Comparative study of astigmatic changes following pterygium excision with conjunctival autograft transplantation

This prospective clinical study compared the corneal astigmatism before and after pterygium excision surgery with conjunctival autograft transplantation. The study included 37 eyes of 37 patients diagnosed with pterygium. All participants underwent pterygium excision with conjunctival autograft transplantation and were examined preoperatively and on the first and third month post-intervention. Comprehensive ophthalmic examination was done and measurements included: pterygium size, uncorrected and best corrected visual acuity and corneal astigmatism. Preoperative and postoperative values were compared using the nonparametric Wilcoxon signed-ranks test. The mean pterygium horizontal length was 2.18 mm (range 1–4 mm). A statistically significant correlation was observed between the pterygium length and preoperative astigmatism. The mean corneal astigmatism preoperatively was 1.26 ± 1.18 D and decreased to 0.84 ± 0.73 D three months after the intervention (p < 0.001). The mean UCVA (uncorrected visual acuity) preoperatively was 0.75, improving to 0.77; the mean BCVA (best corrected visual acuity) before surgery was 0.86, improving to 0.87 after the procedure. These results demonstrated that the amount of induced astigmatism increased in proportion to the size of the pterygium increase. The corneal astigmatism tended to decrease significantly following pterygium excision with conjunctival autograft transplantation

Temperament traits and personality disorders. Predictors for personality disorders

The objective of this study is related to the hypothetical assumption that there are biologically set predispositions as predictors of behavioural and personality disorders. The present work focused on identification of specific inherent predispositions as predictors of behavioural and personality deviations. The examined population of 901 subjects was provided with a battery of self-rating questionnaires: Temperament Evaluation of the Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) for assessment and diagnosis of the temperament, Eysenck Personality Questionnaire (EPQ) for the assessment and diagnosis of relatively constant personality characteristics, International Personality Disorder Examination (IPDE-s) screening autoquestionnaire for the assessment and diagnosis of personality disorders and State Trait Anxiety Inventory – Form Y (STAI-Y) autoquestionnaire for the assessment and diagnosis of personality and situational anxiety. The results for the represented population showed statistically significant relationships, ranging from weak to strong positive correlation between the types of temperament in TEMPS-A and the personality disorders identified in screening IPDE, with the exception of the hyperthymic temperament scale in which very low non-significant negative relationships were observed. The analysis did not show significant correlations between personality disorders and the hyperthymic temperament type according to TEMPS-A. This temperament type showed weak statistically significant correlations with personality disorders from different clusters. Based on the high values of the linear correlation coefficients, some conclusions could be made on the causal correlation between the presence of a certain type of temperamental predispositions and the registered manifestations of possible personality disorders, namely, which personality disorder is most likely to occur in the prevalence of which temperament

Outcomes analysis of hospital management model in restricted budget conditions

Facing conditions of market economy and financial crisis, the head of any healthcare facility has to take adequate decisions about the cost-effective functioning of the hospital. Along with cost reduction, the main problem is how to maintain a high level of health services. The aim of our study was to analyse the quality of healthcare services after the implementation of control over expenses due to a reduction in the budgetary resources in Military Medical Academy (MMA, Sofia, Bulgaria). Data from the hospital information system and the Financial Department about the incomes and expenditures for patient treatment were used. We conducted a retrospective study on the main components of clinical indicators in 2013 to reveal the main problems in the hospital management. In 2014, control was imposed on the use of the most expensive medicines and consumables. Comparative analysis was made of the results of the medical services in MMA for 2013 and 2014. Our results showed that despite the limited budget in MMA over the last year, the policy of control over operational costs succeeded in maintaining the quality of healthcare services. While reducing the expenses for medicines, consumables and laboratory investigations by ∼26%, some quality criteria for healthcare services were observed to be improved by ∼9%. Financial crisis and budget reduction urge healthcare economists to create adequate economical instruments to assist the normal functioning of hospital facilities. Our analysis showed that when a right policy is chosen, better results may be achieved with fewer resources

Standardization and approbation of the Bulgarian version of the TEMPS-A for temperament evaluation. An example of “delinquent temperament” assessment

The aim of this study was to approbate the Bulgarian version of the international instrument for evaluation of temperamental traits, TEMPS-A (Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego –Autoquestionnaire), and to prove the need to include it in the instruments for research and diagnosis of personality. The study included 901 subjects, 540 of whom are healthy volunteers. One month after the initial test, 118 subjects from the control group were retested with a set of clinical tools to check the reliability of the instrument (temporal stability). The TEMPS-A scales showed high test–retest reliability and high internal consistency. The number of scales was verified and the construct validity of the Bulgarian version of TEMPS-A was confirmed. The results outline the limit for predictive scores on the axis normal–pathological values. The observed correlations did not prove a causal link between the measured variables but verified a statistically significant correlation between the TEMPS-A and Eysenck Personality Questionnaire results, which proved that the two instruments measure the same basic personality characteristics, namely the temperamental construct. The analysis verified the successful standardization and approbation of the Bulgarian version of TEMPS-A for Bulgaria. The comparative analysis of a group of 74 persons serving custodial sentence on the territory of Bulgaria and a control group (N = 74) showed statistically significant differences between the mean scores in the two groups on all TEMPS-A scales, except for hyperthymic temperament, suggesting that delinquent behaviour is connected with an individual's temperamental characteristics