[Outcomes of bilateral implantation of trifocal and extended depth of focus IOLs]. / Rezul'taty bilateral'noi implantatsii trifokal'noi intraokulyarnoi linzy i intraokulyarnoi linzy s rasshirennoi glubinoi fokusa.

In recent years, a new class of extended depth of focus (EDOF) intraocular lenses (IOLs) has become available on the market. There is only a limited number of scientific papers comparing trifocal and EDOF IOL data, and the results are often contradictory. PURPOSE: Comparative analysis of the results of trifocal and EDOF IOL implantation in patients with presbyopia and/or cataract. MATERIAL AND METHODS: This prospective study included 72 patients (144 eyes) after bilateral implantation of either Tecnis Symfony EDOF IOL (18 patients, 36 eyes; group I) or AcrySof PanOptix trifocal IOL (54 patients, 108 eyes; group II). In 18 patients out of 72 (25%) the implantation involved mini-monovision, i.e. the calculation of the IOL power on the nondominant eye was performed at -0.5 D. The average follow-up period for the patients was 7.1±1.2 months. RESULTS: There was a significant (p<0.05) increase in uncorrected near visual acuity (UCNVA), uncorrected intermediate visual acuity (UCIVA) and uncorrected distance visual acuity (UCDVA) at the maximum follow-up time compared to the preoperative indices in all groups. Group II was characterized by slightly better UCNVA dynamics (0.85±0.13 versus 0.2±0.04 before surgery, as comparted to 0.78±0.11 versus 0.19±0.06 before surgery in group I), but differences were not statistically significant (p>0.05). Statistically significant differences (p=0.046) were observed when comparing best corrected near vision acuity (BCNVA) in groups I and II (0.79±0.05 and 0.98±0.08, respectively) at 6 months compared to the preoperative period (0.62±0.09 and 0.6±0.11, respectively). CONCLUSION: Trifocal IOL implantation was associated with acceptable near and far vision correction and a higher frequency of adverse optical phenomena, while implantation of the EDOF IOL was associated with slightly better correction of intermediate vision and a significantly lower incidence of halo and glare. Patients were satisfied with the outcomes of surgery in all cases.

[LAPAROSCOPIC TREATMENT OF PRIMARY ABDOMINAL PREGNANCY: A CASE REPORT AND REVIEW OF THE LITERATURE].

Abdominal pregnancies are 1.4% of all ectopic pregnancies. They are mostly complicated and usually managed by laparotomy, but laparoscopy is an alternative method which some surgeons perform instead of laparotomy, especially in early pregnancy. We reported a 29 year old woman with supra pubic pain and vaginal bleeding. After sonographic evaluations, ectopic pregnancy was diagnosed and the patient underwent laparoscopic surgery for termination of pregnancy. Laparoscopy is a successful alternative method of surgery for abdominal pregnancies in first trimester.

[Nutritional status of patients with different types of gastroesophageal reflux disease].

The aim of the study was to assess dietary intake in patients with erosive (ERD) and non-erosive reflux disease (NERD). One hundred and sixty seven patients (103 women and 64 men, mean age 47±13,6 years) were divided according to symptoms and endoscopic findings into three groups: 88 patients with NERD, 38 patients with ERD and 41 healthy controls. Symptoms were scored by validated GERDQ questionnaire, dietary intake was assessed by validated food questionnaire and 24-h pH/impedance monitoring was used for confirmation of pathological reflux. All groups were homogenous by age and sex, both NERD and ERD patients demonstrated higher BMI (28.1±6.5 vs 28.4±6.1 kg/m2) in compare to the patients from control group (24.3±2.8 kg/m2). Average daily calorie intake was higher in patients with NERD and ERD (2579±854 vs 2467±710 kcal/day) in compare to the control group (2093±696 kcal/day) due to increased consumption of fat (121±52 vs 112±52 g/day) and carbohydrates (244±88 vs 216±64 g/day) consequently. Consumption of dietary fiber was low in all groups in compare to recommended daily allowance, but even lower in NERD and ERD patients in compare to control (6.0±3.8 g/day vs 5.2±4.8 g/day vs 9.45±5.6 g/day). There was direct correlation between gastroesophageal reflux disease (GERD) and average energy consumption (R=0.23, p<0.05) and daily total fat consumption (R=0.21, p<0.05), but inverse correlation with consumption of dietary fiber (R=-0.23, p<0.05). Consumption of alcohol was higher in NERD patients in compare with ERD patients and control group (1.2±4.9 vs 0.2±2.6 vs 0±0.87 g/day), but generally it was low. Total daily number of refluxes as well as number of acid refluxes were highly correlated with daily consumption of energy (R=0.35, p<0.05; R=0.35, p<0.05), fat (R=0.33, p<0.05; R=0.32, p<0.05) and protein (R=0.3, p<0.05; R=0.25, p<0.05), however inverse correlation was found between total number of refluxes and consumption of fibers (R=-0.22, p<0.05). There was no correlation between consumption of carbohydrates or alcohol and total number of refluxes or acid refluxes. In conclusion, GERD is associated with higher BMI, increased consumption of calories and fat and low consumption of dietary fiber. Total number of refluxes is related to consumption of fat and fibers. No association with consumption of carbohydrates or alcohol was found. These findings need to be taken in account for prescription of diet to GERD patients.

[THE VALUE OF COLPOSCOPY EXAMINATION IN DIAGNOSIS OF PRECANCEROUS AND CANCEROUS DISEASES OF THE CERVIX].

The aim of this study is to present the value of colposcopy examination in diagnosis of precancerous and cancerous diseases of the cenvix. A retrospective study analyze 127 patients at SA GBAL" Dr. Shterev Hospital" that undenNent, firstly cervical smear test and secondly a colposcopic punch biopsy The patients are divided in two groups--one group of cytologically non-signaled patients with results from the Pap test I-II and one group with cytologically -signaled patients with results from the Pap test III-IV The data shows a correlation between the cytological and histological results of the second group and absence of such a correlation in the first group. In the non-signaled group the mild precancerous lesions to Thvasive cen'ical cancer were left undiagnosed. The conduct of a routine colposcopy during preventive gynecological examination will reduce the deficiencies of the cytological method and by amplifying it, it will lead to better results of the diagnosis and treatment of the precanceroses and the cervical cancer.

[Microbiological efficacy of a one-day treatment with triazole antimycotic I traconazole in mycotic colpitis].

INTRODUCTION: Fungal colpitis is the most common inflammatory disease of the vagina, whose proportion in the different groups of the patients ranges from 30% to 60%. The major cause is genus Candida. In 80% to 95% of the cases the reason is Candida albicans species and in 10% to 20%--the representatives of the species Candida Non-albicans. One problem that arises in this genital infection is the insufficient effectiveness of the drug treatment in many of the cases. MATERIALS, METHODS AND RESULTS: This study is a prospective and monitors 40 non-pregnant women, accounting therapeutic effect of Itraconazol in fungal colpitis. Patients had administered treatment with Itraconazol 2 x 200 mg/1 day, per oral. Microbiological testing was performed prior to the treatment and 2 to 4 weeks after completion of the therapy. We found C. albicans in 75% of the cases and in 25%--C. non-albicans (C. glabrata, C. kefyr, C. krusei, C. famata). In the group of C. albicans, good therapeutic efficiency was observed in 93.3% of the cases, while in patients with C. non-albicans it was in 80% of the cases. CONCLUSION: Itraconazol showed sufficiently high therapeutic effect for patients with fungal colpitis, it proved to be suitable for patients with Candida albicans and also in the cases with Candida non-albicans.

[The influence of different types of bathes for general health on the efficiency of combined spa and resort treatment of coronary heart disease].

The spa and resort treatment of coronary heart disease was given to 106 patients (34 men and 72 women) aged from 45 to 69 years presenting with angina of effort It consisted of basic therapy in combination with a rational diet, remedial physical exercises, thalassotherapy, underwater shower massage, low-mineralized Chvizhense water. The patients were allocated to three groups depending on the type of prescribed baths for general health, viz. radon baths (group 1), iodine-bromine baths (group 2), and hydrogen sulfide baths (group 3). The evaluation of the efficacy of different therapeutic modalities has demonstrated that the differential application of combined treatment with the inclusion of mineral waters of the Sochi health resort and underwater shower massage shower massage produces beneficial effect on the patients presenting with coronary heart disease.

[Magneto-peloidotherapy and hydrogen sulfide baths for the correction of dyslipidemia and immune inflammation in patients with ischemic heart disease during resort treatment].

A total of 55 patients with angina of effort (functional classes I-II) were treated by magneto-peloidotherapy and hydrogen sulfide baths. Effectiveness of he treatment was evaluated based on the lipid profile (total cholesterol, triglycerides, high and low density lipoproteides), atherogenicity index, lipid peroxidation, reactivity of the antioxidative defense system, and immune characteristics. Results of the study indicate that combination of magneto-peloidotherapy and hydrogen sulfide baths has hypolipidemic effect and reduces lipid peroxidation in the absence of activation of the antioxidative defense system and correction of the disbalanced immune system. Taken together, these effects decrease severity of the systemic inflammatory reaction and facilitate remission of the atherosclerotic process.

[Three years experience of using mycosyst]. / Nashiiat trigodishen opit ot prilozhenieto na preparata mycosyst.

The aim of this study was to estimate therapeutical potentialities of the Mycosyst (Fluconazole) preparation, of the Gedeon-Richter company (Budapest, Hungary), in women with data for mycotic colpitis. 157 patients for three years period (April 2001-2004) were included in this study. Two groups of patients were formed. In 104 patients mycotic colpitis was diagnosed during curettage for feticide or missed abortion. Another 53 women were treated for mycotic colpitis unrelated to pregnancy. Complains of the patients disappear by the 48-th hour and in almost all women there were not complaints by the 4-th day. The most quickly were influenced itching, discomfort, erythema and dyspareunia and slowly and hardly discharge had been influenced. Mycosyst is a broad spectrum antimycotic agent of bistriazol type. It has good absorption and tissue saturation. 1-2 hours after oral administration maximal plasma concentration is achieved. Plasma half life is about 30 hours. This gave us opportunity for single or two doses Mycosyst for vaginal candidosis treatment. Use of two doses of 150 mg. was enough for acute forms treatment in almost 95% of cases. Mycosyst is sure, easy for use broad spectrum antimycotic from the azole group. This preparation is comparatively cheep and in the average Bulgarian income possibilities.