Journal of Health Sciences <p><img style="float: right;" src="/OJS/imgs/jhsci-cover-6-1.jpg" alt="Journal of Health Sciences"></p> <p><em>The Journal of Health Sciences</em> is international, open access, peer-reviewed and evidence-based scientific&nbsp;journal&nbsp;published by the University of Sarajevo Faculty of Health Sciences (UNSA FHS; <a href="" rel="noopener"></a>).&nbsp;It follows publishing standards set by the International Committee of Medical Journal Editors (ICMJE; <a href="" rel="noopener"></a>), Committee on Publication Ethics (COPE; <a href="" rel="noopener"></a>), and the World Association of Medical Editors (WAME; <a href="" rel="noopener"></a>).</p> <p>The Journal's mission is to promote excellence in nursing and a range of disciplines and specialties of <a href="" rel="noopener">allied health professions</a>.&nbsp; It welcomes submissions from <strong>international academic and health professionals community</strong>. The Journal publishes&nbsp;<strong>evidence-based</strong> articles with solid and sound methodology, clinical application, description of best clinical practices, and discussion of relevant professional issues or perspectives. Articles can be submitted in the form of <strong>research articles, reviews, case reports, and letters to editor or commentaries.</strong></p> <p>The Journal's priority are papers in the fields of nursing, physical therapy, medical laboratory science, environmental health, and medical imaging and radiologic technologies. Relevant papers from other disciplines of&nbsp;<a href="" rel="noopener">allied health professions</a> may be considered for publication.</p> <div> <p><strong>Editor-in-chief: Dijana Avdić, MD, PhD</strong></p> <p><strong>ISSN:</strong>&nbsp;2232-7576<br><strong>EISSN:</strong>&nbsp;1986-8049</p> <p><strong>Frequency:</strong>&nbsp;three times per year (April, September, December)</p> <p><strong>Indexed/abstracted in:</strong> SCOPUS, EBSCO, DOAJ, Google Scholar, PROQUEST, Bielefeld Academic Search Engine (BASE), CAB Abstracts, ULRICH'S, Academic Journal Database, Elektronische Zeitschriftenbibliothek, Index Copernicus, Geneva Foundation for Medical Education and Research, SciLit Basel, ScienceOpen</p> </div> University of Sarajevo Faculty of Health Studies en-US Journal of Health Sciences 2232-7576 The role of a dry needling technique in pain reduction <p><strong>Introduction:</strong> Dry needling is a therapeutic procedure using the insertion of thin needles through the skin into myofascial trigger points (MTrPs), muscular or connective tissue with the aim to reduce pain intensity. The objective of this systematic review is to analyze the literature for the efficacy of the dry needle technique in pain reduction in conditions of musculoskeletal pain caused by MTrPs.</p> <p><strong>Reference Sources:</strong> Web of Science, Scopus and EBSCOhost database were searched for studies and e-books published from January 2010 to December 2018.</p> <p><strong>Studies Selection:</strong> We included randomized controlled studies, prospective and longitudinal studies, and case studies which analyzed the efficacy of dry needling for musculoskeletal pain reduction.</p> <p><strong>Data Extraction Method:</strong> The studies, which satisfied criteria for inclusion were further analyzed. The primary instrument of the evaluation was pain intensity analyses.</p> <p><strong>Results:</strong> Dry needling treatment is efficient in pain intensity reduction in patients who suffer musculoskeletal pain and is more efficient compared to sham dry needling treatment. In addition, different techniques of dry needling are efficient in the treatment of myofascial pain syndrome.</p> <p><strong>Conclusion:</strong> Based on systematic review of the literature, dry needling, independently or as an addition to other intervention, is recommended for treatment of musculoskeletal pain conditions caused by myofascial trigger points. Various techniques of dry needling treatment are almost equally efficient in myofascial pain intensity reduction.</p> Eldad Kaljić Namik Trtak Dijana Avdić Samir Bojičić Bakir Katana Muris Pecar Copyright (c) 2018 Eldad Kaljić, Namik Trtak, Dijana Avdić, Samir Bojičić, Bakir Katana, Muris Pecar 2018-10-09 2018-10-09 8 3 128 139 10.17532/jhsci.2018.610 The effects of programmed therapeutic exercises on fall risk factors in elderly <p><strong>Introduction</strong>: &nbsp;Identification of the risk factors that can be modified is an essential aspect in the development of the effective strategy for therapeutic intervention with the purpose to improve mobility and injury prevention and post-fall consequences. This research aimed to analyze the impact of programmed therapeutic exercises on the fall risk factors in the elderly.</p> <p><strong>Methods</strong>: We included 260 patients older than 65 years, and assigned them randomly into three groups. Group A: 65 patients subjected to therapeutic exercises for moderate-intensity muscle strengthening with Theraband stretch straps (corresponding to 11-14 on the Borg rating of perceived exertion scale). Group B: 65 patients subjected to therapeutic anti-gravity exercises. Control group: 130 patients not participating in programmed therapeutic exercises.</p> <p>Presence of fall risk factors was assessed in all three groups with standardized Fast Evaluation of Mobility, Balance, and Fear test (FEMBAF) before the initiation of therapy, after three and after six months of treatment.</p> <p><strong>Results:</strong> At the end of the study, the subjects of the group A had significantly fewer limitations in performing basic life activities at home compared to the patients of the control and Group B, p = 0.037. The control group subjects were statistically significantly more likely to complain of vertigo than subjects of the experimental groups, p = 0.021. The subjects of the experimental groups had more than two falls than the control group subjects, p = 0.003 statistically. In the control group, the number of fractures after the fall at the end of the study increased significantly, statistically higher than in the subjects of the experimental groups, P = 0.037.</p> <p><strong>Conclusion:</strong> Programmed therapeutic exercise significantly reduces the risk of falling factors, and significant effects have been achieved among subjects who have exercised with elastic strips.</p> Bakir Katana Samir Bojičić Muris Pecar Eldad Kaljić Namik Trtak Emina Smajić Copyright (c) 2018 Bakir Katana, Samir Bojičić, Muris Pecar, Eldad Kaljić, Namik Trtak, Emina Smajić 2018-12-05 2018-12-05 8 3 140 147 10.17532/jhsci.2018.621 New Topical Treatment of Symptomatic Internal Haemorrhoids in a General Practice Setting <p><strong>Introduction:</strong> Oral usage of flavonoid-based drugs can be successfully applied in the conservative treatment of internal haemorrhoids; however, its efficiency in a form of topical preparations has not been demonstrated yet. The aim of the present study was to determine the efficiency of ointment with propolis extract (containing minimally 115 mg/kg of flavonoid galangin) in relief and suppression of the symptomatic internal haemorrhoids grade 1 and 2 (bleeding, prolapse, pain, and itching).</p> <p><strong>Methods:</strong> This prospective cohort epidemiological study that included 46 participants of both genders, mean age 53.6±14.3 years, was conducted in the general practice setting in Osijek, Croatia and lasted for three months. A specially designed questionnaire was used to collect demographic data and data concerning the haemorrhoid disease symptoms and to evaluate the intensity of the latter data according to the scale defined in the research protocol.</p> <p><strong>Results:</strong> The study showed statistically significant improvements in the intensity of all the symptoms connected with the internal haemorrhoids grade 1 and 2 (p&lt;0.001) during the follow up period, as well as statistically significant differences in proportions of participants with and without of the each of the analysed symptoms before and after the therapy (p&lt;0.001). After three months of therapy with ointment containing propolis extract 82.7% patients (38/46) had none of the analysed symptoms.</p> <p><strong>Conclusions:</strong> Ointment with propolis extract efficiently affected all the analysed symptoms of the haemorrhoid disease thus having a very significant place within the conservative treatment of haemorrhoids.</p> Maja Miškulin Zdenka Lalić Albina Dumić Ivan Miškulin Matea Matić Nika Pavlović Copyright (c) 2018 Maja Miškulin, Zdenka Lalić, Albina Dumić, Ivan Miškulin, Matea Matić, Nika Pavlović 2018-12-04 2018-12-04 8 3 148 153 10.17532/jhsci.2018.454 Serum levels of oxidative stress marker malondialdehyde in breast cancer patients in relation to pathohistological factors, estrogen receptors, menopausal status, and age <p><strong>Introduction:</strong> The aim of this study was to determine the serum levels of malondialdehyde (MDA) in patients with invasive breast cancer in relation to its serum levels in patients with benign breast disease, and to investigate correlation between MDA serum levels with pathohistological prognostic factors (tumor size, lymph node involvement, and histologic grade [HG]), estrogen receptor (ER) status, and with breast cancer patient’s age and menopausal status.</p> <p><strong>Methods:</strong> A total of 43 with well-documented invasive breast cancer were included in this study: 27 with positive axillary’s lymph nodes, and 16 with negative axillary’s lymph nodes, and 39 patients with findings of benign breast diseases. MDA determination in serum of breast cancer and benign breast disease patients was performed by the fluorimetric method, immunohistochemical staining was performed for ER, and routine pathohistological examination was conducted for pathohistological factors.</p> <p><strong>Results:</strong> MDA serum levels in breast cancer patients were significantly higher than MDA serum levels in benign breast disease patients (p = 0.042). No statistically significant difference between MDA serum levels in breast cancer patients with and without lymph node metastases was found (p = 0.238). No statistically significant correlations between MDA serum levels and tumor size (p = 0.256), HG (p = 0.124), or number of positive lymph nodes (0.113) were found. A statistically significant correlation between serum MDA levels and ages of breast cancer patients with lymph node metastases was found (p = 0.006).</p> <p><strong>Conclusion:</strong> Obtained results support the importance of MDA in the carcinogenesis of breast cancer. According to our findings, serum level of MDA could not be a useful prognostic factor in breast cancer.</p> Jasmina Gubaljevic Nahida Srabović Adlija Jevrić-Čaušević Adaleta Softić Adi Rifatbegović Jasminka Mujanović-Mustedanagić Esmeralda Dautović Aida Smajlović Zlata Mujagić Copyright (c) 2018 Journal of Health Sciences 2018-12-18 2018-12-18 8 3 154 161 10.17532/jhsci.2018.263 Expected professional and personal characteristics of clinical mentors: Differences between physiotherapy and social gerontology students <p><strong>Background:</strong> Clinical mentors play an important role in the development of knowledge and the acquisition of competencies of different health professionals. The success of the entire mentoring process also depends on the professional and personal characteristics of the clinical mentor. The purpose of this study was to identify which professional and personal characteristics of clinical mentors are relevant to physiotherapy (PHT) and social gerontology (SG) students.</p> <p><strong>Methods:</strong> The web survey was performed between January 20 and May 15, 2018, using the adapted version of the nursing clinical teacher effectiveness inventory. The final sample consisted of 100 PHT and SG students from one of the Slovenian Universities.</p> <p><strong>Results:</strong> The competencies “explains clearly” (p ˂ 0.001) and “takes responsibility of own actions” (p = 0.023) were statistically significantly more relevant to PHT students than to the SG students. The competencies “explains clearly” (p ˂ 0.001), “demonstrates clinical skill and judgment” (p = 0.033), “takes responsibility of own actions” (p = 0.023), and “is self-critical” (p = 0.023), were statistically significantly more relevant to PHT than to the SG students, while the statements “discusses current development in his/her field” (p = 0.002), “communicates expectations of students” (p = 0.029), “demonstrates empathy” (p = 0.037), “demonstrates enthusiasm” (p = 0.005), and “has a good sense of humor” (p = 0.005) were statistically significantly more relevant to SG students.</p> <p><strong>Conclusion:</strong> The contrast in responses reflects the differences in the nature of both professions: The predominantly instrumental nature of PHT and the predominantly expressive nature of SG.</p> Bojana Filej Boštjan Žvanut Boris Miha Kaučič Copyright (c) 2018 Journal of Health Sciences 2018-12-11 2018-12-11 8 3 162 170 10.17532/jhsci.2018.255 Assessment of risk factors for hypertension in Dormaa municipality in Ghana using the World Health Organization STEPS approach <p><strong>Introduction: </strong>Hypertension (HPT) is a significant public health challenge worldwide and is the single most important risk factor for cardiovascular disease. As life expectancy rates improve in Ghana and the prevalence of risk factors increase, the burden of non-communicable diseases such as HPT is also expected to increase. However, little is known about the specific factors that predispose of Ghanaians to a higher risk of HPT.</p> <p><strong>Methods:</strong> A cross-sectional study was conducted in the Dormaa Municipality in Ghana using the World Health Organization STEPwise approach to investigate risk factors for HPT. Study participants were recruited by probability proportional sampling technique. In all, 202 males and 198 females participated in this study.</p> <p><strong>Results:</strong> The mean age of the participants was 50.06 years (95% confidence interval [CI]: 48.46–51.66). In all, 40% of all participants in this study had elevated blood pressure (BP) (BP ≥140/90 mmHg). Further, the rate of isolated systolic HPT was 11.2% among the study population (12.9% in males and 9.6% in females). Risk factors as measured in the population were advancing age &gt;45 years (odds ratio [OR] = 2.745, CI 1.20–6.30, p = 0.017), gender (44.6% males versus 35.4% females with elevated BP, male OR = 0.492, CI 0.28–0.86, p = 0.012), and tobacco use (OR = 2.66, CI 1.41–5.04, p = 0.003). Males reported higher mean portions of fruits (p = 0.036) and vegetable servings than females (p = 0.009) and spent more time each day on physical activities compared to females (p = 0.000).</p> <p><strong>Conclusion:</strong> The results of the present study provide useful data on HPT prevalence and associated risk factors in the Dormaa Municipality and the Brong-Ahafo Region of Ghana. To be able to control HPT in the municipality, health practitioners and policymakers should focus on these modifiable risk factors.</p> Fidelis Atibila Ellis Owusu Dabo James Avoka Asamani Charles Ampong Adjei Francis Abande Akugri Priscilla Adumoah Attafuah Copyright (c) 2018 Journal of Health Sciences 2018-12-05 2018-12-05 8 3 171 180 10.17532/jhsci.2018.281 Government and school community member perception on childhood obesity prevention in the primary school settings of Brunei Darussalam <p><strong>Introduction:</strong> Childhood obesity is increasing in the Southeast Asian region, including in the nation of Brunei Darussalam. Within the public health focus on obesity prevention, specific settings, including primary schools, have been singled out as suitable sites for action. Recognizing that stakeholders are, in their various roles, producers of policy or implementers of practice, the purpose of this study in Brunei was to establish a baseline for interventions as well as to establish strengths and limitations in the current practice.</p> <p><strong>Methods:</strong> Semi-structured interview with government and school community stakeholders was conducted, and transcriptions were thematically analyzed.</p> <p><strong>Results:</strong> Three themes emerged from the data. The first theme was “children’s eating habits today = healthy adult population tomorrow;” many of the stakeholders believed that, if healthy eating is not practiced from an early stage, this can lead to the development of harmful diet-related diseases in the future. The second theme was “barriers to effectively addressing the issue of childhood obesity;” all were able to identify barriers such as workforce issues to address obesity prevention and health promotion activities. The third theme was “parental responsibility for children’s diet and physical activity habits.” The majority of respondents believed that parents are responsible for the rise in childhood obesity in Brunei.</p> <p><strong>Conclusions:</strong> The widespread ethos of personal responsibility for health behaviors has resulted in policies having a heavy emphasis on individual health behavior management and blame for the problem being directed primarily at parents. This individualization of the problem of childhood obesity is a barrier to the planning and implementation of ecological interventions.</p> Siti Rohaiza Ahmad Lisa Schubert Robert Bush Copyright (c) 2018 Journal of Health Sciences 2018-12-11 2018-12-11 8 3 181 188 10.17532/jhsci.2018.191 Attachment style and family presence preference during invasive nursing procedures <p><strong>Introduction:</strong> The attachment style and family presence preference are important during invasive medical procedures. We aimed to analyze the effects of adult attachment styles of the patients which prefer the presence of their family members during the invasive medical procedures in emergency departments.</p> <p><strong>Methods:</strong> We included 76 randomly selected patients who received invasive medical procedures in the emergency department of the University hospital. The Patient Information Form and Relationship Scales Questionnaire were used to collect data.</p> <p><strong>Results:</strong> About 57.9% of the patients said that they preferred their relatives to stand by them during invasive nursing procedures. 56.6% of participants stated that they favor their relatives to support them at the time of such interventions. Average scores of adult attachment styles were 3.02 ± 0.63 for fearful, 3.57 ±0.57 for dismissing, 2.87 ± 0.50 for preoccupied, and 2.79 ± 0.66 for secure attachment style. Adult attachment styles of participants were found to have no impact on preferring someone standing by them at the time of invasive nursing interventions (p &gt; 0.05).</p> <p><strong>Conclusion:</strong> Adult attachment styles do not affect the patients' need to have a family member stand beside them during an invasive medical procedure.</p> Nurten Kaya Nuray Turan Copyright (c) 2018 Journal of Health Sciences 2018-12-20 2018-12-20 8 3 189 196 10.17532/jhsci.2018.188 Mild symptomatic Wernicke’s Encephalopathy: a case report <p>Wernicke’s encephalopathy (WE) is an acute, neuropsychiatric syndrome which results from a deficiency in vitamin B1 (thiamine), which in its biologically active form, thiamine pyrophosphate, is an essential coenzyme in several biochemical pathways in the brain, often due to alcohol abuse (alcoholic WE). Non-alcoholic WE variant manifests in many different clinical settings, such as gastrointestinal tumors, hyperemesis gravidarum, chemotherapy, acquired immunodeficiency syndrome, prolonged therapeutic fasting, protracted parenteral nutrition and bariatric surgery, anorexia nervosa and can even be secondary to socioeconomic factors. The classic triad of encephalopathy, oculomotor dysfunction, and gait ataxia is only seen in approximately one-third of patients and is more common in alcoholics; only some of these symptoms are usually present. Here we describe a case of an occasional neuroradiological finding of Wernicke Encephalopathy not related to symptoms or signs.</p> Maria Sofia Cotelli Patrizia Civelli Marinella Turla Copyright (c) 2018 Journal of Health Sciences 2018-12-20 2018-12-20 8 3 197 200 10.17532/jhsci.2018.269