Medical Academy Research Articles

Treatment of Achilles tendon rupture in a patient with alkaptonuric ochronosis

The treatment result of a patient with spontaneous rupture of the Achilles tendon and features of diagnosing alkaptonuric ochronosis, a rare disease, are presented, providing doctors beneficial information for the prevention and/or delay of possible complications. On March 8, 2021, at about 20:50, while at his workplace, getting up from his chair from the table, patient K, 52 years old, felt a sharp pain in the lower third of his right shin and was urgently taken to the hospital. He was examined by a traumatologist and was initially diagnosed with rupture of the right Achilles tendon. His right lower limb was immobilized with a plaster splint. On March 11, 2021, he entered the military traumatology and orthopedics clinic of the Kirov Military Medical Academy for surgical treatment. Upon admission, the patient complained of pain in the right lower leg and impaired support function of the right lower limb. Based on complaints, medical history, laboratory results, and instrumental studies, subcutaneous rupture of the right Achilles tendon was diagnosed. On March 12, 2021, anchor suture of the right Achilles tendon was performed. Anesthesia — combined, access: two separate incisions on the posterior surface of the lower third of the right leg and in the area of the calcaneal tubercle, each 5 cm long, intraoperatively revealed a complete subcutaneous rupture of the right Achilles tendon. Notably, the tendon was black in color when cut. The postoperative period proceeded without complications, and postoperative wounds of linear shape in the right Achilles tendon healed by primary intention. No signs of disturbances were observed in peripheral circulation and innervation of the right lower limb. To confirm the diagnosis, a simple laboratory test was performed: a change in the color of urine during the day, after its additional alkalization. The color change is due to the polymerization of homogentisic acid, which is excreted in large quantities in the urine. To verify the diagnosis, a molecular genetic technique was performed: sequencing of the clinically significant HGD gene and encoding the enzyme homogentisate-1,2-dioxygenase, which are mutations that lead to alkaptonuria. The analysis results confirmed the presence of an amino acid substitution at the pGLy161Arg position, indicating pathogenicity. The use of simple methods of additional laboratory diagnostics and molecular genetic analysis enabled the diagnosis of alkaptonuric ochronosis. Thus, characteristic diagnostic signs were damage to the Achilles tendon in combination with the obtained anamnestic, clinical, and laboratory data of alkaptonuria.

Graduate of the Imperial Military Medical Academy professor A.A. Maximov: St. Petersburg addresses (to the 150th anniversary of the birth)

The key milestones in the life and main scientific achievements of the famous Russian histologist Alexander A. Maksimov (January 22, 1874–December 3, 1928), a graduate and gold medalist of the Imperial Military Medical Academy, who headed its Histology Department with a course of embryology for 20 years, were studied (1903–1922). A.A. Maximov was born in St. Petersburg into a merchant family and spent his childhood years in Vasilyevsky Island. Some buildings where the A.A. Maximov family lived have survived to this day. A.A. Maximov had three older sisters: Vera, Evgenia, and Claudia. The gymnasium in which A.A. Maximov also studied in Vasilyevsky Island. The director of the educational institution (one of the best in St. Petersburg) was the famous teacher–organizer Karl I. May. The archives preserve information about the progress of Maximov’s essay, which testifies to his excellent studies. Maximov graduated with a gold medal. One of his classmates at the Imperial Military Medical Academy was Vladimir A. Oppel, who later became a famous surgeon. He left interesting memories of Maximov during the years of joint study at Imperial Military Medical Academy. While in exile, Maximov constantly remembered his homeland, colleagues, and native places where he spent most of his life. His works remain relevant today. Emphasis is placed on the key scientific developments of A.A. Maximov — unitary theory of hematopoiesis, identifying the morphological basis of inflammatory reactions, and neoplasm of connective tissue in experiment. The results of a search for previously unpublished St. Petersburg addresses related to the life of A.A. Maximov are presented. Based on recently discovered archival documents, new information is provided that complements the biography of the outstanding Russian histologist who pioneered the study of stem cells.

Leader of pathophysiology: on the 70th birthday of professor Vasily N. Tsygan

May 12, 2024, marked the 70th birthday of the Honored Scientist of Russia, corresponding member and honorary doctor of the Kirov Military Medical Academy, Prof. Vasily N. Tsygan. He is a brilliant embodiment of the traditions of academic scientific schools, having gone from being a member and chairman of the Military Scientific Society of Cadets and Students to an adjunct to the deputy head of the academy for scientific work. After graduating from the academy with a gold medal and serving 3 years in the military, Vasily N. Tsygan entire subsequent scientific, pedagogical, and organizational activity has been connected with the academy. The topic of his candidate dissertation, related to changes in homeostasis in mechanical trauma, and performing special assignments from the command in Afghanistan and in the zone of the counter-terrorist operation in the Chechen Republic determined a crucial vector of research into the extreme impacts on the human body during military professional activity. V.N. Tsygan contributed to the study of immunophenotyping problems, the modern concept of molecular remission in oncohematology, and immunodeficiency in various types of pathology and methods for their correction. He is an experienced organizer of science and many large international scientific events. His activities involved the study of the history of Russian medicine, relations with the Nobel Committee, and defending the priority of Russian scientists. V.N. Tsygan’s contribution to the creation and development of the Military Medical Academy journals, where he worked for decades as executive secretary and deputy editor-in-chief, is invaluable. The Academy, the Ministry of Defense, the Academy of Medical Sciences, and the state have highly appreciated the merits of Prof. V.N. Tsygan, honoring him with state and departmental awards, prizes, and honorary titles.

Analysis of the prevalence and structure of dental morbidity among applicants to the Military Medical Academy named after S.M. Kirov

AIM: To determine the qualitative structure of dental diseases and pathological conditions of the maxillofacial region and the level of their prevalence among young individuals entering higher military educational institutions in Russia. MATERIALS AND METHODS: Data obtained during the dental examination of applicants to the Military Medical Academy named after S.M. Kirov as part of a military medical examination to provide admission to a higher educational institution was comprehensively analyzed. RESULTS: The results showed a moderately high level of prevalence of diseases and pathological conditions of the oral cavity in the surveyed population. Among 589 applicants aged 16–25 years who arrived from different regions in Russia, the percentage of those in need of oral sanitation was 51.95%. The most common nosological form among the examined young people was dental caries, including recurrent and secondary forms, which ranged from 19 to 44% in various groups of examined people. Additionally, a low level of oral hygiene was identified, noted in more than 45% of applicants. CONCLUSION: The peculiarities of the obtained research results should be explained by unsatisfactory knowledge and skills in matters of individual oral hygiene (hereinafter referred to as IHPR), insufficient medical education, low level of compliance, and readiness to carry out activities to maintain dental health among young people.

Ivan Alekseevich Pashutin at the origins of training specialists in dentistry in Russia

Ivan Alekseevich Pashutin, the founder of one of the dental schools in Saint Petersburg, played a crucial role in the formation and development of training in the field of dentistry in Russia. However, information about him in the special literature is limited. The aim of the study was to provide information about the role of Doctor of Medicine I.A. Pashutin as one of the organizers of training specialists in the field of dentistry in Russia. This article is based on the information available in the Russian special literature about Pashutin. Information about the life, family, and training of Pashutin as a person, military doctor, scientist, and specialist in dental diseases were provided. The sources of Pashutin’s knowledge and skills in dentistry were noted, as well as his organizational abilities, especially in the training of dentists, including at the dental school he created in Saint Petersburg. Notably, Pashutin was the first head of an independent course of odontology at the Military Medical Academy. Doctor of Medicine Ivan Alekseevich Pashutin was at the origins of the training of specialists in dentistry in Russia. His main achievement was the opening of a modern dental school at that time and his work as a teacher, consultant, and doctor on diseases of the teeth and oral tissues.

The use of biofeedback training in complex therapy of neurotic disorders and correction of negative psychological consequences of combat stress in combatants

The parameters and effectiveness of biofeedback training in the complex treatment of neurotic disorders at the hospital stage and psychological correction at the sanatorium stages of rehabilitation of military personnel were assessed. We examined 40 mentally healthy military personnel who participated in combat operations and 36 military personnel who participated in combat operations and suffered from stress-associated neurotic disorders and who were undergoing inpatient treatment in the S.M. Kirov Military Medical Academy clinics. In identifying possible negative psychological consequences of combat stress in a group of mentally healthy military personnel, a medical and psychological examination was performed using the military version of the Mississippi scale for assessing post-traumatic reactions, Neurotic Disorders-Symptomatic Questionnaire, and Quality of Life Questionnaire-12. The military personnel underwent stress testing according to a specially developed scenario using a biofeedback hardware software complex to assess individual changes in physiological parameters in response to emotionally significant stimuli. In the military personnel who participated in combat operations and suffered from neurotic disorders, a medical and psychological examination was performed using the Neurotic Disorders-Symptomatic Questionnaire and Quality of Life Questionnaire-12 upon admission to the hospital and on the eve of discharge, and stress testing was conducted upon admission to the hospital. The therapeutic effectiveness of biofeedback training in the treatment of neurotic disorders was evaluated by comparing the results of treatment between two groups of 18 individuals each. One group received only drug therapy, whereas the other group, in addition to drug therapy, underwent biofeedback training on the amplitude of the systolic wave. The level of stress-associated psychogenic damage was found to be correlated with the amplitude of the systolic wave according to the digital photoplethysmogram. Moreover, the physiological indicators of the circulatory and respiratory systems, used in foreign studies for psychophysiological training in the treatment of post-stress disorders, were not associated with the level of psychogenic damage, indicating their lack of involvement in pathogenesis and the ineffectiveness of their use. The addition of biofeedback training on the amplitude of the systolic wave to the complex therapy of neurotic disorders leveled astheno-neurotic symptoms and improved quality of life. Therefore, when treating astheno-neurotic disorders in military personnel participating in combat operations, it is critical to include biofeedback training on the amplitude of the systolic wave; this reduces severity of neurotic symptoms, improves quality of life, and forms preventive skill of conscious control of excessive physiological reactions of combat stress. Furthermore, the correlation between the magnitude of the decrease in the amplitude of the systolic wave and level of mental damage in combatants, revealed during stress testing, indicates the importance of biofeedback training on the amplitude of the systolic wave in sanatorium-resort organizations and military clinical hospitals of the Russian Ministry of Defense for the medical and psychological rehabilitation of military personnel exhibiting negative symptoms and those suffering from psychological consequences of combat stress.

Genetic features of a patient may influence the efficacy and safety profile of a medicinal product

Identification of the genetic features that determine a patient’s individual response to a medicinal product and provision of this information to a doctor helps to predict the effectiveness of therapy and the risk of adverse drug reactions. Dmitry A. Sychev — Academician of the Russian Academy of Sciences, Doctor of Medical Sciences, Full Professor, Rector of the Russian Medical Academy of Continuous Professional Education — talks about the importance of a personalised approach to selecting medicinal products and methods for their efficacy and safety control.

Evaluation of Internal Quality Assurance System in Defence Services Medical Academy: Moving Toward Quality Culture

The escalating number of higher education institutions globally has heightened the demand for credible education policies and quality assurance mechanisms. The establishment of organizations for quality assurance providers and accreditors has become widespread to meet this demand. The Myanmar Medical Council Accreditation Committee (MMCAC) was established in 2016 to ensure the quality and standard of medical practice in Myanmar. Defence Services Medical Academy (DSMA), one of Myanmar’s medical universities, transitioned to an outcome-based integrated program in line with the World Federation for Medical Education (WFME) Basic Medical Education Standards. To evaluate the effectiveness of DSMA’s internal quality assurance system and its progression towards a quality culture, this study explores faculty perceptions and practices regarding the internal quality assurance process. An explanatory sequential mixed method design was adopted, comprising quantitative surveys followed by qualitative in-depth interviews. Pre- and post-test surveys were administered to DSMA faculty members before and after an IQA training workshop. The surveys assessed knowledge, attitudes, and practices related to the internal quality assurance system. Qualitative data was collected through in-depth interviews with selected faculty members to delve deeper into their experiences and perceptions regarding the IQA process. Quantitative analysis revealed an improvement in faculty awareness and attitudes towards the IQA system post-training. However, challenges such as confusion about the functional place of the QA unit and concerns about disturbing academic freedom persisted. Qualitative findings highlighted varying levels of experience and awareness among faculty members, with unanimous recognition of the need to strengthen the IQA framework by adhering to international guidelines and fostering a culture of continuous improvement. Faculty attitudes towards the IQA process varied, with some viewing it as an extra burden and others recognizing its necessity for document organization and quality control. Faculty involvement in the IQA process varied, with departmental leadership playing a crucial role in promoting participation. While progress has been made in raising awareness and improving attitudes towards the IQA system at DSMA, challenges remain, indicating the need for ongoing efforts in awareness-building and perception management. Structural improvements, regular training programs, and ongoing evaluation are essential to strengthening the IQA framework and fostering a quality culture at DSMA. The successful implementation of quality assurance program depends on teamwork amongst leadership, academics, and all stakeholders.

To the 100th anniversary of the formation of the Kazan Society of Obstetricians and Gynecologists

In Kazan, training in the “midwifery art” has been carried out for more than 200 years. Scattered publications contain information about the influence of the St. Petersburg school of obstetricians and gynecologists on the formation of the Kazan school of obstetricians and gynecologists. It is of interest to establish connections, continuity and development of the Kazan school with the St. Petersburg school of obstetricians and gynecologists. The study of primary sources showed that from the moment the obstetric clinic was created in Kazan in 1833, its first leaders communicated with St. Petersburg colleagues, adopting their experience (Lentovsky A.E., Kozlov A.I.). Subsequently, obstetrics and gynecology department and clinic of the medical faculty of the Kazan Imperial University were led by students of the St. Petersburg Military Medical Academy (Slavyansky K.F., Florinsky V.M., Fenomenov N.N., Gruzdev V.S.). All of them at the end of the 19th and beginning of the 20th centuries made a lot of efforts for the scientific and practical development of obstetrics and gynecology in Kazan. A particularly noticeable mark was left by Professor V.S. Gruzdev, creating an independent scientific and practical school of Kazan obstetricians and gynecologists. Later his work was continued by student of V.S. Gruzdev — Professor P.V. Manenkov with his students.

Effectiveness of Teaching Communication Skills in Undergraduate Curriculum at Defence Services Medical Academy Myanmar: Mixed Qualitative and Quantitative Study

Introduction: Good communication is the cornerstone of quality healthcare and it should be patient centered. Communication skills is taught and assessed with surrogates in undergraduate training. This study aimed to determine the effectiveness of communication skills taught in undergraduate period in reality. Methodology: It was a combined qualitative and quantitative methods. For qualitative assessment, phenomenology was used. Informal focus group semi-structured interview was done to groups of interns who had completed internship at medical wards. The responses were analyzed interpreted and classified; thematic analysis was done. For quantitative assessments, open ended questions were set by experts in medical education. The questions were answered anonymously; they were grouped into same themes. This study was approved by ‘Hospital Research and Ethics Committee’ of No(1) Defence Services General Hospital. Informed consent was taken from each intern. Results: A total 20 interns were included. Four themes were formed after thematic analysis: (1) the extent of applicability of communication skills they were taught in undergraduate days;(2) self-admitted confidence and degree of satisfaction; (3) the challenges/gaps they faced in reality; and (4) their suggestions on undergraduate teaching to fill the gaps. All interns admitted that the communication skills they taught was 100% applicable in practice. And they were confident out of proportion to their medical experience. They were satisfied with communication skills they were taught in undergraduate days. The challenges faced were as follows; difficulty in understanding volume and clarity of language when dealing with some nationality; low education level of patients leading to difficulty in understanding the information they have given; difficulty in getting trust from patient being youngest doctor in the team; and, taking long time due to emotional reaction of patient in breaking bad news. They admitted that they need to fill their knowledge gaps to answer the questions raised by patients particularly in explanation of diagnosis and management. They realized the importance of facial expression and tone of voice to express sympathy and empathy especially in breaking bad news. To improve communication skills in practice, they suggested to teach with real patients with real scenario. Conclusion: Teaching communication skills in undergraduate period was effective. The interns had good self-reported confidence. The interns need more training and self-directed learning. The challenges faced by interns were acceptable/logical. We should find better teaching method/media in undergraduate teaching to promote communication skills.

#1534 Risk of CKD progression taken into account of metabolic changes

Abstract Background and Aims The purpose of this study was to study the relationship between metabolic syndrome and the risk of progression of CKD in a representative sample of patients who were hospitalized in the nephrology department of the 3rd clinic of the Tashkent Medical Academy and in the department of cardiology and interventional cardiology of the Russian National Medical Research and Medical Center. Method In the retrospective part of the study, 1000 case histories of patients with CKD who were inpatient treatment from 2013 to 2019 in the nephrology department of the 3rd clinic of the Tashkent Medical Academy and in the department of cardiology and interventional cardiology of the Russian National Medical Research Center for Medical Sciences were studied. In the prospective part of the study, information on demographic characteristics, including age, gender, education, and profession, was collected during medical visits using a standard questionnaire. Metabolic syndrome was defined according to international guidelines as the presence of three or more of the following risk factors: waist circumference >102 cm in men or >88 cm in women; serum triglyceride level ≥1.70 mmol/L; HDL cholesterol < 1.04 mmol/L in men or < 1.30 mmol/L in women; Blood pressure ≥ 130/85 mm Hg, including achieved; serum glucose level ≥6.11 mmol/L. Metabolic syndrome definition criteria used Results The demographic characteristics of the patients are presented in the table. Mean serum creatinine was similar, but GFR was estimated to be lower among those with metabolic syndrome compared with those without. The percentage of individuals with CKD and elevated serum creatinine was statistically significantly higher among individuals with metabolic syndrome. Low HDL cholesterol, elevated plasma glucose, and abdominal obesity were found to be statistically significantly associated with the risk of developing C5 CKD and elevated serum creatinine. In addition, a significant relationship was observed between the number of metabolic syndrome components and the percentage of CKD C5 or elevated serum creatinine (P < 0.015 and P = 0.02, respectively). In the multivariate model, patients with 1, 2, 3 and 4 or 5 components of the metabolic syndrome had 1.51; 1.50; 2.13 and 2.72 times higher odds of CKD C5 CKD, respectively, compared with individuals without metabolic syndrome components. Overall, patients with metabolic syndrome had a 64% increased odds of CKD compared with a comparison group without metabolic syndrome. Conclusion The present study revealed a positive and significant association between metabolic syndrome and the risk of CKD C5 in those examined. The risk of CKD increased progressively with increasing number of metabolic syndrome components.

Where Do We Go From Here? An Inventory of Publicly Available Data About Educator Academies, Medical Education Departments, and Offices of Medical Education.

With the recent widespread growth and interest among medical educators, analysis of how departments of medical education are structured and their intersection with existing structures within the same institution, such as an office of medical education and/or academy of educators, is warranted. Based on a review of the literature, the authors determined there was a need for an inventory of what medical schools have to offer their faculty, whether it be an office, an academy, or a department. This project sought to inventory the current structures of medical education departments, offices, and academies at U.S. medical schools to explore reporting structure, functions, and characteristics of these entities. Data were extracted from A Snapshot of Medical Student Education in the United States and Canada: Reports From 145 Schools, published in 2020 in the journal Academic Medicine , for each reporting institution. This led to exploration of medical school websites to catalogue institutional structures. Data collected in this inventory demonstrate the range of structures used by medical schools to offer faculty support for their work as teachers and educational researchers. The hypothesis was that departments of medical education would be the least prevalent structures identified in U.S. medical schools, which was indeed a finding. Although the search yielded considerable data for the inventory, there is a dearth of published literature describing current models and characteristics of these different entities. Significant difficulties were encountered locating information clearly delineating roles and responsibilities of each entity on many medical schools' public-facing web pages. Findings are significant because they underscore the challenges medical education leaders have in obtaining information to research, compare, select, and design the administrative model(s) best suited to support faculty educators at their institution. Future work should include creating a detailed catalogue with descriptive information supplied by schools.

On the question of electrical safety in physiotherapy rooms: protective grounding of electrical equipment

Abstract. The article discusses current issues of electrical safety in medical and preventive organizations. Goal: to attract the attention of physiotherapy specialists to the correct organization of protective grounding as the main means of preventing electrical injuries. Material and research: modern regulatory framework for the technical operation of electrical installations of electrical energy consumers in medical premises, the selection and use of electrical equipment and grounding devices, the frequency of inspections, measurements and tests, passports of grounding devices. Conclusion. It seems important to carry out measures to prevent accidents during the operation of physiotherapeutic equipment in each physiotherapy unit. To increase the level of organization of work on electromedical devices. Exclude the admission of personnel to the work of paramedical personnel without mandatory verification of the implementation of organizational and technical measures in the preparation of workplaces. Health care facilities should regularly hold occupational safety days, during which health care personnel should learn cardiopulmonary resuscitation skills, which today can be done in multidisciplinary accreditation and simulation centers of medical universities and academies.

АНАЛИЗ КАЧЕСТВА ВЕДЕНИЯ МЕДИЦИНСКОЙ ДОКУМЕНТАЦИИ ПРИ ОЦЕНКЕ ДЕЯТЕЛЬНОСТИ СТОМАТОЛОГИЧЕСКОЙ КЛИНИКИ

One of the criteria for assessing the quality of medical care is the complete maintenance of medical records. Defects in the preparation of medical documents lead to serious errors, such as incorrect diagnosis, unreasonable choice of diagnostic methods and treatment. To clarify the causes of their occurrence and adverse consequences, the study and analysis of medical records in dental organizations is of no small importance. Properly completed medical documentation serves as the basis for conducting forensic investigations within the framework of a criminal case in case of defects in the provision of medical dental care. The outpatient card of a dental patient is the object of quality control of medical care in dental organizations in the event of conflict situations. Purpose of the study: To analyze the quality control and safety of medical activities and the examination of the quality of medical dental care carried out in the dental clinic of the Military Medical Academy named after. CM. Kirov. Material and methods. During the study, analytical and statistical methods were used. The collection of primary information was carried out on the basis of data from primary medical documentation - 1067 outpatient records of dental patients. Results and condemnation. A statistically significant influence of a doctor’s work experience on the completeness of providing information about patients’ complaints was revealed. Doctors with less experience provide more complete descriptions of patient complaints. Among all complaints, aesthetic ones were most often described; complaints of a morphological and functional nature were noted quite rarely. In the cards of form No. 043/u, in 46.67% there was no information about the bite, the hygiene index was not determined, treatment plans and visit diaries were not filled out correctly. Conclusions. Internal quality assessment helps to detect defects in filling out dental patient outpatient records. The importance of adequate medical record keeping is beyond doubt; the form of the medical record must meet the needs of dentists and contain information that complies with the legal and regulatory framework.

Demystifying the MRCP exams for IMGs: the impact of five Nigerian Specialist Registrars through a virtual medical academy

‘There is a loftier ambition than to stand tall in theworld, it is to stoop down and raise mankind higher’ – Henry Van Dyke. The MRCP PACES exam is the last hurdle to climb for internal medicine registrars before they become a prestigious Member of the Royal College of Physicians United Kingdom. However, most International Medical Graduates (IMGs) do shy away from the medical specialty because of the failure rate of these exams. According to the Paces Spring Performance Report 2023, the failure rate of IMG in Paces was alarming compared with British Medical Graduates; Around 60% of IMGs failed the exam-700 IMGs in comparison to approximately 30–200% UK graduates [1, 2]. These disparities invigorated five Nigerian IMG registrars to bridge this gap through a free weekly virtual PACES exam for the last 40 weeks. We also started monthly MRCP Courses and PACES-centred MRCP Masterclasses to support International Medical Graduates to ace their PACE exams. Furthermore, through the power of representation, we are inspiring and attracting IMG doctors to the physician specialty [3]. Five Nigerian IMG registrars – ST4 to ST5, trainees of HEE in Acute Medicine, Neurology, Cardiology, and Stroke Medicine across diverse regions in England facilitated weekly tutorials up to three times weekly since June 2023 through the Zoom Platform. The success of the free tutorials led to the development of the Virtual PACES and created a need to start a Virtual MRCP PACES Course. We have facilitated more than 10 PACES courses, 15 Paces Mocks, 4 Neurology Masterclasses, and 4 Communication Master Classes. To the best of our knowledge, we are the first group to conduct a Successful Virtual PACES Mock exam. We have more than 500 International Medical Graduates on our social media platform who participate actively in all our educational courses. The majority of them live in the United Kingdom and completed their medical school in Asia, Africa, or Europe. To rate the impacts of our weekly IMG Paces tutorials, we decided to conduct an anonymous online survey. More than 50 doctors responded. More than 96% of the respondents were IMGs. A third of the respondents were Internal Medicine Trainees (IMTs) in the UK. About a third were trainee registrars and a third were in a non-training role. A third of our respondents have attempted paces before. More than about half of the respondents had attended more than five weekly sessions. When asked to ‘rate their strength in the paces content before attending Free PACES teaching’; more than half of respondents rated themselves as either poor or fair across all pace components, especially in Neurology, Communication, and Consultation [4]. When asked to rate their improvement in the PACES content after attending our free PACES teaching. More than 90% rated improvement across all the paces and approximately 60% of respondents said they ‘improved a lot’ in Communication, Consultation, and Neurology. When asked ‘how do you feel seeing fellow IMG Registrars taking you through the Sessions? More than 90% of respondents feel more confident, more supported, inspired, and more included to pass paces. Almost all respondents now have a more positive perception of IMG registrars following the tutorials [5]. Finally, for people who attend our courses and mocks, we have a success rate of more than 50% in the MRCP exams which is higher than the national average for IMGs. This bold and altruistic step taken by five Nigerian Specialist Registrars has bridged the gap to improve the success rates of IMGs in completing the MRCP PACES exam. We hope to extend this innovative platform to other specialties who are willing to collaborate with us in our quest to empower IMGs. Beyond that, we believe we are changing narratives and shaping the perception of Nigerian doctors, Nigeria, and Africa as a whole. That to us, becomes an ‘icing on the cake’.

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.

УРОВЕНЬ КОМФОРТА И МОТИВАЦИИ К ОРТОПЕДИЧЕСКОМУ ЛЕЧЕНИЮ ПРИ ДЕФЕКТАХ ТВЕРДЫХ ТКАНЕЙ ЗУБОВ

It is impossible to overestimate the role of dentistry in the life of a modern person. What an ordinary, but at the same time – an important procedure was a visit to the dentist's office. Modern dentistry is the result of a long, painstaking, invaluable work of a large number of people who have been passing on their accumulated experience for many centuries, searching for answers to emerging questions. Even today, dentists and scientific researchers continue to conquer the peaks of dental science, but each of these achievements opens up space for new discoveries[9]. For example, the problem of modern dentistry, the relevance of which cannot be underestimated, is the insufficient identification of patterns of influence of orthopedic treatment on the comfort and quality of life of patients. Restoration of defects in the crown of a tooth with the help of an artificial metal-ceramic or ceramic crown has long been commonplace both in the work of an orthopedic dentist and in the lives of patients. Dental prosthetics solves not only the main problem – the restoration of chewing efficiency and aesthetics, but also increases the comfort and quality of life of patients, encouraging them to continue dental treatment, as evidenced by the results of this work. This study is devoted to the study of the effect of prosthetics with metal-ceramic and ceramic artificial crowns on the level of comfort of life and motivation of patients for orthopedic treatment of hard dental tissues. The paper presents the results of the analysis of medical records of dental patients and a survey of patients who applied for dental prosthetics. The purpose of the study was to assess the quality of life of patients before and after orthopedic treatment of defects in hard dental tissues with artificial crowns and, analyzing the data obtained, determine the correlation of various factors with the level of motivation for prosthetics. Material and methods. The study took place on the basis of the Department and Clinic of General Dentistry of the Military Medical Academy n. a. S.M. Kirov. For the study, 90 medical records of dental patients were taken, the age structure of patients, types, quantity and quality of orthopedic structures in the oral cavity were analyzed. Methods such as statistical, questionnaire, analysis and synthesis, and comparison were used to form conclusions. In the future, the subjects were asked to complete the OHIP-14 RU questionnaire. The results and their discussion. The most extensive age group seeking orthopedic dental care is the category between the ages of 18 and 44 (young age) – 48.5%, most of the subjects (36.4%) have one metal-ceramic crown. As a result of the analysis of data obtained from the OHIP-14 RU questionnaire, a pattern was revealed between orthopedic treatment in persons with defects in hard dental tissues and the level of their quality of life, which had a direct relationship. Thus, prosthetics with artificial crowns, if there are indications for this type of dental treatment, increases the comfort and quality of life of the patient, and also helps to increase motivation for dental treatment.

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.