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Biomedical subjects

A Nikolov

Publications and source records attributed to A Nikolov.

At least 73 records · Page 4Linked to original sources
PubMed2001

[A technique of continuous sutures for reconstruction of episiotomies].

The aim of the study is to establish the possibility for reconstructing episiotomies with a continuous uninterrupted suture. In a prospective study are included 54 women with a lateral episiotomy without further lacerations. As sewing material were used Cat-gut or Vicryl Rapide. Reconstruction of vagina, perineum and skin is done by a continuous suture with a single thread. The technical accomplishment does not provide problems to the surgeon. What is more, it reduces the durability of the intervention by achieving a good haemostasis and anatomic adaptation. All episiotomies heal per priman. An important advantage for women from a psychoemotinal point of view is the lack of the necessity to remove threads.

Episiotomy↗
PubMed2000

Gas-liquid transition in a two-dimensional system of millimeter-sized like-charged metal balls

Metal balls with a diameter of 1.59 mm, gently rubbed against a dielectric surface using a shaker, are seen to spontaneously exhibit a two-dimensional liquidlike order with macroscopic dimensions, viz., interball distances of several millimeters. This liquidlike order transforms to a gaslike order through coexistence upon decreasing the area fraction of the balls. The measured pair interaction of like-charged balls surprisingly exhibits a long-range attractive term analogous to that in charged colloids.

Journal Article↗
PubMed2000

Structure of charged colloids under a wedge confinement

Monte Carlo simulations have been performed to study the influence of a wedge confinement by hard walls on the ordering of charged colloidal particles interacting through screened Coulomb repulsive potential in an aqueous medium. The density distribution of particles for a fixed wedge angle straight theta(0) is studied for different suspension parameters, viz., bulk volume fraction straight phi, salt concentration C(s), and charge Ze on the particles. The density distribution rho(straight theta) along the angular direction and that along the radial direction, rho(r), have been analyzed in different regions of the wedge. Simulations show the formation of layered structure along the angular direction and a large gathering of particles along the wall. The number of layers as well as the density of particles within the layer are found to change as the strength and range of the interaction are varied, whereas the density profiles calculated close to the vertex region showed no significant variation in the density. The radial density profiles rho(r) corresponding to the vertex region show one-dimensional (1D) ordering of particles parallel to the vertex at a distance that is close to a wedge height, h equal to diameter of the particle. This 1D ordering is found to be destroyed upon the addition of salt or lowering the straight phi. The reported experimental observations on the "vacuum phase" are discussed in the light of the present results.

Journal Article↗
PubMed2000

[A clinico-epidemiological study of neural tube defects in newborn infants].

This is a retrospective study on the rate of inborn defects of neural tube in University Hospital of Obstetrics and Gynaecology--Sofia for two 5-years-long periods of time: from 1986 to 1990 and from 1993 to 1997. The results show an increasing rate of inborn NTD during the second period of time which can be partly explained by the fact that the hospital is National Perinatal Centre where high risk pregnancies and deliveries are concentrated. Most disturbing is the fact that more than half of life-born and still-born infants with NTD are at an age of gestation higher than 34 g.w. This is a result of late perinatal diagnosis of these defects and brings up serious psychological, social and economical problems.

Bulgaria↗
PubMed2000

[Fetal pulse oximetry: a clinical methodological study].

The aim of the study is to provide preliminary assessment of the possibilities of fetal pulse oximetry as a method for monitoring of fetal pulse rate and oxygen saturation during labour. The study includes 65 pregnant women during active labour at term--all with one fetus and ruptured membranes. A system for fetal pulse oximetry is used, consisting of monitor Nellcor-N 400; oxygen sensor FS-14 and printer P-400 (Nellcor Puritan Bennett incorporation). Sensor is applied by mean dilatation of cervical channel 6.5 +/- 1.9 cm. Mean duration of monitoring of the pregnant woman is 104 +/- 68 minutes, range 30 to 180 min. The time of reliable signal quality is 83% for first stage of labour and 70% for second stage of labour. Mean SpO2 values are 47.1 +/- 9.8%. The conclusion is made that fetal pulse oximetry is an easy method to use, without side effects for mother and fetus. Mean SpO2 values are tower than in adults and vary inside wider range 35-55%.

Adult↗
PubMed2000

[Fetal oxygen saturation during normal delivery].

The aim of the study is to monitor fetal oxygen saturation--SpO2 during uncomplicated labour; to assess normal values and compare them to the data from fetal blood analysis and from clinical finding in the newborn. The study includes 53 pregnant women in term during active labour without evidence of fetal distress. Study is carried out with Nellcor-N 400--a system for measuring fetal pulse oxymetry and fetal pulse rate; oxygen sensor FS-14 and printer P-400 /Nellcor Bennet Incorporation/. Fetal pulse rate is monitored by cardiotograph Hewlett Packard. Mean duration of monitoring during first stage of labour is 98 +/- 48 min, versus 37 +/- 11 min during second stage. Mean values of SpO2 are 48.8 +/- 10% during the first stage of labor v/s 46 +/- 9.6% during second stage. Baby is born in good health--Apgar score more than 7 and mean pH value from umbilical artery 7.25. The conclusion is made that pulse oxymetry is an easy non invasive method for fetal monitoring without side effects concerning woman on labour and fetus. A relatively large range of variations of normal values is observed.

Adult↗
PubMed2000

[Diagnosis and differential diagnosis of space-occupying disorders of the umbilical cord].

In connectiin with a clinical case of a circumscribed edema of the umbilical cord the authors considered the space-occupied disorders of the umbilical cord. The tumorous and nontumorous lesions of the umbilical cord as well as the criteria and their diagnostic difficulties are discussed. The authors pay attention to the complications of such disorders in the pregnancy and their possible influence on the fetus.

Adult↗
PubMed1999

[The diagnosis and management in suspected retained placenta in the late puerperal period].

The aim of this retrospective study is to find out the reasons for RICU in late postpartum period and the reliability of methods for diagnosis of retained placental pieces. We investigated the medical records of all cases with RICU from 24th ours postpartum up to 2 weeks after it. The rate is 0.9% of all births. Hystological confirmation of retained placental tissue there are in 25% of cases. Our data shows that the anamnesis does not help in the diagnosis of retained placental tissue in late puerperium. Most often the curettage is undertaken because of hemorrhage and ultrasound data of retained placental tissue. At the same time the transabdominal ultrasound is of low diagnostic value for residua post partum. The febrility, the subinvolution of the uterus and the number of symptoms in given case are of no importance in the diagnosis of retained placental tissue. The suspicion in the integrity of the placenta after its birth is a reason for RICU in spite of well contracted uterus and lack of hemorrhage. As the diagnosis of retained placental tissue in late puerperium is uncertain the RICU should be undertaken after failed conservative management.

Adult↗
PubMed1999

[The active management of the placental period with Remestyp].

The aim of this prospective study is to asses, the possibility to use Remestyp after the delivery of the head as a prophylaxis of blood lost during the third stage of labor. The material includes 209 cases: 82 with bolus dose of 0.2 mg Methergin, 54 cases with 10 ME Oxytocin, 32 parturition with 200 mg Remestyp, and 41 controls without any uterostonics during the placental period. The blood lost is assessed by gravimetric method. The results show that the total blood lost from the delivery of the neonate to two hours after it is significantly lower in active management of labor than in expectant one. The type of uterostonic is not essential in regard of total blood lost. The prophylactics of blood lost with Remestyp has best results in cases of stimulated with Oxytocin infusion labor. The active management of third stage of labor with Methergin or Remestyp has less complication than are used oxytocin or without uterostonics. The mean time for delivery of placenta is shortest in the group with Remestyp. The three uterostonics in mansion doses do not influenced significantly the artery pressure. Our experience demonstrates that Remestyp can be used for active management of third stage of labor and the results are as those with Methergin. Remestyp is preferable when are expected significant lacerations of the birth canal.

Female↗
PubMed1999

[A comparative efficacy study of the preoperative use of GnRH agonists in women with uterine fibromyomas].

The aim of the study is to establish the efficacy of preoperative use of GnRH agonists in women with uterine fibromyomas. The study is a randomized prospective one and includes 34 patients, divided in two groups: group I--with preoperative application of GnRH agonists--Zoladex and group II--without medication. In Zoladex group amenorrhea was achieved in 76% of patients after 7-8 weeks of treatment. After a 3-months treatment with Zoladex Hb levels increased from 8.9 +/- 0.9 gl/l to 11.7 +/- 1.2 g/l; levels of serum Fe--from 7.3 +/- 4 mumol/l to 18.5 +/- 5 mumol/l. Total uterine volume decreased by 30% before surgery (from 328 +/- 85 ml to 233 +/- 61 ml), while myoma volume decreased by 39% (from 178 +/- 62 ml to 109 +/- 44 ml). Mean blood loss during surgery (hysterectomy) is definitely less in patients, treated with Zoladex--194 +/- 75 ml., compared to 287 +/- 102 ml in control group. The significant reduction in myoma volume in 6 patients due to presurgical treatment with Zoladex made smaller operation--myomectomy, possible. Side effects, related to GnRH agonist Zoladex, are well tolerated and transitory and did not lead to retreatment from the trial.

Adult↗
PubMed1999

[The problems and outcome with newborns who are extremely low birth weight, appropriate for gestational age and small for gestational age].

UNLABELLED: The aim of this study is to evaluate the consequences of being extremely low birth weight (ELBW) under 1000 g at birth, small (SGA) or appropriate for gestational age (AGA). METHODOLOGY: A retrospective comparison of two cohorts of ELBW AGA (n = 47) and SGA (n = 38) infants, admitted to the Intensive Care Unite of State Maternity Hospital "Maĭchin Dom" from 01, 1995 to 06, 1998 is carried out. Infants with major congenital anomalies and those, who died in the first two hours of life, being extremely premature and unviable, are excluded. RESULTS AND CONCLUSIONS: The mean birth weight of the AGA group is 863 g, their mean gestational age is 26.6 weeks of gestation and of the SGA group--795 g and 29.6 weeks respectively. In the Sga C-section is preferred in 85%, vs only 34% in the AGA group. SGA babies are with two times greater survival rate (61%) then AGA (32%). The causes of death are similar. The AGA survivors have a greater rate of stage III-IV intraventricular hemorrhage, more prolonged need for ventilatory support (19 vs 12 days for SGA) and oxygen supplementation (37.5 vs 30.7 for the SGA), more difficulties with enteral feeding and their median hospital stay is somewhat longer (81.9 days), compared with those of the SGA (76.6 days). The two groups show a similar rate of respiratory distress syndrome, chronic lung disease, infections and neurological complications among the survivors.

Bulgaria↗
PubMed1999

[Myomectomy during cesarean section].

The purpose of this prospective study is to assess the possibility of myomectomy during CS as a routine method. The material includes 21 cases of myomectomy during CS. 162 consecutive CS without myomectomy are control group for hemorrhage during the operation. The myomectomy is accomplish according classical technique. Our data show that the myomas and pregnancy is found mainly in women after 30 years of age and is prevalent in nulliparas (70%). Single myomas were found in 85% of cases, 63% located in the corpus uteri and 46% of all myomas are confined to the myometrium. Related to the isthmus uteri are 23% of myomas. Myomectomy as a separate operation during CS increases the hemorrhage by 10%. The analysis of the cases with severe hemorrhage point to the placental disorders (abruptio placentae and placenta praevia) as a main cause of overall increased blood lost. Our limited experience with myomectomy as a protocol during CS irrespective of number and magnitude of myomas shows that this is possible. The postoperative period is without complications.

Adult↗
PubMed1999

[The Apgar score, acid-base equilibrium of the umbilical cord vessels and early postnatal adaptation in healthy term newborns].

UNLABELLED: The aim of the study is to establish a correlation between Apgar score, acid-base status (ABS) and blood gases (bg) from cord blood and the early postnatal adaptation in healthy term newborns. The study is prospective and includes 52 babies at term born at the State University Hospital Maĭchin Dom, Sofia during a three month period--03-05, 1998 without evidence of asphyxia before and during delivery. All babies are monitored for Apgar score at minute 1 and 5, ABS and bg from umbilical artery (u.a.) and vein (u.v.) examined at birth, as well as capillary ABS and bg 1 hour after birth. Early postnatal adaptation is judged by a neonatologist in the course of two hours. RESULTS: A significant difference is found between all the examined points in the ABS and the blood gases in samples from umbilical artery and vein (p < 0.05), most significantly differ pH, pO2 and O2 Sat (p < 0.001). There is a correlation between 1 minute Apgar score and ABS and bg from umbilical vessels, babies with 1 minute Apgar score 7 having significantly lower pH from u.a. requiring wider range of resuscitation. Babies with 1 minute Apgar score 9/8 and 5 minute Apgar score 10 have definitely less early adaptational problems. CONCLUSION: The use of a combination of evaluation criteria for the condition of the newborn after birth (Apgar score, ABS and bg from cord blood and strict monitoring of early cardio-pulmonary adaptation) guarantees adequate resuscitation in term babies.

Acid-Base Equilibrium↗
PubMed1999

[The use of GnRH agonists in severe uterine hemorrhages in adolescence caused by congenital aplastic and hypoplastic anemias].

GnRH agonists, applied for a long period of time or as depot forms, lead to blocking of gonadotropin and ovarian steroid synthesis. We used their property to induce amenorrhea for treating menorrhagic and menometrorrhagic bleeding in adolescence caused by inborn aplastic and hypoplastic anaemia. In patients with uterine bleeding during the first regular menstrual period or recurring during menstrual periods Zoladex (depot GnRH agonist) has been applied, resulting in stop of bleeding in 2 to 4 days. The drug-induced amenorrhea provides the possibility for physiologic restoring of hemoglobin levels, improvement of therapeutic results from adjuvant antianaemic therapy. Thus a more favourable basis for treating of the main disorder is being created. When surgery is indicated, GnRH agonists provide the opportunity for planning of operating management or for laser ablation of endometrium.

Acute Disease↗