Journal of Health Sciences
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CT angiography and Color Doppler ultrasonography features and sensitivity in detection of carotid arteries diseases
No full textIntroduction: The aim of this research was to compare specifi city and sensitivity of Color Doppler ultrasonographywith CT angiography.Methods: A total of one hundred patients suffering from carotid artery disease (n=200) were tested in this research in the period from June till October, 2011. Average age of the patients was 61.5 years, and most of the patients were in the age group ranging from 55 to 65 years. The level of carotid artery stenosis is measured according to Standards of the North America Symptomatic Carotid Endarterectomy Trail study,by method of Color Doppler ultrasonography and CT angiography.Results: Stenosis <50% registered by Doppler ultrasonography was found in 62% and by CT angiography in 64% patients. Stenosis from 70 to 79% registered by Doppler ultrasonography was found in 88% and by CT angiography in 82% patients. In patients with level of stenosis 70-79% there was a tendencyof registering the stenosis to be higher by Color Doppler ultrasonography, than by CT angiography. In the case of the occlusion, there was also the similar observation, with variation of 8% carotid arteries.Conclusion: Extracranial Doppler and color duplex ultrasound enable reliable detection of both stenosis and occlusion of carotid arteries and accordingly they occupy an important place in radiological algorithm. When it comes to CT angiography it can be concluded that it can provide accurate and exact information regarding the condition of blood vessels as good as Digital Subtractive Angiography can
The influence of social environment on the smoking status of women employed in health care facilities
Get PDFIntroduction: Bosnia and Herzegovina has a high prevalence of smoking among women, especially among health care professionals. The goal of this study is to investigate the influence of the social environment of women employed in health institutions in relation to the cigarettes smoking habits.Methods: The study included 477 women employed in hospitals, outpatient and public health institutions in Sarajevo Canton Bosnia and Herzegovina. We used a modifi ed questionnaire assessing smoking habits of medical staff in European hospitalsResults: The results showed that 50% of women are smokers, with the highest incidence among nurses (58.1%) and administrative staff (55.6%). The social environment is characterized by a high incidence of colleagues (60.1%) and friends who are smokers (54.0%) at the workplace and in the family (p<0.005). One third of women (27.8%), mainly non-smokers, states that the work environment supports employees smoking (p=0.003).Conclusion: Workplace and social environment support smoking as an acceptable cultural habit and is contributing to increasing rates of smoking among women
Increased expression and levels of human β defensins (hBD2 and hBD4) in adults with dental caries
No full textIntroduction: Defensins are small anti-microbial peptides produced by epithelial cells. These peptides have a broad range of actions against microorganisms, including Gram-positive and Gram-negative bacteria.Human defensins are classifi ed into two subfamilies, the α-, and β- defensins, which differ in their distribution of disulphide bonds between the six conserved cysteine residues. Defensins are found in salivaand others compartments of the body. Human β defensins 2 (hBD2), beta defensins 4 (hBD4) and alpha defensins 4 (hNP4) in saliva may contributes to vulnerability or resistance to caries. This study aimed to determine a possible correlation between caries and levels of defensins measuring the expression in gingival tissue and concentrations in saliva samples.Methods: Oral examinations were performed on 100 adults of both genders (18-30 years old), and unstimulated whole saliva was collected for immunoassays of the three peptides and for the salivary pH, buffercapacity, protein, and peroxidase activity. mRNA levels of defensins in gingival sample were assessed by semi-quantitative RT-PCR technique.Results: The median salivary levels of hBD2 and hBD4 were 1.88 μg/ml and 0.86 μg/ml respectively for the caries-free group (n=44) and 7.26 μ/ml (hBD2) and 4.25 μg/ml (hBD4) for all subjects with evidenceof caries (n=56). There was no difference in the levels of hNP4, salivary pH, and proteins between groups, however the peroxidase activity and buffer capacity (interval 6.0-5.0) were reduced in caries group. Transcriptional levels of hBD2 and hBD4 did correlate with caries experience, the mRNA expression of hBD2 and hBD4 were signifi cantly higher in patients with caries than in patients with no-caries (p < 0.01).Conclusion: We conclude that high salivary levels and expression of beta defensins, low peroxidase activity and buffer capacity may represent a biological response of oral tissue to caries. Our observation couldlead to new ways to prevent caries and a new tool for caries risk assessment
Age, gender and hypertension as major risk factors in development of subclinical atherosclerosis
No full textIntroduction: Intima-media thickness (IMT) measurement of the common carotid artery (CCA) is considered as useful indicator of carotid atherosclerosis. Early detection of atherosclerosis and its associated risk factors is important to prevent stroke and heart diseases. The aim of the present study was to investigate which risk factors are better determinants of subclinical atherosclerosis, measured by common carotidartery intima media thickness (CCA-IMT).Methods: A total of 74 subjects were randomly selected in this cross – sectional study. Information on the patient’s medical history and laboratory fi ndings were obtained from their clinical records. Risk factors relevant to this study were age, gender, cigarette smoking status, diabetes, hypertension and dyslipidemia. Ultrasound scanning of carotid arteries was performed with a 7,5 MHz linear array transducer (GE Voluson730 pro). The highest value of six common carotid artery measurements was taken as the fi nal IMT. Increased CCA-IMT was defi ned when it was > 1 mm.Results: Our data demonstrated higher CCA-IMT values in male patients compared with female patients. Increased CCA-IMT was the most closely related to age (P<0.001), followed by systolic blood pressure (P=0.001), diastolic blood pressure (P=0.003) and glucose blood level (P=0.048).Conclusion: Age, gender and hypertension are the most important risk factors in development of carotid atherosclerosis. Early detection of atherosclerosis among high-risk populations is important in order to prevent stroke and heart diseases, which are leading causes of death worldwide
Physical activity and bone mineral density in postmenopausal women without estrogen deficiency in menstrual history
No full textIntroduction: The estrogen defi ciency after menopause leads to accelerated loss of bone mass. The aim of this study was to examine influence of physical activity on bone mineral density in postmenopausal women who hadn’t a deficit of estrogen in their menstrual history.Methods: This prospective study included 100 postmenopausal women, ages between 50 and 65, living in Sarajevo area without estrogen deficiency in menstrual history. The women in the examination group had osteoporosis. The women in the control group had osteopenia or normal mineral bone density. Mineral bone density was measured at the lumbar spine and proximal femur by Dual–Energy X–ray Absorptiometry using Hologic QDR-4000 scanner. To assess level of physical activity an International Physical Activity Questionnaire - Long Form was used.Results: In the examination group of women who had no history of menstrual estrogen deficit, level of physical activity was low in 52.00% female, and in 48.00% women level of physical activity was moderate. In the control group of women who had no history of menstrual estrogen defi cit in 10.00% female level of physical activity was low, and in 90.00% female level of physical activity was moderate. The difference in levels of physical activity between the two groups was statistically significant, X2 test = 20.6, p <0.005.Conclusion: Results of this study suggest that moderate physical activity has positive impact on bone mineral density in postmenopausal women without estrogen defi ciency in menstrual history and has the potential to reduce rapid bone loss after menopause
Nurses and burnout syndrome
No full textIntroduction: The work of nurses is human. They help people in protection against diseases. Nurses are the largest group of health workers and all problems that appear in the health system are first recognized among them. Burnout syndrome appears among nurses very frequently. We present the leading factors for burnout among nurses in RMC „Dr Safet Mujic“ in Mostar, Bosnia and Herzegovina.Methods: It is a cross sectional descriptive study. We used an anonymous questionnaire with 20 questions. Our sample was random with 30% of all nurses which were working in this Medical Center in January-February 2012.Results: In our study 77.9% nurses work in the hospital. 52% have over 16 years of work experience. 34.6% of examinees are satisfi ed with interpersonal relationships, 31.7 % are satisfi ed with relationships with the superior. Motivation for work have 51% of examinees, a big number comes unwilling on work.For 83.7% overtime work is the reason for dissatisfaction 71.2% examinees think that they can\u27t make progress on work. A high percentage of examinees doesn\u27t think about problems related to work outside working hours, a good sleep have 38.5% and 56.7% wakes up tired. Many of examinees are not satisfiedwith workplace, and 58.7% would like to change it.Conclusion: Nurses employed in RMC „Dr Safet Mujic“ Mostar are exposed to many factors during work which can cause the burnout syndrome. It is necessary to expand the study on a larger group of nurses and to implement the measures for reducing risks of burnout syndrome
Common variable immunodeficiency – case report
No full textCommon variable immunodeficiency (CVID) or acquired hypogammaglobulinemia is the type of primary immunodeficiency. Deregulation of the immune system, leading to hypogammaglobulinemia, defective activation and proliferation of T cells and dendritic cells, and malfunction of the cytokines are observed in CVID. The clinical picture of CVID varies, any organ or system can be affected, therefore the diagnosis is often difficult and delayed and sometimes is not always possible. This article describes a twelve years old boy with all the clinical signs of immunodeficiency, as confi rmed by laboratory. The main treatment consists of life-long immunoglobulin substitution in intravenous or subcutaneous form
Correlation between serum concentrations of homocysteine, folate and vitamin B12 in patients with schizophrenia
No full textIntroduction: The role of hyperhomocysteinemia in psychotic disorder can be explained by partial antagonism of homocysteine on NMDA-glycine receptor. Plasma concentration of homocysteine is an indicatorof the status of the B-vitamins (folate, B12, B6). Folate deficiency may have different effects on the neurochemical processes of schizophrenia. This suggests that the association between elevated levels of homocysteine and schizophrenia is biologically very likely.Methods: The study was consisted of 20 patients with schizophrenia and 20 healthy controls. We investigated the levels of serum homocysteine concentration using AxSYM (Abbott), levels of folate assay istwo-step immunoassay to determine the presence folate in human serum using CMIA (chemiluminescent microparticle immunoassay) technology and Axsym Holo Tc is microparticle enzyme immunoassay (MEIA)for the quantitative determination of human holo TC in serum and determination defi cit of vitamin B 12.Results: The patients group has higher levels of homocysteine in compare with controls group for 3.85 μmol/L while the concentration of folate in the group of patients was lower for 9.17 ng/mL. The mean level of vitamin B-12 in investigation groups were in reference range 19.1-119 pmol/L, but patient group have lower average concentration of vitamin B-12 lower for 24.81 pmol/L compared to the control group.Conclusion: Our results showed that homocysteine concentration is inversely proportionate to folate concentration,i.e. as homocysteine concentration in serum increases, folate concentration falls. Shizophrenicpatients with elevated tHcy level and low folate levels should have vitamin supplementation with folic acid
Effects of intraneural and perineural injection and concentration of Ropivacaine on nerve injury during peripheral nerve block in Wistar rats
No full textIntroduction: Injury during peripheral nerve blocks is relatively uncommon, but potentially devastating complication. Recent studies emphasized that location of needle insertion in relationship to the fascicles may be the predominant factor that determines the risk for neurologic complications. However, it is wellestablished that concentration of local anesthetic is also associated with the risk for injury. In this study, we examined the effect of location of injection and concentration of Ropivacaine on risk for neurologic complications. Our hypothesis is that location of the injection is more prognostic for occurrence of nerve injury than the concentration of Ropivacaine.Methods: In experimental design of the study fi fty Wistar rats were used and sciatic nerves were randomized to receive: Ropivacaine or 0.9% NaCl, either intraneurally or perineurally. Pressure data during application was acquired by using a manometer and was analyzed using software package BioBench. Neurologic examination was performed thought the following seven days, there after the rats were sacrificed while sciatic nerves were extracted for histological examination.Results: Independently of tested solution intraneural injections in most of cases resulted with high injection pressure, followed by obvious neurologic defi cit and microscopic destruction of peripheral nerves. Also, low injection pressure, applied either in perineural or intraneural extrafascicular area, resulted with transitory neurologic defi cit and without destruction of the nerve normal histological structure.Conclusions: The main mechanism which leads to neurologic injury combined with peripheral nerve blockade is intrafascicular injection. Higher concentrations of Ropivacaine during intrafascicular applications magnify nerve injury
Efficiency of combined treatment and conventional physical treatment in bilateral knee arthrosis
No full textIntroduction: Degenerative joint disease, which is standardized in Europe by the name of arthrosis or osteoarthrosis, while in the Anglo-Saxon literature is in use for a long time by the name of osteoarthritis (OA) although this is not a classical inflammation,is the most common joint disease in general and the most common cause of functional damage of the musculoskeletal system. Recently, the term osteoarthritisappears more frequently in domestic literature. Arthroses are degenerative joint diseases with progressive character, also one of the most frequent diseases in orthopedics. The disease fi rst affects the articular cartilage, then the bony edges of the articular surfaces, and then the articular lining.Methods: Retrospective analysis and evaluation of data of treated patients, with the "Praxis" physical treatment during the period of time from 2000 to the end of 2010 on a sample of 79 patients,valorized the efficacy of Praxis treatment. The correlation of these results, with valorisation of the efficacy of standard physical treatment in clinics D.Z. " Novi Grad " on a sample of 81 patients, during the period of time from 2000 to the end of 2010, a statistical analysis was performed for comparing the effi cacy of the two methods.Results: There is a functional difference after therapy of bilateral gonarthrosis in clinics D.Z. "Novi Grad" and "Praxis" with statistical reliability.Conclusion: A combined approach in the treatment of knee arthrosis has a wider range of treatment procedures, comprehensively approaches to the problem and gives better results, so we can say that this method has priority compared to the standard approach to the knee arthrosis treatment