Journal of Health Sciences
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Early extubation after congenital heart surgery
Get PDFIntroduction: Despite recent advances in anesthesia, cardiopulmonary bypass and surgical techniques, children undergoing congenital heart surgery require postoperativemechanical ventilation. Early extubation was definedas ventilation shorter than 12 hours. Aim of this study is to identify factors associated with successful early extubation after pediatric cardiac surgery.Methods: The study was performed during period from January 2006 to January 2011 at Pediatric Clinic and Heart Center University Clinical center Sarajevo. One hundred children up to 5 years of age, who have had congenital heart disease, with left–right shunt and obstructive heart disease were included in the study. Patients were divided into two groups: Group I - patients extubated within 12 hours after surgery and Group II - patients extubated 12 or more hours after surgery. Results: The most frequently encountered preoperative variables were age with odds ratio 4% 95%CI (1-7%), Down\u27s syndrome 8.5 95%CI (1.6-43.15), failure to thrive 4.3 95%CI( 1-18). Statistically significant postoperative data included lung disease (reactive airways, pneumonia, atelectasis, pneumothorax) and with odds ratio 35.1 95 %CI (4-286) and blood transfusion with odds ratio 4.6 95%CI (2-12). Blood transfusion (p=0.002) (Wald=9.2) 95%CI (2-12), during as well as after operation procedure has statistically significant influence on prediction time of extubation. Proven markers were age with cut of 21.5 months (sensitivity 74% and specificity 70%) and extracorporeal circulation (ECC) with cut-of 45.5 minutes (sensitivity 71% and specificity 65%).Conclusion: Early extubation is possible in many children undergoing congenital heart surgery. Younger age and prolonged ECC time are markers associated with prolonged mechanical ventilation
Innovating in Health Care – Modern Challenges
No full textIntroduction: The goal of this article is to present that innovating in health care begins to become an imperative in present time. Innovating will enable the achievement of the highest quality health care results and the patients\u27 satisfaction with the least amount of financial resources.Methods: The thorough literature review of multifaceted sources was conducted including: studies, books, monographies and peer – reviewed journals with the goal of achieving the clearer picture of today\u27s modern challenges in the complex fi eld of health care innovation.Discussion: Theoretical and empirical studies clearly indicate that the innovation is one of the key factors in the competitiveness of the organization and its survival in the market. Developed countries of the world today are making significant efforts in order for innovation to become a national priority, with special emphasis placed on measuring innovation performance. Results of theoretical and practical studies show that in the future, treatment of the most diffi cult and complex diseases of our time, through the entirely new discoveries and results, derived from the process of innovation, will project entirely new positive forms and outcomes in the health care.Conclusion: There is no doubt that the humanity and medical science will through innovation succeed to win the battles against the majority of the most complex contemporary diseases. Malignant neoplasm of tomorrow, through the application of a new, innovative approaches to research, processes and treatments will become a chronic diseases. Among many, the particular problem in the process of innovation will represent the cost of research and development (R&D), production and the safety of prescription drugs
Frequency of joined disabilities of children with cerebral palsy in Tuzla canton
No full textIntroduction: Cerebral palsy (CP) connotes a group of non-progressive, but often variable symptoms of motor impairment of movement and posture, as well as other impairments which are a consequenceof anomalies or brain impairment in different phases of its development. CP is a pathological condition characterised in the fi rst place by motor function impairment to which other disorders such as: visual andhearing impairment, intellectual defi cit, emotional problems, behaviour disorder, speech disorder, epileptic seizure and similar can join. The aim of this study is to determine frequency of joined disabilities ofchildren with cerebral palsy in Tuzla Canton.Methods: The research covers a total sample of 48 examinees, chronological age from 2-19 years, in Tuzla Canton. Research instrument was a Structural Questionnaire for the parents of children and adolescentswith cerebral palsy. Research data were processed by nonparametric statistics method. Basic statistical parameters of frequency and percentages were calculated, and tabular presentation was made.Results: After classification of examinees as per frequency of joined disabilities was done, work results have shown that speech impairment occurred with 35.4 % of children, visual impairment 33.3 %, epilepsy29.3 %, whereas hearing impairment occurred with 2 % of children.Conclusion: In research of frequency of joined disabilities of children with cerebral palsy in Tuzla Canton, most expressed are speech and visual disorders with children, then epilepsy, whereas a small percentageof children are with hearing disorder
The effects of sex, age and cigarette smoking on micronucleus and degenerative nuclear alteration frequencies in human buccal cells of healthy Bosnian subjects
No full textIntroduction: This study was performed to establish a baseline value of micronucleus frequency in buccal cells and to estimate the impact of the most common factors (sex and age, and smoking) on micronucleus and degenerative nuclear alteration frequencies in the sample of healthy Bosnian subjects.Methods: The Buccal Micronucleus Cytome (BMCyt) assay, based on scoring not only micronucleus frequency but also other genome damage markers, dead or degenerated cells, provides a measure of cytotoxic and genotoxic effects.Results: Our results showed the baseline buccal micronucleus frequency was 0.135% or 1.35‰, as well as positive correlations between micronucleus frequencies and formations of degenerative nuclear alterations (nuclear buds, karyolytic and karyorrhectic cells). The number of micronuclei in buccal cells was significantly higher in females than in males. There was positive association between the age and frequency of analysed cytogenetic biomarkers. Buccal cell micronuclei and degenerative nuclear alternations were more frequent among cigarette smokers than non-smokers and significantly higher in female smokers than in male smokers. Cytogenetic damages showed significantly positive correlation between intensity of smoking and the number of nuclear alterations. The years of smoking had a significant influence not only on the number of nuclear alterations but also in micronuclei and nuclear buds in buccal cells.Conclusions: The sex influences the number of micronuclei in human buccal cells. The ageing increased the number of micronuclei and other biomarkers of DNA damage. The cigarette smoking significantly increases the frequencies of micronuclei and nuclear buds, pyknotic, karyolytic and karyorrhectic cells
Surface coil in the magnetic resonance imaging of the orbital vessels anatomy
No full textIn this paper, we demonstrate a capability of surface coil magnetic resonance imaging in the review of orbital blood vessels anatomy. Surface coil allows a better detection of small anatomic structures including vessels such as ophtalmic artery and its branches, and also orbital veins, particularly superior and inferior ophtalmic veins with accompanying branches. The best results are obtained by the use of T1 sequences with short TE and TR
Awareness and attitude of secondary school students about drug use
No full textIntroduction: Problem of addiction on psychoactive substances is one of the most diffi cult problems in a modern society, which brings serious consequences, both for the individual, his environment and the whole society.Methods: The study included 95 children and adolescents of medical school. Among the respondents, there were 44 subjects of third year of high school and 51 respondent-grader.Results: Students involved in this research as an answer to why young people start using drugs often reported curiosity in over 50% of cases, as well as pressure of friends. For students who use narkotine respondents generally thought they are reasonable and sufficiently weak and limited personality. Thelargest number of high school students who were involved in the study did not know the individuals who use drugs.Conclusion: Drug addiction is a serious problem all over the country, and the number of addicts is becoming larger. Particularly worrisome is the fact that the consumption of the drug phenomenon is a characteristic of young population, especially high school student
Palliative care in the home: a case study of secondary histiocytic sarcoma in a 3-year-old child
No full textThis article describes the medical, psychological, and social challenges encountered during home-based, family-centred palliative care of a 3-year-old female with secondary histiocytic sarcoma diagnosed during treatment for T-cell acute lymphoblastic leukaemia. Histiocytic sarcoma is an exceedingly rare cancer in adults, but even less frequent and highly aggressive when presenting as a secondary cancer in children. Comprehensive, multidisciplinary paediatric hospice care services are not widely available across Slovakia,thus limiting the number of patients and families offered such highly specialized end-of-life care. This case study illustrates the primary benefits for the child and family of such a program as well as the impact on the medical and nursing professionals working in the fi eld of paediatric haematology-oncology
Oral surgical procedures and prevalence of oral diseases in Oral Surgery Department in Faculty of Dentistry Sarajevo
No full textIntroduction: The aim of this study is to determine prevalence of oral diseases and oral surgical procedures at Department of Oral Surgery, Faculty of Dental Medicine, University in Sarajevo.Methods: The current study is retrospective analysis of oral surgical procedures performed from January 2011 to December 2012 at Department of Oral Surgery, Faculty of Dental Medicine, University in Sarajevo. The data were statistically analyzed by T-test of independent samples and using Chi-squared test. P value lower than 0,001 was considered to be statistically significant.Results: A total of 1299 patients were included in study. The age range is from 18 to 84 years, with mean age ± SD= 35±15 years. There were 42 different clinical diagnoses, and 13 diagnoses appeared in more than 1% of all patients. Impacted and semi-impacted teeth, periapical lesions and retained roots are the most frequent diagnoses and represent 68% of all diagnoses. Embedded and impacted teeth (35%) and diseases of pulp and periapical tissues (31%) are the most frequent diagnoses with respect of ICD-10. Impacted teeth is the most common diagnosis and removal of impacted third molars is the most common oral surgical procedure.Conclusion: Study points out variety of dentoalveolar patology and complexity of dental health care that often requires interdisciplinary approach in order to achieve optimal outcome for patient
Etiological factors of preterm delivery
No full textIntroduction: Preterm delivery is the delivery before 37 weeks of gestation are completed. Preterm birth is a major course of neonatal morbidity and mortality, the incidence of premature delivery in developedcountries is 5 to 9%. Aims of this study were to determine the common etiological factors for preterm delivery, most common weeks of gestation for pretern delivery, and most commom way of delivery for preterm delivery.Methods: The study included 600 patients divided into two groups, experimental group (included 300 preterm delivered pregnant women), control group (included 300 term delivered women).Results: The incidence of preterm delivery in pregnant women younger than 18 years was 4.4%, and in pregnant women older than 35 years was 14%. 44.6 % of preterm delivered women at the experimentalgroup had lower education. In the experimental group burdened obstetrical history had 29%, 17.2% had a preterm delivery, 35.6% had a premature rupture of membranes, 15% had a preterm delivery before32 weeks of gestation, 12.4% between 32-33.6 weeks of gestation, while 72.6% of deliveries were between 34- 36.6 weeks of gestation. Multiple pregnancy as an etiological factor was present in 10.07% ofcases. Extragenital diseases were present in 10.4%. In the experimental group there were 29%, while in the control group there were 15% subjects with burdened obstetrical history.Conclusions: Preterm birth more often occurs in a pregnant women younger than 18 and older than 35 years, and in a pregnant women of lower educational degree. Preterm delivery in the most commoncases was fi nished in period from 34 to 36.6 weeks of gestation. The most common etiological factor of preterm delivery in the experimental group was preterm rupture of membranes and idiopathic pretermdelivery
Abnormal colposcopic images in patients with preinvasive cervical lesions
No full textIntroduction: The objective of the study was to determine frequency and to compare frequency of the abnormal colposcopic images in patients with low and high grade pre-invasive lesions of cervix.Methods: Study includes 259 patients, whom colposcopic and cytological examination of cervix was done. The experimental group of patients consisted of patents with pre-invasive low grade squamousintraepithelial lesion (LSIL) and high grade squamous intraepithelial lesion (HSIL), and the control group consisted of patients without cervical intraepithelial neoplasia (CIN).Results: In comparison to the total number of satisfactory fi ndings (N=259), pathological findings were registered in N=113 (43.6 %) and abnormal colposcopic fi ndings in N=128 (49.4%). The study did notinclude patients with unsatisfactory fi nding N=22 (8.5%). Abnormal colposcopic image is present most frequently in older patients but there are no statistically important difference between age categories(Pearson Chi-Square 0.47, df -3, p=0.923). Frequency of abnormal colposcopic fi ndings (N=128) is the biggest in pathological cytological (N=113) and HSIL 58 (45.3%), LSIL 36 (28.1%). There is statisticallysignifi cant difference in frequency of abnormal colposcopic images in patients with low-grade in comparison to patients with high-grade pre-invasive cervix lesions (Chi-Square test, Pearson Chi-Square 117.14,df-12 p<0.0001).Conclusion: Thanks to characteristic colposcopic images, abnormal epithelium is successfully recognized, but the severity grade of intraepithelial lesion cannot be determined