Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
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Aim To present diagnostic and therapeutic possibilities for genital and peritoneal tuberculosis, mimicking to other pathological conditions, mainly, ovarian cancer. Methods Transabdominal and transvaginal ultrasound, computerized tomography, Ca125 and HE 4, ROMA- index (Risk of Ovarian Maligancy Algorithm index) and diagnostic laparoscopy were performed in order to diagnose genital tuberculosis in a female patient. Results: A 23-year-old woman from Morocco presented with intermitting abdominal pain, unintentional weight loss and primary infertility. ⋯ Histological investigation revealed granulomatous abscessing salpingitis with suspicion of genital TB, so antituberculous therapy was administered with success. Conclusion Female genital tuberculosis is very rare but important in differential diagnosis and should be kept in mind regarding suspected fallopian tube or ovarian carcinoma to prevent women from extensive surgery. An algorithm for possible differentiation between peritoneal/female genital TB and EOC may be helpful in clinical setting.
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Aim To determine obstacles in maintaining professional integrity of nurses and their strategy to overcome them. Methods A conventional content analysis was conducted by 16 interviews. The data collection instruments were semi-structured interviews, observation and field notes. ⋯ Inefficient organization was composed of "nursing staff shortages", "underestimation of nurses' roles" and "high workload". "Religious beliefs" and "personal beliefs" constituted the "solid spirituality" theme. Conclusion There are factors that decline motivations in Iranian nurses; nevertheless, it is still possible to be a professionally integrated nurse. Among many factors contributing to internalization of professional integrity of nurses, spirituality is one of the most prominent factors.
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Aim To correlate the maximum anterior sagittal curvature (Kmax) changes and uncorrected (UDVA) and corrected distance visual acuity (CDVA) in keratoconus patients after the cross-linking (CXL) procedure. Methods Forty-four eyes of 34 patients with keratoconus were analysed after the standard Dresden protocol CXL procedure had been performed. All patients underwent complete preoperative examination with a follow-up of 12 months with focus on UDVA, CDVA and Oculus Pentacam (Scheimpflug technology) analysis. ⋯ Even Kmax is the most relevant and most followed parameter for progression and regression of keratoconus, its lowering was not directly correlated with the visual acuity improvement (both uncorrected and corrected) in the first 6 months after corneal CXL procedure. Kmax was changed significantly in the period of 12 months post cross linking, but not in the first 6 months. Conclusion Corneal CXL should be considered as a procedure not just for corneal stiffening and stabilization, but also for visual acuity improvement in keratoconus patients.
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Aim To identify a rate of macrosomic births in a one-year review, associated maternal characteristics and pregnancy outcome. Methods This one-year retrospective review included all macrosomic deliveries at the Department of Obstetrics and Gynaecology at the Cantonal Hospital Zenica between 1 January 2018 and 31 December 2018. The data were collected from maternal and newborn medical records. ⋯ Male macrosomic infants were more frequently represented, 245 (68,1%) comparing to the control group (p<0.01); in the control group female infants were more frequently represented (p<0.01). The overall Cesarean section rate, including elective Cesarean delivery was 23.2%, and 76.1% underwent an attempt of labour delivered vaginally. Conclusion Macrosomia represents a risk for adverse outcome for the mother and neonate, with a higher risk for the operative mode of delivery.
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Aim Colorectal carcinoma is one of the most common neoplasms, especially in Western countries and those with westernisation. On the other hand, high rate of metabolic syndrome (MetSy) has also been noticed, as well as in Western countries. It seems like these two conditions are somehow connected. ⋯ The patients had MetSy more frequently when compared with controls (p=0.048), and also they had more MetSy components (p=0.006). The link between MetSy and localisation of neoplasm was not found, neither with its pathohystological characteristics. Conclusion Patients with MetSy should be warned about the increased risk of colorectal carcinoma, and, in this way, motivated for earlier and more frequent screening colonoscopies, as well as of a change of unhealthy lifestyle.