Introduction. The human voice is an important characteristic that enables the distinction of human from other living beings. Otherwise, it represents a picture of a person΄s personality, his health, mental and emotional state. The research aims are to determine the voice characteristics of vocal professionals with diagnosed vocal cord nodules by subjective voice assessment and objective voice measurement before and after vocal rehabilitation. Methods. This study has involved 25 examinees, aged 23 to 56. The subjective voice assessment was conducted with the Voice Handicap Index - VHI questionnaire and the objective voice measurement by a computerized laboratory for voice analysis ''Kay Elemetrics''. The obtained data were processed using descriptive and analytical statistics. Results. Before the vocal rehabilitation and the subjective and objective voice measurements, the examinees had greater psychosocial difficulties associated with their voice quality. After two months of vocal rehabilitation, there has been a significant improvement in the voice of all subjects on the VHI scale. A statistically significant and highly statistically significant improvement have been noticed in six out of seven analyzed parameters of vocal A, by the objective measurement of voice. Namely, the obtained values - the percentage of jitter Jitt (%), the percentage of shimmer Shim (%), the relative average perturbation value RAP (%) and the coefficient of fundamental frequency variation - vFo were highly statistically significant (p < 0.01). The VTI - voice turbulence index and the SPI - soft phonation index also improved, the observed difference was statistically significant (p < 0.05), while the observed difference in the FTRI parameter was not statistically significant (p > 0.05). Conclusion. Vocal rehabilitation has influenced the improvement of the voice quality, which means that the results obtained by objective voice measurements were more in accordance with the results of the subjective voice assessment.

Background/Aim: Antibiotic use and resistance represent a growing public health issue, with a specific risk of uncontrolled use of antibiotics in children. The aim of the study was to examine differences in parental knowledge, attitudes and practices about antibiotic use in children between urban and rural areas of the Republic of Srpska. Methods: A cross-sectional study was conducted among 1459 parents of children under 6 years of age, out of which 1201 (82.3 %) lived in urban areas while 258 (17.7 %) lived in rural areas. The research is conducted among parents who brought their children to the selected primary healthcare centres and among parents of children in preschool institutions. Results: The majority of respondents (98.4 %) state that doctors are their main source of information. Only 61.2 % of respondents precisely know which drug is an antibiotic when offered different drugs and respondents from rural areas (54.3 %) more often (p = 0.012) gave more accurate answers when compared to respondents from urban areas (37.3 %). Among parents, 86 % agree with the statement that improper use of antibiotics reduces their effectiveness and leads to bacterial resistance, regardless of groups. More than a half of respondents (52.4 %) do not think that children with flu or common cold symptoms recover faster when they receive antibiotics, significantly more respondents from urban areas (p = 0.001). Respondents from rural areas significantly more often believe that antibiotics can produce harmful effects compared to respondents from urban areas (p = 0.049). Respondents from rural areas significantly more often think that antibiotic use can prevent complications caused by inflammation of the upper respiratory tract (p = 0.006). Parents from rural areas give their children antibiotics without a paediatrician's recommendation significantly more often (4.3 %) compared to respondents from urban areas (0.6 %) (p < 0.001). Conclusion: There are differences in parental knowledge, attitudes and practices regarding antibiotic use and antimicrobial resistance among parents in rural and urban areas. There is need for additional education of parents and for greater engagement of paediatricians in providing guidance and explanations regarding the use of antibiotics.

According to the World Health Organization (WHO) and the International Society for Hypertension, elevated blood pressure is defined as the blood pressure the readings of which consistently range ≥140 mmHg systolic and/or 90 mmHg diastolic. Having in mind the fact that hypertension is one of the leading risk factors for cardiovasluar disease, kidney failure and premature mortality, it is clear that preventive measures should be imposed before the diagnosis is established. The main nutritional measures used in preventing hypertension are: weight loss, Dietary Approaches to Stop Hypertension (DASH diet), reducing salt and alcohol intake and increasing potassium intake. The aim of this paper was to show the preventive effect of the DASH diet on hypertension onset in normotensive patients as well as to highlight that the diet is an integral part of hypertension treatment, in addition to the use of drug therapy for hypertensive patients.

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Our aim was to determine the prevalence of potential drug-drug interactions (pDDIs) and to identify relevant factors associated with the occurrence of the most dangerous or contraindicated pDDIs (pCDDIs) in hospitalized patients with spontaneous intracerebral hemorrhage (sICH). A retrospective cross-sectional study was performed enrolling all consecutive patients with sICH treated at the Neurological Intensive Care Unit, Clinical Center in Kragujevac, Serbia, during the three-year period (2012-2014). The inclusion criteria encompassed patients aged 18 years and over, those diagnosed with ICH, and those prescribed at least two drugs during hospitalization, while we did not include patients whose hospitalization lasted less than 7 days, those who were diagnosed with other neurological diseases and patients with incomplete medical files. For each day of hospitalization, the online checker Micromedex® software was used to identify pDDIs and classify them according to severity. A total of 110 participants were analysed. A high prevalence of pDDIs (98.2%) was observed. The median number of pDDIs regardless of severity, was 8.00 (IQR 4.75-13.00;1-30). The pairs of drugs involving cardiovascular medicines were the most commonly identified pDDIs. Twenty percent of the total number of participants was exposed to pCDDIs. The use of multiple drugs from different pharmacological-chemical subgroups and the prescribing of anticoagulant therapy significantly increase the chance of pCDDI (aOR with 95% CI 1.19 (1.05-1.35) and 7.40 (1.13-48.96), respectively). This study indicates a high prevalence of pDDIs and pCDDIs in patients with sICH. The use of anticoagulant therapy appears to be the only modifiable clinically relevant predictor of pCDDIs.

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Introduction: Laboratory and anthropometric parameters for assessing lipid metabolism disorders are important for atherogenesis and the occurrence of cardiovascular disease. Material and Methods: The study was designed as a prospective longitudinal study, meant to assess the risk of cardiovascular disease, which included initial measurement of lipid status, CRP, and BMI, and repeated measurement after DASH diet and exercise. It was conducted on a sample of 60 female respondents. Results: Following the WHO categorization of BMI, the study found that 62% of respondents were overweight, 26% were obese, and only 12% of respondents were at ideal body weight. After the DASH diet and exercise program, the average value of BMI M = 27.02 was established. Analyzing the values of the CASTELLI 1 index in 95.9% of respondents, high values of M = 5.3 were observed, which indicates a high risk of CVD. The study results indicate that the average value of cholesterol, triglycerides, LDL-C significantly reduced after two months of adherence to the DASH diet and exercise. With the help of Spearman’s rank, the correlation coefficient indicated the existence of a positive relationship between the CASTELLI 1 index and total cholesterol, triglycerides and HDL-C. In the initial analysis, CRP had a high value (M = 10 mg/L). In contrast, after the program, the CRP value decreased to (M = 4 mg/L), and a significant negative correlation (p <0.01) was observed between CRP and HDL-C, indicating that HDL-C value as a protective lipoprotein for blood vessels increased. CRP decreased after two months of DASH diet and exercise. Conclusion: With this research, we aim to draw attention to the importance of promoting healthy lifestyles and creating adequate risk assessment models with a well-developed strategy that will include anthropometric, laboratory and other multidisciplinary aspects to combat cardiovascular

Objectives: Improved serological detection of specific antibodies against SARS-CoV-2 could help estimate the true number of infections. Methods: A total of 443 serum samples provided by unvaccinated patients of all ages with unknown COVID-19 status that were originally submitted for routine screening or clinical management from outpatient laboratory during the March–April 2021 (third wave) were collected. Seroprevalence of IgM/IgG antibodies was determined by lateral flow immunoassay (Tigsun, Beijing, China). Results: Among 443 serum samples, 186 (42.0%) were positive (incidence of 5.2/1000) with slight predominace of females, 104 (55.9%), highest seropositivity in 25–50 and 51–64 years age groups, 61 (32.8%) and 57 (30.6%), respectively (P < 0.05); rural population was more prevalent, 101 (54.3%) (P < 0.05) and active workers, 86 (41.1%). Almost equal number of patients was with or without symptoms, 48.4% and 51.6%, respectively. For the comparison, in the same period it was registered 296 (out of 855; 34.6%) PCR SARS-CoV-19 positive persons (incidence of 8.2/1000) with the higher gender (females) and the highest age prevalence in 51–64 years age group (36.8%). In the period March 2020–June 2021, it was registered 804 (out of 3323; 24.2%) (incidence of 22.3/1000) PCR SARS-CoV-19 positive persons with no significant gender and significant age difference (25–50 and 51–64 years group, respectively). Conclusion: In the regions with high prevalence/incidence of SARS-CoV-2 in the general population (Bosnia and Herzegovina is on the World top on the number of deaths) seroprevalence measuring can help tracking the spread of disease.

Objective. Diabetes mellitus and arterial hypertension are chronic, mass non-communicable diseases that are global health problems with characteristics of epidemiology where complications of these diseases are the common reason for visual handicap and disability in the work productive population. The primary aim of this paper was to analyze the frequency of visual dysfunction, and behavioral habits in diabetic and hypertensive patients and the second aim was to analyze the occurrence of work disability in patients with these diseases. Methods. The research is a cross-sectional study made in two Health Centers in the City of Eastern Sarajevo in a period of July 2018 to July 2019 (12 months). 192 patients with diabetes and 100 patients with hypertension were selected using the random sampling method. A special questionnaire was created for this purpose, and statistic analysis was made by SPSS (IBM, Chicago version 19). Statistical significance was tested with ch2 test. Results. Diabetic patients significantly have more visual disturbances than hypertensive patients according to subjective assessment (ch2=14.21, p< 0.001). Worsening of visual acuity is presented more in diabetic than in hypertensive patients (ch2=6.17, p<0.001). There is no significant difference in behavioral habits between diabetic and hypertensive patients for smoking (ch2=1.778, p=0.411) and alcohol consumption.( ch2=2.158, p=0.142). Patients with diabetes are more frequent in the status of work disability than those with hypertension (ch2=13,46, p<0,001). Conclusion. Mass non-communicable diseases are a common cause of visual dysfunction. Diabetes mellitus is the main reason for visual disability in the adult population from the region of Eastern Sarajevo. Behavioral habits like smoking and alcohol consumption have a serious impact on the prognosis of those patients.

Background: Pretreatment differentiation between glioblastoma and metastasis is a frequently encountered dilemma in neurosurgical practice. Distinction is required for precise planning of resection or radiotherapy, and also for defining further diagnostic procedures. Morphology and spectroscopy imaging features are not specific and frequently overlap. This limitation of magnetic resonance imaging and magnetic resonance spectroscopy was the reason to initiate this study. The aim of the present study was to determine whether the dataset of diffusion tensor imaging metrics contains information which may be used for the distinction between primary and secondary intra-axial neoplasms. Methods: Two diffusion tensor imaging parameters were measured in 81 patients with an expansive, ring-enhancing, intra-axial lesion on standard magnetic resonance imaging (1.5 T system). All tumors were histologically verified glioblastoma or secondary deposit. For qualitative analysis, two regions of interest were defined: intratumoral and immediate peritumoral region (locations 1 and 2, respectively). Fractional anisotropy and mean difusivity values of both groups were compared. Additional test was performed to determine if there was a significant difference in mean values between two locations. Results: A statistically significant difference was found in fractional anisotropy values among two locations, with decreasing values in the direction of neoplastic infiltration, although such difference was not observed in fractional anisotropy values in the group with secondary tumors. Mean difusivity values did not appear helpful in differentiation between these two entities. In both groups there was no significant difference in mean difusivity values, neither in intratumoral nor in peritumoral location. Conclusion: The results of our study justify associating the diffusion tensor imaging technique to conventional morphologic magnetic resonance imaging as an additional diagnostic tool for the distinction between primary and secondary intra-axial lesions. Quantitative analysis of diffusion tensor imaging metric, in particular measurement of fractional anisotropy in peritumoral edema facilitates accurate diagnosis.