Orphan drugs of personalized medicine in Bulgaria and their cost-effectiveness

The orphan drugs development is related to the progress of personalized medicine. The relationship between them is based on a treatment tailored to personalized patient needs. Personalized medicine is defined as “providing the right patient with the right drug, at the right dose and at the right time”, while the orphan drug is defined as “intended for the treatment, prevention or diagnosis of a rare disease or condition, which is one that affects less than 200,000 persons in the United States” and no more than 10,000 people for the European Union. The main goal of the article is to study the approved orphan drugs in Bulgaria, determining how many of them are reimbursed by the NHIF and are cost-effectiv

Mycobacterium tuberculosis Latin–American–Mediterranean family in Bulgaria

AbstractIntroductionTuberculosis (TB) remains an important public health issue for Bulgaria. Although a number of new cases are showing a steady decline (44/100,000 in 2000, 40/100,000 in 2005), the TB incidence rate in Bulgaria is still sufficiently high (26.7/100,000 in 2013). The current population structure of Mycobacterium tuberculosis is clonal. Certain genetic families of this species have justly attracted more attention due to their global dissemination and/or remarkable pathogenic properties. Beijing, Haarlem, and LAM are the most known examples. The latter family LAM (Latin–American–Mediterranean) was shown in an increasing number of studies to possess increased transmissibility, hence the importance of its rapid detection and correct estimation of its prevalence in a population. Spoligotyping signature of LAM is absence of signals 21–24 and 33–36, although abridged spoligo-profiles with long blocks of deleted spacers result in an uncertain definition of such strains. The use of other molecular markers may be helpful. This study aimed to evaluate the prevalence of LAM strains among M. tuberculosis strains in Bulgaria based on the use of different molecular markers.Materials and methodsM. tuberculosis isolates were randomly selected among M. tuberculosis strains isolated from newly diagnosed, adult, pulmonary TB patients in different regions of Bulgaria from December 2004 to March 2006. Spoligotyping was used to analyze a variation in the DR locus. The spoligotyping patterns were compared with the international database SITVIT_WEB (Institut Pasteur de Guadeloupe). Analysis of the IS6110 element specific for the LAM genetic family was performed as described previously (Marais et al., 2006).ResultsA study sample included 133 strains from different regions of the country and characterized in previous publications (Valcheva et al., 2008, 2010). Application of the published rules for the definition of the major spoligotype clades and comparison with SITVIT_WEB global database permitted this study to assign most of the 133 strains to the known spoligotype families. All available strains (n=101) were tested for LAM-specific IS6110 insertion. Comparison of results by different methods identified 3 groups of strains. The first group included 11 strains with 2 amplified bands which present an apparent discrepancy; further study is warranted. The second group included 86 strains with a single amplified band, specific for the absence of the IS6110 insertion in the target locus, hence indicative of the other than LAM family. The third group included 4 strains with a LAM-specific band only.ConclusionsApplication of the LAM-specific PCR revealed double-sided discrepancies when the obtained results were compared with those obtained by spoligotyping. As a whole, a phylogenetic family of 38 strains was revised or questioned: 27 strains were shown not to belong to LAM, while 11 more strains showed apparently discrepant results that question the global utility of such PCR or at least highlight an importance of using multiple markers for molecular detection of the LAM family of M. tuberculosis.AcknowledgementsDr. Nadya Markova, Prof. Olga Narvskaya, and Prof. Nalin Rastogi are gratefully acknowledged for kind support and guidance

Research about awareness among students of specialty `nurse` of rendering health care to children with Down syndrome

Down syndrome also known as Trisomy 21 is a genetic disorder. It occurs in about one per 700 babies and it is one of the main reasons about mental retardation in children. They grow up like other children, but with slower pace. The disorder occurs with very typical expression of the face, difficulties in learning new skills and knowledge, defects of the cardiovascular system, eyes, orthopedic abnormalities, gastrointestinal and respiratory difficulties. Thanks to health care and change in social policy, the duration and quality of life of children with Down syndrome has significantly increased.Aim of this study was to determine nursing skills, knowledge and awareness of students about children with Down syndrome.Material and Methods: sociological method - survey, conducted in the March 2016 among students of third year of specialty `Nurse` MU-Varna. Documentary method - analysis of literature, academic documentation.Results: More than half of surveyed students said that the skills and knowledge they got from the education so far is enough for giving health care to children with Down syndrome. Bigger part of the problems of the students comes from lack of experience with such patients. They evaluate the specifics of the disease and think that they need more practical exercises.Conclusions: Future nurses value their skills and knowledge high. They need more information and more practical exercises

Physicochemical and Microbiological Characteristics of Thermal Healing Spring Waters in the District of Varna

Defined are the physicochemical properties of healing thermal and non-thermal spring waters in the area of Varna District. It is shown that according to 18 controlled parameters included in the research, the thermal healing spring water drilling №Р-83хКК “Saints Constantine and Helena”, thermal healing spring water  Р-1х “Aquarium”, thermal healing spring water  Р-106 х “Dom Mladost”, thermal healing spring water Р-161х Varna at “Primorski” swimming pool, fulfill the required conditions for drinking water.The spring waters from the given four water sources are characterized by microbiological indicators, as the pathogenic micro-organisms are defined by the membrane method. It is established that thermal healing spring water drilling №Р-83хКК “Saints Constantine and Helena”, thermal healing spring water  Р-1х “Aquarium”, thermal healing spring water  Р-106 х “Dom Mladost”, thermal healing spring water Р-161х Varna at “Primorski” swimming pool, fulfill the standard requirements. “The healing water” of village Goren Chiflik, District of Varna does not conform with the physicochemical indicators given for nitrates, and microbiological indicators with regards to coliform bacteria and enterococci. Keywords: spring water, drinking water, physicochemical properties, microbiological indicators DOI: 10.7176/JMPB/59-02 Publication date:September 30th 201

SOIL CHARACTERISTICS OF PROTECTED AREA “CHINAR DERE”

The soil types in the protected area “Chinar dere”, village of Topolovo, municipality of Assenovgrad, were studied. For this purpose, 4 soil samples from depth of 0-20cm and from different locations in the area – under cereal plants, sunflower, vineyard, and natural meadows, were collected. The soil samples were analyzed with respect to humus content, mechanical characteristics, sorption capacity, pH in water and in KCL, and exchangeable acidity /H+ and AL+/. On the basis of the conducted analyses the soil types were defined as koluvium soils suitable for growing various vineyard cultivars, and among the fruit cultivars they are suitable for growing plums, cherries, sour cherries, walnuts, apricots, and peaches. These soil types are also suitable mainly for growing small-leaved tobacco, and in the higher regions – raspberries. In the case when the subterranean waters are closer to the surface, the soils are suitable for growing forage crops or can be used as meadows

Investigation of the variety and use of herbal antidepressants containing St. John`s Wort (Hypericum perforatum) in Bulgaria for the period 2014-2016

St. John`s Wort (Hypericum perforatum L.) is a very popular herb that is mainly used for mild to moderate depression. The purpose of this study was to explore the available on the market in Bulgaria pharmaceuticals and dietary supplements containing St. John`s Wort, and to analyze the use of such products. The use of St. John`s Wort containing products was studied by collecting sales data from 19 pharmacies in Varna for the period 2014 - 2016. According to the study results, on the pharmaceutical market in Bulgaria St. John`s Wort is available as two pharmaceutical monoproducts and a number of dietary supplements (monoproducts and combined). In the studied period, there was an increase in the sales of products containing St. John`s Wort. The price of the products during the study period remained relatively constant. Predominant was the use of pharmaceutical products. It is preferable that products containing St. John`s wort be used on prescription as the herb is involved in multiple drug interactions

Gelişmiş yulaf (avena sativa L.) soy hatlarının üretim potansiyelleri ve uyumlulukları

This comparative study was performed on advanced oat breeding lines within the period of 2011-2013 in order to determine the productive potential of the studied genotypes and the variation of productivity, which determines the varietal adaptability. The results showed that the studied group of advanced oat lines was highly productive. The yield variation was most strongly affected by the genotype x environment interaction. Genotype played the greatest role in the variation of the traits: length of panicle, grain weight per panicle and 1000-grain weight. The greatest significance in yield formation was displayed in the number of spikelets per panicle, the number of grains per panicle and grain weight per panicle. The weakest contribution was observed for length of panicle. Lines 1104-19-1, N. Pr. 1 and 1402-2 appeared to have the highest productivity, which was relatively constant by years. Lines 1058 Re 1, 1089 Re 3 and 1176-1 were also highly productive, but they have specific responses to environmental changes.2011-2013 yılları arasındaki periyotta yulaf hatları üzerinde gerçekleştirilen bu karşılaştırmalı çalışma, çalışmaya dahil edilen genotiplerin üreme potansiyellerinin ve çeşit uyumululuğunun bir göstergesi olan üreme çeşitliliğinin belirlenmesi amacıyla yapılmıştır. Elde edilen sonuçlar kullanılan yulaf hatlarının oldukça üretken olduklarını göstermiştir. Ürün varyasyonu en çok genotipxçevre etkileşiminden etkilenmiştir. Genotip, salkım uzunluğu, salkım başına dana ağırlığı ve 1000 dana ağırlığı gibi özelliklerdeki varyasyon üzerine büyük etkili olmuştur. Ürün oluşumundaki en büyük anlamlılık salkım başına başakçık sayısında, salkım başına dane sayısında ve salkım başına dane ağırlığında gözlenmiştir. En zayif genotip katkısı ise salkım uzunluğunda tespit edilmiştir. 1104-19-1, N. Pr. 1 ve 1402-2 hatlarının üretkenliklerinin en yüksek olduğu ortaya çıkmış ve bu bu durum çalışma süresince devam etmiştir. 1058 Re 1, 1089 Re 3 ve 1176-1 hatlarındaki üretkenlik de yüksektir ancak bu hatlarda çevresel değişikliklere karşı spesifik yanıtlar söz konusudur

Flavonoids and the liver—a review

INTRODUCTION: Liver diseases (hepatitis, steatosis, non-alcoholic fatty liver disease, cirrhosis and hepatocellular carcinoma) are among the most common causes of disability and death worldwide. An accumulating body of evidence has established a relationship between the intake of polyphenol-rich foods and beverages and the lower incidence of liver diseases. Flavonoids are important ingredients in human diet.AIM: The aim or the present review article was to summarize the current knowledge about the effects of flavonoids on liver health and the mechanisms involved.MATERIALS AND METHODS: Literature in Pubmed, Google Scholar and ScienceDirect has been studied and analyzed.RESULTS: Flavonoids protect the liver from viral, toxic, drug-induced and obesity-associated liver damage, but the data are almost exclusively derived from animal studies. However, the number of clinical trials is insufficient and additional human studies are needed to confirm their effect in clinical practice.CONCLUSION: Analysis of the literature data from scientific databases showed promising hepatoprotective effects of flavonoids proved predominantly in experimental animal studies

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.