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Cough is a natural protective reflex of the body and plays an important role in the innate immunity of the respiratory system. It helps clear mucus, microorganisms, and irritants from the airways. The mechanism of coughing includes three phases: inhalation, compression, and exhalation. The effectiveness of a cough depends on several factors: • the proper width of the airways (narrowing reduces its efficiency), • the properties of mucus, • and the strength of the respiratory muscles. It’s very important not to suppress the cough reflex without identifying and treating the underlying cause. Cough occurs in almost all children, including premature infants (about 10% of babies born at 27 weeks and up to 90% of full-term newborns). It is one of the main clinical signs of respiratory diseases, but it can also appear in non-respiratory conditions. Types of Cough • Normal (expected) — during viral infections • Specific — with sudden shortness of breath, recurrent pneumonia, neuromuscular disorders, or chest/jaw anomalies • Nonspecific — dry cough without an identified respiratory disease (may resolve spontaneously) Cough is also classified by: 1. Cause 2. Duration: Acute — up to 4 weeks Chronic — longer than 4 weeks 3. Nature: Dry or wet (productive) Acute Cough In children, acute cough is most often associated with viral infections of the upper respiratory tract. It usually resolves on its own after the infection and rarely requires further testing. If the cough is persistent, lasts more than 4 weeks, or is accompanied by other concerning symptoms, a doctor’s visit is necessary. Acute cough may also develop after foreign body aspiration, especially in children aged 3–5 years, who tend to put small objects in their mouths. This situation requires immediate medical attention. Acute cough can indicate both respiratory and non-respiratory diseases. Respiratory causes include: nasopharyngitis, sinusitis, false croup, tracheitis, bronchitis, pneumonia, and asthma. Non-respiratory causes include neurological problems, congenital heart defects, and others. The most common cause of acute cough is the common cold, accompanied by sneezing, fever, runny or blocked nose, headache, and sore throat. These are usually self-limiting viral infections that don’t require antibiotics. However, if the child breathes rapidly, has a persistent fever, weakness, or refuses fluids — medical evaluation is necessary. Chronic Cough Chronic cough lasts more than 4 weeks and may be accompanied by wheezing, burning, breathing difficulty, nasal congestion, or hoarseness. You should see a doctor if your child has: • frequent, persistent cough, • barking or nighttime cough, • wheezing or noisy breathing, • productive cough with mucus, • rough or hoarse-sounding cough. Chronic cough may occur in both younger and older children. • In children under 5 years old, it can be caused by infections, asthma, foreign body aspiration, passive smoking, or congenital abnormalities. • In children over 5 years old, causes include asthma, prolonged bacterial bronchitis, allergies, long-term use of nasal drops, and passive smoking. What to Do During autumn, when viral infections are more common, it’s important to pay close attention to cough symptoms and seek timely care. If your child has a cough, don’t wait for it to pass on its own. Consult a pediatrician. Our clinic’s experienced doctors will identify the cause, prescribe the right treatment, and, if necessary, perform modern diagnostic tests. Our clinic offers all the necessary advanced diagnostic methods to ensure accurate diagnosis and effective treatment.

The duplex examination is a modern ultrasound method that allows for the assessment of blood circulation in the lower limbs and the structural condition of the vessels. Through this technique, it is possible to evaluate vessel patency, the degree of narrowing, the state of the vessel wall and lumen, measure vessel diameter, assess blood flow velocity, and detect deformations or the presence of atherosclerotic plaques. Advantages of Duplex Examination • Painless and short (takes about 15–30 minutes) • Absolutely safe (can be performed even during pregnancy) • Affordable and highly informative • No age or gender limitations When the Examination Is Recommended • Swelling of the legs • Feeling of heaviness or discomfort in the lower limbs • Pain or muscle tension during walking (after 10, 50, or 100 meters) • Visible varicose veins • Changes in skin color • Numbness • Vascular “stars” or pronounced subcutaneous vein changes • Diabetes mellitus People at Risk • Those with arterial hypertension • Individuals with cardiovascular diseases • People with obesity • Patients with atherosclerosis or high cholesterol • Individuals with diabetes mellitus • Smokers Duplex examination plays an important role in the early diagnosis of vascular diseases. It allows timely detection of circulation disorders, helps prescribe effective treatment, and prevents the development of complications.

An endometrial polyp is a benign growth of the uterine cavity lining. The incidence increases during reproductive age and the perimenopausal period. Main factors contributing to the development of uterine polyps 1. Hormonal imbalance Increased estrogen levels and decreased progesterone levels lead to endometrial hyperplasia (excessive thickening), which contributes to polyp formation. 2. Inflammatory and infectious processes Chronic inflammations, such as endometritis, and infections, including sexually transmitted diseases, can disrupt endometrial cell processes and promote abnormal growth. 3. Mechanical injury Damage to the uterine lining caused by miscarriages or diagnostic curettage may lead to the development of polyps. 4. Endocrine diseases Women suffering from type 2 diabetes, polycystic ovary syndrome (PCOS), or thyroid dysfunction are at higher risk of developing polyps. 5. Excess weight and sedentary lifestyle Obesity and low physical activity affect hormonal balance, which in turn increases the risk of polyp formation. 6. Genetic predisposition Hereditary susceptibility to gynecological diseases and reproductive system tumors may also be a risk factor. 7. Early menarche or late menopause Menstrual onset before age 12 or menopause after the typical age is associated with elevated estrogen levels, which raises the risk of polyp development. Symptoms In many cases, polyps may be asymptomatic, but sometimes the following symptoms occur: • Irregular or intermenstrual bleeding • Heavy menstrual bleeding • Lower abdominal pain • Infertility Diagnosis A polyp can be detected by: • Ultrasound examination (sonography) • Hysterosonography • Hysteroscopy (considered the “gold standard”) Treatment Polyp removal is mainly performed by hysteroscopy, which serves both diagnostic and therapeutic purposes. The removed tissue must be sent for histopathological examination to exclude the presence of malignant cells.Prevention and Monitoring • Regular gynecological examinations • Sonography for early detection • Regulation of hormonal balance Uterine polyps are generally benign and treatable. Timely detection and proper management are crucial for maintaining both women’s health and reproductive function.

Demodicosis is a common yet often overlooked inflammatory disease of the eyes and eyelids, caused by the excessive multiplication of microscopic mites — Demodex folliculorum and Demodex brevis — which normally live on the human skin. These mites inhabit the hair follicles and meibomian glands, feeding on skin sebum and dead cells. Under normal conditions they do not cause harm, but when their number exceeds the norm, an inflammatory reaction occurs, leading to irritation, itching, and various ocular surface disturbances. The activation of these mites is related to both internal and external factors. The main causes include: • Weakened immune system due to chronic diseases, infections, or prolonged stress. • Increased skin oiliness, which creates a favorable environment for mite growth. • Hormonal imbalance, such as thyroid or ovarian dysfunction. • Age-related changes, as the condition is more common in middle-aged and elderly people. • Poor eyelid hygiene and overuse of oily cosmetics, especially mascara and eye creams. When several of these factors act together, Demodex mites begin to reproduce rapidly, causing inflammation of the eyelids and eye surface. Symptoms Demodicosis develops gradually. Initially, a person may notice mild itching or tingling around the eyelids, but over time the symptoms become more pronounced. Typical symptoms include: • Itching and burning of the eyelids, especially in the morning. • Redness, swelling, and a feeling of heaviness in the eyelids. • Yellowish-white crusts or discharge at the base of the eyelashes. • Tearing, a gritty or foreign body sensation. • Recurrent inflammation along the eyelid margins, sometimes involving the cornea and conjunctiva. If the mites affect the meibomian glands, meibomian gland dysfunction may develop, causing chronic eye dryness, irritation, and light sensitivity. Diagnosis Diagnosis is confirmed by an ophthalmologist through microscopic examination of eyelashes to identify mites and their eggs. Additionally, the condition of the cornea and tear film is evaluated to determine the severity of inflammation and to detect possible complications. Modern Treatment Approaches Treatment of demodicosis is lengthy and requires a complex, combined approach aimed at reducing mite activity, eliminating inflammation, and restoring normal eyelid function. The main treatment directions are: 1. Eyelid and eyelash hygiene — daily cleansing with special lotions or wipes to remove secretions and mite waste; warm compresses to improve meibomian gland function. 2. Topical therapy — ointments and drops containing anti-mite components such as tea tree oil, metronidazole, or ivermectin; anti-inflammatory agents to reduce redness and swelling. 3. Systemic therapy — oral medications in severe cases, prescribed only under medical supervision. 4. Supportive therapy — artificial tears to relieve dryness, as well as lifestyle adjustments including healthy diet, adequate sleep, and stress management. Prevention To prevent recurrence, it is essential to maintain regular eyelid hygiene, limit the use of oily cosmetics, and avoid using old or contaminated makeup products. Any early signs such as itching, redness, or tearing should prompt a visit to an ophthalmologist to avoid complications. Conclusion Demodicosis does not threaten vision directly, but it can significantly affect quality of life by causing chronic discomfort, irritation, and cosmetic concerns. Early diagnosis, proper hygiene, and comprehensive treatment allow effective control of the disease and help prevent relapses.

Helicobacter pylori is a spiral-shaped bacterium that lives and multiplies in the human stomach. With its thin flagella, it easily moves through the stomach’s mucous layer and attaches to it, surviving even in the strong acidic environment of the stomach. Discovery and Importance Helicobacter pylori was first discovered in 1982. Since then, it has been proven that the bacterium is associated not only with gastritis and stomach or duodenal ulcers, but also with certain types of stomach cancer. Transmission The infection is mainly transmitted from person to person: • Through oral contact (for example, when sharing spoons, cups, or dishes), • Or through dirty hands. How It Causes Disease Once inside the stomach’s mucosal layer, Helicobacter pylori produces an enzyme called urease, which neutralizes stomach acid around it. This creates a “safe zone” that allows the bacterium to survive. Over time, it damages the stomach lining, leading to inflammation — gastritis, ulcers, and, in some cases, even cancer. Main Symptoms Although some people may carry Helicobacter pylori without symptoms, common signs include: • Pain in the upper part of the stomach • Heartburn and discomfort after meals • Nausea, sometimes vomiting • Loss of appetite and weight loss • Dark or bloody stools (in case of ulcer bleeding) If Left Untreated If not treated, Helicobacter pylori can cause: • Chronic gastritis • Stomach and duodenal ulcers • Ulcer complications such as perforation or bleeding • Increased risk of stomach cancer Treatment Treatment follows a specific antibiotic-based therapy, often combined with acid-suppressing medications. It usually lasts from 15 days to 1 month and must be completed under a doctor’s supervision. Prevention To prevent Helicobacter pylori infection: • Maintain good personal hygiene — wash hands before and after eating, • Avoid sharing utensils, spoons, and cups, • Eat clean, well-prepared food, • Get regular checkups if you have gastritis or ulcer symptoms. Conclusion Helicobacter pylori is a very common bacterium that may remain unnoticed for years, but over time it can cause serious problems. Early diagnosis and proper treatment are key to preventing complications and protecting your stomach health.

Myocardial infarction (MI) is ischemic necrosis of the heart muscle caused by an acute disruption of its blood supply. It is one of the most dangerous cardiovascular diseases and remains one of the leading causes of death worldwide. According to statistics, most cases occur in individuals aged 45–65. Men tend to develop the disease at a younger age than women. In recent years, due to preventive measures in developed countries, the incidence of infarction has somewhat decreased, but it remains a major global health problem. Etiology and Risk Factors The main cause of myocardial infarction is atherosclerotic damage to the coronary arteries. After rupture of an atherosclerotic plaque, a thrombus forms, blocking the artery and leading to myocardial ischemia.The main risk factors are: • High blood pressure. • High cholesterol or lipid disorders. • Diabetes mellitus. • Smoking. • Overweight and physical inactivity. • Age, especially over 50. • Stress and unhealthy lifestyle. Clinical Picture 1. The main symptom of MI is a compressive, burning, or pressing chest pain lasting more than 20 minutes. 2. The pain may radiate to the left arm, neck, lower jaw, or back. 3. It is often accompanied by cold sweats, weakness, shortness of breath, and nausea. 4. In elderly patients and those with diabetes, pain may be mild or absent. Classification Myocardial infarction is classified according to several principles. 1. Based on ECG findings: • ST-segment elevation MI (STEMI). • Non-ST-segment elevation MI (NSTEMI). 2. Based on localization: • Anterior wall infarction. • Posterior wall infarction. • Lateral, inferior, or extensive infarction. 3. Based on stages: • Early stage — first 24 hours. • Acute stage — up to 7 days. • Subacute stage — up to 4 weeks. • Chronic stage — formation of myocardial scar. Diagnosis 1. Diagnosis is based on three main criteria: • Typical clinical symptoms. • ECG changes — ST-segment elevation or depression, Q-wave formation. • Elevated biochemical markers of myocardial injury (Troponin I/T, CK-MB). 2. Echocardiography helps detect areas of segmental hypokinesia or akinesia. Complications The complications of acute myocardial infarction are divided into early and late stages. Early Complications (from the first hours to the first days) 1. Arrhythmias: • Ventricular tachycardia or fibrillation. • Atrioventricular block. • Sinus bradycardia or tachycardia. 2. Heart failure: • Acute left ventricular failure. • Pulmonary edema. 3. Cardiogenic shock. 4. Myocardial rupture (often on the 3rd–5th day): • Free wall rupture leading to cardiac tamponade. • Ventricular septal rupture. • Papillary muscle rupture leading to acute mitral insufficiency. 5. Early fibrinous pericarditis. Late Complications (weeks to months) 1. Myocardial aneurysm, acute or chronic. 2. Impaired ejection of blood from the heart. 3. Thrombosis in the aneurysmal cavity. 4. Thromboembolic complications — cerebral stroke or pulmonary embolism. 5. Late pericarditis (Dressler’s syndrome) of autoimmune origin. 6. Chronic heart failure. 7. Recurrent infarction or ischemic attacks. Treatment The main goal of treatment is to restore coronary blood flow as quickly as possible to prevent myocardial damage. Coronary angiography is considered the “gold standard” because it identifies the occlusion site and allows restoration of circulation. Thrombolysis is most effective during the first hours after onset, while percutaneous coronary intervention (PCI, stenting) is the preferred method. If PCI is not possible, coronary artery bypass grafting (CABG) is performed. Additional medications are used, including morphine for pain relief, antiplatelet therapy with aspirin and P2Y12 inhibitors, heparin for anticoagulation, as well as beta-blockers and ACE inhibitors to reduce cardiac workload. This comprehensive approach lowers the risk of complications and improves recovery outcomes. Prevention Secondary prevention is essential after myocardial infarction to reduce the risk of recurrence and complications. Patients should remain under regular cardiologist supervision, with strict control of blood pressure, glucose, and lipid levels. Cardiac rehabilitation exercises play an important role in restoring cardiac function. Prescribed medications must be taken consistently and according to medical recommendations. Myocardial infarction is a severe but controllable disease if diagnosed and treated in time. Early detection and appropriate therapy can save lives and prevent complications. Prevention begins with every individual — through a healthy lifestyle and regular medical check-ups.

Adrenal insufficiency, also known as Addison’s disease, is an endocrine disorder in which the adrenal cortex fails to produce adequate amounts of vital hormones. The adrenal cortex secretes several steroid hormones — cortisol, aldosterone, and androgens. Cortisol production is regulated by the adrenocorticotropic hormone (ACTH), produced by the pituitary gland. Cortisol is a vital “stress hormone” that affects fat and carbohydrate metabolism, supports immune regulation, and helps the body respond to physical and emotional stress. Aldosterone maintains water and electrolyte balance, regulating blood pressure and sodium–potassium levels. There are three types of adrenal insufficiency: primary, secondary, and tertiary. Primary Adrenal Insufficiency In this form, the adrenal glands themselves are damaged. Main causes: 1. Autoimmune destruction, where antibodies attack the steroid-producing cells of the adrenal cortex. 2. Amyloidosis 3. Metastatic lesions 4. Hemorrhagic infarction of the adrenal glands 5. Infectious diseases such as tuberculosis, meningococcal infection, or cytomegalovirus. Secondary Adrenal Insufficiency This type results from pituitary gland dysfunction, which leads to reduced secretion of ACTH and, consequently, decreased adrenal activity and cortisol production. Main causes: 1. Tumors 2. Head injuries 3. Circulatory disturbances 4. Inflammatory conditions Main Symptoms of Adrenal Insufficiency 1. Muscle weakness 2. Brownish skin pigmentation 3. Low blood pressure 4. Bradycardia 5. Low sodium levels 6. Elevated potassium levels 7. Hypoglycemia 8. Eosinophilia 9. Fatigue 10. Nausea, vomiting, diarrhea 11. Abdominal pain 12. Dizziness 13. Drowsiness Diagnosis A detailed medical history is essential, including any past or current use of glucocorticoid medications (pills, injections, or creams). These drugs have anti-inflammatory properties and are often prescribed for chronic conditions, but they must be used according to a strict medical schedule. Abrupt dose reduction or sudden discontinuation may suppress ACTH production in the pituitary gland, leading to adrenal insufficiency. Laboratory and imaging tests: • Hormonal assays (cortisol and ACTH levels) • MRI of the brain and CT scan of the adrenal glands Treatment The cornerstone of treatment is hormone replacement therapy to compensate for the lack of adrenal hormones. During stress (surgery, infections, fever, trauma, or intense emotional or physical exertion), the body’s need for cortisol increases, so the medication dose must be temporarily raised. After recovery, the dose should return to the previous level. Conclusion Adrenal insufficiency is a serious endocrine disorder that requires timely diagnosis and carefully monitored hormone therapy. If the above symptoms occur, it is essential to consult an endocrinologist for proper evaluation and treatment.

Dry eye syndrome is one of the most common eye conditions, in which the surface of the eye loses its normal moisture. This happens when the tear film becomes unstable or when tear production is insufficient. As a result, the eyes “dry out,” causing irritation, fatigue, and a feeling of grittiness. According to ophthalmologists, almost one in five people experiences this condition, most often women over 40. Modern habits — long computer use, air conditioning, and contact lenses — make the problem even more widespread. Causes and development The tear film protects the cornea from drying and irritation. It consists of three layers — oily, watery, and mucous. When any of these layers are disrupted, moisture evaporates quickly and the eye surface becomes unprotected. Causes can be internal or external. Internal factors include hormonal changes (such as during menopause or pregnancy), chronic illnesses, and deficiency of vitamins A and E. External ones include dry air, wind, air conditioners, and infrequent blinking while using screens. Improperly fitted lenses or long-term use of some medications can worsen the problem. Symptoms The main symptoms are dryness, burning, redness, and a feeling of sand or a foreign body in the eyes. Sometimes excessive tearing occurs as a reaction to irritation. Vision may become blurry or fluctuate during the day. Symptoms often worsen by evening, after prolonged reading or computer work, or in dry environments. In severe cases, corneal inflammation and visual impairment may develop. Diagnosis An ophthalmologist can diagnose dry eye syndrome during an eye exam. The doctor evaluates the eyelids, cornea, and tear film. Common diagnostic tests include: • Schirmer’s test – measures tear production; • Norn’s test – checks how quickly the tear film evaporates; • Fluorescein test – identifies dry spots on the cornea. These tests are painless and take just a few minutes. Treatment and care The main goal of treatment is to restore normal eye moisture and relieve irritation. Most patients benefit from “artificial tears” — drops or gels that imitate natural tears and protect the cornea. Inflammation may require anti-inflammatory or regenerative medications. It’s also important to remove triggering factors: avoid dry or dusty environments, choose lenses carefully, and take breaks from screens. In rare severe cases, minor surgery can help retain natural moisture. Prevention To prevent dry eye syndrome: • blink more often when using a computer, • maintain indoor humidity, • drink enough water and eat foods rich in vitamin A and omega-3, • avoid using eye drops without a doctor’s advice. Even mild dry eye requires attention. Early treatment helps preserve eye health and visual clarity.