Journal of Health Sciences <div style="display: none; text-align: left; padding: 10px 10px 10px 10px; margin: 0px; background-color: #cee3f6; color: #690000; border-radius: 3px; width: 100%;"><strong>ⓘ </strong>Please note that the website of the Journal of Health Sciences will undergo scheduled maintenance on Sunday, 30 May 2021<strong>. </strong></div> <div style="display: none; text-align: left; padding: 10px 10px 10px 10px; margin: 0px; background-color: #ffd7d7; color: #690000; border-radius: 3px; width: 100%;"><strong>ⓘ Notice to readers and authors: </strong>The is a duplicate and fake website of the Journal of Health Sciences, created by a malicious third party, fraudulently offering academicians the opportunity to rapidly publish their research online for a fee. The legitimate website of the Journal of Health Sciences is <strong></strong>. <br />If you have been a victim of the fraudulent website please report it here: <a href="" target="_blank" rel="noopener nofollow"></a></div> <div> <p><strong><em><br />The Journal of Health Sciences</em></strong> is international, open access, peer-reviewed, and evidence-based scientific journal published by the University of Sarajevo, Faculty of Health Studies (UNSA FHS; <a href=""> ;</a> <a href="" rel="noopener nofollow"></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 nofollow">allied health professions</a>. It welcomes submissions from international academic and health professionals community. The Journal publishes evidence-based 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 research articles, reviews, case reports, and letters to the editor or commentaries.</p> </div> <div> <p>The Journal's priorities are papers in the fields of nursing, physical therapy, medical laboratory science, environmental health, and medical imaging and radiologic technologies. Relevant articles from other disciplines of <a href="" rel="noopener nofollow">allied health professions</a> may be considered for publication.</p> <p>It follows publishing standards set by the International Committee of Medical Journal Editors (<strong>ICMJE</strong>; <a href="" rel="noopener nofollow"></a>), Committee on Publication Ethics (<strong>COPE</strong>; <a href="" rel="noopener nofollow"></a>), and the World Association of Medical Editors (<strong>WAME</strong>; <a href="" rel="noopener nofollow"></a>).</p> <p><strong>This journal is indexed or abstracted by</strong> <a href="" target="_blank" rel="noopener nofollow"><strong>SCOPUS</strong></a>, <strong><a href="" target="_blank" rel="noopener nofollow">EBSCO</a></strong>, <strong><a href="" target="_blank" rel="noopener nofollow">DOAJ</a></strong>, <strong><a href="" target="_blank" rel="noopener nofollow">Scilit</a></strong>, <strong><a href=";user=fOhsyZ8AAAAJ&amp;view_op=list_works" target="_blank" rel="noopener nofollow">Google Scholar</a></strong>, <strong><a href=";order=date" target="_blank" rel="noopener nofollow">Dimensions</a></strong>, <strong><a href="" target="_blank" rel="noopener nofollow">Researcher</a></strong>, <strong><a href=";tip=sid&amp;clean=0" target="_blank" rel="noopener nofollow">Scimago</a></strong>, PROQUEST, <a href="" target="_blank" rel="noopener nofollow"><strong>ScienceOpen</strong></a>, <strong><a href="" target="_blank" rel="noopener nofollow">MIAR</a></strong>, <strong><a href="" target="_blank" rel="noopener nofollow">Bielefeld Academic Search Engine (BASE)</a></strong>, CAB Abstracts, ULRICH'S, Academic Journal Database, Elektronische Zeitschriftenbibliothek, Index Copernicus, Geneva Foundation for Medical Education and Research, and other libraries.</p> </div> University of Sarajevo, Faculty of Health Studies en-US Journal of Health Sciences 2232-7576 COVID-19 and children <p>Most children with a proven coronavirus disease (COVID-19) infection are asymptomatic or have mild symptoms. However, a small number of children have been identified in the past 2 months with developed significant multisystem inflammatory response. All children were treated according to standard protocols. Children with this disease may require hospitalization in pediatric intensive care unit with a multisystem team approach to the disease, which includes pediatricians, infectologists, cardiologists, rheumatologists, immunologists, and epidemiologists. This extremely rare disease is curable if diagnosed in time. This rare syndrome has features in common with other pediatric inflammatory diseases including Kawasaki syndrome, staphylococcal and streptococcal toxic shock syndrome, bacterial sepsis, macrophage activation syndrome, and may present with unusual abdominal pain including elevated inflammation markers. Early recognition of this disease by a pediatrician or family doctor specialist is crucial for the timely treatment and outcome of the disease.</p> Senka Mesihovic-Dinarevic Copyright (c) 2021 Journal of Health Sciences 2021-01-13 2021-01-13 11 1 57 59 10.17532/jhsci.2021.1194 Gross Anatomy for Physical Therapy course <p>The study of anatomy supported with human dissection is foundational to training of health science professionals. For a student, cadaver dissection offers an active learning experience. For the training of physical therapists, we created a manual that efficiently instructs the dissection of the whole body over the course of 30 laboratory periods. In the spirit of academic collegiality, this letter provides health science educators a direct download link (<a href=""></a>) to the dissection manual hosted by the University of Minnesota (USA) Digital Conservancy. No registration is required, the download is free, and the PDF file of the dissection manual can be reproduced or adapted for any educational use.&nbsp;&nbsp;</p> Ward M. Glasoe James R. Carey Brendan J. Dougherty Copyright (c) 2021 Ward M. Glasoe, James R. Carey, Brendan J. Dougherty 2021-03-19 2021-03-19 11 1 60 60 10.17532/jhsci.2021.1246 The relationship of tumor microenvironment and clinicopathological parameters in different molecular subtypes of breast cancer <p><strong>Introduction:</strong> Tumor microenvironment plays a significant role in tumor progression. Tumor stroma is one of the strongest modifiers of tumor cell response, cancer behavior, and cancer progression. This study aimed to investigate the correlation of matrix metalloproteinase-9 (MMP-9) expression and tumor-stroma ratio (TSR) with standard clinicopathological parameters in different molecular subtypes of breast cancer.<br /><strong>Methods:</strong> Ninety biopsy samples of primary breast cancer diagnosed at the Department of Pathology, School of Medicine, Sarajevo, were selected for this study. The molecular subtype was determined based on the immunohistochemical expression of estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and Ki-67. Stromal and tumoral MMP-9 immunohistochemical expression and the TSR were determined for each tumor.<br /><strong>Results:</strong> Tumoral MMP-9 expression correlated positively with the presence of lymphovascular invasion (p= 0.016). TSR showed significant association and correlation with tumor grade (G) (p= 0.031; p= 0.049) and tumor size (pT) (p = 0.049;p= 0.021, respectively). Stromal MMP-9 expression correlated with histologic type, histologic grade of tumor, and lymphocytic inflammatory infiltrate (p= 0.021;p= 0.047, p= 0.038, respectively). A higher percentage of stromal MMP-9 expression correlated with the strongest lymphocytic response (p = 0.007). Significant correlation was observed between molecular subtypes and histologic grade of the tumor (p= 0.032).<br /><strong>Conclusion:</strong> Our results, to some extent, confirm the significance of the tumor microenvironment in breast cancer, especially when it is about stromal MMP-9 expression. Although we observed significant association, without linear correlation, we found no significant correlation between molecular subtypes of breast cancer and MMP-9 expression.</p> Nina Čamdžić Suada Kuskunović-Vlahovljak Svjetlana Radović Mirsad Dorić Mirsad Babić Edina Lazović Salčin Amir Spahić Copyright (c) 2021 Nina Camdzic, Suada Kuskunovic-Vlahovljak, Svjetlana Radovic, Mirsad Doric, Mirsad Babic, Edina Lazovic Salcin, Amir Spahic 2021-01-22 2021-01-22 11 1 17 24 10.17532/jhsci.2021.1121 Structure and psychometric properties of the maslach burnout inventory in Croatian nurses <p><strong>Introduction:</strong> The role of nurses in healthcare is of great importance for the well-being of patients. Nurses are exposed to daily stress in the workplace due to the lack of staff, irregular working hours, and lack of support from the management. Such conditions greatly affect the emotional and psychological health of nurses. This study aims to explore the factor structure of the Maslach Burnout Inventory (MBI) on the Croatian sample of nurses.<br /><strong>Methods:</strong> A cross-sectional study on the sample of 119 nurses, using the MBI scale to assess burn-out in nurses.<br /><strong>Results:</strong> The reliability of individual subscales expressed by Cronbach’s alpha coefficients showed that all three scales meet the criterion of internal consistency of 0.832. The obtained coefficients of internal consistency are 0.860 for the dimension of emotional exhaustion, 0.809 for the dimension of depersonalization, and 0.791 for the dimension of personal accomplishment.<br /><strong>Conclusion:</strong> According to this research and comparative research results, we can conclude that MBI 22 can be applied as a valid and reliable burn-out assessment indicator among nursing staff.</p> Sandra Bošković Copyright (c) 2021 Sandra Bošković 2021-03-25 2021-03-25 11 1 25 28 10.17532/jhsci.2021.1082 Anxiety Symptoms Among Lebanese Health-care Students: Prevalence, Risk Factors, And Relationship With Vitamin D Status <p><strong>Introduction:</strong> Various emotions may arise in the context of extensive curriculum of paramedical education. Their association to biological aspects such as Vitamin D status is to be examined with regard to the prevalence of Vitamin D deficiency in the region. This research aims to evaluate the prevalence of anxiety symptoms and their relationship with Vitamin D status among Lebanese health-care students.<br /><strong>Methods:</strong> A total of 157 university students aged 18-25 years old completed a questionnaire related to medical and psychiatric history, nutritional intake, lifestyle habits, and social difficulties. Anxiety symptoms were assessed by Hamilton Anxiety Rating Scale. Vitamin D serum levels were analyzed using ELISA technique.<br /><strong>Results:</strong> Anxiety symptoms were present in 37.5% of students with 2.5% presenting severe anxiety. Anxiety symptoms were significantly associated to health problems (p = 0.0038), social difficulties (p = 0.001), and a family history of psychiatric disorders (p &lt; 0.0001). Low Vitamin D levels were detected in 49.3% of participants; 77.5% having a Vitamin D insufficiency while the rest presenting a Vitamin D deficiency. Students with anxiety symptoms had significantly lower Vitamin D levels as compared to those having no anxiety manifestations (17.9 ng/mL ± 7.9 vs. 24.2 ng/mL ± 9.9, p = 0.0023). However, no significant correlation was registered between anxiety symptoms scores and Vitamin D levels.<br /><strong>Conclusion:</strong> Anxiety symptoms were found to be relatively prevalent among health-care students and associated to low Vitamin D levels. Further studies are warranted to clarify the beneficial effect of Vitamin D supplementation in the prevention, management, and treatment of anxiety symptoms among health-care students.</p> José-Noel Ibrahim Léa Audi Copyright (c) 2021 José-Noel Ibrahim, Léa Audi 2021-04-26 2021-04-26 11 1 29 36 10.17532/jhsci.2021.1191 Quality of Croatian inland bathing areas: Reference to the region and European Union <p><strong>Introduction:</strong> The Republic of Croatia (HR) has significantly invested in monitoring the quality of inland bathing areas during the past 10 years. The aim of this paper was to analyze the results obtained during the 2014-2019 period and to compare them with the Region (non-European Union [EU] countries neighboring Croatia) and EU. Moreover, bathing water quality data at two bathing areas of Zagreb (lakes Jarun and Bundek) were processed in more detail.<br /><strong>Methods:</strong> The quality of inland bathing areas in the HR is monitored in five rivers and five lakes in nine Croatian counties; 19 of the 35 monitored sites are located in Zagreb County. Escherichia coli (EC) was determined by EN ISO 9308-3: 1998, while intestinal enterococci (ENT) were defined by EN ISO 7899-2: 2000. Statistical processing of the results was performed using the Microsoft Excel Statistical Package (Redmond, USA) and Statistica 13.5. (Stat.Sof.Inc., Tulsa, USA); the significance level was set to p &lt; 0.05.<br /><strong>Results:</strong> During the study period, the worst Croatian inland water quality was recorded in 2019 (excellent quality for only 25.9% of the bathing areas), while the best quality was recorded in 2015 (excellent quality in 57.1%). On average (2014-2019), the share of bathing areas with excellent quality in Croatia was 46.3% (i.e., under the EU average of 85.3%); with no poor locations (EU average was nearly 2%). A significant positive correlation was found between fecal indicators (EC&amp;ENT) and the amount of precipitation, while a negative correlation with water and air temperature in lakes.<br /><strong>Conclusions:</strong> The quality of Croatian inland bathing areas is significantly lower than the European average, while EU water quality is improving. Regarding the countries bordering Croatia, Italy, Slovenia, and Hungary have achieved better results, while Montenegro, Serbia, and Bosnia and Herzegovina are still in the process of developing the monitoring of the bathing water quality.</p> Dominik Galić Arijana Cenov Dražen Lušić Marin Glad Slaven Jozić Bruno Cvetković Daniel Maestro Nerma Maestro Diana Mance Darija Vukić Lušić Copyright (c) 2021 Dominik Galić, Arijana Cenov, Dražen Lušić, Marin Glad, Slaven Jozić, Bruno Cvetković, Daniel Maestro, Nerma Maestro, Diana Mance, Darija Vukić Lušić 2021-03-05 2021-03-05 11 1 37 46 10.17532/jhsci.2021.1110 Knowledge of coronavirus 2019 and stress with oral health-care personnel of the Faculty of dentistry in Sarajevo: A cross-sectional study <p><strong>Introduction:</strong> Dentists and generally dental personnel work under the risk of being infected by patients suffering from coronavirus 2019 (COVID-19), who are unaware that they are infected. The reason lies in the fact that during dental procedures, aerosol is formed with droplets that may contain the virus. Thus, it is extremely important that dental personnel comply with adequate protective measures and equipment during clinical work. The aim of this investigation was to evaluate the knowledge of COVID-19 and to determine the amount of stress with dental personnel of the Faculty of Dentistry in Sarajevo, Bosnia and Herzegovina.<br /><strong>Methods:</strong> Health-care personnel of the Faculty of Dentistry with Clinics of the University in Sarajevo has been included in the research: teaching staff, clinical doctors, dental nurses, and dental technicians. The research was conducted in April 2020. It was conducted by an anonymous survey that participant’s filled-in. Out of 157 distributed questionnaires in paper form, 134 participants responded. The questionnaire was divided into three parts: (1) personal data; (2) knowledge of infection COVID-19 (diagnostic methods, transmission pathways, and prevention measures); and (3) the amount of stress (feelings and thoughts) during epidemic COVID-19 with personnel.<br /><strong>Results:</strong> The largest number of participants (61.97%) considers that COVID-19 may be transmitted from infected to a healthy person by inhalation of droplets generated through coughing of an infected person and by direct contact with aerosol dispersed from the mouth of the infected patient during dental treatment. The largest number of participants, 80 of them (59.7%) considers that the method of nucleic acid test is used in diagnosing COVID-19. COVID – 19 had a significantly larger influence on females; they showed higher extent of concern for the claim „I hardly fall asleep because of thinking about it,“ „I try not to talk on this topic“ and „In my mind appear pictures in relation to this“ (p &lt; 0.05).<br /><strong>Conclusion:</strong> Knowledge of COVID-19 and measures of protection of health-care personnel at the Faculty of dentistry with Clinics in Sarajevo is satisfactory. The largest fear of participants was fear of unconsciously transmitting the infection on people close to them and that members of their families become infected with COVID-19.</p> Muhamed Ajanović Selma Tosum Pošković Karlo Kožul Alma Kamber-Ćesir Amela Đonlagić Mirsad Kacila Lejla Kazazić Copyright (c) 2021 Muhamed Ajanović, Selma Tosum Pošković, Karlo Kožul, Alma Kamber-Ćesir, Amela Đonlagić, Mirsad Kacila, Lejla Kazazić 2021-04-28 2021-04-28 11 1 47 52 10.17532/jhsci.2021.1291 Incidence and risk factors for neural tube defects in a Bosnian population <p><strong>Introduction:</strong> Neural tube defects (NTDs) are multifactorial congenital anomalies of the central nervous system that results from failed neural tube closure between the 3rd and 4th weeks of embryonic development. Numerous clinical and experimental studies indicate that supplementation with folic acid before and during early pregnancy reduces the development of these anomalies. The present study examined the incidence and risk factors for NTDs and evaluated the effects of folic acid supplementation.<br /><strong>Methods:</strong> This cross-sectional study included all children with NTDs who were hospitalized at the Pediatric Clinic, Clinical Centre University of Sarajevo during the period from January 01, 2008 to December 31, 2012. Data were collected retrospectively from the medical histories of hospitalized children. The study included children in pediatric clinics from four cantons (Sarajevo, Zenica–Doboj, Unsko–Sanski, and Central Bosnia) of the Federation of Bosnia and Herzegovina. The number of live births for the specified period in each of the four cantons was taken from a report by the Cantonal Ministry of Health.<br /><strong>Results:</strong> Among the 69,096 live births recorded during the study period, 39 children had verified NTDs, with an overall incidence of 0.56:1,000 (or 5.6:10,000) in all four cantons. The most common NTDs were myelomeningocele with hydrocephalus (22/39, 56.4%), followed by isolated myelomeningocele (9/39, 23.1%), spina bifida occulta (7/39, 17.9%), and occipitocele (1/39, 2.6%). A total of 33.3% (13/39) of mothers took folic acid, but only one began supplementation prior to pregnancy, while 67.7% (26/39) of mothers did not take folic acid during pregnancy. NTDs were found more frequently in primiparas (53.8%), women with low education (basic school, 64.1%), and unemployed women (82.1%).<br /><strong>Conclusion:</strong> It is important to make national recommendations for folic acid supplementation for women of reproductive age, but also change the public health policy that includes mandatory fortification of basic foods as this is the best measure for primary prevention of NTDs in the whole population regardless of employment and education status. Additional comprehensive studies are required to assess the incidence and risk factors throughout Bosnia and Herzegovina.</p> Elmedina Mrkulić Emina Vukas Hajrija Maksić Meliha Sakić Jasmina Mahmutović Selma Dizdar Alma Mizdrak Verica Mišanović Copyright (c) 2021 Elmedina Mrkulić, Emina Vukas, Hajrija Maksić, Meliha Sakić, Jasmina Mahmutović, Selma Dizdar, Alma Mizdrak, Verica Mišanović 2021-04-28 2021-04-28 11 1 53 56 10.17532/jhsci.2021.1167 N-Acetylcysteine for COVID-19: A Potential Adjuvant Therapy <p>Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) infection or known as coronavirus disease 2019 (COVID-19) is a highly infectious disease that has been declared as a world pandemic by WHO. Although the majority of patients only experience mild symptoms, older patients and those with comorbidities are in the risk of falling into critically ill and even death. This is thought to correlate with systemic inflammatory response and oxidative stress imbalance. N-acetylcysteine (NAC) is recognized as a potent mucolytic, yet its lesser-known function as an antioxidant is a precursor of glutathione. Basic aspects and either in vivo or in vitro studies showed various mechanisms of NAC acting as a counterbalance in viral infections and its role in decreasing inflammation and oxidative stress. High-dose NAC is reported to be effective as an antioxidant in pneumonia, influenza, sepsis, and acute respiratory distress syndrome. Early evidence in COVID-19 patients showed that NAC could be beneficial. This review gives the scientific background in considering NAC as an adjuvant treatment for COVID-19.</p> Mia Elhidsi Fanny Fachrucha Rizky Yudha Irawan Copyright (c) 2021 Mia Elhidsi, Fanny Fachrucha, Rizky Yudha Irawan 2021-01-07 2021-01-07 11 1 1 6 10.17532/jhsci.2020.1156 Work Caused Musculoskeletal Disorders in Health Professionals <p><strong>Introduction:</strong> Work-related musculoskeletal disorders (WRMSDs) are the most common work-related diseases and describe a wide range of degenerative and inflammatory conditions affecting blood vessels, peripheral nerves, joints, ligaments, tendons, and muscles. WRMSDs are becoming an increasing problem in modern society. They are the second biggest cause of short-term or temporary incapacity for work just following a cold. At the workplace, health professionals represent a very vulnerable category in terms of musculoskeletal disorders (MSDs) development. It is estimated that almost one-third of all cases of absence from work among health care professionals are related to MSDs. Studies also show that a large number of health professionals report the occurrence of MSDs in one or more regions of the body, with a problem with the lower back being one of the most common.<br /><strong>Methods:</strong> This article presents a non-experimental (qualitative) research, or a scientific review of the published literature<br />where the databases were reviewed in which the keywords for the review were: MSDs, work, health, intervention program,<br />and ergonomics. Various databases were used in the preparation of this article, including PubMed, Google Scholar, Medline, Hrčak, Dabar, Science Direct, and Science Citation.<br /><strong>Results:</strong> The results include a review and analysis of eighteen published scientific articles in the period 2001-2020. The studies published in these articles has been conducted in the United States, Australia, Switzerland, Portugal, Slovenia, Turkey, China, Nigeria, Israel, Tunisia, Iran, Croatia, Taiwan, Bangladesh, Serbia, Macedonia, and Greece.<br /><strong>Conclusion:</strong> This article should indicate the magnitude of the problems of WRMSDs in health professionals and that this topic is an inexhaustible and very interesting basis for further studies by current and future researchers to create strategies for the prevention and treatment of this disorder and to eliminate its causes.</p> Dženan Pleho Amra Mačak Hadžiomerović Kenan Pleho Jasmina Pleho Dinko Remić Davor Arslanagić Miloš Lazić Aldina Alibegović Copyright (c) 2021 Dženan Pleho, Amra Mačak Hadžiomerović, Kenan Pleho, Jasmina Pleho, Dinko Remić, Davor Arslanagić, Miloš Lazić, Aldina Alibegović 2021-03-05 2021-03-05 11 1 7 16 10.17532/jhsci.2021.1209