Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
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Obstetric shock (OS) has been defined as a life-threatening cardiovascular collapse syndrome associated with pregnancy, childbirth and puerperium (obstetrics causes), and is the most significant cause of high maternal mortality (MM) throughout human history. Shock in obstetrics (SIO) refers to indirect causes of non-obstetrics causes in pregnancy, childbirth and puerperium (polytrauma, aesthetic incidents, cardiovascular or cerebrovascular incidents, other septic syndromes). ⋯ Surgical treatment of septic shock includes exploratory laparotomy (laparoscopy), ectomy or resection of the necrotized organ, abdominal lavage with multiple drainages, continuous peritoneal drainage with lavation, extensive triple antibiosis per admission or per antibiogram and thromboprophylaxis. OS seems to remain a permanent miasma in practical clinical obstetrics, which we will not be able to influence, because we have obviously caused today's increase in MM from haemorrhagic OS by iatrogenic increase in the number of caesarean sections, especially elective ones.
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Aim Results of ultrasound guided fine needle aspiration cytology (FNAC) as the compatibility of cytological findings with histopathological diagnoses (the "gold standard") in the diagnosis of nodular thyroid lesions are inconsistent. The aim of this prospective study was to determine the validity of FNAC, as well as the compatibility of findings with histopathological diagnoses. Methods The study included 92 patients who underwent FNAC and later surgery and histopathological assessment with a final diagnosis. ⋯ Conclusion The results confirmed the correctness of the algorithm in which, following clinical or ultrasound confirmation of nodular thyroid lesions with suspicious changes, FNAC is indicated. The FNAC results should guide a clinician to further diagnostic and therapeutic procedures. Certainly, in case of suspected follicular/ Hurthle cell lesions one should be vigilant and aware of the fact that in these cases malignancy is defined by the invasion of blood vessels and/or the capsule, which FNAC is unable to detect.
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Aim To investigate infl uence of neutrophil-to-lymphocyte ratio (NLR) and proatherogenic risk factors to improve the accuracy of pneumonia severity index (PSI) in the prediction of community acquired pneumonia (CAP) outcome in healthy individuals. Methods A retrospective observational cross-sectional study conducted at the Clinic for Pulmonary Diseases and Tuberculosis "Podhrastovi", University Clinical Centre Sarajevo, included 83 patients with the diagnosis of CAP during the period March 2019-March 2021. Once diagnosed with CAP, PSI score was calculated and according to its value the need for hospital treatment was identifi ed. ⋯ Diastolic blood pressure, lymphocytes, eosinophils were signifi cantly lower in patients with high risk of CAP (p<0.05;) compared to patients with low risk of CAP (p<0.01). The optimal cut-off value of NLR for CAP patients was 3.089 with an estimated area under curve (AUC) of 0.664. Conclusion Proatherogenic parameters such as age, systolic blood pressure and leukocytes in combination with neutrophil-lymphocyte count ratio could improve accuracy of the pneumonia severity index in community acquired pneumonia outcome.
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Aim To investigate the efficacy of electrolyzed water against viruses and its safety to the skin. Methods Virus culture was carried out at level-3 Bio-Safety (BSL3) facilities. The test material was prepared at room temperature mixed with one part virus suspension and one organic load. ⋯ The sensitivity test showed that participants with reactions to electrolyzed water were all female, with a mean age of 32.6 years. The patch-test was positive in 3 of 4 participants who reacted to the product. Conclusion Electrolyzed water is effective as a new antiseptic and disinfectant against viruses and safe for human skin.
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Aim To investigate analgesic and side effects of different doses of fentanyl in combination with propofol for colonoscopy. Methods This prospective randomized double-blind study conducted between 2019 and 2020 included 64 patients. Patients were randomized: Group 1 (fentanyl 0.5 μg/kg) and Group 2 (fentanyl 1.0 μg/kg) both in combination with propofol. ⋯ Anxiety (p=0.010), weakness (p=0.000) and confusion (p=0.023) proved to be significantly higher for Group 1, and hypotension (p=0.001) for Group 2 than in another group. No statistical significance of Visual Analogue Pain Scale (VAS) (p=0.501) and Aldrete recovery score (ARS) (p=0.845) was found. Conclusion There was no significance in postprocedural abdominal pain between the group of patients administered fentanyl at a dose of 0.5 μg/kg and the group of patients administered fentanyl at a dose of 1.0 μg/kg; however, prevalence of complications was more significant in the group with a fentanyl at a dose of 0.5 μg/kg.