Sanja Brekalo Lazarević, Edina Handžić, Abdel Đozić, Ivan Lazarević, Z. Ademovic, E. Jusufovic
The development of industry, agriculture, transport and urbanization has resulted in excessive emissions of heavy metals into the environment, which due to their bioaccumulative properties express negative effects on the environment and living organisms as a whole. In this work the presence of heavy metals in the soil samples of the urban area of Lukavac and Kalesija municipality and their effect on the health of the population were studied. Soil samples were collected in October 2017 at five locations in the urban area of Lukavac municipality and two urban locations in Kalesija municipality. Concentrations of chromium (Cr) copper (Cu), cobalt (Co), nickel (Ni), cadmium (Cd), lead (Pb), manganese (Mn), iron (Fe) and zinc (Zn) in the soil samples were determined. The results indicated that in some locations the concentration of heavy metals exceeded the maximum permissible concentration (MPC). MPC value for chromium was exceeded at four locations in the urban area of Lukavac, whereas MPC value for nickel and cadmium was exceeded at all locations. In Kalesija, MPC value was exceeded for chromium and nickel at one location, while cadmium MPC was exceeded at both locations. The negative impact of heavy metals on the health of the population is the cause of many malignant diseases. Statistical analysis of the number of patients with malignant diseases in the area of the Lukavac and Kalesija revealed significantly higher prevalence of malignant diseases of the lungs, breast, skin and cervix in the Lukavac (p<0,05) in comparisson to Kalesija municipality.
{"title":"Presence of heavy metals in the soil of urban areas of Lukavac and Kalesija and malignant disease prevalence","authors":"Sanja Brekalo Lazarević, Edina Handžić, Abdel Đozić, Ivan Lazarević, Z. Ademovic, E. Jusufovic","doi":"10.5457/ams.v49i1.485","DOIUrl":"https://doi.org/10.5457/ams.v49i1.485","url":null,"abstract":"The development of industry, agriculture, transport and urbanization has resulted in excessive emissions of heavy metals into the environment, which due to their bioaccumulative properties express negative effects on the environment and living organisms as a whole. In this work the presence of heavy metals in the soil samples of the urban area of Lukavac and Kalesija municipality and their effect on the health of the population were studied. Soil samples were collected in October 2017 at five locations in the urban area of Lukavac municipality and two urban locations in Kalesija municipality. Concentrations of chromium (Cr) copper (Cu), cobalt (Co), nickel (Ni), cadmium (Cd), lead (Pb), manganese (Mn), iron (Fe) and zinc (Zn) in the soil samples were determined. The results indicated that in some locations the concentration of heavy metals exceeded the maximum permissible concentration (MPC). MPC value for chromium was exceeded at four locations in the urban area of Lukavac, whereas MPC value for nickel and cadmium was exceeded at all locations. In Kalesija, MPC value was exceeded for chromium and nickel at one location, while cadmium MPC was exceeded at both locations. The negative impact of heavy metals on the health of the population is the cause of many malignant diseases. Statistical analysis of the number of patients with malignant diseases in the area of the Lukavac and Kalesija revealed significantly higher prevalence of malignant diseases of the lungs, breast, skin and cervix in the Lukavac (p<0,05) in comparisson to Kalesija municipality.","PeriodicalId":53635,"journal":{"name":"Acta Medica Saliniana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46155461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: This study aims to compare the early and late diagnosis of foreign body aspiration (FBA) in children. Patients and methods: A pediatric rigid bronchoscpe under general anesthesia was used to identify and extract the foreign body in 48 children up to 14 years old. A retrospective review of a 4-year experience (from 2011 to 2014) in ENT Clinic Tuzla, Bosnia and Herzegovina. Results: The were slight prevalence of boys, the majority were up to three years, average time for bronchoscopy was 90.7 hours. There was not significant difference between timing for bronchoscopy for children under and above three years. Near 100% children had timing for bronchoscopy less than one week. Conclusion: Delay in diagnosis of foreign body aspiration can produce morbidity in children and foreign body aspiration always has to be in mind when children have cough like main symptom. Early referral of patients following foreign body aspiration should be encouraged.
{"title":"Delay in diagnosis of foreign body aspiration in children","authors":"F. Brkić, Šekib Umihanić, Hasan Altumbabić","doi":"10.5457/ams.v49i1.482","DOIUrl":"https://doi.org/10.5457/ams.v49i1.482","url":null,"abstract":"Introduction: This study aims to compare the early and late diagnosis of foreign body aspiration (FBA) in children. Patients and methods: A pediatric rigid bronchoscpe under general anesthesia was used to identify and extract the foreign body in 48 children up to 14 years old. A retrospective review of a 4-year experience (from 2011 to 2014) in ENT Clinic Tuzla, Bosnia and Herzegovina. Results: The were slight prevalence of boys, the majority were up to three years, average time for bronchoscopy was 90.7 hours. There was not significant difference between timing for bronchoscopy for children under and above three years. Near 100% children had timing for bronchoscopy less than one week. Conclusion: Delay in diagnosis of foreign body aspiration can produce morbidity in children and foreign body aspiration always has to be in mind when children have cough like main symptom. Early referral of patients following foreign body aspiration should be encouraged. ","PeriodicalId":53635,"journal":{"name":"Acta Medica Saliniana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44775449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Lower Back Pain (LBP) is one of the most frequent reasons for visiting physican. Authors of guidelines scrutinizing use of radiography and Computed tomography (CT) or Magnetic resonance imaging (MRI) in LBP diagnostic. Method of choice in the LBP diagnostic should be MRI except in cases where we should get diagnostic informations as soon as possible (traumas etc.) and in strict indications in bone structures where CT should be a method of choice. Increase of CT use and following icrease CT derived radiation dose in patients are very serious problems of last decades. Aim: To show the nessesary of procedure algorithm adjusment in LBP diagnostic. Reasons are: danger of overdiagnosis leading to chronifications, loosing time and money to get exact diagnose and leading to cumulate very high ionizing doses (10 mSv per person with average body weight from lumbar spine CT) that could couse a cancer if it is over 100 mSv (in some studies if it is over 50 mSv). Patients and methods: Sixty-nine patients, average age of 51.35 years, were included in the study. Lumbar spine CT was performed and repeated procedure at MRI in a very short time in Clinic for Radiology and Nuclear Medicine of University Clinical Centre Tuzla from January 1 2017 to February 9 2018. The sample of patients was formed consecutively. Referral diagnosis for CT procedures were: M51 in 36 patients (52.17%), N/A in 13 (18.84%), M05 in 4 (5.8%), G83.4 in 3 (4.35%) and other in 13 (18.84%). Results: 30 (83.33%) of patients were referred from CT to MRI procedure in time under 42 days (during acute phase). Relation of justified and unjustified undertaken CT procedures were: 71% unjustified, 10% justified and 19% N/A.Conclusion: Performed study showed unjustified undertaken CT procedures and high unnecessary radiation dose in 71% patients. There are justified reasons for procedure algorithm adjusment in LBP diagnostic. Key words: lower back pain, diagnostic procedure algorithm, CT, MRI
{"title":"JUSTIFICATION OF RADIOLOGICAL PROCEDURES ALGORITHM ADJUSTMENT IN DIAGNOSIS OF LOWER BACK PAIN CAUSE AT UNIVERSITY CLINICAL CENTER TUZLA","authors":"Aida Denjagić","doi":"10.5457/AMS.V49I1.489","DOIUrl":"https://doi.org/10.5457/AMS.V49I1.489","url":null,"abstract":"Introduction: Lower Back Pain (LBP) is one of the most frequent reasons for visiting physican. Authors of guidelines scrutinizing use of radiography and Computed tomography (CT) or Magnetic resonance imaging (MRI) in LBP diagnostic. Method of choice in the LBP diagnostic should be MRI except in cases where we should get diagnostic informations as soon as possible (traumas etc.) and in strict indications in bone structures where CT should be a method of choice. Increase of CT use and following icrease CT derived radiation dose in patients are very serious problems of last decades. Aim: To show the nessesary of procedure algorithm adjusment in LBP diagnostic. Reasons are: danger of overdiagnosis leading to chronifications, loosing time and money to get exact diagnose and leading to cumulate very high ionizing doses (10 mSv per person with average body weight from lumbar spine CT) that could couse a cancer if it is over 100 mSv (in some studies if it is over 50 mSv). Patients and methods: Sixty-nine patients, average age of 51.35 years, were included in the study. Lumbar spine CT was performed and repeated procedure at MRI in a very short time in Clinic for Radiology and Nuclear Medicine of University Clinical Centre Tuzla from January 1 2017 to February 9 2018. The sample of patients was formed consecutively. Referral diagnosis for CT procedures were: M51 in 36 patients (52.17%), N/A in 13 (18.84%), M05 in 4 (5.8%), G83.4 in 3 (4.35%) and other in 13 (18.84%). Results: 30 (83.33%) of patients were referred from CT to MRI procedure in time under 42 days (during acute phase). Relation of justified and unjustified undertaken CT procedures were: 71% unjustified, 10% justified and 19% N/A.Conclusion: Performed study showed unjustified undertaken CT procedures and high unnecessary radiation dose in 71% patients. There are justified reasons for procedure algorithm adjusment in LBP diagnostic. Key words: lower back pain, diagnostic procedure algorithm, CT, MRI","PeriodicalId":53635,"journal":{"name":"Acta Medica Saliniana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46079115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: cesarean section rates show a wide variation among countries, ranging from 0,4-40%, and continuous rise. Our aim was to test hypothesis that higher Cesarean rate than 15% does not correlates with lower perinatal mortality rate.Methods: We analysed 18-year period with high–quality cesarean delivery and perinatal mortality rates information data. Data were analised by Chi-square test with Yate's correction for large values.Results: Cesarean section rates has increasing trend. In first six-years of observed period (1998-2003) mean cesarean section rate was 17,24%, in second (2004-2010) 19,33% and in third (1011-2015) 23,97%. In observed period mean perinatal mortality rate was 9,90‰, with fluctuation of 20,70‰ to 3,82‰. In first six-years of observed period (1998-2003) mean perinatal mortality rate was 13,81‰, in second (2004-2011) 8,28‰ and in third (2011-2015) 7,46‰. These data clearly showed that increase of cesarean section rate more than 19,33% is not correlate with decreasing od perinatal mortality.Conclusion: Despite many suggestions that improvement in perinatal mortality does not necessarily rely upon an ever-increasing cesarean section rate and recommendation by World Health Organisation that cesarean section rate should not exceed 10-15 percent to optimise neonatal outcomes, this recommendation may be too low, and suggests rate of 19%.
{"title":"Correlation between cesarean section and perinatal mortality rate","authors":"Jasenko Fatušić, Maida Skokic, Z. Fatušić","doi":"10.5457/ams.v49i1.499","DOIUrl":"https://doi.org/10.5457/ams.v49i1.499","url":null,"abstract":"Objectives: cesarean section rates show a wide variation among countries, ranging from 0,4-40%, and continuous rise. Our aim was to test hypothesis that higher Cesarean rate than 15% does not correlates with lower perinatal mortality rate.Methods: We analysed 18-year period with high–quality cesarean delivery and perinatal mortality rates information data. Data were analised by Chi-square test with Yate's correction for large values.Results: Cesarean section rates has increasing trend. In first six-years of observed period (1998-2003) mean cesarean section rate was 17,24%, in second (2004-2010) 19,33% and in third (1011-2015) 23,97%. In observed period mean perinatal mortality rate was 9,90‰, with fluctuation of 20,70‰ to 3,82‰. In first six-years of observed period (1998-2003) mean perinatal mortality rate was 13,81‰, in second (2004-2011) 8,28‰ and in third (2011-2015) 7,46‰. These data clearly showed that increase of cesarean section rate more than 19,33% is not correlate with decreasing od perinatal mortality.Conclusion: Despite many suggestions that improvement in perinatal mortality does not necessarily rely upon an ever-increasing cesarean section rate and recommendation by World Health Organisation that cesarean section rate should not exceed 10-15 percent to optimise neonatal outcomes, this recommendation may be too low, and suggests rate of 19%.","PeriodicalId":53635,"journal":{"name":"Acta Medica Saliniana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44290790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction According to guidelines for the management of hyperthyroidism, patients with hyperthyroidism should be treated with radioactive iodine, antithyroid drugs, or thyroidectomy. Oral administration of radioiodine is a safe and cost effective treatment option for patients with toxic multinodular goiter (TMG)/toxic adenoma (TA) or Grave’s disease (GD). The aim of the study was to evaluate the use of thyroglobulin values as a possible predictor of a dose of radioiodine therapy (RAI) in hyperthyroidism in patients GD, TA and TMG. Results The study included 105 patients (14.4 % males and 85.6% females). The average duration of the disease was 9 years. Graves’s disease is registered among 50.68%, toxic multinodular goiter among 30.83% and toxic adenoma among 18.49% of patients. Patients were divided into four groups, and they received four doses of radioiodine therapy: 10mCi, 15mCi, 20mCi and 25mCi. The values of thyroglubulin were measured before RAI, and in period of one, three and six months after the therapy. Conclusion It can be concluded that the higher average value of thyroglobulin before therapy suggests the need for administering a higher doses of RAI, so determination of thyroglobulin levels in serum, may serve as a good predictor to assist in monitoring the administered dose of RAI in patients with hyperthyroidism.
{"title":"Thyroglobulin as a possible predictor of doses radioiodine therapy in hyperthyroidism","authors":"S. Azabagić","doi":"10.5457/ams.v48i1-2.445","DOIUrl":"https://doi.org/10.5457/ams.v48i1-2.445","url":null,"abstract":"Introduction According to guidelines for the management of hyperthyroidism, patients with hyperthyroidism should be treated with radioactive iodine, antithyroid drugs, or thyroidectomy. Oral administration of radioiodine is a safe and cost effective treatment option for patients with toxic multinodular goiter (TMG)/toxic adenoma (TA) or Grave’s disease (GD). The aim of the study was to evaluate the use of thyroglobulin values as a possible predictor of a dose of radioiodine therapy (RAI) in hyperthyroidism in patients GD, TA and TMG. Results The study included 105 patients (14.4 % males and 85.6% females). The average duration of the disease was 9 years. Graves’s disease is registered among 50.68%, toxic multinodular goiter among 30.83% and toxic adenoma among 18.49% of patients. Patients were divided into four groups, and they received four doses of radioiodine therapy: 10mCi, 15mCi, 20mCi and 25mCi. The values of thyroglubulin were measured before RAI, and in period of one, three and six months after the therapy. Conclusion It can be concluded that the higher average value of thyroglobulin before therapy suggests the need for administering a higher doses of RAI, so determination of thyroglobulin levels in serum, may serve as a good predictor to assist in monitoring the administered dose of RAI in patients with hyperthyroidism.","PeriodicalId":53635,"journal":{"name":"Acta Medica Saliniana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45641231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim To assess the relationship between the clinical sign of excessive hip abduction (abduction of the hip 90 degrees or more) and developmental dysplasia of the hip (DDH). Methods The research was conducted on 450 newborns in the Neonatal Unit at the Clinic of Gynecology and Obstetrics and the Clinic of Orthopedics and Traumatology of the University Clinical Centre, Tuzla, between 30th August 2011 and 30th April 2012. Clinical (degree of hip abduction) and ultrasound examination of all newborns hip were performed using the Graf method on their first day of life. Results Clinical sign of excessive hip abduction showed significant predictive value for DDH. There were 37 (8.2%) newborns with the clinical sign of excessive hip abduction, of which 13 of them had DDH while 24 of them did not have this clinical sign. There were 89 newborns, in the overall sample, with one of the forms of DDH, 13 (12.7%) of them had this clinical sign, while from 324 newborns witouth DDH, 24 (6.9%) had this clinical sign. Excessive hip abduction had a positive predictive value (PPV) of 35.1% and a negative predictive value (NPV) of 78.5% for DDH. Conclusion Excessive hip abduction is an useful and important clinical sign of DDH. Doctors who perform the first examination of the child after birth, would have to turn their attention to this clinical sign. The newborns with this clinical sign would have to go to an ultrasound examination of the hips for further diagnosis.
{"title":"The predictive value of the clinical sign of excessive hip abduction for developmental dysplasia of the hip (DDH)","authors":"S. Čustović, K. Custović","doi":"10.5457/ams.v48i1-2.479","DOIUrl":"https://doi.org/10.5457/ams.v48i1-2.479","url":null,"abstract":"Aim To assess the relationship between the clinical sign of excessive hip abduction (abduction of the hip 90 degrees or more) and developmental dysplasia of the hip (DDH). Methods The research was conducted on 450 newborns in the Neonatal Unit at the Clinic of Gynecology and Obstetrics and the Clinic of Orthopedics and Traumatology of the University Clinical Centre, Tuzla, between 30th August 2011 and 30th April 2012. Clinical (degree of hip abduction) and ultrasound examination of all newborns hip were performed using the Graf method on their first day of life. Results Clinical sign of excessive hip abduction showed significant predictive value for DDH. There were 37 (8.2%) newborns with the clinical sign of excessive hip abduction, of which 13 of them had DDH while 24 of them did not have this clinical sign. There were 89 newborns, in the overall sample, with one of the forms of DDH, 13 (12.7%) of them had this clinical sign, while from 324 newborns witouth DDH, 24 (6.9%) had this clinical sign. Excessive hip abduction had a positive predictive value (PPV) of 35.1% and a negative predictive value (NPV) of 78.5% for DDH. Conclusion Excessive hip abduction is an useful and important clinical sign of DDH. Doctors who perform the first examination of the child after birth, would have to turn their attention to this clinical sign. The newborns with this clinical sign would have to go to an ultrasound examination of the hips for further diagnosis.","PeriodicalId":53635,"journal":{"name":"Acta Medica Saliniana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41921681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The use of nanotechnology in the diagnosis of diseases, treatment and monitoring of cancer patients has become a subject of study for the last 20 years. This paper presents brief overview of general characteristics, synthesis and application of dendrimers and quantum points in oncology. Dendrimers and quantum dots are nanostructures whose application in oncology is still being examined. QDs are used in magnetic resonance, wherein very well detect the location of tumor. Dendrimers are intensively tested, especially in cancer therapy. Dendrimers are intensively tested, especially in cancer therapy, because, due to their extremely small dimensions, they have the ability to pass through the mucous barriers and vascular pores, enabling safe delivery of the drug to the tumor cells.
{"title":"Application of dendrimers and quantum dots in cancer diagnosis and therapy","authors":"E. Horozić","doi":"10.5457/ams.v48i1-2.450","DOIUrl":"https://doi.org/10.5457/ams.v48i1-2.450","url":null,"abstract":"The use of nanotechnology in the diagnosis of diseases, treatment and monitoring of cancer patients has become a subject of study for the last 20 years. This paper presents brief overview of general characteristics, synthesis and application of dendrimers and quantum points in oncology. Dendrimers and quantum dots are nanostructures whose application in oncology is still being examined. QDs are used in magnetic resonance, wherein very well detect the location of tumor. Dendrimers are intensively tested, especially in cancer therapy. Dendrimers are intensively tested, especially in cancer therapy, because, due to their extremely small dimensions, they have the ability to pass through the mucous barriers and vascular pores, enabling safe delivery of the drug to the tumor cells.","PeriodicalId":53635,"journal":{"name":"Acta Medica Saliniana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44712143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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