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Biserka Pigac, Silvija Mašić, Zdenka Hutinec, Svjetlana Marić, Valentina Mašić
Journal of Health Sciences, Volume 7, pp 124-127;

Osteoma is benign tumor composed of well- differentiated matured osseous tissue. Its presence in mandible and paranasal sinuses is common, yet appearance in external auditory canal is rare. We present a case of a 26- year- old male complaining of hearing loss and pain in the affected ear. Pathohistological analysis of surgically removed tissue revealed tumor consisted of mature trabecular bone, which represents benign lesion without tendency of metastasis.
Amir Ibrahimagić, Selma Uzunović, Branka Bedenić
Journal of Health Sciences, Volume 7, pp 80-90;

Introduction: Co-existence type of ESBL-producing isolates are serious problem in the public health world. Methods Antibiotic susceptibility was determined by disc diffusion and broth microdilution according to CLSI guidelines. Double-disk synergy test was performed in order to screen for ESBLs/pAmpC beta-lactamases. PCR was used to detect blaESBL/blaampC/blacarb genes. Genetic relatedness of the strains was determined by pulsed-field-gel-electrophoresis (PFGE). Results In this study 88 of the inpatient isolates (n=126; 10.0%) and 62 of the outpatient (n=184; 6.4%) Beta-lactamase-producing isolates were taken for the study. They included 50.0/29.0% K. pneumoniae, 12.5/30.6% E. coli, 11.4/4.8% A. baumannii, 8.0/14.5% K. oxytoca, 8.0/4.8% E. cloacae, 5.7/8.1% Proteus spp., and less than 3.5% of other isolates. Co-existence of more than two type of beta-lactamases was detected in 77.3% of inpatient and 45.2% of outpatient isolates. Among inpatient isolates, Klebsiella spp. and E. coli were the most frequent isolates which produce more than two type of genes; in ≈ 65% and ≈12% cases. Separately, combination of four: TEM+SHV+CTX-M+OXA-1 beta-lactamases in inpatient K. pneumoniae isolates were detected in 63.6% cases respectively. Differents in antimicrobial resistance were higher to cephalosporins agents in Klebsiella spp., and E. coli at inpatient and outpatient isolates which produce more than two types of beta-lactamases than in isolates which produce one type of beta-lactamases. Conclusion: This work demonstrates a progressively increasing prevalence of co-existence type of beta-lactamases expecially in inpatient isolates. Continous monitoring and surveillance and proper infection control and prevention practice will limit the further spread of these isolates.
Adna Besic, Zarema Obradovic, Adisa Dautbegovic, Amina Obradovic
Journal of Health Sciences, Volume 7, pp 50-58;

Introduction: Legionella bacteria are ubiquitous microorganisms mostly found in artificial water environments, especially those which produce aerosol, such as swimming pools, saunas, and spas. Development of Legionella depends on several factors, including water temperature and chlorine. The aim of this study was to evaluate the occurrence of Legionella spp. to the temperature and free residual chlorine in tap water, water from fountains, swimming pools, cooling and heating systems. Methods: We collected 238 samples of water taken from different places and analyzed the presence of Legionella spp. by BAS EN ISO 11731-2:2009 - Water quality – Detection and enumeration of Legionella - Part 2: A direct membrane filtration method for waters with low bacterial counts, as samples were the waters with low expectancy of bacterial contamination compared to the temperature and free residual chlorine. The X2 test was used to show statistical significance. Results: Legionella spp. was detected in 18.62% of tap water and in 8.82% samples of water taken from fountains, swimming pools, and cooling and heating systems. The highest number of positive samples were detected in waters with the temperature higher than 20°C and lower than 50°C. The highest number of positive samples were reported by the concentration of free residual chlorine lower than 0.2 mg/l. The X2 test showed a statistically significant difference between positive and negative results for the presence of Legionella spp. among three groups of water samples. Conclusion: The research has shown a connection between environmental factors and the presence of Legionella spp. in the water systems of public and tourist facilities.
Enver Vardar, Ahmet Mücteba Öztürk, Erdem Comut, Didem Ersoz, Zehra Erkul,
Journal of Health Sciences, Volume 7, pp 44-49;

Introduction: The presence of increased ratio of obesity caused a rapid increase of bariatric surgery practice. In this study, our purpose is to clarify the histopathologic findings of the patients who have experienced this type of bariatric surgery and to learn more about the distinguishable features of laparoscopic sleeve gastrectomy (LSG) specimens and to contribute to the related literature. Methods: A retrospective study was designed with the histopathologic findings from pathology specimens of 109 patients who experienced LSG between April 2014 and May 2016. To collect essential data, we used the database system of our institution that contains all of the selected patients for our study. Results: Overall, the average age was 36.2 years, and 85 were female while 24 were male. The principal histopathologic features were active chronic gastritis in 9, chronic gastritis in 68, atrophy in 5, and intestinal metaplasia in 8 patients. In two patients, gastrointestinal stromal tumor was found and in another patient, neuroendocrine cell hyperplasia was found. In addition to the dominant histopathologic features including chronic and active chronic gastritis, a small percent of patients had clinically significant pathologic findings in the sleeve gastrectomy specimens and this may have an effect on postoperative management and morbidity. Conclusion: Considering these results, having histopathologic examination of the sleeve gastrectomy specimens as a standard procedure is strongly recommended.
Mehmet Sargin, Bülent Hanedan, Eyüp Aydoğan, Fatma Akin, Sadık Özmen
Journal of Health Sciences, Volume 7, pp 23-26;

Introduction: Lumbar puncture is a procedure frequently used in anesthetic practice. For the success of the procedure, prediction of skin to subarachnoid space distance (SSD) is valuable. In this study, we aimed to evaluate the relationship between SSD with age and body mass index (BMI). Methods: Two hundred and fifty patients, ASA physical status I, II, and III scheduled to undergo elective surgery under spinal anesthesia, were studied. Spinal anesthesia was induced in the sitting position at the L3–4 vertebral level using a midline approach. Furthermore, the level of L3–L4 was identified by palpation, using Tuffier’s line as a guide. Following an intrathecal injection, the spinal needle was grasped between the thumb and the index finger during its removal from the patient’s back. From the grasping point, SSD was measured using rulers. Results: Mean values of SSD at the L3-4 interspace were 55.43±6.47 mm (range 35-74). Statistically significant correlations were observed between SSD with BMI and body weight (ρ=0.650, P
Bruno Camporeze, Renata Faria Simm, Iracema Araújo Estevão, Luis Roberto Mathias Junior, Paulo Henrique Pires De Aguiar, Sylvine Carrondo-Cottin
Journal of Health Sciences, Volume 7, pp 68-79;

Introduction: The spinal cord stimulation (SCS) has been described as a valuable neuromodulating procedure in the management of chronic and medically untreated neuropathic pain. Although, many studies have discussed the use of this technique, a question still remains regarding its efficacy in different medical conditions with different etiology in the long term. The aim of this paper is to discuss the risks, complications, cost-effectiveness and results of SCS in patients affected by chronic neuropathic pain based on the comprehensive literature review. Methods: Bibliographic search of references from 1950 to 2016 using the databases MEDLINE, LILACS, SciELO, PubMed, and applied language as selection criteria, choosing preferably recent articles written in Portuguese, Spanish or English. Results: Based on literature review, SCS is a safe, reversible, adjustable and nondestructive surgical procedure demonstrating a significant effect in the reduction of pain intensity and improvement in quality of life in these patients. Furthermore, in spite of the initial high cost to its application, SCS has been associated with lower rates of complications and high rates of cost-effectiveness when compared to standard therapies. Conclusion: Although used in medical conditions with different etiology, the procedure is still an effective and a cost-effective approach to neuropathic pain, mainly in patients affected by failed back pain syndrome (FBSS) and complex regional pain syndrome (CRPS).
SuadA Brankovic, Aida Pilav, Šeila Cilović-Lagarija, Arzija Pašalić, Jasmina Mahmutović
Journal of Health Sciences, Volume 7, pp 27-34;

Introduction: Currently, there is a growing interest in alcoholism-related studies among healthcare community. Cigarette smoking is five times more prevalent among adult men compared to women but these gender differences have been decreasing among young people. In developed countries, harmful effects of sedentary lifestyle and physical inactivity have led to increased rates of obesity in young population. The main aim of this study was to explore the lifestyles of students at the University of Sarajevo. We investigated the prevalence of cigarette smoking and alcohol consumption, eating habits, and physical activity in this student population. Methods: Students from Faculty of Health Sciences [FHS], Faculty of Political Science [FPS], and Faculty of Traffic Engineering and Communications [FTEC]) voluntarily participated in this questionnaire-based study. We surveyed a total of 410 students. Results: On average, 21.8% of participants consumed cigarettes (a significantly higher number of those who smoked cigarettes was in FPS group). The highest number of students who reported physical activity (recreational or active sport) was in FTEC group (66.5%), and the difference was statistically significant compared to FHS (48.2%) and FPS (51.9%) groups. Over 60% of participants in all three groups experienced stress occasionally. The majority of students in three groups consumed fast food while at campus. The highest number of students in all three groups reported to drink water compared to other drinks. Conclusions: Our results indicate that the lifestyles of university students in Sarajevo are subject to concern. Frequent alcohol consumption and cigarette smoking are typical examples of behaviour that should be reduced through educative programs and workshops.
Mark O. Akpotu, , Chika C. Abba, Blessing O. Umeokoli, Charles U. Nwachukwu, Festus B. C. Okoye, Charles O. Esimone
Journal of Health Sciences, Volume 7, pp 15-22;

Introduction: Recently, several endophytes have been shown to possess the potentials to synthesize novel bioactive compounds that have found use for drug discovery. We isolated endophytic fungi associated with Catharanthus roseus collected from the river banks of Amassoma in Southern Nigeria, and identified some of their bioactive secondary metabolites. Methods: The fungi were subjected to solid-state fermentation on rice medium and the metabolites were extracted using ethyl acetate. The fungal crude extracts were screened for antimicrobial activity and were also subjected to high-performance liquid chromatography-diode-array detection (HPLC-DAD) analysis for the identification of the bioactive compounds. Results: The fungal extracts showed both antibacterial and antifungal activities with minimum inhibitory concentrations ranging from 0.0625 to 1 mg/mL. The HPLC-DAD analysis of the extracts suggested the presence of citreoisocoumarin, citreoisocoumarinol, questinol, hydroxyemodin, acropyrone, methyl 2-(4-hydroxyphenyl) acetate, nigricinol, and cladosporin. Conclusion: The results of this study suggest that endophytic fungi associated with C. roseus could be a promising source of novel bioactive compounds with pharmaceutical and industrial importance.
Haris Niksic, Elvira Kovac-Besovic, , Samija Muratovic, Jasna Kusturica, Kemal Duric
Journal of Health Sciences, Volume 7, pp 35-43;

Introduction: We studied the chemical composition and antimicrobial, antioxidant, and antiproliferative activities of essential oils from flowers of Lavandula angustifolia grown in Southern Bosnia and Herzegovina. Methods: The chemical profile of essential oil was evaluated by means of gas chromatography-mass spectrometry. Antimicrobial activity was tested against six bacterial strains. The antioxidant activity by the 1,1-diphenyl-2-picrylhydrazyl (DPPH) test and the antiproliferative activity against three human cancer cell lines, MCF-7, NCI-H460, and MOLT-4, were investigated using 3-(4,5-dimethylthiazol-2-Yl)-2,5-diphenyltetrazolium bromide tests. Results: In L. angustifolia essential oil, monoterpene alcohols were the most represented class of volatiles (51.8%), including linalool, lavandulol, and terpinen-4-ol, α-terpineol as the major components, followed by monoterpene esters (22.6%). The most important antibacterial activity of essential oil was expressed on Gram-negative strains. Investigated essential oil was able to reduce DPPH radicals into the neutral DPPH-H form (inhibitory concentration 50% [IC50] = 0.421 mg/ml), and this activity was dose dependent. The essential oil showed significant antiproliferative activity against three cancer cell lines, MOLT-4, MCF-7, and NCI-H460 cells, with IC50 values of 17, 94, and 97 µg/ml, respectively. The result of the antiproliferative assay indicates that MOLT-4 cell line was the most sensitive to investigated essential oil. Conclusion: The results revealed that L. angustifolia essential oil may be important growth inhibitor against the microbes studied. It also possesses significant antioxidant activity and demonstrated excellent antiproliferative activity against MOLT-4 cells.
Aida Pilav, Zaim Jatić
Journal of Health Sciences, Volume 7, pp 9-14;

Introduction: Managing organizational culture has been increasingly viewed as a lever for health care improvement. The aim of this study was to investigate the correlation between the type of organizational culture and patient satisfaction in the selected health care centers in the Federation of Bosnia and Herzegovina (FBIH). Methods: We conducted a cross-sectional survey in two municipal primary health care (PHC) centers in the FBIH, referred as Primary health care (PHC) center A and Primary health care (PHC) center B. A validated questionnaire, known as the Organizational Culture Assessment Instrument (OCAI), was used for the assessment of organizational culture. The questionnaire was distributed among the family health care teams at the two PHCs. Simultaneously, we carried out a survey about patient satisfaction among patients during their visits to the family health care teams. Results: We observed the differences in the type of the organizational culture between the health care centers. The hierarchical culture was found the dominant culture in PHC center A, whereas the market culture was the dominant culture in PHC center B. Also, the statistical significance (t test) was recorded in the overall patient satisfaction in the health care center with the dominated hierarchical culture followed by the clan culture (PHC center A). Conclusions: Considering the lack of similar surveys in Bosnia and Herzegovina, we believe that this study might be a good starting point for education of human resource managers in health care.
Kim Trobec, Melita Peršolja
Journal of Health Sciences, Volume 7, pp 1-8;

Introduction: Kinesio taping is rehabilitative technique used to facilitate the body’s natural healing process while providing support and stability to muscles and joints, without restricting their range of motion. We conducted a thorough literature search and evaluation to clarify whether kinesio taping is effective in reducing lower back pain. Methods: Cochrane Library, CINAHL, COBIB.SI, PubMed and Science Direct were searched using Boolean operators search strings of different keywords such as: adult, low back pain, Kinesio tape, Kinesio taping, kinesiotaping, effects. The search was limited to full-text articles published from 2011 to 2016. Results: A total of 137 records were identified, 123 abstracts screened, and 14 full-text articles assessed for eligibility. Finally, nine publications were selected using CASP tool: eight randomized clinical studies and one literature review. The key variables from collected data were the subject characteristics, taping technique, control interventions, instrument, and outcome. Conclusions: The effect of Kinesio taping in reducing low back pain is positive, but was not statistically significant in analyzed studies. Taping therapy may therefore be used as a supplementary method to conventional physical therapy procedures, and may be important for patients because of its easy accessibility and safet
Alper Birgul, Gokhan Canaz, Murat Ugur, Mehmet Tokmak, Metin Kasap, Ibrahim Alatas, Huseyin Canaz
Journal of Health Sciences, Volume 6, pp 174-183;

Introduction: Recent studies have demonstrated that alpha-lipoic acid (ALA) has a strong antioxidant property and it exerts neurotrophic effects on the peripheral nerves. In this study, we investigated potential effects of ALA on secondary injury mechanisms as well as on apoptosis.Methods: Forty Sprague-Dawley rats were equally divided into 5 groups, as follows: laminectomy (control), laminectomy + trauma (Trauma), laminectomy + posttraumatic methylprednisolone [MP] (Trauma + MP), laminectomy + posttraumatic ALA (Trauma + ALA), laminectomy + posttraumatic MP and ALA (Trauma + MP + ALA). Yasargil aneurysm clip method was used to induce the spinal cord injury. Twenty-four hours after the procedure the rats were sacrificed. Spinal cord samples were harvested to analyze malondialdehyde (MDA), superoxide dismutase (SOD), and catalase (CAT) levels, as well as histopathological characteristics.Results: The Kruskal-Wallis test (95% confidence level, p < 0.05) showed a statistically significant difference between the groups in MDA (p = 0.006), CAT (p = 0.000), and SOD (p = 0.001) levels. Pairwise comparisons, with Bonferroni correction, of control and Trauma group with the other groups, revealed a significant difference in CAT and SOD levels. Overall, our results showed that ALA administration significantly decreased MDA levels in Trauma + ALA compared to the same effect of MP in Trauma + MP group. Furthermore, ALA administration increased SOD and CAT levels in Trauma + ALA group. The combined use of ALA and MP demonstrated synergistic effects and yielded even more significant results.Conclusions: A combined use of ALA and MP might provide a benefit in patients exposed to spinal cord injury. However, at present, further studies are required to confirm these results.
Ebru Turhan,
Journal of Health Sciences, Volume 6, pp 168-173;

Introduction: Personal hygiene is one of the most important determinants of health. A scale of personal hygiene is a useful tool to evaluate effects of health care interventions. The aim of this study was to develop a new, reliable, and valid measurement scale which can be used to evaluate the hygiene status of children, as well as the effects of the interventions.Methods: A total of 248 students and their parents, from Hatay Province in Turkey, participated in this school-based, cross-sectional study. An item pool was created for the Antioch Child Hygiene Scale (ACHS). Same questions were asked both for children (ACHS-C) and parents (ACHS-P) Data were collected in September 2013. Face validity, Cronbach's alpha, split-half, test-retest, factor analysis, and parallel form reliability were determined for the ACHS.Results: Twelve items that showed a weak correlation were removed from the ACHS. The mean score (standard deviation) was 159.4 ± 9.2 for ACHS-C and 152.2 ± 16.9 for ACHS-P. Cronbach's alpha for ACHS-C was 0.82 in the first test and 0.87 in the retest. Cronbach's alpha for ACHS-P was 0.91 in the first test and 0.94 in the retest. Split-half correlation was 0.59 for ACHS-C and 0.75 for ACHS-P. Correlation between pre-test and post-test scores was 0.54 for ACHS-C and 0.64 for ACHS-P (p < 0.001). In the principle component analysis, (Eigen value was taken greater than 1), 20 components for ACHS-C and 13 components for ACHS-P were extracted. Conclusions: Although both ACHS forms (i.e., ACHS-C and ACHS-P) were reliable in assessing the hygiene status of children, the reliability was higher for ACHS-P. In addition, validity should be improved in both forms of the ACHS. Nevertheless, both scales can be used to assess the hygiene status in school children.
Ľubica Ilievová, Peter Žitný, Jana Jakobejova
Journal of Health Sciences, Volume 6, pp 162-167;

Introduction: The quality of life is perceived individually and subjectively. The quality of life of elderly people in nursing home nursing homes depends on the degree to which their needs are fulfilled. The need to adapt to a new environment in an older age is a risky situation and may result in depression. The aim of the study was to analyze the change of quality of life and level of depression, as well as possible association of quality of life and level of depression, in elderly people admitted for the first time to nursing home.Methods: The research included 38 participants (10 men and 28 women). The data were obtained using the Geriatric Depression Rating Scale Short Form (GDS-SF) and a short form of the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF).Results: The average age was 79.2 (SD = 6.9) with a variation span of 30 years, minimum age was 62 (n = 1) and maximum age was 92 years (n = 1).The participants experienced a clinically significant reduction in depression symptoms, moving from a mild depression zone (8-12 points) to the zone of clinical standard (7 points or less). An essential finding was a strong negative correlation between the quality of life and depression.Conclusions: Obtaining information on depression and the quality of life of elderly in nursing home settings should be introduced as a standard part of nursing activities in order to improve the quality of customer care in the nursing homes.
Marina Titlic, Mario Mihalj, Amira Beganovic Petrovic, Enra Suljic
Journal of Health Sciences, Volume 6, pp 143-148;

Cognitive functions can be assessed and followed up over a period of time with cognitive evoked potentials (CEP) P300. In this context, brainstem auditory evoked potentials (BAEP) are most commonly used, but visual evoked potentials (VEP) are utilized as well. The research in this area has demonstrated that these techniques could be used as a supplemental method in diagnostics of numerous diseases such as Alzheimer's disease, mild cognitive impairment, vascular dementia, epilepsy, craniocerebral trauma, Parkinson's disease, multiple sclerosis, and other degenerative diseases. In addition, P300 can also be used as an auxiliary method in the diagnostics of mental disorders conditions such as schizophrenia, panic disorders, narcotic drug addiction, nicotinism, alcoholism, etc. The method assists in monitoring the course of diseases leading to encephalopathy, such as liver and kidney damage and grave anaemia. The advantages of P300 testing are easy application, non-invasiveness, and an unlimited number of potential applications. Moreover, the results obtained with this method are measurable and can be compared.
Tanja Carli, Tadeja Pintar, Uroš Godnov
Journal of Health Sciences, Volume 6, pp 184-187;

There is a lack of data about daily difficulties and life quality, especially among young patients having arteriovenous fistula (AVF) affected by (pseudo)aneurysm. In this retrospective cohort study, 195 patients with AVF were followed up from May to June 2015. An unstandardized questionnaire was used for the evaluation of patients’ screening needs and expectations. Retired married men in their sixties, with completed secondary education, represented the majority of patients with AVF in this study. The patients had a positive attitude towards the disease and AVF, and they received the majority of information related to the care and treatment of AVF from the medical personnel and doctors in selected dialysis centers. Employed, well-educated single men, aged between 21 and 40 years, had the highest interest in having an aesthetic correction of AVF, especially due to the formation of (pseudo)aneurysm at the AVF site. Establishment of rules for reconstructive procedures of AVF, once circulatory and hemodynamic stability is achieved after renal transplantation, is suggested in addition to establishing criteria for determining vascular access affected by (pseudo)aneurysm.
Fuad Julardžija, , Melika Bukvić, Fahrudin Smajlović
Journal of Health Sciences, Volume 6, pp 149-153;

Introduction: Diffusion weighted imaging (DWI) is a form of magnetic resonance imaging (MRI) based on measuring the random Brownian motion of water molecules within a tissue. The aim of this study was to show the significance of diffusion-weighted imaging (DWI) in differentiating pancreatic cystic formations from normal pancreatic parenchyma using MRI 1.5 T.Methods: A total of 52 patients were included in the study (25 with pancreatic cystic formations and 27 with normal MRI findings of the pancreas). DWI technique was used with b values of 0.500 and 1 000 mm2/s at 1.5 T. The signal intensity was measured, as well as apparent diffusion coefficient (ADC). Visual estimation of the signal intensity of detected cystic lesions was performed and compared to the normal appearance of pancreas.Results: The highest signal intensity of the cystic lesions with hyper-signal was observed with DWI b0 value in the pancreatic head (M 185.1 ± 47.205, p < 0.05). Similarly, the highest apparent diffusion coefficient (ADC) value of the cystic formations with hyper-signal was observed in the pancreatic head (2.09 x 10-3 mm2/s, p < 0.05). In the group with healthy pancreas, the highest signal intensity was observed with DWI b0 value (M 76.40 ± 18.28, p < 0.05). The observed ADC value in this group was 1.21 x 10-3 mm2/s in the head, 1.24 x 10-3mm2/s in the neck, 1.21 x 10-3mm2/s in the body, and 1.06 x 10-3mm2/s in the tail; p > 0.05.Conclusions: Differences in signal intensity and ADC values have an important diagnostic value in differentiating the cystic formations from normal pancreatic parenchyma in MRI examination.
Zarema Obradovic, Amina Obradović, Arzija Pašalić
Journal of Health Sciences, Volume 6, pp 137-142;

Influenza is one of the most common respiratory diseases in the world, annually causing over one million of deaths. It is triggered by one of the types of influenza viruses (A, B or C). Most usually, it assumes the form of epidemic disease, sometimes it is a pandemic, and is very rare as a sporadic disease. In temperate zones, the influenza occurs seasonally - during the cold months of a year. In tropics, however, it occurs throughout the year, though the highest number of patients is registered during the rainy seasons. Influenza is a mild disease for young and healthy persons; however, if affecting those with a weakened immune system, it can lead to complications and even to death. The only effective preventive measure is vaccination, which precludes the disease. So far, no consensus is reached on whether the vaccination should be compulsory or recommended and who should be vaccinated. In most European countries, vaccination is recommended for certain categories of the population, while the United States recommend it to the entire population above six months of age.
Izet Eminovic, Emira Kahrovic, , Emir Turkusic, Dzenana Kargic, Adnan Zahirovic, Zana Dolicanin
Journal of Health Sciences, Volume 6, pp 112-120;

Introduction: Treatment of cancer has been subject of great interest. Researchers are continuously searching for new medicines. In this sense, ruthenium complexes have big potential. Some evidences suggest that ruthenium compounds possess anticancer activities. We synthesized two recently published ruthenium(III) complexes with bidentate O,N and tridentate O,O,N Schiff bases derived from 5-substituted salicylaldehyde and aminophenol or anilineare. These compounds showed affinity for binding to the DNA molecule, however, insufficient data are available regarding their possible toxic effects on biological systems.Methods: In the present study we evaluated genotoxic, cytotoxic, and cytostatic effects of Na[RuCl2(L1)2] and Na[Ru(L2)2], using the Allium cepa assay.Results: Different toxic effects were observed depending on the substance, tested concentration, and endpoint measured. In general, the tested compounds significantly lowered the root growth and mitotic index values as compared to the control group. Additionally, a wide range of abnormal mitotic stages, both clastogenic and non-clastogenic were observed in the treated cells. Na[RuCl2(L1)2] significantly increased the frequency of sticky metaphases, chromosome bridges, micronuclei, impaired chromosome segregation, as well as number of apoptotic and necrotic cells over the controls. In contrast, Na[Ru(L2)2] did not show significant evidence of genotoxicity with regard to chromosome aberrations and micronuclei, however, significant differences were detected in the number of apoptotic and necrotic cells when the highest concentration was applied.Conclusions: In this study we demonstrated antiproliferative effects of Na[RuCl2(L1)2] and Na[Ru(L2)2]. At clinical level, these results could be interesting for further studies on anticancer potential of the ruthenium(III) complexes using animal models.
Anja Haverić, Sanin Haverić, Slavka Ibrulj
Journal of Health Sciences, Volume 6, pp 121-127;

Introduction: Cigarette smoking is associated with severe health problems, especially cancers. In addition, cigarette smoking causes different genotoxic effects. Chromosome aberrations are one of well-known intermediate end points in carcinogenesis. The aim of this study was to compare frequencies of chromosome aberrations in peripheral blood lymphocytes between young smokers and non-smokes groups.Methods: The study was conducted with 30 smokers (average age 26.93 years) and 30 non-smokers (average age 26.96 years), and included the analysis of 100 metaphases per each blood sample. Differences in the arithmetic means of determined frequencies of chromosome aberrations were tested by two-tailed t-test for independent samples with the significance level of p < 0.05.Results: The results showed a significant increase in the frequencies of chromatid-type aberrations and total structural chromosome aberrations in smoker group. Frequencies of numerical aberrations did not differ significantly between two groups.Conclusions: This study confirmed genotoxicity of cigarette smoking and provided new evidence about its clastogenic activity.
Dijana Avdić, Amila Jaganjac, Arzija Pašalić, Fatima Jusupović, Amila Kapetanović
Journal of Health Sciences, Volume 6, pp 87-93;

Substantial changes have occurred in the nutritional management of many diseases in the last twenty years. Introduction of standards, clinical review and implementation of evidence based practice led to re-evaluation of some established dietary interventions. The most common form of osteoporosis is the primary osteoporosis, which is the result of the bone loss and deterioration of bone structure, as people age. Bone loss and osteoporosis can be prevented through adequate nutrition, physical activity, and, if necessary, appropriate treatment. This review will focus on nutritional and clinical aspects of bone tissue homeostasis, with references to physiological and pathophysiological processes.
Journal of Health Sciences, Volume 6, pp 76-86;

Introduction: Several studies regarding the association of the ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) K121Q gene polymorphism with the risk of type 2 diabetes mellitus (T2DM) showed inconsistent results. This study aimed to investigate the association of ENPP1 K121Q gene polymorphism with T2DM risk using meta-analysis. The study was limited to the American, European, and African populations.Methods: PubMed and Embase databases were searched for eligible publications. The following information was extracted from each study: name of first author, publication year, country of origin, sample size of cases and controls, and size of each allele. The combined odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between ENPP1 K121Q gene polymorphism and T2DM risk were assessed using random or fixed effect model. A comprehensive meta-analysis (CMA) 2.0 was used to analyze the data.Results: Nineteen studies (17717 cases/28022 controls) on the association between ENPP1 K121Q gene polymorphism and T2DM risk were included in this meta-analysis. The results indicated that the ENPP1 K121Q gene polymorphism was associated with increased T2DM risk (Q vs. K genetic model, OR 95% CI = 1.11 [1.02–1.22], p = 0.014; QQ vs. KK + KQ, OR 95% CI = 1.14 [1.01–1.23], p = 0.039) and decreased T2DM risk (K vs. Q, OR 95% CI = 0.90 [0.82–1.00], p = 0.014; KK vs. KQ + QQ, OR 95% CI = 0.89 [0.80–0.98], p = 0.024).Conclusions: The results indicate that the ENPP1 K121Q gene polymorphism is associated with the risk of T2DM in the American, European, and African populations.
Milovan Jovanovic, Nebojsa Kavaric, Najdana Gligorovic-Barhanovic, Verica Skerovic, Aleksandra Klisic
Journal of Health Sciences, Volume 6, pp 105-111;

Introduction: Data suggesting that cystatin C levels are linked to obesity, apart from renal pathology, are conflicting. The aim of the study was to explore the potential association between serum cystatin C levels, anthropometric, and cardiometabolic parameters in healthy middle-aged adults.Methods: A total of 132 participants (mean age 56.2 ± 6.73 years, 69% females) were included in this cross-sectional study. Anthropometric and biochemical parameters, as well as blood pressure, were obtained.Results: Obese participants displayed higher cystatin C levels than normal-weight participants (p < 0.001). Multiple linear regression analysis revealed that waist circumference (WC) (Beta = 0.376, p < 0.001) and estimated glomerular filtration rate (Beta = -0.484, p < 0.001) were independently associated with cystatin C levels (R2 = 0.447; p < 0.001).Conclusions: Cystatin C is associated with abdominal obesity independent of renal function. Its relationship with changes in other target organs should be determined.
Sabina Dahija, Sanin Haverić, Jasmina Čakar, Adisa Parić
Journal of Health Sciences, Volume 6, pp 100-104;

Introduction: The objective of the present study was to evaluate the antimicrobial and cytotoxic activities of water extracts of leaves and barks from Alnus glutinosa (L.) Gaertn., A. incana (L.) Moench, and A. viridis (Chaix) DC.Methods: The antimicrobial activities of extracts were tested against gram-negative and gram-positive bacteria as well as yeast strains by the agar diffusion method. The cell viability was determined by the Trypan blue dye exclusion method.Results: The largest diameters of inhibition zone (DIZ) were recorded with Staphylococcus aureus ATCC 6538 and Bacillus subtilis 168M. The highest percentage of cell viability was observed with water bark extracts of A. glutinosa (97.46%).Conclusions: Potential antimicrobial properties of A. glutinosa, A. incana, and A. viridis demonstrated in this study, as well as their low levels of toxicity, make them an interesting subject for further studies.
, Nazif Erkan, Enver Vardar, Enver Ilhan, Zehra Erkul
Journal of Health Sciences, Volume 6, pp 133-136;

The gastric remnant cancer is defined as a cancer that has developed 5 or more years after distal gastric resection for benign diseases of the stomach. The choriocarcinomatous differentiation of adenocarcinoma in the stomach is a very rare tumor. A 75-year-old woman underwent resection of remnant stomach which she had operated for benign gastric pathology 54 years ago. Pathologic examination of the resection revealed areas of choriocarcinomatous differentiation in addition to classical adenocarcinoma. In the literature on English language, this report presents the first case of adenocarcinoma associated with choriocarcinomatous differentiation in the gastric remnant. The treatment of these patients depends on the clinical setting, and early diagnosis is an important factor for the treatment strategies. Therefore, due to the probability of arising adenocarcinoma in the remnant stomach, the patient should be investigated with endoscopic examination periodically, despite the long postoperative period.
Amir Ibrahimagić, Emina Idrizović, Edita Divjan, Biljana Klimenta
Journal of Health Sciences, Volume 6, pp 94-99;

Introduction: Infections due to extended-spectrum beta-lactamase (ESBL)-producing isolates in patients are hard to treat and cause high morbidity and mortality. ESBL-producing bacteria have been increasingly detected in environmental samples in different countries since 2002, and have gained considerable attention worldwide.Methods: Antibiotic susceptibility of all isolates was determined using the disk diffusion method. The production of ESBLs was determined by the double-disk synergy test.Results: Among the outpatient clinical samples, out of 2857 Gram-negative bacteria, 184 (6.5%) ESBL-producing bacteria were isolated. In this group, 143 (77.7%) were from urine samples, 26 (14.1%) from surgical wounds, 6 (3.3%) from umbilical swabs, and 9 (4.9%) from other patients sites (upper respiratory tract, cannula, eyes, genital swabs). Escherichia coli was isolated in 62 (33.7%), and Klebsiella spp. in 50 (27.8%) cases. Among the environmental samples, out of 381 Gram-negative bacteria, 52 (13.6%) were ESBL-producing isolates. In this group, 37 (71.2%) were sampled from water, 7 (13.5%) from food, and 8 (15.4%) from environmental surfaces. The most prevalent ESBL-producing bacteria isolated from the environmental samples were E. coli (isolated from 26 samples), Klebsiella spp. (10), non-fermenters (9), and other bacteria isolated from 7 samples. The clinical outpatient ESBL-producing isolates showed resistance to all cephalosporins, ranging from 25% (cefepime) to 100% (cefuroxime). The environmental ESBL-producing isolates showed resistance to cefuroxime, aztreonam, cefpodoxime, amoxicillin/clavulanate, and cefoxitin in the range of 65-100%.Conclusions: Prevalence of antibiotic resistance of ESBL-producing strains is high and requires routine detection of ESBL-producing isolates in the laboratories, designing of appropriate antibiotic prescribing policies and control of the risk factors.
Haris Vukas, Nedžad Rustempašić, Samra Kadić-Vukas, Dragan Totić, Muhamed Djedović, Sid Solaković
Journal of Health Sciences, Volume 6, pp 128-132;

Introduction: We can define extracranial carotid artery aneurysm (ECAA) as bulb dilatation greater than 200% of the diameter of the internal carotid artery (ICA) or in a case of common carotid artery (CCA) greater than 150% of the diameter. Surgical intervention is required for the treatment of this disease.Case report: This study presents an open vascular surgical procedure to resolve ECAA. We report a case of 61 years old woman with an extracranial internal carotid artery berry aneurysm, presented with a headache and dizziness when turning the head aside. Classic open surgery was performed and the lumen of berry aneurysm was separated with three clips from the lumen of ICA.Conclusions: The open surgical approach is the method of choice for the treatment of extracranial internal carotid artery pathological conditions.
Hadzan Konjo, Emira Švraka, Đemil Omervić, Dijana Avdić
Journal of Health Sciences, Volume 6, pp 67-71;

Introduction: In the late 70s of the last century, the mortality rate due to polytrauma amounted to 40%. This led to a new approach to this patient category with the goal of improving the treatment outcome. According to the German trauma register, the rate of mortality in polytrauma at the end of the last century was 18.6%. The goal of this study is to determine the incidence of hospital mortality in polytrauma patients in a tertiary institution in Bosnia and Herzegovina.Methods: We analyzed patient medical records from the Intensive Care Unit of the Clinic of Orthopedics and Traumatology at University Clinical Center Sarajevo, from January 1, 2012 to December 31, 2012.Results: There were 70 polytrauma patients in 2012, with average age 47.55 (range 8-77) years. Half of the patients were younger than 50 years. Age groups most frequently affected were 61 and older (25.7%), 51-60 years (24.3%), and 31-40 years (21.4%). Lethal outcome occurred in 10 patients (14.3%), while 60 patients (85.7%) survived and were treated until discharge or transfer to a different department. The average Injury Severity Score (ISS) in patients with lethal outcome was 71.50, while in survivors was 37. The largest percentage of lethal outcomes was recorded in cases of traffic accidents.Conclusion: The mortality rate among hospitalized polytrauma patients in the tertiary institution in Bosnia and Herzegovina is similar to reported mortality rates in other countries with developed healthcare system.
Amila Kapetanovic, Sabina Jerkovic, Dijana Avdic
Journal of Health Sciences, Volume 6, pp 59-66;

Introduction: The aim of this study was to assess core stabilization exercise effects in reducing functional disability in patients with chronic low back pain (CLBP).Methods: This study included total of 90 patients aged 40 to 60 years. After a ten-day rehabilitation program the patients from an examination group (n = 30) performed home exercise program five times a week, patients from a first control group (n = 30) three times a week, while patients from a second control group (n = 30) did not perform the exercises at all. The patients performed core stabilization exercises of moderate intensity once a day in 30 minutes sessions. The patient's functional disability was estimated using the Oswestry Disability Index (ODI).Results: After two months of rehabilitation there was a statistically significant increase in functional ability in patients who performed the core stabilization exercises five times a week(p = 0.0001) and in patients who performed the core stabilization exercises three times per week (p = 0.0001). A statistically significant difference in functional ability was not recorded in patients who did not perform the exercises. The analysis of the average values of the ODI differences at the beginning and after two months of rehabilitation showed a statistically significant difference between the group who did not perform the exercises and the group who performed the core stabilization exercises three times a week (p = 0.0001), and between the group who did not perform the exercises and the group who performed the core stabilization exercises five times a week (p = 0.0001).Conclusions: The implementation of the core stabilization exercises leads to a reduction of functional disability in patients with CLBP.
Enisa Sljivo, Aida Rudic, Fatima Jusupovic
Journal of Health Sciences, Volume 6, pp 52-58;

Introduction: Our aim was to evaluate quality of life (QOL) as a predictor of work abilities of employees in a tobacco factory.Methods: The study was performed in the period between 2011 and 2012. The sample comprised of 270 workers, males and females, aged from 20-65, with different educational backgrounds. The study was performed as cross-sectional research, on a voluntary basis, using two standardized and anonymous questionnaires: The World Health Organization Quality of Life-Brief Version questionnaire (WHOQOL-BREF) and the Work Ability Index questionnaire (WAI).Results: The participants subjectively perceived high values of QOL in general, with the highest values in the area of living environment. The lowest value was in the area of social interactions. Statistically significant differences were observed in the subjective assessments of QOL, especially in three defined areas (physical health, mental health, and social interactions). Workers age 50-65 years and workers with basic (primary) level of education exhibited a suboptimal (
Rusmira Fazlić, Amina Huseinbegović, Sniježana Hasanbegović, Mediha Selimović Dragaš
Journal of Health Sciences, Volume 6, pp 46-51;

Introduction: While the influence of type 1 diabetes mellitus (T1DM) on periodontal health is well established, results of previous studies regarding the association of this metabolic disease and caries experience are rather inconsistent. The aim of this study was to assess the differences between caries status of healthy and adolescents with T1DM, as well as to determine the differences in caries experience among diabetic patients in relation to their metabolic control.Methods: Assessment of caries status was performed using the DMFT index (decayed, missing, and filled teeth). The study group (Diabetic) included 60 patients diagnosed with T1DM, aged 12-18 years, from Sarajevo Canton. This group was divided into two sub-groups: a sub-group Diabetic-W consisted of 30 patients with well-controlled glycaemia, while a subgroup Diabetic-P comprised of 30 patients with poorer glycemic control. The control group consisted of 30 age-matched metabolically healthy individuals.Results: The T1DM adolescents had a significantly higher (p < 0.01) mean DMFT score than the healthy subjects, 11.49 and 6.19 respectively. Statistically, the diabetic group had also significantly higher values of the D and M components. Concerning the metabolic control, mean DMFT score in the Diabetic-W subgroup was lower (10.57) than in the Diabetic-P subgroup (12.39), however the difference was not statistically significant.Conclusions: The results demonstrate that the T1DM patients have a higher caries experience, regardless of the degree of metabolic control. The level of untreated dental decay and missing teeth components among the diabetic adolescents indicates irregular dental attendance.
Biserka Pigac, Silvija Masic
Journal of Health Sciences, Volume 6, pp 72-75;

Ectopic decidua is defined as extrauterine deposits of decidual stromal cells. It occurs in 85-100% of pregnancies. Focal sites can be present in various locations, yet a peritoneal location is rare. A 24- year- old woman underwent a cesarean section in 39th week of her first pregnancy, during which adhesions of the omentum to the fundus, entire left side of the uterus, and a part of the right front abdominal wall were found. An operative specimen was taken for a pathohistological analysis under the assumption of being fibrous adhesive tissue. The analysis revealed ectopic decidual tissue composed of large, polygonal cells with eosinophilic cytoplasm, and large nuclei with conspicuous nucleoli infiltrated with mature fatty cells and lymphocytes. Strong staining for vimentin was observed in the decidual cell cytoplasm and for a progesterone- receptor in the cell nuclei, medium staining was detected for S-100, and negative staining for CK 5/ 6, HMB-45, desmin, smooth muscle actin, estrogen and androgen- receptors. We present this case in order to educate clinicians and pathologists about the phenomenon of ectopic deciduosis. Although it can exist as asymptomatic condition, we point out the importance of considering this condition since it can result in serious pathology, like intraperitoneal hemorrhage and labour obstruction, if remains unrecognized. Another pitfall is possible confusion of this entity with other conditions. A resemblance to adhesions of the omentum and malignant neoplastic lesions, like squamous cell and metastatic carcinoma, metastatic melanoma, malignant decidual mesothelioma, metastatic mucin -producing adenocarcinoma, can be deceiving. These obstacles may present a pitfall to clinicians and pathologists, with a negative impact on patient treatment and outcome.
Şerife Mehlika Kuşkonmaz, Sema Yıldız
Journal of Health Sciences, Volume 6, pp 12-15;

In parallel to the increased use of computed tomography, iodinated contrast agents are increasingly becoming a source of excess iodide. Iodinated contrast agents may induce thyroid dysfunction in exposed patients, especially in the presence of an underlying thyroid disease. Thus, an ordinary dose of the contrast used for the imaging, can induce hyper or hypothyroidism in a patient with subtle thyroid disease. This review will briefly discuss the physiology of iodine and the clinical evaluation of iodine induced thyroid dysfunction.
Tarik Catic, Begler Begović
Journal of Health Sciences, Volume 6, pp 37-45;

Introduction: Adverse drug reactions (ADRs) are threat to the patient’s safety and the quality of life, and they increase the cost of health care. Spontaneous ADR reporting system mainly relies on physicians, but also pharmacists, nurses, and even patients. The aim of this study was to explore attitudes, barriers, and possible improvements to ADR reporting practices in Bosnia and Herzegovina.Methods: A self-reported questionnaire was developed to collect data on the perception of pharmacovigilance practice and ADR reporting. The survey was conducted in the period between September, 2014 and October, 2014.Results: The response rate was 73% (44 of 60) and 93% (148 of 160) among the pharmacist and family medicine physician groups, respectively. Regarding the attitudes to pharmacovigilance practice and reporting, both the pharmacists and physicians found the practices important. The majority of pharmacists and physicians in year 2014 did not report any ADR, while 18% of the pharmacists and 12% of the physicians, who participated in this study, reported one ADR. Reporting procedure, uncertainty, and their exposure were the main barriers to reporting ADRs for the pharmacists. The physicians claimed lack of knowledge to whom to report an ADR as the main barrier. A significant number of the respondents thought that additional education in ADR reporting would have a positive impact, and would increase the ADR reporting rate.Conclusions: Despite the overall positive attitude towards ADR reporting, the reporting rate in Bosnia and Herzegovina is still low. Different barriers to the ADR reporting have been identified, and there is also the need for improvements in the traditional education in this field.
Aida Pilav, Enes Šačić
Journal of Health Sciences, Volume 6, pp 16-22;

Introduction: The aim of this paper was to evaluate the managerial knowledge and skills of mid-level managers – medical doctors in Medical center of the Canton Sarajevo.Methods: A cross-sectional study of the mid-level managers in the Medical center of the Canton Sarajevo was conducted using an originally developed questionnaire for self-assessment of managerial knowledge and skills. The respondents answered each of the questions using a 5-point Likert scale. Apart from the quantitative section, the respondents could present their observations concerning the educational needs in the health care system.Results: Almost 40% of the respondents said that the process of assessing health care needs is not conducted. No statistical significance was observed in the responses according to the length of service in a managerial position. In total, 41% of the respondents were not sure whether a plan exists, even though the development of these plans should be a principal managerial responsibility in the quality management. Managers who were longer in the position reported no plans for corrective actions. This result was in contrast with the answers obtained from the managers who were in the position for a shorter period. In addition, 91% of the respondents said that they regularly discuss problems with their employees.Conclusions: Self- assessment and assessment of managerial competencies should be regular activities in a health care organization, in order to monitor the knowledge and skills, as well as to make the development plans. The results of this study could serve as the basis for planning and developing the health management education in the Canton Sarajevo.
Mehmet Yildirim, Nazif Erkan, Enver Vardar
Journal of Health Sciences, Volume 5, pp 113-114;

Excision of small intestine epiploic appendage: Over-estimated or not?
Halil Ibrahim Serin, Sebahattin Albayrak, Kemal Arda, Seda Uygun, Kursad Zengin, Kadriye Mine Ergun
Journal of Health Sciences, Volume 5, pp 110-112;

A 32-years old woman presented to the emergency room of Bozok University Research Hospital with right renal colic. Multidetector computed tomography (MDCT) showed compression of the proximal ureter by the right ovarian vein and compression of the right distal ureter by the right external iliac vein. To the best of our knowledge, right proximal ureteral compression by the ovarian vein together with distal ureteral compression by the external iliac vein have not been reported in the literature. Ovarian vein and external iliac vein compression should be considered in patients presenting to the emergency room with renal colic or low back pain and a dilated collecting system.
Mustafa Cellalettin Haksal, Murat Burc Yazicioglu, Cagri Tiryaki, Ali Ciftci, Murat Coskun, Selim Yigit Yildiz
Journal of Health Sciences, Volume 5, pp 99-103;

Introduction: The aim of this study was to compare the outcomes following surgical treatment of hemorrhoids between elderly (≥60 years old) and young patients (
Journal of Health Sciences, Volume 6;

The complex interaction between inflammatory mediators in allergic rhinitis (AR) is determined by the role of genetic polymorphisms, including interleukin (IL) and toll-like receptor (TLR) genes. This study aimed to discuss the effects of H1-antihistamines on IL and TLR systems. Several ILs involved in AR pathogenesis are: IL-4 (rs2243250, rs1800925, rs1801275, rs2227284, rs2070874), IL-6 (rs1800795, rs1800797), IL-10 (rs1800871, rs1800872), IL-12R (rs438421), IL-13 (rs1800925, rs20541), IL-17 (rs3819024), IL-18 (rs360721, rs360718, rs360717, rs187238), IL-23R (rs7517847), and IL-27 (rs153109, rs17855750). In the IL system, histamines stimulate the IL production in Type 2 helper T (Th2) cells through protein kinase A (PKA), janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway, and the activation of H1-histamine receptor and histidine decarboxylase (HDC) genes. On contrary, antihistamines down-regulate the H1-histamine receptor gene expression through the transcription suppression of HDC and IL genes and suppress histamine basal signaling through the inverse agonistic activity. TLRs involved in AR pathogenesis are TLR2 (rs4696480, rs3804099, rs5743708), TLR4 (rs4986790), TLR6 (rs2381289), TLR7 (rs179008, rs5935438), TRL8 (rs2407992, rs5741883, rs17256081, rs4830805, rs3788935, rs178998), and TLR10 (rs11466651). In the TLR system, histamines trigger the TLR expression by stimulating interferon-γ (IFN-γ) to up-regulate mast cells and by stimulating receptor-interacting protein (RIP) to activate IκB kinase-β. Contrastingly, antihistamines suppress TIR-domain-containing adaptor protein inducing IFN-β (TRIF) and RIP protein and thus inhibit the expression of TLR. In addition, several studies indicated that H1-antihistamines inhibit the IL and TLR systems indirectly.
, Florence Naab, Adelaide Maria Ansah Ofei
Journal of Health Sciences, Volume 6, pp 23-36;

Introduction: Nursing is a people-centred profession and therefore the issue of leadership is crucial for success. Nurse managers’ leadership styles are believed to be important determinant of nurses’ job satisfaction and retention. In the wake of a global nursing shortage, maldistribution of health workforce, increasing healthcare costs and expanding workload, it has become imperative to examine the role of nurse managers’ leadership styles on their staff outcomes. Using the Path-Goal Leadership theory as an organised framework, this study investigated the leadership styles of nurse managers and how they influence the nursing staff job satisfaction and intentions to stay at their current workplaces.Methods: The study employed a cross-sectional survey design to collect data from a sample of 273 nursing staff in five hospitals in the Eastern Region of Ghana. Descriptive and regression analyses were performed using SPSS version 18.0Results: Nurse managers used different leadership styles depending on the situation, but were more inclined to the supportive leadership style, followed by the achievement-oriented leadership style and participative leadership style. The nursing staff exhibited moderate levels of job satisfaction. The nurse managers’ leadership styles together explained 29% of the variance in the staff job satisfaction. The intention to stay at the current workplace was low (2.64 out of 5) among the nursing staff. More than half (51.7%) of the nursing staff intended to leave their current workplaces, and 20% of them were actively seeking the opportunities to leave. The nurse managers’ leadership styles statistically explained 13.3% of the staff intention to stay at their current job position.Conclusions: These findings have enormous implications for nursing practice, management, education, and human resource for health policy that could lead to better staff retention and job satisfaction, and ultimately improve patient care.
Ľubica Ilievová, Peter Žitný, Zuzana Karabová
Journal of Health Sciences, Volume 5, pp 53-58;

Introduction: The integral part of the treatment of pediatric oncological patients is a range of diagnostic and therapeutic procedures. These procedures are often associated with the fear and anxiety of the suffering child. We investigated whether a psychological preparation through drama therapy and the therapeutic puppet may reduce the anxiety related to diagnostic and therapeutic procedures in the preschool or early school children suffering from cancer.Methods: Twenty consecutive pediatric patients of preschool and early school age, with the diagnosis of lymphoblastic leukemia, were included in the study. The patients were alternatingly assigned to experimental or control group, and subjected or not subjected to drama therapy, respectively. We measured the changes in heart rate, blood pressure and respiratory rate as indicators of anxiety and fear, before and after the diagnostic or therapeutic procedures.Results: Heart rate, blood pressure, and respiratory rate in pediatric oncological patients before and after the diagnostic or therapeutic procedure were significantly lower in the experimental group of patients.Conclusion: Our results show that psychological preparation using drama therapy and therapeutic puppet reduced the fear and anxiety related to diagnostic or therapeutic procedures in pediatric oncological patients.Key words: drama therapy; therapeutic puppet; children; oncology; psychology
Mehmet Yildirim, Nazif Erkan, Enver Vardar
Journal of Health Sciences;

Excision of small intestine epiploic appendage: Over-estimated or not?
Aleksandra Klisic, , Verica Skerovic, Milovan Jovanovic, Nebojsa Kavaric
Journal of Health Sciences, Volume 5, pp 78-84;

Introduction: Menopause is associated with an increase in visceral fat and obesity and is the leading risk factor for insulin resistance (IR) and type 2 diabetes mellitus (T2DM). Recent evidence suggests that retinol-binding protein 4 (RBP4) is not an independent determinant of IR and its role in human glucose metabolism is not well clarified. We examined RBP4 and its association with IR, cardiometabolic and kidney parameters in obese postmenopausal women with and without T2DM.Methods: Basic anthropometric, biochemical parameters, and blood pressure (BP) were determined in 50 obese diabetic and 50 obese non-diabetic sedentary postmenopausal women, and compared with 50 healthy normal weight controls.Results: Higher levels of RBP4 were observed in obese individuals, as compared with normal weight group (p=0.033). However, we did not find significant difference between obese non-diabetic and obese-diabetic individuals (p=0.583). Serum RBP4 did not correlate with anthropometric measurements or any indicator of glucose metabolism in diabetic group, whereas RBP4 correlated with creatinine (r=0.416, p=0.003), eGFR (r= -0.304, p=0.032) and triglycerides (r=0.484, p
Jasmina Pluncevikj Gligoroska, Sanja Manchevska, Ljudmila Efremova, Lidija Todorovska, Slobodan Nikolic
Journal of Health Sciences, Volume 5, pp 85-92;

Introduction: The purpose of this study was to investigate the relationship between active and passive body mass components and maximal aerobic consumption (VO2max) in adult male soccer players.Methods: The study involved seven hundred (700) male soccer players, mean age 25.06 ± 4.41 years (range 18 to 35), divided in six age groups. Body composition was assessed according the anthropometric protocol by Matiegka, and relative muscle mass (MM%), bone (BM%) and fat (BF%) and absolute muscle mass (MMkg), bone (BMkg) and fat (BFkg) components were calculated. The Bruce protocol (incremental multistage treadmill test) was used for the estimation of maximal oxygen consumption.Results: Mean values of body mass components for total sample were as follows: muscle mass (MM%)= 52.75 ± 2.63%, bone mass (BM%)=16.63 ± 1.29% and body fat (BF%)=14.12 ± 1.54%. Mean VO2max was 48.89±5.17 ml/kg/minute. Relative muscle mass (MM%) showed similar values across age different groups (ANOVA: F=2.174; p=0.06) while absolute muscle mass (MMkg) showed tendency of increment with age (ANOVA: F=2.136; p=0.01). Body fat (BFkg and BF%) was statistically higher in the older groups (ANOVA F=3.737; p
Suad Trebinjac, Hamda Kitchbi
Journal of Health Sciences, Volume 5, pp 93-98;

Introduction: The objective of this study was to assess a long-term clinical effect of Prolotherapy on chronic symptomatic rotator cuff tendinopathy.Methods: We conducted a retrospective, uncontrolled study in the outpatient setting with 12 months follow-up. Adults diagnosed clinically and radiologically with rotator cuff tendinopathy that has been persisting for a minimum of six months were included. Patients received 15% extra-articular and 25% intra-articular hyperosmolar dextrose injections, repeated at weeks 5, 9, 13, 17 and 21. Primary outcome measure was validated Shoulder Pain and Disability Index (SPADI). Secondary outcome measure was validated visual pain analogue scale (VAS 0-10). The third outcome measures were patient’s satisfaction with Prolotherapy and adverse reactions after injections.Results: Twenty-one patients, 14 male and 7 female were treated with 6 sessions of hyperosmolar dextrose Prolotherapy repeated every 4 weeks. Average SPADI before starting the treatment was 73.995 ± 13.6, while 12 months after completed treatment was 20.84 ± 26.03 (P< 0.0001). Average VAS score before starting the treatment was 8.14 ± 1.2, while 12 months after completed treatment was 2.29 ± 2.8 (P
Monika Ulamec, Davor Tomas, Tihana Dzombeta, Igor Tomaskovic, Borislav Spajić, Božo Krušlin
Journal of Health Sciences, Volume 5, pp 72-77;

Introduction: The interchanged stromal-epithelial relations and altered expression profiles of various extracellular matrix (ECM) proteins creates a suitable microenvironment for cancer development and growth. We support the opinion that remodeling of the extracellular matrix (ECM) plays an important role in the cancer progression. The aim of this study was to examine the expression of ECM proteins tenascin-C, fibronectin and galectin-3 in prostatic adenocarcinoma. Methods: Glands and surrounding stroma were analyzed in randomly selected specimens from 52 patients with prostate cancer and 28 patients with benign prostatic hyperplasia (BHP). To evaluate the intensity of tenascin-C, fibronectin and galectin-3 expression the percentage of positively immunostained stromal cells was examined.Results: Compared to BPH, stroma of prostatic adenocarcinoma showed statistically significant increase in tenascin-C expression (p
Ferdane Sapmaz, Sebahat Basyigit, Metin Uzman, Gulcin Guler Simsek, Tolga Akkan, Yasar Nazligul
Journal of Health Sciences, Volume 5, pp 104-106;

A 60 year old man was referred to our hospital with the chief complaints of abdominal pain and vomiting. He underwent a distal gastrectomy with a Billroth II gastrojejunostomy for a peptic ulcer 13 years ago. Esophagogastroduodenoscopy (EGD) did not reveal any gross lesion in the stomach but depigmented areas were seen in the anastomosis line. The histopathology of the anastomotic area revealed poorly differentiated adenocarcinoma. Gastric stump cancers can be polypoid, fungating, ulcerated and diffusely infiltrating tumors respectively. In our case, the appearance of adenocarcinoma was quite different from that described in the classification system.
Sezgin Mutlu, Süleyman Kargın, , Ersin Turan, Osman Doğru
Journal of Health Sciences, Volume 5, pp 107-109;

Mesenteric cysts are a rare phenomenon and can be encountered in different regions of the mesentery or in the retroperitoneal region. They are usually asymptomatic but may lead to a variety of symptoms depending on their site. We report a case of a mesenteric cyst presenting as a femoral hernia, which is, to our knowledge, the second case found in the literature. Forty-eight years old female patient presented with a history of pain and swelling in her left inguinal region for six months. Although femoral hernias are rare conditions, mesenteric cysts can protrude inside the femoral canal. In a case of clinical suspicion of such a condition, appropriate imaging should be performed.
, Želimir Orkić, Maja Miškulin
Journal of Health Sciences, Volume 5, pp 46-52;

Introduction: In the past several decades there has been a substantial increase in the incidence of skin cancers worldwide and Croatia is no exception. The aim of this study was to estimate the financial cost of skin cancer treatment in the Osijek-Baranja County from 2000 to 2009 and to compare it with the cost of a primary prevention campaign organized in the Baranja County.Methods: We conducted a retrospective analysis of patients with skin cancer in the Baranja County and related health care costs. We designed a potential primary prevention campaign on a County level and calculated the financial expenses of campaign and then compared the results to health care costs from previous years.Results: The total cost of the treatment involving skin cancer (C43-C44) cases in the Osijek-Baranja County during the 2000-2009 periods was €483,710. The cost of a primary prevention campaign described in this study suggests that the estimated annual cost of a primary prevention campaign on the County level makes around 5.9% of the annual cost of all the medical treatment involving skin cancer patients in the County, which shows that a planned preventive approach towards the issue of skin cancer in Eastern Croatia is extremely justified and reasonable.Conclusion: The present study reveals the urgent need for the implementation of a primary prevention campaign in Eastern Croatia and puts emphasis on the economic potential of such an approach towards the problem of skin cancer.
Lejla Pojskic, Ismet Gavrankapetanovic, Naida Lojo-Kadric, Rifat Hadziselimovic, Kasim Bajrovic
Journal of Health Sciences, Volume 5, pp 59-64;

Introduction: Progressive pseudorheumatoid dysplasia (PPD) is an autosomal recessive genetic disorder reported to be caused by gene alterations of the Wnt1-inducible signaling pathway protein 3 corresponding gene (WISP3) located on chromosome position 6q22. Up to date, there is only a handful of WISP3 mutations identified in Europe, whereas most mutations are identified in Asia and Middle East. According to our knowledge, this is the first report of genetic dissection of WISP3 associated with spondyloepiphyseal dysplasia tarda from Bosnia and Herzegovina. Based on clinical examination findings (general manifestations, physical examination, characteristics of their bones on X-ray and laboratory results), an index patient was directed to WISP3 genotyping for confirmation of suspected diagnosis of PPD.Methods: DNA was extracted from peripheral blood leukocytes. All 5 exons and their exon-intron boundaries of the WISP3 gene were amplified by polymerase chain reaction (PCR) and sequenced by Sanger method. Segregation analysis was done to confirm the familial carrier status.Results: A missense mutation (C223G) - homozygous T to G transition at c.667 in exon 4 was identified in index patient. This mutation changed codon CAG to TAG and resulted in a subsequent change of the cysteine to glycine codon. Same mutation was observed in both parents in heterozygous form confirming the familial segregation.Conclusion: Due to its nature, the identified mutation C223G in exon 4 in WISP3 gene is the most probably causative for PPD in described patient. Here we describe the PCR based method for genotyping of specific mutation in WISP3 gene. The identification of this mutation might be a valuable addition to a regional databases on rare genetic variant although a functional analysis should be performed to explain its pathological effect.
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