Journal of Health Sciences
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The effect of Benson relaxation technique on fatigue of patients diagnosed with multiple sclerosis
Get PDFIntroduction: The previous studies showed that fatigue is a very common symptom in patients diagnosed with multiple sclerosis (MS) and has the greatest effect on their activities of daily living. Benson relaxation technique (BRT) is one of the most relaxation techniques used to decrease fatigue, improve emotional status and quality of life in patients with several chronic diseases. This study aimed to investigate the effect of BRT on fatigue level of patients diagnosed with MS in Jordan.Methods: This is a quasi-experimental repeated measure study. It involved six neurological clinics in the Ministry of Health and five neurological clinics at private hospitals. In this study, 95 patients returned the completed questionnaire and attended BRT.Results: The mean age of the patients was 33 years. Females accounted for 60% of the patients and almost half of the patients were single. All patients reported having a university degree and three-quarters of the patients were employed. Almost, two-thirds of the patients reported having not more than 1 time of relapse in the past 2 years. The majority of them reported <3 years from the confirmed diagnosis. Findings showed a statistical significant reduction in the overall level of fatigue including physical, cognitive, and psychosocial fatigue of patients with MS after BRT (p < 0.001).Conclusions: Results suggested that this technique is a very effective strategy for reducing fatigue in patients with MS. Therefore, in addition to prescribing medication, it is recommended that this method be applied in the care of patients diagnosed with MS
Stigmatization towards cancer among university students in Malaysia
Get PDFIntroduction: Stigmatization towards cancer is a barrier to early cancer screening and treatment. This study was conducted to determine the level of cancer stigma among Malaysian university students in Malaysia with different sociodemographic backgrounds.Methods: This cross-sectional study recruited 400 students (mean age, SD = 22.22 ± 1.67 years) from a selected university in Malaysia. Data were collected from October 2019 to February 2020 through an online survey. The Cancer Stigma Scale (CASS) was used in assessing the levels of cancer stigma among university students with different courses and social backgrounds. The CASS was used in assessing multiple aspects of cancer stigma, including severity, personal responsibility, awkwardness, avoidance, policy opposition, and financial discrimination.Results: Data were analyzed using SPSS (version 23). Results showed that the stigmatization level toward cancer among university students varied across the six subscales. Items regarding the severity of a cancer diagnosis showed the highest level of agreement (32–52%; M = 3.05, SD = 0.96), whereas the item ‘avoiding someone with cancer’ showed the lowest agreement, 7–10% (Mean = 1.85, SD = 0.97). Stigma was significantly higher in young students, males, non-health science students, students in the junior year level, students without family histories of cancer, and the low-income group (p < 0.05).Conclusion: These findings may provide a benchmark of stigmatization level among university students in Malaysia and may be a valuable basis for delivering information and education on cancer screening and treatment
Short-term effects of carrying a school bag on the distribution of force and plantar pressure during walking of children of different levels of physical activity
Get PDFIntroduction: Carrying a school bag is a dominant activity that a child performs during daily productive activities. The aim of the research is to examine how carrying a school bag of different weights affects the distribution of force and plantar pressure during normal walking on the flat terrain of children of varying levels of physical activity.Methods: The pilot study included 124 students aged 11-12 from Banja Luka. According to the protocol, each group of respondents was treated with an intervention-customized school bag and a comparator-school bag that the child only opted for. For the research, the Physical Activity Questionnaire for Older Children, measurement of anthropometric parameters, school bag weight, and Zebris tape (Zebris Medical GmbH, Germany) were used for gait analysis.Results: Inactive children achieved the lowest and active children’s highest walking speed during normal walking without a bag, with their customized school bag. When carrying a custom school bag: The highest maximum force is projected on the left heel 330.72 N in inactive children, and the lowest 265.93 N in moderately active children, the highest maximum pressure on the left heel is registered in inactive children, 27.60 N/cm2, and the lowest 21.85 N/cm2 in moderately active children. The maximum force-time of % of standing time on the left foot in the middle part lasted the longest in inactive children, and the shortest active children carried their school bag 40.31% and a custom school bag 39.76%.Conclusion: High physical activity and individual adjustment to distribute the burden well allow the child to adequately respond to the loads carried by the weight of the school bag
C – reactive protein in saliva of non-smoking patients with periodontitis (a pilot study)
Get PDFIntroduction: C-reactive Protein (CRP) as an inflammatory biomarker can be easily determined in saliva, but the values of salivary CRP in periodontitis are not well-studied. The aim of this study was to analyze and determine the values of salivary CRP in non-smokers with periodontitis stage 3 or 4 before and after supragingival and subgingival full-mouth periodontal therapy.Methods: Standard periodontal parameters and saliva samples were collected in 12 non-smoking patients. Patients in the test group (n = 6) underwent supragingival and subgingival full-mouth periodontal therapy, and the control group (n = 6) received only supragingival full-mouth therapy. Both groups received the same oral hygiene instructions in addition to therapy. After 3 months, re-registration of periodontal parameters and re-sampling of saliva for analysis of salivary CRP were done for both groups.Results: Statistical analysis revealed large differences in the values of clinical periodontal parameters and CRP levels in the test group after therapy. Values of salivary CRP in the test and control groups were lower 3 months the therapy; however, the results were not statistically significant. The correlation of clinical periodontal parameters and salivary CRP varied in both groups.Conclusion: Our pilot study reveals decreased concentrations of salivary C-reactive protein in non-smoking patients following non-surgical periodontal therapy. Further studies are needed to prove the reliability of salivary CRP as a biomarker for periodontitis
Post-coronavirus disease 2019 children in Sarajevo-Lessons learnt?
Get PDFIntroduction: A new disease coronavirus disease 2019 (COVID-19) is with insufficiently known epidemiological characteristics and spectrum of clinical expression in childhood. Children have a lower incidence of this disease with a predominance of mild forms but severe clinical forms, such as among others, acute respiratory distress syndrome, and multisystem inflammatory syndrome may occur, according to current findings. In children with atypical symptomatology and positive or suspicious epidemiological survey, practitioners should consider the possibility of COVID-19.Methods: This study formed the group of 70 children previously healthy or with no pre-existing heart disease from Sarajevo with positive post-COVID history. Following the history of disease and epidemiological data, establishing the 1st day of disease or contact, a detailed cardiovascular examination was performed, including parameters of body weight, height, oxygen saturation, pulse, blood pressure, 12 leads electrocardiogram (ECG) done on Schiller machine, values of polymerase chain reaction (PCR), or serological test on corona: Immunoglobulin (Ig) G and IgM. Echocardiographic examination was done using M, B mode, color, continuous wave, and pulse wave Doppler in standard views. Laboratory blood tests included: Full blood count, creatinine phosphokinase myofibril, creatinine phosphokinase, lactate dehydrogenase; liver enzymes, D dimer, C reactive protein, and urine.Results: Majority of children (64.3%) were asymptomatic. ECG was normal in relation to patients’ age except in eight patients (intermittent palpitations on exertion) who had short PR interval 0.120–0.140 ms, with no delta wave, with heart rate within the normal range according to age, so 24 h ECG Holter was performed without any significant arrhythmias, incomplete right branch block has been documented in 12%, monofocal ventricular ectopic extrasistoly in 15%. Mean IgG, as a marker of infection, showed a statistical significance when compared between age Groups I and II (<5) and older groups: III, IV, and V (>5) (p < 0.05; p = 0.043). PCR test was negative in 9 (70 children), although they showed symptoms, COVID-19 infection clinical data, and positive laboratory findings. Echocardiogram was normal in all patients with normal ejection fraction of the left ventricle.Conclusion: The possibility of COVID-19 in children with atypical symptomatology and positive or suspicious epidemiological survey should be in the focus of every pediatrician at primary care institutions nowadays. Cardiovascular assessment should always be an option in post-COVID patients. Immunological assessment is necessary in post-COVID patients in order to gain a further understanding of PTS status. With more serological testing for severe acute respiratory syndrome coronavirus 2 physicians would be able to make a diagnosis of COVID-19 timely and more accurately, as well as to evaluate the role of asymptomatic children in disease transmission and to assess the importance of protective antibodies and the distribution of COVID-19
Nursing students\u27 attitudes about their profession
Get PDFIntroduction: Positive attitudes toward the nursing profession among nursing students improve the sustainability of the profession. Studying the attitudes of nursing students toward nursing is of great importance, as it can indicate their remaining in the profession. This study aimed to determine the attitudes of nursing students toward the nursing profession.Methods: This was a cross-sectional, descriptive, analytical study. The research was conducted at the Faculty of Health Studies at the University of Sarajevo from May to June 2019. The study involved a convenience sample of 107 currently enrolled Bachelor of Nursing students from the 1st to the 4th (and final) year of full-time study and part-time students in the Baccalaureate of Nursing Care program at the University of Sarajevo. The students voluntarily and anonymously completed a questionnaire consisting of demographic information and the Nursing Image Questionnaire.Results: Overall, 107 students participated in the research. Their mean age was 23 years old (standard deviation, 5 years). Spearman’s correlation factor shows a statistically significant correlation between the scores and the mode of studying (full-time or part-time) (rho = −0.200*, p = 0.039) and whether respondents working in the profession or not (rho = 0.249*, p = 0.010).Conclusion: The attitudes of future Bachelor of Nursing toward the nursing profession were very positive. Full-time students had more positive attitudes toward the profession, compared with part-time students, although the difference was not statistically significant
The relationship of tumor microenvironment and clinicopathological parameters in different molecular subtypes of breast cancer
Get PDFIntroduction: Tumor microenvironment plays a significant role in tumor progression. Tumor stroma is one of the strongest modifiers of tumor cell response, cancer behavior, and cancer progression. This study aimed to investigate the correlation of matrix metalloproteinase-9 (MMP-9) expression and tumor-stroma ratio (TSR) with standard clinicopathological parameters in different molecular subtypes of breast cancer.Methods: Ninety biopsy samples of primary breast cancer diagnosed at the Department of Pathology, School of Medicine, Sarajevo, were selected for this study. The molecular subtype was determined based on the immunohistochemical expression of estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and Ki-67. Stromal and tumoral MMP-9 immunohistochemical expression and the TSR were determined for each tumor.Results: Tumoral MMP-9 expression correlated positively with the presence of lymphovascular invasion (p= 0.016). TSR showed significant association and correlation with tumor grade (G) (p= 0.031; p= 0.049) and tumor size (pT) (p = 0.049;p= 0.021, respectively). Stromal MMP-9 expression correlated with histologic type, histologic grade of tumor, and lymphocytic inflammatory infiltrate (p= 0.021;p= 0.047, p= 0.038, respectively). A higher percentage of stromal MMP-9 expression correlated with the strongest lymphocytic response (p = 0.007). Significant correlation was observed between molecular subtypes and histologic grade of the tumor (p= 0.032).Conclusion: Our results, to some extent, confirm the significance of the tumor microenvironment in breast cancer, especially when it is about stromal MMP-9 expression. Although we observed significant association, without linear correlation, we found no significant correlation between molecular subtypes of breast cancer and MMP-9 expression
Assessment of functional mobility of persons in the 3rd age of life after programmed therapeutic exercises
Get PDFIntroduction: Active aging is a process of optimizing of opportunities for health, participation, and safety to improve the quality of life as people age. Therapeutic exercises to strengthen muscles are especially important for the elderly, and the results of such exercises are positive in people with functional limitations. The aim of the study was to assess functional mobility of people in the 3rd age of life after programmed therapeutic exercises.Methods: The prospective study included two groups of 130 respondents over the age of 65 who came to the “Centre for Healthy Aging” in Novo Sarajevo in the period from September 1, 2014, until March 1, 2015. Using the time up and go test (TUG), the basic functional mobility was assessed and it represents the minimum time the respondent needs to get up from the armchair, walk a distance of three meters, turn around, and sit back in the armchair. We tested the respondents at the beginning, in the middle, and at the end of the study, which lasted for 6 months.Results: Analysis of the gender structure of the control and the test groups, using the Chi-square test, found a statistically significant difference, and in the test group, there were more female subjects than in the control group, χ2 = 50.620; p = 0.001. Analysis of the functional mobility of the respondents of the test groups using the TUG at the end of the study found that the respondents of the test group needed statistically significantly less time to perform the test (8.84 seconds) compared to the control group (9.59 seconds) and test Group B (9.41 seconds), F = 4.711; p = 0.041.Conclusion: Programmed therapeutic exercise leads to a significant improvement in functional mobility of persons in the 3rd age of life
Subhepatic Appendicitis: A diagnostic conundrum
Get PDFOne of the most common presentations of acute abdominal pain in the emergency setting is appendicitis. Although it can occur in both genders, when it comes to females with appendicitis, reaching a definite diagnosis can be challenging as it can mimic other diseases such as ovarian cysts/torsions, pelvic inflammatory diseases, endometriosis, and urinary tract infection or physiological reasons like menstrual pain which are exclusive to females and can occur as frequently as appendicitis. Therefore, it is crucial to make an accurate diagnosis as early as possible with the right diagnostic tools to reduce morbidity and mortality in females of child-bearing age. This is a summarized case report of an adolescent female who experienced two atypical attacks of appendicitis 1 year apart. Since the patient had mainly right upper flank pain associated with nausea, vomiting, and fever with a largely non-tender abdomen, various diagnoses such as chronic cholecystitis, biliary colic, peptic ulcer, gastroenteritis, mesenteric lymphadenitis, renal colic, mittelschmerz, and torsion of ovarian cyst were considered and treated for. The patient had no relief and underwent numerous investigative procedures in the 2 years she suffered from her illness. The final diagnosis was only obtained when exploratory laparoscopy was performed. This article aims to remind clinicians to have a high index of suspicion for acute appendicitis in all atypical presentations of acute appendicitis. The latest WSES Jerusalem guidelines for the workup for patients at risk of acute appendicitis should be meticulously followed
Factor V Leiden homozygous mutation: Recurrent venous thromboembolism during periods of discontinuation of anticoagulant therapy
Get PDFVenous thromboembolism (VTE), also known as deep vein thrombosis and pulmonary thromboembolism, is a medical condition that has a high incidence and a multifactorial pathogenesis. One of the causes is a mutation of the Factor V Leiden (FVL), which is the most common inherited thrombotic disorder. A mutation inherited from both parents is found in about 0.05-0.5% of cases, making our case more medically interesting. We presented the case of a young male patient with recurrent VTE and few risk factors who was admitted to the hospital 4 times with VTE symptoms over a 5-year period. In the background, there was a homozygous FVL mutation and improper use of anticoagulant therapy. We examined the medical data, diagnostics, therapy, and precautions that were and are required