<p><strong>Aim <br /></strong>To assess a psychosocial impact of the Coronavirus disease 2019 (COVID-19) on health care workers and to quantify the size of depression symptoms, anxiety and stress levels.<br /><strong>Methods</strong> <br />This cross-sectional study used an anonymous online survey questionnaire as a research instrument and it included 114<br />health workers of all profiles from the Sarajevo Canton employed in private and public institutions. The research was voluntary, non-commercial and all participants provided an oral informed consent. Depression, Anxiety and Stress Scale (DASS-21) questionnaire was used for assessing emotional status of depression, anxiety and stress.<br /><strong>Results</strong> <br />The mean age of participants was 40.5&plusmn;8.44 years with male:female ratio of 0.28. Prevalence of depression was 46.5%,<br />anxiety61.4%, and 36.9% stress. Age and gender had no effect on emotional status, but it was revealed that women achieved higher depression, anxiety and stress scores than men (without statistical significance). The most notable effect on the emotional state was found for direct or indirect contact with COVID-19 patients. Medical workers in direct contact with COVID-19 patients achieved greater depression (p=0.005), anxiety (p=0.001), stress (p=0.030)<br />and total DASS-21 (p=0.003) scores.<br /><strong>Conclusion</strong> <br />High prevalence of health workers affected by various psychological ailments during the COVID-19 pandemic was found. This evidence underscores the need to address adverse effects of the pandemic on mental health of health care workers.</p>
Background: Immunization is a key step in preventing the occupational risk of acquiring hepatitis B infection for healthcare workers (HCWs). The aim of the study was determination of hepatitis B vaccine (HepB) coverage rate among HCWs and support staff and immune response 10 years after primary vaccination. Methods: A retrospective study was conducted in the Public Institution Health Centre of Sarajevo Canton in Bosnia and Herzegovina during 2005-2017. Second-generation vaccines Euvax (Sanofi Pasteur, Thailand/LG Life Sciences Ltd, Korea) and Engerix B (GlaxoSmithKline, Belgium) were applied. For quantification of antibody response to hepatitis B virus surface antigen three laboratory methods were used. A level of ≥ 10 IU/L anti-HBs was set as a cut-off value indicating the presence of protective immunity against new HBV infections and successful vaccination. Results: In total, 1541 (75.80%) were fully vaccinated, out of 1126 (73.07%) were females. The median age of participans was 50.5 ± 9.4 years. Control measurement of the anti-HBs level was performed for 409 (26.54%) HCWs, and the presence of protective antibodies was confirmed in 304 (74.33%). During the research, 37 booster doses were administered. Of the 23 retested participants, anti-HBs ≥10 IU/L were observed in 19 (82.16%). Three non-reactors subject were revealed. Conclusion: A satisfying HepB coverage rate and a high protective rate against hepatitis B infection among HCWs and support staff was achived, although vaccination is voluntary in Bosnia and Herzegovina. These results indicate the active engagement of the institution in the implementation of preventive measures and the high level of awareness regarding the significance of immunization. Our results demonstrated the effectiveness of booster doses. A low prevalence of non-reactors was revealed. Additional research with a focus on occupational risk factors in dental service is advised.
Introduction: Low sensitivity and specificity in traditional laboratory tests became insufficient for accurate diagnostics and initiation of proper treatment of patients infected with bacterial meningitis. High sensitivity Creactive protein (hsCRP) may be an appropriate supplement for rapid diagnosis of bacterial meningitis. The subject of our investigation was the determination of C-reactive protein in cerebrospinal fluid (CSF) during acute bacterial meningitis. Methods: HsCRP was analysed by a sensitive immunoturbidimetric assay using the Dimension RxL analyser (Siemens). Cerebrospinal fluid concentrations of C-reactive protein have been measured in 20 patients (age range,1 to 50 years) presenting with acute bacterial meningitis and also in a non-infected, non-inflamed control group (n=25). Results:The accuracy and precision of the method proved to be satisfactory. Repeatability of serial sampling for hsCRP described by coefficient of variation were CV=2.1-4.5%. This assay hsCRP in cerebrospinal fluid demonstrates adequate performance characteristics for routine clinical use. Elevated levels of CRP were found in 95% patients with bacterial meningitis. The mean CRP value in 25 uninfected control group was 0.25 mg/L (range 0.10-0.55). The mean CRP for patients with bacterial meningitis was 21.4 mg/L (range 0.40-100). Conclusions: A sensitive assay for CRP in CSF would be an useful adjunct to conventional investigation of acute infective meningitis.
The principal role of biochemical laboratories is responsibility for reliable, reproducible, accurate, timely, and accurately interpreted analysis results that help in making clinical decisions, while ensuring the desired clinical outcomes. To achieve this goal, the laboratory should introduce and maintain quality control in all phases of work. The importance of applying the Six SIGMA quality model has been analyzed in a large number of scientific studies. The purpose of this review is to highlight the importance of using six SIGMA metrics in biochemical laboratories and the current application of six SIGMA metrics in all laboratory work procedures. It has been shown that the six SIGMA model can be very useful in improving all phases of laboratory work, as well as that a detailed assessment of all procedures of the phases of work and improvement of the laboratory's quality control system is crucial for the laboratory to have the highest level of six SIGMA. Clinical laboratories should use SIGMA metrics to monitor their performance, as it makes it easier to identify gaps in their performance, thereby improving their efficiency and patient safety. Medical laboratory quality managers should provide a systematic methodology for analyzing and correcting quality assurance systems to achieve Six SIGMA quality-level standards.
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