[The therapeutic potentials of the drug Hevizos in genital herpes simplex viral infection]. / Terapevtichni vuzmozhnosti na medikamenta Khevizosh pri genitalna kherpes simpleks virusna infektsiia.

The author assessed the effect of a new medicine called Hevizos on patients with herpes simplex genital infection. He proved good therapeutic results in both pregnant and non-pregnant women as well as in parturients. Parturients needed longer period of treatment with Hevizos than pregnant and non-pregnant women.

[Our experience in using the preparation Proctosedyl from the Roussel firm in pregnant women with hemorrhoids]. / Nashiiat opit ot prilaganeto na preparata "Proktosedil" na firma "Rusel" pri bremenni s khemoroidi.

The therapeutical efficacy of PROCTOSEDYL (Rousel Ltd., France) was investigated in 25 pregnant women with chronic hemorrhoids. Excellent results, including elimination of clinical symptoms and good tolerability, were achieved in 100% of the cases by the local conservative treatment only, which makes Proctosedyl especially suitable for application during pregnancy.

[The use of Solcoderm in acute condylomas of the vulva (preliminary report)]. / Prilozhenie na solkoderm pri ostri kondilomi na vulvata (predvaritelno suobshtenie).

A preliminary study was carried out on women with acute condylomas, treated with the preparation solkoderm. Preliminary data from the clinical trial show that the preparation should be used in some women with acute condylomas of the vulva after available clinical evaluation.

[Our experience with the clinical trial of postinor--an oral hormonal preparation for postcoital contraception]. / Nashiiat opit ot klinichnoto izpitvane na postinor--khormonalen oralen preparat za postkoitalna kontratseptsiia.

PIP: Postcoital contraception aims at the avoidance of unwanted pregnancy in women who have a regimen of rare or accidental sexual contacts. For the 1st time in Bulgaria, the authors examined clinically an oral postcoital preparation, Postinor, which originated in Hungary. Each tablet contains 0.75 mcg of d-norgestrel. The observation included 49 volunteers, ages 19-38, with proven fertility. The preparations were given during the course of 150 menstrual cycles. 1 women became pregnant as a result of improper dosage/multiple contacts during incomplete hormonal protection. There were 3 cases of bleeding (6.1%) and 1 required estrogen correction. The authors found that the best administration regimen was 1 tablet, with the exception of 2 tablets/week. The authors suggest that Postinor could be successfully combined with the rhythm method of Ogion-Knaus. They recommend it for daily contraceptive practice. (author's modified)^ieng

[A clinical trial with the monophasic contraceptive Marvelon]. / Klinichen opit s monofazen kontratseptiv--Marvelon.

The authors present their clinical experience with a monophasic preparation consisting of 30 mcg ethynyl estradiol and 150 mcg desogestrel (Marvelon, Organon). 121 cycles of 24 fertile women were followed. The results show a full contraceptive success, a stable cycle control as well as a low incidence of the side effects.

PIP: The objective of the study was to assess the clinical effectiveness of the monophasic oral contraceptive Marvelon by examining its safety and its effectiveness in controlling the menstrual cycle as well as the frequency and types of side effects. 24 healthy women with an average age of 24.5 years (range of 18-33 years) were the subjects. 23 had previous reproductive events: 18 births, 5 spontaneous abortions, and 16 induced abortions. 17 women had used contraceptives sporadically: 3 postcoital pills, 8 triphasic pills, and 6 monophasic pills. During the year prior to initiating Marvelon use 2 women had experienced oligomenorrhea, 5 had had hypermenorrhea, 6 had had dysmenorrhea, and 3 had had irregular uterine bleeding. The observation period of contraceptive use lasted 4-6 months, during which a total of 121 cycles were evaluated without one single case of pregnancy. This meant a 100% contraceptive safety or a Pearl index of 0. 20 of the patients had stable cycles. 4 women with 13 of the 121 cycles (10.5%) had menstrual disorders. There were 5 cases of breakthrough bleeding and 8 cases of spotting. Weak dysmenorrhea occurred only in 2 patients. Other side effects included: nausea (2), headache (2), nervousness (2), mastodynia (3), vertigo (1), depression (1), and increase of body weight (2). As the duration of taking Marvelon increased the frequency of menstrual disorders declined. Not a single case of post-pill amenorrhea occurred. At the present time over 5 million women use Marvelon in the world. Epidemiological studies involving 14,903 women with a total of 98,225 menstrual cycles have revealed only 4 pregnancies or a Pearl index of 0.06. In the present study regular pseudomenstrual bleeding was confirmed in 89.5% of investigated cycles, which compares to 96.1% indicated in the literature. Marvelon proved to be a modern, safe contraceptive with stable control of the menstrual cycle, and which exhibited only minor side effects.

[Our experience in using the triphasic contraceptive trisiston for contraception]. / Nashiiat opit ot prilozhenieto na trifazniia kontratseptiv trisiston za kontratseptsiia.

The authors carried out studies on 80 women, using Trisistone, a preparation of Germed, Jenapharm, DDR, in the course of 250 cycles, taking into consideration the advantages of triphasic contraceptive preparations as well as the fact that till this moment there were not applied in our country. A good contraceptive efficiency was established. No case with conception was recorded. The side effects were mild and and their frequency varies between 2.4 and 9.7% Irregular bleedings were the only disadvantage of Trisistone, which caused refusal for its usage. It is proposed that Trisistone should be used as an initial contraceptive preparation like the preparations with "mini" doses. In cases with good tolerance women should continue to use it, but they should take another contraceptive preparation, when bleeding occurs.

PIP: Contraceptive efficacy of triphasic combined preparation trisistone (East German drug identical to triphasil) was evaluated in 80 women with the average age of 31 years. The trisistone package consisted of 6 violet tablets (0.030 mg of ethinyl estradiol and 0.050 mg of 1- norgestrel), 6 pink tablets (0.40 mg of ethinyl estradiol and 0.075 mg of 1-norgestrel), and 9 orange tablets (0.030 mg of ethinyl estradiol and 0.125 mg of 1-norgestrel). The women started to take trisistone on day 1 of the menstrual cycle and continued to take tablets in exact sequence. Indications and contraindications for trisistone were similar to those for monophasic combined contraceptives. A total of 250 cycles were followed-up. Throughout the entire trial period, no women became pregnant. Mild side-effects included subjective sensation of pregnancy (9.7%), headache (7.1%), vertigo (2.4%), and weight gain (2.4%). Almost 20% of women developed hemorrhage, usually following administration of 8-9 tablets in the middle of the 2nd phase. Repeated hemorrhage during the 2nd and 3rd cycle was an indication for discontinuation of trisistone administration.

[Estrogen-gestagen prevention and treatment of uterine hemorrhages in the premenopause]. / Estro-gestagenna profilaktika i lechenie na matochnite kruvotecheniia v premenopauzata.

Clinical and laboratory study was carried out on 28 women, aged 47,80 years on the average, with uterine bleedings during the premenopausal phase of climacterium and accompanying neurovegetative climacteric symptoms. A cyclic preparation, containing 2 mg of estradiol-17 valerate in the first 11 tablets and the same dose of estrogen with supplement of 0.5 mg of norgestrel in the following 10 tablets was used for a period of 3 months(84 cycles in all). The preparation eliminated efficiently climacteric symptoms in addition to its assurance provision of stable clinical characteristic of succeeding pseudomenstrual symptoms cycles. The preparation did not induce increased thrombogenic risk, because the basic hemostatic indices before and after treatment were not changed. Lipid profile was not altered substantially as there was a favourable tendency to its occurrence in antiatherogenic direction (a reduction of LDL- and VLDL-cholesterol).

[The treatment and prevention of premenopausal uterine hemorrhages with Trisequens]. / Lechenie i profilaktika na premenopauzalnite matochni kruvotecheniia s Trisequens.

The authors describe the results from 30 women with premenopausal uterine bleedings and accompanying neuro-autonomic climacteric symptoms, treated with the combined estrogestagenic preparation (Trisequens--Novo Nordisk A/S). The mean age of the contingent is 47.64 years. The clinical characteristics of pseudomenstrual function, climacteric symptoms, fatty metabolism and carbohydrate tolerance are examined. Stable pseudomenstrual function, discontinued or sharply reduced climacteric symptoms, lack of substantial changes in the fatty and carbohydrate metabolism are found after treatment. It is necessary that similar treatment could be used considerably more widely in the daily gynecological practice.

[The results of a clinical trial of the preparation Ossopan]. / Rezultati ot klinichnoto izpitanie na preparata Ossopan.

The preparation Ossopan was used for period of one month in 20 pregnant women at 28 to 40 weeks' gestation with pain syndrome in the long bones, lumbosacral region and disturbed dental status. Its effect was studied on second group of 13 women with established clinically and roentgenologically climacteric osteoporosis, using a therapeutic course of 1 pill daily for a period of 6 months. A considerable clinical improvement of pain syndrome and dental status was found in the end of the treatment. The positive therapeutic effect, easy way of administration, its good tolerance and lack of side make it convenient for treatment of disturbances in calcium-phosphorus balance.

[The importance of the prophylactic use of antibiotics with women undergoing elective cesarean section]. / Za smisula ot profilaktichnoto prilozhenie na antibiotitsi pri zheni, ponesli elektivno tsezarevo sechenie.

Postoperative infectious morbidity was described in two groups of low risk cesarean sections (CS). The frequency of postoperative infectious complications was 6.89% of women, who received penicillin for a period of 3 to 5 days, but 5.67% of women, who did not received antibiotics prophylactically. Data were presented, which showed also the economic insignificance of antibiotic prophylaxis (AP) in women with low risk CS. On the basis of the indicated data an inference was made that AP was of no clinical efficiency in women with low risk cesarean sections. The authors recommend restraint in AP of such women, in whom postoperative infectious inflammatory complications are anyway very rare.

[The use of the triphasic contraceptive preparation trisiston for therapeutic purposes]. / Prilozhenie na trifazniia kontratseptiven preparat trisiston za lechebni tseli.

After a brief review of the qualities of the new triphasic contraceptive preparation Trisistone and some of its advantages in comparison with the other combined contraceptive drugs the authors report on the results from the first study, carried out in our country, on the therapeutic effect of Trisistone. Thirty-eight women with various gynecological diseases were treated. The largest group was that of women with irregular bleedings. In this group the effect was not good in all women. It was found that Trisistone had limited possibilities to control irregular uterine bleedings, which most probably was connected with its comparatively low dose of steroid hormones. The side effects were comparatively slight and not quite frequently. The most frequent side effect was the occurrence of irregular bleeding in 9.5% of the treated women. The state without any side effects was improved in 30.1% of the patients. Best results were found in women with postcastration syndrome, hypoestrogenism and congenital anomalies in the development of ovaries--primary ovarian dysgenesis. Trisistone is especially suitable for substituted treatment in women with ovarian hormonal deficit.

PIP: The therapeutic efficacy of the new triphasic contraceptive agent trisistone was evaluated in 42 women (20-35 years old) with various gynecological diseases. The group included 25 with uterine hemorrhage, 4 with post-castration syndrome, 4 with endometriosis, 4 with hypogonadism, and 5 with other diseases. The drug was dispensed monthly. The patients received 1 to 14 packages of trisistone (average number 3-4). The first phase consisted of 6 violet tablets containing 0.003 mg of ethinyl estradiol and 0.05 mg of levonorgestrel; the second phase consisted 6 pink tablets containing 0.04mg of ethinyl estradiol and 0.075 mg of levonorgestrel and third phase consisted of 9 orange tablets containing 0.03 mg of ethinyl estradiol and 0.125 mg of levonorgestrel. Of 42 patients, 16 had stopped taking the drug after the first cycle, while 26 showed clinical improvement. The treatment was the most effective in patients with estrogen and gestagen insufficiency, luteal insufficiency, and primary ovarian dysgenesis. Side-effects of trisistone included hemorrhage (9.5%), headache (7.1%), sensation of pregnancy (7.1%), dizziness (2.4%), and nausea (2.4%).

[The treatment of vaginal candidiasis with a single oral dose of fluconazole]. / Lechenie na vaginalnata kandidoza s edinichna oralna doza ot fluconazole.

Fluconazole is a new oral absorbing triazolic antimycotic, inhibiting specifically the sterol synthesis of fungal membrane. Treatment with a single dose of 150 mg of fluconazole was carried out on 33 nonpregnant women with clinical and microbiological data for vaginal candidiasis. The high percentage of recovered patients, good tolerance to the preparation as well as easy scheme for usage gives ground to be recommended for wide gynecological practice.

[The therapeutic potentials of the vaginal antimicrobial preparation Chlorchinaldin]. / Terapevtichni vuzmozhnosti na vaginalniia antimikroben preparat--Chlorchinaldin.

The aim of this study is the clinical testing of the vaginal wide-range, antimicrobial, quinolone--Chlorchinaldin/0,2/by POLFA, which has a strong antibacterial, antifungal, trichomonal and keratoplastic effect. The medicine was used on 43 patients with complaints of aggravated fluor. The clinical, colposcopic and microbiologic study showed: candidiasis--in 16 trichomoniasis--in 8, bacterial vaginalis--in 3 and anaerobic vaginitis--in 2 patients. The rest of the women (14) had various aerobic microbial findings. The treatment was daily using one vaginal tablet, every night for 10 days. A control examination was carried out one week after the any of therapy. The results showed a positive clinical effect, since in 67.4% there were negative microbiological findings. The lack of effect in cases with bacterial vaginosis and anaerobic vaginitis was painted out. These results give reason to believe that the wide antimicrobial range of Chlorchinaldin B will be complementary to the currently used drugs in the treatment of vaginal infections.

[Clinical study of a low-dose contraceptive--Femodene]. / Klinichno prouchvane na niskodoziran kontratseptiv--Femoden.

The authors present their clinical experience with a low-dose monophasic contraceptive consisting of 30 mcg ethinylestradiol and 75 mcg a gestagen--gestodene (Femoden, Schering). 112 menstrual cycles of 22 women in fertile age were followed. The results show 100% contraception, a good control of the menstrual cycle and tolerance of the preparation.

[Our experience in treating pelvic inflammatory disease caused by Chlamydia trachomatis with the preparation roxithromycin]. / Nashiiat opit ot lechenieto na tazovata vuzpalitelna bolest, prichinena ot Chlamydia trachomatis s preparata roxithromycin.

The authors are analyzing their results of the treatment with roxithromycin 150 mg of the pelvic inflammatory disease, caused by chlamydia trachomatis. 29 patients with proved chlamydial infection were treated. The most popular diagnosis was cervicitis. 23 patients were totally cured, 4 patients were with considerable better status after the treatment, and 2 of the patients were with insignificant amelioration of the status. A conclusion can be made, that the roxithromycin is a very good alternative of the existing treatment with doxycicline.

[Our clinical experience in treating endometriosis genitalis externa with the preparation Danoval]. / Nashiiat klinichen opit za lechenie na endometriosis genitalis externa s preparata Danoval.

By means of the serum level of estradiol and the vaginal smear indexes the antigonadotropic activity of the preparation Danoval (2-3-isoxasol-17-ethinyltestosterone) is indirectly evaluated on 15 infertility patients with laparoscopic proved endometriosis. After 5 month's course of treatment with 400 mg daily the level of estradiol decreased from 1.54 to 0.31 nmol/l, IA from 20.8 to 10.4 and IP from 32 to 17.3. The side effects are slight and descend from the pharmacological properties of the preparation. Two patients became pregnant in three months after the treatment.

[Our experience with the use of the new Bulgarian intrauterine contraceptive device, the Venus Cu 300 (preliminary report)]. / Nashiiat opit ot prilozhenieto na novite bulgarski vutrematochni kontratseptivi Venus Cu 300 (predvaritelno suobshtenie).

A team of the family planning centre at the Research Institute of Obstetrics and Gynecology carried out a trial on a new Bulgarian intrauterine contraceptive device (ICD), produced by the firm Venus in the town of Varna: Venus Cu 300. This is a T-shaped device with horizontal arm of 30 mm, vertical arm of 34 mm, a copper thread with an area of 300 mm2 and two control threads. It is produced from PVC. Purity of copper is over 99.9% in the copper thread. The construction of Venus Cu 300 has the positive properties of other intrauterine contraceptive devices, used in our country during the last 15 years. 87 women have been followed in 320 cycles for a period of 6 months. A larger part of them are parous, mainly with one or two children. Venus Cu 300 has been used in seven nulliparas, presenting risk for frequent abortions. Three Venus Cu 300 have been placed immediately after abortion. No pregnancy occurs, which is explained by the careful choice of the patients. Extraction of ICD has been made only in one case due to medical causes: bleeding and pain. More abundant menstruation after ICD has been found in 11.5% of women, but there has been no need to extract ICD. Inferences are made that Venus Cu 300 is in every way equal to the known models of ICD, that the trial should include a larger group of women to accumulate data in dynamics, in order to improve Venus Cu 300 eventually.