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Sandra Bošković
Journal of Health Sciences; doi:10.17532/jhsci.2021.1082

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; doi:10.17532/jhsci.2021.1246

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 ( 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; doi:10.17532/jhsci.2021.1209

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, Daniel Maestro, Nerma Maestro, ,
Journal of Health Sciences; doi:10.17532/jhsci.2021.1110

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; doi:10.17532/jhsci.2021.1121

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; doi:10.17532/jhsci.2021.1194

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; doi:10.17532/jhsci.2020.1156

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; doi:10.17532/jhsci.2020.1112

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; doi:10.17532/jhsci.2020.1086

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; doi:10.17532/jhsci.2020.930

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; doi:10.17532/jhsci.2020.1085

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; doi:10.17532/jhsci.2020.1073

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; doi:10.17532/jhsci.2020.1041

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; doi:10.17532/jhsci.2020.1072

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; doi:10.17532/jhsci.2020.983

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; doi:10.17532/jhsci.2020.969

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; doi:10.17532/jhsci.2020.1064

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; doi:10.17532/jhsci.2020.1031

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; doi:10.17532/jhsci.2020.972

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.
Adegbenro Fakoya, Jessica Heymans, Amanda McCrary, Omar Rodriguez, Abdiel Cardona, Abayomi Afolabi, Thomas McCracken
Journal of Health Sciences; doi:10.17532/jhsci.2020.903

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.
Dražan Jaroš, Goran Kolarević, Aleksandar Kostovski, , , Goran Marošević, , Dragoljub Mirjanić
Journal of Health Sciences; doi:10.17532/jhsci.2020.886

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
, , Maitri Agarwal
Journal of Health Sciences; doi:10.17532/jhsci.2020.950

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; doi:10.17532/jhsci.2020.912

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.
Natalia Velasco-Nieves, , Shannon Matthew, Wirda Zafar, Mahrukh Zafar, Kevin Alonso Milla, Sushanth Yerra, Abayomi Afolabi, Thomas McCracken
Journal of Health Sciences; doi:10.17532/jhsci.2020.904

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.
, Pierre Gomes De Morais Silva, Jalber Almeida Dos Santos, Luiz Roberto Coutinho Manhães Júnior,
Journal of Health Sciences; doi:10.17532/jhsci.2020.888

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.
, Nataša Bizovičar, Nataša Kos, Miroljub Jakovljević
Journal of Health Sciences; doi:10.17532/jhsci.2020.880

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.
, Daniel Maestro, Zarema Obradović,
Journal of Health Sciences; doi:10.17532/jhsci.2020.882

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; doi:10.17532/jhsci.2020.893

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; doi:10.17532/jhsci.2020.885

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; doi:10.17532/jhsci.2020.856

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.
G. Pooja Sharma, P. Antony Leo Aseer, P.M.Venkata Sai, N. Venkatesh
Journal of Health Sciences; doi:10.17532/jhsci.2020.840

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.
Vijayakumar Kathirgamam, Mandar Ambike, Raju Bokan, Vaishaly Bharambe, Arun Prasad
Journal of Health Sciences; doi:10.17532/jhsci.2020.876

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.
Ebtesam Esmail Hassan, Naglaa Mohammed Amein, Sanaa Mohmoud Ahmed
Journal of Health Sciences; doi:10.17532/jhsci.2020.865

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; doi:10.17532/jhsci.2020.862

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.
, Leena Khonji
Journal of Health Sciences; doi:10.17532/jhsci.2020.887

Introduction: Vascular access is considering to the patient undergoing hemodialysis (HD) as his/her soul which indicating patient survival, moreover, vascular access can controlling, directing the dialysis regimen effectiveness. Cannulation techniques are a crucial skill for nurses to minimize arteriovenous fistula (AVF) or graft (AVG) complications. Methods: A cross-sectional study was applied to assess vascular complication and related factors. The participants were 65 patients on maintenance HD therapy enrolled at the dialysis unit, central Ehnasa’ government hospital, Beni Suef City. Data were collected using developed questionnaires regard patients’ demographic data, clinical, and HD session characteristics, designed Nursing Practice guidelines for needling of AVF/AVG booklet. Results: Statistically, the results show the most common cannulation technique which was demonstrated is an area method (65%) and needle direction is retrograde with bevel up (66.2%). whereas, the significant positive correlation shows between the cannulation techniques and vascular access complication, duration of dialysis and complication during the dialysis session. Furthermore, the most common complication related to needling practice is aneurysm (44.6%). Conclusion: Following cannulation, technique guidelines will prevent potential complication, increase vascular access durability, and improve patients’ quality of life.
, Ebere Emilia Ayogu, Blessing Adaora Ngwoke, Eleje Oboma Okonta
Journal of Health Sciences; doi:10.17532/jhsci.2020.860

Introduction: The burden of uncontrolled asthma is high and caregivers can offer support in the management of asthma. Asthma is one of the most common chronic diseases in children. The objective of this study was to assess the knowledge, attitudes, and quality of life (QoL) of caregivers toward asthma in their children. Methods: This cross-sectional study was conducted in the Paediatric Respiratory Unit of the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State (July 2017-September 2017). We utilized a 46-item questionnaire comprising knowledge and attitude domains and the 13-item Pediatric Asthma Caregiver’s QoL Questionnaire (PACQLQ). Data were analyzed using the IBM SPSS Version 25.0. Statistical significance was set at p < 0.05. Results: Fifty-one caregivers participated in the study. More than half (n = 36, 70.6%) of the caregivers were 40 years old and above, female (n = 37, 72.5%), graduates from higher institutions (n = 33, 64.7%), and self-employed (n = 27, 52.9%). About a quarter (n = 13, 25.5%) had a family history of asthma and a similar proportion (n = 14, 27.5%) knew the three main symptoms of asthma. Conclusion: Less than half (n = 24, 47.1%) of the caregivers had good asthma knowledge. Dust (n = 35, 68.6%) and smoke (n = 31, 60.8%) were identified as the most common asthma triggers in their children. The majority of the caregivers (n = 41, 80.3%) agreed that most people can have well-controlled asthma without seeing a doctor regularly. Overall, less than half of the caregivers (n = 24, 47.1%) showed positive attitudes toward their children’s asthma. The overall score for the PACQLQ was 3.91 (0.98) which implied a poor QoL. The caregivers had both impaired activity and emotional function from managing asthma in their children. More female caregivers had better knowledge about asthma than their male counterparts (t = −3.178; df = 49; p = 0.003). Less than half of the caregivers had good asthma knowledge and positive attitudes toward asthma in their children. They had an impaired QoL from managing asthma in their children.
Nurul Akilah Mohd Yusoff, Tuan Nadrah Naim Ismail Ismail,
Journal of Health Sciences; doi:10.17532/jhsci.2020.831

Introduction: Alocasia denudata is a herbal plant used by traditional healers as a wound healing agent and its potential as a healer has been proven scientifically. Normally, wounded tissue offers the opportunity for microflora to adhere, colonize, invade, and infect the surrounding healthy tissue. Therefore, the aim of this study is to assess the antimicrobial effect of A. denudata on selective oral pathogen as well as to analyze its phytochemical compound. Methods: The stem of A. denudata was extracted with 80% ethanol solution, freeze-dried, and sent to poison center to analyze its phytochemical constituents. The bioassay applied for determining the antimicrobial effect employs the well agar diffusion method to the selected Gram-positive oral bacteria; Streptococcus mutans, Staphylococcus aureus, Enterococcus faecalis, and non-oral pathogen Streptococcus pyogenes. These bacteria were incubated and the inhibition zone was recorded. Results: Our results showed that the mean yield of extraction was 12.8% and that the different concentrations of A. denudata show no antimicrobial effects toward the selected Gram-positive oral pathogen including non-oral pathogen bacteria. However, the gas chromatography–mass spectrometry result showed that antimicrobial compound is present along with anti-inflammatory and antioxidant compounds but showed no effect on the oral pathogen. Conclusion: A. denudata extract has antimicrobial compound but did not show antimicrobial activity toward the selected Gram-positive oral pathogen.
Kiran Sree Pokkuluri, Sssn Usha Devi Nedunuri
Journal of Health Sciences; doi:10.17532/jhsci.2020.907

Introduction: China has witnessed a new virus Corona,which is named COVID-19. It has become the world’s most concern as this virus has spread over the worldat a higher speed;the world has witnessed more than one lakh cases and one thousand deaths in a span of few days. Methods: We have developed a preliminary classifier with non-linear hybrid cellular automata, which is trained and tested to predict the effect of COVID-19 in terms of deaths, the number of people affected, the number of people being could be recovered, etc. This indirectly predicts the trend of this epidemic in India. We have collected the datasets from Kaggle and other standard websites. Results: The proposed classifier, hybrid non-linear cellular automata (HNLCA), was trained with 23,078 datasets and tested with 6785 datasets. HNLCA is compared with conventional methods of long short-term memory, AdaBoost, support vector machine, regression, and SVR and has reported an accuracy of 78.8%, which is better compared with the cited literature. This classifier can also predict the rate at which this virus spreads, transmission within the boundary, and of the boundary, etc.
Kirian Sree Pokkuluri, Sssn Usha Devi N
Journal of Health Sciences; doi:10.17532/jhsci.2019.907

China has witnessed a new virus Corona, which is named COVID-19. It has become the world's most concern as this virus has spread over the world at a higher speed, the world has witnessed more than one lakh cases and one thousand deaths in a span of a few days. We have developed a preliminary classifier with non-linear hybrid cellular automata, which is trained and tested to predict the effect of COVID-19 in terms of deaths, the number of people affected, the number of people being could be recovered, etc. This indirectly predicts the trend of this epidemic in India. We have collected the data sets from Kaggle and other standard websites. The proposed classifier, HNLCA (Hybrid Non-Linear Cellular Automata) was trained with 23078 datasets and tested with 6785 data sets. HNLCA is compared with conventional methods LSTM, Adaboost, SVM, Regression, and SVR has reported an accuracy of 78.8%, which is better compared with the cited literature. This classifier can also predict the rate at which this virus spreads, transmission within the boundary, and of the boundary, etc.
, Mohammad Shariful Islam, Jotsna Akter, Shanzida Khatun
Journal of Health Sciences; doi:10.17532/jhsci.2019.818

Background: Diabetes Mellitus (DM) has been a global epidemic in the new millennium and the majority of all diabetic patients constitute Type 2 diabetes mellitus. Medication adherence to prescribed treatments is a key determinant to achieve therapeutic success reduces diabetic complications. Objectives: The aim of the study was to examine the level of medication adherence to Type 2 diabetic patients hospitalized at tertiary care hospital in Bangladesh. Methods: The study was descriptive cross-sectional design. A total of 112 Type 2 diabetic patients were conveniently recruited from tertiary care hospital in Bangladesh. Results: The mean age of the participants was 57.46 (SD=11.65) years. More than half of the patients (60.7%) were male and majority of them (94.6%) were married. The mean score of diabetic medication adherence was calculated as 26.46 (SD=1.58). Adherence to diabetic medications was significantly associated with age (p=.01), occupation (p=.003), duration of DM (p=.003), oral hypoglycemic agents (p=.02), HbA1c (p=< .01) and Fasting Blood Ssugar (p=< .01). Medication non-adherence significantly found in patients with presence of diabetic retinopathy (p=<.01), microabuminuria (p=.01), dyslipidemia (p=.006), hypertension (p=.01) and other chronic diseases (p=.01). Conclusion: The level of medication adherence among Type 2 diabetic patients was found to be suboptimal. Good adherence has beneficial effects on HbA1c and FBS. For improving adherence particular focus should pay to diabetic patients with different age groups and the presence of comorbidities. Keywords: Medication Adherence; Type 2 Diabetes Mellitus; Oral Hypoglycemic Agents; Comorbidities.
Asma Abdullah, Wan Nabila Wan Mansor, Mark Paul,
Journal of Health Sciences; doi:10.17532/jhsci.2019.693

Purpose : We present a-12-year old female with canal stenosis and canal cholesteatoma. We discuss the clinical, radiological and treatment option for canal cholesteatoma in canal stenosis Discussion : Congenital canal atresia is a failure of the development of the external auditory canal which comprises anomalies of variable severity involving pinna, external acoustic canal, middle ear structures and rarely inner ear leading to hearing impairment. Congenital canal stenosis is considered to be a subset of congenital canal atresia. This malformation results in mild to severe conductive hearing loss. Furthermore, risk of cholesteatoma increased when it is associated with stenotic ear. Radiological evaluation in the form of HRCT scan of temporal bones should always be done in these patients during their initial presentation and surgery should be planned accordingly. Their presence should be rule out prior any corrective surgery. Conclusion : Although the incidence of canal cholesteatoma is rare in congenital canal stenosis, all patients presenting with canal atresia or stenosis should be evaluated thoroughly due to their potential to develop cholesteatoma as it may be challenging to treat at an advanced stage in view of morbid complications.
Amela Halilbašić, Amir Kreso, Muhamed Klepić, Amila Jaganjac, Dijana Avdic
Journal of Health Sciences; doi:10.17532/jhsci.2019.895

Introduction: Osgood-Schlatter’s syndrome (Osgood-Schlatter disease [OSD]) is caused by an accumulation of repeated microtraumas and is classified as a type of chronic injury called “overload syndrome“. It is considered that the root causes of OSD are accelerated growth as well as excessive sports and recreational activity. Currently, more than 50% of children of school age are involved in sports activities. In this study, 40 external risk factors were analyzed. Considering that frequent medical examinations, expensive rehabilitation, time-consuming sports activities, and school obligations result in major socio-economic and financial consequences, a need to work on a preventive program was recognized. The aim of this study was to determine external risk factors and to develop an algorithm for the prevention of injuries caused by overload syndrome through a detailed analysis of Osgood-Schlatter’s syndrome concerning aerobic and anaerobic sports (football, basketball, karate, and taekwondo). Methods: The research has been conducted on 200 patients who were previously diagnosed with Osgood-Schlatter’s syndrome. The participants were divided into two groups, each containing 100 patients, first group – aerobic sports (football and basketball) and the second group – anaerobic sports (karate and taekwondo). Personal information, anthropometric measurements, complete medical, and sports history were taken from the patients. A clinical examination was conducted by the researcher himself. This clinical study was prospective, comparative, analytical, and descriptive. The research was conducted in the Public Center for Sports Medicine of Canton Sarajevo. Software used for statistical data analysis was SPSS for Windows (version 20.0, SPSS Inc., Chicago, Illinois, USA) and Microsoft Excel (version 13 of Microsoft Corporation, Redmond, WA, USA). Results: Patients experienced the first symptoms of OSD at 4 years (football) and 6 years (taekwondo). About 60% of patients who trained in anaerobic sports and 38% of patients who trained in aerobic sports trained other sports more often as well. The research showed that a higher percentage of patients who trained anaerobic sports trained multiple sports at the same time (karate 88%, and taekwondo 82%) compared to patients who trained aerobic sports (football 68%, and basketball 76%). Patients who trained in anaerobic sports were also more likely to engage in recreational activities (58.3%) compared to patients who trained in aerobic sports (41.7%). On average, the number of hours per week which patients spent actively training (primary sport, additional sports activity, and recreational sport) was 17.2 h for basketball players, 16.8 h for taekwondo trainees, 16.7 h for caratists, and 15.7 h in case of football players. About 32% of football players, 24% of basketball players, 12% of karate trainees, and 18% of taekwondo trainees did not engage in additional sports or recreational activities. Only 36% of patients who trained in aerobic sports and 37% of patients who trained anaerobic sports respected the planned rest days, and in both groups, some subjects trained for 12 months. Conclusion: The research showed that patients who trained in anaerobic sports more frequently trained more than one sport at the same time and spent more hours doing recreational activities compared to patients who trained in aerobic sports. By analyzing weekly physical activity, it was concluded that the rest is limited. Future research aims to identify risk factors so that children, parents, and trainers can be educated to work on prevention through teamwork.
, Oleg Pajalić,
Journal of Health Sciences; doi:10.17532/jhsci.2019.820

Introduction: Help at birth is one of the historically oldest volunteers supports that a woman has offered to another woman. One of the reasons for high maternal and infant mortality was identified as a lack of basic medical knowledge among the woman who helped during birth and this required immediate action to secure the survival of nations. When the Church and government made demands for education and professional license, the voluntary help at birth transformed into an educated and paid profession for women. The study aimed to describe the evolution of women’s education and the midwifery profession in Nordic countries from the 1600s until today. Methods: Historical and contemporary documents, research and grey literature, are drawn together to provide a historical description of the midwifery professional development and education in Nordic countries. Results: In the Nordic countries, governments from the 1600s had significant problems with high maternal and infant mortality. Most vulnerable were unmarried women and their children. To change the trend, northern countries had been inspired by France, Holland, England, and Germany, which had introduced education and a professional license for midwives. The targeted and systematic investment in midwifery education, followed by industrialization and welfare development in Nordic countries, has resulted in one of the highest survival rates for mothers and infants in the world today. In parallel with this, it has created the first female paid profession in history. Today, midwifery education is at the university level in all Nordic countries, and the certified midwife is responsible for pre- and post-natal care and normal birth. In Sweden, Norway, and Iceland, the midwife’s responsibility also includes contraception counseling and prescription of drugs for birth control purposes. Conclusions: The education and professional licenses have contributed to a progressively improved care of birth women and infants. The professional and licensed midwife is positioned in society as an essential player in the current development of pre- and post-natal care. Furthermore, the graduated and licensed midwife positioned herself as the first paid professional female profession in modern history.
, Amila Jaganjac, Dijana Avdić, Bakir Katana, Samir Bojičić, Muris Pecar, Fuad Julardžija
Journal of Health Sciences; doi:10.17532/jhsci.2019.883

In the study, the development of physiotherapy was described through the history and education in Bosnia and Herzegovina (BiH) with a special review on the significance of physiotherapy as a health-care discipline and the display of its development to the academic level of education in BiH.
Deniz Bulja, Jasmin Havić, Sandra Vegar-Zubović, Merim Jusufbegovic, Adnan Šehić, Fuad Julardžija
Journal of Health Sciences; doi:10.17532/jhsci.2019.827

Vertebral artery fenestration is a rare vascular anomaly. It most commonly occurs in extracranial segments of the vertebral artery. This congenital anomaly can occur during the various stages of embryonic development of the vertebral artery. This usually does not have clinical significance, but the possibility of associated anomalies such as saccular aneurysms and arteriovenous malformations should be noted. Awareness of vascular anomalies is key to avoiding iatrogenic injury during endovascular diagnostic and therapeutic interventions. Here, we present incidental findings of vertebral artery fenestration in a 46-year-old woman evidenced by CT angiography of the neck's blood vessells after I .V. contrast medium applications.
, Larissa Leci Fernandes, Debora Magalhaes Barreto, Cornelis Robert Springer
Journal of Health Sciences; doi:10.17532/jhsci.2019.795

Introduction: The objectives of the study were to evaluate the prevalence of orofacial injuries in soccer players of a Brazilian club, considering the category, the position in the field, and the most affected anatomic site, through medical records. Methods: A total of 126 charts of players from the base categories (sub-15, sub-17, and sub-20) and male and female professional categories from 2016 to 2018 were evaluated. It was considered inclusion criteria to be a soccer player hired by a club in the indicated period. The exclusion criteria of the study correspond to the medical records registered after the chronological date stipulated or that did not have the correct registry of the occurred trauma. Results: The data analyzed presented a moderate value in relation to the orofacial traumas prevalence, and 64.3% of the athletes of the club have some record type of trauma in the face. We observed that soft-tissue lacerations of the lips and dental fractures present the highest frequencies (73% and 27%, respectively). The positions of defender, striker, and midfield are the most susceptible to injuries (31%, 24%, and 23%, respectively). Conclusion: Dental and orofacial trauma are a problem commonly encountered in sports, being present also in collective sports, such as football. It was observed a moderate prevalence of injuries on the face, especially among the athletes who are ahead of the attack line, with lip lacerations and dental fractures being the most common events.
Jetsada Ruangsuriya, , Pisittawoot Ayood, Krongporn Ongprasert, Navakoon Kaewtunjai, Somdet Srichairatanakool, , Jiraporn Chittrakul
Journal of Health Sciences; doi:10.17532/jhsci.2019.737

Introduction: Thailand has a rapidly aging population; assessing frailty earlier with biochemical markers could identify many adverse outcomes such as disability, hospitalization, and death. We aimed to examine the correlation between Trolox equivalent antioxidant capacity (TEAC), thiobarbituric acid reactive substances (TBARS), and telomere length and frailty for elderly people in Northern Thailand. Methods: A cross-sectional study was performed between May 2017 and March 2018 with a total of 350 elderly aged 60 and older for frailty phenotype assessment by five frailty criteria including unintentional weight loss, exhaustion, slowness, low physical activities, and grip strength weakness. Twenty-eight subjects in both the frailty and non-frailty groups were analyzed for basic clinical parameters, including plasma TEAC, TBARS, and telomere length. Results: Alanine aminotransferase activity, albumin concentration, cholesterol level, and telomere length were significantly low in the frailty group. The albumin level, TEAC, and telomere length were significantly higher between the ages of 60 and 75 years compared to those with non-frailty over 75 years of age. Likewise, albumin and cholesterol levels were significantly higher in the frailty group aged 60–75 years. Albumin concentration, cholesterol level, TEAC, and telomere length were significantly higher in the non-frailty group when compared to the frailty group aged 60–75 years, but no significant difference was found among these biochemical parameters of frailty and non-frailty whose age was above 75 years. Conclusion: The reduction of albumin concentration, cholesterol level, TEAC, and telomere length supports the underlying mechanism of frailty screened by the frailty phenotype tool in a specific age range. However, further analyses with multi-parameters must be validated before the application in clinical diagnosis for frailty.
Mirsad Kacila, Mirza Halimic, Merjema Karavdic, Almira Kadic, Sasa Lukic, Sanko Pandur, Nusreta Hadzimuratovic
Journal of Health Sciences; doi:10.17532/jhsci.2019.871

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is rare, but life-threatening condition. The treatment of choice in patients with ALCAPA is the establishment of a dual coronary artery system with surgical reimplantation of the left coronary artery in the left coronary sinus. Percutaneous coronary intervention is infrequent in the pediatric population but can be a life-saving by promptly restoring flow to an obstructed coronary artery. It is a highly demanding and high-risk procedure in infants due to the technical difficulties and the small coronary artery diameter in infants.
Alija Sadiković, Azra Kurtić, Olivera Sadiković, Maida Mulić, Amela Džubur- Alić, Munib Smajović, Arzija Pašalić
Journal of Health Sciences; doi:10.17532/jhsci.2019.884

Introduction: Occupational stress is inevitable, but prolonged and intense can lead to serious health problems. Neglecting this significant aspect of work and inadequate treatment of the first indicators results in the reduced working capacity of healthcare professionals. Material and methods: Assessing working conditions of 100 healthcare professionals regarding stress impact on empathy and workability was the primary goal of this study. A survey was conducted to identify differences between work in intensive care units and other clinical departments all related to empathy, workability, and stress perceiving to determine what is a better predictor of workability. Results: In the research group “intensive care units”, significantly lower empathy quotients, poorer workability, and different stressors were registered compared to research groups named “other departments”. Conclusion: The main conclusion of the study states different dynamics in the working environment of intensive care units compared to other departments that could potentially harm the personal capacity of healthcare professionals.
Journal of Health Sciences; doi:10.17532/jhsci.2019.745

Introduction: Ghana introduced a maternal health policy in July 2008 to provide free of cost health services to women. However, the utilization of services does not depend on affordability alone but acceptability as well. Acceptability includes attitudes and behaviors of providers and satisfaction with the quality of care. The study explored women’s views and perceptions about attitudes and behaviors of providers and satisfaction with the quality of services under the free maternal health policy in Ghana. In addition, the views and perceptions of providers were examined. Methods: A convergent parallel mixed-methods study was conducted. The study was carried out in the Kassena-Nankana Municipality in Ghana. A structured questionnaire was distributed among women (n=406) who utilized health facilities during pregnancy. Further, focus group discussions (FGDs) with women (n=10) and in-depth interviews with midwives and nurses (n=25) were held. Quantitative data were analyzed using descriptive statistics, while the qualitative data were recorded, transcribed, read, and coded thematically. Results: Women perceived facilities to be clean, especially the smaller ones. Ninety-eight percent of women (n=313/320) perceived providers to be respectful or friendly, and this was mostly confirmed in the FGDs. More than two-thirds of the women (74%, n=300) were also very satisfied or satisfied with the quality of care due to the respect accorded them by providers. Equally, midwives and nurses were satisfied with the quality of care they provided. Nonetheless, providers believed that the unavailability of drugs and supplies, laboratory services, accommodation, and transportation for emergencies reduced women’s satisfaction with services and the quality of care they could provide. Conclusion: The services provided to women during pregnancy were acceptable under the free maternal health policy. There remain challenges in addressing a lack of infrastructure and commodities that affects the quality of care.
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