Review on the pharmacological activities of anethole

In recent years there has been an increasing interest in the activities of phytopharmaceutical products and biologically active substances of plant origin. Anethole is such a substance used from ancient times in traditional medicine in many countries. Nowadays it is widely used in food and beverage industry. Its widespread use and accessible price justify carrying out extensive scientific research in order to support the traditional uses of anethole with scientific evidence. This review article summarizes the current knowledge of the traditional use of anethole, its pharmacological activities and the possible mechanisms underlying its effects.

Palliative large bowel resections. Impact of the laparoscopic approach

INTRODUCTION: Nowadays colorectal cancer (CRC) incidence rate increases in the Western world. The lack of effective screening programs results in diagnosis of advanced cases in our country. Combination of hematogenic, peritoneal or systemic CRC dissemination with present or potential complications from local disease is not an exception. The decision for palliative resection is not easy and is a matter of balance be­tween potential risks of operative intervention and advances due to local tumour resection. Positive aspects of the laparoscopic approach are important in planning of these interventions. The aim of this study is to as­sess the indications for laparoscopic palliative large bowel resections in the literature available and to share our own experience.PATIENTS AND METHODS: During a two-year period, in the HPB and General Surgery Clinic, Acibadem City Clinic, Tokuda Hospital of Sofia, six laparoscopic palliative colon resections were performed. In the all cases, multiple liver metastases were diagnosed without possibility of liver resection. The early periopera­tive results were analyzed.RESULTS: Four left colon resections were performed with primary anastomosis due to high-level large bow­el obstruction and two right colectomies were done for primary tumour bleeding. Three patients were over 77 years old and presented with comorbidity. Average hospital stay was 5,6 days. No perioperative compli­cations were observed.CONCLUSION: Minimal surgical trauma, short recovery period and well-defined indications are important features in the process of planning of palliative large bowel resections in patients with disseminated CRC. The objective is to reduce risks of complications connected with primary tumour and to assure a good pa­tient`s quality of life. Scr Sci Med 2017; 49(3): 27-3

Laparoscopic or conventional abdominoperineal extirpation in low rectal cancer

INTRODUCTION: Laparoscopic abdominoperineal resection (LAPR) as a minimally invasive approach for the treatment of large rectal cancer is widely used. It has been proven to be technically feasible and safe with fewer complications and faster postoperative recovery than the open procedure. Our aim was to evaluate LAPR safety and feasibility as compared to the open procedure in large low rectal cancer.PATIENTS AND METHODS: A total of 34 low rectal cancer patients who underwent open APR (OAPR) were matched with 42 patients who underwent LAPR in a one-to-one fashion between 2011 and 2014 in the Divi­sion of General Surgery, Kaspela University Hospital of Plovdiv.RESULTS: Intraoperative parameters of LAPR were better than those of OAPR as followed: mean operation time (121.8±47.8 min versus 152.1±49.2 min), mean operative blood loss (82±30.0 mL versus 120±35.0 mL), mean total number of retrieved lymph nodes (12±1 versus 12±1.4), and percentage of surgical complications (12.3% versus 15.1%). Laparoscopically treated patients showed significantly shorter postoperative analge­sia (2.1±0.7 days versus 3.7±0.6 days), earlier first flatus (36.3±7.9 hours versus 48.5±9.2 hours), shorter uri­nary drainage (3.8±3.4 days versus 5.8±1.3 days), and shorter hospital stay (6.2±1 days versus 8±2.0 days). Local recurrence rate during a three-year period (in 3 versus 4 patients) and metachronous liver metastasis (in 5 versus 6 patients) were less common after LAPR than after OAPR.CONCLUSION: The risks of APR-specific surgical complications such as perineal wound infection and para­stomal hernia were comparable between the laparoscopic and open surgery groups. There were no signifi­cant differences regarding local recurrence and metachronous liver metastasis between these groups. Com­plication and locoregional recurrence rates in low large rectal cancer patients after laparoscopic and open were quite similar. Scr Sci Med 2017; 49(3): 22-2

Hip Arthroplasty - Method of Choice for Some Trochanteric Fractures

Introduction: We present 25 cases of operated patients, diagnosed with trochanteric fractures of the femur, which by definition should be treated by osteosynthesis.Materials and Methods: In these presented cases, we show an alternative method - hip arthroplasty (unipolar or bipolar), striving mainly to avoid both prolongation of bed healing and not putting pressure on the operated leg (which is needed after osteosynthesis  for a period of at least 45 days).Results: After arthroplasty, the patients can stand up and start putting pressure on the operated leg  two days after the operation (50% of body weight on the operated limb for a period of 15 to 30 days, and after that - 100% of body weight). More indications for arthroplasty are:1. Definite - coxarthrosis 3th and 4th grade. 2. Relevant:  a) when an early rising of old and/or frail patients is needed; b)severe osteoporosis, which would prolong the period of consolidation after osteosynthesis.When it is possible to put weight on the operated limb earlier, the probability of complications from prolonged bed rest is lower, and delayed weight putting can cause thromboembolism, hypostatic pneumonia and decubitus ulcers.Conclusions: We based our consideration on our database and results, comparing them with a group of 25 trochanteric fractures, operated by the method of osteosythesis. We defined arthroplasty in our study: 1. Patients with better chances to outlive the critical period; 2.  A method of less complications; 3. A method, after which a second surgery is not needed.We consider that arthroplasty after certain trochanteric fractures is a good alternative method when it is needed

Pharmacological Study of the Effects of Biologically Active Substances of Plant Origin in an Experimental Model of Inflammatory Bowel Disease // Фармакологично проучване на ефектите на биологично активни вещества от растителен произход в експериментален модел на възпалителни чревни заболявания

Inflammatory bowel disease (IBD) is a group of diseases with diverse clinical manifestations, which are united by the presence of chronic intestinal inflammation and are divided into two main nosological units: Crohn’s disease (CD) and Crohn’s disease (CD). Despite the huge amount of scientific work involved, the etiopathogenesis of the disease is still not well understood. Recent genetic and immunological discoveries undoubtedly shed light on the genetic mechanisms of the disease. At the same time, however, new factors have been discovered that contradict previous theories, which further increases the complexity of the problem. It is becoming increasingly clear that IBD is a heterogeneous group of diseases, and the varying phenotypic manifestation is an expression of the complex interaction of many genetic, immune and ecological factors. As a result of this immune dysregulation, a pathological, excessively strong inflammatory response to the normal intestinal microflora eventually develops. In recent years there has been a growing interest in studying the effects of alternative natural products that affect intestinal inflammation. Experimental animal models are an indispensable stage in the process of developing new therapeutic options. Anethole, eugenol and gallic acid are powerful natural antioxidants. Their anti-inflammatory activity has been studied in many aspects, but experimental data on their effects in models of intestinal inflammation are still lacking. Given the scientific data accumulated so far, it is safe to assume that the results of these studies would be promising.Възпалителните чревни заболявания (ВЧЗ) представляват група заболявания с разнообразна клинична изява, които се обединяват от наличието на хронично чревно възпаление и се разделят на две основни нозологични единици: болест на Крон (БК) и улцерозен колит (УК). Въпреки огромния положен обем научна работа, етиопатогенезата на заболяването все още не е достатъчно добре изяснена. Скорошните генетични и имунологични открития несъмнено хвърлят светлина върху патогенетичните механизми на заболяването. Успоредно с това обаче са открити нови, противоречащи на досегашните теории фактори, което още повече увеличава комплексността на проблема. Тъй като е невъзможно прилагането на етиологична терапия, терапевтичните усилия са насочени към патогенетично повлияване на заболяването чрез употреба на конвенционални или биологични имуномодулиращи медикаменти. Последните години се наблюдава нарастващ интерес към изучаване на ефектите на алтернативни природни продукти, повлияващи чревното възпаление. Експерименталните животински модели са незаменим етап от процеса на разработване на нови терапевтични опции. Анетол, евгенол и галова киселина са мощни природни антиоксиданти. Противовъзпалителната им активност е изследвана в множество аспекти, но все още липсват експериментални данни относно техните ефекти в модели на чревно възпаление. Предвид натрупаните досега научни данни може убедено да се предположи, че резултатите от тези изследвания биха били обещаващи

Osteoplasty in Surgical Treatment of Chronic Exogenous Osteomyelitis

Introduction: The aim of our research is to show the role of osteoplasty and surgical treatment of chronic exogenous osteomyelitis and to present exact rules of performing its different types - primary osteoplasty (PO - right after the renovation of the area of the infection), primary delayed osteoplasty (PDO - till the 30th day after the renovation of the area of infection ) and secondary osteplasty (SO - after more than 30 days after the renovation of the area of infection ).Many authors recommend performing of PO and many others claim that the best way of performing the procedure is PDO, based on results of their own researches. The dispute PO or PDO (SO) has continued for many years, but recently with the improved possibilities of planning ahead, the various ways of antibacterial treatment, the osteoplasty suggestions of the second group authors is starting to sound more convincing.Materials and Methods: We present 255 patients suffering from chronic exogenous osteomyelitis with defect of the bones, which means cases, in which two types of activities need to be performed:1. Removing bone infection from the osteomyelitic area by sanitizing it; 2. Creating good conditions for the bone consolidation via fixation (internal, external) and osteoplasty.Results: In 205 cases, we have sanitized the osteomyelitic area by using fixation and osteoplasty at the same time (PO). In 50 cases, because of the inability to perform PO, we proceeded with PDO or SO later.A good result would be a lack of bone infection and presence of bone consolidation for the first year. We observed that in 90% of PO and 60% of PO and PDO. Because of our database, we consider that PO should be prioritized if sanitizing the osteomyelitic area is performed perfectly.Conclusions: Based on our data we consider that PO is a priority if the renovation of the area of infection is performed perfectly

Epidemiology and risk factors for meniscus injuries

Meniscus injuries are the cause of some of the most common surgical interventions. They represent 15% of all sports injuries. There are modifiable and non-modifiable risk factors. The modifiable ones include body mass index (BMI), sports and occupational exposure. The second type includes: sex, age, anatomical features—differences in the length of the limbs, biconcave tibial plateau, joint laxity, and disc-shaped meniscus

A CASE REPORT OF A CHILD WITH SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS - A RARE BUT POTENTIALLY DANGEROUS DISEASE

Introduction:Juvenile idiopathic arthritis (JIA) is a heterogeneous group of conditions unified by the presence of chronic childhood arthritis without an identifiable cause. Systemic juvenile idiopathic arthritis (sJIA) is a rare form of this group characterised by systemic autoinflammation. It contributes to about two-thirds of the total mortality rate of JIA and is frequently complicated by macrophage activation syndrome. Clinical manifestations of the disease can be non-specific in the beginning and as a result the diagnosis can be delayed.Materials and Methods:We present a 13-year-old boy hospitalized at the St. Marina University Hospital, Varna with complaints of a fever over 38oC accompanied by a rash on the trunk. After physical examination, hyperemic throat, erythematous rash and cervical lymphadenopathy were discovered. The laboratory tests showed leukocytes - 19.32x109/L and CRP - 203.78 mg/l. Echocardiography and computed tomography revealed pericardial effusion and splenomegaly. The patient was diagnosed with acute pericarditis and treated with antibiotics but his condition was not improving. After a month he developed symptoms such as dyspnea, cough and joint pains and was admitted urgently to the Hospital. Further examinations were performed showing hemoglobin- 114 g/l, leukocytes - 23.37x109/L and pleural effusion in addition of the previous objective symptoms.Results: Due to the clinical presentation, the patient was diagnosed with sJIA. Now he is successfully treated with tocilizumab and methotrexate. Conclusion: The clinicians should be aware of sJIA as a disease with various clinical features in the beginning and the resemblance to infectious or malignant diseases. Early diagnosis and effective treatment are essential to achieve the best outcomes for the patients and to prevent fatal complications

Abstracts Of The Proceedings And The Posters From The Third Scientific Session Of The Medical College Of Varna

October 2-3, 201