Almir Dervisevic | University of Sarajevo (original) (raw)
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Foreword Preface Acknowledgements PART ONE: THE SKILLS NEEDED BEFORE YOU START: THE FIVE FOUNDATI... more Foreword Preface Acknowledgements PART ONE: THE SKILLS NEEDED BEFORE YOU START: THE FIVE FOUNDATION PILLARS THAT DEFINE YOUR CURRENT AND FUTURE STAGE OF EVOLUTION Chapter 1: The Stages in the Evolution of Customer Care Building the Foundation: Where Are You Right Now? The Stages of Evolution What Stage Are You In? Lessons Learned Chapter 2: Who Are Your Customers?: The Need for Customer Profiles Bulding the Foundation: Who Are My Customers and What Are Their Needs? In Which Supplier Category Do You Fall? The Significance of the Customer Profile: Why It Defines Your Stage Information Gathering Best Practices Lessons Learned Chapter 3: Segmentation: Some Customers Are More Important Than Others Building the Foundation: Not All Customers Are Created Equal The Importance of Customer Segmentation Getting Started: A Step--by--Step Guide to Segmentation Best Practices Lessons Learned Chapter 4: Focusing on Customer Needs Through the Voice of the Customer Building the Foundation: The Voice ...
Medical Archives, 2019
Introduction: Change in the fundus in myopic patients are often characterized by partially atroph... more Introduction: Change in the fundus in myopic patients are often characterized by partially atrophic and tilted optic disc insertions. Due to the altered nerve fiber arrangement, it is more difficult to detect the initial pathological changes of the optic disc. This subject is important because myopia represents well known risk factor for glaucoma. Aim: This study explored frequency of tilted optic disc in different degree of myopia which has major effect on glaucoma assesment due to unreliable OCTs parameters of the neuroretinal rim in patients with tilted disc. Methods: Between September 2013 and December 2014, total number of 150 patiens from ophtalmic polyclinic "Dr Sefic" underwent complete ophtalmic examniation. Total of 300 eyes were tested. Patients were separated in 3 groups by diagnosis. Each group was divided by the size of the optic disc diameter into three categories. ANOVA test was used in analysis. Results: Subjects with tilted disc shape have the highest degree of myopia, and there is a statistically significant difference with other forms of optic disc regardless of the size of the disc itself (p <0.05). The patients with a large disc (4.05 ± 0.65) had the highest degree of myopia in subclass of tilted discs, and these values decreased linearly in relation to the size of the tilted disc. Conclusion: Myopia height values decreased linearly with respect to the size of the tilted disc.
Acta Informatica Medica, 2017
Introduction: One of the most frequently used method for scanning patients with indication for de... more Introduction: One of the most frequently used method for scanning patients with indication for dental implantation in dentistry is cone beam computed tomography. Implantation, CBCT imaging and implant programme are inevitable when planning a successful replacement of lost teeth. CBCT offers exact information about available bone and its density, adjacent tooth roots, the place of mandibular canal and maxillary sinus and adjacent anatomical structure. Aim: The goal of this study is to estimate accuracy of measurements on CBCT images ofpatients who have implants of different producers and determine if there is any statistically significant correlation between four test groups regardless of the alloy of which implants are made. Material and methods: The study was a prospective-comparative, and included fifteen patients with hundred dental implants divided in four groups depending on the producer. Results: Over dimensioning in the gained measurements of the whole sample on CBCT images in relation to dimensions of producers is between 0.1006mm and 0.368mm. Even though over dimensioning is measured in millimetres, it has to be taken into consideration in clinical practice when planning an implant placement, and we can recommend safety zone of 0.5mm. There have been no statistically significant differences in the gained results in over dimensioning of implants of different alloys for horizontal and vertical measurements on CBCT images of Astra Tech, Brendet titanium implants and Straumann titanium-zirconium implants. Based on the goals of the study there have been confirmed statistically significant correlations of great value (from 0.841 to 0.936) of high level of importance between manufactured value of dimensions and average dimensions values gained through CBCT imaging in four types of implants (four test groups). The total exactness of measurements on CBCT scan in this research is 96.66% for horizontal measuring and 96.92% for vertical measuring. Therefore, we can conclude that CBCT as radiological method has an unavoidable importance in planning and successful realisation of dental implant procedure. Conclusion: Cone Beam Computed Tomography provides exact measurements of dimensions of placed dental implant in relation to dimensions of the producers of the implant because the material from which dental implants have been made does not significantly affect the precision of the measurement.
Materia Socio Medica, 2017
The aim of this study was to assess the importance of early diagnosis of potentially malignant le... more The aim of this study was to assess the importance of early diagnosis of potentially malignant lesions in the prevention of oral cancer. Material and methods: In order to achieve the set objectives, we selected our participant pool. Of the 340 patients who came to the initial examination at the Clinic for Oral Medicine and Periodontology, we selected 40 patients with potentially malignant oral lesions (PMOL) of both sexes and of different ages. After an extensive anamnesis and a clinical examination of all mucous membranes, we documented potentially malignant lesions, their localization, subjective and objective symptoms, duration of pathological lesion, and bad habits (smoking and alcohol). All lesions were colored with Toluidine blue, which indicates malignancy in 75% of cases. Patients who had a positive Toluidine blue staining test were sent to biopsy and pathohistological analysis. Results: The most common potentially malignant lesions are Lichen reticularis (25%), Lichen erosivus (20%), and Leukoplakia (15%). The most common localization of lesions is the buccal mucosa bilaterally (26%), buccal mucosa unilaterally (10%), and the lower lip (10%). The staining test with Toluidine blue was positive at 23% PMOLs. In patients with positive Toluidine staining findings, biopsy and pathohistological analysis were performed, which showed that 20% of all lesions are carcinoma (CIS, Baseocellular Carcinoma, Squamocellular Carcinoma), while 14% are mucosal epithelial dysplasia. Statistical analysis confirmed the significance of positive staining of Toluidine blue and Leukoplakia (Spearman's coefficient = 0.427, p = 0.006, N = 40), and statistically significant positive association of Squamocellular Carcinoma and Toluidine blue staining (Spearman's coefficient = 0.619, p = 0.000, N = 40). Conclusion: Most oral cancers are caused by potentially malignant lesions, which is why a very detailed clinical examination with the visualization of pathological lesions is very important. Toluidine blue test can be an auxiliary tool for clinical diagnosis but does not replace the pathohistological finding. Biopsy and pathohistological findings are the gold standard in the diagnosis of oral cancers, as confirmed in our research.
Medical Archives, 2016
Introduction: Glaucoma is the most common optic neuropathy which is characterized by progressive ... more Introduction: Glaucoma is the most common optic neuropathy which is characterized by progressive loss of retinal ganglion cells, the excavation of the optic nerve head, associated with defects in the visual field. It is not a disease, but the final result of united and yet completely unidentified cellular and subcellular processes and effects of many factors responsible for changes in retinal ganglion cells leading to their accelerated apoptosis. Methods: This is a prospective-retrospective, comparative, randomized clinical trial that included 150 patients, 97 were female and 53 male. The age of patients ranged from 18 to 80 years. Results: The highest degree of myopia in category of tilted optic discs had patients with large disc (4.05 +-0.65). Values of the degree of myopia have linearly declined in relation to the size of the oblique disc. The analysis of the results revealed that the subjects who had a higher degree of myopia associated with glaucoma had frequent parapapillar atrophy of alpha and beta zones. The highest percentage of subjects with parapapillar changes were in the group of patients who had other than glaucoma and myopia (62%), then in the group of patients with glaucoma only (56%). Conclusion: Previous studies on the relationship between myopia and open-angle glaucoma are based on the results of observational studies. However, according to recent findings, based on the available studies, the systematic approach to estimate the association between myopia and glaucoma does not exist. Disc Damage Likelihood Scale (DDLS) is a new system for assessing glaucomatous damage of the optic disc which strongly correlates with the degree of visual field loss.
Medicinski arhiv, 2010
A cutaneous horn is a uncommon and rare lesion. It is a conical projection of hyperkeratotic epid... more A cutaneous horn is a uncommon and rare lesion. It is a conical projection of hyperkeratotic epidermis. Vary from a few milimeters to a several centimeters in length. The cutaneous horn is a clinical diagnosis and different histologic lesions have been documented at the base of the keratin mound. We presented a 77 years old female with a large "horn" of 3 years duration, arising from her forehead. Excision was performed and defect was covered by split thickness skin graft. Hystopathology reported keratoacanthoma at the base of the horn. By reviewing cutaneous horns presented in literature we can declare that this is one of the biggest cutaneous horn recorded cases. Also it is important to mention that horn itself is not the most important issue, but rather the underlying condition, which may be malignant.
Medical Archives, 2012
I ntroduction: Pedicled temporalis muscle flap presenting a good flap for closing large craniofac... more I ntroduction: Pedicled temporalis muscle flap presenting a good flap for closing large craniofacial defects. Careful surgeons usually do not mobilize temporalis muscle flap enough to make appropriate use, fully closure, especially if defect exceeds the median line. Patients and methods: Temporalis flap was used in 16 patients, ages ranged between 12 and 76. In all cases defect reconstruction was done by useing new method of extending standard temporal muscle flap. During surgical procedure it is very important to keep periosteal elevator in close contact with the bone. Then, there is no risk for pedicle injury. After vascular pedicle is identified elevating temporal muscle has to be continued by releasing the muscle insertion from the coronoid process. By this way, flap length and arc of rotation is increased. Results: The flap remained viable in all instances. Most of the patients experienced no perioperative complications. There was no major complications or mortality as a result of performed procedures. Conclusion: With this division, flap length was increased at least 2 cm wich is enough for covering defects crossing the midline. Instead of using bilateral temporalis muscle flaps for defect closure, unilateral is sufficient. With this extension of the pedicle length now rotation point is not at the level of the zygomatic arch but lower part mandibular neck.
Medical Archives, 2010
a cutaneous horn is a uncommon and rare lesion. It is a conical projection of hyperkeratotic epid... more a cutaneous horn is a uncommon and rare lesion. It is a conical projection of hyperkeratotic epidermis. Vary from a few milimeters to a several centimeters in length. The cutaneous horn is a clinical diagnosis and different histologic lesions have been documented at the base of the keratin mound. We presented a 77 years old female with a large "horn" of 3 years duration, arising from her forehead. Excision was performed and defect was covered by split thickness skin graft. Hystopathology reported keratoacanthoma at the base of the horn. By reviewing cutaneous horns presented in literature we can declare that this is one of the biggest cutaneous horn recorded cases. Also it is important to mention that horn itself is not the most important issue, but rather the underlying condition, which may be malignant.
Foreword Preface Acknowledgements PART ONE: THE SKILLS NEEDED BEFORE YOU START: THE FIVE FOUNDATI... more Foreword Preface Acknowledgements PART ONE: THE SKILLS NEEDED BEFORE YOU START: THE FIVE FOUNDATION PILLARS THAT DEFINE YOUR CURRENT AND FUTURE STAGE OF EVOLUTION Chapter 1: The Stages in the Evolution of Customer Care Building the Foundation: Where Are You Right Now? The Stages of Evolution What Stage Are You In? Lessons Learned Chapter 2: Who Are Your Customers?: The Need for Customer Profiles Bulding the Foundation: Who Are My Customers and What Are Their Needs? In Which Supplier Category Do You Fall? The Significance of the Customer Profile: Why It Defines Your Stage Information Gathering Best Practices Lessons Learned Chapter 3: Segmentation: Some Customers Are More Important Than Others Building the Foundation: Not All Customers Are Created Equal The Importance of Customer Segmentation Getting Started: A Step--by--Step Guide to Segmentation Best Practices Lessons Learned Chapter 4: Focusing on Customer Needs Through the Voice of the Customer Building the Foundation: The Voice ...
Medical Archives, 2019
Introduction: Change in the fundus in myopic patients are often characterized by partially atroph... more Introduction: Change in the fundus in myopic patients are often characterized by partially atrophic and tilted optic disc insertions. Due to the altered nerve fiber arrangement, it is more difficult to detect the initial pathological changes of the optic disc. This subject is important because myopia represents well known risk factor for glaucoma. Aim: This study explored frequency of tilted optic disc in different degree of myopia which has major effect on glaucoma assesment due to unreliable OCTs parameters of the neuroretinal rim in patients with tilted disc. Methods: Between September 2013 and December 2014, total number of 150 patiens from ophtalmic polyclinic "Dr Sefic" underwent complete ophtalmic examniation. Total of 300 eyes were tested. Patients were separated in 3 groups by diagnosis. Each group was divided by the size of the optic disc diameter into three categories. ANOVA test was used in analysis. Results: Subjects with tilted disc shape have the highest degree of myopia, and there is a statistically significant difference with other forms of optic disc regardless of the size of the disc itself (p <0.05). The patients with a large disc (4.05 ± 0.65) had the highest degree of myopia in subclass of tilted discs, and these values decreased linearly in relation to the size of the tilted disc. Conclusion: Myopia height values decreased linearly with respect to the size of the tilted disc.
Acta Informatica Medica, 2017
Introduction: One of the most frequently used method for scanning patients with indication for de... more Introduction: One of the most frequently used method for scanning patients with indication for dental implantation in dentistry is cone beam computed tomography. Implantation, CBCT imaging and implant programme are inevitable when planning a successful replacement of lost teeth. CBCT offers exact information about available bone and its density, adjacent tooth roots, the place of mandibular canal and maxillary sinus and adjacent anatomical structure. Aim: The goal of this study is to estimate accuracy of measurements on CBCT images ofpatients who have implants of different producers and determine if there is any statistically significant correlation between four test groups regardless of the alloy of which implants are made. Material and methods: The study was a prospective-comparative, and included fifteen patients with hundred dental implants divided in four groups depending on the producer. Results: Over dimensioning in the gained measurements of the whole sample on CBCT images in relation to dimensions of producers is between 0.1006mm and 0.368mm. Even though over dimensioning is measured in millimetres, it has to be taken into consideration in clinical practice when planning an implant placement, and we can recommend safety zone of 0.5mm. There have been no statistically significant differences in the gained results in over dimensioning of implants of different alloys for horizontal and vertical measurements on CBCT images of Astra Tech, Brendet titanium implants and Straumann titanium-zirconium implants. Based on the goals of the study there have been confirmed statistically significant correlations of great value (from 0.841 to 0.936) of high level of importance between manufactured value of dimensions and average dimensions values gained through CBCT imaging in four types of implants (four test groups). The total exactness of measurements on CBCT scan in this research is 96.66% for horizontal measuring and 96.92% for vertical measuring. Therefore, we can conclude that CBCT as radiological method has an unavoidable importance in planning and successful realisation of dental implant procedure. Conclusion: Cone Beam Computed Tomography provides exact measurements of dimensions of placed dental implant in relation to dimensions of the producers of the implant because the material from which dental implants have been made does not significantly affect the precision of the measurement.
Materia Socio Medica, 2017
The aim of this study was to assess the importance of early diagnosis of potentially malignant le... more The aim of this study was to assess the importance of early diagnosis of potentially malignant lesions in the prevention of oral cancer. Material and methods: In order to achieve the set objectives, we selected our participant pool. Of the 340 patients who came to the initial examination at the Clinic for Oral Medicine and Periodontology, we selected 40 patients with potentially malignant oral lesions (PMOL) of both sexes and of different ages. After an extensive anamnesis and a clinical examination of all mucous membranes, we documented potentially malignant lesions, their localization, subjective and objective symptoms, duration of pathological lesion, and bad habits (smoking and alcohol). All lesions were colored with Toluidine blue, which indicates malignancy in 75% of cases. Patients who had a positive Toluidine blue staining test were sent to biopsy and pathohistological analysis. Results: The most common potentially malignant lesions are Lichen reticularis (25%), Lichen erosivus (20%), and Leukoplakia (15%). The most common localization of lesions is the buccal mucosa bilaterally (26%), buccal mucosa unilaterally (10%), and the lower lip (10%). The staining test with Toluidine blue was positive at 23% PMOLs. In patients with positive Toluidine staining findings, biopsy and pathohistological analysis were performed, which showed that 20% of all lesions are carcinoma (CIS, Baseocellular Carcinoma, Squamocellular Carcinoma), while 14% are mucosal epithelial dysplasia. Statistical analysis confirmed the significance of positive staining of Toluidine blue and Leukoplakia (Spearman's coefficient = 0.427, p = 0.006, N = 40), and statistically significant positive association of Squamocellular Carcinoma and Toluidine blue staining (Spearman's coefficient = 0.619, p = 0.000, N = 40). Conclusion: Most oral cancers are caused by potentially malignant lesions, which is why a very detailed clinical examination with the visualization of pathological lesions is very important. Toluidine blue test can be an auxiliary tool for clinical diagnosis but does not replace the pathohistological finding. Biopsy and pathohistological findings are the gold standard in the diagnosis of oral cancers, as confirmed in our research.
Medical Archives, 2016
Introduction: Glaucoma is the most common optic neuropathy which is characterized by progressive ... more Introduction: Glaucoma is the most common optic neuropathy which is characterized by progressive loss of retinal ganglion cells, the excavation of the optic nerve head, associated with defects in the visual field. It is not a disease, but the final result of united and yet completely unidentified cellular and subcellular processes and effects of many factors responsible for changes in retinal ganglion cells leading to their accelerated apoptosis. Methods: This is a prospective-retrospective, comparative, randomized clinical trial that included 150 patients, 97 were female and 53 male. The age of patients ranged from 18 to 80 years. Results: The highest degree of myopia in category of tilted optic discs had patients with large disc (4.05 +-0.65). Values of the degree of myopia have linearly declined in relation to the size of the oblique disc. The analysis of the results revealed that the subjects who had a higher degree of myopia associated with glaucoma had frequent parapapillar atrophy of alpha and beta zones. The highest percentage of subjects with parapapillar changes were in the group of patients who had other than glaucoma and myopia (62%), then in the group of patients with glaucoma only (56%). Conclusion: Previous studies on the relationship between myopia and open-angle glaucoma are based on the results of observational studies. However, according to recent findings, based on the available studies, the systematic approach to estimate the association between myopia and glaucoma does not exist. Disc Damage Likelihood Scale (DDLS) is a new system for assessing glaucomatous damage of the optic disc which strongly correlates with the degree of visual field loss.
Medicinski arhiv, 2010
A cutaneous horn is a uncommon and rare lesion. It is a conical projection of hyperkeratotic epid... more A cutaneous horn is a uncommon and rare lesion. It is a conical projection of hyperkeratotic epidermis. Vary from a few milimeters to a several centimeters in length. The cutaneous horn is a clinical diagnosis and different histologic lesions have been documented at the base of the keratin mound. We presented a 77 years old female with a large "horn" of 3 years duration, arising from her forehead. Excision was performed and defect was covered by split thickness skin graft. Hystopathology reported keratoacanthoma at the base of the horn. By reviewing cutaneous horns presented in literature we can declare that this is one of the biggest cutaneous horn recorded cases. Also it is important to mention that horn itself is not the most important issue, but rather the underlying condition, which may be malignant.
Medical Archives, 2012
I ntroduction: Pedicled temporalis muscle flap presenting a good flap for closing large craniofac... more I ntroduction: Pedicled temporalis muscle flap presenting a good flap for closing large craniofacial defects. Careful surgeons usually do not mobilize temporalis muscle flap enough to make appropriate use, fully closure, especially if defect exceeds the median line. Patients and methods: Temporalis flap was used in 16 patients, ages ranged between 12 and 76. In all cases defect reconstruction was done by useing new method of extending standard temporal muscle flap. During surgical procedure it is very important to keep periosteal elevator in close contact with the bone. Then, there is no risk for pedicle injury. After vascular pedicle is identified elevating temporal muscle has to be continued by releasing the muscle insertion from the coronoid process. By this way, flap length and arc of rotation is increased. Results: The flap remained viable in all instances. Most of the patients experienced no perioperative complications. There was no major complications or mortality as a result of performed procedures. Conclusion: With this division, flap length was increased at least 2 cm wich is enough for covering defects crossing the midline. Instead of using bilateral temporalis muscle flaps for defect closure, unilateral is sufficient. With this extension of the pedicle length now rotation point is not at the level of the zygomatic arch but lower part mandibular neck.
Medical Archives, 2010
a cutaneous horn is a uncommon and rare lesion. It is a conical projection of hyperkeratotic epid... more a cutaneous horn is a uncommon and rare lesion. It is a conical projection of hyperkeratotic epidermis. Vary from a few milimeters to a several centimeters in length. The cutaneous horn is a clinical diagnosis and different histologic lesions have been documented at the base of the keratin mound. We presented a 77 years old female with a large "horn" of 3 years duration, arising from her forehead. Excision was performed and defect was covered by split thickness skin graft. Hystopathology reported keratoacanthoma at the base of the horn. By reviewing cutaneous horns presented in literature we can declare that this is one of the biggest cutaneous horn recorded cases. Also it is important to mention that horn itself is not the most important issue, but rather the underlying condition, which may be malignant.