MEDIS – International Journal of Medical Sciences and Research
type: channel
description: MEDIS – INTERNATIONAL JOURNAL OF MEDICAL SCIENCES AND RESEARCH Vol. 5. Issue 2 / 2026 Distinguished Teachers, Scientists, and Researchers in the field of Medicine We are pleased to inform you of that procedure for applying for your scientific and research papers in the field of Medicine, Medical Sciences, and Health, for the MEDIS IJ Vol. 5 Issue. 2. 2026, has started. The purpose of this publishing venture is to persevere the continuity and raise the quality of the work so far, in order for MEDIS IJ to be included in the SCOPUS or WOS list as soon as possible. From now on we offer a new opportunity to do so in MEDIS IJ, where papers will be published in English only. Important: One author can publish only 1 paper per issue The deadlines are as follows: - 27. 04. 2026 abstract submission deadline - 02. 05. 2026 till 12:00 AM full paper submission deadline More Info... Abstract template
publisher: Institute of Management & Knowledge
language: en
publication name: MEDIS – International Journal of Medical Sciences and Research
issn: 2671-3497
items: HYPERCOAGULABILITY AND THROMBOTIC RISK IN BETA-THALASSEMIA: CLINICAL AND LABORATORY INSIGHTS
items: PRONATED AND FLAT FEET: DISTINCT ENTITIES OR OVERLAPPING CONDITIONS
items: INFLAMMATION-LINKED PSA VARIABILITY IN BPH PATIENTS TREATED WITH ANTIBIOTICS: A LONGITUDINAL STUDY WITH HISTOPATHOLOGIC CORRELATION
items: ANTI-AGING ESTHETIC TREATMENTS: PSYCHOLOGICAL EFFECTS, EXPECTATIONS, AND CLINICAL OUTCOMES
items: ADDRESSING THE ESCALATING HIV EPIDEMIC IN ALBANIA: POLICY EFFICACY, IMPLEMENTATION CHALLENGES, AND STRATEGIC PATHWAYS FOR IMPROVEMENT
items: FOREIGN BODY INGESTION IN CHILDREN - AN EMERGENCY CONDITION REQUIRING IMMEDIATE EVALUATION
items: THE EVOLUTION OF GOOD CLINICAL PRACTICE: A COMPARATIVE REVIEW OF ICH GCP E6 (R2) AND E6 (R3)
items: ASSOCIATION OF SCREEN TIME WITH BMI AND ACADEMIC PERFORMANCE AMONG CHILDREN AGED 6-17 YEARS IN TIRANA
items: PREREQUISITES FOR EFFECTIVE COMMUNICATION IN SEASONAL INFLUENZA VACCINATION- A STUDY OF GENERAL PRACTITIONERS IN BULGARIA
items: REHABILITATION STRATEGIES FOR MEDIAL TIBIAL STRESS SYNDROME: A PHYSIOTHERAPY PERSPECTIVE
items: LEVELS OF GENE EXPRESSION FOR LAD1 AND EGFR IN PATIENTS WITH LARYNGEAL CANCER
items: SPEECH AND ORTHODONTIC ANALYSIS IN CHILDREN WITH SYMPTOMS OF OBSTRUCTIVE SLEEP APNEA - PILOT STUDY
items: EFFECTIVENESS OF LACTOBACILLUS JENSENII IN TREATING VAGINAL AND UROGENITAL INFECTIONS: AGE-RELATED DIFFERENCES IN RESPONSE AND IMMUNE FUNCTION
items: SILENT INTRUDERS: HOW STREPTOCOCCUS AGALACTIAE AFFECTED THE PREGNANCY OF PRETERM BIRTHS
items: PERFORMANCE PROFILLING AND DATA ANALYTICS IN ELITE SHORT TRACK SPEED SKATING: A CASE STUDY OF THE HUNGARIAN OLYMPIC TEAM
items: ARTIFICIAL INTELLIGENCE IN DRUG DEVELOPMENT: CURRENT APPLICATIONS, CHALLENGES AND FUTURE PERSPECTIVES
items: RADIOLOGICAL FEATURES OF LUNG CANCER SUBTYPES: A STUDY OF CT PATTERNS AND PATHOLOGICAL CORRELATES
items: ANTI-XA ACTIVITY IN CHILDREN ON TREATMENT AND PROPHYLAXIS WITH LOW MOLECULAR WEIGHT HEPARIN
items: COMPARISON OF THE EFFECTS OF TWO PHYSIOTHERAPY APPROACHES IN THE TREATMENT OF CERVICO-THORACIC SYNDROME
items: INFLUENCE OF NUTRITIONAL FACTORS ON LIPID PROFILE AND LEVELS OF MAGNESIUM, COPPER, ZINC, SELENIUM AND RUBIDIUM
items: PROVING THROMBOPHILIA IN SYMPTOMS OF HYPERSPLENISM
items: QUALITY IN TERMS OF DENTAL HEALTH SERVICES
items: PULMONARY REHABILITATION IN THE ELDERLY PATIENT
items: BOTTLED OR TAP WATER – THE CONSUMER’S CHOICE?
items: HERBAL SEDATIVES AND HYPNOTICS: A COMPARATIVE ANALYSIS OF THEIR USE IN THE WESTERN REGION OF NORTH MACEDONIA
items: ADVANCES IN FOOT MEASUREMENT: IMPLICATIONS FOR PHYSIOTHERAPEUTIC DIAGNOSIS AND INTERVENTION
items: THE EFFECTS OF KINESITHERAPY ON FUNCTIONAL PARAMETERS (MUSCLE STRENGTH AND RANGE OF MOTION) IN PATIENTS WITH RHEUMATOID ARTHRITIS
items: HRCT PATTERNS IN FIBROTIC INTERSTITIAL LUNG DISEASES: COMPARATIVE ANALYSIS OF IDIOPATHIC PULMONARY FIBROSIS, SARCOIDOSIS, HYPERSENSITIVITY PNEUMONITIS, AND CONNECTIVE TISSUE DISEASE–RELATED ILD
items: THE ROLE OF Ca 15-3 IN THE DIAGNOSIS AND SCREENING OF BREAST CANCER
items: INFLUENCE OF BREATHING EXERCISES AND RESPIRATORY REHABILITATION ON POSTURAL DISORDERS IN CHILDHOOD AND ADULTHOOD

HYPERCOAGULABILITY AND THROMBOTIC RISK IN BETA-THALASSEMIA: CLINICAL AND LABORATORY INSIGHTS
type: item
description: Beta-thalassemia is increasingly recognized as a multisystem disorder associated with a chronic hypercoagulable state and an elevated risk of thrombotic complications. Beyond ineffective erythropoiesis, chronic anemia, and transfusion-related iron overload, abnormalities in coagulation and vascular function play an important role in long-term morbidity. Accumulating evidence indicates that patients with beta-thalassemia exhibit persistent activation of cellular and plasma components of hemostasis, even in the absence of overt clinical thrombosis. Hypercoagulability in beta-thalassemia is multifactorial, arising from altered red blood cell membrane architecture with phosphatidylserine externalization, chronic platelet activation, endothelial dysfunction driven by hemolysis and nitric oxide depletion, increased circulating procoagulant microparticles and extracellular vesicles, and imbalances in natural anticoagulant pathways. Iron-related oxidative stress and inflammation further amplify vascular activation and thrombin generation. The magnitude and clinical expression of these abnormalities differ substantially across disease phenotypes. Beta-thalassemia trait is generally not associated with clinically significant thrombosis, whereas non-transfusion-dependent thalassemia (NTDT) carries a particularly high thrombotic burden, especially in splenectomized patients. In transfusion-dependent thalassemia (TDT), regular transfusion modifies erythroid-driven procoagulant mechanisms but introduces additional risk modifiers, including iron overload and catheter-related thrombosis. This review summarizes current knowledge on coagulation disturbances and thrombotic complications in beta-thalassemia, integrating pathophysiological mechanisms with clinically relevant laboratory markers. Particular emphasis is placed on global coagulation assays, cellular biomarkers, and phenotype-specific clinical-laboratory patterns, as well as on contemporary monitoring strategies in TDT. A be…
subject: Articles
  topic: section
subject: Beta-thalassemia
  topic: keywords
subject: hypercoagulability
  topic: keywords
subject: thrombotic risk
  topic: keywords
subject: iron overload
  topic: keywords
creator: Snezhana Stoencheva
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-21
publication date: 2026-03-21
starting page: 33
ending page: 38
doi: 10.35120/medisij0501033s

PRONATED AND FLAT FEET: DISTINCT ENTITIES OR OVERLAPPING CONDITIONS
type: item
description: The terms pronated foot and flat foot are often used interchangeably in clinical practice, despite representing distinct biomechanical and morphological conditions. In many respects, the two conditions present with analogous clinical manifestations and may elicit similar symptomatology; however, their underlying genesis differs. Accurate differentiation between these conditions requires not only advanced expertise in biomechanics and the anatomy of the ankle–foot complex, but also comprehensive knowledge of the distinct stages of foot development from a podiatric perspective. Misinterpretation of these entities may lead to inappropriate therapeutic strategies and suboptimal clinical outcomes, particularly in pediatric and physically active populations. The purpose of this article is to clarify the differences between pronated foot posture and flat foot deformity, with emphasis on structural characteristics, functional behavior, and clinical relevance. The paper reviews current concepts of foot biomechanics and presents commonly used plantographic assessment methods, including Clarke’s angle and footprint-based indices, to illustrate diagnostic distinctions. Special attention is given to the clinical applicability and limitations of these assessment tools in routine physiotherapy practice. Understanding the difference between dynamic pronation and structural flattening of the medial longitudinal arch is essential for accurate diagnosis, appropriate treatment planning, and prevention of misclassification. Clear differentiation between these conditions may improve clinical decision-making in physiotherapy and related disciplines.
subject: Articles
  topic: section
subject: pronated foot
  topic: keywords
subject: flat foot
  topic: keywords
subject: physiotherapy
  topic: keywords
subject: orthotic treatments
  topic: keywords
creator: Kristian Stoychev
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-21
publication date: 2026-03-21
starting page: 47
ending page: 49
doi: 10.35120/medisij0501047s

INFLAMMATION-LINKED PSA VARIABILITY IN BPH PATIENTS TREATED WITH ANTIBIOTICS: A LONGITUDINAL STUDY WITH HISTOPATHOLOGIC CORRELATION
type: item
description: Benign prostatic hyperplasia (BPH) frequently coexists with prostatic inflammation, which may elevate prostate-specific antigen (PSA) and complicate differentiation from prostate cancer. To evaluate longitudinal changes in C-reactive protein (CRP) and PSA parameters following culture-guided antibiotic therapy in men with BPH, and to assess associations with prostate biopsy outcomes. A longitudinal retrospective observational study included 24 men with BPH followed from January to December 2025. CRP, total PSA (tPSA), and free PSA (fPSA) were measured at baseline without antibiotics (January) and at three subsequent timepoints (May, September, December) after antibiotic therapy guided by urine culture and antibiogram. Antibiotic regimens included levofloxacin 500 mg once daily for 28 days, nitrofurantoin 100 mg three times daily for 10 days, and cefixime 400 mg once daily for 10 days. Prostate biopsy was recommended to all patients; those declining biopsy were retained as a descriptive subgroup. Statistical analysis: Continuous variables were summarized as median and interquartile range. Repeated-measures comparisons across four timepoints were performed using the Friedman test. Between-group comparisons were performed using the Mann–Whitney U test. A two-sided p value < 0.05 was considered statistically significant. Results: CRP and PSA parameters demonstrated longitudinal variation over the four timepoints. PSA kinetics differed according to histopathologic findings among biopsied patients. Conclusion: Serial CRP and PSA assessment under culture-guided antibiotic therapy may support risk stratification and biopsy decision-making in BPH patients with suspected inflammation.
subject: Articles
  topic: section
subject: benign prostatic hyperplasia
  topic: keywords
subject: C-reactive protein
  topic: keywords
subject: prostate-specific antigen
  topic: keywords
subject: prostatitis
  topic: keywords
creator: Majlinda Ademi
creator: Ilbert Ademi
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-21
publication date: 2026-03-21
starting page: 21
ending page: 26
doi: 10.35120/medisij0501021a

ANTI-AGING ESTHETIC TREATMENTS: PSYCHOLOGICAL EFFECTS, EXPECTATIONS, AND CLINICAL OUTCOMES
type: item
description: Anti-aging esthetic dermatology has become an increasingly important area of contemporary medical practice, primarily due to advances in minimally invasive procedures, improved technologies, and growing social interest in maintaining a youthful appearance. In addition to medical and technological progress, psychological and social factors play an increasingly important role in the decision-making process of patients seeking esthetic treatments. Expectations regarding improved self-confidence, social acceptance, and overall quality of life frequently influence the motivation to undergo anti-aging procedures. The aim of this paper is to analyze psychological factors influencing patients’ decisions to undergo anti-aging esthetic treatments and to examine the relationship between patient expectations, perceived outcomes, and overall satisfaction. The study is based on a narrative review of relevant scientific literature in the fields of dermatology, psychology, and medical aesthetics, with particular attention to recent studies addressing patient-reported outcomes, psychosocial determinants of treatment satisfaction, and quality-of-life indicators. Available evidence indicates that patient satisfaction depends not only on objective clinical results but also on the alignment between expectations and achieved outcomes. Unrealistic expectations, inadequate communication, and insufficient understanding of treatment limitations may lead to dissatisfaction even when clinical results are technically successful. Conversely, effective physician–patient communication, clear explanation of treatment goals, and individualized therapeutic approaches significantly improve both subjective satisfaction and long-term treatment adherence. Psychological determinants such as body image perception, self-esteem, aging anxiety, and social influence are consistently identified as important predictors of treatment demand and satisfaction. Ethical considerations and professional responsibility a…
subject: Articles
  topic: section
subject: anti-aging
  topic: keywords
subject: esthetic dermatology
  topic: keywords
subject: patient satisfaction
  topic: keywords
subject: psychological factors
  topic: keywords
subject: clinical outcomes
  topic: keywords
creator: Haris Varupa
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-21
publication date: 2026-03-21
starting page: 9
ending page: 14
doi: 10.35120/medisij0501009v

ADDRESSING THE ESCALATING HIV EPIDEMIC IN ALBANIA: POLICY EFFICACY, IMPLEMENTATION CHALLENGES, AND STRATEGIC PATHWAYS FOR IMPROVEMENT
type: item
description: Albania, despite its historically low HIV prevalence, is experiencing a concerning and continuous rise in new infections, with reported cases doubling over the past decade. This trend necessitates a critical examination of the nation's public health response to HIV/AIDS within its unique socio-cultural and economic context. This section outlines the methodological approach for reviewing grey literature. Due to its complexity and limited indexing, a structured search plan based on a systematic review protocol was developed, using four strategies: grey literature databases, customized Google searches, targeted websites, and expert consultation. Grey literature, including government, NGO, and institutional reports, which were assessed. This study conducted a qualitative policy analysis using national reports, global agency data (e.g., UNAIDS, WHO), and academic literature It critically examined the implementation and impact of Albania’s core legal frameworks: the “Prevention and Control of HIV/AIDS Law” (2008) and the “National Action Plan 2020–2025.” Results indicate that 60–72% of new HIV cases are diagnosed at late stages, exposing serious gaps in early detection and access to testing. Key populations, such as men who have sex with men, people who inject drugs, and sex workers, remain underserved due to stigma, and traditional cultural values. Additionally, the withdrawal of major international donors, including the Global Fund, has led to critical shortages in testing supplies and awareness campaigns. While ART is available, it remains centralized in Tirana, limiting rural access. Albania's progress in controlling its HIV epidemic is substantially impeded by deeply entrenched social stigma, systemic under-reporting, and an unsustainable reliance on external funding. To meet SDG Target 3.3 by 2030, Albania must decentralize HIV services, establish sustainable national funding mechanisms, and prioritize anti-stigma strategies through multi-sectoral collaboration. Add…
subject: Articles
  topic: section
subject: HIV/AIDS
  topic: keywords
subject: Public Health Policy
  topic: keywords
subject: Stigma
  topic: keywords
subject: Albania
  topic: keywords
subject: Health System
  topic: keywords
creator: Klarisa Rexhvelaj
creator: Geraldo Enes Rexhvelaj
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-21
publication date: 2026-03-21
starting page: 1
ending page: 7
doi: 10.35120/medisij0501001

FOREIGN BODY INGESTION IN CHILDREN - AN EMERGENCY CONDITION REQUIRING IMMEDIATE EVALUATION
type: item
description: Accidental foreign body ingestion is common in pediatric practice. Young children, especially those under five years, tend to put different kinds of small objects from their environment into their mouths. Sometimes due to the still immature reflexes, they are unintentionally swallowed. Most often these are coins, followed by magnets, button batteries, toys or jewelry, but also many others. Luckily, in most cases, these foreign bodies pass through the gastrointestinal tract without causing any symptoms or injuries. Some of them don’t even get noticed or registered. However, it is estimated that in 10 to 20 percent of the cases there is a need for medical intervention. A critical condition is lodgment in the esophagus because it requires extraction as soon as possible. Most often it occurs in its upper third. At this location the object is able to cause serious clinical discomfort, requiring rapid approach. Even dyspnea by compressing the trachea is possible. Injuries of the tissues, particularly after delayed diagnosis and treatment, might be a further dangerous consequence. Especially lodged button batteries cause critical damage of the esophageal wall in a very short time due to an electrolysis reaction on the site of the negative pole. This generates an alkali burn that might lead to life-threatening complications as perforation, fistulas to the trachea or to major blood vessels. Lethal outcomes are reported. Studies have demonstrated the development of significant injuries even only two hours of impaction. This emphasizes the importance of initiation of the extraction immediately. Thus, in spite of the overall good prognosis clinicians have to be extremely alert when confronted with a child after foreign body ingestion. Immediate and profoundly evaluation is necessary in order to detect or exclude lodgment in esophagus- a condition requiring quick intervention. Especially when button batteries are involved time is crucial in order to prevent devastating complicat…
subject: Articles
  topic: section
subject: children
  topic: keywords
subject: foreign body
  topic: keywords
subject: ingestion
  topic: keywords
subject: button battery
  topic: keywords
creator: Boyana Grozeva
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-21
publication date: 2026-03-21
starting page: 43
ending page: 46
doi: 10.35120/medisij0501043g

THE EVOLUTION OF GOOD CLINICAL PRACTICE: A COMPARATIVE REVIEW OF ICH GCP E6 (R2) AND E6 (R3)
type: item
description: Good Clinical Practice (GCP) provides the ethical and scientific foundation for conducting clinical trials and safeguarding participant welfare. The transition from ICH GCP E6 (R2) to E6 (R3) represents a significant evolution in response to increasingly complex study designs, digital technologies, and decentralized trial models. These developments require regulatory guidance that remains robust while allowing sufficient flexibility to support innovation. In addition, the globalization of clinical research and the growing involvement of multiple stakeholders have further emphasized the need for harmonized yet adaptable regulatory standards. The aim of this review is to compare ICH GCP E6 (R2) and E6 (R3) and evaluate the practical impact of the updated framework on investigators, sponsors, and other research stakeholders. Specific attention was given to how the revised guidance supports operational efficiency without compromising ethical safeguards or scientific validity. A structured qualitative analysis of both versions was conducted. Key aspects examined included trial design, quality management, data governance, investigator and sponsor responsibilities, monitoring strategies, and participant protection. The review focused on identifying major conceptual shifts and evaluating their significance for contemporary clinical research practice. The analysis demonstrates that ICH GCP E6 (R3) adopts a principle-based, risk-proportionate approach, moving beyond the more prescriptive structure of R2. It prioritizes the identification and management of factors critical to participant safety and data integrity, encouraging sponsors and investigators to tailor processes according to study-specific risks. This approach supports innovative methodologies, including decentralized and hybrid trials, facilitates the integration of digital health technologies, and promotes proactive quality management systems embedded throughout the trial lifecycle rather than relying primarily on …
subject: Articles
  topic: section
subject: ICH-GCP
  topic: keywords
subject: clinical trials
  topic: keywords
subject: participant safety
  topic: keywords
subject: risk-based monitoring
  topic: keywords
creator: Brisilda Pashaj
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-21
publication date: 2026-03-21
starting page: 39
ending page: 42
doi: 10.35120/medisij0501039p

ASSOCIATION OF SCREEN TIME WITH BMI AND ACADEMIC PERFORMANCE AMONG CHILDREN AGED 6-17 YEARS IN TIRANA
type: item
description: Excessive engagement with screen-based devices has emerged as a significant behavioral risk factor in childhood, contributing to sedentary lifestyles and increasing rates of overweight and obesity. Although extensive international research has documented these associations, evidence from Balkan countries remains limited, particularly regarding the combined relationship between screen exposure, body mass index (BMI), and academic performance. The aim of this study was to assess the relationship of daily screen time with BMI status, and academic achievement in schoolchildren aged 6 to 17 years in Tirana, Albania. The research was a descriptive analytical, cross-sectional and observational study conducted in 2025, with 600 pupils selected through a multi-stage probabilistic sampling procedure from public schools. The data collection instrument was a structured questionnaire, designed based on international literature. Variables included socio-demographic characteristics, sleep duration, physical activity, BMI, academic performance, and screen exposure. Screen time was categorized as ≤2 hours/day and >2 hours per day, while BMI was determined in three categories: underweight, healthy weight, and overweight / obese. Nonparametric tests such as Chi-Square, Mann Whintey U and binary logistic regression were used in the analysis. The level of statistical significance was set at 0.05. Overall, 26.3% of participants reported more than two hours of daily screen exposure. Schoolchildren who spent more than 2 hours/ day on screens were significantly more likely to belong to higher BMI categories. Chi-square analysis demonstrated a significant relationship between daily digital use and BMI categories (χ² = 23.743, df = 2, p = 0.000). Watching TV during a meal was significantly related to higher BMI. (χ²=8.500; p=0.014). Pupils with normal BMI achieved significantly better academic results than their overweight/obese peers (p<0.001). Furthermore, prolonged screen time was independ…
subject: Articles
  topic: section
subject: Screen time
  topic: keywords
subject: Body mass index
  topic: keywords
subject: Academic performance
  topic: keywords
subject: Childhood obesity
  topic: keywords
subject: Sedentary behavior
  topic: keywords
creator: Floriana Marku
creator: Loreta Kuneshka
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-21
publication date: 2026-03-21
starting page: 27
ending page: 32
doi: 10.35120/medisij0501027m

PREREQUISITES FOR EFFECTIVE COMMUNICATION IN SEASONAL INFLUENZA VACCINATION- A STUDY OF GENERAL PRACTITIONERS IN BULGARIA
type: item
description: This study investigates the prerequisites and barriers to effective communication regarding seasonal influenza vaccination by examining the perspectives of general practitioners (GPs) in Bulgaria. GPs play a crucial role in providing primary healthcare services, including health information, promotion of health, disease prevention, and vaccination programs. However, they face significant challenges related to patient trust in social media and internet sources, patients' tendency to neglect their health, and administrative burdens that can hinder their ability to engage in preventive measures. The survey involved 368 GPs who completed an anonymous questionnaire assessing various aspects of their work and relationships with patients. Results indicate that most GPs believe patients heavily rely on potentially misleading information from social media, which complicates efforts to promote vaccinations. Additionally, many patients tend to neglect their health, making them less receptive to health promotion campaigns. Furthermore, GPs often feel overwhelmed by administrative tasks, limiting their capacity to participate in additional preventive programs. Despite these challenges, GPs recognize the importance of communication skills, with 94% considering them as vital as diagnostic and treatment skills. This highlights the need for ongoing training and development of communication skills to improve interactions with patients and enhance the effectiveness of vaccination programs. In conclusion, addressing misinformation, promoting patient responsibility, and reducing administrative burdens are essential steps towards improving communication and increasing vaccination rates among the Bulgarian population.
subject: Articles
  topic: section
subject: General Practitioners (GPs)
  topic: keywords
subject: communication plan
  topic: keywords
subject: flu vaccination
  topic: keywords
subject: patient trust
  topic: keywords
subject: administrative burden
  topic: keywords
creator: Mario Rachev
creator: Radka Goranova-Spasova
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-21
publication date: 2026-03-21
starting page: 15
ending page: 19
doi: 10.35120/medisij0501015r

REHABILITATION STRATEGIES FOR MEDIAL TIBIAL STRESS SYNDROME: A PHYSIOTHERAPY PERSPECTIVE
type: item
description: Chronic overuse is a social problem that affects not only athletes but also the general population. It can lead to a variety of injuries, including microtears, stress fractures, tendinitis, and articular cartilage damage. Medial tibial stress syndrome (MTSS), commonly known as "shin splints," is a frequent overuse injury among athletes and physically active individuals. It is often ignored or mismanaged, which results in complications, reduced physical activity, and impaired quality of life. MTSS is characterized by pain along the medial border of the tibia induced by physical activity, often associated with repetitive loading, biomechanical dysfunctions, and training errors. Pain typically worsens with activity and subsides with rest. Risk factors include gender, navicular bone drop, elevated body mass index, high-intensity activities, and increased external hip rotation range in males. Patients often report bilateral pain in the distal leg, particularly on the anterior and medial aspects. The medial tibial border—most commonly in the distal third—is a frequent pain site, though shin splints can affect the entire length of the tibia.
subject: Articles
  topic: section
subject: Physiotherapy
  topic: keywords
subject: medial tibial stress syndrome
  topic: keywords
subject: rehabilitation
  topic: keywords
subject: chronic overuse
  topic: keywords
creator: Kristian Stoychev
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 57
ending page: 61
doi: 10.35120/medisij040457s

LEVELS OF GENE EXPRESSION FOR LAD1 AND EGFR IN PATIENTS WITH LARYNGEAL CANCER
type: item
description: Laryngeal cancer is a multiheterogenic disease. Numerous genetic mechanisms are known to be involved in oncogenesis, disease progression, and patient survival prognosis. Some authors speculate that there is a genetic difference between the primary site and the secondary metastasis. We analyzed the known mutations associated with squamous cell cancers. We decided to evaluate gene expression levels of LAD1 and EGFR at three sites: the primary laryngeal site, the tumor periphery, and the lymph node suspected of metastatic spread. In this current study, we present patients operated on for advanced-stage laryngeal cancer. In every patient, a bilateral neck dissection has been performed as well as a total laryngectomy. The cohort consists of 20 patients. The tissues were fresh-frozen in liquid nitrogen, transported to the Genetics Department at Medical University Sofia, and evaluated by real-time PCR. Every tissue sample was pathologically evaluated. In the evaluated tissue samples, we identified gene expression differences between LAD1 and EGFR, even within samples from the same patient. 100 % of the patients are heavy smokers. 100% of the patients are male. We established a notable difference in EGFR and LAD1 gene expression. In some cases, even in different sites of the same patient. There may be prognostic value in LAD1 expression levels and in tumour progression and metastasis. Further studies are needed to establish and validate LAD1 as a predictive marker.
subject: Articles
  topic: section
subject: advanced laryngeal cancer
  topic: keywords
subject: oncogenetics
  topic: keywords
subject: LAD
  topic: keywords
subject: laryngectomy
  topic: keywords
subject: neck dissection
  topic: keywords
subject: oncological surgery
  topic: keywords
creator: Venelin Marinov
creator: Savina Hadjidekova
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 45
ending page: 49
doi: 10.35120/medisij040445v

SPEECH AND ORTHODONTIC ANALYSIS IN CHILDREN WITH SYMPTOMS OF OBSTRUCTIVE SLEEP APNEA - PILOT STUDY
type: item
description: The topic of children's sleep health and the consequences that arise from its disorders is becoming an increasingly relevant and discussed topic. The interdisciplinary team is united around the idea that the manifestation of symptoms of obstructive sleep apnea is also associated with manifestations of orthodontic deformities, as well as communication disorders. The purpose of this study is to investigate the relationship between obstructive sleep apnea, speech disorders, and orthodontic deformities. Methodology: For this study, nine children were examined, their histories were taken, and diagnoses were provided by an ENT specialist, an orthodontist, and a speech-language therapist. Each parent completed the sleep questionnaire after an otorhinolaryngological examination. For the study of language and speech, the "Methodology for assessing the educational needs of children and students" was applied, as well as the Diagnosis and prevention of language 3–4. Orthodontic diagnostics was performed through a primary examination by an orthodontist. The patients were given a photo protocol with extra- and intraoral photographs; digital impressions were taken; X-ray examinations were prescribed (orthopantomography and teleradiography); and they underwent a detailed orthodontic analysis. Results: The PSQ results divided the children into a clinical group (five) and a borderline group (four). The ENT diagnosed adenoid vegetation in all children, grades III-IV, and four with hearing loss after audiometry and tympanometry. In three children from the clinical sample, disorders of receptive language were observed, and in one, an expressive language disorder was also present. Among the children with a borderline value according to the PSQ, one child with an expressive form of language disorder stood out. All children were diagnosed with an articulation disorder of the polymorphic type. The orthodontic examination in the clinical group identified two children with an Angle Class II o…
subject: Articles
  topic: section
subject: adenoid vegetation
  topic: keywords
subject: orthodontic analysis
  topic: keywords
subject: ENT
  topic: keywords
subject: speech and language disorders
  topic: keywords
subject: upper jaw compression
  topic: keywords
subject: distal bite
  topic: keywords
subject: open bite
  topic: keywords
creator: Tsvetomira Boycheva
creator: Ekaterina Todorova
creator: Venelin Marinov
creator: Greta Yordanova
creator: Gergana Gurgurova
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 33
ending page: 40
doi: 10.35120/medisij040433b

EFFECTIVENESS OF LACTOBACILLUS JENSENII IN TREATING VAGINAL AND UROGENITAL INFECTIONS: AGE-RELATED DIFFERENCES IN RESPONSE AND IMMUNE FUNCTION
type: item
description: This study aimed to evaluate the effects of Lactobacillus jensenii on vaginal and urogenital infections in women aged 20 to 45. A total of 30 participants were included, with those aged 20–35 showing the most significant improvement, as no pathogens or infections were detected post-treatment. However, women older than 40 experienced persistent infections, such as bacterial vaginosis, vaginal candidiasis, and urinary tract infections, despite the probiotic treatment. These results indicate that older women may have reduced immune function and hormonal changes that hinder the effectiveness of probiotics.The findings suggest that L. jensenii can effectively reduce pathogen presence and infections in younger women, likely due to their stronger immune response and hormonal balance. However, in older women, the decreased immune function and altered hormonal levels, such as during postmenopause, might prevent complete resolution of infections. This age-related immune sensitivity, combined with shifts in vaginal microbiota, may necessitate more personalized and multifaceted therapeutic approaches for older populations.Moreover, while probiotics like L. jensenii show promise in restoring microbial balance and preventing infections, the persistence of infections in older women implies that additional therapies may be needed to support the immune system and optimize microbial management. Further research is needed to explore combined probiotic therapies or integrative approaches to improve long-term outcomes for women in this age group. Additionally, attention should be given to factors like comorbidities and previous infections, which could contribute to the higher frequency of infections in older women.This study underlines the potential of Lactobacillus jensenii as a therapeutic agent for vaginal and urogenital health, but also emphasizes the need for age-specific treatment strategies that account for immunological and hormonal changes in postmenopausal women.
subject: Articles
  topic: section
subject: Lactobacillus jensenii
  topic: keywords
subject: menopauze
  topic: keywords
subject: infection
  topic: keywords
subject: bacterial infection
  topic: keywords
subject: vaginal candidiasis
  topic: keywords
creator: Una Suljić Fatić
creator: Lana Lekić
creator: Gabrijela Malesevic
creator: Valentina Soldat Stanković
creator: Nina Pinjuh Markota
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 27
ending page: 31
doi: 10.35120/medisij040427s

SILENT INTRUDERS: HOW STREPTOCOCCUS AGALACTIAE AFFECTED THE PREGNANCY OF PRETERM BIRTHS
type: item
description: Cervico-vaginal infection with Streptococus agalactiae is a known risk factor for premature rupture of amniotic membranes and preterm birth, significantly increasing the incidence of neonatal complication such as sepsis, pneumonia, neonatal meningitis etc. This study analyzes the impact of cervico-vaginal infection with Streptococcus agalactiae on preterm birth using clinically collected data from our patients.This prospective, analytical study included 819 women with preterm delivery in the period between January 1, 2023, and December 31, 2023, at the University Hospital and Clinical Service of Kosovo, Clinic of Gynecology and Obstetrics in Prishtina, Kosovo. Cervico-vaginal samples were collected and analyzed for Streptococcus agalactiae using standard microbiological and PCR methods. Preterm birth was defined according to WHO guidelines (birth before the 37th week of gestation). Data were analyzed using SPSS v.26 with the Chi-square (χ²) test, t-test, and Mann-Whitney U test. As statistically significant was used p <0.0001. The prevalence of cervico-vaginal infection with Streptococcus agalactiae was 11.44% (74 cases). Infection was associated with significantly increased leukocytes and CRP in mothers and newborns, lower birth weight, lower Apgar scores, and a higher probability of cesarean section. A statistically significant association was found between infection and preterm birth (p<0.0001). Cervico-vaginal infection with Streptococcus agalactiae significantly contributes to preterm birth. Early screening and treatment of this infection is essential for preventing preterm birth.
subject: Articles
  topic: section
subject: Streptococcus agalactiae
  topic: keywords
subject: preterm birth
  topic: keywords
subject: bacterial vaginosis
  topic: keywords
subject: inflammation
  topic: keywords
creator: Fisnik Sinani
creator: Jadranka Georgievska
creator: Sajra Birdaini
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 21
ending page: 25
doi: 10.35120/medisij040421s

PERFORMANCE PROFILLING AND DATA ANALYTICS IN ELITE SHORT TRACK SPEED SKATING: A CASE STUDY OF THE HUNGARIAN OLYMPIC TEAM
type: item
description: This study explores the composition and performance of the Hungarian Olympic short track speed skating team, with a focus on data-driven analysis to assess trends, strategies, and athlete development. Hungary has emerged as a competitive force in short track speed skating, notably securing its first Winter Olympic gold medal in 2018. By compiling biographical and performance data of team members across multiple Olympic cycles, the analysis identifies key factors contributing to success, including age, experience, specialization (e.g., 500m vs. 1500m), and team dynamics in relay events. Advanced performance metrics such as lap times, split consistency, and overtaking patterns are examined using statistical and machine learning techniques to uncover predictive indicators of medal contention. The research also highlights the importance of strategic decision-making, pacing, and positioning, especially in relay events where Hungary has consistently excelled. This study provides insights into how data analysis can be used to enhance training, selection, and race strategies, offering a model for other national teams seeking to improve performance through evidence-based approaches.
subject: Articles
  topic: section
subject: data analysis
  topic: keywords
subject: performance optimization
  topic: keywords
subject: short track speed skating
  topic: keywords
subject: biomechanics
  topic: keywords
creator: Imre Emil
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 15
ending page: 19
doi: 10.35120/medisij040415i

ARTIFICIAL INTELLIGENCE IN DRUG DEVELOPMENT: CURRENT APPLICATIONS, CHALLENGES AND FUTURE PERSPECTIVES
type: item
description: Drug development is a complex, time-consuming, and costly process, with average timelines exceeding a decade and success rates remaining low. Artificial intelligence (AI) has emerged as a transformative tool with the potential to accelerate and optimize every stage of the drug development pipeline. By leveraging vast biomedical datasets, advanced algorithms, and computational power, AI can support target identification, predict molecular properties, design novel compounds, and optimize clinical trial processes. Recent advances in machine learning, deep learning, and natural language processing have demonstrated the ability to uncover patterns and relationships beyond the reach of conventional approaches. AI-driven platforms have already contributed to the discovery of promising therapeutic candidates and facilitated more efficient decision-making. Despite significant progress, challenges remain in data quality, model interpretability, regulatory acceptance, and ethical considerations. This review provides a comprehensive overview of AI methodologies applied to drug discovery and development, highlights notable case studies from academia and industry, and critically examines both the opportunities and limitations of these technologies. We also explore future directions, including integration with complementary technologies, collaborative data sharing models, and evolving regulatory frameworks. By evaluating the current state and potential of AI in pharmaceutical research, this article aims to provide scientists, clinicians, and policymakers with a clear understanding of how AI can be harnessed to transform the drug development landscape.
subject: Articles
  topic: section
subject: Artificial intelligence
  topic: keywords
subject: drug discovery
  topic: keywords
subject: machine learning
  topic: keywords
subject: clinical trials
  topic: keywords
subject: pharmaceutical innovation
  topic: keywords
creator: Marija Dimitrovska
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 1
ending page: 5
doi: 10.35120/medisij040403d

RADIOLOGICAL FEATURES OF LUNG CANCER SUBTYPES: A STUDY OF CT PATTERNS AND PATHOLOGICAL CORRELATES
type: item
description: Primary lung cancer encompasses heterogeneous histopathological subtypes with distinct clinical and radiological features. Accurate correlation of CT patterns with histology can improve diagnostic assessment and contribute to earlier recognition of aggressive tumor behavior. A retrospective study was conducted on 33 patients (25 males, 8 females; mean age 67.3 years) with histologically confirmed primary lung cancer. Demographic factors, smoking history, histological subtype, and CT characteristics—including lesion size, lobar and segmental distribution, necrosis, and metastatic spread—were analyzed. Radiological staging was performed according to the TNM system, and findings were correlated with histopathology. Results: Histology: Adenocarcinoma was the most frequent subtype (51.5%), followed by squamous cell carcinoma (27.3%), with fewer cases of large cell, small cell, mixed, and plano-cellular carcinomas. Adenocarcinoma predominated in both smokers and non-smokers, whereas squamous carcinoma was more frequent among smokers. Tumor size and location: Mean lesion diameter was 5.9 cm (range: 1.5–13 cm). The most common sites were the right lower lobe (33.3%) and right upper lobe (30.3%), particularly in posterior basal and posterior segments. Necrosis: Present in 54.5% of tumors, necrosis was more frequent in squamous carcinomas (44.4%) compared with adenocarcinomas (33.3%), while adenocarcinomas were more often necrosis-free (75%). Metastases: Distant spread occurred in 27.3% of patients, predominantly to adrenal glands (44.4%) and brain (22.2%), with additional involvement of liver (11.1%) and lymph nodes/contralateral lung (55.6%). Adenocarcinoma accounted for two-thirds of metastatic cases. Staging: Advanced disease predominated, with stage IIIB (27.3%) and stage IVA (18.2%) most frequent. Only 24.2% of patients were diagnosed at early operable stages (IA–IIB). CT–pathology correlation demonstrated that adenocarcinoma is the predominant subtype across smoking ca…
subject: Articles
  topic: section
subject: Computed tomography
  topic: keywords
subject: lung cancer
  topic: keywords
subject: adenocarcinoma
  topic: keywords
subject: squamous cell carcinoma
  topic: keywords
subject: necrosis
  topic: keywords
subject: TNM staging
  topic: keywords
subject: metastases
  topic: keywords
creator: Sonja Nikolova
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 7
ending page: 14
doi: 10.35120/medisij040404n

ANTI-XA ACTIVITY IN CHILDREN ON TREATMENT AND PROPHYLAXIS WITH LOW MOLECULAR WEIGHT HEPARIN
type: item
description: In recent years, the use of low molecular weight heparins (LMWHs) for the prevention and treatment of thrombosis in children has increased. This is due to the increased percentage of critically ill children and the rate of thrombotic events. The efficacy and dose-dependent laboratory and clinical response data to achieve target levels in treatment and prophylaxis with LMWH have not yet been clarified. According to recommendations from leading experts in the field, monitoring of anti-Xa activity is mandatory in children receiving LMWH. However, there are still many questions about the most appropriate dose and time to achieve target anti-Xa levels. Objective: To investigate and monitor anti-Xa activity in pediatric patients of different age groups undergoing prophylaxis or treatment with LMWH. Material and Methods: We studied 22 children (mean age of 11.77±1.6 years) with malignant diseases, ischemic stroke, cerebral venous sinus thrombosis, deep vein thrombosis (DVT) and multisystem inflammatory syndrome. 41% (n=9) of the children were on treatment with LMWH and 59% (n=13) on prophylaxis, with the dose adjusted for age and weight. Plasma levels of anti-Xa activity were determined by chromogenic anti-Xa assay on a Sysmex CS 2500 coagulation system, using LMWH-specific calibrators and controls. Screening coagulation tests were also performed. Results: In 30.7% (n=4) of the children on prophylaxis, plasma levels of anti-Xa activity were lower than the recommended prophylactic range and in 55.5% (n=5) of the children on treatment, anti-Xa levels were below the therapeutic range. Conclusion: Our findings support current clinical recommendations that emphasize personalized dose adjustment guided by serial anti-Xa measurements. Active and dynamic monitoring of plasma levels of anti-Xa activity in pediatric patients on treatment and prophylaxis with LMWH is essential for optimizing the efficacy of anticoagulant therapy while minimizing its adverse effects.
subject: Articles
  topic: section
subject: anti-Xa activity
  topic: keywords
subject: children
  topic: keywords
subject: low molecular weight heparin
  topic: keywords
subject: thrombosis
  topic: keywords
creator: Snezhana Stoencheva
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 51
ending page: 56
doi: 10.35120/medisij040451s

COMPARISON OF THE EFFECTS OF TWO PHYSIOTHERAPY APPROACHES IN THE TREATMENT OF CERVICO-THORACIC SYNDROME
type: item
description: Cervico-thoracic syndrome is extremely common in modern life, which motivated us to investigate it - specifically in the cervico-thoracic region. This condition is characterized by impaired posture, often resulting in pain, which is the most frequent complaint among affected individuals. Objective: The aim of this study was to examine and compare the effects of selected physiotherapeutic interventions in the treatment of cervico-thoracic syndrome. Materials and Methods: The study included 24 patients experiencing cervical pain accompanied by motor deficits and postural disturbances. Participants were divided into two groups: Group A (control) and Group B (experimental). Both groups underwent a physiotherapy program consisting of 10 sessions over 15 days. Group A (Control): Ultrasound therapy applied to the cervico-thoracic junction, medical massage of the cervico-thoracic region, post-isometric relaxation, and kinesitherapy. Group B (Experimental): Techniques for soft tissue mobilization in the form of manipulative massage, positional release techniques, and kinesitherapy. To assess treatment effectiveness, measurements were taken before and after therapy, including subjective pain assessment (VAS), Cervical mobility palpatory evaluation of muscle tone. Results: Both therapeutic approaches demonstrated positive effects on patients’ conditions, with slightly better outcomes observed in the experimental group. Differences were noted across all measured parameters. Conclusion: The application of soft tissue manipulation techniques combined with kinesitherapy has a beneficial effect on pain reduction, correction of muscle imbalance, and improvement of movement range and control. Restoration of normal function begins with pain control, which enables better and more accurate proprioception. These findings are consistent with previous research.
subject: Articles
  topic: section
subject: Cervico-thoracic syndrome
  topic: keywords
subject: physiotherapy
  topic: keywords
subject: kinesitherapy
  topic: keywords
subject: soft tissue mobilization
  topic: keywords
creator: Ivica Docevski
creator: Toshe Krstev
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 41
ending page: 44
doi: 10.35120/medisij040441d

INFLUENCE OF NUTRITIONAL FACTORS ON LIPID PROFILE AND LEVELS OF MAGNESIUM, COPPER, ZINC, SELENIUM AND RUBIDIUM
type: item
description: Background: Nutrition has been shown to significantly influence the biomarkers of both the multielement status and the lipid profile. However, there are some specific local environmental and genetic factors, that define the substantial variability of their levels in different populations. Several large studies in the last decade report that Bulgaria is among the first countries in the European Union in terms of premature death from cardiovascular diseases under the age of 65. This emphasizes the importance of the recommended annual screening of the lipid profile by adults. The essential role of the elements copper (Cu), zinc (Zn), selenium (Se), rubidium (Rb) and magnesium (Mg) for the antioxidant and immune defense of the body has been a subject of scientific interest in the last thirty years. However, there is scarce data on the influence of nutrition habits of Bulgarians on the serum levels of Mg, Cu, Zn, Se, and Rb. Aim: To determine the serum levels of Mg, Cu, Zn, Se, Rb, total cholesterol, LDL-, HDL-cholesterol, and triglycerides, and evaluate their relationship with nutrition. Methodology: A group of 107 directly selected healthy volunteers of Bulgarian nationality (50 males and 57 females, aged 18 to 65 years) were included in the study. Exclusion criteria were acute or chronic diseases, and intake of dietary supplements containing Se, Zn, Cu, Rb and Mg in the last 6 months. Venous blood serum levels of Cu, Zn, Se, Rb, and Mg were determined via collision cell inductively coupled plasma mass spectrometry (ICP-MS). Enzymatic methods were used to measure total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides. Results: In participants consuming fish less than once a week, we measured significantly lower Se levels (р < 0.0001) and lower LDL-cholesterol (p = 0.038). Significantly higher total cholesterol levels were found in the group consuming meat less than twice a week (p = 0.038). We observed suboptimal Se levels (less than 80 μg/L) in 42% of …
subject: Articles
  topic: section
subject: nutrition, minerals; trace elements, lipid profile, atherosclerotic risk.
  topic: keywords
creator: Delyana Davcheva
creator: Gergana Kirova
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-25
publication date: 2025-09-25
starting page: 63
ending page: 67
doi: 10.35120/medisij0403063d

PROVING THROMBOPHILIA IN SYMPTOMS OF HYPERSPLENISM
type: item
description: Our interest in proving thrombophilia in symptoms of hypersplenism was sparked by a common and, at first glance, innocent clinical symptom - heaviness or pain in the left lower abdomen, in patients with anemia caused by iron deficiency or vitamin deficiency B12. We aimed to investigate some aspects of hypersplenism. Our task was to pay attention to how some, insignificant at first glance, clinical symptoms could hide the pathogenesis of tomophilias. For the realization of this task, we examined 130 patients, using their subjective complaints, supplemented them with abdominal ultrasound and laboratory blood analysis (PCK - WBC count; Er; Thr (thrombopenia; erythropenia; leukopenia;-pancytopenia), morphology of erythrocytes, morphology of platelets. Biochemistry - bilirubin - total and direct, iron, VLDL, VLDL, ferritin, vitаmin B12, etc. Coagulation - bleeding time). In the course of the study, we found that more than two-thirds of the patients with the diagnosed disease (97 people) complained of this type of heaviness or pain, which appeared very often after physical, and in some cases even after nervous- mental strain. Often, precisely these symptoms are the reason, if the patient comes to a competent doctor, to do the right tests, to make the correct diagnosis and to start adequate treatment. In the specific setting, we found that with adequate application of the substitution therapy and reaching the laboratory parameters characterizing the recovery, the pain and severity subside. Such symptoms, however, should always provoke the difficult and often very unpleasant diagnosis of thrombophilias in terms of differential diagnosis.
subject: Articles
  topic: section
subject: thrombophilia; hypersplenism; iron; ferritin; vit. B12.
  topic: keywords
creator: Stoyanka Tancheva
creator: Dilyana Zvezdova
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-25
publication date: 2025-09-25
starting page: 51
ending page: 54
doi: 10.35120/medisij0403051t

QUALITY IN TERMS OF DENTAL HEALTH SERVICES
type: item
description: Providing quality medical and dental services has become a major task and priority of every health system. Dental medicine, as an integral part of primary and specialized medical care, in order to function properly requires clear and reliable indicators for assessing the dental care, which ensure that the dental services provided are timely, safe, effective and focused on the specific needs of the patient. In recent decades, there has been a significant increase in interest in measuring and assessing the quality of dental services and various research approaches have been used for this purpose. The most widely used quality assessment model is Donabedian’s invented in 1988, which categorizes the assessment indicators into three main groups: structure, process and outcome. Aim: The present study aims to present a systematic review of dental service quality indicators and to assess their applicability in clinical practice. Materials and methods: A systematic review of the scientific literature on the topic published in the period from 1980 to 2025 was conducted, including articles from the databases PubMed, Web of Science (WoS), Scopus, Wiley. Keywords which were used for the purposes of scientific research are: “oral health care quality”, “quality of dental services”, “dental quality indicators”, “Donabedian´s model”. Only publications with validated indicators for assessing the quality of dental services were included in the scientific study. Results: The results of the scientific study show that the most frequently used indicators are from the process group, which reflects the desire for traceability and control over daily clinical dental activity. Outcome indicators, such as the indicator of patient satisfaction with the provided dental care and Oral Health- related Quality of Life (OHRQoL), are described in the scientific literature as being more difficult to measure. Digitalization in dentistry creates the need to create new indicators, such as Dental Data Synthe…
subject: Articles
  topic: section
subject: oral health care quality, quality of dental services, dental quality indicators
  topic: keywords
creator: Gergana Georgieva
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-25
publication date: 2025-09-25
starting page: 41
ending page: 45
doi: 10.35120/medisij0403041g

PULMONARY REHABILITATION IN THE ELDERLY PATIENT
type: item
description: Ageing is a physiological process in which body deterioration is observed, which is associated with a variety of pathologies in different organs and systems, most often of the cardiovascular, respiratory and nervous systems. Degenerative joint diseases also become more frequent in elderly and old people. The chronic respiratory diseases are common in the elderly patient, and therefore the application of pulmonary rehabilitation is of utmost importance. It includes special breathing exercises and techniques that improve the function of the respiratory system, the general body condition and the quality of life of the elderly patient. The aim of the present review was to analyse the literature sources associated with the application and effects from pulmonary rehabilitation in elderly patients with chronic respiratory illnesses and following COVID-19. The research methodology includes a literature overview of scientific publications in the following databases: Research Gate, PubMed, Google Scholar. According to the reviewed scientific sources, the application of breathing exercises has a beneficial effect on respiratory function and the quality of life in elderly patients. The pulmonary rehabilitation is used in chronic diseases of the respiratory system and in patients recovering from COVID. It is applied in clinical, outpatient and sanatorium settings. The respiratory rehabilitation improves the lung vital capacity, respiratory volume and psycho-emotional tone of elderly patients.
subject: Articles
  topic: section
subject: chronic respiratory illnesses, pulmonary rehabilitation, elderly people, quality of life.
  topic: keywords
creator: Violeta Ivanova
creator: Ruska Paskaleva
creator: Vanya Pavlova
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-25
publication date: 2025-09-25
starting page: 1
ending page: 4
doi: 10.35120/medisij0403001i

BOTTLED OR TAP WATER – THE CONSUMER’S CHOICE?
type: item
description: This study investigates consumer preferences between bottled and tap water, emphasizing health concerns, environmental awareness, and sociodemographic influences. An anonymous survey was conducted among 79 students and workers at the Medical University of Plovdiv, Bulgaria, between April and May 2025. The questionnaire included 40 questions regarding water consumption habits, health perceptions, environmental attitudes, and demographic data. Findings show that 55.7% of respondents consume bottled water daily, while 46.8% consume tap water. The preference for consuming mostly bottled water or the choice of tap water is related to the situation in which consumers find themselves. Although many prefer bottled water due to taste and safety concerns, 88.6% would drink tap water if properly filtered, and 77.2% would pay more for improved tap water quality. According to 74.7%, long-term consumption of water stored in plastic bottles poses serious health risks, and 82.3% would not reuse plastic water packaging. A large proportion (78.5%) support banning single-use plastic bottles, and 94.9% favor alternative packaging. Over 74% believe bottled water poses long-term health risks. Despite recognizing health and environmental risks, bottled water consumption remains high. Public education, programе development, improved infrastructure, and promotion of safe, filtered tap water are essential to shift consumer behavior toward sustainable choices.
subject: Articles
  topic: section
subject: bottled water, tap water, consumer behavior, environmental awareness, health risks.
  topic: keywords
creator: Paolina Yavorova
creator: Stanislava Harizanova
creator: Elka Toseva
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-25
publication date: 2025-09-25
starting page: 31
ending page: 36
doi: 10.35120/medisij0403031y

HERBAL SEDATIVES AND HYPNOTICS: A COMPARATIVE ANALYSIS OF THEIR USE IN THE WESTERN REGION OF NORTH MACEDONIA
type: item
description: This study aims to analyze the use of herbal sedatives in North Macedonia, comparing their usage to conventional sedatives and hypnotics. The analysis examines sales data of herbal and conventional sedatives from January 2022 to December 2024, collected from pharmacies in the western region of North Macedonia. The findings reveal that the use of herbal sedatives is relatively low, ranging from 1.2% in Tetovo to 7% in Struga, although there is an increase in demand in certain cities. Despite this growth, the overall use of herbal sedatives remains limited. Furthermore, the study underscores the need for developing healthcare policies that integrate herbal sedatives into the healthcare system. This can be achieved through the creation of educational programs, training for healthcare professionals, and the establishment of guidelines for the safe and effective use of these medicines. Such integration could lead to an increase in the use of herbal sedatives and improve public health by providing new treatment options for sleep and anxiety disorders.
subject: Articles
  topic: section
subject: herbal sedatives
  topic: keywords
subject: anxiety disorders
  topic: keywords
creator: Arijeta Shabani
creator: Mirlind Bexheti
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-05-18
publication date: 2025-05-18
starting page: 41
ending page: 47
doi: 10.35120/medisij040241s

ADVANCES IN FOOT MEASUREMENT: IMPLICATIONS FOR PHYSIOTHERAPEUTIC DIAGNOSIS AND INTERVENTION
type: item
description: The human foot is a vital structure responsible for stability, balance, and efficient movement. Its anatomical complexity requires precise and reliable assessment methods, especially within physiotherapy practice. This study aims to present and analyze contemporary foot measurement techniques, including podometry, plantography, 3D scanning, baropodometric analysis, and functional testing. A comprehensive review of the scientific literature was conducted to evaluate the applicability, reliability, and clinical value of each method. The results demonstrate that digital technologies such as 3D scanning and baropodometry provide high accuracy and objectivity, while traditional techniques like podometry and plantography remain widely used due to their affordability and accessibility. Combining multiple methods enables comprehensive clinical evaluation. The choice of method should be guided by clinical objectives, resource availability, and the therapist’s expertise.
subject: Articles
  topic: section
subject: biomechanics, postural analysis, plantar pressure, physiotherapy, functional assessment.
  topic: keywords
creator: Kristian Stoychev
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-25
publication date: 2025-09-25
starting page: 47
ending page: 50
doi: 10.35120/medisij0403047s

THE EFFECTS OF KINESITHERAPY ON FUNCTIONAL PARAMETERS (MUSCLE STRENGTH AND RANGE OF MOTION) IN PATIENTS WITH RHEUMATOID ARTHRITIS
type: item
description: Rheumatoid arthritis (RA) is a chronic and progressive autoimmune disease characterized by joint pain, inflammation, and limited mobility. This condition leads to a significant deterioration of functional capacity and a reduced quality of life for patients. Kinesitherapy represents a non-pharmacological alternative in the management of rheumatoid arthritis, playing a crucial role in maintaining muscle strength and joint mobility. These factors are known to improve the lives of these patients. The purpose of this study was to evaluate the effects of a structured 12-week kinesitherapy program on improving functional parameters such as range of motion (ROM) and muscle strength in patients diagnosed with rheumatoid arthritis. The study included 30 patients with a confirmed diagnosis of RA. Patients were evaluated before and after the therapy, with functional parameters of muscle strength measured using the manual muscle strength scale (0-5), and ROM measured in degrees using a goniometer. The statistical results showed a significant improvement in both parameters. The average muscle strength increased from 3.32 (±0.73) to 4.14 (±1.05), while the average ROM increased from 39.06° (±13.91°) to 46.88° (±18.06°). These findings highlight that a structured kinesitherapy program contributes to increased strength and joint flexibility. The improvement in functional capacities significantly impacts the increase in independence and a reduction in disability among patients with rheumatoid arthritis. The study suggests the integration of kinesitherapy into multidisciplinary treatment programs for RA. For confirmation of these results and for determining long-term effects, further research with control groups and a larger sample size is needed.
subject: Articles
  topic: section
subject: rheumatoid arthritis, kinesitherapy, range of motion (ROM), muscle strength, rehabilitation.
  topic: keywords
creator: Lorena Merolli
creator: Ekaterina Mitova
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-25
publication date: 2025-09-25
starting page: 37
ending page: 40
doi: 10.35120/medisij0403037m

HRCT PATTERNS IN FIBROTIC INTERSTITIAL LUNG DISEASES: COMPARATIVE ANALYSIS OF IDIOPATHIC PULMONARY FIBROSIS, SARCOIDOSIS, HYPERSENSITIVITY PNEUMONITIS, AND CONNECTIVE TISSUE DISEASE–RELATED ILD
type: item
description: High-resolution computed tomography (HRCT) remains the cornerstone in the non-invasive evaluation of fibrotic interstitial lung diseases (ILDs), providing essential information for diagnostic classification and guiding clinical management. Despite well-established imaging criteria, many fibrotic ILDs share overlapping features that can complicate interpretation. This study aimed to evaluate and compare the HRCT patterns of idiopathic pulmonary fibrosis (IPF), sarcoidosis, fibrotic hypersensitivity pneumonitis (fHP), and connective tissue disease–associated ILD (CTD-ILD) in a single-center cohort, highlighting the distinguishing characteristics that aid in differential diagnosis. A total of 50 patients with multidisciplinary consensus diagnosis were retrospectively included: 15 with IPF, 12 with sarcoidosis, 13 with fHP, and 10 with CTD-ILD. All underwent volumetric inspiratory HRCT with collimation ≤1.5 mm. Image interpretation was performed by one experienced thoracic radiologist with over 10 years of subspecialty practice, who assessed the scans for zonal predominance, axial distribution, and fibrotic features including reticulation, honeycombing, traction bronchiectasis, ground-glass opacity, mosaic attenuation, and nodules. In the IPF group, fibrosis was predominantly basal and subpleural in 93% of cases, with honeycombing in 80% and traction bronchiectasis in 87%, while mosaic attenuation was rare. Sarcoidosis was characterized by upper- and mid-lung predominance in 75%, perilymphatic nodules in 83%, bronchial distortion in 58%, and less frequent honeycombing (25%). fHP showed diffuse or mid-lung fibrosis in 69% of patients, mosaic attenuation in 85%, lobular air-trapping in 77%, and centrilobular nodules in 54%. CTD-ILD was most often associated with peripheral or peribronchovascular fibrosis (60%), an NSIP-like pattern in 70%, ground-glass opacity in 65%, and traction bronchiectasis in 55%. Comparative analysis demonstrated statistically significant differenc…
subject: Articles
  topic: section
subject: HRCT, idiopathic pulmonary fibrosis, sarcoidosis, hypersensitivity pneumonitis, connective tissue disease, interstitial lung disease.
  topic: keywords
creator: Sonja Nikolova
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-25
publication date: 2025-09-25
starting page: 17
ending page: 24
doi: 10.35120/medisij0403017n

THE ROLE OF Ca 15-3 IN THE DIAGNOSIS AND SCREENING OF BREAST CANCER
type: item
description: Tumor markers are specific substances secreted by healthy cells of the body as an immune response to the presence of malignant cells. Determination of the concentration of the tumor marker Ca 15-3 in serum is used to monitor breast cancer, i.e. the effect of the applied anticancer therapy. The increase or decrease in the concentration of the marker Ca 15-3 is correlated with the progression or regression of the disease. Carcinoma mammae or breast cancer occurs when abnormal cells begin to grow and multiply in the tissue, creating a benign or malignant tumor mass. The most common risk factors for the occurrence of breast cancer are hereditary gene mutations of the tumor suppressor genes BRCA1, creates tumors that do not grow under the influence of estrogen hormones, or BRCA2, creates tumors that need estrogen hormones for their growth. Men can also get breast cancer, but less often in about 1% of cases. The most common type of cancer is ductal carcinoma of the epithelial ductal cells, in the glandular tissue, lobular carcinoma, and less commonly lymphoma and sarcoma. Breast cancer develops in 4 stages, of which in the second stage it metastasizes to the other breast, in the third to the lymph nodes and in the fourth stage it metastasizes to more distant organs. It is most often treated with chemotherapy, hormone therapy or complete removal of the breast (mastectomy). The aim of the research and determination of the level of the tumor marker Ca 15-3 was to establish a suspected diagnosis of Carcinoma mammae, which with further testing and investigations will determine a final diagnosis. The aim was also to confirm the success of the treatment with anticancer drug therapy. For this purpose, patients aged 30-60 years were divided into 3 groups: a control group with a normal level of Ca 15-3 in serum, a group of patients with a confirmed diagnosis of Carcinoma mammae, and a group of patients treated with therapy to reduce the level of Ca 15-3, Tamoksifen. The determinati…
subject: Articles
  topic: section
subject: Ca 15-3, Carcinoma mammae, Tamoksifen, estrogen blockers.
  topic: keywords
creator: Mire Spasov
creator: Hristijan Spasov
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-25
publication date: 2025-09-25
starting page: 25
ending page: 29
doi: 10.35120/medisij0403025s

INFLUENCE OF BREATHING EXERCISES AND RESPIRATORY REHABILITATION ON POSTURAL DISORDERS IN CHILDHOOD AND ADULTHOOD
type: item
description: Postural abnormalities in childhood and adulthood are a relevant medical and social problem associated with significant alterations of the spine and several internal organs and systems. Impaired posture, spine and chest deformities impair the respiratory and cardiovascular functions. Breathing exercises, respectively respiratory rehabilitation, are an key means exerting a beneficial influence on the impaired functions of these organs and systems, and are also successfully applied in musculoskeletal pathologies. The aim of the study was to overview the scientific reports on the influence and application of breathing exercises and respiratory rehabilitation in various postural disorders in childhood and adulthood. For the purposes of the study, a search in electronic databases such as Pubmed, Web of Sciences, Academic search complete on EBSCO, Scopus, Google Scholar, etc. was carried out. According to the studied sources, breathing exercises are an essential part of traditional and innovative methods for conservative and surgical treatment of postural abnormalities. Studies demonstrate better results with protocols that include breathing exercises as element of the rehabilitation programme compared to those without breathing exercises. Respiratory rehabilitation plays an important role in the treatment of postural disorders in childhood and adulthood, both in their conservative and postoperative treatment. It not only improves the respiratory function, but has also a positive effect on the general posture, muscle balance and quality of life of the individual.
subject: Articles
  topic: section
subject: respiratory rehabilitation, postural disorders, breathing exercises.
  topic: keywords
creator: Vanya Pavlova
creator: Ruska Paskaleva
creator: Violeta Ivanova
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-25
publication date: 2025-09-25
starting page: 5
ending page: 10
doi: 10.35120/medisij0403005p