The serum triglyceride to high-density lipoprotein (HDL) ratio in patients with acute coronary syndrome with and without renal dysfunction

Aim To assess triglyceride – to high-density lipoprotein cholesterol (TG/HDL)-C ratio in patients with acute coronary syndrome (ACS) and to verify its association with renal dysfunction. Methods A cross sectional study included 85 ACS patients divided in two groups with (ACS – RD) and without (ACS-nRD) presence of renal dysfunction, and 35 healthy subjects. Blood pressure, blood glucose, C-reactive protein, urea, creatinine, eGFR and serum lipids levels (total cholesterol, triglycerides, LDL-C, HDL-C) was measured in all participants. Based on the values of the measured lipid fractions TG/HDLc ratio was calculated. Results Patients in ACS group had significantly lower HDL-C level (p<0.0005) but significantly higher TG level (p=0.046) and TG/HDL-C ratio (p<0.0005) than controls. There was a significant increase (p<0.0005) in TG/HDL-C ratio in ACS-RD group compared to ACS-nRD group. The ACS-RD group had significantly higher level of TG (p=0.001), serum urea (p=0.02) and creatinine (p<0.0005) compared to the ACS-nRD group. With a cut-off level of 1.135 TG/HDL-C ratio had a sensitivity of 77.6% and a specificity of 62.9% in distinguishing between ACS patients and healthy subjects. With cut-off value of 1.905 TG/HDL-C ratio had a sensitivity of 75.9% and a specificity of 78.6% in distinguishing between ACS patients with and without renal dysfunction. Conclusion This study confirms the reliability of the TG/HDL-C ratio as a simple, low cost and useful marker in distinguishing between patients with ACS and healthy subjects and ACS patients with and without renal dysfunction

The influence of social environment on the smoking status of women employed in health care facilities

Introduction: Bosnia and Herzegovina has a high prevalence of smoking among women, especially among health care professionals. The goal of this study is to investigate the influence of the social environment of women employed in health institutions in relation to the cigarettes smoking habits.Methods: The study included 477 women employed in hospitals, outpatient and public health institutions in Sarajevo Canton Bosnia and Herzegovina. We used a modifi ed questionnaire assessing smoking habits of medical staff in European hospitalsResults: The results showed that 50% of women are smokers, with the highest incidence among nurses (58.1%) and administrative staff (55.6%). The social environment is characterized by a high incidence of colleagues (60.1%) and friends who are smokers (54.0%) at the workplace and in the family (p&lt;0.005). One third of women (27.8%), mainly non-smokers, states that the work environment supports employees smoking (p=0.003).Conclusion: Workplace and social environment support smoking as an acceptable cultural habit and is contributing to increasing rates of smoking among women

Road to healthcare professional’s burnout: poor empathy and impaired work ability, are they cause or effect?

Introduction: Occupational stress is inevitable, but prolonged and intense can lead to serious health problems. Neglecting this significant aspect of work and inadequate treatment of the first indicators results in the reduced working capacity of healthcare professionals. Material and methods: Assessing working conditions of 100 healthcare professionals regarding stress impact on empathy and workability was the primary goal of this study. A survey was conducted to identify differences between work in intensive care units and other clinical departments all related to empathy, workability, and stress perceiving to determine what is a better predictor of workability. Results: In the research group “intensive care units”, significantly lower empathy quotients, poorer workability, and different stressors were registered compared to research groups named “other departments”. Conclusion: The main conclusion of the study states different dynamics in the working environment of intensive care units compared to other departments that could potentially harm the personal capacity of healthcare professionals.&nbsp

A Study of Patient Satisfaction With Healthcare in Zenica-Doboj Canton

Aim: Patient satisfaction and patient evaluation of healthcare can be seen as important results of provided care, as they reflect the level to which the patient’s subjective and objective needs have been met. The aim was to evaluate patient satisfaction with healthcare and compare the results for 2017 with the results from 2011. Methods: The study was conducted in the territory of Zenica-Doboj Canton in May 2011 and in October 2017. A questionnaire was filled out by 2,008 examinees in 2011 and by 2,000 examinees in 2017 outside healthcare institutions (in the street), using the EUROPEP questionnaire as a research instrument. The average age of the respondents was 38.4. The participants in the study were 52 % male and 48 % female. Student’s T-test was used to compare the results between the two samples. Results: A statistically significant difference was observed between the mean patient satisfaction in 2011 (3.19 ± 0.3, min. = 2.6, max. = 3.83, P = 0.00032) and the mean patient satisfaction in 2017 (3.47 ± 0.17, min. = 3.14, max. = 3.94, P = 0.000647), t(23) = 3.75. Increase in patient satisfaction in 2017 is evident compared to their satisfaction in 2011. Conclusion: Surveying the satisfaction of healthcare recipients should be a common method of work as it gives the patients the impression that their opinion is valued, while at the same time it indicates to healthcare staff that their attitudes may need to be changed, their knowledge expanded and the organization of work improved, if they want to provide services of improved quality. (Cilović Lagarija Š, Kuduzović E, Hasanica N, Begagić S, Džubur-Alić A, Lisica D. A Study of Patient Satisfaction With Healthcare in Zenica-Doboj Canton SEEMEDJ 2020; 4(2); 129-135

Burnout syndrome in primary healthcare professionals

Introduction: The aim of this study was to assess the level of burnout syndrome among primary healthcare professionals in Canton Sarajevo and whether there is a link between the levels of burnout syndrome and sociodemographic parameters. Methods: We included a total of 300 primary healthcare professionals. The burnout syndrome level was measured by Maslach Burnout Inventory, consisting of 22 particles (3 subscales) measuring the level of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). We analyzed the correlation and difference between the level of burnout and sociodemographic parameters. Results: The study revealed that in Canton Sarajevo 25.3% of healthcare professionals experience a high level of EE, 17.7% experience DP, and 19.0% experience a low level of PA. The subjects under 40 years experienced a higher level of EE than older subjects (p=0.000). There were significant differences in PA subscale between men and women (p=0.033), women having lower level of PA than males. Respondents who worked in shifts and respondents with indefinite period employment experience significantly a high level of EE. Subjects who drink alcohol had a higher level of DP. Conclusion: Healthcare professionals are at increased risk of burnout. Factors which increase the burnout syndrome risk in health professionals in Sarajevo Canton were: age under 40 years old, female, working in shifts and drinking alcohol

Relation between thyroid hormonal status, neutrophillymphocyte ratio and left ventricular systolic function in patients with acute coronary syndrome

Aim To examine a relation of thyroid function, neutrophil-lymphocyte ratio (NLR) with left ventricular function measured through the left ventricular ejection fraction (LVEF) in patients with acute myocardial infarction treated with percutaneous coronary intervention (PCI). Methods This prospective research involved 160 consecutive patients with acute myocardial infarction. Patients were divided into those with normal thyroid hormone status (n=80) and those with hypothyroidism (newly diagnosed) (n=80). Inflammatory parameters and parameters of hormonal status were taken for analysis: thyroid-stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), free thyroxine (FT4), and free triiodothyronine (FT3). All patients underwent transthoracic echocardiographic examination (TTE) five days upon admission, and left ventricular ejection fraction (LVEF) was analysed. Results Significant difference between the two groups was verified in values of T3, T4, erythrocytes, haemoglobin, haematocrit, neutrophil, lymphocytes, NLR, C-reactive protein (CRP) and sedimentation rate. Patients with euthyroidism had a higher frequency of coronary single-vessel disease (p=0.035) and a significantly lower frequency of triple vessel disease (p=0.046), as well as a higher median value of LVEF (p=0.003). There was a significant correlation between LVEF with haemoglobin values (p=0.002), NLR (p=0.001), and CRP (p=001). Conclusion The altered status of the thyroid gland in acute myocardial infarction is associated with the severity of the coronary blood vessel lesion, LVEF and correlates with inflammatory response

ELEVATED SERUM C-REACTIVE PROTEIN LEVEL IS NOT ASSOCIATED WITH SERUM NITRIC OXIDE IN PATIENTS WITH POSTTRAUMATIC STRESS DISORDER

Background: The aim of the present study was to evaluate serum nitric oxide (NO) and C reactive protein (CRP) concentration in veterans with and without PTSD. Furthermore, we aimed to assess whether there is a correlation between serum NO and CRP concentrations in tested groups. Subjects and methods: Cross-sectional study included 90 male individuals, with and without experience of direct war combat, divided into three equal groups (n=30): group 1- included war veterans with PTSD, group 2 - included war veterans without PTSD, and control group - 30 apparently healthy volunteers, without experience of direct war combat. The diagnosis of PTSD was assessed according to the guidelines in the 10th revision of the International Classification of Diseases (ICD-10). High-sensitivity CRP was determined by immunonephelometry. The serum NO level was determined by classic colorimetrical Griess reaction. Results: Serum CRP concentration in veterans with (3.54±1.19 mg/L) and without PTSD (3.24±2.04 mg/L), was significantly higher (p<0.05) compared to control group (1.26±1.06 mg/L). Serum NO concentration in veterans with (7.64±4.43 μmol/L) and without PTSD (7.12±2.60 μmol/L) was significantly lower (p<0.05) compared to control group (11.26±7.01 μmol/L). Statistically significant correlation between serum NO and CRP concentration was determined in veterans without PTSD (r=-0.473; p<0.01). No correlation was observed between serum NO and CRP concentration in veterans with PTSD (r=0.118; p=0.534) and in control group (r=-0.067; p=0.727). Conclusion: The present study has showed significant increase of serum CRP and significant decrease of serum NO concentrations in veterans with and without PTSD. Furthermore, statistically significant negative correlation between serum NO and CRP concentration was determined only in veterans without PTSD. Obtained results indicate that the complex mechanism of the pathogenesis of PTSD requires further research

The influence of social environment on the smoking status of women employed in health care facilities

Introduction: Bosnia and Herzegovina has a high prevalence of smoking among women, especially among health care professionals. The goal of this study is to investigate the influence of the social environment of women employed in health institutions in relation to the cigarettes smoking habits.Methods: The study included 477 women employed in hospitals, outpatient and public health institutions in Sarajevo Canton Bosnia and Herzegovina. We used a modifi ed questionnaire assessing smoking habits of medical staff in European hospitalsResults: The results showed that 50% of women are smokers, with the highest incidence among nurses (58.1%) and administrative staff (55.6%). The social environment is characterized by a high incidence of colleagues (60.1%) and friends who are smokers (54.0%) at the workplace and in the family (pConclusion: Workplace and social environment support smoking as an acceptable cultural habit and is contributing to increasing rates of smoking among women

Role of bone scintigraphy and tumor marker-Ca 15-3 in detection of bone metastases in patients with breast cancer

Breast cancer is one of the most frequent types of cancer affecting women. After hematogenous spreading of cancer, axial skeleton is most frequently involved. Bone scintigraphy is commonly performed in detection and evaluation of bone metastases. In breast cancer, marker Ca15-3 is widely accepted in follow-up and detection of disease recurrence. Aim of the study was to correlate levels of tumor marker Ca 15-3 and presence of bone metastases detected by bone scintigraphy. Study included 25 patients with breast cancer, previously surgically treated. All patients underwent total body scintigraphy. Ca 15-3 was measured by radioimmunoassay. Presence, number and location of bonemetastases were correlated with Ca 15-3 levels. Bone scintigraphy revealed bone metastases in 16 (64%) patients. 11 (44%) patients with metastases and 1 patient (4%) without scintigraphically visible metastases had elevated Ca 15-3 levels. Significant difference in distribution of metastases was found for spine (t=3.930, p=0.008). Correlation between intensity of radiopharmaceutical uptake and level of Ca 15-3 in patients was positive (r =0.405). A weak correlation was found between number of metastases and level of Ca 15-3 (r=0.139). Significant differences in Ca 15-3 level was found in patients with metastases compared to patients without metastases (chi square 0, p =1.0). Since no significant correlation was found between level of Ca 15-3 and number of metastases, we consider scintigraphy an appropriate method for assessment of bone metastases in breast cancer