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Biomedical subjects

B Nalbanski

Publications and source records attributed to B Nalbanski.

At least 37 records · Page 2Linked to original sources
PubMed2000

[The correlation between intrauterine filling defects during hysterosalpingography and endometriosis at laparoscopy].

The association of intrauterine filling defects on hysterosalpingogram with endometriosis was evaluated. One hundred twenty patients were prospectively investigated with both methods, hysterosalpingography (HSG) and laparoscopy (LSC), for period of two years. HSG was performed on days 7-10 with water-soluble contrast medium. The presence of endometriosis was proved laparoscopically and scored according to the American Fertility Society classification. Forty-one women had endometriosis at LSC. In 25 of all 30 women with filling defects on hysterosalpingogram endometriosis was found. The presence of intrauterine filling defects on HSG is significantly associated with the presence of pelvic or peritoneal endometriosis.

Adnexal Diseases↗
PubMed1999

[The most suitable tests for studying chlamydial infection in women with sterility].

The study was carried out on 280 infertile women (185 with primary and 95 with secondary infertility), patients of the University Clinic of Gynecologic Endocrinology and Infertility, Sofia. The present study was designed to estimate which is the most suitable test for detection of chlamydial infection in women with infertility. Evidence of past chlamydial infection was determined by the presence of antichlamydial IgG antibodies by commercial ELISA test. From 196 of the patients examined, 101 were positive for antichlamydial IgG antibodies (62.7%). 84 women were examined by means of direct antigen test for Chlamydia trachomatis from the endocervix (DIF. ELISA). Tubal patient was examined by means of hysterosalpingography and/or laparoscopy. In 34 women with unilateral or bilateral tubal occlusion the endocervical direct antigen test was positive in 4 (11.8%) and in 30 women with patient tubes 2 were positive by this test (6.7) In 38 women with tubal occlusion 29 of the women with unilateral or bilateral tubal occlusion had a presence of IgG antichlamydial antibodies in their sera (76.3%) compared to 17 of 38 women with patient tubes (44.7%). The results of the present study indicate that the examination antichlamydial IgG antibodies in the sera of women with infertility has a better predictive value with regard to tubal pathology compared to the direct antigen test for detection Chlamydia trachomatis in the endocervix. Examination for latent infection or reinfection has to be carried out before the administration of more invasive methods for the management of infertility.

Adolescent↗
PubMed1999

[The postcoital test: clinico-laboratory observations].

The choice of optimal time, the technique and limitations of the post-coital test (PCT) have been described. They are of important significance for getting reliable information both concerning the cervical mucus, quality and migration of spermatozoa in female genital tract. It has been stressed that a negative PCT does not necessary exclude pregnancy. There are shown data for prognostic value of the PCT. The observation of more than 20 motility spermatozoa per HPF and higher frequency of pregnancy is common finding in comparison to low motility and number of spermatozoa in cervical mucus. The data support the hypothesis of "filtering" mechanism, excluding entrance of abnormal spermatozoa. Observing "shaking" phenomenon directs to searching immunological factor (local or systemic) against male gametes.

Cervix Mucus↗
PubMed1999

[The effect of chlamydial infection on tubal patency].

The study was carried out on 162 infertile women (110 with primary and 52 with secondary infertility), patients of the University Clinic of Gynecologic Endocrinology and Infertility, Sofia. The present study was designed to estimate the effect of chlamydial infection as a cause of tubal pathology in infertile women. Evidence of past chlamydial infection was determined by the presence of antichlamydial IgG antibodies by commercial ELISA test. 101 of the patients examined were positive for antichlamydial IgG antibodies (62.3%). 76 women were examined for tubal patience by means of hysterosalpingography and/or laparoscopy. 38 women had patient tubes and 38 women had tubal occlusion (20 had bilateral and 18 unilateral occlusion). 29 of the women with unilateral or bilateral tubal occlusion had a presence of IgG antichlamydial antibodies in their sera (76.3%) compared to 17 of the women with patient tubes (44.7%). The risk for tubal obstruction in women with positive serology for Chlamydia is 3.22 compared to 0.85 risk in the women with negative serology for chlamydia. The results of the present study indicate that women with evidence of past chlamydial infection are 4 times more likely to have obstructed fallopian tubes compared to women who had no such evidence. It is mandatory to examine the patient for chlamydial serology at the beginning of the diagnostic protocol in order to ensure adequate management prior to more invasive procedures such as hysterosalpingography or laparoscopy.

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↗
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 protein profile of the cervical mucus: cyclic and ovulatory values].

Immunological and biochemical analysis on cervical mucus requested application of micromethods on sindle small specimens. The following micro-methods in agar gel are applied: immunoelectrophoresis--the normal cervical mucus developed by antiserum against total human serum is presented with 5 precipitin lines: prealbumin, albumin, a1-antitrypsin, transferrin and IgG. The single immunodiffusion technique in agar gel (Mancini et al., 1964) is suitable method to assess these proteins. The same diffusion method is applied for enzyme assessment with special importance like a-amilase and muraminidase (lysozyme). The assessment of these proteins shows pre-ovulatory decrease and post-ovulatory remarkable increase. These changes are not simply due to the increased water content of the cervical mucus during the fertile period but reflects estrogen effect on cervical secretions.

Cervix Mucus↗
PubMed1998

[Ultrasonic follow-up of the endometrium in women with sterility after Serpafar treatment].

UNLABELLED: We investigated 25 women with anovulation or defects in the follicular growth after treatment with Serpafar for period of 6 months. During the first cycle investigation is without treatment and the patients were analysed for BBT follicular maturation endometrial thickness, cervical mucus, FSH, LH. For next 5 month the patients are treated with Serpafar. We established that endometrial thickness is dynamic changes in every cycle. The comparison was done when the leading follicular diameter was 18-24 mm. CONCLUSION: There was not difference in endometrial thickness in treatment cycles nor a trend for thickness to increase or decrease. Probably the mechanism of ovulation and pregnancy rates after Serpafar is not connected with thickness of the endometrium.

Adult↗
PubMed1998

[Tumors in childhood and adolescence].

The trial present the results for the incidence and histology of tumours in patients below 18 years, examined at the State University Hospital Maĭchin Dom in Sofia for two consequent periods of 4 years each. An increase is registered in the incidence of neoplastic disease from 1.85% to 3.42%. There is no significant difference in hystological characteristics of the tumours when comparing I and II period: 85.7% versus 77.4% benign tumours (mucous cysts, dermoid ovarian cysts and polyps) and 14.3% versus 22.6% malignant tumours (ill differentiated teratomas, cystadenocarcinomas, dysgerminomas, ovarian embryocarcinomas and rhabdomyosarcomas). Accurate diagnostics requires detailed gynaecological examination, including a rectal one, vaginal probing, vaginal scopia, ultrasound, laparoscopy. Early discovery followed by surgery provides a possibility for adequate and definite treatment.

Adolescent↗
PubMed1997

[An analysis of the indications for episiotomy in current obstetrical practice].

The aim is to analyze the accepted indications for episiotomy in nowadays practice. The investigations is retrospective for the period from April to May 1996. The material includes 459 term singleton pregnancy in vertex presentation and 46 cases of premature neonates with weight from 1300 to 1499 g. The results show high risk (77.1%) of episiotomy in nulliparous women. The multiparity, the length of second period and the high risk pregnancies have not effect on the use of episiotomy. The wight of the fetus is essential factor. The highest rate of episiotomy is at premature births (65.2%) followed by the group of neonates with weight over 4000 g (61.5%). The lowest rist of episiotomy is then the weight of newborn is between 2500 and 3800 g (21.8%). Almost hundred percent rate of episiotomy in operative vaginal and breech deliveries show that we accept the episiotomy as obligatory of these vaginal deliveries.

Adult↗
PubMed1997

[Surgical pelvioscopy in gynecologic surgery].

The author tells his experience from the operative pelvioscopy performed on 350 women. Using different surgery techniques he coagulates endometrial sites, he performs cystectomy, salpingostomy, myomectomy and ovarian biopsy. The most often diagnosis in these 350 cases is external endometriosis (43.14%), followed by an adhesiolysis of the Fallopian tubes end the ovaries (23.43%) and salpingoneostomy (10.57%). The percentage of pregnancy after an operative pelvioscopy performance is 27.89%. The author thinks a wide spectrum of interventions can be performed on the female internal genital organs with no need of more serious and damaging operations.

Adolescent↗
PubMed1997

[The results of the limited use of episiotomy in managing the second stage of labor].

The purpose is to asses the effect of restrictive use of mediolateral episiotomy on the spontaneous laceration of the low birth canal. The material includes 613 labors some of which gave birth with indication for episiotomy and control group of 441 retrospective cases with routine management of the second period of labor. The restrictive use of episiotomy decreases the rate from 45.6% in the routine practice to 32.8%. The reduced rate of episiotomy has as a consequent increase rate of second degree perineal laceration adn insignificant increase of vaginal lacerations. The management of restrictive and liberal use of mediolateral episiotomy has not effect on third and four degree perineal laceration, on the accessory tears of the vagina and on the rate of perineotomy. If from all labors are subtracted operative deliveries, surgical intervention for repairing the laceration of the birth canal and pathology of the placental period the rate of labors without any intervention is only 13.3%. Our results suggest that labor nowadays is operative activity.

Bulgaria↗
PubMed1997

[Laparoscopic fenestration of the ovaries].

The authors have performed an ovary fenestration in 220 women with primary or secondary amenorrhea. This was made with the help of instrumentation for laparoscopy and a monopolar electrodiathermic coagulator with differently shaped endings. The power supply was provided from Martin Elektrotom 2000. A spontaneous recovers of the menstruation was achieved in 36.84% of the cases as a result of the endoscopic intervention. A follows up pregnancy was achieved in 12.4% of the women. Considering the obtained results, the authors recommend the use of a laparoscopic ovary fenestration when a women with ovarian cysts is treated.

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↗