AimTo assess awareness, knowledge, use, and attitudes toward evidence-based medicine (EBM) and The Cochrane Library (CL) among physicians from Zenica-Doboj Canton (ZDC), Bosnia and Herzegovina.MethodsIn this cross-sectional study, a self-administered anonymous questionnaire was sent by post to all state owned health institutions (2 hospitals and 11 Primary Health Care Institutions) in ZDC. The main outcome measures were physicians’ awareness of the Cochrane, awareness and use of CL, access to EBM databases, and access to internet at work. 358 of 559 physicians responded (63.69%).Results23.18% of respondents stated they had access to EBM databases, but only 3.91% named the actual EBM databases they used. The question on the highest level of evidence in EBM was correctly answered by 35.7% respondents, 34.64% heard about Cochrane and 32.68% heard about CL. They obtained information about CL mostly on the internet and from colleagues, whereas the information about EBM was obtained mainly during continuous medical education.ConclusionAlthough the attitudes toward EBM are positive, there is a low awareness of EBM among physicians in ZDC. Open access to the CL should be used more. Educational interventions in popularizing EBM and Cochrane are needed to raise awareness both among students and practicing physicians, and finally among lay audience.
Introduction:Serum uric acid (SUA) is the final product of purine metabolism in humans.Aim:The present study aimed to identify a potential association between serum UA and cardiac troponin I (cTnI) levels and to find out whether uric acid could differentiate patients presenting with the acute myocardial infarction (AMI) and unstable angina pectoris (UAP) in hyperuricemic and normouricemic acute coronary syndrome (ACS) patients.Methods:Eighty ACS patients, aged 50-83 years, were enrolled in the study, 40 of them presenting with AMI and 40 with UAP. Frequency of patients with serum uric level over threshold for hyperuricemia was investigated and two groups of patients were formed such as hyperuricemic and normouricemic groups (A and B groups, respectively) independently of type of ACS. Those groups of patients were also subjected to cTnI measurement.Results:Levels of SUA are associated with the type of ACS in the hyperuricemic ACS patients (AMI versus UAP, 499(458-590), 425(400-447) mmol/L, p=0.007, respectively). Uric acid correlated significantly with cTnI, moderate positively in the group A (rho=0.358, p=0.038) and moderate negatively in the group B (r=-0.309, p=0.037) of ACS patients. Multiple logistic regression analysis revealed that cTnI and age were independently associated with the SUA levels in the group A of ACS patients.Conclusions:Serum uric acid differentiates AIM and UAP patients in hyperuricemic group of acute coronary syndrome. Therefore it can be used as nonspecific parameter for evaluation of the myocardial lesion extent only in hyperuricemic ACS patients. This is supported by finding that cTnI along with age predicts SUA level in hyperuricemic ACS patients.
To investigate association of mean platelet volume (MPV) and glycemic control markers, and whether MPV could be used as a predictor of deterioration of glucoregulation in Diabetes mellitus type 2 (DMT2) patients.
<p><strong>Aim</strong> <br />To identify rates of most common pre-analytical errors and to document possible (different) error rates between inpatients and outpatients.<br /><strong>Methods <br /></strong>This retrospective study was conducted at the Department of Medical Biochemistry and Immunology Diagnostics,<br />Cantonal Hospital Zenica, from December 2016 until March 2017. Data on rejected blood samples in the laboratory information system were analysed.<br /><strong>Results<br /></strong> During the 3-month period 35,343 patient blood samples (25,545 inpatients and 9,798 outpatients) were received in<br />the laboratory. The study identified 602 (1.70%) rejected samples because of pre-analytical errors, mostly due to haemolysis, 292 (48.50%), and clotted samples, 240 (39.87%). The remaining 70 (11.63%) samples were rejected because of inappropriate sample volume, inappropriate container and identification errors (7.81%, 2.16% and 1.66%, respectively). The proportion of inpatient rejected samples was 8.7-fold higher than in the outpatient samples.<br />The proportion of inpatient rejected samples because of haemolysis, clotted samples, inappropriate sample volume and inappropriate containers were higher than in the outpatient samples (20.5-, 12.1-, 2.3- and 1.3-fold higher, respectively); proportion of rejected samples because of identification errors was 8.0-fold higher in the outpatient (collection sites outside the hospital) than in the inpatient samples.<br /><strong>Conclusion<br /></strong> Higher pre-analytical sample error rates were connected with inpatient samples, while higher identification error rates<br />were connected with outpatient samples. Establishment of periodic stuff training and introduction of information technology could reduce pre-analytical errors.</p>
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