Background/Aim. After having established an indication for surgery, some patients experience sense of fear, unpleasantness and embarrassment due to the expectance of adverse consequences of surgical intervention. Recently an instrument for measuring fear of surgery - the Surgical Fear Questionnaire (SFQ) - was developed and validated on a sample of Dutch patients awaiting surgery. The objective of this study was to translate the SFQ to Serbian language, make cultural adaptation of the translation and test its reliability and validity in a sample of outpatients in Serbia. Methods. The SFQ was translated and adapted according to the accepted international standards (double forward translation, harmonization, backward translation, and piloting). The study was multicentric, involving patients from 7 cities in 3 countries: Serbia, Montenegro, Bosnia and Hercegovina. It was conducted at state-owned health facilities. The sample was of consecutive nature and consisted of 330 outpatients who visited specialists of either internal medicine or general surgery. Results. Translated SFQ showed excellent reliability, both when rated by the investigators (Cronbach’s alpha 0.915), and by the patients themselves (Cronbach’s alpha 0.917). It is temporally stable, and both divergent and convergent validity tests had good results. Factorial analysis revealed one domain on the whole study sample and two domains like in original on the subsample of patients without experience with surgery in general anesthesia. Conclusion. Identification of patients with high level of fear of surgery by this questionnaire should help clinicians to administer measures which may decrease fear and prevent avoidance of absolutely necessary surgery by such patients.
The aim of this paper is to highlight the role and level of vitamin D in chronic diseases at the primary level
Similar to other European countries experiencing growth in their 65+ populations, Bosnia and Herzegovina have also been affected by an intensive population ageing process. This national phenomenon affects the pension system, the health system and the labour market. A brief description of extending working life in the socio-economic context in Bosnia and Herzegovina, including gendered statistics on employment for older workers and pension coverage, is presented in this chapter. There is a discussion on extended working life policies, pension reforms, pensions systems and policy, and relevant employment and health policies for older workers. Flexible employment policies and training for older workers have not yet been introduced in Bosnia and Herzegovina. Future policy recommendations are also discussed.
Introduction. The aim of this study was to determine the prevalence of microvascular complications in type 1 and type 2 diabetes mellitus patients in relation to glycated hemoglobin. Material and Methods. This cross-sectional study analyzed the prevalence of microvascular complications in patients with diabetes mellitus registered at the Primary Health Center Banja Luka. Demographic data, duration of diabetes, blood pressure, glycated hemoglobin, dyslipidemia, type of therapy, presence of retinopathy, neuropathy and nephropathy were analyzed. Data collection was done from December 2017 to November 2018. Results. The study included 228 patients, 132 (57.9%) men and 96 (42.1%) women. The most common microvascular complication was diabetic neuropathy (24.2%). The mean glycated hemoglobin level in patients with diabetic complications was 7.75 ? 1.66%. Although all participants with complications had unregulated diabetes mellitus (glycated hemoglobin > 7%), a statistically significant difference was found in regard to microalbuminuria (> 30 mg/24 h) and/or proteinuria (> 0.15 g/24 h) and/or decreased creatinine clearance (< 1.5 ml/sec) and their mean glycated hemoglobin (p = 0.025), while for other complications (neuropathy and retinopathy) the same was not confirmed. Multivariate logistic regression analysis confirmed that microalbuminuria and/or proteinuria and/or decreased creatinine clearance (odds ratio = 2.174; 95% confidence interval: 1.040 - 4.543; p = 0.039) as well as elevated diastolic blood pressure (odds ratio = 1.09; 95% confidence interval: 1.024 - 1.162; p = 0.007) were factors associated with glycated hemoglobin > 7%. Conclusion. The most common microvascular complication in patients with both types of diabetes mellitus is diabetic neuropathy with a prevalence of 24.2%. The presence of microalbuminuria and/or proteinuria and/ or decreased creatinine clearance were associated with glycated hemoglobin > 7% and elevated diastolic blood pressure.
1Primary Healthcare Center Banja Luka, The Republic of Srpska, Bosnia and Herzegovina 2University of Banja Luka, Faculty of Medicine, Department of Family Medicine, The Republic of Srpska, Bosnia and Herzegovina 3University of Zenica, Faculty of Medicine, Department of Family Medicine, Bosnia and Herzegovina 4University of Banja Luka, Faculty of Medicine, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
Introduction. Diabetic polyneuropathy (DPN) is the most common microvascular complication of diabetes mellitus (DM), which may be present at the time of disease detection. Screening for DPN is performed for the patients with type 2 diabetes at the time of diagnosis and for type 1 diabetes 5 years after diagnosis. The primary objective of this study was to determine the prevalence of DNP among family medicine patients with diabetes mellitus aged 18 to 70 years using nylon monofilament. Methods. The cross-sectional study estimated the prevalence of DPN among primary care patients with DM in Banja Luka. Seemes-Weinstein nylon 10g monofilament was used to detect DPN. Age, sex, duration of diabetes, type of therapy, symptoms, glycosylated hemoglobin (HbA1c) and risk factors (hypertension, smoking, dyslipidemia, obesity, physical inactivity) were analyzed. Data collection took place from 01/06/2017 to 31/05/2018. Results. The study included 228 patients, 132 (57.9%) men and 96 (42.1%) women. There was a statistically significant difference in the duration of diabetes and the presence of all symptoms of DPN (tingling, burning, light burning and stinging) with respect to the presence of polyneuropathy (p <0.01). Multivariate logistic regression revealed that patients who had hypertension (OR=26.2; 95% CI: 4.070-168.488; p=0.001), used oral antidiabetic therapy (OR=12.3; 95% CI: 1.300 -116.309; p=0.029 ) had tingling (OR=5.2; 95% CI: 1.431- 18.571 p=0.012;)and a longer duration (OR=4.27; 95% CI: 1.983-9.175; p=0.000) of diabetes were more likely to have DPN. Conclusion. The prevalence of DPN in patients with diabetes is 24.2%. Determinants of DNP are the presence of symptoms of tingling, duration of diabetes, hypertension, dyslipidemia, and the use of oral antidiabetic therapy alone.
Introduction. Deja vu (franc. Déjà vu) is a phenomenon experienced by two thirds of all people. However, this phenomenon can follow aura during the temporal lobe epilepsy. It is believed that it originates from hippocampus, which plays a major role in generating epileptic discharges. Some authors emphasize that in these patients déjà vu phenomenon is not an aura but rather it sometimes refers to the attack itself. Method. In this case report, an eightyear-old girl suffering from repeated crisis of consciousness is described. Case report. The aim of the study was to present the case of an eightyearold girl who underwent three crisis of consciousness, headache behind the forehead as well as the repeated déjà vu phenomenon. The girl was hospitalized, after which medical history was taken and physical examination, as well as other diagnostic tests, were performed. EEG recording revealed an increased electrocortical epileptic activity above the right frontotemporal region. An antiepileptic therapy (Karbapin) leading to attack control was introduced. Conclusion. It is necessary to give temporal lobe epilepsy in children with déjà vu phenomenon serious consideration.
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