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Effects of neural mobilization on pain, straight leg raise test and disability in patients with radicular low back pain
No full textIntroduction: Radicular low back pain is a disorder involving the dysfunction of the lumbosacral nerve roots. Clinical rehabilitation approaches for low back pain include kinesiotherapy, and physical therapyprocedures: ice , rest , heat, ultrasound, TENS, but evidences regarding their effectiveness are lacking. The purpose of this study was to determine if nerve mobilization brings better improvements in pain, SLR testand functional disability in patients with radicular low back pain compared to standard physical therapy.Methods: The study was conducted on a 60 patients with Radicular low back pain, treated in Regional medical center "Dr Safet Mujić", Mostar, during the period from 01.04.2010 untill 31.04.2011. Patientswere divided into two groups. First group (n=30) received a 4-week rehabilitation program including neural mobilization and lumbar stabilization program. Second group (n=30) received a 4-week rehabilitation program including active range of motion (ROM) exercises and lumbar stabilization program.Results: At the beginning, the two groups were not signifi cantly different in terms of score or SLR. After therapy there was statistically signifi cant improvement between groups in both VAS scores[Group A: 1.16±1.5; Group B: 2.25±2.2] and SLR [Group A: 80.9±17.4; Group B: 65.9±16.4]. ]. After the treatment, in group A, 46.6% (14) participants had been rated with 4, but in Group B: 33.3% (10) participants had been rated with 3.Conclusions: Patients treated with neural mobilization and lumbar stabilization showed better VAS scores and Straight Leg Test scores compared to patients treated with active range of motion exercises and lumbar stabilization. Further research to investigate their long term effi cacy is warranted, with emphasis on greater number of participants
Efficiency of dental health care in Federation of Bosnia and Herzegovina
No full textIntroduction: Despite the great improvements in the oral health status of the population across the world, oral diseases remains a major public health issue connected with a lost of numerous school days for childrenand absenteeism from work in adults. This effect is particularly evident in low and middle income countries as Bosnia and Herzegovina. This retrospective study presents the effi ciency of dental health carein Federation of Bosnia and Herzegovina measured by number of visits and performed dental treatments during the time period of six years, from 2005-2011.Methods: Data were collected by evaluation of the results obtained by forms which are mandatory to be completed by dentists.Results: The number of graduated dentists from 2007 to 2011 decreased from 108 in 2007 to 68 in 2011. In the same time, number of dentists employed in public sector slightly increased from 529 in 2005 to587 in 2011. Number of extracted permanent teeth decreased from the 412 extracted permanent teeth per dentist in 2005 to 364 in 2011. Small number of fi lled primary teeth comparing to large number ofextracted primary teeth showed negligence in their treatment.Conclusion: Having in mind that improving oral health in developing countries is a very challenging objective we can conclude that dental health care system in Federation of Bosnia and Herzegovina need to bereform in order to improve oral health in general, particularly in children population
Uterine cervix squamous cell carcinoma metastatic to the Ampulla of Vater: a case report with review of the literature
No full textMetastases to gastrointestinal tract are uncommon. In particular, metastases to the ampulla of Vater are very rare and may represent a significant diagnostic challenge. Metastases from the uterine cervix to the ampulla of Vater are exceedingly rare and only one case has been described in the available literature. We describe here a second case of metastatic squamous cell carcinoma of the cervix to the ampulla of Vater in a 45-year-old woman. Poorly differentiated squamous cell carcinoma presented as an isolated metastasis to the ampulla of Vater, two years after the initial diagnosis. While the squamous cell carcinoma could occur as primary ampullary carcinoma, albeit very rare, it is necessary to exclude the possibility of metastatic cancer
The synergistic antinociceptive effect of lornoxicam in combination with tramadol
No full textIntroduction: One of the most important priorities in therapy is pain control. Therefore, many different groups of drugs are being used for this purpose, primarily opioid analgesics and non-steroidal anti-inflammatory drugs (NSAIDs). Opioid analgesic tramadol, by binding to specific receptors, modulates the perception and response to painful stimuli and inhibits transmitting and further processing of pain impulses. Lornoxicam, which belongs to the oxicam class of NSAIDs, is a non-selective cyclooxygenase inhibitor with strong analgesic and anti-inflammatory effects, and better tolerance profile. Preliminary research, which requires further verification, suggests that lornoxicam may be a better alternative or adjunctive therapy to opioid analgesics in the treatment of moderate to severe pain. The aim of this study was to investigate antinociceptive effects of lornoxicam, as well as the combination of lornoxicam with tramadol.Methods: Analgesic effect of combination of lornoxicam and tramadol or lornoxicam applied alone was examined on female albino mice, using a hot plate method. Measurements were made 30, 60, 90 and 120 minutes after intraperitoneal and subcutaneous administration, in dose of 10 mg/kg.Results: Combination of lornoxicam and tramadol, applied intraperitoneally, increases the threshold of sensitivity to painful stimuli, which was not the case with subcutaneous administration.Conclusions: Lornoxicam significantly increases analgesic effect when applied intraperitoneally in combination with tramadol. On the other hand, lornoxicam in combination with tramadol, did not increase the threshold of sensitivity to painful stimuli with significant difference, after subcutaneous administratio
Views of the Slovenian nursing profession regarding leadership
No full textIntroduction: New, up-to-date approaches to professionalism presuppose the formation of a nursing team in such a way that relationships are not based on classical hierarchical relationships between superiors and subordinates but on relationships of interdependence and acknowledgment of the role the individual plays in the team. The objective of this article is to present the competences required by nurses in top organizational leadership positions from two viewpoints: as seen by nurses in top leadership positions and as seen by nurses in subordinate positions.Methods: A descriptive research method using a questionnaire as the measuring instrument was used. The questionnaire was based on the competence model of leadership in public administration in Slovenia and was tested on various professional groups.Results: Statistically signifi cant differences were observed with regard to the majority of competences between nurses in top leadership positions and nurses in non-leadership positions. Therefore, the views regarding what competences nurses in leadership positions should have substantially differed within theprofessional group.Conclusions: The fi rst conclusion is therefore that education on leadership on both the theoretical and practical levels must be introduced into undergraduate study programmes of health colleges. With the help of factor analysis we formed fi ve subgroups within the professional group of nurses: three subgroups within the group of nurses in leadership positions and two subgroups within the group of nurses in nonleadershippositions. A special education programme should be prepared for each of these subgroups
Dose-volume histogram constrains for small intestine in postoperative transcutaneous radiotherapy of endometrial carcinoma: comparison between conventional and conformal techniques
No full textIntroduction: The aim of this study was to determine the dose-volume histogram (DVH) constrains of conventional and conformal transcutaneous radiotherapy for small intestine and perform their comparison.Methods: This retrospective-prospective study included patients who were treated for endometrial cancer using conventional transcutaneous radiotherapy at the Department of Radiotherapy Clinic of Oncology,Hematology and Radiotherapy, University Clinical Center Tuzla in the period from 2009 to 2011. The study was performed on patients of all ages suffering from this condition. The study involved 35 patients. DVHparameters which were analyzed are: minimum dose (Dmin), maximum dose (Dmax), medium dose (Daver) of the small intestine, as well as the volume of the small intestine, which is included in 75%, 95% and 100%dose (V33,75Gy, V42,75Gy, V45Gy) expressed in percentages and cubic centimeters of the affected organ. Working hypothesis was tested with paired t test. The difference between the variables at the level of p <0.05 was considered statistically significant.Results: DVH constrains of transcutaneous conformal radiotherapy showed signifi cantly smaller dose contribution on small intestine than DVH parameters of conventional transcutaneous radiotherapy (p<0.0001).Conclusion: The dose contribution on small intestine was signifi cantly lower by planning three-dimensional conformal transcutaneous radiotherapy in comparison to the conventional planning
Fostering the practice of rooming-in in newborn care
No full textPractice of rooming-in meant that baby and mother stayed together in the same room day and night in the hospital, right from the time of delivery till the time of discharge. Adoption of rooming-in offers multiple benefits to the newborn, mother, and mother-child as a unit. It is a cost-effective approach wherefewer instruments are required and spares additional manpower. Rooming-in endeavors the opportunity to contribute signifi cantly in the child’s growth, development and survival by assisting in timely initiation of breastfeeding. To ensure universal application of rooming-in in hospitals, a comprehensive and technically sound strategy should be formulated and implemented with active participation of healthcare professionals. Measures such as advocating institutional delivery through outreach awareness activities; adoption of baby-friendly hospital initiative; inculcating a sense of ownership among health professionals, can be strategically enforced for better maternal and child health related outcomes
Frequency of neonatal complications after premature delivery
No full textIntroduction: Preterm delivery is the delivery before 37 weeks of gestation are completed. The incidence of preterm birth ranges from 5 to 15%. Aims of the study were to determine the average body weight, Apgar score after one and five minutes, and the frequency of the most common complications in preterminfants.Methods: The study involved a total of 631 newborns, of whom 331 were born prematurely Aims of this study were to (24th-37th gestational weeks-experimental group), while 300 infants were born in time (37-42 weeks of gestation-control group).Results: Average body weight of prematurely born infants was 2382 grams, while the average Apgar score in this group after the fi rst minute was 7.32 and 7.79 after the fifth minute. The incidence of respiratory distress syndrome was 50%, intracranial hemorrhage, 28.1% and 4.8% of sepsis. Respiratory distresssyndrome was more common in infants born before 32 weeks of gestation. Mortality of premature infants is present in 9.1% and is higher than that of infants born at term.Conclusions: Birth body weight and Apgar scores was lower in preterm infants. Respiratory distress syndrome is the most common fetal complication of prematurity. Intracranial hemorrhage is the second most common complication of prematurity. Mortality of premature infants is higher than the mortality of infants born at term birth
The role of human papillomavirus (HPV) testing in the follow-up of patients after treatment for cervical intraepithelial neoplasia (CIN)
No full textIntroduction: The aim of this study was to examine the role of human papillomavirus testing in the follow-up after treatment for CIN, as a prognostic sign for residual/recurrent cervical precancerous lesions.Methods: A hospital-based analysis was performed on 460 patients previously treated for CIN with cold knife conization, at the University Clinic for Gynecology and Obstetrics and General Hospital Remedika, in Skopje, Republic of Macedonia, in a period of 3 years. The patients were followed-up with HPV testing in addition to cytology, colposcopy and/or biopsy. The first after treatment HPV testing was performed8 months after cold knife conization, proceeded by follow-up within 24 months after treatment, at 4 months intervals.Results: Among 460 treated patients, at the fi rst HPV and cytologic testing, 8 months after treat-ment, 69 (15%) were HPV+, and 391 (85%) HPV negative. From the 69 HPV+ patients, 41 (59.4%) were withcytologic abnormalities and 28 (40.6%) without abnormalities. 12 months after treatment, the number of HPV+ patients developing cytologic abnormalities raised to 45/70 (64.29%). Within the 24 months aftertreatment, the number of patients who had recurrent/ residual CIN from the HPV+ patients reached 50/71 (70.42%); which was 10.87% from all 460 treated patients.Conclusion: Persistence or clearance of HPV especially 8 months after treatment even in patients with normal cytology, is an early valid prognostic marker of treatment failure, and is more accurate than cytologyat the same follow-up intervals
The effect of mineral radon water applied in the form of full baths on blood pressure in patients with hypertension
No full textIntroduction: Due to patients’ safety, increased blood pressure often restricts wider use of mineral water for therapeutic purposes in rehabilitation practice. The aim of this study was to examine the effect of radon mineral water applied in the form of full baths on blood pressure in people with hypertension.Methods: A total of 27 patients, average age 58.10 years with hypertension were included in the study. Balneotherapy was applied in the form of full baths with mineral radon water of neutral temperature. Values of systolic and diastolic blood pressure were measured before and after twenty minutes therapy on the first and fifth day of treatment.Results: On the first day of treatment there was no significant change in blood pressure after the application of full baths with mineral radon water of neutral temperature (systolic pressure t = 0.697, not significant; diastolic pressure t = 0.505, not significant). On the fi fth day of treatment there was no significant changes in blood pressure after the application of medical baths with mineral radon water of neutral temperature (systolic pressure t = 1.372, not significant; diastolic pressure t = 1.372, not significant).Conclusion: The significant increase of blood pressure in patients with mild and moderate hypertension is not expected when Fojnica water (radioactive mineral water) is being used in the form of full baths of neutral temperature, which allows a broader application of this balneo procedure in rehabilitation practice