Introduction: Hepatitis B is a viral infection of the liver that can present as both an acute and chronic disease, caused by the hepatitis B virus (HBV). Despite the availability of an effective vaccine and antiviral therapies capable of suppressing viral replication , hepatitis B remains a significant public health concern. The aim of the study is to collect, statistically analyze, and compare data on age, gender, and the number of hepatitis B cases in the Herzegovina-Neretva (HNC) and Split-Dalmatia (SDC) Counties. Participants and methods: In this retrospective study, data were collected on the number of inhabitants and the number of registered patients with hepatitis B in the areas of these two counties, as well as demographic data of patients (age, gender) for the period from January 1, 2014, to December 31, 2024. Results: In HNC region, 11 individuals with hepatitis B were registered during the study period, with nearly equal numbers of women and men. The affected men were significantly younger than the women (p<0.05). In the SDC, 55 individuals with hepatitis B infection were registered during the same period, with significantly more men than women (p<0.05), while there was no statistically significant difference in the age of the patients (p>0.05). The average annual rate of reported hepatitis B infections in the observed period in the HNC was 0.42 %000, while in the SDC, it was 0.96 %000,. The overall notification rate of cases in the SDC was 12.21 %000,, significantly higher than in the HNC, where it was 4,66 %000, (p<0.05). Conclusion: It was determined that both counties have a low incidence rate of hepatitis B. The epidemiological data on hepatitis B obtained in this study are important for guiding prevention and treatment of the disease in the areas studied and contribute to one of the World Health Organization (WHO) goals, which is the elimination of hepatitis worldwide by 2030. Keywords: hepatitis B, incidence, elimination, Split-Dalmatia County, Herzegovina-Neretva County.

Introduction: Adults over 65 years of age have the highest mortality rate from lower respiratory tract infections caused by influenza. People who live with or care for patients in risk groups, such as healthcare workers, should be vaccinated. Low influenza vaccination rates among certain at-risk groups contribute to the burden of disease and remain a major public health challenge. The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on seasonal influenza. Aim: Investigate the coverage of influenza vaccination among adults at the Health Center of the Split-Dalmatia County in Vrgorac. Materials and methods: A retrospective analysis was conducted. Data on influenza vaccinations from January 01, 2019 to December 31, 2024 at the Health Center of the Split-Dalmatia County in Vrgorac were analyzed from the electronic immunization database. The following variables were included in the analysis: vaccination coverage by year, subject category (older than 65, chronically ill, healthcare worker, other), and subject gender. Results: A total of 2090 doses of influenza vaccine for adults were consumed. The most vaccine doses were consumed in 2020, 512 doses, and the fewest vaccine doses were consumed in the last two years, 257 and 296, respectively (p<0.05). The largest number of patients was over 65 years old, 1214, 833 were chronic patients, while 26 were healthcare workers (p<0.05). Conclusion: A statistically significantly lower consumption of vaccine doses was found during and after the end of the COVID-19 pandemic compared to the time before the pandemic. Healthcare workers were statistically significantly less vaccinated against influenza compared to other groups. Keywords: Influenza, human flu, vaccination, immunization, vaccines

Understanding how spirituality affects mental health can provide important insights into treatment and support methods for people with mental illness. In modern society, spirituality is increasingly recognized as an important aspect of human life. It signifies the deep values and life views that people want to live by. A higher level of spirituality aids personal growth and development, including an individual's mental health and emotional well-being. Providing spiritual health care is considered important for the prevention of depressive symptoms and includes activities such as listening to patients, offering peace, respect, comfort and hope. A holistic approach to treating patients is increasingly being recognized and applied throughout the world. A holistic approach to health recognizes the interconnectivity of the psychological, social, biological and spiritual aspects of a person, which is reflected in the application of various methods including medication, education, communication, self-help and alternative therapies. History shows that scientific research has long confirmed the connection between spirituality and improved health. Spirituality seems increasingly important in the context of increased life stress, and recent research suggests that spiritual practices can contribute to the reduction of depressive symptoms. Spiritual beliefs and practices can also provide comfort to people who are fearful or anxious, increasing their sense of control, security and confidence. The effects of spirituality on mental health are individual and depend on personal beliefs, life experiences and the context in which it is practiced. An individualized approach in the assessment and integration of spiritual and religious aspects in the treatment of mental disorders is key. This paper explores the connection between spirituality and mental illness, with the aim of illuminating how spirituality can be both a source of support and challenge for people struggling with mental disorders. Keywords: spirituality, mental diseases, mental health

ntroduction: The thyroid hormone secretion disorders may be hyperthyroidism (reduced TSH levels and increased levels of FT3 and FT4) and subclinical hyperthyroidism (decreased concentration of TSH with normal FT3 and FT4).Aim: To investigate levels of thyroid hormones (TSH, FT3, and FT4) in patients with hyperthyroidism or subclinical hyperthyroidism treated at Tuzla Blue Clinic.Materials and methods:The study included 120 patients divided into three groups: a control group, groups with respondents who have hyperthyroidism, and a group of patients with subclinical hyperthyroidism. The concentrations of the hormones TSH, FT3, and FT4 were analyzed. The determination was carried out on the device IMMULITE 1 Siemens using the immunochemistry method. Results:TSH between our group investigated the existence of significant statistical differences between the control group and the group with hyperthyroidism (p<0.0001) and between the control group and the group withsubclinical hyperthyroidism (p=0.0001), and the parameter FT3 showed that a statistically significant difference exists between the control group and the group with hyperthyroidism (p<0.0001), and between patients with hyperthyroidism andsubclinical hyperthyroidism (p<0.0001). For FT4, we found a statistically significant difference between the control group and the group with hyperthyroidism (p<0.0001) and between groups with hyperthyroidism and subclinical hyperthyroidism (p <0.0001).Conclusions: The concentration of TSH is reduced in both hyperthyroidism and subclinical hyperthyroidism. The serum concentrations of FT3 and FT4 are elevated in hyperthyroidism, while in subclinical hyperthyroidism, the serum concentrations of FT3 and FT4 stand in the reference area.Keywords:Thyrotropin, thyroxine, TSH, FT3, FT4, hyperthyroidism

Introduction: Vaccines for protection against 10 infectious diseases are available in the Program of Regular Immunization in the Federation of Bosnia and Herzegovina. These vaccines save the lives of up to 3 million people worldwide every year. The latest report of the Institute of Public Health of the Federation of Bosnia and Herzegovina on regular immunization carried out during 2020 shows that the rate of vaccination of children during the 2019 coronavirus disease (COVID-19) pandemic with regular vaccines has decreased compared to previous years. Such a situation in the health system leads to a potential risk of outbreaks of infectious diseases that are prevented by vaccination.Objective: To examine the impact of the COVID-19 pandemic on the regular immunization of children in the Mostar Health Center.Materials and methods: A retrospective cross-sectional epidemiological study was conducted. Data on regular immunization of children from theMostar Health Center, Herzegovina-Neretva County in the Federation of Bosnia and Herzegovina from 2017, 2018, 2021 and 2022 were used.Results: A statistically significant difference was obtained in vaccination against measles, mumps and rubella during a period of four years. Vaccination with the mentioned vaccines was significantly higher in 2017 and 2018 than in 2021 and 2022.Conclusion: It was shown that the COVID-19 pandemic affected the regular immunization of children in the Mostar Health Center.Keywords: regular immunization of children, COVID 19 pandemic, MMR vaccine, Mostar

This study aimed to investigate the cytotoxic activity of decidual lymphocytes and the mRNA/protein expression of cytotoxic proteins in various cell types in the context of preeclampsia (PE) compared to those of healthy pregnancies. We analyzed fresh decidua basalis tissue and tissue embedded in paraffin (FFPE) from PE pregnancies (n = 15) and compared them with those of healthy pregnancies (n = 15) of the corresponding gestational age. Using double immunofluorescence staining, we observed differences in the intensity and distribution of staining for granzyme K (GZMK) and FasL in extravillous trophoblasts. RT-qPCR analysis of FFPE placental tissue showed that GZMK mRNA expression was statistically higher (p < 0.0001) in PE compared to that of healthy controls. On the contrary, there was a low expression (p < 0.001) of FasL mRNA in PE compared to controls, while there was no statistically significant difference for IFN-γ mRNA between PE and controls. Although the level of cytotoxic activity changed depending on the ratio of effector and target cells, there was no significant difference observed between PE and controls in this in vitro study. In conclusion, in PE, extravillous trophoblasts exhibited increased expression of GZMK and decreased expression of FasL. These changes may contribute to impaired trophoblast invasion. However, these alterations did not appear to affect the cytotoxic properties of decidual lymphocytes. Additionally, the possibility of cell sorter separation of decidual lymphocytes would greatly contribute to a better understanding of single cells’ genetic profiles.

In recent decades, conventional medicine has begun to include natural remedies and spiritual therapy in the treatment of people with mental disorders, and in recent years, physicians and healthcare professionals more often refer to alternative and complementary methods in the treatment of mental disorders. Alternative medicine includes “other treatments” and a more suitable term would be complementary medicine which supplements the definition of conventional medicine accepted by the World Health Organization. After the rise of pharmaceutical industry in the second half of the 20th century and significant advancement in the treatment of mental disorders, comes a period of disappointment and acceptance of the fact that synthetic drugs are not omnipotent and may have serious and unpleasant side-effects. Due to this fact, there is a growing interest in the treatment of mental disorders with the use of complementary methods. It is important to note that these methods are not a substitute for standard treatment procedures and their appropriate application does not diminish the importance of classical treatment of psychiatric disorders. Numerous patients refuse classical therapy and seek the help of complementary medicine methods. It is therefore important for physicians and healthcare professionals to have knowledge of complementary medicine which is science based and advises on treatment methods provided they are scientifically justified. Key words: complementary medicine, psychiatry

Healthy and controlled immune response in COVID-19 is crucial for mild forms of the disease. Although CD8+ T cells play important role in this response, there is still a lack of studies showing the gene expression profiles in those cells at the beginning of the disease as potential predictors of more severe forms after the first week. We investigated a proportion of different subpopulations of CD8+ T cells and their gene expression patterns for cytotoxic proteins (perforin-1 (PRF1), granulysin (GNLY), granzyme B (GZMB), granzyme A (GZMA), granzyme K (GZMK)), cytokine interferon-γ (IFN-γ), and apoptotic protein Fas ligand (FASL) in CD8+ T cells from peripheral blood in first weeks of SARS-CoV-2 infection. Sixteen COVID-19 patients and nine healthy controls were included. The absolute counts of total lymphocytes (p = 0.007), CD3+ (p = 0.05), and CD8+ T cells (p = 0.01) in COVID-19 patients were significantly decreased compared to healthy controls. In COVID-19 patients in CD8+ T cell compartment, we observed lower frequency effector memory 1 (EM1) (p = 0.06) and effector memory 4 (EM4) (p < 0.001) CD8+ T cells. Higher mRNA expression of PRF1 (p = 0.05) and lower mRNA expression of FASL (p = 0.05) at the fifth day of the disease were found in COVID-19 patients compared to healthy controls. mRNA expression of PRF1 (p < 0.001) and IFN-γ (p < 0.001) was significantly downregulated in the first week of disease in COVID-19 patients who progressed to moderate and severe forms after the first week, compared to patients with mild symptoms during the entire disease course. GZMK (p < 0.01) and FASL (p < 0.01) mRNA expression was downregulated in all COVID-19 patients compared to healthy controls. Our results can lead to a better understanding of the inappropriate immune response of CD8+ T cells in SARS-CoV2 with the faster progression of the disease.