Favorite colors of patients with drug-resistant epilepsy: pilot study.

OBJECTIVE: To evaluate the favorite colors of patients with drug-resistant epilepsy. METHODS: Following examination, 50 patients were diagnosed in accordance with the 2005 proposal of the International League Against Epilepsy and the definition of drugresistant epilepsy since 2010. The favorite color examination used a six-color tape and Trycolors, an online color mixing tool. The patients' color preferences were compared with those of 50 individuals without epilepsy. RESULTS: Patients with drug-resistant epilepsy preferred the color blue the most (30%), significantly more yellow (p = 0.0001), and significantly less green (p < 0.0001) compared to individuals without epilepsy. By mixing these colors at a certain percentage, we obtained the Go Ben color. SIGNIFICANCE: This information on preferred colors can help to improve compliance and can be utilized in designing medications and environments for patients with epilepsy.

Acute Stroke Patients with Sleep Apnea Acording to the Disability and Incidence of Relapse.

BACKGROUND: Sleep is a complex process involving the interactions of several brain regions, which play a key role in regulating the sleep process, particularly the brainstem, thalamus, and anterior basal brain regions. The process of sleep is accompanied by a change in body functions, as well as a change in cerebral electrical activity, which is under the control of the autonomic nervous system. OBJECTIVE: The aim of the study was to analyze the frequency of stroke recurrence and disability of patients with stroke and apnea. METHODS: It was analyzed 110 acute stroke patients with sleep apnea. All patients were evaluated with: Glasgow scale, The American National Institutes of Health Scale Assessment, Mini Mental Test, The Sleep and snoring Questionnaire Test, The Berlin Questionnaire Test, The Epworth Sleepiness Scale, The Stanford Sleepiness Scale, and The general sleep questionnaire. RESULTS: The largest number of patients with apnea on admission had a degree of disability of 4, and on discharge of 1. There was a statistically significant difference between the mean values of incapacity for admission and discharge. The student's t - test did not determine a statistically significant difference in disability according to the Rankin scale between patients with and without apnea at admission (t = 0.059, p = 0.95) and discharge (t = 0.71, p = 0.48). According to the NIHS scale, patients of both sexes with apnea had a neurological deficit of 7.55 ± 5.22 on admission and 7.1 ± 4.3 without apnea. Statistically significant difference was not found on the neurological deficit of both sexes, with and without apnea, at admission and discharge. With apnea, there were 13 relapses of stroke during one year, and without apnea in only 3 patients. CONCLUSION: Patients with acute stroke have a significantly higher correlation rate according to sleep apnea. There is no significant correlation in the degree of disability between patients with and without apnea.

Cognitive Disorders in Patients with Multiple Sclerosis.

INTRODUCTION: Multiple sclerosis (MS) is a chronic, inflammatory, (auto) immune disease of the central nervous system (CNS). Cognitive disorders are found in over 50% of patients. AIM: The aim of the study was to determine the distribution of cognitive disorders in people with MS. METHODS: The prospective study included 135 respondents with MS and 50 healthy respondents. The respondents were divided into three groups: the first group consisted of 85 respondents where the disease lasted longer than one year, the second group consisted of 50 respondents with newly diagnosed MS, the third group consisted of 50 healthy respondents. Clinical assessment instruments were: Extended Disability Score in Multiple Sclerosis Patients, Mini Mental Status, Battery of Tests to Assess Cognitive Functions: Wechsler Intelligence Scale, Revised Beta Test, Raven Colored Progressive Matrices, Wechsler Memory Scale, Rey Audio Verbal Learning Test -Osterriecht's complex character test, verbal fluency test. RESULTS: Cognitive disorders were present in 40-60% of respondents with MS. Visuospatial, visuoconstructive and visuoperceptive functions are worse in the first group. Mnestic functions (learning process, short-term and long-term memory, recollection, verbal-logical memory) were most affected in both groups of respondents, ranging from 30-60%. Poorer cognitive domains are in the first groups of respondents. Immediate working process memory (current learning), memory, attention, short-term and logical memory is worse in the examinees of the first group. At the beginning of the disease, 16% had verbal fluency difficulties, and as the disease progresses, the difficulties become more pronounced. CONCLUSION: Cognitive disorders are heterogeneous, they can be noticed in the early stages of the disease. They refer to impairments of working memory, executive functions and attention, while global intellectual efficiency is later reduced.

Contributing Factors to the Quality of Life in Multiple Sclerosis.

INTRODUCTION: Multiple sclerosis (MS) is a chronic, inflammatory, (auto) immune disease of the central nervous system (CNS). Quality of life (QoL) refers to the perception of an individual's life in the context of the system of culture and values in which they live. AIM: The aim of the study was to determine the distribution of cognitive disorders in people with MS. METHODS: The prospective study included 135 participants with MS and 50 healthy participants. Participants were divided into three groups: the first group consisted of 85 participants where the disease lasted longer than one year, the second group consisted of 50 participants with newly diagnosed MS, the third group consisted of 50 healthy participants. The instruments of clinical assessment were: Extended Disability Score in Multiple Sclerosis Patients, Mini Mental Status, Beck Depression Scale, and Quality of Life Scale (SF-36, Contemporary Health Survey). RESULTS: The quality of life related to health is impaired in the physical, mental dimension and overall quality of life. In the first group of participants, 62% had mild depression, and in the second group 38% of participants, while more severe forms were recorded in 16% of participants in both groups. As depression increases, the quality of life decreases in all measured dimensions, which would mean that depression negatively affects the quality of life. The results of all dimensions as well as the overall quality of life score are worse with the increase in the degree of clinical disability, for both groups of study patients. CONCLUSION: Quality of life is impaired in MS patients, and a higher degree of clinical disability and an increase in depressive disorder are predictors of deteriorating quality of life in MS patients.

Post-Stroke Depression.

INTRODUCTION: The depression is a common mental disorder, especially after a stroke, which further aggravates the recovery. AIM: To analyze depression within 48 hours and fifteen days after ischemic stroke in relation to gender and location (brain hemisphere and brain circulation). METHODS: We analyzed 40 patients (65.3±10.3 years), half of them were women. Mean age of women was 66.35±7.31 years and men 64.2±12.68 years (p= 0.5). Ischemic stroke was verified by computed tomography. Levels of depression were measured with self-estimated Zung's scale. On the tests, score of 50 and higher verified depression. Criteria made by Domasio were used to determine location of the IS. RESULTS: Mean value on depression scale in acute phase of ischemic stroke was 46.85 ± 8.6 and in subacute phase 43.4 ± 8 (p =0.06). In 19 (47.5%) patients (55% of women, 40% of men; p=0.3) depression was found during the first and in 10 (25%) patients (35% of women, 15 % of men; p=0.06) during the second evaluation (p<0.019). Mean value on depression in acute phase of illness in women was 49.1 ± 7.38, as well as in men 44.6 ± 9.22 (p=0.088) and in subacute phase in women 45.25 ± 8.04, as well as in men 41.5 ± 7.75 (p=0.16). Concerning location of ischemic stroke, there were no significant differences in levels of depression. CONCLUSION: Number of patients with post-stroke depression is significantly lower in subacute phase of ischemic stroke. Although the number of depressive women and their depression scores are higher, gender differences are not statistically significant. There is no correlation between post-stroke depression and location of lesion in acute and subacute phase of illness.

The role of fibrin glue polypropylene mesh fixation in open inguinal hernia repair.

UNLABELLED: The aim of this study was to compare two methods of polypropylene mesh fixation for inguinal hernia repair according to Lichtenstein using fibrin glue and suture fixation. MATERIAL AND METHODS: The study included 60 patients with unilateral inguinal hernia, divided into two groups of 30 patients--Suture fixation and fibrin glue fixation. All patients were analyzed according to: age, gender, body mass index (BMI), indication for surgery--the type, localization and size of the hernia, preoperative level of pain and the type of surgery. Overall postoperative complications and the patient's ability to return to regular activities were followed for 3 months. RESULTS AND DISCUSSION: Statistically significant difference in the duration of surgery, pain intensity and complications (p < 0.05) were verified between method A, the group of patients whose inguinal hernia was repaired using polypropylene mesh-fibrin glue and method B, where inguinal hernia was repaired with polypropylene mesh using suture fixation. Given the clinical research, this systematic review of existing results on the comparative effectiveness, will help in making important medical decisions about options for surgical treatment of inguinal hernia. CONCLUSIONS: The results of this study may impact decision making process for recommendations of methods of treatment by professional associations, making appropriate decisions on hospital procurement of materials, as well as coverage of health funds and insurance.

Quality of life in patients suffering from Parkinson's disease and multiple sclerosis.

INTRODUCTION: Multiple sclerosis (MS) and Parkinson's disease (PD) are chronic diseases with unpredictable course causing progressive physical disability and cognitive decline, and broadly affecting the patient's life, social interaction, recreational activities and overall life satisfaction. GOALS: To examine the quality of life of patients with PD and MS, and investigate the existence of differences between the degree of impairment to the quality of life in PD and MS. METHODS: A prospective study was conducted at the Neurology Clinic, University Clinical Center in Tuzla in the period from December 2005 until May 2007. The study included subjects with confirmed diagnosis of MS and PD. We analyzed 50 patients with PD and 50 patients with MS, with disease duration 1-5 years without any or with mild cognitive impairment. Quality of life was assessed using the SF-36 scale comprised of 36 questions in eight health profiles. RESULTS: There was no significant difference in gender frequency in our study sample of patients with PD, while in MS group of patients there were a significantly more females. The average age of the PD patients was 63.18 +/- 10.42, and in patients with MS 37.4 +/- 8.65 years. In our study the relative influence of PD and MS on quality of life was similar after controlling the duration of the disease, and there were some differences in relation to the degree for clinical disability. Subjects showed reduced QoL independently of the duration of illness (patients with PD in 88% of cases, and multiple sclerosis in 84% of cases). There are significant differences in the occurrence of poor quality of life in patients with PD were in advanced clinical stages of disease for the physical, mental dimension of the SF 36 and the total score. Respondents in stages III-V of the disease were 5.23 times (23%) likely to experience reduced QoL compared to those with less physical disability. In subjects suffering from MS reduced QoL was not related to the degree of clinical disability in physical, nor the mental dimension of the SF 36 and the total score. These results in MS patients can be partially explained by the small sample size, on the other hand it is possible that patients with MS, although they have greater physical disability seen as a very difficult diagnosis which determines the entire life. CONCLUSIONS: Patients who are treated for PD and MS had a high degree (> 80%) of reduction of the overall quality of life, and there were no significant differences in the extent of QoL reduction between these groups of patients. Reduced quality of life in patients with PD is observed during severe stages of the disease, while the QoL does not depent on the degree of clinical disability in MS patients. In both groups of patients the appearance patients reduced QoL does not depend on the duration of the disease.

Angiotensin-converting enzyme gene polymorphism in patients with multiple sclerosis from Bosnia and Herzegovina.

BACKGROUND: Increased activity of angiotensin-converting enzyme (ACE) in the blood and cerebrospinal fluid of patients with multiple sclerosis (MS), and the inhibition of ACE in experimental autoimmune encephalomyelitis, suggested that ACE may play a role in the pathogenesis and progression of MS. We recently published the first report on the potential association of MS and ACE I/D polymorphism in Slovenian and Croatian patients with MS, in which it was shown that the DD genotype might contribute to a higher risk of developing MS in men. To confirm these findings in a similar ethnic population, we analyzed ACE I/D gene polymorphism in patients with MS from Bosnia and Herzegovina. SUBJECTS AND METHODS: One hundred and seventy patients with MS and 170 healthy controls were genotyped by the polymerase chain reaction method. RESULTS: There was no significant difference in the distribution of ACE I/D genotypes (p=0.783) or in the allelic frequencies (p=0.538) between patients with MS and control subjects. When patients with MS were stratified by sex, no statistically significant differences in allele or genotype distributions were observed. Finally, there was no indication of an impact of the ACE I/D genotype on disease course or severity. CONCLUSION: The ACE I/D polymorphism is not a risk factor for development of MS, nor does it contribute to disease severity in this Bosnia and Herzegovina population.

Betaferon in the treatment of multiple sclerosis.

The aim of the study was to analyze the usefulness and side effects of treatment with interferon beta 1B (Betaferon) in patients with the relapsing-remitting form of multiple sclerosis (RRMS). The study included 32 RRMS patients that had completed two-year therapy with interferon beta 1B or were still receiving this therapy. Every six months, patients were clinically evaluated and scored by the Expanded Disability Status Scale (EDSS). Two-year therapy was completed by 11 (34.3%) of 32 RRMS patients. Relapse was verified in 4 (36.36%) patients. The mean EDSS score was 2.45 +/- 1.03 at the beginning of therapy and 2.54 +/- 0.98 after two-year therapy; the difference was not statistically significant. In 2 (6.25%) patients on therapy for 18 months there was no relapse, and the mean EDSS was 1.75 +/- 0.35 (both at therapy introduction and at 18 months). Five (15.62%) patients were on therapy for one year. The mean EDSS was 1.6 +/- 1.08 at the beginning of therapy and 1.5 +/- 0.70 at one year. One patient experienced relapse. Two patients were on therapy for six months. They had no relapses with the same EDSS at six months as at therapy introduction (2.0). At the beginning of 2008, another 12 patients started therapy with interferon beta 1B. In conclusion, our experience with two-year interferon beta-1B therapy for RRMS is favorable, with a relatively low rate of relapses (36.36%) and without significant worsening on EDSS. The medication side effects were mild and transient.