Scientific journal
European Journal of Natural History
ISSN 2073-4972

TRADITIONAL AND LAPAROSCOPIC METHODS OF TREATMENT IN SURGERY OF ECHINOCOCCUS (PRACTICAL CASES)

Baizharkinova A.B. 1 Kelimberdiyev S.M. 1 Zhalnisinov S.S. 1
1 State Medical University of Marat Ospanov and Railroad Clinic Hospital

Urgency. Diagnostics and treatment of echinococcus has a long story. Regardless of this fact, nowadays, in XXI century this problem remains urgent. Important aspects of it are: modern diagnostics of echinococcus, pre-surgical preparation, selection of rational treatment, and post-surgical attendance over patients. Development of surgical technology in scientific progress provides for improvement not only in diagnostics, but also surgical treatment of organ echninococcus.

Objective of work. Demonstrate results of surgical treatment of 22 patients with diagnosis of liver echinococcus (21 cases) and echinococcus of lungs (1 case) in surgical department of railroad hospital of the city of Aktobe during the recent 10 years (2005–2015). During the pre-surgical period all patients were taken to a complete clinical-laboratory and roengenologic examination (CT, MRT, etc). Examination was complimented with apparatus: UZI”Apogei” – 800 (USA) “Aloka” (Japan). During the laboratory examination of patients it eosinophilia (above 4 %) was registered among one third of them.

All patients endured surgical treatment after the corresponding preparation, but only 10 patients were operated via laparoscopic method in stomach and chest cavity. The foundation of traditional surgeries in case of liver echinococcus is formed by laparotomy, and in case of combined pathology in lungs torocoabdominal access is facilitated. In one case lung echinococcus was diagnosed on a patients during the secondary examination in one year after removing liver echinococcus via traditional method, the surgery was carried out with torocoscope. Duration of post-surgical period depended on selection of treatment method. Traditional surgery is traumatic and usually results in different complications, thus leading to additional days of immobility for a patient. For all types of surgical treatment the selected method of anaesthesia was endotracheal narcosis. For laparotomic method the surgery started with puncture of echinococcus cyst, aspiration contents, sanitization of its cavity with formalin, and then removal of all cyst elements. Drainage was placed in the cavity, and section of a large omentum was adjusted to this place, for small and uncomplicated cysts half-closed or closed (ideal echinococcoectomy) methods of treatment were implemented. An open method of surgery (marsupilization) was also used. For modern non-invasive, low-traumatic method of treating echinococcus laparoscope, produced by “Olympus” was used. As we have already mentioned, for all laparoscopic echinococcoectomies, as well as majority of traditional interventions, pathology was located in liver.

Conclusion

We should outline that traditional and laparoscopic methods should be and are implemented in surgery of liver and lungs echnococcus according to the provided indications. But, as a rule, laparoscopic methods of treatment, in comparison to traditional, are low-traumatic and apodous, lead to less complications, and don’t result in long period of patient’s immobility. All patients (22) who endured traditional and laparoscopic surgeries, were dismissed for dispensary observation. The remote results are positive.

The work is submitted to the International Scientific Conference «Modern sociology and education» England (London), October 15–22, 2016, came to the editorial office оn 06.10.2016.

MEDICAL SCHOOL E-LEARNING: THE FACTOR OF EDUCATIONAL PROCESS INDIVIDUALIZATION

Snegireva L.V.

Kursk State Medical University, Kursk, e-mail: sneglv1@gmail.com

E-learning opportunities studies in university students’ educational process individualization is provided by the author. The most often used educational process e-learning elements were chosen as the research object. Testing of first-year medical faculty students was carried out at the end of an academic year. The students were distributed into 3 groups according to their academic progress. Research results shows that all e-learning elements of medical school educational process are highly demanded by students. And, low academic rate students are interested in e-learning much more, than students with good results of studies, because e-learning provides effective self-control, psychological comfort and educational process individualization with respect to the students’ cognitive activity. Research results can be used by the university medical faculties to increase an e-learning efficiency of medical students.

University e-learning various elements are intensively developed recent years, taking their own place between the traditional teaching methods in educational process of high school. The e-learning effectiveness, its role in university students’ cognitive activity development, e-learning opportunity in students’ skills formation are the objects of modern scientific research [2, 3, 5, 6]. However, e-learning effectiveness in medical school educational individualization process is still questioned [1, 4, 7].

That’s why, the aim of our research is defined as e-learning opportunities studies in university students’ educational process individualization.

We chose the often used educational process e-learning elements as the research object.

Materials and methods of research

Testing of 179 first-year medical faculty students was carried out. First-year students were involved into testing at the end of an academic year.

The students were distributed into 3 groups according to their educational activity results: students with excellent results – 27,4 %, good results of studies – 66,5 %, and 6,1 % – the poor educational activity results.

The experiment was held in constant conditions for all groups of students: the research was held at 11 a.m. in the academic auditory. The research duration was about 12 minutes. The medical faculty students performed the testing independently. The testing was built on the basis of original author test including 12 questions.

Results of research and their discussion

First, students were asked to arrange e-learning various elements according to their frequency in high school educational process use. Examinees arranged the elements in the following order:

– computer testing;

– electronic manuals;

– multimedia lectures;

– university website information;

– problem tasks on computer;

– laboratory works on computer.

The next step of our research e-learning various elements effectiveness in educational process was esteemed by first-year medical faculty students. According to the test results 96,1 % of all students consider multimedia lectures as highly efficient element of university educational process. 100 % of students with poor educational activity results think that multimedia lectures are the great instrument of representing and visualizing the information. While 4,2 % of students with good results of studying and 4 % of examinees with excellent indicators of educational activity consider multimedia lectures as un useful element of university educational process.

To our mind, such results proof that visualization of studying material is highly important for students with poor educational activity results.

Illustrated and animated studying material of multimedia lectures in addition to the lecturer explanation helps students to understand the subject better, and to consider processes and phenomena from different points of view.

Further research results made us sure about the real base of our conclusion. 87,7 % of first-year students noted high efficiency of practical training with e-learning materials. More than that, 100 % of students with poor educational results of the pupils regard the problem tasks on computer to be useful, while 6 % of high academic rate students, and 15,8 % of students with good educational results consider solving the problem tasks on computer inexpedient.

Computer laboratory works performing is highly appreciated by 74,9 % of medical students. In particular, students with poor results of studies note that laboratory works on the computer gives them the chance to repeat an educational experiment necessary number of times, allowing to achieve the required result. The timing of laboratory work and educational process individualization make 81,8 % of low academic rate students assess computer laboratory work efficiency as high. For example, 73,1 % of first-year students with good results of studies consider computer laboratory work as effective e-learning element.

86,6 % of examinees noted high efficiency of computer testing. However, 27 % of poor educational activity results students think that computer testing does not give the objective results. 8,2 % of high academic rate students and 14,3 % of students with good results of studies endorse the opinion of approximately the fourth part of low academic rate students.

In our opinion, dissatisfaction of poor results of educational activity students with computer testing is explained, first of all, by the computer work rigid time limitations. Restriction in time, in opinion of low academic rate students, is the barrier in demonstrating the actual knowledge level. Secondly, computer testing does not esteem the intermediate chain of reasonings. In this regard we consider it expedient to supplement computer testing with interview for the students with poor educational results.


The work is submitted to the International Scientific Conference «Modern sociology and education» England (London), October 15–22, 2016, came to the editorial office оn 06.10.2016.