Halyna Lugova

Introduction. The growing demand for rehabilitation services, driven by demographic changes, chronic conditions, armed conflicts and the need to restore functional abilities, calls for effective approaches to assessing the capacity of rehabilitation facilities. Modern international rehabilitation systems are shifting from a medically-centered model to a functional and patient-centered approach, based on evidence-based practice, interdisciplinary collaboration and outcome assessment. Aim. To analyze international approaches to assessing the capacity of rehabilitation facilities considering the evolution of rehabilitation models, evidence-based practice, and the role of multidisciplinary teams in ensuring quality rehabilitation services. Materials and Methods. An analytical review of international scientific literature, regulatory documents, and recommendations of international organizations in rehabilitation and healthcare management was conducted. Publications from international databases and official sources addressing rehabilitation models, quality assessment systems, interdisciplinary care, evidence-based interventions, and organizational approaches were analyzed. Results. It has been established that international approaches to assessing the capacity of rehabilitation facilities cover staffing, organizational structure, accessibility and continuity of services, interprofessional collaboration, evidence-based methods and functional outcomes. It has been determined that a multidisciplinary team is a key element of effective rehabilitation, ensuring the identification of patient needs, the planning of an individualized programme and the monitoring of its outcomes. The quality of rehabilitation facilities should be assessed not only on the basis of structural indicators, but also on the results of restoring functioning and participation in social life. Conclusions. International experience demonstrates a shift toward functional, patient-centered and integrated rehabilitation models based on continuity of care, evidence-based practice, interdisciplinary collaboration and measurable functional outcomes. Rehabilitation facility capacity should be assessed through structural, process and outcome indicators. Adaptation of international approaches to the Ukrainian context provides a basis for developing a draft Standard for assessing rehabilitation facility capacity and evaluating their ability to deliver accessible, coordinated, evidence-based and patient-centered care. Further research should focus on piloting and validating the proposed assessment indicators.

Aim. Urban areas in Malaysia are highly exposed to disasters, mainly floods and landslides. Effective civil-military coordination is critical for the health-sector disaster response. This study examines civil-military coordination in urban disaster health response in Kuala Lumpur and its implications for community outcomes. Methods. Semi-structured interviews were conducted with purposively selected institutional health responders, and the transcripts were analysed thematically. A cross-sectional household survey was conducted in a flood-affected community, with households stratified by housing type to assess flood impacts and response satisfaction; data were analysed using descriptive and inferential statistics. Results. Key responders highlighted strengths in the military’s command structure and communication tools, and emphasized the value of the Incident Command System. Major challenges included unclear triggers and authority for military involvement, role ambiguity, inter-agency territoriality, funding constraints, and high staff turnover. Responders recommended establishing a national multi-stakeholder advisory council, conducting joint tabletop exercises, and improving integration of military and civilian expertise. The community survey documented substantial short- and long-term health and social consequences of flooding: 92.5% reported significant financial or property loss; 89.6% experienced anxiety when it rains; 66.0% reported sleep disturbance. Fewer than one-third (27.4%) were satisfied with the government response, although the majority (59.4%) expressed satisfaction with community response. Older age predicted higher satisfaction with flood response (B=1.813, t=2.124, p=0.036). Conclusion. Health responders identified strengths in communication and command structures, but unclear triggers, role ambiguity, and governance gaps undermined coordination. Clear trigger protocols, a multi-stakeholder advisory council, and joint exercises are recommended to strengthen collaboration. Community survey findings show how coordination failures lead to poor service delivery and survivor dissatisfaction, highlighting the need to align institutional capabilities with community needs.

Insulin resistance is a critical pathophysiological process in the onset and advancement of type 2 diabetes mellitus. It is well-recognized that alterations in the metabolism of lipids and aberrant fat buildup effectively trigger the development of resistance to insulin. Adjusting one’s eating habits and managing weight appropriately are crucial for treating, controlling, and reducing the risk of T2DM because obesity and a lack of physical exercise are the primary factors responsible for the worldwide rise in T2DM. Omega-3 fatty acid is one of the polyunsaturated fatty acids (PUFA) that include long-chain omega-3 fatty acids such as eicosapentaenoic acid and docosahexaenoic acid, commonly found in fish oils. Omega-3 and omega-6 polyunsaturated fatty acids (PUFAs; 3 and 6 PUFAs) are essential for human health because they serve as metabolic precursors of eicosanoids, a class of signaling molecules that are essential for controlling a body’s inflammation. Since humans are unable to produce any of the omega-3 or omega-6 PUFAs, they both constitute imperative nutritional ingredients. Long-standing concerns about long-chain omega-3 fatty acids’ impact on diabetes management have been supported by experimental investigations that found significant increases in fasting glucose following omega-3 fatty acid supplementation and foods rich in PUFA and omega-3 fatty acid. Cellular explanations to explain the connection between inflammation and IR include mitochondrial dysfunction, endoplasmic reticulum (ER) stress, and oxidative stress. Modifications in the lipid composition of mitochondrial membranes and/or receptor-mediated signaling may be part of the mechanism behind the activation of mitochondrial fusion by fish oil/omega-3 PUFA. The exact molecular processes by which omega-3 PUFAs control mitochondrial activity to defend against IR are still unknown.

Axial length (AL) and corneal curvature (CC) are one of the furthest critical parameters for optometry and oculoplastic surgery. These two variables are crucial in biometry for accurately measuring the power of the intraocular lens in cataract surgery. This research aimed to determine the association linking axial length and corneal curvature with demographic characteristics in emmetropic eyes of Bangladeshi people. This descriptive cross-sectional research was carried out among 200 emmetropic eyes of Bangladeshi people attending the Department of Ophthalmology at Rajshahi Medical College, Bangladesh, with different eye conditions, between July 2017 and June 2018. Data was gathered by conducting person-to-person interviews, checking visual activity using the Snellen chart, and measuring corneal curvature using an auto-keratometer and axial eyeball length using A-scan ultrasonography. A total of 200 attendances were studied, 90 males and 110 females. All were emmetropic. The age range was 21-52 years, and the highest contributors were in the 21-30-year age group. The association between right axial length and right corneal curvature shows a negative relation among both sexes. It was -0.61 (β-coefficient (β-coff)), and highly significant in females at -0.89 (β-coff). Additionally, the association between left axial length and left corneal curvature shows a negative relation of -0.65 (β-coff), which was again highly significant in females at -0.87 (β-coff). Both were not significant in males. There was no significant association linking axial length and eye axis in both sexes. The multivariate regression model was used to assess the p-value, and the regression model was adjusted by age. Optical parametric measurement is a noninvasive diagnostic and assessment tool that might help in the actual measurement of intraocular lens implantation in cataract surgery and may also provide supplementary information to the researcher domain.

Background: Health policy is a set of comprehensive principles and legislations that guide how healthcare should be effectively delivered in the community. Medical schools should prepare students to undertake managerial responsibilities by incorporating health policy into the curriculum to deal with the intricacies of healthcare systems and their clinical roles in their future professional careers. Objective: To examine medical students’ perception at a Public University in Malaysia regarding teaching health policy and their participation in health policy roles. Material and Methods: A cross-sectional study using universal sampling was carried out among the medical students using a paper-based questionnaire to collect the data. Results: Most respondents opined their willingness to learn health policy (80.9%) and that teaching health policy (83.6%) should be compulsory for medical students. The respondents thought health policy should be introduced earlier in Year 1 or 2. The student scores on their knowledge regarding health policy and year of study were significantly associated with their involvement in the health policy roles in both the simple and multiple logistic regression. Both statistical tests reported higher participation in health policy roles with the higher year of study, though only Year 4 and 5 were significant in the simple logistic regression and only Year 5 in the multiple logistic regression compared to Year 1. On the other hand, age and type of admission show significant results only in the simple logistic regression, while the race was only significant at the multivariate level. Conclusions: This study demonstrated that most respondents showed their willingness to learn health policy, participate in the health policy programs, and recommend that health policy be considered an essential topic in the medical curriculum, which should be taught right from the first year of medical school. We recommend encouraging students’ participation in health policy activities.

Background: Worldwide, microbes are becoming more challenging by acquiring virulent skills to adapt and develop antimicrobial resistance (AMR). This is a concern as AMR increases morbidity, mortality, and costs. Consequently, physicians need to be trained on appropriate antimicrobial prescribing, starting as medical students. Objective: To evaluate medical students’ confidence in antimicrobial prescribing and AMR. Methods: Cross-sectional study assessing medical students’ knowledge, perception, and confidence in prescribing antimicrobials and AMR in a Malaysian University. A universal sampling method was used. Results: Most responding students believed that educational input regarding overall prescribing was sufficient. Regarding the principle of appropriate and accurate prescriptions, female medical students had less knowledge (odds ratio (OR) = 0.51; 95% confidence interval (CI) 0.25–0.99; p = 0.050). Year-IV and Year-V medical students had more excellent knowledge than Year-III students regarding confidence in potential antibiotic prescribing once qualified. Year-V students also showed an appreciably higher confidence in the broad principles of prescribing, including antibiotics for infectious diseases, compared to those in other years. Conclusion: Overall, medical students gain more knowledge and confidence regarding the potential prescribing of antimicrobials as their academic careers progress. This is important given concerns with the current excessive use of antimicrobials in Malaysia.

Background: Health policy is a set of comprehensive principles and legislations that guide how healthcare should be effectively delivered in the community. Medical schools should prepare students to undertake managerial responsibilities by incorporating health policy in the curriculum to deal with the intricacies of healthcare systems and their clinical roles in their future professional careers. Objective: To examine medical students' perception at a Public University in Malaysia regarding teaching health policy and their participation in health policy roles. Material and Methods: A cross-sectional study using universal sampling was carried out among the medical students using a paper-based questionnaire to collect the data. Results: Most respondents opined their willingness to learn health policy (80.9%) and that teaching health policy (83.6%) should be compulsory for medical students. The respondents thought health policy should be introduced earlier in Year 1 or 2. The student scores on their knowledge regarding health policy and year of study were significantly associated with their involvement in the health policy roles in both the simple and multiple logistic regression. Both statistical tests reported higher participation in health policy roles with the higher year of study, though only Year 4 and 5 were significant in the simple logistic regression and only Year 5 in the multiple logistic regression compared to Year 1. On the other hand, age and type of admission show significant results only in the simple logistic regression, while the race was only significant at the multivariate level. Conclusion: This study demonstrated that most respondents showed their willingness to learn health policy, participate in the health policy programs, and recommend that health policy be considered an essential topic in the medical curriculum, which should be taught right from the first year of medical school. We recommend encouraging students’ participation in health policy activities.

Background: Worldwide, microbes are becoming more dangerous by acquiring virulent skills to adapt and develop antimicrobial resistance (AMR). This is a concern as this increases morbidity, mortality, and costs. Consequently, physicians need to be trained inappropriate prescribing, starting with medical students. Objective: Evaluate medical students' confidence in antimicrobial agent prescribing and drug resistance Methods: Cross-sectional study assessing medical students' knowledge, perception, and confidence in prescribing antimicrobial agents and drug resistance in a Malaysian University. A universal sampling method was used. Results: Most respondents believe that educational input regarding overall prescribing was sufficient. Regarding the principle of appropriate and accurate prescriptions, female medical students had less knowledge [Odds Ratio (OR)=0.51; 95% Confidence Interval (CI) 0.25-0.99; p=0.050]. Year-IV and Year-V students had more excellent knowledge than Year-III students regarding confidence in antibiotic prescribing. Year-V students also showed appreciably higher confidence in the broad principles of prescribing, including infectious diseases, compared to those in other years. Conclusion: Overall, medical students, gain more excellent knowledge and confidence regarding prescribing, including antimicrobials, as their academic careers progress.

Objective: Lockdown and other measures, including the closure of universities, introduced by Governments across countries in response to the COVID-19 pandemic have appreciably impacted on the education of dental and medical students across countries. Key challenges included the need to rapidly move to e-learning as well as instigate new approaches to practicals for health science students. This involves lecturers and students necessarily needing to rapidly adapt to e-learning and other approaches. There have also been affordability issues among students to regularly access the Internet, and purchase the necessary equipment, particularly among those from low- and middle-income countries such as Bangladesh. Consequently, there is an urgent need to assess current challenges among senior level physicians and educators in Bangladesh regarding the education of dental and medical students arising from the current pandemic, and how these are being addressed, to provide future direction. This is particularly important in Bangladesh with high rates of both infectious and non-infectious diseases. Materials and Methods: Pragmatic investigation involving a purposely developed questionnaire based on previous studies and the experience of the co-authors. The questionnaire was distributed to 15 senior-level educators with the findings analysed by themes. Results: Key issues included little experience with e-learning at the start of the pandemic among both staff and students, poor internet access and cost of internet bundles. In addition, fear and anxieties among both students and staff. The colleges responded by instigating teaching classes for educators on e-learning and providing adequate personal protective equipment for staff and students during teaching and practical sessions. These formed the basis of future recommendations. Other recommendations included increased flexibility among staff and students. Conclusion: The pandemic posed appreciable challenges to both staff and students attending dental and medical colleges in Bangladesh. Some of the key issues are starting to be addressed. Bangladesh Journal of Medical Science Vol. 21 No. 02 April’22 Page : 444-454

Recent severe acute respiratory syndrome 2 (SARS-CoV-2) known as COVID-19, presents a deadly challenge to the global healthcare system of developing and developed countries, exposing the limitations of health facilities preparedness for emerging infectious disease pandemic. Opportune detection, confinement, and early treatment of infected cases present the first step in combating COVID-19. In this review, we elaborate on various COVID-19 diagnostic tools that are available or under investigation. Consequently, cell culture, followed by an indirect fluorescent antibody, is one of the most accurate methods for detecting SARS-CoV-2 infection. However, restrictions imposed by the regulatory authorities prevented its general use and implementation. Diagnosis via radiologic imaging and reverse transcriptase PCR assay is frequently employed, considered as standard procedures, whereas isothermal amplification methods are currently on the verge of clinical introduction. Notably, techniques such as CRISPR-Cas and microfluidics have added new dimensions to the SARS-CoV-2 diagnosis. Furthermore, commonly used immunoassays such as enzyme-linked immunosorbent assay (ELISA), lateral flow immunoassay (LFIA), neutralization assay, and the chemiluminescent assay can also be used for early detection and surveillance of SARS-CoV-2 infection. Finally, advancement in the next generation sequencing (NGS) and metagenomic analysis are smoothing the viral detection further in this global challenge.