Nursing cares at fast - track (laparoscopic and robotic ) surgery

 Introduction: The concept of accelerated surgical recovery after laparoscopic surgery, also called ERAS aims at faster discharge from the hospital and faster recovery of the body after various volumes of surgical interventions without increasing complications or mortality. The application of nursing care with the fast recovery method postoperatively can reduce postoperative complications and pain, shorten the hospital stay, so that the quality of rehabilitation is significantly improved.Aim: To study the application of rapid recovery syrgery (RRS) by surgical nurses (SN) and to reveal the possibilities for its optimization..Material and methods: In nine large hospitals in Bulgaria the opinion of doctors and senior nurses (122) on the application of RRS by SN was studied; self-assessment of SN (147) who are working according to the rules of RRS. Applied methods - documentary analysis, structured interview and direct anonymous poll.Results: A high degree of knowledge of the rules and experience in practicing RRS from SN is established, as well as the need for additional nursing documentation related to postoperative care - algorithms for work and introduction of a checklist. Suggestions for improvement of the SN work protocol have been made

The Influence of Physical Activity on the Blood Sugar of Diabetic Patients During the COVID-19 Pandemic

The COVID-19 pandemic arises at times when the numbers of people with diabetes are increasing too.Diabetes is a clinical condition characterized by abnormal metabolic glucose and hyperglycemia due to absolute or relative insulin insufficiency, insulin resistance, or both.The spread of the news about COVID-19 makes it necessary for the World Health Organization (WHO) to declare a state of emergency as a response to the spread of the disease. Severe acute respiratory syndrome, also known as SARS-CoV-2, is a virus that causes the disease COVID-19, which mainly begins with an asymptomatic incubation period (approximately 5–6 days, but could continue for 1–14 days).Diabetes is considered a key risk factor for lethality in a considerable proportion of hospitalized COVID-19 patients, and a high percentage of COVID-19 complications result in acute respiratory insufficiency due to diabetes.Aim: To collect data on how physical activity affects blood sugar levels in people with diabetes during the COVID-19 pandemic by interviewing patients who had diabetes prior to the pandemic.Methods: For the purposes of the following scientific research, a volunteer, anonymous questionnaire was used in the period January–April 2022. Patients diagnosed with diabetes prior to the pandemic (n = 32) participated in it.Results: The scientific research proves that 1/3 of the patients suffering from diabetes during the COVID-19 pandemic have had difficulties getting enough physical activity throughout the day and, as a result, have gained weight. A high degree of stress and a feeling of inability to cope with this chronic condition were found among the research participants

EMERGENCE AND PERSPECTIVES FOR THE DEVELOPMENT OF PALLIATIVE CARE IN BULGARIA

Abstract: Palliative care is undergoing rapid development with medical advances in the control of chronic pain as well as the accompanying symptoms of the disease. Over the years, palliative care has not received the attention it deserves, but today the focus is increasingly on it because of the unfoldedpotential it holds.Objective: To review the development of palliative care, to identify the problems and outline the prospects in Bulgaria.Material and methods: The study was conducted in 2022. A documentary method was used to research national and international literature, documents and regulations concerning the problem.Discussion: The beginnings of palliative care began as hospice care, often provided by caregivers in religious institutions. Caring for the sick and alleviating people's suffering are values that are present in every religion, but Christianity is especially important. The path of origin and development of hospiceand palliative care is long, with the beginning dating back to ancient times, flourishing in the Middle Ages, followed by a decline for a short period of time, to unfold with new force in the 17th century in France. Cicely Saunders' contribution to the development and consolidation of the hospice work is indisputable.She develops and implements a concept of hospice care, including ways to alleviate patients' suffering, respecting people's wishes and needs at the end of life. In 1990, the WHO developed a strategy for the integration of palliative care into health systems, updated in 2007, including four main elements. Inrecent years, indicators have been developed and used to evaluate palliative care practices around the world. The situation in our country is worrisome, because palliative care is extremely necessary and at the same time insufficient, marked by a number of unsolved problems waiting for their solutions.Conclusion: Guaranteeing quality palliative care requires the need for increased public awareness, training of medical professionals and commitment from the state

Role of Post-Harvest Residue Treatment on the Spring Crops Productivity in Haplic Chernozems

The investigation was carried out at Dobrudzha Agricultural Institute during 2014-2016. The type of the previous crop post-harvest residue treatment (PHR- wheat) on the yields from sprig crops (common bean, maize, sunflower) was investigated in six-field crop rotation. The PHR were utilized in three different ways (removed from the field; chopped and subsequently incorporated into the soil; and burned). The productivity of the spring crops was significantly affected by the meteorological conditions and by the ways of utilizing the PHR. The complex action of the main meteorological elements was determining for the productivity of common bean and maize. These crops reached maximum productivity in 2014 - 2550 kg/ha and 9417 kg/ha respectively. The sunflower demonstrated high productivity in all three years of the investigation (over 3000 kg/ha), with a maximum in 2016 - 3517 kg/ha. The removal of the post harvest residues from the field decreased the productivity of common bean and maize in comparison to their plowing or burning. The burning of the PHR had negative effect on the productivity of sunflower in all three years of the investigation. In 2016, the greatest differentiation of yield was observed depending on the way of PHR utilization. Among the three spring crops, the positive effect of the plowing of the PHR was most expressed in sunflower. The interaction between the meteorological factor and the way of post harvest residue utilization was decisive for its productivity. Averaged for the investigated period, the ways of PHR utilization did not significantly influence the productivity of maize

Effect of the Main Soil Tillage Types on the Agronomic Response of Wheat in the Region of Souht Dobrudzha

Wheat yield (Triticum aestivum L. – cv. Enola) obtained under different main soil tillage systems in 4-field crop rotation (common bean-wheat-sunflower-grain maize), is strongly influenced by the regional soil (Haplic Chernozems) and the climatic conditions. This study was carried out at the trial field of Dobrudzha Agricultural Institute-General Toshevo from 2014 to 2016. The influence of seven main soil tillage systems (MSTS) on the yield and the physical properties of wheat grain was investigated. Four of these MSTS were applied independently and annually in crop rotation: 1. CP - conventional plowing (24-26 cm); 2. D – disking (10-12 cm) 3. C – cutting; 4. NT - nil tillage (direct sowing). The other three MSTS systems included: 5. Plowing (for spring crops) – Direct sowing (of wheat); 6. Cutting (for spring crops) - Disking (for wheat) and 7. Plowing (for spring crops) - Disking (for wheat). The mineral fertilization in the crop rotation was as follows: Common bean – N60P60K60; Wheat – N120P120K60; Sunflower - N60P120K120 and Maize – N120P60K60.The objectives were: (i) to investigate the seasonal variability in wheat yield as influenced by the tillage systems; (ii) to investigate the variability in the physical properties of wheat grain and (iii) to evaluate the correlations between the grain yield and the physical properties of wheat grain. A significant differentiation in the productivity of wheat was found depending on the tested MSTS systems. Lowest mean yields were obtained at the annual use of systems 3 and 4 - 4541 kg ha-1. Among the annually applied systems, constant disking was the most favorable for expression of the crop’s production potential. The mean addition to yield according to constant plowing in the crop rotation was 4541 kg ha-1. The systems involving annual alternation of tillage types with and without turning of the plow layer exceeded with 232.0 kg ha-1 (4.77%) the same systems, which were applied independently. The alternation of plowing for root crops with direct sowing of wheat was most efficient from an agronomic point of view. In comparison to annual plowing, the increase of productivity was with 280.5 kg ha-1 (5.62%). The values of the physical properties of grain were also highly differentiated according to MSTS. The constant application of disking in the crop rotation contributed to the production of grain with the best physical indices – absolute weight 43.15 g and test weight 76.86 kg. The use of the systems Cutting – Cutting and Direct sowing – Direct sowing had negative effect on both the yield and the physical properties of gain. Averaged for the period, the correlation between the grain yield and the physical indices of grain was high and positive. The mean value of the correlation coefficient between the yield and the test weight (0.930**) was higher than the correlation coefficient of the yield with 1000 kernel weight (0.780**). The correlation between the absolute and the test weight of grain was very high in all three years of the investigation

HEALTH PREVENTION AT STUDENTS AT MEDICAL UNIVERSITY VARNA

The World Health Organization defined health as "a state of complete physical, mental and social well-being and not necessarily the absence of disease or infirmity. Health and medical prevention are all measures taken by health professionals and society as a social organization to protect and prevent the spread of risk factors for diseases and their complications among the population. It is a set of medical and non-medical measures that are taken to achieve better health and quality of life, by isolating risk factors, preventing diseases, reducing their consequences and premature death. Aim: To investigate and analyze the opinion of students from Medical University - Varna regarding their health prevention during their studies.Material and methods: Documentary analysis and direct anonymous poll.Results: From the survey conducted among students from the University of Varna, we can draw the following conclusions:1. Of the 201 respondents, almost half claimed that they did not use their right to one preventive examination per year at their general practitionerr for taking an anamnesis and complete objective status, laboratory tests of blood and urine, filling in a questionnaire. Only with this statement, 20.1% shared that within a year they visited their personal doctor for preventive examinations. 2. Almost all respondents, with few exceptions, agree that their lifestyle, risk factors and diet have an impact on the eventual discovery of a new disease. 3. Over 80% of the respondents regularly measure their vital signs for the purpose of self-control and health monitoring. 4. The majority of respondents indicated that their psychological stress decreased after they received the necessary information about their health after a preventive examination. Conclusion: In conclusion, the students share that prevention is important, but they do not have the opportunity to go for examinations due to insufficient time

Role of Post-Harvest Residue Treatment on the Spring Crops Productivity in Haplic Chernozems

The investigation was carried out at Dobrudzha Agricultural Institute during 2014-2016. The type of the previous crop post-harvest residue treatment (PHR- wheat) on the yields from sprig crops (common bean, maize, sunflower) was investigated in six-field crop rotation. The PHR were utilized in three different ways (removed from the field; chopped and subsequently incorporated into the soil; and burned). The productivity of the spring crops was significantly affected by the meteorological conditions and by the ways of utilizing the PHR. The complex action of the main meteorological elements was determining for the productivity of common bean and maize. These crops reached maximum productivity in 2014 - 2550 kg/ha and 9417 kg/ha respectively. The sunflower demonstrated high productivity in all three years of the investigation (over 3000 kg/ha), with a maximum in 2016 - 3517 kg/ha. The removal of the post harvest residues from the field decreased the productivity of common bean and maize in comparison to their plowing or burning. The burning of the PHR had negative effect on the productivity of sunflower in all three years of the investigation. In 2016, the greatest differentiation of yield was observed depending on the way of PHR utilization. Among the three spring crops, the positive effect of the plowing of the PHR was most expressed in sunflower. The interaction between the meteorological factor and the way of post harvest residue utilization was decisive for its productivity. Averaged for the investigated period, the ways of PHR utilization did not significantly influence the productivity of maize

Special nursing care of patients with orthotopic bladder in the postoperative period

Bladder cancer is one of the main problems in urology in terms of diagnosis and treatment, due to its high in­cidence and its course of development. Bladder cancer ranks fifth as the cause of death from malignant cancer (1.2% for women and 4.0% for men). Radical cystectomy has become the primary method for the treatment of invasive bladder cancer.AIM: The aim of this paper is using the general experience, to make tabular algorithm of early and late postop­erative urological nursing care of patients with radical cystectomy and orthotopic substitutionMATERIALS AND METHODS: Our research is based on: Olivia Herdiman et al. and the Clinic of Urology at the St. Anna University Hospital, Varna for the period 2012-2016. Our methods include: a documentary meth­od, observation, and analysis conclusions.Referring to the presented special urological nursing care of the postoperative period of orthopic bladder in the report we can arrive at the conclusion that:Special urological care is intensive and patients need overall treatment.An educated and observant urologic nurse can avoid much of the postoperative complications with timely and quality health care.After cystectomy and orthotopic replacement patients need psychological, family and social support. After cystectomy, patients need to be trained by a urologic nurse to monitor urination, fluid intake and ad­here to a proper diet. The instructions include involving a relative to have as a support outside the hospital. Advantages of the algorithm for early and late postoperative complications: contributes to the analytical and clinical way of thinking of urologic nurses; reduces the period of hospitalization of the patient; reduces the cost of postoperative recovery; provides quality health care; increases confidence in the team; increases the trust of the patient

Behavior of the nurse to overcome the complications of laparoscopic and robotic surgery

Introduction: In order to monitor the patient's condition and timely behavior, it is essential in nursing practice to know the complications of laparoscopic procedures.Some authors divide the complications of laparoscopic surgery into two groups:• complications related to laparoscopy;• complications related to specific surgical interventions.According to Perugini and Calari, complications can be grouped into the following three categories:• complications at the access point;• physiological complications of the pneumoperitoneum;• complications of the operational procedure.Material and Methods: The methods used were analysis of documentary sources for the period September–October 2020 and a documentary method.Conclusion: All complications discussed in the report are possible, which changes the focus of nursing care postoperatively. There is a big difference in the period of care and their application, when there is a complication of septic origin or a combination of several different ones. Therefore, nursing care should be planned individually and after information from the course of the operation and the patient's condition during admission to the surgical sector and should be changed, where necessary, in accordance with changes in the patient's condition