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V. Katica

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This manuscript addresses behavior change intentions and consumer risk perceptions in the context of uncertainty and crisis such as the Covid-19 pandemic. Based on the theory of planned behavior and health behavior theories, a conceptual framework is developed that focuses on the role of attitudes toward the Covid-19 pandemic, their determinants in the context of the public campaign conducted, and the resulting behavior change intentions. The empirical study, based on an actual campaign and a representative nationwide sample in a developing country, is conducted to test the developed hypotheses. The results suggest that information search is relevant to predicting attitudes and intention to change behavior. At the same time, exposure to the campaign is directly relevant to motivating the target audience to change their behavior. There is also a gap between attitude and behavior, but it is bridged by perceived risk, which plays a vital moderating role when rated high or low. Finally, in the presence of this moderating effect, an indirect effect of information search on behavior change intention is confirmed by attitudes toward the Covid-19 pandemic. Overall, this study provides valuable insights for research in health behavior and crisis management.

Naima Imshiria, V. Katica, Lejla Imshiria, Amila Hodžić, Nedim Galijasevic

Introduction: Bilateral ectopic pregnancy is a very rare condition which occurs in 1/725 - 1/1580 ectopic pregnancies, most commonly after induced assisted reproductive techniques. Aim: To present the case of spontaneous bilateral tubal pregnancy, and the problem of insufficiency of available diagnostic methods, which causes that an accurate diagnosis can mostly be made intraoperatively. Case Report: A 37-year-old female, nulliparous, comes at the Clinic of Gynecology and Obstetrics of CCUS, complains of intense suprapubic pain, and difficulty urinating. The expected menstruation was absent for more than 2 weeks. The Grav index test was positive. Beta hCG values were 6312 IU/L. On examination, the patient was extremely pale, hypotensive, gave the impression of hemorrhagic shock, and the abdomen was diffusely palpably painful. After emergency TV ultrasound, then ultrasound and CT of the abdomen and small pelvis, which indicate a moderate amount of thicker fluid in the abdomen and small pelvis in terms of hemoperitoneum and with the left contour of the uterus an oval zone most likely to correspond to ectopic pregnancy, an indication for emergency surgery was made. A laparotomy was performed, and partly liquid and partly coagulated blood was found in the abdomen. The left tube in the isthmic part was ruptured with active bleeding. Right Fallopian tube was pathologically changed, livid, with visible suspicious pregnancy in the ampullary part. Bilateral salpingectomy was performed, and samples are sent for PHD analysis that shows the presence of chorionic villi in both tubes. Conclusion: When ectopic pregnancy is suspected, the possibility of bilateral tubal pregnancy should always be kept in mind, especially in cases accompanied by acute pelvic pain with signs of hemorrhagic shock

Research goal: The aim of the research is to define the possibilities of TVU and the MRI in the diagnosis of the most common benign ovarian lesions which cause pelvic pain. Patients and methods: In study were included n=74 patients with pelvic pain, who were examined with TVU and then with an MRI of pelvis. Diagnostic results of all patients (n=74) divided into two groups according to the modality that was performed (TVU results n=74 and MRI results n=74 MRI ). We compared the results of TVU and MRI, and with a pathohistological finding after surgery. TVU test sensitivity and MRI test sensitivity has been made for each pathological entity in particular. The overall sensitivity test of TVU was performed for all pathological entities together. The overall sensitivity test of MRI was performed for all pathological entities together. Results: TVU demonstrated sensitivity of 83.3% for ectopic pregnancy, 83.3% for ovarian torsion, 84% for endometriotic cyst, 88.2% for hemorrhagic cysts, 58.3% for tubo-ovarian abscesses, 62.5% for dermoid cysts. Overall sensitivity of TVU for all these pathological entities was 78.4%. MRI showed a sensitivity of 100% for ovarian ectopic pregnancy, 83.3% for ovarian torsion, 100% for endometriotic cyst, 100% of hemorrhagic cysts, 83.3% tubo-ovarian abscess, and 87.5% for dermoid cysts. Overall sensitivity of MRI in all of these pathological entities was 94.6%. The analysis using the chi square test shows that there is a significant difference in the sensitivity between the US and MRI in favor of greater overall MRI sensitivity in diagnosing ovarian pain caused by benign lesions. (χ2 = 14.352, df = 9, p = 0.0021). Conclusion: TVU is the first choice method for ovarian analysis due to the convenience and absence of radiation, and MRI is a very useful modality when TVU’s results are confusing and unspecific.

Nermana Ahmetbegović, Nadira Suljagić, V. Katica

Aim To compare finding of thyroid gland scintigraphy with serum concentration of parathyroid hormone in patients undergoing hemodialysis. Methods This retrospective-prospective study included 50 patients undergoing hemodialysis with established hyperparathyroidism who were treated at Cantonal Hospital Zenica in the period 2009 - 2014. Besides anthropological data, concentration of parathyroid hormone in serum of patients was monitored too. Scintigraphy was performed at the Department of Nuclear Medicine using two-headed gamma camera Prism 2000xp. Results Of the total number of 50 patients, 24 (48%) were males and 26 (52%) were females. The average age was 49.34±11.82 years. A total of 17 (34%) patients had normal findings of scintigraphy, 11 (22%) had mildly pronounced uptake of radiopharmaceuticals (score of 1), 14 (28%) had moderately pronounced uptake (score of 2), and eight (16%) had intensive uptake of radiopharmaceuticals (score of 3). A statistically significant difference was established in the length of hemodialysis treatment and scintigraphy finding (p=0.041). Conclusion Scintigraphy of parathyroid glands in patients undergoing hemodialysis allows us to select them for parathyroidectomy. Scintigraphy of parathyroid glands and a value of parathormone in serum should be incorporated into the test algorithm for patients with secondary hyperparathyroidism caused by chronic kidney disease.

V. Katica, A. Rama, Nidžara Abadžić

Introduction : When other causes are excluded, polycystic ovary syndrome (PCOS) refers to a state of chronic hyperandrogenemia and anovulation. There are four basic treatment goals: to treat hirsutism and its equivalents, treat anovulation, reduce insulin resistance and possible metabolic sequelae and reduce the risk of endometrial cancer. Approach in the treatment of anovulation should be gradual - from simple to more complex methods. Aim : To determine the effectiveness of ovulation induction in women with polycystic ovary syndrome in relation to given pharmacologic therapy. Patients and methods :The study included 30 women with a PCOS diagnosis. Patients were randomized in three study groups. The first study group included patients who used clomiphene citrate 50 mg 2-7 day of the cycle, the second study group included patients who used metformin 2 x 850 mg daily, while the third group included patients who used metformin 2 x 850 mg daily and clomiphene citrate 50mg 2-7 days of the cycle. Folliculometry was performed on each patient. Results : The average number of basal antral follicles bilaterally compared between study groups is not statistically significant, F=0.220, p = 0.804. The average number of basal antral follicles bilaterally was 15.40 } 3.93. The difference in average size of follicles during the last folliculometry was not statistically significant between the study groups, F = 1.369, p = 0.271. Each induction at which the follicle size is less than 18 mm we consider a failed induction. At last measurement, patients who used clomiphene citrate and metformin had the most successful inductions. Combined use of clomiphene citrate and metformin also affected the thickness of the endometrium. Patients in the third test group had a thicker endometrium than patients from the first and second group to a degree that is statistically significant. Conclusion : If there are no problems with other factors (tubal patency, spermiogram etc.), in ovulation induction the combination of metformin and clomiphene citrate in women with polycystic ovary syndrome can be successful and achieve pregnancy.

S. Zubčević, M. Gavranović, V. Katica, D. Brajkovic, F. Catibusic

Carbamazepine is the one of the most prescribed antiepileptic drugs in treatment of partial and generalized tonic-clonic seizures. Its efficacy in treatment of seizures was discovered incidentally during the trials of neuroleptic drugs. Generally it is well tolerated with relatively rare serious side effects. Therapy is introduced gradually, with mean dose between 10-20 mg/kg, and given this way it has the least side effects. Aim of the study was to assess interaction between efficacy, tolerability and overall efficacy of the first prescribed drug, in this case carbamazepine, in the group of patients with partial seizures and generalized tonic-clonic seizures. Patients hospitalized at University Pediatric Hospital in Sarajevo with newly diagnosed epilepsy and started therapy with carbamazepine in period from 07.1999 to 07.2002 were investigated. There were 89 patients that fulfilled the criteria. In 29 patients seizures remitted after the introduction of therapy (32.58%). After the subsequent correction of therapy further 8 patients were seizure free. In total, drug was efficient as a monotherapy in 68 patients (76.40%). Other antiepileptic drugs or polytherapy with carbamazepine were tried in the patients that were not seizure free. Adverse effects were reported in 28 patients (31.46%). The most frequent was benign leucopoenia (16 patients, 17.97%) that did not require changes in therapy. Rash was found in 8 patients (8.98%), out of which in 6 therapy had to be stopped. Compliance with therapeutic regime was slightly better with controlled release formulation (89.98%) then with simplex formulation (77.52%), but generally was good. We think that carbamazepine is still the drug of the first choice in treatment of patients with partial epileptic seizures and generalized tonic-clonic seizures. It showed good overall efficacy with relatively rare serious side effects.

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