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Muzafer Mujić

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From February 2023 (Volume 23, Issue 1), the title of the Bosnian Journal of Basic Medical Sciences will be changed to Biomolecules and Biomedicine. The new title reflects the increasing number of published research done on subcellular/molecular level as well as translational and clinical research contained in the term Biomedicine. Biomolecules and Biomedicine will continue to be published by the Association of Basic Medical Sciences of the Federation of Bosnia and Herzegovina. Read more in the PDF.

Sore shoulder or shoulder region is frequently encountered in general population. According to reference data prevalence ranges between 15 and 20% in 40-45 age group. A weak bone support enables extensive excursions of this joint and simultaneously reduces its stability. We analyzed successfulness of sore shoulder treatment in a sample of 1115 patients treated in the Center for physical medicine and rehabilitation between 1996 and 2004. All the patients reported to the Center either in acute phase or in the phase of chronic state exacerbation, with limited function that was graded on the scale 0 to 5. Type and kind of sore shoulder cause was determined by clinical examination and, where needed, by X-ray. Of the total number of cases, 33 patients did not report for follow up examination, 166 patients were forwarded to other physical therapy centers for treatment so the final analysis included 916 patients (82%) whose treatment success was evaluated on the scale 0 to 5. In 659 (58%) patients the inflammation of musculus biceps long tendon was identified as a cause of sore shoulder. The least frequent cause was the blow syndrome (impingement)--20 (2%). In 666 patients (73%) the problem was resolved by local instillation of depo corticosteroids (Betamethason 7 mg) so the physical treatment was not required.

Acute lumbar syndrome occurs suddenly and is accompanied with strong pain in the lower part of the back. The most frequent APLS causes are vertebral (herniation of intervertebral disc, subluxation of intervertebral disc, subluxation of intervertebral joint, fracture of vertebra--traumatic or pathological), or extravertebral (subluxation of sacroiliac joint, acute bursitis of iliolumbar segment, muscle injuries or injuries of tendo-ligamentous apparatus of lumbosacral region). The treatment of acute lumbar painful syndrome is classified as medical, alternatively medical, surgical and combined. On the basis of durable experience, "Praxis method" as a treatment of lumbar pain (general and acute) is being applied in the Centre for Physical Medicine and Rehabilitation "Praxis" in Sarajevo. During the period from 1996 to 2000, the total number of 5.663 patients were examined in the centre "Praxis". Out of that number, 17.7% (1.003) of patients had acute lumbar painful syndrome (ALPS). Immediately after the therapeutic manipulation, which included "Praxis method, 31.5% (317) patients experienced the cessation of pains followed by ending of the treatment. The length of treatment for the rest of patients lasted: 1-7 days in 412 or 41.07 % of patients, 8-21 days in 195 or 19.48% of patients, and more than 21 days in 79 or 7.88% of patients. For all patients (1.003) the average treatment duration was 6.6 days. The recidivation occurred in 127 patients (12.66%). Throughout the treatment successfulness estimation according to clinical results scaled from 0 to 5, it was confirmed that out of the total number of 831 patients (82.85%) results were excellent in 459 patients (45.76%) or very good in 372 patients (35.09%). The average age of patients was ranging between 35 and 45 years (621 patients or 61.9%). The male/female distribution was 2:1.

D. Pecar, I. Masic, M. Karić, H. Kulenović, Muris Pecar, M. Mujić

The war injuries are the most frequent multiple, with the difficult distructions of the tissue and the lesions of the peripheral nerves. By the injuries, the lesions of the nerv system represent the delicate problem for the physical medicine and the rehabilitation during the siege of Sarajevo (1992-1995), in the injuries with the lesions of the peripheral nerves, if they are not treated in the frame of the multiple las urgent, they are postponed the operative treatments longer than three months. This is from the aspect of the successfullness, prognostically and therapeutically, the limiting moment. The successfullness of the operative treatment of the lesions of the peripheral nerves significantly depends on that whether the operation was performed incide tree months. The more difficult consequences in these injuries can appear if simultaneously with the taking care of war injuries does not perform adequately surgical treatment adn the in time physical therapy trough the sufficient long time period. On the four year sample was analyzed the success fullness of the rehabilitation of the injuries of the upper extremities with the lesions of the peripheral nerves. Clinically, uniform, we valorized the success fullness of the treatment of all the patients by the marks from 0.5. In the complete sample the excellent success of the rehabilitation we confirmed in more than a half of patients. The better results show the group of the operated patients, in which is performed neuropathia or neurolisis. The capability of the regeneration of the injured peripheral nerves offers the real possibility for extraordinary recovery also in the most difficult injuries, then the preventions of the significant number of the consequences.

D. Pecar, I. Masic, M. Karić, H. Kulenović, Muris Pecar, M. Mujić

In this paper is valoriziaed the successfulness of the treatment of 1,431 patients with the verification disc hernia (CT, MRI) in the surgery for the physical medicine and the rehabilitation in the period from 1966 till 2000 year, by "Praxis method". It is established that in the structure of the treated patients by the structure of the treated patients by the application of this method the best results were achieved by disc hernia in the level L4-L5 without the motor deficiency (567 patients), with the average treatment length 24.38 days and the average estimation of the results 4.06 and then in patients with the disc hernia L5-S1. In disc hernia without diagnostic verified disorder of the motorics, the result of the physical therapy and the rehabilitation was better. This can be observed from the treatment successfulness estimation and the treatment length and number of days of the treatment. The longest treatment was by hernia L5-S1 with the motor disorderly (43.10 days), and the shortest in the disc lesion at the level L4-L5 (24.38 days). Among the patients with disc hernia which in this period were treated was operated only 58 or 4.05%. The age structure of the treated patients with disc hernia amounted averagelly 49.95 years, and the greatest number of the treated belonged to the age group 35 to 44 years.

M. Beganović, B. Lagerkvist, I. Masic, M. Mujić, I. Cerić, D. Pecar

The number of war victims in need of physical rehabilitation in Bosnia and Hercegovina is not exactly known but less than one per cent of the population. Anyhow physical rehabilitation services needs to be reorganized in the community taking care of about 70-80% of the patients. The rest are partly in need of institutional care, which is also important for training and research purposes. The reorganization of services for the mentally ill is aimed at both war victims and others and reorganized at Community Mental Health Centers. The number of mentally ill war victims is definitely exceeding the number of physically injured from the war.

E. Nakas-ićindić, M. Mujić, Z. Knezević, N. Frljak, H. Kulenović

his study was designed and performed under very difficult conditions during intensive war activities in Sarajevo. The specific characteristics of this aggressive war were a long lasting. Middle Ages siege of the city with sudden shelling and shooting of civilian targets. It can be expected that these abnormal, stressful conditions caused changes in mental and emotional reactions, as well as in the functioning of numerous organic systems. The aim of this study was to assess whether the long exposure to war conditions influenced the functioning of the cardiovascular system and its response in stress exercise in young adults of Sarajevo.Multistage, incremental exercise treadmill testing under the Bruce protocol was performed by 14 male students of Sarajevo University (aged 18-23 years). It was planned for each subject to complete two exercise sessions in a three-month interval. Only 8 persons completed the second session because some of the subjects left Sarajevo, some were wounded, and the rest of them had to complete their duties in the Army.The results of the two exercise sessions showed that resting values of the cardiovascular variables (heart rate, arterial blood pressure) were within physiological range. The mean maximal exercise capacity expressed as metabolic units (METS) was 15.40 for the first exercise session and 15.23 for the second one. There were neither significant differences in exercise test duration between the two exercise sessions nor in maximal achieved heart rate.It could be concluded that in young men the overall exercise capacity was well preserved but the other results (indirectly calculated maximal oxygen uptake, V02) indicated hyperreactive response. The three-month interval was short to emphasize the differences because the war conditions, under which the testing was performed, were not changed.

E. Nakas-ićindić, M. Mujić, Z. Knezević, J. Radovanović, V. Loza

The health problems associated with PTSD include multiple physical symptoms and signs. It was observed that PTSD was often accompanied with cardiovascular problems. The aim of this study was to estimate the characteristics of arterial blood pressure response on stress exercise in PTSD patients who were forced to stay in a war zone of Sarajevo. This study was carried out in 1995, during the period of intensive war activities in Sarajevo. Exercise stress testing was performed on treadmill, under the Bruce protocol in age matched 9 male PTSD patients and 14 healthy young volunteers (age 18-23 years). Arterial blood pressure was obtained by the cuff method in rest, at the last minute of each exercise stage and four times in the recovery period (1, 3, 6 and 9 minutes). Our results did not confirm previous reports related to the resting values of arterial blood pressure in PTSD patients. In rest, there were no significant differences in systolic, diastolic and mean arterial pressure between PTSD and control group. Systolic blood pressure (SBP) increased during exercise in both groups, especially at advanced exercise stages. Maximal mean SBP values were 222.00 +/- 24.80 mm Hg (control group), and 179.80 +/- mm Hg (PTSD). Exaggerated systolic blood pressure response (over 200 mm Hg) was observed only in the control group. This is probably due to physiological hyperreactive with enhanced sympathetic activity in response to stress caused by war. The luck of hyperreactive response in PTSD patients could be explained by diminished sympathetic influence on systolic blood pressure probably caused by psychoactive medication.

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