Background: Nasal decongestants are drugs that are used to prevent excessive nasal secretions, and to facilitate breathing in case of a cold, allergy or other disorders of the upper respiratory tract. They are most often used locally in the form of sprays, nasal drops or inhalation products, but they can also be used oraly in the form of tablets or capsules, alone or in combination with other medicines. Monitoring the consumption of medicines is important for the analysis and improvement of its rational use, and the aim of this paper is to analyze the outpatient consumption of nasal decongestants for local administration, in the Republic of Srpska during the period from 2020 to 2022. Methods and Objectives: The data were obtained from the Annually Drug Consumption Report of the Public Health Institute of the Republic of Srpska, and are expressed in defined daily doses per 1000 inhabitants per day (DID), in accordance with the recommendations and classifications of the World Health Organization. Results: Among the drugs for the treatment of the respiratory tract, nasal preparations (drugs for the treatment of diseases of the nasal mucosa) are in second place, right after the drugs for the treatment of obstructive lung diseases. Among the nasal preparations, the sympathomimetics xylometazoline and oxymetazoline, and the combination of xylometazoline with dexpanthenol, are used the most, similarly to other countries in the region. Conclusions: During the observed period, a slight increase in the consumption of nasal preparations was observed, and it is necessary to continue monitoring the trend of consumption and work on improving cooperation between doctors, pharmacists and patients in order to rationalize therapy and raise knowledge and awareness about the correct use of nasal decongestants in accordance with modern therapeutic guidelines.

Background/Aim: Dental fear and anxiety (DFA) are psychological phenomena normally arising and developed in the dental office during various kinds of dental procedures and interventions. The most usual stressors for the DFA appearance are those related to dental pain, no matter if the pain has already been caused, or potentially will be committed. There are a few main dental pain-provoking factors related to endangering body integrity in the oral cavity, and tooth extraction is the strongest one. The research aimed to observe, notify, and analyze physiological parameters of DFA in adults related to oral surgical therapy procedures of removing impacted third permanent molars. Material and Methods: After inclusive selection 500 patients entered into the study. The study protocol included preoperative assessment of DFA presence with Corah's Dental Anxiety Scale (CDAS) on examination day, preoperative assessment of physiological parameters on examination day and operative day before the treatment, as well as their postoperative assessment followed by evaluation of postoperative pain, on the day after the treatment. Results: The results of our research indicated that an increase in DFA led to increased values of the measured physiological parameters for all preoperative measurement days. The postoperative decrease in the physiological parameters values could be explained by the fact that the oral-surgical procedure was completed, so the psychological burden of the patients was also less. Conclusions: Patients with higher values of the DFA presence have also declared more postoperative pain.

Background: Cholelithiasis is one of the most common issues affecting the gastrointestinal tract. The prevalence of cholelithiasis ranges from 11% to 36%. The prevalence is found to be associated with a number of factors including age, gender and ethnicity. Women have three times higher risk of developing this condition in comparison to men. Objective: This The aim of this study is to prove that occurrence of early and late postoperative complications is lower in patients who had three metal clips placed on cystic artery and ductus cysticus in comparison to the patients who had two metal clips placed. Methods: In this retrospective study we included all the patients who underwent acute laparoscopic cholecystectomy between January 1st 2021 and December 31st 2022 at the Department of Abdominal Surgery of University Clinical Centre Tuzla. Total number of patients included in the study is 148. A total of 1200 laparoscopic cholecystectomies were performed, of which 1052 patients had chronic calculus cholecystitis, and the performed laparoscopic cholecystectomies were part of elective surgical procedures. Remaining 148 patients had acute calculus cholecystitis, and were admitted and operated laparoscopically in an emergency protocol. Results:: Out of total amount of 82 laparoscopic surgeries were performed with the placement of two clips on the cystic artery and cystic duct, and 66 laparoscopic cholecystectomies with the placement of three clips on the cystic artery and cystic duct. Out of a total of 82 patients who were implanted with two clips, 6 of them had some of the postoperative complications. In the group of patients who had three clips implanted, none of the 66 subjects had any postoperative complications. Conclusion:: The study confirms that patients who underwent placement of three clips had lesser odds of developing complications, and that this occurrence is not accidental but rather a consequence of the choice of the surgical method.

Introduction: Colorectal cancer (CRC) is one of the most common malignancies with significant global health and economic implications. Genetic mutations in genes such as TP53, APC, KRAS, and MMR play a crucial role in the development and progression of this cancer. This review paper analyzes current knowledge about the impact of these mutations on colorectal carcinogenesis, using available literature. Objective: To provide a comprehensive review of the role of genetic mutations in TP53, APC, KRAS, and MMR genes in the development of colorectal cancer and to consider their impact on diagnosis and treatment. Materials and Methods: This review examines peer-reviewed research articles and reports sourced from databases such as PubMed, Google Scholar, and other academic sources. The focus was on studies investigating genetic mutations, their prevalence, and their role in the pathogenesis of CRC. Results: Mutations in the TP53 gene, present in more than 50% of CRC cases, are critical for malignant cell transformations. KRAS mutations, found in about 50% of cases, lead to abnormal signaling contributing to unchecked proliferation. APC mutations are associated with hereditary predisposition to CRC, while MMR genes, such as MLH1 and MSH2, play a key role in DNA repair and are linked to hereditary nonpolyposis colorectal cancer. Conclusion: Genetic mutations in TP53, APC, KRAS, and MMR genes play a significant role in the development of colorectal cancer. A deeper understanding of these mutations may significantly enhance diagnostic and therapeutic strategies, guiding future research in this rapidly evolving field.

Introduction: Breast cancer, the most common malignancy in women, represents a significant health issue, and biomarkers such as the Ki-67 index and uPA/PAI-1 complex can provide insight into treatment outcomes and therapeutic response. Objective: The primary outcome of the study was the assessment of 5-year disease-free survival (DFS), defined as the postoperative period until the occurrence of loco-regional or distant metastases and death from any cause. Patients and Methods: A retrospective cohort study included 166 patients with early invasive breast cancer, in whom the prognostic and predictive significance of the uPA/PAI-1 complex and Ki-67 biomarkers in surgically treated patients at the Clinic for General and Abdominal Surgery of the University Clinical Center in Sarajevo was evaluated during the period from September 2015 to February 2017. Results: Univariate regression analysis identified an increased probability of DFS shorter than five years in patients with negative hormone receptors, positive HER-2 receptor, ≥ 8 positively mph nodes, and a Ki-67 index ≥ 14% (p < 0.05). Multivariate regression analysis revealed that T2 stage, tumor size of 20-50 mm, and a Ki-67 index ≥ 14% were associated with a higher probability of DFS shorter than five years (p < 0.05). The five-year DFS rate was higher in patients with a Ki-67 index < 14% compared to those with ≥ 14% (p = 0.011), while there was no difference in five-year DFS among patients with different levels of the uPA/PAI-1 complex (p = 0.636). Conclusion: Our study highlights the importance of the Ki-67 proliferative index as a strong prognostic and predictive factor for DFS in patients operated on for early invasive breast cancer. Additional monitoring and tailored therapeutic strategies may be beneficial in patients with elevated Ki-67 index values, T2 stage, and tumor size of 20-50 mm.

Working with various tools is demanding and can also be very dangerous. Many standards regulate this area, including ISO 45001:2018. Workplace injuries and illnesses significantly burden employers and impact the economy in general, which has led to the development of this important standard. Additionally, many companies have internal work instructions for using specific tools to protect the health and lives of individuals. Forklifts are such tools that require personnel to be trained in their operation to ensure the protection of themselves and others. This paper presents the operational instructions for handling forklifts at the Zenica Steelworks, which have been in place for a considerable period and can serve as a model for other manufacturing or service companies.

Background: The First Dorsal Metacarpal Artery (FDMA) Flap or Foucher’s flap is an island pedicle flap proximally based on the first dorsal metacarpal artery and veins. A branch of radial sensory nerve is incorporated in the flap to make it a sensate flap. Objective: The aim of our study was to evaluate the functional and aesthetic outcomes of the seven FDMA flaps done over a period of four years for reconstruction of the distal thumb soft tissue defects and one defect over proximal phalanx of the index finger. Methods: This prospective study was performed between 2018 and 2022 at the Clinic of Reconstructive and Plastic Surgery. We present a series of six cases of distal thumb soft tissue defects and one patient with defect over the dorsal aspect of the index finger that were reconstructed with the FDMA flap. Results: In six patient donor site was grafted by full-thickness skin graft harvested from the groin and in one case was closed primary. All flaps survived and one case that was closed primary had donor site complication that was related to primary closure of the skin. All the patients had good fine touch and average two-point discrimination of 8.7 mm. Conclusion: FDMA flap is a useful and reliable flap to cover the defects of the dorsal aspect and to a certain extent the volar aspect of the thumb. We showed that can be used to cover the defects over proximal phalanx of the index finger. The flap provides adequate soft tissue coverage and good aesthetic results.

Corrugated cardboard finds extensive use in the packaging industry due to its performance characteristics. It is a lightweight material with excellent mechanical properties, easy recyclability, and environmental friendliness, making it the preferred choice. While numerous studies have investigated the effects of external factors on corrugated cardboard and its mechanical properties using simulation modeling, there is a lack of research focusing on simulating and predicting the construction of corrugated cardboard itself. The shape and size of the corrugated medium significantly impact the performance of corrugated cardboard. However, strict standards for the parameters of the medium's size and shape to achieve optimal elasticity and strength are lacking. Therefore, this study aims to explore the modification of the design of one component of corrugated cardboard to enhance its performance

Background: In the year 2024 Bosnia and Herzegovina celebrates anniversaty of three important healthcare institutions: the Vaqf's hospital in Tuzla established in 1874, Regional hospital in Sarajevo (Landesspital) established in 1894 and the first Faculty of Medicine in Bosnia and Herzegovina established in Sarajevo in 1944. Objective: The aim of this article was to describe historical facts how mentioned institutions were founded and what was importance of functioning all of them during history of health care education and healthcarte protection. Methods: The author searched important historical facts about establishing and works Hastahana in Tuzla, Landesspital in Sarajevo and Medical faculty in Sarajevo, writen in the books and articles deposited in indexed databases PubMed Central, Scopus, Hinari, Embase, etc. Results and Discussion: The first hospital (hastahanas, named as Waqf's hospitals, besides other 4 - established in Tuzla, Mostar, Travnik and Banja Luka) has been founded in Sarajevo in 1866, which was founded by Governor Serif Osman Topal Pasha and doctor Jozef Kecet. These hastahanas were definitely the embryo of an organized health services in Bosnia and Herzegovina, which have had enormous hystorical significance. Vakuf's hospital in Tuzla (Hastahana) founded by doctor Mehmed Serbic Sami, the first Muslim physician, graduated in Instanbul, Turkey at Lecole de Medicine in 1873. The first official hospital established during Austrian-Hungarian period was Regional (Landesspital) hospital opened in the July 1st 1894 and had 303 hospital beds in 4 departments: the first Internal department with diseases of the throat and nose (not the ear) with 45-50 beds, the Second - Surgical Department with ophtalmology (for ear surgery) with 45-50 beds, the Third - Dermatology and Venerology ward with 70-80 beds and the fourth - Gynaecology-obstetrics department with 70-80 beds. It will be a good basis for training future teachers pioneers of medicine, which will be opened in Sarajevo in November 22nd 1944 as a part of Medical Faculty in Zagreb. An generation of medical students attend the first year of study in Sarajevo. True, most students of this generation will be mobilized during the war, some will move on to medical faculties in other cities, and some other faculties in Sarajevo. The first Faculty of Medicine in Bosnia and Herzegovina officialy established in November 16th 1946. Conclusion: All institutions described in this article played important role in the history of healthcare education and healthcare protection in Bosnia and Herzegovina.