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Edited by:

Selma Uzunović

Vol 21, No 2 (2024):

Medicinski Glasnik

Published: 01.09.2024.

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01.11.2024. Original article In the next Issue
Lower urinary tract symptoms (LUTS) as a clinical feature of lumbar spinal stenosis (LSS): a prospective study with lumbar spine morphometry analysis

By Harun Hodzic, Hakija Bečulić, Emir Begagic, Nejla Huseinspahić, Igor Sladojević, Andrej Popov, Rasim Iriškić, Tarik Zulović, Emir Becirovic, Goran Lakičević, Adem Nuhović, Haso Sefo, Aldin Jusić, Jovana Radovanović

Aim To investigate clinical and morphometric characteristics of patients with lower urinary tract symptoms (LUTS) due to lumbar spinal stenosis (LSS).
Methods This study evaluated LSS patients using clinical assessments of motor, sensory, bladder, and bowel functions, and functional disability scores from the Oswestry Disability Index (ODI) and Swiss Spinal Stenosis Questionnaire (SSSQ). Morphometric analysis included MRI measurements of the anteroposterior diameter of the intervertebral disc and dural sac, and the modified Torg-Pavlov ratio (mTPR), with follow-up re-evaluations at 6 months.
Results Of 159 patients, 49 (30.8%) had LUTS and 110 (69.2%) were in the control group. LUTS patients had a significantly higher prevalence of neurogenic claudication (100% vs. 47.3%; p<0.001), lower back pain (93.9% vs. 77.3%; p=0.011), and lower extremity pain (57.1% vs. 34.5%; p=0.008). The LUTS group also had higher ODI (54.0 vs. 50.0; p=0.019) and SSSQ score (44.0 vs. 34.0; p<0.001). Morphometric analysis showed significantly lower mTPR in LUTS patients (median 0.31 vs. 0.45; p<0.001), with an AUC of 0.704 (95%CI 0.627-0.774). mTPR≤0.31 predicted surgical revision within 6 months (OR:3.4, CI: 1.2-9.8), motor deficiency (OR:2.1, 95%CI: 1.4-5.2), and persistent LUTS post-surgery (OR:4.5, 95%CI: 1.1-18.9). mTPR≤0.34 was associated with worse follow-up outcome, including increased ODI (β:3.2; 95%CI: 1.1-5.3; p=0.004) and SSSQ score (β:4.8; 95%CI:2.1-7.5).
Conclusion LUTS patients with LSS exhibit more severe symptoms and poorer outcome, with mTPR≤0.34 being a predictor of adverse clinical outcome and the need for surgical revision within 6 months.

01.11.2024. Original article In the next Issue
Predictive factors for biochemical relapse in non-metastatic prostate cancer following primary radiotherapy

By Amila Kovčić, Šefika Umihanić, Hasan Osmić, Almedina Muhić, Enida Trumić, Eldar Hamzić, Emir Becirovic, Semir Hadžić, Amir Bećirović, Minela Becirovic, Emir Begagic

Aim To investigate the predictors of biochemical relapse (BCR) among patients with non-metastatic prostate cancer treated with radiotherapy as the first-line therapy. 
Methods The study included 91 patients diagnosed with prostate cancer at the University Clinical Centre in Tuzla, Bosnia and Herzegovina. After the radiation treatment as the first line of treatment, the patients were monitored for the next 36 months. If patients were classified in medium and high-risk groups, hormone therapy was administered. The occurrence of BCR was determined based on prostate-specific antigen (PSA) values. Potential prognostic parameters, including Gleason score (GS), PSA, tumour size (TNM), and standardised risk classification (RC), were monitored.
Results A total of 46 (50.5%) patients were aged 66-75, with a median PSA of 14.50 ng/mL. A Gleason score <6 was found in 72 (79.1%) of patients, and 31 (34.1%) had T2c tumours. The BCR occurred in 32 (35.2%) patients, with a median relapse time of 18 months. Significant predictors of BCR were Gleason score ≥6 (OR:4.46; p=0.006) and tumour stage >T2b (OR:3.59; p=0.021). The RC showed an Area Under Curve (AUC) of 0.634 (p=0.050), indicating its potential diagnostic accuracy.
Conclusion Gleason score ≥6 and TNM>T2b are significant predictors of biochemical relapse in prostate cancer patients treated with radiotherapy. These results emphasize the need for additional monitoring and timely treatment of clinical disease progression in patients with Gleason score ≥6 and tumour stage >T2b.

Aim To investigate clinical and morphometric characteristics of patients with lower urinary tract symptoms (LUTS) due to lumbar spinal stenosis (LSS).
Methods This study evaluated LSS patients using clinical assessments of motor, sensory, bladder, and bowel functions, and functional disability scores from the Oswestry Disability Index (ODI) and Swiss Spinal Stenosis Questionnaire (SSSQ). Morphometric analysis included MRI measurements of the anteroposterior diameter of the intervertebral disc and dural sac, and the modified Torg-Pavlov ratio (mTPR), with follow-up re-evaluations at 6 months.
Results Of 159 patients, 49 (30.8%) had LUTS and 110 (69.2%) were in the control group. LUTS patients had a significantly higher prevalence of neurogenic claudication (100% vs. 47.3%; p<0.001), lower back pain (93.9% vs. 77.3%; p=0.011), and lower extremity pain (57.1% vs. 34.5%; p=0.008). The LUTS group also had higher ODI (54.0 vs. 50.0; p=0.019) and SSSQ score (44.0 vs. 34.0; p<0.001). Morphometric analysis showed significantly lower mTPR in LUTS patients (median 0.31 vs. 0.45; p<0.001), with an AUC of 0.704 (95%CI 0.627-0.774). mTPR≤0.31 predicted surgical revision within 6 months (OR:3.4, CI: 1.2-9.8), motor deficiency (OR:2.1, 95%CI: 1.4-5.2), and persistent LUTS post-surgery (OR:4.5, 95%CI: 1.1-18.9). mTPR≤0.34 was associated with worse follow-up outcome, including increased ODI (β:3.2; 95%CI: 1.1-5.3; p=0.004) and SSSQ score (β:4.8; 95%CI:2.1-7.5).
Conclusion LUTS patients with LSS exhibit more severe symptoms and poorer outcome, with mTPR≤0.34 being a predictor of adverse clinical outcome and the need for surgical revision within 6 months.

01.11.2024. Original article In the next Issue
Approaches to rhythm control: Impact of electrical cardioversion versus pharmacological management on left atrial size and systolic performance in atrial fibrillation and flutter

By Emir Bećirović, Minela Bećirović, Amir Bećirović, Lejla Tupković Rakovac, Amira Jagodić Ejubović, Begajeta Čaušević, Malik Ejubović, Aida Ribić, Lamija Ferhatbegović, Ammar Brkić, Semir Hadžić, Maida Skokić, Emir Begagić

01.11.2024. Editorial In the next Issue
Bariatric surgery in University Clinical Centre Tuzla and Bosnia and Herzegovina: where we are and where we want to be

By Fuad Pašić, Nermin Salkić, Emir Ahmetašević, Ervin Alibegović, Jasmina Smajić, Lejla Jašarević, Rusmir Softić, Jasmin Hamidović, Amina Krupalija

01.11.2024. Original article In the next Issue
Which accessible clinical features and laboratory findings might predict methotrexate success in children with juvenile idiopathic arthritis in Bosnia and Herzegovina?

By Adisa Čengić, Velma Selmanović, Sniježana Hasanbegović, Hamza Izeta, Lamija Zečević, Nejra Džananović

01.11.2024. Original article In the next Issue
Effect of Arabic Gum on Gentamicin Nephrotoxicity in Mice: A Pathological Study

By Liqaa Alhyali, Firas Abed, Entisar AL-Kenanny

01.11.2024. Original article In the next Issue
Risk Factor Analysis and Predictive Model Development for Problematic Internet Gaming Disorder Occurrence

By Andrian Fajar Kusumadewi, Raihan Hananto, Arrum Putri Amalia, Muhammad Dicky Hertanto, Hermanuaji Sihageng, Muhammad Jordan Diandraputra

Current issue
01.09.2024. Review paper
Obesity and atherosclerosis in children

By Senka Mesihović-Dinarević

01.09.2024. Review paper
Urban thoracic trauma: diagnosis and initial treatment of non-cardiac injuries in adults

By Vasileios Leivaditis, Athanasios Papatriantafyllou, Ioanna Akrida, Michail Galanis, Emmanouil Dimopoulos, Anastasia Papaporfyriou, Benjamin Ehle, Efstratios Koletsis, Nikolaos Charokopos, George Pappas-Gogos, Francesk Mulita, Georgios-Ioannis Verras, Konstantinos Tasios, Vasiliki Garantzioti, Levan Tchabashvili, Manfred Dahm, Konstantinos Grapatsas

01.09.2024. Original article
The comparison of erector spinae plane block and caudal block for postoperative analgesia in paediatric surgery - meta-analysis

By Mahendratama Purnama Adhi, Rapto Hardian, Arif Budiman Susatya, Elizeus Elizeus, Arie Utariani

01.09.2024. Original article
Out-of-hospital cardiac arrest (OHCA) in Bosnia and Herzegovina in the period 2018 -2022: current trends, usage of automated external defibrillators (AED) and bystanders’ involvement

By Armin Šljivo, Tatjana Jevtić, Selma Terzić-Salihbašić, Arian Abdulkhaliq, Leopold Reiter, Faris Salihbašić, Ajla Bečar-Alijević, Adin Alijević, Ilma Dadić, Fatima Gavrankapetanović

01.09.2024. Original article
Predictors for major adverse cardiovascular events among patients with acute coronary syndrome in Bosnia and Herzegovina

By Namik Selimović, Amina Marić, Armin Šljivo, Aladin Altic, Irma Fajić, Lana Lekić, Azra Durak-Nalbantić

Recent issues
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22.09.2019. Review paper
Impact of hand hygiene knowledge on the hand hygiene compliance

By Martin Novák, Jozef Breznický, Jana Kompaníková, Nora Malinovská, Henrieta Hudečková

Aim
Hand hygiene practice is still burdened by inadequate compliance, whether in the professional sphere by health professionals or in the non-professional sphere by lay population. Aim of this study was to map the hand hygiene knowledge and its compliance in the monitored group of people.
Methods
The research was conducted at the Jessenius Faculty of Medicine in Martin of Comenius University in Bratislava (JFM CU) among seventy 3 rd year students of General Medicine (medical study program), and Nursing, Midwifery and Public Health (non-medical study programs). Knowledge of hygienic hand washing according to the WHO guidelines from 2009 was investigated, as well as differences in the level of microbial contamination of hands after routine hand washing between the group that had been acquainted with hand hygiene protocols and the group that had not sufficiently.
Results
The results have shown that 32.9% of the students did not perform hygienic hand washing properly. The differences between the groups of students with and without the proper hand hygiene compliance in routine hand washing were not statistically significant. Conclusion
The results of our survey have suggested that the reasons for decreased compliance with hand washing protocols may be related to forgetting to wash the hands or not being acquainted with hand washing protocols at all. The strategies focused only on one aspect of hand hygiene are, according to scientific literature, ineffective in the long term.

12.07.2020. Review paper
The effect of Aloe vera ethanol extract on the growth inhibition of Candida albicans

By Via Karina Nabila, Imam Budi Putra

06.11.2023. Review paper
ChatGPT's contributions to the evolution of neurosurgical practice and education: a systematic review of benefits, concerns and limitations

By Hakija Bečulić, Emir Begagić, Rasim Skomorac, Anes Mašović, Edin Selimović, Mirza Pojskić

12.07.2020. Review paper
Epidemiology of injuries connected with dance: a critical review on epidemiology

By Giuseppe Rinonapoli, Marta Graziani, Paolo Ceccarini, Cristina Razzano, Francesco Manfreda, Auro Caraffa

01.09.2024. Review paper
Obesity and atherosclerosis in children

By Senka Mesihović-Dinarević

Atherosclerosis, one of the leading causes of death in developed countries is characterized by lumen reduction of blood vessels due to local thickening of internal blood vessels caused by plaque/atheroma. It begins in childhood, goes for a long time without manifesting symptoms, increasing with age it begins to seriously threaten health. The most important risk factors for the development of atherosclerotic disease are: hyperlipidemia, hypertension, smoking, diabetes, high fibrinogen, excessive weight, increased level of homocysteine, physical inactivity, heredity and immune response in some diseases. The primary intention of prevention is to preclude the occurrence of risk factors for atherosclerosis, and the secondary is to prevent the development or aggravation of the illness along with the reduction or control of existing risks. There is an increasing number of studies that show that children are overweight, which in adolescence is certainly a risk factor for the onset of many chronic diseases, namely: cardiovascular, type 2 diabetes, orthopedic, and psychological diseases. The obesity epidemic is one of the most serious health problems of today affecting individuals of all ages. Atherosclerosis demands action with the aim of early detection and treatment as well as the reduction of development of risk factors for coronary artery diseases. Finding the most effective preventive measures for obesity in each country requires precise epidemiological data on the number of obese children and youth, as well as on their eating and activity habits.

01.09.2024. Review paper
Urban thoracic trauma: diagnosis and initial treatment of non-cardiac injuries in adults

By Vasileios Leivaditis, Athanasios Papatriantafyllou, Ioanna Akrida, Michail Galanis, Emmanouil Dimopoulos, Anastasia Papaporfyriou, Benjamin Ehle, Efstratios Koletsis, Nikolaos Charokopos, George Pappas-Gogos, Francesk Mulita, Georgios-Ioannis Verras, Konstantinos Tasios, Vasiliki Garantzioti, Levan Tchabashvili, Manfred Dahm, Konstantinos Grapatsas

12.07.2020. Review paper
Combination of vitamin A and D supplementation for ischemic stroke: effects on interleukin-1ß and clinical outcome

By Alfansuri Kadri, Hasan Sjahrir, Rosita Juwita Sembiring, Muhammad Ichwan

01.09.2024. Original article
Predictors for major adverse cardiovascular events among patients with acute coronary syndrome in Bosnia and Herzegovina

By Namik Selimović, Amina Marić, Armin Šljivo, Aladin Altic, Irma Fajić, Lana Lekić, Azra Durak-Nalbantić

22.10.2021. Review paper
Cancer rate of Bethesda category II thyroid nodules

By Francesk Mulita, Fotios Iliopoulos, Christos Tsilivigkos, Levan Tchabashvili, Elias Liolis, Charalampos Kaplanis, Ioannis Perdikaris, Ioannis Maroulis

Aim
Thyroid nodules are very common and may be found in more than 50% of the population. Fine-needle aspiration cytology
(FNAC) of thyroid nodules is a very useful diagnostic tool with high sensitivity and predictive value for diagnosis. The Bethesda System for Reporting Thyroid Cytopathology (BSRTC) uses six categories for thyroid cytology reporting (I-nondiagnostic, IIbenign, III-atypia of undetermined significance (AUS)/ follicular lesion of undetermined significance (FLUS), IV-follicular neoplasm/suspicious for follicular neoplasm (SFN), V-suspicious for malignancy, and VI-malignant. Our objective was to determine the malignancy rate in Bethesda II nodules.
Methods
From June 2010 to May 2020 a retrospective analysis was performed among 1166 patients who underwent thyroid surgery for benign thyroid diseases in our institution. Thyroid cytopathological slides and Ultrasound (US) reports were reviewed and classified according to the BSRTC. Data collected included age, gender, cytological features, and histological type of thyroid cancer.
Results
During the study period, 44.77% (522/1166) of patients with an FNA categorized as Bethesda II underwent thyroid surgery. Incidental malignancy was found in 1.53% (8/522) cases of Bethesda II. The most common malignant tumour type was papillary thyroid carcinoma.
Conclusion
The current study demonstrates that incidental thyroid carcinoma can be diagnosed after thyroidectomy even in patients
with an FNA categorized as Bethesda II.

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