Southeastern European Medical Journal

Comparison of Modern Surgical Techniques in a Treatment of Myopia

Karla Bodakoš*, Mateja Jagić, Antonio Kokot — Thu, 24 Jul 2025 10:32:15 +0000

Aim: To examine whether there is a difference in the outcomes of surgical techniques photorefractive keratectomy (PRK), laser in situ keratomileusis (LASIK) and implantable collamer lens (ICL) for: short-term visual outcome after 6 months, long-term visual outcome after 24 months, procedures safety and remaining refractive error after surgery.

Methods: The research was conducted on patients with myopia and myopic astigmatism. Data was collected on the surgical technique performed binocularly: PRK, LASIK or ICL. Visual acuity was measured: before the procedure, 6 months after the procedure and 24 months after the procedure. Data were collected on the occurrence of complications and performed additional corrections.

Results: The research was conducted on 150 patients. The median age was 33 years with an interquartile range of 28 to 39 years. The visual outcome was satisfactory in all three groups during two measurement periods after 6 months and after 24 months after procedures. Complications in this study occurred in 13 patients (8,7 %), mostly in LASIK group with total of 11 patients. Suboptimal refractive result that was corrected by additional correction amounts 1,3 % meaning only 2 of patients underwent the correction procedure due to suboptimal refractive error.

Conclusion: Short-term and long-term visual outcome after binocularly performed PRK, LASIK and ICL showed success in all groups. ICL and PRK showed the highest safety rate, while LASIK had more frequent complications in this study. A suboptimal refractive result occurred rarely and were additionally corrected if needed.

Key words: Keratomileusis, Laser In Situ; Myopia; Phakic Intraocular Lenses; Photorefractive Keratectomy; Refractive Surgical Procedures.

Influence of Phacoemulsification on Intraocular Pressure in the Eye after Trabeculectomy

Marija Olujić, Dubravka Biuk*, Ivana Kotromanović Šimić — Thu, 24 Jul 2025 10:36:18 +0000

Aim: The aim of this study was to question whether there is a difference in the change of intraocular pressure (IOP) between groups of participants, achieved by phacoemulsification after trabeculectomy, considering the height of IOP at beginning. As well as whether there is a decreased necessity for topical antiglaucoma (ATG) medications.

Participants and methods: Study was conducted on 26 participants submitted to cataract surgery after trabeculectomy at the Clinic for Eye Diseases in Osijek (January 2017 - December 2019). IOP values were noted at day zero, seventh day, after a month and six months after patients underwent cataract surgery with phacoemulsification; also, number and type of topical medications.

Results: Historic cohort study included 26 patients (19 women, 7 men). Statistically significant decrease of IOP was noticed from day zero and six months after (Friedman's test, P < 0.001). Significant difference was in measured value of IOP at day zero and the first day (Friedman's test, P < 0.05). No statistically significant difference was in participant groups according to IOP (Marginal Homogeneity test, P = 0.06).

Conclusion: Trabeculectomy alone and trabeculectomy combined with phacoemulsification, are justified procedures to achieve a decrease in the IOP value and its regulation with subsequent possibility of decrease in usage of local ATG therapy. Phacoemulsification after trabeculectomy ensures an additional decrease of the IOP.

Key words: glaucoma; intraocular pressure; phacoemulsification; trabeculectomy

Very Early Treatment of Recurrent Strokes with Mechanical Thrombectomy in a Patient with Severe Anemia

Thu, 24 Jul 2025 10:33:52 +0000

Introduction: Recurrent ischemic strokes requiring repeated mechanical thrombectomy (MT) within 24 hours of the initial event are uncommon. This case report describes a 61-year-old woman who underwent two MTs 6 hours apart for ischemic strokes associated with severe anemia due to pure red cell aplasia (PRCA) in different vascular territories.

Case Presentation: The patient, with a history of PRCA presented with left-sided hemiparesis and facial paresis. Neuroimaging revealed a right middle cerebral artery (MCA) M1 segment occlusion. She underwent MT with complete recanalization. Four hours later, new neurological symptoms emerged due to a left MCA occlusion, and a second MT was performed successfully.

Management and Outcome: Alongside MTs, the patient received supportive care, including blood transfusions, analgesics, and anticoagulants. Her neurological status improved significantly two weeks upon discharge with residual left-sided weakness and facial paresis. At 90 days, the patient was able to walk, indicating further functional improvement.

Discussion: This case is notable for the short interval between two MTs and the patient's underlying hematological condition. Severe anemia and PRCA likely contributed to hypercoagulability and increased stroke risk. Despite these unusual risk factors, the patient’s outcome was favorable, which is consistent with the effectiveness of repeated MT for early recurrent ischemic strokes.

Conclusion: Early recurrent stroke in different vascular territories, particularly in the context of hematological disorders, is rare but can be managed effectively with timely MT. Further research is needed to evaluate stroke recurrence risk and therapeutic responses in patients with hematological conditions, including PRCA and severe anemia.

Key words: anemia; ischemic stroke; thrombectomy

Coronary Angiography Optimized by Optical Coherence Tomography in Patients with Coronary Artery Disease

Klara Đambić*, Zorin Makarović — Thu, 24 Jul 2025 10:30:57 +0000

The aims of the study: The aims of this study were to examine whether there is a difference in the clinical findings of the lesion obtained by coronary angiography and OCT and to examine the association of OCT findings in the decision-making on additional optimization of PCI.

Respondents and methods: The research was conducted as a cross-sectional study using historical data. The study included patients who underwent OCT at the Department of Cardiovascular Diseases of the Osijek Clinical Hospital Center from 2021 to 2023.

Results: The research involved 62 patients, with a median age of 67. The most common location of the lesion was the LAD, in 52 (84%) cases. Thirty-nine respondents (63%) required additional optimization. Three (5%) patients were recommended for cardiosurgical consultation based on OCT. There was a significant increase in the length of the LAD (Wilcoxon test, P < 0.001), LCx (Wilcoxon test, P < 0.001), and RCA (Wilcoxon test, P = 0.006) as measured by OCT compared to coronary angiography. Regarding proximal width, the values for the LAD (Wilcoxon test, P < 0.001) and RCA (Wilcoxon test, P = 0.03) were significantly higher.

Conclusion: The research demonstrated the important role of OCT in clinical practice, particularly in the detailed assessment of coronary artery lesions, management of PCI, and assessment of additional optimization in patients with coronary disease.

Key words: coronary angiography, OCT, PCI

Hypodermoclysis in Palliative Care

Alen Breček*, Romana Bastalić, Andreja Oković, Marta Čivljak — Thu, 24 Jul 2025 10:33:02 +0000

With the aging population, the prevalence of oncological and other incurable chronic diseases is increasing, which raises the demand for palliative care. Patients in the final stages of illness often experience reduced food and fluid intake, leading to dehydration, while impaired swallowing hinders the oral administration of medications. Traditionally, fluid replacement is performed via intravenous (IV) routes; however, in elderly patients with long-term comorbidities and compromised veins, establishing venous access can be challenging and traumatic. Subcutaneous infusion, also known as hypodermoclysis, represents a simpler and less invasive alternative, especially in palliative care.

Hypodermoclysis enables safe and effective administration of fluids and medications into the subcutaneous tissue, reducing the need for repeated venipunctures and minimizing patient discomfort. This method has a long history, first being described in 1865 during a cholera epidemic. Despite its longstanding use, it is still not widely recognized among healthcare professionals. Its advantages include ease of application, lower costs, and the potential for use in home settings, allowing patients to remain in a familiar environment.

This study involved a literature search in databases such as PubMed, Scopus, and Web of Science, focusing on research published after 1995. A total of 401 studies, including meta-analysis, review articles, and clinical trials, were analysed to assess the efficacy and applicability of subcutaneous infusion in palliative care. The results indicate that hypodermoclysis is a suitable method for fluid replacement and medication administration, with a lower risk of complications compared to intravenous therapy.

Subcutaneous infusion is a safe, effective, and easily applicable method in palliative care. Its wider application can improve the quality of life for patients in the terminal stages of illness, reduce unnecessary medical procedures, and facilitate care in home settings with the active involvement of family members and palliative care teams.

Exposure of Physicians to Workplace Violence

Marta Milošević*, Anamarija Petek Erić — Thu, 24 Jul 2025 10:35:27 +0000

Introduction: The main goal of the research was to determine whether the doctors who work at the Clinical Medical Center Osijek are exposed to violence in the workplace, in what form of violence, whether there are differences in exposure between doctors according to age, gender and depending on whether they are specialists or residents.

Participants and methods: This study is organized as a cross-sectional study. 101 doctors employed at the Clinical Medical Center Osijek participated in this research. The data were collected by answering an anonymous online questionnaire.

Results: The majority of respondents who were exposed to violence at the workplace indicated that they had experienced verbal abuse (41.6%), followed by mobbing (21.8%), physical (5%) and sexual abuse (3%).

Conclusion: Due to the small sample of the study, there are no significant differences in the distribution of respondents according to exposure to any form of violence in relation to gender, age or whether they are residents or specialists.

Keywords: aggression; physicians; workplace violence

Attitudes and Activities of Primary and Secondary School Pupils and Medical Students in Relation to Social Networks, Sport, Friends and the Use of Mobile Phones

Silvija Kozari Golob*, Ana Popović, Slavica Kvolik — Thu, 24 Jul 2025 10:37:51 +0000

Aim of the study: The aim of the work is to find out what primary and secondary school pupils and medical students think and talk about most often, how they use mobile phones and social networks, and to identify possible interventions that could promote socialising with friends and sporting activities.

Methods. The attitudes and behaviours of primary school pupils (N = 51), high school pupils (N = 69), and medical students (N = 108) were compared using a questionnaire on the frequency of activities during the long breaks between lectures. Answers were provided on a 1 to 5 Likert scale.

Results. The topic most frequently discussed by all respondents was school (median 4 [IQR 3-5], P = 0.77), while primary school students most frequently discussed and thought about sport (3 [2-4]). High school pupils and medical students discuss and think about food (4[3-4]) and love (4[3-4]) as well. Primary school pupils rarely use social networks (1[1-2]), while high school pupils and medical students use them frequently (4[3-5]) and often search in the networks (4[3-5]) (P<0.001 between primary school pupils and older pupils and students). All respondents believe they should spend more time with friends in person (5[4-5] for all, P = 0.485, ns).

Conclusion. Primary school children have the greatest interest in sport and it is at this age that systematic educational programmes should be implemented to encourage participation in sport. Older respondents are more likely to think about having fun. Leisure activities can be a more effective motivator to stimulate their interest in sport and build personal bonds.

KEYWORDS: education; leisure activities; exercise; friends; mobile phone use