Varna Medical University Press: Journals
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The epidemiological significance and etiological structure of Salmonella sp. as a cause of food- and waterborne infections in Bulgaria
Get PDFINTRODUCTION: Salmonella is a leading cause of gastroenteritis in humans and animals, causing typhoidal and non-typhoidal infections that can develop into widespread food- and waterborne outbreaks.AIM: The incidence of salmonellosis among humans in our country has remained relatively high in recent years despite annual fluctuations. In this work, we aim to clarify the dynamics of the prevalence of salmonella-causing human infections in Bulgaria from 2017 to 2023.MATERIALS AND METHODS: We used data from annual analyses of isolated Salmonella cultures from patients and contacts of the NRL Enteric Infections, Pathogenic Cocci and Diphtheria.RESULTS AND DISCUSSION: During the study period, a total of 3208 human salmonellosis cases were laboratory confirmed by bacterial culture isolation, of which 1847 were from patients with enterocolitis syndrome and 1361 from infectious carriers. These cultures belonged to two species of Salmonella enterica and S. bongori, 4 subtypes – enterica, salame, arizonae and diarizonae, and 66 Salmonella serotypes. Salmonella Enteritidis plays the leading etiological role in the patients, occupying a relative share of 47%, followed by Salmonella Typhimurium – 32.8%, and 40.5% are monophasic. Salmonella Infantis ranked third with 4.85%. The following serotypes were isolated for the first time in our country: Brazzaville, Larochelle, Ndolo, Kuoka, Jerusalem, Vejle, and the unique for the world, new serotype –Salmonella 11: z41: enz15. In carriers, in contrast to patients, other serotypes come to the fore Muenster, Bazenheid, Dublin, etc. The data obtained in the analysis again confirm that infants and young children are the group most affected by Salmonella infections. Salmonella outbreaks in the country have been declining sharply since 2020, in contrast to sporadic cases. In 2018, there was an outbreak of a rare serotype, London.CONCLUSION: Nontyphoidal salmonellosis is a socioeconomic and public health problem that requires control of Salmonella infections in animals and humans. In the effort to contain them, it is necessary to know in detail and follow in dynamics the etiological structure of salmonellosis and to apply non-antibiotic-based approaches such as prophylaxis with probiotics, bacteriophages, and vaccines among farm animals
Parental awareness of children attending child care facilities in Varna region regarding scarlet fever
Get PDFIntroduction: Scarlet fever is an extremely relevant issue in the field of public health due to its widespread distribution and the complications that can arise from untimely diagnosis and treatment. Parents' knowledge regarding the modes of transmission of the pathogen, possible complications, and prevention measures plays a key role in controlling the disease.Aim: The aim of this article is to study the awareness of parents of children attending organized care facilities in the city of Varna regarding scarlet fever.Materials and Methods: An anonymous survey was conducted among 639 parents of children attending six child care facilities in the city of Varna. The survey contained 29 closed-ended and 1 open-ended question. Sociological, statistical and mathematical, and graphical methods were used.Results: From the conducted survey, we found that 92.6% of respondents knew the main symptoms of scarlet fever and 77.2% of them were informed about the transmission methods of the pathogen, but 43% of parents did not know about the complications from the infection. For main sources of information about the disease, the respondents indicated mainly the general practitioner (41.8%) and social networks (18.8%).Conclusion: Targeted educational campaigns among parents are necessary to increase their awareness regarding the spread of infectious diseases in child care facilities
The Opinion Of Dental Technology Students About The Educational Qualification Degree ‘Professional Bachelor’
Get PDFThe transformation of semi higher medical education into university-college education is a step towards its harmonisation with the European educational framework. The Dental Technician specialty is a regulated profession from the Health Care field of studies, which incorporates treatment-restorative and medical-technical activities. The training lasts three years with the only possibility of regular form of education. The educational qualification degree has been a professional bachelor since 2008. The horarium is determined by the Uniform State Requirements. The practical training has a leading role and includes various practical studies and activities as well as undergraduate internship.The purpose of the research is to study the opinion of students specializing in Dental Technology and their attitude to changes regarding the educational qualification degree. In order to achieve the goal literary sources, normative documents and curricula have been studied. An anonimous survey was conducted in March 2024. The target of research are 86 dental technology students in their study stage – 65 students from Medical University-Varna and 21 students from Medical University-Plovdiv. Graphical and comparative analyses have been used to present and interpret data.The following conclusions can be drawn from the analysis of the research results and the studied sources: the majority of the students support the change regarding the educational qualification degree and the increase of the duration of the educational process (three and a half academic years); more than half of the respondents share the opinion that the change in the educational qualification degree is a prerequisite for future development; the increase of the duration of the education will lead to better practical training in the specialty; opportunities for better professional realisation and competitiveness on the labour market; the research data can be useful to the Ministry of Education to initiate the change in the educational qualification degree
A Study of Parental Attitudes in the Varna Region Towards the Chickenpox Vaccine
Get PDFIntroduction: Chickenpox is an acute infectious disease caused by the varicella-zoster virus, a member of the herpesvirus family. The disease primarily affects children, and after the illness, the virus remains in a latent state with the potential for reactivation, causing shingles at any age. The use of the chickenpox vaccine significantly reduces the incidence of the disease and the possibility of subsequent complications.Aim: The study aims to investigate the attitudes of parents of children attending childcare facilities in the Varna region regarding the chickenpox vaccine.Materials and Methods: An anonymous survey was conducted among 639 parents of children attending six childcare facilities in the municipality of Varna. Sociological, statistical-mathematical, and graphical methods were used.Results: The survey found that 77.3% of the respondents were aware that a chickenpox vaccine is available in Bulgaria, with 28% stating that the vaccine is recommended. Only 19.4% expressed willingness to vaccinate their children. One-third of the respondents (36%) would not vaccinate their child even if the vaccine were provided for free by the Ministry of Health, and 17.2% declared a categorical refusal to vaccinate. More than half of the parents (53.8%) were unaware of the risks associated with the vaccine, and only 13% agreed that accessible information exists regarding the action, reliability, and benefits of the chickenpox vaccine.Conclusion: The study demonstrates a negative attitude among parents towards the chickenpox vaccine. The lack of awareness and access to reliable information based on scientific evidence and facts are the main reasons for vaccine refusal. Targeted actions and informational campaigns among parents of children attending childcare facilities are necessary to communicate the benefits and risks of the chickenpox vaccine
The Role of Potassium in the Management of Chronic Kidney Disease – Dietary Approaches
Get PDFIntroduction: Chronic kidney disease (CKD) affects approximately 13% of the adult population worldwide and represents a significant health problem. In recent years, the morbidity and mortality associated with kidney diseases have increased significantly, and by 2040 these diseases are expected to become the fifth leading cause of disease burden. Potassium is an important electrolyte that plays an essential role in the proper functioning of the kidneys and must be maintained within reference limits to prevent dyskalemia conditions. Management of dyskalemia is key in CKD and requires the application of appropriate pharmacological and non-pharmacological approaches.Aim: The objective is to review the possibilities of maintaining potassium balance through nutrition, as potassium balance is important for managing dyskalemia and reducing the risk of complications in patients with CKD.Material and Methods: The review included publications related to CKD, potassium, dyskalemia, and dietary approaches to managing the condition, based on evidence from scientific databases. The search was performed using the following keywords in English: chronic kidney disease, potassium, dyskalemia, diet foods, low potassium foods, hyperkalemia, hypokalemia, diet.Results: The review shows that dietary interventions, including the restriction of potassium-containing foods and the selection of appropriate cooking methods, effectively control potassium balance in patients with CKD. Replacing common salt with potassium-fortified substitutes may reduce cardiovascular risks but requires caution in these patients due to the risk of hyperkalemia.Conclusions: Effective management of potassium balance in patients with CKD requires an integrated approach with dietary and medical interventions. Individualized dietary strategies tailored to the stage of the disease are key to preventing complications and improving quality of life
Complications and Causes of Addiction – Quality of Care
Get PDFDependencies on psychoactive substances and alcohol represent significant medical and social issues, necessitating intensive efforts in psychiatric healthcare. Addiction is a severe disease that psychologically devastates individuals, further complicating social integration due to stigma and discrimination, which are major obstacles to the rehabilitation and resocialization of those affected. Individuals with dependencies often exhibit insecurity and emotional instability, requiring specialized approaches in treatment.This article examines the causes of dependencies on psychoactive substances (PAS) and alcohol, as well as related complications. A retrospective analysis of data from the Second Psychiatric Clinic of St. Marina University Hospital in Varna highlights the importance of somatic comorbidities and their impact on the treatment of dependent patients. This analysis emphasizes the high level of strain psychiatric patients with complications impose on the healthcare system. Data on the socio-demographic characteristics of the patients, modes of admission, types of diagnoses, and associated somatic comorbidities are included.The increased complexity of care for these patients demands adequate training and preparation of medical staff, particularly nurses, who are often the first point of contact with patients. The necessity of a multidisciplinary approach involving specialists from various medical fields is critical for the effective management of both the psychiatric and somatic aspects of dependency. Providing coordinated and integrated health services thus becomes a primary priority for enhancing the chances of successful recovery and reintegration of dependent individuals into society
Pharmacist Attitudes Towards Providing Pharmaceutical Care for Patients with Ankylosing Spondylitis – A Pilot Study
Get PDFThe pharmacist in community pharmacies, as an accessible and reliable source of health information, could play an important role in the comprehensive care of patients with Ankylosing Spondylitis (Bechterew's disease). This can begin at the prevention stage through effective early screening of potential patients with back pain and continue with diagnosed AS patients by implementing the concept of Pharmaceutical Care, which is fundamental to the principles of Good Pharmacy Practice.The goal of this pilot study is to explore pharmacists' attitudes toward providing pharmaceutical care for patients with Ankylosing Spondylitis. The results show that most pharmacists are familiar with the concept of Pharmaceutical Care and are willing to implement it, but they face several challenges and barriers, such as lack of time, lack of designated space, insufficient knowledge about the pharmaceutical care algorithm for this specific condition, and others.Pharmacists recognize the importance and value of pharmaceutical care, especially for patients with chronic diseases like Ankylosing Spondylitis. Moreover, the willingness to provide pharmaceutical care and attitudes towards it may be influenced by factors such as the pharmacist's age, level of education, and years of work experience.The results of the study will be useful in identifying and overcoming the barriers that pharmacists face in applying pharmaceutical care to patients with Ankylosing Spondylitis, thereby achieving optimal treatment outcomes in collaboration with other healthcare professionals
Regional inequalities in infant mortality rates in Bulgaria (2000–2019)
Get PDFIntroduction: Infant mortality indicators are core public health measures and criteria for the wellbeing as well as the quality of healthcare within a country. Despite the significant decline of infant mortality in Bulgaria between 1990 and 2020 (from 14.8 to 5.1‰), the country remains at the penultimate position among the 27 European member states. We are investigating the causes behind this unfavorable position of the country looking into the regional inequalities in infant mortality rates across the six regions in Bulgaria during the period 2000–2019.Materials and Methods: Data on still and live births, early, late, and postnatal deaths by region for the period 2000–2019 were obtained from the Bulgarian Statistical Institute. Infant mortality rates were calculated using conventional definitions for each of the 6 regions. Comparisons were made by estimating rate ratios (RR) between regions with highest and lowest rates.Results: All of the six regions experienced a decline of all infant mortality indicators between 2000–2019, albeit at a varying degrees and rates. The most significant disparity between regions was observed in early neonatal mortality (ENM), with RR of 2.6 in 2019, followed by post-neonatal inequality, with RR of 2.5. The smallest difference between regions was observed in fetal mortality, with RR of 1.7, and late neonatal mortality (LNM) with a 90% difference between the region with highest and lowest LNM rates. The southwestern region (including the capital Sofia) demonstrated permanent advantage with all infant mortality rates comparable to the lowest rates in EU countries. Conversely, the northwestern and the southeastern regions consistently exhibited disadvantaged outcomes worse than the lowest rates in Europe.Conclusion: Significant regional disparities in infant mortality, indicative of health and well-being disparities, have existed in Bulgaria over the past two decades. The widening regional disparities underscore the need for both a more cohesive regional policy framework and urgent interventions proportionate to the regional needs
Parents’ Responsibilities When Forming Healthy Habits In Children Under 3 Years Of Age
Get PDFHealth education is a purposeful process of influence through which knowledge, skills and habits related to health are obtained and formed. Through it, healthy behaviour is established to prevent disease, retore, protect and enhance the health of both individuals and society as a whole.The aim of this report is to investigate and analyse parents’ responsibility in the formation of healthy habits in children under 3 years of age.Materials and methods: A direct anonymous survey was conducted among parents of children of up to 3 years of age, regarding their participation in building healthy habits in their children. The survey included parents of 774 children from Varna and was conducted during July 2020. The data were processed statistically. A documentary method was used.Results and discussion: The specificity of health education with young children is that it starts on the first day of their life and the first educators are their parents. The first three years are particularly important for a child when developing a positive attitude towards healthy habits and their mastery. According to 69.8% of the surveyed parents, both parents are involved in building those healthy habits, while 25.2% answer that the main responsibility of upbringing the child falls with the mother. A significant proportion of parents share that they daily spend time building healthy habits during other daily activities (94.2%). Just over half of respondents (55.4%) claim that sometimes they encounter difficulties when forming healthy habits, with the relative share of those experiencing difficulties when forming such habits decreasing with each subsequent child born.Conclusion: The science Psychology has proven that in adult life, a person repeats the patterns of behaviour they learned during childhood. In this connection is the huge role of the family, as a role model