Introduction: Various risk factors contribute to the occurrence of acute myocardial infarction as the most serious type of ischemic heart disease and the leading cause of sudden death worldwide. Aim of the Study: The aim of this study was to assess the frequency of changeable and unchangeable risk factors in patients with acute myocardial infarction in the Republic of Srpska. Patients and Methods: This cross-sectional study included patients treated for acute myocardial infarction at the University Clinical Center of Banja Luka, in the period from January 1st to December 31st, 2011. The patients were from the municipalities of Banja Luka and Laktaši. We analyzed the following risk factors: hypertension, total cholesterol values, diabetes, increased body weight and obesity, smoking, family history and physical inactivity. Results: Out of 273 patients, the majority were male (64%), and there was a statistically significant difference between age and sex (p <0.01) of the respondents. The most common risk factor for both genders was hypertension (70.1%), while the least frequent risk factor was diabetes mellitus (25.6%). Smokers and ex-smokers accounted for 58.1%, with a statistical significance between men and women (p <0.01). The average BMI in both genders was in the overweight category (27.69 kg / m2). A positive family history was found in almost half of the respondents (49.4%), with a statistically significant difference between age groups and family history (p = 0.036). Conclusion: Acute myocardial infarction mainly affects men in their sixties, while women are averagely affected nine years later than men. The number one risk factor for both genders is hypertension. Given the large impact of risk factors on the occurrence of acute myocardial infarction, priority must be given to the prevention and control of the aforementioned, especially in the primary health care.

, ABSTRACT Introduction: Traumatic flail chest is segment of the chest wall, which is caused by multiple fractures or by separation of bone structures (at least three sequential broken ribs or separated into two fracture lines). These injuries are mainly seen in polytrauma patients. Aim of the Study: Our aim is to show the therapeutic benefits of surgical treatment (operative stabilization) of the flail chest. Patients and Methods: We retrospectively analyzed patients who underwent surgery at the Clinic of Thoracic Surgery, University Clinical Centre of the Republic of Srpska, Banja Luka, in the period from 01. 12. 1997 - 04. 06. 2016. Results: 50 patients with traumatic flail chest with average age of 47.42 years were surgically treated in the twenty-year period at the Clinic of Thoracic Surgery, University Clinical Centre of the Republic of Srpska, Banja Luka. The average length of a hospital stay was 15 days. Survival rate in the operated group was 91.43%. Conclusion: If conservative measures such as internal stabilization, the use of analgesics, antibiotics, oxygen therapy and airway toilet does not lead to stabilization of respiratory function, surgical chest wall stabilization is necessary.

Introduction: Spinal column represents a strong and flexible body axis. It is consisted of vertebrae which are connected by the intervertebral disk and solid fibrous joints. Aim of the Study: To ascertain whether or not and to what extent foraminotomy affects the final outcome of lumbar herniated disc surgery. Patients and Methods: This retrospective study analyzed 71 patients who were operated at the Clinic of Neurosurgery in Banja Luka, in the period from 2009 to 2016. Extirpation of disc was performed in 41 respondents, while in 30 patients, a nerve root was further alleviated, along with the extirpation of disc. All patients were operated under the same conditions. Results: There was no statistically significant difference in the age of women and men who underwent classical discectomy and foraminotomy. There was a statistically significant difference in the disc protrusion and extrusion in patients who underwent conventional discectomy and those who underwent foraminotomy, along with conventional discectomy. There was no statistically significant difference in diagnosis in respondents who underwent conventional discectomy and those who underwent foraminotomy, along with conventional discectomy. There was statistically significant difference in the severity of pain in patients who underwent conventional discectomy and those who underwent foraminotomy, along with conventional discectomy. There was a statistically significant difference in clinical recovery, where the findings were in favor of the respondents who underwent foraminotomy, compared to the respondents who did not. Discussion: The treatment of this syndrome is complex, multidisciplinary and with problematic success, and in cases when the operation is performed, the results are not as good as in the primary operation. Conclusion: The results of this study show that the patients who underwent foraminotomy during the operation of prolapsed lumbar disc have a clinically better result.

Introduction: Drug-induced liver injury (DILI) is a rare but potentially life threatening adverse drug reactions. DILI may mimic pathophysiology or histopathologic features of an acute or chronic liver disease, and they may be indistinguishable from those of other causes of liver injuries. Liver can be affected directly, in a dose-dependent manner, or idiosyncratically, independently of the dose, and therefore unpredictably developed. Methods: In this special article we provided results given in the articles published in PubMed in the period 2006-2016. The search was made based on the most frequent reported drugs inducing liver injuries, diagnostic assessment, monitoring and outcomes of DILI. Results: The true incidence of DILI still remains unknown but the incidence of up to 14 cases per 100,000 inhabitants/year has been most frequently reported. Antimicrobial agents, analgesics, hipolipemics and antiepileptics are the most common drugs causing DILI. Conclusion: Although several biomarkers have been found through analytical tests, none of them have been able to display enough specificity and sensitivity in DILI diagnosis. Therefore, diagnostic assessment of DILI is still based on clinical examination, pharmacological treatment history, current RUCAM criteria, and liver function laboratory test.

The objective of this paper is to present new and simple mathematical approach to deal with uncertainty transformation for fuzzy to random or random to fuzzy data. In particular we present a method to describe fuzzy (possibilistic) distribution in terms of a pair (or more) of related random (probabilistic) events, both fixed and variable. Our approach uses basic properties of both fuzzy and random distributions, and it assumes data is both possibilistic and probabilistic. We show that the data fuzziness can be viewed as a non uniqueness of related random events, and prove our Uncertainty Balance Principle. We also show how Zadeh’s fuzzy-random Consistency Principle can be given precise mathematical meaning. Various types of fuzzy distributions are examined and several numerical examples presented.

Objective - The purpose of this investigation was to determine the frequencies and types of associated congenital heart disease and other cardiac lesions in children with congenital anomalies of the kidneys and urinary tract (CAKUT). Participants and method - This was a prospective cardiac evaluation of children with diagnosed CAKUT, conducted between January 2013 and December 2015 at the Department of Pediatrics of the University Clinical Hospital, Tuzla. All cases were reviewed for age, gender, consanguinity, occurrence of congenital heart disease (CHD) and CAKUT in family history. Cardiac examination included: physical examination, noninvasive blood pressure measurement, a twelve lead electrocardiogram and echocardiogram. Results - Complete cardiac examination was performed in 144 children with congenital anomalies of the kidneys and urinary tract. Clinically insignificant morphological or hemodynamical changes were noted in 13% or 9.0% children. Congenital heart disease was found in 32 (22.2%), hypertrophic cardiomyopathy in 2 and pulmonary hypertension in 1 of the 144 children. In 4 children congenital heart disease was part of other known genetic syndromes, and all of these cases had severe CHD. In twenty-six or 76.5% of the total of 32 patients it was already known, and in 6 (23.5%) CHD was discovered during this research. Ventricular septal defect was the most common malformation (13% or 40.6% of patients). Vesicoureteral reflux was the most frequent CAKUT associated with CHD. Conclusions - The results of this study showed a significant association between CAKUT and CHD. Therefore we suggest performing cardiac assessment of all children with CAKUT.

Foreign direct investment (FDI) is one of the most important international factors in relation with money movements. For this reason it has a major effect on the country’s financial development and employment increase. Various studies in the world and mainly on European developing countries show that FDI plays an important role in creating new employment positions in host countries. A lot of research has been going on regarding FDI on a world scale which issue is already documented, however further information is needed in order to have a better understanding about FDI in the Balkan Region and particularly in Macedonia. In the last two decades, Macedonia has been one of the main receivers of FDI, compared to other countries from Central and Eastern Europe. The main purpose of this study is to analyze the effect of FDI on the level of GDP in Macedonia. To conduct the study, data are gathered from World Bank, International Monetary Fund, and State Statistical Office of Macedonia, for the country over a period of seventeen years from 1998-2014. http://dx.doi.org/10.17130/ijmeb.2016icafr22428

The aims of this paper were to investigate the impact of changes in the milk payment system and the season on the hygienic quality of raw milk. The bulk cow’s milk samples were collected throughout the whole area of Bosnia and Herzegovina over the period of four years (2010-2013), from farms that deliver milk to the dairy industry. The total bacterial count (TBC) was analysed in 52,999 milk samples and the somatic cell count (SCC) in 53,363 milk samples. The results of the research showed that the proportion of bulk milk with the SCC < 300,000 mL-1 significantly increased in the observed period, as well as the proportion of farms that produce milk of EU quality (P < 0.05). The season had a significant effect (P < 0.05) on the SCC; in April the proportion of bulk milk with SCC < 300,000 mL-1 was significantly higher (P < 0.05). A significant increase (P < 0.05) in the proportion of milk with the TBC < 200,000 cfu∙mL -1 was perceived, as well as the proportion of farms which deliver that type of milk (P < 0.05). A Significant lower (P < 0.05) proportion of milk in the summer period with TBC < 200,000 cfu∙mL-1 was determined. It can be concluded that consistent appliance of regulations which determine the quality of milk, leads to the improvement of the hygienic quality of redeemed milk, as illustrated by the case of Bosnia and Herzegovina. This kind of milk payment system is important for both, the higher economic benefit of farms and the dairy processing industry.