Opportunity To Build A Supervision In Midwifery Profession In Bulgaria

The development of professional competencies is a prerequisite for the successful implementation of current and future specialists. The obstetric profession requires the development of a set of skills and qualities that specialists need in the process of providing obstetric care to pregnant women, newborns and women with reproductive and gynecological problems. Performing midwifery care requires high qualifications, communication skills, analytical thinking, and innovative approaches to achieve a certain level of quality of the care offered.An important aspect of supervisee in the training of specialists in the maternity ward is a clinical medical structures and their implementation, as well as the problem of relations professionals to carry it out of Supervised activities of key importance to practitioners, medical personnel and implemented as a shared responsibility, the supervisor and supervision that ensures the effectiveness of their support and encouragement, court practice. With its help, mentors have the opportunity to acquire knowledge, skills and experience, receive advice and support, analyze their thoughts, feelings and experiences of patients in order to face the challenges of the professional environment and achieve changes and development in relation to themselves and professional responsibility. Significant in this direction is the attitude of medical specialists who provide obstetric care to conducting supervision in the real working environment of a hospital institution. The dynamics of the environment requires constant development, adaptation to changes, improvement and development of new products

The Impact of COVID-19 on the Pregnant Woman and the Fetus

This review presents the current incidence of COVID-19 and the impact of the SARS-CoV-2 virus on the course of pregnancy. The authors review the latest recommendations of obstetric and gynecological societies in Europe and the world regarding vaccination and the degree of vertical transmission of the infection and its impact on the pregnant woman, the fetus, and the mother

Coconut Oil

Въведение: Кокосовото масло представлява дериват на кокосовата палма, получен от вътрешната месеста част на кокосовия орех, която се нарича копра. Процесът на получаване на маслото включва настъргване и изсушаване на кокосовото месо, внимателното му пресоване при ниска температура и филтрация. Този механизъм за добиване е необходим, за да бъдат запазени структурно и функционално основните му полезни съставки. Употребата на кокосовото масло е позната на човечеството от близо 4000 години.Цел: Да се анализира достъпната литература, реферирана в базите-данни MEDLINE (PubMed), Scopus и Web of Science през последните 10 г.Материал и методи: Проучени са съдържанията на резюметата и пълнотекстовите публикации по проблема кокосово масло и ефекти върху кожата.Резултати: Кокосовото масло е ценен източник на хранителни вещества и натурални съставки за изготвяне на козметични и дерматологични формулировки. Поради своя състав, кокосовото масло има противовъзпалителни, антипиретични, аналгетични, антимикробни, антиоксидативни, хепатопротективни, имуномодулиращи свойства, инсулинотропен ефект, спомага за редуциране на телесното тегло, запазване бариерната функция на кожата, редуциране загубата на вода, поддържане на кожната хидратация, омекотяване, противостареене, регулиране нивата на холестерола, подпомагане невротрансмисията, забавяне еволюцията на болестта на Алцхаймер.Изводи: Кокосовото масло е натурална суровина с ценен състав, намираща приложение в козметичната, фармацевтичната и хранителна индустрия. Активните съставки са полифеноли, токофероли, средноверижни мастни киселини, които обуславят широкия диапазон от приложения. Кокосовото масло е с позитивно въздействие само ако в процеса на получаване не е използвана термична или химична обработка, при която се разрушават ценните му съставки. Кокосовото масло може да се прилага локално и системно. Влиза в състава на много козметични средства, лекарствени продукти, хранителни добавки.Introduction: Coconut oil is a derivative product of the coconut palm tree, obtained from the inner, edible part of the coconut, called copra. The process of obtaining coconut oil includes shredding and drying of the coconut meat, then processing under low temperature and filtration. This way all its beneficial ingredients are preserved. The use of coconut oil by people has been known for more than 4000 years.Aim: The aim of this paper is to evaluate the literature in the last 10 years in MEDLINE (PubMed), Scopus and Web of Science – referred literature data bases.Materials and Methods: Abstracts and full text publications on the topic were reviewed.Results: Coconut oil is a precious source of nutritional substances and natural ingredients for preparing cosmetic products and dermatological formulations. Coconut oil has anti-inflammatory, antipyretic, analgesic, antimicrobial, hepatoprotective and immunomodulating action. It also has an insulin-like effect, it helps in weight loss, restores the skin barrier, prevents water loss, maintains the skin hydration, controls the level of cholesterol, amplifies the neurotransmission, prevents progression of Alzheimer’s disease. In dermatology, coconut oil is used as an emollient and antiaging product.            Conclusion: Coconut oil is widely used in the cosmetic, pharmaceutical and nutritional industries. The active ingredients of coconut oil that define its broad specter of activity are polyphenols, tocopherols and mid-chain fatty acids. The effectiveness of coconut oil depends on its beneficial ingredients, which are not being processed by chemical or thermal processing. Coconut oil can be applied locally and systemically. Many cosmetic products, drugs and nutritional supplements contain coconut oil as an active ingredient

PatientsLikeMe® Online Epilepsy Community: Patient characteristics and predictors of poor health-related quality of life

AbstractObjectiveThe online PatientsLikeMe® Epilepsy Community allows patients with epilepsy to record, monitor, and share their demographic, disease, and treatment characteristics, providing valuable insights into patient perceptions and understanding of epilepsy. The objective of this retrospective analysis was to characterize the profile of users and their disease and identify factors predictive of poor health-related quality of life (HRQoL), while assessing the platform's potential in providing patient-reported data for research purposes.MethodsData recorded (January 2010–November 2011) by Epilepsy Community members, with an epilepsy diagnosis and who reported >1 seizure, included the following: sociodemographic and disease characteristics, treatments, symptoms, side effects perceived as medication-related, seizure occurrence, and standardized questionnaires (Quality of Life in Epilepsy Inventory [QOLIE-31/P], EuroQoL 5-Dimensions Scale, 3 Levels [EQ-5D-3L], and Hospital Anxiety and Depression Scale [HADS]). Univariate and multivariate logistic regressions were conducted to identify predictors of poor HRQoL.ResultsDuring the study period, the Epilepsy Community comprised 3073 patients, of whom 71.5% were female, had a mean age of 37.8years, and had a mean epilepsy duration of 17.7years. The most frequently reported moderate/severe symptoms (n=2135) included memory problems (60.2%), problems concentrating (53.8%), and fatigue (50.0%). Medication-related side effects (n=639) included somnolence (23.2%), fatigue (17.2%), and memory impairment (13.8%). The QOLIE-31/P scores (n=1121) were significantly worse in patients who experienced a recent seizure. For QOLIE-31/P, highly predictive factors for poor HRQoL included the following: mild/moderate problems concentrating, depression, memory problems, treatment side effects, occurrence of tonic–clonic seizures, and epilepsy duration ≤1year. For EQ-5D-3L, highly predictive factors for poor HRQoL included the following: pain, depression, and comorbidities. Patients on newer AEDs were less likely to report poor HRQoL (QOLIE-31/P).SignificanceThese findings move further towards supporting the feasibility and usefulness of collecting real-world, anonymized data recorded by patients online. The data provide insights into factors impacting HRQoL, suggesting that a holistic treatment approach beyond seizure control should be considered in epilepsy

Efficacy and tolerability of adjunctive lacosamide in pediatric patients with focal seizures

To evaluate efficacy and tolerability of adjunctive lacosamide in children and adolescents with uncontrolled focal (partial-onset) seizures.In this double-blind trial (SP0969; NCT01921205), patients (age ≥4-<17 years) with uncontrolled focal seizures were randomized (1:1) to adjunctive lacosamide/placebo. After a 6-week titration, patients who reached the target dose range for their weight (<30 kg: 8-12 mg/kg/d oral solution; ≥30-<50 kg: 6-8 mg/kg/d oral solution; ≥50 kg: 300-400 mg/d tablets) entered a 10-week maintenance period. The primary outcome was change in focal seizure frequency per 28 days from baseline to maintenance.Three hundred forty-three patients were randomized; 306 (lacosamide 152 of 171 [88.9%]; placebo 154 of 172 [89.5%]) completed treatment (titration and maintenance). Adverse events (AEs) were the most common reasons for discontinuation during treatment (lacosamide 4.1%; placebo 5.8%). From baseline to maintenance, percent reduction in focal seizure frequency per 28 days for lacosamide (n = 170) vs placebo (n = 168) was 31.7% (p = 0.0003). During maintenance, median percent reduction in focal seizure frequency per 28 days was 51.7% for lacosamide and 21.7% for placebo. Fifty percent responder rates (≥50% reduction) were 52.9% and 33.3% (odds ratio 2.17, p = 0.0006). During treatment, treatment-emergent AEs were reported by 67.8% lacosamide-treated patients (placebo 58.1%), most commonly (≥10%) somnolence (14.0%, placebo 5.2%) and dizziness (10.5%, placebo 3.5%).Adjunctive lacosamide was efficacious in reducing seizure frequency and generally well tolerated in patients (age ≥4-<17 years) with focal seizures.NCT01921205.This trial provides Class I evidence that for children and adolescents with uncontrolled focal seizures, adjunctive lacosamide reduces seizure frequency

Evaluation of apical foramen localisation of maxillar and mandibular molars

Introduction: The success of nonsurgical root canal therapy is dependent on a thorough knowledge of the root and root canal morphology in order to locate all canals and properly clean, shape, and obturate the canal space in three dimensions Aim: The aim in our study was to to determine the morphologic shape and position of the root apex and the major foramen in maxillary and mandibular molars. Material and method: A total of 100 human upper and lower molars with completely formed apices were evaluated. Each root specimen was measured at each root apex by using a electronic microscopy and SEM analysis at magnification 20x - 200x. The anatomic parameters evaluated were the shapes of peripheral contours of major apical foramen (rounded, oval, asymmetric, semilunar) and the root apex (rounded, flat, beveled, elliptical). The location was classified as center, buccal, lingual, mesial, or distal surface for both root apex and the major apical foramen. Results: The results of the internal canal morphology revealed that a single canal was present in 77% of the teeth. Two or more canals were found in 23% of the teeth studied. A single apical foramen was found in 80% of the teeth, whereas 20% had two or more apical foramina. Conclusion: The most common morphology of the root apex the round shape, followed by oval and the most common shape of the major foramen was round, followed by oval. The root apex was most commonly located in the center in all teeth followed by distal and buccal locations. Key words: root canal morphology, apical foramen, root ape

Rehabilitation and correction of spine in children

Introduction: Bone-muscular system in children developing under the influence of internal and external factors is subject to various distortions. Heredity and poor posture, lack of physical activity leads to disruption of the statics of the spine, resulting in the occurrence of deformities. Recent research shows that the back pain that occurs in children is correlated with several factors which are bad posture, improper seating, muscle weakness. Since the occurrence of back pain in children in their childhood is an important deterrent factor, prevention of its prevention is of great importance. Measurements of upright posture in children is a useful tool for the identification and prevention of the development process of the musculoskeletal condition. Purpose: this is to show the presence of spinal deformities and distortions that occur in children in early childhood and adolescenskiot period, and the most common deformities that have revealed within 2011do 2014 in the municipality Strumica.Materiali and methods: used statistical data on the presence of spinal deformities in children in Strumica, R. Macedonia for the period from 2011 to 2014 and using the standard tools of research as Adam test and interviews in a larger group of subjects exhibited as a group in order to get a clearer and richer review of data necessary for further analysis. Results are set on the basis of four years of continuous testing and research on a sensitive and vulnerable category of children that deserve special interest and attention. It validated treatments in deformities of the spine as well as prevention and treatment of dysfunction of locomotor system in young people in the period of growth and development. For four years the number of children is reviewed 585 of which in 2011 were 68 boys, 71 girls, in 2012 a total of 144 children examined, 65 are male and 79 female. In 2013 examined 70 male and 76 female children out of 146 children examined. 2014 analysis examined the children show the results of total 156 children examined, 80 were female and 76 male. Discussion: The results and the comparison data relative to the determined parameters.This discussion is a summary of the overall knowledge acquired through research and confirmation of the identified hipotetska framework of research.Conclusion: The treatments with deformities of the spine as well as prevention and treatment of dysfunction of locomotor system in children in the period of growth and development is of great significance.Great occurrence of scoliosis, which is most common among girls in adolescence.Seeing the results, and the frequent problem of developing spinal distortions in children - scoliosis, kyphosis and lordosis, which are becoming increasingly common among young people, the need for their correction and rehabilitation or application of Kynesitherapy

Употреба на анализа на конечни елементи во стоматолошка протетика

Методот на конечни елементи (МКЕ) претставува серија на процедури и калкулации со кои се одредува оптеретувањето на секој елемент, со што се одредува со кој метод ке се реши случајот и поставената ситуација. Таа структурна анализа овозможува да се одреди стресот кој ќе настане од некоја надворешна сила, притисок, промена на температура и други фактори. Оваа метода е многу корисна за да се одреди механичкото влијание на биоматеријалите врз гингивалното ткиво бидејки тоа тешко може да се измери во живо. Потоа добиените резултати можат да се студираат и да се користат при методот на конечни елементи во посебен софтвер кој се користи да се одредат потребните параметри и комплетно да се идентификува каде ке се примени анализата. Оваа тема го објаснува основниот концепт, предностите, границите и употребата на методот на конечни елементи во стоматологијата. Клучни зборови: Анализа на конечни елементи, 2D модел, 3D модел, забно оптоварување

Hand lay-up vs machine impregnation of the textile structures

In this paper with the application of hand lay - up and machine impregnation technology, prepregs with suitable characteristics were produced and additionally processed into composite plates by using compression molding technology. Woven structure from E -glass fibers was used as a reinforcing component in the composite materials. For all manufactured composite plates, an analysis of the content of the constituent’s components and the percentage of voids (%) was made. Determining the content of the constituent’s components is significant from the aspect of modeling the properties (mechanical, physical, thermal or electrical) of the composite structure which are affected by the reinforcing component or matrix. The percentage of the voids of a composite material can significantly affect some of its mechanical properties. High void contents usually mean less fatigue resistance, greater susceptibility to moisture penetration and atmospheric influences and increased variation in strength. Knowing the content of the void in the composite material is desirable since it is a significant indicator of the quality of the composite

Употреба на анализа на конечни елементи во стоматолошка протетика

Методот на конечни елементи (МКЕ) претставува серија на процедури и калкулации со кои се одредува оптеретувањето на секој елемент, со што се одредува со кој метод ке се реши случајот и поставената ситуација. Таа структурна анализа овозможува да се одреди стресот кој ќе настане од некоја надворешна сила, притисок, промена на температура и други фактори. Оваа метода е многу корисна за да се одреди механичкото влијание на биоматеријалите врз гингивалното ткиво бидејки тоа тешко може да се измери во живо. Потоа добиените резултати можат да се студираат и да се користат при методот на конечни елементи во посебен софтвер кој се користи да се одредат потребните параметри и комплетно да се идентификува каде ке се примени анализата. Оваа тема го објаснува основниот концепт, предностите, границите и употребата на методот на конечни елементи во стоматологијата. Клучни зборови: Анализа на конечни елементи, 2D модел, 3D модел, забно оптоварување