DOI: 10.3897/jbcr.e166383

Authors: Zlatko Kirovakov, Elitsa Petkova

Abstract: Background: Vitamin D is essential for maternal health, fetal development, and pregnancy outcomes. Despite its importance, vitamin D deficiency is highly prevalent among pregnant women, increasing the risk of gestational diabetes mellitus (GDM), preeclampsia, preterm birth, and fetal growth restriction.Objective: This article explores the impact of maternal vitamin D deficiency on pregnancy outcomes and evaluates current strategies for its management and prevention, and supplementation.Methods: We onducted a comprehensive literature review of clinical trials, meta-analyses, and systematic reviews, focusing on the association between vitamin D levels and pregnancy complications and the effectiveness of supplementation and public health interventions.]Results: Studies suggest that vitamin D deficiency is linked to poor pregnancy outcomes, including hypertension, GDM, low birth weight, and neonatal health complications. Vitamin D supplementation (600–4,000 lU/day) has shown potential benefits in reducing these risks, but the optimal dosage and screening strategies remain debated. Food fortification and sunlight exposure may be complementary approaches to improve maternal vitamin D status.Conclusion: Managing vitamin D deficiency during pregnancy requires a multifaceted approach, including early screening, appropriate supplementation, dietary interventions, and public health policies. However, further large-scale clinical trials are needed to establish standardised guidelines for universal supplementation. Addressing vitamin D deficiency can significantly enhance maternal and neonatal health outcomes, making it a crucial public health priority.

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DOI: 10.3897/jbcr.e166507

Authors: Borislava Ivanova, Eleonora Mineva-Dimitrova, Mariela Kamburova

Abstract: Introduction: According to the current regulations of the Ministry of Health of the Republic of Bulgaria, the administration of the recommended vaccines is implemented at the request of the patient and for a fee. In this context, one of the key functions of the general practitioners (GPs) within the framework of outpatient primary care is to conduct health prevention, including the performance of immunizations. In 2024, the number of general practitioners in the Pleven district with a contract with the National Health Insurance Fund (NHIF) was 176.Objective: The objective of the study was to assess the influence of general practitioners’ personal experience and commitment on the implementation and promotion of recommended vaccinations.Materials and methods: In 2024, a comprehensive survey was carried out in the Pleven district covering 82 general practitioner selected at random from a total of 176 registered in the region. To analyse the correlation between the qualitative variables, a χ2 test was applied, with statistical conclusions drawn at a significance level of 0.05. Data collection was performed through semi-structured interview and processed by SPSS Statistics v.26.Results: Data analysis revealed high vaccination coverage among the respondents – 75 (91.5%), as well as significant activity in recommending the additional immunizations – 80 (97.6%). The personal experience with the recommended vaccines had an important impact on the professional behaviour of medical professionals (χ² = 21.964, df = 1, p < 0.001, Cramer’s V = 0.518).Conclusion: The present study outlined the significant influence of personal experience with the recommended immunizations on the professional behaviour of general practitioners. That highlighted the need to increase awareness and personal commitment to vaccination among healthcare professionals as a key factor in improving vaccination coverage of the population.

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DOI: 10.3897/jbcr.e145777

Authors: Sidi Mohammed Lahbib Seddiki, Mohammed Reda Mediouni, Wafa Benkhedda, Meghnia Hafdi

Abstract: The use of cell phones during medical care is a concern due to the transmission of pathogenic bacteria between medical staff and patients. This habit can lead to treatment errors, resulting in high mortality and additional therapeutic costs. The study aims to evaluate the infectious risk associated with using cell phones in the pediatric-neonatology department in Mecheria-Algeria, focusing on identifying bacteria that contaminate cell phone surfaces, the formation of biofilms and their resistance to antibiotics. The results showed that the microbial burden on cell phone surfaces ranged from 35±5 to 28×104±120 CFU/phone surface (CFU/PS). Gram-positive strains were predominant, including Staphylococcus xylosus and Bacillus sp. However, Gram-negative bacteria such as Aeromonas hydrophila, Micrococcus sp., Pseudomonas luteola and Sphingomonas paucimobilis were also isolated. The isolated bacteria showed complete resistance to Ceftazidime, while tetracycline and ciprofloxacin appeared effective against these isolates. The ability to form microbial biofilms was one of the characteristics observed in clinical isolates from the pediatric neonatology department, alongside isolates with hydrophobicity greater than 50%. However, most strains showed strong auto-aggregation at T = 0 min to T = 90 min, suggesting that initial incubation periods allowed for high auto-aggregation potential.

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DOI: 10.3897/jbcr.e144426

Authors: Elitsa H. Gyokova, Ahamed Akkeel Anzaar

Abstract: Introduction: Abortion is the termination of pregnancy, whether spontaneous or intentional. Attitude regarding abortion varies widely according to culture or religion and even political siding. Restricted access to abortion leaves women in need vulnerable to seeking unsafe termination methods. Objectives: To gauge medical students‘ attitude regarding abortion and their willingness to carry out terminations as qualified doctors, and to establish factors that impacted their attitude towards it. A secondary aim was to assess students‘ knowledge of Bulgarian abortion laws. Methods: A cross-sectional study was conducted in the form of a self-administered questionnaire, which was then distributed and collected online. It consisted of five distinct sections: (A) sociodemographic data; (B) personal experience of abortion; (C) attitude; (D) knowledge of Bulgarian laws regarding abortion; and (E) willingness to perform abortions as qualified doctors. Results: Being Christian or Agnostic/Atheist, being in clinical years, and believing that life begins at birth showed a higher positive attitude toward abortion. On the converse, being in preclinical years, being religious, and believing that life begins at the time of conception lends itself to having a poorer attitude towards abortion. Individuals with negative attitudes denied performing abortions if the need arose during their professional careers. Conclusion: By appreciating the differences and understanding the relationships with attitudes towards abortion, we can create strategies to minimize the stigmatization of women and reduce the harm they may encounter with unsafe abortions.

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DOI: 10.3897/jbcr.e144006

Authors: Georgi Danielov Prandzhev, Grigor Angelov Gortchev, Dobromir Dimitrov Dimitrov, Radoslav Iliev Miltchev, Dimitar Rangelov, Slavcho Tomov Tomov

Abstract: Cervical cancer remains a leading cause of morbidity and mortality among women worldwide, particularly in regions with limited access to advanced medical care. Accurate and timely diagnosis of precancerous changes in the cervix is critical for effective prevention and treatment. This study introduces a deep learning algorithm for colposcopic analysis of the transformation zone of the uterine cervix. Intel & MobileODT Cervical Cancer Screening competition provided a comprehensive dataset designed to advance the application of artificial intelligence (AI) in classifying transformation zones (TZ) of the cervix, a key site where precancerous changes develop due to Human Papillomavirus (HPV) infection. This study highlights the significance of TZ classification for targeted biopsy during colposcopy, a gold-standard diagnostic method. However, challenges such as clinician’s subjectivity and interobserver variability, false negatives and positives interpretations limited accessibility, and resource intensity have spurred the integration of AI into colposcopic evaluations. The dataset comprises diverse cervical images, categorized into three types of TZs, enabling the development of AI models to distinguish between these categories. By leveraging deep learning algorithms, AI has demonstrated potential in enhancing the sensitivity and specificity of colposcopic findings while mitigating subjectivity and observer dependency. This abstract outlines the anatomical basis of cervical pathology, the critical role of colposcopy in diagnosing transformation zone abnormalities, and the transformative potential of AI in improving cervical cancer screening processes. The integration of AI-assisted tools could significantly improve diagnostic accuracy, reduce invasive procedures, and enhance access to cervical cancer prevention measures, particularly in underserved regions.

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DOI: 10.3897/jbcr.e139155

Authors: Atanas Drumev, Danelina Vacheva

Abstract: The ability of living organisms to navigate their environment is essential for survival. In scientific literature, this ability is known as locomotion, with walking being the primary mode of human movement. Our focus on the potential for independent movement within the environment arises from the high incidence of lower limb injuries and the significant number of patients requiring assistive devices to improve their walking ability, which is why we are conducting this review. The gait cycle begins with the stance phase, marked by heel contact, and consists of five subphases: initial contact, loading response, mid-stance, terminal stance, and pre-swing. The subsequent swing phase includes three subphases: initial, mid, and terminal swing. Key characteristics for assessing gait parameters are categorised into spatial and temporal indicators. Spatial indicators include stride length, step length, stride width, and foot angle, while temporal indicators encompass stance and swing phases, cadence, stride and step time, single and double support time, and speed. Human gait analysis has been done using numerous research methods, with traditional approaches being semi-subjective. Recent technological advancements have led to devices for objective evaluation, classified into non-wearable and wearable sensors. Our research focused on gait parameters to monitor recovery in patients with lower limb injuries and evaluated the G-WALK model, a wearable inertial sensor device which effectively registers spatial and temporal gait parameters.Numerous unanswered questions about gait recovery after lower extremity trauma motivated this review.

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