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Aim To investigate a profile of patients with peripheral artery disease (PAD) in Bosnia and Herzegovina. Methods This observational study included 1022 patients hospitalized at the Clinical Centre University of Sarajevo in a 5-year period, 2015 to 2019. Results Disease prevalence rises sharply after the age of 50. Most patients, 797 (78%) had proximal PAD; 658 (64.4%) were males. The death occurred in 73 (7.1%) patients, more often in females (66- 10%), and in patients with chronic kidney disease (10- 23.8%). Amputation occurred in 153 (15%) patients, where 102 (66.7%) patients had diabetes. Other surgical procedures were more common in males and smokers. Necrosis and phlegmon on lower extremities were found in 563 (55.1%) and 43 (4.2%) patients, respectively. History of tobacco use was noted in 620 (60.2%) patients, and 414 (40.8%) patients were current smokers. More than a half of patients had hypertension and diabetes, 596 (58.3%) and 513 (50.2%), respectively. One in 10 patients had a history of myocardial infarction or stroke. Most patients had high fibrinogen and blood glucose and low high-density lipoprotein (HDL). Conclusion Patients with PAD have multiple comorbidities and risk for various complications. Primary and secondary prevention of risk factors is the mainstay of treatment.

Background: Although scientometry gradually became prevalent way of measuring one’s research output, there are many inherent drawbacks in main indices that are used: impact factor, number of citations, number of published papers and Hirsch’s index. Objective: The aim of this study was to analyze effects of inflated co-authorship on values of scientometric indices among authors in biomedicine who participated in published papers with more than 30 co-authors. Methods: The study was of cross-sectional type, based on 100 publications randomly extracted from the MEDLINE database. The inclusion criterion was publication with more than 30 authors. The studies with topics not related to humans were excluded from further analysis. Results: On average about 10% of papers published by the surveyed authors had more than 30 co-authors, but these papers brought more than 40% of all citations and more than 40% of Hirsch’s index attributed to these authors. The duration of scientific activity was well correlated to number of citations, Hirsch’s index and the number of publications themselves with 30 or less co-authors, while the correlation did not exist with number of citations, Hirsch’s index and the number of publications with more than 30 authors. In summary, publications with > 30 authors carry more scientometric points than publications with less co-authors, and the researchers with shorter scientific activity had larger scientometric benefit from publications with more than 30 authors than senior researchers. Conclusion: Unjustified and prolific co-authorship is one of methods for inflation of scientometric indices that are not further reflecting true quality of research output of an individual. Further improvement of scientometric indicators may prevent unjustified co-authorship if it reflects the work invested in a research result.

Background: Previous pandemic and catastrophic events significantly changed the life of every human being, bringing him/her into a state of stress and the need to quickly adapt to new ways of daily activity. COVID-19 has a negative impact on all elements of health: social, physical and mental. Pharmacotherapy, as well as protective measures (isolation, wearing masks and maintaining physical distance) did not give the expected results. Vaccination has not yet led to herd immunity, so it is still jeopardizing every aspect of human health (1, 2). Non-pharmacological methods, such as stress and sleep control, physical activity and contact with nature are of great importance since they can significantly contribute to staying healthy during a pandemic. Objectives: The aim of this paper is to evaluate the impact of non-pharmacological measures such as stress and sleep control (with different measures against the negative effects of anxiety and depression on mental state) and the possible positive impact of “forest bathing” on improving the immune response to the virus and its consequences. Methods: Available evidence-based studies on ways to com- bat stress and the effect of the proposed measures on human mental health and the im- mune system were analyzed. From the mentioned studies, recommended measures have been registered, which refer to stress and sleep control, diet and eating habits, contact with nature (“forest bathing”, gardening), virtual communication and meditation (mindfulness practice). Results and Discussion: The combined results of these studies indicate that COVID-19 has a chronic course and complications that significantly affect the physical, mental and emotional state of the patient. Proven positive effects of non-pharmacological measures can be applied in the daily practice of primary health care in the comprehensive fight against the COVID-19 pandemic. Conclusion: Non-pharmacological measures such as stress and sleep control, spending time in nature, healthy diet, and physical activity may improve the immune response to COVID-19. These measures, with their positive effects on all aspects of health, can make a major contribution to controlling and improving the quality of life during the COVID-19 pandemic.

Amaç: İnterlökin-6’nın (IL-6) periodontal hastalık patogenezi ve periodontal doku yıkımındaki rolü geniş çapta ele alınmıştır. Çalışmanın amacı, evre IV periodontitis hastalarının tükürüklerindeki IL-6 seviyelerini değerlendirmektir. Gereç ve Yöntemler: Araştırmaya evre IV periodontitis teşhisi konulan 28 hasta ile 22 hastadan oluşan kontrol grubu dahil edildi. Hastaların tümü sistemik olarak sağlıklıydı. Tükürük örnekleri toplandı ve sondalama derinliği (SD), klinik ataşman seviyesi (KAS), papil kanama indeksi (PKİ), sondalamada kanama yüzdesi (SK %), plak indeksi (Pİ) ve diştaşı indeksini (Dİ) içeren klinik periodontal ölçümler kaydedildi. Her bir hastanın uyarılmamış tükürükleri, tükürük toplayıcı ile toplandı ve örneklerdeki IL-6 seviyesi enzim bağlı immünosorbent testi ile analiz edildi. Bulgular: Evre IV periodontitis hastalarının ortalama IL-6 değeri 22,18±5,96 pg/mL idi. Kontrol grubunun ortalama IL-6 değeri ise 2,23±2,17 pg/mL idi. Periodontitis Objective: The role of interleukin-6 (IL-6) in the pathogenesis of periodontal disease and tissue destruction at the periodontal site has been widely reported. This study aimed to evaluate the salivary IL-6 levels in patients with stage IV periodontitis. Materials and Methods: The study included 28 patients who were diagnosed with periodontitis stage IV and the control group of 22 periodontally healthy patients. All the patients were systemically healthy. Saliva samples were collected, and clinical periodontal measurements, including probing depth (PD), clinical attachment level (CAL), papilla bleeding index (PBI), the percentage of sites with bleeding on probing (BOP) %, plaque index (PI) and calculus index (CI), were recorded. The unstimulated saliva of each patient was collected by a saliva collector, and all samples were analysed using the enzyme-linked immunosorbent assay method for the detection of IL-6. Results: The mean value of salivary IL-6 in patients with periodontitis stage IV was 22.18±5.96 pg/mL. In the control group, the average measured value of IL-6 was 2.23±2.17 pg/mL. The periodontitis group had a significantly higher salivary IL-6 levels than the control group. A strong positive correlation was observed between the salivary IL-6 and clinical periodontal parameters (PD, CAL, PBI, BOP %, PI and CI) in patients with periodontitis stage IV (p<0.0001). Conclusion: We demonstrated a statistically significant relationship between periodontal parameters and salivary IL-6 in patients with periodontitis stage IV. New studies are needed to accurately establish salivary IL-6 potential as a biomarker for periodontal disease monitoring, including all stages and grades of periodontitis.

Aim To investigate the benefit of high-dose lipophilic statin therapy on cardiac remodelling, function and progression of heart failure (HF) in patients with ischemic heart disease. Methods A total of 80 patients with ischemic HF diagnosis were followed during 6 months, and they were divided in two groups. First group (n=40) was treated by high-dose lipophilic statin therapy (atorvastatin 40 mg) and conventional therapy for HF, while the second group (n=40) had no atorvastatin in the therapy. Results In the beginning of study, from all of the observed parameters, only the ratio of flow rates in early and late diastole (E/A ratio) differed between the test groups (p=0.007). After six months, a statistically significant increase in left ventricular end-diastolic diameter (LVIDD) in patients who had not been treated with atorvastatin was found. In the patients treated with atorvastatin, there was a significant reduction in basal right ventricle diameter in diastole and systole (p<0.001 and p<0.001, respectively), and in tricuspid annular plane systolic excursion (TAPSE) (p<0.001); there was a reduction in LVIDD (p<0.001), and an increase of ejection fraction of the left ventricle according to Teicholtz and Simpson (p<0.001 and p<0.001, respectively). Also, there was an increase of deceleration time of early diastolic velocity (DTE) (p<0.05) and a decrease of isovolumic relaxation time (IVRT) (p<0.001). Conclusion The reduction in the right and left ventricle diameters was noted after the six-month atorvastatin therapy. Atorvastatin in the therapy resulted in increased EFLV and better systolic function and should be a part of a therapeutic modality of HF.

Athletes who train in public places in urban and rural areas are just as attacked and injured by dogs of known owners as they are by dogs with no owners, in a relatively equal proportion. The largest number of bites occurs in the summer, what makes up half of all bites, just when sports activity is most pronounced. Athletes who are most often exposed to potential attacks and bites are cyclists, long-distance athletes, marathon runners, recreational athletes, etc. both during training and competitions. Off-road cyclists are at a significantly higher risk of dog attacks because cycling takes place off-road, that is, away from urban areas. Dog attacks can adversely affect the psycho-physical readiness of athletes. In Bosnia and Herzegovina there have been no cases of injuries to athletes recorded by competent medical institutions or umbrella sports associations. It is necessary to work on more efficient administration (registration and recording of attacks and bites of dogs). It is of utmost importance to educate athletes on dog behaviour, the reasons for their aggressive behaviour and causal mechanisms of dog attacks as well as the first aid education, what can have a great impact on reducing further complications.

Brigitte Fuchs, H. Tahirović

This short biography traces the life and medical activities of Rosalie Sattler, née Feuerstein (1883-19??), who was employed as an official female physician at the Austro-Hungarian (AH) provincial public health department in Sarajevo from 1914-1919. Born in 1883 into a Jewish middle-class family in Chernivtsi (then Czernowitz), Ukraine, in Bukovina, the easternmost province in Austria, Feuerstein moved to Vienna in 1904 to study medicine. After earning her MD from Vienna University in 1909, she started her career as an assistant physician at the Kaiser Franz Josef Hospital in Vienna. In spring 1912, Feuerstein moved to Sarajevo to work as an intern at the local provincial hospital (Landeskrankenhaus). In the same year, she married AH district physician Moritz Sattler (1873-1927) in Vienna. In 1914, Sattler-Feuerstein successfully applied to be an AH official female physician in Bosnia. She was an employee of the provincial public health department in Sarajevo and never functioned as an official female physician in the sense of the relevant AH service ordinance. After the collapse of the monarchy, Sattler-Feuerstein continued to be employed as an official female physician of the Kingdom of Serbs, Croats, and Slovenes. She resigned from service in 1919 and established herself as a private general practitioner in Sarajevo with her husband, who had also resigned as an official physician and started to practice privately at that point. Widowed in 1927, she left Sarajevo for an unknown destination, likely in 1938-1939, and vanished from historical records. CONCLUSION: Rosalie Sattler-Feuerstein (1883-19??) came to Bosnia as the eighth AH official female physician and worked as an employee of the AH provincial public health department in Sarajevo from 1914-1919, after which she practiced as a private physician in Sarajevo for more than 25 years.

Sunčica Poček, Z. Milošević, N. Lakicevic, Kristina Pantelić-Babić, Milka Imbronjev, E. Thomas, A. Bianco, P. Drid

Although absolute jump heights should be considered an important factor in judging the performance requirements of volleyball players, limited data is available on age-appropriate categories. The purpose of this study is to determine the differences in specific anthropometric characteristics and jumping performance variables in under−19 female volleyball players in relation to playing position and performance level. The sample of subjects consisted of 354 players who prepared for the U19 Women’s Volleyball European Championship 2020 (17.4 ± 0.8 years, 1.81 ± 0.07 m, 67.5 ± 7.1 kg). Playing positions analyzed were setters (n = 55), opposites (n = 37), middle blockers (n = 82), outside hitters (n = 137), and liberos (n = 43). The results showed player position differences in every performance level group in variables of body height, spike, and block jump. Observed differences are a consequence of highly specific tasks of different positions in the composition of the team. Players of different performance levels are significantly different, with athletes of higher-ranked teams achieving better results. The acquired data could be useful for the selection and profiling of young volleyball players.

Adriana Haller, A. Haller, Dejan Tirić, V. Tomić

Aim To evaluate satisfaction of mothers who gave birth at term with received hospital care and to find areas for improvement at a tertiary hospital. Methods A cross-sectional study at the Department of Obstetrics & Gynaecology at the University Clinical Hospital Mostar was conducted by an anonymous survey using a questionnaire designed exclusively for this study. A total of 100 mothers were included in the study. Results Satisfaction with midwives' communication and their approach to the women during their stay in the delivery room was rated significantly higher (4.7±0.6) when compared to obstetricians-gynaecologists (4.5±0.8) (p=0.02). Midwives were rated better in providing breastfeeding information (4.5±0.8) than for the speed of arrival after a call bell (average grade 4.2±1.0). Respondents were least satisfied with the hygiene (toilet, shower and rooms) and the quality of food (average grades 3.8±1.1 and 3.9±1.0, respectively). Mothers with previous experience in childbirth at the same hospital rated current stay with a similar level of satisfaction. Conclusion Good communication skills of medical and non-medical staff are a recommended step to maintain mothers' childbirth satisfaction, while improvement in quality of nutrition and hygiene should be mandatory.

A. H. Andersen, S. Santurette, M. Pedersen, E. Alickovic, L. Fiedler, Jesper Jensen, T. Behrens

Abstract Hearing aids continue to acquire increasingly sophisticated sound-processing features beyond basic amplification. On the one hand, these have the potential to add user benefit and allow for personalization. On the other hand, if such features are to benefit according to their potential, they require clinicians to be acquainted with both the underlying technologies and the specific fitting handles made available by the individual hearing aid manufacturers. Ensuring benefit from hearing aids in typical daily listening environments requires that the hearing aids handle sounds that interfere with communication, generically referred to as “noise.” With this aim, considerable efforts from both academia and industry have led to increasingly advanced algorithms that handle noise, typically using the principles of directional processing and postfiltering. This article provides an overview of the techniques used for noise reduction in modern hearing aids. First, classical techniques are covered as they are used in modern hearing aids. The discussion then shifts to how deep learning, a subfield of artificial intelligence, provides a radically different way of solving the noise problem. Finally, the results of several experiments are used to showcase the benefits of recent algorithmic advances in terms of signal-to-noise ratio, speech intelligibility, selective attention, and listening effort.

Zoran Matković, M. Zildžić

Background: Haematochesia (Lower Gastrointestinal Bleeding (LGIB) is the most common reason for endoscopic examination. Generaly it is caused by hemorrhoids and diverticular disease, but other anorectal conditions can also lead to LGIB. Recurrent bleeding may result in secondary iron deficiency anemia. Colonoscopy is the primary diagnostic option for establishing a diagnosis of colonic bleeding. Objective: This study aimed to analyze symptoms and endoscopic finding (specialy hemorrhoids) who may be sources of LGIB.Second goal of this study is to estimate time from onset of symptoms to performance of a colonoscopy. Methods: A retrospective study included 603 adult patients who underwent colonoscopy in General Hospital “Sv. Apostol Luka“, Doboj, Bosnia and Herzegovina, between 1.1.2020 and 31.12.2020. Results: Average age of the examined population was 62±13,3years. According to the gender they were mostly men. To be exact,by percentage it was 53.7% of men and 46,3% of women, or by number: 324 men and 279 women. The most common indications for colonoscopy were LGIB (48,8%), abdominal pain and irregular stool. Most frequent endoscopic findings were hemorrhoids 42%. Normal findings had almost one third of all examinated patients. Combined findings-presence of more clinical entities in one patient were presented in 95 cases. In the group with hemorrhoids were almost two thirds of males, but there was no gender difference noted in between group with LGIB and without LGIB. More than half patients were older than 61 years. Anemia was presented in almost 20% of cases. Significantly it is higher frequency of abdominal pain, irregular stool and weight loss observed on the group without LGIB. Also, significantly more frequently patients with LGIB underwent colonoscopy in 0-30 days when compared with patients without LGIB (p=0,016). Conclusion: In patients with haematochezia, taking a careful medical history is mandatory. Hemorrhoids, diverticular disease and colorectal cancers are the most common causes of bleeding. Patients with LGIB and abdominal pain were previously examined with colonoscopy. Completely colonoscopy is advocated to detect probable proximal lesions.

Aim To present the regulations governing the operation of pharmacies in Bosnia and Herzegovina over the Austro-Hungarian rule (1878-1918). Methods Qualitative secondary data analysis was used. Results The Austro-Hungarian government had found poor population's health, insufficient health facilities and qualified staff. For a long time, population was treated by old methods of medicine and pharmacy, and directed to folk doctors, healers and herbalists. As early as 1879, orders requesting mandatory possession of a university diploma to practice pharmacy and medicine, thus taking the initial steps to combat quackery. The production and dispensing of medicines became the exclusive competence of pharmacists. The Law on Pharmacies adopted in 1907 comprehensively regulated the apothecary activity. Pharmacy Gremium was founded, the first association of pharmacists with the task of protecting professional interests. All types of quackery were explicitly forbidden to pharmacy staff. Apothecary activity was regulated as a craft, not as a health activity. During this period, pharmacy became a regulated profession with educated and qualified personnel. The number of public pharmacies and qualified staff was growing. In 1878 only one graduated pharmacist was found, while in 1910 in 47 pharmacies there were 79 pharmacy staff. At the end of 1918, the masters of pharmacy were the owners of 48 pharmacies, in 38 cities. Conclusion All enacted regulations contributed to the development and improvement of the apothecary activity over the observed period, and laid the foundations for the future development of the profession.

Aim To analyse the resolution of chest X-ray findings in relation to laboratory parameters in patients infected with acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a two- month followup. Analysis of chest X-ray findings in the first few months after the disease is the main goal of our work. Methods Out of the total of 343 patients chest X-ray findings were followed in 269 patients. Patients were divided into groups according to the severity of findings. D-dimer, inflammatory markers, blood cell count, neutrophil lymphocyte ratio (NLR) were analysed. Chest X-ray was analysed during the hospitalization on the day of admission, on the third, the seventh and the fourteenth day (scoring method was used). After discharge chest X-ray was performed in a two-week follow-up, then after one and two months, and after three months if necessary. Results Incomplete chest X-ray resolution was identified in 24 (39.34%) patients with severe, 27 (22.31 %) patients with moderate and in three (3.91%) patients with mild findings. Statistical significance was established in overall score by comparison between all groups (p<0.001), and in the moderate compared to the mild group (p=0.0051). The difference of NLR in the severe compared to the moderate group was observed (p=0.0021) and in the severe group compared to the mild group (p=0.00013). Conclusion Chest X-ray findings persisted mostly in the severe group followed by the moderate and mild ones. Long-term followup is necessary for the appropriate treatment and prevention of fibrosis, and reduction of symptoms.

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