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.

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: 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.

Background/Aim: To evaluate the effect of curing light parameters (intensity, duration, and distance of curing tip) on the depth of cure of conventional resin-based composite. Material and methods: Cylindrical specimens made of nanohybride resin-based composite are cured with 12 different curing protocols, combined with 3 different light intensities (300, 650, and 1100 mW/cm²), 2 distances of curing tip (0 and 8 mm), and 2 exposure times (20 and 40 seconds). The specimens were measured after scraping the uncured composite material according to the ISO 4049 standard. The depth of cure was calculated by dividing the length of the remaining composite by 2. Data were analyzed using: Levene's test and Multivariate Analysis-of-variance (MANOVA). The level of significance was set at P<0.05. Results: The highest depth of cure (3.332 mm) was observed for curing protocol 1100mW/cm²/0mm/40s. The lowest depth of cure had specimens cured with curing protocol 300 mW/cm²/8mm/20s (2.034mm). MANOVA showed a significant influence of the distance of the curing tip (P=0.014; P=0.001) regardless of light intensity and duration of exposure time. Exposure time was a significant factor (P=0.009) when cured from different distances. Although higher light intensity produced a higher depth of cure, light intensity was not a significant factor. Conclusions: The depth of cure can be increased by reducing the distance of the curing tip, when it is possible. At a distance of 8 mm, the depth of cure can be increased by a longer exposure time, regardless of curing light intensity.

Background: In aim to promote HPV vaccination among children and youth, the Institute for Public Health of the Federation of BiH in 2023 developed an HPV immunization program, furtherly accepted by the Federal Ministry of Health. In collaboration with WHO and UNFPA country offices, the Institute for Public Health of the Federation of BiH initiated education to emphasize the importance of improving the knowledge and skills for over 280 health professionals in effective communication with parents in the promotion of HPV vaccination. Methods and materials: Paper presents an analysis of results of the pre and post testing of the health professionals directly involved in the HPV vaccination process in the Federation of BiH, regarding their self-confidence in communication with parents about HPV vaccination. For data collection was used the questionnaire as a part of the WHO document "Communicating with caregivers about HPV vaccination: facilitator's guide" published in 2023. The questionnaire was created in Google Forms for health professionals who participated on training. For descriptive and inferential statistics of collected data used IBM SPSS20 package. Results: The data showed an increase in self-confidence of health professionals in communication with parents after completed training. Before training 32.5% of health professionals confirmed self-confidence in talking to parents about HPV vaccination while 68.0% of them after training. Self-confidence about adverse reactions after HPV vaccination is confirmed by 27.4% health professionals before training and by 64.4% of them after training. Conclusions: A systematic approach in improving the communication knowledge and skills of health professionals is significant support for increasement of the coverage and promotion of HPV vaccination.

The choice of steel depends on environmental factors like temperature, pressure, and chemical exposure. Steel components in machinery often face varying conditions that can lead to damage, such as cavitation erosion. In this study, steel 42CrMo4 samples were chosen to represent a common and widely used steel. Application of this type of steel is often related to the statically and dynamically stressed components for vehicles, engines, and machines, where corrosion or cavitation can occur. The behavior of steel samples under conditions of cavitation erosion in distilled water was the focus of this paper. Testing was performed using a standard cavitation vibratory setup using a stationary specimen, according to the ASTM G-32 procedure. Image and morphological analyses were implemented to quantify the level of sample degradation caused by cavitation. The observed changes in the monitored parameters during testing are linked to the degradation mechanism of cavitation erosion. The results showed that pits began forming within 60 minutes, and afterward, the growth and merging of these pits significantly impacted the degradation process.

Engineering materials are often exposed to various extremely harsh surroundings such as high temperatures and/or pressure, thermal shocks, aggressive solutions, or cavitation erosion. The phenomenon of cavitation erosion might be expected in conditions of fluid-flowing where the parts of equipment include turbine blades, high-speed propellers, or pump parts. Such conditions usually cause surface degradation with defects in the form of pits and fractures, resulting in strength deterioration with a potential risk of failure, as well as a reduction in the materials' lifespan that requires additional expenses for failure analysis, repair, and/or replacement of parts. This paper will present the main results regarding the study on cavitation erosion resistance of two different engineering materials, austenitic stainless steel 316L and CuAlNi shape memory alloy (SMA). Cavitation erosion testing was carried out using an ultrasonic vibratory method with a stationary sample. The comparison of the behavior between these two materials in cavitation erosion conditions will be shown based on the results of mass loss and analysis of the pits formed over time. Using image analysis tools, the surface damage levels were quantified. Detailed analyses revealed that CuAlNi shape memory alloy (SMA) exhibited superior in terms of resistance and behavior compared to stainless steel.

Numerous industrial equipment are designed to withstand harsh operating conditions that among others include cavitation erosion. This study examined the cavitation erosion behavior of mullite, a common material used in furnace linings and casting processes such as Lost Foam which is a novel way to produce castings offering both high quality and reasonably priced. The ultrasonic vibratory method with a stationary sample was employed to achieve cavitation erosion, while image analysis was used to measure the degree of surface deterioration. This study aimed to assess the lifetime of mullite under cavitation exposure by quantifying the morphological parameters of the defects through image analysis and by monitoring material behavior. The obtained results were discussed and analyzed in order to understand degradation mechanisms and sample resistance to cavitation erosion. The results demonstrate that mullite is highly resistant to cavitation, as the volume loss is minimal and the surface degradation is below 6% after 180 minutes of exposure.

Many steels are used in specific environments, while one of these is maritime applications. High-strength 42CrMo4 steel finds numerous applications in the marine industry, including shaft parts, crankshafts, connecting rods, drilling joints, pump parts, steam turbines, and salvage equipment. In order to provide performance reliability in the marine environment, it is essential to study the corrosion resistance of surfaces of 42CrMo4 steel components and parts. The steel's behavior is typically evaluated in a synthetic NaCl solution, which is prepared as a standard substitute for seawater. This paper is focused on the behavior of the steel samples under corrosion conditions in NaCl solution. The level of sample surface degradation which is caused by the corrosion over a 4-month exposure period was evaluated using SEM/EDS analysis. The mass loss increased during the testing period, following an almost linear model in all time periods.