Background: Out-of-hospital cardiac arrest (OHCA) refers to the cessation of mechanical cardiac activity outside healthcare facilities which requires prompt intervention and intensive resuscitative efforts. The COVID-19 pandemic has caused significant disruptions to OHCA systems-of-care, adversely affecting every component of the chain of survival. Objective: The objective of this study was to examine the potential impacts of the COVID-19 pandemic on OHCA events, to draw comparisons between the period before and during the COVID-19 pandemic. Methods: This cross-sectional study encompassed data pertaining to all OHCA incidents attended to by the Emergency Medical Service of Canton Sarajevo, covering the period from January 2017 to December 2022, before and during the COVID-19 pandemic. Results: During observed period, a total of 1418 [796 (56.1%) before and 622 (43.9%) during COVID-19 pandemic] OHCA events have occurred in Canton Sarajevo of which 297 (20.9 %) [180 (12.7%) before and 117 (8.2%) during COVID-19 pandemic] obtained ROSC. After a 30-day period following the ROSC) it was observed that the predominant outcome, accounting for 181 (12.7%) [106 (7.4%) before and 75 (5.2%) during COVID-19 pandemic] of cases, was a complete recovery. An examination before and during COVID-19 pandemic revealed a decline in OHCA during the year 2021 and 2022 when COVID-19 pandemic was at its highest in the country Being younger, quicker EMT response time and individuals with the initial rhythm of VF or VT were significantly associated with obtaining ROSC (p<0.05). Only 48 (3.3%) of 1418 OHCA events were assisted by bystanders There was no report of AED usage. Conclusion: In conclusion, our investigation highlights the impact of the COVID-19 pandemic on OHCA events in Canton Sarajevo, revealing a decrease in OHCA incidence and a reduction in cases achieving ROSC. Notably, EMT response time was shorter during the pandemic.

Obesity is a chronic, complex, relapsing disease impacting healthcare systems and the economy worldwide. We aim to analyze the utilization trends of antiobesity drugs, and their reimbursement status on drug lists of health insurance funds (HIF) in selected European countries. The DDD/1000 inhabitants/day methodology is used for utilization trend analysis, where data from official national utilization reports were used. For the reimbursement status analysis of 5 antiobesity drugs (orlistat, semaglutide, liraglutide, naltrexone/bupropion, setmelanotide), the websites of national health insurance funds (HIF) of 22 European countries were screened. Trend analysis revealed fluctuation for almost all antiobesity drugs (the highest decrease seen for orlistat in Serbia, and the highest increase for liraglutide in Croatia). Novel antiobesity drugs show an increasing utilization trend in almost all the countries. In two out of three European countries, 437 antiobesity drugs are not covered by the HIF. Slovenia and Denmark reimburse most of the antiobesity drugs. The Netherlands is the only country where the cost of setmelanotide is paid by the HIF. Our results emphasize the importance of prioritizing the introduction and implementation of new strategies and reimbursement scheme models in global and national antiobesity policies.

This paper proposes an ac fault ride-through (FRT) method for high-voltage dc (HVDC) transmission systems that serve as an interconnector between the onshore ac grid and an islanded offshore ac grid. In conventional HVDC systems for offshore wind farms FRT is realized by consuming excess power with braking resistors. However, the same method cannot be applied if the offshore ac grid includes not only wind farms but also various loads, which are being considered for integration into multipurpose interconnectors or energy islands. In this article, a novel FRT method based on voltage control for HVDC interconnectors operating with bidirectional power flow is proposed. The proposed method curtails the ac voltage formed by the offshore converter according to the converter’s dc current and voltage. The effectiveness of the proposed FRT method is established through experiments on a mini model.

Background: The term stress refers to the internal state of the organism (sometimes labeled as "load"), an external event ("stressor"), an experience created by the transaction of a person and the environment. Stress is an extremely used term in all areas of human activity. It is a natural phenomenon and a companion of mankind since its very existence. Although a large number of professional and scientific articles related to the concept of stress and reaction to stress have been published during the last 60 years, various authors state that not all concepts are clearly and unambiguously defined in this field. Objective: The aim of this paper is to present different theories of stress and to familiarize the reader about the consequences of everyday stress on human health. Methods: The subject of research is stress and its impact on health in today's modern world. The type of research on this topic is based on a retrospective and descriptive method based on the use of published articles in the PubMed and Scopus index databases. Results and Discussion: Therefore, different theories of stress define differently the concept of stress, reactions to stress, coping with stress and the consequences of a stressful event. Studies on stress was started by Hans Selye in the thirties of the 20th century. Understanding stress as the organism's reaction to various physical and physiological stressors, Selye also became the originator of the first, so-called of the reductionist model in the study of stress. Another theoretical approach in the concepts of stress boils down to the explanation that stress is determined by the nature of the stressor. This paradigm has been offered since the late sixties of the 20th century and is called the interactionist model of stress. At the same time as the interactionist model, a third, transactional model in the study of stress appeared, created by Richard Lazarus. According to this model, the consequences of a stressful transaction are the result of the interplay of personal and external factors that continuously affect each other. Conclusion: The stress is a state in which the psychophysical balance of the organism is disturbed and which, in order to adapt, requires additional efforts. Circumstances that cause stress are also called stressors. Among the psychological changes characteristic of stress, the most pronounced are changes in the sphere of emotional processes. Emotional reactions characteristic of stress are most often anxiety, anger and sadness, and shame, guilt, oversaturation can also occur. After a traumatic or other intense stress (related to losses or diagnosed with an incurable disease), emotional flattening can occur. Changes in psychological functioning during stress can be so intense that they take on the dimensions of a psychological crisis.

Background/Aim: Until March 2023, it has been reported over 676 million cases of COVID-19 globally with almost 7 million deaths caused by this disease. Aim of this study was to determine COVID-19-related deaths and to study how COVID-19 pandemic impacted mortality of residents in the Canton of Sarajevo in 2020-2022 time period. Also, aim was to analyse to what extent the number of registered non-COVID-19-related deaths have changed in the Canton of Sarajevo compared to what would have been expected in the absence of the virus to better measure the impact of COVID-19. Methods: This study used mortality data obtained from Federal Institute for Statistics for period 2017-2022. Data was analysed and presented as raw numbers, age-, sex-, cause of death - crude death rates (CDR), excess mortality and P-score. Results: CDR in the Canton of Sarajevo in 2020 was 1246.3 per 100.000 persons, 1488.6 in 2021 and 1153.4 in 2022, while in period from 2017-2019 CDR ranged from 1051.3 to 1057.9. Total CDR in 2020 increased by 18.3 % compared to 2017-2019 average CDR, this relative difference being even greater in 2021 (41.3 %) and lower in 2022 (9.5 %). In 2020-2022 time period, 9 of the 10 leading causes of death remained the same as in 2019. COVID-19 was the 3rd leading cause of death in 2020 and 2022, while in 2021 spiked as the leading cause of death. In 2020 there was increase of 7 % in deaths from non-COVID-19 related deaths compared to mean number of deaths for period 2017-2019. As for 2021, this number goes higher (9.5 %) and in 2022 was much lower (1.0 %). Conclusion: In the Canton of Sarajevo, COVID-19 pandemic made a big impact on mortality in 2020-2022 years period. Data have changed in total mortality, leading causes of death and excess mortality. Deep-rooted organisational weaknesses that were exposed during pandemic that can bring harm to population from preventable chronic diseases needs to be addressed which have impact on morbidity and at the end, on mortality.

Background: Thyroid dysfunction includes hyper- and hypofunction of the thyroid gland (hyperthyroidism and hypothyroidism). The spectrum encompasses both subclinical and clinical disease presentation. The etiology is vast and varied, as are the risk factors and simptoms. Objective: The main aim of the research is to indicate the leading symptom for initial thyroid hormone status evaluation, as well as to identify the distribution of positive and negative test results, and specific disorders according to sex and age groups. Methods: The research is designed as a retrospective, clinical, descriptive study. There were 500 participants included, 355 female and 145 male. Patients were referred to the Department of endocrinology by their primary care physicians. The data was collected through patient documentation. Results: The study included 500 participants, 71% of diagnostic requests made were for women. 80% of subjects had normal thyroid hormone status, p<0.001. Most requests were made for the 41-60 age group, p<0.001. Women had similar number of positive and negative test outcomes, as well as men. When it comes to the age groups, outcomes were similar in all of them, 15-23% positive and 77-85% negative. There were significant differences in the type of symptom expressed in both men and women, as well as all the age groups. Men reported high blood pressure as the most common symptom (30.3%), while women reported weight gain (22.3%). In the 18-25 and 26-40 age groups most common symptom belongs to the category of other. Age group of 41-60 reported weight gain as the most common symptom, while in participants older than 60, high blood pressure is proven to be the most common. Hypothyroidism is the most common disorder in both men and women, as well as in all age groups. Conclusion: It is statistically proven that there were more requests made for women, and older age groups. Leading symptom for initial thyroid hormone status evaluation is high blood pressure. There is no statistically significant difference in distribution of thyroid disorders according to sex or age groups.