Ivano-Frankivsk National Medical University Research Articles

Christian education of young people is a guarantee of Ukraine's national security in the context of the Russian-Ukrainian war

The article explores the crucial role of Christian education for the youth in the context of fortifying Ukraine's national security, particularly during the Russian-Ukrainian war. An analysis of research and publications indicates that Christian education contributes to the development of resilient individuals grounded in high moral values, possessing advanced social responsibility, and capable of self-sacrifice for the benefit of the homeland. An essential component involves instilling mercy, tolerance, and patriotism in the youth. The article's objective is to study the impact of Christian education on the youth on Ukraine's national security and to identify ways to strengthen it in wartime conditions. The article provides an example of the successful implementation of Christian education among student youth in collaboration between the Ivano-Frankivsk National Medical University and the clergy of the Ivano-Frankivsk Eparchy of the Ukrainian Greek-Catholic Church. The experience of organizing meetings between priests and youth, as well as educators, in university and outreach settings aimed at the development and strengthening of spirituality among both students and their mentors, is discussed. The main conclusions of the article underscore the importance of Christian education for the reinforcement of Ukraine's national security.

FEATURES OF THE FOREIGN STUDENTS TRAINING IN THE ELECTIVE DISCIPLINE "QUALITY SYSTEMS IN PHARMACY"

The pharmaceutical industry is rapidly developing and implementing new innovative approaches and legal regulation of the drugs quality management system, which includes a set of process methods and resources that are necessary for quality management. Therefore, the mastery by students of the specialty 226 "Pharmacy, Industrial Pharmacy" of the elective discipline "Quality Systems in Pharmacy" is an important issue of their professional training which will help them to master the methodology of quality management, normative-legislative and organizational-economic aspects of quality control of medicinal products at pharmaceutical enterprises. The elective discipline "Quality Systems in Pharmacy" is closely connected to some other disciplines, such as “Pharmacy and Industrial Technology of Drugs”, and “Technology of Cosmetic Drugs”. Training takes place according to the credit-module system in accordance with the basic requirements of the Bologna Convention.
 The main tasks of the elective discipline "Quality Systems in Pharmacy" are: providing the students with general knowledge about the quality indicators of medicines depending on the stage of their life cycle by fulfilling the requirements of good pharmaceutical practices and developing documentation in accordance with their requirements; formation of practical skills related to the rules and requirements for the creation, manufacture, research, distribution, sale, and storage of medicines in accordance with the requirements of good pharmaceutical practices operating in the European Union; improvement of the level of general and scientific development of students, formation of their outlook and perspective as modern qualified specialists in the field of pharmacy.
 The aim of the research is to study the peculiarities of the training of foreign students of the specialty 226 "Pharmacy, Industrial Pharmacy" in the Ivano-Frankivsk National Medical University (IFNMU) in the elective discipline "Quality Systems in Pharmacy". The subject of study of the discipline "Quality Systems in Pharmacy" is the methodology of pharmaceutical development, the components of the quality assurance system of medicines, including the requirements of the Guidelines of good practices in pharmacy for each stage of the life cycle of a medicinal product. The discipline is usually chosen by the well formed specialists.
 Teaching the elective discipline "Quality Systems in Pharmacy" at the specialty 226 "Pharmacy, Industrial Pharmacy" of IFNMU is necessary for students to thoroughly master the quality management system of medicines, it contributes to the optimization of the educational process and the improvement of the new principle of problem-oriented education of students and its control. This discipline orients students to the importance of the following issues: ensuring the quality of medicines at all stages of their life cycle; regulatory activities in the field of quality control of medicines; implementation of medicines; optimization and monitoring of pharmaceutical quality systems processes. This discipline forms the important competencies, knowledge, skills, abilities, and aspirations of students for self-development, while their teacher also develops and improves in the professional field together with students. Taking into account the trend of the European development of the pharmaceutical industry, the quality management system of medicines also should be harmonized with European standards.

Optimization of Diagnostics and Treatment of Nasopharyngeal Cysts

Nasopharyngeal cysts are typically benign, congenital lesions filled with fluid and encapsulated from surrounding tissues. Both children and adults may present with clinical signs.
 The aim of the study was to improve the efficiency of diagnostics and treatment of nasopharyngeal cysts in adults based on the differential diagnosis.
 Materials and Methods. The study was carried out at the Department of Otolaryngology with the Course of Head and Neck Surgery, Ivano-Frankivsk National Medical University, Ukraine, and encompassed both outpatient and inpatient-to-outpatient observations. Fifteen (9 females, 6 males) patients with nasopharyngeal cysts at the age of 28 to 51 years were examined. All patients underwent a comprehensive assessment, including a thorough evaluation of their medical history, a standard examination of the ears, nose, and throat (ENT) using conventional and optical techniques, alongside computed tomography (CT) of the nasopharynx and paranasal sinuses, complemented by a general physical examination.
 Results. Fifteen patients with nasopharyngeal cysts were examined and treated. In nine (60%) cases, the cyst appeared as a round mass with a dense wall, partially or completely obstructed by the excretory duct and containing dense content, localized in the central region of the nasopharynx. In four (26.6%) cases, the cyst ruptured. Cysts were localized laterally, originating from the fossa of Rosenmüller in three (20%) cases. All patients underwent minimally invasive surgery.
 Conclusions. Endoscopic examination, CT, and magnetic resonance imaging are the most informative diagnostic methods for nasopharyngeal cysts. A definitive diagnosis can be made based on pathomorphological examination. The treatment of choice for nasopharyngeal cysts is endoscopic endonasal surgery with a microdebrider and laser coagulation.

Peculiarities of the Clinical Picture of Hirschsprung’s Disease in Children of the First Year of Life Taking Into Account the Extent of Aganglionosis

The aim of the work. To investigate the peculiarities of the clinical course of Hirschsprung’s disease in children of the first year of life and to determine the significance of symptoms in the verification of the disease.
 Research materials and methods. Since 1980 up to 2021, at the pediatric surgery clinic of the National Medical University named after O.O. Bohomolets on the basis of the National Children’s Specialized Hospital “OKHMATDYT” and in the pediatric surgery clinic of the Ivano-Frankivsk National Medical University on the basis of the Ivano-Frankivsk Regional Children’s Clinical Hospital, there were examined and treated 483 children of the first year of life suffering from Hirschsprung’s disease.
 Results of the study. The clinical manifestation and course of aganglionosis varied in length at the time of hospitalization and depended on the time after birth. During the first month of life, 97 (20.08%) patients were hospitalized; of them 39 (8.07%) patients had an atypical clinical picture due to: colonic atresia in 15 (3.10%), colonic atresia + gastroschisis in 3 ( 0.62%), ileal atresia in 9 (1.86%), esophageal atresia in 3 (0.62%), cleft of the hard and soft palate in 9 (1.86%) patients. Depending on the age, there were 280 (57.97%) patients under 6 months, and 203 (42.03%) patients between 6 months and 1 year. The classic typical clinical picture was in 444 (91.93%) patients, which was characterized by the absence of meconium excretion, abdominal distension in 444 (91.93%) patients, delayed physiological weight gain against the background of nutritional insufficiency with the development of hypotrophy in 327 (67.70%) patients, vomiting of stagnant gastric and intestinal contents in 417 (86.34%) patients. On the other hand, there occurred enterocolitis in 315 (65.22%) patients, toxic megacolon in 16 (3.31%) patients, and anemia of various degrees in 241 (49.89%) patients, among the complications that arose during the examination of patients with Hirschsprung’s disease. According to the results of a comprehensive examination, the following extent of aganglionosis was determined: rectal form in 100 (20.70%) patients, rectosigmoid form – in 192 (39.75%), subtotal – in 150 (31.06%) and total in 41 (8.49%) patients. Concomitant malformations were found in 98 (20.29%) patients: renal malformations were diagnosed in 7 (1.45%) patients, concomitant heart malformations in 18 (3.73%) patients. Associated intraoperative findings were: Meckel’s diverticulum in 5 (1.03%) patients, and congenital cyst of the right ovary in 1 (0.21%) patient. The clinical course was affected by the concomitant malformations: incomplete bowel rotation in 10 (2.07%) patients and internal abdominal hernia in 2 (0.42%) patients.
 Conclusions. Clinical manifestations and course of HD primarily depend on the presence of accompanying developmental defects, which may prevail during the examination due to vital disorders. In the clinical course of Hirschsprung’s disease, it is necessary to distinguish between typical and atypical forms. Typical clinical symptoms were in 444 (91.93%), and atypical in 39 (8.07%) patients.

Professional self-determination of future dentists in the modern realities of Ukraine.

Aim: To research how the future dentists' professional self-determination (reflects the cognitive-reflexive component of higher medical education applicants' readiness to use digital technologies in their professional activities) develops within the formation of information technology competence in the modern realities of Ukraine. Materials and Methods: The author's questionnaire consisted of 15 questions. The questionnaire surveys covered 98 future dentists who studied 'Medical Informatics' and 'Information Technology in Dentistry' at the Ivano-Frankivsk National Medical University in the September-December 2017-2018 and September- December 2022-2023 academic years. The research results were assessed according to the algorithm described. The research used such methods as analysis, synthesis, comparison, concretisation, systematisation, and generalisation, as well as methods of mathematical statistics for evaluating data, namely correlation analysis, Kolmogorov-Smirnov test, Cronbach's alpha, Fisher's test (F-test of equality of variances), Student's t-test and ranking. Results: The research found positive dynamics of the professional self-determination levels (in 2022 compared to 2017, the low level decreased by 20.5%, the satisfactory level - by 19.0%, the average level increased by 20.6%, the high level - by 18.9%) and their quality, which within the research increased by 39.5%. Conclusions: By forming information technology competence, future dentists changing the priorities of professional self-determination in the modern realities of Ukraine and acquiring readiness (within the cognitive-reflexive component) to use digital technologies in professional activities.

Mіжнародний конгрес Європейського респіраторного товариства 2023: Презентація українських здобутків

Abstract. From September 9 to 13, 2023, the hybrid Congress of the European Respiratory Society (ERS) was held in Milan (Italy) for the second time. In 2023, more than 20.000 people attended the Congress, participating both in person and online. The aim: to analyze abstracts of scientific works on pulmonology and phthysiology that were presented by Ukrainian scientists at the ERS International Congress 2023. Materials and methods. The data regarding the abstracts of scientific reports were obtained from the Congress website and the online program of the personal account of an ERS member, doctor of medical sciences, professor Galyna Gumeniuk. Results. Scientists from Ukraine presented 52 scientific reports at the Congress: 45 on pulmonology and 7 on phthisiology, which is 1.28 % (52 out of 4 067) of all posters submitted to this forum. The largest number of Ukrainian papers — 15 — was devoted to the problems of COVID-19, 14 to the issues of chronic obstructive pulmonary disease, 3 to the issues of bronchial asthma, 3 to tobacco smoking and two related to bronchiectasis. In 2023, both international cooperation and interaction of Ukrainian pulmonologists of various institutions in joint work within the countries continued. Conclusions. The main directions of scientific developments in respiratory medicine in Ukraine are issues of broncho-obstructive pulmonary diseases and COVID-19. The most active participation in the event were taken by the scientists from the Dnipro State Medical University, Yanovsky National institute of phthisiology and pulmonology National Academy of Medical Sciences of Ukraine, Vinnytsya National Pirogov Memorial Medical University, and Ivano-Frankivsk National Medical University.

Professional self-determination of future doctors: priorities in conditions of the war in Ukraine.

Aim: Our goal was to find out the dynamics of the levels of professional self-determination of the higher medical education applicants who acquire information technology competence within the learning of 'Medical Informatics' and 'Modern Information Technologies in Medicine' during the war in Ukraine and investigate how the professional self-determination of future doctors develops. Materials and Methods: The questionnaire for the survey consisted of 15 questions. 382 future specialists covered the questionnaire survey. All respondents studied majoring in 222 'Medicine' at the medical faculty of the Ivano-Frankivsk National Medical University. The results of this research we evaluated according to the defined algorithm. Results: We established that under the condition of the formation of information technology competence, during the war there is a positive dynamic of the professional self-determination levels and their quality as the cognitive-reflexive component of future doctors' readiness to use digital technologies in their professional activity and there is also a change in the priorities of professional self-determination. Conclusions: In extreme conditions, during the war in Ukraine, the future doctors as subjects of professional activity who use digital technologies within the information technology competence which formed during the learning of 'Medical Informatics' and 'Modern Information Technologies in Medicine' changed the priorities of professional self-determination, the quality of the levels of which has improved.

Студентоцентрична спрямованість у медичному освітньому просторі України на прикладі Івано-Франківського національного медичного університету

The issues of student-centred learning are fundamental in the organisation of educational activities of higher education institutions in Europe and are covered in many final documents of the Ministerial Conferences of the European Higher Education Area. Student-centredness is the accumulation and concentration of efforts focused more on the needs of the student, based on the consideration of the individual qualities of students, the ability to form individual educational trajectories. The essence of student-centredness is to create a model of education development in which a student turns from an object into a subject of educational activity, i.e. an active participant in the educational process. Purpose - to analyse the peculiarities of student-centredness as a modern direction of organising the educational process in higher education institutions and to determine the peculiarities of implementing a student-centred approach in the training of students at Ivano-Frankivsk National Medical University. On the example of Ivano-Frankivsk National Medical University, student-oriented/student-centred learning is one of the most effective pedagogical and methodological approaches. It is implemented by creating an individual educational trajectory in the first place. This is an individual way of realising the personal potential of each faculty applicant in educational activities, which is formed by determining and taking into account his/her personal abilities, own interests, educational and social needs, professional motivation, opportunities, and experience, based on the choice of types and forms of education of participants in the educational process and the proposed educational programmes, selected academic disciplines, their level of complexity, methods and means of teaching. An individual educational trajectory at the university is carried out through an individual curriculum, in particular, through the individual choice of disciplines, courses and educational programmes, the applicant’s research work, the development of spiritual potential and professional training. No conflict of interests was declared by the authors.

Лікування та профілактика спайкової кишкової непрохідності в дітей

Despite the achievements of modern pediatric surgery, to date there is no single comprehensive approach to the treatment and prevention of adhesive intestinal obstruction (AIO), both primary (prevention of adhesions formation after primary surgery) and secondary (prevention of recurrence). Purpose - to study the clinical effectiveness of treatment, primary and secondary prevention of postoperative intestinal adhesive obstruction in children. Materials and methods. An examination and analysis of medical records of 119 children aged 5 months to 17 years who were treated at the Pediatric Surgery Clinic of Ivano-Frankivsk National Medical University over the past 10 years for post-operative AIO was carried out. In 35 (29.41%) children a positive effect was achieved from conservative treatment. The remaining 84 (70.59%) children were operated on. Two groups of patients were formed: the comparison group - 38 (45.24%) children, who received traditional treatment, and the main group - 46 (54.76%) children, who were intraoperatively applied anti-adhesive gel to prevent recurrence of postoperative AIO. Results. It was established that postoperative AIO occurred in only 1 (1.19%) child after laparoscopic intervention, in the rest of the children primary surgical interventions were performed by an open method. In the comparative assessment of the postoperative course in two groups of patients, we drew attention to a more favorable course in the children of the main group, which was manifested by a faster recovery of peristalsis, a decrease in the duration of gastric stasis, a faster appearance of independent defecation, and a shorter period of inpatient treatment. When comparing the results of treatment between groups of patients, it was established that the frequency of recurrences of AIO in the main group of patients was 5.44 times lower than in children of the comparison group, and the frequency of relaparotomy for recurrent AIO was 7.28 times lower than in patients of comparison group. We did not observe complications associated with the use of anti-adhesive gel. We did not notice a significant difference in the results of treatment between patients who were treated with anti-adhesive gel of different composition (based on carboxymethylcellulose and sodium hyaluronate). Conclusions. The most effective method of primary prevention of postoperative adhesive intestinal obstruction is the use of laparoscopic primary surgical interventions. Intraoperative application of anti-adhesive gel is a highly effective and safe recurrence prevention method of adhesive intestinal obstruction in children. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Importance of Integrated Simulation Approaches in Medical Education when Teaching Therapy Disciplines to Students of Medical Faculty

The article is devoted to reviewing the main methods of practice-oriented teaching of medical students at the Department of Internal Medicine No. 1, Clinical Immunology and Allergology named after Academician Y. M. Neyko of Ivano-Frankivsk National Medical University (Ukraine). The significance of not only theoretical but also practical training of medical students in the conditions of blended learning is highlighted. The impact of new teaching methods on the level of future doctors' professionalism has been analyzed. Another important aspect of training is the introduction of simulation training, which allowed for obtaining a high level of knowledge without harming the patient. The article focuses on the role of the “virtual patient” in supervision, as this method, regardless of the form of study, allowed the student to be acquainted with a standardized patient, improve communication skills and choose the right method of diagnosis or treatment by the European guidelines. The article describes prospective systems for simulating clinical cases, which allow the creation of interactive training cases of various complexity levels depending on the goals set or the level of a specialist's training. The article presents the main online platforms for creating the most realistic cases with photographs of the affected body area and protocols of instrumental examinations, which allow you to reproduce the order of the doctor's actions and modify the intensity of the patient's condition if the prescription was incorrect. Moreover, the article highlights the positive impact of interactive teaching methods on student motivation and encouragement to deepen knowledge in a particular discipline, as an essential aspect is the discussion of examination results and prescription of therapy based on modern guidelines. It additionally outlines actions to be taken for ensuring efficient handling of new “virtual patient” cases and for inputting data on previously created clinical cases into the system. The article describes the main advantages of simulation-based teaching methods in comparison with traditional forms of teacher-student interaction. It is noted that training with the help of ”virtual patients” allows us to evaluate the acquired practical skills and competencies of future doctors.

The values of indices of non-specific resistance and cytokine regulation for early diagnosis of secondary peritonitis

The aim of the work is to study the changes in indices of non-specific resistance and cytokine regulation, relevant for the early diagnosis of secondary peritonitis. During the period 2016-2022, in the Surgery Department of the Communal Non-Profit Enterprise “Regional Clinical Hospital, Ivano-Frankivsk Regional Council” there were treated 192 patients with postoperative peritonitis. Of them, in 69 (35.9%) patients the changes in indices of non-specific resistance and cytokine regulation were studied. These studies were performed in the laboratory of the Department of Biological and Medical Chemistry of the Ivano-Frankivsk National Medical University. The content of CD3+-lymphocytes in the blood of patients with secondary peritonitis on admission to the hospital was 35.49±3.39%, which is 1.8-fold less than in the comparison group (p<0.002), with their subsequent drop up to 31.00±2.88% (p<0.002) during the third day of the disease. When determining CD4+-lymphocytes during the first day of observation, their indices were 21.49±3.11%, by 56% less than in the comparison group (p<0.002). During the third day of the disease, we observed a slight increase in this index – up to 23.90±3.26% (p<0.01). The study of the level of CD8+-lymphocytes showed that, on admission to the hospital, their level in blood serum was 13.92±1.05%, which is 1.6-fold lower than in patients of the comparison group (p<0.002). Their decrease was observed further, and during the third day this index was 8.08±2.28% (p<0.002). The content of CD11a+-cells on hospitalization was 11.32±0.54%, which is more than 6-fold less than in the comparison group (p<0.002). The content of CD162+-cells in the blood on hospitalization was 21.49±3.11%, which is 3.1-fold less than in the comparison group (p<0.002). The content of CD16+-cells in the blood on hospitalization was 10.83±0.87% (p<0.002). A significant increase in the content of IL in the blood serum at the initial stage of secondary peritonitis with subsequent pathological changes are contributing factors in the disorder of the body’s immune response. The content of IL-6 on admission was 759.72±28.06%, which is almost 3.4-fold higher than the indices in the comparison group (p<0.002). After surgery, this index gradually decreased and during the seventh day was 438.63±19.84% (p<0.002). The results obtained on such indices of non-specific resistance and cytokine regulation as CD3+, CD4+, CD8+, CD11a, CD162, CD95, CD16, HLA-DR+, IL-2, IL-4, IL-6 showed their significant differences between the subgroups studied (p<0.002), indicating their high sensitivity for diagnosing and predicting the development of secondary peritonitis.

PREVENTION OF HYPERALGESIA IN CHILDREN WHEN USING VARIOUS ANESTHESIA TECHNIQUES

Introduction. Opioid-induced hyperalgesia is characterized by a paradoxical response whereby a patient receiving opioids for pain management could actually become more sensitive to certain painful stimuli. Regional anesthesia can also impact central sensitization and reduce hyperalgesia after surgery.The objective of the study was to determine the method of preventing hyperalgesia in the early postoperative period when using different analgesic regimens in children after anterior abdominal wall surgery.Materials and Methods. The study included 87 children at the age of 7-18 years who underwent anterior abdominal wall surgery using different analgesic techniques. Group I included 33 children who underwent anterior abdominal wall surgery under general anesthesia using fentanyl. Group II comprised 27 children who underwent anterior abdominal wall surgery under general anesthesia using the transversalis fascia plane block (TFPB). Group III involved 27 children who underwent anterior abdominal wall surgery under general anesthesia using the TFPB, combined with the quadratus lumborum block 4 (QLB-4) via a single injection.All clinical and laboratory studies were conducted in accordance with the World Medical Association Declaration of Helsinki “Ethical Principles for Medical Research Involving Human Subjects”. According to the Law, prior to a subject’s participation in the study, a written informed consent form was signed by each subject (parents/adult guardians). The manuscript was approved by the Ethics Committee of the Communal Non-Profit Enterprise “Ivano-Frankivsk Regional Children’s Clinical Hospital of Ivano-Frankivsk Regional Council”, as evidenced by an Excerpt from the Minute of the Committee Meeting No. 2 dated February 24, 2022.The results obtained were statistically processed using statistical measures of variation, correlation analysis, Student’s t-test. Differences were considered statistically significant at p<0.05. The proportions were statistically compared by a z-test.The study is a fragment of the research project of the Department of Children Diseases of Postgraduate Medical Education Faculty, Ivano-Frankivsk National Medical University “Health Status and Adaption of Children from the Pre-Сarpathian Region with Somatic Diseases, Their Prevention” 2021-2026, state registration number 0121U111129; the author is a co-researcher.Results. In most (48.5 %) patients of Group I, the response to stimulation occurred only when applying pressure forces of 8 and 10 g, while the motor response was observed to stimulation with a pressure force of 8 g, with the FLACC scale score of 5.1±0.3, indicating insufficient pain threshold and potential development of opioid-induced hyperalgesia in the early postoperative period. In patients of Group II and Group III, the response to stimulation occurred when applying a pressure force of 8 g and the FLACC scale scores were 2.9±0.27 and 2.4±0.32, respectively (p<0.05).Conclusions. The results obtained confirmed the benefits of using regional anesthesia techniques in combination with conventional analgesia.

IMPLEMENTATION OF EDUCATIONAL HUB AT IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY'S PROFESSIONAL MEDICAL COLLEGE

The development of technologies transforms, develops, and improves old and creates new forms of human life organization, optimizing and modernizing them. Technologies also influence transformational changes in education and require the joint efforts and collective work of all educators, which necessitates updating approaches to organizing educational processes, determining the renewal of the educational space, and developing a modern educational environment characterized by technological saturation. One of the elements of the information and digital learning environment is the so-called digital (virtual) educational hub. Digital educational hubs can support any educational field, including the «Health care» sector. Learning during the pandemic and war has prompted us to create an online platform for self-education or an Education Hub based on the university website.
 The target audience of the hub includes students of the specialized medical college of Ivano-Frankivsk National Medical University in the field of knowledge 22 «Health Care», specialties 223 «Nursing», 221 «Dentistry», 226 «Pharmacy»; students of the medical and dental faculties of IFNMU, and students of other medical educational institutions.
 The Educational hub consists of a homepage that provides general information about the Professional Medical College, Ivano-Frankivsk National Medical University, the goals of the hub, and more. The next page, «Nursing» is designed for students of specialty 223 «Nursing». Virtual learning blocks have been created for students, which contain videos and algorithms for various manipulations, test tasks, materials for preparation for the Krok M exam, tactical medicine guides, and more.
 From the «Nursing» page, one can navigate to the «Dentistry» page, designed for students of specialty 221 «Dentistry» and the «Pharmacy» page, designed for students of specialty 226 «Pharmacy».
 As part of the cooperation between the professional medical college of the Ivano-Frankivsk National Medical University and the Andrey Krupinsky Lviv Medical Academy before the war, various events took place. The war has had an impact on our lives...
 However, our cooperation continues. During times of unstable electricity and constant anxiety for the implementation of academic mobility, we have used the Educational Hub. In particular, professors Natalia Tsubanova, Oleksandra Palahitska, and Natalia Rudakova from the Andriy Krupinsky Lviv Medical Academy posted a series of educational materials on the Educational Hub. Associate Professor Oleksandr Bulbuk (professional medical college of the Ivano-Frankivsk National Medical University) shared his educational materials on dentistry. This ensured free access and the establishment of organized learning opportunities, allowing all interested students from both educational institutions to participate in the educational process regardless of their location and time.
 The Educational Hub of the Professional Medical College of Ivano-Frankivsk National Medical University is an element of the information and digital learning environment that modernizes and enhances it, providing the development of the educational process in the field of "Healthcare". Additionally, this educational platform enables academic mobility for all participants of the educational process.

Право на паліативну допомогу: досвід реалізації проєктів

The key elements of medical and social care for palliative care patients should be the educational component such as information campaigns and cultural projects, which explain that palliative care is not waiting for death, but a dignified and organized life of the patient and his relatives. Ivano-Frankivsk National Medical University has joined to different projects to support vulnerable groups. In particular, with the financial support of the Public Health program initiative of the International Renaissance Foundation, the university has been implementing measures aimed at social support of children treated in the oncohematology department of Ivano-Frankivsk Regional Children's Clinical Hospital and their families for four years. These children receive high-dose chemotherapy, the procedure of which is long, they do not leave the department for many months, and therefore in addition to treatment they desperately need communication, interesting games, smiles, sincere prayer. At the same time, members of their families need to be able to take a «social break» to watch a movie, visit a theater or swimming pool, feel psychological and legal support, learn to relieve stress and anxiety, counteract stress, not be confined to problems. The quality of life of such people can be greatly improved when they try to see something positive in each day. No conflict of interests was declared by the authors.

CHANGES IN THE INDICATORS OF ABDOMINAL ARTERIAL CIRCULATION WHEN APPLYING VARIOUS ANESTHETIC TECHNIQUES IN CHILDREN

Intra-abdominal hypertension and abdominal compartment syndrome result from increased intra-abdominal pressure. In addition, intra-abdominal hypertension has been reported to be an independent risk factor for pediatric intensive care unit mortality.The study aimed to compare the efficacy and the effect of various anesthetic techniques using regional anesthesia on the indicators of abdominal arterial circulation in anterior abdominal wall surgery in children.Materials and Methods. The study included 90 children at the age of 7-18 years. All children underwent anterior abdominal wall surgery under general anesthesia and were divided into 3 groups: Group I included 30 children who underwent anterior abdominal wall surgery under general anesthesia using morphine; Group II comprised 30 children who underwent anterior abdominal wall surgery under general anesthesia using the transversalis fascia plane block combined with the quadratus lumborum block 4 via a single injection; Group III included 30 children who underwent anterior abdominal wall surgery under general anesthesia using the TFPB.The manuscript was approved by the Ethics Committee of the Communal Non-Profit Enterprise “Ivano-Frankivsk Regional Children’s Clinical Hospital of Ivano-Frankivsk Regional Council”, as evidenced by an Excerpt from the Minute of the Committee Meeting No. 2 dated February 24, 2022.The results obtained were statistically processed using statistical measures of variation, correlation analysis, Student’s t-test. Differences were considered statistically significant at p<0.05. The proportions were statistically compared by using a z-test.The study is a fragment of the research project of the Department of Children Diseases of Postgraduate Medical Education Faculty, Ivano-Frankivsk National Medical University “Health Status and Adaption of Children from the Precarpathian Region with Somatic Diseases, Their Prevention” 2021-2026, state registration number 0121U111129; the author is a co-researcher.Results and Discussion. The analysis of acute pain on the selected scales found significantly higher indicators of acute pain on the FLACC scale in the group of conventional anesthesia (Group I, p<0.001) as compared to Group II, where the TFPB in combination with the QLB-4 was used. The analysis of the Likert scale responses found that, over the course of treatment, there was a significant reduction in pain indicators among patients of Group II as compared to those in Group I and Group III (p<0.001). High pain intensity in children who received conventional anesthesia led to a prolonged length of hospital stay and increased IAP (FLACC scale (rx,y=0.38±0.16, р=0.02).Conclusions. A combination of regional anesthesia techniques and conventional anesthesia leads to a reduction in IAP, and increase in APP, a decrease in the resistance index in the superior mesenteric artery and shortens the length of hospital stay as compared to conventional anesthesia management.

RISK FACTORS OF UMBILICAL CORD PATHOLOGY AND FACTORS OF NEGATIVE PERINATAL CONSEQUENCES AND NEWBORN INCIDENCE

According to literature sources, the real frequency of many umbilical cord pathologies differs significantly from the statistical data indicated by researchers in their works (from 15% to 38%). The implementation of a system of diagnostic and treatment and preventive measures, based on mandatory antenatal and postnatal assessment of the features and characteristics of the umbilical cord, allows to improve perinatal outcomes and reduce perinatal morbidity. The aim of the work was to identify the main risk factors of umbilical cord pathology and negative perinatal consequences; to develop elements of standardization of antenatal and postnatal diagnosis of umbilical cord pathology. Research materials and methods. A retrospective assessment of medical documentation data (3,280 individual medical records of pregnant women) made it possible to establish the frequency of umbilical cord pathology in the population. In the future, a more detailed extended antenatal and postnatal examination of the umbilical cord and placenta after delivery was carried out in 637 patients of reproductive age with pregnancy complicated by pathology of the umbilical cord (main group). The control group was formed by 40 patients with an uncomplicated course of pregnancy and live birth of full-term healthy children. The study was conducted taking into account the main principles of the Helsinki Declaration on Biometric Research and the powers of the GCH ICH, in accordance with biometric norms with compliance with the principles of confidentiality and ethics (excerpt from protocol No. 128/22 of the meeting of the Bioethics Commission dated September 29, 2022, Ivano-Frankivsk National Medical University, Ministry of Health of Ukraine).Data analysis was performed using the Statistica 7.0 package of statistical programs (StatSoftInc., USA). The association of independent variables with the condition being studied is presented as odds ratio (OR) and 95% confidence interval (CI).The materials of the article are the result of the research of the complex research work fragment of the Department of Obstetrics and Gynecology named after I.D. Lanovyi of the Ivano-Frankivsk National Medical University: “Development of diagnostic tactics and pathogenetic substantiation of effective methods of preserving and restoring reproductive potential and improving parameters of a woman’s quality of life in obstetric and gynecological pathology” (state registration number 0121U109269, implementation dates 2021-2026 ), the author is a co-executor of the topic.Research results and their discussion. The following data were noted: an excess of the population norm of the length of the umbilical cord, a high proportion of eccentric and marginal insertion of the umbilical cord (22.14%) and umbilical cord coiling (33.28%), a decrease in the proportion of the reference limits of the umbilical cord tortuosity index (15.86%), in 56.7% of observations, the specific gravity of the umbilical cord was lower. Probable risk factors for umbilical cord pathology with a predominance of age over 35 years, nicotine addiction in pregnant women, multiple fertility, use of IVF programs, change in the amniotic fluid index, overweight and obesity, other clinical conditions associated with metabolic disorders (gestational diabetes, insulin resistance) were identified. Conclusion. The share of the umbilical cord pathology both in the isolated type and in the combination of characteristic features of the umbilical cord is 40.98%. The increase in the risk of negative perinatal consequences has a close relationship with the umbilical cord pathology and the combination of different types of pathology, as well as the addition of gestational complications, which allows for the formation of screening programs and optimization of the diagnostic algorithm.

CLOUD TECHNOLOGIES AND FEATURES OF THEIR USE IN THE EDUCATIONAL PROCESS OF TRAINING MASTERS OF PHARMACY

Cloud technologies are an important area of development of modern information technologies. They provide Internet users with access to the computer resources of the server and the use of its software online.
 The article describes the experience of using cloud technologies in mixed and distance learning at the Ivano-Frankivsk National Medical University when studying chemical disciplines by students of the Faculty of Pharmacy.
 The role of cloud technologies in the modern period of education is highlighted. It is shown that the use of cloud technologies in the educational process contributes to the improvement of students perception of educational material from disciplines, encourages them to do individual work, makes it possible to better orient themselves when performing the practical part of classes, contributes to the professional and creative growth of students, improves interpersonal communication between the teacher and the student, and for teachers it simplifies the process of teaching and encouraging students to study.
 When teaching chemical disciplines at the Faculty of Pharmacy, teachers successfully use the Microsoft Teams learning platform for both distance and blended learning, pre-posting all the necessary learning materials, including presentations and videos. As you know, what is perceived simultaneously by several senses is best learned. Today, information and computer technologies are one of the most effective means of learning, with the help of which the ancient, but still correct principle of the teaching method is implemented - it is better to see once than to hear a hundred times.
 The construction of virtual chemical laboratories allows the teacher to more easily explain the essence of complex phenomena and processes with the help of visual models and interactive animation, to demonstrate «virtual experiments» and experiments without the necessary laboratory equipment. A set of virtual chemical laboratory options allows you to study the quantitative and qualitative characteristics of environmental processes and phenomena, models of complex technical devices and equipment used in scientific research and technological processes.
 Also, thanks to cloud-based learning technologies, students will be able to learn new materials in real time, communicate with teachers and complete the tasks given to them by teachers at any time convenient for them using their own gadgets. The main feature is the mediated nature of «teacher-student» communication, because it is this form of education that makes it possible to activate students' independent work at the maximum level. Computer technologies and Internet resources ensure the efficiency and interactivity of the educational process, increase the student's activity in educational activities, and ensure the intensification of the educational process. The use of the latest technologies (forums, webinars, blogs, creation of Internet projects) in asynchronous and online modes in the process of studying chemical disciplines contributes to the formation of a communicative connection between the participants of the educational process.
 The use of cloud technologies in the teaching of chemical disciplines makes it possible to intensify the educational process, accelerate the transfer of knowledge and experience, and also improve the quality of training and education. Without cloud technologies, it is impossible to imagine the educational process in conditions of mixed or distance learning.

IMPROVING THE TEACHING OF THE ELECTIVE COURSE "URGENT ISSUES OF CARDIOLOGY" IN THE SIXTH YEAR OF THE FACULTY OF MEDICINE OF THE IVANO- FRANKIVSK NATIONAL MEDICAL UNIVERSITY

This article highlights the main components of the curriculum of the elective discipline "Urgent issues of cardiology" of the Ivano-Frankivsk National Medical University for students of the 6th year of the medical faculty. The results of students' mastery of integral, general, professional competencies according to the educational and professional program "Medicine", second (master's) level are provided. The importance of using innovative technologies in independent extracurricular work to ensure a high level of the educational process is highlighted. The purpose of teaching the academic discipline "Urgent issues of cardiology", the method of organizing practical classes using all types of teaching methods recommended for higher education, the basic knowledge and skills that a student acquires when learning the materials of the discipline are clarified. The article emphasizes the importance of using various teaching methods recommended for higher education (explanatory and illustrative, reproductive, problem presentation, heuristic, research) when conducting practical classes, according to the approved thematic plan. The discipline is aimed at students achieving the corresponding learning outcomes reflected in this article. The optimal combination of modern technologies, work in educational and practical centers of the university, the development of clinical thinking focused on deepening knowledge and skills in the study of the pathology of the cardiovascular system are the main goals of studying the elective discipline "Urgent issues of cardiology".
 Aim. Establish new opportunities and analyze the main provisions of the discipline "Urgent issues of cardiology" to improve the assimilation and further use of the acquired knowledge and skills by students.
 Materials and methods. According to the curriculum, teaching of the discipline "Urgent issues of cardiology" is carried out in the 6th year of the medical faculty during the XI-XII semester. The program on "Urgent issues of cardiology" in the 6th year involves the study of the basics of cardiology, while the emphasis is on the study of etiology, pathogenesis, clinic, diagnosis, treatment and prevention of the main and the most common diseases of the cardiovascular system. The subject of study of the academic discipline is the improvement and expansion of knowledge about diseases of the circulatory system.
 Results. The teaching of the elective discipline "Urgent issues of cardiology" is carried out in accordance with the provisions of the educational and professional program "Medicine" of the second (master's) level of higher education, work and training programs of the elective discipline. When studying the discipline "Urgent issues of cardiology", all types of teaching methods recommended for higher education are used. The discipline is aimed at students achieving appropriate learning outcomes.
 Conclusions. Taking into account the specifics of a doctor's professional activity, the need to improve and optimize the educational process of the selective discipline "Urgent issues of cardiology" is aimed at the formation of a competent person who is able to solve professional problems in non-standard circumstances. This discipline provides the future doctor with the knowledge and skills to suspect, diagnose and prescribe individual treatment, according to modern guidelines and recommendations, for the treatment of the main diseases of the cardiovascular system.

CHANGES IN THE BIOELECTRIC ACTIVITY OF MUSCULUS MASSETER IN CASE OF MANDIBLE EDENTULOUSNESS TREATMENT

The objective of the research: to define the dynamics of changes in bioelectric activity of mm. masseter dexter et sinister in patients with mandible edentulousness treated by means of four implant-supported dental prostheses of various types.
 105 patients were examined at the premises of the Center of Dentistry of the University Clinic of Ivano-Frankivsk National Medical University. 30 individuals out of 105 at the age of 23-28 with intact dentition, without somatic pathology were included in the control group.
 75 patients with mandible edentulousness underwent clinical examination, prosthodontic treatment, and follow-up. 3 clinical groups (Group I; II; III) were formed from this cohort of patients depending on the structural features of the manufactured dental prostheses.
 We conducted electromyography of mm. masseter dexter et sinister to the patients of the examination groups (n = 75) and the control group (n = 30) in order to achieve the objective of the research. The examination was performed by means of two-channel electroneuromyographic complex “Neuro-EMG-Micro” (“Neurosoft”) in the functional diagnostics office at the premises of the Department of Dentistry of Postgraduate Study Faculty at IFNMU.
 Quantitative indicators of bioelectrical activity of the right and left masticatory muscles were analyzed. Namely, the average values of the maximum amplitudes (μV) when performing the test of maximum bite force were analyzed. Recording of electromyographic indicators was performed before the prosthodontic treatment, 14 days after the fixation of the dental prosthesis, in 6 months and 12 months after the dental prosthesis functioning in order to study the dynamics of changes in the indicators of the examination groups.
 Electromyography recording and analysis of the findings in the individuals of the control group was performed once.
 Analyzing quantitative indicators of electromyographic examination significant differences in the dynamics of an increase in the indicators in 12 months compared to the initial indicators depending on the type of fixed dental prosthesis (subgroup A рІ-ІІІ<0.001; subgroup B рІ-ІІІ<0.001) and the order of prosthodontic treatment (рА-Б <0.001 for all groups of patients) were observed.
 
 Despite the fact that bioelectric indicators of mm. masseter dexter et sinister activity in the patients of the examination groups approximated to the indices of the control group, the dynamics of change was not equivalent and depended on the type of the dental prosthesis.
 The dynamics of an increase in the indicators of the patients in the examination groups differed by growth, however, the greatest increase was recorded in the period of “14 days” – “6 months” after the fixation of the dental prosthesis.
 On performing the test of maximum bite, the indicators of the masticatory muscles bioelectrical activity increased during the period named “before the treatment” – “12 months of functioning” most of all in IIIA examination group – by 66.52% (рd<0.001) on the right and by 76.37% (рd<0.001) on the left; and IIIB examination group – by 61.63% (рd<0.001) on the right and 67.20% (рd<0.001) on the left. The lowest indicators have increased in patients of IA examination group – 39.98% (рd<0.001) on the right and 39.95% (рd<0.001) on the left and IB examination group – by 32.48% (рd<0.001) on the right and by 34.75% (рd<0.001) on the left.

The influence of the ethno-territorial factor on the state of physical abilities development of students of Ukrainian educational institutions

Background and Study Aim. The development of motor skills depends on the process of physical development, as well as the ethno-territorial and cultural context. The study of inter-ethnic differences can provide information about how different lifestyles and contexts of physical activity can influence the process of motor competence development. This can be a real strategy for developing students’ lagging basic motor skills. The purpose of the work is to investigate the ethno-territorial variability of the level of development of physical abilities of students studying at Ukrainian universities.
 Material and Methods. Data were obtained from cross-sectional surveys from 2014 to 2019. Students of Ivano-Frankivsk National Medical University (Ukraine) (young men, n = 488, age 18–25) from different countries were recruited. Pedagogical testing was carried out using a battery of tests that were recommended by the State Tests of Physical Fitness of the Population of Ukraine and the European Sports Council (Evrofit Test Battery). Assessment of physical fitness of students was carried out on the basis of a combined percentage scale of multi-level gradation with a step of 1%. Experimental data were processed using the SPSS Statistics 17.0 program.
 Results. In almost all countries (with the exception of India and Tunisia), from 41.2% to 70.0% of students are characterized by a low level of development of cardiorespiratory endurance and speed-power fitness (from 54.4% to 58.3%). More than 50.0% of students from Jordan and Egypt have a low level of speed and strength abilities and flexibility. It was found that students from India and Tunisia have the highest rates (endurance - 75.5–80.8%); from China and Tunisia (speed-power abilities - from 69.1% to 78.8%); from Tunisia (speed –79.8%); from China and Tunisia (flexibility -70%); test participants completed the test; from China (power capacity – 76.7%). Students from European countries showed mostly average and above average level of development of physical abilities.
 Conclusions. The results of the study indicate the specificity of the development of motor skills of students from different countries, which is manifested in statistically significant differences in the results of test tasks. Students from different countries perform better on those tests that are closer to their known motor experience. This is due to the cultural environment, geographical factor, socio-economic status, as well as the content and goals of the physical education program.