Archive of Clinical Medicine <p>The Journal of Research and Practice “Archive of Clinical Medicine” is a journal covering innovative research and practice in medicine.&nbsp;It publishes the results of original clinical&nbsp;research, review papers, case reports&nbsp;and the results in sphere of medical education.</p> <div class="page" title="Page 2"> <div class="layoutArea"> <div class="column"> <p>The Journal is on the <a href="" target="_blank" rel="noopener">List of Specialized Editions</a> in which the main results of theses are allowed to be published (The Order of Ministry of Education and Science of Ukraine of 16.05.2016, No 515)&nbsp;</p> </div> </div> </div> <p>p-ISSN&nbsp;<strong>2312-7007 (<span lang="EN-GB">Ukrainian ed. Print)</span></strong></p> <p>e-ISSN&nbsp;<strong><span lang="EN-US">2414-9853 (<strong><span lang="EN-GB">English ed. Online)</span></strong></span></strong></p> en-US Authors who publish with this journal agree to the following terms:<br /><ol type="a"><li>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a <a href="" target="_new">Creative Commons Attribution License</a> that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li><li>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li><li>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See <a href="" target="_new">The Effect of Open Access</a>).</li></ol> (Popadynets O.H.) (Тарас Котик) Thu, 25 Jun 2020 11:51:35 +0300 OJS 60 Cluster Analysis of Myelin Nerve Fibers of the Periferal Nerve <p style="text-align: justify;">One of the unsolved issues in neuromorphology is the classification of myelin nerve fibers (MNF). <strong>Objective:</strong> to use cluster analysis to classify the sciatic nerve MNF.</p> <p style="text-align: justify;"><strong>Material and methods.</strong> The work was performed using 5 one-year-old male Wistar rats. Semi-thin sections were stained with methylene blue. MNF morphometry was performed using ImageJ, and statistical processing – using the software environment R.</p> <p style="text-align: justify;"><strong>Results of the study.</strong> Ward’s and k-means methods were used to cluster the MNF. Three clusters of MNFs are defined and their parameters are determined. The presented algorithm for adapting the literature data to the format of the obtained results includes determining the total average for the combined set of each indicator and the total variance, which is the sum of intragroup and intergroup variances.</p> <p style="text-align: justify;"><strong>Conclusions:</strong> 1) for the classification of MNF it is advisable to use cluster analysis; 2) clustering should be performed according to the transsection areas of the axial cylinder and myelin sheath; 3) the number of clusters is determined by the agglomerative method of Ward, and their metrics – by the iterative method of k-means; 4) three clusters of MNF of the rat sciatic nerve differ in the transsection areas of the fibers, the axial cylinder and the myelin sheath and the percentage of nerve fibers; 5) when comparing identical indicators according to the obtained and literature data, the results were equivalent in the areas of the axial cylinder and myelin sheath and their shape coefficients, despite the fact that the classification of myelin fibers and their morphometry was performed using different methods.</p> Omelian Yurakh, Oksana Popadynets, Halyna Yurakh, Mykhailo Osypchuk, Nadiya Tokaryk, Mariia Hryshchuk, Taras Kotyk ##submission.copyrightStatement## Thu, 25 Jun 2020 09:47:40 +0300 Menstrual Disorders and Main Indicators of Hormonal and Metabolic Homeostasis in Teenage Girls Against the Background of Endemic Goiter <p style="text-align: justify;">Along with the widespread prevalence of goiter endemics, the medical and social significance of this problem is determined by the multifaceted spectrum of pathological abnormalities associated with asymptomatic course or hypothyroxinemia, causing numerous disorders at almost all stages of menstrual and reproductive function development.</p> <p style="text-align: justify;"><strong>The objective of the research</strong> was to substantiate and conduct a comprehensive analysis of the prevalence, structure and leading factors of dishormonal disorders of menstrual function in adolescent girls with diffuse endemic goiter, and to develop a diagnostic algorithm based on the risk of the formation of this pathology.</p> <p style="text-align: justify;"><strong>Materials and Methods. </strong>Two study groups were formed and a clinical laboratory examination was performed in 210 patients: 120 of them were diagnosed with menstrual dysfunction against the background of thyroid dysfunction (the main group); 60 girls were diagnosed with menstrual dysfunction and healthy thyroid gland (the comparison group); 30 apparently healthy girls made up the control group. Experimental and psychological methods, hormonal investigation of the level of thyroid, gonadotropic and steroid hormones, lipid and carbohydrate metabolism and vitamin D content in blood plasma were used.</p> <p style="text-align: justify;"><strong>Results and Discussion.</strong> Hypomenstrual syndrome, secondary amenorrhea, dysmenorrhea, manifestations of premenstrual syndrome and anovulatory conditions are the main menstrual disorders in adolescents suffering from endemic goiter. One third of the girls in the main group had an increase in the proportion of delayed sexual development, while in the control group, physiological rates of sexual development occurred in 96.7% of observations. The presented hormonal studies made it possible to identify differentiated changes taking into account different clinical forms of menstrual disorders in this category of patients. The transition to the “mature” type of reproductive system functioning in girls with endemic goiter is associated with changes in prolactin secretion from low levels to the indicators that exceed the reference values, which is characterized by increased functional hyperprolactinemia. Generalization of the frequencies of the main psycho-emotional characteristics and indicators of the personal profile in the girls of the studied cohort allowed revealing the constant dominance of psycho-emotional manifestations of moderate degree, as well as high levels of psycho-emotional stress and depressive disorders against the background of dishormonal disorders and thyroid gland dysfunction. Obtained deviations of 25-hydroxyvitamin D level were noticed at the initial stages of thyroid disorder, and low 25-hydroxyvitamin D levels contributed to the manifestation of thyroid pathology.</p> <p style="text-align: justify;"><strong>Conclusions</strong>. Dissociation of the thyroid system and the hypothalamic-pituitary-ovarian axis initiates menstrual disorders, development of functional cysts and multifollicular structure of the ovarian tissue, and, in case of hypothyroidism, is considered as a factor of metabolic disorders and polycystic ovary syndrome.</p> Svitlana Hafiichuk, Nataliya Henyk ##submission.copyrightStatement## Thu, 25 Jun 2020 09:49:32 +0300 Foreign Bodies of the Nasal Cavity in Adults <p>Several cases of foreign bodies in adults’ nasal cavities have been analyzed. There were represented some peculiarities of clinical course, diagnostics and medical care providing.</p> Diana Orishchak, Nataliia Vasyliuk, Ostap Orishchak ##submission.copyrightStatement## Tue, 23 Jun 2020 22:16:14 +0300 Waste of Research. Is There Any Solution? “Beginning from the Beginning” instead of “Beginning from the End” <p style="text-align: justify;">There have always been challenges concerning tackling knowledge to practice. It is estimated that 85% of the investment in health research are wasted. Due to low quality, not all systematic review and meta-analysis are placed at the top of the hierarchy of evidence. Many individual clinical trials do not have the essential standards; therefore, conducting systematic reviews based on these low-quality individual studies is unreliable as they cannot be applied in healthcare decision-making and lead to resource waste. To overcome this great issue, several organizations have been worked hard to improve data extraction from only well-developed individual studies. However, it is not sufficient.</p> <p style="text-align: justify;">It is time to stop and look back all years behind. It is time to reconsider our efforts to make the best conclusion in order to prohibit the huge waste of energy, time, and resources. The old viewpoint “the Beginning from the End” must be replaced with the new one “the Beginning from the Beginning”.&nbsp; It means, we must do all struggles to conduct clinical trials in a standard high-quality format from the beginning as much as we could. Although, it does not seem easy, it might be possible by funding a high discipline, well-respected organization that is engaged in this critical issue. The supposed organization must define standards, flexible criteria for clinical trials, and all investigators must perform clinical trials under the supervision of this organization. Providing a considerable financial resource to grant the researches of the low- and middle-income countries to do clinical trials based on the designed protocol, considering an independent, high discipline journal for publishing well-conducted clinical trials regardless of their results, teaching researchers, considering another efficient policy to rank the journals rather than “impact factor” could help achieve this far-reach goal.</p> Hamideh Amirfakhryan ##submission.copyrightStatement## Tue, 16 Jun 2020 12:36:26 +0300 Optimization of the Educational Process at the Department of Otorhinolaryngology of IFNMU Considering the Competency-Based Approach <p style="text-align: justify;">The paper presents modern competency-based approach to teaching otorhinolaryngology using new technologies that will improve the assimilation of new material considering each student’ knowledge, skills, and experience. The competency-based approach can be successfully implemented based on active learning, introducing elements of professional activity in the educational process. While analyzing clinical cases, business and learning games, the student becomes a specialist and future’s team member. The quality of education should be improved through an effective organization and informatization of the educational process, the introduction of the latest research results in teaching practice, the provision of high-quality teaching and the development of modern learning and teaching base.</p> Diana Orishchak, Vasyl Popovych, Nataliia Vasyliuk, Ivanna Koshel, Ostap Orishchak ##submission.copyrightStatement## Tue, 23 Jun 2020 21:39:12 +0300 Learning and Teaching Support for Modular-Rating Educational System <p style="text-align: justify;">The main purpose of the modular system is to change organizational foundations of the pedagogical process in higher education to those that would ensure its substantial democratization and the conditions for a real change in the student’s role in learning (from the object to the subject of this process), provide the educational process with the necessary flexibility, introduce the principle of teaching individualization.</p> <p style="text-align: justify;">The regulation on the organization of the educational process in higher educational institutions determines scientific and methodical support that includes the State Standards for Specialties (Course Description, Educational and Professional Program), the curriculum, the syllabus for all normative and elective disciplines, discipline-specific teaching materials, the programs of practices of various kinds, textbooks, manuals, instructional and methodical guidelines, tasks for final, current and state control, etc.</p> <p style="text-align: justify;">The modular-rating and credit-modular educational systems require a detailed development of the system of learning and teaching support considering students’ individual characteristics to form a methodological culture of thinking of general phenomena and patterns of developing the physical world, as well as the ability of interdisciplinary synthesis and a deep understanding of scientific and professional tasks. The role a teacher plays in the system of such training is to motivate, determine the level of knowledge, consult and inform students, while students transform from passive listeners to active participants of the educational process. Such training enables students to study at their own pace, considering their own abilities and temperament.</p> <p style="text-align: justify;">The teaching and methodical complex on the discipline is the system of normative, methodical and didactic documents that determine the objectives of learning, the content of an academic discipline, didactically and scientifically substantiated sequence, methods and means of the formation of knowledge, skills, abilities, professional and civic qualities in students.</p> Nadiia Skrobach, Vitalii Petryna, Oksana Shapoval, Vira Vyshyvanyuk ##submission.copyrightStatement## Wed, 24 Jun 2020 21:08:54 +0300