The aim of this study was to identify family factors determining risk sexual behavior among students aged 12- 18 in Veliko Turnovo region. A cross-sectional study was conducted in 2014. Three hundred and ten students were included in a representative sample of students attending seven schools in Veliko Turnovo region. The respondents filled in a self-administered questionnaire, designed to collect data on family interactions, acts of sexual coercion, parental social status and their influence on the sexual behavior of the students. Data were processed using SPSS.v.19. Parametric and non-parametric statistical methods were applied. About one-fifth of the students were nurtured in incomplete families. History of a sexually transmitted diseases correlated with type of family (p<0.05). Poorer family interactions (rare family dinners and no conversations about sex) determined acts of risk sexual behavior - accidental contraceptive use during sex and postponing an obstetric examination (p<0.05). Students reporting sexual coercion had also had frequent casual sexual intercourse (p<0.05). Identifying family factors is of essential importance in planning effective sexual health education at school.
Early diagnosis of congenital hearing impairment is of great importance to later development and social life of the affected newborns. Otoacoustic emission screening test (OAEs) is a useful tool for early evaluation of hearing in neonates and infants. Some specific risk factors (RFs) associated with prenatal, birth and early postnatal periods may influence the first screening results and further diagnostic findings. Results from OAEs in newborns in University Hospital in Pleven between 2013-2015 years are analyzed. In low birth weight children (under 2500 grams or g), and those born before the 36th gestation week (GW), we found deviations in the OAEs. A negative test result proved higher in newborns subjected to oxygen therapy during the first hours after birth (15.5%), as well as in newborns with higher leucocytes count (11.0%) or higher serum bilirubin value immediately after birth. The average birth weight of the newborns was lower in the cases with negative test results (2848.7±506.5 g) and unilateral negative test results (2823.3±535.2 g), as compared with the group with positive test results (3191.9±387.9 g). Elevated bilirubin levels were more frequently established and can be expected with higher probability in low birth weight children. They shall be subject to a follow-up in time, and newborns with initial negative test result shall undergo a second test 2 months after birth. Long term monitoring is recommended for newborns with these risk factors.
The aim of this study was to identify risk sexual behavior in students aged 12-18 in Veliko Turnovo region. A cross-sectional study was carried-out in 2014. Three hundred and ten students attending seven schools filled in a self-administered questionnaire. The questionnaire included 48 questions, sixteen of which collected information about sexual behaviour, regarding contraception, casual sex with different partners, sexually transmitted diseases (STD), hygiene after sex, etc. The data were processed with SPSS.v.19. Parametric and non-parametric statistical methods were applied. Over 50% of the students reported being sexually active, most of them since they turned 16. Almost half of the respondents had had casual sexual partners and 46 percent had had sex within a week after initiation of a new relationship. Less than one third of the students reported safe sex behaviour. Seven percent of the students had a history of STDs, and one in six did not practice proper hygiene after sex. Identification of all aspects of risk sexual behavior in students aged 12-18 provides an opportunity to study the problem systematically and comprehensively. Planning and implementation of effective health education programs in schools require the application of an integrated approach with the participation of students, teachers, parents, health professionals and policy makers.
The aim of the study was to develop the norms for physical growth (birth weight-, birth height- and head circumference- for age) of the full-term babies born from singleton pregnancy in UMHAT „Dr. G. Stranski” – Pleven (total, by gender and gestational age at birth). A cross-sectional study was carried-out in 2017; 1092 live infants born from singleton pregnancy between 38 and 42 weeks were included in the study. We obtained information about three anthropometric measurements (birth weight-, birth height- and head circumference-for age). Data were processed by SPSS v.24.0. Norm group ranges (3, 5 and 7 groups) were developed for three indicators using percentile methods. Kruskal-Wallis test was used. The mean birth weight- and height-for age were higher for baby boys (P50, 3280 g and 50 cm) compared with baby girls (P50, 3150 g and 49 cm). Baby boys and girls weighed <2570 g at birth fell into the group ,,very slow growth” (P3). A ,,very fast growth” (P97) was found in baby boys weighed >4120 g at birth (vs. >3870 g for baby girls). Norm group ranges allow to identify the newborns with a higher risk and to focus efforts and health resources to them; it should be updated periodically.
The aim of the study was to identify socioeconomic and psychological determinants of self-rated health among ambulatory and hospitalized patients. A cross-sectional study was carried-out in 2014. Two hundred and twelve patients over 44 years of age filled in a self-administrated questionnaire. Self-rated health (SRH) was measured by 5-point range scale. The level of well-being (WB), sources of social support, personal financial capacity, social status, etc. were studied as well. Data were processed by SPSS.v.19. Parametric and non-parametric statistical methods were applied. Over 70% of patients evaluated their health as fair and good. The persons with higher WB had higher SRH, that correlation was moderate (r=0.452; p=0.001). In regard to the social status the differences were significant - the unemployed, old age retirees or ill health retirees evaluated their health lower (p<0.05). A proportion of patients indicated two or more sources of emotional and instrumental support, but increased number of support sources had no effect on SRH (p>0.05). Identification of socioeconomic and psychological factors of self-rated health allows clarifying better their effect mechanisms and planning appropriate health services
A cross-sectional study was carried out in 2016 in the research project No 4/2016. We selected 98 patients aged 40-89 and diagnosed with hypertension. The patients were admitted to Cardiology Clinic One of the University Hospital in Pleven. The study aimed to measure and compare direct and indirect costs of hypertensive patients aged 40-89 years, who were treated with lisinopril and perindopril. We estimated the total and average costs of 50 (51.0%) patients treated with lisinopril and 48 (49.0%) treated with perindopril. Males were 46.4%, and the mean age of the sample was 65.9.0±11.2 years. Data were processed by Statistical Package for Social Science version 19.0 (SPSS.v.19.0). Total costs exceeded amount reimbursed for the clinical path (BGN 420.00) in 64.6% of the patients treated with perindopril and 48.0% of the patients treated with lisinopril. We found that treatment costs within 6-months after discharge were BGN 673.82 in patients treated with lisinopril, as compared to BGN 171.92 reimbursed by the National Health Insurance Fund (NHIF), and BGN 781.18 for those treated with perindopril, compared to BGN 216.33 reimbursed by NHIF. The NHIF reimbursement rate for antihypertensive treatment is insufficient to cover all direct costs. Increased hospital costs and out-of-pocket payments present a significant restriction on access to treatment for arterial hypertension.
The aim of the cross-sectional study was to estimate the absolute 10-year risk for fatal cardiovascular disease (CVD) in patients with hypertension by Systematic Coronary Risk Estimation (SCORE). The study was carried out in 2016 as part of Project No 4/2016. Ninety-one patients aged 40-89 years were included. The mean age of the sample was 66.0±11.0, and 44.0% were males. Information of the patients’ risk profile included about age, gender, blood pressure, smoking and total cholesterol. The patients with hypertension were stratified according to a 10-year absolute risk of CVD. Data were processed by Statistical Package for Social Science versions 19.0 (SPSS.v.19.0). Over two-thirds of the patients had 1 stage hypertension (31.9%) and 2 stage hypertension (37.4%). Median systolic blood pressure on admission to the clinics was 160 mg Hg, and median diastolic blood pressure was 90 mm Hg. Total serum cholesterol values exceeded 4.9 mmol/L in 64.0% of the patients. Smokers accounted for about one-fourth of the patients, most of them having smoked for 40 years. The mean number of risk factors for CVD was 3.0. Over 65% of the patients were found to be at a very high 10-year absolute risk of fatal CVD by SCORE. Cardiovascular risk assessment has important role in prevention of morbidity, premature death and disability of CVD.