No abstract

Introduction: Various risk factors contribute to the occurrence of acute myocardial infarction as the most serious type of ischemic heart disease and the leading cause of sudden death worldwide. Aim of the Study: The aim of this study was to assess the frequency of changeable and unchangeable risk factors in patients with acute myocardial infarction in the Republic of Srpska. Patients and Methods: This cross-sectional study included patients treated for acute myocardial infarction at the University Clinical Center of Banja Luka, in the period from January 1st to December 31st, 2011. The patients were from the municipalities of Banja Luka and Laktaši. We analyzed the following risk factors: hypertension, total cholesterol values, diabetes, increased body weight and obesity, smoking, family history and physical inactivity. Results: Out of 273 patients, the majority were male (64%), and there was a statistically significant difference between age and sex (p <0.01) of the respondents. The most common risk factor for both genders was hypertension (70.1%), while the least frequent risk factor was diabetes mellitus (25.6%). Smokers and ex-smokers accounted for 58.1%, with a statistical significance between men and women (p <0.01). The average BMI in both genders was in the overweight category (27.69 kg / m2). A positive family history was found in almost half of the respondents (49.4%), with a statistically significant difference between age groups and family history (p = 0.036). Conclusion: Acute myocardial infarction mainly affects men in their sixties, while women are averagely affected nine years later than men. The number one risk factor for both genders is hypertension. Given the large impact of risk factors on the occurrence of acute myocardial infarction, priority must be given to the prevention and control of the aforementioned, especially in the primary health care.

No abstract

Introduction. The aim of this study was to determine the prevalence of microvascular complications in type 1 and type 2 diabetes mellitus patients in relation to glycated hemoglobin. Material and Methods. This cross-sectional study analyzed the prevalence of microvascular complications in patients with diabetes mellitus registered at the Primary Health Center Banja Luka. Demographic data, duration of diabetes, blood pressure, glycated hemoglobin, dyslipidemia, type of therapy, presence of retinopathy, neuropathy and nephropathy were analyzed. Data collection was done from December 2017 to November 2018. Results. The study included 228 patients, 132 (57.9%) men and 96 (42.1%) women. The most common microvascular complication was diabetic neuropathy (24.2%). The mean glycated hemoglobin level in patients with diabetic complications was 7.75 ? 1.66%. Although all participants with complications had unregulated diabetes mellitus (glycated hemoglobin > 7%), a statistically significant difference was found in regard to microalbuminuria (> 30 mg/24 h) and/or proteinuria (> 0.15 g/24 h) and/or decreased creatinine clearance (< 1.5 ml/sec) and their mean glycated hemoglobin (p = 0.025), while for other complications (neuropathy and retinopathy) the same was not confirmed. Multivariate logistic regression analysis confirmed that microalbuminuria and/or proteinuria and/or decreased creatinine clearance (odds ratio = 2.174; 95% confidence interval: 1.040 - 4.543; p = 0.039) as well as elevated diastolic blood pressure (odds ratio = 1.09; 95% confidence interval: 1.024 - 1.162; p = 0.007) were factors associated with glycated hemoglobin > 7%. Conclusion. The most common microvascular complication in patients with both types of diabetes mellitus is diabetic neuropathy with a prevalence of 24.2%. The presence of microalbuminuria and/or proteinuria and/ or decreased creatinine clearance were associated with glycated hemoglobin > 7% and elevated diastolic blood pressure.

Uvod. Periferna arterijska bolest (PAB) je progresivna, okluzivna, aterosklerotskabolest krvnih sudova, a pacijenati sa dijabetes melitusom (DM) imajuznačajno veći rizik za razvoj ove bolesti. Cilj ove studije je bio da se utvrdiučestalost PAB kod pacijenata sa tipom 2 DM mjerenjem pedo-brahijalnog(PB) indeksa u ambulanti porodične medicine.Metode. Studija presjeka je uključila pacijente sa tipom 2 DM registrovaneu ambulantama porodične medicine Doma zdravlja Laktaši. MjerenjePB indeksa je vršeno na oscilometrijskom aparatu “Boso ABI Mess 100“, aPAB je dijagnostikovana ako je vrijednost PB indeksa bila manja od 0,9 iliveća od 1,3.Rezultati. Ispitivanje je obuhvatilo 178 (90 muškaraca) ispitanika sa tipom2 DM preko 50 godina starosti. PAB je registrovana kod 26 (14,6%) ispitanika,sa potvrđenom značajnom razlikom u PB indeksu (lijeva/desna noga)između pacijenata sa PAB i pacijenata bez PAB (0,82/0,84 vs. 1,04/1,05; p< 0,01). Prosječno trajanje DM bilo je duže kod bolesnika sa u odnosu naone bez PAB (12 vs. 8 godina; p = 0,097), a srednje vrijednosti HbA1c subile podjednake u obje grupe (7,7% vs. 7,9% ; p = 0,634). Nije potvrđenarazlika u učestalosti hipertenzije, dislipidemije i gojaznosti između bolesnikasa, odnosno bez PAB, ali je bilo značajno više pušača među bolesnicimasa PAB (p<0,01).Zaključak. Prevalencija PAB kod ispitanih pacijenata sa tipom 2 DM jeiznosila 14,6%. Dijabetes je trajao neznačajno duže kod pacijenata sa PABi među njima je bilo značajno više pušača nego u grupi bez PAB. Edinburškiupitnik za klaudikacije je bio pozitivan kod samo trećine pacijenata sa PAB.Mjerenjem PB indeksa se može rano dijagnostikovati PAB kod mnogo većegbroja pacijenata sa tipom 2 DM nego primjenom Edinburškog upitnika.

Background/Aim. Diabetic polyneuropathy (DPN) is the most common microvascular complication of diabetes mellitus (DM), which may be present at the time of disease detection. Screening for DPN is performed for the patients with type 2 diabetes at the time of diagnosis and for type 1 diabetes 5 years after diagnosis. The primary aim of this study was to determine the prevalence of DNP among family medicine patients with DM aged 18 to 70 years using nylon monofilament. Methods. The cross-sectional study estimated the prevalence of DPN among primary care patients with DM in Banja Luka, Republic of Srpska, Bosnia and Herzegovina. Semmes-Weinstein nylon 10 g monofilament was used to detect DPN. Age, gender, duration of DM, type of therapy, symptoms, glycosylated hemoglobin (HbA1c), and risk factors (hypertension, smoking, dyslipidemia, obesity, physical inactivity) were analyzed. Data collection took place from June 1st, 2017 to May 31st, 2018. Results. The study included 228 patients, 132 (57.9%) men and 96 (42.1%) women. There was a statistically significant difference in the presence of all symptoms of DPN (tingling, burning, light burning, and stinging) among patients with different duration of DM (p < 0.01). Multivariate logistic regression revealed that patients who had hypertension [odds ratio (OR) = 26.2; 95% confidence interval (CI): 4.070?168.488; p = 0.001], used oral anti-diabetic therapy (OR = 12.3; 95% CI: 1.300?116.309; p = 0.029), had tingling (OR = 5.2; 95% CI: 1.431?18.571; p = 0.012) and a longer duration of diabetes (OR = 4.27; 95% CI: 1.983?9.175; p = 0.000) were more likely to have DPN. Conclusion. The prevalence of DPN in family medicine patients with DM using nylon monofilament was 24.2%. Determinants of DNP were the presence of symptoms of tingling, duration of diabetes, hypertension, and the use of oral antidiabetic therapy alone.

No abstract