Introduction: Gated tangential field-in-field (FIF) technique is used to lower the dose to organs at risk for breast cancer radiotherapy (RT). In this study, the authors investigated the accuracy of the delivered treatment plan with and without gating using a two-dimensional detector array for patient-specific verification purposes.Methods: In this study, a 6MV beams were used for the merged FIF RT (forward Intensity Modulated Radiation Therapy). The respiration signals for gated FIF delivery were obtained from the one-dimensional moving phantom using the real-time position management (RPM) system (Varian Medical Systems, Palo Alto, CA). RPM system used for four-dimensional computed tomography scanner light-speed, GE is based on an infrared camera to detect motion of external 6-point marker. The beams were delivered using a Clinac iX (Varian Medical Systems, Palo Alto, CA) with the multileaf collimator Millennium 120. The MapCheck2 (SunNuclear, Florida) was used for the evaluation of treatment plans. MapCheck2 was validated through a comparison with measurements from a farmer-type ion chamber. Gated beams were delivered using a maximum dose rate with varying duty cycles and analyzed the MapCheck2 data to evaluate treatment plan delivery accuracy.Results: Results of the gamma passing rate for relative and absolute dose differences for all ungated and gated beams were between 95.1% and 100%.Conclusion: Gated FIF technique can deliver an accurate dose to a detector during gated breast cancer RT. There is no significance between gated and ungated patient-specific quality assurance (PSQA); one can use ungated PSQA for verification of treatment plan delivery

Abstract We present an overview of the case of a patient with early hysterorrhaphy dehiscence (uteroperitoneal fistula) with endomyometritis and post-cesarean section peritonitis and puerperal acute abdomen in a 35-year-old puerpera. A exploratory relaparotomy, necrectomy, and resuture of the dehiscent part of the hysterotomy were performed with placement of hemostatic sponges on the same portion of the uterus with good recovery.

Background Altered levels of many hematological parameters have been directly associated with diabetes in adults, while studies on children with type 1 diabetes mellitus are lacking. The aim of this study was to determine hematological indices in diabetic Bosnian children in comparison to healthy controls as well as to correlate their levels to blood glucose and hemoglobin A1c. Methods 100 healthy and 100 children with type 1 diabetes mellitus (age 1-18) were included in this study. Complete blood count, hemoglobin A1c, and glucose were tested. Results were analysed by IBM SPSS Statistics version 23. Results Significant differences (p<0.05) between healthy and diabetic children were found in relation to HbA1c, glucose, mean platelet volume, the number of white blood cells and erythrocytes, hematocrit, hemoglobin and MCH values. No gender differences or significant age differences were seen for hemoglobin, hematocrit, and MCV, while platelets, MPV, and MCH differed by age only in healthy children. When diabetic children were classified according to HbA1c levels, significant differences were seen for erythrocyte count and hematocrit value (p=0.013 and 0.019, respectively). The number of erythrocytes and white blood cells correlated significantly with HbA1c (p=0.037 and 0.027, respectively). Conclusions Lower levels of erythrocytes, hematocrit, and hemoglobin in diabetic compared to healthy children indicate possible development of anemia, while higher MCV, MCH, and MPV values indicate an alteration in erythrocyte morphology. Hematological indices could be a useful inexpensive tool in the diagnosis and follow up of type 1 diabetes in children.

ABSTRACT Objective Hemangioblastomas of the posterior cranial fossa and spinal cord in adults are excessively vascularized, well-differentiated, and scarce tumors with no metastatic potential. This paper discusses its surgical management and outcome, pointing out their morphological, radiological, and histopathological aspects. This report based on a personal series of six patients and on a literature review. Methods A single-institution personal 6-case series of adult patients diagnosed and operated on by a senior neurosurgeon (KIA) due to posterior cranial fossa or spinal cord hemangioblastoma was analyzed. For easier understanding of hemangioblastoma, we have classified them into four different types. Results The tumors, which were all surgically treated, were located in the posterior cranial fossa in five patients (4 cerebellar, 1 brain stem) and intramedullary in the thoracic spinal cord in one patient. All patients successfully recovered neurologically after a complete tumor resection, having no post-operative neurological deficit or other complications. Conclusion Surgical management of cerebellar and spinal cord hemangioblastoma in adults is highly dependent on its morphological features, as well as on microsurgical technique applied. Since huge differences exist between the cystic/nodular tumor type (Type 1) and the solid type and its two additional variants (Types 2–4), morphology is the most important consideration when deciding surgical approach. Despite significant morphological differences among different subtypes of hemangioblastomas, their histology appears to be relatively similar. Nonetheless, a meticulous and refined surgical technique has to be utilized to achieve a successful outcome.

Background Coronary chronic total occlusion (CTO) is characterized by the presence of collateral blood vessels which can provide additional blood supply to CTO-artery dependent myocardium. Successful CTO recanalization is followed by significant decrease in collateral donor artery blood flow and collateral derecruitment, but data on coronary hemodynamic changes in relation to myocardial function are limited. We assessed changes in coronary flow velocity reserve (CFVR) by echocardiography in collateral donor and recanalized artery following successful opening of coronary CTO. Methods Our study enrolled 31 patients (60 ± 9 years; 22 male) with CTO and viable myocardium by SPECT scheduled for percutaneous coronary intervention (PCI). Non-invasive CFVR was measured in collateral donor artery before PCI, 24 h and 6 months post-PCI, and 24 h and 6 months in recanalized artery following successful PCI of CTO. Results Collateral donor artery showed significant increase in CFVR 24 h after CTO recanalization compared to pre-PCI values (2.30 ± 0.49 vs. 2.71 ± 0.45, p  = 0.005), which remained unchanged after 6-months (2.68 ± 0.24). Baseline blood flow velocity of the collateral donor artery significantly decreased 24 h post-PCI compared to pre-PCI (0.28 ± 0.06 vs. 0.24 ± 0.04 m/s), and remained similar after 6 months, with no significant difference in maximum hyperemic blood flow velocity pre-PCI, 24 h and 6 months post-PCI. CFVR of the recanalized coronary artery 24 h post-PCI was 2.55 ± 0.35, and remained similar 6 months later (2.62 ± 0.26, p = NS). Conclusions In patients with viable myocardium, prompt and significant CFVR increase in both recanalized and collateral donor artery, was observed within 24 h after successful recanalization of CTO artery, which maintained constant during the 6 months. Trial registration ClinicalTrials.gov (Number NCT04060615 ).

Air pollution is a complex mixture of toxic components that has the direct impact on human health, life quality, and the environment. In this study, meteorological variables and concentration of air pollutants are used to predict the common air quality index (CAQI) in Bjelave neighborhood, Sarajevo, BiH. CAQI prediction models were built using five popular machine learning techniques in the air pollution domain: Support Vector Regression, Random Forest, Extreme Gradient Boosting, Multiple Linear Regression and Multilayer Perceptron, using three-year period data (2016–2018). Prediction performance was measured using regression metrics: R-squared and RMSE. Ensemble technique, Random Forest method achieved the best performance results from the five evaluated machine learning methods: R2 = 0.99 and RMSE = 2.30, using the dataset when missing values were removed, and R2 = 0.99 and RMSE = 2.58 using the dataset when missing values were imputed using linear regression method.

In this paper, analogy of heat- or mass-transfer problem and progression of species in natural environments is used. Time-dependent spatial distributions of species in a given population (such as microbes, bacteria, viruses or herewith infected individuals etc.) are described by time-dependent convection-diffusion equation, which is widely used in analysis of a number of physical, engineering or environmental problems. In the presented example, a finite-volume method is used for its numerical solution. The source term is calibrated using the available recorded data on the species concentration development in the beginning stage. The integral results of the proposed model are compared with another, integral model (SIR) based on ordinary differential equations. Calculated spatial distributions for three different modeling cases are given.

Artificial intelligence has been used in the medical field for many years finding its way in assisting medical professionals to solve complex tasks in almost every application domain. Patient care and health care costs are in the forefront of any medical system. With the emergence of electronic games (EG), originally entertaining in nature, potential was seen for their application in the medical field in terms of exploring the capabilities of educating patients in the areas of need. Design of serious games emerged with a focus on helping with the patient’s therapeutic modality. Some of the medical field serious games are part of the daily work of a medical professional. With the development of mobile devices, this type of gaming has also become available to the wider population. The aim of this research was to demonstrate the possibilities and benefits of using EG in the daily clinical work of medical professionals. This work has a descriptive character where a section of the literature is given outlining the increased research interest in using serious games as therapy enhancements. We limited ourselves to research involving patients who need medical treatment or intervention.

Purpose: To determine the potential value of an adapted questionnaire to discover the predictors of preceptors' higher interest in precepting pharmacy interns and to evaluate preceptors' motivational factors and incentives for teaching as well as their professional satisfaction. Method: A link to the survey study of adapted questionnaire (JSAMPPP) was e-mailed to all pharmacists registered with the Pharmaceutical Chamber of the Republic of Srpska. Pharmacists' demographic and work experience characteristics, their attitudes related to motivation for precepting, value of incentives for precepting, job satisfaction, and influence of interns on pharmacists' professional practice were obtained. Results: Half of the preceptors who reported feeling satisfied with their professional life also showed interest in teaching. In addition, teaching pharmacy students positively contributed to the overall job satisfaction of the preceptors. Pharmacy preceptors were found to be most motivated by intrinsic factors. The most valued incentives reported were those related to continuing education. Conclusions: The adapted questionnaire has potential value and it revealed the following predictors of preceptors' higher interest in precepting: enjoyment of teaching, satisfaction with professional life, satisfaction as a pharmacy preceptor, and interns' influence on preceptors. These identified predictors can be emphasized to improve pharmacy students' internship experiences, thereby reinforcing the pharmacy profession.

Firearms injuries are a major public health problem in Kosovo. Injuries from firearms injuries are those caused by any firearm (cartridge, Cannonball) and from the special properties war, mine explosive grenades, and other subjects. Epidemiology of the use of firearms in males ranges corresponding 1.9 per 100,000 population, while for women 0.3 per 100,000 inhabitants The most common injuries are caused by weapons fire, rarely with special tools of war, Causes with firearms injuries blamed mental health problems, domestic violence, disparities in family, social cases, use of drugs and alcohol Preventing injuries and deaths by firearms is one of the most complex issues at the country in recent years. Management and Access Principles, Access, Evaluation of Emergency Medical Care at Three Levels of Care based on EMS Standard. It is important to take a step, contributing significantly to the reduction of premature deaths, diseases, and disability. Careful medical certificates should be given for carrying weapons, assessing the psychophysical and social aspects. The Kosovo Police should control nightclubs, schools and universities, respecting, implementing legal and institutional mechanisms, educating communities through brushes, lectures, media, and social networks, as well as international cooperation. The significant number of injuries with disabilities and deaths should be prevented through national preventive strategies and the need to provide emergency medical care for the rapid transport of firearm victims to the emergency clinic for definitive treatment. Educational efforts are trying to promote safer use of firearms, but they have not led to a significant reduction in the number of victims.