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.

Trains move in a specific way, along a pre-determined path, i.e. rails. The wheels of railway locomotives and rails are steel, and because of this, it is possible to achieve very high speeds, with relatively low resistance to movement. Analysis and research related to the movement of trains are very important from many aspects, especially for traffic safety. In this paper, a simulation of train movement under realistic conditions was performed. The simulation was created using the Python programming language. Infrastructure data, locomotive data, and resistances were used as input data, which Python later converts for simulation. The results of the simulation are presented both graphically and numerically. All data used in the Python simulation model was also input into the verified railway simulation software OpenTrack. The results from both tests were compared and analyzed, and a report was generated on the feasibility of using the created program in real-world scenarios.

The safety of drinking water is crucial for public health. Industrial and human activities have increased the use of heavy metals (cobalt, nickel, manganese) in water sources. These non-biodegradable, potentially carcinogenic metals pose serious health risks in drinking water. This study developed an efficient aqueous biphasic system (ABS) for removing these metals using real drinking water samples. Two ionic liquids, tetrabutylphosphonium DTPA ([TBP][DTPA]) and tetrabutylphosphonium acetate ([TBP][Ac]), were selected as ABS components, with ammonium sulfate as the salting-out agent. Phase diagrams were established, and extraction efficiencies were evaluated. The [TBP][DTPA] IL demonstrated superior performance, achieving over 95% extraction efficiency for all metals due to the stable complex formation with metal ions. The ABS proved highly effective for real samples, making it a promising approach for ensuring safe drinking water.

This study investigates tetrabutylphosphonium-based ionic liquids for food dye removal via extraction using aqueous biphasic systems with ammonium sulfate. Furthermore, these ionic liquids were used for activated carbon regeneration and employed for dye removal from the water as well. This dual approach achieved high extraction efficiencies (≈ 90%) and nearly complete regeneration (98%) of the activated carbon used as a food dye adsorbent. These findings underscore the potential of tetrabutylphosphonium ionic liquids for managing dye-contaminated water.

Sage has been used in traditional medicine to prevent and treat many health problems. This study aimed to determine and compare the phytochemical composition and antioxidative activity of sage leaf extracts obtained with 50% methanol (50MSE) and 80% methanol (80MSE). We determined the total phenolic content (TPC), total tannin content (TTC), and total flavonoid content (TFC) in extracts. Terpenoids were identified using gas chromatography-mass spectrometry (GC–MS), and the radical scavenging capacity of extracts was measured using DPPH assay. TPC was higher in 80MSE, TTC was higher in 50MSE, and TFC did not differ. GC–MS analysis showed that the content of α-thujone and L-camphor was low in both extracts, with higher content in 50MSE. DPPH assay indicated that a slightly lower IC50 value and higher antioxidant potential had 80MSE. Results pointed out that the polarity of the solvent and water content had different effects on the extraction of polyphenols and terpenoids.

Capacity of railway station is highly dependable on used interlocking system and traffic management pattern. Interlocking system's improvement requires significant financial resources, while traffic pattern could be changed by applying different management rules, depending on transport demand. This means that it is desirable to determine a certain trade-off between these parameters, up to the maximum capacity utilization index with the existing interlocking system. Several methods have been developed that consider given parameters for station capacity determination. In this paper we compare some of the methods for capacity determination, using the example of the Kalenic station, which was recently taken over by TENT from another industrial system.

This publication has always been a cornerstone of our community, providing valuable insights, updates, and a platform for sharing the incredible work of our members. It was initiated during the EFMI presidency of Catherine Chronaki (Belgium, Greece), with our enthusiastic colleague, Izet Masic (Bosnia Herzegovina), serving as the first Editor-in-Chief. The past year has been a period of reflection and rejuvenation for our team. We took this time to evaluate how best to serve you, our esteemed members, and ensure that our newsletter remains a vital resource in our professional journey together. We continue the traditional general content of previous editions, introducing a structural organization by sections, each coordinated by a guest editor. Additionally, we have expanded the range of topics, introducing articles on opinions as well as including some highlights from our previous meetings. This edition features three special sections.

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.

Background. The novel SARS-CoV-2 virus initiated one of humanity’s biggest pandemics, swiftly spreading worldwide and inducing significant health issues. This virus prompted widespread changes, with initial inadequate immune response and a lack of effective drug therapies. Consequently, every organ, particularly the respiratory and nervous systems, was susceptible to infection. The Covid-19 pandemic ended in 2023, but ongoing symptoms led to the term Long Covid and chronic manifestations. Objective: The aim of this article was to describe the important role of health professionals, especially family physicians and their teams when and how to identify common neurological symptoms and clinical conditions during pandemic and post-pandemic period. Methods. A systematic review gathered data on neurological symptoms and complications in Covid-19 patients, ranging from mild, like headache, to severe, such as encephalitis and stroke. Results and Discussion. Analysis revealed a significant proportion of Covid-19 patients experiencing neurological manifestations, with about one-third exhibiting symptoms. Epidemiological data showed ongoing Long Covid symptoms alongside acute manifestations. Many of cases with Long Covid related neurological complications were presented. Common neurological manifestations included chronic fatigue, changes in smell and taste, brain fog, headaches, fibromyalgia, cognitive impairment, and mood disorders. Severe Covid-19 cases were more likely to exhibit neurological complications, such as ischemic brain vasculitis and thromboembolic events, associated with higher mortality rates. Neurological complications of Covid-19 are frequent and diverse, necessitating a multidisciplinary approach in diagnosis and treatment, coordinated by primary care physicians. In practice, it is necessary to monitor the patient’s immune status over a longer period, and coagulation disorders (D-dimer) for adequate therapy and rehabilitation. Very important is to recognize the immune response after an acute infection. Due to the epidemic occurrence of Long Covid, it is necessary to introduce the above-mentioned procedures also in case of clinical signs of Long Covid. There are several hypotheses for the causes of Long COVID symptoms, including immune disorders, persistence of the virus in various organs, and microvascular coagulation changes. Within primary healthcare as the first line of defense it is necessary to address stress caused by COVID-19, try to recognize the affected other organ systems. Conclusion: The family doctor with his communication skills can make connection with the secondary and tertiary levels and the consulting services of immunologists, microbiologists, nutritionists, pharmacist, physiatrist and infectiologist. The family medicine team plays a key role in prevention, random detection and adequate medical procedures. The main interventions at the primary level should include education, emotional support, specific nutrition interventions and lifestyle modifications.

Background: Autoimmune limbic encephalitis (ALE) is an inflammatory brain process involving a group of diseases with antibodies against neuronal synaptic and cellular antigens. Diagnosis is based on clinical examination, neurological functional tests, cerebrospinal fluid analysis, immunological testing, and radiological findings. Objective: This case report aims to present the case of a 68-year-old patient initially hospitalized for intermittent neurological deficits in the form of cognitive disorders of consciousness, which was initially declared as dementia without physical neurological deficit. Case presentation: Initial brain MRI (SIEMENS Magnetom Avanto, 1.5 T, Erlangen, Germany) showed changes differentially diagnosed characterised as glial neoplasm of mixed-grade astrocytoma or inflammatory process of unilateral autoimmune encephalitis. Since the neurosurgical opinion suggested a higher-grade glioma with proposed surgical treatment, the patient was referred for repeated MRI with MR spectroscopy in order to exhaust all diagnostic possibilities before surgery. MRI with MR spectroscopy (SIEMENS Magnetom Lumina, 3 T, Erlangen, Germany) revealed radiologically altered findings, in the right hippocampus and parahippocampal gyrus, which primarily corresponded to changes due to unilateral autoimmune encephalitis,due to its morphology characteristics and spectroscopy profile, making the primary glial neoplasm of lower grade less likely. Since the neurological mosaic IIFT result showed a positive LGI1 antibody finding, therapy for autoimmune encephalitis was initiated, leading to significant improvement in cognitive functions and the return of short-term memory. Conclusion: Although the detection of antibodies against onconeural, cellular, and synaptic proteins represents a significant advancement in diagnosing autoimmune limbic encephalitis, the role of conventional diagnostic tools such as MRI, EEG, and cerebrospinal fluid analysis should not be overlooked, where the application of new functional imaging techniques such as MR spectroscopy can be beneficial and should be considered.

Introduction: Doping which includes veterinary drugs as irrational human medicine after the infection with COVID 19 still leaves the field open from the aspect of vascular surgery and angiology of the iliac segment. Reflection of the effect of the COVID 19 virus on the sports performance of athletes in various sports after the corona virus is still present. Some athletes have had a hard time individually coping with the clinical consequences after a long illness of the COVID 19 virus. Even though covert doping is part of the everyday life of an elite athlete, it still remains an unresolved topic in the form of a solution for post-COVID 19 symptoms or switching to or taking some other masked substances that are impossible to detect in the blood, as well as a potential reflection on the morphological changes of the arteries. Although consequences of the corona virus for the cardiorespiratory system have been reported, a question arises as to the connection between the development of iliac syndrome and pathomorphological arterial iliac changes in athletes with suspicion of potential correlation with underground doping substances of pharmacologically untested origin in the Balkan population. Widespread global COVID 19 pandemic and the isolation factor have forced numerous athletes to switch their normal training routine and protocols to alternatives such as cycling with or without abusing illegal substance. Increased intima-media thickness, the first structural change detected in atherosclerosis, is an important surrogate marker in atherosclerosis can be connected with high intensity endurance cyclists, running and triathlon competitive athletes affecting their poor performance status and professional doping levels. In some cases, amateur and recreational athletes are also affected especially if they were exposed to COVID 19 infection and doping. Goals: The primary focus of the present study is to determine the initial progression of the disease during and after the COVID 19 pandemic, starting from morphological changes and obstructive arteriopathy of the external iliac artery on account of measuring intima media thickness and the possibility of outset of kinking and obstructive arterial disease of the external iliac artery after 3 years. The secondary focus of the study is to examine the influence of doping on the pathomorphological changes of the external iliac artery during 3 years of research. Subjects and Methods: two groups of were observed (recreational and amateur cyclist). In total 63 selected subjects in the demographic area of ​​former Yugoslavia without cardiovascular disease were observed during the January 2021 and January 2024 period (3 years). Results: Changes in intima-media thickness of iliac artery from baseline 3 years were observed between the standard exercise amateur group and recreational control group. However, intensity exercise under 9000km per year were no significant developing progression of intima-media thickness of iliac artery during 3 years in recreational control group, but minimal progression of intima-media thickness of iliac artery were significant in amateur cycling group due to the potential effect of doping. Conclusion: The application of doping itself is indisputable, but the missing link that would confirm this claim is scientifically limited. We cannot confirm with certainty what is the trigger for the progression of pathomorphological changes and whether the consequences of overcoming the COVID 19 infection or doping. But there are many scientific facts and studies that confirm the connection between progressive atherosclerosis and illegal underground doping substances of pharmacologically untested origin. The consequences may result with a tendency for a futuristic vascular invasive patch or bypass surgical treatment.