Varna Medical University Press: Journals
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Meibomian gland dysfunction and azithromycin—what is the optimal regimen?
Get PDFIntroduction The meibomian glands are an important part of the homeostatic apparatus of the anterior ocular surface (AOS). Their dysfunction is a common condition and is associated with quantitative and qualitative changes in the lipid layer of the tear film. These changes, in the end, lead to disruption of the normal functioning and a subsequent damage to the eye surface. There are different methods of managing the condition, but setting a gold standard still poses a challenge to scientists and clinicians.Methodology The survey was conducted on the territory of the Specialized Eye Hospital, Medical University of Varna. All participants have signed an informed written consent. The study was carried out after approval by the Ethics Committee of the Specialized Eye Hospital in Varna. The criteria for inclusion were the presence of symptomatic meibomian gland dysfunction (MGD) and age over 18 years. The criteria for exclusion were a history of surgery and trauma of the eye surface, pregnancy, lactation, intake of oral contraceptives or hormonal therapies, known hypersensitivity to azithromycin, use of contact lenses, change in the position of the eyelids. The study included 40 patients, divided into two groups of 20 people matched by age (average age 45 years) and gender (10 female and 10 male) and all of them filled out a verified questionnaire about the state of the AOS (Ocular Surface Disease Index, OSDI) and underwent a detailed ophthalmological examination. Group 1 was treated with oral azithromycin 500 mg/day, 3 consecutive days in 3 cycles every 7 days, and Group 2 was on a managed azithromycin regimen consisting of 1 g/day, 1 x week, for 3 consecutive weeks. Both groups maintained eyelid hygiene with cleaning wipes in the morning and evening, and warm compresses in the evening. Examinations were performed at baseline, after 4 weeks (first follow-up), and after 8 weeks (second follow-up), and parameters were compared between the two groups. The clinical evaluation was carried out using the MGD staging guide of the International Workshop. The statistical analysis was performed with SPSS v.26 program (IBM Inc., Chicago, IL, USA).Results There was no difference between the two groups in terms of age and gender. On the first visit, in both groups, an improvement in the results of the OSDI questionnaires was reported. An unpaired T-test was performed. Regarding the clinical evaluation, no anatomical improvement in the condition of the eyelid edge, as well as in the expressibility of the meibomian glands, and the quality of the meibum, was reported after 4 weeks. On the 8-week visit, however, there was no change in the results of the questionnaires compared to the previous visit, but in both groups there was an improvement in the condition of the eyelid edge and the characteristics of the meibum, i.e., in the staging of the condition. The only indicator that reported a statistically significant difference was the expressibility of the glands with a predominance in Group 1.Conclusion Oral use of azithromycin has been shown to have a positive impact on MGD. The exact regimen, however, has not yet been clarified. More randomized clinical trials are needed to determine the optimal therapy
Periodontal disease etiology. A review
Get PDFPeriodontitis is a chronic inflammatory disease that is characterized by destruction of the tooth-supporting tissues, periodontal pocket formation, and ultimately, loss of teeth. The primary cause of periodontitis is bacteria in the dental biofilm. The development of effective treatment strategies is challenging due to the complex pathogenesis of the disease, which is best explained by a polymicrobial synergy and dysbiosis model
Dry Needling Combined with Physiotherapy for Treating Shoulder Impingement Syndrome
Get PDFIntroduction: Impingement syndrome is one of the most common pathologies affecting the shoulder girdle, comprising almost 60% of all complaints in the glenohumeral joint. It is characterized by pain, reduced range of motion (ROM), and severely decreased functional and work capacity of the upper limb. If left untreated, the condition can lead to severe tissue alterations and complications, such as adhesive capsulitis and partial or complete tears of the rotator cuff. When properly diagnosed, shoulder impingement can be treated successfully with physiotherapy, as well as with treatment modalities such as dry needling.Aim: The aim of the current report is to assess the effectiveness of applying physiotherapy combined with the dry needling treatment modality in patients suffering from shoulder impingement syndrome who chose a non-operative option as part of their recovery routine.Methods: A total of 10 patients, divided into two groups of 5, participated in our study. The first group received only a traditional physiotherapy program and was designated the control group. The second group received a traditional physiotherapy program with the addition of the dry needling treatment modality and was designated the experimental group. Measurements and data regarding active range of motion (ROM), VAS results, manual muscle testing, and the functional assessment scale were collected at the beginning and end of the study.Results and Discussion: The experimental group that received the dry needling treatment modality in addition to the traditional physiotherapy program achieved significantly higher results compared to the control group. The mean end value for shoulder flexion was 15 degrees higher compared to the control group. The mean end values for abduction and the UCLA functional assessment scale (32 points) were identical for both groups.Conclusion: The collected data in the current study indicate that physiotherapy combined with the dry needling treatment modality can significantly decrease pain and increase recovery potential in patients suffering from shoulder impingement syndrome
Anti-Proliferative Effect of Propolis on Glioblastoma
Get PDFIntroduction: Glioblastoma is the most aggressive and malignant central nervous system tumor. The high mortality of patients suffering from glioma and the difficulties in treatment lead to the search for new and more effective potential antitumor agents. In combination with other natural products, propolis shows potential in the antitumor treatment of glioblastoma.Aim: This review aims to present literature data on the role of propolis in the treatment of glioblastoma.Materials and Methods: A literature review of scientific publications in various scientific databases (PubMed, Web of Science, ScienceDirect, Scopus, etc.) was conducted using a documentary method. Keywords used were glioblastoma, propolis, Hypericum perforatum, Bacopa monnieri, and temozolomide.Results: After treatment with a combination of propolis and St. John's wort ethanol extracts, inhibition of U87MG cell migration was observed. Propolis extract combined with B. monnieri also demonstrated cytotoxic and antiproliferative activity on human glioblastoma cell lines.Conclusion: The effects of propolis, alone or in combination with other natural products, on tumor cell lines of different origins (including glioblastoma) are being increasingly studied. Accumulating scientific evidence on the effects of propolis could lead to its inclusion in the standard treatment of glioblastoma
The Beneficial Effect of Essential Oils and Herbs in Cosmetic Medicine
Get PDFThis article elaborates on the significant role of essential oils and herbs in cosmetic medicine, focusing on their therapeutic benefits and applications in skin care, hair care, and overall dermatological health. Essential oils, extracted from plants, have been used for centuries due to their powerful antimicrobial, anti-inflammatory, and antioxidant properties. Herbs, with a rich historical background in traditional medicine, are increasingly popular in contemporary cosmetic products.This exposition provides a comprehensive review of the scientific literature, highlighting how these natural substances exert their effects and their potential as alternatives or supplements to synthetic ingredients in cosmeceutical products. Several studies suggest that essential oils and herbs not only offer a natural and holistic approach to beauty but also meet the growing consumer demand for clean and sustainable solutions for the aesthetic health and biological well-being of the skin.The study aims to examine the most significant properties of essential oils and herbs that affect the skin and their application in modern cosmetic medicine
Skin Allergic Reactions to Essential Oils
Get PDFEssential oils, derived from various plant sources, are highly concentrated aromatic compounds widely used in medicine, cosmetics, and aromatherapy. These oils possess numerous therapeutic properties, including antiseptic, antioxidant, and anti-inflammatory effects, which contribute to their popularity. However, their high concentrations of bioactive components can lead to unwanted allergic reactions, particularly on the skin. An increasing number of cases of skin allergic reactions caused by essential oils range from mild irritative conditions to more severe allergic dermatitis. These allergic reactions result from the immune system's individual reactivity to specific components in essential oils, necessitating a more in-depth study of their composition, mechanisms of action, and associated risk factors. This report examines the main types of skin allergic reactions caused by essential oils
Ex Vivo Permeation Study of Levodopa Using In Situ Gelling Systems for Nasal Drug Delivery
Get PDFThe intranasal drug administration route offers reduced peripheral toxicity, targeted drug delivery, and improved bioavailability, especially for therapeutics intended for the treatment of neurological disorders. The most common therapy for Parkinson's disease includes the use of the aromatic amino acid levodopa, whose chronic oral application precedes the onset of on/off phenomena, dyskinesia, and other adverse drug reactions. Additionally, levodopa has low oral bioavailability, and therapeutic challenges remain unresolved even after combining it with enzyme inhibitors. The aim of the present study is to investigate the ex vivo effects of in situ gelling systems with levodopa and the sesquiterpene alpha-bisabolol, included due to its known permeation-enhancing properties. The studied nasal formulations were designed to deliver the active pharmaceutical ingredient directly to the brain through the olfactory region of the nasal cavity, bypassing first-pass metabolism and the blood-brain barrier. Two in situ thermogelling systems were prepared, each loaded with 0.1% levodopa in Poloxamer 407 15% hydrosol, with alpha-bisabolol solubilized at 1% in the second system. The test formulations underwent an ex vivo permeation study using nasal mucosa as a membrane on a Franz diffusion cell. The results of the conducted analysis showed that the in situ gelling system containing alpha-bisabolol ensured a higher drug permeation rate (Jss) of levodopa through the mucosa (2.00 µg·cm⁻²·min⁻¹) compared to the reference formulation without alpha-bisabolol (1.35 µg·cm⁻²·min⁻¹). The well-known permeation-enhancing mechanism of alpha-bisabolol, which increases the fluidity of membrane lipids, along with the obtained results, suggests that the primary transport mechanism for levodopa is intracellular, passing through the lipid membranes of epithelial cells
Study of the Volume of Movement in the Shoulder Joint in Children Practicing Karate
Get PDFImpaired shoulder joint function is associated with the prolonged use of repetitive movements during karate training. Maintaining good shoulder mobility is an important factor for children practicing martial arts. This study aims to investigate the range of motion in the shoulder joint in children practicing karate.Materials and Methods: Between March and June 2024, we worked with 20 children aged 8–12 years who practice Eastern martial arts at the sports karate club "Fighters" in Varna. For the most accurate results, we formed two groups of 10 children each. Participants in the control group performed the exercises assigned to them in the standard karate program, while children in the experimental group performed a specially designed set of exercises. All the children trained for a period of 4 months, training twice a week, with each session lasting one astronomical hour.Results: We assessed the condition of the children's shoulder joints at the beginning and end of the study period using the standard SFTR method. The results at the end of the study period showed that the range of motion in the shoulder joint in the experimental group of children had significantly improved. Compared with the control group, the shoulder range of motion showed only minimal improvement.Conclusions: The results of this study demonstrate that practicing karate with the inclusion of special exercises for the upper limb leads to an improvement in the range of motion in the shoulder joint. The correct selection of physiotherapy methods and their regular application can not only improve shoulder joint function but also prevent injuries
Vaccination Prophylaxis for Bacterial Infections
Get PDFIntroduction: Bacterial infections affect an increasing portion of the population and pose a significant threat to global health. Treatment has become more challenging due to bacterial resistance to various antibiotics, leading to the need for alternative methods to combat these infections. One such method is vaccination prophylaxis.Aim: The aim of this study is to analyze data from scientific publications and assess the effectiveness of vaccines against some of the most common bacterial pathogens.Materials and Methods: This study was conducted using a literature review approach, focusing on articles published in PubMed and Google Scholar from 2019 to 2024.Results: Our study found that vaccination prophylaxis is a widely used method for combating various bacterial pathogens. A strict vaccination program and adherence to it significantly reduce the spread of life-threatening infectious diseases. In Bulgaria, immunization begins in maternity wards, while in some European countries, it starts after the second month of life.Conclusion: The increasing spread of bacterial infections can be mitigated by developing new vaccines and optimizing the prophylaxis of existing ones. Adherence to immunization schedules significantly reduces the spread of serious infections and improves public health
A Comparative-Legal Study of the Regulation of Independent Nurses in the USA, Canada, and France
Get PDFIntroduction: The ever-increasing societal needs for quality and efficient healthcare, both nationally and globally, highlight the importance of independent practice nurses. Achieving clarity and legal certainty in their activities is essential for providing effective healthcare. In this regard, a comparative-legal study of the experience of other countries in the normative regulation of independent nursing practices holds significant scientific and practical importance.Aim: The purpose of the current study is to conduct a comparative-legal analysis of the regulatory framework governing independent practice nurses in the USA, Canada, and France.Materials and Methods: A documentary method was applied, involving a comparative-legal analysis of the legislation of the USA, Canada, and France on the researched problem.Results and Discussion: The comparative-legal analysis of the legislation in the USA, Canada, and France regarding the regulatory framework for independent practicing nurses revealed that the establishment of independent nursing practices and their activities is clearly and systematically organized by the legislatures of these countries. Although different methods are employed, a unified approach to addressing the problem emerges. According to the legal definitions analyzed, registered nurses assist individuals, families, groups, and communities in achieving optimal physical, emotional, mental, and spiritual health and well-being.Conclusion: Societies face similar challenges, and while they may employ different means, they often achieve comparable solutions. Foreign legal systems may use different terms, organizational structures, and institutional logic, yet they provide analogous legal frameworks. The applied comparative-legal approach highlights opportunities for regulating or improving the relevant institute within Bulgarian legislation