Medical Academy Research Articles

A qualitative study of the value of simulation-based training for nursing students in primary care

BackgroundClinical placement is an essential component of nursing education, providing students with the opportunity to apply theoretical knowledge to practice. However, challenges such as lack of supervision and passive involvement in tasks can hinder the learning experience. Supplementing clinical placement with simulation-based training (SBT) has been explored as a potential solution, though this approach has been underexplored within primary care. This study aimed to explore the educational value of a supplemental SBT course for nursing students during primary care placement, as well as the adaption of this approach to a primary care setting.MethodsA qualitative descriptive study was conducted at a medical education and simulation academy in Denmark. Sixth-semester nursing students on placement in primary care were invited to participate. The intervention consisted of a three-day simulation course covering core nursing competencies and common clinical conditions encountered within primary care. Simulation adopted a standardised patient approach. Data was collected using focus group interviews, which was analysed using inductive thematic analysis.ResultsThirty-one nursing students participated in the study. Seven themes emerged from the analysis, including perceptions, educational value, simulation adjustments to primary care, educators’ competencies, learning needs within primary care, challenges of clinical placement and career guidance. Generally, participants perceived the intervention positively, appreciating its relevance to their clinical placement and its educational impact in this context. Participants also provided insights into the adaptation of SBT to a primary care setting, as well as nursing students’ learning needs within this context.ConclusionThe findings indicate that the intervention had a positive impact on participant competencies within this context and enhanced their clinical practice within primary care. Furthermore, the results inform educators on how to effectively employ primary care-related SBT. Overall, this study supports the need for an increased application of SBT within primary care.Trial registrationNot relevant.

Characteristics of antibiotic sensitivity of Acinetobacter baumannii bv. tryptophandestruens and Acinetobacter baumannii clinical isolates

The aim of the study was to determine the sensitivity of the bacteria of the biovar Acinetobacter baumannii bv. tryptophandestruens to antibiotics used to treat Acinetobacter-infection. The object of the study was 86 primary clinical isolates of A. baumannii, of which 34 strains of A. baumannii bv. tryptophandestruens isolated in the microbiological laboratory of the Military Medical Academy in 2021–2022. Species identification of bacteria was carried out by MALDI-ToF mass spectrometry. The biovar tryptophandestruens of A. baumannii was determined on a dense chromogenic medium. The sensitivity of A. baumannii isolates to antibiotics was determined by a “Vitek 2 compact” microbiological analyzer (bioMerieux, France). Clinical categories of isolates sensitivity to antibiotics (S) were identified based on the boundary values of minimum suppressive concentrations (MSC, mg/L) established by the European Committee for the Determination of Sensitivity to Antimicrobial Preparates (EUCAST), version 11.0. Isolates of A. baumannii bv. tryptophandestruens and groups of isolates of other A. baumannii very rarely sensitive to meropenem (8.8±4.6%; 3.8±2.6%, respectively, p 0.05), ciprofloxacin (5.8±4.0; 9.6±4.1%, p 0.05). Strains sensitive to gentamicin are rarely represented in both groups (26.7±7.55; 19.3±5.5%, p 0.05) trimethoprim/sulfamethoxazole (38.8±8.3%; 23.6±5.3%, p 0.05). Sensitivity to polymyxin B was preserved in all strains of both groups (100%). Strains of the tryptophandestruens biovar A. baumannii group surpass strains of the other strain of A. baumannii group in the frequency of isolates with MSC50% tigecycline (MSC50% — 0.5 mg/l; MSC50% — 2 mg/l, respectively), and also have significantly more strains with MSC 0.5 mg/l (52.9% and 15.4%, respectively, p 0.01 ). Thus, the clinical isolates of the biovar A. baumannii bv. tryptophandestruens have no significant differences with isolates of other strains of A. baumannii in the frequency of strains sensitive (S) to meropenem, ciprofloxacin, gentamicin, trimethoprim/sulfamethoxazole, polymyxin B, but they differ in terms of sensitivity to tigecycline — a higher frequency of strains with an MSC of 0.5 mg/l (p 0.01) and an MSC of 50%.

Oleg Konstantinovich Bumay (in memory of a teacher, colleague, comrade)

January 1, 2024 marked the 70th anniversary of the birth of the former head of the organization and tactics of the medical service of the fleet (with a course of tactics and combat weapons of the fleet) department of the S.M. Kirov Military Medical Academy, effective director for modern topics of the Federal State Budgetary Institution Research Institute of Industrial and Marine Medicine FMBA of Russia, candidate of medical sciences, associate professor Oleg Konstantinovich Bumay (1954–2022). O.K. Bumay was born in the village of Bogudenka, Belarus. He was alumnus the faculty of training doctors for the Navy of the S.M. Kirov Military Medical Academy. After graduating from the academy in 1977, for a decade he provided and organized medical support for nuclear submarines as the head of the ship’s medical service, the cheef of medical a submarine forces in the Northern Fleet, and subsequently served as a senior medical officer in the Baltic Fleet. Over the course of two decades, O.K. Bumay was associated with the organization and tactics of the naval medical service (with a course of tactics and combat weapons of the fleet) department of S.M. Kirov Military Medical Academy. In 1991, he entered the adjunct program at the department; upon completion of his studies, he was appointed as a teacher, subsequently as a senior teacher, and since 2009 — deputy head of the department. He received the rank of Philosophy doctor of Medical Sciences (1994), associate professor (1998). After leaving the Armed Forces of the Russian Federation in 2007, he continued his career as deputy director for special topics at the Federal State Budgetary Institution Research Institute of Industrial and Marine Medicine of the Federal Medical and Biological Agency of Russia. O.K. Bumay developed origins medical support system for the domestic nuclear submarine fleet. Was appointed on the post the head of the ship’s medical service and after that officer of the command-and-control body of an operational-tactical formation. Throughout their career he left a multifaceted scientific and practical legacy, which is used by new generations of naval doctors.

To the 100th anniversary of professor Viktor Pavlovich Baskakov

The article describes the main milestones in the labor, scientific and pedagogical activities of Professor Viktor Pavlovich Baskakov, born on November 28, 1923. After graduating from the Military Medical Academy and defending his dissertation for the degree of Candidate of Medical Sciences in 1950, he was hired as a teacher in the Department of Obstetrics and Gynecology, in 1958 he was appointed to the position of associate professor, in 1970 he received the title of professor, after which in 1974 he became head of department, where he worked until 1984. Viktor P. Baskakov was the first in the country to begin studying endometrioid disease. Three of his monographs are devoted to this complex pathology: “Endometriosis” (1966), “Clinic and treatment of endometriosis” (1979, 1990) and “Endometrioid disease” (2002). In 1968, based on the published monograph “Endometriosis” by V.P. Baskakov was awarded the academic degree of Doctor of Medical Sciences without defending a dissertation. For many years, Viktor Pavlovich was a member of the presidium of the Leningrad Obstetrics and Gynecology Society, a member of dissertation councils, and the editorial board of the Journal of Obstetrics and Women’s Diseases. He was awarded the Order of the Red Star and medals, including the medal “For Military Merit” and the medal “For Victory over Germany in the Great Patriotic War of 1941–1945.” Professor Viktor Pavlovich Baskakov remained in the memory of his contemporaries as a talented scientist, teacher, and surgeon. It was difficult to find a person more concerned about the problems of others. Students remember him with a smile and great warmth.

Features of diagnostics of sialadenosis of parotid salivary glands in patients with gastrointestinal tract pathology associated with Helicobacter pylori

AIM: is improving the diagnostic efficiency of patients with sialadenosis of the parotid salivary glands and acid-dependent diseases associated with Helicobacter pylori.
 MATERIALS AND METHODS. At the clinical base of the Department of Dentistry of the Central State Medical Academy at the Department of Presidential Affairs of the Russian and the Department of Gastroenterology and Hepatology of the Polyclinic № 1 of the Office of the President, 40 people with sialadenosis of the parotid salivary glands and acid-dependent diseases associated with Helicobacter pylori-infection were examined. The mean age of the study patients was 47,03±6,33 years. The control group consisted of 20 practically healthy people aged 35-55 years.
 RESULTS. In the course of the work, data were obtained on a significant increase in IL-1β, 6 and TNFα indicators in patients with sialadenosis and a positive result for Helicobacter pylori, detected using a rapid urease test and PCR diagnostics in parotid saliva.

The hypothermic effect of the antihypoxant 2-aminobenztiazole

BACKGROUND: One of the compounds studied at the Department of Pharmacology of the Kirov Military Medical Academy is a compound with a proven antihypoxic effect of 2-aminobenzothiazole (2-ABT). The mechanism of action of this substance is partially associated with the central action, and its protective effect may potentially be due to the general hypothermic effect.
 AIM: To determine the effect of 2-ABT on body temperature.
 MATERIALS AND METHODS: Experiments were carried out on 24 adult males of white outbred mice. 2-ABT was previously dissolved in 0.9% sodium chloride solution and administered intraperitoneally to mice at doses of 32.5 mg/kg (with proven antihypoxic effect), 21.7 mg/kg or 10.8 mg/kg. Rectal temperature was measured with an electronic thermometer DT-623 (China) before administration of the test substance, as well as 5, 30 and 60 minutes after the injection.RESULTS: Compound 2-ABT has a pronounced dose-dependent hypothermic effect. This effect is maximally expressed in a dose in which the compound has a proven antihypoxic property – 32.5 mg/kg. The hypothermic effect manifests itself within 5 minutes after administration, the maximum decrease in body temperature is observed after 30 minutes, while the effect persists for an hour.
 CONCLUSION: 2-ABT may be a promising compound for the creation of a drug for drug-induced (controlled) hypothermia.

Modern concept of treatment of patients with ventral hernias

INTRODUCTION. The relevance of treating patients with hernias of the anterior abdominal wall is beyond doubt, since the incidence of the disease is on average 5 people per 1000, and hernioplasty itself is one of the most common operations in a general surgical hospital. However, the relapse rate remains quite high. There remains a debate about the choice of surgical option; the issues of prevention and treatment of pain syndrome, as well as tactics for managing patients with a complicated postoperative period, remain unresolved.The OBJECTIVE was to evaluate the effectiveness of the modern concept of treating patients with ventral hernias and to substantiate the principles for choosing a hernioplasty technique.METHODS AND MATERIALS. The study is based on the results of treatment of 1938 patients operated on at the Faculty Surgery Clinic named after S.P. Fedorov Military Medical Academy in the period from 2015 to 2022. Both open and endovideosurgical options for surgical interventions were performed for isolated umbilical hernias or in combination  with diastasis of the rectus muscles, hernias of the white line of the abdomen, inguinal and postoperative hernias, including reduction of the volume of the abdominal cavity.RESULTS. During the study, an algorithm for the treatment of patients with ventral hernias was developed, various options for perioperative pain relief were proposed, and the tactics for treating infectious and purulent complications were substantiated.CONCLUSION. A specialized surgical hospital must perform all possible options for both traditional and endovideosurgical hernioplasty, use innovative options for pain relief in the perioperative period, and apply modern methods for diagnosing and treating postoperative complications in order to provide personalized medical care. 

Dedication to Morphology (to the 70th Anniversary of the Birth of Professor I.V. Gaivoronsky)

In February 2024, Professor Ivan Vasilyevich Gaivoronsky, Doctor of Sciences in Medicine, the prominent Russian morphologist, Head of the Department of Normal Anatomy at S.M. Kirov Military Medical Academy, celebrated the 70th anniversary. Ivan Vasilyevich was born on February 2, 1954 in the town of Kadievka, Voroshilovgrad region. In 1979, he graduated with a gold medal from S.M. Kirov Military Medical Academy; within its walls, he came a long way from an adjunct to the Head of the Department of Normal Anatomy, which he has headed for more than 35 years. Ivan V. Gavoronsky is a member of the Presidium of the All-Russian Scientific Medical Society of Anatomists, Histologists and Embryologists and Chairman of its St. Petersburg branch, a member of the Coordinating Council responsible for the field of education “Health and Medical Sciences” and its educational and methodological commission in anatomy and anthropology, Chairman of the dissertation council in the specialties Anatomy and Anthropology, Pathological Anatomy and Forensic Medicine, created at S.M. Kirov Military Medical Academy. Professor Ivan V. Gaivoronsky focused his attention on the development of modern aspects of the collateral circulation issues, the state of various parts of the vascular bed under normal conditions and under the influence of various extreme factors, innovative technologies for preparing and preserving anatomical sections for educational purposes, medical craniology, the study of individual and typological features of the human body, applied issues, dictated by the needs of practical medicine, the history of anatomy, and the improvement of the educational process in the departments of morphological profile. He created a scientific morphological school, which trained 11 doctors and 60 candidates of medical sciences. For significant contribution to the development of Russian science and modernization of the educational process, Professor IvanV. Gaivoronsky was twice awarded the Russian Government Prize in the field of education; he was awarded the honorary titles “Honored Scientist of the Russian Federation” and “Honored Figure of Russian Higher Education”, academician of the Russian Military Medical Academy, Honorary Doctor of the Russian Military Medical Academy; he was awarded the Order of Honor and a medal of the Order for Merits to the Fatherland, II degree.

Creator of the concept of antihypoxants and actoprotectors: On the occasion of the 100th anniversary of Professor V.M. Vinogradov

Vasiliy M. Vinogradov (1924–2003) and his scientific school are famous for their creation and study of two fundamental new classes of pharmacological drugs, promising for military medicine, medicine for disasters and extreme conditions, and for civilian healthcare. This refers to the development of antihypoxants, which are drugs that protect the body when there is a lack of oxygen in the cells or disturbances in its utilization, and actoprotectors (from the Latin “actus” — movement), which are drugs of a nondepleting type of action that increase and maintain the physical performance of the body in unfavorable conditions. At the Department of Pharmacology of the Military Medical Academy in the 1960s, F.Yu. Rachinsky synthesized the first highly effective antihypoxants structurally related to aliphatic and cyclic aminothiols — gutimin, amtizole, bemitil, almid, and etomerzole. Hypoxia is the most common, everyday factor in resuscitation practice; however, it is not the only factor causing energy deficiency with severe, often dramatic consequences for cells, organs, and the body as a whole. Therefore, when we talk about antihypoxants, we are referring to drugs that can smooth out this deficiency using various mechanisms, protect cells at the reversible stage of their damage, and activate the formation of structure and functions. These drugs were subjected to a detailed pharmacological study, and a key link in their mechanism of action was identified — normalization of energy metabolism when there is a lack of oxygen in cells or disturbances in their use. All aliphatic and cyclic aminothiols (gutimin, amtizole, bemitil, almid, etomerzol, and many of their analogs) have three main types of activity, which are expressed differently in each of the drugs, which makes it possible to profile their use in different clinical situations and in healthy people. These include (1) antihypoxic effects, (2) antioxidant effects, and (3) ability to accelerate the repair and adaptive synthesis of RNA, enzymes, and functional and structural proteins under various types of damage, such as hypoxic, infectious, toxic, and stress, and in adaptation to complicated conditions. All these directions were not only evaluated experimentally but also confirmed in practice. This article examines various aspects of antihypoxic drugs synthesized and studied at the Department of Pharmacology of the S.M. Kirov Military Medical Academy for the last 60 years.

Comparison of thrombodynamic tests with determination of anti-Xa activity in evaluation of the efficacy of anticoagulant therapy in patients suffering deep vein thrombosis of the lower extremities

Deep vein thrombosis of the lower extremities remains an important medical and social problem in practical medicine. Currently, a weight-dependent low-molecular-weight heparin dosing approach is used to treat deep vein thrombosis of the lower extremities in wounded patients without regard to the state of the hemostasis system. This observational study included 30 patients with deep vein thrombosis of the lower extremities who were hospitalized for examination and treatment at the Kirov Military Medical Academy. During treatment with enoxaparin sodium at therapeutic doses, depending on body weight, the parameters of the thrombodynamics test were assessed in all patients, and antiXa activity was determined at the peak of the drug (after 3–4 h) and at the end (before the next injection) of its action. A strong inverse correlation was established between the growth rate indicator of the thrombodynamics test clot and antiXa activity at the peak (–0.777; p 0.05) and at the end (–0.715; p 0.05) of the action of sodium enoxaparin. The standard dose of anticoagulant drug, depending on body weight, revealed that 30% of patients were in the hypercoagulation zone, not reaching the target values of the thrombodynamic clot growth rate and anti-Xa activity. The thrombodynamics test results identified the growth rate of the test clot with antiXa activity, which allows both methods to be considered comparable for laboratory monitoring low-molecular-weight heparin therapy in wounded individuals. The insufficient anticoagulant effect in one-third of the injured individuals that received the standard and therapeutic doses of low-molecular-weight heparins requires the development of a personalized approach to titration of low-molecular-weight heparins, which may be based not on the concentration of the drug per body weight but on the achieved anticoagulant effect that optimizes the treatment outcomes and patient prognosis. Accordingly, further research is required.

Professor I.V. Gaivoronsky — an outstanding domestic scientist-anatomist and teacher

On February 2, 2024, the prominent Russian morphologist, head of the department of normal anatomy at the Kirov Military Medical Academy to MD, Dr. Sci. (Med.) Professor Ivan V. Gaivoronsky. Ivan V. was born in the town of Kadievka, Voroshilovgrad region, in 1954.
 On February 2, 2024, a prominent Russian morphologist, Professor Ivan V. Gaivoronsky became the head of the Department of Normal Anatomy at the Kirov Military Medical Academy to Doctor of Medical Sciences. Ivan V. was born in the town of Kadievka in the Voroshilovgrad region in 1954.
 In 1973, after graduating from the Starooskolsky Medical School, he entered the Kirov Military Medical Academy, from which he graduated in 1979 with a gold medal. He then studied in an adjunct course at the Department of Normal Anatomy. After completing his studies and defending his dissertation within the walls of his native alma mater, he worked his way up from a teacher to the head of one of the oldest departments, the Department of Normal Anatomy, which he has headed for 35 years. Professor I.V. Gaivoronsky pays great attention to solving modern scientific problems of morphology: collateral circulation, medical craniology, morphology of a gunshot wound, applied problems according to the needs of surgical practice, study of individual and typical characteristics of the human body, development of innovative technologies for the production and preservation of anatomical preparations for scientific and educational purposes, and improvement of the educational process in the departments of morphological profile and history of anatomy. He created a scientific morphological school, which trained 11 doctors and 63 medical science candidates. Professor I.V. Gaivoronsky is the author of polymer embalming technology, which has radically changed the principle of teaching fundamental medical disciplines. Thanks to the development of numerous innovative areas, numerous scientific studies, and use of the latest equipment in the educational process, the Department of Normal Anatomy of the Kirov Military Medical Academy, under the leadership of Professor I.V. Gaivoronsky, became one of the best methodological and scientific centers in the Russian Federation, dealing with the most pressing problems of modern morphology. For his great contribution to the development of domestic science and the organization of the educational process, Professor I.V. Gaivoronsky was twice awarded the Government of the Russian Federation Prize in the field of education. He was awarded the honorary titles “Honored Scientist of the Russian Federation” and “Honored Worker of the Higher School of the Russian Federation”, Academician of the Russian Military Medical Academy, and Honorary Doctor of the Kirov Military Medical Academy. He was also awarded the Order of Honor and the Medal of the Order for Services to the Fatherland, II degree.

Relationship of professional success and development of cognitive mental processes and personal qualities of Vietnam Naval specialists

The levels of development of cognitive mental processes and personal qualities among specialists of the Navy of the Socialist Republic of Vietnam undergoing military service under a contract were considered, and their relationship with military-professional success was assessed. In July 2023, specialists from the Kirov Military Medical Academy together with Vietnamese specialists of the Russian–Vietnamese Tropical Center, conducted a pilot psychological and psychophysiological examination of naval specialists of the Navy of the Socialist Republic of Vietnam to study the characteristics of cognitive mental processes (attention, memory, and thinking), motivational and personal qualities, and expert assessments of the success of military-professional adaptation. Statistically significant relationships between expert assessments of professional success and the level of development of cognitive mental processes, characteristics of the motivational sphere, neuropsychic stability, and psychological adaptation characteristics have been identified. The results showed sufficient validity and reliability of the methodological apparatus used for assessing cognitive mental processes and personal psychological adaptive abilities in relation to assessing their relationship with the success of military-professional adaptation, an effective solution of professional and service tasks. The possibility and prospect of considering them in professional psychological selection and medical and psychological (psychophysiological) support of professional activities, examination, and, if necessary, subsequent medical and psychological rehabilitation of naval specialists of the Socialist Republic of Vietnam to maintain a high level of their professional health, as well as the need for further research.

The 50th anniversary of corresponding member of the Russian Academy of Sciences Pavel N. Romashchenko

February 22, 2024, marks the 50th anniversary of Pavel N. Romashchenko, a famous scientist, specialist in the field of endocrine, abdominal surgery, and oncology, corresponding member of the Russian Academy of Sciences, Doctor of Medical Sciences, professor, and colonel of the medical service. For more than 30 years, his life has been inextricably linked with the S.P. Fedorov Faculty of Surgery of the Military Medical Academy names after S.M. Kirov, where he worked his way up from a cadet to the head of the department. In the walls of his alma mater, he evolved into a brilliant clinician, scientist, and leader, defended his doctoral dissertation, and received the title of professor. His fundamental work, as well as scientific research conducted in the clinic under his leadership, substantiated diagnostic and treatment algorithms and expanded the possibilities of using innovative and minimally invasive technologies in endocrine and abdominal surgery. Over the years of P.N. Romashchenko’s leadership of the department and clinic, much has been done to improve it with modern equipment, allowing it to perform various surgical and diagnostic interventions as part of the provision of specialized and high-tech surgical care. P.N. Romashchenko was awarded the honorary title “Honorary Doctor of the Russian Federation”. Under his leadership, 2 doctoral and 10 candidate dissertations were defended. P.N. Romashchenko is the author of more than 460 scientific works, including 14 monographs on various areas of endocrine and abdominal surgery. Currently, Pavel Nikolaevich successfully manages various scientific research as well as training scientific, pedagogical, and medical personnel.

Bogdan N. Kotiv — surgeon, professor, general of medicine (on the 60th anniversary of his birth)

March 14, 2024, marked the 60th anniversary of Bogdan N. Kotiv, the Deputy Head of the Military Medical Academy named after S.M. Kirov for clinical work, abnormal chief surgeon of the Academy, Honorary Doctor of the Russian Federation, Doctor of Medical Sciences, Professor, and Major General of the Medical Service. After graduating from the academy, B.N. Kotiv served in the Transcaucasian Military District as a leading surgeon in a separate medical battalion. In 1988, a young military surgeon participated in the provision of assistance to victims of the earthquake in the city of Spitak (Armenia) and received the first experience in providing medical care in military field conditions. In 1990, B.N. Kotiv entered the adjunct school at the Department of General Surgery, and in 1993, he successfully defended his dissertations for the degree of candidate of medical sciences. In 1998, the dissertation for the Doctor of Medical Sciences degree was brilliantly defended. In 2006, Bogdan N. Kotiv headed the Department of Hospital Surgery. When it was going through difficult times, a reorganization of the educational process occurred. Bogdan N. carefully preserved the traditions of teaching thoracic surgery and actively introduced the experience of modern complex surgical interventions into the educational process, including on the abdominal organs. The surgical school of the Department of Hospital Surgery rapidly took a leading position. In 2013, B.N. Kotiv was appointed the Deputy Head of the Academy for Academic and Scientific Work. Since 2021, Bogdan N. Kotiv has been the Deputy Head of the Academy for Clinical Work. He controlled and coordinated the clinical base of the academy, organized interactions with military hospitals throughout the country, and often went on business trips. At the beginning of a special military operation, a colossal responsibility fell on his shoulders. There was a need to quickly solve the permanently emerging problems of organizing the provision of medical care to the wounded in the conditions of the Academy clinics. With his direct participation, the clinical base was redesigned, its bed capacity was expanded, and new technologies for providing specialized medical care to the wounded, sick, and injured were introduced. For several generations of surgeons, Bogdan N. has been a wise mentor and role model. Under the leadership of Bogdan N. Kotiv, the range of scientific research conducted at the academy has significantly expanded. The fundamental directions of medicine for the study of the molecular and cellular foundations of combat lesions and cellular and tissue engineering technologies have received new development, and multidisciplinary scientific research is being conducted regarding the regenerative abilities of the liver.

Current state and prospects for the development of the domestic pharmaceutical industry

The main stages of the development of the Russian medical and pharmaceutical industry in 2010 are presented in the context of the dominance of large foreign companies producing medicines and medical devices in the pharmaceutical market. This reflects the political and economic restrictive measures illegally taken against Russia by the European Union, the United States of America, and some other unfriendly countries and has influenced the dynamics of the development of the medical and pharmaceutical industry in our country. To harmonize approaches to the production and quality control of medicines, this paper presents the stages of large-scale reforms on the transition of the Russian pharmaceutical industry to standards of good manufacturing practice and the implementation of state programs aimed at modernizing the industrial segment of the pharmaceutical industry. As part of the improvement of the standardization system of medicines, the study also presents the characteristics of the XIII, XIV, and XV editions of the State Pharmacopoeia of the Russian Federation published during the study period, in the development of which employees of the Military Medical Academy named after S.M. Kirov participated. The role and purpose of the creation of the developed Pharmacopoeia of the Eurasian Economic Union, approved by the Board of the Eurasian Economic Commission, is also reflected in this paper. This article describes the phased implementation of federal target programs, state programs, and other strategic plans and measures of nonfinancial support from the state, which have significantly expanded competencies in the field of development and production of medicines and medical devices and increased their output during the period analyzed. The development of medicines and increasing their production volumes with the help of pharmaceutical clusters, which acted as the “locomotives” of the industry, and various projects in establishing the production of innovative medical products with the help of the Industrial Development Fund, which increased the investment attractiveness of these sectors of the national economic complex, played an important role. The results revealed the essence of the changes concerning the revival of the activities of industrial pharmacies, considering a personalized approach to the treatment of patients. The study also presents an assessment of the Pharmaceutical industry Development Strategy for the period up to 2030.

Depression Among Indian Students and Its Association with Perceived TMA Academic Environment, Living Arrangements and Personal Issues

The point of the ponder is to discover the level of discouragement among college understudies over sexual orientation, scholarly stream, semesters, recognition of family environment and relationship with guardians, scholarly execution, and family wage. In expansion, the think about analyzes the affiliation between students' seen college scholarly environment, living courses of action, individual issues, and sadness. Seven speculations were defined for confirmation. An add up to of 717 understudies were selected taking after the multistage cluster inspecting strategy, and information were collected by an extraordinarily planned organized survey, scholastic accomplishment record and a standardized College Understudies Misery Stock. Discoveries unveiled that 37.7%, 13.1%, and 2.4% of the understudies were enduring from direct, extreme, and amazingly serious misery. A critical contrast was found over semester, that's, semester II students detailed the next level of misery than semester III understudies. So distant as scholastic stream is concerned, understudies from humanities and social science were found to be enduring from more sadness compared to understudies from science and administration streams. The think about advance unveiled that the understudies who detailed positive sees almost the college scholarly environment and living courses of action had lower level of misery compared to their partners. Individual resilience's such as being able to sharing individual issues with others and doing customary work out were found to be related with positive mental wellbeing. The discoveries of the consider emphasize the require for quick mental wellbeing back administrations for approximately 15.6% of the understudies who were either enduring from serious or greatly extreme sadness at the Tashkent medical academy

An Intra-Hospital Spread of Colistin-Resistant K. pneumoniae Isolates-Epidemiological, Clinical, and Genetic Analysis.

Background and Objective: Klebsiella pneumoniae appears to be a significant problem due to its ability to accumulate antibiotic-resistance genes. After 2013, alarming colistin resistance rates among carbapenem-resistant K. pneumoniae have been reported in the Balkans. The study aims to perform an epidemiological, clinical, and genetic analysis of a local outbreak of COLr CR-Kp. Material and Methods: All carbapenem-resistant and colistin-resistant K. pneumoniae isolates observed among patients in the ICU unit of Military Medical Academy, Sofia, from 1 January to 31 October 2023, were included. The results were analyzed according to the EUCAST criteria. All isolates were screened for blaVIM, blaIMP, blaKPC, blaNDM, and blaOXA-48. Genetic similarity was determined using the Dice coefficient as a similarity measure and the unweighted pair group method with arithmetic mean (UPGMA). mgrB genes and plasmid-mediated colistin resistance determinants (mcr-1, mcr-2, mcr-3, mcr-4, and mcr-5) were investigated. Results: There was a total of 379 multidrug-resistant K. pneumoniae isolates, 88% of which were carbapenem-resistant. Of these, there were nine (2.7%) colistin-resistant isolates in six patients. A time and space cluster for five patients was found. Epidemiology typing showed that two isolates belonged to clone A (pts. 1, 5) and the rest to clone B (pts. 2-4) with 69% similarity. Clone A isolates were coproducers of blaNDM-like and blaOXA-48-like and had mgrB-mediated colistin resistance (40%). Clone B isolates had only blaOXA-48-like and intact mgrB genes. All isolates were negative for mcr-1, -2, -3, -4, and -5 genes. Conclusions: The study describes a within-hospital spread of two clones of COLr CR-Kp with a 60% mortality rate. Clone A isolates were coproducers of NDM-like and OXA-48-like enzymes and had mgrB-mediated colistin resistance. Clone B isolates had only OXA-48-like enzymes and intact mgrB genes. No plasmid-mediated resistance was found. The extremely high mortality rate and limited treatment options warrant strict measures to prevent outbreaks.

Склерокорнеальная фиксация заднекамерных интраокулярных линз в осложненных случаях хирургии катаракты с использованием политетрафторэтиленовых нитей

Original article Sclerocorneal fixation of posterior chamber intraocular lenses in complicated cases of cataract surgery using polytetrafluoroethylene sutures T.G. Sazhin, M.O. Sokolova Clinical Hospital «RZD-Medicine», Saint Petersburg, Russian Federation S.M. Kirov Militar y Medical Academy Ministr y of Defense of the Russian Federation, St. Petersburg, Russian Federation Relevance. Dislocation of the intraocular lens (IOL) is a serious complication in cataract surgery. Therefore, the search for an effective method of IOL fixation for non-standard surgical situations is still important. Purpose. To analyze clinical results of flanged corneoscleral IOL fixation the technique using polytetrafluoroethylene sutures. Material and methods. The results of surgical treatment of 34 patients (34 eyes) who underwent IOL suturing with suture material made of polytetrafluoroethylene 6-0 (Ecoflon) through the sclera and fixation of flanges in the lumen of corneal paracentesis (Sclerocorneal IOL Fixation Technique) without incisions of the conjunctiva and sclera were analyzed. Results. The average index of maximally corrected visual acuity before surgery was 0.27±0.11. A day after surgery, this parameter increased to 0.41±0.1. One week after surgery, the average index of maximally corrected visual acuity was 0.65±0.1, while the improvement in visual acuity was statistically significantly different from the parameter before surgery and a day after surgery (p<0.05). Conclusion. Application of polytetrafluoroethylene suture material in the ab externo technique, passing through the sclera and fixing the flanges in the lumen of the corneal paracentesis is safe and effective method. As a result, patients had positive visual acuity dynamics with a low frequency of complications. Key words: dislocation of IOL, aphakia, sclerocorneal fixation, polytetrafluoroethylene suture, flanged technique

[The Russian priority of development of intravenous anesthesia (Report I).]

The article analyses research activities of the discoverers of "Russian narcosis" from the Military Medical Academy of St. Petersburg: the head of the Department of Pharmacology N. P. Kravkov, the head of the Department of Hospital Surgery S. P. Fedorov and his resident A. P. Eremich. They for the first time in the world developed ideas of comprehensive experimental substantiation and then safe clinical administration of preparation "hedonal" to achieve stage of safe general anesthesia and implementation of long-term and traumatic operations. The scientific works of Russian discoverers indicated fundamentally new direction in formation of anesthesiology in the Russian Empire and in the world. A. P. Eremich at stage of preparatory tests, working out technique of intravenous infusion, determination of range of safe therapeutic doses and creation of special installation facilitating work with hedonal during operations of Professor S. P. Fedorov, can be recognized as the first Russian anesthesiologist and also as the first National resuscitator.

Aesthetic communication as a nursing education trend: Case study of teaching professional English

A future medical practitioner is a holder of high moral qualities, possessing ethics and the method of aesthetic communication. A good command of aesthetic communication in nursing practice has a positive impact on achieving desired outcomes. The aim is to highlight the conceptual frame and the specificity of aesthetic communication for future nurses and how to implement it during the educational process. Analysis, synthesis, and systematization were used to shape the complex characteristics of developing aesthetic communication; comparative and descriptive methods were used to distinguish the effective features of aesthetic communication; the analytical method was applied to receive information about the theoretical and practical problems of developing aesthetic communication; and the Pearson test χ2 was used as a statistical method to compare and verify the obtained data. The research involved 90 students of the nursing faculty at Andrey Krupynsky Lviv Medical Academy in Ukraine, divided into experimental and comparison groups. The results showed a high level of aesthetic communication in the experimental group (42%), versus the comparison group (22%). Students’ academic performance improved in four language skills: reading, speaking, listening, and writing competence. All students demonstrated significant improvement in speaking fluently due to the implementation of aesthetic communication exercises into the teaching process. Our suggested technique for teaching a basic course, “Professional English”, in combination with an optional course, “Aesthetic Communication,” works properly and should be implemented in other higher educational institutions, as good aesthetic communication skills are crucial in building a nurse-patient relationship.