Background: Normal sleep duration is crucial for maintaining brain homeostasis. Sleep disorders in Parkinson's disease are numerous, multifactorial, and result in significant morbidity. Objective: The aim of the study was to investigate the association between gender and the duration of therapy on sleep quality in patients with Parkinson's disease. Methods: The study is prospective, and includes 40 consecutively hospitalized patients with verified Parkinson's disease. The study included subjects of both genders and all age groups. To analyze the data on the subjects, we used: medical histories, nursing documentation of patients, a questionnaire with sociodemographic data, and the Parkinson's Disease Sleep Assessment Scale. We divided all subjects into two groups: subjects who have been using therapy for up to 5 years and those who have been using therapy for more than 5 years. Results: Among subjects who have been taking medication for less than 5 years, 33.3% were female and 66.6% were male. Of the total number of respondents who have been taking therapy for more than 5 years, 36.3% are female and 63.6% are male. The duration of the therapy has a statistically significant effect on the quality of sleep in patients with Parkinson's disease (p < 0.05). The subject's gender does not have a significant independent influence on the quality of sleep in patients with Parkinson's disease (p > 0.05). The interaction of gender and length of therapy use has no significant separate effect on the quality of sleep in Parkinson's disease patients (p > 0.05). The quality of sleep is better in male and female subjects who take the therapy until the age of 5. Conclusion: The duration of therapy use has a significant impact on the quality of sleep in Parkinson's disease patients. The gender of the subject has no significant independent influence on the quality of sleep in patients with Parkinson's disease.

Background: More than 50% of stroke patients have sleep-disordered breathing (SDB), mostly in the form of obstructive sleep apnea (OSA). SDB represents both a risk factor and a consequence of stroke. The presence of SDB has been linked with the poorer long-term outcome and increased long-term stroke mortality. About 20 to 40% of stroke patients have sleep-wake disorders (SWD), mostly in form of insomnia, excessive daytime sleepiness/fatigue, or hypersomnia (increased sleep needs). Objective: The aim of this study was to analyze the frequency of risk factors in patients with acute stroke and sleep apnea. Methods: The study included patients without cognitive impairment or with mild cognitive impairment. The diagnosis of apnea syndrome was made on the basis of the Snoring and Apnea Syndrome Questionnaire, the Epworth Sleep Scale, the Berlin Questionnaire, the Stanford Sleepiness Scale, and the General Sleep Questionnaire. The severity of stroke was assessed by the National Institutes of Health Stroke Scale and the Rankin Disability Scale. Patients with a Glasgow score <8 on the day of neuropsychiatric examination were excluded from the study, as well as patients with epileptic seizures at the onset of stroke, with aphasia, with Mini - mental test <23, with verified previous dementia / cognitive impairment. Results: There is no statistically significant difference in the age of men and women, both with apnea and without apnea. In patients with apnea, heart disease was in the first place 91.8%, followed by hypertension 86.4%, Body mass index 79.1%, hyperlipidemia 50%, smoking 38.2 % and diabetes mellitus 20.9%. Hypertension was the most common risk factor in patients without apnea 83.6%, followed by heart disease 81.0%, Body mass index 60.9%, hyperlipidemia 48.21%, smoking 28.2 % and diabetes mellitus 20%. Conclusion: Heart diseases, hypertension and body mass index are significantly more frequent in patients with than in patients without sleep apnea.

Aim: To show a case report of mental health consequances of a felow who survived Trauma brain injury (TBI) with commotio cerebri that was not properly diagnosed in the first emergency medical examination and harm that he and his family suffer because of lack of knowledge and ethics of medical, economic and judical authorities. Case report: A twenty-six year old male survived a traffic accident that caused TBI. He was misdiagnosed during the emergency examination. Because of that (and other factors) he has not returned to his previous level of functioning. After he treated in the Department of Psychiatry, he went back to his environment a sick leave council interrupted his sick leave, showing mistrust to him and his condition and towards the discharge diagnoses from the Department of Psychiatry. The council sent him to his job without occupational rehabilitation that was recommended. As he could not work in his full capacity, the authorities from his job discharged him on January 2012. When he was on the trial for getting his compensation because of health damages the insurance health expert denied his sufferings and all mental consequences of the commotio cerebri because it was not diagnosed on the first examination in the evening of the accident. So the destiny of this young fellow is very questionable in perspective because of lack of knowledge and ethics of medical staff who are not responsible regarding Hippocratic oath and of industry management who do not take adequate care about their workers who survive traffic accident on the way back to home from their job and who continually suffer because of health particularly mental health consequences. Conclusion: The TBI is an important health public problem and the hospital must establish a perfect managemet in this patients for avoid Mental Changes of Commotio Cerebri.

Aim. To demonstrate our experiences of thrombolytic therapy in acute ischemic stroke. Subjects and Methods. Patients with ischemic stroke treated with rt-PA, admitted at the Department of Neurology, Tuzla, Bosnia and Herzegovina, in the period between April 1, 2008, and December 31, 2012, were included. Results. Between April 2008 and December 2012, intravenous rt-PA was given to 87 patients with acute ischemic stroke, which represents 3.2% of patients with acute ischemic stroke admitted to our department in that period. Hypertension was the leading stroke risk factor. The mean NIHSS score before thrombolysis was 12 (range 4–21). Large artery arteriosclerosis was the most common stroke etiology. The mean door-to-needle time was 72 minutes and onset-to-needle time 152 minutes. Half of patients (44/87) had a significant improvement within the first 24 hours. Parenchymal hemorrhage occurred in 5 patients (6%) and was fatal in two cases. At 3-month follow-up, 45% of patients (39/87) had good outcome (mRS 0 or 1). Sixteen patients were dead at 3 months, and mean baseline stroke severity was significantly higher in patients who died (NIHSS 16.5 versus 11, ). Conclusion. The number of patients with acute ischemic stroke treated using rt-PA in the Department of Neurology, Tuzla, is lower than in developed countries. Thrombolytic therapy is safe and leads to favorable outcome in half of the patients.