Incidence and risk factors for neural tube defects in a Bosnian population

Introduction: Neural tube defects (NTDs) are multifactorial congenital anomalies of the central nervous system that results from failed neural tube closure between the 3rd and 4th weeks of embryonic development. Numerous clinical and experimental studies indicate that supplementation with folic acid before and during early pregnancy reduces the development of these anomalies. The present study examined the incidence and risk factors for NTDs and evaluated the effects of folic acid supplementation.Methods: This cross-sectional study included all children with NTDs who were hospitalized at the Pediatric Clinic, Clinical Centre University of Sarajevo during the period from January 01, 2008 to December 31, 2012. Data were collected retrospectively from the medical histories of hospitalized children. The study included children in pediatric clinics from four cantons (Sarajevo, Zenica–Doboj, Unsko–Sanski, and Central Bosnia) of the Federation of Bosnia and Herzegovina. The number of live births for the specified period in each of the four cantons was taken from a report by the Cantonal Ministry of Health.Results: Among the 69,096 live births recorded during the study period, 39 children had verified NTDs, with an overall incidence of 0.56:1,000 (or 5.6:10,000) in all four cantons. The most common NTDs were myelomeningocele with hydrocephalus (22/39, 56.4%), followed by isolated myelomeningocele (9/39, 23.1%), spina bifida occulta (7/39, 17.9%), and occipitocele (1/39, 2.6%). A total of 33.3% (13/39) of mothers took folic acid, but only one began supplementation prior to pregnancy, while 67.7% (26/39) of mothers did not take folic acid during pregnancy. NTDs were found more frequently in primiparas (53.8%), women with low education (basic school, 64.1%), and unemployed women (82.1%).Conclusion: It is important to make national recommendations for folic acid supplementation for women of reproductive age, but also change the public health policy that includes mandatory fortification of basic foods as this is the best measure for primary prevention of NTDs in the whole population regardless of employment and education status. Additional comprehensive studies are required to assess the incidence and risk factors throughout Bosnia and Herzegovina

Assessment of patient safety perception nurses in health system of Bosnia and Herzegovina in COVID period: Descriptive and cross-sectional study

Introduction: Patient safety depends on a number of factors such as teamwork, working climate, employee satisfaction, work environment, stress awareness, management perception, and attitude. Nurses have a key role to play in protecting and supporting patients, and their assessment serves as a reliable predictor of overall hospital safety. A positive attitude toward patient safety is associated with a significant reduction in complications. The aim of the study was to analyze the perception of nurses about all aspects of patient safety in relation to the workplace and length of service. Methods: The research included 647 nurses employed in health care institutions at the primary, secondary, and tertiary levels of health care. A descriptive and cross-sectional study included nurses from the Federation of Bosnia and Herzegovina. It was conducted in the period from November to December 2021, during the COVID pandemic. A standardized questionnaire on the perception of patient safety was used – Safety Attitudes Questionnaire – SAQ. Results: The analysis of the examined factors in relation to the workplace of the respondents revealed a statistically significant difference in job satisfaction (p < 0.001), as well as in the safety climate at work in relation to the workplace (p = 0.005), working conditions (p < 0.001), and management perception (p < 0.001). Stress levels showed significant differences regarding working position (p = 0.017), but also through the years of service (p = 0.012). Stress was significantly correlated with teamwork (r = 0.124; p = 0.003), showing that better teamwork will help with stress. Conclusion: The synthesis of concepts that includes patient safety and orientation toward patients should be implemented as a strategic quality orientation and set as a priority of every health care system

Kvaliteta pruženih usluga tijekom bolesti covid-19 u primarnoj zdravstvenoj zaštiti kantona Sarajevo

Introduction: Quality health services is a priority in the health system. However, after the outbreak of the COVID- 19 pandemic, the goals of the health system had to be adapted to the changed circumstances, in order to meet the health needs of patients and the expectations of health workers related to ensuring safe working conditions in a crisis. Aim: To examine the attitudes and opinions of patients on the quality of services provided during treatment for the infection of COVID-19 Research material and methods: The study included patients aged 18 and over at the Sarajevo Canton Health Center who were infected with the COVID-19 virus in the second (autumn 2020) and third (spring 2021) waves of the pandemic and who used primary health care services during their treatment. To conduct the research, we surveyed a total of 524 patients in the period from 15 September 2022 – 30 November 2022. Results: By the recommendations of the Crisis Staff of the Ministry of Health and the rules of the profession, the majority of respondents contacted the doctor on the third day after the onset of symptoms, 193 of them (36.8%). During the second and third wave, the majority of patients, 287 (54.8%) believed that there were no health workers during that period who did not behave professionally during the treatment. During treatment and visits to healthcare institutions, 72 (13.7%) patients felt that they always felt that healthcare professionals treated them differently. During treatment for COVID- 19, 78 (14.89%) patients believed that there were always enough health workers during their treatment. Conclusion: a large number of respondents think that the healthcare professionals treated them professionally during the treatment, and that they had enough information about the situation, and that they acted in accordance with the instructions published by the profession.Uvod. Pružanje kvalitetnih zdravstvenih usluga prioritet je u zdravstvenom sustavu. Međutim, nakon izbijanja pandemije bolesti COVID-19, ciljevi zdravstvenog sustava morali su se prilagoditi promijenjenim okolnostima, kako bi se zadovoljile zdravstvene potrebe pacijenata, ali i očekivanja zdravstvenih radnika povezana s osiguranjem sigurnih uvjeta rada u kriznoj situaciji. Cilj. Ispitati stavove i mišljenje pacijenata o kvaliteti pruženih usluga tijekom liječenja od bolesti COVID-19. Materijal i metode istraživanja. U studiju su uključeni pacijenti u dobi od 18 i više godina Doma zdravlja Kantona Sarajevo koji su bili inficirani virusom SARS-CoV-2 u drugom (jesen 2020.) i trećem valu (proljeće 2021.) pandemije i koji su se koristili uslugama primarne zdravstvene zaštite tijekom svojeg liječenja. U periodu od 15. rujna do 30. studenoga 2022. radi provođenja istraživanja ukupno smo anketirali 524 pacijenta. Rezultati. U skladu s preporukama Kriznog štaba Ministarstva zdravstva i pravilima struke, većina se ispitanika liječniku javila treći dan od pojave simptoma, njih 193 (36,8 %). Tijekom drugog i trećeg vala većina pacijenata (287 – 54,8 %) smatra da u tom periodu nije bilo zdravstvenih radnika koji se nisu odnosili profesionalno tijekom liječenja. Pri tretmanu te posjetu zdravstvenim ustanovama 72 (13,7 %) pacijenta smatrala su da uvijek osjete kako ih zdravstveni radnici drugačije tretiraju. Sedamdeset osam (14,89 %) pacijenata smatra da je uvijek bilo dovoljno zdravstvenih radnika tijekom njihova liječenja od bolesti COVID-19. Zaključak. Velik broj ispitanika misli da su se zdravstveni radnici profesionalno odnosili prema njima tijekom liječenja te da su imali dovoljno informacija o nastaloj situaciji i da su se ponašali u skladu s uputama koje je objavljivala struka

Risk Assessment and Perception of Healthcare Professionals in the Age of the Covid-19 Pandemic.

Introduction: Knowledge of all safety factors: teamwork, employee satisfaction, work environment, stress awareness, risk perception and attitude are the basis for improving the safety performance of health care providers - health professionals. The aim of the research is to analyze the risk perception of health professionals on aspects of occupational safety in relation to the workplace during the COVID-19 pandemic.&#x0D; Methods: A descriptive cross-sectional study included health professionals of all profiles from the Sarajevo Canton. It was conducted in the period from November to the end of December 2021. Respondents voluntarily and anonymously filled out a survey questionnaire, distributed electronically in the Google forms form.&#x0D; Results: The research included 266 health professionals of all profiles employed in health care institutions at the primary, secondary and tertiary levels of health care.&#x0D; Conclusion: The concept of risk perception of health professionals in a pandemic should be viewed as a group rather than an individual phenomenon.perception</jats:p

Ulcus Diabetica Hallucis Pedis: The Importance of Timely Treatment.

Introduction. Diabetes mellitus represent a global problem in public health, and the incidence of diabetic foot is constantly increasing Patients with diabetes have a tendency to infections, due to previously present neuropathy, vascular insufficiency, as well as neutrophil dysfunction. The most important risk factor is the existence of peripheral neuropathy, and it is present in 30% to 50% of patients with diabetes. The foot becomes sensitive to trauma as a result of sensory, motor and autonomic dysfunction, and there is excessive pressure in the deformed foot, also the development of ischemia.&#x0D; Case  report. A 59-year-ol male patient sought medical help at the Clinic of Emergency Medicine of the Clinical Center in Sarajevo. He had edematous ulcers on the foot of his right leg. On the first day of therapy, the antibiotic amoxicillin + clavulanic acid, 875/125 mf film-coated tablets were included. Ulcerative formation on the injured finger healed relatively slowly in the first five days of therapy, so from the sixth day of therapy, another broad-spectrum antibiotic per os was included, for synergistic effects: metronidazole 500 mg tablets. On the tenth day of the therapy, visible progress was observed in the healing of the injured finger. Ultimately, the treatment of the injured finger was completed routinely and successfully.&#x0D; Conclusion. Identification of risk factors as well as patients’ education is an important prerequisite for the prevention of complications arising from the chronic course of diabetes.&#x0D; Early initiation of treatment, with an adequate multidisciplinary approach, can cure ulcerative, inflammatory diabetic foot, which in our case corresponded to the Wagner-Meggitt classification, superficial ulcer, with a corresponding gradation 1.</jats:p

The long road to an efficient safety culture

Introduction/Objective Patient safety is defined as the prevention of errors and adverse effects aimed at patients and associated with health care. Patient safety culture (PSC) is "the product of individual and group values, attitudes, perceptions, competencies and patterns of behaviour that determine the commitment to, and the style and proficiency of, an organization's health and safety management." Improving the perception of the PSC within the healthcare sector plays a key role in improving its overall quality, efficacy and productivity. This article aims to point out the importance of the inexhaustible and very interesting topic of safety culture as a basis for further research and strategy creation. Methods This is a qualitative research paper, based on a scientific review of the literature. Relevant articles for this review have been identified by searching digital databases: PubMed, Medline and Google Scholar. The research was retrospective and covered a timeframe of five years. Articles were selected by introducing keywords relevant to the subject. Results The results are based on the analysis and review of 12 published scientific articles from 2017 to 2021. Conclusion Patient safety must be the priority of the healthcare provider. Theoretical foundations should be combined with educational experiences following the development of knowledge, skills and attitudes for effective patient safety. Adverse event reporting should include learning from mistakes, supporting an environment that encourages reporting without blame or fear of punishment. The healthcare system needs to be made as safe as possible for both the patients and all those providing healthcare. Improving and developing the quality of healthcare requires knowledge, selection and application of specific methods and tools tailored to the capabilities of individual healthcare institutions.</jats:p

Incidence and risk factors for neural tube defects in a Bosnian population

Introduction: Neural tube defects (NTDs) are multifactorial congenital anomalies of the central nervous system that results from failed neural tube closure between the 3rd and 4th weeks of embryonic development. Numerous clinical and experimental studies indicate that supplementation with folic acid before and during early pregnancy reduces the development of these anomalies. The present study examined the incidence and risk factors for NTDs and evaluated the effects of folic acid supplementation.Methods: This cross-sectional study included all children with NTDs who were hospitalized at the Pediatric Clinic, Clinical Centre University of Sarajevo during the period from January 01, 2008 to December 31, 2012. Data were collected retrospectively from the medical histories of hospitalized children. The study included children in pediatric clinics from four cantons (Sarajevo, Zenica–Doboj, Unsko–Sanski, and Central Bosnia) of the Federation of Bosnia and Herzegovina. The number of live births for the specified period in each of the four cantons was taken from a report by the Cantonal Ministry of Health.Results: Among the 69,096 live births recorded during the study period, 39 children had verified NTDs, with an overall incidence of 0.56:1,000 (or 5.6:10,000) in all four cantons. The most common NTDs were myelomeningocele with hydrocephalus (22/39, 56.4%), followed by isolated myelomeningocele (9/39, 23.1%), spina bifida occulta (7/39, 17.9%), and occipitocele (1/39, 2.6%). A total of 33.3% (13/39) of mothers took folic acid, but only one began supplementation prior to pregnancy, while 67.7% (26/39) of mothers did not take folic acid during pregnancy. NTDs were found more frequently in primiparas (53.8%), women with low education (basic school, 64.1%), and unemployed women (82.1%).Conclusion: It is important to make national recommendations for folic acid supplementation for women of reproductive age, but also change the public health policy that includes mandatory fortification of basic foods as this is the best measure for primary prevention of NTDs in the whole population regardless of employment and education status. Additional comprehensive studies are required to assess the incidence and risk factors throughout Bosnia and Herzegovina.</jats:p

How to improve health-related quality of life for children and adolescents with Type 1 Diabetes Mellitus

Introduction:Type 1 Diabetes Mellitus is one of the most significant and serious chronic diseases targeting children and adolescents worldwide. Improving or at least maintaining health-related quality of life in children and adolescents with chronic disease is one of the main objectives of healthcare. Methods: Article presents a qualitative research, or a scientific review of the published literature. The databases were reviewed using the following keywords: adolescents, children, diabetes mellitus type 1, health related quality of life. We used PubMed database in the preparation of this article. Results: The results include a review and analysis of 12 published scientific articles in the period from 2019 to 2021. Conclusion: It is necessary that healthcare professionals include children, adolescents and their family members as part of the team in order to achieve better results in the treatment of Type 1 Diabetes Mellitus. Education of children, adolescents and their family members is essential in the treatment of type 1 Diabetes Mellitus in children and adolescents. Assessing the quality of life and satisfaction with health care, reported by patients, can improve holistic approach in the treatment of Type 1 Diabetes Mellitus in children and adolescents, to help patients and their family to overcoming problems in treatment and thereby improve the quality of their lives.</jats:p