Journal of Health Sciences
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Doppler measurements of feto-placental blood stream in pregnant smokers
No full textIntroduction: Doppler analysis of the feto-placental and fetal circulation give dynamic information on the condition of the bloodstream during pregnancy, and early detection of fetal hypoxia. The objectives of the study were: testing whether there is influence of smoking on feto-placental circulation; determining whether there is a link to a number of smoked cigarettes during the day; assessing the benefits of Doppler ultrasonographic screening in detection of fetal hypoxia in pregnant women who smoke during pregnancy.Methods: 300 pregnancies were included in the prospective research. With regard to a number of smoked cigarettes the pregnant women were divided into three groups: I. the first group (moderate smokers) consisted of 100 pregnant women who smoked up to 15 cigarettes a day during pregnancy; II. the second group (heavy smokers) 100 pregnant women who smoked more than 15 cigarettes a day during pregnancy and III. the third group (control group) 100 pregnant women who did not smoke during pregnancy. All pregnant women underwent Doppler measurements of blood circulation (determination of resistance index – RI) in the umbilical artery, fetal aorta and middle cerebral artery.Results: The intensity of smoking has influence to circulation because RI in the umbilical artery and fetal aorta is increased and RI is decreased in the middle cerebral artery in pregnant women heavy smokers in comparison to pregnant women moderate smokers.Conclusion: Doppler sonography of the blood vessels could have an important role in detection of hypoxia and monitoring of the condition of the fetus of pregnant women who smoked during pregnancy
Gender related differences in demographic and clinical manifestations in patients suffering from various subtypes of schizophrenia
No full textIntroduction: Schizophrenia is devastating neuropsychiatric disorder that has no clearly identified etiology. The subtypes of schizophrenia are distinguished by the prevalent symptomatology. The aim of this study was to determine gender related differences in demographic and clinical manifestations in patients suffering from various subtypes of schizophrenia.Methods: A longitudinal, prospective,original,clinical investigation first in our local area, with application of Structured Clinical Interview for DSM IV Axis I Disorders (SCID I) was used in this work. The study included 121 patients during five years period. Patients were recruited as consecutive admissions to the Psychiatric clinic, from all parts of Bosnia and Herzegovina, mostly Sarajevo region.Results: The study was conducted on a group of schizophrenic patients which consisted of 52.1% male and 47.9% female patients. Average duration of the episode was about a month. Majority of patients (male) were in the group of disorganized (hebephrenic) schizophrenia. The duration of current psychotic episode was similar in all three groups regarding subtypes of schizophrenia. Psychotic episodes appear equally in both gender (higher in disorganized group) with a statistically significant difference between all groups (p<0.001).Conclusions: Male group patients showed tendency to be younger than women. Most of the schizophrenic individuals start to suffer from this disease between age of 20 and 39 years. Male group patients suffered mostly of disorganized (hebephrenic) type of schizophrenia. Duration of psychotic episode was proportionally the same in both groups while in male group the highest number of episodes was found in group of disorganized schizophrenia
The presence of risk factors for diabetes mellitus type 2 in patients of family practice medicine
Get PDFIntroduction: Diabetes mellitus (DM) type 2 is a heterogeneous disorder of complex etiology that occurs in response to genetic influences and impacts of the external environment. There are numerous risk factors thatcontribute to the development of type 2 diabetes such as: heritage, overabundant food and as a consequence of obesity in animals, physical inactivity, the presence of hypertension, psychogenic stress and many others. The aim of this study is to analyze and determine the existence of risk factors for type 2 diabetes in patients of all ages and both sexes treated in the general practice of the Health Centres for municipality Ilidza.Methods: The research is cross-sectional study, which is carried out in February 2010 in the general practice of the Health Centres for municipality Ilidža. Research instrument was a questionnaire and anthropometric measurements.Results: The results show us that in our sample 62% of patients had increased body mass index 25% of male respondents and 48% of females has waist I and II risks, both sexes are fairly large percentage (40%) inactive, a large percentage of respondents (52%) taking antihypertensive medications, 21% of respondents have a genetic predisposition of developing diabetes.Conclusions: There is a risk of developing type 2 diabetes in a large percentage of patients. Risk factors, important for the development of type 2 diabetes, were present at more than half of examinees and promotion of health and healthy lifestyles is necessary in all age groups
Spina bifida in surgically treated infants in Sarajevo region of Bosnia and Herzegovina
Get PDFIntroduction: Spina bifida is a congenital anomaly characterized by incomplitnes of vertebral arches in the medial line which occurs in 3rd and 4th month of intrauterine life. It is often associated with other congenital malformations, but hydrocephalus and Chiary II malformation are the most frequent. Aim: The aim of this work was to obtain the frequency of surgical cases of spina bifida treated at the Clinic for Neurosurgery, ClinicalCenter University of Sarajevo, Bosnia and Herzegovina.Methods: Retrospective study was carried out on the basis of the clinical records during the period January 2005. to December 2008. Standard methods of descriptive statistics were performed for the data analysis. Results: A total of 31spina bifida cases were surgically treated in the period from 2005. through 2008. Out of that number 14 (48.2%) were female patients, while 17 (54.8%) were male patients; sex ratio – 1.21:1. The most common type of spina bifida was myelomeningocele, treated in 24 surgical patients (77.45%), and the most common location was thoracolumbal part of the vertebral column, treated in 13 patients (41.91%).Conclusion: Anomalies associated with spina bifida were present in 19 patients (61.3%). Hydrocephalus, in 18 patients (58.05%) and Chiary II malformation, in 5 cases (16.13%) were the most frequent anomalies associated with spina bifida
Antibiotic prophylaxis and inflammatory complications after Cesarean section
Get PDFIntroduction: Gynaecological and obstetric surgeries are high risk operations for the development of postoperative inflammatory complications due to the proximity of the genitourinary tract. The aim of this study was to compare the frequency of inflammatory complications in emergency or elective cases of caesarean sections as well as the frequency of complications related to the method of surgical treatment used.Methods: We analyzed inflammatory complications in 450 caesarean sections, which developed in a one year period from June 1st, 2000. to June 1st 2001. Patients were grouped according to the method of the surgery, and on emergency or elective case. Misgav Ladach or Dorfler surgical methods were used.Results: The most common inflammatory complication was wound infection and the most common risk factors for inflammatory complications were premature rupture of membranes and anemia.Conclusions: Long term use of one antibiotic was the most commonly implemented form of antibiotic prophylaxis
The concentration of homocysteine in patients after ischemic brain stroke and vascular dementia
Get PDFoai:ojs2.jhsci.ba:article/1Introduction: The aim of this study is to examine whether moderate hiperhomocysteinemia is an independent risk factor for cerebral infarction.Methods: We have measured homocysteine levels in 50 patients with ischemic stroke during acute phase and postacute phase, 50 patients diagnosed with vascular dementia and healthy group of 50 subjects. Homocysteine concentration in serum was measured, on the basis of fluorescent polarisation measuring.Results: The study demonstrated that homocysteine concentration was 16.93 µmol/L in the patient group with ischemic stroke, and in the group of patients with vascular dementia was 20.39 µmol/L. Homocysteine increases during the postacute phase of ischemic stroke after 7 days for 1.54 µmol/L and 14 days for 3.66 µmol/L compared to the concentration of homocysteine after the first hours of hospitalization. Using Wilcoxon signed ranks and Mann-Whitney (P < 0.05) tests we got significant difference between homocysteine concentration at acute phase and post-acute phase of ischemic stroke and it was significant difference between concentrations of homocysteine in the acute and post-acute phase of ischemic stroke and vascular dementia. The Spearman correlation test was found signifiant correlation between the number of strokes and the concentration of homocysteine in serum of patients with vascular dementia.Conclusions: The homocysteine concentration rises significantly during of acute phase of ischemic brain stroke, and it is significantly increased during post-acute phase, which is a predictor factor for further development of vascular dementia, or a new ischemic brain stroke
Influence of osteoporosis risk faktors on bone mass loss in postmenopausal women
Get PDFIntroduction: Estrogen deficiency plays a critical role in the development of osteoporosis. However, some other factors may contribute to bone loss as well. Aim: To show presence of osteoporosis risk factors and to examine its influence on bone mass loss in women with normal menstrual history.Methods: The study included 30 postmenopausal women, ages from 50 to 65 with osteoporosis who entered into menopause before the age of 45, and 30 postmenopausal women, ages from 50 to 65 with osteoporosis who had normal menstrual history. Presence of risk factors has been calculated for both groups and statistical significance of differences between two groups presented.Results: In the group with normal menstrual history 33.33% women had low level of physical activities, 56.66% suffered from insuficient intake of calcium, 63.33% of women were active smokers. Body mass index bellow 19 had 6.66% women, insuficient exposure to the sun was registered in 60%, and 23.33% women were either taking medicaments or had diseases that could cause osteoporosis. Statistical significance of differencies in presence of certain risk factors between two groups was registered for : insuficient daily intake of calcium (p <0.001), insuficient exposure to the sun (p<0.001), and smoking (p <0.001).Conclusion: Results of the study indicate high presence of osteoporosis risk factors in women with normal menstrual history and indicate influence of certain factors (calcium, sun exposure, smoking) on occurence ofosteoporosis in this group
Health promotion in families who have children with intellectual and developmental disabilities
Get PDFIntellectual disability is the state of stopped or incomplete mental development which is featured by the impairment of abilities occurring at the development age and contributes to general level of intelligence, such as speech, cognitive, motor and social abilities. Disability can occur together or separately from other mental or physical disorders. 290 million people worldwide are estimated to have disabilities. Health is a core element in quality of life, but poverty, marginalization, limited access to primary health care, and lack of health promotion knowledge compromise health. Based on a research results in all nine areas of the family life quality (health, nancial status, family relations, support of other, support of services, influence of values, career, leisure and recreation, and community interaction) community could influence with the permanent preventive measures on 6 concepts of family life quality: importance, possibility, initiative, achievement, stability and satisfaction. The research could be of great help for the development of comprehensive strategies for improvement of quality of life for families that have one or more members with intellectual disability. From inclusion we expect approach to individual and his/her family by the society, to take into account all their diversities, preservation and improvement of their personal physical and mental health, for optimal possible functioning, at all personal and social levels
Conventional radiotherapy of localized right side breast cancer after radical mastectomy: development of innovative “field in field” technique
No full textIntroduction: The aim of this paper is to study the distribution of the therapy dosage applied by a modified conventional “field in field” technique and compare it to the distribution of the dosage applied by the standard conventional technique.Methods: The study included ten patients with right side breast cancer, after they were exposed to radical mastectomy and chemotherapy. Radiotherapy dosage of TD 50 Gy in 25 fractions was applied to the anterolateral side of the right thoracic wall, with two opposite conventional tangential fields by the linear accelerator Elekta Synergy and the energy of 6 megavolts (MV). A delineation of the target volume (CTV – Clinical Target Volume) was done within conventional fields. At the XiO system for planning we included additional fields within the existing conventional fields, which was the so called “field in field” technique. On the basis of CTV the Dose Volume Histogram (DVH) was calculated for conventional and “field in field” plans. VD90%, VD95%, VD107%, VD115%, CI and HI were calculated for both techniques. Means were pared with the paired Student\u27s t-test. The results were considered significantly different if p<0.05.Results: VD90% and VD 95% were significantly higher for the “field in field” technique. Therefore, CI also favored the “field in field” technique (p=0.02). There was no difference in VD107% and VD115% between the compared groups. Consequently, there was no statistically significant difference in HI (1.13±0.03 vs.1.13±0.03, p=0.06).Conclusion: Conventional postoperative radiotherapy of localized right side breast cancer by “field in field” technique provides excellent coverage of the target volume by radiotherapy isodose
Effects of improper posture during work on lumbal pain syndrome of discogenic etiology
Get PDFIntroduction: Lumbar pain syndrome is the most common cause of why patients, especially the active ones, are reported to physicians. It is manifested as nonspecific or non-radicular lumbar pain syndrome which is not associated with neurological symptoms, and specific which is associated with spinal nerve root compression. Aims of this study were to determine correlation between inadequate equipment and improper position for work with disk caused lumbar pain syndrome.Methods: The study included 913 patients who have visited the Community-based rehabilitation ambulance "Praxis" due to low back pain syndrome and verified disc hernia in the five year period. Lumbar pain syndrome was diagnosed by clinical examination (history, inspection, palpation, Lasegue sign, neurologic and motoric dysfunction tests), then radiologic diagnostic methods (CT, MRI). The data about inadequate equipment and position during work were obtained in interview with patients.Results: Lumbar pain syndrome is most common among workers (268 or 29.35%), followed by officials (239 or 26.17%). With the conducted research we determine that all the patients had inadequate equipment and the position of labor and weak abdominal and spinal muscles.Conclusion: Based on research conducted through the before mentioned variables, we can determine not only the association, but a strong influence of inadequate equipment and improper position for work to the occurrence of disk caused lumbar pain syndrome