Medical College Research Articles

Assessment of Quality of Life and Determinants Among the Elderly Population in Rural Areas of Puducherry: A Mixed Method Study

Background: Elderly people living in rural areas often faces unique challenges that affect their quality of life (QOL), including limited access to healthcare and social support. Understanding the factors influencing their well-being is essential to improve the quality of life. The study aims to assess the QOL and its determinants among the elderly in rural areas of Puducherry. Methods: A community based sequential explanatory mixed method study was conducted among the elderly residing in the rural field practice area of a medical college in Puducherry district. 200 participants were recruited by simple random sampling from the family health records in the Rural Health Training Centre of a medical college. WHO QOL-BREF questionnaire was used to assess the Quality of Life quantitatively and an interview guide to explore its determinants. Data were entered in MS excel and analyzed using SPSS v16.0. Results: The mean age of the participants was 68.8± 2.5 years with majority being females. The environmental domain scored the highest mean QOL and psychological domain the lowest mean QOL. The overall mean QOL was 234.8 ± 65.4. The main determinants of poor QOL are age ≥ 75 years, lower socio-economic class, those who are widow/separated and presence of comorbid conditions. The binary logistic regression predicts the factor for poor QOL was age ≥ 75 years with OR (95% CI) as 6.23 (2.44-15.91). Conclusion: The overall mean QOL was moderate. The factors identified for poor QOL need to be addressed with key intervention strategies. Quality affordable medical services at door step to improve physical domain and targeted health education for family members and the community, who form the immediate environment around the elderly, can play a crucial role in enhancing the social domain.

Characterization of Gingival Epulis Lesions: A Histological and Morphological Approach

Objective: To conduct a clinical and histopathological study of Epulis at Bhittai medical and Dental College, Mirpurkhas. Methodology: A descriptive cross-sectional study was carried out at the Bhittai medical and Dental College Mirpurkhas. Patients clinically diagnosed with gingival outgrowth, across all age groups and both genders, were included. A provisional diagnosis of epulis was made based on clinical examination. After taking a careful history, relevant clinical features were recorded, and a biopsy procedure was performed using infiltration near the lesion or regional nerve block techniques. The data was documented using a pre-designed proforma and analyzed using SPSS version 22.0. Results: Out of 50 subjects, 30 (60%) were female and 20 (40%) were male. Most cases involved the maxillary gingiva (anterior or posterior) (62%). The majority of lesions measured between 2cm and 3cm (76%). Lesions typically exhibited a soft consistency (70%), with fewer cases being firm (8%) or hard (22%). Histologically, peripheral giant cell granuloma (PG) was most prevalent (50%), followed by fibrous epulis (42%), peripheral ossifying fibroma (4%), and peripheral giant cell granuloma with features of central giant cell granuloma (PGCG) (4%). No cases of congenital epulis or pregnancy tumor were reported. Histological evaluation revealed no significant gender differences (p-value 0.86). Conclusion: Clinically, most epulis lesions presented as painless, soft, coral pink masses, typically measuring approximately 2-3 cm in diameter and exhibiting a sessile form and observed more commonly in females, with a predominant occurrence in the maxillary region. Histopathological examination revealed that the most frequent types were fibrous epulis and peripheral giant cell granuloma.

Knowledge and Attitude regarding Cardio Pulmonary Resuscitation (CPR) among Nurses in Bangladesh

Cardiac arrest remains a leading cause of mortality worldwide. The effective management of cardiac arrest requires a thorough understanding of cardiopulmonary resuscitation (CPR) techniques. As frontline healthcare providers, nurses are pivotal in identifying cardiac arrest and initiating CPR. This study aimed to evaluate the level of knowledge and attitude regarding CPR among nurses at Chittagong Medical College Hospital (CMCH), Bangladesh. A descriptive cross-sectional study was conducted involving government-registered nurses employed at CMCH. A convenience sampling method was employed to select participants. Data were collected using self-administered semi-structured questionnaires. The study found that 68.1% of the nurses had a diploma in nursing and limited experience in CCU/ICU and emergency departments. Furthermore, 76% of the nurses had not received CPR training. Only 1.4% of the participants exhibited good knowledge of CPR, 37.2% had an average level of knowledge, and 61.5% demonstrated poor knowledge. Regarding attitudes towards CPR, 24% of the nurses had a good attitude, while 76% had an average attitude. The findings indicate that nurses at CMCH possess inadequate knowledge of CPR despite a moderate attitude towards its practice. This study provides foundational data that could guide efforts to enhance CPR training and knowledge among nurses in Bangladesh.

Pattern of Onychomycosis among Diabetic and Non-Diabetic Patients at a Tertiary Care Hospital in Bangladesh

Any fungal infection affecting the nail apparatus is referred to as onychomycosis. Onychomycosis is a prevalent nail infection worldwide and is more common among patients with diabetes. A variety of fungus species are responsible for onychomycosis. The purpose of this study was to determine the pattern of onychomycosis among patients with and without diabetes at the Department of dermatology and venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital, Dhaka, Bangladesh. In this study, a total of 87 clinically diagnosed patients of onychomycosis with diabetic or non-diabetic were included purposively. The infected nail materials were scraped and then processed in Sabouraud's dextrose agar media (SDA) and Dermatophyte test media (DTM) for microscopy and culture. Clinical features, microscopic examination findings and culture interpretations were recorded and compared between the groups. Out of 87 patients of onychomycosis, 54 patients had diabetic and 33 patients were non-diabetic. Growth of fungus was found significantly higher among diabetic patients (85.19% versus 57.58%, p= 0.004). Dermatophytes were more frequent in diabetic patients, but Candida albicans and non-albicans Candida species were more common in non-diabetic patients. Trichophyton rubrum, and Trichophyton mentagrophytes were found in 24 (44.44%) and 19 (35.18%) diabetic patients. On the other hand, Candida albicans 8 (24.24%) and non-albicans candida species 8 (24.24%) were found majority of the non-diabetic patients. Nail discoloration and disfigurement of nails are the common presentation of onychomycosis. Dermatophytes are significantly more frequent among diabetic patients. The clinical presentation of onychomycosis in patients with diabetes differed from that in non-diabetic subjects.

ACCREDITATION EXPERTISE OF THE “GENERAL MEDICINE” TRAINING PROGRAM FOR THE SPECIALTY 222 “MEDICINE” OF THE SECOND (MASTER’S) LEVEL OF HIGHER EDUCATION AT IVAN HORBACHEVSKY TERNOPIL NATIONAL MEDICAL UNIVERSITY OF THE MINISTRY OF HEALTH OF UKRAINE

The article characterizes the procedure of accreditation expertise of the “General Medicine” training program for the second (master’s) level in the specialty 222 “Medicine”, implemented at Ivan Horbachevsky Ternopil National Medical University of the Ministry of Health of Ukraine. The relevance of the topic is determined by new approaches to the accreditation of educational programs in Ukraine, which require the implementation of autonomous methods for managing the quality of education in accordance with European standards. The results of the expertise carried out by the members of the expert group and the sectoral expert council of the National Agency for Higher Education Quality Assurance (NAQA) was analysed. The article describes how the Ministry of Education and Science of Ukraine, the Accreditation Commission, and the National Agency for Higher Education Quality Assurance conduct monitoring of training programs through assessing their compliance with established standards. The research shows that accreditation not only determines the quality of education but also helps identify the strengths and weaknesses of training programs, providing information to all stakeholders. The main results of the expert evaluation highlight a high level of training for specialists in line with current labour market demands and emphasize the importance of adapting curricula to the conditions of healthcare reform. The article underscores the significance of ongoing monitoring of education quality to enhance the competitiveness of graduates. The manuscript focuses on the uniqueness and advantages of the training program, its evaluation, as well as the recommendations and suggestions provided by NAQA experts.

Combination of body mass index and body fat percentage in middle and late pregnancy to predict pregnancy outcomes in patients with gestational diabetes in Wenzhou, China: a single-centre retrospective cohort study

ObjectivesThe present study aimed to evaluate whether body mass index (BMI) and body fat percentage (BFP) could be used to predict pregnancy outcomes in patients with gestational diabetes mellitus (GDM).DesignRetrospective...

Analysis of the effectiveness and safety of 7.5 Fr ultra-thin flexible ureteroscope combined with a tip-flexible suctioning ureteral access sheath for the treatment of kidney stones.

To compare the efficacy and safety of using a 7.5 Fr flexible ureteroscope (f-URS) with tip-flexible suctioning ureteral access sheath (TFS-UAS) versus a 9.2 Fr f-URS with traditional ureteral access sheath (T-UAS) in the treatment of kidney stones. A retrospective analysis was conducted on 205 patients with kidney stones measuring 1.0-2.0cm treated with 7.5 Fr and 9.2 Fr f-URS in the Urology Department of The Affiliated Dazu Hospital of Chongqing Medical University from November 2022 to November 2023. The patients were randomly divided into two groups. Among them, 78 patients were selected to use the 7.5 Fr f-URS, which was designated as the GroupA. The remaining 127 patients were selected to use the 9.2 Fr f-URS, which served as the GroupB. The study compared the operation duration, lithotripsy duration, surgical success rate, immediate postoperative stone-free rate (SFR), 1-month postoperative SFR, and the incidence rate of postoperative complications between the two patient groups. In terms of demographic characteristics, the size of calculi, surgical success rate, and 1-month postoperative SFR, there was no statistically significant difference between GroupA and GroupB. However, GroupA demonstrated superior performance compared to GroupB in operation duration (48 (40.55) min vs 74 (56.94) min), lithotripsy duration (35 (27.43) min vs 59 (42.78) min), and immediate postoperative SFR (53.52% (38/71) vs 29.41% (35/119)), with statistically significant differences observed (P < 0.05). In terms of complication occurrence, GroupA reported 10 cases of minor (Grade 1) complications, whereas GroupB had 32 cases of minor (Grade 1) complications and 7 cases of severe complications (including 2 cases of Grade 3 and 5 cases of Grade 4). The difference between the two groups was statistically significant (P < 0.05). The GroupA reported significantly fewer cases of postoperative fever (4) and analgesic treatment (3) compared to GroupB, which had 18 fever cases and 19 analgesic cases (P < 0.05).The GroupA did not experience any cases of septicemia or steinstrasse. Conversely, the GroupB had 5 cases of septicemia and 3 cases of steinstrasse, including 2 patients who underwent reoperation. Both groups also reported cases of ureteral mucosal rupture (5 in GroupA, 10 in GroupB), but these differences were not statistically significant (P > 0.05). Compared with 9.2 Fr f-URS combined with T-UAS, the use of 7.5 Fr f-URS with TFS-UAS in the treatment of kidney stones has higher lithotripsy efficiency and lower complication rate. This combination is safe and effective in the treatment of kidney stones.

The chain mediation effects of self-confidence and positive coping style on academic satisfaction and professional identity among Chinese medical students

Due to the importance of medical students in the buildup of the health system and the influence of professional identity in their study, the aim of the study is to focus on the impact of academic satisfaction and professional identity on Chinese medical students during their career transformation, taking into consideration other factors that play a role in this relationship. 735 junior and senior medical university students from two training hospital were surveyed by using a cluster sampling method. The questionnaire included academic satisfaction scale, career transition psychological scale, simple coping style questionnaire and professional identity questionnaire. Pearson correlation and process plug-in model 6 were used for chain mediation analysis. The results show that in the career transition period, there is a direct relationship between academic satisfaction and career identity, and a chain intermediary relationship between academic satisfaction and self-confidence and coping style. In addition to our findings, we also assert that academic satisfaction has a direct impact on self-confidence and positive coping style in the transition period, and is a predictor of professional identity, whether directly or through the chain intermediary of self-confidence and coping style in the transition period. The results showed that academic satisfaction was sequentially associated with increased self-confidence, and then increased positive coping styles, which resulted in higher professional identity among medical students.

Health-preserving physical culture and wellness competences as an important condition for ensuring and spreading a high level of public health (methodological aspects)

WHO indicates that the purpose of actions aimed at strengthening public health protection is to ensure conditions under which people can remain healthy, able to strengthen health and well-being, and prevent deterioration of health. However, in the basic documents, there is no place for health-preserving physical culture and health-improving competencies of a person in the system of general efforts. The aim of the work is to reveal the need and place of health-preserving physical culture and wellness competencies of a person as a condition for ensuring and spreading a high level of public health in Ukraine. Material and methods. The study was organized at the Dnipro State Academy of Physical Culture and Sports, the Ukrainian State University of Science and Technology, the National Technical University “Dnipro Polytechnic” (all in Dnipro) and the Zaporizhzhia State Medical and Pharmaceutical University. The used methods of theoretical research were: study and generalization of data from domestic and foreign official and literary sources, as well as abstraction, analysis and synthesis, induction and deduction. Results. Conceptual principles and didactic technology of physical education of a non-professional physical education (NpPhE), with an emphasis on strengthening the general cultural component of the educational component “Physical education” in higher education, aimed at eliminating existing shortcomings. Provided with pedagogical technology, NpPhE contributes to the formation of the building blocks of one’s own health. And the system of effective pedagogical mechanisms of NpPhE is significantly different from the provision of information about health, which is the subject of modern valeology. In this context, the development of conceptual directions of creative valeology is relevant, as a means of supporting a person’s creativity in a safe effect on health. Namely, the formation in institutions of higher education of the builders of their own health. Conclusions. A system of pedagogical mechanisms is proposed, which is significantly different from just providing information about human health as a benefit/harm of influences and actions, which is what valeology is focused on. This is a prerequisite for the formation and development of creative concepts of modern valeology based on the improvement of cultural and practical components of the educational component “Physical education” in the conditions of a higher education institution for specialists who take care of building their own health from specialties related to civilians. In conditions where the majority of their graduates are engaged not in physical, but intellectual work, the further implementation of approaches related to professional-applied physical training for professional activities is something that it is time to abandon.

Computer prediction of toxicity of new S-alkyl derivatives of 1,2,4-triazole

1,2,4-Triazole derivatives are of researchers’ significant interest due to their diverse biological properties, such as antimicrobial, anti-inflammatory, anticancer, and antioxidant activities. The integration of a 2-bromo-4-fluorophenyl fragment into the triazole structure can significantly enhance these activities. However, the evaluation of the toxicity of such compounds remains a critically important aspect for their practical application. To reduce the time and cost of experimental studies, QSAR (Quantitative Structure-Activity Relationship) methods are actively used, allowing the prediction of toxicity based on the molecular structure of compounds. Aim of the study. To assess the toxicity of new S-derivatives of 5-(2-bromo-4-fluorophenyl)-4-R-1,2,4-triazol-3-thiols using the QSAR method, specifically to predict acute toxicity parameters (LD50), and to determine the influence of different (length) radicals on the toxicity of these compounds. Materials and methods. The objects of the virtual study were derivatives of 5-(2-bromo-4-fluorophenyl)-4-ethyl-1,2,4-triazol-3-thiols. They were evaluated at the Department of Toxicological and Inorganic Chemistry of the Zaporizhzhia State Medical and Pharmaceutical University. The toxicity assessment was conducted using the nearest neighbor method via the Toxicity Estimation Software Tool (TEST). The prediction of the lethal dose (LD50) for rats was based on the structural similarity of the studied compounds with known substances, for which experimental toxicity data are available. Results. The conducted QSAR analysis demonstrated that structural changes in S-derivatives of 5-(2-bromo-4-fluorophenyl)-4-ethyl-1,2,4-triazol-3-thiols significantly affect the predicted toxicity. The primary factor influencing the changes in LD50 values is the variation of radicals at the 5th position of the triazole ring. Conclusions. The results of the study showed, that the toxicity of new S-alkyl derivatives of triazol-3-thiols depends on the type of alkyl substituent. Compounds with propyl to heptyl fragments exhibit increased toxicity, while derivatives with thiol, octyl, nonyl, and decyl residues are characterized by lower toxicity.

QSAR prediction of toxicity for a new 1,2,4-triazole derivatives with 2-bromo-5-methoxyphenyl fragment

New derivatives of 1,2,4-triazole are promising research targets due to their unique biological properties, including antimicrobial, antifungal, antitumor, and antioxidant activities. The introduction of the 2-bromo-5-methoxyphenyl fragment into the triazole structure potentially enhances these properties. However, the issue of toxicity for such compounds remains a critical factor for their further application. To reduce experimental costs and time, QSAR (Quantitative Structure-Activity Relationship) methods are widely applied, allowing to predict compounds toxicity based on their molecular structure. The aim of this study was to evaluate the toxicity of new derivatives of 5-(2-bromo-5-methoxyphenyl)-4-R-1,2,4-triazole-3-thiols, their acids, and esters using the QSAR method to predict parameters of acute toxicity (LD50) and to assess the influence of various radicals on the toxicity of the compounds. Materials and methods. The objects of this study were derivatives of 5-(2-bromo-5-methoxyphenyl)-4-R-1,2,4-triazole-3-thiols, synthesized at the Department of Toxicological and Inorganic Chemistry of Zaporizhzhia State Medical and Pharmaceutical University. The nearest neighbor method was used for toxicity evaluation, applying the Toxicity Estimation Software Tool (TEST). The prediction of rats lethal dose (LD50) was based on the structural similarity of the studied compounds with known substances that have experimental toxicity data. Results. The QSAR analysis revealed that structural modifications in the derivatives of 5-(2-bromo-5-methoxyphenyl)-4-R-1,2,4-triazole-3-thiols significantly influence their toxicity. Specifically, increasing the size of the radicals, especially through the introduction of aromatic fragments, contributed to the enhanced safety of the compounds, as evidenced by the increase in LD50 values. The highest LD50 values were observed for compounds containing phenyl radicals. Conclusions. The results of this study indicate the feasibility of using QSAR models to predict the toxicity of 1,2,4-triazole derivatives containing a 2-bromo-5-methoxyphenyl fragment. The observed trend of increasing safety with the introduction of larger aromatic radicals can be used for the rational design of new compounds with improved toxicological properties.

Clinical characteristics and bloodstream infection pathogens by gram-negative bacteria in different aged adults: A retrospective study.

This study aims to determine the characteristics and distribution of pathogenic bacteria in bloodstream infections (BSIs) by gram-negative bacteria in adults. One hundred seventy-one adult patients with BSIs who were treated at the Affiliated Hospital of Chengde Medical College between January 2018 and January 2020 were included in this study. The patients were assigned to the young- and middle-aged group and elderly group based on age. General patient data were analyzed. More elderly patients had BSIs and gram-negative bacteria than young- and middle-aged patients. The incidence of underlying diseases in elderly patients was significantly higher than the young- and middle-aged patients (P < .01). The composition of Brucella spp. was significantly different between the elderly group and young- and middle-aged group (P < .05). There were significantly more gallbladder infections in the elderly group than the young- and middle-aged group, and significantly fewer elderly patients had no definite infection sites than the young- and middle-aged group (P < .05). The incidence of complications and in-hospital mortality in the elderly group was higher than the young- and middle-aged group (P < .05). BSIs caused by gram-negative bacteria mainly involved elderly patients. BSIs were characterized by complications and a poor prognosis, as well as pathogenic bacteria and primary infection sites.

Analysis of influencing factors of clinical pregnancy rate in second cycle intrauterine insemination.

To explore the factors influencing the clinical pregnancy rate in the Reproductive Center of the Affiliated Hospital of North Sichuan Medical College in the second cycle, a retrospective analysis of the clinical data of 175 patients who underwent the second cycle of intrauterine insemination (175 cycles) from July 2019 to July 2022 was performed. According to whether the patients reached clinical pregnancy, they were divided into the pregnant group (32 cycles) and non-pregnant group (143 cycles). The age, infertility years, infertility factors, infertility type, number of sinus follicles, intimal thickness, intimal type, basal follicle-stimulating hormone, basal luteinizing hormone, basal estradiol, stimulation regimen, season, body mass index, and male semen quality were statistically analyzed between the 2 groups. The number of intrauterine insemination (IUI) in the second cycle was 175, and the clinical pregnancy rate was 18.3% (32/175). The age of the pregnant group was lower than that of the non-pregnant group [(26.7 ± 1.07) vs (30.56 ± 0.51), P = .05]. The clinical pregnancy rate in patients aged ≤30 years was significantly higher than that in patients aged > 30 years [28.6% vs 7.1%, P < .05]. Among infertility factors, the pregnancy rate of patients who underwent IUI due to female factors was significantly higher than that of male factors, combined factors (both male and female), and unexplained infertility, and the differences were statistically significant [37.1% vs 22.4%, 18.2%, 3.2%, P < .05]. In multivariate logistic regression analysis, age and infertility factors were independent influencing factors of clinical pregnancy rate in the second cycle of IUI. In, while in artificial insemination, female age and infertility factors were important factors affecting the clinical pregnancy rate of the second cycle of IUI. If the outcome of the first cycle is not pregnant, the female age is <30 years, infertility is the female factor, and the second cycle of IUI can be considered.

Trends and Outcomes of the Management of Common Bile Duct Stones at KIST Medical College Teaching Hospital

Introduction: Common bile duct (CBD) stones are found in 10% to 15% of patient having cholelithiasis. Various surgical methods including endoscopic, laparoscopic and open surgical techniques are practiced but there is no consensus on the management. This cross-sectional study aims to analyze the demographics and trends un management of CBD stones at KIST Medical College. Methods: Patient undergoing CBD stone management from 15 June 2021 to 31 December 2023 were included in the study. Different treatment methods applied and outcomes were analyzed. Results: Fifty-one patients were included in the study with 18 (25.3 %) males and 33 (64.7%) females. Abdominal pain was the most common symptom. Laparoscopic cholecystectomy(LC) with intraoperative(io)-ERCP was done in 30 (58.8%) patients, while LC + Laparoscopic CBD exploration(LCBDE) was done in 11 (21.6 %) and Endoscopic Retrograde Cholangiopancreatography(ERCP) only was done in 10 (19.6%) patients. The significant difference was observed in the length of hospital stay [5.03 ± 2.13 vs 6.36 ± 2.29, p=0.046] and the number of days the drain was kept [2.20 ±0.45 vs 4 ± 1.90, p=0.037] both favoring LC + io-ERCP group. Stone clearance, post-operative complications and operative time were comparable between the two groups. Conclusion: Single-stage management of cholelithiasis and choledocholithiasis is feasible at our center. Both LC with io-ERCP and LC + LCBDE can be performed selectively with acceptable and comparable outcomes.

ON THE 80TH ANNIVERSARY OF THE FOUNDATION OF THE BUKOVINIAN STATE MEDICAL UNIVERSITY: SCIENTIFIC ACHIEVEMENTS

Bukovinian State Medical University is a leading institution of higher medical education in Ukraine, which will celebrate its 80th anniversary in October 2024. The priority direction of the university activity is scientifi c. During the years of its existence the university has created research infrastructure and opportunities for training scientifi c and pedagogical personnel in the specialties «221 Dentistry», «222 Medicine», «223 Nursing» and «228 Pediatrics». The University publishes 7 scientifi c and practical journals, 2 of which are A-rated. The Student Scientifi c Society and the Council of Young Scientists are actively working at the Bukovinian State Medical University. Today the Bukovinian State Medical University confi dently pursues the course of integration into the world scientifi c space. International scientifi c projects, cooperation with the leading research centers of the world, exchange of experience and knowledge – all this makes the University a real fl agship of medical science and practice.

Low antiviral uptake of nirmatrelvir/ritonavir and molnupiravir in adult patients with COVID-19 in Taiwan in 2022.

Antivirals are effective in reducing hospitalisation and death in mild-to-moderate coronavirus 2019 (COVID-19) patients. We estimated the antiviral uptake of nirmatrelvir/ritonavir and molnupiravir in adult patients with a syndrome coronavirus 2 (SARS-CoV-2) infection during the Emergency Use Authorization (EUA) period in Taiwan. A retrospective cohort study was conducted in Taiwan between January 2022 and December 2022. Patients aged ≥18 years with a SARS-CoV-2 infection were included from the Taipei Medical University Clinical Research Database (TMUCRD) and stratified in three risk groups according to World Health Organization criteria. In total, 96 398 COVID-19 patients (mean age 46.7 ± 17.7 years, 45.8% male) were included. Of these patients 69.8% were classified as low risk, 29.8% as moderate risk, and 0.4% as high risk for progression to severe COVID-19. Nirmatrelvir/ritonavir was prescribed in 5.1% of the COVID-19 patients (low risk = 1.0%, moderate risk = 14.3%, high risk = 17.6%). Molnupiravir was prescribed in 1.9% of the COVID-19 patients (low risk = 0.1%, moderate risk = 5.8%, high risk = 6.9%). Nirmatrelvir/ritonavir and molnupiravir were poorly used in the treatment of adult COVID-19 patients in Taiwan during the pandemic in 2022, especially in moderate-to-high risk groups for progression to severe COVID-19.

PSYCHOLOGICAL AND PEDAGOGICAL FEATURES OF ORGANIZING INDEPENDENT WORK OF STUDENTS IN HIGHER MEDICAL EDUCATION INSTITUTIONS DURING THE STUDY OF "OBSTETRICS AND GYNECOLOGY"

Modern medical education faces numerous challenges that require new approaches to student training. In the context of rapid changes in medicine and increasing demands on professionals, it is essential not only to transmit knowledge but also to foster students' ability to work independently and think critically. Psychological and pedagogical aspects of organizing independent learning activities become key to ensuring effective education. Research on motivation, psychological barriers, and innovative teaching methods opens new horizons for developing professional skills in students. The true goal of the educational process is to cultivate not only qualified but also adaptive medical professionals who can respond quickly to changes and challenges in contemporary practice.Aim of the study. To investigate the psychological and pedagogical features of organizing independent work of students in higher medical institutions when studying obstetrics and gynecology, focusing on motivational factors, psychological barriers, and effective teaching methods that promote the development of professional skills and readiness for practical activities.Material and methods. The impact of psychological and pedagogical aspects on organizing independent work of students in higher medical educational institutions during the study of obstetrics and gynecology has been examined, as well as the analysis of scientific articles and research that highlight effective approaches to improving the educational process in this field.Results. The Bologna Declaration emphasizes the importance of student activity and autonomy, making the organization of their independent work particularly relevant in modern conditions. The transition to a credit-module system of education ensures the individualization of the educational process, promoting self-development and active cognitive activity. This system changes traditional approaches to teaching, transforming the roles of instructors in the process. Students become more responsible for their own preparation, which increases their motivation to learn. As a result, independent work becomes a key element in forming professional skills and competencies of future medical practitioners, opening up new opportunities for their development.Conclusions. Independent work of students in the context of a credit-module system of education in a medical university occupies 29% to 42% of educational time and opens up broad opportunities for the development of students' cognitive independence. The main conditions for its effective implementation include motivating students towards this activity, taking into account the psychological characteristics of the youth collective, as well as organizing education with mandatory monitoring of the results of independent work.

Research trends and foci in chondrosarcoma: A bibliometric and network analysis.

Chondrosarcoma is 1 of the most common malignant bone tumors, with dedicated research being conducted by scientists worldwide. The purpose of this study was to guide researchers in identifying valuable scholars, institutions, and countries, provide recommendations for journal submissions, and explore research trends and hotspots in chondrosarcoma studies through literature analysis. Data for this study were collected from the Web of Science Core Collection website. The R package bibliometrix was utilized for citation metrics analysis, VOSviewer for network analysis, and CiteSpace for generating keywords citation burst maps. The analysis focused on publications from 2000 to 2023, identifying trends, authorship patterns, and collaboration networks. A total of 2085 articles were initially identified, but after excluding non-English articles and those outside the study's time range, 2022 articles were included. The field comprised 9954 author records, with an average of 6.37 coauthors per document and 13.9% international co-authorships. Publications in chondrosarcoma research have shown an average annual growth rate of 3.9%. The most influential author identified was Tang Chih-Hsin from China Medical University. Significant contributions came from China Medical University and Leiden University, with China showing a dramatic increase in publications while the United States maintained a leading position in the field. The study highlights an increasing trend in chondrosarcoma research publications and identifies key contributors and institutions. Cancer emerged as 1 of the most influential journals in the field. Future research is likely to focus on targeted therapy for refractory chondrosarcomas, indicating a potential new hotspot in the ongoing efforts to understand and treat this malignancy.

REHABILITATION IN NEPHROLOGY: HISTORY, CURRENT STATE, PROSPECTS

Rehabilitation assistance at healthcare institutions is a comprehensive package of measures designed to enhance the functional abilities of individuals who experience or may potentially experience limitations in their daily functioning within their surrounding environment. Nephrology is a branch of medical science that studies the etiology and pathogenesis of kidney damage, develops and improves diagnostic methods, treatments, and prevention strategies for congenital and acquired primary and secondary kidney damage at all stages of development. Pediatric urological disorders remain a signifi cant concern due to their high prevalence among children. Chronic kidney disease (CKD) is a particularly worrisome complication, as it is characterized by a relapsing nature and the potential for severe complications. The current system of healthcare is regarded as a costly branch of medical services, with expenditures on therapeutic and rehabilitative care (inpatient and outpatient stages) constituting a signifi cant proportion of the overall costs.The article presents the results of an analysis and a summary of the recommendations set forth in international and Ukrainian medicaltechnologicaldocuments based on evidence- based medicine with regard to rehabilitation care in pediatric nephrology. The methodology for establishing a clinical and rehabilitation patient pathway, comprising an individual rehabilitation patient plan, is presented. This pathway considers the most common urinary diseases among children at the hospital district level. The scientifi c research was conducted within the scientifi c focus of the Department of Pediatrics, Neonatology and Perinatal Medicine of Bukovinian State Medical University and the research project entitled «Chronobiological and Adaptive Aspects and Features ofAutonomic Regulation in Pathological Conditions in Children of Diff erent Age Groups.» The registration number is 0122U002245, and the project will run from January 1, 2022, to December 31, 2026.

Exploring Spiritual Care Competency in Palliative Medicine: A Narrative Inquiry of Physician Care Notes on Spiritual Distress.

Background: Spiritual care is a critical component of hospice and palliative medicine; however, physicians frequently lack the necessary competencies to adequately address patients' spiritual needs. This study aims to examine the spiritual care competencies of physicians as reflected in their care notes, thereby providing insights into their approaches for managing spiritual distress. Methods: A narrative inquiry approach was employed to qualitatively analyze interaction notes from 30 palliative care patients experiencing spiritual distress. Data were collected from a medical university professor's care notes between April 2019 and February 2024. Results: The most common form of spiritual distress observed was reluctance to leave life, followed by loss of dignity. Physicians demonstrated expertise in holistic care, addressing physical, psychological, and spiritual needs with a comprehensive approach. Their demeanor reflects acceptance of mortality and acknowledgment of the limitations of medical care, helping foster gratitude and contentment in patients. Effective communication was pivotal, involving the conveyance of information, empathetic engagement, and active listening. Compassionate interactions emphasized the importance of spiritual care in patient-centered care delivery. Conclusions: Spiritual care competencies are essential for improving patient outcomes and advancing comprehensive palliative care. Future efforts should integrate these competencies into communication training within medical education to more effectively enhance health care providers' competencies.