Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
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Aim The Epibloc elastic-dynamic fixation has been applied for many years at several hand surgery centres in Italy. This technique has been considered safe and reliable in the treatment of distal meta-epiphyseal fractures of the radius with dorsal displacement. The aim of this study was to evaluate an alternative use of this method in the treatment of volar displaced wrist fractures in cases where an internal fixation could not be recommended. ⋯ In 15 patients, the wrist range of motion was restored with values greater than 100. In 17 cases, forearm pronation-supination was restored to more than 120°. Conclusion In cases of non-comminuted, one or two fragments volar displaced wrist fractures, the elastic-dynamic fixation associated with an intrafocal pinning reduction may be proposed as an alternative to open reduction and internal fixation in elderly patients.
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Aim To assess our personal experience of a case of tuberculosis of the talus, and to provide an overview of the literature about the tuberculosis manifestations, including all its aspects: epidemiology, clinical and imaging presentation, and all the treatments available to the current state of knowledge. Methods We present our experience in a case of a 34-year-old patient, who came to our attention with difficulty in walking and pain due to a talar tuberculosis, with consequent bone disruption and reabsorption, and foot deformities. ⋯ Today, almost two years after the treatment, the patient can walk independently with no major limitations in everyday life. Conclusion Tibiotalocalcaneal arthrodesis with bone graft showed good functional results in this case study, with complete graft fusion and good functional and radiological outcomes.
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Aim To examine safety and efficiency of electrocardioversion (EC) in elective treatment of atrial fibrillation and atrial flutter in the setting of Day Hospital by determining success rate, frequency of adverse events and possible cost benefit compared to admitting a patient into hospital. Methods This prospective observational cohort study was performed in Day Hospital and in Intensive Care Department of Internal Medicine Clinic, University Clinical Centre Tuzla from January 2019 to December 2022 and included 98 patients with a persistent form of atrial fibrillation (AF) or atrial flutter. The patients who were divided in two groups, 56 hospitalized and 42 patients accessed in Day Hospital. ⋯ Results In hospital setting group overall succes rate of electrocardioversion was 85%, with average 2.1 EC attemps, there was with one fatal outcome due to stroke, one case of ventricular fibrillation (VF) due to human error, and 6 minor adverse events; with average cost of was 1408.70 KM (720.23 €) per patient. In Day Hospital setting succes rate was 88%, with average 2 EC attempts, no major adverse events, 8 minor adverse events; and average cost was of 127.23 KM (65.05 €) per patient. Conclusion Performing elective electrocardioversion in Day Hospital setting is as safe as admitting patients into hospital but substantially more cost effective.
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Aim To investigate the prevalence of familial hypercholesterolemia in patients with acute coronary syndrome (ACS). Methods The study included fifteen patients with first or repeated ACS and treated/nontreated dyslipidaemia admitted to the Department of Cardiovascular Diseases of Clinical Hospital Centre Osijek between 1 January 2020 and 1 January 2021. The cut-off value of low-density lipoprotein (LDL)-C was 4.5mmol/L as a possible cut-off value for familial hypercholesterolemia presence. ⋯ According to LDL-C profile and by calculating the Dutch Lipid Clinic Network Score, one (of 15) patient was categorized as having definite familial hypercholesterolemia and two (of 15) as having probable familial hypercholesterolemia leading to the use of triple hypolipidemic therapy (statin+ezetimibe+PCSK9 inhibitor) in 2 (13%) patients (one female and one male). Conclusion LDL-C level of 4.5 mmol/L and higher represents an indication for screening for familial hypercholesterolemia in patients with ACS. The prevalence of familial hypercholesterolemia in ACS, estimated by the Dutch Lipid Clinic Network Score, could be higher than previously reported.
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Aim The Assessment of Spondyloarthritis International Society Health Index (ASAS HI) Croatian version was used to assess health and functioning of patients with spondyloarthritis (SpA) covering aspects of physical, emotional and social functioning. Methods A cross sectional study was conducted at the Clinic for Internal Diseases Tuzla from January to June 2021. Inclusion criteria: fulfilled the ASAS diagnostic criteria for SpA. ⋯ The correlation between ASDAS-CRP and ASAS HI, (r=0.62; p<0.0009) was positive, statistically significant. However, the significant correlation between disease duration and ASAS HI values was not found (r=0.11; p=0.28). Conclusion The ASAS HI, Croatian version, is valid and reliable disease specific questionnaire for the assessment of health status in patients with SpA in the Bosnian speaking area.