Background/Aim: In the realm of healthcare services, the satisfaction of medical professionals in their workplace environment has become a central concern closely associated with the perceived satisfaction levels of patients. This research investigated the intricate relationship between employee satisfaction and patient satisfaction within the context of communi-ty health centres. The study aimed to identify specific factors of employee satisfaction, such as compensation, supervision and work environment, that potentially influence the level of patient satisfaction. Methods: Employing a cross-sectional descriptive design, a total of 162 employees and 276 patients from 13 community health centres partici-pated in this study, conducted between June and September 2023. The participants were selected based on specific criteria, including age above 17, fluency in Indonesian and ability to complete the questionnaires. The study utilised two questionnaires: one measuring patient satisfaction with aspects of healthcare service and the other gauging employee satisfaction concerning management practices in community health centres. Both questionnaires employed Likert scale measurements to gather responses. Results: The findings indicated a significant influence of investigated fac-tors on patient satisfaction. Notably, compensation of employees emerged as a crucial factor significantly affecting patients satisfaction, aligning with previous research emphasising its importance in healthcare settings. Conversely, other factors such as supervision, work relationships, nature of work, opportunities for status change and work interactions with col-leagues of employees did not exhibit a significant impact on patient sat-isfaction. Conclusions: The study findings conformed the importance of compensation of employees a pivotal factor in designing strategies to improve pa-tient satisfaction in community health centres. While other factors like supervision and work interactions did not demonstrate statistically significant correlations, this suggests the potential for more complex relationships that warrant further investigation. Identifying specific factors that influence patient satisfaction in community health centres can significantly contribute to enhancing healthcare service quality and overall patient satisfaction in the future.

Background/Aim: Ovarian cancer is one of the most important causes of tumour-associated mortality and morbidity in women. Some genetic alterations, determining predisposition to ovarian cancer have already been identified, but these are mostly syndrome-associated cases, most ovarian tumours are still regarded as sporadic. The aim of this research was to identify new predisposing factors that might increase ovarian cancer risk. Genetic variants of IL-10 gene in patients with ovarian cancer was analysed. Methods: Forty-eight patients with ovarian cancer along with 48 agematched controls were included in the study. Single nucleotide polymorphism (SNP) genotyping and gene expression assays for IL-10 were performed using TaqMan assay (Thermo Scientific, USA). The selected SNP was rs1800896 upstream of IL-10 gene (IL-10-1082). All statistical analyses were performed by GraphPad Prism 9.3.1 for Mac. Results: The genotype distributions of IL-10 gene polymorphisms among cancer and control groups were all according to the expected Hardy-Weinberg equilibrium. There was no statistically significant difference in frequency of genotypes and alleles between the two study groups (p > 0.05). In another analysis, the samples were grouped according to the polymorphic variant IL-10 (-1082) A/G. Subjects having the homozygous variant (A/A) had lower IL-10 mRNA levels than those with the homozygous wild (G/G) genotype in both, ovarian cancer patients and controls, p < 0.05. mRNA levels on IL-10 were different among cases and controls (p < 0.05). Patients with ovarian cancer had higher level of mRNA for IL-10. Conclusions: These results support the theory that IL-10 gene expression levels differ in patients with and without ovarian cancer. Polymorphic variant IL-10 (-1082) A/G couldn't be confirmed to explain this difference in gene expression levels.

Background/Aim: Flavonoids, tannins, saponins and polyphenols in yellow kepok banana (Musa x paradisiaca L. var. kepok) peel potentially could be a solution for peptic ulcer prevention. This study aimed to prove the efficacy of kepok banana peel extract as gastroprotective by analysing the number of gastric ulcers and markers of oxidative stress - malondialdehyde (MDA) and nitric oxide (NO). Methods: The study was performed on 33 female Wistar rats aged 3-4 months, weighed 100-250 g. Rats were divided into 3 groups: Musa Paradisiaca Var Kepok 1 (MPVK1) treatment group, Musa Paradisiaca Var Kepok 2 (MPVK2) and control group (K). In MPVK1 kepok banana peel extract at a dose of 80 mg / 200 g body weight (BW) was given and the MPVK2 group dose was 160 mg / 200 g BW. The gastritis induction was performed by using 5 % acetylsalicylic acid at a dose of 1500 mg/kg BW. MDA examination by HPLC method, NO examination by ELISA method and macroscopic examination by counting the number of ulcers on the gastric mucosa was performed. Results: The results showed that the lowest average MDA level, as well as the highest average NO level was in the MPVK2 group 3.27 and 286.17, respectively. The highest mean number of ulcers was in the control group 3.55. By analysing all the results it can be concluded that there is a significant difference in the average levels of MDA (p = 0.013), NO (p < 0.001) and the number of ulcers (p < 0.001) in the three groups. Conclusion: Banana peel extract was proven to be effective as a gastroprotective through markers of MDA, NO and the number of ulcers in Wistar rats.

Only a few cases of lipofibromatous hamartoma (LFH) of the median nerve have been described in the literature. LFH is a rare and low growing benign fibro-fatty tumour. It is characterised by the proliferation of mature adipocytes within the epineurium and the perineurium of the peripheral nerves. The median nerve is most frequently affected in the upper extremities. Carpal tunnel syndrome, paraesthesia, numbness and pain are frequently the results of involvement of the median nerve. In presented case, in addition to fibrolipoma, there was also new blood vessel formation noted, which was attributed to the chronicity of the lesion. Diagnosis was missed by ultrasound and MRI due to the presence of blood vessels. Histopathological diagnosis was confirmed. Surgical treatment with carpal tunnel release and neurolysis were performed. This resulted in favourable outcome in 3 months.

Background/Aim: Due to the numerous beneficial effects of pomegranate that can be explained through its antioxidative effects, the aim of this study was to determine the antioxidant potential of pomegranate peel extract (PoPEx) prepared from pomegranate that was harvested in the southeast region of Herze-govina (Bosnia and Herzegovina), through in vitro and in vivo studies. Methods: In PoPEx total phenols, flavonoids, flavonols, flavan-3-ols and antho-cyanins content was determined, as well as several antioxidative assays, including 2,2 diphenyl-1-picrylhydrazyl assay (DPPH), 2,2'-azino bis(3-ethylbenzothi-azoline-6-sulphonic acid) assay (ABTS), iron (III)-2,4,6-tripyridyl-S-triazine complex assay (FRAP), reduction of copper(II) ions (CUPRAC) assay, Briggs-Rauscher oscillatory reactions, neutralisation of OH radicals and lipid peroxidation assay. In vivo studies were performed by administrating 100 mg/ kg of body weight of PoPEx to the rats by gavage for 7 days, after which the rats were euthanised and prooxidative parameters (thiobabrituric acid reactive substances-TBARS as an index of lipid peroxidation, nitrites-NO 2 , hydrogen peroxide-H 2 O 2 and superoxide anion radical O 2-) were determined in plasma, as well as antioxidative parameters (superoxide dismutase-SOD, reduced gluta-thione-GSH and catalase-CAT) in erythrocyte lysates. Results: High content of phenolic compounds was found in PoPEx, which resulted in high antioxidative potential in all in vitro tests performed. In vivo study showed that PoPEx administration caused a significant decrease in TBARS, NO 2-, as well as an increase in reduced glutathione (p < 0.05) in comparison to the control group, while H 2 O 2 and O 2 * showed a lowering trend and SOD and CAT showed an increasing trend in PoPEx group, but without statistical significance. Conclusion: PoPEx demonstrated high antioxidative capacity measured in vitro and in vivo and can be potentially used as a supplement treatment in the prevention of various inflammatory conditions.

Background/Aim: Acute myocardial infarction (AMI) is a consequence of complete coronary artery occlusion. There is a considerable seasonal variation in the incidence of AMI. The aim of the study was to establish a circadian and seasonal pattern of AMI. Methods: A retrospective observational study was conducted, using the database of the Institute of Emergency Medical Service of the City of Novi Sad. The study included 982 patients, both male and female, diagnosed with AMI (I.21 - ICD-10 code) in the period between 15 March 2018 and 14 March 2022. Data were classified according to the time of the day, days of the week, quarters and months. Data were analysed by using descriptive statistical methods, Mann-Whitney U test, Chi-squared test and Fisher's exact test. Results: AMI most frequently occurred between 6 am and 2 pm (389; 39.6 %). A statistically significant incidence of AMI was calculated for the periods between 6 am and 2 pm (ch2 = 39.69; p < 0.001) and between 2 pm and 10 pm (ch2 = 28.06; p < 0.001). Most cases of AMI were noted on Monday (153; 15.6 %) and in January (93; 9.5 %). The highest incidence of AMI was in the period between 15 March 2021 and 14 March 2022 (304; 31.0 %), while the lowest incidence was noted between 15 March 2019 and 14 March 2020 (190; 19.3 %). Conclusion: Circadian, seasonal and annual rhythm may have a significant impact on the incidence of AMI. This fact can have an important role in the prevention, timely recognition and adequate treatment of acute coronary disease.

Background/Aim: There is an association between patient general health, socioeconomic status and fracture incidence. Aim of this study was to demonstrate the relation between the socioeconomic and health status and the occurrence of fractures in Al-Kindy Hospital residents. Methods: A prospective cross-sectional study was performed by using data collected from fractured patients in Al-Kindy Teaching Hospital / Baghdad Orthopaedics Outpatient Clinic, between 12 December 2021 and 8 March 2022. A hundred patients aged 20 to 75 years were included in this study. The data were collected using a researcher-administered questionnaire, which included items to assess patient's socioeconomic status (accommodations, occupation, income status, level of education, owing motor vehicle) and assessed patient's health status (height, weight, presence of chronic disease(s), smoking status, alcohol consumption, water source quality, sun exposure, nutrition status). Results: A 100 patients from Al-Kindy Teaching Hospital between the age 20-75 participated in the study. The incidence of fractures was higher in younger and more active males (68 %) than females (32 %). Highest percent appeared in lower group of socioeconomic status (58 %) and in lower group of health status (44 %). There was a significant relation between health status and body mass index (BMI). Obese and overweight patient were the more vulnerable to fractures. Conclusion: Fractures are more likely to happen to people with low socioeconomic status, low general health status and overweight people.

Background/Aim: Ventricular septal defect (VSD) is the most common congenital heart anomaly that in many cases closes spontaneously. The spontaneous closure (SC) rate of VSD varies widely between studies. The aim of this study was to identify clinical and echocardiographic factors influencing SC of isolated VSD in the first year of life among a group of patients presented at the Paediatric Clinic. Methods: Prospective study was performed in 60 consecutive patients with trivial, small or medium isolated VSD during the first year of life. Patients were divided into groups, according to gender and gestational age of the patient, type, number and the size of the defect and persistence of pulmonary hypertension. The size of defect was described in comparison to the diameter of the aortic annulus (VSD/Ao ratio). Results: At the time of diagnosis, the mean VSD/Ao ratio was 0.33 mm. Muscular VSD was more common (76.7 %) than perimembranous (23.3 %). SC of VSD occurred in 60 % of all patients, in case of muscular defect in 73.9 % and in case of perimembranous in 14.3 %. There was a negative correlation between defect size and SC rate. SC probability for a given defect size was described by the formula: probability = -1.82933X+1.20145. None defect with pulmonary hypertension closed. Conclusion: It was found that type and size of VSD and the persistence of pulmonary hypertension were significant predictors for SC, while gender and gestational age of the patient and the number of defects were not. This study can be useful in predicting the natural outcome of the VSD to make proper follow-up and management plans.

The COVID-19 pandemic is abating, but the threat of a new epidemic is growing due to the spread of monkeypox in non-endemic regions of the world. In 2022, there were the monkeypox outbreaks throughout Europe, in the Western Hemisphere. With the cessation of the vaccine, due to the global eradication of smallpox, outbreaks of monkeypox have become more common. Currently, there are no exact recommendations for complex treatment and alleviation of the monkeypox symptoms for infected people. Under these conditions, it is especially important to know the pathogenetic mechanisms and epidemiology of the virus for the most effective containment of its spread, especially in view of the negative experience gained in combating the COVID-19 epidemic. The purpose of this study was to summarise the known data on the epidemiology, clinical course and treatment of monkeypox, as well as an attempt to assess the possibility of a new world-spanning pandemic. A targeted search was performed on the keywords "monkeypox", "virology", "Tecovirimat", "Cidofovir", "Brincidofovir" in PubMed, in the period up to July 2022. 661 articles were reviewed, among them as reviews, original research and clinical trials. Preference was given to articles in English that dealt in most detail with cases of monkeypox infection outside the Africa and included comments on the therapy. Seventeen articles were selected and analysed, as well as links within them for additional information on the case. It was revealed that monkeypox is mainly treated with maintenance therapy and the treatment of more complex cases is based on the use of specific antiviral drugs: Tecovirimat, Cidofovir, Brincidofovir. However, there is no widespread therapeutic practice for these drugs. Little is currently known about the monkeypox virus; the transmission of infection, the animal reservoirs, the host range and the prospects for specific treatment are not fully understood. Sharing resources and data with outbreak tracking around the world will greatly facilitate the process of learning about the virus and how to deal with it effectively

Background/Aim: Nowadays, adolescents are exposed to some negative challenges. Bullying is one of the horrible phenomena that can be seen in the physical and mental harassment of children and teenagers. Another challenge is addiction to computer games as well as writing on social networks. Gambling addiction, habituation and exposure to psychostimulants are also a trap for causing severe pathology. The aim of this study was to present an insight into the possible challenges of today to which adolescents are exposed and how they affect their personality and maturation. Methods: The authors collected data and materials on the mentioned topics from their daily medical work. They also used articles in professional magazines and newspapers and television shows. Results: Society must make efforts to eradicate such events in schools. We are witnessing various challenges and pitfalls that affect youth, society, culture and civilisation. Among the bad things, drug addiction, alcoholism, smoking, addiction to the Internet and computer games are in the first place. Conclusion: Due to negative challenges, the youth neglect their schoolwork and duties. The school environment can be a place for violent behaviour, brachial attacks (bullying and harassment). Recognising social interactions, family relationships and understanding the underlying psychiatric conditions which may be associated with risky behaviour in adolescents could be essential for treatment planning.