bluuebunny/crossref_metadata_2025 huggingface dataset:
The relationship between protective factors and a measure of psychological resistance in women diagnosed with breast cancer
Authors: Lisica Delila , Kolenović-Ðapo Jadranka , Džubur Amela , Abdulahović Damir , Ejubović Malik
Published: April 2024

Aim
 To examine the relationship of protective factors (self-esteem, optimism, proactive coping), and a measure of psychological resistance in women diagnosed with breast cancer, and the contribution of protective factors in explaining the criterion of posttraumatic growth.
Methods
The study included 100 women diagnosed with breast cancer. To examine optimism the Scale of Dispositional Optimism and Pessimism, the Scale of Self-esteem for self-esteem and the Scale of Proactive Coping for proactive coping were used. The posttraumatic growth measured five factors: relating to others, new possibilities, personal strength, spiritual changes, appreciation of life.
Results
 Self-esteem, optimism and proactive coping were associated with posttraumatic growth and its factors: new possibilities, personal strength, appreciation of life. Optimism and proactive coping positively corelated also with relating to others. Final model of posttraumatic growth in all three steps (self-esteem, optimism, proactive coping) explained 20.4% variability of the posttraumatic growth total score.
Conclusion
 Posttraumatic growth does not mean a decrease in trauma, but leads to a change in the perception and view of life. It refers to more favourable management and use of its own resources, relying on its own strengths and capabilities, identifying new opportunities and connecting with others.
The most common etiological agents of prosthetic joint infections in orthopaedics
Authors: Breznicky Jozef , Novak Martin
Published: April 2024

Aim
To determine the spectrum of causative agent of prosthetic joint infections in orthopaedics.
Methods
 In the group of 50 patients with periprosthetic infection the results of microbiological analysis of minimally two samples
gained intraoperatively were analysed.
Results
 The only pathogen in the group of acute infection was Staphylococcus (S.) aureus. In case of delayed infection the most
frequent pathogen was also S. aureus and in case of late infection it was coagulase-negative staphylococcus.
Conclusion
 A better understanding of the most common agents responsible for prosthetic joint infection helps us to properly prepare the patient (by eradicating of potential focus) with adequate antibiotic prophylaxis and early treatment of suspected infections
to further reduce the incidence of infectious complications in orthopaedics. It is important to bear in mind that patients who have undergone total joint replacement have a risk of infection for the rest of their lives.
Provoked venous thromboembolism during ten-year follow up at the Clinical Centre University of Sarajevo
Authors: Mlačo Akif , Mlačo Nejra , Bejtović Demir , Spužić Muhamed , Džubur Alen , Begić Edin
Published: April 2024

Aim
 To determine risk factors for deep vein thrombosis (DVT) in hospitalized patients in a 10-year follow-up.
Methods
In this observational study data were collected from the disease history of patients admitted to the Department of Angiology of the Clinical Centre University of Sarajevo in the period of 10 years (2008-2017). Of 6246 hospitalized patients, 1154 were with established diagnosis of DVT and included in the study as a basic inclusion criterion.
Results
 Provoked venous thromboembolism was recorded in 45.75% of hospitalized patients. In 54.25% cases DVT was classified as idiopathic; in the remaining cases with DVT external risk factors were identified. Every fourth patient had a history of malignancy, and this risk factor was significantly more common among women and younger patients. Cancer of female reproductive organs, colon, lung, breast and prostate cancer were most common. One of 10 women had DVT during pregnancy or postpartum period. Out of the total number, 10.9% patients had DVT after surgery, 2.3% after injury. DVT was found in 1.6% of drug addicts. Rethrombosis was diagnosed in 5.2% patients within a year, while 9.2 % patients had rethrombosis within five years.
Conclusion
 Provoked venous thromboembolism is an entity that can be prevented. Malignancy and surgical treatment are the most common risk factors and these patients should be treated with special care. The creation of a register of patients with venous thromboembolism in Bosnia and Herzegovina would enable the development of a preventive strategy in the groups of patients at risk.
Therapeutic hypothermia as a treatment option after out-of hospital cardiac arrest: our experience
Authors: Iglica Amer , Godinjak Amina , Begić Edin , Hodžić Enisa , Zvizdić Faris , Kukavica Nihad , Aganović Kenana , Šabanović-Bajramović Nirvana , Kukuljac Adis , Gojak Refet
Published: April 2024

Aim
To examine the effects of therapeutic hypothermia on the outcome of patients with the diagnosis of out-of-hospital cardiac arrest (OHCA).
Methods
 The study included 76 patients who were hospitalised at the Medical Intensive Care Unit (MICU) of the Clinical Centre University of Sarajevo, with the diagnosis of out-of-hospital cardiac arrest, following the return of spontaneous circulation. Therapeutic hypothermia was performed with an average temperature of 33 o C (32.3-34.1 o C) on the patients who had coma, according to the Glasgow Coma Scale (GCS).
Results
 Multiple organ dysfunction syndrome (MODS) significantly affected survival (p=0.0001), as its presence reduced patients' survival by 96%. In addition, ventricular fibrillation (VF) as the presenting rhythm, also significantly affected survival (p=0.019). A degree of patient's coma, as measured by the GCS, significantly affected survival (p=0.011). For each increasing point on the GCS, the chance for survival increased twice. Moreover, other physiological factors such as the pH and the lactate serum levels significantly affected patients' survival (p=0.012 and p=0.01, respectively).
Conclusion
In patients with the diagnosis of OHCA who underwent to the treatment with therapeutic hypothermia, verified VF as a presenting rhythm was a positive predictive factor for their outcome. Therefore, therapeutic hypothermia represents an option of therapeutic modality for this type of patients.
Digital dermatoglyphics in the evaluation of the genetic basis of breast cancer in Bosnian-Herzegovinian population - quantitative analysis
Authors: Mušanović Jasmin , Metović Azra , Husremović Faruk , Bejić Samir , Hasković Aldina , Babić Aida , Šljuka Senad
Published: April 2024

Aim
To determine differences in quantitative traits of digital dermatoglyphics between breast cancer women and the women in the control group (healthy women).
Methods
 This case-control study included digital dermatoglyphics of 50 patients with confirmed breast cancer diagnosis compared with 50 healthy examinees with the absence of familial history of any type of cancer. Collecting samples was performed among Bosnian-Herzegovinian population by Printake method. The comparison of the mean values between the examined groups was made by the Student's t-test and Mann-Whitney U test.
Results
The results showed that, with regards to the pattern intensity, no statistically significant difference was detected between the two examined groups (p>0.05).The absence of any significant difference in the number of papillary ridges on an individual finger between the breast cancer patients and the control group was found (p>0.05), although the total number of papillary ridges on all ten fingers had somewhat lower values in the examined group.
Conclusion
 This research confirms the existence of genetic predisposition for breast cancer development, emphasizing the relevance of hereditary factors in the ethiopathogenesis of this disease. The quantitative traits of digital dermatoglyphics were not a reliable and predictive tool for detecting a potential risk for breast cancer in small populations.
The impact of co-existing comorbid diseases on long-term mortality in bronchoscopic lung volume reduction
Authors: Elif Tanrıverdi , Doğan Deniz , Turan Demet , Uğur Chousein Efsun Gonca , Yıldırım Binnaz Zeynep , Demirkol Barış , Özgül Mehmet Akif , Çınarka Halit , Çetinkaya Erdoğan
Published: April 2024

Aim
Emphysema is a lung disease in which alveolar capillary units are destroyed supporting tissue lost. Bronchoscopic lung volume reduction (BLVR) is a novel treatment for emphysema. Several comorbidities have been reported to coexist in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate comorbidities of patients with severe emphysema who underwent BLVR and association of these comorbidities with mortality.
Methods
 Between January 2011 and December 2017 the records of severe emphysema patients who underwent endobronchial valve (EBV) or lung volume reduction coil (LVRC) placement were reviewed retrospectively.
Results
 There were 37 patients who received EBV therapy and 29 received LVRC therapy. There were no significant differences in the demographic and clinical characteristics between two groups before the treatment. There were seven deaths (10.6%) over the period of twelve months following the BLVR treatment. All deaths occurred in patients with at least one comorbid condition. Mortality was increased in the presence of comorbidities (14.3% vs 0%, respectively; p=0.099), and it was significantly increased in the presence of multiple comorbidities (18.5% vs 0%; p=0.059). The mortality rate was higher (37.5% vs 10.5%) in the LVRC comparing to the EBV treatment group in the presence of multiple comorbid conditions, albeit not reaching statistical significance (p=0.099).
Conclusion
 The presence of more than one comorbidity in patients who underwent the LVRC treatment are associated with significant increase of mortality. For patients with severe emphysema who have more than one comorbidity, EBV is a better choice than LVRC.
Risk factors for periprosthetic joint infection of the hip and knee
Authors: Breznicky Jozef , Hlavac Marian , Novak Martin , Hrncar Matej
Published: April 2024

Aim
To investigate risk factors for the development of prosthetic joint infection.
Methods
 A group of 50 patients with periprosthetic infection was compared with a group of 100 randomly selected patients with total hip or knee arthroplasty without infectious complications. Twelve risk factors in both groups were analysed.
Results
 Five factors showed to be significant: body mass index higher than 40, diabetes mellitus on insulin therapy, kidney and liver disease, vascular disease of the lower extremities and positive drain tip culture.
Conclusion
 One of the ways to reduce the incidence of periprosthetic infection is the maximum possible elimination of risk factors in patients who have a high probability of endoprosthesis infection. If this elimination is not possible for a long time, it is advisable to consider abandoning the planned operation.
Rehabilitation of patients with spondyloarthritis: a narrative review
Authors: Grazio Simeon , Grubišić Frane , Brnić Vedran
Published: April 2024

Nonpharmacological interventions are one of the mainstreams of treatment for patients with spondyloarthritis (SpA). They include education, measures regarding joint protection, posture and rest, therapeutic exercise, physical therapy modalities, orthoses, and acupuncture. A key component in the rehabilitation of patients with SpA entities is therapeutic exercise, which can be performed as land-based or water-based. Positive effects of the exercises are manifested in reducing pain, maintaining mobility, improving posture, increasing aerobic capacity and improving quality of life. The best effects can be obtained when exercise is performed under the supervision of a physiotherapist at a health institution. The majority of studies on therapeutic exercise in SpA are related to ankylosing spondylitis (AS), while there is a paucity of studies devoted to other conditions. Although progress has been made in the quantity and quality of research on this topic, there are still issues regarding the quality of studies and considerable variability among them, which makes it difficult to compare different methods and harmonize and develop rehabilitation protocols according to evidence-based medicine.
Demographic and epidemiologic evaluation of mushroompoisoning: a retrospective study in 4-year admissions of Razi Hospital (Qaemshahr, Mazandaran, Iran)
Authors: Khatir Iraj Goli , Hosseininejad Seyed Mohammad , Ghasempouri Seyed Khosro , Asadollahpoor Ailin , Moradi Siavash , Jahanian Fatemeh
Published: April 2024

Aim
Wild mushroom intoxication is a public health problem, which causes a wide range of symptoms: from mild gastrointestinal symptoms to multiple organ failure and death. The present study aims to evaluate the epidemiology of mushroom intoxication in 4-year admissions of Razi Hospital, Qaemshahr, Mazandaran, Iran.
Methods
Medical records of all identified cases of mushroom poisoning admitted during the period between 2015 and 2018 were extracted and patients' demographic data including age, sex, latency period, season of poisoning, clinical presentations, laboratory findings, prognosis, duration of hospitalization and therapeutic interventions were recorded.
Results
A total of 65 mushroom poisoning cases were identified (mean age of 35.68 years), of which 32 (49.2%) were females. Latency of ≤ 6 hours was seen in 63 (96.4%) cases. The most prevalent season of intoxication was spring (60.7%). The most frequent symptoms were nausea and vomiting (86.5%) and abdominal pain (51.2%). No case required intensive care unit (ICU) care or mechanical ventilation. Mean hospital stay was 1.89 days without any mortality. Mean aspartate aminotransferase (AST) level was 21.89 (±9.55), but the disturbance of liver function tests (LFTs), coagulopathy, elevated level of bilirubin and/or platelet was not noted. In 93% of patients ranitidine, in 7% Penicillin G, and in 3.6% cefaclor and ceftriaxone was administrated.
Conclusion
People and health care providers must be educated about mushroom poisoning. Prompt transfer of suspicious cases with history of wild mushroom ingestion to the emergency department is crucial since patients showing toxicity symptoms after 6 hours might have worse and mortal prognosis despite treatment.
Impact of hand hygiene knowledge on the hand hygiene compliance
Authors: Novák Martin , Breznický Jozef , Kompaníková Jana , Malinovská Nora , Hudečková Henrieta
Published: April 2024

Aim
 Hand hygiene practice is still burdened by inadequate compliance, whether in the professional sphere by health professionals or in the non-professional sphere by lay population. Aim of this study was to map the hand hygiene knowledge and its compliance in the monitored group of people.
 Methods
The research was conducted at the Jessenius Faculty of Medicine in Martin of Comenius University in Bratislava (JFM CU) among seventy 3 rd year students of General Medicine (medical study program), and Nursing, Midwifery and Public Health (non-medical study programs). Knowledge of hygienic hand washing according to the WHO guidelines from 2009 was investigated, as well as differences in the level of microbial contamination of hands after routine hand washing between the group that had been acquainted with hand hygiene protocols and the group that had not sufficiently.
Results
The results have shown that 32.9% of the students did not perform hygienic hand washing properly. The differences between the groups of students with and without the proper hand hygiene compliance in routine hand washing were not statistically significant. Conclusion
The results of our survey have suggested that the reasons for decreased compliance with hand washing protocols may be related to forgetting to wash the hands or not being acquainted with hand washing protocols at all. The strategies focused only on one aspect of hand hygiene are, according to scientific literature, ineffective in the long term.
Premature and preterm premature rupture of membranes in adolescent compared to adult pregnancy
Authors: Marković Sergije , Bogdanović Gordana , Cerovac Anis
Published: April 2024

Aim
 To compare the prevalence of premature rupture of membranes (PROM) and preterm premature rupture of membranes (PPROM) between adolescent and adult pregnancies, and the influence of gestational age and adolescent pregnancy on the frequency of occurrence of PROM and PPROM.
Methods
 This prospective study included 300 pregnant patients, 13 to 35 years of age, divided into two groups. The first group consisted of 150 pregnant women aged 13-19 (experimental group) and the second group consisted of 150 pregnant women aged 20-35 (control group).
Results
 There was a statistically significant higher incidence of both PPROM and PROM in the group of adolescent pregnant women compared to adult pregnant women (p<0.000001). Preterm delivery with PPROM was significantly more common in the group of adolescent pregnant women (p<0.004). Term delivery with PROM was statistically significantly more common in the adolescent pregnancy group than in the adult pregnancy group (p<0.001). Term delivery with PROM was statistically significantly more common than preterm delivery with PPROM in the group of adolescent pregnant women (p<0.0001).
 Conclusion
Adolescent pregnancy has a greater impact on the frequency of PROM and PPROM.
Incidence and outcome of traumatic brain injury in paediatric population of Bosnia and Herzegovina: a single centre experience
Authors: Omerhodžić Ibrahim , Mahmutbegović Nevena , Rovčanin Bekir
Published: April 2024

Aim
To evaluate the incidence, modalities of treatment and outcome in paediatric patients with traumatic brain injury (TBI). Methods
A retrospective cross-sectional study including 353 paediatric patients with head injury was carried out in the Department of Neurosurgery of University Clinical Centre Sarajevo during the period 1 July 2006-30 June 2012 (72 months). For each patient the lowest Glasgow Coma Scale (GCS) was established and the patient was accordingly classified as suffering from mild, moderate or severe TBI. Neuroimaging data included computer tomography (CT). Survival rates and method of treatment were compared according to age group, and matched with the total number of patients examined.
Results
 A total of 353 children with head trauma were identified. A severe TBI (GCS < 8) was found in 33 (out of 353) children, mostly in the age group 11-18. Falls were the most common cause of trauma, followed by traffic accidents. Falls were the most common mechanism in the infants, preschool, and school children up to 10 years old; children aged 11-18 showed a higher rate of traffic accidents comparing to children younger than 3 years. Of 353 patients, 49 (13,9%) required surgical procedure, 304 (86.1%) were threated conservatively. Survival rate was 96.6 %.
Conclusion
 The majority of hospitalized patients qualify for medical treatment and surgical intervention is reserved for selected cases. Thus, the adequate pre-hospital care is essential.
Transient osteomyelitis of the distal radius in a three-year-old patient
Authors: Rinonapoli Giuseppe , Bisaccia Michele , Meccariello Luigi , Mancini Giovanni Battista , Marrani Flavia , Grubor Predrag , Rollo Giuseppe , Caraffa Auro
Published: April 2024

Aim
Reporting on an atypical case of a three-year-old patient affected by osteomyelitis of the distal radius, completely healed without antibiotic therapy.
Methods
The clinical case is related to a three-year-old patient, whose clinical picture began with fever, pain and swelling of the right wrist. After three days, fever and swelling disappeared, but pain persisted. Plain x-rays of the right wrist, hematologic analyses, magnetic resonance imaging (MRI) with contrast medium and biopsy were performed in order to make a differential diagnosis between acute osteomyelitis and a malignant neoplasm, i.e. Ewing's sarcoma.
Results
The plain x-rays of the right wrist showed an osteolytic area of the distal radio, with blurred rim. Haematology showed high erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP); MRI confirmed the presence of a lesion, of no certain origin, therefore a biopsy was done. The histology was that of an inflammatory tissue. The patient, after the biopsy, was completely asymptomatic, ESR and CRP were back to normal. Before starting antibiotic therapy, it was preferred repeating x-rays. From the latter, the osteolysis completely disappeared. On the basis of the x-rays, blood exam and symptomatology, it was decided not to submit the patient to any treatment. After two years, the patient never had similar episodes. Conclusion
 Patient presented with all characteristics of an osteomyelitis of distal radius, was unexpectedly spontaneously healed, without antibiotic therapy. Two years after the onset of the disease the patient recovered without clinical and radiographic sequelae. No similar cases are found in the literature .
Cross-linking treatment for better visual acuity
Authors: Grišević Senad , Gilevska Fanka , Biščević Alma , Ahmedbegović-Pjano Melisa , Pidro Ajla , Patel Sudi , Bohač Maja
Published: April 2024

Aim
 To correlate the maximum anterior sagittal curvature (Kmax) changes and uncorrected (UDVA) and corrected distance visual acuity (CDVA) in keratoconus patients after the cross-linking (CXL) procedure.
Methods
Forty-four eyes of 34 patients with keratoconus were analysed after the standard Dresden protocol CXL procedure had been performed. All patients underwent complete preoperative examination with a follow-up of 12 months with focus on UDVA, CDVA and Oculus Pentacam (Scheimpflug technology) analysis. We analysed and correlated K max changes in the postoperative period of 12 months together with visual acuity changes.
Results
 Visual acuity improved significantly in the first 3 months after the procedure and even more significantly until the end of the first year. Even K max is the most relevant and most followed parameter for progression and regression of keratoconus, its lowering was not directly correlated with the visual acuity improvement (both uncorrected and corrected) in the first 6 months after corneal CXL procedure. K max was changed significantly in the period of 12 months post cross linking, but not in the first 6 months.
Conclusion
Corneal CXL should be considered as a procedure not just for corneal stiffening and stabilization, but also for visual acuity improvement in keratoconus patients.
Antibiotic prescription rate for upper respiratory tract infections in general practice – a Croatian study
Authors: Gačina Anja , Vrca Botica Marija , Botica Iva , Horvat Hodžić Andrea , Borovečki Žuti Iva , Kobaš Antonio
Published: April 2024

Aim
 Acute upper respiratory tract infections are the most common indication for antibiotic prescribing in primary care. The frequency of antibiotics prescribed to patients with upper respiratory tract infections has been studied.
Methods
A cross-sectional survey has been conducted from October to December 2017 with participation of 17 General Practices in Croatia. Visits of patients with symptoms of upper respiratory tract infections made the survey framework. A specially structured questionnaire was a tool for the assessment of reasons for encounters, clinical statuses and practitioners' decisions. According to the registered clinical status, two independent doctors classified patients using Centor criteria, which were used to evaluate appropriate indication for antibiotic prescription.
Results
The survey analysed 709 patients' visits. Seventy three percent of general practice visits due to acute respiratory tract infection were initial. Antibiotics had been prescribed in the total of 32.6% of cases. Analysing upper respiratory tract infections with Centor score 1 and 2, antibiotics had been prescribed in 22.8% cases of the first visit and in 31.7% of the second visit, and with the Centor score 3 and 4 antibiotics had been prescribed in 85.1% of cases during the initial visit, and 66.7% of cases during the second visit. Logistic regression analysis about the contribution of nonclinical variables to antibiotic prescribing showed that most often antibiotics had been prescribed on Mondays. The most prescribed group of antibiotics was the penicillin group (74.8%), followed by macrolides (17.6%) and cephalosporins (4.0%).
Conclusion
 General practitioners prescribe antibiotics for acute respiratory tract infections more than recommended by evidence based medicine and professional criteria.
Characteristics of lymphovascular metastatic spread in lung adenocarcinoma according to the primary cancer location
Authors: Grbić Kemal , Mehić Bakir
Published: April 2024

Aim
To compare the localization of lung adenocarcinoma with tumour size and lymphovascular invasion (LVI) presence, and to determine the frequency of metastasis findings in hilar and mediastinal lymph nodes depending on the localization of the tumour and status of lymphovascular invasion.
Method
 This observational cross-sectional study included 261 patients with complete resection of confirmed lung adenocarcinoma. The dependence between categorical variables were performed with χ2 and Fisher's exact tests. A p<0.05 was considered as statistically significant.
Result
 Metastases to hilar lymph nodes at lung adenocarcinoma with central localization and presented lymphovascular invasion were more frequently found than tumours with peripheral localization (p<0.001). In tumours with peripheral localization, lymphovascular invasion was less frequent; even in tumours greater than 7 cm in the largest dimension the presence of LVI was not 100%. Metastases to mediastinal lymph nodes in tumours with central localization and presented lymphovascular invasion were less frequent than in tumours with peripheral localization and presented lymphovascular invasion (p=0.002).
Conclusion
 In invasive adenocarcinoma, lymphovascular invasion was much more common in centrally positioned than in peripherally positioned tumours. Metastases to the hilar and mediastinal lymph nodes, regardless of the findings of lymphovascular invasion, usually originated from upper lobe tumours.
Association of colorectal carcinoma and metabolic syndrome
Authors: Lesko Josip , Rastović Pejana , Azinović Anđela , Ðurasović Sanja , Bogut Ante , Zovko Jelena , Pavlović Marko , Zovko Zdenka
Published: April 2024

Aim
 Colorectal carcinoma is one of the most common neoplasms, especially in Western countries and those with westernisation. On the other hand, high rate of metabolic syndrome (MetSy) has also been noticed, as well as in Western countries. It seems like these two conditions are somehow connected. In this study, we wish to explore some characteristics of colorectal carcinoma and its correlation with MetSy.
Methods
In this retrospective study the data were taken from medical records of 67 patients with colorectal carcinoma, and for 30 healthy controls. Input parameters of patients were compared mutually, as well as with parameters of healthy, control examinees that had negative screening colonoscopy for neoplasm.
Results
 Average age of patients was 68 years. The most frequent localisation of neoplasm was on rectum (53.7%) and most frequent level was Dukes C (38.8%). The patients had MetSy more frequently when compared with controls (p=0.048), and also they had more MetSy components (p=0.006). The link between MetSy and localisation of neoplasm was not found, neither with its pathohystological characteristics.
Conclusion
 Patients with MetSy should be warned about the increased risk of colorectal carcinoma, and, in this way, motivated for earlier and more frequent screening colonoscopies, as well as of a change of unhealthy lifestyle.
Impact of social and psychological factors on academic achievement of university students
Authors: Džubur Amela , Lisica Delila , Abdulahović Damir , Ejubović Malik
Published: April 2024

Aim
 To examine the correlation between personality traits, learning styles, and academic achievement and a difference between students' gender, residency status and academic achievement.
Methods
 The study included 95 students of first year of the School of Medicine, University of Sarajevo. The survey used the sociodemographic questionnaire, Index of Learning Style and Big Five Inventory. Academic achievement was represented by a cumulative grade point of each student.
Results
 There was significant difference between the students' gender, information processing style, i.e. active/reflective learning style and academic achievement. Academic achievement was correlated with extraversion (negatively), conscientiousness and active/reflexive learning style.
Conclusion
 With this study we wanted to improve awareness of teachers about the importance and use of different styles during lecture, to show the importance of students knowing their own preferences and learning styles, and how personality traits can affect students' academic achievement. Academic performance is an important outcome for students. It can increase motivation, student participation in class and wish to volunteer in different activities.
Effect of Poguntano leaves extract (Picria fel-terrae Merr.) to procalcitonin level in acute bacterial rhinosinusitis model of Wistar mice
Authors: Murni Rambe Andrina Yunita , Munir Delfitri , Sembiring Rosita Juwita , Ilyas Syafruddin
Published: April 2024

Aim
 Acute rhinosinusitis (AR) is of viral aetiology and only 0.5-2% develop into acute bacterial rhinosinusitis. Herbal therapy is a promising alternative in acute bacterial rhinosinusitis treatment. The aim of this study was to evaluate the effect of ethanol extract of Poguntano leaves (EEPL) to procalcitonin level and the amount of bacteria in acute bacterial rhinosinusitis mice model.
Methods
Experimental research with posttest only control group design in 32 Wistar mice that were divided into 4 groups, 3 of which were being inoculated with Staphylococcus aureus by inserting a sponge to right nasal cavity of the mice (group K2, K3, and K4); another one was the negative control group (K1). Group K2 was not given any kind of therapy (positive control), group K3 was given 10 mg/kd EEPL for 5 days orally during an induction, and group K4 was given 10 mg/kd EEPL for 5 days orally on the 10th day after induction. Mice in the groups K2 and K3 were sacrificed on the 10th day after induction, while mice in group K4 were sacrificed on the 15th day after induction.
Result
A statistically significant decrease in procalcitonin level (p<0.001) and amount of bacterial colony (p<0.001) was found in four groups.
 Conclusion
 Poguntano leaves extract can lower procalcitonin and amount of bacteria colony, showing an anti-inflammatory and antibacterial effect.
The effect of roselle flower petals extract (Hibiscus sabdariffa Linn.) on reducing inflammation in dextran sodium sulfateinduced colitis
Authors: Lubis Masrul , Siregar Gontar Alamsyah , Bangun Hakim , Ilyas Syafruddin
Published: April 2024

Aim
To determine the effect of roselle (Hibiscus sabdariffa) petals in dextran sodium sulfate (DSS)-induced colitis model by measuring pro-inflammatory cytokines expressions (IL-6, and TNF-α), anti-inflammatory cytokine expression (IL-10) and histological colitis inflammation score (HCIS).
Methods
This study was conducted in two phases. For the first phase, five DSS-induced colitis mice were sacrificed (group 1) and compared with six healthy mice (group 2) after five-cycle induction (70 days). For the second phase, roselle-treated DSS-induced colitis mice were sacrificed on day 7, 14, 21, and 28 after induction and compared with mesalazine-treated DSS-induced colitis mice. Expressions of IL-6, TNF-α, and IL-10 were determined by immunohistochemistry and HCIS were assessed by two experienced pathologists.
Results
 The expressions of IL-6, TNF-α, and IL-10, and HCIS in DSS-induced colitis mice were increased compared with control. The expressions of IL-6, TNF-α were significantly higher in roselle-treated group on day 7 and 14, but not on day 21 and 28, whereas, the expression of IL-10 was significantly lower only on day 7 compared with mesalazine-treated group. The inflammation was higher in roselle-treated group assessed by using HCIS. Compared to day 0, the reduction of HCIS was significant in roselle-treated and mesalazine-treated groups.
Conclusion
Roselle flower petal can attenuate the inflammation in DSS-induced colitis in mice. The extract of roselle can be given as an adjuvant therapy to the first-line therapy to enhance anti-inflammatory effect by increasing expression of anti-inflammatory cytokines and decreasing pro-inflammatory cytokines.
The effect of Aloe vera ethanol extract on the growth inhibition of Candida albicans
Authors: Nabila Via Karina , Putra Imam Budi
Published: April 2024

Aim
 Candida albicans can cause two major types of infections: superficial infections (such as oral or vaginal candidiasis) as well as life-threatening systemic infections, and Aloe vera extract is one of the potentially useful therapeutic options. The aim of this study was to determine antifungal properties of Aloe vera ethanol extract on vulvovaginal candidiasis caused by Candida albicans.
Methods
Aloe vera ethanol extract was prepared by the maceration method with 70% ethanol and dissolved in DMSO into multiple concentrations (6.25%, 12.5%, 25%, and 50%). Candida albicans was cultured in Sabouraud dextrose agar for 72 hours and disc diffusion method was used to evaluate the inhibitory effect of each concentration in comparison with fluconazole. Zones of inhibition at 72 hours were measured and documented, then analysed to get the mean inhibition zone (MIZ).
Results
 After 72 hours, all concentrations of Aloe vera ethanol extract showed inhibition effect against C. albicans with mean inhibition zones of each concentration, 12.450±0.208 mm (6.25%), 13.975±0.457 mm (12.5%), 15.650±0.420 mm (25%), and 17.225±0.512 mm (50%), respectively. Fluconazole revealed comparable antifungal effect with MIZ of 11.025±0.478 mm. Oneway ANOVA test showed a significant effect of Aloe vera ethanol extract on inhibition zone of Candida albicans growth (p<0.005). Conclusion Aloe vera ethanol extract possesses concentration dependent activity against Candida albicans that is comparable with standard antifungal agents.
HLA-DRB1 allele distribution among children with rheumatic heart disease in Haji Adam Malik Hospital Medan, Indonesia
Authors: Lumban Tobing Tina Christina , Ontoseno Teddy , Rahayuningsih Sri Endah , Akbari Ganie Ratna , Siregar Yahwardiah
Published: April 2024

Rheumatic heart disease (RHD) is influenced by genetic factor, microorganism's virulence, and environmental factor. The aim of this study was to determine human leukocyte (HLA)-DRB1 allele among children with RHD in Medan, Indonesia. Methods
An observational study was conducted at the Department of Child Health, Haji Adam Malik Hospital Medan from April to June 2017. Inclusion criteria were children aged 5-18 years diagnosed with RHD. Children with concomitant congenital heart disease were excluded. HLA-DRB1 alleles were analyzed using the PCR sequence-specific priming (SSP) technique. Statistical analysis was done using computer software.
Results
A total of 62 children were enrolled. The mean age of children was 12.6 (SD 3.44) years; 33 (53.2%) were male. The most dominant allele was HLA-DRB1*12, followed by HLA-DRB1*15.
Conclusion
 It is proven in this research that RHD is influenced by genetic factor with HLA-DRB1*12 allele found to be the most common allele in children with RHD in Medan, Indonesia.
Screening of undiagnosed depression among elderly primary care patients: a cross-sectional study from the Republic of Srpska, Bosnia and Herzegovina
Authors: Stanetić Kosana , Petrović Verica , Stanetić Bojan , Kević Vesna , Stanetić Mirko , Matović Jelena , Kusmuk Srebrenka , Račić Maja
Published: April 2024

Aim
 To examine the prevalence of undiagnosed depression among primary care elderly patients in the entity of the Republic of Srpska (Bosnia and Herzegovina) as well as the sociodemographic and clinical risk factors associated with depression. Methods
 A cross-sectional study was conducted between April and June 2019 in nine towns of the Republic of Srpska. The study sample included 1,198 primary care patients older than 65 years of age. Research instruments included a sociodemographic questionnaire and Geriatric Depression Scale-Short Form (GDS-SF).
Results
 Positive screening test (GDS-SF score > 5), which indicates depression was found in 484 (40.4%) participants. Multivariate regression analysis showed that lower education levels [OR = 1.565, 95% CI (1.13-2.17)], divorced and widowed [OR = 1.366, 95% CI (1.16-1.62)], poor financial situation [OR = 1.690 , 95% CI (1.25-2.29)], non-home residents [OR = 2.200, 95% CI (1.41-3.44)], non-hobby patients [OR = 2.115, 95% CI (1.54-2.91) ], non-friends [OR = 3.881, 95% CI (2.70-5.57)], patients suffering from chronic pain [OR = 2.414, 95% CI (1.72-3.39)], patients with daily life limitation activities [OR = 1.415, 95% CI (1.03-1.95)], patients with three or more chronic diseases [OR = 1.593, 95% CI (1.12-2.27)], patients using five or more drugs [OR = 1.425. 95% CI (1.00-2.03)], and patients with history of previous depression [OR = 2.858, 95% CI (1.94-4.21)] were at higher risk for depression.
Conclusion
 The prevalence of undiagnosed depression in the elderly in Republic of Srpska is high. Future strategies are needed to strengthen screening of geriatric depression in primary health care.
Pregnancy outcome in women who survived genital or extragenital cancer
Authors: Cerovac Anis , Ljuca Dženita , Bogdanović Gordana , Grgić Gordana , Zukić Haris
Published: April 2024

Aim
 To investigate clinical and obstetrical characteristics, an outcome and a prognosis for pregnant women with diagnosed and treated genital or extragenital cancer and their newborns.
 Methods
This retrospective cohort study included pregnant and childbearing women with a history of cancer diagnosed before pregnancy during the period between 1 January 2014 and 31 December 2018. Data related to the course of pregnancy and childbirth were collected from medical records (mothers' disease history and partogram). The analysis covered clinical and histopathological characteristics of cancers, type of the treatment (surgery, chemotherapy, radiotherapy), demographic data, obstetric characteristics, comorbidities of women, and outcome of the newborns.
Results
 The study recorded 18 414 deliveries, of which 30 (0.16%) were pregnancies in women who had been diagnosed and treated earlier for genital or extragenital cancer. The average age of the women at the time of delivery was 29.43±5.97 years. There were six (20%) women with genital and 24 (80%) with extragenital cancer. The most frequent extra genital cancer was Hodgkin lymphoma, in eight (26.6%) cases; ovarian cancer was the most frequent genital cancer, in four (13.3%) cases. The average time span from the cancer diagnosis and start of the treatment to the delivery was 59.2±44.4 months (5 years) (range 12 months-15 years). Two (6.6%) women died.
Conclusion
Our data demonstrate a favourable obstetric and neonatal outcome for women who have survived cancer.
The preemptive effect of tramadol and metamizole on the intensity of postoperative pain
Authors: Suljević Ismet , Hadžiavdić Muamer , Šurković Ismana , Suljević Omer , Turan Maida , Mušija Ehlimana
Published: April 2024

Aim
 To demonstrate the analgesic effect of preemptively administered tramadol and metamizole on the postoperative pain severity, after an elective operative hysterectomy with adnexectomy.
Methods
 There were three groups with 30 patients in each group. Patients included in the study were between 45 to 67 years old. They were all in the ASA group II. Randomization was performed in random order according to the regular elective operating program. Patients in Group I received i. m. tramadol 1mg/kg, and in Group II 30mg/kg of metamizole, five minutes before anaesthesia induction. Patients did not receive preemptive analgesia in Group III (control). All patients underwent the same induction anaesthesiology procedure with propofol, fentanyl, tracrium, supplemented with O2, N2O, and sevoflurane at an appropriate dose until MAC 1 was reached. Surgeries lasted for 80-120 minutes. Every patient performed a resting pain assessment 30 minutes after an extubation by Numerical Pain Scale (NPS).
Results
We found out that tramadol had a better effect in preemptive analgesia and that the average pain score for Group I was 6.10 (p=0.043). In Group II, it was 7.93 (p=0.022). There is significant difference in pain intensity between patients in the control group, (pain intensity was 9.16), and those who received tramadol and metamizole. There was no significant difference in the intensity of pain when using these two analgesics (p=0.733).
Conclusion
The effect of preemptively administered tramadol prior to the introduction of general anaesthesia in postoperative pain is significantly more favourable than the effect of metamizole.
Securing the base of the appendix during laparoscopic appendectomy
Authors: Delibegović Samir , Karabeg Reuf , Simatović Milan
Published: April 2024

In contrast to classical appendectomy where the appendiceal stump is secured by a single or double ligature, in laparoscopic appendectomy various ways of securing the stump are mentioned. Each of these methods has advantages and disadvantages. Since different possibilities exist for closing the stump, it is very important to find the optimum method for closure of the appendiceal stump, bearing in mind their simplicity, biocompatibility and price. The aim of this review article has been to present the problem of securing the base of the appendix during laparoscopic appendectomy.
Association between working memory impairment and activities of daily living in post-stroke patients
Authors: Irfani Fitri Fasihah , Fithrie Aida , Rambe Aldy S
Published: April 2024

Aim
Stroke is one of the leading causes of adult disability and functional impairment worldwide. Cognitive impairments including memory dysfunction are common after stroke and may have a negative impact to the functional status and activities of daily living (ADL). The study aimed to determine the impact of working memory impairment after stroke on ADL.
Methods
 This cross-sectional study involved post-stroke patients who underwent neurologic examination and mini mental state examination (MMSE), forward digit span (FDS) and backward digit span (BDS) to assess cognitive function, and assessment of daily life activities (ADL) and instrumental activities of daily living (IADL) scales.
Results
 This study included 38 patients, 23 (60.5%) males and 15 (39.5%) females. The mean MMSE, FDS and BDS scores were 24.60±4.49, 4.87±1.166 and 3.47±1.158, respectively. There were 17 (44.7%) patients with cognitive impairment (MMSE Score was lower than 24). The mean ADL and IADL scores were significantly higher in patients with cognitive impairment, showing greater dependency in this group of patients. There was a significant negative correlation between global cognitive function, working memory and ADL and IADL scores in post-stroke patients.
Conclusion
 Cognitive impairment has a negative impact on daily life activities in post-stroke patients.
Neutrophil gelatinase-associated lipocalin is a predictor of complications in the early phase of ST-elevation myocardial infarction
Authors: Šabanović-Bajramović Nirvana , Hodžić Enisa , Iglica Amer , Begić Edin , Resić Nerma , Aganović Kenana , Halilčević Mirela , Bajramović Senad
Published: April 2024

Aim
 To evaluate a correlation of serum level of neutrophil gelatinase-associated lipocalin (NGAL) to the risk of the occurrence of complications in patients with the early phase of ST-segment elevation myocardical infarction (STEMI) treated with fibrinolytic therapy prior to percutaneous coronary intervention (PCI).
Methods
 A total of 54 patients with the diagnosis of STEMI treated with fibrinolytic therapy (alteplase) prior to PCI were included. Patients were admitted to the Intensive Care Unit (ICU) of Clinic for Heart, Blood Vessel and Rheumatic Diseases in the period January to March 2018. All patients underwent coronary angiography and PCI within the maximum of 48 hours delay after fibrinolysis, according to the hemodynamic and electrical stability and PCI availability. Blood samples were taken immediately after admission prior to fibrinolytic administration. Patients were divided into two groups according to NGAL values (less or more than 134.05 ng/mL).
Results
 Higher values of NGAL have effect on a higher mean systolic and diastolic pressure (p=0.001 and p=0.003, respectively). Patients with higher NGAL values also have higher values of brain natriuretic peptide (p=0.0001) and highly sensitive troponin I (p=0.002). In that group relative risk (RR) for lethal outcome was 6.4 times significantly higher (p=0.002), for the development of heart failure 2.88 times (p=0.0002), for post-myocardial infarction angina pectoris 2.24 times (p=0.0158), and for ventricular rhythm disturbances (ventricular tachycardia, ventricular fibrillation) 1.96 times higher (p=0.0108).
Conclusion
 Increased NGAL value is related to an unfavourable outcome of patients in the early phase of STEMI treated with fibrinolytic therapy prior to PCI.
Endovascular or open surgical treatment of high-risk patients with infrainguinal peripheral arterial disease and critical limb ischemia
Authors: Totić Dragan , Ðurović Sarajlić Vesna , Vranić Haris , Hadžimehmedagić Amel , Rustempašić Nedžad , Djedović Muhamed , Vukas Haris , Ahmetašević Alen
Published: April 2024

Aim
To determine preferable type of treatment in our clinical circumstances by following two groups of patients with critical limb ischemia (CLI), who were treated endovascularly and surgically.
Methods
 Research was carried out in the form of a prospective study of 80 patients with CLI and TransAtlantic Inter-Society Consensus (TASC) C or D type of arterial disease, with American Society of Anesthesiology (ASA) class III risk, who were randomly divided in two groups as per the treatment they received, surgical and endovascular. Patients were followed during 28 months using clinical examination and Duplex Ultrasound (DUS) in accordance with prescheduled control visits.
Results
 There was a statistical difference between surgical and endovascular group in two years patency (82.5% vs. 55%; p=0.022) but it did not result in the difference in amputation free survival (AFS) (95% vs. 85%; p=0.171) or two-year freedom from major adverse limb events (MALE) (87.5 vs. 77.5; p=0.254). Also, there was no difference in the overall survival of patients (100% vs. 97.5%; p=0.317).
Conclusion
 Initial endovascular treatment is a preferred form of the treatment for selected patient population.
Preterm and term birth in twin pregnancies during a seven-year period: a call for obstetricians to declare about amnionicity and chorionicity
Authors: Cerovac Anis , Grgić Gordana , Softić Dženana , Ljuca Dženita , Marković Sergije , Mandžić Amer
Published: April 2024

Aim
To compare maternal, foetal and neonatal characteristics, and perinatal outcome of preterm and term deliveries in twins pregnancies in order to improve perinatal care in Bosnia and Herzegovina.
Methods
 This retrospective cohort study included pregnant women with twin pregnancy who delivered during the period between 1 January 2012 and 31 December 2018 at the Clinic for Gynaecology and Obstetrics, University Clinical Centre Tuzla.
Results
During the seven-year period 26 734 deliveries were recorded, out of which 362 (1.35 %) were twin pregnancies, 226 (62.4%) preterm and 136 (37.5%) term ones. In the preterm group 38 (16.8%) pregnancies were assisted medical reproduction, and 16 (11.7%) of those were in the term group. The average birth weight was significantly higher for the first twin in both groups (p<0.00001). Incipient intrauterine foetal asphyxia was more frequent in the preterm group (p<0.05). The most common indication for Caesarean section was abnormalities of foetal presentation and lie, 176 (68.2%) for the overall sample.
Conclusion
 Cornerstone of twin pregnancy antenatal care is to get correct data about amnionicity and chorionicity. Since majority of prenatal data did not have this information we call all obstetricians to declare about amnionicity and chorionicity in twin pregnancies during the first trimester ultrasound examination.