Publications by authors named "Mahira Jahic"

19 Publications

  • Page 1 of 1

Cytological, Colposcopic and Pathohistological Correlation of HSIL and ASC H Findings.

Med Arch 2020 Oct;74(5):381-383

Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina.

Introduction: Cervical cancer can be successfully prevented by timely detection of changes that precede it such as atypical (ASC-H) and high grade squamous lesions (HSIL).

Aim: To investigate the correlation between Pap smear and colposcopy in the detection of premalignant and malignant cervical lesions based on a pathohistological finding.

Methods: In a retrospective study 118 patients with HSIL and ASC-H findings were examined. A Pap smear, colposcopic examination and cervical canal biopsy were performed. The study was conducted at the Gynecological Center "Dr Mahira Jahic" Tuzla and the Clinical Center Tuzla, Department of Gynecology and Obstetrics.

Results: 1049 abnormal Pap tests were analyzed, ASCUS in 51,8% (N-544), LSIL 32,1% (N-337), HSIL 7,7% (N-81) and ASC-H 3,5% (N-37), AGC 4,8% (N-51). The mean age of the subjects with the abnormal Pap test was 46.33 ± 3.2. The age of patients with ASCUS lesion was 38,6 , LSIL 41,0, ASC-H was 47,3 , HSIL (CIN II and CIN III) 45,8 , while patients with CIS were 51,2 years. Pathological histology HSIL confirmed a high grade lesion in 67,7% (CIN II, CIN III and CIS) (N-55), in 32% (N-26) a lower grade CIN I in 18,5% and chronic cervicitis in 13,5% (N-11). In ASC-H lesion pathohistological HSIL was found in 13,5% (N-5), CIN I 13,5% (N-5) and chronic cervicitis 48,6 % (N-18). Abnormal colposcopic imaging with HSIL lesion was found in 72,9% (N-69), in 8,6% (N-7) was unsatisfactory and in 18,5% (N-15) the colposcopic finding was normal. In ASC-H lesions, abnormal colposcopic imaging was found in 40,5% (N-15), unsatisfactory findings in 10,8% (N-4), and normal findings in 48,6% (N-18).

Conclusion: Colposcopy has proven to be better method than cytology with an accuracy of 72,9% in high-grade lesion such as HSIL and ASC-H.
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http://dx.doi.org/10.5455/medarh.2020.74.381-383DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7780795PMC
October 2020

Progression Low Squamous Intraepithelial Lesion and Human Papillomavirus Infections.

Mater Sociomed 2020 Jun;32(2):127-130

Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina.

Introduction: Infection with human papillomavirus is the main cause of cervical carcinoma. In Bosnia and Herzegovina (BIH) 556 cases of cervical carcinoma are diagnosed annually, and 141 women die from it.

Aim: To determine the most common HPV type found in ASCUS and LSIL and progression, regression and persistence of lesions.

Methods: In a retrospective study, 11 051 PAP tests, performed in several private gynecological practices located in Tuzla Canton from January 2016 to December 2019, were analyzed. In processing of data , X - statistical method was used.

Results: 11051 PAP test were inspected. Normal findings were found in 90.48% (N-10002) and pathological findings in 9.49% (N- 049). ASCUS was present in 4.9% (N-544), LSIL in 3.04% (N-337), HSIL in 0.74% (N-84), ASC-H in 0.27% (N-30) and AGC in 0.49% (N-55) of cases. The most common is HPV 16, found in 50.5% (N-44) of ASCUS and LSIL. Monoinfection with HPV 16 was found in 40.9% (N-18) ASCUS (N-3) and LSIL (N-15), and a combination of HPV 16 with other types like HPV 18, 31, 33, 39 in 59% (N-26). Progression of ASCUS lesion in HSIL 1.6% (N-2), and LSIL 9.6% (N-12). Progression of LSIL to HSIL was found in 9.0% (N-10). HSIL progresses significantly more frequent from LSIL (p<0.05) than from ASCUS changes. Lesions that progress into higher grade HSIL are HPV 16 positive. Progression into HSIL is not found in patients with low-risk HPV 6 and 11 infection.

Conclusion: Women infected with HPV 16 have more a frequent progression of a lesion into higher grade HSIL. They should be intensively monitored because of the increased risk for development of cervical carcinoma.
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http://dx.doi.org/10.5455/msm.2020.32.127-130DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428887PMC
June 2020

Cryotherapy of Genital Warts.

Authors:
Mahira Jahic

Mater Sociomed 2019 Sep;31(3):212-214

Gynecology centre ,,Dr Mahira Jahić" Tuzla, Bosnia and Herzegovina.

Introduction: Genital warts are a frequent form of sexually transmitted disease. Cryotherapy represents the first line of therapy. Healing occurs in 94%, and recurrence in 10% . Side effects are common during the treatment.

Aim: The aim of this study is to determine the successfulness of cryotherapy of genital warts, frequency of recurrence, and side effects.

Patients And Methods: In a retrospective study, data from 50 women with genital warts who were treated in the Gynecological Centre "Dr Mahira Jahić" in Tuzla in a period from 2012-2018 were analyzed. Every woman was treated with cryotherapy. Treatments were repeated every 7 days, maximal number of treatments being 7. In processing of data, X2statistical method was used.

Results: 50% (N-25) of genital warts eliminated after 3 treatments with cryotherapy . Genital warts are eliminated in 78% (N-39) of women, while this treatment was unsuccessful in 18% (N-9). Recurrence after 3 months in 4% (N-2). Most common side effect was exudation in 78% (N-39), swelling in 72% (N-36) and pain in 66% (N-33). PAP smears in women with genital warts in 64% (N-34) of cases were inflammatory benign changes, while in 36% (N-18) mild abnormal changes in cells ASCUS and LSIL were found. LSIL lesions of cervix are more common (p<0,01) in women with genital warts of vulva.

Conclusion: Cryotherapy is a method with a high success rate in healing of genital warts, and it decreases the concentration of HPV virus and removes the trigger that allows the development of cancer.
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http://dx.doi.org/10.5455/msm.2019.31.212-214DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6853748PMC
September 2019

Cryotherapy of Erosion of Cervix and Low Grade Squamous Intraepithelial Lesion.

Authors:
Mahira Jahic

Mater Sociomed 2018 Dec;30(4):294-296

Private Gynecology Ordination ,,Dr Mahira Jahic" Tuzla, Bosnia and Herzegovina.

Introduction: Cervical erosion and squamouse intraepithelial lesion of low grade are most common gynecological problems of women. These changes on cervix are cause of painful coitus and enhanced vaginal secretion. Cryotherapy is widely accepted method in treating these changes and sympthoms.

Aim: The aim of this study is to examine the efficiency of cryotherapy in eliminating erosion of cervics and LSIL, as well as conditions following these states.

Patients And Methods: Cryotherapy was performed in 124 women with cervical erosion (N-74) and LSIL (N-50). Sympthoms that were followed are: vaginal secretion, abnormal vaginal bleeding and pain. Assessment of epithelisation of cervix and evaluation of sympthoms were done 4 and 6 weeks after cryotherapy and PAP test after 4 months in women with LSIL. Statistical method used in result processing was X2 test.

Results: The average age of examined women is 37,75±8,2. Enhanced vaginal secretion had 87,09% (N-120), painful coitus 61,29% (N-76), pain in lesser pelvis 52,41% (N-65) and abnormal vaginal bleeding 28,22% (N-35). Erosion of cervix had 14% (N-7) of women with LSIL. After cryotherapy, enhanced vaginal secretion remained in 21,77% (N-27) of women, painful coitus remained in 8,06% (N-10), pain in lesser pelvis remained in 5,6% (N-7) and abnormal vaginal bleeding in 6,4% (N-8). Four weeks after cryotherapy, complete epithelisation of cervix was in 87,90% (N-109) and after six weeks in 93,54% (N-116) of examined women. LSIL was eliminated in 92% (N-46) of women after cryotherapy and in 8% (N-4) results remained the same.

Conclusion: Cryotherapy is successful method of elimination of cervical erosion, LSIL and pains with enhanced vaginal secretion.
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http://dx.doi.org/10.5455/msm.2018.30.294-296DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6377929PMC
December 2018

Difference Between Cryotherapy and Follow Up Low Grade Squamous Lesion of Cervix Uteri.

Med Arch 2017 Aug;71(4):280-283

University of Tuzla, Faculty of Medicine Tuzla, Tuzla, Tuzla, Bosnia and Herzegovina.

Introduction: Cervical cancer can be successfully prevented by effective treatment.

Aim: Analyse of success of cryotherapy in LSIL and ASCUS.

Materials Et Methods: In retrospective study between January 2016 to March 2017, 3244 PAP test were analysed. 257 patients who had been diagnosed with LSIL and ASCUS from PAP smear were divided in two groups: women who had HPV positive, colposcopic positive and cytologic finding of LSIL or ASCUS treathed with cryotherapy and women with LSIL, ASCUS and negative colposcopy. χ test was used for statistical analysis of data.

Results: Analysis of 3244 PAP smears showed negative for intraepithelial lesion or malignancy (NILM) in 90,10% (N-2923), and abnormal in 9,8% (N-321) of women. ASCUS was found in 4,8% (N-156) and ASC-H in 0,2% (N-6), LSIL in 3,1% (N-101), HSIL in 0,64% (N-21). The average age of patients with ASCUS lesion was 41 ± 12 years. After cryotherapy, HSIL had progression in 1,5% (N-1), persistence in 6,3% (N-4) and regression in 91,7% (N-58). Progression occured in 10,5% (N-4) of HSIL, persistence in 52,6% (N-20) and regression in 36,7% (N-14) in 38 women with LSIL lesion after repeated PAP test. Progression occured in 8% (N-10) of LSIL and 4% HSIL (N-5), persistence in 58% (N-72) and regression in 29,8% (N-37) in 124 women with ASCUS lesion after treatment and repeated PAP test. Difference in progression lesions in HSIL between women with cryotherapy (1,5%) and follow-up (10,5%) after LSIL is not significant, but progression to CIN II occured after cryotherapy. CIN III or cervical cancer was not found.

Conclusion: Cryotherapy prevents progression of LSIL in HSIL and in cervical cancer. Because of that cryotherapy is successful method in prevention of cervical cancer.
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http://dx.doi.org/10.5455/medarh.2017.71.280-283DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585814PMC
August 2017

Behavioral Sexual Characteristics of Female Students in Bosnia and Herzegovina.

Mater Sociomed 2017 Jun;29(2):101-104

Gynecologic Practice "Dr Mahira Jahić", Tuzla, Bosnia and Herzegovina.

Introduction: Characteristics of sexual behaviour of female students, which will affect fertility in adulthood, represent one of the critical parameters of reproductive health.

Aim: The aim of this study was assess characteristics of sexual behavior of female students in Bosnia and Herzegovina.

Materials And Methods: In a prospective study on a representative sample of 2,872 regular girls aged 19-24 years, an anonymous survey on the reproductive health of female students in Bosnia and Herzegovina from 2007 to 2009 was conducted.

Results: Of the total number (N = 2872) of surveyed female students, 49.44% were sexually active. Average sexarcha age was 18.14±1.83 years, and there was statistically significant earlier sexarcha in female students in Banja Luka vs. female students of the University of Sarajevo (p<0.001), as well as in female students in Mostar vs. female students of the University of Tuzla (p<0.001). Sexually active female students in 74,4 % cases had intercourses with only one partner, and 7,7 % of them had intercourses with three or more partners. Regarding the use of contraceptive methods, 69.4% female students were using contraception at first intercourse and 66.7% of them at last intercourse. 3.5% of sexually active students (N=50) had intentional abortion. Almost half (46.9%) of surveyed female students had regular pelvic exams; nearly two-third of those (63.4%) had gynecological exams in private institutions, and 36.6% of them in public health facilitie. Only one-third (35.8%) sexually active female students in BiH stated that Pap test was performed.

Conclusion: Sexual behaviour of female students in BiH is less risky than in the immediate environment, but health care quality is poor.
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http://dx.doi.org/10.5455/msm.2017.29.101-104DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5544443PMC
June 2017

Diagnostic Approach to Patients with Atypical Squamous Cells of Undetermined Significance Cytologic Findings on Cervix.

Med Arch 2016 Jul;70(4):296-298

Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina; Cardiovascular Clinic, University Clinical Center Tuzla, Bosnia and Herzegovina.

Background: Atypical squamous cells of undetermined significance (ASCUS) is a term that refers to inflammatory, reactive and reparative processes which are atypical and of higher level and insufficient to be classified as cervical intraepithelial lesions (CIN).

Aims: Examine of frequency of HPV infection in ASCUS lesions and regression, stagnation and progression during six-month period.

Subjects And Methods: Prospective study was conducted over a period of 3 years. In private gynecological ambulance "Dr Mahira Jahic". Analysis of PAP smears and HPV typization have been done in 50 patients and PAP test has been repeated after six months. X² test was used for statistical analysis.

Results: Analysis of 1784 PAP smears showed normal results in 86,6% (N-1530), and abnormal in 13% (N-254). ASCUS in 7,4% (N-133) and ASC-H in 0,5% (N-9), LSIL in 4,4% (N-80), HSIL in 1,3% (N-24), CIN II in 1,2% (N-20), CIN III in 0,2% (N-4). Progression occurred in 18% (9), persistence in 74% (37) and regression in 8%. Patients with ASC-H lesion 0,5% (N-9), PH results showed 22% (N-2) Carcinoma in situ, 33% (N-3) CIN II, 22% (N-2) CIN I and 22% (N-2) chronic cervicitis. Patients with CIN I in 88% (N-7) were positive on HPV of high risk. Patients with persistent ASCUS result were positive in 51% (N-19). The number of CIN I lesions found in women with ASCUS is bigger and statistically significant (p<0,05) in relation to number of CIN I findings found in regular examinations.

Conclusion: Monitoring women with ASCUS lesion, especially HPV positive to high risk group is the best way of selection of women who should be treated and monitored in order to prevent cervical cancer.
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http://dx.doi.org/10.5455/medarh.2016.70.296-298DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5035008PMC
July 2016

Diagnostic Significance of Reduced IgA in Children.

Med Arch 2015 Aug 4;69(4):236-9. Epub 2015 Aug 4.

Policlinic for laboratory diagnostic. University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina.

Introduction: The finding of reduced value of immunoglobulin A (IgA) in children is frequent in daily medical practice. It is important to correctly interpret the findings as adequate further diagnostic evaluation of the patient in order to make the determination on the significance of such findings. In children younger than 4 years always consider the transient impairment of immunoglobulins, maturation of child and his immune system can lead to an improvement in the clinical picture. In older children decreased IgA may lead to serious illnesses that need to be recognize and acknowledge through the appropriate diagnostic methods. At the University Clinical Center Tuzla, children with suspected deficient immune response due to reduced values of IgA, goes through further diagnostic evaluation at the Polyclinic for Laboratory Medicine, Department of Immunology and Department of Microbiology, as well as the Clinic of Radiology.

Material And Methods: Our study followed 91 patients, for the year 2013, through their medical charts and made evaluation of diagnostic and screening tests.

Conclusion: The significance of this paper is to draw attention to the importance of diagnostic approach to IgA deficient pediatric patient and relevance of knowledge of individual diagnostic methods as well as to the proper interpretation of the results thereof.
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http://dx.doi.org/10.5455/medarh.2015.69.236-239DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610608PMC
August 2015

Diagnostic significance of reduced IgA in children.

Med Arch 2014 Dec 16;68(6):381-3. Epub 2014 Dec 16.

Polyclinic for laboratory diagnostic. University Clinical Centre Tuzla, Bosnia and Herzegovina.

Introduction: The finding of reduced value of immunoglobulin A (IgA) in children is frequent in daily medical practice. It is important to correctly interpret the findings as adequate further diagnostic evaluation of the patient in order to make the determination on the significance of such findings. In children younger than 4 years always consider the transient impairment of immunoglobulins, maturation of child and his immune system can lead to an improvement in the clinical picture. In older children decreased IgA may lead to serious illnesses that need to be recognize and acknowledge through the appropriate diagnostic methods.

Material And Methods: Research was realized at the University Clinical Center Tuzla. Children with suspected deficient immune response due to reduced values of IgA observed and, goes through further diagnostic evaluation at the Polyclinic for Laboratory Medicine, Department of Immunology and Department of Microbiology, as well as the Clinic of Radiology. In the period of year 2013, there were a total of 91 patients with reduced values of IgA, age up to 13 years, of which 55 boys and 36 girls.

Results: Our study followed 91 patients, for the year 2013, through their medical charts and made evaluation of diagnostic and screening tests. The significance of this paper is to draw attention to the importance of diagnostic approach to IgA deficient pediatric patient and relevance of knowledge of individual diagnostic methods as well as to the proper interpretation of the results thereof.
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http://dx.doi.org/10.5455/medarh.2014.68.381-383DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314178PMC
December 2014

Clinical characteristics of aerobic vaginitis and its association to vaginal candidiasis, trichomonas vaginitis and bacterial vaginosis.

Med Arch 2013 Dec 28;67(6):428-30. Epub 2013 Dec 28.

Clinic for Cardiovascular Disease, Department of Interventional Cardiology, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.

Aim Of The Work: Examine clinical characteristics of aerobic vaginitis and mixed infection for the purpose of better diagnostic accuracy and treatment efficiency.

Materials And Methods: Prospective research has been conducted at Clinic for Gynecology and Obstetrics, Department for Microbiology and Pathology at Polyclinic for laboratory diagnostic and Gynecology and Obstetrics Department at Health Center Sapna. Examination included 100 examinees with the signs of vaginitis.

Examination Consisted Of: anamnesis, clinical, gynecological and microbiological examination of vaginal smear.

Results: The average age of the examinees was 32,62±2,6. Examining vaginal smears of the examinees with signs of vaginitis in 96% (N-96) different microorganisms have been isolated, while in 4% (N-4) findings were normal. AV has been found in 51% (N-51) of the examinees, Candida albicans in 17% (N-17), BV in 15% (N-15), Trichomonas vaginalis in 13% (N-13). In 21% (N-21) AV was diagnosed alone while associated with other agents in 30% (N-30). Most common causes of AV are E. coli (N-55) and E. faecalis (N-52). AV and Candida albicanis have been found in (13/30, 43%), Trichomonas vaginalis in (9/30, 30%) and BV (8/30, 26%). Vaginal secretion is in 70,05% (N-36) yellow coloured, red vagina wall is recorded in 31,13% (N-16) and pruritus in 72,54% (N-37). Increased pH value of vagina found in 94,10% (N-48). The average pH value of vaginal environment was 5,15±0,54 and in associated presence of AV and VVC, TV and BV was 5,29±0,56 which is higher value considering presence of AV alone but that is not statistically significant difference (p>0,05). Amino-odor test was positive in 29,94% (N-15) of associated infections. Lactobacilli are absent, while leukocytes are increased in 100% (N-51) of the examinees with AV.

Conclusion: AV is vaginal infection similar to other vaginal infections. It is important to be careful while diagnosing because the treatment of AV differentiates from treatment of other vaginitis.
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http://dx.doi.org/10.5455/medarh.2013.67.428-430DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4272474PMC
December 2013

Frequency of precancerous changes and cervical cancer recorded in three health centres in tuzla canton in period 2010-2011.

Mater Sociomed 2013 Dec 24;25(4):259-61. Epub 2013 Nov 24.

Clinic for Cardiovascular Disease, Department of Interventional Cardiology, University Clinical Center Tuzla, Bosnia and Herzegovina.

Unlabelled: Cervical cancer is the second most common cancer in the world and the leading cause of death. Frequency and mortality are significantly reduced thanks to cytological Papanicolau test (PAP). Regular PAP test can reduce approximately 80% of cases of this cancer.

Aim Of The Study: To examine frequency of cervical cancer and changes of cervix, the age of risk for the changes and effect of frequency of PAP test.

Materials And Methods: 3383 PAP (cytological) findings have been retrospectively ana lysed in three Health Centres of Tuzla Canton: Tuzla, Srebrenik and Sapna. During 2010 and 2011 protocols of Health Centers have been analyzed.

Results: Analysis of 3383 smears detected the following: abnormal PAP tests in 20.8% (705) and without abnormalities in 79.1% (2678). Normal findings in 9.1% (311), inflammatory changes in 69.6% (2357), ASCUS in 12.9% (438), ASC-H in 0.3% (11), LSIL in 5.4% (183), HSIL in 1.4% (49) and Squamous cell carcinoma in 0.7% (24). Cervical cancer has mostly been found in women from Srebrenik 1.1% (15) and least in women from Tuzla 0.3%(4).The highest number of abnormal findings (ASCUS, ASC-H , LSIL, H SIL and Cc) was also found in women from Srebrenik 39.5% (279). The average age of the examinees with the cancer was 41.7. In 62.5% (15) of women PAP test was performed for the first time and they were diagnosed with cervical cancer. Cervical cancer hasn't been found in women who had PAP test once a year or more.

Conclusion: Women with the abnormal findings in their first PAP test and should be persuaded to accept the treatment in order to prevent development of cervical cancer.
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http://dx.doi.org/10.5455/msm.2013.25.259-261DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3914754PMC
December 2013

Association between aerobic vaginitis, bacterial vaginosis and squamous intraepithelial lesion of low grade.

Med Arch 2013 ;67(2):94-6

Clinic for Cardiovascular Disease, Department of Interventional Cardiology, University Clinical Center Tuzla, Tuzla, B&H.

Goal: To determine frequency of HPV infection, aerobic vaginitis and bacterial vaginosis in respondents with squamous intraepithelial lesion of lower grade comparing to respondents with normal PAP test results.

Material And Methods: Prospective research of 100 respondents has been conducted at University-Clinic Center Tuzla and Gynecology and Obstetrics Department at Primary Health Care Center Tuzla in period from May 2011 untill January 2012. Examination program included: anamnesis, clinical gynecological examination, HPV typization, microbiological examination of vaginal and cervical smear and PAP test.

Results: High risk HPV group has been found more frequently among the respondents with LG SIL 46% (23) than in those with normal PAP result 14% (7) p < 0.05. Aerobic vaginitis has been found in the respondents with LG SIL in 28% (14) and there is statistically significant difference of this vaginitis comparing to the respondents with normal PAP result (p < 0.05). Bacterial vaginosis has been found in 12% (6) of the respondents with LG SIL and in 4% (2) of those with normal PAP result which is not statistically significant. In women with LG SIL and aerobic vaginitis in 9 cases E. coli has been isolated, in 4 E. faecalis and in 1 Staphylococcus aureus, while in women with normal PAP test results 3 cases of E.coli have been isolated. Examining changes in pH value of vaginal environment, higher measured values have been found in the respondents with LG SIL- 5.26 while in the respondents with normal PAP test result was 4.94 (p < 0.05). There is also statistically significant increase in the number of leukocytes in the respondents with LG SIL in relation to those with normal result.

Conclusion: In women with LG SIL aerobic vaginitis is very common but is not an indicator of HPV infection. An adequate treatment of aerobic vaginitis would decrease the frequency of LG SIL and number of precancerous lesions which may
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http://dx.doi.org/10.5455/medarh.2013.67.94-96DOI Listing
February 2014

Corelation between cytologic, colposcopic and pathohistological findings of cervical intraepithelial lesions.

Med Arh 2012 ;66(2):122-4

Women's Health Care Department in Health Center Dr.Mustafa Sehovic Tuzla, Bosnia and Herzegovina.

Unlabelled: AIM OF THIS STUDY was to examine the frequency of cervical cancer and cervical intraepithelial lesions of a different degree in women, corelation between cytologically diagnosed CIN I, CIN II and CIN III lesions and colposcopic findings and corelation between cytologic and pathohistologic findings of CIN III lesion.

Material And Methods: Cytologic and colposcopic findings have been analysed retrospectively in 2652 women who went through systematic examinations in Women's Health Care Department at Health Center "Dr.Mustafa Sehovic" Tuzla in period 2008-2011. For 93.2% (N = 2475) cytology results were normal. Abnormal cytology result was found in 6.71% (N = 178): CIN I in 5.54% (147), CIN II in 0.67% (18) and CIN III in 0.49% (13) of women examined.

Results And Discussion: Colposcopy in women with cytology results CIN I, CIN II and CIN III showed abnormal result in women with CIN I in 29.9% (44/147), CIN II in 61.1% (11/18) and CIN III in 61.5% (8/13). Significant association between abnormal colposcopic and abnormal cytologic findings (Chi2 = 36.30, p < 0.0005). Abnormal colposcopic result is twice as often with CIN II and CIN III changes on cervix in relation to CIN I. Byopsy of cervix in 13 women with CIN III pathohistologicaly confirmed the diagnose in 46.1% (4/13), cervix lesion was of higher degree in 30.8%, and in 23.0% (3/13) lesion of cervix was of a lower degree. Abnormal colposcopic image is an indicator for the abnormal cytological result.

Conclusion: Systematic examination of women represents an efficient way of organized screening and prevention of cervical cancer.
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http://dx.doi.org/10.5455/medarh.2012.66.122-124DOI Listing
May 2012

Biomarkers of plaque instability in acute coronary syndrome patients.

Med Arh 2010 ;64(2):103-6

Department of Immunology, Polyclinic for Laboratory Diagnostics, University Clinical Centre Tuzla, Bosnia and Herzegovina.

The aim of the study was to determine serum levels of matrix metalloproteinase 9 (MMP-9) and high sensitivity C reactive protein (hsCRP) in patients with diagnosis of acute coronary syndrome (ACS). The study included 150 patients divided in three groups: patients with significant coronary artery disease (CAD), patients without significant coronary artery disease and patients with acute myocardial infarction (MI). Method used for determination of coronary artery disease significance is coronary angiography, and CAD is determined as significant if level of stenosis is > 50%. The group without significant CAD had lower MMP-9 serum concentrations than group with significant CAD, which has lower MMP-9 than group with acute MI. Difference in levels of MMP-9 serum concentration between groups with and without CAD is statistically significant. Level of serum hsCRP in group with MI is significantly higher than in other two groups. There is no significant difference in hsCRP serum level between group of patients with significant CAD and without significant CAD. Our results demonstrate the significance of MMP-9 and hsCRP level determination in assessment of acute coronary syndrome patients in the future as a biomarker of plaque instability.
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July 2010

[Local combined therapy of vaginal infections by nifuratel-nistatin].

Med Glas (Zenica) 2010 Feb;7(1):86-8

Sluzba za zdravstvenu zastitu zena, Dom zdravlja Tuzla s poliklinikom z'Dr. Mustafa Sehović", Tuzla, Bosna i Hercegovina.

A test included 40 women in the reproductive age with clinical symptoms of vaginitis and microbiological examination. They were treated by combined therapy of vaginal tablets of nifuratel, 500 mg and nistatin 200 000 i. u. during six days, after which they underwent gynaecological reexamination and repeated microbiological examination of vaginal and cervical smears. An analiysis of vaginal secretion found bacterial flora in 34 smears (65%), fungus (Candida albicans) in 15 (24%) and Trichomonas vaginalis in 7 (11%). Local vaginal therapy in vaginitis caused by Trichomonas vaginalis was successfull in all 7 patients, vaginitis caused by Candida albicans was successly treated in 14 (93%) patients. Bacterial vaginitis was cured in 29 (71%) patients during this tharapy. Local vaginal combined therapy of nifuratel and nistatin is eficient in patients with vaginitis caused by fungi and Trichomonas vaginalis too.
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February 2010

[Hypertension in pregnancy].

Med Arh 2008 ;62(3):169-71

Dom zdravlja Sapna

Unlabelled: About 50,000 women dead due to result hypertension in pregnancy every year worldwide. Frequency of hypertension in pregnancy is 5-10% and complicate pregnancy. Control of high blood presure in pregnancy and therapy of hypertension are elements that prevent complication as a praeclampsia, eclampsia, abruption of placenta and operation end pregnancy. Aim of work is to establishing frequency of hypertension of controlled group of pregnen women and determinate results of pregnancy in pregnant women with high blood presure. The sample were 230 pregnant women which we controlled in Health Care Sapna. Hypertension was found at 7 pregnant women or 3.04%, at 14.28% was found chronic hypertension and at 87.1% was found gestation hypertension. Pregnant women were controlled, averagely 4 times and pregnant women with hypertension were controlled 8 times. Hypertension was treated with drugs at 6 pregmnant women with hypertension and one pregnant women did not take a medicine. 28.57% pregnant women with hypertension was delivered Caesarean section and 71.42% was vaginal delivery. Pregnancy of one pregnant women with chronic hypertension who did not take medicine was complicated of abruption of placenta and she was delivered Caesarean section. Pregnant women with gestation hypertension did not complicate during delivery.

Conclusions: Regular control and therapy of hypertension during pregnancy can significantly reduce perinatal morbidity and mortality. Health educated pregnant women is important for control pregnancy as using advise and regular treating of medicine of pregnant women.
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October 2008

[The significance of the colposcopy and PAP test in the primary health care].

Authors:
Mahira Jahić

Med Arh 2006 ;60(6 Suppl 2):74-7

JZU Dom zdravlja Sapna.

Colposcopy and Pap examination in the Primary health care influence on increasing of detection precancerous lesions and cervical cancer. We analyzed 245 women from Sapna region: 90 women who were controled in University clinical centre Tuzla during 3 years period and 155 women who were controled during 9 months in the Primary health care Sapna. The results showed that the introduction of colposcopy and Pap examination in the Primary helath care increased the number controled women. There were found precancerous lesons in 48 cases: Cervical intraepithelial lesions grade 1 (CIN 1) in 38, CIN 2 in 6 and CIN 3 in 4 cases. Cervical cancer was found and confirmed in 2 cases. We concluded that the colposcopy and Pap examination on the Primary health care is most efficacious and the cheapest method for detection and prevention of the cervical cancer.
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March 2008

[Association of the pH change of vaginal environment in bacterial vaginosis with presence of Enterococcus faecalis in vagina].

Med Arh 2006 ;60(6):364-8

Poliklinika za Laboratorijsku Dijagnostiku, Univerzitetski Klinicki Centar Tuzla.

Normal pH value of vagina from 3.8 to 4.2 has regulatory and protectors mechanisms of vaginal environment. The change in the pH value indicates to presence of disbalance in the ecosystem of vaginal environment. The value of pH above 4.0 is indicator of the decreased number of lactobacillus bacteria and the increased number of other microorganisms in the vaginal environment. This situation is present in the case of developing of bacterial vaginosis. One of the bacteria which is often isolated from vaginal swabs is Enterococcus faecalis. Aims of this study are to examine presence o f Enterococcus faecalis in vagina in healthy women and womenwith signs of bacterial vaginosis, the most often present signs in patients with bacterial vaginosis and isolated Enterococcus faecalis from vaginal swabs, and to determine whether the change of the pH value of vaginal environment could be indicator for bacterial vaginosis associated with Enterococcus faecalis. In this study there were included 90 patients. To all patients there were done: gynecological survey, determined pH of vaginal environment and color of vaginal secret, amino odor test, and taken vaginal swabs for microbiological examination. Enterococcus faecalis was found in the patients with pH 4.0 in 24.05 % cases, but in the patients with signs of bacterial vaginosis it was found in 52.78 %. Positive findings of Enterococcus faecalis was the most often associated with presence of all tree signs of bacterial vaginosis (pH>4.0, changed color of vaginal secret and positive amino odor test) it is in 60.78 6% cases. With two signs of bacterial vaginosis (pH>4.0, changed color of vaginal secret) Enterococcus faecalis was present in 60 % cases. The only presence of change in the pH>4.0 was associated with Enterococcus faecalis in 52.78 %. This study showed that pH change of vaginal environment was associated with Enterococcus faecalis in bacterial vaginosis in high percentage but it can not be used as the sure sign of presence of Enterococcus faecalis in vaginal discharge. Therefore it is necessary to make microbiology examination vaginal discharge.
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March 2007

[Enterococcus faecalis in vaginal smear of women who have been treated with antibiotics].

Med Arh 2005 ;59(5):275-80

JZU Dom zdravlja Sapna, Klinika za ginekologiju i akuserstvo.

This investigation had an aim to establish the incidence of Enterococcus faecalis in vaginal smears and its correlation with antibiotics used for the treatment of genital and extragenital diseases, as well. By this prospective study 300 women in reproductive period have been involved. An average age was 34.5 years and 282 of them are married. They have been divided in 4 groups, 75 in every group. First group consisted women who have not been treated by an antibiotic in last 6 months; second group--women who have been treated due to infections of genital tract; third group--women were treated for unspecific colpitis and last one group were women treated for extragenital infections. A special designated questionnaire has been used to collect data from patients. A vaginal smears for microbiology examination has been taken at the Gynecological Clinic and Clinic for Infective diseases of The University Clinical Center Tuzla from patients of group I, II and IV and at the Outpatient Clinic from patients of group III. Enterococcus faecalis has been found in 112 patients (37.33%); in first group in 13 (17.33%) cases, in second group in 26 (34.66%), in third group 39 (52%), and in last group in 34 (45.33%) patients, which significantly different. Investigation on sensitivity showed a minimal sensitivity on Penicillin and Streptomycin and no resistance on Vancomycin. In conclusion, it could be said that Enterococcus faecalis was found in 17.33% patients who has not been treated by antibiotics and in 44% who used antibiotics, which differ significantly (p<0.01).
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November 2005
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