Prevalence of restless legs syndrome during pregnancy and postpartum period.

OBJECTIVES: Restless legs syndrome (RLS) is a disease from the spectrum of movement disorders, the prevalence of which increases significantly during pregnancy and is associated with poor sleep, a drop in daytime energy, and the development of psychological disorders during pregnancy and the postpartum period. METHODS: The IRLSS scale was used to determine the presence of RLS symptoms. The total test sample that included the tested and control groups was (n=390) subjects. The examined group consisted of pregnant women (n=260), and the control group consisted of female students (n=130). In total, 260 pregnant women were monitored 6 months after pregnancy. Three measurements were performed, first in the third trimester of pregnancy, second two months after delivery, third 6 months after delivery, while one cross-sectional measurement was performed for the control group. RESULTS: The prevalence of RLS in pregnancy is highest in the third trimester and amounts to 26.5 %. In the postpartum period, a significant decrease in the prevalence of RLS was observed, measured two months after delivery (18.1 %). Postpartum, over time, a decrease in the prevalence of RLS was noticed, and six months after delivery it was (7.3 %), when it practically approached the prevalence of the control group (standard population) which was (6.2 %). CONCLUSIONS: The prevalence of RLS is highest during the third trimester of pregnancy and decreases after delivery so that 6 months after delivery it approaches the prevalence of the standard population.

Sensory Fibers in Martin-Gruber Anastomosis: An Electrophysiological Study.

INTRODUCTION: Anatomical variations in the innervation of intrinsic hand muscle are well known as Martin - Gruber anastomosis (MGA) that spread from the median to the ulnar nerves in the forearm. Although anatomical studies have shown that a crossover of sensory fibers is not rare in forearm MGA, it has been electrophysiologically described only in rare subjects. We hypothesized that the sensory fibers are not rare in MGA, and often follow the motor fibers. SUBJECTS AND METHODS: The study included 59 of subjects with a total of 111 arms, with electrodiagnostically confirmed the presence of MGA on the forearm for motor fibers. In order to demonstrate the presence of sensory fibers in MGA, we stimulated the median nerve at the elbow and recorded the antidromic sensory potential from ulnar innervated digit (5th finger). RESULTS: Sensory MGA were present in 42 out of 111 arms (37.8%) with CI 95. There were 54 left hands with motor MGA, of which 18 (33.3%) had sensory fibers MGA, and 57 right hands with motor MGA, and 24 (42.1%) of which had sensory MGA. CONCLUSION: This electrophysiologically study demonstrated the high incidence of sensory fibers in MGA anastomosis. Presence of sensory fibers as a possible anatomical variation should be taken into consideration during electroneurography analysis, diagnosis and surgical therapy.

COVID-19 Pandemia: Neuropsychiatric Comorbidity and Consequences.

Infection with the new corona virus (SARS-CoV-2) was first registered in December 2019 in China, and then later spread rapidly to the rest of the world. On December 31, 2019, the World Health Organization (WHO) informed the public for the first time about causes of pneumonnia of unknown origin, in the city of Wuhan (Hubei Province, China), in people who were epidemiologically linked to a seafood and wet animal whole sale local market in Wuhan. Coronavrus disease, called COVID-19 (Corona virus disease 2019), after China quickly spread to most countries in the wold, and the WHO on March 11, 2020 declared a pandmic with this virus. SARS-CoV-2, has a high level of sequential similarities to the SARS-CoV-1 and uses the same receptors when it enters the human body (angiotensin-converting enzyme 2/ACE2). COVID-19 is respiratry infection that is primarily transmitted via respiratry droplets. Typical symptoms of COVID-19 infection can be very moderate (infected can be even asymptomatic) to very severe, with severe respiratory symptoms (bilateral severe pneumonia), septic schock, and fatal outcome. Numeous unknows regarding the biological, epidemilogical adn clinical characteristics of COVID-19, still exist, and make it impossible to predict with certainty the further course of the current pandemic. COVID-19 is primarily a disease of the respiratory system, but SARS-CoV-2, in a number of patients also penetrates the CNS, and apparently could be responsible for fatal outcome in some cases. The entrry of the virus into the brain can lead to neurological and psychiatric manifestationss, which are not uncommon, including headache, paresthesia, myalgia, impaired consciousnessm, confusion or delirum and cerebrovascular diseases. SARS-CoV-2 positive individuals should be evaluated in a timely manner for neurological and psychiatic symptoms because tretament of infection-related neurological and psychiatric complications is an important factor in better prognosis of severe COVID-19 patients.From the current point of view, it seems that in COVID-19 survivors, in the coming years and decades, the inflammatory systemic process and/or the inflammatory process of the brain could trigger long-term mechanisms that generally lead to an increase of neurological and neurodegenerative disorders. Psychosocial consequences as well as consequences for mental health are also significant, both for the general population and especially for health workers of all profiles. COVID-19 pandemia is associtaed with negative psychosocial consequences, including depressive symptoms, anxiety, anger and stress, sleep disorders, simpotms of posttrauamtic stres disorder, social isolation, loneliness and stigmatization.

Assessment of diabetic polyneuropathy and plantar pressure in patients with diabetes mellitus in prevention of diabetic foot.

INTRODUCTION: Risk assessment for development foot ulcer in diabetics is a key aspect in any plan and program for prevention of non-traumatic amputation of lower extremities. MATERIAL AND METHODS: In the prospective research to assessed diabetic neuropathy in diabetic patients, to determined the dynamic function of the foot (plantar pressure), by using pedobarography (Group I), and after the use of orthopedic insoles with help of pedobarography, to determined the connection between the risk factors: deformity of the foot, limited joint movements, diabetic polyneuropathy, plantar pressure in effort preventing changes in the diabetic foot. RESULTS: Out of 1806 patients, who are registered in one Team of family medicine examined 100 patients with diabetes mellitus Type 2. The average age of subjects was 59.4, SD11.38. The average HbA1c was 7.78% SD1.58. Combining monofilament and tuning fork tests, the diagnosis of polyneuropathy have 65% of patients. Comparing Test Symptom Score individual parameters between the first and second measurement, using pedobarography, in Group I, statistically significant difference was found for all of the assessed parameters: pain, burning sensation, paresthesia and insensitivity (p<0,05). The measurements of peak pressure, both first and the second measurement, for all of the subjects in Group I(45) show values above 200kPa. That's a level of pressure that needs to be corrected. The study finds correlation between the foot deformation, diabetic polyneuropathy and plantar pressure (p>0,05). CONCLUSION: A detail clinical exam of diabetic food in a family doctor office equipped with pedobarography (plantar pressure measurements), use of orthopedic insoles, significantly reduces clinical symptoms of diabetic polyneuropathy in patients with diabetes.

Evaluation of the Cartinorm Use in the Therapy of Patients with Knee Osteoarthritis.

Background: Knee osteoarthritis is the most common rheumatic disease characterized by pain, structural changes and impairment of quality of life. This disease has a multifactorial etiopathogenesis, and the main role is attributed to mechanical factors. There is a primary and secondary form of osteoarthritis. Osteoarthritis diagnosis is carried out on the basis of history, clinical picture and radiological examinations. Osteoarthritis is a major cause of absenteeism for middle-aged people. In the treatment of osteoarthritis, the triad is important: education, rehabilitation and supportive therapy with chondroprotective drugs. As part of the study, 60 patients with clinical and radiographic signs of knee osteoarthritis were given Cartinorm (1500mg glucosamine sulfate, 800mg chondroitin sulfate, 5000mg forti gel, 250mg vitamin C). After 3 months of treatment, there was an improvement in movement, a reduction in pain and an improvement in activities of daily living as measured by the Oswestry score. Objective: The aim of this study was to evaluate the reduction of pain, improvement of the clinical picture and improvement of the quality of life, after three months of supportive therapy with chondroprotective drugs (Cartinorm -1500mg glucosamine sulfate, 800mg chondroitin sulfate, 5000mg forti gel, 250 mg vitamin C). Methods: In a study that is prospective, analytical and descriptive, 60 subjects of both sexes with clinical and radiological signs of knee osteoarthritis were included. The study was conducted in six cities (Sarajevo, Tuzla, Banja Luka, Mostar, Zenica and Bijeljina) and lasted three months. During the study for pain relief, patients could only use Paracetamol and all patients took Cartinorm 1x a day. Pain Scale and Ostwestry index tests were performed for each patient to assess the quality of life at the beginning of the study, at the end of the first, second and third month. Results and. Results: Total number of 60 subjects with clinical and radiological signs of knee osteoarthritis were included in the study. The analysis of the gender structure showed the dominance of the female gender (43 respondents), compared to the male population (17 respondents). The largest number of respondents had bilateral knee osteoarthritis. Assessment of pain through the VAS pain scale on the first day and at the end of the 3-month study showed a statistically significant reduction in pain. Analysis of the quality of life at the beginning of the study showed that 22 subjects performed activities with many difficulties, and at the end of the study only 5 subjects performed activities with many difficulties, which shows an improvement in the quality of life after 3 months of taking Cartinorm. Conclusion: Proper education of subjects with knee osteoarthritis and application of chondroprotective drugs (Cartinorm) for a period of 3 months showed an improvement in terms of pain reduction measured through the VAS scale, improvement of knee mobility and improvement of quality of life measured through Oswestry Scor.

The accessory deep peroneal nerve and anterior tarsal tunnel syndrome: case report.

The accessory deep peroneal (ADPN) nerve has been regarded as an anomalous nerve derived from the superficial peroneal nerve or its branch and supplies motor innervations for extensor digitorum brevis (EDB) and sensory innervations for the lateral part of the ankle and foot regions. The EDB is usually innervated exclusively by the deep peroneal nerve, a major branch of the the common peroneal nerve, however, in as many as 28% of patients (with same male/female frequency), one or both of the EDB muscles are (partially or exclusively) innervated by the ADPN nerve. This anomaly appears to be inherited in autosomal dominant fashion with incomplete gene penetrance. ADPN existence is of great clinical and surgical importance, and the aim of this study is to describe a very rare case of coexistence ADPN and anterior tarsal tunnel syndrome.

Osteoporosis--comparative study between quantitative ultrasound of calcaneus and DXA.

INTRODUCTION: Osteoporosis is bone disease characterized by reduced bone mass and reduction of bone tissue. Main complications of osteoporosis and major cause of morbidity and mortality in elderly population are fractures. Early diagnosis and detection of osteoporosis can prevent complications of osteoporosis in terms of fractures. OBJECTIVES: Diagnostic assessment of osteoporosis is mostly being done threw two commonly used methods: ultrasound of calcaneus and osteodensitometry (DXA). The results were compared through a prospective study involving two groups of patients with osteoporosis. PATIENTS AND METHODS: The study included 100 female patients with average age 54. In I phase every patient had some protocol. That protocol included: age, body, mass index (BMI), employment, marrital status, risk factors (smoking, coffee, physical activity), endocrine causes of osteoporosis and osteoporotic fractures. ln II phase for every patient we were using two methods in diagnostics of osteoporosis: ultrasound of calcaneus and DXA. In both methods, we analyzed T score and Z score. RESULTS: 21% patients had 21,12 BMI (low BMI), 58% patients were in menopauses, triad of risk factors (smoking, consumption of coffee, low physical activity) had 32%, 28% of patients had osteoporotic fractures. Quality of life patients with osteoporosis was weak. T score is main score for diagnostics. Results of T score with UZ and DXA had statisticly significant differents. CONCLUSION: T score (UZ) and maximum T score (DXA) (lumbal spine and hip) has statisticly similar value with potential possibility to predict osteoporosis fractures.

Impact of Yoga Practice on Level of Stress During COVID-19 Pandemic.

Background: The COVID-19 pandemic has become a major cause of stress and anxiety worldwide. It has generated stress among people from all sections of society, especially to workers who have been assigned to cater to healthcare service or those constrained to secure daily essential items. Yoga practice is actively sought to achieve reduced anxiety and stress so that improved sleep may positively impact immunity. Objective: The aim of this cross-sectional study was to determine whether those who practice Yoga during the COVID-19 pandemic have lower levels of stress, anxiety, and depression than those who do not. Methods: The sample consists of 51 females who have been attending Yoga sessions for many years and who continued this practice during the COVID-19 pandemic twice a week. The control group consisted of 50 non-Yoga respondents. The survey was conducted during April 2021. The Revised Event Impact Scale (IES-R) (4) and the Brief Symptom Inventory (BSI) (Derogatis, 1993) were used to assess stress. Student T-test was used to check the statistical significance of differences. Results: In our research yoga practitioners show a statistically significantly lower average severity of stress symptoms compared to those who do not practice yoga on 5 of the 6 stress indicators shown. The only statistically significant difference was not obtained on the measure of total number of symptoms (PST). Conclusion: The results suggest that yoga practice during COVID-19 pandemic is associated with lower levels of stress, anxiety and depression.

Prevalence of Accessory Deep Peroneal Nerve in Sample of Bosnia and Herzegovina Subjects: an Electrophysiological Study.

BACKGROUND: The accessory deep peroneal nerve (ADPN) is as an anomalous nerve derived from the superficial peroneal nerve or its branch and supplies motor innervations for extensor digitorum brevis (EDB) and sensory innervations for the lateral part of the ankle and foot regions. It is the most common anomalous innervation present in the lower limb. OBJECTIVE: The aim of this study was to determine the prevalence of ADPN electrophysiologically in a sample of Bosnia and Herzegovina subjects who referred to an electromyography lab. METHODS: This cross-sectional descriptive study included 316 lower limbs from 171 subjects referred for electrodiagnostic studies to Electromyography Lab, Department of Neurology, University Clinical Center Tuzla (Bosnia and Herzegovina) (102 females/60% and 69/40%) males). Motor nerve conduction studies for the peroneal nerve and ADPN were done. Compound muscle action potential (CMAP) and nerve conduction velocity (NCV) of deep peroneal nerve (DPN) were measured by using EMG machine by stimulating DPN at knee, ankle and lateral malleolus areas accordingly, with recording from extensor digitorum brevis (EDB) muscle. RESULTS: ADPN was found in 46 (14.5%) of 316 legs. ADPN was found in 18 (39.1%) right lower limbs and 28 (60.9%) left lower limbs. Ten subjects (5.8%) had bilateral ADPN. There was no statistically significant difference between the occurrence of ADPN in women versus men (p=0.757), as well as in right versus left legs (p=0.237). CONCLUSION: This study demonstrated that ADPN prevalence, in a sample of Bosnia and Herzegovina subjects who referred to an electromyography lab is 14.5%. Recognition of ADPN is very important for proper interpretation of lower limbs electrophysiological data.

Surgical Treatment of the Patients with Cervical Disc Herniation at Clinical Center of University of Sarajevo, Bosnia and Herzegovina.

BACKGROUD: Intervertebral disc herniations are caused by rupture of the fibrous ring and migration of one part of the nucleus pulposus towards the spinal canal. The most commonly affected levels are C5-C6 and C6-C7. Surgical treatment of cervicobrachialgia is indicated in the presence of long-term intense pain syndrome with or without radicular sensory-motor deficit and magnetic resonance (MRI) verified disc herniation with a compressive effect. OBJECTIVE: The most common surgical treatment is anterior lateral microdiscectomy with or without the use of implants. In addition to this method, dorsolateral microsurgical treatment can be used for foraminal hernias. METHODS: This retrospective study included 110 (58 / 52.7% male and 52 / 47.3% female) patients with cervical disc herniations who were surgically treated at the Neurosurgery clinic of Clinical Center of Sarajevo University (CCUS) in a five-year period. Stability, postoperative curvature, arthrodesis, implants, and changes in adjacent segments were radiographically analyzed. In the outcome assessment, functional outcome and patient satisfaction were analyzed using the Pain Self-Evaluation Scale (VAS), Prolo functional and economic score, and White's classification of treatment outcomes. RESULTS: The dominant prevalence of changes was recorded at the levels of C5-C6 (58%) and C4-C5 (28%) with a ventrolateral approach performed in 90% of patients. The largest representation is hard dorsolateral discs (n = 77). In the group of patients with placed implant, hard discs were present in 96 (90%) cases (p <0.001), while soft discs were dominant in patients without implant placement (p <0.001). In the group of subjects with implant, the most common are hard dorsolateral discs and those of mixed localization in 41 of 55 patients (65.5%; p = 0.001). The most common implant is PEEK cage (74.5%). From complications, we had partial vertebral body fractures in 4.5% of patients. Furtehr, the most common are sensory disturbances in 2.73% of respondents. Reduction of symptoms and improvement of preoperative neurological status were observed in over 95% of patients. CONCLUSION: Surgical treatment of cervical disc herniation is a safe method with a minimal percentage of complications. Microsurgical discectomy significantly contributes to the improvement of the functional status of patients, the reduction of pain, and the improvement of neurological deficit and overall mobility.

Effects of Transcutaneous and Percutaneous Tibial Nerve Stimulation in Bosnian Female Patients with an Idiopathic Overactive Urinary Bladder.

OBJECTIVE: The purpose of this study was to evaluate the efficacy of daily transcutaneous tibial nerve stimulation (TTNS) versus weekly percutaneous tibial nerve stimulation (PTNS) on the quality of life of patients with idiopathic overactive bladder (OAB). PATIENTS AND METHODS: The study was designed as a randomized controlled trial. The diagnosis of OAB was made on the basis of clinical symptoms, and urodynamic tests were performed to check whether uncontrolled contractions of the derusor during bladder filling were responsible for the OAB symptoms. The tests used to assess symptoms and quality of life were Overactive Bladder Questionnaires (OAB-q) SF. The patients were divided into 2 groups of 30 patients each. The first group was treated with TTNS every day for 3 months and the second group with PTNS once a week, also for 3 months. RESULTS: Stimulation with both TTNS and PTNS led to the reduction of all clinical symptoms of OAB and improved quality of life, with statistical significance (P<0.05) and with no side effects. When comparing these two groups, the improvement was statistically more significant in the group treated with PTNS. When the quality of life scores and symptoms were compared to the type of treatment, it was found that the improved quality of life parameters and the reduced OAB symptoms were more statistically significant in the treatment with PTNS than TTNS therapy (P<0.001). CONCLUSION: The results of the study suggest good efficacy of both TTNS and PTNS in the treatment of OAB. Better effects are achieved with weekly PTNS, as it leads to a statistically significant reduction in symptoms as well as an improvement in quality of life, without side effects.

Time Management of Tuzla University Clinical Center Health Managers.

INTRODUCTION: Time management is an important aspect of successful leadership and involves mastering your own work and time instead of allowing them to master you. Time management is a daily process that is applied in order to rationally use time, work schedules, lists of tasks, delegation of responsibilities and everything else that helps to efficiently use time. MATERIAL AND METHODS: This research was prospective, descriptive, analytical and controlled. There was 100 medical worker involved, who have managing jobs of different levels and 100 medical workers who do not have managing jobs, who represented the control group. The questionnaire on "time stealers" according to Sewert. Demographic data was gathered according to the questionnaire on self construction. RESULTS AND CONCLUSIONS: Based on conducted research, it was established that there were differences in frequencies of certain "time stealers" in managers of different levels of University Clinical Center Tuzla; the "time stealers" are more frequent among these with shorter length of service; These differences are significantly more frequent (p<0.05) for some questions e.g. being distracted by phone calls, meetings that are held just for the sake of having a meetings, insufficient, one-way or bad communication with superiors, and have negative effects on management of business hours.

Influence of Motion Therapy in the Prevention of Lumbar Pain Syndrome Relapse.

INTRODUCTION: Lumbar pain syndrome is one of the most common conditions in clinical practice, more common than 290 other pathological conditions, which affect up to 84% of adults in a certain period of their life. The origin of the lower back pain can be classified as mechanical, neuropathic and secondary due to another illness. Patient education and information, muscle strengthening exercises, maintenance of routine daily physical activity and pain therapy are the basis of acute non-specific pain syndrome therapy. AIM: To determine the success of the motion therapy procedure in the prevention of lumbar pain syndrome relapse. MATERIAL AND METHODS: The research is prospective, longitudinal, manipulative and controllable. It was conducted in the private practice "Praxis - dr. Pecar" in the period from June 20, 2014 to June 1, 2016, and included 200 respondents with symptoms of lumbar pain syndromes divided into the experimental (n=100) and control (n=100) groups. The presence of lumbar pain syndrome relapse in respondents experimental and control group was recorded in the second and third clinical examination. RESULTS: In the second examination, 4 (4%) of the respondents from experimental group and 37 (37%) of the control group responded had LBS relapse. In the third examination, the number of respondents with recurrent LBS in the experimental group was 4 (4%), while in the control group was 17 (17%). After the study, no statistically significant difference was observed in the mean age of respondents who had LBS relapse compared to respondents without LBS relapse, as well as significant influence of sex structure on relapse in the experimental and control group during the second and third examination. CONCLUSION: After the second examination, the relapse rate in the experimental group was statistically significantly higher in the respondents withstanding jobs, while there was no statistically significant difference in the control group and both groups after the third examination.

Pedobarography in diagnosis and clinical application.

INTRODUCTION: Pedobarography as a new diagnostic tool enables measuring the pressure between the foot and the floor during dynamic loading. Dynamic analysis of the foot shows advantage over static analysis due to its capabilities for detecting high load points in certain diseases and in certain phases of walking. Pedobarography as a new method in the context of rehabilitation include wide range of clinical entities. GOAL: To show the advantages of pedobarography as new diagnostic and rehabilitation method in prevention programs. MATERIAL AND METHODS: A prospective study included 100 patients with diabetes mellitus type 2. Research was conducted in the Primary Health Care Center of the Sarajevo Canton and the Center for Physical Medicine and Rehabilitation. The test parameters were: Test of balance-symmetric load for the test, the number of comorbidity, clinical examination of foot deformity, test with 10 g monofilament, HbA1c. From the total sample 45 patients (Group I) were selected, aged 50-65 years, which underwent pedobarography (on the appliance Novel Inc., Munich with EMED™ platform) and robotic fabrication of individual orthopedic insoles, followed by control pedobarography. Plantar pressure was determined using standard pedobarography, computer recorded parameters: peak pressure (kPa), force (Ns), area (cm). RESULTS: The average age of the respondents was 59.4±11.38 years; altered results on the balance test were present in 34% of patients; 61% of respondents have ≤2 comorbidity. In the total sample, the average number of foot deformity was 2.84. Flat feet have 66% of respondents, and valgus position 57%. The average HbA1c values were 7.783±1.58% (min.5-max.15.0). All subjects (45) after the first, and after the second measurement of peak pressure, have values above 200 kPa, or are in the designated zone of peak pressure that needs to be corrected. In a study was determined the correlation between the number of deformities and peak pressure, the number of deformities and the area upon which plantar pressure act, test with 10g monofilament and peak pressure. CONCLUSION: Within the framework of prevention programs early diagnosis, detection of sensitivity disorders, adequate treatment and taking load from the feet with the help of pedobarography, are of great importance for the patient suffering from diabetes.

Evolution of Sports-medical Team Management in the Program of Posture Correction in Children.

GOALS: The goal of this study was to determine the effectiveness of the organization and coordination of multidisciplinary team consisted of health and kinesiology professionals at the correction of posture among girls in the period of the second phase of intense growth and development. MATERIAL AND METHODS: Testing was conducted on a sample of 70 girls, aged 11.9±2.3 years, in which by the expert evaluation is recorded weakness of individual muscle groups, but also of the whole musculature. For the assessment of posture we applied the method of Napoleon Wolanski. Used are 9 variables that included the observed region of the body and an overall assessment of posture. The subjects were included in the program of kinesiology treatment with duration of 28 weeks. For all the parameters have been applied statistical procedures at univariate and multivariate level. RESULTS: Data on subjects were obtained by measuring the same variables at two time points, i.e. before and after the application of kinesiology treatments. Analyses of differences arithmetic mean and mean values were done with the t-test for paired samples. In order to determine global quantitative differences of tested variables tested discriminant analysis was applied. The results showed that the models which complement the experience and practical application of expert health professionals and kinesiology knowledge is a very effective tool for improving posture of girls in the second phase of intensive growth and development. In this way can be prevented health problems that might arise later in life.

Therapeutic ultrasound and pain in degenerative diseases of musculoskeletal system.

INTRODUCTION: Therapeutic ultrasound is a physical modality which is constantly expanding range of indications. Analgesic effect of ultrasound is still under discussion. Regardless the extensive application of pulsed ultrasound of low intensity, continuous ultrasound has a better analgesis effect, which is explained by its mechanism of action. AIMS: The main research objective of this study was to determine the effect of continuous ultrasound to pain caused by degenerative diseases of the musculoskeletal system in the intensity and duration of ultrasound treatment. Other objectives are entailed determining the correlation between the degree of pain reduction with: location of pain, age, gender and body mass index (BMI). MATERIAL AND METHODS: The study included 68 patients with chronic pain localized in the region of the spine or major joints of the extremities, depending on the localization of the degenerative changes. Patients are divided into two groups. The first group was treated with 10 applications of continuous ultrasound with frequency of 1 MHz, intensity 0.4 W/cm2 for 8 minutes, and the other group with 10 applications of ultrasound with frequency of 1 MHz, intensity 0.8 W/cm 2 for 4 minutes. RESULTS AND DISCUSSION: Pain intensity was assessed before and after ultrasound therapy performed by subjective visual analogue scale (VAS) for pain, numbered from 0-10, where 0 is the rating for the state of no pain, and 10 grades for severe pain. The average VAS improvement in the first group was 3.97, and 4.74 in second one. The results of F (1.66) = 2.93, p = 0.09 analysis of variance showed no significance difference between the average improvement of two groups. Correlation between the degree of pain reduction showed significance only with BMI, or that higher BMI is associated with a lower degree of pain reduction. The results of this study showed that application of continuous ultrasound in patients with chronic pain, caused by degenerative changes in the musculoskeletal system, led to a significant reduction in pain. Different intensity and duration of ultrasound application showed no significant effect on the degree of pain reduction. Body mass index showed significant negative correlation with the degree of pain reduction, but age, gender and location of pain did not show significant correlation.

[Osteoporosis associated with spinal cord lesion]. / Osteoporoza udruzena sa spinalnom lezijom.

One of the complications caused by spinal lesion is osteoporosis which development is induced by lesion itself, and its mechanism is not explained enough. Risk factor of this kind of osteoporosis is fracture which management is difficult and is cause of further complications which aggravate already damaged quality of life of patients with spinal cord injury, and demand additional health insurance expenses. Importance of prevention and treatment of spinal cord injury induced osteoporosis is enlightened by case report.

[Determination of residual urine volume using a portable ultrasound apparatus in a rehabilitation center for spinal lesions]. / Odredivanje volumena rezidualnog urina prenosivim ultrazvucnim aparatom u rehabilitacionim centrima kod spinalnih lezija.

Due to the high incidence of voiding dysfunction (patients with SCI) in the rehabilitation setting, a safe, efficient method for monitoring residual bladder volume is needed. A controlled trial was performed to compare the use of a portable ultrasound unit that calculates bladder volume to catheterization regarding complications, speed of usage and patients feelings. Urethral catheterization, the standard method for measurement of bladder volume is associated with patient discomfort plus risks of urethral trauma and urinary tract infection. A portable ultrasound instrument Bladder Scan 3000 that automatically determines bladder volume was used for 100 patients. This instrument is a noninvasive alternative to urethral catheterization for the determination of bladder volume and it is recommended for clinicians in patients undergoing catheterization programs that can reduce the number of required catheters. It is associated with a high degree of patients satisfaction.

[Deep Relief sonophoresis in degenerative changes of the knee joint]. / Sonoforeza Deep Relief gelom kod degenerativnih promjena koljenog zgloba.

We analysed 130 persons with osteoarthritis of knee and compared efficiency Deep Relief gel with sonophoresis and ultrasound with standard gel. Deep Relief has significant better effect for less pain and better improvement of functional capacity in comparison with ultrasound. Results of examination are statistic significant.