HEALTH CARE IN SLAVONIAN PROVINCE DURING THE 19th CENTURY

Due to its proximity to the Ottoman Empire, Slavonia was constantly exposed to the threat of invasion by numerous infectious and non-infectious diseases. An additional aggravating circumstance was the poor living and hygienic conditions in Slavonia, poverty, droughts, and floods. After the withdrawal of the Ottomans at the end of the 17th century, medical care was provided only by a few barbers and ‘ranarniks’ (i.e., feldshers) who remained in the Slavonian province. Due to the poor medical care, in 1770, the Empress and Queen Maria Theresa issued the General Health Law, which applied to the entire Habsburg Monarchy, including Slavonia. Among other things, it provided for the introduction of formal training for health personnel, ultimately leading to a better quality medical workforce. At the same time, charlatans were increasingly prohibited from working. The shortage of trained physicians, dentists, midwives, pharmacists, and veterinarians was addressed through various measures to promote their education and training. After obtaining their diplomas, these professionals were employed in hospitals, old people’s homes, nursing homes, homes for people with disabilities, and other healthcare institutions where the inhabitants of the Slavonian province received medical care.

Lateral orbital wall reconstruction after basal cell carcinoma penetration—Case report

Advanced periorbital basal cell carcinomas may necessitate orbital exenteration and consequent vision loss, which significantly reduces patients’ life quality. Orbital reconstruction is a demanding surgical procedure due to the complex orbital anatomy and vital structures located in the orbit. In this report, we presented an 83-year-old patient with advanced basal cell carcinoma that had expanded into the orbit. An orbitotomy was performed to remove the tumor completely while preserving the eye function. Orbital reconstruction was performed by a standard surgical method using a titanium mesh modeled according to a natural phantom skull. This maintained the eye function and achieved satisfactory facial esthetics.

The Influence of COVID-19 Pandemic on the Frequency of Suicides in Croatia

BACKGROUND

Suicides are among the leading causes of death in the world and pose a major public health problem. It is not yet entirely clear to what extent the 2019 coronavirus pandemic (COVID-19) affects suicide rates, but is likely to result in an increase in risk factors for suicidal behaviors. The research objective was to compare the suicide rate in 2019 with the suicide rate in 2020 in the Republic of Croatia.

SUBJECTS AND METHODS

A cross-sectional study was conducted for the period from January 2019 to December 2020. The necessary data on persons who committed suicide in the Republic of Croatia in that period were collected in cooperation with the Osijek-Baranja County Police Department. The number of suicides in that period was statistically processed according to demographic characteristics, suicide motives, days of the week and months by years.

RESULTS

There was no significant difference in the total number of suicides comparing 2019 and 2020. Observed by months, significantly more suicides were committed during February 2020 compared to February 2019 (χ²-test, p=0.04). According to marital status, in 2019 compared to 2020, significantly more suicides were recorded among married persons (χ²-test, p<0.001) and among those who were unemployed (χ²-test, p<0.001). Persons with the status of veterans committed suicide significantly more often in 2019, compared to 2020 (χ²-test, p<0.001) During 2019, compared to 2020, significantly more suicides were committed by persons working in service and trade occupations (χ²-test, p=0.001).

CONCLUSION

At the beginning of the pandemic in Croatia, in February 2020, there was a significant increase in suicides compared to 2019, which may indicate that the spread of the pandemic since the end of 2019, with uncertainty and cataclysmic atmosphere, had a negative effect on mental health.

Epidemiologija problema mentalnog zdravlja u mladih s područja Osijeka, korištenjem upitnika snaga i teškoća (SDQ)

Introduction: Mental disorders begin at an early age. Screening is the first step in early intervention for the mental health problems of children and adolescents. The aim of this study was to analyse the prevalence of mental health problems among adolescents from Osijek, to early detect the risks of possible mental disorders, and to analyse gender differences. Materials and methods: The main screening instrument was The Strengths and Difficulties Questionnaire (SDQ), which assesses the emotional and behavioural difficulties of children and adolescents, as well as the prosocial skills. Over 5 school years (2012/13-2016/17), a total of 5787 students were examined. 5514 (95.3%) first-year students from 16 high schools and 273 (4.7%) seventh-grade students from 10 elementary schools were examined in the City of Osijek. Results: 10.4% of students had the borderline or abnormal score on the Total difficulties score. Girls had higher scores on the Total difficulties score (p<0.01), Emotional symptoms subscale (p<0.01), Prosocial behaviour subscale (p<0.01), and on the Hyperactivity/inattention subscale (p<0.01). On the Conduct problems subscale and the Peer relationships problem subscale, boys scored significantly higher than the girls (p<0.01). Conclusion: In the Osijek area, girls are more affected by mental problems than boys, scoring higher on the total scale, as well as on the emotional and hyperactivity scale. Whereas boys scored higher on the conduct and peer relationship scales. The data obtained through this screening allows for further planning of public health measures, preventive activities, treatment, and mental health promotion.

SURGICAL ASPECT OF BLEPHAROSPASM TREATMENT: A CASE REPORT

Blepharospasm is an idiopathic condition characterized by involuntary eyelid closure mainly caused by bilateral tonic-clonic contractions of the orbicularis oculi muscle. It results in patient inability to open their eyes, thus significantly impairing their ability to perform activities of daily living. First-line treatment for blepharospasm are primarily botulinum toxin type A injections. However, surgical procedure as a treatment option can also be taken in consideration. In this overview, we present a case of a 75-year-old female patient who received surgical treatment as per Anderson's method after being treated with botulinum toxin type A for 3 years. This form of therapy proved to be an extremely successful permanent solution in the treatment of severe cases of refractory blepharospasm, without any long-term complications, especially ectropion and lagophthalmos.

Positive Effect of Breastfeeding on Child Development, Anxiety, and Postpartum Depression

BACKGROUND

Postpartum depression is a psychiatric disorder that starts from the second to the sixth week after birth. Breastfeeding is considered a protective factor for postpartum mood swings. This paper aims to examine the effect of breastfeeding on postpartum depression and anxiety, and how it affects child development.

METHODS

The study included 209 pregnant women, 197 puerperea, and 160 women at the end of the third month after delivery, followed through three time-points. The instruments used in the study were the Edinburgh Postpartum Depression Scale (EPDS), Beck's Depression Inventory (BDI), and Beck's Anxiety Inventory (BAI).

RESULTS

Postpartum mothers with low risk of PPD breastfed their children more often than mothers with a mild or severe risk of perinatal depression. Mean values on the BDI scale three months after giving birth were higher in mothers who did not breastfeed their child (M = 3.53) than those who did breastfeed their child (M = 2.28). Postpartum anxiety measured by BAI was statistically negatively correlated (rs-, 430) with the duration of breastfeeding.

CONCLUSION

Nonbreastfeeding mothers are more depressed and anxious compared to breastfeeding mothers.

IMPORTANCE OF ZINC CONCENTRATION IN SEMINAL FLUID OF MEN DIAGNOSED WITH INFERTILITY

The prevalence and importance of male infertility make it a serious worldwide medical and social problem. The aim of this study was to determine if there were any significant differences in zinc concentrations in seminal fluid in men diagnosed with infertility compared to control group, and if there were, to determine how it affected the number and percentage of sperm cells with normal motility and morphology. A case-control study was conducted in the Osijek-Baranja County from January 2014 to June of 2015. The study included 276 subjects referred to biochemistry laboratory of the Osijek University Hospital Centre, 100 (36.2%) of them with low sperm count confirmed by spermiogram after 3 months. Semen samples were processed according to the World Health Organization criteria, and zinc concentrations were determined using spectrophotometry and direct colorimetry without deproteinization on a chemistry analyzer (Olympus AU 680, Beckman Coulter, Tokyo, Japan). Study results showed the men with low sperm count to be significantly older (Mann Whitney U test: p=0.013) and to have lower zinc levels (χ²-test: p<0.001). Further analysis included 100 (36.2%) patients with low sperm count. In the group of infertile men, those with low sperm count had higher zinc levels compared to men with azoospermia (Mann Whitney U test: p=0.036), suggesting a connection between lower zinc level in seminal fluid and male fertility. Zinc as a biological marker and an antioxidant affects sperm count, motility and morphology. Zinc supplemental therapy could improve seminal parameters in patients diagnosed with low sperm count. Dietary habits of the subjects differ regionally, and future research could make a solid foundation for complementary approach to treatment of male infertility.

THE EFFECT OF DAILY PHYSICAL ACTIVITY ON THE ACTIVITY OF INFLAMMATORY BOWEL DISEASES IN THERAPY-FREE PATIENTS

It has been suggested that various environmental factors play a very important role in the etiology of inflammatory bowel diseases (IBDs) and that they have a significant effect on the course of these diseases. The aim of this study was to investigate the effect of daily physical activity on the activity of IBDs in therapy-free patients. This cross-sectional population based study was conducted in eastern Croatia from January to June 2016. The study included 312 patients, mean age 49.9±15.0 years, 53.2% of males and 46.8% of females; there were 63.4% of ulcerative colitis (UC) and 36.6% of Crohn’s disease (CD) patients. Sociodemographic characteristics of patients, data on their daily physical activity and type of therapy taken were collected through a specifically designed and validated questionnaire, while the activity of UC and CD was evaluated using the Mayo index and Harvey-Bradshaw index. The study showed that 24.0% of patients were not taking therapy. Daily physical activity was connected to IBD in study patients when taking both diseases collectively (Fisher exact test; p<0.001), as well as to the inactivity of CD (Fisher exact test; p=0.001) and UC (Fisher exact test; p=0.006), when observing each disease separately. Daily physical activity was connected to the inactivity of IBDs in patients not taking therapy. It is necessary to educate all IBD patients about the importance of physical activity in order to control their disease.