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

{"title":"Granulomatous Myocarditis Caused by Candida Spp Infection in a Spontaneously Diabetic Torii Rat.","authors":"Kinuko Uno, Soon Hui Teoh, Keita Sekiguchi, Noriko Suzuki-Kemuriyama, Takeshi Ohta, Katsuhiro Miyajima","doi":"10.5455/medarh.2024.78.177-179","DOIUrl":"https://doi.org/10.5455/medarh.2024.78.177-179","url":null,"abstract":"<p><strong>Background: </strong>Myocarditis refers to myocardial inflammation with necrosis caused by non-infectious of infectious agents such as bacteria, fungi, or drugs. Candida is known to cause myocarditis in healthy and immunocompromised individuals. Diabetes mellitus causes chronic hyperglycemia due to impaired secretion or hypofunction of insulin, induces a compromised state, and increases the risk of contracting various infections.</p><p><strong>Objective: </strong>We report a case of granulomatous myocarditis caused by Candida in a Spontaneously Diabetic Torii rat, a non-obese diabetic model.</p><p><strong>Case report: </strong>A male SDT rat, 61 weeks of age, was housed in conventional environment. The rat was provided a commercial diet and tap water ad libitum. The heart was sampled and prepared the specimen of hematoxylin-and-eosin-, Sirius-red-, Giemsa-, Grocott-stain. Histologically, formation of large granulation tissue was observed in the left ventricular wall. A center of the foci showed necrosis. Moreover, inflammatory cells infiltration and fibrous component were increased surrounding the foci and between myocardial cells. A Grocott and Giemsa staining-positive cell masses occasionally appearing in the foci were considered to be Candida because of their characteristic form.</p><p><strong>Conclusion: </strong>The development and progression of myocarditis were potentially related to a diabetes-induced compromised state.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 2","pages":"177-179"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10983084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862145","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":"Maternal and Neonatal Outcomes of Adolescent Pregnancy in Vietnam.","authors":"Nguyen Thi Thu Ha, Phan Thi Huyen Thuong, Dang Hong Hai, Duong Thi Tra Giang, Nguyen Duy Anh","doi":"10.5455/medarh.2024.78.220-225","DOIUrl":"10.5455/medarh.2024.78.220-225","url":null,"abstract":"<p><strong>Background: </strong>Adolescent pregnancy is a global concern worldwide. According to the World Health Organization (WHO), adolescent pregnancy, also known as teenage pregnancy, is defined as pregnancy in girls between the ages of 10 and 19, with those aged 10 to 15 years termed younger adolescents.</p><p><strong>Objective: </strong>The aim of this study was to evaluate the maternal and neonatal outcomes of adolescent pregnancy.</p><p><strong>Methods: </strong>This descriptive cross-sectional study included 333 singleton pregnancies aged under 19 years at the time of delivery, and delivering at Hanoi Obstetrics and Gynecology Hospital from January 2022 to December 2022. The maternal and neonatal outcomes were collected.</p><p><strong>Results: </strong>The rate of at least one maternal or neonatal adverse outcomes was 84.7%. There were 26.4% anemia, 18.9% preterm birth, 1.8% pre-eclampsia, 2.4% gestational diabetes mellitus, 30.9% urinary tract infection, 41.4% cesarean delivery and 21.0% neonatal low birth weight. Comparable to older adolescents (aged 16-19 years), younger (aged under 16 years) were at higher risk for complications regarding maternal anemia (43.8 vs. 24.6%, p < 0.05), threatened abortion (15.6 vs. 5.0%, p < 0.05), and urinary tract infection (50.0 vs. 28.9%, p < 0.05).</p><p><strong>Conclusion: </strong>Almost adolescent pregnancies have at least one maternal or neonatal adverse outcome. In which, anemia, preterm birth, and neonatal low birth weight are of concern. Thus, it is prior to provide various modalities and improve the antenatal quality to reduce pregnant complication for adolescents.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 3","pages":"220-225"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412040","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":"Prognostic Factors of Preterm Birth After Selective Laser Umbilical Cord Coagulation for Twin-twin Transfusion Syndrome at Hanoi Obstetrics and Gynecology Hospital.","authors":"Do Tuan Dat, Phan Thi Huyen Thuong, Nguyen Thi Thu Ha, Nguyen Duy Anh","doi":"10.5455/medarh.2024.78.215-219","DOIUrl":"10.5455/medarh.2024.78.215-219","url":null,"abstract":"<p><strong>Background: </strong>Twin-Twin Transfusion Syndrome (TTTS) is a serious complication affecting 10-15% of monochorionic diamniotic twin pregnancies, characterized by imbalanced blood flow between fetuses, which can lead to high morbidity and mortality if untreated. Fetoscopic laser photocoagulation has become the standard treatment, offering improved survival rates by interrupting abnormal blood vessel connections.</p><p><strong>Objective: </strong>This paper focuses on creating models for treatment and diagnosis of patients suffering from Ovaria This study evaluates the prognostic factors influencing the risk of preterm birth after selective laser umbilical cord coagulation in cases of Twin-Twin Transfusion Syndrome (TTTS) stages II-IV.</p><p><strong>Methods: </strong>A prospective study was conducted from September 2019 to November 2020 at the Fetal Medicine Center of Hanoi Obstetrics and Gynecology Hospital. Twenty-one monochorionic-diamniotic twin pregnancies diagnosed with TTTS underwent selective laser umbilical cord coagulation. Gestational age, cervical length changes, and surgical outcomes were recorded and analyzed.</p><p><strong>Results: </strong>The mean gestational age at birth was 34.7 ± 4.3 weeks, with an average pregnancy retention of 12.97 weeks post-surgery. Preterm births occurred in 52.6% of cases, with 31.6% before 34 weeks. Surgery performed after 22 weeks of gestation increased the risk of preterm birth by 4.3 times (p = 0.025), while a cervical length reduction of more than 9.5% within 48 hours post-surgery raised the risk by 8.7 times (p = 0.006).</p><p><strong>Conclusion: </strong>Gestational age at surgery and postoperative cervical length reduction are critical factors influencing the risk of preterm delivery following TTTS treatment.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 3","pages":"215-219"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412106","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":"Surgical Treatment of Bleeding Ulcer in Cases When the Gastroenterological and Radiological Approach is Insufficient or Disabled - Single Center Expirience.","authors":"Zijah Rifatbegovic, Maja Kovacevic, Muharem Zildzic, Amar Kesetovic, Emir Ahmetasevic","doi":"10.5455/medarh.2024.78.211-214","DOIUrl":"10.5455/medarh.2024.78.211-214","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Urgent surgical treatment of bleeding gastric and duodenal ulcer is indicated in cases where there is no treatment by an interventional gastroenterologist and radiologist readily available, or there is no satisfactory response to the applied interventional procedure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of our study is to show that there is the still large number of patients with massive bleeding gastric or duodenal ulcers who had to undergo emergency surgery, in order to achieve hemostasis, provide survival analisys, and to present a methode of the surgical procedure which we perfomed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study analysed 49 patients in the period of 5 years (2013-2018), who underwent emergency surgery due to bleeding ulcer. All patients had one or more gastroscopies in order to stop the bleeding, which were ineffective. Surgical treatments which are used in managing ulcer bleedings depended on the localization of the lesion and how severe the bleeding is. Indicated treatment is direct compression of a bleeding blood vessel (ulcer niche), truncal vagotomy, pyloroplasty, gastroduodenal artery ligature, ligature of the right gastroepiploic artery. Resection procedures were performed as well: antrectomy, proximal, subtotal and total gastrectomy. All surgical treatments aimed to preserve the patients of gastrointestinal tract where such an approach could be carried out.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were total of 49 patients who underwent surgical treatment of bleeding ulcer of which 31 are male (63,27%) and 18 are female (36,73%). The survival was 38,78% (19 patients); mortality 61,22% (30 patients). The most common surgical treatment was direct suture of a bleeding vessel with a ligature of the gastroduodenal and right gastroepiploic artery. When we observe the results of resection procedures subtotal gastrectomy was most commonly used. Surgical procedure performed were bilateral vagotomy, ligature of gastroduodenal and right gastroepiploic artery if the ulcer is localized in the antral, pyloric or duodenal region and not penetrating showed that there is no need for gastrotomy/duodenotomy and direct suturing of the bleeding vessel significantly reduces operative procedure, and saves the patient from additional surgical trauma and allows the desired hemostasis. In 5-10% of patients with bleeding ulcers, emergency surgery is indicated due to massive bleeding and hemorrhagic shock and then surgery is the only chance of survival. The primary goal of any surgery for bleeding ulcer is to establish bleeding control. massive ulcer bleeding. All these patients did not have the opportunity to avoid surgery and stop the bleeding with the treatment of an interventional gastroenterologist and radiologist. Survival is 38.78%, mortality is still high 61.22% but it is encouraging that without the application of surgical treatment it would be 100% in this group of patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/str","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 3","pages":"211-214"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412126","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":"Clinical Study on the Use of Botulinum Toxin for Blepharospasm and Hemifacial Spasm.","authors":"Ajla Skopljak-Salkica, Ivana Gabric, Mateja Jagic, Nita Bejdic, Alma Biscevic, Melisa Ahmedbegovic-Pjano","doi":"10.5455/medarh.2024.78.326-328","DOIUrl":"10.5455/medarh.2024.78.326-328","url":null,"abstract":"<p><strong>Background: </strong>Botulinum toxin (BoNT) type A, commonly known by its brand name Botox, has gained widespread recognition as a therapeutic intervention for conditions such as blepharospasm and hemifacial spasm. These conditions are classified as focal dystonias and are characterized by involuntary muscle contractions that can cause both functional disabilities and cosmetic concerns for those affected.</p><p><strong>Objective: </strong>The primary aim of this study was to comprehensively assess the efficacy, safety, and tolerability profile of Botulinum toxin in a cohort of 21 patients, comprised of 16 individuals diagnosed with blepharospasm and 5 with hemifacial spasm.</p><p><strong>Methods: </strong>Each patient underwent a series of Botox injections tailored to their specific condition and symptom severity. Following the administration of the treatment, participants were closely monitored over a six-month period to evaluate clinical outcomes and any potential adverse effects.</p><p><strong>Results: </strong>The treatment with Botulinum toxin resulted in a significant reduction in the frequency and intensity of involuntary muscle contractions in all participants. Furthermore, patients reported substantial improvements in their quality of life, indicating enhanced daily functioning and overall well-being. Notably, the treatment was generally well-tolerated, with only a few mild side effects, suggesting that adverse reactions were minimal and manageable.</p><p><strong>Conclusion: </strong>The findings from this study bolster the evidence supporting the use of Botulinum toxin as an effective first-line treatment option for individuals suffering from both blepharospasm and hemifacial spasm. The promising results highlight its role in alleviating symptoms and improving the quality of life for patients affected by these challenging conditions.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 4","pages":"326-328"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470339","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":"Attention-deficit Hyperactivity Disorder and Autism Spectrum Disorder: Towards Better Diagnosis and Management.","authors":"Kholoud Al Ghamdi, Jawaher AlMusailhi","doi":"10.5455/medarh.2024.78.159-163","DOIUrl":"https://doi.org/10.5455/medarh.2024.78.159-163","url":null,"abstract":"<p><strong>Background: </strong>Attention-deficit hyperactivity disorder (ADHA) is one of the most common comorbid disorders of autism spectrum disorder (ASD) that can accompany autism, triggered by it, or be a consequence of it.</p><p><strong>Objective: </strong>This review explored the prevalence of the comorbidity of both disorders, neurobiological background, symptoms, latest assessment methods, and therapeutic approaches. <b>Results and Discussion:</b> It concluded that effective assessment, diagnosis and management of ADHD in ASD children and adults is essential for this group of patients to thrive and live a good quality of life. Further research is recommended to explore the most effective intervention for such important members of our society.</p><p><strong>Conclusion: </strong>More studies are needed to understand the mechanisms underlying these comorbidities, and to prevent the misdiagnosis and mismanagement of these disorders. Also, to develop up to date personalized therapeutic plans for such children.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 2","pages":"159-163"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10983102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872881","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":"Role of Calprotectin, IL-6, and CRP in Distinguishing Between Inflammatory Bowel Disease and Diarrhea Predominant Irritable Bowel Syndrome.","authors":"Bui-Thi Thu Huong, Nguyen Minh Hien, Nguyen Tien Dung, Dao Minh Quang, Nguyen Thanh Vinh, Tran Thanh Tu, Tran Khanh Chi, Le-Thi Bich Phuong, Nguyen-Thi Nhan","doi":"10.5455/medarh.2024.78.105-111","DOIUrl":"https://doi.org/10.5455/medarh.2024.78.105-111","url":null,"abstract":"<p><strong>Background: </strong>The early establishment of prophylaxis and immediate administration of anticoagulant therapy upon the diagnosis of venous thromboembolism should be the treatment objectives in these patients.</p><p><strong>Objective: </strong>The study aimed to determine the optimal cut-off point of Calprotectin, IL-6 (interleukin-6), CRP (C reactive protein) to differentiate UC, IBS-D.</p><p><strong>Methods: </strong>A cross-sectional descriptive study of 335 individuals ≥15 years old was performed, including 31 healthy controls, 215 with IBS-D, 71 diagnosed with UC, and 18 diagnosed with CD. Receiver Operating Characteristics (ROC), sensitivity, specificity, and area under curve (AUC) were computed.</p><p><strong>Results: </strong>The results showed that the median value of calprotectin (IQR) in healthy participants was 20.0 (6.0 - 34.0) µg/g; 17,7 (8,7-38,9) µg/g in IBS-D group; 1710.0 (588 - 4260,0) µg/g in UC group; and 560.5 (177.8 - 1210.0) µg/g in CD group. Calprotectin concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The median value of CRP (range IQR) was 1,3 (0,9 - 2,3) mg/L in IBS-D group; 7.0 (2.4 -16.6) mg/L in UC group; and 10.1 (2.2 - 42.5) mg/L in CD group. CRP concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The median value of IL-6 (range IQR) was 2.3 (1.6 - 5.7) pg/mL in IBS-D group; 16.8 (9.4 - 47.0) pg/mL in UC group; and 9.4 (7.9 - 11.0) pg/mL in CD group. Calprotectin concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The optimal cut-off point of calprotectin that differentiated IBS-D from IBD was 110.5 µg/g, with sensitivity and specificity of 93.3% and 91.4%, respectively; of IL-6 was 7.2 pg/mL with sensitivity and specificity of 92.0% and 78.0%, respectively; of CRP of 2.4 mg/L had specific sensitivities of 83.3% and 86.0%, respectively.</p><p><strong>Conclusion: </strong>The Calprotectin immunoassay has the best value in discriminating between IBD and IBS-D.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 2","pages":"105-111"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10983091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873802","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":"Level-2 Oncoplastic Surgical Techniques for Breast Cancer: A Preliminary Vietnamese Report.","authors":"Hoang Anh Dung, Le Hong Quang, Le Van Quang, Bui Tien Cong","doi":"10.5455/medarh.2024.78.131-138","DOIUrl":"https://doi.org/10.5455/medarh.2024.78.131-138","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is the most common malignancy and remains the first cause of death related to cancer among Vietnamese women, with an incidence of 21,555 cases in 2020. Most breast cancer patients present with invasive disease and relatively large tumor sizes. While oncoplastic surgery (OPS) are commonly applied in Western countries, data on Asian population remains relatively limited.</p><p><strong>Objective: </strong>This study aims to assess the outcomes of level-2 oncoplastic techniques in breast-conserving surgeries at the Vietnam National Cancer Hospital.</p><p><strong>Methods: </strong>From January 2017 to June 2021, a cohort of 257 breast cancer patients who underwent breast-conserving surgery with OPS techniques were examined. Surgical complications, cosmetic outcome, recurrence and survival rates were assessed.</p><p><strong>Results: </strong>The mean age was 47.6±9.4 years, most patients had breast cup sizes B and C. The mean tumor size upon pathological examination was 2.00 ± 0.74 cm. Only 7 cases required reoperation, resulting in a mastectomy rate of 1.17%. The overall complication rate was low at 11.46%, with 9 cases (3.56%) experiencing delayed complications. Cosmetic results were rated as \"excellent\" in 20.6% and \"good\" in 60.5%, with a statistically significant difference. The rates of local recurrence, regional recurrence, and distant metastasis at five years were 2.78%, 1.19%, and 2.36%, respectively.</p><p><strong>Conclusion: </strong>The level 2 oncoplastic techniques had low complication rates, favorable oncological outcomes, and cosmetically satisfying results.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 2","pages":"131-138"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10983099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864206","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":"Academic Burnout, Stress, and the Role of Resilience in a Sample of Saudi Arabian Medical Students.","authors":"Feras A Al-Awad","doi":"10.5455/medarh.2024.78.39-43","DOIUrl":"10.5455/medarh.2024.78.39-43","url":null,"abstract":"<p><strong>Background: </strong>Medical school can be difficult and stressful. Academic burnout is described as exhaustion from curricular activities. Medical students are more likely to experience anxiety.</p><p><strong>Objective: </strong>This study investigated the level of academic burnout and stress as well as their level of resilience.</p><p><strong>Methods: </strong>Saudi medical students were surveyed in a cross-sectional questionnaire-based study. We used the following scales: Perceived Stress Scale, Maslach Burnout Inventory-Student Survey, and the Connor-Davidson Brief Resilience Scale to assess stress, academic burnout, and resilience respectively.</p><p><strong>Results: </strong>The mean score for emotional exhaustion, 20.23 ± 6.8, indicated a high level of burnout among students. The students reported a moderate level of stress. Females, students who were single or lived away from home had higher levels of burnout in certain domains. Students with a higher level of resilience experienced less stress and burnout.</p><p><strong>Conclusion: </strong>Academic burnout has a negative impact on mental health. Effective interventions should be designed to assist students to cope better with stress and also identify solutions to avoid burnout. More research is needed to investigate the social and environmental factors contributing to medical student burnout.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 1","pages":"39-43"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10928680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121648","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":"Survey of Using Oral Anticoagulants in Patient with Non-valvular Atrial Fibrillation.","authors":"Bui The Dung, Nguyen Thanh Hien, Tran Hoa, Cao Ngoc Mai Han","doi":"10.5455/medarh.2024.78.16-21","DOIUrl":"10.5455/medarh.2024.78.16-21","url":null,"abstract":"<p><strong>Background: </strong>In Vietnam, there has been no survey conducted on the prescribing and monitoring practices of oral anticoagulants to ensure that patients with atrial fibrillation receive appropriate. Objective: Therefore, we conducted this research to clarify the aforementioned issue in our hospital.</p><p><strong>Methods: </strong>We carried out a cross-sectional study by reviewing outpatient electronic medical records at the University Medical Center in Ho Chi Minh City. Our study included 1087 patients aged 18 years or older diagnosed with non-valvular atrial fibrillation (NVAF), who visited the Cardiology clinic between January 1st, 2021, and June 30th, 2021.</p><p><strong>Results: </strong>Among the 1087 patients with non-valvular atrial fibrillation (NVAF), 1036 were eligible for anticoagulant therapy. However, only 847 (81.8%) received prescriptions for either Vitamin K antagonists (VKAs) (n=129, 15.2%) or Non-Vitamin K antagonist oral anticoagulants (NOACs) (n=718, 84.8%). NOAC prescriptions were more commonly found in patients aged 75 or older (adjusted odds ratio [OR]=2), those with health insurance coverage (adjusted OR=2.9), and in individuals with a history of hypertension (adjusted OR=2). On the contrary, patients with a farming occupation were less likely to be prescribed NOACs (adjusted OR=0.4). About 75% of patients adhered to the guidelines recommending close monitoring during anticoagulant treatment. Notably, inappropriate prescriptions were identified in 27.7% of cases, especially among those with no recorded body weight (which is necessary for precise dosing based on creatinine clearance), those without health insurance, those with undocumented CHA2DS2-VASc scores, or those who were concurrently using antiplatelet agents.</p><p><strong>Conclusion: </strong>A discrepancy persists between clinical guidelines and the actual practice in diagnosing and managing patients with non-valvular atrial fibrillation (NVAF). It is crucial to prioritize the regular reevaluation of thromboembolic risk scores at follow-up appointments, ensure strict adherence to clinical monitoring standards, and align anticoagulant medication prescriptions with established guidelines.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 1","pages":"16-21"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10928685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121707","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}