Time management is one of the biggest problems of medical students. In this study, we examined the circadian rhythms of medical students and factors which may affect academic performance: perceived stress, sleep quality, time management. Students answered a Morningness-Eveningness questionnaire, the Time Management Personal Assessment questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the Perceived Stress Scale questionnaire. The correlation (R=0.87) between chronotype and GPA (P<0.001) showed a higher GPA in students with morning chronotypes. The PSQI analysis demonstrated 47% of the students had poor sleep quality; a correlation (R= -0.56) between the PSQI and GPA (p< 0.04), supporting a link between higher GPA and good sleep. Results also showed a correlation (R=0.59) between time management and GPA (p< 0.01), implying that the students with excellent time management skills (17%) had excellent GPAs. Chronotypes, quality of sleep and time management, influence GPA and can be used as a guidance tool for academic advisors. UDC IntroductionTime management is one of the biggest problems of medical students. Good time management skills such as setting goals and monitoring the use of time can facilitate productivity and minimize stress, contributing to work effectiveness, maintaining balance and academic success (Al Khatib, 2014). Balduf (2009) recognized that poor time management skills can affect academic achievement negatively. Britton and Tesser (1991) found that the undergraduate students identified time management as their most pressing problem, which lead to anxiety, stress and poor sleep habits, and have a damaging effect on health and performance (Schneiderman et al., 2005). Not all time management methods work for everyone; (it depends on individual circadian rhythms (chronotypes). Understanding which circadian type is predominant in the body can help to assess what schedule is best. Laboratory studies which were conducted among medical students by Medeiros et al. (2001) showed that the irregularity of the sleep-wake cycle, the sleep deprivation, and internal desynchronization could be causing increased stress, and the stress could be influencing students' academic performances. Our body has daily rhythms of hormone concentrations, core temperature, and the sleep-wake cycle, all of which have wide spread effects on the function of the entire body (Saper et al., 2005). This rhythm is known as the circadian rhythm and is controlled by an internal body clock. Widely acknowledged individual differences in circadian rhythms, commonly called morningness and eveningness, indicate preferences associated with morning or evening activities. A morning chronotype is often awake between 6 AM and 10 PM and is most energetic in the morning. The evening chronotype is often awake between 9 AM and 1 AM and is most energetic in the afternoon and in the evening (Allebrandt et al., 2014). Studies conducted at the University of Zurich led by Steven Brown (Roenneberg, 2012) showed that the natural biologica...

Background: Metacognition influences the academic performance of medical students. The objective of our study was to determine the metacognitive awareness level of medical students in different academic groups in physiology course and develop a guideline on that basis to provide academic support.Methods: A 52-items metacognitive awareness inventory (MAI) devised by Schraw and Dennison was used to assess the metacognition level of low (<70%), average (70-84%), and high performing (>85%) students in a physiology course at Trinity Medical Sciences University (TMSU).Results: Sixty-four students participated in the study. A significant positive correlation (rs=0.462) was found between the total MAI score and the final score in the physiology course. High performing students reported significantly higher score on declarative knowledge (p=0.001); procedural knowledge (p=0.048); implementation of strategies (p=0.003); correction (p=0.000) and evaluation of effectiveness (p=0.000) subscale than their low performing counterparts. Compared to average performing students, high performers were found significantly superior in terms of declarative knowledge (p=0.006), better planning (p=0.047), monitoring (p=0.008) and evaluation of effectiveness (0.004) of the learning process.Conclusions: Metacognitive awareness level has a significant impact on the academic performance of medical students in the physiology course. Low performers need to improve both declarative and procedural knowledge while average performers should augment their declarative knowledge. In terms of regulation of cognition, low performers should develop better implementation, correction, and evaluation skills while average performers should make better planning other than improving their monitoring and evaluating skills.

The acute destructive pneumonias (ADP) occupy up to 80% of the total number of pneumonias. They require constant improvement of treatment strategy. Nowadays the use of surfactants is a part of most treatment protocols. The aim was to study the features of the solid phase bronchoalveolar lavage in children with the ADPs in the dynamics of complex treatment with exogenous surfactant.Material and methods: We examined 39 patients of contaminated surgery. We identified 2 groups of patients. The patients of first group (n=27) had pulmonary pleural form of ADP, the second group (n=12) had pulmonary form of ADP. All patients got classical treatment and the earlier draining of pleural cavity. We used as an antiseptic reamberin 1.5% by 10 ml/kg and endobronchially injected exogenous surfactant Bl in dose12 mg/kg body weight a day, 6 mg/kg every 12 hours. All the children were made a bronchoscopy to obtain BAL to study the crystallization properties. The solid phase of BAL was studied by method of cuneal dehydration.Results: All facies before treatment were divided into two groups according to classification of facies of biological fluids. Only the facies of the second and the third types were detected there. It was revealed that the sizes of the zones of the facies were different in the comparison groups before treatment and after. And the level of crystalline structures and amorphous aggregates were different in the groups with different degrees of inflammation.Conclusion: So, we can assume that the change in surfactant system is characterized by changes in the morphological structure of solids phases of BAL. And the morphological structure of BAL depends on the chemical composition of BAL.■ UDC: 616.24 002.31 07 ■ Bronchoalveolar lavages ■ Cuneal dehydration ■ Lung surfucant system

In the last decade the health of young people in Ukraine as well as in many other countries of the world significantly deteriorated according to the results of screening tests. Because of this the main task of prophylactic medicine is development and introduction of new methods of early diagnostics of diseases. The aim of the work to assess the peculiarities of adaptation of students with different types of vegetative regulation.Material and methods: 415 second year students of Lugansk State Medical University were tested. The mechanisms of physiological functions of the body regulation were assessed by registration of cardiac rhythm variability (CRV). Analysis of CRV was performed by three methods: statistical, geometrical, and spectral analysis. The express method proposed by Shlyk, N.I. (2009) was later used to determine the prevailing type of vegetative regulation. To assess adaptability the method of R.M. Baevskij (1979) was used.Results: In the result of investigation 4 types of functional states of regulatory systems were determined: I type 295 (71 %) of tested, II in 14 (3 %), III in 96 (23 %) and IV only in 10 (2%). I type of functional state of regulatory systems in the wakeful state at rest was characterized by moderate prevalence of central regulation of heart rhythm (MPCR), decreased activity of autonomic regulation. It was noticed that some of the parameters of CRV (like RR, SDNN, RMSSD and pNN50) which characterize autonomic regulation, were statistically lowere (р≤0.01) compared to type III, and some (like AMo and SI) higher, in both female and male students. Summarized spectrum capacity and components of its wave structure (HF, LF, VLF) which characterize central regulation were statistically significantly lower (р≤0.01) for the I type of regulation compared to the III one which is characterized by moderate prevalence of autonomic regulation of the heart rhythm. In female students with type I autonomic regulation compared to male students such CRV parameters as RR and AМo were statistically significantly lower (р≤0.05), while the parameters of total potency (TP) and high frequency waves (HF) were higher (р≤0.05), which could point to more centralized heart rhythm regulation in male compared to female. The evaluation of regulatory systems overstress allowed to determine the state of adaptation and risk of overstress or breakdown in students with different types of autonomic regulation.Conclusions: Thus, evaluation of adaptation state in students with different types of autonomic regulation allows to characterize the current functional state and uncover the risk of disease development.

Objective -The aim of this study is to report a rare clinical case of a 16-month-old boy with a sudden episode of hemorrhaging deterioration, which required immediate laparotomy 14 hours after a successfully performed non-surgical reduction of intussuscepton. Inflamed Meckel's diverticulum was identified as the cause of hemorrhage due to the reperfusion of this region of the intestine after the invagination was resolved. Case Report -A 16-month-old boy was presented to the emergency department with the signs and symptoms of acute intestinal invagination, which were visually confirmed by ultrasound. The successful reduction of intussusceptions by air enema was performed and confirmed by ultrasound. On physical examination five hours after the gas enema procedure patient had no complaints, and no signs or symptoms of peritoneal irritation. However, 14 hours after the reduction of intussusception patient developed signs of hemorrhage, which suggested the presence of hemorrhaging Meckel's diverticulum due to a reperfusion of that region of intestine. Conclusion -Despite the successful use of nonsurgical methods of disinvagination, it remains critical for the management team to keep in mind that one of the predisposing factors of acute intestinal invagination such as Meckel's diverticulum can cause post therapeutic complications, manifesting as acute hemorrhage.