bluuebunny/crossref_metadata_2025 huggingface dataset:
Communication and assessment of pain in hip fracture patients with dementia - experiences of healthcare professionals at an accident and emergency department in Sweden
Authors: Seffo Nail , Hamrin Senorski Eric , Westin Olof , Svantesson Eleonor , Krupić Ferid
Published: April 2024

Aim
 To describe the experience of healthcare professionals in assessing pain and communication in patients with hip fractures and dementia in an emergency department.
Methods
 Data were collected through focus group interviews using open-ended questions, following an interview guide and qualitative content analysis. Twenty one registered nurses participated in the interviews, five male and 16 female, aged 26 to 55 years. Results
 The analysis of the interviews resulted in three main categories: "Arrival at the emergency department", "Hip track" and "Handover to the ward", including a number of subcategories. All nurses reported that the assessment of pain and communication with patients with dementia and hip fractures was a complex process. A great deal of stress, fast and brief communication, quick decisions and quick treatments in assessment of pain were only some of the difficulties the nurses emphasized. They also suggested a whole series of improvements for those patients.
Conclusion
The situation of patients with hip fracture and dementia on the emergency department and healthcare professionals who communicate and assess their pain can be said to be untenable. The care environment in the emergency department is not adapted to patients and can of course depend on several factors. To meet the needs of the future and increased numbers of those patients, some improvements such as more extensive research and more studies on the experiences of both the patients and healthcare professionals are required.
Feasibility and value of non-locking retrograde nail vs. locking retrograde nail in fixation of distal third femoral shaft fractures: radiographic, bone densitometry and clinical outcome assessments
Authors: Bisaccia Michele , Caraffa Auro , Rinonapoli Giuseppe , Mancini Giovanni Battista , Rollo Giuseppe , Carrato-Gomez Miguel , Gomez-Garrido David , Ibáñez-Vicente Cristina , Trilleras-Berrío John W. , Pace Valerio , Franzese Raffaele , Vastarella Mariagiovanna , Pieretti Gorizio , Errico Giacomo , Meccariello Luigi
Published: April 2024

Aim
 Distal femoral shaft fractures are characterized by increasing incidence and complexity and are still considered a challenging problem. No consensus on best surgical option has been achieved. The aim of this study is to investigate mineral bone densitometry, radiographic and clinical outcomes of locking retrograde intramedullary nailing (LRN) and non-locking retrograde intramedullary nailing (NLRN) regarding surgical treatment of distal femoral shaft fractures in adults based on the hypothesis that there is no statistical difference among the results of both surgical options.
Methods
 Retrospective study: 30 patients divided into 2 groups (Group 1 LRN, Group 2 NLRN). Average age was 42.67±18.32 for Group 1 and 44.27±15.11 for Group 2 (range of age 18-65 for both groups). Gender ratio (male:female) was 2.75 (11:4) for both groups. AO Classification, Non Union Scoring System (NUSS) and Radiographic Union Score Hip (RUSH), Visual Analogic Score (VAS), Dexa scans, plain radiographs were used. Evaluation endpoint: 12 months after surgery.
Results
 No statistical difference was obtained in terms of surgery time, transfusions or wound healing. There were similar results regarding average time of bone healing, RUSH scores, VAS, regression between RUSH and VAS, average correlation clinical-radiographic results and patients outcomes. Only one patient of LRN group had reduction of mineral bone densitometry values.
Conclusion
No statistical difference in terms of radiographic, bone densitometry and clinical outcomes among LNR and NLNR for the treatment of distal femur fractures was found. The presence of no statistical difference regarding radiological findings is the main factor supporting our hypothesis given their strong objectivity.
Snakehead fish extract as an enhancer of vascular endothelial growth factor and nitric oxide levels in cerebral angiogenesis: an insight of stroke therapy
Authors: Nasution Iskandar , Sjahrir Hasan , Ilyas Syafruddin , Ichwan Muhammad
Published: April 2024

Aim
 To assess the effect of snakehead fish extract administration in angiogenesis focusing on the level of vascular endothelial growth factor (VEGF), nitric oxide (NO) and VEGF receptor 2 (R2) expression is ischemic stroke models.
Methods
 An experimental study was conducted on 5 groups of ischemic stroke rats models: Group K-without carotid artery ligation, Group K+ with artery ligation, Group P1 with artery ligation and administration of 200 mg/day extract, Group P2 with artery ligation and 400 mg/day extract, and Group P3 with artery ligation and 800 mg/day extract. The VEGF expression and NO levels were assessed on day 3.
Results
 Snakehead fish extract significantly increased VEGF levels along with increasing doses, in which the highest VEGF level was observed in P3 group (361.7±40.2; p<0.001). The NO level also increased along with an increasing dose of snakehead fish extract, in which the highest NO level was found in P3 group (59.43±0.88 μmol/gr; p<0.001). The VEGFR2 expression also increased significantly after snakehead extract administration along with increasing doses (p<0.001) in which administration of 800 mg extract yielded the highest VEGFR2 expression compared with lower doses (17.7 vs. 15.6; p<0.001)
Conclusion
 Snakehead fish extract administration increased angiogenesis process marked by an increased level of VEGF, NO and VEGFR2 expression in ischemic stroke rat models.
The level of tumour necrosis factor-alpha and its relationship to the cognitive function of Malayan-Mongoloid patients with schizophrenia
Authors: Amin Mustafa M. , Rasyid Abdul , Effendy Elmeida , Amir Nurmiati , Amir Nurmiati , Suryandari Dwi Anita
Published: April 2024

Aim
Schizophrenia is a mental disorder and one of the suspected causes is cytokines. One of them is tumour necrosis factor-alpha (TNF-α). Cytokines have the potential to affect cognitive function. The study aimed to find a correlation of TNF-α level with the Mini-Mental State Examination (MMSE) score in patients with schizophrenia (PwS), and comparing the level of TNF-α levels between PwS and healthy controls.
Methods
We conducted a cross-sectional analytic study and the study designs were correlation and comparative analysis, i.e. using
a Mann-Whitney U test. A total number of 100 subjects were collected, and they were divided into two groups of PwS and control group, respectively.
Results
The results found that most of the PwS subjects were 39 men (78.0%), while the control group were 28 men (56.%). The
differences in TNF-α levels between PwS and control groups were found to be significant p <0.001, there was no significant correlation between TNF-α level and the score of MMSE of the PwS with p = 0.938, with a very weak correlation that was r = -0.011, and a negative correlation direction.
Conclusion
There was a significant difference between TNF-α level of PwS and control group, i.e. PwS group had lower TNF-α
level compared to the control group. The TNF-α level of PwS group had a very weak effect on the cause of cognitive dysfunction in PwS group, yet the higher level of it could reduce MMSE score in PwS group.
The impact of pain intensity on quality of life of postherpetic neuralgia patients
Authors: Putri Mellaratna Wizar , Jusuf Nelva K. , Yosi Ariyati
Published: April 2024

Aim
To investigate the impact of pain intensity of postherpetic neuralgia (PHN) patients.
Methods
This cross sectional study included 30 PHN patients attended to the Dermatology and Venereology Department of the School of Medicine of Universitas Sumatera Utara during the period between April 2019 and October 2019. Zoster Brief Pain Inventory questionnaire including the worst pain in 24 hours and the level of interference with seven domains of quality of life (QoL) (general activity, mood, walking ability, working, relationship with other people, sleep and enjoyment of life) were used. Pearson's correlation (r) was categorized as very weak (0.0-< 0.2), weak (0.2-< 0.4), moderate (0.4-< 0.6), strong (0.6-<0.8), and very strong (0.8-1.0).
Results
There was a very strong correlation between worst pain intensity and mood disturbance (r=0.846) and working status (r=0.818). Worst pain intensity had a strong correlation with general activity (r=0.673), relationship with other people (r=0.653), sleep (r=0.774) and disturbance of enjoyment of life (r=0.783). Therefore, the correlation between worst pain intensity and walking ability was moderate (r=0.475). The worst pain intensity had a significant correlation with all seven domains of QoL (p< 0.05).
Conclusion
Pain intensity influences the QoL with directly proportional correlation between pain intensity and disturbance of QoL.
A therapeutic effect of Nigella sativa extract on female Wistar rats vulvovaginal candidiasis model
Authors: Rusda Muhammad , Ganis Siregar Muhammad Fidel , Lelo Aznan , Ilyas Syafruddin , Akbari Ganie Ratna , Effendi Yusuf , Zaitun Hasibuan Poppy Anjelisa , Lia Iswara Raden Roro
Published: April 2024

Aim
Vulvovaginal candidiasis (VVC) is a disease mostly caused by Candida albicans and affects the quality of life of women especially in the form of chronic recurrent vulvovaginal candidiasis (RVVC). Nigella sativa is known to have several effects such as antimicrobial, anti-inflammatory, immune stimulation and anticancer properties. The aim of this study was to evaluate the effect of Nigella sativa on vulvovaginal candidiasis.
Methods
This study is a true experimental design, we used 28 Wistar strain rats divided into 4 groups, all groups were conditioned in a pseudoestrus state. Candida albicans was inoculated into the rats' vagina for 3 consecutive days. All groups were observed every 24 hours, 48 hours and 72 hours to evaluate the number of Candida albicans colonies, IgG and IgM anti Candida. Results
 After administration of intervention, there was a significant difference in the amount of fungal colonization after the treatment in each group (p<0.001). There was no significant difference in the effectiveness of Nigella sativa and fluconazole in supressing Candida albicans colonies after 72 hours (p=0.101). The administration of Nigella sativa showed a significant difference in the increase in IgM levels compared to the others group (p<0.001), while the IgG level did not show a significant difference (p=0.423).
Conclusion
Nigella sativa provides a therapeutic effect by decreasing the number of fungal colonies and increasing IgM levels.
Combination of vitamin A and D supplementation for ischemic stroke: effects on interleukin-1ß and clinical outcome
Authors: Kadri Alfansuri , Sjahrir Hasan , Juwita Sembiring Rosita , Ichwan Muhammad
Published: April 2024

Aim
 Accumulated evidence suggests that vitamin A and D agonists can alleviate the development of atherosclerosis. Therefore, the aim of this study was to determine the effect of vitamin A and D combination supplement on interleukin-1β (IL-1β) and clinical outcome in ischemic stroke.
Methods
 A single-blind, randomized controlled trial was conducted on ischemic stroke patients at Adam Malik Hospital between March 2018 to February 2019. The patients were randomized into 4 groups of the treatment consisting of supplementation using vitamin A or D only, combination of vitamin A and D, and placebo group, all given for 12 weeks. Clinical outcome was determined using the National Institute of Health Stroke Scale (NIHSS). At the time of admission and after the treatment was completed, all patients were measured for vitamin A, vitamin D, and IL-1β serum level, and NIHSS score.
Results
From the total of 120 patients, in the combination group there were significant increments on both vitamin A (p=0.04) and vitamin D (p=0.01) serum level after 12 weeks of the treatment, compared to the other groups. In conjunction, IL-1β serum level showed a significant decrement in the combination group (p<0.001). Lastly, the biggest improvement of NIHSS could be seen in the combination group, which was marked by the highest decrement of NIHSS score (p<0.001).
Conclusion
 Administration of combination of vitamin A and D supplementation can significantly increase vitamin A and D serum level, decrease IL-1β serum level, and ultimately improve clinical outcome in ischemic stroke patients.
Strut graft vs. traditional plating in the management of periprosthetic humeral fractures: a multicentric cohort study
Authors: Rollo Giuseppe , Biserni Michele , Huri Gazi , Carulli Christian , Ronga Mario , Bisaccia Michele , Gomez-Garrido David , Ziroglu Nezih , Bonura Enrico Maria , Ruberti Andrea Alberto , Schiavone Andrea , Meccariello Luigi
Published: April 2024

Aim
The gradual increase in shoulder implants in active elderly patients has appeared in a parallel increase in periprosthetic humeral fractures. The aim of this study was to investigate the advantages of using strut grafting with plate fixation during periprosthetic humerus fractures.
Methods
Thirty patients diagnosed with periprosthetic humeral fracture were divided into two groups. The first group of 15 patients (PS) underwent plate, ring, screws and strut allografts. The second group with resting 15 patients (PWS) was treated with only plate and screws. The criteria to evaluate the groups during followup were the Constant Shoulder Score (CSS) and Oxford Shoulder Score (OSS); the bone healing was measured by X-rays, controls measured by radiographic union score (RUS), and complications. The follow up was terminated at 12nd month in both groups.
Results
The difference between the two groups in all parameters was not significant. However, all patients gained adequate shoulder motor skills for normal daily living activities. All fractures were healed. Only two complications were registered, and blood loss was minimal.
Conclusion
We believe a revision to reverse shoulder prosthesis with a long-stem implant with or without cortical strut allograft
augmentation to be safe and appropriate in the management of these complex injuries, though technically challenging, and having good results for normal activities daily life.
Model "P" in gender prediction based on the mastoid process
Authors: Sarač-Hadžihalilović Aida , Hojkurić Edin , Musić Miralem , Hasanbegović Ilvana , Ajanović Zurifa , Dervišević Lejla , Brkić Selmira
Published: April 2024

Aim
 To determine the degree of accuracy in determining the sex of the skull based on classical morphometric analysis of the mastoid process. Morphometric analysis excluded a subjective approach expressed in osteoscopic analysis.
Methods
The study was conducted on a sample of 100 macerated skulls of known gender and age from the second half of the 20th century, including the Bosnian population. Of the 100 skulls, 50 (50%) were male and 50 (50%) were female. Male skulls were on average 60 (47-71) years old and female 57 (43-76) years old. At each mastoid process, 3 measurements were made: mastoid length, mastoid width (medio-lateral diameter) ML) and anteroposterior diameter (AP) of the mastoid process. Results
Using the univariate method, we found a significant difference between length, width, AP diameter and size of mastoid processes as well as between gender (p <0.05). Multivariate binary logistic regression showed statistically significant differences in AP diameter of the mastoid process (p<0.05).
Conclusion
 The created model "P" ("P"=exp [X]/1+exp [X]) for sex determination based on mastoid process showed sensitivity of 82% correct prediction for female skulls and 65% accurate prediction for male skulls. This discourse with respect of population standards grants most effective anthropological proof and as such may be suggested for forensic expertise based on human skull.
Surgical treatment of multifragmentary segmental femur shaft fractures with ORIF and bone graft versus MIPO: a prospective control-group study
Authors: Rollo Giuseppe , Ronga Mario , Bonura Enrico Maria , Erasmo Rocco , Bisaccia Michele , Pichierri Paolo , Marsilio Antonio , Pasquino Andrea , Garrido David Gomez , Franzese Raffaele , Schiavone Andrea , Meccariello Luigi
Published: April 2024

Aim
 Multifragmentary segmental femoral shaft fracture is a high energy injury frequently associated with life-threatening conditions. The aim of this study was to compare the use of bio metallic open reduction internal fixation (ORIF) (plate with allograft bone strut) with minimally invasive plate osteosynthesis (MIPO) fixation for the treatment of multi-segmental femoral shaft fracture in terms of outcomes, bone healing and complications.
Methods
 Forty patients with segmental femoral shaft fractures were included and divided into two groups: 20 patients treated with ORIF+, 20 with MIPO. All fractures were classified according to AO (Arbeitsgemeinschaft für Osteosynthesefragen) and Winquist and Hansen Classification. Evaluation criteria were: duration of follow up and surgery, Non-Union Scoring System, Pain Visual Analogic Scale (VAS), objective quality of life and hip function, subjective quality of life and knee function, quality of life the Short Form-12 Survey Questionnaires (SF-12), bone healing and femoral alignment (radiographs), Radiographic Union Score for Hip (RUSH).
Results
 Better results of ORIF in terms of complication rate, RUSH, VAS, regression between RUSH and VAS, average correlation clinical-radiographic results and patients' outcomes (Cohen k) were obtained, and similar results for the length of follow up, surgery duration, perioperative blood transfusion, wound healing. No statistical difference for Harris Hip Score (HHS), Knee Society Score (KSS), quality of life (SF-12).
Conclusions
 The ORIF and bone strut allograft technique had better results compared to the MIPO technique with regards to complication rate, RUSH, VAS, regression between RUSH and VAS, and average correlation clinical-radiographic results and patients' outcomes (Cohen k) in the surgical treatment of multifragmentary segmental femoral shaft fractures.
Pectoralis (PecS) nerve block 1 for port-a-cath removal and central venous catheter (CVC) replacement
Authors: Renzini Massimo , Ripani Umberto , Golia Luisa , Nisi Fulvio , Gori Fabio
Published: April 2024

Aim
The use of PecS block 1 as perioperative analgesia for a central catheter removal-reimplantation combined procedure. Methods
 A 55-year-old woman suffering from peritoneal metastases from gastric cancer needed to have a port-a-cath implanted for infection removed and to have a central venous catheter (CVC) implanted in the homolateral axillary vein due to patient's history of deep vein thrombosis of the right upper limb. We used PECS 1 block for perioperative analgesia.
Results
 Compared to the traditional catheter implantation technique, reduction in the doses of local anaesthetics, shortening in the execution time, less intra-procedural bleeding, better patient's compliance, and no need for a rescue dose of local anaesthetic were observed.
Conclusion
The PEC1 block was effectively and safely used to remove an infected port-a-cath and to place a CVC on the same side. We hypothesize that it may be useful also for simple port-acath positioning.
Factors associated with overweight and obesity in preschool children
Authors: Kurspahić-Mujčić Amira , Mujčić Amra
Published: April 2024

Aim
 To determine factors associated with overweight/obesity in preschool children.
Methods
 This cross-sectional study was carried out in paediatric outpatient departments of the Public Institution Primary Health Care Centre of Canton Sarajevo, Bosnia and Herzegovina. The study included 300 preschool children who were divided into two groups: normal weight (n=150) and overweight/obese (n=150). Children were weighed and measured and body mass index was calculated. Data concerning potential childhood overweight/obesity risk factors (sociodemographic characteristics of child and mother, physical activity and sedentary behaviour of the child) were collected using a designed questionnaire filled in by the mothers. Logistic regression analysis was used to estimate the association between potential risk factors and overweight/obesity in preschool children.
Results
Male gender of the children (p=0.043) and maternal overweight (p=0.000) were positively associated with child overweight/obesity. Male children were 1.6 times more likely to be overweight/obese than female (95% CI: 1.01-2.53). Children of overweight mothers were 3.34 times more likely to be overweight/ obese than children with mothers of normal weight (95% CI: 1.77-6.28). Physical activity <60 minutes/day) (p=0.014), screen time >180 minutes/day (p=0.020), regular snacking while watching television, using computer/tablet/ mobile phones (p=0.000) were associated with overweight/obesity status of the preschool children.
Conclusion
 Public health programs that aim to reduce overweight/ obesity in preschool children should mainly help mothers understand the serious risk of childhood obesity and the importance of them creating a healthy lifestyle in childhood.
Treatment effectiveness and outcome in patients with a relapse and newly diagnosed multidrug-resistant pulmonary tuberculosis
Authors: Butov Dmytro , Myasoedov Valeriy , Gumeniuk Mykola , Gumeniuk Galyna , Choporova Oleksandra , Tkachenko Anton , Akymenko Oleksandra , Borysova Olena , Goptsii Olena , Vorobiov Yevhenii , Butova Tetiana
Published: April 2024

Aim
 To investigate the treatment effectiveness and outcome in patients with pulmonary tuberculosis relapse and newly diagnosed multidrug resistant pulmonary tuberculosis (MDR-TB).
Methods
 A total of 240 pulmonary MDR-TB patients, including 114 ones with tuberculosis relapse and 126 cases of newly diagnosed pulmonary tuberculosis, were examined. Effectiveness of the basic antimycobacterial therapy course was evaluated based on the time to normalization of tuberculosis clinical manifestation, sputum culture and acid-fast bacilli stain conversion, cavity closure, disappearance of infiltrative and focal changes in the pulmonary tissue. Treatment outcomes were evaluated as cured, treatment completed, treatment failed, died and lost to follow-up according to the World Health Organization guidelines.
 Results
When assessing the treatment effectiveness in patients with MDR-TB, a worse clinical and chest radiograph dynamics was observed in tuberculosis relapse against the background of high parameters of treatment failure (18.4 %) and low cured (34.2 %) compared with newly diagnosed pulmonary tuberculosis (7.1% and 58.7 %, respectively) (p=0.008 and p<0.001, respectively).
Conclusion
Standard treatment effectiveness in patients with newly diagnosed MDR-TB manifested by faster improvement and stabilization of health, earlier sputum culture and smear conversion, higher frequency of cavity closure and achievement of certain clinical and radiographic improvement against the background of fewer cases of treatment failure and a higher number of cured patients compared with MDR-TB relapse.
Interdisciplinary aspects of possible negative effects of dogs on humans in Bosnia and Herzegovina
Authors: Katica Muhamed , Obradović Zarema , Ahmed Nasreldin Hassan , Mehmedika-Suljić Enra , Stanić Žana , Abdalaziz Mohamed Rowida Seifeldin , Dervišević Emina
Published: April 2024

The coexistence of humans and dogs, in addition to all positive effects, can result in negative effects on human health. A particular risk is posed by a population of stray dogs, that is, dogs without owners and veterinary supervision. A contact with dogs in addition to bites, carries the risk of viral, bacterial and parasitic zoonoses, and can also cause psychological trauma. Children, the elderly and pregnant women are the categories most susceptible to the negative effects of dogs. The aim of the paper was to make an interdisciplinary analysis of the negative effects of dogs on humans. Dog bites cause wounds and dysfunction of damaged tissue, and often lead to various infections. The risks of rabies and tetanus are particularly significant if proper and timely treatment is not performed. Ongoing training for dog owners can significantly reduce the number of bites inflicted by owned dogs, but stray dogs remain a serious social problem and pose potential health risks of some zoonosis. Timely and adequate management of bite wounds and the use of rabies-post-exposure prophylaxis as well as psychotherapy , where indicated, significantly reduce possible adverse health effects for patients who have been bitten by dogs.
Ten-year risk assessment for type 2 diabetes mellitus using the Finnish Diabetes Risk Score in family medicine
Authors: Savić Suzana , Stanivuković Saša , Lakić Biljana
Published: April 2024

Aim
 To assess ten-year risk of diabetes mellitus type 2 (T2DM) using the Finnish Diabetes Risk Score (FINDRISC) in respondents over 18, in Primary Health Centre in Banja Luka.
 Methods
A prospective study was conducted using data from a population with undiagnosed T2DM in Primary Health Centre in Banja Luka. Eligible respondents were those aged 18 to 70 years. Sociodemographic, behavioural and anthropometric variables were those related to the risk models evaluated by FINDRISC.
Results
 Data were collected from 520 individuals, 58.8% female and 41.2% male (p=0.005). A very high risk of developing T2DM in the next ten years was found in 5.6% females and 3.7% males. A high risk was found in 12.4% females and 15.9% males, 34.2% respondents ≥ 65 years, 28.8% with body mass index >30 kg/m 2 , 26.6% who were not practicing physical activity (p=0.000), 24.0% who took antihypertensive drugs, 42.3% who were diagnosed with impaired glycaemia, 30.4% and 22.9% respondents whose parents and distant relatives, respectively, had T2DM. A moderate risk occurred in 31.4% females with waist circumference >88 cm. Half (50%) males with waist circumference >102 cm and 33.2% respondents who were not eating fruits and vegetables every day had a slightly increased risk of developing T2DM (p<0.05).
 Conclusion
The FINDRISC may be used as a tool which would help general practitioners in everyday work, to detect patients with T2DM risk factors and to encourage them to change life style towards healthy habits.
Glycaemia, renal function and body mass in men and women with type 2 diabetes
Authors: Pirić Marko , Šojat Dunja , Mišković Valentina , Šapina Matej , Popović Zvonimir , Bačun Tatjana
Published: April 2024

Aim
To determine parameters of glycaemic control, renal function and anthropometric measurements in patients with type 2 diabetes in family medicine offices and to examine whether there is a difference in these parameters between genders. Methods
 This cross-sectional study included 136 patients of both genders diagnosed with type 2 diabetes, with an average age of 69.33±10.87. General and demographic data were collected, anthropometric measurements were taken, as well as data on fasting plasma glucose, HbA 1 c and creatinine level from laboratory findings. Estimated glomerular filtration rate (eGFR) was calculated.
Results
 The average results of fasting plasma glucose test were 8.43 mmol/L, of HbA1c 7.15%, and of creatinine 79.00 µmol/L. In 19.12% of patients eGFR was <60 mL/min/1.73m 2. 80.15% were overweight and 38.97% had a body mass index (BMI) of 30 kg/ m 2 or higher. Morbid obesity was recorded in 2.94% of patients. Females had a statistically significantly higher hip circumference (p=0.002) and BMI (p=0.019), while males had a statistically significantly higher waist-to-hip ratio (p=0.006) and BMI (p=0.007).
Conclusion
The patients did not reach the target value of fasting plasma glucose (<7mmol/L) and HbA1c was above recommended (<7%). Given that the patients were elderly, glucoregulation can be considered as adequate. The average eGFR classified the patients into G2 group (mildly decreased glomerular filtration). The mean BMI was not within the recommended values. It is important to educate patients on a healthy diet and physical activity, to control their weight, but also to choose medications that reduce weight in addition to glycaemic control.
Spatio-temporal data visualization for monitoring of control measures in the prevention of the spread of COVID-19 in Bosnia and Herzegovina
Authors: Ponjavić Mirza , Karabegović Almir , Ferhatbegović Elvir , Tahirović Emin , Uzunović Selma , Travar Maja , Pilav Aida , Mulić Maida , Karakaš Sead , Avdić Nermin , Mulabdić Zarina , Pavić Goran , Bičo Medina , Vasilj Ivan , Mamić Diana , Hukić Mirsada
Published: April 2024

Aim
The damage caused by the COVID-19 pandemic has made the prevention of its further spread at the top of the list of priorities of many governments and state institutions responsible for health and civil protection around the world. This prevention implies an effective system of epidemiological surveillance and the application of timely and effective control measures. This research focuses on the application of techniques for modelling and geovisualization of epidemic data with the aim of simple and fast communication of analytical results via geoportal.
Methods
 The paper describes the approach applied through the project of establishing the epidemiological location-intelligence system for monitoring the effectiveness of control measures in preventing the spread of COVID-19 in Bosnia and Herzegovina.
Results
 Epidemic data were processed and the results related to spatio-temporal analysis of the infection spread were presented by compartmental epidemic model, reproduction number R, epi-curve diagrams as well as choropleth maps for different levels of administrative units. Geovisualization of epidemic data enabled the release of numerous information from described models and indicators, providing easier visual communication of the spread of the disease and better recognition of its trend.
Conclusion
 The approach involves the simultaneous application of epidemic models and epidemic data geovisualization, which allows a simple and rapid evaluation of the epidemic situation and the effects of control measures. This contributes to more informative decision-making related to control measures by suggesting their selective application at the local level.
An epidemiological study of neuroendocrine tumours at tertiary hospitals in Bosnia and Herzegovina
Authors: Konrad Čustović Maja , Iljazović Ermina , Sadiković Azra , Karasalihović Zinaida
Published: April 2024

Aim
Neuroendocrine neoplasms (NENs) are a heterogeneous group of tumours with varying clinical expression and behaviour. Because of indolent behaviour of NENs, reviewing and evaluation of epidemiological characteristics is a challenge. The aim of this study was to assess prevalence of NENs at tertiary hospitals considering age, gender, location, and grade.
Methods
Electronic files were used for a retrospective assessment of the patients with NENs of the gastroenteropancreatic tract and
bronchopulmonary system in tertiary hospitals in Bosnia and Herzegovina over the past 15 years (2005-2020).
Results
Among 438 patients, 291(66.4%) were males and 147 (33.6%) females; the median age was 62 years. The lungs were
the most frequent site, 304 (69.4%), followed by the pancreas, 22 (5.0%), colon, 14 (3.2%), stomach, 13 (2.9%), appendix,
13 (2.9%), rectum,11 (2.5%), small intestine, eight (1.8%) and gallbladder, one (0.2%). Metastases were most frequently found in the liver, 35 (8%) and lymph nodes, 15 (3.42%).
Conclusion
 The results were largely consistent with those in literature, including age, gender, location, and the degree of differentiation. Most metastases originated from high-grade tumours and greater impairment of the liver.
Minimal impact of COVID-19 outbreak on the postoperative morbidity and mortality following emergency general surgery procedures: results from a 3-month observational period
Authors: Seretis Charalampos , Archer Lucy , Lalou Lida , Yahia Shuker , Katz Christian , Parwaiz Iram , Haji Altaf , Selvam Lourdusamy
Published: April 2024

Aim
The outbreak of the COVID-19 pandemic has had a major impact on the delivery of elective, as well as emergency surgery on a worldwide scale. Up to date few studies have actually assessed the impact of COVID-19 on the postoperative morbidity and mortality following emergency gastrointestinal surgery. Herein, we present our relevant experience over a 3-month period of uninterrupted provision of emergency general surgery services in George Eliot Hospital NHS Trust, the United Kingdom.
Methods
 We performed a retrospective analysis of a prospective institutional database, which included the operation types, paraclinical investigations and postoperative complications of all patients undergoing emergency general surgery operations between March-May 2020.
Results
 The occurrence of a 5% overall respiratory complication rate postoperatively, with 3% infection rate for COVID-19 was found; no patient had unplanned return to intensive care for ventilator support and there was no mortality related to COVID-19 infection.
Conclusion
 When indicated, emergency surgery should not be delayed in favour of expectant/conservative management in fear of COVID-19-related morbidity or mortality risks.
Impact of load on the knee in relation to a treadmill angle
Authors: Veljović Fikret , Begić Edin , Voloder Avdo , Karabeg Reuf , Iglica Amer , Begić Nedim , Begić Alden , Chikha Adisa
Published: April 2024

Aim
To determine the effect of the load on the meniscus in relation to a different angle, and to present the impact of force on eventual injury of menisci.
Methods
Research included 200 males with average height of 178.5 cm, mass 83.5 kg, and average age of 22 years. The simulation of treadmill that was used in the evaluation of ischemic heart disease was made. Effects on the knee were evaluated by measuring at different inclinations (5°70’, 6°80’, 7°90’, 9°10’, 10°20’, 11°30’ and 12°40’).
Results
With increasing ascent of treadmill the load on the meniscus also increased. Each increase in ascent after 22% (which
corresponded to the angle of 12°40’ and seventh degree of load according to the Bruce protocol) at given anthropological values was an etiological factor for meniscus injury.
Conclusion
The seventh degree of load according to the Bruce protocol can lead to the meniscus injury.
Does low intensity direct current affect open fracture wound healing?
Authors: Dias Ismiarto Yoyos , Mutholib Luthfi Kemas Abdul , Mahyudin Mahyudin , Benedict Adriel
Published: April 2024

Aim
To explore the effects of a molecular pathway from the application of low-intensity direct current (LIDC) for wound healing
through the pathway signalling growth factor and initiation of fibroblast activation.
Methods
This randomized clinical trial included 32 patients with open fracture wounds who came to Hasan Sadikin Hospital in
Bandung, Indonesia. The patients were divided in the control and the treatment group. Extensive assessment of wound contractions, FGF2 and FGF7 levels, and fibroblast expression were evaluated before and after the treatment.
Results
This study showed a better wound area repair in the treatment group than the standard group, 3.17±0.11 and 0.78±0.07, respectively. The increase of FGF-2 level (42.69±3.5 and 15.09±1.8, respectively), FGF-7 level (42.99±3.55 and 14.67±1.9, respectively), and fibroblast group expression (7.62±0.79 and 3.54±0.6, respectively) were found to be higher in the treatment group (p<0.05).
Conclusion
Low-intensity direct current accelerates wound healing through the increase of growth factor and fibroblast activation.
Lived experiences of patients with COVID-19 infection: a phenomenology study
Authors: Jesmi Ali-asghar , Mohammadzade-tabrizi Zohreh , Rad Mostafa , Hosseinzadeh-younesi Elyas , Pourhabib Ali
Published: April 2024

Aim
To describe experiences of patients with COVID-19 infection.
Methods
 This qualitative research was conducted using a phenomenological approach, and participants were selected via purposive sampling. In total, 14 patients with COVID-19 were selected (nine women and five men) aged 20-60 years. Data were collected via in-depth interviews with open questions and through observation. Data analysis was performed using Colizzi's phenomenological approach.
Results
Three themes and nine categories were extracted; the main themes were mental strains, physical manifestations, and
coping mechanisms. Mental strains entailed concerns, fears and isolation, on the other hand, physical manifestations comprised nervous, respiratory and gastrointestinal system, and systemic disorders. Coping mechanisms included religiosity and home remedies categories.
Conclusion
Mental strains were the most important issues in the patients with COVID-19, which were interwoven with concerning
physical manifestations. Most of the participants used self-medication and spiritual resources to cope with the disease. Therefore, it is recommended to carry out proper planning by healthcare personnel to psychologically and spiritually support these patients, while alleviating physical manifestations of the disease. 
Appropriateness of colonoscopy at a tertiary care centre – are we overdoing gastrointestinal endoscopy?
Authors: Čustović Nerma , Džananović Lejla , Rašić Ismar , Zubčević Nadža , Šaranović-Čečo Lejla , Redžepagić Jasmina
Published: April 2024

Aim
To evaluate the pattern of indications and a spectrum of colonic pathology, and to determine appropriateness of indications for colonoscopy in order to improve patient selection for colonoscopy.
Methods
This retrospective study includes 294 patients who were referred to the Gastroenterology Department from a primary care
physician in order to approach endoscopic examination. Study data included patients’ anamnestic data (comorbidities, positive family history, performed radiological examinations) an indication for the procedure, and colonoscopy findings.
Results
Haematochezia was confirmed in 186 (63.26%), positive radiologic finding in183 (62.24%) and anaemia in 157 (53.40%)
patients. Adenoma and colorectal carcinoma were detected in 40 (13.6%) and 53 (18%) patients, respectively. A significant association between haematochezia and colorectal neoplasm was confirmed (p=0.019), haematochezia and inflammatory bowel disease (p=0.027), and between radiological finding and colorectal neoplasm (p=0.018). There was no significant association between anaemia and any of the colonoscopic findings. According to EPAGE II criteria indications were appropriate in 187 (63.6%), uncertain in 67 (22.8%) and inappropriate in 40 (13.6%) patients.
Conclusion
This study confirmed a slightly larger number of uncertain and inappropriate indications for colonoscopy compared
to other studies that examined indications for colonoscopy, which can be attributed to a high number of patients with functional bowel disorders. 
Intermittent traction therapy in the treatment of chronic low back pain
Authors: Tanović Edina , Čelik Damir , Omerović Đemil , Zovko Omeragić Vanda , Jaganjac Amila , Konjo Hadžan , Rovčanin Emina , Omerović Hana
Published: April 2024

Aim
To investigate the effect of intermittent traction therapy (ITT) on pain in patients with chronic low back pain (CLBP).
Methods
A total of 81 patients with CLBP were included: experimental group received ITT (n=40) and control group received
conservative physical treatment (n=41) 10 times for two weeks. A visual analogue scale (VAS) was used for measuring low back pain.
Results
In the experimental group, 26 (out of 40; 65.0%) patients were females, in the control group 20 (out of 41; 48.8%) were
females (p=0.141). In a within-group comparison, median of VAS value was significantly decreased in both groups after ITT. A comparison of pre-intervention and post-intervention VAS value showed no statistically significant difference. Females from the experimental group had a significantly greater decrease of VAS compared with females from the control group. Patients in the ITT group with L5/S1 level of hernia had lower estimated marginal mean of VAS scale compared to the control group, as well the patients with left side of leg pain.
Conclusion
Intermittent traction therapy is an effective treatment for pain reduction in patients with chronic low back pain. 
Posthumous sperm retrieval: a procreative revolution
Authors: Negro Francesca , Beck Renata , Cotoia Antonella , Varone Maria Cristina
Published: April 2024

Aim
Postmortem sperm retrieval with consequent artificial insemination has become a technically possible option for future use in assisted reproductive technology (ART). The authors have set out to discuss the social and ethical significance of posthumous sperm retrieval, and the laws currently in force in Italy, the United States
and elsewhere.
Methods
International literature from 1997 to 2020 has been reviewed from Pubmed database, Google Scholar and Scopus,
drawn upon American, Italian and international sources (an ethically acceptable solution can only be achieved through an overhaul of the laws currently in effect). One of the most contentious issues was about donor consent. In Italy, a donor's will to retrieve his sperm in the event of premature disappearance can be proven according to the Law 219/2017, through advance health care directives.
Results
A substantial increase, both in requests and protocols, was documented in the United States. In Italy, over the last two years, three rulings were issued concerning posthumous insemination. However, no official standardized protocols, guidelines or targeted legislation exist at the national level to regulate medical activity in that realm, whereas established laws often set implicit limitations.
Conclusion
Current legal frameworks appear to be inadequate, because in most cases they were conceived under conditions that
have radically changed. The need for newly-updated regulatory frameworks to promptly bridge that gap is increasingly clear, if current social needs related to reproductive rights are to be met in the foreseeable future.
A randomized, placebo-controlled trial of zinc supplementation during pregnancy for the prevention of stunting: analysis of maternal serum zinc, cord blood osteocalcin and neonatal birth length
Authors: Rohmawati Lili , Keumala Sari Dina , Sitepu Makmur , Rusmil Kusnandi
Published: April 2024

Aim
To investigate the influence of zinc supplementation on pregnant women for the prevention of stunting through an analysis
of maternal serum zinc, cord blood osteocalcin and neonatal birth length.
Methods
This study was conducted with pre-test/post-test control groups and double-blind randomization. Patients were pregnant
mothers in second or third trimester and with their newborns who met the inclusion criteria. A total of 71 pregnant mothers and their newborns completed this study. They were divided into two groups of 35 and 36 patients, the supplementation (20 mg/day) and placebo groups, respectively for 12 weeks. The parameters assessed were maternal serum zinc levels, cord blood osteocalcin and birth length measurements.
Results
The mean maternal serum zinc level was 54.6±8.7 µg/dL from 71 patients. The mean maternal serum zinc levels after zinc
supplementation were significantly higher than those of the placebo group: 55.1±9.9 to 59.1±8.6) μg/dL (p=0.017) and 54.2±7.5 to 50±8.6 μg/dL (p=0.001), respectively. The comparison of mean cord blood osteocalcin levels and median neonatal birth lengths in the supplementation group was higher than in the placebo group: 131.8±35.3 vs 90.6±35.4 ng/ml (p=0.001) and 49.3 (46.5-51.3) vs 48.3 (46-50.8) cm (p=0.004), respectively. Maternal serum zinc levels after zinc supplementation had a positive significant correlation with cord blood osteocalcin and neonatal birth length: r=0.434
(p=0.001) and r=0.597 (p=0.001), respectively.
Conclusion
There was a significant correlation of maternal serum zinc with cord blood osteocalcin and neonatal birth length after
zinc supplementation. 
Concordance of non-invasive serology-based scoring indices and transient elastography for liver fibrosis and cirrhosis in chronic hepatitis C
Authors: Trnačević Emir , Salkić Nermin , Trnačević Alma , Divković Anja , Hukić Fatima , Butković Nusret , Serak Amra , Mujkanović Amer
Published: April 2024

Aim
To assess concordance of eight frequently used serology-based scoring indices for liver fibrosis and cirrhosis with transient elastography (TE) in chronic hepatitis C (CHC) patients in order to determine serum indices with the highest concordance and clinical usability in clinical practice.
Methods
In this prospective study, 63 CHC patients were included and TE results were compared with eight non-invasive indices.
The diagnostic performance of these tests was assessed using receiver operating characteristic curves with kappa index calculated for the concordance analysis.
Results
Median age of 63 patients was 54 years (interquartile range: 42 to 63); 27 (42.9%) were females. According to areas under the Receiver Operating Characteristics (AUROC), the best performing serum markers for significant liver fibrosis (METAVIR ≥F2), advanced liver fibrosis (≥F3) and cirrhosis (F4) determined by TE measurements (≥7.1kPa, ≥9.5kPa and ≥12kPa, respectively) were Fibrotest (AUROC=0.727 for ≥F2) and FIB-4 score (AUROC=0.779 for ≥F3 and AUROC=0.889 for F4). Fibrotest cut-off at >0.50 was concordant with TE for presence of significant fibrosis in 30 (out of 45; 66.7%), FIB-4 cut-off at <1.45 was concordant for absence of significant fibrosis in 13 (out of 18; 72.2%) and
Goeteborg University Cirrhosis Index (GUCI) cut-off at >1 was concordant for presence of cirrhosis in 16 (out of 22; 72.7%) patients, but not for exclusion of cirrhosis.
Conclusion
Serology-based scoring indices had moderate overall concordance with TE. We propose that FIB-4 score, Fibrotest and
GUCI be used in routine practice to exclude and diagnose significant fibrosis and diagnose cirrhosis, respectively.
Effectiveness of teriparatide combined with the Ilizarov technique in septic tibial non-union
Authors: Rollo Giuseppe , Luceri Francesco , Falzarano Gabriele , Salomone Carlo , Bonura Enrico Maria , Popkov Dmitry , Ronga Mario , Pica Giuseppe , Bisaccia Michele , Russi Valentina , Grubor Predrag , Franzese Raffaele , Peretti Giuseppe M. , Meccariello Luigi
Published: April 2024

Aim
The septic non-union is a common compliance in bone healing due to bone infection. Bone resection, associated with Ilizarov osteo-distraction technique, is commonly used in these cases. The aim of this study was to analyse clinical and radiological results of teriparatide in combination with the Ilizarov technique and to compare this treatment with the standard treatment.
Methods
Forty adult patients underwent surgery because of type C of the Association for the Study and Application of Methods
of Ilizarov (ASAMI) classification non-union were enrolled. The patients were divided in two groups: those treated with Ilizarov technique (Norm group) and those treated with Ilizarov technique combined with teriparatide injection (Teri group). Surgical duration, complication rate, bone healing status, clinical and functional outcomes were assessed according to the A.S.A.M.I. classification in the mean follow-up of 12 months. The subjective quality of life was assessed by the Short Form Survey (SF)-12.
Results
Teri group showed less time wearing Ilizarov's frame (p<0.05) than the Norm group and a statistical significance in the inter-rater reliability Cohen’s k (p>0.05) respect to Norm according the score between the bone healing and clinical outcome results. There was no statistically significant difference between the two groups in other parameters that were assessed.
Conclusion
A benefit of teriparatide was found as adjuvant in the treatment of septic non-union.