Background: The aim of this study was to evaluate the morbidity profile and survival of critically ill children admitted to the tertiary pediatric intensive care unit (PICU) during the last ten years.Methods: A retrospective single-center, observational study, which included all consecutive children treated in the PICU over a ten years. Clinical and demographic data were obtained from medical records and an electronic database of patients. Statistical analysis applied standard methods, and the research was approved by the Ethics Committee of the institution.Results: In the ten-year, 28,214 children were hospitalized at the clinic, of which 4,052 (14.36%) in the PICU, 2488 of them were neonates (61.4%), and 1564 over neonatal age (38.6%), 508 infants (32.5%), and 1056 children >1.0 years (67.5%), without gender difference. The morbidity profile and survival were age-specific. Respiratory failure was the most common, especially in premature neonates. Mortaliti rate in neonates was 10.8%, and over neonatal age 6.7%.Conclusion: In the past decade in our centre decreased number of total hospitalisations, and increased admissions to PICU. The number of neonates admitted to our PICU increased significantly, especially premature ones, without gender differences. The morbidity profile and survival were age-specific.
Background: The posterior communicating artery (PComA) is crucial in the formation of the circle of Willis, displaying variations such as hypoplasia and aplasia. These impact collateral blood flow, with false diagnoses, posing risks in pre-surgical planning. Discrepancies between cadaveric and radiological studies highlight the imaging modality precision concerns.Aim: To explore the sensitivity of 3D TOF (time-of-flight) angiograms in visualizing the PComA compared to maximum intensity projection (MIP) tomograms, and to assess whether CE-MRA (contrast-enhanced MRA) improves PComA visualization compared to native MRA.Methods: In this retrospective study there were 137 subjects who underwent MRA between July 2008 and May 2013. Subjects with cerebrovascular disease, vascular malformations and brain tumors were excluded. The study focused on 274 PComA in 137 subjects, evaluating visualization on native and CE-MRA, as well analyzing axial 3D TOF angiograms and MIP images. The analysis categories were: not visualized, poorly visualized or well visualized.Results: Among 211 arteries visualized on CE-MRA, only 2 (0.95%) were not seen on native MRA. CE-MRA, improved visualization in 5.22% of cases, with no significant difference (p=0.99) in PComA visualization between native and CE-MRA. Out of 209 PComA visualized on native MRA, 54 (25.84%) were visible on axial 3D TOF angiograms, but not on MIP reconstructions. Basic 3D TOF tomograms significantly outperformed MIP images (p=0.038) in visualizing PComA.Conclusion: Contrast MRA does not significantly improve the visualization of PComA compared to native MRA, but basic 3D TOF tomograms are significantly better in visualizing PComA compared to MIP reconstructions.
Varicella-zoster virus (VZV) belongs to the group of alpha herpesviruses, and causes two epidemiologically and clinically distinct diseases, chickenpox or varicella as the primary VZV infection, while shingles respresents the endogenous reactivation of latent VZV infection, typically occuring in older individuls and rarely in younger ones. This is a case report of a 12-year-old boy who was hospitalized at the Clinic for Infectious Diseases at the University Clinical Center Tuzla, diagnosed with meningitis from February 20, 2023, to March 7, 2023. Cerebrospinal fluid analysis upon admission showed moderate pleocytosis with mild proteinorrhoea and hypoglycorrhoea. Cerebrospinal fluid was also subjected to microbiological analysis, which returned a positive PCR result for varicella-zoster virus. Laboratory findings showed stable parameters of inflammation throughout the hospitalization. Parenteral antiviral therapy (acyclovir ampoules) was initiated upon admission and continued for 14 days. Follow-up cerebrospinal fluid analysis showed significant improvement. The boy was discharged home in a recovered state with recommendations for follow-up tests and examinations. Varicella-zoster meningitis is a rare but serious and potentially life-threatening complication following primary infection with the varicella-zoster virus, particularly in immunocompromised patients with symptoms of CNS involvement.
The most significant contribution to the development of dentistry was made by Pierre Fauchard (1678-1761), whom we rightly consider the "father of modern dentistry". He wrote down his observations, thoughts, and innovations and in 1728 published "Le Chirurgien Dentiste ou Traite des Dentes". It is the first scientific textbook in this field and is considered to be the basis of a new age in dentistry. For the next hundred years, it was a basic textbook in dentistry. He managed to separate dental medicine from surgery, which has since been called odontology and set it on its own feet as an independent profession. As a result of Fauchard’s efforts, dental practice has changed for the better.
Introduction: Specific therapeutic methods (STM) are manual techniques used to treat tissue blockade.Aim of this research is to determine efficacy of STM in treatment of lumbar facet syndrome (LFS).Patients and methods. The study included 60 patients suffering from LFS (65% women) aged ~47. The patients were treated ~24 days with the following 2-8 procedures: osteopathy, “myofascial release”, acupuncture, acupressure, “cupping”, neurodynamic, proprioceptive neuromuscular facilitation, kinesiotherapy, “kinesio-type taping”, homeopathy and electrotherapy. All patients were evaluated at admission and discharge through: a. pain scale with visual analogue scale (VAS) marked with numbers 1 to 10 (1 being state of no pain, 10 being state of maximum pain); b. disability with so-called Oswestry index (ODI) expressed in percentages (0-20% being minimum, 80-100% being complete disability); c. quality of sleep, rated through modified Pittsburgh index of sleep quality (PSQI) expressed between 0 (very poor) and 4 (very good). The assessment of improvement in pain intensity and level of disability was conducted via subtraction of values noted before treatment from values at the end of treatment, while the assessment of sleep quality improvement was conducted via subtraction of values noted at the end of treatment from the values noted before treatment. Non-parametric statistical analyses were used. Results: significantly lower values of VAS (p<0.0001) and ODI (p?0.0001), significant increase in PSQI (p?0.0001) at the end in relation to the beginning of treatment, as well as significant correlation between decrease in pain and disability (r=0.3292, p=0.0105). No significant difference in pain (p=0.9856) and disability (p=0.9171 decrease was noticed between sexes.Conclusion: STM is efficient in the treatment of pain attacks in patients of both sexes suffering from LBS.
Hemolytic uremic syndrome (HUS) is a multiorgan clinical syndrome characterized by the simultaneous occurrence of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. This is the most important form of thrombotic microangiopathies in children and is considered the main cause of acute renal insufficiency in children, especially under the age of five. Over 90% of HUS in children is associated with infection, and the prodromal manifestation most often includes bloody diarrhea. Atypical hemolytic uremic syndrome (aHUS) is a rare but progressive, life-threatening condition that affects about 10% of HUS cases in children. It is predominantly caused by dysregulation of the alternative complement pathway and genetic predisposition. Conditions that enhance complement, such as some viral infections, malignancies, autoimmune diseases and transplantation may be comorbid in up to 70% of aHUS cases. The 2016 International Hemolytic Uremic Syndrome Group classification, based on the etiology, separates 4 groups: caused by infection, with coexisting conditions, due to cobalamin C disorders and due to complement dysregulation. Monoclonal antibody that effectively blocks complement activation, has significantly changed aHUS treatment and outcome. Early etiological recognition in order to start specific treatment as soon as possible is crucial for the outcome. This paper, through a rapid review and series of three children treated for HUS in our pediatric intensive care unit over a two-year period, aims to emphasize the complexity of the diagnosis and treatment of HUS, and the importance of a multidisciplinary team in order to to avoid complications, and achieve the best short- and long-term outcome
Background: Oral health is the main indicator of general health, individual well-being, and quality of life. Oral health in children and adolescents is often reflected by the state of their dental hard tissues in a form of their previous caries experience. Poor oral health in children increases the likelihood of more complex dental treatment and emergencies, which can lead to absenteeism from school and reduced learning abilities, causing slowed physical development, and overall reduced oral health-related quality of life.Aim: To determine the state of oral health and its influence on the overall quality of the life in six-year-olds in the city of Živinice.Methods: The study participants were psychophysically healthy six-year-old children of both genders with residences in the urban and rural areas of the city of Živinice. Oral examinations were conducted according to the WHO Oral Health Survey manual. The previous caries experience indexes of primary teeth (dmft, SiC, pufa) were noted during clinical examinations of children, with a simultaneous filling of the POQL questionnaire by children's parents.Results and Conclusion: The state of oral health of six-year-olds in the area of the city of Živinice was not on a satisfactory level. Analyzed oral health indexes were higher worldwide and national findings. High scores of all analyzed indexes indicated that oral health could have an impact on the quality of life and that these values are high in comparison to the given recommendations. KEYWORDS: six-year-old children, dmft, pufa, SiC, POQL
Background: Screening for colorectal cancer (CRC) can identify premalignant lesions and detect asymptomatic malignant tumors at an early stage that have a better chance of healing, but also longer-term better treatment outcomes. Screening has been shown to reduce mortality from CRC. The aim of this paper is comprehensive education of health care professionals in the Tuzla Canton about this disease, adoption of new guidelines and simpler route from diagnosis to surgical treatment,which ultimately leads to reduced mortality and better outcomes in treatment. Material and methods:The project included family medicine specialists, surgeons and gastroenterologists, 100 of them. The education project was led by two surgeons, who implemented the guidelines ofthe American College of Gastroenterology (ACG) 2021, when it comes to screening CRC. Results: None of the participants offered all correct answers in tests, prior to the training, in both groups of doctors. For a post-educational test, data suggest that there has been a noticeable improvement in the results. In a group of doctors with over 10 years of service, 71 (98.61%) answered correctly all the questions offered and only 1 (1.39%) between 5 and 9 correct answers. For a group of doctors with less than 10 years of service, 26 (92.86%) provided all correct answers and only 2 (7, 14%) between 5 and 9 correct answers.Conclusion: This project pointed to the necessary education of healthcare professionals in this area, who are involved in early detection programmes for CRC, especially family medicine specialists, surgeons and gastroenterologists.
Background: Coronary Artery Perforation is a rare Percutaneous Coronary Intervention (PCI) complication which may lead to pericardial effusion frequently accompanied by tamponade. This complication occurs in 0.2 to 0.6% of all patients undergoing the procedures. The initial approach commonly comprises prolonged balloon inflation, placement of a covered stent graft (CSG), pericardiocentesis, or urgent coronary artery bypass graft (CABG) surgery.The aim: To present a patient with a type III Ellis classification of coronary artery perforation, who had previously underwent primary PCI due to an acute extensive anterior STEMI, and discussed its managementConclusion: Management of coronary artery perforation can be customized based on the categorization and hemodynamic condition of the hole. Our patient was effectively managed with extended balloon inflations and intra-coronary vitamin K administration without the need for surgical management intervention.
AbstractAim Hydatidiform mole is a rare pregnancy disorder, with wide variety of reported incidence. The aim of the study was to estimate the incidence of hydatidiform moles (HM) in Tuzla Canton, specifically partial (PHM) and complete (CHM) forms.Material and methods All cases of HM that have been diagnosed at the University Clinical Center, Tuzla, between January 2011 and December 2015 were registered. The overall incidence of HM, as well as the incidence of PHM and CHM was calculated using the Tuzla Canton's live birth rate during the study period. A second review of tissue slides and p57 immunohistochemistry (IHC) staining was performed to determine the validity of the criteria for the diagnosis and distinction of the molar specimens. Results There have been 256 cases of HM, 243 cases of PHM, 12 cases of CHM, and one case of unspecified HM. The average incidence of PHM was estimated at 11.03/1,000 and CHM at 0.54/1,000 live births. A second pathologist review revealed one PHM as a non-molar specimen, confirmed all CHM and identified an unknown HM as a PHM. Out of the 50 randomly chosen samples of PHM, p57 expression confirmed the diagnosis in 48 cases, disclosed one case as unrecognized CHM, and one sample showed discordant staining. IHC staining for p57 approved the diagnosis for all cases of CHM.Conclusion: HM incidence reporting remains a challenge due to the study design. p57 immunohistochemistry confirmed the strong validity of histopathological criteria in the diagnosis of CHM.
Aim: To evaluate results of surgical intervention of horizontal strabismus or to evaluate results of horizontal strabismus surgery intervention and to identify factors that influence the success of the surgery. Medical documentation of 144 patients that have done their first horizontal strabismussurgery at the Clinic for Eye Diseases in Tuzla from February 2017 until February 2023. Main measure of successful surgery was defined as an eye deviation no more than 10 prism diopters 2 years after the surgery. Results of post-operative binocular vision and vision acuity improvements were analyzed. Pre-operative deviation, diagnosis, binocular function, visual acuity and age were analyzed as factors that influence the success of the surgery.Patients and methods: Patients were divided into 2 groups, first under the age of 7 (48.6%) and above the age of 7 (51.4%). In order to assess set goals of the research, Chi square test, Wilcoxon matched-pairs signed-rank test and logistic regression analysis with forced entry were used. Average age of the respondents was 9.67±4.15 years old (med. 8, mod. 7, min. 5 and max 20), while 69 (47.9%) had esotropia and 75 (52.1%) had exotropia. Average pre-operative deviation was 6.62±42.28 PD, (median 0, modus 60 PD), while minimum and maximum deviation was in range from -60 PD to +35 PD. Average post-operative deviation was 5.46±10.06 PD.Results:Success of the surgery for esotrpia was 49.3% and for 97.3%. Before surgery, 13 (9%) had binocular vision, and after the surgery 80 (55.6%) of the respondents had the binocular vision. Success rate of the surgery was 67.1% for respondents younger than 7 and was 81.1% for the respondents older than 7.Conlusion: No statistically significant improvement for vision acuity was observed.
Objectives: The aim of this study is to investigate the compatibility of pathohistological and Pap findings on material obtained by cervical biopsy and excoalation, and to investigate the compatibility of qualitative histological pattern and diagnosisMaterial and Methods: The study included 152 patients with premalignant lesions of the cervix who underwent Pap testing and targeted cervical biopsy. Archival data on Pap test and histologic diagnosis were collected from available medical records. Information on age and advisable clinical diagnoses was obtained from referrals for pathohistologic examination of tissue. The age of the subjects was determined at the time the tissue samples were collected for analysis. Data on the quality of the material were obtained from microscopic evaluation of the collected materialResults: The largest number of patients was diagnosed with cervical intraepithelial neoplasia type 3 (CIN 3) cytologically (57.2%) and pathohistologically (55.2%). The largest percentage of treated material was rated as very good (46.1%). The majority of respondents (92.4%) had no difference in diagnosis based on Pap test and pathohistological analysis. There was no statistically significant difference in the diagnosis made on the basis of the Pap test and pathohistologic analysis depending on the quality of the materialConclusion: There was a strong positive correlation between the grade established by cytology (Pap test) and the pathohistological diagnosis (PHD). There was no statistically significant difference in the diagnosis made on the basis of the Pap test and pathohistological analysis depending on the quality of the material.M
Aim: The research aims to explore healthcare workers' attitudes towards and acceptance of artificial intelligence in radiology, focusing on its potential to enhance diagnostic accuracy, reduce waiting times, increase service efficiency, and improve patient care. It seeks to assess their willingness to adopt artificial intelligence, along with their concerns, expectations, and educational needs to effectively utilize this technology in radiological practice.Methods: A prospective study surveyed 50 healthcare workers, including radiologists, technicians, nurses, and others using various radiological techniques for diagnosing diseases. Using a quantitative approach, numerical data from distributed surveys assessed their attitudes and knowledge regarding artificial intelligence in radiology. Conducted at Public Health Institution "Zdravstveni centar Brcko" in Bosnia and Herzegovina's Brcko District over 60 days, the research adhered to ethical principles and received approval from the center's Ethics Committee.Results: The majority of respondents recognize the potential of artificial intelligence to improve the efficiency of radiological services and treatment processes, but at the same time express the need for additional education and training in order to optimally use this technology. Despite the positive perception, part of the respondents are still not sure about the use of artificial intelligence, which emphasizes the importance of continuous information and education of healthcare workers.Conclusion: Ultimately, the research results indicate the importance of further steps in the implementation of artificial intelligence in radiology in order to improve the quality of health care and optimize treatment processes.Keywords: Artificial intelligence, radiological diagnostics, challenges, perspectives, quality of health care.
INTRODUCTIONTransfusiontreatmentinmodernclinicalpracticeincludessubstitutiontherapy certaincomponentsoftheblood,whichadequatelyandeffectivelycontributetoquickrecoveryandhealing diseases[1].Almosteverybranchofmedicineistransfusion-dependent,startingwithsurgeryandinternalmedicine branchtodiagnosticones,wherethesafetyofthepatientisensuredbysubstitutionwithcertainblood preparations[2]. Bloodandbloodproductsdifferfromotherdrugsandpharmaceuticalpreparationswhile the only source is humanbloodfromvoluntarydonors[3].Inpractice theyusetwowaysofgettingblood,byvoluntarydonation,whenwholebloodistaken,whichisthemostcommon usedasastartingpointfortheproductionofotherdrugsfromblood,andbytheapheresisprocedureon cellseparator,whenonlyonebloodcomponentistaken,suchasplatelets,plasma, erythrocytes[1,4] Anadequatebloodtransfusionsupplyiscrucialforthefunctioningofthehealthsystem[5].Althoughtheyare bloodanditscomponentsrecentlyaddedtotheWHOessentialdruglist,insufficientbloodsuppliesinmost oflow-andmiddle-incomecountriesstillleadtomortalityandmorbidity,whichcan preventbyensuringsufficientbloodreserves[6,7]. Ensuringsufficientamountsofbloodimpliesstrategicconsiderationoflocal,epidemiological factors,demographicstructure,equipmentandabilitytoproducemedicinesfromwholeblood[8,9]. Currently,voluntaryblooddonationinmanylow-andmiddle-incomecountriesisnot adequately[10].Themainreasonsfortheunavailabilityofbloodisthehighprevalenceofviralhepatitisand inadequateproductionofbloodcomponents[11].Overallrelationsinsociety,socio-economicand demographicsareanimportantfactorforassessingthepossibilitiesofensuringstablereservesofsafeblood,which theyrepresentthenationalresourceofacountry[12].Theestimationofthedailyconsumptionofbloodproductsis unpredictablenature,duetopossibleincidentsituations,naturaldisasters,andlimited lifetimeofdifferentpreparations.Thelimitedlifespanofbloodincreasesthenumberofunuseddoses, resultinginadecreaseinstablereservesandhighcosts[6]. AccordingtoWHOguidelines,recommendationsforensuringstablebloodreservesinclude10to20 donationsper1000inhabitants[13].Theseassessmentsareimportantbecausetheycanservetoguidefurtherones investmentsinstrategiestoensuresufficientamountsofblood,thenanalysisofcurrenttransfusionpractice, introductionofrationalizationmeasuresduringtransfusiontreatmentandimplementationofthesystemfor bloodmanagement[14,15].IntheareaofTuzlaCanton,theannualblooddonationisapprox. 13000doses.Formorethanthreedecades,thePolyclinicforTransfusionhasbeenproducingvariousmedicinesfrom blood,whoselifespanandstoragemethodaredifferent,namely:wholeblood,erythrocyteconcentrate,concentrateerythrocyteswithareducednumberofleukocytes,irradiatederythrocyteconcentrate,freshfrozenplasma, plateletconcentrate,plateletconcentratewithreducednumberofleukocytes,irradiatedconcentrate platelets,plateletapheresisconcentrateandcryoprecipitate. MATERIALANDMETHODSThis retrospective study was carried out at the Polyclinic for Transfusion, University Clinical Center Tuzla data from the Renovatio information system in the period from July 1, 2022 to December 31, 2022. Data were analyzed on voluntary blood donors (age and gender), who donated blood during that period. Then data on the number of blood doses collected, as well as the number and type of medicines produced from blood (whole blood, erythrocyte concentrate, erythrocyte concentrate with reduced number of leukocytes, irradiated concentrate platelets, fresh frozen plasma, cryoprecipitate, platelet concentrate, platelet concentrate with a reduced number of leukocytes, irradiated platelet concentrate, irradiated platelet concentrate with reduced number of leukocytes, as well as platelet concentrate produced by the apheresis method using of the Amicus cell separator. Also, data was collected for patients who received blood preparations: age, gender, diagnosis, type of blood preparation indicated, name of the clinic where the patients were hospitalized, and the type and quantity of blood products issued. RESULTSThelargestnumberofdonatedbloodunitswasusedinthepreparationoffreshfrozenplasma,5742units,then5498unitsofplateletconcentrate,797unitsofcryoprecipitate,and308unitsofconcentrate plateletswithareducednumberofleukocytes,200unitsofirradiatedplateletconcentrateand119units irradiatedplateletconcentratewithareducednumberofleukocytes (Figure 1).
Introduction: Globally, the most common mental disorders in the elderly include dementia (5% - 8%), depression (7%), anxiety disorder (4%), and substance abuse (1%). Moreover, 25% of suicide deaths occur among the elderly. Whether the prevalence rate of psychiatric disorders increases in later life is currently debated in the literature. During the previous two decades of their lives, older adults in Bosnia and Herzegovina have experienced many specific psychosocial circumstances. The experience of war aggression on our country, and the post-war period with a very complex socioeconomic environment of the current socio-political climate, were accompanied by special challenges for the mental health of this population. Motivated by a large number of questions and dilemmas related to the state of mental health of this population, we conducted research at the Department of Psychiatry at the University Clinical Center Tuzla.Objective: Our objective was to investigate psychiatric morbidity and comorbidity in people over 55 years of age.Methods: The research sample consisted of all patients older than 55 years treated at the Department for Psychiatry during 2018 (N=281), divided into four age categories. To obtain data, we used medical documentation, i.e., medical records, and we constructed a special questionnaire for research purposes.Results: Diagnoses by ICD-10 groups: 33.4% of patients in the entire sample had affective disorders (F30.0-F39.0): "young" (39.2%), "middle" (43.3%), "older "(75%) (p<0.001); women had significantly more affective disorders (61.8%) than men (26.8%) (p<0.001). Men had significantly more organic mental disorders (F00.0-F09.0) (63.3%) than women (22.6%) (p<0.001).Hypertensio arterialis was the most common comorbid dg. of the entire sample, without significant differences according to age groups and sex (p>0.05). Diabetes mellitus was the second comorbid dg. By frequency in the total sample (19.6%) without significant differences according to age groups and according to sex (p>0.05).Conclusion: In the entire sample, the most common diagnoses are from the affective disorders group; the most common somatic comorbidities are hypertensio arterialis and diabetes mellitus.
Severe acute respiratory syndrome novel coronavirus (SARS-CoV-2) has rapidly progressed from an outbreak to a global pandemic, with new variants emerging rapidly. Coronavirus disease 2019 (COVID-19), a disease caused by SARS-CoV-2 infection, can lead to multiorgan damage. Due to the highly contagious and fatal nature of the virus, the priority of medical research has been to find effective treatments. Amid this search, the role of vitamin D in modulating various aspects of the innate and adaptive immune system has been debated.The aim of the work: research on the role of vitamin D in the treatment and prevention of COVID-19. Although there are some conflicting results, the consensus is that vitamin D has a number of immunomodulatory effects that may be beneficial in the context of COVID-19 and that low vitamin D levels may result in dysfunction of key antimicrobial effects, potentially contributing to a poor prognosis. The aim of the paper is to investigate the impact and importance of vitamin D in patients with the corona virus.Work methods: During this retrospective study, data were taken from the Registry of those tested for the presence of the SARS-CoV2 virus, Specialist Center "Health House" in Bijeljina. The research included 30 patients positive for the presence of the SARS-CoV2 virus and 30 patients negative for the presence of the SARS-CoV2 virus. The following parameters were observed in the research: age, gender and vitamin D values, data on the body temperature of the patients and the duration of the disease, as well as the obtained results of the inflammatory parameters (Leukocytes and C- reactive protein CRP). The dana of all patients are anonymous. All patients were tested using the molecular method of polymerase chain reaction known as RT-PCR (Reverse transcription polymerase chain reaction). Separate samples were tested with Arhitectt Vitamin D reagent by the chemiluminescence method (CMIA), manufactured by Abott Arhitectt and 1000sr. Reference values of Vitamin D are from 75 to 150 nmol/L.Results: The concentration of vitamin D was lower in the group of patients with the coronavirus disease (COVID-19) compared to individuals with the absence of the coronavirus disease. There is a tendency towards a negative correlation between the concentration of vitamin D and the duration of the disease in the group of patients with the coronavirus disease (COVID-19), as like as the concentration of vitamin D and body temperature in the group of patients with the coronavirus disease (COVID-19). There is also a tendency towards a negative relationship between the concentration of vitamin D and parameters of inflammation (CRP, Le) in the group of patients with coronavirus disease (COVID-19).
Background: This research paper is an expression of a desire to view COVID 19 from the perspective of a spontaneous hemorrhage induced on different organ systems. Introduction of a stratified approach to the problem of hemorrhage has become an imperative in medical treatment. Aim: To determine the real figure of spontaneous hemorrhage cases in severe forms of infections caused by Covid 19.Material and methods: The research included 745 patients that suffered from severe forms of infections caused by Covid 19 who were treated in a Respiratory clinic in Tuzla University Clinical Center during 2020 and 2021. The spontaneous hemorrhage was determined on the grounds of laboratory parameters of blood counts and CRP, hemodynamic monitoring of TA and pulse, and CT imagining diagnostic technique.Results: The study presents information about the medical treatment outcome in the case of 5 patients (0,67%) who experienced spontaneous hemorrhage as a part of Covid 19 infection in relation to the total number of 745 patients who were treated during that period in the Respiratory clinic as Covid patients with severe forms of infection. Out of 5 patients who acquired spontaneous hemorrhage 3 were operated. For 4 patients the outcome was lethal. One of the female patients who was in the group of those who were not operated and who had undergone a conservative treatment has survived. In our group of analyzed patients two patients suffered from the hematoma of the front abdominal wall, two had retroperitoneal hematoma and one patient acquired hemorrhage in the abdomen and thoracic with the developing DIC.Conclusion: Relatively low percentage of cases developing spontaneous hemorrhage 5 (0, 67%) but relatively high mortality rate in the cases where it did occur, 4 out of 5 monitored patients, requires certain suggestions that are being presented in this study as to how to approach the cases of spontaneous hemorrhage in the severe forms of Covid 19 infections in more consistent manner in order to improve the outcome of the medical treatment of these cases.
Aim: The aim of this study was to assess the impact of the COVID-19 pandemic and its management on the rate of newly diagnosed cancers from the perspective of a tertiary referral center in Tuzla Canton.Methods: All patients diagnosed with gynecological cancer at Department of Gynecology and Obstetrics, University Clinical Center Tuzla, in prepandemic, pandemic and postpandemic period, were presented in this study. Gynecological cancer was defined as one of the following diagnoses: ovarian or tubal carcinoma, cervical carcinoma, endometrial carcinoma, uterine sarcoma, vulvar carcinoma, vaginal carcinoma, and germ cell tumors.A total of 579 patients with newly diagnosed cancers were collected in 2020. There were 109 newly diagnosed gynecological cancers in 2020., while in 2019 there were 134, and 136 in 2021. Numbers of gynecological cancers diagnosed during pandemic were compared to numbers in prepandemic and postpandemic period. Results: There was a total of 579 patients with newly diagnosed cancer in Clinical Center of Tuzla during 2020. That showes strong decline of newly diagnosed cancers compared to 2019 with 1030 newly diagnosed cancers. Of these 579 patients, 109 presented in 2020 with newly diagnosed gynecological cancers. That shows strong decrease compared to 2019. with 134 newly diagnosed gynecological cancers and 2021 with 136 gynecological cancers. In 2019. 4015 PAP tests were examined, with only 1917 PAP tests examined in 2020 (diagram 4). In 2019. we did 199 HPV typisation test, while in 2020. there were only 34.Conclusion: The lockdown coused by COVID - 19 pandemic led to decreased number of routine examinations including annual PAP smear testing and HPV typisation tests. It also led to decrease number of other checkups. All of that led to decreased number of newly diagnosed gynecological cancers.
Bacterial conjunctivitis is a common condition in paediatric ophthalmology. Incidence and symptoms depend on etiological factor, clinical presentation and age. The most common pathogens which cause bacterial conjunctivitis are: Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis etc. Conjunctivitis is treated empirically in most cases, the treatment is defined by symptoms and clinical findings, physician prescribes the available antibiotic treatment. Eye swab is indicated in cases of prolonged or non efficient treatment or in case of relapse. Goals: To evaluate bacterial conjunctivitis according to microbial pathogen detected in eye swab, the most common microbial pathogens found and drug susceptibility of antimicrobial agents given in antibiogram. Methods: We retrospectively evaluated 73 microbiological findings of eye swabs in 53 children between January 2019 and March 2020. The sample was cultured on blood and chocolate Gram staining agar incubated under 5-10% CO2, 35-37ËšC with daily reading 40-48h. Bacteria collected from eye swabs were tested for the following antibiotics: chloramphenicol, ciprofloxacin, gentamicin, moxifloxacin, ofloxacin, trimethoprim/sulfamethoxazole, tetracycline, erythromycin, ampicillin, azithromycin, amoxicillin, clindamycin and penicillin. Results: In a total of 53 patients eye swabs were taken, 23(43,39%) male and 30(56,60%) female, age ranged from 0-17 (mean age 32,3±52,3 months or 2,7±4,4 years) most common patient age was 2 years in 40(75,5%) cases. Number of performed eye swabs was 73, and pathogens were isolated in 70(95,9%) cases, and only in 3(4,1%) cases there were no pathogens in eye swab, meaning that indication for eye swab was highly justified. Among isolated pathogens, Staphylococcus aureus was proved to be the most common, in 20(27,4%) cases, the antibiotic with highest drug susceptibility was chloramphenicol in 33(62,3%) cases. Conclusion: Microbiological evaluation of bacterial conjunctivitis is reasonable in moderate to severe cases associated with mucopurulent discharge, prolonged treatment, and as confirmation of diagnosis. Choosing the accurate antibiotic therapy requires identification of pathogen and assessing its susceptibility. Targeted treatment reduces risk of antibiotic overdosing or unnecessary use of antibiotics. Prudent use of antibiotics reduces antimicrobial resistance.Â
Background: The coronavirus disease (Covid 19) is caused by the SARS-CoV-2 virus. The virus has spread globally, causing millions of deaths.Aim: This study was made with the aim of revealing the clinical features of corona virus infection, as well as assessing the prevalence of comorbidities in patients infected with coronavirus 2 (SARS-CoV-2).Methods: In this analysis the data was obtained from the hospital information system, involving patients who were treated for Covid-19, in the period January 1 until April 8, 2021.Results: 400 infected patients were included in the study, 86.2% of whom had comorbidities, and 8.8% without comorbidities. The results showed that the most common clinical symptom is fever in 62%, followed by difficulty breathing in 53%, and cough in 42%. The most prevalent comorbidities were cardiac 68.3%, then endocrinological 33.8%, surgical 16.5%, neurological 15%, oncological 12%, nephrological 11%, and pulmonary 10%. The existence of a significant association between the presence of comorbidities and the patients suffering from COVID-19 on mechanical ventilation due to treatment complications was determined, p=0.000 (p<0.05) at the 95% significance level.Conclusion: We assessed the prevalence of comorbidities in patients with COVID-19 and found that underlying disease, including cardiac and endocrinological diseases, may be a risk factor for severe forms of the disease.Key words: Covid-19, clinical features, comorbidities
