Objective: We aimed to investigate the frequency of seizure after acute carbamazepine poisoning and the important risk factors related to the outcomes of therapy. Methods: In this two-year cross-sectional study conducted in a University Hospital in Iran, 114 patients with acute carbamazepine poisoning were divided into two groups of with seizure (n = 8) and without seizure (n = 106) after intoxication. Demographic data, average amount of drug ingestion, time elapsed from ingestion to hospital admission, history of seizure before poisoning, mental status, visual disturbances and nystagmus, duration of hospitalization, the outcomes of therapy, arterial blood gas values and serum biochemical indices were compared between the two groups. Findings: Patients with seizure had an estimated (Mean ± SD) ingestion of 14,300 ± 570 mg carbamazepine, which was significantly higher (P < 0.0001) than the seizure-free group (4600 ± 420 mg). The estimated average time between drug ingestion and hospital admission in patients with seizure and the seizure-free group were 515 ± 275 and 370 ± 46 minutes, respectively (P < 0.0001). In this study, 104 out of the total number of patients had recovered without any complication. Need for respiratory support, including airway support or intubation were the most recorded complication. One patient died after status epilepticus and aspiration pneumonia. Conclusion: The ingested amount of carbamazepine and the time elapsed from the ingestion of drug to hospital admission may influence the occurrence of seizure after acute carbamazepine poisoning; however, the outcome of supportive care in these patients seems to be positive.
Hospitality, as a cultural receptional factor, has a great importance for a tourism planning and tourism & geographical destination development. Research problem considers an analysis and evaluation of hospitality in Sarajevo tourism destination. The aim of this article is to research the basic parameters/ indicators of hospitality in order to understand their value. Parameters of hospitality are: qualifications, affability and English language skills. The basic methodology will include collecting data for statistical analysis and survey research that will be used to assess opinions of tourists, tourism managers and tourism employees.
Introduction: Pedobarography as a new diagnostic tool enables measuring the pressure between the foot and the floor during dynamic loading. Dynamic analysis of the foot shows advantage over static analysis due to its capabilities for detecting high load points in certain diseases and in certain phases of walking. Pedobarography as a new method in the context of rehabilitation include wide range of clinical entities. Goal: To show the advantages of pedobarography as new diagnostic and rehabilitation method in prevention programs. Material and methods: A prospective study included 100 patients with diabetes mellitus type 2. Research was conducted in the Primary Health Care Center of the Sarajevo Canton and the Center for Physical Medicine and Rehabilitation. The test parameters were: Test of balance–symmetric load for the test, the number of comorbidity, clinical examination of foot deformity, test with 10 g monofilament, HbA1c. From the total sample 45 patients (Group I) were selected, aged 50-65 years, which underwent pedobarography (on the appliance Novel Inc., Munich with EMED™ platform) and robotic fabrication of individual orthopedic insoles, followed by control pedobarography. Plantar pressure was determined using standard pedobarography, computer recorded parameters: peak pressure (kPa), force (Ns), area (cm). Results: The average age of the respondents was 59.4±11.38 years; altered results on the balance test were present in 34% of patients; 61% of respondents have ≤2 comorbidity. In the total sample, the average number of foot deformity was 2.84. Flat feet have 66% of respondents, and valgus position 57%. The average HbA1c values were 7.783±1.58% (min.5–max.15.0). All subjects (45) after the first, and after the second measurement of peak pressure, have values above 200 kPa, or are in the designated zone of peak pressure that needs to be corrected. In a study was determined the correlation between the number of deformities and peak pressure, the number of deformities and the area upon which plantar pressure act, test with 10g monofilament and peak pressure. Conclusion: Within the framework of prevention programs early diagnosis, detection of sensitivity disorders, adequate treatment and taking load from the feet with the help of pedobarography, are of great importance for the patient suffering from diabetes
Introduction: Risk assessment for development foot ulcer in diabetics is a key aspect in any plan and program for prevention of non-traumatic amputation of lower extremities. Material and methods: In the prospective research to assessed diabetic neuropathy in diabetic patients, to determined the dynamic function of the foot (plantar pressure), by using pedobarography (Group I), and after the use of orthopedic insoles with help of pedobarography, to determined the connection between the risk factors: deformity of the foot, limited joint movements, diabetic polyneuropathy, plantar pressure in effort preventing changes in the diabetic foot. Results: Out of 1806 patients, who are registered in one Team of family medicine examined 100 patients with diabetes mellitus Type 2. The average age of subjects was 59.4, SD11.38. The average HbA1c was 7.78% SD1.58. Combining monofilament and tuning fork tests, the diagnosis of polyneuropathy have 65% of patients. Comparing Test Symptom Score individual parameters between the first and second measurement, using pedobarography, in Group I, statistically significant difference was found for all of the assessed parameters: pain, burning sensation, paresthesia and insensitivity (p<0,05). The measurements of peak pressure, both first and the second measurement, for all of the subjects in Group I(45) show values above 200kPa. That’s a level of pressure that needs to be corrected. The study finds correlation between the foot deformation, diabetic polyneuropathy and plantar pressure (p>0,05). Conclusion: A detail clinical exam of diabetic food in a family doctor office equipped with pedobarography (plantar pressure measurements), use of orthopedic insoles, significantly reduces clinical symptoms of diabetic polyneuropathy in patients with diabetes.
Pharmacy practice is an ever-changing science and profession. We are witnessing many advancement of pharmacy technology, drug-related information and applied clinical pharmacy literature, which influence our every day's life. Thus, new knowledge generated by research and clinical experience widen the knowledge; change the understanding of drugs and their application in therapeutics and every days life. Thus, policy makers, pharmacists, clinicians and researchers must evaluate and use the information existing in the literature to implement in their healthcare delivery. This paper is prepared for pharmacy researchers and pharmacy students and analyzes the major principles of ethical conduct in general science and also closely related topics on ghost authorship, conflict of interest, assigning co-authorship, redundant/repetitive and duplicate publication. Furthermore, the paper provides an insight into fabrication and falsification of data, as the most common form of scientific fraud. Scientific misconduct goes against everything that normal scientific method wants to reach for and pharmacy practitioners as one the first line available health care professionals all round the world should be enough aware of its importance and details when they want to evaluate the medical and pharmaceutical literature and deliver unbiased and ethically published knowledge of drugs both for the research or during consultations for patients care.
ABSTRACT Technological diseases are diseases of the modern era. Some are caused by occupational exposures, and are marked with direct professional relation, or the action of harmful effects in the workplace. Due to the increasing incidence of these diseases on specific workplaces which may be caused by one or more causal factors present in the workplace today, these diseases are considered as professional diseases. Severity of technological disease usually responds to the level and duration of exposure, and usually occurs after many years of exposure to harmful factor. Technological diseases occur due to excessive work at the computer, or excessive use of keyboards and computer mice, especially the non-ergonomic ones. This paper deals with the diseases of the neck, shoulder, elbow and wrist (cervical radiculopathy, mouse shoulder and carpal tunnel syndrome), as is currently the most common diseases of technology in our country and abroad. These three diseases can be caused by long-term load and physical effort, and are tied to specific occupations, such as occupations associated with prolonged sitting, working at the computer and work related to the fixed telephone communication, as well as certain types of sports (tennis, golf and others).
Introduction: Family medicine as a part of the primary health care is devoted to provide continuous and comprehensive health care to the individuals and families regardless of age, gender, types of diseases and affected system or part of the body. Special emphasis in such holistic approach is given to the prevention of diseases and health promotion. Family Medicine is the first step/link between doctors and patients within patients care as well as regular inspections/examinations and follow-up of the health status of healthy people. Most countries aspire to join the European Union and therefore adopting new regulations that are applied in the European Union. Aim: The aim of this study is to present the role and importance of family medicine, or where family medicine is today in 21 Century from the beginning of development in these countries. The study is designed as a descriptive epidemiological study with data from 10 countries of the former Communist bloc, Slovenia, Croatia, Bosnia and Herzegovina, Serbia, Montenegro, Macedonia, Kosovo, Albania, Bulgaria, Romania, Czech Republic, Slovakia and Hungary, just about half of them are members of the EU. We examined the following variables: socio-organizational indicators, health and educational indicators and health indicators. The data used refer to 2002 and as a source of data are used official data from reference WebPages of family medicine doctors associations, WONCA website (EURACT, EQuiP, EGPRN), WebPages of Bureau of Statistics of the countries where the research was conducted as well as the Ministries of Health. Results: Results indicates that the failures and shortcomings of health care organizations in Southeast Europe. Lack of money hinders the implementation of health care reform in all mentioned countries, the most of them that is more oriented to Bismarck financing system. Problems in the political, legal and economic levels are obstacles for efficient a problem reconstructing health care system toward family medicine and primary prevention interventions. The population is not enough educated for complicated enforcement for and prevention of diseases that have a heavy burden on the budget. Health insurance and payment of health services is often a problem, because the patients must be treated regardless of their insurance coverage and financial situation. The decrease in production and economic growth, as well as low gross national income in the countries with economic crisis, lead to the inability of treatment for a large number of the population. Such situation a system leads to additional debts and loans to healthcare system. Measures implemented for provision of acute curative care largely did not lead to improvements in the health status of the population. Educational and preventive measures, as well as higher standards for quality and accessibility of health care services for entire population in each country, especially those struggling are bound to joining the European Union and their implementation must start. The most A large number of medical institutions are is inefficient in health education and health promotion and must work to educate patients and families and increase the quality of preventive health services. Modernization of health care delivery and joining the European Union by increasing overall economic stability of countries is one of the primary goals of all countries in Southeast Europe.
Objective: The aim of this study is to confirm the effect of one month dietary treatment on the level serum lipids (cholesterol and tryglicerides) and aminotransferases in overweight patients aged over 50 years. Methods: In agreement with the respondents we requested that they immediately only reduce consumption and that in the reporting period use only food without the use of pharmacotherapy (fat lowering agents and lipid lowering medications). The reason for this assumption is that there is physiological variation for biochemical and hematological examinations by number of internal and external influences determine the size of physiological changes, as well as the necessity of the necessary concentration of certain nutrients for basal metabolism, and function of the body–cells or metabolites. These same subjects, we monitored the frequency of the results, the results of blood glucose, cholesterol, triglycerides, aminotransferase, acidum uricum creatinine after 1 month. The study was carried out on a targeted sample of 10 respondents in the Primary health care center in Gracanica for a period of 30 days. The tests on this sample were conducted survey on health status and nutrition, HIV treatment and diagnosis. Findings: Thee results show that there is an increased number of obese subjects. The paper analyzes the results of biochemical tests in subjects aged over 50 years. On the target medical and biochemical laboratory diagnostic examinations in 10 subjects of both sexes were observed: elevated results of blood glucose, cholesterol, triglycerides, aminotransferase, uric acid and creatinine. It was also observed the fact that most patients was with increased body mass (BMI = and> 25). It has been observed continuous decline or normalization of laboratory test results after one month. Conclusion: There is a growing number of people who are overweight (BMI 25-30) and obese (BMI> 30) due to poor habits, which is dominated by excessive calorie intake. Due to the increased supply of food nutrients: glucose and/or triglyceride, cholesterol, protein in the body, there is increase in the metabolism of carbohydrates, proteins, nonprotein compounds, purine and lipid, with an intense oxidative processes in the mitochondria in particular fat cells and liver disorder utilization of glucose, lipids, purine. As a consequence, the pathological results: higher levels of glucose in the blood, cholesterol, triglycerides, uric acid, creatinine and aminotransferase were observed.
Telemedicine itself is not the medical profession, it is not a medical specialty, but the way in which the medical profession conduct its activity. Therefore we are talking about tele otorhinolaryngology, tele cardiology or tele pathology. In the definition of a multitude of telemedicine that can be found in the literature is the following: Telemedicine is a system that supports the process of health care by providing ways and means for more efficient exchange of information that allows multitude of activities related to health care, including health care and health personnel, including education, administration and treatment. Telemedicine applications include tele diagnosis, tele consultation, tele monitoring, tele-care, tele consultations and remote access to information contained in one or more databases. It turned out that telemedicine is an important factor in technological, professional, financial and organizational uniformity of development of the health system. Telemedicine, although a new area, to a large extent already changed the ways of providing health care, and even more influence on the ways of designing the future of medicine.
Introduction: Endoscopic surgery and endourological procedures imply the use of special instruments that are introduced into the urinary system through the urethra and percutaneous techniques that allow ante grade access to the urinary tract. The risk of urinary tract infection after endourological procedures and the use of antibiotic prophylaxis for these procedures is a question about which there is no unique opinion. Goal: The objective of this study was to determine the connection between endourological procedures and occurrence of urinary infections and to analyze the risk factors of urinary infection for patients who were hospitalized at the Urology Clinic of the Clinical Center University of Sarajevo (CCUS). Material and methods: The research was conducted as a prospective study on a sample of 208 patients of both genders, who were hospitalized at the Urology Clinic of the CCUS and to whom one of endourological procedures was indicated either for diagnostic or therapeutic purposes. All patients were clinically examined prior to endoscopic procedures and after the treatment attention was focused on the symptoms of urinary tract infections. Results: Analysis of the presence of postoperative bacteriuria shows that it has been more common in men or in 48 cases (28.1%) compared to women with 8 cases (21.6%) (p>0.05). Preoperative catheterization was statistically significantly more present in patients who have had a postoperative bacteriuria (16 or 28.6%) compared to those without bacteriuria (8 or 5.3%) (p<0.05). Analysis of the average duration of postoperative catheterization shows that patients with postoperative bacteriuria had longer duration of postoperative cauterization of 1.97±0.14 days (range 1-20 days) compared to those without postoperative bacteriuria with 1.4±0.4 days (range 0-5 days) and with a statistically significant difference (p<0.05). Antibiotic prophylaxis in relation to the occurrence of postoperative bacteriuria did not show a statistically significant difference (p> 0.05). Analysis of the correlation coefficient indicates that a statistically significant effect on the occurrence of postoperative bacteriuria have preoperative bacteriuria, duration of postoperative catheterization and duration of hospital stay, as well as the total duration of hospitalization before and after endourological treatment (p<0.05). Conclusion: It is important to emphasize that the endourological procedures are safe procedures in terms of urinary tract infections. This study should lay pathway to establishment of guidelines for the application of antibiotic prophylaxis in endourological procedures. This would standardize the perioperative use of antibiotics, taking into account the local prevalence of pathogens and antibiotic resistance, but keeping the individual approach to each patient, considering all risk factors for the development of urinary infection after endourological procedures..
During the medieval which is called the dark period of Western culture there were minimal scientific advancements in many aspects of medical and pharmaceutical sciences. In contrast, the Islamic culture in this period had its big boom. Although little attention was devoted to documenting all aspects of it, works produced during this period by the Islamic intellectuals have served as the basis for some aspects of Western Renaissance. Books, treatises, other types of manuscripts, and discussions have been translated into many languages and remained in use for hundreds of years after their creation. Although advanced, unfortunately, Muslims and their culture were not able to keep the places where they previously exist, and the best examples of this are the Moors.
Introduction: Antimicrobials are widely used in infectious diseases. Only the timely intervention will contribute to the positive outcome of the disease. Unjustified use of antimicrobial prophylaxis may have adverse effects, i.e., result in bacterial resistance to existing antimicrobials, as well as toxic effects on leukocyte lineage and other parameters of the blood. Goal: The goal of this study was to confirm that the antimicrobial therapy of urinary, gynecological and respiratory infections has a toxic effect on leukocyte lineage. Followed by lowered immunity and the emergence of risk for health complications especially in oncology and other immunodeficient patients for whom to apply pharmacotherapy it is necessary to have adequate immunity, or white blood cell count that is greater than 4.0x109/L. Material and methods: A prospective-retrospective study was conducted on a sample of 30 patients in a Primary Health Care Center in Gracanica during the period from March 01, 2013 until April 01, 2014. Testing of this sample was conducted by survey on health status and treatment, or on taking of antimicrobial therapy and other treatment regimens, with the referral diagnosis and determination of leukocytes count in by hematology counter SYSMEX. Results of leukocytes below and close to the lower reference values were statistically analyzed by Students t-test. Results: Mean WBC count in the group treated with antimicrobial therapy was 3.687±0.83 x109/L, in the group which during repeated infection did not use the antimicrobial therapy 5.09±1.04 x109/L, and in the control group of healthy subjects 7.178±1.038 x109/L. Statistical analysis with Student’s t test indicate highly significant differences between group of patients that used antimicrobial therapy with the group of patient that did not used antimicrobial during repeated infection (t=6.091; p=0.0001), as well as significant differences in mean WBC count of both of these groups and the controls (t=4.984; p=0.0001, and t=8.402, p=0.0001). Conclusion: Use of antimicrobial drugs leads to serious toxic reactions, or leukopenia. Indications for the use of antimicrobial therapy must be strictly followed, because banal, frequent infections are not indication for antimicrobial therapy. It is necessary to know the types of infection causes. Important is the proper and timely selection of antimicrobial therapy. When selecting the drug we should bear in mind its antimicrobial activity, pharmacokinetic and toxic properties, as well as patient health status. Possible is also the application of preventive medicine as well as other manner of solving infection.
ABSTRACT Introduction: Measurements of extracellular pH show that the micro environment of malignant tumors is more acidic than that of normal cells, whereas pH does not differ appreciable in normal and malignant cells. The acid micro environment of tumors is created by the secretion of tumor factors and ATP hydrolysis in hypoxic tumor tissue. In order to survive in a low pH-environment tumor cells develop regulatory mechanisms which keep their intracellular pH stable. Two of the most important systems are the Na+/H+ ion pump and the Na-dependent HCO3-/Cl- pump of stilbenian derivatives. Material and methods: Experiments were carried out on DBA mice of both sexes at the age of 4 month. Laboratory animals were grown in our institute and supplied with food and aqua ad libitum. Results: After termination of the experiments the mean tumor diameter in the control group was 12.4±0.8mm, in group A it was 6.9±0.6mm, and in group B we measured 6.6±3.1mm. At the final day the tumor size in treated animals was twice as small as in the control group. In addition we observed the rate of survival. In the control group only 18% of the animals were still alive at day 18. Considering the rate of survival a statistically significant difference between treated and untreated animals was observed. The survival of tumor cells is dependent on the function of these ion pumps which keep their intracellular pH values constant in the setting of an acid extracellular environment. Conclusion: The activity of the ion pump is especially important at the beginning of cell division and in cell proliferation. Our in vivo experiments demonstrate that prolonged administration of intratumoral ion pump inhibitors suppresses tumor growth as well as enhances survival of tumor-bearing animals. Research of inhibitors of ion pumps and their action in tumor growth opens new perspectives into pathophysiology of malignant tumors and may create new therapeutic options.
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