Background/Aim: Dehiscence of the colorectal anastomosis is one of the most serious complications in digestive surgery that is still present in a large percentage today, which significantly increases the cost of treatment and can lead to death. Due to all the above, early detection of anastomotic dehiscence is very important, as well as the decision on surgical treatment. Procalcitonin (PCT) is thought to be an important marker of inflammation and sepsis. Aim of this paper was to confirm PCT as a marker of great sensitivity in early diagnosis of anastomotic leakage. Methods: The study included patients who underwent surgery for colorectal cancer in the period from 2016 to 2020. Patients were operated according to an elective protocol and with an open surgical approach. In patients, PCT values were measured on the 2nd and 4th postoperative day (POD) to determine the association between elevated PCT values and the onset of dehiscence of the colorectal anastomosis. Results: A study was conducted in 118 patients in whom a stapler colorectal anastomosis was created. Colorectal anastomosis dehiscence occurred in 10 patients. In 4 patients with dehiscence, no re-surgical intervention was required, but they were taken care of by conservative methods. Repeated surgery was performed in 6 patients. In all patients with dehiscence, there was a multiple increase in the value of PCT above normal. Conclusion: PCT has high sensitivity and specificity (85 and 74 % respectively) as a marker in dehiscence of colorectal anastomosis. In this study it was found that PCT values were significantly correlated with the dehiscence of anastomo-sis 2nd POD and especially 4th POD.

Background/Aim: Breast-conserving surgery is a type of surgery used as a treatment option for breast cancer. It was introduced at the end of the 20th century following and in accordance with relevant clinical studies. With heightened public awareness of breast cancer and the introduction of new diagnostic procedures, despite the proven oncological safety of this type of surgery, a growing number of women choose to undergo total mastectomy. The aim of this study was to confirm the oncological safety of breast-conserving surgery performed on breast cancer patients at the University Clinical Centre of the Republic of Srpska. Methods: This study analysed 305 female patients with I and II stage of breast cancer, operated on between March 2009 and December 2013. One group of patients underwent breast-conserving surgery (BCS), followed by adjuvant radiation therapy and the other total mastectomy (MX). The patients were followed up for 5 years after the surgery. Analysed herein were the local-regional recurrence, distant metastases, disease-free survival and overall survival rates. Results: After a five-year follow-up, the local-regional recurrence rate for patients in the BCS group was 4.3 %, while for the MX group it was 4.2 %. The overall survival rate of patients in the BCS group was 90.9 %, as opposed to 89.1 % for MX patients. Conclusion: After a five-year follow-up, no statistically significant difference was observed between the two groups of patients regarding the local-regional recurrence (p = 0.967) and overall survival rates (p = 0.610). Breast-conserving surgery is an oncologically safe surgical treatment for breast cancer.

Determining the demographic characteristics of a person post-mortem is a fundamental task for forensic experts, and the dental system is a crucial source of those information. Those characteristics, namely age and sex, can reliably be determined. The mandible and individual teeth survive even the harshest conditions, making them a prime target for forensic analysis. Current methods in forensic odontology rely on time-consuming manual measurements and reference tables, many of which rely on the correct determination of the tooth type. This study thoroughly explores the applicability of deep learning for sex assessment, age estimation, and tooth type determination from x-ray images of individual teeth. A series of models that use state-of-the-art feature extraction architectures and attention have been trained and evaluated. Their hyperparameters have been explored and optimized using a combination of grid and random search, totaling over a thousand experiments and 14076 hours of GPU compute time. Our dataset contains 86495 individual tooth x-ray image samples, with a subset of 7630 images having additional information about tooth alterations. The best-performing models are fine-tuned, the impact of tooth alterations is analyzed, and model performance is compared to current methods in forensic odontology literature. We achieve an accuracy of 76.41% for sex assessment, a median absolute error of 4.94 years for age estimation, and an accuracy of 87.24% to 99.15% for tooth type determination. The constructed models are fully automated and fast, their results are reproducible, and the performance is equal to or better than current state-of-the-art methods in forensic odontology.

Background/Aim: Unintentional injuries among children and adolescents have become a common issue in public healthcare. The study objective was to analyse the characteristics and identify predictors associated with unintentional injuries in children and adolescents treated in emergency medical services (EMS) in the Republic of Srpska, Bosnia and Herzegovina. Methods: A cross-section study with retrospective analysis of WebMedic e-database from 14 EMS, in the period between January 2018 and December 2020 was conducted. Research included patients with unintentional injuries, aged ≤ 19 years, of both sexes. For comparison between groups, Chi-squared and multivariate logistic regression were used in risk factor analysis. Results: A total of 1,856 cases were identified, most injuries resulted from falls (46.7 %) and traffic injuries (26.9 %). Boys were significantly more affected by injuries than girls (p < 0.001). Falls were the major cause for reporting to EMS among age groups of children (0-9 years) and adolescents (10-14 years), whereas injuries in traffic were dominant in adolescents aged 15 to 19. The most common injuries were head injuries (35.7 %). Risk factors of unintentional injuries were age (p < 0.001), sex (p = 0.046), weekday (p = 0.016), winter (p = 0.014), body region (head, abdomen, lower and upper limbs (p < 0.001), thorax (p = 0.009)). Conclusions: There were significant differences in characteristics of unintentional injuries according to age and sex. Chances for occurrence of unintentional injuries among children increased with their age, especially for boys. These differences might indicate areas where preventive measures should be undertaken.

The research sample consisted of 43 first-year male students at the Faculty of Security Studies Banja Luka. This study was conducted to with the aim of determining the relationship between student self-assessment of motor skill performance and the results of the same obtained based on the application of appropriate tests for the assessment of students' motor status. The assessment of motor skills was performed through a battery of seven tests: maximum number of push-ups in 10 seconds (MSKL) - used to assess the dynamic strength of the arm and shoulder girdle, standing long jump (MSDM) - used to assess the explosive power of the lower extremities, agility with a stick (MOKP) - used to assess coordination, the maximum number of trunk lifts in 30 seconds (MPTR) - used to assess the dynamic strength of the trunk, hand tapping (MTAR) - used to assess the frequency of hand movements, forward roll - backward roll - running (MKNT) - used to assess agility, and the Cooper's 12-minute running test (MKUP) - used to assess aerobic endurance. For the self-assessment of motor skills, a constructed questionnaire with six responses was used: excellent (5), above average (4), average (3), below average (2), poor (1), and very poor (0). The obtained results showed a positive transfer of the Special Physical Education (SPE) curriculum to body coordination, agility, and the dynamic strength of the arm and shoulder girdle. Students' self-assessments of motor skills in the test for the assessment of trunk dynamic strength, dexterity and agility were excellent. The students provided poor self-assessments regarding the test for the assessment of explosive power of the lower extremities, speed, and the frequency of movement, the dynamic strength of the arm and shoulder girdle and body coordination. The students provided overestimated self-assessments in the aerobic endurance test. The obtained results indicate the need to enrich the teaching content of SPE, primarily in the area of motor skills aimed at the development of aerobic endurance, as well as the implementation of the self-assessment method in the same.

Introduction. Combustible tobacco smoking accounts for nearly 30% of all cancer deaths in the United States of America and about 7 million deaths worldwide each year. Nowadays, e-cigarettes are increasingly used, especially among young people, but nicotine addiction that develops by such smoking easily converts to smoking combustible tobacco. Therefore, public health efforts must be directed to the prevention of initiation of smoking all nicotine-containing products. Role of Physicians. Medical doctors are very influential in smoking-related changes in local society, especially those who work in primary care, and they have an important role in both prevention and cessation of tobacco smoking. Tobacco smoking should be eliminated among medical doctors, yet many of them still smoke. The lowest percentage of smoking among physicians is in Oceania and North America (less than 11%) and the highest in Eurasia (25%). Smoking prevalence among medical students is higher than 35% in Georgia, Greece, Spain, and Italy, but less than 5% in the United States of America and Australia. In Serbia, 23% of physicians smoke. The age of physicians does not affect the number of smokers, but gender has a significant effect; women smoke less than men. Smoking Prevention and Cessation. Education about the effects of combustible tobacco smoking is a critical issue for successful smoking prevention and cessation; the best way is to provide educational programs on smoking at medical schools by introducing a mandatory course on combustible tobacco smoking at the beginning of the first year of study, especially in societies with a large percentage of smokers. Conclusion. In this paper, we showed how smoking can be eliminated among physicians and how they can affect the patients, public health policies, and antismoking campaigns.

Let me explain the principle of bioassay. It is an analytical method for determination of the relative strength (concentration or potency) of a substance by comparing its effect on a test organism (living animal, cells or tissues) with that of a standard preparation. Bioassays are used in pharmacology mainly to determine the concentrations of hormones or drugs, eg biologically active peptides, acetylcholine, catecholamines, prostaglandins, histamine and prostacyclin. However, there are other forms of bioassay in which one can use isolated tissues and determine actions of their nerves, such as the nerve to the diaphragm from rats. Bioassays may also be done in vivo in individual humans. The assessment of drug effects in humans is designated by clinical pharmacologists as a clinical trial. Such trials often require hundreds or sometimes thousands of patients in order to test efficacy and safety of any new drug before it can be marketed. If the human investigations produce unexpected results, quite different of those obtained in the animal experiments the trials must be redesigned, to examine why and how this occurred. There are many examples of how such discoveries resulted in new clinically useful medications (eg, discovery antihypertensive effect of beta-adrenergic blocking agents).6 Accordingly, the pharmacologists have the bioassays, as a tool, which help them in the discovery process. I wrote on the renowned pharmacologist Professor Ervin G Erdös and his scientific opus in my reminiscence article written on the occasion of his death in 2019.1 When I attended the Fourth International Congress in Pharmacology in Basel in 1969, Dr Ervin G Erdös invited me to join his laboratory. Thus, in April 1970, I arrived in Oklahoma City as a Fulbright Fellow to work with him for two years. Later on, as a visiting scientist I frequently worked in his research laboratories in Dallas and Chicago and we shared research interests through visits across the Atlantic between the former Yugoslavia and the United States.2, 3

Tobacco smoking is a mental and behavioral disease. It causes significant pathology and premature death in more than seven million individuals a year around the globe. Because smoking is such important public health issue, the general public will benefit from targeted preventive strategies. Medical doctors have a vital role in smoking cessation of their patients. Non-smokers are more successful in this role than chronic smokers. Governmental regulation on smoking, as well as strict no-smoke policy in hospitals and university campuses will help not only medical students, other health workers and the general public to quit smoking and contribute to the general good health of this population. The aim of this comment is to analyse the current smoking habits of physicians and medical students and presents policies and other help to the medical students to stop tobacco smoking.

The promptness of providing services to patients directly affects the success of healthcare organizations. In this regard, the implementation of contemporary concepts in healthcare organizations is synonymous with success. Subject of research: The subject being researched in this paper is the possibility of applying the SIPOC method to the clinical process in obstetrics. A more precise application of the abovementioned method would mean a prompter implementation of activities within the clinical process (pregestational counseling, antenatal care of expectant mothers, deliveries, supervision of women during puerperium). Through the activities of the abovementioned clinical process, an effort is made to meet the health needs of expectant and new mothers. The application of the SIPOC method is not sufficiently present in clinical processes, especially the clinical process in obstetrics, and therefore this paper opens a new research area. Aim: The aim of this paper is to indicate the relevance of the SIPOC method as one of the tools within the Lean methodology, which can be used to improve the clinical process in obstetrics. Materials and methods: The following materials and methods were applied in this study: the method of analysis, the inductive - deductive method, the method of synthesis, the method of description, the method of proof. Case analysis was also used in the application of the SIPOC matrix at a gynecology and obstetrics outpatient clinic. Results: The results of the research showed that there was a positive impact on improving the efficiency of the provision of health services, through the implementation of modern methods. The SIPOC method affected the improvement of the efficiency of the clinical process in obstetrics. The review of the literature and the obtained results revealed that there is no formalized concept with instructions on the implementation of clinical process improvement methods.

Background / Aim: Hidradenitis suppurativa (HS) is a chronic inflammatory disease that most often affects apocrine gland-bearing areas of the skin. The treatment depends on the severity of the clinical presentation. The paper objective was to present new modalities in management and treatment of HS. Methods: The subjects in this research included the patients suffering from the severe form of HS, who were treated in the University Clinical Centre of the Republic of Srpska for the past three years. The effect of treatment of HS were monitored. In four patients, biologic therapy with adalimumab or adalimumab biosimilars was administered, while four patients received radiotherapy and 17 of them, were treated surgically. Depending on the type of treatment, the effects of therapy were monitored after 6-12 weeks by using clinical examination and by assessing the disease stage according to the Hurley staging. Due to a small number of subjects, especially in patients treated with biologic and radiotherapy, it was not possible to perform any statistical analysis and the results were presented by description, in tables and photographs. Results: Biologic therapy: Adalimumab was administered subcutaneously 80 mg, twice a month. After 12 weeks, in 4 patients was observed a regression of changes by 60-70 % when compared to previous skin changes. Radiotherapy: the total radiation dose was 5 Gy, distributed in 5 or 10 fractions. After 12 weeks an improvement by 60-70 % was observed. Surgical treatment: after 6-8 weeks, the patients were fully recovered. Conclusions: Application of biologic and radiotherapy after 12 weeks had similar results, ie it brought to regression of changes by 60-70 %. The best results were achieved after surgical treatment of HS.

Background/Aim: Sulphur mineral water is widely used in the treatment of musculoskeletal diseases. Hydrogen sulphide is an important regulator of bone metabolism and its application in the treatment of osteoporosis is intensively researched. The aim of this study was to analyse biochemical and histological effects of H2S containing mineral water of "Mlječanica" spring on ovariectomy-induced experimental osteoporosis in rats. Methods: In this experiment a 14-week-old Wistar female rats were used. The animals undergone bilateral ovariectomy (OVX groups) as an experimental model for oestrogen-deficient osteoporosis. After six weeks, animals were divided into control and the experimental group. Rats from the experimental group treated with H2S (SW group) containing mineral water ad libitum during five weeks. Biochemical parameters for monitoring sulphur water effects were concentration in serum of osteocalcin, alkaline phosphatase, calcium and phosphorus. Histological analyses of the left tibia coloured with haematoxylin-eosin were carried out. Results: Regarding the biochemical parameters, a statistically significant increase was observed in the OVX group for osteocalcin, alkaline phosphatase calcium and phosphorus compared to the sham-operated (CNT) group (p < 0.01). In SW + OVX, alkaline phosphatase was statistically significantly decreased (p < 0.01) and serum osteocalcin and phosphorus increased (p < 0.01). Calcium values were increased without significance. In the OVX + SW group, histological analyses showed numerous osteoblasts along the trabecular endosteum and the growth of young chondrocytes in the central bone zone and their migration to the peripheral parts. Conclusion: Drinking the H2S containing "Mlječanica" mineral water has led to decreased alkaline phosphatase, increased osteocalcin and phosphorus concentration in serum and stimulated the bone reparation in osteoporotic rats.

Protests among citizens of Bosnia and Herzegovina are becoming more frequent. Most often, their aim is to decry the dysfunctionality and opacity of the government, which are the result of the ethno-political structure created by the Dayton Agreement, but also a trend towards democratic regression and autocracy. A number of authors have tackled the ?JMBG? protests of 2013 and the Plenums that emerged from the February 2014 protests, from their particular disciplines. The focus of this paper is the social movement ?Justice for Dzenan,? organized by the Memic family upon the tragic death of Dzenan Memic in Sarajevo in February 2016. An in-depth study was conducted with key actors of the movement, as well as those who follow or in some way support the protests. Particular emphasis in the research was paid to the pragmatic symbiosis of the social movement and one political party. We argue that it is possible to identify a pragmatic symbiosis as a novel form (democratic innovation) of socio-political cooperation that can impede rising autocratization. Through the quest for accountability, social movements are introducing new strategic practices of mobilization and a novel type of alliance-building with external factors (new political parties as well as other social movements). The goal of the paper is to explore how the social movement ?Justice for Dzenan? interacts with political parties and approach the political sphere in BiH. Also, the idea is to examine the possibilities and functionality of this kind of cooperation with the framework of contentious politics.

Plant extracts are widely used as biofungicides and medical bioproducts because of their eco-friendly nature and cost effectiveness. The present investigation focuses on the activity of a solvent based on industrial hemp extracts against two phytopathogenic fungi and five human pathogenic bacteria. The present study suggests the potential of the industrial hemp extracts for the development of novel broad spectrum herbal formulations used in plant protection and medicine.

Using natural and modified Ca-bentonite as an adsorbent to observe a satisfactory trend in the removal of heavy metal ions As(V) and Hg(II) from simulated wastewaters. In this original scientific paper, Ca-bentonite was modified in two ways, thermally activated at a temperature of 300 °C for 3 hours and acid activated with HCl and H2SO4, molar concentrations 0,4 mol/L. Ca-bentonite used in this original scientific work was used from the Shipovo mine (Šipovo mine), Bosnia and Herzegovina and proved to be an excellent bioadsorbent for the removal of present ions from simulated wastewaters. Also this is eco-friendly adsorbent and low costed compared to other expensive adsorbents. Due to its chemical composition in which two oxides predominate, namely SiO2 (48.28 mass %) and Al2O3 (23.04 mass%), it can be concluded that Ca-bentonite from the Shipovo mine (Šipovo mine), Bosnia and Herzegovina belongs to the group of refractory materials. The highest removal efficiency of As(V) ions expressed in % was 75.11 at the initial concentration of 1.5 mg/L and was recorded using HCl acid-activated Ca-bentonite. The efficiency of Hg(II) ion removal was the highest using thermally activated Ca-bentonite and this value was 99.66% at an initial concentration of 1 mg/L.