The Journal Acta Medica Bulgarica, published continuously since 1973, is the leading scientific journal of the Medical University – Sofia.
It is peer-reviewed and circulated entirely in English. AMB is available online as an open-access journal. AIM AND SCOPE
Journal subjects: Medicine, Basic Medical Science, Immunology, Clinical Medicine, other. Types of manuscripts accepted for publication: original research articles, scientific reviews and case reports in all areas of Medicine. Language: English
ISSN: 0324-1750
еISSN: 2719-5384
PUBLICATION TIMEFRAME AND ACCESS
This journal is published quarterly with 4 issues annually. It provides immediate open access to its content so as to make research freely available to the public in support of a greater global exchange of knowledge. Each issue is also available in print, and is distributed to libraries and medical organizations etc. If you'd like to receive a print or digital copy, please subscribe. REVIEW PROCESS
All manuscripts are subject to peer review and are expected to meet high academic standards. If approved by the editor, submissions will be considered by peer reviewers whose identities will remain anonymous to the authors (single blinded). The median peer review turnaround is 4-8 weeks. The time from acceptance to publication is from 4 weeks to 18 months. The current acceptance rate is approx. 40 %. About 10-20 % of articles are rejected upon submission and do not reach peer-review, due to lack of compliance with the Journal’s Author Guidelines or English language issues. An average of 20 articles are submitted each month, of which 70-80% are original research articles, and the remaining are case reports and review articles. ABSTRACTING AND INDEXING
AMB is covered by a range of indices, such as Scopus, CABI: Global Health Database, DOAJ, Embase, EBSCO, Elsevier - Reaxys, ExLibris, Google Scholar, etc. Scopus Cite Score 2022: 0.3
SJR 2022: 0.119
SNIP 2022: 0.028
🔜Какво да очаквате в следващото ни онлайн обучение на 5 ноември (сряда):
✅критерии за избор на правилно списане, в което да публикувате Вашата статия;
✅избягване на хищнически и фалшиви списания;
✅какво представляват наукометричните индикатори на списанията, напр. Impact factor, Scimago Journal Rank, CiteScore, Quartile и др.
📌Само за студенти и преподаватели в МУ-София
📌С предварителна регистрация, чрез QR-кода или линк bit.ly/Webinar05112025
✍️Запишете се, за да участвате на живо или да получите записа от уебинара.
08/10/2025
Oxidative stress, dietary supplementation and hypertensive disorders in pregnancy: a review
Abstract. Objective. To provide an understanding of the effects of oxidative stress and hypertensive disorders during pregnancy and the significance of dietary supplementation in addressing the related adverse outcomes and complications. Methodology. The review methodology was designed to provide a flexible but a comprehensive overview of pregnancy in terms of oxidative stress, hypertensive disorders and dietary supplementation through identification of applicable and relevant literature that was based on an inclusion and exclusion criteria that followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) framework for systematic reviews. Findings. Hypertensive disorders are a primary risk factor for adverse pregnancy outcomes, accounting for 14 percent of maternal mortality and occurring in up to 10 percent of all pregnancies. The mechanisms leading to oxidative stress during pregnancy can cause the excessive generation of highly reactive and unstable reactive oxygen species radicals, which can directly disrupt gestational processes such as oocyte maturation, luteolysis, and embryo implantation. Excessive production of reactive oxygen species can directly interfere with the placental membrane, which can disrupt the exchange of nutrients and oxygen between the mother and fetus, leading to poor embryo development and pregnancy complications. There is a direct association between imbalanced serum nutrient levels and adverse health outcomes during pregnancy, such as inflammation and dyslipidemia. Conclusion. The adverse pregnancy outcomes associated with genetic and biological risk factors, such as oxidative stress and hypertensive disorders, are preventable and manageable through proper hygienic conditions, appropriate lifestyle choices, and pharmacological and dietary interventions.
The full article in the first comment 👇
08/10/2025
Ultrasonography – a new method for airway assessment: a review of the literature
B. Dimitrova, M. Gaydarova, G. Nikolova, T. Ilchev, Z. Jeleva, M. Mladenova
Abstract. Introduction: Endotracheal intubation is an important part of the anesthetic practice; however, sometimes, it can be difficult and/or impossible. Complications of difficult airway management include hypoxia, hypoxic brain injury, cardiovascular instability, cardiac arrhythmias and death. The objective of the current review is to determine the feasibility and advantages of ultrasonography as a method for airway assessment in patients undergoing laryngeal surgery. Materials and Methods: The literature review is conducted using the PubMed, Scopus and Google Scholar scientific databases to identify relevant studies and clinical guidelines related to difficult airway management and methods of assessment. The literature review revealed 16,300 articles during the period from 1 January 2014 to 2024, of which only 54 most closely represented the specific issues. Results and Discussion: There are numerous bedside tests for identifying and evaluating difficult airways, but their sensitivity remains unclear. Ultrasonography is a non-invasive, safe, painless, and easy-to-perform method. It provides dynamic real-time images, as well as detailed anatomical information of the pathological changes of the larynx. Conclusion: According to various studies, ultrasonography has been found to be an effective method for the identification and evaluation of difficult airways in patients undergoing elective surgery.
The full article in the first comment 👇
08/10/2025
Weight drop models of traumatic brain injuryin rats associated with cognitive disorders and glial scar formation: a systematic review
Abstract. Objective: Traumatic brain injury (TBI) causes persistent cognitive disorders due to glial scar formation, inhibiting axonal regeneration. Targeting glial scar formation may improve TBI-related cognitive disorders, and require standardized animal models for research. This review aims to identify a weight drop model inducing cognitive disorders and glial scar formation in rats with TBI, supporting further investigations. Methods: A literature search using PubMed, Science Direct, and ProQuest databases identified relevant articles. Inclusion criteria were randomized controlled trials published in English, in full text, between 2012 and 2022. Review articles and abstracts were excluded. Keywords were chosen via the P.I.C.O framework, and article quality was assessed using the Systematic Review Center for Laboratory Animal Experimentation guideline by three reviewers. Results: Among 1,042 articles, 32 studies demonstrated cognitive disorders in rats using the weight drop model. Three studies explored glial scar formation and found that two weight drop methods were associated with cognitive disorders and glial scar formation in rats with TBI: applying a 10-gram load from a 5 cm height to the exposed heads of Sprague–Dawley rats or using a 200 gram weight from a 2.5 cm height to the exposed skulls of mice. Conclusion: Two weight drop model methods were found to induce the formation of glial scar, which consequently resulted in persistent cognitive disorders. These discoveries provide significant insights for future research on potential interventions aimed at preventing glial scar formation and improving cognitive disturbances in TBI. Clinically, this research holds significant promise for informing treatment strategies in TBI patients by identifying targets to prevent or reverse glial scar formation. Such interventions could reduce cognitive decline, improve rehabilitation outcomes, and support the restoration of brain function. Early therapeutic approaches targeting glial scars may enable timely and effective strategies to minimize permanent neurological damage and enhance recovery in TBI patients.
The full article in the first comment 👇
07/10/2025
Creutzfeldt-Jakob disease – a series of four clinical cases
A. Karameshev, B. Yoshinov, P. Dimova, R. Tanova, M. Penkova, B. Kochmalarski, K. Mihaylova, D. Stoilova, P. Shotekov
Keywords: Creutzfeldt-Jakob disease, dementia, myoclonus, EEG, MRI, case series
Abstract. Creutzfeldt-Jakob Disease (CJD) is a rare, progressive, and fatal degenerative brain disorder caused by prion proteins. The diagnosis of the disease is based on established criteria and biomarkers – cerebrospinal fluid analysis, real-time quaking induced conversion (RT-QulC), magnetic resonance imaging, electroencephalographic findings and brain biopsy. We present a series of four patients with confirmed CJD, followed in our clinical center. We discuss the current diagnostic approach in these patients.
The full article in the first comment 👇
07/10/2025
Minimally invasive lung adenocarcinoma, Mycobacterium avium intracellulare and Langerhans histiocytosis
S. Ivanova, R. Cherneva, R. Krasteva, Z. Makshutova, G. Yankov
Abstract. Adenocarcinoma of the lung is the most common lung tumor, accounting for about 40% of the cases. Minimally invasive adenocarcinoma may be a part of a continuum of morphological changes, leading to the development of invasive adenocarcinoma of the lung. It is defined as a predominantly lepidic lesion measuring ≤3.0 cm with only small foci of invasion, the largest of which should be less than 0.5 cm. An association between lung cancer, Mycobacterium avium infection and Langerhans cell histiocytosis has already been described in past studies. We present a case of a 59-year-old patient with PET/CT data for metabolically active tumor (28 mm), which had increased in size and activity compared to the previous scan. On admission to our hospital, he had undergone 14 courses of chemotherapy at another institution for diffuse large B-cell lymphoma (DLBCL). After the left upper lobectomy, minimally invasive lung adenocarcinoma, Mycobacterium avium intracellulare and accompanying Langerhans cell histiocytosis were histologically verified.
The full article in the first comment 👇
06/10/2025
Perforation repair of a primary tooth: a 1-year follow-up case report
P. Sushmitha, A. P. Nayak, Y. M. Karuna, C. Thimmaiah
Keywords: primary teeth, perforation, mineral trioxide aggregate, case report
Abstract
Aim and Background: Primary teeth are more susceptible to perforation during endodontic treatment due to their anatomical features. Perforations, unintended communications between the root canal and external root surface, are a common procedural accident in endodontics, often leading to tooth loss. Managing these perforations in primary teeth is challenging, with prognosis dependent on factors such as location, size, and contamination. Traditional sealing materials have limitations like microleakage and toxicity. Mineral trioxide aggregate (MTA) is superior due to its sealing ability, biocompatibility, and promotion of hard tissue formation. Case Presentation: This case report describes a furcal perforation repair in a primary molar using MTA in a 5-year-old child. Repulpectomy with calcium hydroxide based obturating material was performed. Follow up was done at 3, 6 months and 1 year. Conclusion: With availability of bioactive materials like MTA, perforations in primary teeth can be repaired with good clinical and radiographic success. Clinical significance: As stated the best space maintainer is the primary tooth by itself. Therefore, perforation repair with MTA can be a viable alternative to extraction in young children thus the tooth can be preserved and meet the functional demands.
The full article in the first comment 👇
06/10/2025
Protective effects of quercetin, curcumin and resveratrol in an in vitro model of doxorubicin-induced cardiotoxicity
B. Stoyanov, D. Stefanova, R. Bogdanova, V. Tzankova
Keywords: doxorubicin, cardiotoxicity, curcumin, quercetin, resveratrol, Rat H9c2 cardiomyoblasts
Abstract. Introduction: Over the past two decades, drug-induced cardiotoxicity has resulted in the withdrawal of several drugs, including prenylamine, rofecoxib, and levomethadyl acetate, while others like rosiglitazone remain available only under restricted conditions. However, some cardiotoxic drugs, like doxorubicin (DOX), are still used due to their potent antitumor activity despite their dose-dependent cardiotoxicity. This cardiotoxicity, often caused by lipid peroxidation and reactive oxygen species (ROS), can be mitigated by natural substances like quercetin (QR), curcumin (CRC), and resveratrol (RES), which have notable antioxidant and cardioprotective effects. Aim: This study aimed to evaluate the potential of QR, RES, and CRC to enhance the viability of H9c2 cardiomyocytes in an in vitro model of doxorubicin-induced cardiotoxicity. Materials and Methods: H9c2 cells were treated with doxorubicin (0.25 μM and 1 μM) and varying concentrations of QR, RES, and CRC (0.01 μM, 0.1 μM, 1 μM, 2.5 μM, 5 μM, 10 μM) for 24 and 48 h. Cell viability was assessed using the MTT assay to determine the protective effects of the natural antioxidants on H9c2 cell line. Results: Our data demonstrated that QR and CRC significantly improved the viability of H9c2 cells in the DOX-induced cardiotoxicity model of treatment with 0.25 μM DOX (24 h). At these conditions, RES also showed protective cell viability effects, but it was not effective at the injury with higher DOX concentration (1 μM, 24 h). Conclusions: This study highlights the in vitro protective effects of QR and CRC in reducing DOX-induced cardiotoxicity in H9c2 cardioblast cells, most probably attributed to their well-established antioxidant effects.
The full article in the first comment 👇
03/10/2025
Does methanolic leaf extract of Cassia tora possess hepatoprotective properties in paracetamol-induced liver damage in rats?
Abstract. Folklore in Africa holds that Cassia tora L. has numerous health-promoting qualities. We looked at how methanolic leaf extract of Cassia tora (MLECT) affected the hepatotoxicity caused by paracetamol in this case. Six groups of five male rats each, all in good health, were randomly allocated. Paracetamol overdose (2000 mg/kg body weight, peroral, 1 day) was administered to rats in all groups except the normal control group, resulting in liver damage. Following induction, the treatment groups› animals received different dosages of MLECT via gastric gavage (100, 300, and 500 mg/kg b.w./5 days). Following a nighttime fast, the animals were euthanized on the sixth day, and the serum levels of the liver marker enzymes (ALT, AST, and ALP), total bilirubin, total protein, renal function (urea and creatinine), electrolytes (Na+, K-, Cl-, and HCO3), and antioxidant levels were assayed using standard methods. Terpenoids (81.84 ± 0.01 mg/100 g), flavonoids (17.86 ± 0.16 mg/100 g), saponin (15.72 ± 0.07 mg/100 g), glycosides (14.63 ± 0.03 mg/100 g), steroids (13.23 ± 0.03 mg/100 g), tannins (11.97 ± 0.13 mg/100 g), and phenols (6.62 ± 0.06 mg/100 g) were identified during phytochemical screening of MLECT . Safety was demonstrated at dosages up to 5000 mg/kg b.w. in the LD50 investigation. Based on the findings, an overdose of paracetamol (2000 mg/kg b.w.) caused hepatotoxicity, which was characterized by enhanced liver marker enzyme activity, elevated serum levels of urea and creatinine, decreased total protein, antioxidant enzymes, and skewed electrolyte values. In contrast to the aberrant levels shown in the positive control, treatment with different dosages (100, 300, and 500 mg/kg b.w p.o./5 days) of MLECT dramatically decreased liver marker enzymes and restored normalcy in the levels of antioxidant enzymes and kidney function indices. As a result, the study’s findings imply that the methanolic leaf extract of Cassia tora has both antioxidant and hepatoprotective capabilities concerning paracetamol-induced hepatotoxicity.
The full article in the first comment 👇
03/10/2025
Assessment of enamel microroughness in primary and permanent teeth with initial carious lesions before and after acid application
R. Bogovska-Gigova, K. Hristov, N. Gateva, L. Angelova
Abstract. Aim: To evaluate the microroughness of primary and permanent teeth in the initial carious lesion (white spot) area before and after orthophosphoric and hydrochloric acid application. Material and Methods: The in vitro study included physiologically exfoliated primary molars and permanent third molars extracted for orthodontic reasons. The teeth were divided into eight groups according to the presence of initial caries lesions, type of dentition, the acid used, and the time of its application. The surface microroughness in the area of the carious lesion, both before and after etching, was assessed using a profilometer, and the results were compared. Carious lesions were etched either with 37% orthophosphoric acid for 30 seconds or with 15% hydrochloric acid for 120 seconds. Results: Higher microroughness values were found in the area of the initial carious lesion compared to the area with intact enamel for both dentitions. The microroughness of the enamel surface in the carious lesion area increased after applying orthophosphoric and hydrochloric acids in both primary and permanent teeth. The highest microroughness was recorded after conditioning with 15% hydrochloric acid. Microroughness data from carious primary and permanent teeth showed increased microporosity after etching with 37% orthophosphoric acid. Conclusion: Etching (with hydrochloric and orthophosphoric acid) of initial carious lesions of primary and permanent teeth significantly increases their microroughness.
The full article in the first comment 👇
02/10/2025
Change of VO2 max and muscle mass after one-month and two-month upper and lower body exercises in stable chronic obstructive pulmonary disease
A. P. Tarigan, M. Simatupang, Egipson, P. Pandia,
A. Pradana, A. H. Tarigan, Maryaningsih, Zulkarnain, L. Agustin, P. Eyanoer
Keywords: COPD, upper and lower body exercises, VO2 max, muscle mass
Abstract. Background: Skeletal muscle dysfunction inevitably occurs due to systemic inflammation of Chronic Obstructive Pulmonary Disease (COPD), which manifests as muscle atrophy and dysfunction. It also exhibits decreases in muscle strength and endurance, leading to a deconditioned state and a reduction in maximal oxygen uptake (VO2 max) in tissues. Exercise training can increase VO2 max value. The main purpose of this study is to evaluate the benefits and compare the effectiveness of upper and lower body exercises given for one to two months in stable COPD patients. Methods: This quasi-experimental study was conducted on 25 stable COPD patients from December 2018 to May 2019 at the Physiotherapy Unit of Siti Hajar Hospital, Medan, Indonesia. All participants performed upper-body exercises and stationary bicycles for lower-body exercises twice a week for one month, then continued for two additional months. VO2 max was calculated using the Nury Formula, specially developed for the Indonesian population, while muscle mass values were assessed using the OMRON Karada Scan scales. VO2 max and muscle mass were measured before training (baseline) after one-month and two-month training. The statistical analysis used is the Repeated ANOVA test. Results: The baseline of mean muscle mass in COPD patients was 28.8 ± 2.43%. Muscle mass increased to 29.1 ± 2.34% in one month and 29.5 ± 3.01% after two months (p < 0.05). The mean value of VO2 max before doing upper and lower body exercises was 21.0 ± 3.08%. VO2 was significantly increased after two-month training to 23.0 ± 3.6% (p < 0.001), but not after one-month training (VO2 max: 21.32 ± 3.22%; (p < 0.001). Conclusion: Two-month upper and lower body training provides a greater impact in improving VO2 max and muscle mass in stable COPD patients.
The full article in the first comment 👇
02/10/2025
Polymorphic variants in acenocoumarol-related genes CYP2C9 and VKORC1 and their frequencies in Bulgarian population
R. Tzveova, A. Dimitrova-Karamfilova, S. Vandeva, P. Atanasov, D. Pendicheva-Duhlenska, G. Nachev, V. Mitev, R. Kaneva
Abstract. Introduction. Acenocoumarol is an indirect anticoagulant, a 4-hydroxycoumarin derivative, which is used in the treatment of various thromboembolic diseases. Polymorphic variants in the CYP2C9 and VKORC1 genes significantly contribute to the optimal maintenance acenocoumarol dose requirements in different populations. Purpose. The purpose of the study was to establish the allele and genotype frequencies of the following polymorphic variants: CYP2C9*2; CYP2C9*3; VKORC1*2A; VKORC1*2B; VKORC1*3 and VKORC1*4 in Bulgarian participants and to compare them to these in other European populations. Materials and Methods. Our study included 155 unrelated controls from different regions of Bulgaria. Genomic DNAs were extracted from peripheral venous blood. The analysis of selected polymorphisms was performed by High Resolution Melting Analysis. The allele frequencies of various genotypes were calculated by Hardy–Weinberg Equilibrium (HWE). Results. The obtained frequencies of polymorphisms studied in this study are presented below: 1. CYP2C9*2 – CC (85.71%), CT (13.47%), TT (0.82%), C (92.00%), T (8.00%), HWE χ²=2.58, 2. CYP2C9*3 – CC (0.04%), CT (16.94%), TT (82.66%), C (8.87%), T (91.13%), HWE χ²=0.26, 3. VKORC1*2A – GG (32.47%), GA (48.70%), AA (18.83%), G (56.82%), A (43.18%), HWE χ²=0.01, 4. VKORC1*2A – GG (32.47%), GA (48.70%), AA (18.83%), G (56.82%), A (43.18%), HWE χ²=0.01, 5. VKORC1*2B – GG (11.43%), GT (44.29%), TT (44.29%), G (33.57%), T (66.43%), HWE χ²=0.01, 6. VKORC1*3 – GG (41.04%), GA (48.23%), AA (9.93%), G (65.96%), A (34.04%), HWE χ²=0.77, 7. VKORC1*4 – CC (64.93%), CT (32.09%), TT (2.99%), C (80.97%), T (19.03%), HWE χ²=1.51. Conclusion. The established genotypic and allelic frequencies of the studied polymorphisms in CYP2C9 and VKORC1 were according to the Hardy–Weinberg equilibrium and correspond to these in other European populations.
Be the first to know and let us send you an email when Acta Medica Bulgarica posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.
In 1973, on the initiative of “Medicine and Physical Culture" Publishing House, more precisely the then manager Mr. Trayan Ivanov, the Ministry of Health set up and approved to subsidize a new medical journal, published only in the English, which to reflect the status and achievements of Bulgarian medical science. Thus the language barrier was overcome and stable relations were established with the international medical societies, large libraries and university centres.
The internationally known scientist Prof. Assen A. Hadjiolov was elected Editor-in-chief by the first editorial board and the journal was named Acta Medica Bulgarica. For more than 20 years, the “Medicine and Physical Culture" personnel did all the work related to the publishing of Acta Medica Bulgarica, regardless of the fact that the magazine kept on its appearance as an organ of the Medical Academy, respectively of the Sofia Medical University.
Through the years, following the tradition of electing the Rector of Sofia Medical University to lead the publishing of the journal, Editors-in-chief were Prof. Atanas Maleev, Prof. Nikolay Belovezhdov, Prof. Dimiter Djerov, Prof. Vladimir Ovcharov, and Prof. Vanyo Mitev. Presently, Prof. V. Zlatkov,, the Rector of Sofia Medical University, is the Editor-in-chief of Acta Medica Bulgarica.
Gradually, a greater number of scientists from all over the world, as well as universities and scientific institutes, demonstrated a stronger interest in publishing their papers in AMB. The journal is on demand by over 300 world medical libraries working on principles of medical information exchange.
For the last couple of years, Acta Medica Bulgarica, being an edition of Sofia Medical University, has been published by the Central Medical University Library, namely, the Department of Medical Information.
For more than 35 years, Prof. W. Bossnev and Prof. K. Tzachev were been responsible for the scientific edition, while Prof. S. Danev was devoted to the English version of the journal.
The editorial board has been respectfully marking out the joint efforts of all colleagues in publishing the journal through the years of complex social changes and encourages endeavours of the new generation of scientists to further develop and improve the scientific level of Bulgarian medical publications and consolidate its position in international medical literature.
