Varna Medical University Press: Journals
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Natal primary mandibular molar. A case report
Full text linkINTRODUCTION: Natal or neonatal teeth are a rare anomaly. The distribution ratio between girls and boys is approximately 2:1. When a child is born with teeth, they are called natal teeth, or if teeth erupt in the first month after the birth, they are neonatal. There are many risk factors for their occurrence, but the etiology is unknown. Only 3% of the cases are natal mandibular primary molars or canines.AIM: This article aimed to report a rare case of a supernumerary mandibular natal tooth in the molar region of a 3-year-old girl.MATERIALS AND METHODS: The subject of this study was а 3-year-old girl who came to the dental office for the first time at the age of 4 months with a gingival overgrowth along the alveolar ridge, visible on the mandibular molar area. According to the parents, the child was born with this anomaly.RESULTS: After a period of follow-ups, a controlled clinical examination revealed a difficult eruption of tooth 84 and a delayed eruption of tooth 85. A segmental radiograph was taken, which clearly showed a supernumerary primary molar. The diagnosis was an unerupted natal tooth with visible mucosal swelling. It was decided to extract the tooth under sedation. The patient was sedated and after local anesthesia, the natal tooth was removed.CONCLUSION: A supernumerary natal tooth in the mandibular molar region is a rare anomaly. A pediatric dentist should recommend early diagnostics of natal/neonatal teeth. Each case is individual, and treatment depends on the clinical and radiographic findings
Management of postoperative edema in oral surgery
Full text linkPostoperative pain, edema, and trismus are normal sequelae after oral surgery interventions. Their manifestation depends on some individual characteristics and surgery-related factors. To reduce their extent, different medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and enzyme-based products have been used. This literature review aims to discuss the methods for postoperative edema control in oral surgery and analyze their efficiency based on the existing scientific data. An electronic search in Web of Science, PubMed, and Scopus was conducted using a combination of keywords and MeSH terms (edema, oral surgery, control, and management). The results have demonstrated that the most commonly used medications were corticosteroids. They induce the synthesis of endogenous proteins that block the activity of the enzyme phospholipase A2 and thus the release of arachidonic acid. This suppresses the synthesis of prostaglandins (PGs), leukotrienes, and thromboxane, responsible for inflammation and pain. However, there is some study heterogeneity regarding the most appropriate route of administration to limit postoperative edema. Further research is necessary to validate the effect of the other suggested methods for edema control, such as physical therapy, NSAIDs, enzyme products, and hyaluronic acid, as the results in the literature are not uniform
Prevention of surgical site infection in oral surgery
Full text linkInfectious complications after oral surgery occur during the first postoperative month (or up to 1 year after dental implant therapy). Various patient-related and surgery-related factors influence the risk of surgical site infections (SSIс). This research aims to discuss and analyze the methods for preventing SSI in oral surgery and evaluate the effectiveness and risks of antibiotic prophylaxis (AP). An electronic search in several databases, including Web of Science, Scopus, PubMed, and Google Scholar was conducted on 20 February 2025 using the following combination of keywords and MeSH terms: surgical site infection, prevention, oral surgery, antibiotics, antibiotic prophylaxis, and antimicrobial resistance. The review indicated that although AP has proven its effectiveness in reducing the risk of SSI, its use should be avoided in healthy patients, as antimicrobial resistance (AMR) has become a growing threat to public health worldwide. The benefit-risk ratio for its administration should be carefully evaluated for each patient. Global trends aim to develop strategies and strict drug policies that ensure antibiotic use only in cases with a high risk of severe infection. Asepsis and antisepsis, and the appropriate surgical technique are the most important factors for reducing the risk of SSI
Application of the International Prostate Symptom Score in patients with benign prostatic hyperplasia and large gland volume
Full text linkBenign prostatic hyperplasia with large gland volume considerably disturbs patients’ individual quality of life. In recent years, a contemporary specialized International Prostate Symptom Score has been introduced among these patients in other countries. The results from the use of this score in 28 patients treated by means of transurethral thulium laser vapor resection and vaporization during the period between 2015 and 2018 at Maichin Dom Multiprofile Hospital for Active Treatment – Varna, are presented. The patients were at a mean age of 72.61 ± 7.765 years (range, 56 to 83 years) and with a mean prostatic volume of 156.71 ± 43.014 mL (range, 90 to 260 mL). The average total International Prostate Symptom Score in all patients prior to the operation amounted to 28.50 (range, 22 to 35), corresponding to a severe degree of disturbed quality of life. After three months, a considerable reduction of this score down to 2.14 (range, 0 to 5) occurred, which testified to a substantial improvement in the quality of life parameters analyzed. The main rating of the individual quality of life of patients with urinary symptoms also diminished considerably following the operative intervention (from 5.46 down to 0.61), proving their improvement in quality of life. Transurethral thulium laser vapor resection and vaporization in patients with benign prostatic hyperplasia is very effective in terms of improving quality of life
The influence of higher education and professional experience on nurses’ digital competencies
Full text linkВъведение: Настоящото изследване разглежда влиянието на образователното равнище и професионалния опит върху дигиталните компетентности на медицинските сестри. Акцентът е поставен върху ролята на висшето образование и продължаващото обучение като ключови фактори за ефективното приложение на дигитални технологии в здравеопазването.Цел: Да се оцени степента, в която образованието и трудовият стаж допринасят за формирането и развитието на дигитални умения сред медицинските сестри, в контекста на съвременните професионални изисквания.Материали и методи: Проведено е анкетно проучване сред практикуващи медицински сестри, използващо стандартизиран въпросник. Изградени са индекси за оценка на шест области на дигитална компетентност: информационна грамотност и работа с данни, комуникация и сътрудничество, създаване на съдържание, онлайн безопасност, решаване на проблеми и електронна здравна грамотност. Надеждността на инструментите е потвърдена чрез коефициента на вътрешна консистентност на Кронбах (α).Резултати и обсъждане: Данните показват, че трудовият стаж оказва ограничено влияние върху дигиталната компетентност, като статистически значима разлика се наблюдава единствено при уменията за решаване на проблеми (p = 0.004), където по-младите специалисти демонстрират по-високи резултати. Образователното равнище има по-съществено въздействие: участниците с висше образование постигат значимо по-високи резултати в четири от изследваните области – информационна грамотност, създаване на дигитално съдържание, решаване на проблеми и електронна здравна грамотност (p < 0.05).Заключение: Образованието оказва по-силен ефект върху дигиталната компетентност на медицинските сестри в сравнение с професионалния опит. По-високото образователно ниво кореспондира с по-добро овладяване и прилагане на дигитални умения. Продължаващото обучение се явява съществено условие за поддържане на висока дигитална грамотност и за подобряване качеството на медицинската практика.Introduction: This study examines the impact of educational level and professional experience on the digital competencies of nurses. The focus is on the role of higher education and continuing education as key factors for the effective application of digital technologies in healthcare.Aim: To assess the extent to which education and work experience contribute to the formation and development of digital skills among nurses in the context of contemporary professional requirements.Materials and Methods: A survey was conducted among practicing nurses using a standardized questionnaire. Indices were developed to assess six areas of digital competence: information literacy and data handling, communication and collaboration, content creation, online safety, problem solving, and e-health literacy. The reliability of the instruments was confirmed by Cronbach's internal consistency coefficient (α).Results and Discussion: The data show that work experience has a limited impact on digital competence, with a statistically significant difference observed only in problem-solving skills (p = 0.004), where younger professionals demonstrate higher results. Educational level has a more significant impact: participants with higher education achieve significantly higher results in four of the areas studied – information literacy, digital content creation, problem solving, and e-health literacy (p < 0.05).Conclusion: Education has a stronger effect on the digital competence of nurses than professional experience. A higher level of education correlates with better mastery and application of digital skills. Continuing education is an essential condition for maintaining high digital literacy and improving the quality of medical practice.
Modern laser therapy of benign prostate hyperplasia
Full text linkDuring recent years, the medico-social importance of benign prostatic hyperplasia has increased worldwide and in our country. Some results from the application of contemporary laser therapy and several other methods for the operative treatment of patients are presented. Holmium laser enucleation of the prostate plays a major role. Its use in patients with a large gland volume is characterized by a number of advantages in terms of effectiveness and safety achieved. For comparison, thulium laser enucleation of the prostate, transurethral prostate resection, transurethral plasma kinetic prostatectomy, robot-assisted simple prostatectomy, contact diode laser vaporization, and GreenLight vaporization are discussed. The popularization of positive world experience would contribute to the further improvement of the operative treatment of benign prostatic hyperplasia in our country
The role of the medical universities in the care for mental health of medical students
Full text linkAbstract: A number of studies have shown that medical students have poorer mental health compared to age-matched controls from the general population. Although medical students are trained to help improve people's health, they often lose sight of their own well-being. Many students suffer from anxiety, depression, and burnout. In response, it is important for medical universities to take active measures to prevent poor mental health among students and to ensure they have access to timely and appropriate support for their mental health problems
Peripherial vestibular disorders in children
Full text linkIntroduction: Vestibular dysfunction is classified into two main categories: central and peripheral. Peripheral vestibular disorders are more common than central ones in both children and adults. Diagnosing vestibular dysfunction in children is challenging due to unclear histories provided by children and their parents, as well as the need for collaboration among specialists from various fields to rule out other conditions that may cause vestibular symptoms.Materials and Methods: For a period of 5 years, 45 children aged 3 to 18 years with vestibular disorders were monitored. The most common symptoms were dizziness, nausea, vomiting, instability, and unsteady gait. In nearly 60% of the children with vestibular symptoms, Eustachian tube dysfunction was observed, often as a result of acute rhinitis or inflamed/enlarged nasopharyngeal tonsils.Conclusion: Peripheral vertigo is more common than central vertigo in childhood. Clinicians should be aware of, and actively investigate, the common causes of vertigo in children (congenital, acquired, neurological, endocrine, inflammatory, or hormonal) to ensure accurate diagnosis and effective treatment