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Soldiers suicides risk factors in the Serbian Army Forces
Dedi? Gordana,Pani? Milivoj
Vojnosanitetski Pregled , 2010, DOI: 10.2298/vsp1007548d
Abstract: Background/Aim. Analyses of suicide risk factors enable to undertake appropriate preventive measures within the Suicide Prevention Program in Military Environment, which was fully applied in 2003 in the Serbian Army Forces. The aim of our study was to identify the most important suicide risk factors in soldiers within the period from 1998 to 2007. Methods. Analysis of suicide risk factors was carried out on the basis of data obtained by psychological suicide autopsy. The control group was matched with adapted soldiers by socio-demographic factors. A descriptive statistical analysis was used. Comparison of groups of soldiers was done by the t-test and Pearson's χ2-test. Results. A total of 35 soldiers aged 22-49 years (21.76 ± 1.76 years on average) committed suicide within the period 1999-2007, the 2/3 within, and 1/3 out of a military compound. More than one half soldiers committed suicide after transferring to a different post. Soldiers who committed suicide had come from uncompleted, dysfunctional families (p < 0.05). In comparison with the adapted soldiers, in premilitary period they had more interpersonal problems with their comrades (p < 0.001) and problems with law (p < 0.05). During military service, alcohol consumption was less presented; they used to have fewer separation problems (p < 0.05) and to be rarely awarded (p < 0.001) in comparison with the adapted soldiers. A soldier who committed suicide was emotionally and socially immature persons. The commonest motives for suicide were: decreased capacity of adaptation to military service, actual psychic disturbance, emotional interruption, fear of environment judgment, actual family problems, but in the one fifth, motive stayed unrecognized. Conclusion. Suicide risk factors in soldiers are primary in their immature personality organization, its relation with family and military environment factors which, in coexistence with actual life accidents, result in suicide as a consequence. A suicide prevention program in Serbian Army Forces should be designed to prevent multiple suicide risk factors.
Suicide risk factors in the professional military personnel in the Army of Serbia
Dedi? Gordana,Pani? Milivoje
Vojnosanitetski Pregled , 2010, DOI: 10.2298/vsp1004303d
Abstract: Background/Aim. Recognition of suicide risk factors is important in taking adequate suicide preventive measures, Suicide Prevention Program for Professional Military Personnel (PMP) implemented in the Army of Serbia in 2003. The aim of our study was to establish suicide risk factors in PMP of the Army of Serbia. Methods. Analysis of suicide risk factors in PMP was carried out on the basis of data obtained by psychological suicide autopsy. The controls were demographically similar psychiatric outpatients with no history of suicidal behavior. A descriptive statistics method was used for risk factors analysis. The t-test was used for testing statistical hypotheses. Results. A total of 30 PMP, aged 22-49 years (30.53 ± 6.24 on average) committed suicide within the period 1998-2007. Distal suicide risk factors in PMP were considered to be not being married, psychiatric heredity, having no outpatient psychiatric treatment, gambling, regular physical practice (bodybuilding), less transfer to a different post, low motivation for military service (p < 0.001), not having children, parental loss in early childhood, alcohol abuse (p < 0.005), low salary (p < 0.01) uncompleted military school, debts in the family (p < 0.05). The commonest proximal suicide risk factors were: actual family problems (36.6%), actual mental problems (13.3%), burnout (13.3%), negative balance of accounts (13.3%), professional problems (6.7%), behavioral model while for 10.0% PMP suicide risk factors could not be established. Conclusion. According to the presence of multiple suicide risk factors, Suicide Prevention Program for PMP in the Army of Serbia is directed to the prevention of both proximal and distal suicide risk factors.
Late stent thrombosis
Petrovi? Milovan,Bikicki Miroslav,PaniGordana,?anji Tibor
Medicinski Pregled , 2009, DOI: 10.2298/mpns0902079p
Abstract: Introduction. Late stent thrombosis is a serious complication after stent Implantation and it can lead to the development of acute myocardial infarction or death. A case report. A 43-year-old patient was admitted to our clinic to coronary care unit. He was diagnosed with acute ST elevation myocardial reinfarction of inferoposterior localisation and with right ventricular myocardial infarction. Eighteen months ago, he had acute myocardial infarction of the same localisation, and at the same time, PCI (Percutaneous Coronary Intervention) was performed in acute phase, and two bare metal stents were implanted. Now, the patient had chest discomfort two hours before admittance, and PCI was performed once again in acute phase. The diagnostic coronarography resulted in occlusion of the right coronary artery, on the spot of the previously implanted stents. After the passage of guidewire, the artery was recanalized, and defects of artery opacification, which might have been thrombs, were noticed. The thrombs were seen on the spots of earlier implanted stents and in the posterior inteventricular and posterolateral branches of the right coronary artery. PTCA was performed and the patient received the GP IIb/IIIa antagonist therapy after which the control coronarography showed minimal defects of artery opacification, with good anterograde flow. After complete treatment the patient was in good condition. Conclusion. Late stent thrombosis, although not very often, is a very serious complication and can lead to death or acute myocardial infarction. To prevent it, it is necessary that the patient receives dual antiplatelet therapy, and that PCI procedure is performed technically correctly (suitable stent dimensions and proper stent expansion).
The use of low molecular weight heparins in patients with acute ST-elevated myocardial infarction
Petrovi? Milovan,PaniGordana,?anji Tibor,Srdanovi? Ilija
Medicinski Pregled , 2006, DOI: 10.2298/mpns0610476p
Abstract: Introduction. According to the published guidelines for the management of acute coronary syndromes (ACS), treatment of acute ST-elevated myocardial infarction is based on rapid revascularization, either mechanical or pharmacological. Pharmacological revascularization consists of fibrinolytic therapy with antiplatelet and anticoagulant therapy. In regard to the anticoagulant therapy, low molecular weight heparins (LMWHs) are of special importance. LMWHs cause less complications (bleeding, thrombocytopenia, better bioviability) in comparison with unfractionated heparin (UFH). Some studies on use of LMWHs in ACS, show that LMWHs are equally efficient and safe as UFH, causing less complications (different types of hemorrhagic complications) (ESSENCE, TIMI 11B (enoxaparin), FRAXIS - fraxiparin), whereas some studies show better efficacy and safety of enoxaparin in therapy of acute ST-elevated myocardial infarction (ASSENT 3, ASSENT 3 PLUS, HART II, AMI-SK). Material and methods. Inclusion criteria: acute anterior myocardial infarction with ST-elevation, first myocardial infarction, no other structural heart defects, no signs of cardiogenic shock. Our study included 30 patients receiving fibrinolytic therapy with streptokinase, antiplatelet therapy and LMWH during 6 days, and 30 patients receiving UFH instead of LMWH. The follow-up period lasted for 6 months. Results. Significantly more patients receiving unfractionated heparin presented with major adverse cardiac events (73.3%) in regard to patients in the study group (44,2% nadroparin, 39.8% enoxaparin) (p=0.025). In the group receiving UFH, 6.7% patients had hemorrhagic complications, while none of patients receiving LMWHs. An equal number of patients died. Conclusion. Patients who were treated with LMWHs experienced less major adverse cardiac events and lower mortality. None suffered from hemorrhagic complications. .
Our experiences with therapeutic hypothermia
Petrovi? Milovan,Srdanovi? Ilija,PaniGordana,?anji Tibor
Medicinski Pregled , 2007, DOI: 10.2298/mpns0710431p
Abstract: Introduction. The single most important clinically relevant cause of global cerebral ischemia is cardiac arrest. The estimated rate of sudden cardiac arrest is between 40 and 130 cases per 100.000 people per year. Almost 80% of patients initially resuscitated from cardiac arrest remain comatose for more than one hour. One year after cardiac arrest only 10-30% of these patients survive with good neurological outcome. The ability to survive anoxic no-flow states is dramatically increased with protective and preservative hypothermia. The results of clinical studies show a marked neuroprotective effect of mild hypothermia in resuscitation. Material and Methods. In our clinic, 12 patients were treated with therapeutic hypothermia. A combination of intravascular and external method of cooling was used according to the ILCOR (International Liaison Committee on Resuscitation) guidelines. The target temperature was 33oC, while the duration of cooling was 24 hours. After that, passive rewarming was allowed. All patients also received other necessary therapy. Results. Six patients (50%) had a complete neurological recovery. Two patients (16.6%) had partial neurological recovery. Four patients (33.3%) remained comatose. Five patients (41.66%) survived, while 7 (58.33%) patients died. The main cause of cardiac arrest was acute myocardial infarction (91.6%). One patient had acute myocarditis. Conclusion. Mild resuscitative hypothermia after cardiac arrest improves neurological outcome and reduces mortality in comatose survivors. .
Therapeutic hypothermia and neurological outcome after cardiac arrest
Petrovi? Milovan,PaniGordana,Joveli? Aleksandra,?anji Tibor
Vojnosanitetski Pregled , 2011, DOI: 10.2298/vsp1106495p
Abstract: Introduction/Aim. The most important clinically relevant cause of global cerebral ischemia is cardiac arrest. Clinical studies showed a marked neuroprotective effect of mild hypothermia in resuscitation. The aim of this study was to evaluate the impact of mild hypothermia on neurological outcome and survival of the patients in coma, after cardiac arrest and return of spontaneous circulation. Methods. The prospective study was conducted on consecutive comatose patients admitted to our clinic after cardiac arrest and return of spontaneous circulation, between February 2005 and May 2009. The patients were divided into two groups: the patients treated with mild hypothermia and the patients treated conservatively. The intravascular in combination with external method of cooling or only external cooling was used during the first 24 hours, after which spontaneous rewarming started. The endpoints were survival rate and neurological outcome. The neurological outcome was observed with Cerebral Performance Category Scale (CPC). Follow-up was 30 days. Results. The study was conducted on 82 patients: 45 patients (age 57.93 ± 14.08 years, 77.8% male) were treated with hypothermia, and 37 patients (age 62.00 ± 9.60 years, 67.6% male) were treated conservatively. In the group treated with therapeutic hypothermia protocol, 21 (46.7%) patients had full neurological restitution (CPC 1), 3 (6.7%) patients had good neurologic outcome (CPC 2), 1 (2.2%) patient remained in coma and 20 (44.4%) patients finally died (CPC 5). In the normothermic group 7 (18.9%) patients had full neurological restitution (CPC 1), and 30 (81.1%) patients remained in coma and finally died (CPC 5). Between the two therapeutic groups there was statistically significant difference in frequencies of different neurologic outcome (p = 0.006), specially between the patients with CPC 1 and CPC 5 outcome (p = 0.003). In the group treated with mild hypothermia 23 (51.1%) patients survived, and in the normothermic group 30 (81.1%) patients died, while in the group of survived patients 23 (76.7%) were treated with mild hypothermia (p = 0.003). Conclusion. Mild therapeutic hypothermia applied after cardiac arrest improved neurological outcome and reduced mortality in the studied group of comatose survivors.
Clinical characteristics, management and mortality in patients with acute coronary syndrome from 2002 to 2005: Report from the National registry of acute coronary syndrome in Serbia
Vasiljevi? Zorana,Mickovski-Katalina Nata?a,PaniGordana,Krotin Mirjana
Srpski Arhiv za Celokupno Lekarstvo , 2007, DOI: 10.2298/sarh0712645v
Abstract: Introduction Data regarding patients with acute coronary syndrome (ACS) did not exist in Serbia until 2002. By establishing the National Registry for Acute Coronary Syndrome (NRACS), the data collection based on the filled-in "coronary questionnaire" for each patient hospitalized and diagnosed with acute infarction of the myocardium (AIM) and unstable angina pectoris (UAP) was initiated in Serbia. Objective The aim of the study was to analyze clinical characteristics, complications, applied reperfusion-thrombolytic treatment and standard therapy, and mortality rate of patients treated in coronary or intensive care units during the 2002, 2003, 2004 and 2005. Method We chose a "coronary protocol" with minimal set of the patient’s data that was filled-in by the attending physician. The collection of the data was initiated in July 2002. Results During four months of 2002, 4202 patients were treated for ACS; in 2003 12739 patents, in 2004 12351 patients and 12598 patients in 2005. AIM with ST elevation (STAIM), as related to AIM without ST elevation (NSTAIM), was more often encountered in Serbian population in comparison to other European countries: in 2002, it was registered among 52.3% of patients, in 2003 among 52.7%, in 2004 among 51.8%, and in 2005 among 50.7% of patients. The patients suffering from the ACS in Serbia were of younger age, with a significant prevalence of females, as compared to the data from the European countries. Thrombolytic therapy in STAIM was applied in only 24.5% of patients in 2002, which then rose by each year, to reach 36.4% of patients in 2005. At the same time, as expected, hospital mortality rate decreased: from 14.8% in 2002 to 8.2% in 2005. STAIM patients untreated by thrombolytic therapy had a considerably higher mortality rate: in 2002 it was 20.3%, in 2003 15.3%, in 2004 14.3%, and in 2005 13.8%. Total mortality rate in patients with STAIM gradually decreased from 19% in 2002 to 11.7% in 2005. Conclusion From 2002-2005, the patients treated for ACS in Serbia were younger, with higher prevalence of females, and with a higher incidence of STAIM in relation to NSTAIM. The administration of reperfusion therapy in STAIM patients has been increasing significantly, from 24.5% in 2002 to 36.4% in 2005, and was followed by a decrease in hospital mortality rate of 14.8% in 2002 to 8.2% in 2005. Overall mortality of STAIM patients treated with or without thrombolytic therapy gradually decreased from19% in 2002 to 11.7% in 2005.
Investigation of Performance and Combustion Characteristics of DI Diesel Engine Fuelled with Ternary Fuel Blend at Different Injection Pressure  [PDF]
Pani Sharanappa, Mallinath C. Navindgi
World Journal of Engineering and Technology (WJET) , 2017, DOI: 10.4236/wjet.2017.51011
Abstract: The depletion of fossil diesel fuels, global warming concerns and strict limits on regulated pollutant emissions are encouraging the use of renewable fuels. Biodiesel is the most used renewable fuel in compression ignition (CI) engine. The majority of literature agrees that the particulate matter (PM), unburnt total hydrocarbons (THC) and carbon dioxide (CO) emission from biodiesel are lower than from conventional diesel fuel. One of the most important reasons for this is the oxygen content of the biodiesel. This induces a more complete and cleaner combustion process. In addition to this the absence of aromatic compounds in biodiesel leads to particulate matter reduction with respect to diesel fuel. The potential emission benefits induced by the presence of oxygen in fuel molecules has increased the interest in using the bio-alcohols fuel blends in CI engines such as ethanol. Although alcohols are more suitable for blending with diesel fuel, properties like lubricity, viscosity, stability, heating value and cetane number of diesel-alcohol (Diesohol) still require improvement. One of the techniques is addition of biodiesel which can improve all of these properties forming diesel-biodiesel-alcohol (ternary) blends. The blends of diesel-biodiesel-ethanol can be used in the existing CI engines without any major modifications and most significant result of using this blend is the lower emission with almost the same performance as of diesel fuel alone. The present study focused on investigation of performance and combustion characteristics of ternary fuel blend in DI diesel engine operating at different injection opening pressure (IOP). The different injection opening pressures are: 180 bar, 200 bar and 220 bar.
Aging, Gender and Poverty: The Case of a Slum in Bangalore
Sarayu Pani
Socio-Legal Review , 2010,
Abstract: This paper attempts to analyse the relationship between aging and gender relations in a slum in Koramangala, in Bangalore, which is deeply influenced by poverty, the phenomenon of globalisation and the changed social relations that accompany these factors. The paper makes the argument that while aging is influenced by gender, usually negatively, certain other factors like health and modified social relations bring other influences to the experience of aging. Hence, while patriarchal structures in the slum remain oppressive, the role a particular woman may play in this structure can change with age, owing to factors such as poverty and her role in the family.
Maquiavelo en el Septentrión: Las posibilidades del republicanismo en Hispanoamérica
Erika Pani
Prismas : Revista de Historia Intelectual , 2009,
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