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Dijana Laštro, Mirsad Muftić, Nenad Ponorac, Goran Talic, Slavica Janković
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1329

Abstract:
Introduction: Carrying a school bag is a dominant activity that a child performs during daily productive activities. The aim of the research is to examine how carrying a school bag of different weights affects the distribution of force and plantar pressure during normal walking on the flat terrain of children of varying levels of physical activity.Methods: The pilot study included 124 students aged 11-12 from Banja Luka. According to the protocol, each group of respondents was treated with an intervention-customized school bag and a comparator-school bag that the child only opted for. For the research, the Physical Activity Questionnaire for Older Children, measurement of anthropometric parameters, school bag weight, and Zebris tape (Zebris Medical GmbH, Germany) were used for gait analysis.Results: Inactive children achieved the lowest and active children’s highest walking speed during normal walking without a bag, with their customized school bag. When carrying a custom school bag: The highest maximum force is projected on the left heel 330.72 N in inactive children, and the lowest 265.93 N in moderately active children, the highest maximum pressure on the left heel is registered in inactive children, 27.60 N/cm2, and the lowest 21.85 N/cm2 in moderately active children. The maximum force-time of % of standing time on the left foot in the middle part lasted the longest in inactive children, and the shortest active children carried their school bag 40.31% and a custom school bag 39.76%.Conclusion: High physical activity and individual adjustment to distribute the burden well allow the child to adequately respond to the loads carried by the weight of the school bag.
Sabira Šahinović, Vildana Huskić, Adis Kauković
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1283

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Venous thromboembolism (VTE), also known as deep vein thrombosis and pulmonary thromboembolism, is a medical condition that has a high incidence and a multifactorial pathogenesis. One of the causes is a mutation of the Factor V Leiden (FVL), which is the most common inherited thrombotic disorder. A mutation inherited from both parents is found in about 0.05-0.5% of cases, making our case more medically interesting. We presented the case of a young male patient with recurrent VTE and few risk factors who was admitted to the hospital 4 times with VTE symptoms over a 5-year period. In the background, there was a homozygous FVL mutation and improper use of anticoagulant therapy. We examined the medical data, diagnostics, therapy, and precautions that were and are required.
Bakir Katana, Eldad Kaljić, Amra Mačak Hadžiomerović, Amila Jaganjac, Samir Bojičić, Namik Trtak
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1151

Abstract:
Introduction: Active aging is a process of optimizing of opportunities for health, participation, and safety to improve the quality of life as people age. Therapeutic exercises to strengthen muscles are especially important for the elderly, and the results of such exercises are positive in people with functional limitations. The aim of the study was to assess functional mobility of people in the 3rd age of life after programmed therapeutic exercises.Methods: The prospective study included two groups of 130 respondents over the age of 65 who came to the “Centre for Healthy Aging” in Novo Sarajevo in the period from September 1, 2014, until March 1, 2015. Using the time up and go test (TUG), the basic functional mobility was assessed and it represents the minimum time the respondent needs to get up from the armchair, walk a distance of three meters, turn around, and sit back in the armchair. We tested the respondents at the beginning, in the middle, and at the end of the study, which lasted for 6 months.Results: Analysis of the gender structure of the control and the test groups, using the Chi-square test, found a statistically significant difference, and in the test group, there were more female subjects than in the control group, χ2 = 50.620; p = 0.001. Analysis of the functional mobility of the respondents of the test groups using the TUG at the end of the study found that the respondents of the test group needed statistically significantly less time to perform the test (8.84 seconds) compared to the control group (9.59 seconds) and test Group B (9.41 seconds), F = 4.711; p = 0.041.Conclusion: Programmed therapeutic exercise leads to a significant improvement in functional mobility of persons in the 3rd age of life.
Monika Sadar,
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1272

Abstract:
Introduction: Health literacy of secondary school students is particularly important as they are exposed to higher health risk. Therefore, the aim of the study is to determine the level of basic health literacy, critical and mental health literacy, and numeracy of Slovenian secondary school nursing students using a cross-sectional comparative method.Methods: The questionnaire measuring the level of basic numerical, critical, and mental health literacy was completed by 249 secondary school students, divided into a group of secondary school students attending a nursing program and students of others similar secondary schools such as economic technician, chemical technician and preschool education.Results: Secondary nursing students were found to have statistically significantly higher levels of basic and mental health literacy than their peers, rather than numerical and critical health literacy. In addition, the results show that there is no statistically significant difference in the level of health literacy between the groups of secondary school students in relation to the environment (rural/urban area).Conclusion: Numerical and critical health literacy should be systematically developed in nursing schools, and at least the basic aspects of health literacy should be introduced in all secondary school curricula.
Dijana Babić, Danica Železnik, Milan Milosević
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1174

Abstract:
Introduction: Adverse events, safety incidents, and medical errors in healthcare can be avoided only by understanding the causes of their occurrence, and by applying the knowledge gained from the analysis of similar previous events. Since it is known that most adverse events do not originate from a single cause, most important is timely identification of numerous contributory states that can give us the opportunity to define a number of possible solutions to correct process errors and deficiencies in the system itself. The aim of this paper is to investigate the association between functional capacity of elderly living with cardiovascular diseases and the occurrence of adverse events during use of health-care services.Methods: Assessment of functional limitations was done using the Groningen Activity Restriction Scale (GARS). The presence of adverse events was evaluated after interviews with subjects and review of medical records. Differences in continuous numerical values between inpatient and outpatient service users were analyzed by the Mann–Whitney U-test. Spearman’s correlation coefficients of the number of actual adverse events with the presence of restrictions in daily activities were calculated. Fisher’s exact test or Fisher-Freeman-Halton test (in cases of table sizes larger than 2 × 2 format) analyzed the differences in category variables.Results: The total number of adverse events was 30 (10.1% of the total number of subjects), while there were 12 actual adverse events (40.0% of the total number of adverse events). No statistically significant correlation was found between the limitations in performing daily activities and the occurrence of actual adverse events (p = 0.173).Conclusion: The research conducted in this paper showed that the functional capacity of the elderly with chronic disease is not exclusively related with the occurrence of adverse events associated with health-care utilization.
Zerina Hadžić,
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1327

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Introduction: C-reactive Protein (CRP) as an inflammatory biomarker can be easily determined in saliva, but the values of salivary CRP in periodontitis are not well-studied. The aim of this study was to analyze and determine the values of salivary CRP in non-smokers with periodontitis stage 3 or 4 before and after supragingival and subgingival full-mouth periodontal therapy.Methods: Standard periodontal parameters and saliva samples were collected in 12 non-smoking patients. Patients in the test group (n = 6) underwent supragingival and subgingival full-mouth periodontal therapy, and the control group (n = 6) received only supragingival full-mouth therapy. Both groups received the same oral hygiene instructions in addition to therapy. After 3 months, re-registration of periodontal parameters and re-sampling of saliva for analysis of salivary CRP were done for both groups.Results: Statistical analysis revealed large differences in the values of clinical periodontal parameters and CRP levels in the test group after therapy. Values of salivary CRP in the test and control groups were lower 3 months the therapy; however, the results were not statistically significant. The correlation of clinical periodontal parameters and salivary CRP varied in both groups.Conclusion: Our pilot study reveals decreased concentrations of salivary C-reactive protein in non-smoking patients following non-surgical periodontal therapy. Further studies are needed to prove the reliability of salivary CRP as a biomarker for periodontitis.
Senka Mesihovic-Dinarevic, Timur Šečić
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1331

Abstract:
Introduction: A new disease coronavirus disease 2019 (COVID-19) is with insufficiently known epidemiological characteristics and spectrum of clinical expression in childhood. Children have a lower incidence of this disease with a predominance of mild forms but severe clinical forms, such as among others, acute respiratory distress syndrome, and multisystem inflammatory syndrome may occur, according to current findings. In children with atypical symptomatology and positive or suspicious epidemiological survey, practitioners should consider the possibility of COVID-19.Methods: This study formed the group of 70 children previously healthy or with no pre-existing heart disease from Sarajevo with positive post-COVID history. Following the history of disease and epidemiological data, establishing the 1st day of disease or contact, a detailed cardiovascular examination was performed, including parameters of body weight, height, oxygen saturation, pulse, blood pressure, 12 leads electrocardiogram (ECG) done on Schiller machine, values of polymerase chain reaction (PCR), or serological test on corona: Immunoglobulin (Ig) G and IgM. Echocardiographic examination was done using M, B mode, color, continuous wave, and pulse wave Doppler in standard views. Laboratory blood tests included: Full blood count, creatinine phosphokinase myofibril, creatinine phosphokinase, lactate dehydrogenase; liver enzymes, D dimer, C reactive protein, and urine.Results: Majority of children (64.3%) were asymptomatic. ECG was normal in relation to patients’ age except in eight patients (intermittent palpitations on exertion) who had short PR interval 0.120–0.140 ms, with no delta wave, with heart rate within the normal range according to age, so 24 h ECG Holter was performed without any significant arrhythmias, incomplete right branch block has been documented in 12%, monofocal ventricular ectopic extrasistoly in 15%. Mean IgG, as a marker of infection, showed a statistical significance when compared between age Groups I and II (5) (p < 0.05; p = 0.043). PCR test was negative in 9 (70 children), although they showed symptoms, COVID-19 infection clinical data, and positive laboratory findings. Echocardiogram was normal in all patients with normal ejection fraction of the left ventricle.Conclusion: The possibility of COVID-19 in children with atypical symptomatology and positive or suspicious epidemiological survey should be in the focus of every pediatrician at primary care institutions nowadays. Cardiovascular assessment should always be an option in post-COVID patients. Immunological assessment is necessary in post-COVID patients in order to gain a further understanding of PTS status. With more serological testing for severe acute respiratory syndrome coronavirus 2 physicians would be able to make a diagnosis of COVID-19 timely and more accurately, as well as to evaluate the role of asymptomatic children in disease transmission and to assess the importance of protective antibodies and the distribution of COVID-19.
Anka Vukičević, Ranka Ogurlić, Miloš Lazić, , Emira Švraka
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1314

Abstract:
Introduction: The assessment of the health-care system by its beneficiaries is based on evaluation of the public perception in regards to the performance of healthcare workers, the functioning of the health system, the effectiveness of health policy measures, and a number of other components. The aim of this study was to determine patients’ trust in the work of physiotherapists and the health-care system; determine the quality of communication between the patient and the physiotherapist and determine the quality of cooperation between healthcare workers in the provision of health services.Methods: The study is descriptive, conducted in five cities: Banja Luka, Bihać, Herceg Novi, Nikšić, and Podujevo. The confidence in health-care questionnaire developed by Calnan and Sanford (2004) was used as a research instrument, containing six areas of research: Attitude toward the patient, Health policy and patient care, Professionalism and expertise, Quality of health care, Communication and information, and Quality of cooperation.Results: The mean age of the subjects was 41 years, 24 females and 26 males. Subjects expressed the greatest satisfaction on subscales I - Attitude toward the patient (27.44 ± 3.59 out of 30) and IV - Quality of health care (36.60 ± 4.19 out of 40), which represents 91.5% of the possible maximum. This is followed by subscale V - Communication and information (20.8 ± 3.17 out of 25) corresponding to 83.2% of the possible maximum, followed by subscale III - Professionalism and expertise (15.68 ± 3.29 out of 20) which represents 78.4% of the possible maximum. Subjects showed the least satisfaction on subscales II - Health policy and patient care (16.94 ± 5.56 out of 25), which represents 67.8% of the possible maximum, and subscales VI - Quality of cooperation (9.94 ± 0.42 out of 15) which corresponds to 66.3% of the possible maximum.Conclusions: The research showed a high degree of satisfaction of subjects in various fields, which indicates a high degree of confidence in the work of physiotherapists and the health-care system. Research on a larger sample in needed for creation and implementation of the guidelines in the strategic documents of the countries in the region and for improvement of health policies and patient care.
Eldad Kaljić, Edina Hadžipašić, Amila Jaganjac, Namik Trtak, Bakir Katana, Muris Pecar
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1142

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Introduction: Cervical pain syndrome (CPS), or pain in the neck, is defined as a set of symptoms that limit performing movements in the upper part of the back and last more than 1 day. When the mentioned symptoms last for more than 12 weeks, we talk about chronic CPS. It often represents the condition that results from disability. It is associated with poor posture, work in sitting position, stress, and long-lasting and repetitive movements. The aim of the study was to examine the effect of physical therapy on the degree of disability, pain intensity, and daily life and work activities of persons with chronic CPS.Methods: The research was conducted in the health spa center “Reumal” Fojnica from June 2020 until July 2020. It included 50 subjects of both genders, more than 18 years old, and of all occupations, treated with physiotherapy procedures (transcutaneous electrical nerve stimulation, magnetotherapy, therapeutic ultrasound, and kinesitherapy in the form of McKenzie exercises). In addition, a pre- and post-treatment study analyzed the condition of the respondents at the first examination and the control examination after completion of treatment.Results: By analyzing the results, we established that of the total number of respondents, 74% were female, and the average age was 57.36 years. At the end of the study, the degree of disability caused by neck pain was significantly lower (p < 0.05) than the degree of disability before the therapy. Discomfort caused by symptoms of CPS that occurred and interference with work before the therapy was significantly lower (p < 0.05) after the treatment program. Therapeutic procedures have reduced the pain intensity and improved the activities of everyday life.Conclusion: The treatment with physical therapy procedures effectively reduces the degree of disability and pain intensity and improves people’s daily life and work activities with chronic CPS.
, Nimali N. Karunaratne, Winitha S. Jayasundara
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1261

Abstract:
Introduction: Various positioning techniques are utilized to enhance the visualization of lower cervical vertebrae on lateral radiographs. However, the effectiveness of these techniques still remains unclear. This study was conducted to determine the effect of the weight-bearing (WB) technique in visualizing lower cervical vertebrae and cervicothoracic junction (C7-T1) on standing lateral cervical radiographs of adult non-trauma patients. The study was conducted using both computed radiography (CR) and digital radiography (DR) systems.Methods: Forty-four CR (29 WB and 15 non-WB – NWB) and 61 DR (26 WB and 35 NWB) lateral C-spine radiographs were prospectively evaluated to assess the visible number of cervical vertebral bodies and C7-T1 junction. The instructions given by the radiographer to the patient for the imaging procedure were also assessed on the Likert scale (very good, good, fair, poor, very poor).Results: There was no significant difference (p > 0.05) in the visualization of the number of vertebral bodies between the two techniques of WB and NWB for CR or DR. Further, no significant relationship (p > 0.05) was observed between the WB technique and the visualization of C7-T1 junction in DR systems. However, a significant difference was identified for CR (p = 0.012). The instruction given to the patient significantly correlated with the visibility of the lower C-spine region within each group of WB and NWB in both imaging systems.Conclusions: The visibility of the number of vertebral bodies in the lower C-spine region in either CR or DR systems did not demonstrate any enhancement with the WB technique. Regardless of the imaging system or techniques used, adequate instructions given to the patient before and during the imaging procedure of C-spine lateral radiography demonstrated a significant improvement in visualizing the lower C-spine region. In this preliminary study, the application of erect WB radiography technique in evaluating the lower cervical region of adult non-trauma patients gives limited advantage.
Muhamed Ajanović, Selma Tosum Pošković, Alma Kamber-Ćesir, Edita Redžović, Mirsad Kacila, Karlo Kožul
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1293

Abstract:
Introduction: Dental implantology is the branch of dentistry that is gaining greater significance because a larger number of patients come with requests of implant placements. During dental implant placements, with patients with whom operation is carried out in the mandible, very frequently nervus alveolaris inferior can be injured. The nerve injury may occur during the implant placement, but the nerve may also be injured in case of harvesting of intraoral bone graft. During the bone graft harvesting, but also during any other procedure in the dentistry that entails working on vestibular side of corpus of the mandible, in order not to injure the nervus alveolaris inferior, it is important to familiarize oneself with the distance of the nerve from the outer vestibular cortex of the mandible. The objective of the study was to assess the vestibular bone thickness of the mandible in relation to the mandibular canal with the help of analysis of cone-beam computed tomography (CBCT) images.Methods: It was accessed the database of CBCT images taken at the School of Dental Medicine at the University of Sarajevo, where out of 700 reviewed CBCT images, an analysis of 322 CBCT images was conducted that satisfied inclusion criteria of the study. CBCT images were taken using of ORTHOPHOS SLX imaging unit. The measurement was conducted by Sidexis program on cross-section of CBCT image. The measurement of vestibular bone thickness was performed, by measuring the distance from the lateral wall of the mandibular canal to buccal mandibular compact bone, in the region of the second premolar, of the first and the second molar.Results: There were statistically significant differences in vestibular bone thickness between men and women on both sides in the region of the second premolar (p < 0.001) and first molar (p = 0.016 right, p = 0.018 left). T-test demonstrated no statistically significant difference in the vestibular bone thickens between men and women on either side in the case of vestibular bone thickness of the center of the second molar (p = 0.397 right, p = 0.743 left).Conclusion: Values of vestibular thickness of the mandible are larger with men than with women in all measuring points; however, statistically more significant differences between genders have been detected in the second premolar and center of the first molar.
Biji Thomas George, Youmna Ayman, Hadi Zafar, Godfred Menezes
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1265

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One of the most common presentations of acute abdominal pain in the emergency setting is appendicitis. Although it can occur in both genders, when it comes to females with appendicitis, reaching a definite diagnosis can be challenging as it can mimic other diseases such as ovarian cysts/torsions, pelvic inflammatory diseases, endometriosis, and urinary tract infection or physiological reasons like menstrual pain which are exclusive to females and can occur as frequently as appendicitis. Therefore, it is crucial to make an accurate diagnosis as early as possible with the right diagnostic tools to reduce morbidity and mortality in females of child-bearing age. This is a summarized case report of an adolescent female who experienced two atypical attacks of appendicitis 1 year apart. Since the patient had mainly right upper flank pain associated with nausea, vomiting, and fever with a largely non-tender abdomen, various diagnoses such as chronic cholecystitis, biliary colic, peptic ulcer, gastroenteritis, mesenteric lymphadenitis, renal colic, mittelschmerz, and torsion of ovarian cyst were considered and treated for. The patient had no relief and underwent numerous investigative procedures in the 2 years she suffered from her illness. The final diagnosis was only obtained when exploratory laparoscopy was performed. This article aims to remind clinicians to have a high index of suspicion for acute appendicitis in all atypical presentations of acute appendicitis. The latest WSES Jerusalem guidelines for the workup for patients at risk of acute appendicitis should be meticulously followed.
Karina Karina, Krista Ekaputri, , Ratna Herawati Purwoko, Tommy Partunggul Sibuea, Sarah Listyo Astuti, Anastasia Maria Loho, Yuliardy Limengka, , Grady Krisandi, et al.
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1276

Abstract:
Introduction: Autologous platelet-rich plasma (PRP) has been a growing trend in the field of medicine due to its broad range of application and is considered safe from bloodborne diseases. Furthermore, various studies have tried to optimize the use of autologous PRP through various preparation protocols, including PRP activation. However, most of the studies available have not evaluated the safety for intravenous delivery of PRP, especially autologous activated PRP (aaPRP). Therefore, this study aimed to evaluate the safety of intravenous delivery of aaPRP.Methods: Blood was drawn from each patient and aaPRP was isolated through calcium activation and light irradiation. Each aaPRP was administered intravenously to all patients. Adverse events were documented and analyzed.Results: Six hundred eleven patients participated in this study with a total of 4244 aaPRP therapies. Quality control of autologous aaPRP showed no platelets present after both calcium activation and light irradiation. No adverse events such as allergic reaction, infection, and coagulation problems were observed on all patients over the course of the study.Conclusion: Our results showed that intravenous administration of autologous aaPRP is safe even in patients with various pathological conditions.
Muhamed Ajanović, Selma Tosum Pošković, Karlo Kožul, Alma Kamber-Ćesir, Amela Đonlagić, Mirsad Kacila, Lejla Kazazić
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1291

Abstract:
Introduction: Dentists and generally dental personnel work under the risk of being infected by patients suffering from COVID-19, who are unaware that they are infected. The reason lies in the fact that during dental procedures, aerosol is formed with droplets that may contain the virus. Thus, it is extremely important that dental personnel complies with adequate protective measures and equipment during clinical work. The aim of this investigation was to evaluate the knowledge of COVID-19 and determine the amount of stress with dental personnel of the Faculty of Dentistry in Sarajevo, Bosnia and Herzegovina. Methods: Health care personnel of the Faculty of Dentistry with Clinics of the University in Sarajevo have been included in the research: teaching staff, clinical doctors, dental nurses and dental technicians. The research was conducted in April 2020. It was conducted by an anonymous survey that participants filled-in. Out of 157 distributed questionnaires in paper form, 134 participants responded. The questionnaire was divided into 3 parts: 1) personal data 2) knowledge of infection COVID-19 (diagnostic methods, transmission pathways, prevention measures); 3) the amount of stress (feelings and thoughts) during epidemic COVID-19 with personnel. Results: The largest number of participants (61.97%) consider that COVID-19 may be transmitted from infected to a healthy person by inhalation of droplets generated through coughing of an infected person and by direct contact with aerosol dispersed from the mouth of the infected patient during dental treatment. The largest number of participants, 80 of them (59.7%) consider that the method of nucleic acid test is used in diagnosing COVID-19. COVID – 19 had a significantly larger influence on females; they showed higher extent of concern for the claim „I hardly fall asleep because of thinking about it“, „I try not to talk on this topic“ and „In my mind appear pictures in relation to this.“ (p<0.05) Conclusion: Knowledge of COVID-19 and measures of protection of health care personnel at the Faculty of dentistry with Clinics in Sarajevo is satisfactory. The largest fear of participants was fear of unconsciously transmitting the infection on people close to them and that members of their families become infected with COVID-19.
Elmedina Mrkulić, Emina Vukas, Hajrija Maksić, Meliha Sakić, Jasmina Mahmutović, Selma Dizdar, Alma Mizdrak, Verica Mišanović
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1167

Abstract:
Introduction: Neural tube defects (NTDs) are multifactorial congenital anomalies of the central nervous system that results from failed neural tube closure between the 3rd and 4th weeks of embryonic development. Numerous clinical and experimental studies indicate that supplementation with folic acid before and during early pregnancy reduces the development of these anomalies. The present study examined the incidence and risk factors for NTDs and evaluated the effects of folic acid supplementation.Methods: This cross-sectional study included all children with NTDs who were hospitalized at the Pediatric Clinic, Clinical Centre University of Sarajevo during the period from January 01, 2008 to December 31, 2012. Data were collected retrospectively from the medical histories of hospitalized children. The study included children in pediatric clinics from four cantons (Sarajevo, Zenica–Doboj, Unsko–Sanski, and Central Bosnia) of the Federation of Bosnia and Herzegovina. The number of live births for the specified period in each of the four cantons was taken from a report by the Cantonal Ministry of Health.Results: Among the 69,096 live births recorded during the study period, 39 children had verified NTDs, with an overall incidence of 0.56:1,000 (or 5.6:10,000) in all four cantons. The most common NTDs were myelomeningocele with hydrocephalus (22/39, 56.4%), followed by isolated myelomeningocele (9/39, 23.1%), spina bifida occulta (7/39, 17.9%), and occipitocele (1/39, 2.6%). A total of 33.3% (13/39) of mothers took folic acid, but only one began supplementation prior to pregnancy, while 67.7% (26/39) of mothers did not take folic acid during pregnancy. NTDs were found more frequently in primiparas (53.8%), women with low education (basic school, 64.1%), and unemployed women (82.1%).Conclusion: It is important to make national recommendations for folic acid supplementation for women of reproductive age, but also change the public health policy that includes mandatory fortification of basic foods as this is the best measure for primary prevention of NTDs in the whole population regardless of employment and education status. Additional comprehensive studies are required to assess the incidence and risk factors throughout Bosnia and Herzegovina.
José-Noel Ibrahim, Léa Audi
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1191

Abstract:
Introduction: Various emotions may arise in the context of extensive curriculum of paramedical education. Their association to biological aspects such as Vitamin D status is to be examined with regard to the prevalence of Vitamin D deficiency in the region. This research aims to evaluate the prevalence of anxiety symptoms and their relationship with Vitamin D status among Lebanese health-care students.Methods: A total of 157 university students aged 18-25 years old completed a questionnaire related to medical and psychiatric history, nutritional intake, lifestyle habits, and social difficulties. Anxiety symptoms were assessed by Hamilton Anxiety Rating Scale. Vitamin D serum levels were analyzed using ELISA technique.Results: Anxiety symptoms were present in 37.5% of students with 2.5% presenting severe anxiety. Anxiety symptoms were significantly associated to health problems (p = 0.0038), social difficulties (p = 0.001), and a family history of psychiatric disorders (p < 0.0001). Low Vitamin D levels were detected in 49.3% of participants; 77.5% having a Vitamin D insufficiency while the rest presenting a Vitamin D deficiency. Students with anxiety symptoms had significantly lower Vitamin D levels as compared to those having no anxiety manifestations (17.9 ng/mL ± 7.9 vs. 24.2 ng/mL ± 9.9, p = 0.0023). However, no significant correlation was registered between anxiety symptoms scores and Vitamin D levels.Conclusion: Anxiety symptoms were found to be relatively prevalent among health-care students and associated to low Vitamin D levels. Further studies are warranted to clarify the beneficial effect of Vitamin D supplementation in the prevention, management, and treatment of anxiety symptoms among health-care students.
Sandra Bošković
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1082

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Introduction: The role of nurses in healthcare is of great importance for the well-being of patients. Nurses are exposed to daily stress in the workplace due to the lack of staff, irregular working hours, and lack of support from the management. Such conditions greatly affect the emotional and psychological health of nurses. This study aims to explore the factor structure of the Maslach Burnout Inventory (MBI) on the Croatian sample of nurses.Methods: A cross-sectional study on the sample of 119 nurses, using the MBI scale to assess burn-out in nurses.Results: The reliability of individual subscales expressed by Cronbach’s alpha coefficients showed that all three scales meet the criterion of internal consistency of 0.832. The obtained coefficients of internal consistency are 0.860 for the dimension of emotional exhaustion, 0.809 for the dimension of depersonalization, and 0.791 for the dimension of personal accomplishment.Conclusion: According to this research and comparative research results, we can conclude that MBI 22 can be applied as a valid and reliable burn-out assessment indicator among nursing staff.
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1246

Abstract:
The study of anatomy supported with human dissection is foundational to training of health science professionals. For a student, cadaver dissection offers an active learning experience. For the training of physical therapists, we created a manual that efficiently instructs the dissection of the whole body over the course of 30 laboratory periods. In the spirit of academic collegiality, this letter provides health science educators a direct download link (https://hdl.handle.net/11299/218174) to the dissection manual hosted by the University of Minnesota (USA) Digital Conservancy. No registration is required, the download is free, and the PDF file of the dissection manual can be reproduced or adapted for any educational use.
Dženan Pleho, Amra Mačak Hadžiomerović, Kenan Pleho, Jasmina Pleho, Dinko Remić, Davor Arslanagić, Miloš Lazić, Aldina Alibegović
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1209

Abstract:
Introduction: Work-related musculoskeletal disorders (WRMSDs) are the most common work-related diseases and describe a wide range of degenerative and inflammatory conditions affecting blood vessels, peripheral nerves, joints, ligaments, tendons, and muscles. WRMSDs are becoming an increasing problem in modern society. They are the second biggest cause of short-term or temporary incapacity for work just following a cold. At the workplace, health professionals represent a very vulnerable category in terms of musculoskeletal disorders (MSDs) development. It is estimated that almost one-third of all cases of absence from work among health care professionals are related to MSDs. Studies also show that a large number of health professionals report the occurrence of MSDs in one or more regions of the body, with a problem with the lower back being one of the most common.Methods: This article presents a non-experimental (qualitative) research, or a scientific review of the published literaturewhere the databases were reviewed in which the keywords for the review were: MSDs, work, health, intervention program,and ergonomics. Various databases were used in the preparation of this article, including PubMed, Google Scholar, Medline, Hrčak, Dabar, Science Direct, and Science Citation.Results: The results include a review and analysis of eighteen published scientific articles in the period 2001-2020. The studies published in these articles has been conducted in the United States, Australia, Switzerland, Portugal, Slovenia, Turkey, China, Nigeria, Israel, Tunisia, Iran, Croatia, Taiwan, Bangladesh, Serbia, Macedonia, and Greece.Conclusion: This article should indicate the magnitude of the problems of WRMSDs in health professionals and that this topic is an inexhaustible and very interesting basis for further studies by current and future researchers to create strategies for the prevention and treatment of this disorder and to eliminate its causes.
Dominik Galić, , , Marin Glad, , Bruno Cvetković, , Nerma Maestro, ,
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1110

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Introduction: The Republic of Croatia (HR) has significantly invested in monitoring the quality of inland bathing areas during the past 10 years. The aim of this paper was to analyze the results obtained during the 2014-2019 period and to compare them with the Region (non-European Union [EU] countries neighboring Croatia) and EU. Moreover, bathing water quality data at two bathing areas of Zagreb (lakes Jarun and Bundek) were processed in more detail.Methods: The quality of inland bathing areas in the HR is monitored in five rivers and five lakes in nine Croatian counties; 19 of the 35 monitored sites are located in Zagreb County. Escherichia coli (EC) was determined by EN ISO 9308-3: 1998, while intestinal enterococci (ENT) were defined by EN ISO 7899-2: 2000. Statistical processing of the results was performed using the Microsoft Excel Statistical Package (Redmond, USA) and Statistica 13.5. (Stat.Sof.Inc., Tulsa, USA); the significance level was set to p < 0.05.Results: During the study period, the worst Croatian inland water quality was recorded in 2019 (excellent quality for only 25.9% of the bathing areas), while the best quality was recorded in 2015 (excellent quality in 57.1%). On average (2014-2019), the share of bathing areas with excellent quality in Croatia was 46.3% (i.e., under the EU average of 85.3%); with no poor locations (EU average was nearly 2%). A significant positive correlation was found between fecal indicators (EC&ENT) and the amount of precipitation, while a negative correlation with water and air temperature in lakes.Conclusions: The quality of Croatian inland bathing areas is significantly lower than the European average, while EU water quality is improving. Regarding the countries bordering Croatia, Italy, Slovenia, and Hungary have achieved better results, while Montenegro, Serbia, and Bosnia and Herzegovina are still in the process of developing the monitoring of the bathing water quality.
Nina Čamdžić, SuadA Kuskunović-Vlahovljak, Svjetlana Radović, Mirsad Dorić, Mirsad Babić, Edina Lazović Salčin, Amir Spahić
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1121

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Introduction: Tumor microenvironment plays a significant role in tumor progression. Tumor stroma is one of the strongest modifiers of tumor cell response, cancer behavior, and cancer progression. This study aimed to investigate the correlation of matrix metalloproteinase-9 (MMP-9) expression and tumor-stroma ratio (TSR) with standard clinicopathological parameters in different molecular subtypes of breast cancer.Methods: Ninety biopsy samples of primary breast cancer diagnosed at the Department of Pathology, School of Medicine, Sarajevo, were selected for this study. The molecular subtype was determined based on the immunohistochemical expression of estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and Ki-67. Stromal and tumoral MMP-9 immunohistochemical expression and the TSR were determined for each tumor.Results: Tumoral MMP-9 expression correlated positively with the presence of lymphovascular invasion (p= 0.016). TSR showed significant association and correlation with tumor grade (G) (p= 0.031; p= 0.049) and tumor size (pT) (p = 0.049;p= 0.021, respectively). Stromal MMP-9 expression correlated with histologic type, histologic grade of tumor, and lymphocytic inflammatory infiltrate (p= 0.021;p= 0.047, p= 0.038, respectively). A higher percentage of stromal MMP-9 expression correlated with the strongest lymphocytic response (p = 0.007). Significant correlation was observed between molecular subtypes and histologic grade of the tumor (p= 0.032).Conclusion: Our results, to some extent, confirm the significance of the tumor microenvironment in breast cancer, especially when it is about stromal MMP-9 expression. Although we observed significant association, without linear correlation, we found no significant correlation between molecular subtypes of breast cancer and MMP-9 expression.
Senka Mesihovic-Dinarevic
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2021.1194

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Most children with a proven coronavirus disease (COVID-19) infection are asymptomatic or have mild symptoms. However, a small number of children have been identified in the past 2 months with developed significant multisystem inflammatory response. All children were treated according to standard protocols. Children with this disease may require hospitalization in pediatric intensive care unit with a multisystem team approach to the disease, which includes pediatricians, infectologists, cardiologists, rheumatologists, immunologists, and epidemiologists. This extremely rare disease is curable if diagnosed in time. This rare syndrome has features in common with other pediatric inflammatory diseases including Kawasaki syndrome, staphylococcal and streptococcal toxic shock syndrome, bacterial sepsis, macrophage activation syndrome, and may present with unusual abdominal pain including elevated inflammation markers. Early recognition of this disease by a pediatrician or family doctor specialist is crucial for the timely treatment and outcome of the disease.
Mia Elhidsi, Fanny Fachrucha, Rizky Yudha Irawan
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.1156

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Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) infection or known as coronavirus disease 2019 (COVID-19) is a highly infectious disease that has been declared as a world pandemic by WHO. Although the majority of patients only experience mild symptoms, older patients and those with comorbidities are in the risk of falling into critically ill and even death. This is thought to correlate with systemic inflammatory response and oxidative stress imbalance. N-acetylcysteine (NAC) is recognized as a potent mucolytic, yet its lesser-known function as an antioxidant is a precursor of glutathione. Basic aspects and either in vivo or in vitro studies showed various mechanisms of NAC acting as a counterbalance in viral infections and its role in decreasing inflammation and oxidative stress. High-dose NAC is reported to be effective as an antioxidant in pneumonia, influenza, sepsis, and acute respiratory distress syndrome. Early evidence in COVID-19 patients showed that NAC could be beneficial. This review gives the scientific background in considering NAC as an adjuvant treatment for COVID-19.
Nejc Mekiš, Rebeka Viltužnik
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.1112

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Introduction: General radiography is a common imaging technique and X-ray examinations of the thoracic and lumbar spine are among the most frequent procedures undertaken. The aim of this research was to investigate the success rate, dose-area product (DAP), and effective dose values of 1st and 2nd cycle radiographer students performing X-ray imaging of the thoracic and lumbar spine using a phantom. Methods: The students were divided into four groups according to the year of study (1st, 2nd, and 3rd years of 1st cycle degree, and all 2nd cycle degree students). They were asked to perform imaging of thoracic and lumbar spine on the phantom in both anteroposterior and lateral projections where IQ and DAP measurements were collated. The study was blind, so they did not know about the purpose of the study. Results: First, we have inspected the acceptability rate of the images performed. The highest success rate of performing an optimal image was discovered with the 2nd cycle degree students where the 1st year students had the most difficulties there. In the second part, DAP and effective dose values were compared, only for the acceptable images in which case the 1st and 2nd years, students of the 1st cycle degree were most successful. Conclusion: Based on that, we can conclude, that the 2nd cycle degree students had the lowest rejection rate regarding the optimal image quality, which was the price of using a larger primary X-ray field which leads to higher dose values.
Šeila Cilović-Lagarija, Nino Hasanica, Sanela Tukulija, SuadA Branković, Jasmina Mahmutović, Dragana Galić, Kristina Perić, Selma Čajdrić, Senada Mujačić, Salih Slijepčević, et al.
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.1086

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Introduction: Aim of the study is to piloting nursing documentation to obtain comments based on the experience of nurses/medical technicians from the primary, secondary, and tertiary health care about the documentation before it is published and starts being used.Methods: A questionnaire was designed in the electronic form to be used for the evaluation and suggestions by nurses/medical technicians on the piloted form and content of nursing documentation for all levels of health care. A piloting sample was prepared to make 10% of nurses/medical technicians from health care institutions from the territory of the Federation of Bosnia and Herzegovina.Results: A total of 94.3% of examinees at the primary health care level and only 17.2% of the examinees in the secondary and tertiary health care fill out nursing documentation both manually and electronically. All examinees at all levels of health care understand the purpose and importance of nursing documentation. A total of 27.7% of the examinees at the primary and 40.9% of the examinees at the secondary and tertiary level of health care pointed out that filling out nursing documentation was too time-consuming.Conclusion: A total of 51.2% of the examinees at the primary and 64.2% at the secondary and tertiary level of health care agreed that submitted nursing documentation was adequate for use. It is suggested that after the adoption of nursing documentation at all levels of health care, piloting of its use should be conducted to evaluate the quality and quantity of all nursing documentation.
Redžo Čaušević, Irmelina Karić, Sanela Salihagić, Indira Prguda, Dženana Hrustemović
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.930

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Introduction: Rhinoplasty is an esthetic and functional nasal reconstruction surgery. The elimination of physical disabilities directly affects mental health and leads to a better psychological balance. Therefore, patient satisfaction is considered a valuable measure of medical service outcomes. The objectives of this study were to evaluate subjective patient satisfaction 1 year after surgery and its influence on the quality of life.Methods: This was a clinical, retrospective, randomized, and single-blinded study in which patients were randomly questioned by the same examiner. All subjects underwent pre-operative preparation and post-operative flow at Eurofarm Centre from 2007 to 2010. The survey was conducted through anonymous questionnaires that were provided to each respondent at least 1 year after discharge from the hospital.Results: Overall, 20 (50%) patients had esthetic and 20 (50%) had functional nasal surgery. Most respondents were born between 1971 and 1980 (52.5%) and between 1981 and 1991 (40%), with the least born between 1951 and 1960 (2.5%). Regarding the education level, 27 had university degrees (67.5%), 1 had postgraduate education (2.5%), and 12 (30.0%) were secondary school graduates. In addition, 25 (62.5%) were unmarried and 15 (37.5%) were married.Conclusion: No statistically significant correlation was found between the subjective assessment of patient’s health based on eight dimensions of health assessment and variables such as type of surgery, age, level of education, and marital status 1 year after undergoing rhinoplasty. A statistically significant difference was found between the type of surgery and physical pain (p = 0.004 < 0.05, Mann–Whitney U test). Based on the research findings, we can conclude that patient satisfaction after undergoing rhinoplasty was moderately correlated positively with the quality of life (r = 0.180-0.345, p < 0.05).
Goran Kolarevic, Dražan Jaroš, Bojan Pavičar, Tatjana Ignjć, Aleksandar Kostovski, Goran Marosevic, Branko Predojević, Dragoljub Mirjanić
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.1085

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Introduction: Using computed tomography (CT) and treatment planning systems (TPS) in radiotherapy, due to the difference in photon beam energy on CT and linear accelerator, it is necessary to convert Hounsfield units (HU) to relative electron density (RED) values. The aim of this dosimetric study was to determine whether there is a significant effect of potential in the CT tube, field of view size (FOV), and phantom dimensions on the CT conversion curve CT-RED. The second aim is whether there are significant differences between the CT-RED obtained by the Computerized Imaging Reference Systems (CIRS) Thorax 002LFC phantom and the “reference” curve in the TPS, obtained by the CIRS 062M pelvis phantom, at the same CT conditions.Methods: Heterogeneous CIRS 062M and CIRS Thorax 002LFC phantoms were used, which anatomically and dimensionally represent the human pelvis, head, and thorax, with a set of known RED inserts. They were scanned on a CT LightSpeed GE simulator and obtained CT-RED.Results: The high voltage in the CT tube had a significant effect on the HU (t = 10.72, p < 0.001) for RED values >1.1, while FOV as a parameter did not show statistical significance for the 062M pelvis phantom. Comparing the slopes (062M pelvis and head) of the CT-RED for RED ≥ 1.1, the obtained value is t = 1.404 (p = 0.163). In the case of a 062M pelvis and a 002LFC phantom, we have seen a difference in RED values (for the same HU value) of 5 % in the RED region ≥ 1.1 (bone).Conclusion: Patients should be imaged on a CT simulator only at the potential of the CT tube on which the conversion curve was recorded. The influence of the FOV and scanned phantom dimensions is not statistically significant on the appearance of the calibration curve (RED ≥ 1.1).
Daniel Maestro, , Dinko Remić, Arzija Pašalić, Anes Jogunčić
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.1073

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Introduction: Worldwide, COVID-19 pandemic caused millions of infected people and thousands of deaths. Due to enormous pressure on health-care systems and its inadequate preparedness, utter collapse is expected. In the current epidemic response, healthcare workers’ (HCWs) knowledge and practice are crucial, while the impact on their mental health is still unknown.Methods: The cross-sectional study was conducted among HCWs redeployed to COVID points in the Public Institution Health Centre of Sarajevo Canton. According to guidelines and information provided by the World Health Organization and Ministries of Health, a questionnaire was developed. In addition, General Anxiety Disorder-7 as a screening tool for anxiety disorders was used.Results: Of 180 respondents, 26 (14.4%) were in direct contact with the sick patient. In total, 79 (43.9%) respondents consider their personal protective equipment is in accordance with the guidelines of the world health authorities. A total of 72 (39.7%) of respondents used the same mask for several days. In general, the danger from new coronavirus was considered minimal by 59 (32,6%) HCWs. Based on the achieved score for assessing the anxiety disorder, in 63 (35%) subjects, the presence of severe symptoms was detected.Conclusion: This study found that most HCWs do not have enough knowledge about the COVID-19 pandemic. We identified that there are differences in the sources of information and gap in perceptions of the native origin of the virus. Considering the frequency of anxiety symptoms among HCWs, interventions are necessary in order to preserve their mental health.
Ilijaz Pilav, Orhan Čustović, Arijana Horman-Leventa, Alma Alihodžić-Pašalić, Safet Mušanović, Alen Pilav, Kemal Grbić, Kenan Kadić, Meho Dapčević, Ademir Hadžismailović, et al.
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.1041

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Descending necrotizing mediastinitis (DNM) is a rare, life-threatening form of mediastinitis caused by odontogenic, pharyngeal, or cervical infections. The retropharyngeal space is the most common primary site of infection. Given the fulminant course and high mortality rate, early diagnosis and prompt treatment are important predictors of survival in patients with DNM. Appropriate empirical antibiotic treatment, prompt surgical intervention, and proper management of patients in the intensive care unit can be of vital importance. We present the case of a previously healthy 20-year-old male patient who was successfully cured and discharged from the Clinical Center University of Sarajevo after suffering from a severe form of mediastinitis as a complication of the retropharyngeal abscess caused by anaerobes.
, Aida Pilav, Marijan Marjanović, Jenny Phillips, Deana Švaljug, , Hadžan Konjo, Đemil Omerović
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.1072

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Introduction: Insufficient physical activity is one of the leading public health problems in the world, but also in Bosnia and Herzegovina. Modern civilization is characterized by a significant decrease in physical activity, and the number of people whose lifestyle can be called sedentary has never been higher, which is especially emphasised among children and adolescents. Aim of the study is to examine public health significance of physical activity on the occurrence and the degree of obesity in children and adolescents in primary and secondary schools and to determine the applicability of the Fels questionnaire on physical activity of children in rural areas of Bosnia and Herzegovina. Methods: We used a transversal research method of a cross-sectional study at a one-time point, and for obtaining results we used the Fels physical activity questionnaire for children and measurement protocol. Results: 276 primary and secondary school students in two cities participated in this survey. Respondents in Busovača are more physically active than their peers in Sarajevo. One-third of the total number of respondents is overweight and obese, and respondents in Sarajevo are significantly more nourished than their peers in Busovača. The Fels questionnaire is conditionally applicable, especially in rural areas. Conclusion: This study confirmed that the Fels questionnaire for assessing the level of physical activity for children and young people, which is the general instrument for research of physical activity in children, is too generalized because it is based on a homogeneous urban population.
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.983

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Introduction: Normative data on handgrip strength (HGS) and body mass index (BMI) are scarce among adolescents in the Nigerian context. The aims of this study were to evaluate patterns of HGS in relation to gender and age in Nigerian adolescents and its correlation with BMI.Methods: This cross-sectional study involved 1966 participants (1275 males) and (691 females) aged 12–20 years in Northern Nigeria. Body mass and height were measured. HGS was assessed using a dynamometer.Results: The right HGS (RHGS) was significantly higher than the left HGS (LHGS) (t = 21.337, p < 0.05). There were significant age differences in the RHGS and the LHGS (p < 0.05); however, no significant difference occurs at 12–14 years. Males participants aged 16–20 years had significantly higher RHGS values than females of the same age (p < 0.0038). Conversely, males aged 15–20 years had significantly higher LHGS values than females of the same age (p < 0.0038). There was a significant interaction between gender and age for the RHGS (F = 72.2, p < 0.05) and the LHGS (F = 92.1, p < 0.05). There was a significant correlation between the BMI and RHGS (r = 0.480, p < 0.01) and the LHGS (r = 0.465, p < 0.01).Conclusion: There are gender and age difference in the HGS of Nigerian adolescents, with the dominance of the RHGS in both genders. HGS correlated with BMI. This normative data on HGS may serve as baseline data for future comparative studies assessing HGS among the adolescent population in Nigeria.
, Najda Veladžić, Amra Mačak Hadžiomerović, SuadA Branković, Hadžan Konjo, Đemil Omerović
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.969

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Introduction: The primary source of strength and support is the child’s family. A special role in caring for a child with developmental disabilities is played by his mother. The objective of this research is to find out the assessment of the quality of life (QOL) of disabled children mothers as well as to research the relation of sociodemographic variables of the respondents, as specified in this study and estimate the quality of their life and health.Methods: The cross-sectional study was performed by the use of the descriptive-analytical method. In a targeted association of families which have children and persons with difficulties was conducted this research on a sample of 100 registered mothers. The research instrument was the standardized questionnaire for QOL, the World Health Organization QOL-BREF and the users’ records of the mothers in the association.Results: The average age of the respondents was M = 48. 01 ± 11. 68. About 62% of the respondents are married, 54% have a high school diploma, 67% are not employed, 68% of the respondents did not declare to have health problems, and among those who declared to have health problems, the most common disease was diabetes mellitus. The average number of household members was M = 3. 44 members. The number of the household members was significantly and positively related to the domain of social interaction (rs = 0. 219; p < 0. 05), the domain of the environment (rs = 0. 220; p < 0. 05) and to the general QOL (rs = 0. 227; p < 0. 05). The age of the respondents was significantly and positivelyrelated only to the environmental domain (rs = 0. 205; p < 0. 05). The respondents who drive a car showed a significantly higher level of QOL in the field of mental health (p = 0. 042) and the environment (p = 0. 005). Concerning mothers with higher incomes rate, their QOL was better in the following domains: Physical health (p = 0. 030), mental health (p = 0. 002), environment (p = 0. 000001), and general QOL (p = 0. 0002).Conclusion: The respondents with a larger number of household members, those who have the support of family members, who were without health problems, and who independently use own car for transportation, consider their QOL as being better. Therefore, a promotional – preventive program for improving the life quality of mothers of children and persons with disabilities should include accessible life in the community and the ability to recognize the unique needs of the entire family of children and persons with disabilities.
SuadA Hasanović-Vučković, , Sandra Vegar-Zubović, Lejla Milišić, Adnan Šehić, Ilvana Hasanbegović, Adnan Beganović
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.1064

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Introduction: Intervertebral disc (IVD) degeneration (IDD) is one of the main causes of low back pain (LBP). Standardized diagnostic algorithms for adequate estimation and classification of changes of lumbar discs are mandatory before starting with therapy.Methods: One hundred patients who were indicated for lumbar magnetic resonance imaging (MRI) were included in the study. Pfirrmann grading system was used for the determination of IDD, while the visual analog scale (VAS) is used for evaluation of the intensity of LBP. To quantification of disability for LBP, we used the Oswestry Disability Index (ODI).Result: Results showed higher Pfirrmann grades II and III for L2/L3 and L3/L4 lumbar levels and lower scores at L4/L5 and L5/S1. The analysis also showed low scores at the L2/3 and L3/4 lumbar level for Pfirrmann grades IV and V, and there was an increased at more inferior lumbosacral levels L4/5 and L5/S1. There was a significant correlation between Pfirrmann grades and ODI (p = 0.24) as well as VAS (p = 0.16).Conclusion: Higher Pfirrmann grades correlated with increased ODI and VAS. Therefore, MRI can be used as a strong indicator of clinical appearance, but it is important to take into consideration that LBP should be correlated with clinical features. By summing Pfirrmann grades of all lumbar intervertebral levels in each patient, we can get more accurate insight for the status of the lumbar spine.
, Aida Pilav, Anisa Bajramović, Snežana Bursač-Aranđelović, Aida Pošković-Bajraktarević, Emina Kurtagić-Pepić, Aida Pitić, Zimka Šeremet, Denis Đurović, SuadA Branković
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.1031

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Introduction: Sarajevo is the capital city of Bosnia and Herzegovina, with the population in Canton Sarajevo of 438,443 people. The first cases of COVID-19 in Canton Sarajevo were on 20th March. On that day, we had three positive cases. These days at the beginning of the COVID-19 epidemic in Canton of Sarajevo around 2500 citizens were in self-isolation at home. The aim of this paper is to show the journey of Canton Sarajevo in the fight against COVID-19 infection, the impact of measurements that were taken to stop the infection spreading and to compare pre- and post-lockdown stats.Methods: During the period March-July 2020, we have analyzed daily newly cases and followed them through the period of at least 14 days. All data were analyzed using SPSS 25.0 (IBM Corp. Released in 2019. IBM SPSS Statistics for Windows, NY: IBM Corp.) and MS Office 2019 suite (Excel). For comparison, we have used the Chi-square test.Results: In the period of 10 weeks from the beginning of March to the 25th of May in Canton of Sarajevo, we had a total of 113 cases of COVID-19 infection. The number of conducted tests was 7515. In total, with positive retests, we had only 161 positive tests, which is 2.14% of all analyzed tests. From that number of patients, 58 (51.3%) were male and 55 (48.7%) were female. Regarding age distribution, under 65 years were 91.1% of patients.Conclusion: Choosing the best method to fight against COVID-19 is hard to determine. Staying at home would decrease the infection rate, but in the long term, it is not sustainable. Perhaps the mix of methods that we had in Sarajevo is the best option. Fighting against one epidemic cannot be the source for other epidemics.
Lutvo Sporišević, Senka Mesihović-Dinarević, Anes Jogunčić, Aida Pilav
Journal of Health Sciences, Volume 10; https://doi.org/10.17532/jhsci.2020.972

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Coronavirus disease 2019 (COVID 19) is a pandemic disease that is today a global public health problem caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). COVID-19 is a disease of middle and old age, but clinical expression may also be present in childhood. Asymptomatic and mild clinical forms are most often present in persons aged 0-19, but severe clinical forms such as, among others, acute respiratory distress syndrome and multisystem inflammatory syndrome may occur. In addition to presenting the epidemiology, clinical symptomatology of COVID-19, the authors consider certain specifics of COVID-19, that is, possible reasons for the lower incidence of the disease as well as unusual and rare clinical forms of the disease in children. The current activities of health professionals in the supervision of COVID-19 are mainly focused on early detection, isolation and treatment of patients, isolation of contacts, the regular and thorough practice of respiratory hygiene, hand hygiene, and physical distancing. Future efficient and safe vaccination will solve the biggest global medical challenge caused by the new coronavirus in the best possible manner.
Dražan Jaroš, Goran Kolarević, Aleksandar Kostovski, , , Goran Marošević, , Dragoljub Mirjanić
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.886

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Introduction: Gated tangential field-in-field (FIF) technique is used to lower the dose to organs at risk for breast cancer radiotherapy (RT). In this study, the authors investigated the accuracy of the delivered treatment plan with and without gating using a two-dimensional detector array for patient-specific verification purposes.Methods: In this study, a 6MV beams were used for the merged FIF RT (forward Intensity Modulated Radiation Therapy). The respiration signals for gated FIF delivery were obtained from the one-dimensional moving phantom using the real-time position management (RPM) system (Varian Medical Systems, Palo Alto, CA). RPM system used for four-dimensional computed tomography scanner light-speed, GE is based on an infrared camera to detect motion of external 6-point marker. The beams were delivered using a Clinac iX (Varian Medical Systems, Palo Alto, CA) with the multileaf collimator Millennium 120. The MapCheck2 (SunNuclear, Florida) was used for the evaluation of treatment plans. MapCheck2 was validated through a comparison with measurements from a farmer-type ion chamber. Gated beams were delivered using a maximum dose rate with varying duty cycles and analyzed the MapCheck2 data to evaluate treatment plan delivery accuracy.Results: Results of the gamma passing rate for relative and absolute dose differences for all ungated and gated beams were between 95.1% and 100%.Conclusion: Gated FIF technique can deliver an accurate dose to a detector during gated breast cancer RT. There is no significance between gated and ungated patient-specific quality assurance (PSQA); one can use ungated PSQA for verification of treatment plan delivery
Adegbenro Fakoya, Jessica Heymans, Amanda McCrary, Omar Rodriguez, Abdiel Cardona, Abayomi Afolabi, Thomas McCracken
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.903

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Hyperostosis frontalis interna (HFI) is a rare disorder common among postmenopausal females that involve increased volume and porosity of the frontal bone. Depending on the size, it could be symptomatic or asymptomatic. With a little report on the pathophysiology of HFI, we present a peculiar case of HFI with speculations that could shed more light on the already established literature and pose questions for future research.
, , Maitri Agarwal
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.950

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Introduction: This paper fulfills an identified need to study the mental health status of the population under situations like lockdown, thereby helping fill a persistent gap in Indian research on this issue, and present research on the impact of lockdown on mental health during epidemics is limited, especially in India. This study aims to scale the association between anxiety and sociodemographic factors during the coronavirus disease 2019 lockdown among the general Indian population.Methods: A descriptive cross-sectional nationwide study designed to enroll the general population. The inclusion criteria for this study were Indian citizens aged 18 years and above. The study was conducted from March 29, 2020, to April 12, 2020, using an online google questionnaire. The anxiety among respondents was detected and measured using a Generalized Anxiety Disorder (GAD) Scale, which consists of seven questions (in English), that is, GAD-7.Results: Responders were 392, and from these participants, the prevalence of anxiety was 25.3%. The predictors of anxiety were gender, religion, occupation as business/self-employed, marital status, family size, health status, and sleep deprivation based on the bivariate logistic regression analysis.Conclusion: This study reports the early prevalence of anxiety among the Indian population who were grounded at their homes during lockdown due to coronavirus pandemic in the country.
Michael Egbe, Antor O. Ndep, Philip Imohi, Kingsley Obase, Frank Eyam, Betta Edu
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.912

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Introduction: A hotspot is a geographical location having evidence of high STIs/HIV prevalence, and/or behaviors that put people at high risk of becoming infected. Therefore, Nigeria, with almost two million people living with HIV, could be considered a giant “hotspot.” The main aim was to describe how the geospatial clustering of newly diagnosed HIV-infected adults in Cross River State helps define new “hotspots.”Methods: Secondary data collected between January 2020 and March 2020, identified and mapped around a presumed hotspot’s radius of influence (ROI), were analyzed using a “Hotspot Analysis” plugin in QGIS software. With a sample size of 3019, both seropositive and seronegative results were geo-referenced and the resultant map was analyzed to determine HIV-positive clusters.Results: From the 3019 spatial locations mapped, 720 (23.9%) were positive cases. Of these, 328 (45.6%) were thus estimated as being associated with the presumed hotspots. The remaining 392 (54.4%) were positive cases identified outside of the ROI of the originally presumed hotspots. The total number of mapped HIV testing services (HTS) points (both negative and positive cases) within the hotspot ROI was 1319, while those outside of the hotspot ROI were 1700.Discussion: Collectively, the clustering of the HTS points into various groups indicating that hard-to-reach communities along the borders with the Republic of Cameroon on the east and Akwa Ibom State on the southwest had a majority of the new clusters.Conclusion: Unique hotspots where social gatherings occur tended to have a wider ROI. Targeted testing in these hard-to-reach communities is recommended.
, Pierre Gomes De Morais Silva, Jalber Almeida Dos Santos, ,
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.888

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Introduction: Dental surgeries involving structures adjacent to the mandibular canal require greater knowledge of the intraosseous path, anatomical structure, and its variables, reducing the risk of injuries to this region. This research aimed to verify on the panoramic radiographs the anatomical characteristics of the mandibular canal, as well as to analyze and classify its pathways.Methods: The classification of anatomical variations of the mandibular canal was divided into four types: Class A (inferior direction); Class B (mesial direction); Class C (alveolar direction); and Class D (retromolar direction). The sample consisted of 500 exams, 207 (41.4%) males and 293 (58.6%) females, with a mean age of 29.51 years.Results: A prevalence of 30 anatomical variations of the mandibular canal was observed. The most prevalent classifications were Class B (43.6%) followed by Class C (23.1%) and D (33.3%). In no case was the presence of bifid canals classified as Class A. The anatomical variations of the mandibular canal appeared both unilaterally and bilaterally, in which unilaterally the prevalence was on the left side (50%), on the right side (20%), and bilaterally (30%).Conclusions: According to the results obtained in this study, a prevalence of 6% of bifid mandibular canals was found. The most prevalent types of the bifid canal were Class B and Class D, and the highest occurrence of bifid mandibular canals was left unilateral. It is concluded that the appearance of mandibular canal anatomical variations in panoramic radiographs is frequent and that additional care must be taken to approach the region.
Natalia Velasco-Nieves, , Shannon Matthew, Wirda Zafar, Mahrukh Zafar, Kevin Alonso Milla, Sushanth Yerra, Abayomi Afolabi, Thomas McCracken
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.904

Abstract:
Surgical procedures on the thyroid are usually complicated by damage to the parathyroid glands, the external branch of superior laryngeal nerves, inferior laryngeal nerves, and hematoma due to vascular injury and the chance of residual thyroid tissue being left in case of cancer and Graves' disease, and the presence of anatomical variations. In this study, we describe the presence of a levator glandulae thyroideae that could misguide surgeons during surgical procedures.
, Nataša Bizovičar, Nataša Kos, Miroljub Jakovljević
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.880

Abstract:
Introduction: Work-related musculoskeletal disorders (WMSDs) represent a major problem for society, employers, and employees. These kinds of problems can cause discomfort, pain, and poor work performance. Among physiotherapists, the 1-year prevalence of WMSD ranges from 28 to 96%. Most problems occur in the lower back, with a 1-year prevalence of up to 83%. This study aimed to determine the prevalence of WMSD on a sample of physiotherapists from Slovenia and to identify associations between demographic/anthropometric variables, job satisfaction, and physical activity with WRMD aiming to contribute to the development of effective prevention and control strategies. Methods: The extended Nordic musculoskeletal questionnaire was used to obtain data from a sample of 102 physiotherapists. Data were presented with descriptive statistics and processing was performed with the Spearman’s rank correlation coefficient for non-parametric variables. The level of statistical significance was set as p ≤ 0.05. Results: The 1-year prevalence of WMSD was 92.2%. One-year prevalence of WMSD was highest for the neck (64%) and lower back (63%). Higher age and more years of practice were correlated with WMSD for shoulders and ankles/feet areas. Several patients treated by a physiotherapist were a risk factor for difficulties in the neck and multiple body areas. The level of physical activity was not correlated with WMSD in different body areas. Conclusion: The prevalence of WMSD found in our study sample was among the highest compared to other countries, despite probably having similar working conditions as elsewhere in Europe. The first WMSD of Slovenian physiotherapists mostly did not occur in the first 5 years of practice as other studies reported, which could be explained as a result of a good educational training of young physiotherapists. Possible reasons for the high prevalence of WMSD could be that our study sample represented only secondary and tertiary levels of health care; another reason could also be non-ergonomic and hard working conditions during their careers. Physiotherapists are mostly adequately physically active, however, that did not turn out to be effective WMSD prevention in our sample. The relatively high prevalence is indicating the need for better interventions and prevention of WMSD in Slovenian physiotherapists.
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.882

Abstract:
Introduction: The nasals and hand carriage of Staphylococcus aureus in food handlers (FHs) represent a significant source of Staphylococcal food contamination and food poisoning. Antimicrobial resistance (AMR) is a microorganism’s ability to resist the action of one or more antimicrobial agents. S. aureus has demonstrated the ability to rapidly respond to each new antimicrobial with the development of a resistance mechanism. The aim of the study was to assess the prevalence of nasal carriage rate and AMR pattern of isolated strains S. aureus among FHs in Canton Sarajevo, Bosnia and Herzegovina. Methods: The retrospective study included laboratory results of 11.139 tested subjects between January 2014 and December 2018. The study was conducted in the laboratory of the Institute of Public Health of the Federation of Bosnia and Herzegovina in Sarajevo. Samples of nasal swabs were collected from FHs, employees in companies located in Canton Sarajevo, during sanitary surveillance prescribed by applicable legal standards. S. aureus isolates were identified according to conventional microbiological methods and antimicrobial susceptibility testing was performed by the agar disk diffusion method according to the European Committee on Antimicrobial Susceptibility Testing; 2013 standard. Results: Among the 11.138 subjects, 792 (7.1%) were carriers of S. aureus. Isolated strains were tested on eight different antibiotics, and the resistance to penicillin, ampicillin, and amoxicillin was 788 (99.5%), 776 (97.9%), and 752 (94.9%), retrospectively. In total, 86.36% of isolated strains were multidrug-resistant. Conclusions: The low percentage of S. aureus carriers indicates that preventive measures of carrier control are being actively implemented within the legally prescribed measures. The emergence of numerous isolated strains with multidrug-resistance characteristics is a significant public health problem and consequently limits the range of antibiotics available for therapeutic purposes. The results of this research indicate that AMR has increased in Sarajevo Canton and it is following the trend of global growth.
, Amra Mačak Hadžiomerović, Bakir Katana, Namik Trtak, Eldad Kaljić, Hadžan Konjo, Amra Redžović
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.893

Abstract:
Introduction: The challenges faced by visually impaired people in their efforts to integrate themselves into the labor market and the general position of persons with disabilities, regarding their employment and social security, is extremely difficult. Employment is the best safeguard against social exclusion and one of the main ways to achieve a full involvement in the society of the visually impaired people.Methods: The research was conducted on a sample of 25 visually impaired people employed at “TMP” d.o.o. Sarajevo. The study was used as a cross-sectional survey method wherein data were collected through appropriate survey instruments, using a modified survey questionnaire.Results: Out of the total number of respondents, 48% are male and 52% are female. The majority of respondents use other persons’ assistance when moving (n = 16). The largest number of respondents had 100% visual impairment (n = 17). The majority of subjects have no strenuous physical activity. The largest number of respondents during the previous week walked for at least 10 minutes, in the sequence of all 7 days and was driven in motor vehicles. When doing household chores, 56% of respondents said they had no difficulty. The most common difficulties in recreation, sports and physical activity in leisure time, that were encountered by 32% of respondents, are poor sound signalling and difficulties of visual nature, though 68% of respondents said that they had no difficulty in their recreational activities.Conclusion: The daily activities of employed visually impaired persons have a positive impact on their quality of life. Various are occupations of visually impaired people that improve their quality of life.
, Zora Raboteg-Šarić
Journal of Health Sciences, Volume 10, pp 1-33; https://doi.org/10.17532/jhsci.2020.885

Abstract:
Introduction: Menopause is a complex physiological, self-perceived health condition caused by the reduction and termination of ovarian function, a process that results in a range of both psychological and physiological symptoms. The aim of this literature review was to synthesize the results of published studies on factors associated with menopausal symptoms in women during the transition to menopause and the postmenopausal period.Methods: This systematic review was carried out according to the PRISMA statement. Primary studies published between 2007 and 2017 were identified through the following databases: PUBMED, SCOPUS, and CINAHL. In total, 3301 studies were identified and 279 were screened in full text. Of these, 54 studies were included for quality assessment using checklists from the Norwegian Institute for Public Health. A total of 22 studies were ultimately selected for inclusion in the results. These were thematically reviewed.Results: A wide range of determinants was sorted as socio-demographic predictors, reproductive factors, clinical characteristics, behavioral, and lifestyle characteristics, and their association with the following outcomes was examined: The prevalence and severity of menopausal symptoms; sexual functioning; health indicators and health behaviors; health-related quality of life; physical performance; cognitive changes and attitudes; and the prevalence and age of natural menopause.Conclusions: The current state of knowledge regarding menopause indicates that a wide array of instruments and variables have been employed and assessed to further understanding about menopause-related symptoms. This systematic review provides information on factors that should be considered in the treatment of menopause-related changes that may be bothersome for menopausal women.
Ioannis Nikolaou, , Foteini Tzavella, Sofia Zyga, , Paraskevi Theofilou
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.856

Abstract:
Introduction: The increasing needs of an aging population and the shortage of nursing personnel have a negative impact on the workload of nurses increasing the risk of developing anxiety and depressive symptoms. This research aims to evaluate the strength of occupational and demographic characteristics in predicting anxiety and depression among nurses. Methods: In this cross-sectional study, a sample of 164 Greek nurses from three hospitals employed full-time participated. Anxiety and depression were measured using the validated Greek versions of the State-Trait Anxiety Inventory – State and Trait Y forms and the Centre for Epidemiological Studies Depression scale, respectively. The statistical analysis of the data was performed using the statistical program SPSS version 19.0. The statistical significance level was set up at 0.05. Results: Younger nurses, unmarried, those without children, those with less work experience, and working in the general medical units were more vulnerable. The average number of patients per nurse during the day shift may not predict anxiety or depression scores. Strong positive correlation between state and trait anxiety (r [162] = 0.77, p < 0.001), state anxiety and depression (r [162] = 0.62, p < 0.001), and trait anxiety and depression (r [162] = 0.63, p < 0.001) was revealed. Conclusion: Anxiety and depression are prevalent among nurses. Demographic and working characteristics are strong predictors of anxiety and depression among nurses. Nursing managers should emphasize emotional interventions (cognitive behavioral therapy, training on emotional intelligence, strengthening coping skills, and development of high resilience) in supporting nurses at higher risk.
Vijayakumar Kathirgamam, Mandar Ambike, , Vaishaly Bharambe, Arun Prasad
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.876

Abstract:
Introduction: Human body types (somatotypes) are classified into ectomorph, mesomorph, and endomorph. The ectomorphs are physically weak and usually tall. Mesomorphs were characterized as muscular, thick skinned with good upright posture. Endomorphs characterized as fat, heavy, and usually short. Methods: This study is an interventional study, in which a total number of 45 healthy male volunteers between the age group of 22 and 28 years were observed. Written consent was obtained from the patients after a detailed explanation of the study. Exercises were prescribed and executed based on the American College of Sports Medicine (ACSM) guidelines for exercise testing and prescription. Body composition, cardiorespiratory endurance, muscular strength, muscular endurance, and flexibility were assessed. Results: The statistical analyses were done using the SPSS software version 16 executed at a 95% confidence interval. Mean and standard deviations were calculated by descriptive statistics. A paired t-test was done to find the effectiveness of the intervention. The level of significance in all tests was set to p < 0.05. Positive changes were observed in health-related fitness among the three groups. Conclusion: This study reports about finding the somatotypes, and exercising based on that will provide the best results in health-related fitness components designed by the ACSM.
G. Pooja Sharma, P. Antony Leo Aseer, P.M.Venkata Sai, N. Venkatesh
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.840

Abstract:
Adhesive capsulitis is a painful condition of unknown etiology with restriction of active and passive movements of the glenohumeral joint. The condition is a result of inflammation, adherence, and swelling in the lining of the shoulder joint capsule and its associated ligaments, causing resultant contracture of the capsule. We describe a patient with calcified and thickened coracohumeral ligament with adhesive capsulitis and diabetes mellitus.
Ebtesam Esmail Hassan, Naglaa Mohammed Amein, Sanaa Mohmoud Ahmed
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.865

Abstract:
Introduction: Violence against nurses at the workplace is an alarming problem in both developed and developing countries affecting the quality of their work. The aim of this study is to assess the prevalence of external (patient initiated) and internal violence (initiated by staff members) against nurses and studying the violence-associated factors such as perpetrators, the attitude of nurses following aggression incidents, consequences, and impact on nurses and work. Methods: A cross-sectional study included 385 nurses from three different hospitals in Minia district was agreed to participate in the study. These hospitals included Health Insurance Hospital, Minia University Hospitals (Minia University Gynecological, Obstetric, and Pediatric Hospital and Minia Renal Hospital), and Minia general hospital. The well-structured questionnaire covered four main domains; sociodemographics, lifetime working experience of violence, external and internal violence and its effects on work, the perpetrators of violence, and attitude of nurses following violent incidents. Results: More than half of nurses (55.8%) were exposed to workplace violence during their working lifetime. Experiencing external violence (patient initiated) during the past year was significantly higher (57.4%) than the internal (staff initiated) type (33.5%). Verbal violence was the most common type of violence. Reporting violence incidents were done by 68.3% and 38.7% of the nurses who were exposed to external and internal violence, respectively. Conclusion: Violence against nurses working in different health-care facilities at Minia district was prevalent and has a significant impact on nurses and their work.
Derya Atik, Songül Güngör
Journal of Health Sciences; https://doi.org/10.17532/jhsci.2020.862

Abstract:
Introduction: The aim of this study was to the determinate adaptation to chronic disease and applications for arteriovenous fistula (AVF) care and protection of hemodialysis (HD) patients with an AVF, and to determine the relationships between adaptation and application. Methods: This research is a prospective, descriptive, and cross-sectional type of research. The universe of the study accounted for 180 patients who underwent HD. The research was completed with 114 patients. The research was conducted from July 2019 to September 2019, in two different dialysis centers in Osmaniye Province. The data were collected using The Patient Identification Form and Adaptation to Chronic Illness Scale. Mean ± Standard deviation, percentages, and independent samples t-test analysis were used. Results: When the scale scores of the patients participating in the study were evaluated, determined to level of total adaptation with chronic disease and physical adaptation was to above the average score (40.24 ± 5.99). Social adaptation (21.82 ± 6.39) and psychological adaptation (22.91 ± 5.39) levels can be said to be moderate. Individuals who exercised with the ball to mature the fistula, who was careful to dress and keep the area dry on the 1st day of the operation, who was careful not to apply lotion to the fistula area, and who complied with the fluid restriction were found to have higher levels of adaptation with the disease. Conclusion: It can be said that the patients who make the right application for fistula care and protection have in general adaptation levels can also be said to be high. The level of adaptation is effective for applications. The level of adaptation is effective on applications for AVF care and protection.
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