THE MEDICO-SOCIAL CHARACTERISTIC OF GIRLS WITH VARIOUS CLINICAL FORMS OF PREMENSTRUAL SYNDROME Текст научной статьи по специальности «Фундаментальная медицина»

THE MEDICO-SOCIAL CHARACTERISTIC OF GIRLS WITH VARIOUS CLINICAL FORMS

OF PREMENSTRUAL SYNDROME

Abstract

The article is devoted to studying of features of course and clinical manifestations of premenstrual syndrome (PMS) at first-year girls of medical university which are risk group on factors of a cognitive and psychoemotional overstrain. The received results are the basis for optimization of preventive actions and prediction of a course of PMS directed on timely delivery of health care to girls for prevention of emergence and progressing of this disease.

Keywords

premenstrual syndrome, PMS forms, girl-students of medical university, associated diseases, social factors, lifestyle

AUTHORS

Svetlana Belik Zita Avetisyan

PhD in Medicine, Associate Professor PhD in Medicine, Associate Professor

Department of general hygiene Department of general hygiene

Rostov State Medical University Rostov State Medical University

Rostov-on-Don, Russia Rostov-on-Don, Russia

superbelik@maH.ru avetisyan-rostgmu@yandex.ru

Igor Podgorny Tatyana Zhukova

Assistant of a lecturer PhD in Medicine, Professor

Department of Obstetrics Department of Hygiene

and Gynecology No. 2 Rostov State Medical University

Rostov State Medical University Rostov-on-Don, Russia

Rostov-on-Don, Russia zog.zhukova@yandex. ru

rd2@bk.ru

Yuliya Mozhinskaya

Student

Rostov State Medical University

Rostov-on-Don, Russia

atheletka@mail. ru

Introduction. At present, one of the most actual problems of gynecology is the premenstrual syndrome (PMS) which is among the most widespread and least studied states (Prilepskaya et al., 2012). The premenstrual syndrome is characterized by physical, cognitive, affective and behavioral symptoms which arise cyclically during a luteal phase of a menstrual cycle and quickly are eliminated at the beginning or within several days. Today PMS affects a half of all girls of early age and is the leading reason of absences of classes in educational institutions (Belik et al., 2016; Padmavathi, 2014; Tacani, 2015). In a number of foreign researches it is confirmed that educational conditions in medical university contribute to frequency of incidence of PMS among girl-students (Goker et al., 2015; Farrokh-Eslamlou et al., 2015), at the same time features of prevalence and a course of PMS depending on a study year aren't considered. It is evident that first year girl-students are special risk group. It is caused by:

- specifics of pre-university education which lasts from one to five years and represents classes in three-four subjects in addition to the educational program;

- stress at passing of the Unified State Exam;

- adaptation to educational conditions after enrolment at Higher Education Institution, caused by new methods of the organization of education, by high intellectual and informational loads, by sessions with high psychoemotional stress (Avetisyan, 2005; Belik et al., 2014; Belik et al., 2016).

In addition there are no improved interpersonal relations in new collective and living conditions change. All this actualizes the necessity of studying of features of a course and clinical manifestations of PMS at girls of this group, and also studying of a contribution to development of a syndrome of associated diseases, social factors and lifestyle.

The purpose of the study is to give the medico-social characteristic to the girl-students of the medical universities with various clinical forms of premenstrual syndrome.

Materials and Methods. The research was carried out at the Rostov state medical university. Questioning on personally developed algorithm became a basis of research. 200 first year girl-students of treatment-and-prophylactic faculty whose average age was 18,8±1,4 years were examined. At 184 (92%) girls PMS was revealed. They were included in the main group. Students with absence of a premenstrual symptomatology (8%) were included into control group. Both groups were comparable in age parameters (p>0,05). The main conditions for taking part in research were voluntary consent of respondents and also absence in the anamnesis of craniocerebral injuries, chronic diseases of kidneys, diseases of a thyroid gland, lack of use of hormonal contraceptives within at least last 3 months before research. The PMS clinical form was determined by prevalence of symptoms of any group. Digital data were processed by methods of descriptive statistics with use of the Microsoft Excel application program and Statistica 6.0.

Results. By results of questioning it is established that the cephalgic form (CF) and neuropsychic form (NPF) of PMS are the most frequent forms in our sample that exceeds the average values of the population more than twice and by 40,6% respectively. The edematous form (EF) is observed in 8% of cases, crisis form (CF) - isn't taped (tab. 1).

TABLE 1. PREVALENCE OF PMS DEPENDING ON A CLINICAL FORM

PMS form Frequency of manifestations

Rostov state medical university (2014-2015 yrs) All-population (T.F. Tatarchuk et al., 2003)

NPF 39,0 % 18,0%

EF 8,0 % 4,0%

CF 45,0 % 32,0%

CF 0 % 4,0%

The compensated and subcompensated stages occur approximately identical frequency at all forms of a clinical current of PMS. Decompensated stage has wider prevalence at CF (28,3%).

Results of research of the somatic anamnesis of the main group revealed the highest frequency of allergic reactions (27%), frequent catarrhal diseases (32%), the syndrome of vegetative dystonia (SVD) before menarche (25,0%) and gastrointestinal tract diseases (37,5%) at girls with EF of PMS. 12% of respondents with CF of PMS had allergic reactions, 17,8% of respondents with CF of PMS had diseases of a gastrointestinal tract and SVD before menarche and 8,9% of respondents noted frequent catarrhal diseases. Girls with NPF of PMS had the lowest occurrence of allergic reactions (15,4%) and SVD before

menarche (7,7%); frequent catarrhal diseases and diseases of a gastrointestinal tract were noted by 15,4% and 17,9% of respondents respectively.

In the analysis of the somatic anamnesis in control group the associated diseases weren't revealed.

Average age of a menarche in the main group was 12,3±1,5 years (p > 0,05). At students with EF, CF and NPF of PMS a regular menstrual cycle was noted by 46%, 82,6% and 77,2% respectively, at the same time painful and excessive menstruation were noted at 17,3%, 12,6 and 8,4% of respondents respectively. Manifestation of the first symptoms of PMS on average is noted at the age of 15,3±1,4, 17,4±1,1 and 16,7 ±1,4 years respectively at girls with EF, CF, NPF of PMS.

Average age of a menarche in control group was 12,8±0,2 years.

93,8% girls had a regular menstrual cycle (25-31days) with duration of menses for 35 days. The irregularity of a menstrual cycle was noted by 6,2% of respondents.

The contribution of social factors (tab. 2) was defined, first of all, by the residence of girls before entering a higher education institution. It was established that at residence in rural areas the prevalence of PMS is twice lower, than at residence in the large cities. Material security of the families has a significant importance. At girls with the family income below living wage at the time of research PMS occurs twice more often. The contribution of social factors to development of PMS is 66,7% at NPF, 62,5% at EF and 59% at CF. Besides it is established that 100% of students with absence of a syndrome had full, secured families, and from 12,5% to 15,5% of girls with PMS lived in incomplete families.

TABLE 2. CONTRIBUTION OF SOCIAL FACTORS TO DEVELOPMENT OF PMS

Factor, % Control NPF CF EF

Family structure (incomplete / full) 0/100 15,4/ 74,6 15,5/ 74,5 12,5/ 87,5

Residence (village / city) 0/100 38,5/ 61,5 33,0/ 67,0 37,5/ 62,5

Living wage of a family (|/|) 25/75 66,7/ 33,3 59,0/ 41,0 62,5/ 37,5

74,4% of girls with NPF, 66,7% of girls with CF and 75,0% girls with EF pointed to existence of symptoms of PMS at relatives of the first generation. The interesting fact was that at students with absence of a syndrome (control group) the relative suffered from PMS in 87,5% of cases.

At an assessment of a contribution of lifestyle to formation and development of PMS it is established that most often the existence of stressful situations in life was noted by respondents with EF of PMS at 50,0%. In this group the highest values of such factors as work at the computer till 5 hours a day, abuse of tonics and the use of fast food are noted (62,5%, 87,5% and 75,0% respectively).

TABLE 3. CONTRIBUTION OF LIFESTYLE TO DEVELOPMENT OF PMS

Factor, % Control NPF CF EF

Frequent stresses 12,5% 10,3% 35,5% 50,0%

Work at the computer till 5 hours a day 75,0% 35,9% 31,1% 62,5%

Coffee/tea use several times a day 12,5°%/ 50,0% 15,4%/ 46,2% 8,9%/ 51,1% 25,0%/ 87,5%

Irregular exercises 62,5% 61,5% 60,0% 62,5%

Regular training of professional sport 0% 12,9% 13,3% 25,0%

Use of fast food 25,0% 82,1% 67,7% 75,0%

Girls with NPF of PMS most less often noted the heightened psychoemotional strain (10,3%), but 82,1% of them used fast food. The lowest parameters of such factors as work at the computer till 5 hours a day and irregular exercises are noted at CF.

Thus, when studying the medico-social characteristic of girls with the PMS various clinical forms it was established that the significant contribution to development of PMS of all clinical forms at girls of the main group was made by social factors: residence in the large cities before entering a higher education institution, the family income below living wage, living in an incomplete family, and also adverse factors of lifestyle: insufficient physical activity and professional sports, abuse of tonics and use of fast food. At the same time, at the students suffering from EF of PMS the features associated with to existence in the anamnesis of early manifestation of the first symptoms of PMS (15,3±1,4 years), an irregular menstrual cycle, allergic reactions, frequent catarrhal diseases, SVD before menarche and diseases of a gastrointestinal tract, existence of stressful situations in life, work at the computer till 5 hours a day are revealed.

The received results are the basis for optimization of preventive actions and prediction of a course of PMS directed on timely delivery of health care to girls for prevention of emergence and progressing of this disease. As the activities of primary prophylaxis it is necessary to recommend minimization of the above mentioned factors of lifestyle in respect of which since teenage age, not only the public corrective actions realized in school programs of sex education of girls are expedient, but also individual efforts are important. During the education in Higher Education Institution for the girls suffering from PMS it is necessary to pay attention to measures of secondary prophylaxis which basis is made by the organization of a healthy lifestyle of students, at the same time the value of individual efforts increases.

REFERENCES

1. Avetisyan, Z.E. (2005). Hygienic assessment of educational process on 1-2 courses of medical school. Thesis of dissertation in support of candidature for a medical degree / Rostov State Medical University. Rostov-on-Don.

2. Belik, S.N., Dorokhova, I.M., Osmanova, U.Sh. and Saypullayeva, M.M. (2014). Chronic fatigue syndrome as the main sign of a disadaptation at first-year students of medical university. Collections of conferences of Research Center Sociosfera, 43, 201 -206.

3. Belik, S.N., Podgorny, I.V., Mozhinskaya, Yu.V., Zhukova, T.V. and Svintukhovsky, O.A. (2016). The place of a chronic fatigue syndrome among risk factors of disturbance of reproductive potential of youth. Collections of conferences of Research Center Sociosfera, 23, 44-47.

4. Belik, S.N., Zhukova, T.V., Svintukhovsky, O.A., Kharagurgieva, I.M. and Avetisyan, Z.E. (2016). Dependence of adaptive potential on a body-weight index at students. Collections of conferences of Research Center Sociosfera, 23, 58-60.

5. Farrokh-Eslamlou, H., Oshnouei, S., Heshmatian, B. and Akbari, E. (2015). Premenstrual syndrome and quality of life in Iranian medical students. Sex ReprodHealthc, 6(1), 23-27.

6. Goker, A., Artunc-Ulkumen, B., Aktenk, F. and Ikiz, N. (2015). Premenstrual syndrome in Turkish medical students and their quality of life. J ObstetGynaecol, 35(3), 275-278.

7. Padmavathi, P. (2014). Effect of acupressure vs reflexology on pre-menstrual syndrome among adolescent girls-a pilot study. Nurs J India, Sep-Oct, 105(5), 236-239.

8. Prilepskaya, V.N., Mezhevitinova, E.A., Sasunova, R.A. and Ivanova, E.V. (2012). Magnesium role in a pathogenesis of a premenstrual syndrome. Russian Journal of the obstetrician-gynecologist, 3, 81 -87.

9. Tacani, P.M., RibeiroDde, O., Barros Guimaraes, B.E., Machado, A.F. and Tacani, R.E. (2015). Characterization of symptoms and edema distribution in premenstrual syndrome. Int J Womens Health, 7, 297-303.

THE MAIN ASPECTS OF INTERACTION GOVERNMENT AND BUSINESS IN SHAPING THE SOCIO-ECONOMIC SPACE OF A REGION

Abstract

This paper considers the issue of interaction government and business in shaping the socio - economic space of a region. It is known that the business develops in favourable business climate, and at the same time it shapes him, what makes the application of measures of state support of business is an important condition for the successful achievement of national socio-economic priorities. So, the purpose of the article is to determinate the main directs of interaction of government and business.

Keywords

economic space, government economic policy, business support

AUTHORS

Larisa Belousova

PhD in Economics Department of Economics

and Management Southwest State University Kursk, Russia beHars2010@yandex.ru

Inna Babenko

PhD in Economics, Assistant Professor Department of Economics and Management Southwest State University

Kursk, Russia babenkoinny@gmail.com

The successful solution of a whole set of problems, collectively forming the positive dynamics of sustainable socio-economic development of the country and its regions, is directly related to the development of the business. The latter, in turn, is largely determined by the actions of the state. Thus, the question arises about the implementation of business support measures from the state and the formation of appropriate policy.

Note that in the theoretical aspect of such support not being unequivocal perception and interpretation, many of the directions and methods of state support of business remain controversial and contradictory. At the practical level, the state policy of support of business in Russia is often of situation is due to the current economic situation, previous decisions, traditions and other similar circumstances and, moreover, is often perceived and implemented perverted as protectionism.

Among the negative moments in the development of the modern practice of state support of business in Russia's regions, we note the following:

1) is implemented primarily differentiated on the basis of sectoral approach in defining the directions and objectives of business development;