Objectives: The purpose of the present study was to assess neck-to-height ratio (NtHR) and its possible association with other anthropometric measures of obesity and blood pressure (BP) values in Bosnian university students stratified by new 2017 American College of Cardiology/American Heart Association Task Force hypertension (HT) guidelines.Methods: The present study included 417 subjects with median age 20 (19-21) years that were divided into normal BP, elevated BP, stage 1 HT, and stage 2 HT groups based on BP measurements using auscultatory methods. Standard anthropometric indices including neck circumference (NC) were measured. NtHR (cm/m) was calculated in each participant based on the NC and height. Differences between groups were assessed by Kruskal-Wallis followed by Man-Whitney test and correlations were determined by Spearman test.Results: The prevalence of elevated BP was 19.2%, stage 1 HT 21.6%, and stage 2 HT 11.0 %. NtHR was highest in the stage 2 HT group. NtHR correlated significantly with all anthropometric measures in all groups. No correlation between NtHR, systolic BP, and diastolic BP was found, except in the stage 1 HT group, where a significant correlation between NtHR and systolic BP was uncovered.Conclusions: Based on the observed correlations between NtHR and standard measures of obesity, NtHR could be included in clinical practice, since it is simple and does not induce discomfort. The high prevalence of elevated BP found in the present study suggests HT prevention requires the implementation of programs aimed at promoting healthy dietary habits, physical activity, as well as effective stress management and coping mechanisms.

Abstract Objective. The present study assessed the impact of type 2 diabetes mellitus (T2DM) duration on the serum asymmetric dimethylarginine (ADMA) and C-reactive protein (CRP) concentration in Bosnian patients. Methods. Participants for this cross-sectional study were randomly selected from the Family Medicine Clinic (Sarajevo, Bosnia and Herzegovina). Serum ADMA concentration was determined by ELISA. Serum high-sensitivity (hs-CRP) was determined by particle-enhanced immunonephelometry. ANOVA test followed by Scheffe post-hoc test or Kruskal-Wallis test followed by Man-Whitney test were used for statistical analysis. Results. The study included 38 patients in up to 10 years diabetes duration (≤10 years T2DM) group, 22 patients in greater than 10 years diabetes duration (>10 years T2DM) group, and 60 controls. Serum ADMA concentration in the >10 years T2DM group (1.81±0.15 μmol/L) was significantly higher compared to serum ADMA concentration in the ≤10 years T2DM group (1.38±0.41 μmol/L; p<0.001) and in controls (0.62±0.15 μmol/L; p<0.001). A significant difference in serum ADMA concentration was found between the <10 years T2DM group and the controls (p<0.001). The serum CRP concentration in the >10 years T2DM group [5.95 (4.20–9.12) mg/L] was significantly higher compared to serum CRP concentration in the <10 years T2DM group [2.35 (1.40–4.30) mg/L; p<0.001] and controls [0.85 (0.50–1.30) mg/L; p<0.001]. Significant difference in serum CRP concentration was observed between the <10 years T2DM group and controls (p<0.001). Conclusions. The present study showed an increase in the serum ADMA and CRP concentrations with the advancement of T2DM. These results suggest that ADMA and CRP may serve as indicators of endothelial dysfunction and chronic low-grade inflammation progression in patients with T2DM. Larger prospective studies are required to confirm the observed findings.

Different qualitative and quantitative changes in platelets are involved in the pathophysiological processes in inflammatory bowel diseases (IBD): ulcerative colitis (UC) and Crohn's disease (CD). The aim of the study was to determine the diagnostic accuracy of Platelet mass Index (PMI) and other platelet parameters in assessment disease activity in patients with UC and CD. A cross-sectional, observational study consisted of 60 IBD patients (30 UC and 30 CD) and 30 healthy subjects (Control group). Patients were grouped according to disease activity into active and inactive (remission). Platelet count (PLC), Plateletcrit (PCT), Mean Platelet Volume (MPV), Platelet Distribution Width (PDW) and PMI were determined for all study participants. Receiver operating characteristic (ROC) curve and their corresponding areas under the curve (AUC) were used to determine diagnostic accuracy. Although PLC had the highest AUC (0.756) compared to PCT (AUC: 0.731), PDW (AUC: 0.722) and PMI (AUC: 0.724), they all had fair diagnostic accuracy in distinguishing active and inactive UC patients. Discriminatory accuracy of PLC was excellent (AUC: 0.909), PCT and PMI good to excellent (AUC: 0.809 and AUC: 0.893, respectively) and PDW fair (AUC: 0.789) in classifying CD patients as active and inactive. Platelet parameters are simple, routinely available biomarkers more useful for assessing disease activity for patients with CD than for patients with UC. Our results indicate, for the first time, that PMI may serve as a novel and simple marker in identifying whether IBD patients are in the active or inactive phase of the disease.

Different qualitative and quantitative changes in platelets are involved in the pathophysiological processes in inflammatory bowel diseases (IBD): ulcerative colitis (UC) and Crohn's disease (CD). The aim of the study was to determine the diagnostic accuracy of Platelet mass Index (PMI) and other platelet parameters in assessment disease activity in patients with UC and CD. A cross-sectional, observational study consisted of 60 IBD patients (30 UC and 30 CD) and 30 healthy subjects (Control group). Patients were grouped according to disease activity into active and inactive (remission). Platelet count (PLC), Plateletcrit (PCT), Mean Platelet Volume (MPV), Platelet Distribution Width (PDW) and PMI were determined for all study participants. Receiver operating characteristic (ROC) curve and their corresponding areas under the curve (AUC) were used to determine diagnostic accuracy. Although PLC had the highest AUC (0.756) compared to PCT (AUC: 0.731), PDW (AUC: 0.722) and PMI (AUC: 0.724), they all had fair diagnostic accuracy in distinguishing active and inactive UC patients. Discriminatory accuracy of PLC was excellent (AUC: 0.909), PCT and PMI good to excellent (AUC: 0.809 and AUC: 0.893, respectively) and PDW fair (AUC: 0.789) in classifying CD patients as active and inactive. Platelet parameters are simple, routinely available biomarkers more useful for assessing disease activity for patients with CD than for patients with UC. Our results indicate, for the first time, that PMI may serve as a novel and simple marker in identifying whether IBD patients are in the active or inactive phase of the disease.

Aim To present haemoglobin and ferritin parameters in donors to highlight the importance of serum ferritin testing for the purpose of evaluating iron depots in order to make recommendations for preserving a population of blood donors. Method A prospective study was conducted on 80 blood donors divided in two groups: group I (regular donors, n =40) and group II (irregular donors, n=40). Haemoglobin and ferritin were measured twice every 45 days, before two consecutive blood donations. Results By measuring haemoglobin and ferritin values before donation in both groups, a decrease of initial ferritin value in Group I relative to Group II was observed (without statistical significance). A significant decrease was found between repeated measurements for both parameters in both groups, indicating equal intensity of the decline in value regardless of a donor status. Measurement of ferritin before and after donation revealed statistically significant loss of ferritin in all examinees (p=0.011). The decline in haemoglobin after donation, although significant, did not fall below the reference value for donation in either women or men. Conclusion Results indicate the need for periodic monitoring of the plasma value of ferritin in voluntary donors who donate blood more than twice a year and the possible oral supplementation with iron.

Introduction: Optical coherence tomography angiography (OCT-A) is a useful diagnostic tool for assessing eyes’ health in patients with chronic diseases, such as diabetes, hypertension, Parkinson’s disease and chronic kidney disease (CKD). Aim: To detect changes in macular structure and retinal vascular meshwork in the macular area and peripapillary in patients with chronic kidney disease (CKD). Methods: This cross-sectional study included 80 eyes of patients with CKD in stages 2, 3 or 4, who were followed-up in the Nephrology Clinic of University Clinical Center Sarajevo. All patients were categorized according to the stage of CKD. All patients were scanned by a high-speed 840-nm-wavelength spectral-domain optical coherence tomography instrument (RTVue XR Avanti; Optovue, Inc, Fremont, California, USA). Blood flow was detected using a split-spectrum amplitude-decorrelation angiography algorithm. A fully automated microstructural analysis of the foveal avascular zone (FAZ), FAZ perimeter, foveal vessel density in a 300-μm area around the FAZ (FD), nonflow area, flow index in superficial and deep vascular plexus, choriocapillary flow, vascular density, radial peripapillary capillary density was performed. Results: When comparing patients with CKD stage 2 and stage 3 there were no statistically significant changes in microvascular parameters on OCT angiography, as well as when comparing patients with CKD stage 3 and stage 4. But in the comparison between patients with less developed CKD (stage 2) and terminal CKD (stage 4) there was a significant difference between some microvascular parameters such as FAZ area, FAZ perimeter, choriocapillary flow. Conclusion: Many studies demonstrated that evaluation of the microvascular changes in different retinal layers using SS-OCTA may be considered as a key to assessing the systemic perfusion status. Evaluation of retinal microvasculature may ease the management and approach of patients with CKD, having in mind that the retinal and the kidney vascular network are, concerning structure, development and the function, very similar.

Introduction: To show the importance of optical coherence tomography (OCT) angiography imaging of superficial and deep capillary network in patients with non-proliferative diabetic retinopathy (NPDR), and to show the correlation between blood glucose level and changes in the foveal microvasculature. Methods: A cross-sectional study was performed on eyes with NPDR and healthy subjects using a highspeed 840-nm-wavelength spectral-domain optical coherence tomography instrument (RTVue XR Avanti; Optovue, Inc, Fremont, California, USA). Blood flow was detected using the split-spectrum amplitude-decorrelation angiography algorithm. A fully automated microstructural analysis of the foveal avascular zone (FAZ) and avascular surfaces was performed. Quantitative values from diabetic patients were compared with those of healthy subjects. Data about blood status in diabetic patients and healthy subjects were taken from patients’ medical history. Results: Size of both, FAZ and vascular dropout are significantly different between healthy patients and patients with NPDR. OCT angiography detected enlargement and distortion of the foveal avascular zone, retinal capillary dropout, and a higher number of vascular loops and microaneurysms. Sizes of FAZ and vascular dropout increase with the duration of disease. Central macular thickness (CMT) is not significantly different between healthy patients and patients with NPDR. A study has proven a positive correlation between the size of FAZ and the size of vascular dropout in superficial vascular plexus in patients that have DM over 10 years. Conclusion: A qualitative and quantitative OCT angiography approach to retinal vascular status can offer objective data on monitoring patients with non-proliferative diabetic retinopathy as well as indicate the progression of the disease.

Introduction Acute appendicitis (AA) is the most common surgical condition of the abdomen in children. The aim of this study was to analyse the possible use of the neutrophil-to-lymphocyte ratio (NLR) in the diagnosis and prediction of AA complications in children. Material and methods We included 170 AA patients under 15 years of age, who were divided into the following groups: Group 1 – non-operated patients with AA, and Group 2 – patients who underwent appendectomy. Based on pathologic grades of AA, Group 2 was subdivided into: Group A – phlegmonous, Group B – gangrenous, and Group C – perforated AA. NLR was calculated as the absolute neutrophil count divided by the absolute lymphocyte count. Results In Group 2 NLR was significantly higher than in Group 1 (5.5 (1.9–9.9) vs. 2.3 (1.2–3.7); p < 0.001). A significant difference in NLR was found between Group C and Group A (p < 0.001), and as well as between Group B and Group A (p = 0.001). The determined optimal cut-off value of NLR in differentiating Group 1 vs. Group 2 was ≥ 3.48 (p < 0.001). In differentiating Group A from Group C the optimal cut-off value of NLR was ≥ 5.61 (p < 0.001). Furthermore, optimal cut-off value of NLR in differentiating Group A from Group B was ≥ 5.45 (p = 0.001). Conclusions The obtained results suggest that NLR could be used as a simple and reliable test in the diagnosis and prediction of AA complications in children. However, to draw definite conclusions on the predictive power of NLR as a marker of AA large multicentric studies are required.

Introduction: Poor glycemic control, assessed by higher glycated hemoglobin (HbA1c) levels, is associated with greater risk of diabetic complications. Aim: The aim of this study was to assess the association of triglyceride - to - HDL cholesterol (TG/HDL-C) ratio and triglyceride glucose (TyG) index with HbA1c and to evaluate their potential role as predictors of glycemic control in patients with diabetes mellitus type 2 (DM2). Patients and methods: This cross-sectional study was conducted in Health Center Banovici and included a total of 113 patients with DM2 classified according to their HbA1c values in two groups: DM2 HbA1c <7% - DM2 patients with good glycemic control (n=39) and DM2 HbA1c ≥7% - DM2 patients with poor glycemic control (n=74). Anthropometric, biochemical parameters and blood pressure values were measured, while TG/HDL-C ratio and TyG index were calculated. Results: TG/HDL-C ratio and TyG index were significantly higher in DM2 HbA1c≥7% compared to DM2 HbA1c<7% group (p=0.003 and p<0.001; respectively). Both TG/HDL-C ratio and TyG index were positively associated with HbA1c levels (Rho=0.29; p=0.002; Rho=0.37; p<0.001; respectively). In linear regression analysis TG/HDL-C ratio and BMI, and also TyG index and BMI were significantly independently associated with HbA1c even after controlling for age, gender, diabetes duration and smoking. When we stratified patients according to BMI values, independent association between TG/HDL-C ratio and HbA1c remained significant only in normal weight subjects (OR 0.21; 95%CI: 0.05-0.37; β=0.65; p=0.017), while independent association between TyG index and HbA1c remained significant only in overweight and obese subjects (OR 0.063; 95%CI: 0.01- 0.12; β=0.24; p =0.027). Conclusion: TG/HDL-C ratio might be a useful predictor of glycemic control in normal weight, and TyG index in overweight and obese patients with DM2.