Introduction: The fact that learning is moving online is probably a disappointment to most medical students. This is especially true for middle and senior students, in whom most disciplines are clinical and focus on practical work with patients. During the period of forced social distancing and online learning in connection with the COVID-19 pandemic, such a common way of learning became impossible. All these changes obviously affect the mental health of medical students, who are already at risk for such phenomenon as procrastination and disorders as anxiety and depression. Purpose: Investigate and evaluate the level of anxiety, depression, and the nature of the manifestation of procrastination in medical students Faculty of Medicine and the Faculty of Training Foreign Citizens (FTFC) of Ivano-Frankivsk National Medical University (IFNMU) in a period of altered psycho-emotional state during the period of forced social distancing and its impact on academic performance. Methodology: 212 medical students were interviewed. The survey was voluntary and anonymous. We used two clinical test methods to identify emotional disturbances: the Hospital Anxiety and Depression Scale (HADS) and the Montgomery-Asberg Depression Rating Scale (MADRS) (Zigmond A.S. et.al.,1983; Svanborg P., 2001). In order to assess the propensity of students to procrastinate, we also used the "Questionnaire to study the propensity of the individual to procrastination" (Shivari ,O.A., 2015), which is a modification of the "General Procrastination Scale" (Lay, C., 1986) and consists of two scales: "Personally conditioned procrastination scale" (Scale I) and "Situationally conditioned procrastination scale" (Scale II). The statistical analysis of the results was performed using STATISTICA 7.0 software packages and the package of statistical functions of Microsoft Excel. Results and Discussion: During the testing, students note that the most important problem for them is time management. The analysis of the results survey by "Personally conditioned procrastination scale" (Scale I) "showed that 15% of the students have a low, 47.5% - medium, 37.5% - high level of personal propensity to procrastination. The analysis of the results "Situationally conditioned procrastination scale" (Scale II) showed that 25% of students have a low level of situational procrastination, 37.5% - medium and 37.5% - high, respectively. The study of the relationship between the level of propensity to procrastination (Scale I) and academic performance in medical students showed that in the group with low procrastination the success rate is higher than in groups with medium and high procrastination (r = -0.58; p <0.05). We also established a direct correlation between the Scale II indicators and the average academic performance indicators. After the survey and analysis of the results on the HADS and MADRS scales, we found a clear relationship between increased learning during the period of altered psychoemotional state and the severity of anxiety-depressive symptoms in medical students, which manifested itself in an increase in the level of anxiety and mood disorders of varying degrees. Conclusions: Thus, procrastination that occurs in the surveyed medical students in the period of altered psycho-emotional state during forced social distancing because of pandemic COVID-19 has had "situational" situational nature. Besides, the study confirmed that the pandemic of COVID-19, as a stressful moment of the external test of identity, caused the emergence of protective mechanisms in medical students in the form of emotional and behavioral changes and disorders. The results obtained indicate the presence of adjustment disorders in the period of the altered psychoemotional state during forced social distancing because of pandemic COVID-19 in all the studied groups. Medical students also need to be made aware that depression is not a cause for shame. Future doctors should be able to maintain their mental and emotional health, as well as know, how to deal with classmates who suffer from mental illness
The aim: To study the expression of brain-derived neurotrophic factor (BDNF) and matrix metalloproteinase-9 (MMP-9) in the blood serum of patients with paranoid schizophrenia and to trace the features of their dynamics depending on the duration of the disease and analyse the correlation between BDNF, MMP-9 serum levels and symptoms severity by using the Positive and Negative Syndrome Scale (PANSS). Materials and methods: The study included 120 patients, namely 20 patients with paranoid schizophrenia diagnosed less than 3 years ago (Сomparison Group) and 100 patients with a diagnosis of paranoid schizophrenia (Study Group): 20 of them have been suffering from this disease from 3 to 5 years (Subgroup I); 10 patients – from 5 to 10 years (Subgroup II); 10 patients – from 10 to 15 years (Subgroup III); 10 patients – from 15 to 20 years (Subgroup IV); 10 patients – from 25 years and more (Subgroup V). The groups did not differ with respect to age or gender. The content of BDNF and MMP-9 in blood serum was determined by enzyme-linked immunosorbent assay. Results: BDNF concentration averaged 28.327 ± 5.32 pg/ml in the patients of Group I; 25.40 ± 2.31 pg/ml in Group II; 24.32 ± 3.1 pg/ml in Group III; 23.8 ± 1.32 pg/ml in Group IV; 21.39 ± 0.97 pg/ml in Group V; 9.36 ± 4.38 pg/ml in Group VI. The expression of MMP-9 in the experimental groups constituted: 942.84 ± 87.80 pg/ml, 1042.84 ± 87.80 pg/ml, 1142.53 ± 77.20 pg/ml, 1752.84 ± 77.80 pg/ml, 1542.84 ± 37.70 pg/ml, 2042.74 ± 47.80 pg/ml, respectively. Decreased BDNF negatively correlated with MMP-9 expression (r=0.46; p<0.05). Conclusions: The development of paranoid schizophrenia was manifested by an imbalance in BDNF level and MMP-9 expression which could affect neurogenesis, synapticplasticity, ability to learn and remember, therefore, they could be considered as diagnostic markers of the pathology. With the increase in the duration of the studied pathology, BDNF parameters decreased and MMP-9 expression increased. A negative correlation between them was noted.
The objective of the research was to study the features of quality of life dynamics depending on clinical and psychopathological symptoms in patients with paranoid schizophrenia asso ciated with metabolic syndrome on the background of long-term neuroleptic therapy and to study the eff ectiveness of concomitant corrective therapy. 140 patients with paranoid schizophrenia (F20.0) were examined and divided into three groups. Group I included 40 patients who received haloperidol at an ave rage daily dose of 4.6 ± 1.3 mg/day, Group II consisted of 40 patients who received risperidone (3.7 ± 1.8 mg/day), Group III included 40 patients who received quetiapine (413 ± 116 mg/day). Half of the patients in each of the presented groups continued to receive neuroleptic therapy according to the above mentioned regimen, and the other half of the patients received metformin hydro chloride at a dose of 500 mg/day in addition to the standard therapy. The cont rol group consisted of 20 patients diag nosed with "paranoid schizophrenia, remission", without metabolic syndrome signs, who had not received neuroleptics for the past six months. The Positive and Negative Syndrome Scale (PANSS) and the Medical Outcomes Study 36-Item Short-Form Health Status Questionnaire (SF-36) were used to study the patients’ mental health in detail. In this research, we monitored the impact of comorbidity on quality of life indices in the patients with long-lasting treatment of schizophrenia by neuroleptic agents, and noted that concomitant corrective therapy was appropriate in terms of compliance increase and quality of life indices improvement in the studied category of patients. Keywords: paranoid schizophrenia, metabolic syndrome, atypical neuroleptic agents, quality of life
Introduction.According to scientific data, unemployed, lonely and students are most prone to procrastination. And what about teachers, in particular, higher education institutions? There is not enough data in the available literature. As practice shows, in the case of teachers, procrastination or postponement can manifest itself in the form of stress caused by failure to fully realize goals and plans vital to the individual. Negative consequences are expressed both in reduced work capacity and in acute emotional experiences of one's own failure, dissatisfaction with the results of one's work. The aim of the study .was to investigate and evaluate the level of anxiety, depression and the nature of manifestations of procrastination among teachers of the Ivano-Frankivsk National Medical University during the period of altered psycho-emotional state during forced social distancing in connection with the COVID-19 pandemic and its impact on social functioning and quality of life. Materials and methods: The survey was voluntary and anonymous. The research was approved by the Bioethics Committee of Ivano-Frankivsk National Medical University and conducted according to the principles of the Helsinki Declaration. We used two clinical test methods to identify emotional disturbances: the Hospital Anxiety and Depression Scale (HADS) and the Montgomery-Asberg Depression Rating Scale (MADRS) (Zigmond A.S. et.al.,1983; Svanborg P., 2001). In order to assess the degree of expressiveness of the propensity to postpone matters "for later" among the surveyed teachers, we created a special Google questionnaire created on the basis of data."Questionnaire to study the propensity of the individual to procrastination" (Shivari ,O.A., 2015), which is a modification of the "General Procrastination Scale" (Lay, C., 1986) and consists of two scales: "Personally conditioned procrastination scale" (Scale I) and "Situationally conditioned procrastination scale" (Scale II). Scale I indicates the general level of procrastination, and Scale II - motivational procrastination, its high indicators suggest that the questionnaire will perform some work only in the presence of motivation. In addition, in order to assess the quality of life, the data of "The Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form (Q-LES-Q-SF)" were evaluated. (Endicott J; Rapaport MH; Clary C; Fayyad R). The statistical analysis of the results was performed using STATISTICA 7.0 software packages and the package of statistical functions of Microsoft Excel. Results and discussion: Were interviewed 214 teachers of various departments of the Ivano-Frankivsk National Medical University: 174 (81.6%) women, 40 (18.6%) - men. 58 interviewees (27.1%) worked at theoretical departments, 156 (72.9%) – at clinical departments. The analysis of the results of the survey according to the «Personally conditioned procrastination scale» showed that 32 (14.9%) of the teachers interviewed by us have had a low, 96 (44.8%) - medium, and 86 (40.3%) - a high level of personal tendency to procrastination. Data of "Situationally conditioned procrastination scale"showed that 54 (25.2%) have had a low level of situational procrastination,76 (35.5%) - medium and 84 (39.3%) - high, respectively.Based on the results of the survey on the HADS scale, a normal level of anxiety-depressive symptoms (0-7 points on a scale) was found in 9 (15.5%) workers from the theoretical departments and in 52 (33.3%) - clinical departments. According to the data of the conducted questionnaire according "The Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form (Q-LES-Q-SF), the least satisfied respondents were by daily functioning, present depressed mood, inability to perform housework efficiently and to spend leisure time interestingly, engage in hobbies or even perform professional duties. Conclusions. The complex of research methods made it possible to comprehensively consider procrastination as a model of the behavior of the subjects and to determine the factors influencing its occurrence during the period of changes in the psycho-emotional state caused by forced distancing in connection with the Covid-19 pandemic and to study the relationship of procrastination with the level of quality of life (from the point of view of satisfaction and enjoyment of life). The main reasons for procrastination were dominated by: lack of motivation to work; stress, as a result of uncertainty and fear of the future; laziness; limited "live" communication and an excess of virtual, external distractions. It is noteworthy that among teachers this phenomenon is not limited to academic procrastination, in most cases everything is fine in this cluster, but more often it extends to homework, interpersonal communication, social and personal life. Attention is drawn to the fact that among teachers this phenomenon is not strictly limited to academic procrastination, but extends to household tasks, interpersonal communication, social and private life.
Introduction. In the case of gastroesophageal reflux disease (GERD) on the background of undifferentiated connective tissue dysplasia (UCTD) causes an even more significant deterioration in the QOL, including sleep disturbances and the onset of excessive daytime sleepiness (EDS). Thus, the study of the peculiarities of GERD on the background of connective tissue dysplasia and determining the impact of comorbid pathology on the QOL of patients with GERD is a topical issue in internal medicine. It has significant socio-economic significance. We believe that monitoring the most important variables that affect the quality of life of patients with GERD can help raise public awareness in this regard. In addition, it can guide the health care system to address these issues. Purpose. The purpose of the work is to increase the awareness of medical workers about the scale of the problem and ways to solve it. to study the features of the dynamics of quality of life in patients with gastroesophageal reflux disease comorbid with connective tissue dysplasia under the influence of the proposed complex therapy. Methodology. 120 patients were included: 65 men and 55 women. In 75 of them (Study Group) GERD was in the background of UCTD, in 45 (?omparison Group ) - developed as an independent disease. The Study Group was divided into three groups. ?omparison Group - 45 patients with GERD without UCTD, received basic standard therapy, which included PPI "Panocid" 40 mg once a day and alginate-antacid formulation (Gaviscon Double Action Liquid) 20 ml, 3 times per day after meals and before bedtime. I Group - 25 patients with GERD +UCTD, which to the standard basic therapy was added "Magne-B6" for 2 tablets 3 times per day. II Group - 25 patients with GERD +UCTD, which to the standard basic therapy was added "Calcium-D3 Nicomed" 1 tablet 3 times per day. III Group - 25 patients with GERD +UCTD, who used the drug "Magne-B6" 2 tablets 3 times per day and "Calcium-D3 Nicomed" 1 tablet 3 times per day on the background of standard basic therapy. The Medical Outcomes Study 36-Item Short-Form Health Status (SF-36), the Gastrointestinal Symptom Rating Scale (GSRS), and the scale of "Personal and social performance" (PSP) - were used to study patients in detail. A comprehensive examination of patients was performed twice: before and after 30 days of comprehensive treatment. Results and Discussion. Under the influence of the basic therapy in Comparison Group the General Health (GH) improved by 33.03%. While in the groups on the background of complex treatment is increased by 42.52% in patients of the I Group, by 13.10% in patients of the II Group, and 46.28% in patients of the III Group (p1, p2, p3 <0.05).Physical Functiong Scale (PF) improved by 17.9% in patients of the Comparison Group (p <0.05) and by 30.38%; 27.47%, 29.17%, respectively (p1, p2, p3 <0.05). Role Physical Scale (RP) scores improved by 25.14% in Comparison Group (p <0.05) and by 33.6 %, 22.58% and 40.20% respectively (p1, p2, p3 <0.05). Dynamics of data in Body Pain (BP) scale improved by 21.84% in patients of the Comparison Group (p <0.05) and by 37.28%, 25.46%, 35.92% (p1, p2, p3 <0.05).As can be seen from it, under the influence of complex therapy, the values of the Vitality (VT) increased by 17.18% in patients of Group I, by 21.93% – in Group II, by 37.87%– in Group III (p1, p2, p3 <0.05). Among patients of the Comparison Group, the influx of strength and energy felt 9.50% (p <0.05). Data of Social Functioning Scale (SF) improved by 8.8% in patients of the Comparison Group (p <0 , 05) and by 22.7%, 29.6%, 29.31%, respectively(p1, p2, p3 <0.05). Mental Health Scale (MH) improved by 17.23% in patients of Group I, by 22.41% – in Group II, by 21.96% – in Group III (p1, p2, p3 <0.05) and 14.22% - in the Comparison Group (p <0.05). Also in patients were positive dynamics of the Role Emotional functioning scale (RE): by 27.37% in patients of Group I, by 12.36%– in Group II, by 15.7% – in the Group III (p1, p2, p3 <0.05) and 9.05% - in patients of the Comparison Group (p < 0.05). Conclusions. Thus, the inclusion in the standard therapy of gastroesophageal reflux disease in patients with its development on the background of undifferentiated connective tissue dysplasia of magnesium lactate dihydrate in combination with pyridoxine hydrochloride ("Magne -B6 ") and calcium carbonate in combination with cholecalciferol ("Calcium-D3 Nicomed") contributed to a significant improvement in their quality of life
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