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Biomedical subjects

M Sirakov

Publications and source records attributed to M Sirakov.

At least 19 recordsLinked to original sources
PubMed2000

[Late results from operative treatment of complicated chronic cholecystitis].

Assessment is made of the long-term results in 75/232 patients with chronic cholecystitis, operated in the surgical clinic of the Military hospital--Plovdiv over the period 1991 through 1995. To analyze the questionnaire study results, the patients are divided up into three groups, as follows: Group one--61 cases (81/3%) where the complaints are completely eliminated. Group two--13 cases (17/1%) where the condition shows improvement, but during physical atress and nonobservance of the dietary regimen, heaviness and blunt pain in the right subcostal area occur. Group three--one patient with persisting complaints and lethal outcome. Evaluation of the long-term results shows that the positive effect attained is persistent and durable. Cholecystectomy is taken to be as the most rational and often used operative intervention.

Adult↗
PubMed1999

[The use of the preparation Anteovin in dysfunctional uterine hemorrhages and PCOS].

UNLABELLED: The present prospective study is aimed at estimating the therapeutic effect of a biphasic oestrogen dominated contraceptive pill Anteovin in certain forms of dysfunctional uterine bleeding (DUB) and in polycystic ovary syndrome (PCOS) which is associated with dysfunctional bleeding. Two groups of women were studied--the first group (n = 34) consisted of women with DUB; the second group (n = 31) comprised PCOS. The nature and dynamics of uterine bleeding, contraceptive effectiveness and occurrence of side effects were followed up. In the second group the changes in the levels of testosterone (T), dehydroepiandrosterone sulfate (DHEA-S) and prolactin (Prl) were additionally investigated. RESULTS: A significant decrease in bleeding was observed in both groups. In the second group it is in parallel with a significant decrease of T even as early as on the third month and of DHEA-S on the sixth month of treatment. No significant changes in prolactin levels were found out during the treatment. CONCLUSION: The biphasic contraceptive pill Anteovin has a very good therapeutic effect in DUB and metrorrhagic forms of PCOS while at the same time the side effects are slightly expressed and transitory and an excellent contraception is achieved.

Adolescent↗
PubMed1999

[Tumors of the appendix].

Neoplasms involving the vermiform outgrowth are among the rarely met with conditions, accounting for 0.1 to 0.5 per cent of all gastrointestinal tract tumors. This is a report on personal observation of three patients presenting tumors of the appendix, diagnosed over the period 1987 to 1995. As shown by the results, tumors of the appendix run a clinical course characterized by two distinct forms: clinical picture of acute appendicitis--two cases, and clinical picture of tumor of the colon--one case. It is underscored that intraoperative diagnosis is extremely difficult. The diagnosis is usually made by pathoanatomist, while the therapeutic approach and operative tactics are determined on the ground of histomorphological study results and local operative status. The scope of operative intervention includes appendectomy and right hemicolectomy.

Adult↗
PubMed1998

[Low-dose estrogens in the treatment of the climacteric syndrome].

UNLABELLED: The present prospective study is aimed to estimate the effect of a low-dose combined oestrogen drug Cyclo-Menorette on climacteric syndrome in women with early menopause. MATERIAL AND METHODS: The criteria for inclusion in the study were ac follows: 9-12 months of menopause, increased FSH levels, moderately expressed climacteric syndrome confirmed by the menopausal index of Kupperman and Hamilton-Anxiety-Scale /HAMA/. According to acceptance of hormone replacement therapy /HRT/ the women were divided into 2 groups--control T /n = 31/ and Cunder treatment T /n = 35/. The degree of climacteric syndrome expression after Kupperman and HAMA was estimated in all patients at the beginning as well as on the 3-d, 6-th 12-d months. The presence and dynamics of side effects were followed in the patients treated with HRT. RESULTS: Spontaneous improvement of complaints was found out in the control group with an increase of intragroup differences during the follow-up period. Most expressed improvement in the group under treatment was established during the first 3-6 months, the beneficial effect being preserved until the end of the study. CONCLUSION: The use of 1 mg oestradiol valerat in combination with 2 mg oestriol results in a significant decrease of climacteric syndrome manifestation with slightly expressed and transient side effects.

Climacteric↗
PubMed1998

[The Multiload--a modern intrauterine device].

In the first part of publication the authors make a profound review of history of development and qualities of Intra Uterine Devices/IUD's/. There are reflected the first steps dated from the ancient times to come to modern IUD's (Multiload, Copper T. Slimline). In Table 1 and 2 (on W.A.A. van Os) are represented single cases (pregnancy, expulsion and extracted IUD's) related to the modern intrauterine devices: MLCu 250 and MLCu 375 for the periods of 1, 3 and 5 years. In the second part the authors represent their scientific and practical results which has been obtained at the Bulgarian Family Planning and Sexual Health Association and the Ob./Gyn. Department of Medical University-Sofia. A retrospective research has been conducted on 406 women who delivered between 18 and 42 years of age and to which MLCu 375 have been inserted. The so analyzed and presented results show very good qualities of MLCu 375 IUD. The cases' frequency corresponds to the one announced by the world leading practice of contraception.

Adolescent↗
PubMed1998

[Current monophasic hormonal contraception].

Data are presented from an investigation of the use of monophasic contraceptive pills chosen by different age groups. Analyses are made of the data obtained from the Bulgarian Association for Family Planning (BAFP) card index for the last two years. Information is given on the number of observed cycles, type of applied contraceptive pill, aims of their application (contraception, treatment of acne, menstrual disturbances etc.), age of patients, as well as any possible adverse effects--change in blood pressure, bodyweight changes, intermenstrual bleeding, hairiness, breast problems, paraclinical changes, etc. The observed cycles show a very small percentage of adverse effects with hormonal contraception, mainly during the first 2 or 3 cycles, with predominance of intermenstrual bleeding. No bodyweight changes or increased hairiness were observed.

Adolescent↗
PubMed1997

[The use of the preparation Cilest in the practice of the Bulgarian Association for Family Planning].

Data are presented from a questionnaire study on the sexual activity of Bulgarian teenagers as well information on the contraceptive methods chosen by them. The authors inform in short about the activities of the Bulgarian Association for Family Planning (BAFP). Analyses are made of the data obtained from BAFP card-index for the last two years. Information is given on the number of observed cycles, types of applied contraceptive method, aims of their application (contraception, treatment of acne, menstrual disturbances etc.). The attention was concentrated on the third generation contraceptive pills Cilest, on the age of patients, as well as on the adverse effects--change in blood pressure, body-weight changes, intermenstrual bleeding, hairiness, breast problems, paraclinical changes, etc. Underlined is the number of teenagers who seen the BAFP help on problems of contemporary contraception. The observed cycles show a very small percentage of adverse effects with hormonal contraception, mainly during the first 2 of 3 cycles, with predominance of intermenstrual bleeding. No body-weight changes or increased hairiness were observed.

Adolescent↗
PubMed1997

[The testicular feminization syndrome--a report of 9 cases].

We present the data of analysis of 9 cases (girls and young women) aged 14 to 20 years, with syndrome of testicular feminisation. The patients were diagnosed and treated at the departments of Paediatric and Adolescent Gynaecology and of Gynaecological Endocrinology at the University Ob. & Gyn. hospital in Sofia. The diagnosis was based on the clinical picture, karyogram and radioimmunoassay of gonadotropic and sex hormones. Described were some data as family history, clinical picture, from of the disease, appearance, genital and hormonal status, and histodiagnosis of the removed gonads. Out of nine, primarily diagnosed as a syndrome of testicular feminisation girls and women one ws with an incomplete from, in another further investigations evoked a suspicion of Swyer syndrome (a 14-years-old girl, on whom surgical treatment due to big gonadoblastoma was performed, she died a year later). One patient also developed an ovarian tumour, in six we performed gonadectomy. One patient did not come for any treatment. The differential diagnosis with some relatively rare syndromes, as well as the treatment of this patients were discussed.

Adolescent↗
PubMed1997

[The treatment of synechia labiorum minorum].

The data of 89 girls aged 4 months to 12 years, with synechia labiorum minorum, diagnosed for the first time in 1991 at the Outpatient Department of Pediatric and Adolescent Gynecology at the University Ob. & Gyn. Hospital in Sofia were analyzed (age distribution, type of synechia, kind of treatment and the effects). The same girls were followed up during the next two years (healing, adverse reactions, reappearance). According to the treatment the girls were divided in two main groups. The first group (72 girls) were treated with blunt dissection of synechia under local anesthesia (two drops anesthetic jelly), followed by two weeks treatment with non-hormonal ointment. The second group, due to old, solid synechiae, the girls were treated only with oestriol ointment. Statistically there is no significant difference in the number of reappearances between the two groups. There were no cases of scars, narrows and adverse reactions. There are differences in the duration of the treatment and in it's costs. In the first group the duration was two weeks and the costs were several times lower than in the second group which duration is 4-8-12 weeks.

Anesthesia, Local↗
PubMed1997

[Diagnostic laparoscopy in female sterility].

Over a three-year period (1990-1993), a total of 410 diagnostic laparoscopies are performed. The series includes female patients with a minimum one year longstanding of sterility. Diagnostic laparoscopy is taken to be a routine method of making exact diagnosis in female sterility cases, and as a filtering procedure in forthcoming reconstructive operation or in the event of poor outlooks of eventual conception. The commonest finding is endometriosis (in 58.2 per cent), next ranking adhesions free of endometriosis (31.4 per cent) and bilateral obstruction of the uterine tubes (38.5 per cent). Endometriosis is usually located in the uterine body 27.5 per cent, uterine tubes 26.1 per cent and pelvic peritoneum 14.9 per cent.

Adult↗
PubMed1997

[Bilithiasis (cholenephrolithiasis)].

The study covers 232 patients with chronic calculous cholecystitis, operated in the Surgical Clinic of the Military Hospital--Plovdiv over the period 1991 through August 1995. Bilithiasis (cholenephrolithiasis) is diagnosed in 26 cases (11.2 per cent). This is a condition running a clinical course characterized by pain in the right subcostal and lumbosacral regions, accompanied by nausea and vomit in 57.7 per cent. Eighteen patient sustain renal crisis. Palpatorily, pain is established in the right subcostal region, and positive succussio renalis--in twelve patients. In nine patients there is evidence of albuminuria and leukocyturia (34.6 per cent). In 26 cases the echographic study reveals presence of concretions in the gallbladder, and in all of them-renal calculi too (left kidney--9, right kidney--9, and bilaterally--8 patients). Intraoperatively, concretions in the gallbladder are found in all patients, with hydrops and empyema of the gallbladder documented in five, and vesicoduodenal fistula in one (23 per cent), whereas in the patients free of urolithiasis they amount to 10.8 per cent which points to a reciprocal aggravation of the two pathological conditions. The early, as well as the long-term results of the operative management applied are estimated as very good.

Adult↗
PubMed1997

[Spontaneous internal biliary fistulae--a report of 4 clinical cases].

This is a report on personal experience had with operative treatment of chronic calculous cholecystitis. Of the total of 228 patients operated on, spontaneous internal biliary fistulas are discovered in 4 cases (1.75 per cent): Mirizzi's syndrome--1 case. Fistula cholecystoduodenalis--3 cases. The development of fistulas is attributed to the elevated intrabladder pressure and activation of the infectious process and destructive changes taking place in the gallbladder wall, with ensuing breakdown and possibility of the concrement to penetrate an adjacent organ. It is presumed that pain localized in the right subcostal area and epigastrium is the symptom most strongly expressed. Cholecystocolonic fistula runs the heaviest clinical course among the patients operated on.

Aged↗