Cytotoxic activity of Galantamine hydrobromide against HeLa cell line

Cytotoxic activity of Galantamine HBr against human cervical adenocarcinoma cell line HeLa in different concentrations (1.875 μМ ÷ 30 μМ) was evaluated. Inhibition of HeLa cell growth after treatment with Galantamine HBr and index of cell viability were determined. From the experimental results was proven that the drug exerts cytotoxic activity towards HeLa cell line, with antiproliferative activity presented as the value of IC50 = 30 μM ± 0.22

Prevention of cardiovascular diseases

Cardiovascular diseases (CVD) are socially significant diseases due to high morbidity and loss of people of working age. In Bulgaria, they are the leading cause of mortality among the population and are a consequence of the effect of cardiovascular risk factors. The draft of the National Health Strategy (NHS) 2021–2030 reports on their wide distribution, as well as on the insufficient knowledge, skills and motivation for their prevention and control. The purpose of this review is to address the prevention of cardiovascular disease, which is a significant problem worldwide. Prevention goals for patients with established cardiovascular disease and those at high risk include smoking cessation, healthy eating, physical activity, and lowering body mass index. There are various methods that are part of health promotion to reduce CVD risks. These methods include motivational interviewing, non-pharmacological means, the use of certain medications for CVD prevention, as well as physical activity. Strategies for effective primary prevention refer to engaging the patient to change their lifestyle and identifying risk factors, while secondary prevention is aimed at activities to detect the disease early and to slow down its progression. It is necessary to create a strategy for timely preventive actions with a view to preventing the negative influence of risk factors and improving people‘s heart health

Comparative analysis of comorbidity, surgical complications, pharmacotherapeutic needs, and rehabilitation requirements in transabdominal preperitoneal hernia repair versus conventional operative treatment—current results and benefits

Background: Laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair is a relatively new method of inguinal hernia surgical repair that, at theory, provides a good view of the inguinal anatomy and sac contents and, as a laparoscopic procedure, is considered less invasive and with fewer complications compared to total extraperitoneal (TEP) inguinal hernia repair. Purpose: This study aims to assess the short-term outcome of laparoscopic transabdominal preperitoneal inguinal hernia (TAPP) repair. Material and methods: The retrospective clinical data for 138 patients with unilateral and bilateral hernia, operated in the Department of General, Visceral, and Emergency Surgery of the University Emergency Medicine Hospital ‘N. Pirogov’ from 01 January 2022, to 01 January 2023, were included. The risk profile of the patients, the intraoperative and postoperative complications, the duration of hospital stay, the frequency, and the type of analgesics used were analyzed. Results: Forty-one women (29.7%) were included; men comprised 97 (70.29%) of the cohort. Of the selected group, 63 (45.7%) patients had indirect inguinal hernias, 34 (24.6%), and 25 (18.1%) were diagnosed with direct inguinal hernia and accreta inguinal hernia, respectively. A history of repeatedly occurring hernias was found in 16 patients (11.6%). The average hospital stay was 32 hours (or 1.3 days) and ranged from 24 hours (1 day) to 48 hours (2 days). Complications occurred in 11 (7.97%) patients. The need for analgesics and anti-inflammatory agents was reliably reduced compared to the patients undergoing conventional surgical treatment of inguinal hernia. The patients were followed for three months post-discharge for the occurrence of surgical morbidity associated with the TAPP hernia repair. None of the patients used an antimicrobial agent, as indicated by a possible complicating bacterial infection. Rehabilitation was started within the first 12 hours after the operation, thus contributing to a significantly shorter hospital stay compared to patients undergoing conventional surgical repair of an inguinal hernia. Conclusion: Our results demonstrate that TAPP inguinal hernia repair is a safe procedure with reduced postoperative pain. It has fewer complications, with no significantly longer operative time and a shorter overall hospital stay

Operative management of acute cholecystitis in pregnancy: Case report

Introduction: Acute cholecystitis is the second most common non-obstetric surgical disease during pregnancy. There have been several trials comparing operative and non-operative management in the past. Purpose: To present a clinical case from our practice and to compare clinical management with worldwide standards. Materials and methods: A 42-year-old patient in the 20th gestational week presented to our department with complaints of pain in the epigastrium and RUQ, as well as a single incidence of vomiting, during the last two days. Results: We operated 15 h after admission and did a standard laparoscopy. The patient was discharged on the 4th postoperative day. Conclusion: A review of the available literature shows the prevalence of early laparoscopic cholecystectomy, while non-operative management has proven to have higher complication rates. Laparoscopic surgery in pregnancy has proven to be safe for both mother and fetus. In our case, the patient was operated on within the first 24 hours of admission. We did not observe any complications during her stay and follow-up

Laparoscopic IPOMPLUS repair-current outcomes and complications

Purpose: The study aims to assess the current outcomes and complications of laparoscopic ventral hernia repair using intraperitoneal onlay mesh with defect closure (IPOM PLUS) technique by use of dual-sided synthetic mesh. Material and methods: Retrospectively clinical data for 27 patients with umbilical, paraumbilical, incisional, ventral, and primary hernia, operated in the Department of General, Visceral and Emergency Surgery “Pirogov” from 01.06.2022 to 01.06. 2022 was analyzed. The diagnosis was based on history, physical examination(mainly), ultrasound, and CT. Of the hospitalized, women were 16 (59.26%) men 11 (40.74%). Results: Of the selected group, 13 patients had umbilical defects, 3 with an epigastric hernia, 7 with a paraumbilical hernia, and 4 with incisional defects. Adhesiolysis was needed in 18 cases, while others were performed straight with hernia closure. The operating time varied between 49 and 127 minutes (average 57.4 minutes). The hospital stay ranged from 1 day to 4 days (average 1.7 days). We had noticed complications in three of the cases (11.11%). Conclusion: IPOM PLUS repair is safe, practicable, and advantageous over a standard IPOM or open repair as reported in the literature. Accordingly, we prefer this approach with the closure of the fascial defect first while repairing ventral abdominal wall hernias

Monitoring the change in the quality of life of patients with post-COVID syndrome by influence on their functional status

Coronavirus disease 2019 (COVID-19) is still a major medical concern. Patients who have recovered from the infection from COVID-19 face the ordeal of post-covid syndrome. In these patients, there is a decrease in physical abilities, in particular musculoskeletal complications and post-traumatic stress, depression and chronic fatigue, which impair their quality of life. This necessitates long-term rehabilitation, which supports recovery after hospitalization. Treatment through movement is part of the rehabilitation measures contributing to the functional recovery of patients with post-covid syndrome. To study how the functional capabilities of these patients improve and how their quality of life is affected, we created a set of physical exercises to be performed at home for 6 months. At baseline and at the end of the study, patients completed the SF-36 quality of life questionnaire. The aim of the study was to track the changes in the quality of life of patients with post-covid syndrome by influencing their functional state. Our study found a decline in the quality of life of the examined patients. After the application of the kinesitherapy program, the functional status of the patients improved, their functional independence was optimized, which contributed to the improvement of the quality of life of the post-covid patients syndrome

Antitumor and antioxidant activity of some metal complex compounds

In the last few years, interest in platinum drugs has increased. Successful treatment depends to a large extent on complex therapy and early diagnosis, which determines the great importance of knowledge of risk groups, clinical symptoms, and targeted use of diagnostic methods with biomarkers, biopsy and diagnostic imaging for early detection of the malignant process. Today, the mono-target strategy is being replaced by a poly-target therapy strategy, which achieves greater clinical efficacy in tumors with defined biomarkers. Key developments include elucidation of the mechanisms of tumor resistance to these drugs, the introduction of some new platinum- based agents and clinical combination studies using platinum drugs with resistance modulators or new drug-targeted drugs. Improved delivery of platinum drugs to tumors has been studied in early clinical trials using liposomal or copolymer-based products. Other investigated as anticancer agents are ruthenium and iron complexes. Ln(III) complexes have been shown to exert antioxidant activity

Tobacco smokers as target group for complicated coronavirus infection

The aim of current study was to determine, retrospectively, possible correlations between smoking and the incidence, course severity, intubation rate, and mortality (by gender and age) in patients treated for complicated coronavirus infection in the internal medicine clinic at UMHATEM ”N. I. Pirogov” Sofia for the period 01.03.2020–31.12.2020. In a prospective study, the recovery period and immunogenesis in smokers and non-smokers within a one-year period after hospital discharge was investigated. The applied methods were: 1) computed tomography and blood gas analysis 2) chemiluminescent immunoassay for the qualitative determination of total IgM, IgA and IgG anti-SARS-CoV2 AB. Results showed that the part of non-smokers with a positive PCR test is significantly higher compared to the group of former and current smokers. The data obtained from the study confirmed that Covid infection is much more severe among smokers and former smokers with a higher levels of inflammatory markers noticed among the smoking group

Logistical challenges with an emphasis on organizing specialized triage in the conditions of a newly emerging, epidemiologically significant infectious pathogen for humans – SARS-CoV2

Background: UMHATEM „N.I. Pirogov“ Sofia, is one of the largest and busiest hospitals for emergency medical care in Bulgaria. It is the legal successor of the former Institute of Emergency Medicine „N.I. Pirogov“, and it can be said that at the moment it is the only diagnostic- therapeutic, prophylactic and scientific-educational structure of this type within the Bulgarian healthcare system. The concept of adequate functioning and development of this type of hospital does not consider structuring an Infectious Diseases diagnostic-treatment unit. This reality makes necessary the formation of a radically different organization for the admission and treatment of patients in the hospital, both for those with symptoms of Covid 19 and for all other emergency patients. The organization created in this way must absolutely guarantee safety for both streams of patients. In the conditions of a pandemic, in case of a real threat to public health, the main task of triage in the Emergency Department is to establish indications for urgent hospitalization, or to refuse it in the absence of indications. The characteristic course of the disease, the prolonged treatment, the manifestations within the so-called „post-Covid syndrome“, require serious planning not only of the diagnostic-treatment and rehabilitation period, but also adequate monitoring in the first months after the patient‘s discharge. Within the national reorganization measures, during the determined periods, the main changes concerning the MED (Multi-profile emergency department) of Pirogov are implemented, with an emphasis on the formation of a specialized triage for the diagnosis and clinical evaluation of patients with a coronavirus infection. The main goal is the adequate diagnosis, treatment and follow-up of patients with coronavirus infection who have passed through the organized Covid-triage in a period of extreme pressure on the emergency structures and on the hospital system in the country as a whole. Objective: For a MED, which at the time of declaring an epidemic situation does not have a concept for the diagnosis and treatment of infectious diseases, to systematize the main urgently implemented organizational and structural changes, which turned out to be absolutely necessary to meet a newly emerging epidemiologically significant infectious disease. Aims: To systematize the organizational changes imposed by the situation and urgently implemented in the MED (multi-profile emergency department). To systematize the structural changes imposed by the situation and urgently implemented in the work of the MED. To analyze the organizational and structural changes carried out in this way and to differentiate the main difficulties caused by the regulations existing at the time of the announcement of the epidemic situation