Purpose Myasthenia gravis (MG) and amyotrophic lateral sclerosis (ALS) are two different diseases. The coexistence of both of them is extremely rare and represents a diagnostic challenge which requires thoughtful interpretation of clinical characteristics. Case report We present the case of a 46-year-old Bosnian male who developed ALS five months after MG. Diagnosis of MG was based on elevated titers of anti-AchR antibodies, positive edrophonium test, and decremental responses on a repetitive nerve stimulation test while the diagnosis of ALS was based on clinical and neurophysiological findings: upper motor neuron signs in the lumbar region, lower motor neuron signs in the bulbar and cervical regions, generalized fasciculations and muscle atrophy and progressive asymetric muscle weakness together with active and chronic denervation in the cervical and lumbosacral region determined by electromyoneurography. Conclusions The coexistence of MG and ALS is rare and request an adequate interpretation of clinical symptoms. The relationship between these two diseases in as interesting phenomen to present.

Neonatal screening (NBS) was initiated in Europe during the 1960s with the screening for phenylketonuria. The panel of screened disorders (“conditions”) then gradually expanded, with a boost in the late 1990s with the introduction of tandem mass spectrometry (MS/MS), making it possible to screen for 40–50 conditions using a single blood spot. The most recent additions to screening programmes (screening for cystic fibrosis, severe combined immunodeficiency and spinal muscular atrophy) were assisted by or realised through the introduction of molecular technologies. For this survey, we collected data from 51 European countries. We report the developments between 2010 and 2020 and highlight the achievements reached with the progress made in this period. We also identify areas where further progress can be made, mainly by exchanging knowledge and learning from experiences in neighbouring countries. Between 2010 and 2020, most NBS programmes in geographical Europe matured considerably, both in terms of methodology (modernised) and with regard to the panel of conditions screened (expanded). These developments indicate that more collaboration in Europe through European organisations is gaining momentum. We can only accomplish the timely detection of newborn infants potentially suffering from one of the many rare diseases and take appropriate action by working together.

Nowadays, the flour-based confectionery industry is facing different challenges in reducing caloric and increasing nutritive values in order to produce healthier products, given that consumption of flour-based confectionery products has been growing steadily worldwide. In addition to wheat flour, these products include sugar and fat, which contribute to high energy value, but have few micronutrients and are mostly poor in nutritional terms. Due to frequency of consumption, they can harm a balanced diet, especially when it comes to children and young people. Flour-based confectionery is highly suitable for enrichment with ingredients that have pronounced functional properties. In this sense, the text offers some possibilities for improving such products through different approaches and presents new trends in developing functional, flour-based confectionery by using different supplements that could decrease caloric value, improve nutritional and non-nutritional values and develop products with pronounced functional properties.

Abstract More than 30 dog parasite species have been identified in Bosnia and Herzegovina so far, and half of these are zoonotic. The aim of the study was to investigate the occurrence of parasitic infections in dogs from Bosnian-podrinje canton with a focus on zoonotic parasites. The study included 212 dogs (107 owned and 105 stray). One or more of the twenty parasite species were found in 82.55% of tested samples. Dicrocoelium dendriticum (Class Trematoda) was found in 0.94% of dogs. Dipylidium caninum and Mesocestoides lineatus (Class Cestoda) were found in 7.55% and 0.94% of dogs, respectively. Taenia spp. and Echinococcus spp. (Family Taeniidae) were found in 0.47% and 0.94% of samples, respectively. In the family of Nematoda, the following parasite species were identified with corresponding percent among tested dogs: Toxocara canis (25.94%), Toxascaris leonine (8.96%), Strongyloides stercoralis (0.47%), Ancylostoma caninum (3.77%), Uncinaria stenocephala (52.36%), Trichuris vulpis (22.17%), Eucoleus aerophilus (1.42%), Dirofilaria immitis (1.89%) and Dirofilaria repens (1.42%). In the kingdom of Protozoa, the following parasite species were identified with corresponding percent among tested dogs: Cystoisospora canis (8.49%), C. ohioensis (2.36%), Cryptosporidium spp. (4.72%), Sarcocystis spp. (0.47%), Babesia spp. (5.19%), and Giardia duodenalis (15.57%). Leishmania infantum was not identified in tested samples. The results showed a high level of parasitic infestation in the dog population in the Bosnian-Podrinje canton, with a high occurrence of zoonotic parasites. Significant differences were found between owned and stray dogs for all classes of detected parasites with exception of the class Trematoda, disregarding specific parasite species.

Background: In postmenopause there are changes in metabolism of bone tissue and consequent decrease of bone density. With ageing redistribution of fat occurs and an increase in body weight. Because of hormone changes in postmenopause fat is redistributed from gluteofemoral area to the abdominal region. Objective: The objective of this study was to examine the relationship between bone density and a body mass index (BMI), and distribution of the fat tissue in women in postmenopause (WHR). Methods: This research was prospective, and it included total of 83 women, 53 women were in the natural postmenopause and 30 women with the regular menstruation. Results: BMI in women in postmenopause was statistically significantly higher than BMI in women with the regular menstruations (p= 0,005). There was no statistically significant difference between waist hip ratio in women in the postmenopause in relation to the women with the regular menstruations. In women in the postmenopause significant positive correlation between BMI and density of the neck of femur was found (Z and T-score) (p=0,019; p=0,005). There was also significant negative correlation between the WHR and density of the lumbal spine (backbone) in women in the postmenopause (Z-score) (p=0,043). The identical analysis in women with regular menstruations, negative correlation between the density of the lumbal spine was found again (Z-score) and WHR , but the same was highly expressed (p=0,041). The observed correlation between BMI and bone density in this group of women was not statistically significant. Conclusion: Based on the presented results we conclude that the higher the BMI (p=0,019; p=0,005) the higher density of the femoral neck postmenopausal women have, and lower bone density of the lumbar spine the higher ratio waist / hip (p = 0.043). In the women with regular menstruation bone density of the lumbar spine is the lower the higher the ratio of waist and hip (p=0,041), while there was no correlation between BMI and bone density in this group of women.

The oral health situation in Bosnia and Herzegovina is among the worst in Europe. We investigated the oral health behaviour of primary schoolchildren and their parents in Sarajevo. This was an anonymous cross-sectional survey among third-grade schoolchildren and their parents’ oral health habits in Canton Sarajevo. Cluster random sampling yielded a representative sample from all the public schools in Canton Sarajevo in 2019. The survey targeted a total of 441 children and 365 parents. Two thirds (66.5%) of the children reported brushing their teeth twice daily, and almost half of them failed to use fluoride toothpaste daily. Girls brushed their teeth significantly more often than did the boys (74% vs. 58%, p = 0.004). Children living in residential areas of middle and high socioeconomic status (SES) reported better oral health habits than did those living in areas of low SES. Our study showed that Sarajevo children’s oral health habits were poor. One-third of the nine-year-olds failed to brush their teeth according to recommendations, and almost half of them failed to use fluoride toothpaste daily. Improving the children’s oral health in the future will urgently require national oral health promotion and prevention programmes.

The ginger family (Zingiberaceae) includes plants that are known worldwide to have a distinctive smell and taste, which are often used as spices in the kitchen, but also in various industries (pharmaceutical, medical, and cosmetic) due to their proven biological activity. The aim of this study was to investigate and compare the chemical composition and antioxidant activity (AA) of essential oils (EOs) of four characteristic ginger species: Elettaria cardamomum L. Maton (cardamom), Curcuma Longa L. (turmeric), Zingiber Officinale Roscoe (ginger), and Alpinia Officinarum Hance (galangal). Furthermore, the total phenolic content (TPC) and AA of crude extracts obtained after using ultrasound-assisted extraction (UAE) and different extraction solvents (80% ethanol, 80% methanol and water) were evaluated. A total of 87 different chemical components were determined by GC-MS/MS in the EOs obtained after hydrodistillation, 14 of which were identified in varying amounts in all EOs. The major compounds found in cardamom, turmeric, ginger, and galangal were α-terpinyl acetate (40.70%), β-turmerone (25.77%), α-zingiberene (22.69%) and 1,8-cineol (42.71%), respectively. In general, 80% ethanol was found to be the most effective extracting solvent for the bioactivities of the investigated species from the Zingiberaceae family. Among the crude extracts, ethanolic extract of galangal showed the highest TPC value (63.01 ± 1.06 mg GA g−1 DW), while the lowest TPC content was found in cardamom water extract (1.04 ± 0.29 mg GA g−1 DW). The AA evaluated by two different assays (ferric-reducing antioxidant power-FRAP and the scavenging activity of the cationic ABTS radical) proved that galangal rhizome is the plant with the highest antioxidant potential. In addition, no statistical difference was found between the AA of turmeric and ginger extracts, while cardamom rhizome was again inferior. In contrast to the crude extracts, the EOs resulted in significantly lower ABTS and FRAP values, with turmeric EO showing the highest AA.

Abstract The study has aimed to investigate and determine the anatomical position, shape, size, and histological features of the ductus venosus, and its role as a shunt in the fetal circulatory system in domestic ruminants. The research was conducted on 19 bovine, 11 sheep and 5 goat fetuses, aborted at the late stage of pregnancy or deceased just after delivery. The general anatomy of the ductus venosus was investigated by in-situ dissection of the corrosive cast obtained by injection of 25% solution of Vinylite mass through the umbilical vein. For histological examination, the fetal tissue samples were stained with Hematoxylin and Eosin, Masson’s trichrome, Verhoeff-Van Gieson and Gomoriꞌs silver stain. The results showed that ruminant fetal ductus venosus is a curved, trumpet-shaped vessel, situated in the central part of the liver, above the porta hepatis. Its ventral part is constricted in the form of an isthmus, having a prominent lip-like thickening at the junction with the portal sinus. Histological examination showed the dominant presence of collagen and elastic fibers in its tunica media, with thin bands of smooth muscle fibers oriented in a longitudinal and circular direction indicating ability for vasoconstriction and vasodilatation.

This article proposes a new robust dead‐beat controller for multivariable systems using multirate sampled data. Applying a discrete‐time higher order sliding mode control approach, the proposed dead‐beat controller design uses the state‐space nominal model (model without disturbances) of the system and its controllability indices to compute the state feedback matrix. The obtained control annihilates the system state in a minimal number of sampling periods. For example, a heuristic procedure for selecting a sampling time is considered in order to keep maximal amplitudes of control inputs within the allowable limits. Since the dead‐beat control has poor robustness, a new discrete‐time supertwisting disturbance observer is used to suppressed disturbance effects. Stability analysis of the proposed observer has shown that it is suitable for Lipschitz type of disturbances. The sampling period of the disturbance observer is generally smaller than the control sampling period. Properties of the proposed control system are demonstrated in simulation examples.

Background: The corona virus is transmitted in three ways: by direct contact with an infected person, by droplets, and by air. Transmission control according to official guidelines can be prevented by keeping a distance, wearing a mask and washing hands. Sharing a space with several members of the immediate or extended family increases the risk of transmission in all three ways. In Traditional Bosnian families two or three generations live in one household. The family doctor is informed with living conditions of the residents and has the opportunity to monitor the rate of secondary transmission from the index case, and then recommend additional preventative and treatment measures. Objective: The aim of the study was to determine the first occurrence of the symptoms and to monitor possible intrafamilial transmission of the disease through clinical examinations and microbiological-serological tests. Methods: The study was conducted in a family medicine clinic in the region of northeastern Bosnia and Herzegovina from March to December 2020. Patients with symptoms that could indicate the presence of COVID-19 disease were registered. If COVID-19 was proven, the patient became an index case. The other members of the family would be monitored for the secondary transmission via laboratory (PCA SARS-CoV-2 and IgM and IgG antibodies) and clinical parameters. Results: Characteristics of 25 index cases were analyzed. All 25 of them were middle-aged men that worked outside the home. In 25 households, there was a total of 123 members that shared a home with the index patient. Secondary transmission developed in 76 out of 123 family members (61.8%). Only one patient had a severe form of the disease and was hospitalized. 2 patients died. Conclusion: Intrafamiliar transmission of Covid-19 in households of Bosnia and Herzegovina is high. The secondary attack rate of SARS- CoV-2 in households is 61,8%. In the surveyed households, family members use common rooms with an infected patient, and the customs of family gatherings are maintained, without the implementation of protective measures. The family medicine team has the opportunity to apply appropriate preventive action, education and early prehospital treatment as well as adequate selection for the hospital admission.

Introduction: Psoriasis is a chronic disease. Research shows the emergence of harmful habits such as cigarette smoking and alcohol consumption in people with psoriasis. Aim: The aim of this study was to determine the frequency of habits, cigarette smoking and alcohol consumption in patients with psoriasis, sexual distribution, and the relationship of habits with the severity of the disease. Methods: The prospective study included 129 subjects with psoriasis, of which 67 or 51,94% were women and 62 or 48,06% were men. Results: The frequency of cigarette smoking was 41,09%, alcohol consumption 24,80%. The gender distribution of cigarette smoking was: 35,82% of women and 46,77% of men smoked cigarettes. The gender distribution of alcohol consumption is: women 5,97% and men 45,16%. The severity of psoriasis, that is PASI score and cigarette smoking were statistically significantly related (r=0,63), and PASI score and alcohol consumption were not statistically significantly related (r=0,32). Conclusion: Cigarette smoking and alcohol consumption are present in psoriasis sufferers, cigarette smoking is associated with disease severity, and alcohol consumption is not. It takes knowledge of the habits of people with psoriasis and a multidisciplinary approach to get rid of harmful habits.