OBJECTIVE The purpose of this study was to evaluate the efficiency of the anticholinergic therapy with oxybutynin and the effects of daily transcutaneous tibial nerve stimulation (TTNS) on the quality of life of patients with an overactive bladder (OAB) and multiple sclerosis (MS). PATIENTS AND METHODS The study was designed as a randomized controlled trial. The patients who suffer from MS underwent urodynamic tests which showed that they had an OAB. The tests used to assess symptoms and quality of life were Overactive Bladder Questionnaires (OAB-q) SF. Patients were divided into 2 groups of 30 patients each. The first group received a 5 mg oxybutynin tablet twice a day for 3 months and the second group had TTNS every day for 3 months. RESULTS The anticholinergic therapy showed a statistically significant improvement in all symptoms and quality of life (P<0.001). Side effects such as dry mouth were observed in about 35% of patients. The results of the study TTNS daily therapy showed good performance in the reduction all clin ical symptoms of the bladder and improved quality of life, with statistical significance (P<0.05) and with no side effects. It was found that the improved quality of life parameters and the reduced symptoms were more statistically significant in the treatment with oxybutynin tablets than TTNS therapy (P<0.001). CONLCUSION Our recommendation for the treatment of OAB is oxybutynin in doses of 2x5 mg. If a patient can not tolerate anticholinergic drugs, daily TTNS is recommended to reduce OAB symptoms and improve quality of life, without side effects.

Objectives: To assess the prognostic value of pentraxin 3 (PTX3) in patients with ST-elevation myocardial infarction (STEMI) after bare-metal stent (BMS) implantation. Methods: In this prospective study, PTX3, interleukin (IL-6), IL-10, high-sensitivity c-reactive protein (hsCRP), and cardiac troponin I (cTnI) plasma values were determined before and 24hours after BMS implantation in 97 consecutively enrolled patients with STEMI who were admitted to University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina between February 2016 and February 2017. Patients were followed for 24 months to assess major adverse cardiovascular events (MACEs). Results: At 24 hours after percutaneous coronary intervention (PCI), plasma values of PTX3, IL-6, hsCRP, and cTnI were significantly increased; and IL-10 levels were significantly decreased compared with the values determined before PCI. Patients with MACEs had significantly higher plasma PTX3 levels at 24 hours after BMS-PCI than in patients without MACEs. Patients with PTX3 plasma values ≥5042 ng/ml had a significantly higher risk of MACEs than patients with PTX3 levels <5.042 ng/mL. Pentraxin 3 levels exhibited strong and significant correlations with IL-6 and IL-10 levels. Pentraxin 3, cTnI, and IL-6, but not hsCRP levels have showed independent association with MACEs, according to the multivariate Cox regression analysis. Conclusion: Pentraxin 3 might be better serum prognostic marker than IL-6, IL-10 or high sensitivity CRP for MACEs after BMS-PCI. It might help to make better risk stratification of those patients who are undergoing BMS-PCI.

Introduction: Although sense of security in mothers is not clearly specified in literature, most important factors that make it up in women that do not have issues in pregnancy are social support, prenatal health care and partner’s support. Psychological factors play a key role in recognizing fear of childbirth, distinguishing anxiety from clinical depression. Recognizing risk factors and adequate intervention support would significantly reduce fear. Aim: to analyze development of mother’s sense of security during the postnatal period and establish the differences between two study groups. Methods: The Cross section study was conducted in 2017 in the Public Institute for Health care Protection of Women and Maternity in Canton Sarajevo. Using random method in the study were included 395 mothers. The research instrument was PPSS-instrument and modified questionnaire. Results: Postnatal sense of security in n=395 of the mothers on average was 49, 61±7, 6. Mothers’ sense of security during the first week after their child’s birth differed significantly (p=0.004) between mothers whose husband actively participated in psychophysical preparation for childbirth. Development of parents sense of security is in direct connection with psycho-physical preparations of pregnant women for labor only when both partners took active part in preparations for labor. Conclusion: Postnatal sense of security in parents is a term that has not been researched enough and it requires further studies. Bachelor degree in health care/graduated nurse/midwife, especially in primary health care field, according to her competencies would be able to independently create and work on promoting prevention programs through holistic approach with individuals and families.

The aberrant DNA methylation plays a critical role in a number of different malignancies, including melanoma. DNA methylation is catalyzed by DNA methyltransferases (DNMTs), involved in methylation maintenance (DNMT1) and de novo DNA methylation (DNMT3A and DNMT3B). The current study investigated the association of genetic variants in the DNMT1 and DNMT3B with the clinicopathologic features and the clinical course of melanoma patients. In the present study, DNMT1 (rs2228612, rs2228611, and rs2114724) and DNMT3B (rs406193 and rs2424932) polymorphisms were examined in 123 melanoma patients. Single nucleotide polymorphisms were assessed using TaqMan SNPs Genotyping Assays according to the manufacturer's protocols. The carriers of the variant genotype of DNMT1 rs2228612 had poorer overall survival and recurrence-free survival, (P=0.000 and 0.000, respectively), and an increased risk for adverse outcome [hazard ratio (HR)=6.620, 95% confidence interval (CI): 2.214-19.791, P=0.001]. DNMT1 rs2228612 was also associated with ulceration (P=0.045), nodal status (P=0.030), progression (P=0. 007), and stage of disease (P=0.003). Univariate analysis indicated that tumor-infiltrating lymphocytes could be a marker of good prognosis in melanoma patients (HR=0.323, 95% CI: 0.127-0.855, P=0.025), whereas the genotype distribution of the DNMT3B rs406193 polymorphism correlated significantly with the presence of tumor-infiltrating lymphocytes (P=0.012). The multivariate analysis showed that the DNMT1 rs2228612 polymorphism (HR=12.126, 95% CI: 2.345-62.715, P=0.003) is an independent predictor of poor overall survival in melanoma patients. As expected, disease progression was also found to be an independent prognostic factor in melanoma patients (HR=37.888, 95% CI: 3.615-397.062, P=0.002). DNMT1 rs2228612 was found to be an independent predictor of poor overall survival in melanoma patients. DNMTs polymorphisms could serve as a potential target for novel therapeutic approaches.

OBJECTIVE The aim of this study was to assess the relationship between the use of neuroenhancing substances, exam anxiety and academic performance among first-year Bosnian-Herzegovinian (BH) university students. METHODS In a cross-sectional study, an ad hoc questionnaire was delivered to a sample of BH first-year university students. The following data were collected: socio-demographic features, consumption of neuroenchancing substances, the Westside Test Anxiety Scale (WTAS) and academic performance. RESULTS A total of 214 students were included. Consumption of lifestyle substances, coffee, energy drinks, nicotine, alcohol, and marijuana, for the purpose of neuroenhancement increased during the week before the exams. OTC cognitive enhancer use was reported by 31.0%, and of benzodiazepines by 1.5% of students. No psycostimulants were used. A high to extremely high exam WTAS score was reported in 38.3% students. The exam WTAS score was positively correlated with consumption of coffee (rho=0.31; P<0.001), energy drinks (rho=0.18; P=0.009), and nicotine (rho=0.22; P=0.001), and negatively correlated with last exam grade (rho=-0.33; P<0.001). The exam WTAS score was a significant independent predictor (OR=0.55; 95% CI 0.31 to 0.97, P=0.039) for self-assessed academic performance. Self-assessed academic performance was positively correlated with last exam grade (rho=0.15; P=0.043). CONCLUSIONS Although first-year BH university students do not seem to use either prescription or illicit psycostimulants, the consumption of nicotine, alcohol, and marijuana is worrying. However, the consumption of these neuroenhancing substances seems not to be related to better self-assessed academic performance. Finally, exam anxiety seems to be a significant problem among BH first-year university students.

SUMMARY This review article is focused on the impact of antioxidants and prooxidants on health with emphasis on the type of antioxidants that should be taken. Medical researchers suggest that diet may be the solution for the control of chronic diseases such as cardiovascular complications, hypertension, diabetes mellitus, and different cancers. In this survey, we found scientific evidence that the use of antioxidants should be limited only to the cases where oxidative stress has been identified. This is often the case of specific population groups such as postmenopausal women, the elderly, infants, workers exposed to environmental pollutants, and the obese. Before starting any supplementation, it is necessary to measure oxidative stress and to identify and eliminate the possible sources of free radicals and thus increased oxidative stress.

SUMMARY The aim of this paper is to determine nutritive, functional, microbiological and sensory properties of probiotic beverages produced from different volume ratios of cow's milk and soy beverage (25:75, 50:50 and 75:25). Pure cow’s milk and soy beverage served as control samples. Fermentation was performed at 43 °C by a combined culture consisting of the probiotic strain Lactobacillus acidophilus La5 and yoghurt culture. Viable counts of La5 strain in the produced beverages ranged from 7.52 to 8.20 log CFU/mL, which is above the probiotic minimum (106 CFU/mL). Lactic acid was the most prevalent organic acid in all samples (660.1 to 1003.0 mg/100 mL). The fatty acid profiles of fermented beverages were as follows: the mass fraction of saturated fatty acids was 22.2-82.7%, of unsaturated fatty acids 22.3-77.8% and of polyunsaturated fatty acids 15.5-65.9%. The main soy sugars were transformed well (80% stachyose and 50% raffinose conversion) into lactic acid during fermentation. Functional probiotic beverages were successfully produced from different volume ratios of cow's milk and soy beverage by L. acidophilus La5 and yoghurt culture. Mixing cow's milk with soy beverage significantly improved the sensory properties of the product, especially its smell, taste and colour. The acceptability test showed good acceptance by potential consumers of all fermented beverage samples except for the sample made from 100% soy beverage. In the end, the obtained results represent a good basis for further optimisation of the ideal volume ratios of cow's milk and soy beverage for production of fermented beverages characterised by good viability of probiotic bacteria as well as by good functional, nutritive and sensory characteristics.

We propose a novel strategy to construct optimal controllers for continuous-time nonlinear systems by means of linear-like techniques, provided that the optimal value function is differentiable and quadratic-like. This assumption covers a wide range of cases and holds locally in general. The proposed strategy avoids solving the Hamilton-Jacobi-Bellman (HJB) equation, that is a nonlinear partial differential equation, which is known to be hard or impossible to solve. Instead, the HJB equation is replaced with an easy-solvable state- dependent Lyapunov matrix equation without introducing any approximation. We achieve this exploiting a linear-factorization of the underlying nonlinear system and a policy-iteration algorithm (PI) to yield a linear-like PI for nonlinear systems. The proposed control strategy solves optimal nonlinear control problems in an exact, yet still linear-like manner. We prove optimality of the resulting solution and illustrate the results via two examples.

Organizations in today’s extremely competitive environment need to devote significant time, energy as well as human and financial resources to the measurement of their efficiency, in order to increase their profit, reduce costs, better plan their assets and manage their budgets, as well as to improve budget controls and risk assessment. Therefore, they need performance models, including the Balanced Scorecard. Primarily intended for profit organizations, the Balanced Scorecard is today used in the public sector, as well. This paper presents the research into the utilization of the Balanced Scorecard in the public sector, examining whether the performance of higher education institutions may be improved by the design and utilization of the Balanced Scorecard model.

Introduction: Lately, the use of biological therapy in various autoimmune diseases is increasing. The ideal marker for monitoring the effects of modern therapy is still non-existent. Aim: To investigate early response biomarkers of SLE and RA patients under the rituximab treatment are in research phase and each new investigations offer new and original useful data. Material and Methods: Immunophenotyping of cells was carried out by a standard method of sample preparation. We investigated by flow cytometric analyses expression of NK and CD19+ cells at ten SLE and five RA patients before and after treatment with rituximab, in laboratory of Department of Clinical immunology in the Clinical Centre University of Sarajevo. Results: In both cases, SLE and RA patients, reduced number of CD16+ parameter indicates lower cytotoxic activity of NK cells. Increased number of B cells indicates higher pathological activity leading to severe autoimmune disease allegation. Conclusion: Determining the proportion of NK and B will be useful diagnostic tool in therapeutic strategy, and also in monitoring of effect of biological therapy.

Summary The apple (Malus domestica Borkh.) possesses a number of health-promoting properties. The main beneficial effects of apple fruits on human health are associated with the antioxidant properties of components synthesising in apple fruits during their growth and development. Phenolic compounds and flavonoids are such components that contribute significantly to the antioxidant capacity of fruits, thus enhancing their health properties. The purpose of this study is to compare the antioxidant properties (namely antioxidant capacity, ascorbic acid, total phenolic and flavonoid contents) of the ‘Idared’ and ‘Braeburn’ apple cultivars, grown under optimal growing conditions in the Goražde area. Ascorbic acid contents were estimated using the 2.6-dichlorophenolindophenol titration method, whereas total phenolics were determined using the Folin-Ciocalteu method. Furthermore, total flavonoids were determined using the aluminium chloride colorimetric assay, whereas the ferric reducing/antioxidant power assay was used to determine the total antioxidant capacity of the apple fruits examined. The average values of the ascorbic acid, the total phenolic and flavonoids contents, and the total antioxidant capacity of the ‘Idared’ apples under consideration were 8.09 mg 100 g−1, 34.56 mg gallic acid equivalents 100 g−1, 12.62 mg catechin equivalents 100 g−1 and 323.28 μmol Fe2+ 100 g−1of fresh weight, respectively. The average values of the total phenolic and flavonoids contents, as well as the antioxidant capacity of the ‘Braeburn’ apples examined were as follows: 8.89 mg 100 g−1, 33.4 mg gallic acid equivalents 100 g−1, 13.56 mg catechin equivalents 100 g−1 and 367.01 μmol Fe2+ 100 g−1 of fresh weight, respectively. The analyses performed indicate that the differences recorded in the parameter values between the apple cultivars ‘Idared’ and ‘Braeburn’ were statistically non-significant. A correlation data analysis confirmed that phenolic compounds are the carriers of the antioxidant activity of apples.