioxidant System
Get PDFPeriodontal diseases are one of the most important problems in dentistry, due to its very high dissemination. Inflammatory processes in periodontal tissues are more common among young people, which, in the future, without adequate treatment lead to irreversible changes in structure of cellular bone. This causes development of new effective therapeutic complexes aimed at eliminating etiopathogenetic factors development of periodontal tissues inflammatory diseases and the targeted influence on the pathological processes in these tissues.
The objective of the study was to analyze the efficiency of suggested initial-I stage generalized periodontitis treatment among second-year students of medical university.
Materials and methods. To achieve this goal, we examined and treated 50 students with initial-I stage of generalized periodontitis without somatic pathology, which were divided into two groups, depending on treatment method. First group included 25 students who received advanced treatment; second group included 25 students, who received usual treatment. Control group consisted of 20 clinically healthy students. The state of oral cavity prooxidant-antioxidant system was determined by the level of malone dialdehyde (MDA), diene conjugates (DK), superoxide dismutase (SOD) activity, glutathione-S-transferase (G-ST), and the activity of glutathione peroxidase (GPO).
Results and discussion. Periodontal diseases, namely, initial-I stage of GP, are accompanied by an imbalance of oral cavity prooxidant-antioxidant system indicators. This is confirmed by an increase number of MDA and DK (p<0.001), and a decrease in SOD, G-ST, GPO (p<0.001) compared to clinically healthy students.
Conclusions. The results of GP treatment in first group were significantly better in relation to the second one (p<0.05), indicating the effectiveness of the proposed advanced treatment of initial-I stage of GP
Role of Postgraduate Education in the Provision of Social and Professional Mobility of Health Specialists
Get PDFNowadays the development of a modern information society, the intensity of accumulating the latest professional information and systematic obsolescence of professional knowledge necessitate a constant and continuous learning of a 21st-century specialist. The transition to lifelong learning, when basic education is periodically subjected to additions and adjustments that requires graduates of higher education institutions to master professional knowledge, as well as to form social and professional mobility, is now recognized by the analysts as a solution of this problem. According to researchers, social and professional mobility of health specialists consists in their ability to overcome stereotypes, assimilate new technologies and solve professional problems in accordance with modern socio-cultural and economic conditions. In Ukraine, the development of social and professional mobility of future health specialists is directly related to the implementation of the system of continuous professional development of health professionals. The introduction of the problem-solving techniques during postgraduate study enhances the professional training of doctors, that, in its turn, will allow them to effectively use knowledge gained in daily practice. Interactive methods such as case method, role playing games, management games, brainstorming, disputes, discussions, critical incident techniques, project-based learning, competitive learning, small-group learning with elements of management game or carousel strategy, method of interdisciplinary conference with elements of discussion are considered as an effective tool for problem-based learning within health professional education. Thus, the contribution of postgraduate education to the provision of continuous professional development of health professionals creates optimal conditions for the formation of social and professional mobility of health specialists
Focus on Stable Angina from the Perspective of Affected Coronary Artery Number and Structural and Functional Myocardial Changes
Get PDF The objective of the research was to study myocardial hemodynamics and contractility, as well as N-terminal pro-brain natriuretic peptide secretion in the patients with chronic coronary artery disease depending on affected coronary artery number according to coronary angiography.
Materials and methods. The study included 62 patients with chronic coronary artery disease, heart failure with preserved left ventricular ejection fraction. Among the examined patients, males prevailed – 52 (83.9%) individuals. The average age was 61.2±1.2 years. The control group included 15 apparently healthy individuals with preserved gender and age proportions. The patients were randomized by the number of the affected coronary arteries and divided into 2 subgroups according to the results of coronary angiography. Subgroup I included 16 (25.8%) patients with single-vessel coronary artery disease; subgroup II comprised 46 (74.2%) patients with multivessel coronary artery disease.
Results and discussion. According to Holter monitoring, average and maximum heart rate, extrasystoles and episodes of ST-segment depression/elevation were more often found in the patients with multivessel coronary artery disease (p<0.05). According to echocardioscopy, in the patients with coronary artery disease regardless of affected coronary artery number, hemodynamic indicators were higher as compared to healthy individuals (p<0.001), while left ventricular ejection fraction was lower in the patients with multivessel coronary artery disease (р<0.001). Serum level of N-terminal pro-brain natriuretic peptide exceeded reference value in both single-vessel coronary artery disease and multivessel coronary artery disease (р<0.001); however, the secretion of this peptide increased in multivessel coronary artery disease (р<0.05). There was observed a strong inverse correlation between left ventricular ejection fraction and N-terminal pro-brain natriuretic peptide in the patients with multivessel coronary artery disease and a moderate correlation in the patients with single-vessel coronary artery disease.
Conclusions. The nature and severity of coronary artery disease clinical course are associated with the number of the coronary arteries affected by atherosclerotic plaques. In multivessel coronary artery disease, according to the results of clinical, functional and laboratory studies, there was observed persistent progression of coronary artery disease and, consequently, chronic heart failure that is the reason for the improvement of schemata for successful treatment of the disease
A Comparative Study of the Canine Tooth as a Tool in Gender Determination in Nigerian Population
Get PDFDental evidence has been demonstrated as a major forensic tool for the identification of individuals and sex determination.
The objective of the research was to determine sex in Delta Ibo ethnic group of Nigeria using the mandibular and maxillary canine teeth.
Materials and methods. The study comprised 201 (100 males and 101 females) subjects of Delta Ibo ethnicity at the age of 17 – 25 years. The mesiodistal crown width and intercanine distance of both the maxillary and mandibular canines were measured intraorally using a pair of dividers and a ruler. Unpaired T-test at a probability value of p<0.05 was used to ascertain the mean significant differences between the male and female canine indices.
Results. Study results showed a statistically significant difference between male and female mandibular and maxillary canine mesiodistal width. This implied a sexual and reversed sexual dimorphism in the studied population.
Conclusions. The study confirmed that the canines of Delta Ibos exhibit sexual dimorphism like other populations and the maxillary canine indices give the most accurate prediction in sex determination
Radiological Findings in Chronic Contained Rupture of Abdominal Aortic Aneurysm in a Patient Presenting with Lower Back Pain
Get PDFThere is a diagnostic and therapeutic dilemma in cases of chronic contained rupture of abdominal aortic aneurysm, as the symptoms can be more subtle including dull back pain, and thus lacking the typical features of rupture.
The objective of this research was to introduce a case report emphasizing the need to relate the low back pain with atypical radiological appearances of entities, as aortic abdominal aneurysms, capable to compromise the patients’ clinical diagnosis, prognosis and treatment