Initial experience in target peroral endoscopic submucosal myotomy combined with septotomy for epiphrenic diverticulum.

The epiphrenic esophageal diverticulum is a rare non-malignant condition that is commonly associated with motility disorders. It would normally be treated surgically, but with the advancement of endoscopy techniques, peroral endoscopic myotomy with septotomy (D-POEM) has shown its benefits in coping with the symptoms. We present a case of a 71-year-old woman with increasing symptoms of dysphagia, weight loss and imaging data showing a large epiphrenic diverticulum.

Prevention of Migration of Esophageal Self-Expandable Metallic Stents Using Endoscopic Clips.

: Esophageal stenting with self-expandable metallic stents (SEMS), for both benign and malignant reasons, has been widely practiced for decades, but migration still remains the most common complication of the procedure. In this report we aim to review our experience and results in stent fixation with clips. : We present 18 patients who underwent esophageal stenting for both benign and malignant reasons.

Initial experience with peroral endoscopic myotomy in Bulgaria: case series.

Achalasia is a rare motility disorder with unknown etiology that results in failure of relaxation of the lower esophageal sphincter (LES). As there is no etiological treatment, different pharmacological agents and invasive techniques have been used for relieving the symptoms. For the past decade, peroral endoscopic myotomy (POEM) has proven to have excellent results.

Visual noise effect on reading in three developmental disorders: ASD, ADHD, and DD.

Background And Aims: Developmental disorders such as Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), and Developmental Dyslexia (DD) are reported to have more visual problems, oral language difficulties, and diminished reading skills in addition to their different diagnostic features. Moreover, these conditions also have increased internal noise and probably an impaired ability of external noise filtering. The aim of the present study was to compare the reading performance of these groups in the presence of external visual noise which disrupts the automatic reading processes through the degradation of letters.

Treatment approach in malignant left-bowel obstruction using self-expandable metallic stent: a case series.

Endoscopic self-expandable metallic stent (SEMS) decompression in patients with bowel obstruction due to colon carcinoma has been practiced for over two decades now, both in potentially curable cases and metastatic cancer. Using this case series, we aim to review the literature on the subject and to present our initial experience with using this technique as a bridge to single stage surgery, thus minimizing colostomy creation.

[Laparoscopic hysterectomy--the initial experience in Bulgaria].

The paper presents the first cases of laparoscopic-assisted vaginal hysterectomy and laparoscopic hysterectomy with removal of the uterus through the vagina performed in Bulgaria as well as the experience gained by the team from II gynaecology clinic at State University Hospital "Maĭchin dom" in Sofia from seven patients operated on by these techniques. The indications, the conditions and the implemented technique with its advantages and difficulties are described. The procedures are associated with less trauma and blood loss than abdominal surgery and are followed by a very smooth postoperative period which is very well tolerated by the patients.

[The zinc concentration of the blood serum in women with ovarian tumors (preliminary report)].

The aim of the study is to determine the concentration of blood serum zinc of women with ovarian tumors. The patients included in the study are as follows: 15 women with benign ovarian cysts, 5 with endometrial cysts and 5 with ovarian carcinoma. The control group consists of 157 healthy women whose serum zinc concentration was 13.

[A comparative study of the efficacy of antibiotic prophylaxis with cephalosporins in operative gynecology].

The article presents the results of a comparative study on the efficacy of perioperative prophylaxis with cefalosporins in abdominal gynaecological operations. A total of 155 women meeting certain inclusion criteria were operated on and were randomly assigned to one of the following regimens: Cefoxitin 3 x 1 g--14 subjects, Cefotetan 2 x 1 g--43 subjects, Cefalotin 3 x 2 g for 24 hours--27 subjects, Cefalotin 3 x 2 g for 72 hours--41 subjects and a control group of 30 subjects without prophylaxis. The course of the postoperative period, the hospital stay and the average costs in each group were assessed and compared.

[The use of cefotetan for the prevention of infectious postoperative complications in gynecology].

The study presents the results from the use of cefotetan for perioperative prophylaxis in 43 gynaecology patients compared with 29 controls without perioperative antibiotic prophylaxis with similar diseases and operations. Both groups show equal percentage of the cases with smooth postoperative period (70 and 72% respectively). 13 of the patients on cefotetan prophylaxis received additional antibiotic treatment (9 because of temperature up to 37.

[Combined loco-regional anesthesia and intravenous anesthesia with propofol (Diprivan--Zeneca)].

It is the purpose of the study to outline the superiorities of combined anesthesia in 100 patients undergoing orthopaedic (25 cases) and orthopaedic surgery (75 cases) interventions. The average duration of the operation is 90 +/- 25 min, performed under continuous peripheral (40 patients) and central (60 patients) nerve block, using Propofol against the background of continuous i.v.

[The diagnosis and complications of pregnancy in uterine malformation].

During the period from January 1985 until May 1990, 56 pregnant women with malformed uterus were observed for the clinical curse of pregnancy: 22 women in the first, 26 in the second and 8 in the third trimester. The diagnosis was made by complex investigations: vaginal examination--in 48 cases, ultrasound examination-in 51 cases, previous hysterosalpingography--in 14 cases. In 17 women the performance of a cerclage was needed.

[The dynamics and trends in surgical delivery at the Maternity Home of the State Institutional Hospital].

The study discusses the frequency of operative obstetric deliveries (cesarean section, forceps extraction and vacuum extraction) over a period of 18 years from 1976 till 1993. A total of 100,545 deliveries with 100,192 livebirths took place during this period with a decrease of the annual number of deliveries in the last years. The frequency of the various kinds of operative deliveries shows different tendencies.

[A triple pregnancy following heterologous insemination and ovarian stimulation with a favorable outcome].

The larger usage of inducing ovulation drugs in the last decade brought to more frequent multiple pregnancies. The authors describe triplet pregnancy after hetero-insemination and ovaries stimulation which ended the birth (by Cesarean section) of three alive and healthy babies. The triplet pregnancy is high-risky.