Medical archives (Sarajevo, Bosnia and Herzegovina)最新文献

{"title":"Sympathetic Ophthalmia After Complicated Cataract Surgery.","authors":"Nguyen Thanh Nam, Nguyen Quynh Anh","doi":"10.5455/medarh.2025.79.64-66","DOIUrl":"10.5455/medarh.2025.79.64-66","url":null,"abstract":"<p><strong>Background: </strong>Sympathetic ophthalmia (SO) is a bilateral, diffuse granulomatous panuveitis that can occur after a penetrating trauma or intraocular surgery. The time from ocular injury to the onset of sympathetic ophthalmia varies greatly, ranging from several days to decades.</p><p><strong>Objective: </strong>We report on the diagnostic dilemma and clinical outcome of patient with sympathetic ophthalmia within 2 weeks of cataract surgery.</p><p><strong>Case presentation: </strong>A patient underwent left eye cataract surgery that was complicated by postoperative iris prolapse through the corneal wound. The wound was sutures with iris still entrapped, and he presented to our clinic 1 week later with bilateral vision loss and panuveitis. After workup for other inflammatory or infectious causes, sympathetic ophthalmia was diagnosed, and the patient was treated with topical and systemic corticosteroids. One month later, visual acuity improved markedly in both eyes, and inflammatory symptoms and findings resolved. Sympathetic ophthalmia may occur soon after cataract surgery and can be confused with infectious endophthalmitis, which must be considered.</p><p><strong>Conclusion: </strong>Prompt diagnosis and institution of corticosteroid therapy is essential and may result in significant visual improvement in both eyes.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"79 1","pages":"64-66"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Challenges of Tuberculous Meningitis Initially Presenting as Otomastoiditis.","authors":"Hung Quang Nguyen, Hoa Hong Thi Doan, Long Hoang Vo","doi":"10.5455/medarh.2025.79.71-77","DOIUrl":"10.5455/medarh.2025.79.71-77","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), remains a major global health problem, with one-third of the world's population infected.</p><p><strong>Objective: </strong>This report presents five cases of tuberculous meningitis with a particular emphasis on the symptoms and signs of otitis media that, in various combinations, should raise suspicion for tuberculous meningitis.</p><p><strong>Case presentation: </strong>These cases underscore the diagnostic challenges and clinical complexities associated with tuberculous otitis media, particularly when there is concurrent involvement of the central nervous system. It is crucial for physicians to maintain a high index of suspicion for tuberculosis in patients exhibiting chronic otorrhea that does not respond to conventional treatments, especially in endemic regions or in the presence of systemic symptoms. The use of advanced diagnostic tools and a multidisciplinary approach is essential for achieving timely diagnosis and effective management. Early initiation of antituberculous therapy, coupled with surgical interventions when warranted, can lead to favorable clinical outcomes. However, it is important to note that some patients may experience long-term sequelae, which highlights the necessity for prompt diagnosis and treatment to improve prognosis in those presenting with otitis media.</p><p><strong>Conclusion: </strong>The findings of this case series contribute to a better understanding of the relationship between otitis media and tuberculous meningitis, advocating for increased awareness among healthcare providers to facilitate early recognition and intervention.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"79 1","pages":"71-77"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Idiopathic Omental Necrosis in a Young Adult: Diagnostic Challenges and Management.","authors":"Janja Konjevod, Vanja Djukic, Tomislav Vukic, Klara Brekalo, Sara Abbaci Jangjel, Stefan Dimov, Rajko Fures, Vilmica Kapac, Mario Fuckar","doi":"10.5455/medarh.2025.79.237-240","DOIUrl":"10.5455/medarh.2025.79.237-240","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic omental infarction (IOI) is a rare cause of acute abdominal pain that can clinically mimic more common conditions, such as acute appendicitis. IOI occurs due to vascular compromise of the greater omentum, leading to ischemia, pain, and often necrosis. Preoperative diagnosis remains challenging due to nonspecific clinical and laboratory findings, as well as the fact that clinicians rarely include IOI as a \"usual suspect\" in the differential diagnosis. Therefore, the condition is commonly identified intraoperatively.</p><p><strong>Objective: </strong>The aim of this article was to present a rare case of idipathic omental necrosis in young adult with description of appropriate diagnostic challanges and management.</p><p><strong>Methods: </strong>We present the case of a 23-year-old previously healthy male who was admitted for suspected acute appendicitis based on right lower quadrant pain, nausea, vomiting, and elevated inflammatory markers. Exploratory laparoscopy revealed no signs of appendicitis but identified hemoperitoneum and a necrotic segment of the greater omentum in its right upper segment. Appendectomy and resection of the infarcted omental tissue were performed. Histopathological analysis confirmed the diagnosis of omental infarction as well as the absence of histopathological signs of acute appendicitis.</p><p><strong>Conclusion: </strong>Idiopathic omental infarction, though rare, should be considered in the differential diagnosis of acute abdomen, particularly when clinical findings do not align with typical appendicitis. Advanced imaging modalities such as contrast-enhanced CT can facilitate preoperative diagnosis, potentially preventing unnecessary surgical interventions. However, in cases of diagnostic uncertainty, surgical exploration remains a mainstream approach. Awareness of this condition can improve diagnostic accuracy and optimize patient management.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"79 3","pages":"237-240"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12253603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive Aortic Root Surgery (Mini-Bentall): Case Series Study.","authors":"Harun Avdagic, Mustafa Tabakovic, Miha Antonic, Alisa Krdzalic, Selma Sijercic, Melika Piric, Maida Sahinovic","doi":"10.5455/medarh.2025.79.233-236","DOIUrl":"10.5455/medarh.2025.79.233-236","url":null,"abstract":"<p><strong>Background: </strong>The upper mini sternotomy Bentall (mini-Bentall) procedure may result in less trauma and earlier recovery compared with the usual full sternotomy Bentall procedure (Usual Bentall-DeBono procedure).</p><p><strong>Objective: </strong>This study evaluates the efficacy and safety of mini sternotomy aortic root surgery (MSARS), a minimally invasive technique designed to reduce surgical trauma, improve postoperative recovery, and lower healthcare costs.</p><p><strong>Methods: </strong>The upper mini sternotomy (UMS) approach was performed in ten patients focusing on standardized surgical procedures, and rigorous postoperative care. Key findings indicate that MSARS markedly reduces postoperative complications, ICU stay, and overall hospital stay compared to traditional sternotomy.</p><p><strong>Results: </strong>The median postoperative length of stay was seven days for MSARS versus 11 days for traditional sternotomy, with ICU stays of 27 hours and 105 hours, respectively. Our study also highlights the cost-effectiveness of MSARS, with decreased hospital costs per patient due to reduced ICU resource utilization and shorter hospital stays. These findings suggest that MSARS is a valuable and advantageous alternative to traditional sternotomy, offering substantial benefits in terms of patient outcomes and healthcare efficiency.</p><p><strong>Conclusion: </strong>Mini sternotomy aortic root surgery via partial upper sternotomy could be a safe alternative to the full median sternotomy, marking a significant advancement in the field of cardiac surgery.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"79 3","pages":"233-236"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12253582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness and Knowledge, Towards Burn First Aid of Pediatric Burns in Saudi Arabia: a Cross-Sectional Study.","authors":"Saleh Saeed Al Jathnan Al Qahtani, Ahmed Al Abyah, Omar Al-Otaibi, Faisal Alghamdi, Saad Alharthi, Rawan Aljohani, Afnan Alharbi, Fay Alanazi, Azzah Alghamdi, Ali Alyami, Muteb Alharthi, Mohammed Alshehri, Ahmed Arif, Fai Arif","doi":"10.5455/medarh.2025.79.111-116","DOIUrl":"10.5455/medarh.2025.79.111-116","url":null,"abstract":"<p><strong>Background: </strong>Burn injuries are dangerous, difficult, and more likely to cause complications in children.</p><p><strong>Objective: </strong>The purpose of the current study was to examine the knowledge and comprehension of emergency care for pediatric burns among Saudi and non-Saudi citizens.</p><p><strong>Methods: </strong>An observational, cross-sectional study was carried out over a six-month period in various Saudi Arabian regions. A structured survey was utilized to collect information from adult participants recruited through social media. This survey was piloted to guarantee its clarity and relevance. The sample size was estimated to allow for a 95% confidence level and a 5% margin of error. SPSS software was used to conduct statistical analyses on awareness levels, first aid knowledge, and demographic relationships.</p><p><strong>Results: </strong>Majority of participants was Saudi (94.7%), female (60.4%), single (54.9%) and less than 25 years old (51.9%). Only 124 (12.1%) participants had a high level of awareness. A total of 470 (45.9%), 338 (33%) and 216 (21.1%) participants had high, moderate and low knowledge scores, respectively. Also, 757 (73.9%), 231(22.6%) and 36 (3.5%) participants had positive, neutral and negative attitude, respectively. The majority of participants received their information through online resources (40.5%), social media (30%) and educational institutions (25%). Females' participants had significantly better knowledge score. Also, significantly better attitude scores were noticed with participants who had children and who age > 25 years old. Likewise, students and employees had better awareness and knowledge scores compared to other occupations. Meanwhile, participants with advanced level of education (Master/PhD) had better scores.</p><p><strong>Conclusion: </strong>There is a lack of knowledge and practice of pediatric burn's first aid. Thus, courses and training in first aid for burns and awareness campaigns are essential in order to improve the knowledge of the general Saudi population.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"79 2","pages":"111-116"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Date Consumption on Labor and Vaginal Birth.","authors":"Mohammad Abou El-Ardat, Zarema Obradovic, Dzenana Saldo, Minela Velagic, Aida Omeragic, Nedim Galijasevic","doi":"10.5455/medarh.2025.79.56-60","DOIUrl":"https://doi.org/10.5455/medarh.2025.79.56-60","url":null,"abstract":"<p><strong>Background: </strong>Date palm fruits (Phoenix dactylifera L.) are a widely available product that contains numerous macronutrients including a high sugar content. Research has shown that date fruit extracts possess antibacterial and antifungal properties, as well as antimutagenic and antiatherogenic effects. Date fruit can also have a beneficial effect on the female reproductive system. Several studies have examined the impact of date consumption during pregnancy on the outcome of labor, providing useful results.</p><p><strong>Objective: </strong>This study aims to determine the effects of date fruit consumption on the onset and progression of labor.</p><p><strong>Methods: </strong>The study included 120 pregnant women who were pregnant at GAK Sarajevo, in the period from 01.01. 2020 to 31.12. 2020. The patients were divided into two groups, the first group of 60 patients who consumed 6 dates during the last four weeks of pregnancy, and the second group of 60 patients who did not consume dates during pregnancy.</p><p><strong>Results: </strong>There was a significant positive effect of consuming date fruits on maternal outcomes in the first and third stages of labor. The group of pregnant women who consumed dates had a shortened latent phase of labor, which meant that their cervix reached maximum dilation (10 cm) faster. Pregnant women in this group gave birth 8.5 hours faster than pregnant women who did not consume dates, in whom labor lasted about 15 hours. Of the 60 pregnant women in the first group, 60% had a spontaneous natural birth, and only 40% of the patients received oxytocin, because dates enhance the effect of oxytocin, which is responsible for uterine contractions.</p><p><strong>Conclusion: </strong>This study showed a promising effect of consuming date fruits on the duration of the stages of labor. Saturated and unsaturated fatty acids found in dates stimulate the production of prostaglandins, which are necessary for labor. Dates are also rich in folic acid, vitamin K, iron, potassium, and magnesium.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"79 1","pages":"56-60"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Beneficial Effect of Melatonin on Gentamicin-induced Liver Injury in Rats.","authors":"Mersiha Krupalija-Fazlic, Dina Kapic, Maida Sahinovic, Samra Custovic, Visnja Muzika","doi":"10.5455/medarh.2025.79.86-91","DOIUrl":"10.5455/medarh.2025.79.86-91","url":null,"abstract":"<p><strong>Background: </strong>Gentamicin is a potent, broad-spectrum aminoglycoside antibiotic used in the treatment of many infections. Gentamicin can induce hepatotoxicity through oxidative stress and apoptosis. Since melatonin has antioxidant properties, its protective effects on liver tissue damage were evaluated in this study.</p><p><strong>Objective: </strong>The aim of this study was to conduct our investigation to assess the hepatoprotective effects of melatonin in rats treated with gentamicin.</p><p><strong>Methods: </strong>Forty eight adult male Wistar rats were used. The animals were randomly distributed into six groups of equal size. During the period of 11 days, three control groups of rats were daily injected i.p. with the vehicle or with melatonin at a dose of 5 or 10 mg/kg. The gentamicin group was injected with gentamicin at a dose of 80 mg/kg during 8 days and vehicle for 11 days. The other two experimental groups were administered gentamicin (80 mg/kg during) 8 days and melatonin (doses of 5 and 10 mg/kg) 3 days before and 8 days concomitantly with melatonin. Obtained liver sections were analyzed using qualitative, semi-quantitative, and stereological analysis.</p><p><strong>Results: </strong>Gentamicin expressed hepatotoxic effects inducing congestion of lobular blood vessels, hydropic degeneration of periportal hepatocytes and mononuclear infiltration in the portal tract. Treatment with gentamicin resulted in an increase in the Vv of blood vessels, a decrease in the Vv of hepatocytes, and a decrease in the glycogen content in all three lobular zones. Melatonin administration reduced the liver alterations induced by gentamicin; the higher dose had a more potent protective effect.</p><p><strong>Conclusion: </strong>Melatonin has a beneficial effect on gentamicin-induced liver damage and the effect is dose-dependent.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"79 2","pages":"86-91"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic Management of Triangular Fibrocartilage Complex Injuries: Clinical Outcomes and Functional Results in a Vietnamese Population.","authors":"DaoXuan Thanh, Bui HongThien Khanh, Le Trong Tan, TranNguyen Phuong","doi":"10.5455/medarh.2025.79.100-104","DOIUrl":"10.5455/medarh.2025.79.100-104","url":null,"abstract":"<p><strong>Background: </strong>Triangular fibrocartilage complex (TFCC) injuries commonly cause ulnar-sided wrist pain, yet reports on arthroscopic management outcomes in Asian populations remain limited.</p><p><strong>Objective: </strong>This study evaluates clinical outcomes following arthroscopic treatment of TFCC injuries in Vietnamese patients.</p><p><strong>Methods: </strong>This prospective study included 40 patients (60% female, mean age 32.6±8.6 years) with TFCC injuries treated arthroscopically between January 2021 and December 2022. Preoperative assessment included Visual Analog Scale (VAS) pain evaluation, Modified Mayo Wrist Score (MMWS), Disabilities of the Arm, Shoulder, and Hand (DASH) scores, physical examination, and MRI. Surgical techniques included debridement (17.5%), capsular repair (57.5%), and transosseous repair (25.0%). Patients were evaluated at 1, 3, and 6 months postoperatively.</p><p><strong>Results: </strong>Type 1B tears (62.5%) were most common. MRI diagnosis matched intraoperative findings in only 42.5% of cases. Mean VAS pain scores improved from 6.90±1.57 preoperatively to 1.03±1.44 at 6 months (p<0.001). MMWS scores improved from 51.50±12.57 to 88.38±10.15, with 87.5% of patients achieving good or excellent results. DASH scores decreased from 38.73±15.93 to 9.23±8.62 (p<0.001). Complications occurred in 15% of patients, primarily transient ulnar nerve symptoms. No significant outcome differences were observed between surgical techniques. Patient satisfaction was high (92.5%).</p><p><strong>Conclusion: </strong>Arthroscopic management of TFCC injuries in Vietnamese patients demonstrates excellent short-term outcomes regardless of surgical technique. The discrepancy between MRI and arthroscopic findings highlights the importance of thorough arthroscopic evaluation.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"79 2","pages":"100-104"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Serological Predictors of Liver Fibrosis in Vietnamese Chronic Hepatitis B Patients with Persistently Normal or Mildly Elevated Aminotransferase Level.","authors":"Tien Duc Dao, Hieu Van Tran, Khai Hoang Nguyen, Khien Van Vu","doi":"10.5455/medarh.2025.79.147-154","DOIUrl":"10.5455/medarh.2025.79.147-154","url":null,"abstract":"<p><strong>Background: </strong>Chronic hepatitis B (CHB) remains a significant health concern, especially in low- and middle-income countries. Some CHB patients with normal or mildly elevated ALT may have advanced liver fibrosis, which often goes undetected.</p><p><strong>Objective: </strong>The aim of this study was to assess the prevalence of significant fibrosis and the diagnostic accuracy of serum markers in CHB patients with ALT <2× ULN in Vietnam.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at 175 Military Hospital between October 2019 and December 2021. A total of 144 CHB patients with ALT <2× ULN were assessed for liver fibrosis using FibroScan (METAVIR criteria). The diagnostic accuracy of APRI and FIB-4 was evaluated using receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>Among 144 participants, 26.4% exhibited advanced fibrosis (F≥2), including 9% with cirrhosis. Advanced fibrosis correlated with older age (50 vs. 42 years, p=0.012), male sex (p=0.024), higher AST, ALT, and GGT levels (p<0.05), and lower platelet counts (PLT) (p<0.001). APRI and PLT demonstrated the highest diagnostic accuracy (AUC=0.802 and 0.805, respectively). APRI achieved 84.2% sensitivity and 92.5%, negative predictive value (NPV), while PLT had the highest specificity (81.1%). FIB-4 (AUC=0.716), ALT (AUC=0.676), and prothrombin time (PT) (AUC=0.646), had moderate performance. Combining APRI and PLT significantly improved diagnostic accuracy (p<0.05).</p><p><strong>Conclusion: </strong>Significant fibrosis was present in 26.4% of CHB patients with normal or mildly elevated ALT levels. APRI and PLT are reliable and cost-effective to detect early fibrosis in re-source-limited settings. These findings underscore the need to revise Vietnam's CHB management strategies for earlier fibrosis diagnosis and treatment.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"79 2","pages":"147-154"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mid-Term Outcomes and Prognosis of Decompressive Craniectomy in Severe Traumatic Brain Injury.","authors":"Duong Dai Ha, Vo Thanh Toan, Le Ba Tung","doi":"10.5455/medarh.2025.79.142_146","DOIUrl":"10.5455/medarh.2025.79.142_146","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) is one of the leading causes of death and severe neurological sequelae worldwide, profoundly impacting patients' quality of life and imposing a significant economic and social burden. Numerous studies have shown that the mortality and neurological disability rates following TBI remain high, with over 20% of patients either dying or suffering severe disability.</p><p><strong>Objective: </strong>This study aims to assess the outcomes of decompressive craniectomy (DC) in patients with severe traumatic brain injury (TBI) at discharge and 3 months postoperatively, while identifying prognostic factors influencing patient outcomes during this period.</p><p><strong>Methods: </strong>A prospective descriptive study was conducted on all patients with severe TBI indicated for DC from March to December 2024 at Viet Duc University Hospital. CT scan characteristics were evaluated using the Rotterdam and Helsinki scoring systems. Clinical outcomes were assessed using the Glasgow Outcome Scale (GOS) at discharge and 3 months post-injury. Prognostic factors were analyzed through multivariate logistic regression and receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Among 150 patients with severe TBI who underwent DC, 71.33% had poor outcomes (GOS 1-2-3) at discharge. This proportion decreased to 40.85% after 3 months, indicating notable recovery. Poor outcomes at discharge were significantly associated with advanced age, high Helsinki score on admission, and presence of hemiparesis. These factors also demonstrated stronger predictive power at the 3-month follow-up. The Rotterdam score correlated with discharge outcomes and was valuable for early risk stratification, whereas the Helsinki score was predictive at both discharge and follow-up time points.</p><p><strong>Conclusion: </strong>Decompressive craniectomy is an effective life-saving procedure in patients with severe TBI. However, surgical decision-making should be guided by comprehensive prognostic evaluation, including age, neurological status at admission, and radiological scoring systems. Such multifactorial assessment enhances the likelihood of survival, meaningful functional recovery, and long-term quality of life.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"79 2","pages":"142-146"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}