Emergency Room Treatment of Hypertensive Crises.

AIM: The aim of the study was to evaluate efficiency of hypertensive urgency treatment using inhibitors of α1-adrenergic receptors and angiotensin converting enzyme inhibitors-ACE inhibitors in the Emergency Room of Outpatient Hospital and Polyclinic "dr Mustafa Sehovic" Tuzla in relation to age, duration and severity of hypertension. METHODS: The study was conducted from June 2011 to May 2012 and included 120 patients of both sexes diagnosed with arterial hypertension, aged 40 to 80 with verified hypertensive urgency. The patients were divided into two groups: the control group treated with sublingual captopril and the experimental group treated intravenously with urapidil. RESULTS: The results show that the largest number of patients belonged to age group from 60 to 69 years (34,16%), and the average age was 58 (11). The largest number of patients (38,0%) had verified hypertension for 11 to 20 years. The average systolic/diastolic artery blood pressure at reception was 213 (19) / 130 (4) mmHg. The average systolic/diastolic artery blood pressure after the first dose of 12,5 mg captopril in the control group was 177,42 (10,91) / 112,33 (3,50) mmHg, while after the first dose of 12,5 mg urapidil it was 179,25 (16,62) / 110,33 (8,78) mmHg. The average systolic/diastolic artery blood pressure after the second dose of 12,5 mg of captopril in the control group was 152,00 (6,32) / 95,50 (3,76) mmHg, while after the second dose of 12,5 mg of urapidil it was 152,55 (7,17) / 95,29 (5,04) mmHg. CONCLUSION: Urapidil is more efficient in hypertensive urgency treatment, since the decrease of middle artery pressure (MAP) in the group treated with urapidil was statistically significant (p<0,001). No statistical significance was found between the efficiency of urapidil and the patient's age, while captopril was more efficient in older patients (p=0,02). Also, no statistically significant difference was found between the efficiency of captopril and urapidil in relation to duration of hypertension.

Disability Weights and Years Lived with Disability of Depression with and Without Suicidality.

Background: Globally, depression is a silent epidemic, and more than 350 million people suffer from depression. For a long time, the belief prevailed that children and young people cannot suffer from depressive disorders, and depression is slowly becoming one of the leading health problems among the young population. Objective: This research aims to determine the mental health disorders burden attributed to depression, anxiousness, and fear with and without suicidal ideation among youth in Bosnia and Herzegovina. Methods: A prospective cross-sectional study was performed as screening of depression by Hamilton standardized screening instrument from May 3, 2018, to April 4, 2019, among young people, students in secondary schools, and the Faculty of Pharmacy and Medical Faculty of the University of Tuzla in the most populous Tuzla Canton in the Federation of Bosnia and Herzegovina. In achieving the research goals, we expressed the burden attributed to depression with and without suicidality, anxiousness, and fear as Disability Weight (DW) and Years Lived with Disability (YLD). For the population level, YLD was calculated by multiplying DW by the prevalence rate of depression, anxiousness, and fear per thousand of the population (YLD= DW x prevalence/1000), and DW was adjusted for suicidality. Results: The participants' ages ranged from 16 to 24 years, with a mean of 20,6 ± 1,9 years. The Body mass index (BMI) of 21,9 ± 2,7 is the recommended reference value of 18.5-24.9 kg/m2. The depression score of all participants ranged from 0 to 32 with a mean of 7.4± 6.3, which for our population of respondents at the sample level implies entry into the zone of presence of depressive symptoms. Descriptive statistics and differences per gender in sociodemographic variables (age, education state, and secure monthly existence); and modified factors attributed to satisfaction needs (life satisfaction, hope for the future, support from person of influence). Most participants belong to the age group 19-21 years, 71,44% (n=180), and the same 14,28% (n=36) other age groups (16-18 and 22-24 years), and sixty-two percent of participants are university students, and twenty percent are university failures. Conclusion: Based on our findings, the very high burden of depression in Bosnia and Herzegovina was found greatly not recognized and unsolved problem among the young population aged 16-24 years. Recognizing and screening depression in young people is the first step to prevention.