Physicians Research Articles

ANALISIS KESIAPAN RSUD KAREL SADSUITUBUN LANGGUR DALAM IMPLEMENTASI REKAM MEDIS ELEKTRONIK

A hospital is a group that medical professionals do in a well-structured manner. Electronic medical records are a transition from manual to computerized patient medical records. The function of electronic medical records in general is to improve the quality of services provided to patients. The method used in this study is a descriptive qualitative method and data collected through observation and interviews, the informants in this study are 3 people, namely the head of the medical record coordinator, registration officer and IT officer. Factors that hinder the readiness to implement electronic medical records include 3 aspects, namely: Human resources (HR), infrastructure and information technology (IT). The results obtained at the Karel Sadsuitubun Langgur Hospital are the lack of understanding and knowledge of officers related to electronic medical records, inadequate computers in the polyclinic room due to cost constraints, and the lack of integration with Satu Sehat. The readiness of the implementation of electronic medical records at Karel Sadsuitubun Langgur Hospital is still hampered by these 3 aspects so that there is a need for socialization and training to officers, the holding of computers in each polyclinic room so that services can run optimally and immediately cooperate with Satu Sehat.

FAKTOR YANG MEMPENGARUHI KEAKURATAN DATA SENSUS HARIAN RAWAT INAP DI RSUD DR. R SOEDARSONO PASURUAN

The process of operational planning and hospital decision making is assisted by the SIMRS system. Based on a preliminary survey conducted in the Medical Records section of RSUD doctors, R. Soedarsono found 400 SIMRS patient data and 300 manual patient data. Because staff members enter the same patient data multiple times, some of this data is duplicated. Information collected daily from short-term and inpatients is used for ongoing screening considerations from day to day, week to week, and month to month. The aim of this research is to find out what influences the accuracy of SIMRS daily inpatient census data. A quantitative approach with descriptive methods was used for this research. The subject of the examination was a medical records officer, while the object of exploration was a PC gadget. The results of the examination showed a variety of officers' information regarding using SIMRS: 20% inadequate, 40% adequate, and 40% good. The SIMRS strategy was seen as half inappropriate and half inappropriate, while the hardware was 60% complete and 40% short. Medical record officers should receive training on how to calculate daily inpatient census data correctly.

“A pilot trial of objective structured practical examinations (OSPEs) in non-vocational science-based degrees

ABSTRACT There is a need for more teaching innovations targeting the application of knowledge in non-vocational basic science degrees to prepare students for a diverse workforce. Our study showcases a pilot of a four-station objective structured practical examination (OSPE) designed to prepare students for the workforce. We used Kane’s Validity Framework to test the validity of the OSPE and employed a convergent mixed-methods design with 23 students and four examiners. Relaying new drug information to a medical practitioner (no fails) proved to be an easier task than explaining the clinical implications of a drug to a medication professional, with 61.5% in the Master’s student cohort and 30% of the Bachelor cohort failing this station. Post-OSPE focus group data revealed that participants appreciate the need for OSPEs in non-vocational degrees, stating that conversational mode of delivery is a skill they rarely have the opportunity to get practice or receive feedback on, and is vital for the workforce.

‘Counselling is the only thing to do’: healthcare providers’ experience of Kangaroo Mother Care in Bangladesh – a qualitative study

AimTo explore healthcare providers’ (HCPs) experiences of facility-initiated kangaroo mother care (KMC) in Bangladesh.MethodsAn explorative qualitative study based on 11 semistructured interviews with HCPs from 2 hospitals in Dhaka was...

Factors influencing the intention of doctors to emigrate: a cross-sectional study of Ghanaian doctors

BackgroundThe migration of healthcare professionals from developing countries to more developed nations poses a significant challenge to healthcare systems in low- and middle-income countries. This study aimed to determine the proportion of doctors in Ghana who intend to migrate abroad and to identify the sociodemographic and "pull and push" factors that influence their intention.MethodologyA cross-sectional survey was conducted among doctors in Ghana between March 1, 2024, and March 15, 2024, via an online-based semi-structured questionnaire. Doctors working in Ghana, regardless of nationality, were included. Descriptive statistics and logistic regression analyses were conducted to identify factors associated with the intention to emigrate. Statistical significance was set at a p-value of < 0.05.ResultsAlmost all the doctors who responded to the questionnaire consented to participate (99.4%, 641/645). More than half (53.8%, n = 345) of the respondents were medical officers. Most respondents intended to migrate to practice abroad (71.8%, n = 460). The United States (59.7%), the United Kingdom (39.1%), and Canada (34.8%) were the most preferred destinations. After adjusting for covariates, young doctors between 20–29 years [(Adjusted Odd Ratios) AOR = 2.69, 95% CI = 1.13—6.39)], male doctors (AOR = 1.53, 95% CI = 1.04—2.25), doctors in lower professional ranks, and doctors in the field of diagnostics (AOR = 5.70, 95% CI = 1.16 – 28.03) had significantly higher odds of intending to migrate. In descending order of magnitude, the respondents strongly agreed that better remuneration (1.22 ± 0.63), better quality of life (1.22 ± 0.67), better working conditions (1.26 ± 0.69), and better postgraduate training (1.41 ± 0.80) were pull factors. The push factors were economic challenges (1.17 ± 0.49), a lack of a conducive working environment (1.56 ± 0.86), slow career progression (1.95 ± 1.07), excessive workload (2.07 ± 0.12), personal circumstances (2.26 ± 1.19), and poor postgraduate training (2.48 ± 1.22).ConclusionA substantial proportion of doctors in Ghana are considering emigration, driven by a combination of attractive opportunities abroad and challenging conditions in Ghana. Addressing these issues through improved remuneration, better working environments, and enhanced career development and training opportunities is crucial to retaining healthcare professionals.

AI-driven optimisation of EHR systems implementation in Tanzania’s primary health care

Purpose This study aims to explore how artificial intelligence (AI) can be used to overcome the challenges associated with implementing electronic health record (EHR) systems in primary health-care facilities in Tanzania. It aims to assess the technological, organisational and environmental barriers to EHR system implementation and investigate the role of AI in optimising these systems for more effective health-care delivery. Design/methodology/approach The study adopts a qualitative approach, using case studies from five regions in Tanzania: Dar es Salaam, Mwanza, Morogoro, Singida and Pwani. Data were collected through 26 semi-structured interviews with health-care providers, including medical doctors, nurses, pharmacists and IT personnel. The study applied the diffusion of innovation (DOI) theory and the technology-organisation-environment framework to assess the factors affecting EHR implementation and the potential integration of AI to enhance these systems. Findings Key challenges include unreliable network connectivity, frequent power outages, insufficient training and complex system usability issues. Despite these challenges, EHR systems have improved patient data accessibility and workflow efficiency. AI presents opportunities to address these challenges, mainly through predictive analytics, AI-driven encryption for data security and personalised training modules. AI integration can enhance system reliability, usability and security, ultimately improving health-care outcomes. Originality/value This study provides valuable insights into integrating AI to optimise EHR systems in resource-constrained environments like Tanzania. It addresses a gap in the literature by focusing on how AI can be adapted to low-resource settings and provides a framework for future EHR system implementations in similar contexts. The findings contribute to the global discourse on health-care informatics and the role of AI in improving health-care systems in developing countries.

Retention in primary care among unstably housed residents of a low-income, inner-city neighborhood with a high prevalence of substance use and related disorders

IntroductionAccess to and engagement with primary healthcare can be difficult for marginalized low-income populations residing in inner cities in high-income countries. We designed a study to examine retention in primary care among clients of a novel interdisciplinary primary care clinic in the Downtown Eastside of Vancouver, Canada who did not previously have access to care.MethodsBeginning in June 2021, clients of the Hope to Health clinic were offered enrolment in a cohort study which involved a baseline and follow-up surveys every six months, and linking their data to information from the clinic’s electronic medical records. We used Chi-square or Fisher’s Exact test and Wilcoxon rank sum test to compare clients who were lost to follow-up (LTFU) or deceased, with clients who were retained in care at the end of follow-up, Cox proportional hazards modeling was used to examine independent associations with mortality or LTFU.ResultsAmong 425 participants enrolled, the median age was 50 years (IQR 40–59), 286 (67.3%) participants were men and 128 (25.4%) were unstably housed at enrollment. Among 338 participants with at least six months of follow-up after enrolment, 262 participants (67.5%) were retained in care, 20 (5.2%) had moved, 57 (14.7%) were classified as LTFU, and 28 (7.2%) had died with a median of 19.9 months of follow-up time. The risk of death or LTFU was independently associated diagnosed with alcohol use disorder (AUD) (adjusted hazard ratio [AHR] = 2.23 vs. not; 1.38–3.60), frequency of medical doctor visits (AHR = 0.69 per visit per 3 months; 0.60–0.79) and social work visits (AHR = 0.73 per visit per 3 months; 0.59–0.90. Stimulant use disorder or asthma were not significantly associated with retention in care.ConclusionWe found that a primary healthcare model of care was successful in retaining over two-thirds of clients in primary healthcare after more than 18 months of follow-up. Additional supports for those diagnosed with alcohol use disorder are needed to retain them in care.

Pituitary stalk interruption syndrome complicated with liver cirrhosis: A case report

BACKGROUND Pituitary stalk interruption syndrome (PSIS) is a rare disorder, often characterized by delayed growth and development, short stature, and hypogonadism as the main clinical manifestations. It is not clear whether PSIS can lead to liver cirrhosis. CASE SUMMARY This paper reported a case of liver cirrhosis of unknown origin. The patient was admitted to Beijing Ditan Hospital Affiliated to Capital Medical University in November 2023. The diagnosis of PSIS complicated with liver cirrhosis was established after a series of blood tests and pituitary magnetic resonance imaging examination. CONCLUSION We also reviewed the literature from both domestic and international sources to deepen the clinical understanding of PSIS in conjunction with liver cirrhosis among medical practitioners.

Automated brain tumor recognition using equilibrium optimizer with deep learning approach on MRI images

Brain tumours (BT) affect human health owing to their location. Artificial intelligence (AI) is intended to assist in diagnosing and treating complex diseases by combining technologies like deep learning (DL), big data analytics, and machine learning (ML). AI can identify and categorize tumours by analyzing brain imaging approaches like Magnetic Resonance Imaging (MRI). The medical sector has been promptly shifted by evolving technology, and an essential element of these transformations is AI technology. AI model determines tumours’ class, size, aggressiveness, and location. This assists medical doctors in making more exact diagnoses and treatment plans and helps patients better understand their health. Also, AI is used to track the progress of patients through treatment. AI-based analytics is used to predict potential tumour recurrence and assess treatment response. This study presents Brain Tumor Recognition using an Equilibrium Optimizer with a Deep Learning Approach (BTR-EODLA) technique for MRI images. The BTR-EODLA technique intends to recognize whether or not a BT presence exists. In the BTR-EODLA technique, median filtering (MF) is deployed to eliminate the noise in the input MRI. Besides, the squeeze-excitation ResNet (SE-ResNet50) model is applied to derive feature vectors, and its parameters are fine-tuned by the design of the EO model. The BTR-EODLA technique utilizes the stacked autoencoder (SAE) model for BT detection. A sequence of experiments is performed to ensure the improved performance of the BTR-EODLA technique. The investigational validation of the BTR-EODLA technique portrayed a superior accuracy value of 98.78% over existing models.

Skeletal radiograph interpretation discrepancies in the emergency department setting: A retrospective chart review.

To determine the frequency and clinical consequences of discrepancies in skeletal radiograph interpretation between emergency and radiology doctors in an Australian ED. We reviewed the records of adult and paediatric patients assessed with skeletal radiography in an ED in Victoria, Australia over 3 months (January to March 2022). Epidemiological data, the interpretation of the radiograph by ED and radiology doctors, and clinical management of the patient were recorded to determine interpretation discrepancies and the consequences of these. There were 2359 unique skeletal radiographs in 1576 patient presentations during the study period. Of these, 140 (6%) had a discrepancy. Where a discrepancy existed, 47% of the ED interpretation reported a fracture and/or dislocation which was not present in the radiology interpretation (false positive), whereas the remaining (53%) were attributed to a missed fracture and/or dislocation (false negative). Thirty-five discrepancies (2%) required a change in patient management and were therefore clinically significant. The most commonly affected body region was the elbow, where 15% of radiographs were discrepant. Pathology was more often missed when multiple abnormalities were present on the same radiograph (odds ratio = 4.2, 95% confidence interval = 2.5-6.8). The rate of clinically significant discrepancies in the interpretation of skeletal radiographs by emergency medicine doctors is low. This data support using the ED interpretation of radiographs to guide initial management as safe practice.

Advancements in Urethral Reconstruction Using Biodegradable Tissue: A Comprehensive Review

Urethral reconstruction, a pivotal domain within the realm of urology, has undergone a transformative evolution with the advent of innovative strategies utilizing biodegradable tissue. This article presents a comprehensive exploration of the burgeoning field of Urethral Reconstruction with Biodegradable Tissue (URBT), shedding light on its intricate nuances and clinical implications. The utilization of biodegradable materials in urethral reconstruction represents a paradigm shift aimed at circumventing the limitations inherent in traditional non-biodegradable approaches. The inherent ability of these materials to provide temporary structural support during the critical phases of tissue healing, coupled with subsequent degradation, obviates the need for secondary interventions for material removal, thus mitigating the risk of complications associated with prolonged foreign body presence. This review scrutinizes the biomechanical properties of various biodegradable scaffolds, examining their capacity to withstand physiological stresses while fostering optimal tissue regeneration. Immunological responses to these materials are also elucidated, providing insights into the biocompatibility and host reactions critical for long-term success. Furthermore, the nuanced kinetics of biodegradation are explored, emphasizing their impact on the temporal dynamics of tissue healing and functional restoration. Delineating the clinical applicability of diverse biodegradable constructs, ranging from synthetic polymers to naturally-derived matrices, constitutes a focal point of this analysis. The article critically evaluates the outcomes and complications associated with URBT, providing a comprehensive understanding of the efficacy and challenges inherent in this emerging field. As the landscape of urological surgery continues to evolve, this article serves as a beacon for clinicians, researchers, and medical practitioners navigating the complexities of urethral reconstruction. By delving into the molecular intricacies and clinical implications of URBT, it aims to contribute substantively to the ongoing discourse that shapes the future trajectory of urological surgery, offering a roadmap towards optimized patient outcomes and improved quality of life.

Effective Alzheimer’s disease detection using enhanced Xception blending with snapshot ensemble

Alzheimer’s disease (AD), a prevalent neurodegenerative disorder, leads to progressive dementia, which impairs decision-making, problem-solving, and communication. While there is no cure, early detection can facilitate treatments to slow its progression. Deep learning (DL) significantly enhances AD detection by analyzing brain imaging data to identify early biomarkers, improving diagnostic accuracy and predicting disease progression more precisely than traditional methods. In this article, we propose an ensemble methodology for DL models to detect AD from brain MRIs. We trained an enhanced Xception architecture once to produce multiple snapshots, providing diverse insights into MRI features. A decision-level fusion strategy was employed, combining decision scores with a RF meta-learner using a blending algorithm. The efficacy of our ensemble technique is confirmed by the experimental findings, which categorize Alzheimer’s into four groups with 99.14% accuracy. This methodology may help medical practitioners provide patients with Alzheimer’s with individualized care. Subsequent efforts will concentrate on enhancing the model’s efficacy via its generalization to a variety of datasets.

Keeping humans in the loop efficiently by generating question templates instead of questions using AI: Validity evidence on Hybrid AIG

Background Manually creating multiple-choice questions (MCQ) is inefficient. Automatic item generation (AIG) offers a scalable solution, with two main approaches: template-based and non-template-based (AI-driven). Template-based AIG ensures accuracy but requires significant expert input to develop templates. In contrast, AI-driven AIG can generate questions quickly but with inaccuracies. The Hybrid AIG combines the strengths of both methods. However, neither have MCQs been generated using the Hybrid AIG approach nor has any validity evidence been provided. Methods We generated MCQs using the Hybrid AIG approach and investigated the validity evidence of these questions by determining whether experts could identify the correct answers. We used a custom ChatGPT to develop an item template, which were then fed into Gazitor, a template-based AIG (non-AI) software. A panel of medical doctors identified the answers. Results Of 105 decisions, 101 (96.2%) matched the software’s correct answer. In all MCQs (100%), the experts reached a consensus on the correct answer. The evidence corresponds to the ‘Relations to Other Variables’ in Messick’s validity framework. Conclusions The Hybrid AIG approach can enhance the efficiency of MCQ generation while maintaining accuracy. It mitigates concerns about hallucinations while benefiting from AI.

A systematic review, ANCOVA meta-analysis, and meta-regression of clinical trials : Orlistat and body mass index of overweight and obese patients

Background: Obesity or overfat (i.e., excessive fat accumulation in the host) contributes to cerebrocardiovascular and other diseases. Orlistat is a good obesity medication, unlike other drugs that have higher cardiac toxicity. It reversibly inhibits pancreatic and gastric lipases, and improves oxysterol metabolism. This study summarizes and elaborates the impact of orlistat on BMI in overweight and obese adult patients. Methods: All authors systematically searched and retrieved 288 controlled trial articles on orlistat and BMI from three databases, two registries, and citation searches using specific keywords. The quality and bias risks were determined by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), Risk of Bias in Non-Randomized Study (ROBINS-I), and modified Jadad scale. R version 4.2.2 software calculated the effect size and the analysis of covariance (ANCOVA) effect, and subsequently analyzed using metafor. Results: This novel meta-analysis included 114 studies with 24,600 overweight or obese participants. We showed that orlistat substantially reduced BMI (mean difference −0.78 [−0.94, −0.63], p &lt; 0.0001; I2 = 90.19%, pheterogeneity &lt; 0.0001). Similarly, meta-regression showed a significant impact of orlistat daily dose (ß = −0.0019), yet not for duration (ß = −0.0024) and location (ß = −0.8591, −0.0190). Conclusion: Orlistat has the capacity to reduce BMI in overweight and obese individuals. Medical practitioners shall prescribe orlistat as a BMI lowering agent to complement other intervention in those patients

Developing and validating a knowledge, attitude, and practice questionnaire regarding dengue among secondary schoolchildren in Malaysia

IntroductionDengue is a viral disease borne by mosquitoes that infects humans that is a significant public health concern and socio-economic burden globally, especially in countries in the tropics and subtropics. Health education and community participation are the most powerful prevention strategies. Assessing local community knowledge, attitude, and practice (KAP) on dengue is essential for targeted interventions, as enhancing KAP helps communities recognize risks, adopt preventive attitudes, and implement effective measures to reduce dengue transmission. This study developed and validated a questionnaire on dengue KAP among secondary schoolchildren. Questionnaires serve as essential tools in research, allowing for standardized measurement of knowledge, attitudes, and practices, which supports accurate data collection and meaningful analysis.MethodsThe development and evaluation process (structure and content) involved consultations with eight experts including public health medicine specialists, medical officers, behavioural insights officer, academician, and entomologist, to ensure the relevance and comprehensiveness of the questionnaires. A QDengue-KAP questionnaire was administered to 30 secondary schoolchildren in Kuala Lumpur, Malaysia. The online questionnaire was self-administered, closed-ended, distributed anonymously, and participation was voluntary.ResultsThe final questionnaire comprised four sections and 50 items after the initial version had undergone a rigorous evaluation to ensure its reliability and validity. The content validity index (CVI) and content validity ratio (CVR) values exceeded the minimum requirement and indicated that all items met the minimum standards for content validity. Compared to the initial version, the final version of the questionnaire had improved Cronbach alpha values for each dengue KAP domain: knowledge [Cronbach’s alpha: 0.765 (items: 15)], attitude [0.894 (15)], practice Part A [0.735 (15)], and practice Part B [0.876 (5)]. Thus, each statement in the Knowledge (K), Attitude (A), and Practice (P) domains was deemed valid through validity and reliability evaluation, ensuring their relevance and accuracy in assessing dengue-related factors.ConclusionThe validation process demonstrated that each statement in the KAP domains was relevant, accurate, and aligned with the study's objectives, supported by expert validation and representation of the target population. This rigorous approach strengthens the validity and reliability of the questionnaire, making it a valid tool for assessing and improving dengue-related behaviours within the target population.

Identity Crisis Among Clinical Officers at Malawi’s Public Hospitals Amidst the Implementation of Functional Reviews

In Malawi’s healthcare system, a significant doctor shortage compels clinical officers who are mid-level health professionals, to shoulder responsibilities traditionally reserved for medical doctors. This study delves into the unintended consequences of functional reviews within Malawi’s health sector. The research, employing a qualitative case-study approach across five public hospitals, investigated how the functional reviews triggered an identity crisis among clinical officers. The findings revealed that the implemented changes caused an identity crisis among clinical officers. This identity crisis, demonstrably exacerbated occupational stress among clinical officers. To address this unforeseen consequence and safeguard the well-being of clinical officers in particular and healthcare workers in general, this paper proposes the incorporation of psychosocial risk assessments before implementing functional reviews in the health sector. This proactive approach can help identify potential threats to social identity and mitigate the risk of increased stress among healthcare workers. Ultimately, this research contributes to the growing body of knowledge that underscores the intricate link between social identity and the impact of large-scale workplace changes within the healthcare system.

TikTok and frozen shoulder: a cross-sectional study of social media content quality

PurposeThis study aimed to assess the validity and informational value of the material provided on TikTok regarding frozen shoulders. The hypothesis was that the video content on this platform would not provide adequate and valid information.MethodsThe current study focused on frozen shoulder videos on the TikTok social media platform. The terms “frozen shoulder” and/or “adhesive capsulitis” were used as keywords for an extensive online search of video content on TikTok, and the first 100 videos were included. Out-of-topic, non-English, and duplicated videos were excluded from the analysis. The duration and numbers of likes, shares, and views were recorded for each video. Further, videos were categorized based on the source (physiotherapist/osteopath, medical doctor, or private user), type of information (physical therapy, etiopathogenesis, anatomy, clinical examination, patient experience, or symptoms), video content (rehabilitation, education, or patient experience/testimony), and the presence of music or a voice. The assessment of the video content’s quality and reliability was performed by two experienced shoulder surgeons using the DISCERN instrument, the Journal of the American Medical Association (JAMA) benchmark criteria, and the Global Quality Score (GQS).ResultsA total of 100 videos were included in the analysis, of which 86 (86.0%) were published by physiotherapists/osteopaths. Most of the information and video content focused on physical therapy and rehabilitation (83.0% and 84.0%, respectively). Eighty-four (84.0%) videos included voice comments, while the remaining featured music. The mean number of views was 2,142,215.32 ± 6,148,794.63, while the mean numbers of likes, comments, and shares were 58,438.67 ± 201,863.54, 550.81 ± 1712.22, and 3327.43 ± 7320.81, respectively. The mean video duration was 110.20 ± 116.43 s. The mean DISCERN score, JAMA score, and GQS were 16.17 ± 2.36, 0.61 ± 0.51, and 1.18 ± 0.41, respectively. Videos posted by medical doctors or private users received higher scores than those posted by physiotherapists/osteopaths (p < 0.05).ConclusionsThe educational value of videos published on TikTok was poor; videos posted by medical doctors exhibited better quality and educational value than those of physiotherapists or osteopaths. It is the responsibility of orthopedic surgeons to investigate the potential benefits, consequences, and implications of TikTok video content for the health of frozen shoulder patients and to propose necessary adjustments. Given the rapid growth of TikTok, further research is needed.Level of evidenceLevel IV—cross-sectional study.

ЦІННОСТІ ЗДОБУВАЧІВ ВИЩОЇ ОСВІТИ МЕДИЧНОГО УНІВЕРСИТЕТУ:ТЕОРІЯ І ПРАКТИКА

The article analyzes the theoretical and practical aspects of the values of student youth using the example of medical universities. Attention has been focused on the contradictions within the higher education system, the adaptation of first-year students to new conditions, and the features of the functioning of educational systems during wartime. Values are characterized in the context of comparing their positive and negative meanings, their division into material and spiritual categories, and their significance in axiology. The practical aspect of the conducted research reflects the experience of applying the «keyword» method in teaching humanities and social disciplines, aimed at developing skills in medical university students for analyzing and prioritizing academic and professional values. Through the «keyword» method, elements of students' self-assessment and their vision of the specifics of their future professional activities were identified. Based on the analysis of student responses, a list of key words in the field of medicine was compiled. It was found that first-year medical students understand the core professional values of future doctors, which ensure the prioritization of patients’ life and health, as well as the professionalism and moral responsibility of medical practitioners; while sixth-year students focus on the social aspects of the medical field (accessibility), its democratic nature (choice), and development prospects in response to unknown challenges (the future). The key words regarding the positive qualities of modern youth (values) were identified: persistence, tolerance, activity, openness, creativity, confidence, adaptability, and progressiveness; and the negative qualities (anti-values): apathy, irresponsibility, physical inactivity, overconfidence, arrogance, carelessness, laziness, insolence, imperfection, inconsistency, and overabundance. It is concluded that the issue of challenges faced by modern students in new conditions requires separate research. Identifying these challenges will allow for adjustments in the organization of the educational process and consideration of student opinions.

A méh- vagy darázscsípés okozta anafilaxiás sokk vizsgálata a triptáz enzim és a méh-, illetve darázsméreg specifikus immunglobulin E szintek vérből történő meghatározása alapján, egyes rendkívüli haláleseti eljárásokban

Aim: Systemic allergic reactions triggered by bee and wasp venom affect approximately 3% of adults, and in severe cases, can lead to anaphylactic reactions and death. The exact cause of extraordinary deaths resulting from insect stings is often not determined in a significant number of cases. The aim of this study is to provide guidance through methodological recommendations to investigate the precise cause of deaths presumably resulting from insect stings, specifically focusing on uncovering the facts and causes of anaphylaxis. Methodology: The study reviews literature related to anaphylaxis caused by insect stings and animal toxins, as well as its immunological background. It seeks to translate the information found in the literature into the realm of official activities related to extraordinary deaths. The study also summarises knowledge about groups of animals in Hungary that are medically significant due to their venom, providing guidance for on-site recognition, search, documentation, and recording of the most common Hymenoptera species with venom capable of frequently inducing anaphylactic reactions. Findings: The key to diagnosing deaths caused by anaphylaxis lies in crime scene investigation. The attending medical doctor must recognise the symptoms of insect stings and ensure the collection of a blood sample for allergological purposes. A special blood collection kit has been assembled for this purpose. The blood sample, which must be stored at 2–8ºC, should be sent to the Semmelweis University Institute of Laboratory Medicine within 2 days. By measuring the level of tryptase enzyme in the blood sample and detecting the presence of specific immunoglobulin E for the venom of the respective bee or wasp species, the cause of the anaphylactic reaction can be confirmed. The crime scene investigation team should also make an effort to locate and secure the potential insect species responsible for the sting. If the forensic entomologist successfully identifies the species, it facilitates the specific IgE allergological examination for the respective venom. Value: In cases of death resulting from insect stings, the cause is often not determined due to lack of proper caution and appropriate methods. The procedural approach recommended in the study establishes the basis for determining the precise cause of death in cases of suspected insect stings.

Thoracic surgery - An underestimated dream job?

BackgroundThoracic surgery is an expanding surgical specialty, but a shortage of qualified and motivated thoracic surgery residents is expected. It is estimated that around 23 % of all surgical specialist jobs will be vacant by 2030. We therefore need to assess the current clinical situation and urgently improve the recruitment and training of our next generation of surgeons. MethodsUsing the online survey (Lime Survey), a questionnaire (28 questions) was created to analyze the current nationwide situation of residency in thoracic surgery. The survey was sent to all postgraduate trainees in thoracic surgery departments in Germany. The current status on residency-programs, scientific interest, the attractiveness of thoracic surgery, and the demographics of the participants were evaluated. The survey also evaluated specific ways to increase attractiveness.The survey was conducted in collaboration with “Frauen in der Thoraxchirurgie” by the “Junges Forum der Deutschen Gesellschaft für Thoraxchirurgie”. The survey was sent to all residents and young specialists in Germany. A total of 187 participants responded. ResultsOut of 187 participants, 123 questionnaires (65.8 %) were completed. Mean age was 36.3 ± 6.9 years. 62.6 % of the participants were male. About 70 % work in an independent thoracic surgery department, while the rest is affiliated with another specialty department. 50 % have completed a doctorate in medicine. ConclusionThe development of an objective and structured training plan could define the roles and responsibilities of the senior surgeon and the trainee, leading to improved training and, at the very least, ensuring good recruitment of junior thoracic surgeons.