AIM:To evaluate the prognostic value of the CHA2DS2-VASc score in relation to major adverse cardiovascular events (MACE) and cardiovascular mortality in patients with non-ST elevation myocardial infarction (NSTEMI), and to assess its association with clinical and echocardiographic characteristics. METHODS:This prospective, observational, cohort study included 311 NSTEMI patients admitted to the Internal Medicine Clinic at the University Clinical Centre Tuzla between January 2023 and April 2024. The patients were stratified into intermediate-risk (score < 4) and high-risk (score ≥ 4) groups based on the CHA2DS2-VASc score at admission. Demographic, clinical, and echocardiographic data were collected, including electrocardiography (ECG) and transthoracic echocardiography. All patients were followed for 3 months (90 days) to assess the occurrence of MACE and cardiovascular mortality. RESULTS:The patients in the high-risk group were older and had significantly lower left ventricular ejection fractions and larger left atrial diameters compared with the intermediate-risk group. During the 3-month follow-up, MACE occurred in 11.9% of high-risk and 3.9% of intermediate-risk patients; cardiovascular mortality was observed exclusively in the high-risk group (2.5%). A higher CHA2DS2-VASc score was significantly associated with cardiovascular mortality (p = 0.003), but not with overall MACE (p = 0.393). Moderate predictive accuracy for mortality (AUC = 0.64) and shorter event-free survival in the high-risk group (log-rank p = 0.005) were observed. CONCLUSION:The CHA2DS2-VASc score showed potential as a simple and accessible tool for early identification of NSTEMI patients at risk of cardiovascular death. Its significant association with mortality supports its role as a supplementary risk stratification tool, although these findings require validation in larger, multicentre studies.
AIM:To determine the proportion of patients with recorded psychiatric rehospitalisation within one year and examine crude associations with antipsychotic treatment patterns and documented medication adherence. METHODS:This retrospective cohort study included 87 patients with International Classification of Diseases, 10th Revision schizophrenia (F20.0-F20.9) hospitalised in Brčko District during 2014-2018 and with documented 12-month follow-up. Relapse was defined as recorded psychiatric rehospitalisation due to worsening psychotic symptoms. A separate audit described discharge treatment in 236 hospitalisation records. Exact tests and crude odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. RESULTS:Recorded rehospitalisation occurred in 32/87 patients (36.8%). First-generation antipsychotic exposure (OR 2.11, 95% CI 0.74-6.03; p = 0.215) and antipsychotic polypharmacy (OR 2.16, 95% CI 0.82-5.65; p = 0.164) were not significantly associated with rehospitalisation. Medication non-adherence (OR 11.33, 95% CI 3.58-35.87; p < 0.001) and documented non-cooperation (OR 10.00, 95% CI 3.16-31.62; p < 0.001) showed strong crude associations. In the audit, treatment was identifiable in 183/236 records; polypharmacy was documented in 73.8% and long-acting injectable/depot use in 32.8%. CONCLUSION:Documented non-adherence and non-cooperation were strongly associated with recorded rehospitalisation. The findings support structured adherence assessment and post-discharge follow-up but do not establish causal effects of antipsychotic class or regimen complexity.
AIM:To identify factors associated with emergence agitation (EA) in adults undergoing abdominal surgery under general anaesthesia. METHODS:This prospective two-centered study included 107 patients (≥18 years) who underwent abdominal surgery at two hospital centres between February 2025 and September 2025. Collected variables included demographics, American Society of Anesthesiologists (ASA) classification, education level, smoking and alcohol use, comorbidities, fasting status, urgency and type of surgery, and anaesthesia duration. Hemodynamic parameters were recorded before induction, before endotracheal intubation (ETI), and before extubation. EA was assessed using the Richmond Agitation-Sedation Scale (RASS) and the Sedation-Agitation Scale (SAS) before (T1) and 10 minutes after extubation (T2). RESULTS:At T2, EA incidence was 22% (23 patients) according to SAS and 41% (44 patients) according to RASS. SAS-defined EA at T1 was associated with ASA status ≥ III (aOR 2.35, 95% CI 1.05-5.25; p = 0.028) and lower blood pressure before extubation (aOR 0.62, 95% CI 0.50-0.96; p = 0.016). SAS-defined EA at T2 was associated with higher body weight (aOR 1.20, 95% CI 1.03-1.40; p = 0.017) and higher heart rate before extubation (aOR 1.45, 95% CI 1.25-1.80; p = 0.022). According to RASS, lower blood pressure before induction was associated with EA at T1 (aOR 0.88, 95% CI 0.78-0.99; p = 0.045), while nasogastric tube presence was associated with EA at T2 (aOR 2.10, 95% CI 1.06-4.15; p = 0.034). CONCLUSION:EA after general anaesthesia in adults undergoing abdominal surgery is common. Identification of associated factors may improve perioperative risk assessment and early recognition.
AIM:To evaluate whether treatment approach and Allen's classification are associated with treatment duration after fingertip injury and to identify predictors of prolonged recovery. METHODS:We retrospectively reviewed 91 patients treated for fingertip injuries at Cantonal Hospital Zenica (January 2024 - December 2024). Injuries were classified using Allen's system, and treatment duration was grouped as 7-25, 26-35, or 36-90 days. RESULTS:The cohort was predominantly male (89.0%), with a median age of 47 years (IQR 36-71). Median treatment duration was 24 days (IQR 15-33). Longer treatment duration was associated with exposed distal phalanx (p = 0.016), type 2 diabetes mellitus (p < 0.001), and treatment approach (p < 0.001). In multivariable analysis, osteosynthesis compared with suture (OR 2.95, 95% CI 1.30-12.63) and type 2 diabetes mellitus (OR 3.78, 95% CI 1.22-11.72) were associated with prolonged treatment in exploratory multivariable analysis (36-90 days). CONCLUSION:Treatment approach and selected comorbidities should be considered alongside injury classification when anticipating recovery duration; however, the findings should be interpreted cautiously because of the limited number of prolonged-treatment events and diabetic patients.
AIM:To determine the prevalence and microbiological profile of ventilator-associated pneumonia (VAP) in mechanically ventilated patients and to assess clinical and laboratory parameters associated with its development, with emphasis on C-reactive protein (CRP) levels and duration of mechanical ventilation. METHODS:This single-centre prospective observational cohort study included 118 adult patients who required invasive mechanical ventilation for more than 48 hours in the intensive care unit of the University Clinical Centre Tuzla. Patients were classified into VAP and non-VAP groups. Demographic, clinical, laboratory, and microbiological data were collected, and in-hospital outcomes were recorded. Statistical analysis included between-group comparisons, univariate logistic regression, and receiver operating characteristic (ROC) curve analysis. RESULTS:VAP was diagnosed in 41 patients (34.7%). Gram-negative pathogens predominated (≈ 85%), with Acinetobacter baumannii identified most frequently (43.9%), followed by Pseudomonas aeruginosa and Klebsiella pneumoniae. Patients with VAP had significantly longer durations of mechanical ventilation (12.5 vs. 7.3 days, p < 0.001) and hospitalisation (19.6 vs. 12.2 days, p < 0.001), as well as higher CRP levels (178.2 vs. 126.4 mg/L, p < 0.001). Reintubation, elevated CRP, leukocytosis, hypercapnia, and prolonged mechanical ventilation were associated with VAP. CRP demonstrated good-to-moderate discriminative ability for VAP (AUC = 0.83). CONCLUSION:VAP remains a common and clinically significant complication in mechanically ventilated patients. Elevated CRP levels and prolonged mechanical ventilation may support early clinical suspicion using routinely available parameters.
AIM:To investigate the differences in neutrophil-to-lymphocyte ratio (NLR) between patients with schizophrenia spectrum disorders (SSD) and healthy controls, and their association with metabolic syndrome (MS) in SSD patients. METHODS:A cross-sectional study was conducted involving 70 SSD patients and 55 healthy controls. NLR was calculated using absolute neutrophil and lymphocyte counts (WBC) after obtaining complete blood counts. MS was diagnosed using ATP III criteria, and SSD patients were divided into two subgroups with and without MS. RESULTS:Patients with SSD had significantly higher total WBC (p = 0.001), as well as neutrophil counts and NLR (both p 0.05). CONCLUSION:The findings suggest that inflammation, as indicated by elevated NLR, is linked to SSD independent of MS.
AIM:To examine the association between parental and child body mass index (BMI), and parental perceptions of their own and their child's weight in relation to measured BMI. METHODS:This cross-sectional study included 1,343 children aged 3-6 years and 1,343 parents from primary healthcare centres and preschool institutions in Sarajevo. Data on sociodemographic characteristics, parental weight perceptions, and anthropometric parameters were collected using a questionnaire. BMI was calculated according to the National Centre for Chronic Disease Prevention and Health Promotion recommendations. RESULTS:The mean parental BMI was 25.1 ± 3.8. Overall, 460 (34.25%) parents were overweight and 140 (10.43%) were obese. Among children, 171 (12.7%) were underweight, 790 (58.8%) had normal weight, 159 (11.9%) were overweight, and 223 (16.6%) were obese. Higher parental BMI was associated with lower relative risk of underweight (RRR=0.94; 95%CI = 0.89-0.99; p = 0.021), slightly higher risk of overweight (RRR = 1.04; 95%CI = 1.00-1.09; p = 0.047), and higher risk of obesity (RRR = 1.09; 95% CI = 1.04-1.13; p < 0.001). Parental perception of child weight status differed significantly from measured BMI (p < 0.001), with very low sensitivity for child overweight and obesity of 10.5% (95%CI 7.8 - 13.9) and specificity of 99.2% (95% CI 98.4-99.6). Among parents, 100 overweight and 105 obese individuals perceived themselves as normal weight. CONCLUSION:Parental BMI was positively associated with child BMI. Misperception of parent and child weight was common, supporting improved awareness and targeted prevention.
AIM:To determine if heat-not-burn (HNB) tobacco products are a safe alternative to cigarette smoking by inducing decreased decline of cardiorespiratory function. METHODS:A clinical observational, cross-sectional study was conducted in the period between February and June 2025. It analysed and identified the effects of HNB tobacco products on cardiorespiratory symptoms in 60 adults below 55 years of age with confirmed arterial hypertension, 30 in the HNB users group (≥ 6 months of HNB use and no history of conventional cigarette use (CCU)), and 30 in the non-HNB user group (no history of HNB or CCU). RESULTS:The gender distribution among the groups was similar. HNB tobacco product users reported significantly more respiratory (daily and nighttime shortness of breath, coughing) and cardiologic symptoms (choking, shortness of breath during physical activity). The following parameters were significantly reduced in the HNB tobacco product users: forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and forced expiratory flow at 75% (FEF75) (p = 0.01), SO2 (p < 0.001), pO2 (p = 0.001), HCO3- (p < 0.001), total cholesterol (p = 0.001), and basophils (p < 0.001), while the following parameters were significantly increased in the same group: right ventricular systolic pressure (RVSP) (p = 0.002), hsCRP (p < 0.001), monocytes (p < 0.001), eosinophils (p < 0.001), D-dimer (p < 0.001), and platelet count (p = 0.003). CONCLUSION:HNB tobacco product use in adults with arterial hypertension was associated with worse cardiorespiratory symptoms, impaired pulmonary function, signs of early right ventricular dysfunction, and systemic inflammation.
AIM:To evaluate whether single and two-month average intradialytic blood pressure (BP) measurements, including systolic blood pressure (SBP) and diastolic blood pressure (DBP), are associated with left ventricular mass index (LVMI), and whether intradialytic BP thresholds discriminate left ventricular hypertrophy (LVH) in patients with end-stage renal disease on haemodialysis. METHODS:This prospective observational study was conducted at the Dialysis Centre in Doboj between June and September 2017 and included 97 adults on chronic haemodialysis for at least five months. Intradialytic BP was assessed as a single measurement and as a two-month average. LVMI and LVH were evaluated by echocardiography. Multivariable regression examined associations with LVMI after adjustment for age, haemoglobin, and volume overload, while receiver operating characteristic (ROC) curve analysis assessed LVH discrimination. RESULTS:Median dialysis duration was 3.9 years, and 24 patients (25%) had ischemic heart disease. Median LVMI was 117.5 g/m2, and LVH was present in 44 patients (45%). After adjustment for relevant covariates, single intradialytic SBP and DBP measurements were not associated with LVMI. In contrast, two-month average SBP (B = 0.5364, p = 0.0075) and DBP (B = 0.7308, p = 0.0299) remained independently associated with LVMI. Two-month average SBP showed moderate LVH discrimination (area under the curve (AUC) 0.711; p = 0.0001), with an exploratory cut-off of >143 mmHg. CONCLUSION:Two-month average intradialytic SBP was independently associated with higher LVMI and showed moderate discrimination for LVH but requires external validation.
AIM:To compare outcomes of elective open inguinal hernia repair under local anaesthesia (LA) and general anaesthesia (GA). METHODS:This retrospective cohort included 833 adults treated in Tuzla during 2017-2025. The primary outcome was any early adverse outcome within 30 days. Secondary outcomes included analgesic requirement, chronic groin pain, discomfort, dissatisfaction, and recurrence. Logistic regression adjusted for age, American Society of Anesthesiologists physical status, hernia characteristics, and technique. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were reported; Benjamini-Hochberg correction was applied to secondary outcomes. RESULTS:The LA group included 425 patients and the GA group 408. Postoperative analgesia was required in 338 (79.5%) and 110 (27.0%) patients, respectively (p<0.001). An early adverse outcome occurred in 79 (18.6%) and 35 (8.6%) patients (aOR 2.08, 95% CI 1.31-3.30; p = 0.002), mainly because of more haematomas with LA, 54 (12.7%) versus 20 (4.9%) (p < 0.001). Chronic groin pain did not differ after adjustment (aOR 1.26, 95% CI 0.81-1.96; p = 0.310). Dissatisfaction was higher with LA, 85 (20.8%) versus 40 (10.1%) (aOR 1.95, 95% CI 1.27-2.99; p = 0.002). Eight recurrences were recorded. Median follow-up was 14 months (interquartile range 12-18 months). CONCLUSION:LA was associated with more early adverse outcomes and dissatisfaction than GA. Chronic pain did not differ after adjustment, and recurrence was similar. Selection bias and residual confounding should be considered.
AIM:To evaluate serum serotonin levels in patients with peptic ulcer disease (PUD) and assess its potential as a biomarker associated with depressive symptoms in patients with PUD. METHODS:This case-control study included 50 adult male patients with endoscopically confirmed PUD and 50 apparently healthy male controls. Serum serotonin levels were measured using enzyme-linked immunosorbent assay (ELISA). Depression was diagnosed by a psychologist and assessed using the Patient Health Questionnaire-9 (PHQ-9). Statistical analyses included the Mann-Whitney U test, chi-square test, multivariate logistic regression, and receiver operating characteristic (ROC) curve analysis. RESULTS:Patients with PUD had higher PHQ-9 scores than controls, with a median score of 13.5 (7.0-16.6) versus 4.0 (2.0-8.0) (p<0.001). Serum serotonin levels were lower in patients with PUD than in controls, with a median of 530.086 (435.7-592.8) pg/mL versus 1008.763 (874.89-1120.43) pg/mL (p<0.001). In the adjusted model, lower serotonin levels remained independently associated with comorbid PUD-depression status (OR=0.992; 95% CI 0.988-0.996; p<0.001). ROC analysis showed high diagnostic performance for serotonin in the full sample (AUC=0.920; 95% CI 0.870-0.970; cut-off 803.131 pg/mL; sensitivity 85.0%; specificity 100%). CONCLUSION:Serum serotonin levels were lower in male patients with PUD and depressive symptoms than in healthy controls. Serotonin may have diagnostic value as a biomarker associated with depressive symptoms in patients with PUD, but longitudinal studies including women and PUD patients without depression are required.
AIM:To evaluate the urine flow cytometry flagging feature (UF-5000) for predicting urine culture positivity and assess the agreement between BACT-info Gram outputs and culture Gram classification, with subgroup analyses in catheterised, immunosuppressed, and age-stratified patients. METHODS:This single-centre cross-sectional diagnostic accuracy study included 885 routine urine samples with paired UF-5000 analysis and culture results (440 culture-positive, 445 culture-negative). The diagnostic performance of the urinary tract infection (UTI)-flag (UTI vs. non-UTI) was calculated with Wilson 95% confidence intervals. Agreement between two BACT-info definitions and culture Gram category was also evaluated. RESULTS:UTI flagging demonstrated a sensitivity of 0.670, specificity of 0.921, positive predictive value (PPV) of 0.894, negative predictive value (NPV) of 0.739, and an accuracy of 0.797. The negative predictive value declined markedly in high-risk subgroups: catheterised patients (NPV, 0.612) and immunosuppressed patients (NPV, 0.500). Sensitivity was substantially lower in males (0.412) than in females (0.833). Indicator-derived Gram classification showed excellent agreement with culture Gram category (κ = 0.826), whereas categorical BACT-info label mapping yielded fair agreement (κ = 0.294). Bacterial count (BACT) discriminated culture positivity with an area under the curve (AUC) of 0.812 (optimal cut-off 487/µL, sensitivity 0.795, specificity 0.807), whereas white blood cell count (WBC) showed an AUC of 0.749 (cut-off 76.9/µL, sensitivity 0.735, specificity 0.773). CONCLUSION:UF-5000 UTI flagging provides strong rule-in utility for bacterial UTI triage but should not be used as a universal rule-out test, particularly in catheterised and immunosuppressed patients. The BACT count improves discrimination and may support safety-oriented overriding rules.
AIM:To evaluate and compare the effects of topically applied diclofenac, ketoprofen, and piroxicam on key inflammatory mediators, including interleukin-17 (IL-17), prostaglandin E2 (PGE2), and signal transducer and activator of transcription 3 (STAT3), in a rat model of collagen-induced arthritis (CIA). METHODS:Thirty male Wistar rats were assigned to five groups: three experimental groups receiving topical diclofenac, ketoprofen, or piroxicam, respectively, a positive control group receiving a placebo patch, and a negative control group without collagen injection. CIA was induced using bovine type II collagen and incomplete Freund's adjuvant, with arthritis severity assessed through macroscopic scoring. NSAID patches were applied to the right hind paw for 6 hours daily over 5 days. Immunological parameters were quantified via enzyme-linked immunosorbent assay (ELISA). Statistical analysis included ANOVA, Kruskal-Wallis, and mixed-effects models to evaluate drug effects over time. RESULTS:A significant difference was observed in tissue PGE₂ levels (F(4,25) = 4.235; p=0.009; η² = 0.404), with diclofenac showing significantly lower values compared to the negative control and ketoprofen groups, while no significant differences were found for IL-17 or STAT3. CONCLUSION:Topical NSAIDs demonstrated selective anti-inflammatory effects, primarily through significant suppression of tissue PGE₂, confirming effective local COX pathway inhibition. The absence of significant changes in IL-17 and STAT3 suggests that short-term topical therapy mainly targets prostaglandin-mediated inflammation rather than upstream cytokine or transcriptional pathways involved in rheumatoid arthritis pathogenesis, warranting further investigation into their long-term therapeutic benefits.
AIM:To explore differences in exhaled volatile organic compounds (VOCs) and serum interleukin-12 (IL-12) levels between lung cancer patients and healthy controls, and their potential relationship with tumour-related metabolic and systemic immune alterations. METHODS:A cross-sectional study was conducted involving lung cancer patients and healthy controls. Exhaled breath samples were analysed using the µβreath sensor to quantify VOCs, including total volatile organic compounds (TVOC)(1), TVOC(2), acetone, formaldehyde, toluene, hexane, and methane. Serum IL-12 levels were measured via ELISA. Significant limitations such as age mismatch, unvalidated sensor data, and potential confounders (smoking, chemotherapy, diet, environmental VOCs) were acknowledged. RESULTS:Lung cancer patients exhibited significantly higher TVOC(1) and TVOC(2) levels, and higher acetone levels, while formaldehyde, toluene, hexane, and methane levels were lower than in controls. Serum IL-12 levels were markedly lower in patients, reflecting systemic immune modulation rather than direct diagnostic specificity. ROC analysis indicated high sensitivity for certain VOCs, but specificity remained limited, suggesting that these markers were exploratory rather than definitive diagnostic tools. No significant correlation was observed between VOCs and IL-12 levels. CONCLUSION:Differences in exhaled VOC profiles and serum IL-12 levels provide preliminary insight into tumour-related metabolic and immune alterations in lung cancer. However, due to major methodological limitations, particularly age mismatch and incomplete sensor validation, these findings should be interpreted with caution. Exhaled VOCs and IL-12 should be considered hypothesis-generating exploratory biomarkers that require validation in larger, age-matched cohorts using gold-standard analytical techniques and multivariate modelling.
AIM:Chronic hepatitis B (CHB) is a major cause of liver cirrhosis worldwide. This study aimed to evaluate the red cell distribution width-to-platelet ratio (RPR) as a simple non-invasive predictor of cirrhosis in CHB patients. METHODS:A cross-sectional study was conducted in 221 CHB patients at H. Adam Malik General Hospital, Medan, Indonesia (May 2024-May 2025). Cirrhosis was diagnosed by FibroScan (≥ 14 kPa) or ultrasonography findings. RPR was calculated from routine haematology data. Bivariate analysis was used to compare the cirrhotic and non-cirrhotic groups. ROC curve analysis was used to evaluate the diagnostic accuracy of RPR and determine the optimal cut-off values in terms of sensitivity and specificity. RESULTS:Of 221 patients, 64 (29.0%) had cirrhosis. Cirrhotic patients were older (54.5 vs. 48 years; p = 0.001) and predominantly male (77.6% vs. 56.1%; p = 0.004). RPR was significantly higher in the cirrhotic group (0.16 vs. 0.05; p < 0.001). ROC analysis showed that RPR had an AUC of 0.938 (95% CI: 0.906-0.970; p < 0.001), with an optimal cut-off value of 0.085, yielding sensitivity of 87.5% and specificity of 87.3% for detecting cirrhosis. CONCLUSION:RPR is a simple, inexpensive, and widely available haematological index with excellent diagnostic accuracy for predicting cirrhosis in CHB patients. It may serve as an effective screening tool in settings with limited access to advanced diagnostic modalities.
Aim: To determine whether immunohistochemical B7-H3 expression is associated with magnetic resonance imaging (MRI)-derived tumour volume, peritumoral brain oedema volume, and oedema index in adult gliomas. Methods: This retrospective radiopathological correlation study included 99 consecutive patients with histopathologically confirmed intracranial gliomas surgically treated between 2013 and 2021. B7-H3 expression (clone RBT-B7H3, Bio SB, USA) was evaluated using staining intensity, percentage of positive tumour cells, and a composite immunoreactive score (IRS). Tumour volume (TV), peritumoral brain oedema volume (PTBE), and oedema index (EI) were calculated from orthogonal MRI measurements. Spearman correlation and crude and adjusted linear regression were used. Adjusted models included age, sex, tumour grade, and Ki-67. Results: Median TV was 29.31 cm3 (IQR 12.17-49.12), median PTBE was 84.51 cm3 (IQR 47.59-178.18), and median EI was 4.56 (IQR 3.83-5.00). B7-H3 IRS correlated strongly with TV (r=0.921, p<0.001) and PTBE (r = 0.920, p < 0.001), but not with EI (r = -0.105, p = 0.299). After adjustment, B7-H3 IRS remained associated with ln(TV) (beta = 0.228, 95% CI 0.190-0.265, p < 0.001) and ln(PTBE) (beta = 0.178, 95% CI 0.152-0.204, p < 0.001), but not with EI (beta = 0.001, 95% CI -0.083 to 0.084, p = 0.990). Conclusion: B7-H3 expression is independently associated with MRI-derived tumour volume and peritumoral brain oedema volume in adult gliomas, but not with oedema index, supporting its relationship with absolute MRI-visible lesion burden.
AIM:The gut-brain axis is pivotal in the pathophysiology of irritable bowel syndrome (IBS), with anxiety, depression and quality of life. IBS-C (constipation-predominant) and IBS-D (diarrhoea-predominant) are frequently linked with psychological comorbidities. Neither in Indonesia nor globally has research been conducted regarding the relationship between subtypes of IBS and depression and anxiety. This study aimed to identify the relationship between depression and anxiety and subtypes of IBS. METHODS:From January to December 2023, a cross-sectional study was conducted on 49 IBS patients at Dr Saiful Anwar General Hospital, Indonesia. Demographic data and colonoscopy reports were gathered. Psychological status was measured using the Hospital Anxiety and Depression Scale (HADS). The χ2 test and Spearman's correlation analysis were performed to examine associations between demographic characteristics, IBS subtype, and psychological scores. RESULTS:There were no significant associations between sex, age, or IBS subtype and the presence of anxiety or depression symptoms. Anxiety and depression scores were modestly correlated overall (r = 0.503; p = 0.000). Subgroup analysis revealed a strong correlation in IBS-C (r = 0.613; p = 0.009) and a moderate correlation in IBS-D (r = 0.461; p = 0.008), indicating a notable interrelationship within these subtypes. CONCLUSION:Moderate relationship between anxiety and depression was found in IBS patients, strongest in IBS-C and moderate in IBS-D. Neither demographics nor IBS subtype was significantly related to psychological symptoms independently. The findings warrant routine screening for mental health and multidisciplinary management in IBS patient.
Aim: The most common type of kidney transplantation in Bosnia and Herzegovina is from living donors, but there is a lack of published data on glomerular filtration rate (GFR) values and kidney outcomes in living kidney donors. This study aimed to evaluate the safety of living kidney donation at our centre. Methods: One hundred and seventy living kidney donors at the University Clinical Centre Tuzla were analysed. Initially, there were 170 participants; however, only 31 provided all the required medical data and completed the study. GFR was estimated (eGFR) using the CKD-EPI and MDRD formulas, and a web-based calculator was used to predict GFR >90 ml/min/1.73 m², along with measurement of creatinine clearance (CrCl). Measured GFR (mGFR) was assessed through technetium-99m diethylene triamine pentaacetic acid (DTPA) renogram, with follow-up visits to estimate post-donation GFR. Results: The CKD-EPI, MDRD, and web-based application showed similar diagnostic performances, with MDRD and CKD-EPI systematically underestimating mGFR. CrCl demonstrated strong diagnostic performance. Follow-up visits showed that most donors had post-donation eGFR values between 45 and 89 mL/min/1.73 m², with none progressing to pre-dialysis or the dialysis stage after kidney donation. Conclusion: CrCl demonstrated strong diagnostic performance in our study population, and the DTPA renogram reliably assessed kidney function. Post-donation eGFR levels were satisfactory, indicating that our diagnostic workup for potential living kidney donors in our centre is safe and effective.
Aim: The lumbar spine is vital for supporting body weight and facilitating trunk mobility. Morphometric data of the lumbar spine in Southeast Asian populations, particularly the Indonesian population, remain limited. This study aimed to provide baseline morphometric parameters of the lumbar spine in Indonesia to enhance preoperative planning and surgical outcome. Methods: This descriptive study analysed 150 adult patients (ages 17-55) who underwent CT scans at Dr. Saiful Anwar General Hospital in Malang between 2021 and 2023. Lumbar spine parameters, including vertebral body dimensions, pedicle morphometry, spinal canal diameter, intervertebral foramen size, and segmental height, were measured by independent, trained observers to minimize inter-observer variability. Data were extracted from the hospital's Radiology Information System (RIS). Results: The mean vertebral body height (29.14 mm) and width (42.17 mm) were smaller than those reported in Western populations, but consistent with Indonesian data. The mean pedicle width at L3 was 10.78 mm, and the spinal canal diameter (13.9 mm) was narrower than in Western populations but similar to East Asian and Indian cohorts. These findings highlight anatomical differences that should be considered in spinal surgery, including implant sizing and preoperative planning. Conclusion: This study provides essential baseline lumbar spine morphometric data for the Indonesian population. The results emphasize the need for region-specific surgical approaches. Future studies with larger, diverse samples are recommended to refine these findings and enhance clinical applications.
AIM:To assess demographic and clinical determinants of CKD among patients undergoing haemodialysis in Mosul, Iraq. METHODS:A descriptive cross-sectional study was conducted at a public dialysis centre in Mosul between January and April 2024. A total of 89 patients with confirmed CKD were recruited using purposive sampling. Data were obtained through structured interviews and medical records, including demographic characteristics, etiological factors, CKD stage based on KDIGO criteria, and biochemical indicators (serum creatinine and blood urea nitrogen). Associations between CKD stage and demographic or clinical variables were assessed using chi-square tests. Multivariate logistic regression was applied to identify independent predictors of advanced CKD (stages 4-5), with results expressed as odds ratios and 95% confidence intervals. RESULTS:Diabetes mellitus (27 %) and hypertension (23.6 %) were the leading aetiologies. End-stage kidney disease (ESRD) represented 48.3 % of cases. Male prevalence increased across CKD stages, from 44.4% in mild to 67.4% in ESRD (p = 0.031). Mean creatinine rose from 1.6 ± 0.3 mg/dL in mild CKD to 8.5 ± 2.3 mg/dL in ESRD, with corresponding blood urea nitrogen (BUN) increases from 22.5 ± 5.2 to 89.6 ± 15.1 mg/dL. Overall, 71.9% presented in severe or ESRD stages, reflecting late diagnosis. Multivariate analysis confirmed male sex as an independent predictor of advanced CKD (OR = 2.14; 95% CI: 1.05-4.36; p = 0.031). CONCLUSION:CKD in Mosul is characterized by late-stage presentation and predominance of metabolic aetiologies. Male sex emerged as an independent predictor of advanced CKD. These findings highlight the need for targeted screening, earlier detection, and improved nephrology services in post-conflict communities.
