[Treatment of premenstrual syndrome [corrected] with Femifort].

Premenstrual syndrome is a collection of physical, psychological and emotional symptoms related to a woman's menstrual cycle in the second phase. It have been described various symptoms occurring regularly during last week prior to menses. It have been observed in women with normal ovarian function. The exact causes of PMS are not fully understood. Many treatments have been suggested for PMS. Femifort is food supplement, containing vitamins and phytoproducts and has positive influence in PMS.

[Nutri-mag--right of choice for magnesium tocolytic therapy].

AIM: To assess the feasibility of Nutri-mag as an oral tocolytic for the treatment of preterm labor. METHODS: 36 pregnant women in preterm labour participated in a prospective divided upon gestational age, number pregnancy, other therapy. CONCLUSION: Oral Nutri-mag--effective oral tocolytic in the management of preterm labor.

[Pregnancy and delivery in women with cerebrospinal fluid shunt due to hydrocephalus].

UNLABELLED: The aim of the study is following up the pregnancy and delivery in women with cerebrospinal fluid shunts for hydrocephalus. MATERIAL AND METHODS: The study includes 12 pregnant women (9 nuliparous and 3 multiparous) ranging in age from 19 to 36 years which were initially shunted prior to the pregnancy. 9 of the patients had VP shunts and 3 with VA shunt. They were followed up for evolution of the pregnancy, the state of the shunts and the method of delivery. RESULTS: It was found that the cerebrospinal fluid shunts does not affect the pregnancy outcome. Women with revision of the shunt during the pregnancy were not included in this study. We had 1 case of spontaneous abortion in 26 gestational week and two cases of preterm vaginal delivery. The other included in the study patients have live term births- 5 with vaginal delivery and 4 with caesarean sections. Spinal and epidural analgesia and general anesthesia was performed. Only in one case was performed revision and substitution of the shunt 6 weeks after the delivery due to obturation of the distal part of the shunt. DISCUSSION: Presence of cerebral shunt does not affect essentially the pregnancy development. The vaginal delivery in women with cerebrospinal fluid shunts can be provide successfully with analgesic medicines that does not increase the intracranial pressure. The caesarean section should be performed by obstetrical indications and in cases with increased intracranial pressure.

[Stromal ovary in 14 years old girl].

Struma ovarii was first described in 1899 and is extremely rare, with only 150 reported cases in the medical literature. Struma ovarii is most common between the ages of 40 and 60 years. Women with struma ovarii usually present with a pelvic mass or, less frequently, with hyperthyroidism or ascites. As in follicular tumors of the thyroid gland, the thyroid epithelium in the teratoma may be organized in a solid, embryonal or pseudotubular pattern, rather than thyroid follicles. The authors present an extremely rare case of struma ovarii in 14-year-old girl.

[Sperm parameters in male idiopathic infertility after treatment with prelox].

UNLABELLED: The diagnosis of male infertility is determinate after assessment of sperm quality and clinical study. In nearly 30% of the cases nevertheless detailed clinical and laboratory study it can't be discovered the cause and on the bases of exclusion criteria set the diagnosis idiopathic infertility. The object of our study was investigation of the group patients (n=50) with idiopathic infertility treated with Prelox and to be studied its effects on spermatozoa parameters. MATERIAL AND METHODS: The study design was double-blind, placebo-controlled, cross-over, randomized study, including introduction period (1 month), two therapeutic periods (each one of 1 month) separated with 1 month wash out period and concluding period of 1 month. There was applied a new method for treatment with mechanism of action stimulation the production cGMP of spermatozoa endothelial nitric oxide synthase (eNOS). This is not surprising achieving results show improvement of sperm quality. The methods of the study were: 1. Assessment of the conventional semen analysis (according the criteria of WHO, 1999). 2. Spermatozoa function tests. 3. Spermatozoa-cervical mucus penetration tests. RESULTS: The obtained results showed improvement of sperm quality, in the middle-aged men the therapeutic answers was better than in younger. In conclusion the therapy with Prelox improve sperm parameters in men with idiopathic infertility. Pycnogenol (one of the constituents of Prelox) has powerful antioxidative influence ameliorating spermatozoa function.

[Selecting function of female genital tract in relation with spermatozoa interaction].

The present study includes 50 infertile couples followed sperm parameters: morphology and others indices for ability of penetration in ovulatory cervical mucus during 12 months. It is discussed the possibility of which spermatozoa can participate in the fertilization and the impotence and place of the female genital tract for the selection of morphologically abnormal spermatozoa before reaching the place of fertilization.

[Endometriosis--is it treatable?].

Its etiology remains uncertain, its pathogenesis disputed and its treatment poor. Most medical treatment is based on ovulation suppression and inducing amenorrhoea. New findings on the genetics, the possible roles of the environment and the immune system, intrinsic abnormalities in the endometrium and secreted products of endometriotic lesions have given explanation into the pathogenesis of this disorder and give us new trends for treatment the disease.

[Gonadotropin-releasing agonist in the therapy of patients with laparoscopically confirmed endometriosis]. / Lechenie s gonadotropin rilizing agonist pri patsientki s laparoskopski dokazana endometrioza.

OBJECTIVE: To determinate the effectiveness of treatment with gonadotrophine releasing hormone agonist. METHODS: We investigated 164 patients with laparoscopy divided in two groups. Women in first group received Dipherelin 3. 75 mg /lpsen/ for 3 months. Second group had received Dipherelin 3.75 mg for 6 months. Preparation was done i.m. every 28 days. All patients in the study had endometriosis grade I-II using the AFS classification after laparoscopy. The measures according to compare in the 2 groups was as following: 1. Dysmenorhoea, dyspareunia and pelvic pain before and after treatment. 2. Rate of pregnancy. 3. Bleeding during the treatment. 4. Amenorhoea after treatment. CONCLUSIONS: After analysis of the patients in the 2 groups we decided that Dipherelin 3.75 mg is an effective treatment of sterility related to endometriosis.

[Antibiotic prophylaxis in limited gynecological surgeries for pregnancy termination]. / Antibiotichna profilaktika pri malki ginekologichni operatsii, svurzani s prekusvane na bremennostta.

The authors attempted with this trial to confirm the necessity of periabortal antibiotic prophylaxis after spontaneous and induced abortion. The trial included 172 patients with abortion; 53 of them with induced abortion and 119 with spontaneous abortion. The term of gestation was between 5 and 22 week. Three therapeutic groups were compared to a control no-treatment group. The first group was given Ampicillin orally 4 x 500 mg for 5 consecutive days. The second group was administered a combination of Ampicillin orally 4 x 500 mg plus Gentamycin 2 x 80 mg i.m. for 3 to 5 days postoperatively. The third group was given 3 x 2 g i.v. Cefazolin intraoperatively and 24 hours following the manipulation. The trial aimed at establishing the efficiency and cost-effectiveness of the antibiotic prophylaxis. The results tend to prove the perioperative prophylaxis with Cefazolin is preferable since it is most efficient and cost-effective.

[Treatment of Chlamydia trachomatis with azatril]. / Lechenie na khlamidialnata infektsiia s azatril.

The authors discuss the treatment with Azatril for Chlamydia trachomatis infection in patients with tubar sterility. The study includes 85 women, treated for three months. The authors achieved 57.6% negativation of the results that gives a reason to propose the use of Azatril (Balkanpharma) in the treatment of Chlamydial infection.

[Candidiasis and birth canal injuries]. / Kandidozna infektsiia i rodov travmatizum.

Candidiasis of the lower female genital tract during pregnancy is a leading cause for seeking medical help. During pregnancy candidiasis is encountered about 30% more often compared to non-pregnant (by the time of delivery about 18-22% of the pregnant women would have the infection). It is clinically manifested especially after 36 w.g. This might be the cause of a series of pregnancy complications. Most serious are considered prematurity, chorioamnionitis, descending infection from mother to the newborn during delivery. Significantly less attention has been paid to the birth canal injury and its higher rate if a Candida colpitis is present at the time of delivery.

[Utrogestan--an alternative for synthetic gestagen treatment in spontaneous abortion]. / Utrogestan--alternativa na sintetichnite gestageni v lechenieto na spontanniia abort.

A clinical trial is conducted with 32 pregnant patients with a history of sterility and infertility, uterine malformations as well as progesterone deficiency. The mean week of gestation is 9-10. All patients were treated with Utrogestan in the usual doses 2 x 100 mg for vaginal application. No side effects were observed which is encouraging to its routine use.

[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.

[A case of pregnancy with fetal malformation and an hepatic hydatid cyst]. / Bremennost, malformativen plod i ekhinokokova kista na cherniia drob.

A case of pregnancy, malformation of the foetus--Spina bifida, and hydatidosis hepatis is discussed. The patient is 19-year old, primigravida, pregnant in the 31st gestational week who was admitted to the ward with an observation of Hydrocephalia and fetal compromise (low beat-to-beat variability and lack of accelerations of the fetal heart rate). Un ultrasound scan of the foetus proved hydrocephalia and Spina bifida in the lumbal segment of the fetal spine. Un extended ultrasound scan proved a hydatid cyst of the liver with a 10 mm diameter, corresponding with the data of the serological tests--RAHA 1:400.