Introduction. The human voice is an important characteristic that enables the distinction of human from other living beings. Otherwise, it represents a picture of a person΄s personality, his health, mental and emotional state. The research aims are to determine the voice characteristics of vocal professionals with diagnosed vocal cord nodules by subjective voice assessment and objective voice measurement before and after vocal rehabilitation. Methods. This study has involved 25 examinees, aged 23 to 56. The subjective voice assessment was conducted with the Voice Handicap Index - VHI questionnaire and the objective voice measurement by a computerized laboratory for voice analysis ''Kay Elemetrics''. The obtained data were processed using descriptive and analytical statistics. Results. Before the vocal rehabilitation and the subjective and objective voice measurements, the examinees had greater psychosocial difficulties associated with their voice quality. After two months of vocal rehabilitation, there has been a significant improvement in the voice of all subjects on the VHI scale. A statistically significant and highly statistically significant improvement have been noticed in six out of seven analyzed parameters of vocal A, by the objective measurement of voice. Namely, the obtained values - the percentage of jitter Jitt (%), the percentage of shimmer Shim (%), the relative average perturbation value RAP (%) and the coefficient of fundamental frequency variation - vFo were highly statistically significant (p < 0.01). The VTI - voice turbulence index and the SPI - soft phonation index also improved, the observed difference was statistically significant (p < 0.05), while the observed difference in the FTRI parameter was not statistically significant (p > 0.05). Conclusion. Vocal rehabilitation has influenced the improvement of the voice quality, which means that the results obtained by objective voice measurements were more in accordance with the results of the subjective voice assessment.

Introduction Infective endocarditis is relatively rare in pediatric population, but can result in significant morbidity and mortality. Children with bicuspid aortic valve are at higher risk of developing infective endocarditis as compared to general population. Our objective is to emphasize the importance of rapid diagnosis and proper treatment of infective endocarditis in patients with bicuspid aortic valve with aim to prevent serious adverse events. Case outline We report a case of a 13-year-old girl with newly diagnosed bicuspid aortic valve who developed infective endocarditis with severe complications and underwent cardiac surgery. Recurrent fever and anemia, as well as cardiac murmur were present for six months prior to diagnosing infective endocarditis. During the course of illness, only one of many blood cultures taken was positive for Streptococcus sanguinis. Conclusion Patients with bicuspid aortic valve require careful evaluation for infective endocarditis, especially if recurrent fever associated with anemia is present. Delayed diagnosis of infective endocarditis is associated with serious complications.

According to the World Health Organization (WHO) and the International Society for Hypertension, elevated blood pressure is defined as the blood pressure the readings of which consistently range ≥140 mmHg systolic and/or 90 mmHg diastolic. Having in mind the fact that hypertension is one of the leading risk factors for cardiovasluar disease, kidney failure and premature mortality, it is clear that preventive measures should be imposed before the diagnosis is established. The main nutritional measures used in preventing hypertension are: weight loss, Dietary Approaches to Stop Hypertension (DASH diet), reducing salt and alcohol intake and increasing potassium intake. The aim of this paper was to show the preventive effect of the DASH diet on hypertension onset in normotensive patients as well as to highlight that the diet is an integral part of hypertension treatment, in addition to the use of drug therapy for hypertensive patients.

Background/Aim: Antibiotic use and resistance represent a growing public health issue, with a specific risk of uncontrolled use of antibiotics in children. The aim of the study was to examine differences in parental knowledge, attitudes and practices about antibiotic use in children between urban and rural areas of the Republic of Srpska. Methods: A cross-sectional study was conducted among 1459 parents of children under 6 years of age, out of which 1201 (82.3 %) lived in urban areas while 258 (17.7 %) lived in rural areas. The research is conducted among parents who brought their children to the selected primary healthcare centres and among parents of children in preschool institutions. Results: The majority of respondents (98.4 %) state that doctors are their main source of information. Only 61.2 % of respondents precisely know which drug is an antibiotic when offered different drugs and respondents from rural areas (54.3 %) more often (p = 0.012) gave more accurate answers when compared to respondents from urban areas (37.3 %). Among parents, 86 % agree with the statement that improper use of antibiotics reduces their effectiveness and leads to bacterial resistance, regardless of groups. More than a half of respondents (52.4 %) do not think that children with flu or common cold symptoms recover faster when they receive antibiotics, significantly more respondents from urban areas (p = 0.001). Respondents from rural areas significantly more often believe that antibiotics can produce harmful effects compared to respondents from urban areas (p = 0.049). Respondents from rural areas significantly more often think that antibiotic use can prevent complications caused by inflammation of the upper respiratory tract (p = 0.006). Parents from rural areas give their children antibiotics without a paediatrician's recommendation significantly more often (4.3 %) compared to respondents from urban areas (0.6 %) (p < 0.001). Conclusion: There are differences in parental knowledge, attitudes and practices regarding antibiotic use and antimicrobial resistance among parents in rural and urban areas. There is need for additional education of parents and for greater engagement of paediatricians in providing guidance and explanations regarding the use of antibiotics.

: Introduction Th e concept of the quality of healthcare services is constantly evolving and transforming depending on the interest in it and the level of involvement of medical sta ff and patients. Aim To assess patient satisfaction with the quality of health services in private practice condition. Methods 105 (n=105) subjects participated in the study, and it was conducted by an anonymous survey of the clinic which o ff ers medical services, tests, and diagnostic procedures in the fi elds of gynecology, internal medicine, surgery, radiology, urology, and neurology. Th e research was conducted among patients who used the health services of a private practice institution from January to September 2022. Th e patient questionnaire consisted of 14 questions. Five questions related to identifying the sociodemographic characteristics of the respondents, and 9 questions were research questions of the Lickert type. For this purpose, the standardized Laschinger HCAHPS ( Hospital Consumer Assessment of Healthcare Providers and Systems ) questionnaire on patient satisfaction with the quality of healthcare services was used. Di ff erences in numerical variables were tested by Student’s t-test or analysis of variance (ANOVA). All P values are two-sided (p<0.05). Th e statistical program MedCalc Statistical Software version 18.2.1 was used for statistical analysis. Results Th e research was conducted on 105 patients, 28% of whom were male and 72% female. Most patients were in the age group of 61 to 70 years (30%). Patients are satis fi ed with the quality of healthcare services. Th e highest average score for reception and waiting time (4.9), the lowest score for being informed about upcoming interventions and treatments and professional approach (4.68). Conclusion Patients show a high degree of satisfaction with the general services provided.

The article presents an approach aimed at automatically deriving the initial conceptual database model from a set of business process models. The approach proposes the incremental synthesis of the target model by iteratively composing the partial conceptual database models that are derived from the models contained in the source set. The approach is implemented by the AMADEOS tool, which is the first online web-based tool enabling the automatic derivation of the conceptual database model from a set of business process models. The experimental evaluation proves that the implemented approach enables effective automatic derivation of the initial conceptual database model.