[VITAMIN D AND PREGNANCY].

This arcicle reviews the role of vitimin D during pregnancy. Adequate intake of vitamin D during pregnancy is very important for the health of mother and infant. A number of epidemiological data worldwide show widespread suboptimal levels of vitamin D in pregnant women. Vitamin D deficiency may be associated with an increased risk of infection, bacterial vaginosis, pre-eclampsia, low serum vitamin D levels in the newborn and others. There are not universal recommendations for dosage and intake of vitamin D for pregnant women in the world. It is recommended that serum level of vitamin D in all pregnant women and its adequate supplementation. Normal maternal vitamin D levels would provide sufficient its accumulation in the fetus.

[Socio-demographic characteristics and vitamin D status in women born before 32 weeks'].

UNLABELLED: Deficiency of vitamin D (25-OHD) is a health problem among prematurely born women and their newborns independently of the geographical location of the country. OBJECTIVES: To study serum levels of vitamin D in patients born before 32 weeks and their newborns at birth. To analyse the socio-demographic factors, complications of pregnancy and their relationship with vitamin D status of women. PATIENTS AND METHODS: The study has been carried out in the University hospital "Maichin dom" Sofia for the period August 2013-January 2014. 35 women who gave birth before 32 gestational week and their 41 newborns with birth weight < 1500g have been investigated. The serum level of vitamin D (25-OH D) in mother-infant pairs at birth and 8 weeks of age in infants has been investigated. The ECLIA method has been used. Serum levels of vit D (25-OHD) have been estimated as sufficient:(> 30 ng/ml), insufficient (21-29ng/ml) and deficient (< 20 ng/ml). RESULTS: At delivery according to their vit D (25- OHD) serum levels 63% of the mothers are defficient /12.61 ± 4.8 ng/ml/, 28.5% are insufficient/26.66 ± 2.59/and only 8.5%/40.4 ± 8.48/sufficient with normal levels of vitamin D. For newborns data are respectively 32%/ 20.08 ± 3.69/-deficient, 49%/27.39 ± 2.70/- insufficient and 19 %- sufficient/41.6 + 10/ There is a positive correlation between mother's and children's serum levels of vitamin D (25- OHD). Statistical significant differences are observed in the levels of vitamin D and the presence of infection and preeclampsia in the mothers. During the period of the study there were no seasonal variations in vit D (25-OHD) serum levels of mother-baby pairs. All newborns received Vit D3 1334 IU/daily from 20th day of age. At eight weeks of age sufficient levels of vitamin D have 70% of the children, but 30% of the newborns remains with inadequate supplementation/27.09 ng/ml/. CONCLUSION: 91.5% of mothers are with insufficient serum levels of vitamin D (25OHD) at birth, and a deficit is present in 63% of all women. Only in 8.5% of the women had normal values. This implies more effective monitoring and vitamin D prophylaxis during pregnancy.

[Multipurpose treatment of vaginal infections].

Untreated bacterial vaginosis is related with many complications for non-pregnant women in reproductive age, most common from them are vaginal discharge and postoperative infections. The aim of our investigation was to compare the effectiveness of two therapeutic regimes which consist in Macmiror/Macmiror Complex alone and in combination with Feminella Vagi C for treatment of bacterial vaginosis (BV) and/or mycotic infection. 117 non-pregnant women with symptoms of vaginal infection were prospectively enrolled into two groups according their treatment. First group consist 66 women treated with Macmiror tablets and vaginal capsules followed with local application of Feminella Vagi C, the second group consist 54 women treated with Macmiror tablets and vaginal capsules only. The impact of treatment on clinical symptoms was observed at the end of medication and 20 days after it. Microbiological testing was repeated 20 days after treatment. Over than 80% (78.6 divided by 86.7%) of the cases with vaginal infection (BV and mycotic one) were successfully treated with Macmiror/Macmiror Complex. Supplement treatment with Feminella Vagi C lead to higher percentage of clinically recovery (86.7% vs 84.6%), better microbiological cleaning (86.7% vs 82.1%) and longer effect of treatment. Used medication showed higher efficacy against BV than to fungal infection. According obtained results we may conclude that bacterial vaginosis was better treated with multipurpose treatment (Nifuratel, Nistatin and vit. C) than with Macmiror alone.

[Efficiency of Cikatridina spray for healing of episiotomy and perineal ruptures].

UNLABELLED: Episiotomy is the most common surgical intervention during childbirth. Cikatridina spray allows treatment of this primary contaminated surgical wound and assist its primary healing. The aim of this study is to determine the effectiveness of aid healing of episiotomy, and spontaneous perineal ruptures after normal and operative vaginal delivery. MATERIAL AND METHODS: The study included 90 women after spontaneous or operative vaginal delivery with episiotomy or a spontaneous perineal rupture treated with Cikatridina spray. Control group of 90 women was used to compare the efficency. The status of the wound was determined on the first, third, fifth and 30th day after birth, according to presence of the following symptoms: redness, swelling, pain, exudation, epithelization, open wound. RESULTS: Symptoms of redness, swelling and pain in the group treated with Cikatridina spray after normal birth resolved on the third postpartum day in 100% of cases. Same symptoms after operative vaginal birth persist in average 9% of women and resolved on the 5th day When comparing treated patients with Cikatridina spray with perineal ruptures and the control group in 100% were reported no symptoms in the study group compared with the control group where the redness, swelling persist in 20% and 85.7% epithelization is showing at 5 postpartum day. There was one open episiotomy of a patient from a control group after operative vaginal birth healed in 26 days. CONCLUSIONS: Cikatridina spray effectively eliminates symptoms of redness, swelling and pain regardless of perineal trauma and the method of delivery. There is an earlier epithelization after using the Cikatridina spray. Open and infected perineal wounds are treated with conventional medicines.

[Treatment of preterm delivery with calcium channel blockers--Nifedipine].

AIM: To assess the feasibility of the calcium antagonist Nifedipine as an oral tocolytic for the treatment of preterm labor. METHODS: Thirty-seven pregnant women in preterm labor participated in a prospective longitudinal study. Inclusion criteria were: gestational age between 24 and 32 weeks gestation; uterine contractions in 30 min interval; lack of cervical dilatation and lack of contraindications for tocolysis. In all cases the calcium antagonist Nifedipine was used in dosage 4 x 10 mg per os. The clinical response to tocolysis, gestational age at delivery and potential side effects were analyzed. RESULTS: Forty-one pregnant women participated in the study. Two were lost for follow up and another two cases were excluded because myoma uteri was diagnosed. Thirty-seven pregnancies were finally analyzed. In five of them maternal contractions persisted despite of treatment which necessitated parenteral tocolysis. In two of these five cases the pregnancy was terminated (1--spontalneous abortion in 26 w.g., 1--preterm delivery at 32 w.g.). The other 32 pregnancies were delivered at term without any side effects attributed the treatment. CONCLUSION: Nifedipine is an effective oral tocolytic and a rational alternative to other tocolytic agents in the management of preterm labour.

[Supplemental multivitamin and multimineral preparations during normal pregnancy--effect on a fetus and delivery]. / Multivitamini i multimineralni preparati pri normalno protichashta bremennost--efekt vurkhu ploda i razhdaneto.

UNLABELLED: The aim of this prospective study is to assess the effect of non indicated supplementation with Materna during normal pregnancy on some parameters of the neonate and the process of delivery. The material includes 98 women who had been taking Materna during the pregnancy and 27 cases without any medications. The criteria for inclusion are: normally progressing clinically and paraclinically pregnancy and delivery after completing 37th w.g. (95% confident interval 39.0-40.5). RESULT: Most of the pregnant women take Materna for 3 to 5 months (95% CI) during pregnancy. The supplementation with Materna lead to increase of the BIP from the control group of 94.4 mm to 96.5; the occipitofrontal circumference from 33.9 to 35.1 and the high of the neonate from 50.2 to 51.1 respectively. The impression of the obstetricians engage in the study is that the scull bones are more solid and the molding of the head after the delivery is very small or even missing. CONCLUSION: Unjustified supplementation of normal pregnancy with multivitamins and multiminerals lead to increase in the occipitofrontal circumference and to the decrease of the molding capacity of the fetal head wherefore the labor prolongs and the rate of CS and the operative vaginal deliveries increase.

[Possibilities for an individualized approach to the treatment of climacteric symptoms with phytoestrogens]. / V'zmozhnosti za individualiziran podkhod v lechenieto na klimakterichnata simptomatika s fitoestrogeni.

UNLABELLED: In climacteric women with contraindications and fear or lack of compliance for taking hormonal replacement therapy as well as in those cases where risks exceed benefits, the use of phytoestrogens is appropriate having in mind their especially good effect on neurovegetative symptoms. AIM: The present randomized prospective study is aimed at estimating the possibility for ameliorating climacteric symptoms with Melbrosia and at assessment of its effect on different symptoms in order to individualize the therapeutical approach. PATIENTS AND METHODS: Two groups of women with climacteric complaints were followed-up--control group (n = 32) and treatment group (n = 34). Climateric symptoms were assessed in the beginning and at the end of the study using Kupperman menopausal index. The levels of FSH, LH, oestradiol as well as some parameters of lipid metabolism were determined. RESULTS: A significant decrease of Kupperman index was observed in Melbrosia treatment group in contrast to the control group. No significant changes in gonadotropins, oestradiol and lipid parameters were found in both groups. CONCLUSION: The preparation Melbrosia, consisting of phytoestrogens and amino acids exerts a good therapeutic effect on climacteric symptoms mainly on the nervousness, anxiety, irritability, headache, and hot flashes.

[Pharmacological and clinico-pharmacological studies of diazepam powder in suspensions]. / Farmakologichni i kliniko-farmakologichni prouchvaniia na diazepam-pulvis za suspenziia.

Studied was the preparation diazepam-pulvis for suspension (DPS) with regard to its tranquillizing and myorelaxing doses, inhibiting the aggression, and preventing the stress conditions in domestic animals and birds. It was established that at oral application to pigs at rates of 1 to 2 mg/kg body mass DPS produced a pronounced tranquillizing effect, while at 3 mg/kg it led to myorelaxation as well. In sheep tranquillizing effect was seen when amounts of 3 to 5 mg/kg body mass were used, and myorelaxation was achieved with 6.6 to 13.2 mg/kg. In male calves tranquillization was manifested after doses of 3 mg/kg body mass were applied. In hens the tranquillizing dose was found to be 3 mg/kg body mass, and the myorelaxing one--4 mg/kg; in cocks the respective doses were 5 and 7 mg/kg body mass. At the rate of 3 mg/kg body mass DPS was found to enhance the thiopental-sodium narcosis. When offered to pigs at 2 mg/kg body mass in admixture with the feed DPS led to tranquillization and suppression of the active and passive defense response. No full prevention of cannibalism could be achieved. The daily administration in the course of 30 days with the ration of bull-calves at the rate of 3 mg/kg body mass was shown to calm the animals under loose housing in boxes and affect favourably their weight gain. Admixed with the feed of cocks at 5 mg/kg DPS suppressed aggressiveness.

[Pharmacological and toxicological studies on wild sunflower Doronicum hungaricum Rchb]. / Vurkhu niakoi farmakologichni i toksikologichni izsledovaniia na diviia slunchogled -- Doronicum hungaricum Rchb.

Studied were the total water extracts (infusions) of wild sunflower (Doronicum hungaricum Rchb), and separately of alcohol and water extracts. It was found that the pharmacologic and toxicologic effects were governed by the water-soluble flactions. At oral administration to albino mice the total water extract corresponding to 10 g of the dried plant per kg b. w. no toxic phenomena were observed. At subcutaneous injection of the water extract of 10 g of the dried plant per kg b. w. and venous injection of 3.5 g of the dried plant per kg b. w. of albino mice as well as venous injection of the water extract corresponding to 2.5 g of the dried plant per kg b. w. of cats with narcosis there was enhancement of breathing followed by depression of this process along with a drop of the systemic blood pressure down do the zero line, and exitus. A negative intropic effect was produced on an isolated frog heart by a water extract corresponding to 1 g of the dried plant/100 cm3-500 cm3, and a moderate spasm--on an isolated rabbit intestine by an extract 1/100 cm3-500 cm3. The venous injection of the extract to cats with narcosis at 0.05 to 1.0 g of the dried plant per kg b. w. caused depression. All these effects were blocked after atropine treatment. In an experiment with 3 cows with the use of 50 g of finely ground dried plant mass inthe daily ration per cow for 10 days a moderate enhancement of milk secretion was produced. It is believed that the phenomena observed are due to M cholinemimetic action.

[Biological activity of vitamin E in feed mixtures with a varying santoquin content]. / Prouchvaniia vurkhu biologichnata aktivnost na vitamin E vuv furazhni smesi s razlichno sudurzhanie na santokvin.

Studied was the content of vitamins A and E as well as that of fats, aldehydes, and peroxides and the biologic activity of vitamin E with regard to the amount of santoquin in combined forage mixtures for birds. The experiments were carried out with a finisher forage mixture for broilers to which santoquin was added in amounts of 0.010, 0.016, 0.020, and 0.025 per cent. It was found that at an antioxidant concentration of 0.020 per cent a best protection of the biologic vitamin E activity was provided. The rapid inactivation of vitamin E at a level of santoquin lower than 0.016 per cent was associated with the intense deposition of products of the final oxidation when fats turned rancid. Taking into consideration the importance of fats as a source of energy a 0.020 per cent level of santoquin in the forage mixtures for broilers is suggested.