THE MICROBIOLOGICAL STRUCTURE OF OTOMYCOSIS: SENSITIVITY PROFILE OF AGENTS TO ANTIFUNGAL DRUGS.

OBJECTIVE: Aim: To study the species composition of microorganisms isolated from patients with otomycosis, and to control the sensitivity of isolated microorganisms to the most commonly used antifungal drugs. PATIENTS AND METHODS: Materials and methods: The main group of study was 132 patients with a preliminary diagnosis of Otomycosis was carried out in the period 2020-2022.To study the sensitivity of isolated microorganisms to antifungal drugs, the Himedia paper disk method (India) was used. RESULTS: Results: Analysis of studies showed that among 132 patients, fungal infection was found in 101 patients (76%), the cultural method - in 31 patients (23.5%); of them women - 56 (42.4%), men - 60 (45.5%) aged 16 to 76; children - 16 (12.1%) aged 6 to 12 years. However, among all patients (n = 132) with otomycosis, fungal lesions of the outer ear prevail, which were detected in 85 (64.4%) patients, that is, fungal otitis was detected in 47 (35.6%). CONCLUSION: Conclusions: The general structure of the species spectrum of etiologically significant pathogens of otomycosis: Candida spp. (78.0%) of the total spectrum of isolates. The sensitivity of isolated micromycetes to antifungal drugs varied in different fungal species and in different antifungal drugs.

STRENGTHENING SOCIETAL RESILIENCE DURING COVID-19 PANDEMIC.

OBJECTIVE: The aim: To investigate factors that can negatively affect societal resilience in the context of the COVID-19 pandemic and identify communication aspects of strengthening resilience through information policy formation. PATIENTS AND METHODS: Materials and methods: In the research process, the authors employed the monographic and abstract-logical methods. The communication aspect analysis of strengthening social resilience in the context of the COVID-19 pandemic also grounded upon the results of the authors' sociological study "Motivation of compliance/non-compliance with quarantine restrictions by the population of Ukraine". Focus-group interviews and surveys. A total of 1,700 respondents represent the adult population of Ukraine aged 18 and older (except those living on the territory temporarily not controlled by the Ukrainian authorities - the Autonomous Republic of Crimea, some areas of Donetsk and Luhansk regions). The error of the study representativeness with a probability of 0.95: does not exceed 4%. RESULTS: Results:The analysis results indicate that under pandemic conditions informational space of Ukraine is charging with low-quality and diverse information and is getting out of control, which entails adverse effects on societal resilience. Besides, a survey conducted by the SSU Center for Social Studies endorses the availability of communication gaps. The poll claims 38.6% of Ukrainians to be dissatisfied with their awareness level of Covid-19 because the information is contradictory and unreliable. The opinion poll also proves the low level of Ukrainians' trust in state institutions and official details on the Covid-19 pandemic. Furthermore, violations of quarantine restrictions are socially acceptable, and a significant part of the population tends to ignore such violations by others. That is, among Ukrainians, compliance with quarantine restrictions has not become a social norm. CONCLUSION: Conclusions: An essential component for molding social resilience is the development and adoption of communication policies to change human behavior in the long-term in the context of the COVID-19 pandemic. The government should also develop a Public Health Awareness Concept in the pandemic with appropriate implementation plans at the state, regional and territorial community levels.

EPIDEMILOGY OF ENT DISORDERS IN ADULT POPULATION OF AGRICULTURAL REGION.

OBJECTIVE: The aim:TostudyandanalyzeSumy region population morbidity dynamics taking into account current stage of medical reform. Sumy region here is represented as one of the main agricultural regions of Ukraine. The prevalence of ENT disorders (otolaryngologic diseases) was studied. PATIENTS AND METHODS: Materials and methods: During the study we used data of statistical report of Public Health Board, Sumy State Administration for the period from 2015 to 2019 years by administrative territories. Obtainedresults wereprocessed, usinggeneral statistics methodsandanalyzed, usingstructural-logicalanalysis. CONCLUSION: Conclusions: The study found that the morbidity rates of ENT disorders in adult population during the study period increased and had levels of 2113.0 and 122.1 per 100 thousand adult population, respectively, and the prevalence rates and the prevalence rates ofENT disorders among the adult population decreased , respectively to 167.7; 2113,0; 665.1 and 389.9. All indicators have reliable differences in terms of administrative territories of the region. The results of the study should be taken into account in the process of reforming the otolaryngological service in the region.

RESULTS OF THE ULTRAMICROSCOPIC RESEARCH OF ADENOID VEGETATIONS ACCOMPANIED BY THE PATHOLOGIES OF NASAL CAVITY AND PARANASAL SINUSES IN ADULTS.

OBJECTIVE: The aim: Grounding on the electronic microscopy of PT make conclusions about the tonsil activity in adults depending on the accompanied pathology of nose and PS. PATIENTS AND METHODS: Materials and methods: Ultramicroscopic examination of 111 patients with PT hypertrophy aged 18-55 was done. Depending on the nose and PS pathology (inflammatory, non-inflammatory) patients' PS biopsic materials were distributed into 2 groups: 58 cases on inflammatory and 53 on non-inflammatory background. The control group consisted of 24 patients aged 18 without nose and PS pathology. The images of ultrathin PT sections were received with the help of transmission electronic microscope PEM - 125 with digital camera (SELMI, Sumy). RESULTS: Results: Great variations in PT cell condition, depending on the pathology were distinguished. Features of the adenoiditis in inflammatory and non-inflammatory diseases of nose and PS were proved. CONCLUSION: Conclusions: 1. PT ultra-microscopy in control group shows great activity of lymphocytes and high energy exchange of cells, with prevailing B-lymphocyte population. 2. The complex of PT ultra structural changes while nose and PS inflammatory diseases shows the activation of immune reaction in competent cells with T-lymphocyte increase in patients older than 25, which witnesses chronic inflammation. 3. In group with nose and PT non-inflammatory diseases, activity of PT B-lymphocytes is unchanged accompanied by the T-lymphocytes growth, which is also characteristic for chronic inflammation.

Analysis of medical services financial efficiency in the secondary care institutions of sumy region.

OBJECTIVE: The aim: The aim of the study is to analyze financial indicators and assess the effectiveness of financing secondary medical care enterprises during the transition period in the context of remuneration to doctors. PATIENTS AND METHODS: Materials and methods: To perform the analysis, the financial characteristics of 26 medical facilities have been collected and processed by means of involving the bibliosemantic method, data extract and content analysis. CONCLUSION: Conclusions: Presents a comparative analysis of labour payment expenses to doctors of cardiology, obstetric and gynecological and surgical departments of medical facilities. The predicted labour payment expenses for the number of services provided have been calculated. Besides, the article makes it clear that the allocation of funds according to bed-day loads and the number of medical services rendered is unsustainable and does not correspond to the real load on the actual position.

Vaccination coverage rates and the incidence of vaccine preventable diseases among children in sumy region of Ukraine.

OBJECTIVE: Introduction: Routine immunization contributes immensely to decline the incidence of vaccine preventable diseases among children. Statistical data shown the sharply decrease the vaccination coverage rates in Sumy region of Ukraine. The aim: Assess routine immunization uptake and its effect on the incidence of vaccine preventable diseases among children in Sumy region of Ukraine. RESULTS: Review: During some years, only 50-60 % of Sumy region children had received all recommended vaccines, which is far below World Health Organization target of 80 %. This has led to an increase of morbidity associated with some infectious diseases. Outbreaks of measles were registered in 2006 and 2012, when were ill 9346 and 7931 children respectively. Massive measles outbreak ongoing nowadays. Total number infected have already exceeded 35,000 cases. CONCLUSION: Conclusions: RI uptake in Ukraine is still below World Health Organization target. The main reason for the ongoing measles outbreak was low vaccination coverage for routine immunization antigens as a result of which collective immunity decreased to a critical level. Strict monitoring of the implementation of the immunization schedule by medical institutions at all levels are recommended to improve vaccination status of Ukrainian children.

Algorithm of adenoiditis treatment in adults, depending on the pharyngeal tonsil hypertrophy stage.

OBJECTIVE: Introduction: Implementation of the endoscopic technologies while the upper airways diseases gave opportunity to diagnose the adenoid vegetation in adults. The aim: Тo offer effective algorithm of curing adults for adenoiditis, depending on the degree of pharyngeal tonsil hypertrophy. PATIENTS AND METHODS: Materials and methods: 43 patients aged 18 - 55 with hypertrophy of pharyngeal tonsil were examined. Depending on the degree of hypertrophy three clinical groups of patients was created: the first one receiving only conservative treatment, the second one receiving conservative therapy and radiowaveradiation coagulation with the apparatus "SURGITRON" and the third one receiving the endoscopic shave adenotomy. Statistical processing of the received data was made in the programs «Exсel¼ and «STATISTICA 6.0¼. Data rows were checked for the normality with the help of Shapiro-Wilk statistical criteria (small sample) and Kolmohorov-Smirnov (large sample). Checking of the dispersion uniformity was done by Leneva criteria. During the comparison of the rows criteria of Student and Wilkokson for the non-paired, Kolmogorov-Smirnov were used. RESULTS: Results: During the re-examination of patients who received only conservative therapy treatment in a month endoscopic signs adenoiditis were distinguished and a year later percentage of relapse was higher than in patients with complex treatment. After shave adenotomy adenoiditis recurrence was not observed. CONCLUSION: Conclusions: While treatment of the patients with the pharyngeal tonsil hypertrophy of the 1 and 2 degree conservative therapy is possible. Addition into the scheme of conservative treatment RWCAV actually reduces quantity of adenoiditis recurrence and allows fast recovery. Treatment of patients with the pharyngeal tonsil hypertrophy of 3 degree, in context of contraindication absence requires surgical treatment (adenotomy) in 100% of cases.