Aim To examine the prevalence of undiagnosed depression among primary care elderly patients in the entity of the Republic of Srpska (Bosnia and Herzegovina) as well as the sociodemographic and clinical risk factors associated with depression. Methods A cross-sectional study was conducted between April and June 2019 in nine towns of the Republic of Srpska. The study sample included 1,198 primary care patients older than 65 years of age. Research instruments included a sociodemographic questionnaire and Geriatric Depression Scale - Short Form (GDS-SF). Results Positive screening test (GDS-SF score > 5), which indicates depression was found in 484 (40.4%) participants. Multivariate regression analysis showed that lower education levels [OR = 1.565, 95% CI (1.13-2.17)], divorced and widowed [OR = 1.366, 95% CI (1.16-1.62)], poor financial situation [OR = 1.690 , 95% CI (1.25-2.29)], non-home residents [OR = 2.200, 95% CI (1.41- 3.44)], non-hobby patients [OR = 2.115, 95% CI (1.54-2.91) ], non-friends [OR = 3.881, 95% CI (2.70-5.57)], patients suffering from chronic pain [OR = 2.414, 95% CI (1.72-3.39)], patients with daily life limitation activities [OR = 1.415, 95% CI (1.03-1.95)], patients with three or more chronic diseases [OR = 1.593, 95% CI (1.12-2.27)], patients using five or more drugs [OR = 1.425. 95% CI (1.00-2.03)], and patients with history of previous depression [OR = 2.858, 95% CI (1.94-4.21)] were at higher risk for depression. Conclusion The prevalence of undiagnosed depression in the elderly in Republic of Srpska is high. Future strategies are needed to strengthen screening of geriatric depression in primary health care.

Introduction: Tumors of Fallopian tubes are rare in general, and they are the rarest tumors of female genital tract. According to clasification of World health organisation (WHO), papillomas, cystadenoma, adenofibroma, cystadenofibroma (CAF), metaplastic papillary tumors and endometrioid polyps belong to group of benign tumors. Serous papillary cystadenofibroma (SPCAF) is rare tumor and it is ususally located on fimbrial end of the tube and it is considered that it has „Müllerian“ origin. Aim: The aim of this article is to show a rare case of cystadenofibroma of Fallopian tube which was found as random sample during histopathological analysis of specimen which was extracted during laparatomy due to the large tumor mass in abdomen. Case report: A 43-year-old patient underwent surgery for a large tumor mass in the abdomen, unknown lesions and pathohistology, which was radiologically verified four years before hospitalization. We removed the specimen that made up the tumor, along with the uterus and adnexes, weighing 14 kg and sent for histopatology. A large tumor mass is made up of a giant uterine myoma, and in the analysis of the other preparation, in addition to endometrial adenocarcinoma, there is also a rare Fallopian tube cystadenofibroma. On the sixth day of hospitalization, the patient is discharged home. At control after three months, the patient was without problems, with ongoing adjuvant brachytherapy. Conclusion: Improvement of prevention measures and work on the continuing education of patients and physicians at the primary care level are needed to ensure that patients receive the best treatment in a timely manner. Cystadenofibroma is a rare tumor in general and gynecologic oncology, and as authors it is a great honor for us to contribute to the world literature and to present the twentieth case of this tumor.

Background: Measurements of electrode impedance values are routinely performed after cochlear implantation. The primary objective of the study was to determine if pediatric, prelingually deafened patients with different postoperative performances showed significantly different impedance values one year after implantation. Methods: This study comprised 42 pediatric cochlear implant recipients provided with the device in a single academic tertiary referral center between 1 January 2000, and 31 December 2016. Medical chart analysis was performed in order to assess evolution of impedance values during the first postoperative year on a monthly basis. Electrode impedance values measurements one year postoperatively were compared between children with successful and unsuccessful auditory and language skills development assessed using the EARS protocol (a name of a performance test). Furthermore, values were compared among recipients of different implant types and among different cochlear segments. Results: A gradual rise of average impedance values was found during the first months of implant use (1st month, 7.32 kΩ; 3rd month, 7.86 kΩ) with the peak at the 4th postoperative month (7.96 kΩ), followed by a gradual decrease towards the 12th month (6th month, 7.62 kΩ; 12th month, 6.86 kΩ). Lower values at the 12th postoperative month were observed in recipients with successful development compared to patients presented with unsuccessful development (6.22 kΩ vs. 7.82 kΩ; p = 0.001). Mean impedance values were different when compared among cochlear segments and among different implant types. Conclusion: High electrode impedance values one year after implantation in pediatric patients may imply insufficient auditory and language skills development. Further studies are needed in order to validate our results.

Aim To investigate the usage of chest computed tomography (CT) scan score for improvement in diagnostic and treatment efficacy of repetitive pleural effusion. Methods CT scan scoring system was used as a part of diagnostic procedures in patients with repetitive pleural effusion. Patients with at least two pleurocentesis were included in the study. Chest and abdominal ultrasound, chest x-ray, bronchoscopy, biochemical, microbiological and cytological analysis of pleural fluid specimen were performed for all patients. Results In a two-year period (during 2017-2018) 79 patients were analysed, 27 (34.17%) female and 52 (65.82%) male patients. Malignant pleural diseases were confirmed in 32 cases (40.5%), nonmalignant pleural effusions in 38 (48.1 %) cases, and nine (11.4%) patients rested without exact cause of pleural effusion after two pleurocenteses. Binary regression model showed odds ratio of 1.314; CI 95% 1.119-1.543) (p=0.00088). Confirmed malignancies with pleural effusion were in high correlation with the number of points in CT scan score. Conclusion CT scan scoring system was helpful for diagnostic and treatment decision making in patients with repetitive pleural effusion.

Aim To evaluate vertebral bone marrow adiposity (BMA) using magnetic resonance spectroscopy (MRS) in postmenopausal women and to determine an association of bone density with bone marrow fat content. Methods This cross-sectional study included 120 postmenopausal women referred for osteoporosis screening. All women underwent assessment of bone mineral density by dual X-ray absorptiometry (DXA), who were divided based on T scores into osteoporosis (OST; n=60) and control group (CG; n=60). MRS was used to measure fat fraction (FF), lipid/water ratio (LWR) and fat content (FC) at vertebral spine (L1-L4). Results Mean age, menopause or reproductive period duration was not significantly different between women in OST and control group. Median LWR in OST group was significantly higher compared to CG, 31.5 (22.9-38.8) vs. 28.7 (13.7-37.3) (p=0.039). Median FC was significantly higher in OST compared to the control group, 47.0 (46.3-78.8) and 46.4 (44.3-48.6), respectively (p=0.011). FC was significantly negatively associated with BMD at lumbar spine (Rho=-0.042; p<0.001) and with BMD at hip (Rho=-0.64; p<0.001). In logistic regression model, FC remained independently associated with osteoporosis after controlling for confounders (age, menopause duration, reproductive period duration and body mass index) (OR=1.3; 95% CI 1.1-1.6). Conclusion Bone marrow adiposity is an independent predictor of low bone mass in postmenopausal women suggesting its role as a therapeutic target in postmenopausal osteoporosis management.

Background: Endurance training (ET) and resistance training (RT) are known to be effective in improving anthropometric/body composition and lipid panel indicators, but there is an evident lack of studies on differential effects of these two forms of physical exercise (PE). This study aimed to evaluate the differential effects of 8-week ET and RT among young adult women. Methods: Participants were women (n = 57; age: 23 ± 3 years; initial body height: 165 ± 6 cm; body mass: 66.79 ± 7.23 kg; BMI: 24.37 ± 2.57 kg/m2) divided into the ET group (n = 20), RT group (n = 19), and non-exercising control group (n = 18). All participants were tested for cardiovascular risk factors (CRF), including total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, glucose, and anthropometric/body composition (body mass, body mass index, skinfold measures, body fat %) at the beginning and at the end of the study. Over the 8 weeks, the ET group trained three times/week on a treadmill while the RT group participated in equal number of circuit weight training sessions. Both types of training were planned according to participants’ pre-study fitness status. Results: A two-factor analysis of variance for repeated measurements (“group” × “measurement”) revealed significant main effects for “measurement” in CRF. The “group × measurement” interaction was significant for CRF. The post-hoc analysis indicated significant improvements in CRF for RT and ET. No significant differential effects between RT and ET were evidenced. Conclusions: The results of this study evidence improvements of CRF in young adult women as a result of 8-week ET and RT. The lack of differential training-effects may be attributed to the fact that all participants underwent pre-study screening of their fitness status, which resulted in application of accurate training loads.

INTRODUCTION The objective of this study was to assess perceptions and attitudes among dental practitioners in relation to antibiotic usage and antibiotic resistance. METHODS Self-administered questionnaire was given to dental practitioners employed in south Croatia, west Herzegovina and Sarajevo, Bosnia and Herzegovina (N=115). RESULTS 81.7% of respondents agreed the usage of antimicrobials is frequently uncritical and unnecessary. 83.5% of dental practitioners reported that have used guidelines in their practice, however, only 9 out of 115 stated valid guidelines. One third of the respondents agreed or were undecided that the usage of antimicrobials in every oral inflammatory process treatment is justified. Furthermore, 13% was undecided and 26% agreed that pregnant women and breastfeeding women should not use any antimicrobials. However, three quarters of respondents considered they had satisfactory knowledge on antimicrobials. DISCUSSION The respondents considered they had satisfactory knowledge on antimicrobials, which was in contrast with the knowledge shown, but also expressed the need for additional education. Therefore, adequate measures include the creation of the local guidelines, their implementation, and updating the practitioners' knowledge on antibiotic use and resistance through continuous educational courses.

Individually, trauma and appendicitis are some of the most common conditions in clinical practice, particularly in emergency medicine. In rare cases, trauma and appendicitis may co-exist, imposing a dilemma of whether these are only coincidence or appendicitis develops because of trauma. We report here a case of acute perforated appendicitis after a blunt abdominal trauma caused by a horse hoof kick to the abdomen in a 7-year-old boy. We also discussed the potential pathophysiologic mechanisms behind and reviewed the literature on this rare condition.

Modulation signal classification (MSC) is an indispensable technique to make the possible applications of non-cooperative communications. Currently, convolutional neural network (CNN) based MSC techniques can achieve an outstanding performance at a fixed noise regime. However, they are hard to generalize to all of noise scenarios. Because these conventional methods are trained on specific signal samples with fixed SNR and they only perform well under corresponding noise condition. Unlike the conventional methods, in this paper, we propose a robust CNN based generalized MSC (GMSC) method with powerful generality capability. This capability stems from the mixed dataset, containing in-phase and quadrature (IQ) samples under various SNR regimes. Experimental results show that the proposed method is robust under varying noise conditions, while merely losing a slight performance with comparing with conventional methods.

Software Defined Networking (SDN) is a promising solution because of many advantages over the traditional network. Due to these advantages, SDN can be considered as a tool for energy efficiency in ICT (Information and Communication Technology) networks. In this paper, we have made a comparison between energy consumption in real IP/MPLS (Internet Protocol/Multi-Protocol Label Switching) network and designed SDN network. The results show that a significant reduction of energy consumption is achieved for a scenario with designed SDN solution.

Aim To determine risk factors for deep vein thrombosis (DVT) in hospitalized patients in a 10-year follow-up. Methods In this observational study data were collected from the disease history of patients admitted to the Department of Angiology of the Clinical Centre University of Sarajevo in the period of 10 years (2008-2017). Of 6246 hospitalized patients, 1154 were with established diagnosis of DVT and included in the study as a basic inclusion criterion. Results Provoked venous thromboembolism was recorded in 45.75% of hospitalized patients. In 54.25% cases DVT was classified as idiopathic; in the remaining cases with DVT external risk factors were identified. Every fourth patient had a history of malignancy, and this risk factor was significantly more common among women and younger patients. Cancer of female reproductive organs, colon, lung, breast and prostate cancer were most common. One of 10 women had DVT during pregnancy or postpartum period. Out of the total number, 10.9% patients had DVT after surgery, 2.3% after injury. DVT was found in 1.6% of drug addicts. Rethrombosis was diagnosed in 5.2% patients within a year, while 9.2 % patients had rethrombosis within five years. Conclusion Provoked venous thromboembolism is an entity that can be prevented. Malignancy and surgical treatment are the most common risk factors and these patients should be treated with special care. The creation of a register of patients with venous thromboembolism in Bosnia and Herzegovina would enable the development of a preventive strategy in the groups of patients at risk.

Committee of Publishing Ethics (COPE) announced great problem with retraction of the papers published in journals which are cited in Web of Science data base, before and after retractions from the journals were papers published, because of unethical behaviours of the authors - https://retractionwatch.com/the-retraction-watch-leaderboard/top-10-most-highly-cited-retracted-papers/ (1).

Introduction: Laparoscopic cholecystectomy is now considered the procedure of choice that achieves a shorter recovery period after the surgery and reduction in the cost of treatment. Aim: The aim of the study is to prove which method: early or delayed laparoscopic cholecystectomy is the method of choice in the treatment of acute cholecystitis by examining: duration of hospitalization, conversion rate, duration of surgery, postoperative complications, and total cost. Methods: The study was conducted at the University Clinical Center of Republika Srpska as a retrospective-prospective study from May 1st 2013 until December 31st 2019. Patients diagnosed with acute cholecystitis were divided into two groups: Patients designated for early laparoscopic cholecystectomy within 72 hours of admission (group A–42 patients), Patients designated for initial conservative treatment followed by a delayed interval of 6-12 weeks until surgery (group B-42 patients). Results: In both groups, there were statistically significantly more female respondents. The results showed that the average cost of treatment in the early treated group was statistically significantly lower than the cost of treatment in the delayed treatment group. The patients in the early group had shorter hospitalization times (an average of 2.8 days and 5.6 days in the delayed group of patients), a smaller percentage of conversions (4.8% in the early and 16.7 in the delayed group of patients), the total cost of in the early group it was 1300.83 KM, while in the delayed group it was 1645.43 KM. Conclusion: Early laparoscopic cholecystectomy is a method to be preferred in surgical treatment.

Aim To determine stereological structural parameters of the parenchymal part of the placenta, placental weight and volume of adolescent pregnant women and their correlation with newborns' birth weight. Methods This prospective study was conducted on a total of 60 human placentas of term pregnancy, divided into two groups according to the age of pregnant women. Experimental group consisted of 30 placentas of pregnant women aged 13-19 years. Control group consisted of 30 placentas of pregnant women aged 20-35 years. Stereological analysis was performed. Results Volumetric density of terminal villi of adolescent placentas was significantly higher than the one of control group (p <0.0001). The volumetric density of fibrinoid of adolescent placentas was significantly lower than of the control group (p <0.0001). Total volume of terminal villi of adolescent placentas was significantly higher than of the control group (p<0.0001). The total volume of fibrinoid of adolescent placentas was significantly lower than of the control group (p<0.0001). Newborns of adolescent pregnancies had in average lower birth weight of 439.01 g compared to the newborns of the control group (p <0.00001). Conclusion Adolescent pregnancy affects placental structure, weight and volume. Newborns of adolescent pregnancy have optimal body weight.