Cortisol level and hemodynamic changes during tooth extraction at hypertensive and normotensive patients.

BACKGROUND: The patients that are subjects to oral-surgical interventions produce large amounts of steroids in comparison with healthy patients which are not a subject to any dental intervention. The aim of research was to determine the level of stress hormone cortisol in serum, arterial blood pressure and arterial pulse, and to compare the effectiveness of the usage of lidocaine with adrenalin in comparison with lidocaine without adrenalin during the tooth extraction. PATIENTS AND METHODS: This clinical research includes patients with indication of tooth extraction divided in hypertensive and normotensive patients. RESULTS: There is no important statistical distinction between groups, for the cortisol levels before, during and after tooth extraction regardless of the type of anesthetic used, while we registered higher values of systolic and diastolic values at hypertensive patients, regardless of the type of anesthetic. CONCLUSION: There is significant systolic and diastolic blood pressure rise in both groups of patients hypertensive and normotensive patients, (regardless of anesthetic used with or without vasoconstrictor), who underwent tooth extraction. The special emphasize is attributed to hypertensive patients where these changes are more significant. As per cortisol level and pulse rate, our results indicate no significant statistical difference in between groups.

Prevalence and pharmacologic treatment of patients with low back pain treated at kosovo energetic corporation.

INTRODUCTION: Low back pain (LBP) is a common complaint among the general population with a subgroup developing chronic and disabling symptoms generating large societal costs. Recurrences and functional limitations can be minimized with appropriate conservative management, including medications, physical therapy modalities, exercise and patient education. OBJECTIVES: The purpose of this study was to determine the prevalence of low back complaints in industrial workers, to investigate whether individual risk factors involved in the occurrence of LBP, and to determine the most frequent used drug in LBP treatment. MATERIALS AND METHODS: Data for this study were provided from Kosovo Energetic Corporation. A cross-sectional study design was utilized. Self-administered questionnaires were distributed among 228 industrial workers. Patient with LBP underwent a comprehensive clinical, radiological and biochemical evaluation. RESULTS: showed that LBP occurred in 63.5% of workers. Individual factors did not show significant associations with LBP. Age (OR=0.99/95% Cl 0.95-1.03), weight (OR=1.13/95% Cl 0.99-1.06), height (OR=0.97/95% Cl 0.91-1.02), and work experience (OR=1.01/95% Cl 0.97-1.05) increase odds for LBP but not significantly. The most frequently used drugs in patients included in this study are NSAIDs. In 33 (55.0%) patients for the treatment of LBP two types of drugs are administered. CONCLUSION: Increased physical activity, health promotion and reduced body weight can prevent morbidity from LBP. A continuous consultation with the Clinical Pharmacist demonstrates effective way of dosage and drug re-evaluation for the patients with LBP.

Prevalence and risk factors for low back pain in industrial workers.

OBJECTIVES: The aim of the present study was to determine the prevalence of low back pain (LBP) in industrial workers, check for possible LBP related risk factors and investigate the associations between physical activity and severity of low back pain. METHODS: We conducted a cross-sectional study among 430 workers of an industrial company over the previous 12 months. The industrial workers were given questionnaires and assigned to two groups: (1) with low back pain, (2) without low back pain. Group 1 was then divided into three subgroups according to the answer to question (a) LBP without irradiation, called mild cases, (b) LBP with irradiation above the knee, called moderate cases, LBP with the irradiation below the knee, called severe cases. RESULTS: LBP was found in 61.6% of workers. The prevalence of LBP was significantly associated with physical activity (p = 0.03). There was a significant difference between frequent physical activity and severity of LBP (p = 0.01). Work-related physical factors showed strong associations with LBP. The main risk factors for low back pain among production workers were extreme trunk flexion (OR = 3.5, 95% CI 1.7-7.3), as well as lifting of loads (OR = 3.5, 95% CI 1.9-6.2), pushing or pulling heavy loads (OR = 3.5, 95% CI 1.9-6.2) and exposure to whole body vibration (OR = 1.7, 95% CI 1.0 -3.0). CONCLUSION: Daily life conditions, job-related factors are associated with the occurrence of low back pain. These results suggest that individuals with LBP should avoid nonspecific physical activities to reduce pain and improve psychological health.

Non-steroidal anti-inflammatory drugs and gastroprotection in primary health care users.

OBJECTIVE: The aim of this study is to assess the prevalence of gastroprotection and identify the main factors that influence the taking of protective drugs by the adult population treated with non-steroidal anti-inflammatory drugs (NSAID). METHODS: This study was cross-sectional, conducted by including a contingent of 800 users of primary health care services (n=369, 46% males and n=431, 54% females). Included in the study were individuals of both genders aged 18+ who sought counselling or treatment during the three-month period. The data collection of this study was based on the completion of a structured questionnaire, which included questions related to the use of NSAIDs, the way these drugs were prescribed and administered and the simultaneous taking of gastroprotective drugs. RESULTS: The prevalence of the gastroprotective drugs use was higher among the elderly, individuals living in urban areas, those with higher education, those with daily use of NSAID, individuals receiving prescriptions from their own doctors, and those suffering from side effects from the use of NSAID, as well as subjects that had a longer duration of NSAID use. Diclofenac was the most prescribed NSAID. Gastric pain and dizziness were the most experienced side effects. CONCLUSION: This paper demonstrates the need to improve the quality of primary health care service through informing and educating patients regarding the need to take gastro-protective drugs for those at high risk of adverse effects manifested by the use of NSAIDs.

THE DIFFERENTIAL ALGORITHM BETWEEN RHEUMATOLOGIC AND MALIGN DISEASES.

OBJECTIVE: The aim of this study is to determine the differential algorithm between rheumatism and malignant diseases. For every pediatrician, to be warned when attending joint pain and child arthralgia and prevent and treat within time malignant diseases. METHODS: Our case presented in Pediatric Clinic, was referred by Regional Hospital of Ferizaj with suspected diagnose of Febris Rheumatica and Arthralgia. The main complaint was joint pain. Initially the patient was admitted at Cardiology and Rheumatology department. Then after examinations was referred to Hemato-Oncology department. Hospitalized during the period from 12.12.2014 to 18.01.2015. RESULTS: Bone marrow biopsy as terminal diagnostic tool reviled severe malignant hematologic disease, which was masked by clinical and lab findings as Febris Rheumatica. CONCLUSION: Arthralgia as one of child's often complain, should have a special attention paid to, as it might be a warning sign for a lot of diseases. Steroid treatment should not be used before final diagnose of the disease and before rolling out hematologic etiology with peripheral blood smear.

Kosovo's Public Health Damage from Abusive Use of Antibiotics in Dairy Cattle.

INTRODUCTION: The aim of the study is to assess the state of the use of antibiotics in dairy cattle in Kosovo according to different diagnosis as directed by treatment protocol and to evaluate the methods of their application in dairy cattle. METHODS: We've visited over 80% of dairy farms throughout the territory of Kosovo in 2013. Assessment was carried out through a specific questionnaire, which identifies problems with medical treatment of cattle, the number of cattle treated and untreated, description of dose and type of drugs used, as well as the duration of drugs issuance. RESULTS: In Kosovo for the treatment of sick cows are mainly used beta lactams and sulfonamides. The drugs were not given only to sick cattle by their diagnosis, but they were given to healthy cattle too, as a preventative therapy, mainly through intramuscular route. CONCLUSION: We conclude that the dairy cattle were not treated correctly as directed by the treatment protocol. In Kosovo's general health system there are no rules and procedures on monitoring and recording the expenditures on antibiotics.

Exercise and Therapeutic Ultrasound Compared with Corticosteroid Injection for Chronic Lateral Epicondylitis: A Randomized Controlled Trial.

BACKGROUND: Lateral epicondylitis, or tennis elbow, is a common overuse syndrome of the extensor tendons of the forearm. When the condition is chronic or not responding to initial treatment, physical therapy is initiated. The objective of this study is to compare the effectiveness of corticosteroid injections with physiotherapeutic interventions (ultrasound and exercise) for the treatment of chronic lateral epicondylitis. MATERIAL AND METHODS: We performed a randomized controlled trial of 12 weeks' duration in patients with chronic lateral epicondylitis. We randomly assigned 49 subjects to an exercise group (n=25), who received ultrasound and exercise, and a control group (n=24), who were treated with local infiltration of 1mL triamcinolone acetonide (10mg/mL) and 1mL lidocaine 2%. To evaluate the subjects, three instruments were used: pain intensity, measured with a Visual Analogue Scale (VAS), functional disability, measured with the Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire, and painfree grip strength. All subjects were evaluated before treatment and at the 6th and 12th week. RESULTS: There were no significant differences between the two groups with regard to any variable at baseline (p>0.05). In the exercise group, significant improvements were demonstrated for VAS, PRTEE pain score, PRTEE function score and pain free grip strength, compared to the control group. The exercise group reported a significantly greater increase in all variables at 12 weeks than did the control group (p<0.001). CONCLUSION: Our results suggest that ultrasound therapy and exercise are beneficial in the treatment of tennis elbow.

A comparison of mckenzie therapy with electrophysical agents for the treatment of work related low back pain: A randomized controlled trial.

BACKGROUND AND OBJECTIVE: Chronic low back pain (LBP) is a major public health problem in industrialized countries and is one of the most common reasons for seeking healthcare. Although the McKenzie therapy is widely used for the treatment of low back pain, there is evidence for no improvement with exercise in short-, intermediate-, or long-term outcomes of pain relief or function. The aim of this study was to compare the effect of the McKenzie therapy with electrophysical agents (EPAs) in patients with chronic LBP. MATERIAL AND METHOD: A randomized controlled comparative trial with a 3-month follow-up period was conducted between January 2009 and June 2012. 271 patients with chronic LBP, (more than three months duration of symptoms) were randomized into two groups: the McKenzie therapy group (n=134), and electrophysical agents group, (n=137). The treatment period of both groups was 4 weeks at an outpatient clinic. Clinical outcomes (pain intensity, trunk flexion range of motion, and disability) were obtained at follow-up appointments at the end of the treatment period, 2 and 3 months. RESULTS: Significant improvement of spinal motion, reduction of pain and disability were demonstrated in both groups but the results show the greater improvement in the McKenzie group (p< 0.05). CONCLUSION: McKenzie therapy reduces pain, and disability, among subjects with chronic LBP. This study revealed that the McKenzie therapy is more effective than EPAs group.

The effect of aerobic exercise on quality of life among breast cancer survivors: a randomized controlled trial.

OBJECTIVE: To determine the effect of moderate-intensity aerobic exercise on the quality of life (QOL) and physical functioning in breast cancer survivors. MATERIALS AND METHODS: We randomly assigned 62 breast cancer survivors to an exercise (N = 30) or control group (N = 32). The exercise group trained at a moderate intensity progressing from 25 to 40 min over a 10-week period. The control group did not train. Outcomes were assessed at baseline and postintervention. The primary outcomes were overall QOL--as assessed by the functional assessment of cancer therapy-breast (FACT-B) scale. Secondary outcomes were changes in various subscales of overall QOL, and changes in body composition outcomes: body weight, body mass index, and changes in performance in a 12 min walk test (12MWT). RESULTS: Sixty-two of 73 women randomized (84.9%) completed the study. There were no significant differences amongst the two groups at baseline for any variable. In the exercise group significant improvements were demonstrated for the FACT-B (13.4 points, P < 0.003), functional assessment of cancer therapy-general (FACT-G) (9.16 points, P < 0.008), the functional well-being subscale (P < 0.010), and the emotional well-being subscale (P < 0.035) compared to the control group. No significant changes in body weight or BMI were observed. Exercise group showed a significant increase in 12MWT (P < 0.009). CONCLUSION: We conclude that 10 week of moderate-intensity aerobic exercise program significantly improves QOL and physical functioning in breast cancer survivors. Future studies are needed to evaluate the effectiveness of similar exercise programs over longer periods of time and involving a greater number of breast cancer survivors.

The effect of land versus aquatic exercise program on bone mineral density and physical function in postmenopausal women with osteoporosis: a randomized controlled trial.

BACKGROUND: Osteoporosis is a multifactorial progressive skeletal disorder characterized by reduced bone mass. Exercise is widely recommended to reduce osteoporosis, falls and related fragility fractures. The purpose of this study was to investigate the effects of land exercise (LE) and aquatic exercise (AE) on physical function and bone mineral density (BMD). MATERIAL AND METHODS: Fifty-eight postmenopausal women, aged 50-70 years, diagnosed with osteoporosis according to BMD measures, enrolled in this study. The subjects were randomly assigned to either the intervention group (LE group) or the control group (AE group). Physical function and BMD were assessed in all subjects in both groups before and after 10 months of intervention. Muscle strength, flexibility, balance, gait time and pain were measured to assess physical function. Bone mineral density at the lumbar spine was measured by dual energy X-ray absorptiometry (DEXA). RESULTS: There were no significant differences between the two groups in the baseline anthropometric data. The two groups were similar with respect to age, weight, height, and body mass index (p>0.05). After the exercise program, muscle strength, flexibility, gait time, pain, and bone density (p<0.001) improved significantly with LE compared to AE. There was no significant difference between the two groups with regard to balance at the 10-month follow-up. CONCLUSION: Significant improvements in physical function and BMD suggest that LE is a possible alternative for postmenopausal women with OP.