Characteristics of the hormonal background in women with abnormal uterine bleeding and extragenital disorders.

OBJECTIVE: Aim: To establish the peculiarities of the hormonal background in women with abnormal uterine bleeding and extragenital disorders. PATIENTS AND METHODS: Materials and Methods: The study involved examination of 100 women of reproductive age with concomitant ED and AUB (MG). CG included 50 healthy women. MG women were additionally divided into subgroups depending on the detected pathological changes in the uterine cavity. When examining the hormonal status, concentrations of FSH, LH, estradiol, progesterone, and leptin in BS were determined. Additionally, the level of 25-hydroxyvitamin D ((25-OH) D) was determined. RESULTS: Results: The decrease in FSH level in subgroups of GP, PSL, EH, EHL was 1.8-2.4 times (KWT, p<0.01). LH in BS of MG patients was statistically lower than that of CG patients (MWT, p=0.0083). The lowest level of LH was registered in patients with EHL, which was 2 times lower than this indicator in CG. A statistically significant increase in the level of estradiol was registered in 73% of MG patients (MWT, p=0.044). The lowest level of progesterone was registered in patients with EHL - 8.40, which is 4.7 times lower than in CG (MWT, p=0.0021). A statistically significant increase in the level of leptin in BS was observed in MG patients (KWT, p=0.0021). The highest level of leptin was found in women with AFP, 2.3 times higher than CG indicators. A statistically significant correlation between the level of leptin and BMI (r=0.86, p=0.011) and a statistically significant (p=0.023) correlation between the level of leptin and estradiol in BS of patients of the examined groups (r=0.42) were revealed. In 87% of MG women, vitamin D deficiency was observed in BS (KWT, p=0.03). A statistically significant (p=0.01) negative correlation between the level of estradiol and vitamin D in the BS of female patients was revealed (r=-0.61, p=0.01). CONCLUSION: Conclusions: Women of reproductive age with AUB and ED were found to have disorders in the hypothalamic-pituitary-ovarian system. Most patients are characterized by an elevated level of leptin, the concentration of which is closely correlated with BMI, and an elevated level of estradiol is correlated with the level of vitamin D.

FEATURES OF THE PROCESS OF TRAINING IN EDUCATIONAL MEDICAL INSTITUTIONS OF UKRAINE AT THE PRESENT STAGE. PART 2. REACTION OF HIGHER EDUCATIONAL INSTITUTIONS TO DISTANCE LEARNING.

Higher education is one of the areas most affected by the Covid-19 pandemic and martial law. Against the backdrop of severe restrictions, universities faced the issue of the existing opportunities for the implementation of educational programs, the need to change the format of the educational process with the transition mainly to electronic educational technologies. Under these conditions, it was necessary to consolidate all the forces and resources of the university community. The governments of many countries have recognized the need to provide infrastructural and technological support to educational institutions. Thanks to the institutional support of the state and relevant ministries, universities managed to reduce financial losses and implement initiatives for continuous education. These measures have contributed to the sustainability of universities. In response to the COVID-19 pandemic, educational institutions all over the world have adopted different approaches and made significant changes to the education system itself in accordance with their resources and capabilities.

FEATURES OF THE PROCESS OF TRAINING IN EDUCATIONAL MEDICAL INSTITUTIONS OF UKRAINE AT THE PRESENT STAGE. PART І. ATTITUDES OF STUDENTS AND UNIVERSITY TEACHERS TOWARDS DISTANCE LEARNING.

The review article reflects the results of the assessment of data from individual research papers and personal observations, as well as data from domestic and foreign literature, as well as own opinion about the features of the training process in educational medical institutions of Ukraine at the present stage. First, the COVID-19 pandemic, and then martial law in the state, caused distance learning to become an inseparable component of modern education and contrib¬uting to the effective implementation of the educational process in general and the achievement of high quality results in medical educational institutions in particular. For the successful implementation of the e-learning system, all participants in the educational process need the help and assistance of special technical support services. Therefore, universities need to pay more attention to improving technical support of platforms and academic interaction between teachers and students [1]. Universities that have been able to provide such support have avoided many problems in the transition to distance learning. Practical and clinical skills are essential in the field of medicine, and the lack of opportunities to master and practice these skills could potentially lead to a generation of insecure doctors with limited experience of meeting and examining real patients [2]. Therefore, the task of teachers at the present stage is to do everything possible to prepare competent specialists adapted to the realities of life.

OVARY FUNCTIONAL STATE IN FEMALE ADOLESCENTS WITH A HISTORY OF INTACT UTERINE APPENDAGES TORSION.

OBJECTIVE: The aim: To assess the functional state of gonads in female adolescents with a history of intact uterine appendages torsion (IUAT). PATIENTS AND METHODS: Materials and methods: A total of 55 adolescent girls aged from 13 to 17 years were examined. 35 patients with a history of IUAT were divided into two groups: group 1 consisted of 21 patients with organ-preserving surgical treatment (detorsion) and group 2 of 14 patients with radical surgical treatment of IUAT. 20 healthy girls formed the control group. Assessment of the ovarian reserve was performed by the determination of serum anti-Müllerian hormone (AMH) level. Ultrasound scan was used to evaluate ovaries volume, number and diameter of antral follicles. RESULTS: Results: The AMH level in control group (2.4 ± 0.29 ng/ml) has no statistically significantly differences compared with group 1 (2.2 ± 0.35 ng/ml, p = 0.12) and differed significantly compared with group 2 (0.96 ± 0.11 ng/ml, p < 0.05). No statistically significant differences in ovary volume were found between group 1 and control group (6.02 ± 0.21 cm3 and 6.14 ± 0.17 cm3, respectively, p = 0.125). The number and diameter of antral follicles in group 1 didn`t significantly differ from the control group (3.85 ± 0.35 and 4.00 ± 0.25, p = 0.116, 3.57 ± 0.42 mm and 3.70 ± 0.31 mm, p = 0.128, respectively). CONCLUSION: Conclusions: The method of choice for IUAT treatment taking into account upcoming motherhood is laparoscopy with detorsion. Dynamic ultrasound results and determination of AMH level indicate the organ-preserving tactics for surgical treatment of IUAT.