Duplex Examination of the Lower Limb Vessels

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.

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.