Pub Date : 2022-03-31DOI: 10.15587/2519-4798.2022.256383
K. Shchyrina, S. Koshova, O. Parkhomenko-Kutsevil
The main components of the crisis management system of medical institutions were highlighted. Crisis situations will be understood as the inability of medical institutions to provide the population with medical services on time due to lack of various resources. As a result of catastrophes, natural disasters, armed conflicts, crisis situations arise when medical institutions are not able to fully provide the population with medical services, there is a lack of funding, human and material resources. Ukraine is no exception, as the armed conflict in the East in 2014 and Russia's full-scale invasion of Ukraine confirmed the lack of sufficient labor, logistical resources and financial support to provide quality medical care to the population. In such conditions, there is a need to develop tools, means of overcoming crisis situations in healthcare facilities. The aim of the article is to systematize the recommendations for Ukraine on the formation of a system of crisis management of healthcare facilities. Materials and methods of the research. The basis for the study were provided by private clinics for analysis documents of financial and economic reporting for the pre- and post-crisis periods, as well as scientific works of famous Ukrainian and foreign scientists. The research used methods of analysis, comparison, medical and statistical method and system. The result of the study was an analysis of the state of funding for healthcare facilities in Ukraine and a comparative analysis with the state of funding for such facilities in other developed countries such as Italy, Germany, Sweden, France. Conclusions. The main components of the system of anti-crisis management of medical institutions in crisis conditions are: effective leadership, which is provided by managers and management staff; human resources; equal access to basic medicines, vaccines and technologies of guaranteed quality, safety, efficiency; a functioning health information system has been established; financing of healthcare institutions and their financial protection in case of crisis; the process of providing quality, safe and efficient medical services with minimal expenditure of resources. In most European countries, the basic functions of healthcare management (prioritization, financing, service delivery, supply planning, quality control) are decentralized and carried out at the level of regional or local authorities, or regional health insurance funds or trusts
{"title":"Foreign experience of anti-crisis management of medical institutions","authors":"K. Shchyrina, S. Koshova, O. Parkhomenko-Kutsevil","doi":"10.15587/2519-4798.2022.256383","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.256383","url":null,"abstract":"The main components of the crisis management system of medical institutions were highlighted. Crisis situations will be understood as the inability of medical institutions to provide the population with medical services on time due to lack of various resources. \u0000As a result of catastrophes, natural disasters, armed conflicts, crisis situations arise when medical institutions are not able to fully provide the population with medical services, there is a lack of funding, human and material resources. Ukraine is no exception, as the armed conflict in the East in 2014 and Russia's full-scale invasion of Ukraine confirmed the lack of sufficient labor, logistical resources and financial support to provide quality medical care to the population. In such conditions, there is a need to develop tools, means of overcoming crisis situations in healthcare facilities. \u0000The aim of the article is to systematize the recommendations for Ukraine on the formation of a system of crisis management of healthcare facilities. \u0000Materials and methods of the research. The basis for the study were provided by private clinics for analysis documents of financial and economic reporting for the pre- and post-crisis periods, as well as scientific works of famous Ukrainian and foreign scientists. The research used methods of analysis, comparison, medical and statistical method and system. \u0000The result of the study was an analysis of the state of funding for healthcare facilities in Ukraine and a comparative analysis with the state of funding for such facilities in other developed countries such as Italy, Germany, Sweden, France. \u0000Conclusions. The main components of the system of anti-crisis management of medical institutions in crisis conditions are: effective leadership, which is provided by managers and management staff; human resources; equal access to basic medicines, vaccines and technologies of guaranteed quality, safety, efficiency; a functioning health information system has been established; financing of healthcare institutions and their financial protection in case of crisis; the process of providing quality, safe and efficient medical services with minimal expenditure of resources. In most European countries, the basic functions of healthcare management (prioritization, financing, service delivery, supply planning, quality control) are decentralized and carried out at the level of regional or local authorities, or regional health insurance funds or trusts","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90707401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.15587/2519-4798.2022.256461
D. Mankovskyi
Hypoxic-ischemic lesions of the brain of cardiac surgery patients as a leading factor in stroke have been studied. The importance of prolonged thrombosis, embolism, which exacerbate the general degenerative changes in the central nervous system is recognized. The aim of the research – to study the morphological changes of the vessels of the brain of cardiac surgery patients with postoperative stroke on the background of hypoxic-ischemic complications. Materials and methods. Pieces of cerebral vessels were subjected to microscopic examination. Histological sections were stained according to Van Gieson. Results and their discussion. The study of the structure of the vessels of the brain of persons who were in the group intact to neurological pathology control, showed the presence of anatomical and functional changes that are fully consistent with the sex-age norms of postnatal human ontogenesis. The drugs of the clinical observation group contained signs of pathological changes characteristic of hypoxic-ischemic disorders. It is obvious that their appearance and intensification contributed to the development of ischemic stroke. Structural and functional changes mainly concerned the vascular walls, their layers, paravasal spaces, the blood system as a liquid phase, in fact. Endothelial layer with signs of desquamation. Endothelial cells are characterized by signs of hyperchromia of the nuclei, the shift of the latter in the direction of one of the poles of the cells, the appearance of heterochromatin. Contacts between cells are weakened, defects are visible in the surface layer. Perovascular edema, which is formed in the case of increased permeability, leads to a certain isolation of individual vessels from the surrounding tissues, followed by the development of hypoxia. Defects of the wall layers lead to the activation of the migratory properties of platelets, encourage the appearance of megakaryocytes, erythrocyte thrombi, which are in close contact with the endothelial layer of blood vessels. On histological specimens, brick-red blood clots abundantly cover the damaged inner layer of vascular walls, sometimes completely filling their openings. Over time, defects in the layers of the walls are accompanied by thrombosis, inflammation, edema. Conclusions. Hypoxic-ischemic brain lesions in cardiac surgery patients play a leading role in stroke. Priority is given to hypoxia, which contributes to ischemia, trophic disorders, atrophy, necrosis, necrobiotic changes. The latter are the organic basis of pathogenetic patterns of focal cerebral infarction (with progressive destruction of brain cells, its vessels, the development of prolonged thrombosis, embolism, increased general degenerative changes in the central nervous system)
{"title":"Structural changes of brain vessels in cardiosurgery patients with postoperative stroke","authors":"D. Mankovskyi","doi":"10.15587/2519-4798.2022.256461","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.256461","url":null,"abstract":"Hypoxic-ischemic lesions of the brain of cardiac surgery patients as a leading factor in stroke have been studied. The importance of prolonged thrombosis, embolism, which exacerbate the general degenerative changes in the central nervous system is recognized. \u0000The aim of the research – to study the morphological changes of the vessels of the brain of cardiac surgery patients with postoperative stroke on the background of hypoxic-ischemic complications. \u0000Materials and methods. Pieces of cerebral vessels were subjected to microscopic examination. Histological sections were stained according to Van Gieson. \u0000Results and their discussion. The study of the structure of the vessels of the brain of persons who were in the group intact to neurological pathology control, showed the presence of anatomical and functional changes that are fully consistent with the sex-age norms of postnatal human ontogenesis. \u0000The drugs of the clinical observation group contained signs of pathological changes characteristic of hypoxic-ischemic disorders. It is obvious that their appearance and intensification contributed to the development of ischemic stroke. Structural and functional changes mainly concerned the vascular walls, their layers, paravasal spaces, the blood system as a liquid phase, in fact. Endothelial layer with signs of desquamation. Endothelial cells are characterized by signs of hyperchromia of the nuclei, the shift of the latter in the direction of one of the poles of the cells, the appearance of heterochromatin. Contacts between cells are weakened, defects are visible in the surface layer. Perovascular edema, which is formed in the case of increased permeability, leads to a certain isolation of individual vessels from the surrounding tissues, followed by the development of hypoxia. Defects of the wall layers lead to the activation of the migratory properties of platelets, encourage the appearance of megakaryocytes, erythrocyte thrombi, which are in close contact with the endothelial layer of blood vessels. On histological specimens, brick-red blood clots abundantly cover the damaged inner layer of vascular walls, sometimes completely filling their openings. Over time, defects in the layers of the walls are accompanied by thrombosis, inflammation, edema. \u0000Conclusions. Hypoxic-ischemic brain lesions in cardiac surgery patients play a leading role in stroke. Priority is given to hypoxia, which contributes to ischemia, trophic disorders, atrophy, necrosis, necrobiotic changes. The latter are the organic basis of pathogenetic patterns of focal cerebral infarction (with progressive destruction of brain cells, its vessels, the development of prolonged thrombosis, embolism, increased general degenerative changes in the central nervous system)","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78704899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.15587/2519-4798.2022.254084
Harish Uppala, Mamidi Ajay Kumar, Mohd Moazzam Mohiuddin Ansari
Numerous inhalant anaesthetics are often utilised to provide the optimal operating field required for successful endoscopic sinus surgery (ESS). Modern inhaled anaesthetics such as Sevoflurane and Desflurane enable rapid induction and recovery because to their low blood-gas partition coefficients. The aim: The goal of this study is to compare desflurane with sevoflurane's recovery qualities after functional endoscopic sinus surgery. Materials and methods: The present study was a prospective, randomised, comparative clinical trial that included participants scheduled to have functional endoscopic sinus surgery. The study included 60 ASA I and II patients scheduled for FESS under general anaesthesia and divided them into two groups of 30 each: group D (Desflurane) and group S (Sevoflurane). Results: There was no statistically significant difference in the age, gender, ASA grade, or mean weight distributions between the two groups (p>0.05). There was no statistically significant difference in the mean length of operation or anaesthesia between the two groups. Hemodynamic variables did not alter much. Time in minutes for eye opening (p<0.001) was significantly shorter in group D (Desflurane) than in group S (Sevoflurane). Time in minutes for extubation (p<0.001) was significantly shorter in group D (Desflurane) 6.53±1.14 than in group S (Sevoflurane) 9.37±1.30. Time in minutes for obeying commands (p<0.001) was significantly shorter in group D (Desflurane) 7.87±1.11 than in group S (Sevoflurane) 11.33±1.51. Conclusion: In patients receiving FESS time taken for eye opening, extubation and time taken for obeying commands from termination of anesthetic is significantly shorter with desflurane (group D) when compared with sevoflurane (group S). So desflurane was linked to a quicker early recovery than sevoflurane.
{"title":"Comparative study of recovery parameters of Desflurane and Sevoflurane in functional endoscopic sinus surgery","authors":"Harish Uppala, Mamidi Ajay Kumar, Mohd Moazzam Mohiuddin Ansari","doi":"10.15587/2519-4798.2022.254084","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.254084","url":null,"abstract":"Numerous inhalant anaesthetics are often utilised to provide the optimal operating field required for successful endoscopic sinus surgery (ESS). Modern inhaled anaesthetics such as Sevoflurane and Desflurane enable rapid induction and recovery because to their low blood-gas partition coefficients. \u0000The aim: The goal of this study is to compare desflurane with sevoflurane's recovery qualities after functional endoscopic sinus surgery. \u0000Materials and methods: The present study was a prospective, randomised, comparative clinical trial that included participants scheduled to have functional endoscopic sinus surgery. The study included 60 ASA I and II patients scheduled for FESS under general anaesthesia and divided them into two groups of 30 each: group D (Desflurane) and group S (Sevoflurane). \u0000Results: There was no statistically significant difference in the age, gender, ASA grade, or mean weight distributions between the two groups (p>0.05). There was no statistically significant difference in the mean length of operation or anaesthesia between the two groups. Hemodynamic variables did not alter much. Time in minutes for eye opening (p<0.001) was significantly shorter in group D (Desflurane) than in group S (Sevoflurane). Time in minutes for extubation (p<0.001) was significantly shorter in group D (Desflurane) 6.53±1.14 than in group S (Sevoflurane) 9.37±1.30. Time in minutes for obeying commands (p<0.001) was significantly shorter in group D (Desflurane) 7.87±1.11 than in group S (Sevoflurane) 11.33±1.51. \u0000Conclusion: In patients receiving FESS time taken for eye opening, extubation and time taken for obeying commands from termination of anesthetic is significantly shorter with desflurane (group D) when compared with sevoflurane (group S). So desflurane was linked to a quicker early recovery than sevoflurane.","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85252066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.15587/2519-4798.2022.255487
Rizvan Abdullaeiv, I. Mamedov
The aim: to assess the value of ultrasonography in the diagnosis of a lumbar herniation disc in young adults. Material and methods: 27 patients aged 17-21 years (8 girls, 19 boys) were included in our study. During the examination by a neurologist, all patients reported pain in the lower back. The results of the ultrasound investigation were compared with MRI. Ultrasonography (USG) was conducted on a Philips HD 11XE device using a convection transducer in the frequency range 2-5 MHz; MRI - General Electric, Signa HDI, 1.5T. Results: at the L3-L4 segment, hernia was diagnosed in 2 (7.4±5.0 %) cases, at the L4-L5 segment - in 14 (51.9±9.6 %) cases, and at the L5-S1 segment - in 11 (40.7±9.5 %) cases, respectively. The hernia at the segments of L5-S1 and L4-L5 was diagnosed significantly (P<0.001) more often than at the segment of L3-L4. Median hernia was diagnosed in 12 (44.4±9.6 %) cases, paramedian - in 11 (40.7±9.5 %) cases and posterolateral - in 4 ( 14.8±6.8 %) cases, respectively. The median and paramedian hernia was diagnosed significantly (P<0.05) more than the posterolateral. In ultrasound, only in one case, a posterolateral hernia was interpreted as paramedian Conclusions: 1) The lumbar hernia are localized at the segments of L5-S1 and L4-L5 significantly (P<0.001) more often than at the other segments; 2) Sciatica is significantly more common in posterolateral localization of lumbar disc herniation; 3) The ultrasonography couldbe used to find out the causes of back pain in young adult
目的:评价超声检查对青壮年腰椎间盘突出症的诊断价值。材料与方法:27例患者，年龄17-21岁，其中女孩8例，男孩19例。在神经科医生的检查中，所有患者都报告腰背部疼痛。将超声检查结果与MRI检查结果进行比较。超声(USG)在Philips HD 11XE设备上进行，使用频率范围为2-5 MHz的对流换能器;MRI -通用电气，Signa HDI, 1.5T。结果:L3-L4节段疝2例(7.4±5.0%)，L4-L5节段疝14例(51.9±9.6%)，L5-S1节段疝11例(40.7±9.5%)。L5-S1节段和L4-L5节段疝的诊断率明显高于L3-L4节段(P<0.001)。中位疝12例(44.4±9.6%)，旁位疝11例(40.7±9.5%)，后外侧疝4例(14.8±6.8%)。正中疝和旁正中疝的诊断率明显高于后外侧疝(P<0.05)。结论:1)腰椎疝定位于L5-S1节段和L4-L5节段的发生率明显高于其他节段(P<0.001);2)坐骨神经痛在腰椎间盘突出症后外侧定位中更为常见;3)超声检查可以发现青壮年背部疼痛的原因
{"title":"Ultrasonography in the diagnosis of lumbar disc herniation in young adult","authors":"Rizvan Abdullaeiv, I. Mamedov","doi":"10.15587/2519-4798.2022.255487","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.255487","url":null,"abstract":"The aim: to assess the value of ultrasonography in the diagnosis of a lumbar herniation disc in young adults. \u0000Material and methods: 27 patients aged 17-21 years (8 girls, 19 boys) were included in our study. During the examination by a neurologist, all patients reported pain in the lower back. The results of the ultrasound investigation were compared with MRI. Ultrasonography (USG) was conducted on a Philips HD 11XE device using a convection transducer in the frequency range 2-5 MHz; MRI - General Electric, Signa HDI, 1.5T. \u0000Results: at the L3-L4 segment, hernia was diagnosed in 2 (7.4±5.0 %) cases, at the L4-L5 segment - in 14 (51.9±9.6 %) cases, and at the L5-S1 segment - in 11 (40.7±9.5 %) cases, respectively. The hernia at the segments of L5-S1 and L4-L5 was diagnosed significantly (P<0.001) more often than at the segment of L3-L4. Median hernia was diagnosed in 12 (44.4±9.6 %) cases, paramedian - in 11 (40.7±9.5 %) cases and posterolateral - in 4 ( 14.8±6.8 %) cases, respectively. The median and paramedian hernia was diagnosed significantly (P<0.05) more than the posterolateral. In ultrasound, only in one case, a posterolateral hernia was interpreted as paramedian \u0000Conclusions: 1) The lumbar hernia are localized at the segments of L5-S1 and L4-L5 significantly (P<0.001) more often than at the other segments; 2) Sciatica is significantly more common in posterolateral localization of lumbar disc herniation; 3) The ultrasonography couldbe used to find out the causes of back pain in young adult","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"159 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86393833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.15587/2519-4798.2022.256406
O. Proshchenko, I. Ventskivska
The study examined the development of posthysterectomy syndrome in patients after hysterectomy with preservation of ovarian tissue. The aim of the study was to assess the functionality of ovarian tissue in patients with hysterectomy and opportunistic salpingectomy performed for uterine fibroids. Materials and methods of the research. The study was performed in 160 women of reproductive age. The first group included 90 patients after vaginal hysterectomy with tubectomy and associated with laparoscopy, the second group - 70 patients after abdominal hysterectomy with tubectomy. The control group included 50 women of reproductive age 45.7±1.3 years with asymptomatic fibroids. The diagnostic algorithm included assessment of hormonal status and instrumental study of structural and functional parameters of ovarian tissue both at the stage of preoperative observation and for 12 months, 3 and 5 years after surgery. Research results and their discussion. At the preoperative stage in both groups found a higher percentage of thyroid disease, hypertension and metabolic disorders, as well as combined proliferative processes of the uterus. Normal ultrasound picture of the ovaries was found in 67.8 % - in the first group and in 47.1 % - in the second group. Significant increase in blood flow in the ovarian artery, in the remote period showing atrophic changes with the development of ovarian depletion syndrome. Assessment of hormonal status in both groups shows marked changes in baseline levels of gonadotropic hormones (FSH and LH): increase in baseline FSH levels by 2.2 times, LH - 1.5 times against the control group (p <0.05), dyshormonal disorders persist for up to 5 years after surgery in one third of cases, and up to 36 months - there is an increase in the proportion of cystic and trophic changes, most pronounced in patients with reduced ovarian reserve, dysmetabolic manifestations and combined proliferative processes of the uterus and appendages before surgery, and syndrome chronic pelvic pain and venous pelvic blood supply in the postoperative period. Conclusions. The technique of performing a hysterectomy does not have a significant effect on the functional state of the ovaries in the long term. The main indicators of ovarian blood flow and steroid hormone production after hysterectomy with opportunistic salpingectomy for uterine fibroids are close to the reference values up to 36 months postoperatively
{"title":"Hysterectomy with opportunistic salpingectomy and its influence on structural-functional parameters of ovarian tissue","authors":"O. Proshchenko, I. Ventskivska","doi":"10.15587/2519-4798.2022.256406","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.256406","url":null,"abstract":"The study examined the development of posthysterectomy syndrome in patients after hysterectomy with preservation of ovarian tissue. \u0000The aim of the study was to assess the functionality of ovarian tissue in patients with hysterectomy and opportunistic salpingectomy performed for uterine fibroids. \u0000Materials and methods of the research. The study was performed in 160 women of reproductive age. The first group included 90 patients after vaginal hysterectomy with tubectomy and associated with laparoscopy, the second group - 70 patients after abdominal hysterectomy with tubectomy. The control group included 50 women of reproductive age 45.7±1.3 years with asymptomatic fibroids. The diagnostic algorithm included assessment of hormonal status and instrumental study of structural and functional parameters of ovarian tissue both at the stage of preoperative observation and for 12 months, 3 and 5 years after surgery. \u0000Research results and their discussion. At the preoperative stage in both groups found a higher percentage of thyroid disease, hypertension and metabolic disorders, as well as combined proliferative processes of the uterus. Normal ultrasound picture of the ovaries was found in 67.8 % - in the first group and in 47.1 % - in the second group. Significant increase in blood flow in the ovarian artery, in the remote period showing atrophic changes with the development of ovarian depletion syndrome. Assessment of hormonal status in both groups shows marked changes in baseline levels of gonadotropic hormones (FSH and LH): increase in baseline FSH levels by 2.2 times, LH - 1.5 times against the control group (p <0.05), dyshormonal disorders persist for up to 5 years after surgery in one third of cases, and up to 36 months - there is an increase in the proportion of cystic and trophic changes, most pronounced in patients with reduced ovarian reserve, dysmetabolic manifestations and combined proliferative processes of the uterus and appendages before surgery, and syndrome chronic pelvic pain and venous pelvic blood supply in the postoperative period. \u0000Conclusions. The technique of performing a hysterectomy does not have a significant effect on the functional state of the ovaries in the long term. The main indicators of ovarian blood flow and steroid hormone production after hysterectomy with opportunistic salpingectomy for uterine fibroids are close to the reference values up to 36 months postoperatively","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80503434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.15587/2519-4798.2022.256457
Vitaly Yunger, Z. Hbur, I. Krylova
Highlights the essence of the concept of “self-management” and provides its author's interpretation. The goals and objectives of self-management in general and separately in the field of health care are considered. It was found that in order to effectively manage the staff of a health care institution, the manager, first of all, needs to know the science and art of self-management. General and local principles of science and practice of self-management are indicated. The aim of the article is to develop and analyze the main features of self-management as the basis of success of a modern health care manager. Materials and research methods are general scientific research methods such as systems analysis, comparison, generalization, swat analysis, forecasting. Studying the already studied components of the selected topic, such research methods as generalization, comparison, systems analysis were used. The basis for the study were the works of domestic and foreign scientists. Results: the article establishes that self-management helps the leader: rationally organize their work and the work of their subordinates; realize professional and life goals; avoid stressful situations; increase efficiency; enjoy the work done. An analysis of the scientific literature has led to the conclusion that strong leadership is important to ensure the success of any medical institution. A manager who pays due attention to self-development is the key to the success of a healthy atmosphere in the team. Research indicates a high level of professionalism and creativity achieved by managers only when they have a need for professional self-development, self-improvement, as well as when they show a motivational and value attitude to themselves as a subject of medical activity. Conclusions. Summarizing the above, it should be emphasized that self-management certainly affects the development of the modern manager of health care, so the following suggestions for the implementation of this method: to overcome administrative barriers to maintaining old management methods; to avoid problems caused by the inertial nature of public consciousness; reduce the level of conflict in the team; to overcome differences in professional competence; instill immunity to the fear of sanctions of the team - ridicule, overt and covert condemnation, ignorance
{"title":"Self management as the key to the success of a modern health manager","authors":"Vitaly Yunger, Z. Hbur, I. Krylova","doi":"10.15587/2519-4798.2022.256457","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.256457","url":null,"abstract":"Highlights the essence of the concept of “self-management” and provides its author's interpretation. The goals and objectives of self-management in general and separately in the field of health care are considered. It was found that in order to effectively manage the staff of a health care institution, the manager, first of all, needs to know the science and art of self-management. General and local principles of science and practice of self-management are indicated. \u0000The aim of the article is to develop and analyze the main features of self-management as the basis of success of a modern health care manager. \u0000Materials and research methods are general scientific research methods such as systems analysis, comparison, generalization, swat analysis, forecasting. Studying the already studied components of the selected topic, such research methods as generalization, comparison, systems analysis were used. The basis for the study were the works of domestic and foreign scientists. \u0000Results: the article establishes that self-management helps the leader: rationally organize their work and the work of their subordinates; realize professional and life goals; avoid stressful situations; increase efficiency; enjoy the work done. An analysis of the scientific literature has led to the conclusion that strong leadership is important to ensure the success of any medical institution. A manager who pays due attention to self-development is the key to the success of a healthy atmosphere in the team. Research indicates a high level of professionalism and creativity achieved by managers only when they have a need for professional self-development, self-improvement, as well as when they show a motivational and value attitude to themselves as a subject of medical activity. \u0000Conclusions. Summarizing the above, it should be emphasized that self-management certainly affects the development of the modern manager of health care, so the following suggestions for the implementation of this method: to overcome administrative barriers to maintaining old management methods; to avoid problems caused by the inertial nature of public consciousness; reduce the level of conflict in the team; to overcome differences in professional competence; instill immunity to the fear of sanctions of the team - ridicule, overt and covert condemnation, ignorance","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85085774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.15587/2519-4798.2022.254037
Sravanthi Kanumuri, Jaya Durga Chalamalasetty, A. Reddy, Sridhar Punyapu, Raghavendra Damam, Narella Vasumathi Sai Lakshmi Sri
Benign breast disorders are usually hormone induced and therefore usually seen in the reproductive period of life with dramatic fall in incidence after menopause. As compared to breast cancers, benign breast lesions are 10 times more common. The aim of the study was to determine the spectrum and incidence of various benign breast diseases in female patients attending our institute and to compare the results with those of other studies. Material and methods: 80 cases of benign breast diseases which were clinically diagnosed and confirmed pathologically or radiologically were subjected for therapeutic interventions and the results were analysed. Results: In the present study of 80 cases, the age group most affected by benign breast diseases was 21-30 years. 63 patients (78.8 %) presented with lump in the breast and 23 patients’ common symptom is pain. In most of the cases of lump had duration between 7-12 months (38.8 %), pain for 1-5 days (13.8 %), discharge for 0-5 days (11.3 %). Both breasts were involved in 6 cases (7.5 %) whereas right and left breasts are equally involved in 47 cases each (46.25 %). Most of the patients were nulliparous (46.3 %) followed by multiparous (38.8 %) and uniparous (15.0 %). Fibroadenoma constituted in 53.8 % of patients (44 cases), breast abscess constituted 21.25 % (17 cases). The most commonly affected age group was 21-30 years. 63 patients (78.8 %) presented with lump in the breast and 23 patients presented with pain. HRUSG findings correlated with that of clinical diagnosis in 70 cases. 60 cases underwent core biopsy, and in 41 cases (68.33 %) there were fibroadenoma and 7 cases (11.66 %) fibro adenosis. 59 cases (73.75 %) underwent excision, and 18 cases (22.5 %) incision and drainage. Conclusion: The most common benign breast disease was fibroadenoma. Most common age group affected with benign breast disease was 21-30 years. 88.7 % of clinical diagnosis, 90.3 % of radiological diagnosis, 93.3 % of core needle biopsy diagnoses were correlating with the histopathology diagnosis
{"title":"A study of benign breast disease management based on clinical, radiological and pathological assessment","authors":"Sravanthi Kanumuri, Jaya Durga Chalamalasetty, A. Reddy, Sridhar Punyapu, Raghavendra Damam, Narella Vasumathi Sai Lakshmi Sri","doi":"10.15587/2519-4798.2022.254037","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.254037","url":null,"abstract":"Benign breast disorders are usually hormone induced and therefore usually seen in the reproductive period of life with dramatic fall in incidence after menopause. As compared to breast cancers, benign breast lesions are 10 times more common. \u0000The aim of the study was to determine the spectrum and incidence of various benign breast diseases in female patients attending our institute and to compare the results with those of other studies. \u0000Material and methods: 80 cases of benign breast diseases which were clinically diagnosed and confirmed pathologically or radiologically were subjected for therapeutic interventions and the results were analysed. \u0000Results: In the present study of 80 cases, the age group most affected by benign breast diseases was 21-30 years. 63 patients (78.8 %) presented with lump in the breast and 23 patients’ common symptom is pain. In most of the cases of lump had duration between 7-12 months (38.8 %), pain for 1-5 days (13.8 %), discharge for 0-5 days (11.3 %). Both breasts were involved in 6 cases (7.5 %) whereas right and left breasts are equally involved in 47 cases each (46.25 %). Most of the patients were nulliparous (46.3 %) followed by multiparous (38.8 %) and uniparous (15.0 %). Fibroadenoma constituted in 53.8 % of patients (44 cases), breast abscess constituted 21.25 % (17 cases). The most commonly affected age group was 21-30 years. 63 patients (78.8 %) presented with lump in the breast and 23 patients presented with pain. HRUSG findings correlated with that of clinical diagnosis in 70 cases. 60 cases underwent core biopsy, and in 41 cases (68.33 %) there were fibroadenoma and 7 cases (11.66 %) fibro adenosis. 59 cases (73.75 %) underwent excision, and 18 cases (22.5 %) incision and drainage. \u0000Conclusion: The most common benign breast disease was fibroadenoma. Most common age group affected with benign breast disease was 21-30 years. 88.7 % of clinical diagnosis, 90.3 % of radiological diagnosis, 93.3 % of core needle biopsy diagnoses were correlating with the histopathology diagnosis","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76240210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.15587/2519-4798.2022.253953
Olunike Blessing Olofinbiyi
Health promotion is the best way to prevent mental illness and other illnesses in the community. However, the high rate of corruption and embezzlement of funds has impeded the effectiveness of health promotion in Primary health care system in Nigeria. More so, health promotion is the best way to alleviate diseases and prevent diseases. However, nearly all the health care workers are aware of the benefits of health promotion but to implement it is the problem. The aim: to examine the effect of health promotion on primary health care service through the analysis of Primary Health Care policy. Method: this study was guided by a pragmatic paradigm. The pragmatist paradigm is highly essential to this study because it emphasizes the link between action and truth. It is also ideal for this study as it advocates for mixed methods that are in line with ethnographic research approach to provide the best understanding of a research problem. Furthermore, pragmatic paradigm was adopted for this study and this paradigm encourages the study to combine two research methods (qualitative and quantitative) to achieve quality research findings. In this study a non-experimental, exploratory-descriptive design was used to analyse the quantitative aspect of the national health policies on primary health care service delivery in Nigeria. While ethnographic method analysed the qualitative aspect of the study perfectly. Result: out of three hundred respondents, majority of them revealed that bad leadership is the main reason why health promotion is not effective. While majority of the participants opined that we lack good leaders. The study hereby emphasized more on why the Government is not working on the effectiveness of health promotion in PHC and the findings showed that bad leadership is the main factor that is causing the ineffectiveness of health promotion in PHC and when the respondents were questioned on what to do to ensure a more effective health promotion in the community, majority (34.7 %) of the respondents opined that the community members should be involved actively at every stage while (33.3 %) of the respondents revealed that there is need for active involvement of other essential sectors in formulation and implementation of PHC policy to ensure a permanent change. Conclusion: all things considering, this study shows that poor health promotion in Primary health care is having negative effect on the health of children, adolescents, adults, and old ones. This study here by recommends that the policy makers and the government should eradicate corruption and embezzlement of funds in all sectors especially in primary health care
{"title":"The effect of health promotion on primary health care services: an analysis of primary health care policy","authors":"Olunike Blessing Olofinbiyi","doi":"10.15587/2519-4798.2022.253953","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.253953","url":null,"abstract":"Health promotion is the best way to prevent mental illness and other illnesses in the community. However, the high rate of corruption and embezzlement of funds has impeded the effectiveness of health promotion in Primary health care system in Nigeria. More so, health promotion is the best way to alleviate diseases and prevent diseases. However, nearly all the health care workers are aware of the benefits of health promotion but to implement it is the problem.\u0000The aim: to examine the effect of health promotion on primary health care service through the analysis of Primary Health Care policy.\u0000Method: this study was guided by a pragmatic paradigm. The pragmatist paradigm is highly essential to this study because it emphasizes the link between action and truth. It is also ideal for this study as it advocates for mixed methods that are in line with ethnographic research approach to provide the best understanding of a research problem.\u0000Furthermore, pragmatic paradigm was adopted for this study and this paradigm encourages the study to combine two research methods (qualitative and quantitative) to achieve quality research findings. In this study a non-experimental, exploratory-descriptive design was used to analyse the quantitative aspect of the national health policies on primary health care service delivery in Nigeria. While ethnographic method analysed the qualitative aspect of the study perfectly.\u0000Result: out of three hundred respondents, majority of them revealed that bad leadership is the main reason why health promotion is not effective. While majority of the participants opined that we lack good leaders. The study hereby emphasized more on why the Government is not working on the effectiveness of health promotion in PHC and the findings showed that bad leadership is the main factor that is causing the ineffectiveness of health promotion in PHC and when the respondents were questioned on what to do to ensure a more effective health promotion in the community, majority (34.7 %) of the respondents opined that the community members should be involved actively at every stage while (33.3 %) of the respondents revealed that there is need for active involvement of other essential sectors in formulation and implementation of PHC policy to ensure a permanent change.\u0000Conclusion: all things considering, this study shows that poor health promotion in Primary health care is having negative effect on the health of children, adolescents, adults, and old ones. This study here by recommends that the policy makers and the government should eradicate corruption and embezzlement of funds in all sectors especially in primary health care","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72931712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.15587/2519-4798.2022.255539
R. Abdullaiev, I. Voronzhev
The aim: to evaluate the possibilities of ultrasonography in the diagnosis of herniated cervical intervertebral discs in young people. Material and methods: an analysis of the results of USG in 29 patients with cervical IVD hernia revealed by MRI from 123 patients aged 18–44 years, with complaints of neck pain of varying intensity, duration, and irradiation. 23 (79.3 %) patients had clinical signs of cervical radiculopathy. The results of the ultrasonography (USG) were compared with MRI. USG was conducted on a Philips HD 11XE scanner using a 4–9 MHz frequency transducer; MRI – General Electric, Signa HDI, 1.5T. Results: in 13 (44.8±9.2 %) cases the hernia was registered in the C5-C6 disk, in 12 (41.4±9.0 %) – in the C4-C5 disk, in 2 (6.9±4.7 %) – in the disk C3-C4 and in 2 (6.9±4.7 %) – in the disk C6-C7. In discs C5-C6 and C4-C5 hernia was formed significantly (p<0.01 and p<0.001) more often than in discs C2-C3 and C6-C7. Paramedian hernia was diagnosed in 13 (44.8±9.2 %) cases, posterior – in 12 (41.4±9.1 %), median – in 4 (13.8±6.4 %). Paramedian and posterolateral hernias were registered significantly more often than median (p<0.01 and p<0.05). Conclusions: A direct sign of a herniated cervical intervertebral disc is its uneven protrusion with a discontinuous image of the fibrous ring into the lumen of the spinal canal and spinal nerve canal more than 4 mm. An indirect sign of a herniated cervical intervertebral disc is a local deformation of the anterior epidural space with the absence of its visualization. Ultrasonography is a reliable method for diagnosing herniated cervical intervertebral discs, both in segments and inside the spinal canal. The method can be used to find out the causes of neck pain in young people
目的:探讨超声诊断青年人颈椎间盘突出症的可能性。材料与方法:对123例18-44岁颈部疼痛程度、持续时间、照射程度不同的患者，经MRI检查发现颈IVD疝29例，USG检查结果进行分析。23例(79.3%)患者有颈椎神经根病的临床症状。超声检查结果与MRI检查结果进行比较。USG在Philips HD 11XE扫描仪上进行，使用4-9 MHz频率换能器;MRI -通用电气，Signa HDI, 1.5T。结果:13例(44.8±9.2%)发生在C5-C6椎间盘，12例(41.4±9.0%)发生在C4-C5椎间盘，2例(6.9±4.7%)发生在C3-C4椎间盘，2例(6.9±4.7%)发生在C6-C7椎间盘。C5-C6、C4-C5椎间盘疝的发生率明显高于C2-C3和C6-C7椎间盘(p<0.01和p<0.001)。诊断为旁膈疝13例(44.8±9.2%)，后膈疝12例(41.4±9.1%)，中膈疝4例(13.8±6.4%)。旁疝和后外侧疝的发生率明显高于中位疝(p<0.01和p<0.05)。结论:颈椎间盘突出的直接标志是其不均匀的突出，纤维环进入椎管腔和脊神经管超过4毫米。颈椎间盘突出的一个间接征象是前硬膜外间隙局部变形且不可见。超声检查是一种可靠的方法诊断颈椎间盘突出，无论是在节段和椎管内。该方法可用于找出年轻人颈部疼痛的原因
{"title":"B-mode ultrasonography of herniated cervical discs in young people","authors":"R. Abdullaiev, I. Voronzhev","doi":"10.15587/2519-4798.2022.255539","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.255539","url":null,"abstract":"The aim: to evaluate the possibilities of ultrasonography in the diagnosis of herniated cervical intervertebral discs in young people. \u0000Material and methods: an analysis of the results of USG in 29 patients with cervical IVD hernia revealed by MRI from 123 patients aged 18–44 years, with complaints of neck pain of varying intensity, duration, and irradiation. 23 (79.3 %) patients had clinical signs of cervical radiculopathy. The results of the ultrasonography (USG) were compared with MRI. USG was conducted on a Philips HD 11XE scanner using a 4–9 MHz frequency transducer; MRI – General Electric, Signa HDI, 1.5T. \u0000Results: in 13 (44.8±9.2 %) cases the hernia was registered in the C5-C6 disk, in 12 (41.4±9.0 %) – in the C4-C5 disk, in 2 (6.9±4.7 %) – in the disk C3-C4 and in 2 (6.9±4.7 %) – in the disk C6-C7. In discs C5-C6 and C4-C5 hernia was formed significantly (p<0.01 and p<0.001) more often than in discs C2-C3 and C6-C7. Paramedian hernia was diagnosed in 13 (44.8±9.2 %) cases, posterior – in 12 (41.4±9.1 %), median – in 4 (13.8±6.4 %). Paramedian and posterolateral hernias were registered significantly more often than median (p<0.01 and p<0.05). \u0000Conclusions: A direct sign of a herniated cervical intervertebral disc is its uneven protrusion with a discontinuous image of the fibrous ring into the lumen of the spinal canal and spinal nerve canal more than 4 mm. An indirect sign of a herniated cervical intervertebral disc is a local deformation of the anterior epidural space with the absence of its visualization. Ultrasonography is a reliable method for diagnosing herniated cervical intervertebral discs, both in segments and inside the spinal canal. The method can be used to find out the causes of neck pain in young people","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90189238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-30DOI: 10.15587/2519-4798.2022.252919
V. Bereznyakov
The aim of study was to study of cytokine production levels and their relationship in the mechanisms of regulation of the inflammatory process in community-acquired pneumonia. Materials and methods. The study was carried out in the period 2017–2020 based on the therapeutic department of the Municipal non-profit enterprise “City Clinical Multidisciplinary Hospital No. 25” of Kharkiv City Council. The study involved 34 adult patients with CAP aged 18 to 80 years (mean age 36.5±10.3). The control group consisted of 20 apparently healthy individuals (mean age 39.5±12.5). Levels of IL-17, IL-1Ra, TGFβ1, visfatin, adiponectin were determined by enzyme-linked immunosorbent assay. Results. Levels of IL-1 Ra and IL-17 in the group of patients with САP were 3.77±0.24 and 33.08±0.10 pg/ml, respectively. In the PРI group, the level of these indicators was probably higher (p<0.05) and was 2.53±0.13 and 28.17±0.53 pg/ml. The level of TGFβ1 in the group of patients with CAP was 24.54±0.55 ng/ml and was slightly higher than in the group of AHI (26.33±0.62 ng/ml). No differences were found between adiponectin levels in the AHI group and patients with CAP, as in the case of visfatin levels. The disappearance of relationships in the system of normal regulation of the inflammatory process between one pair of cytokines and their appearance between other pairs indicates a violation of regulatory mechanisms in patients with community-acquired pneumonia. Conclusions. The identified characteristics of the cytokine profile reflect the end of the phase of active inflammation in the lungs and the beginning of the phase of compensatory reactions. The findings suggest the importance of studying the cytokine profile in patients with community-acquired pneumonia, which will help to develop new approaches to predict the course of pneumonia, ways to correct metabolic disorders that develop in this condition, and will help identify risk groups for this pathology
{"title":"Interrelations of cytokine production levels in the mechanisms of inflammatory process regulation in patients with community-acquired pneumonia","authors":"V. Bereznyakov","doi":"10.15587/2519-4798.2022.252919","DOIUrl":"https://doi.org/10.15587/2519-4798.2022.252919","url":null,"abstract":"The aim of study was to study of cytokine production levels and their relationship in the mechanisms of regulation of the inflammatory process in community-acquired pneumonia. \u0000Materials and methods. The study was carried out in the period 2017–2020 based on the therapeutic department of the Municipal non-profit enterprise “City Clinical Multidisciplinary Hospital No. 25” of Kharkiv City Council. The study involved 34 adult patients with CAP aged 18 to 80 years (mean age 36.5±10.3). The control group consisted of 20 apparently healthy individuals (mean age 39.5±12.5). Levels of IL-17, IL-1Ra, TGFβ1, visfatin, adiponectin were determined by enzyme-linked immunosorbent assay. \u0000Results. Levels of IL-1 Ra and IL-17 in the group of patients with САP were 3.77±0.24 and 33.08±0.10 pg/ml, respectively. In the PРI group, the level of these indicators was probably higher (p<0.05) and was 2.53±0.13 and 28.17±0.53 pg/ml. The level of TGFβ1 in the group of patients with CAP was 24.54±0.55 ng/ml and was slightly higher than in the group of AHI (26.33±0.62 ng/ml). No differences were found between adiponectin levels in the AHI group and patients with CAP, as in the case of visfatin levels. The disappearance of relationships in the system of normal regulation of the inflammatory process between one pair of cytokines and their appearance between other pairs indicates a violation of regulatory mechanisms in patients with community-acquired pneumonia. \u0000Conclusions. The identified characteristics of the cytokine profile reflect the end of the phase of active inflammation in the lungs and the beginning of the phase of compensatory reactions. The findings suggest the importance of studying the cytokine profile in patients with community-acquired pneumonia, which will help to develop new approaches to predict the course of pneumonia, ways to correct metabolic disorders that develop in this condition, and will help identify risk groups for this pathology","PeriodicalId":21672,"journal":{"name":"ScienceRise: Medical Science","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84417982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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