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Maida Šahinović

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Introduction: Polycystic ovary syndrome (PCOS) represents a state of androgen-driven metabolic dysregulation where visceral adiposity and inflammation critically define cardiometabolic risk. Visceral adiposity is not a bystander in PCOS; it is an active endocrine organ driving insulin resistance, low-grade inflammation, and androgen persistence. Interventions that reverse adipocyte hypertrophy and inflammatory signaling may therefore alter the metabolic trajectory of PCOS. Beyond its chronobiotic role, melatonin exerts profound metabolic actions via MT1/MT2 receptors in adipose tissue, modulating oxidative stress and inflammatory gene expression. Yet its direct impact on androgen-induced visceral adiposity remains unclear. Aim: The present study aimed to evaluate the effects of melatonin, metformin, and their combination on visceral fat accumulation in a testosterone-induced PCOS rat model. Material and methods: Thirty prepubertal female Wistar rats were randomized into five groups (n=6): control, PCOS (testosterone 20 mg/kg/day), PCOS+metformin (500 mg/kg/day), PCOS+melatonin (2 mg/kg/day), and PCOS+melatonin+metformin. Treatments lasted 36 days. Estrous cyclicity was monitored by daily vaginal cytology, and somatometric parameters were recorded weekly. On day 36, serum, ovaries, and visceral fat were collected for biochemical and histological analysis. Results: Vaginal smear changes and ovarian pathological alteration due to prolonged testosterone exposure confirmed the successful induction of the PCOS model. Measures of central adiposity, including abdominal circumference and the TC/AC ratio, were significantly higher in the PCOS model than in controls (p < 0.001). Abdominal circumference (AC) increase was greatest in the PCOS model (p < 0.001), while all treatment groups showed significant reductions, most notably in the melatonin + metformin group, followed by melatonin monotherapy and then metformin (all p < 0.001 vs. PCOS). Melatonin was more effective than metformin (p=0.029). AC/TC reduction was greatest in the combined treatment group (p < 0.05). Total weight gain among groups did not reach statistical significance. While total visceral fat weight did not differ among groups, histology revealed a marked reduction in adipocyte number in treated animals, most pronounced in the melatonin group (p < 0.033). Conclusion: Our findings identify melatonin as a metabolic modulator of androgen-driven adiposity, supporting its potential as an adjunctive therapy targeting visceral fat and inflammation in PCOS

Harun Avdagić, M. Tabaković, Miha Antonic, Alisa Krdžalić, Selma Sijerčić, Melika Pirić, Maida Šahinović

Background: The upper mini sternotomy Bentall (mini-Bentall) procedure may result in less trauma and earlier recovery compared with the usual full sternotomy Bentall procedure (Usual Bentall-DeBono procedure). Objective: This study evaluates the efficacy and safety of mini sternotomy aortic root surgery (MSARS), a minimally invasive technique designed to reduce surgical trauma, improve postoperative recovery, and lower healthcare costs. Methods: The upper mini sternotomy (UMS) approach was performed in ten patients focusing on standardized surgical procedures, and rigorous postoperative care. Key findings indicate that MSARS markedly reduces postoperative complications, ICU stay, and overall hospital stay compared to traditional sternotomy. Results: The median postoperative length of stay was seven days for MSARS versus 11 days for traditional sternotomy, with ICU stays of 27 hours and 105 hours, respectively. Our study also highlights the cost-effectiveness of MSARS, with decreased hospital costs per patient due to reduced ICU resource utilization and shorter hospital stays. These findings suggest that MSARS is a valuable and advantageous alternative to traditional sternotomy, offering substantial benefits in terms of patient outcomes and healthcare efficiency. Conclusion: Mini sternotomy aortic root surgery via partial upper sternotomy could be a safe alternative to the full median sternotomy, marking a significant advancement in the field of cardiac surgery.

Background: Gentamicin is a potent, broad-spectrum aminoglycoside antibiotic used in the treatment of many infections. Gentamicin can induce hepatotoxicity through oxidative stress and apoptosis. Since melatonin has antioxidant properties, its protective effects on liver tissue damage were evaluated in this study. Objective: The aim of this study was to conduct our investigation to assess the hepatoprotective effects of melatonin in rats treated with gentamicin. Methods: Forty eight adult male Wistar rats were used. The animals were randomly distributed into six groups of equal size. During the period of 11 days, three control groups of rats were daily injected i.p. with the vehicle or with melatonin at a dose of 5 or 10 mg/kg. The gentamicin group was injected with gentamicin at a dose of 80 mg/kg during 8 days and vehicle for 11 days. The other two experimental groups were administered gentamicin (80 mg/kg during) 8 days and melatonin (doses of 5 and 10 mg/kg) 3 days before and 8 days concomitantly with melatonin. Obtained liver sections were analyzed using qualitative, semi-quantitative, and stereological analysis. Results: Gentamicin expressed hepatotoxic effects inducing congestion of lobular blood vessels, hydropic degeneration of periportal hepatocytes and mononuclear infiltration in the portal tract. Treatment with gentamicin resulted in an increase in the Vv of blood vessels, a decrease in the Vv of hepatocytes, and a decrease in the glycogen content in all three lobular zones. Melatonin administration reduced the liver alterations induced by gentamicin; the higher dose had a more potent protective effect. Conclusion: Melatonin has a beneficial effect on gentamicin-induced liver damage and the effect is dose-dependent.

Aim To determine the value of angles between the left coronary artery main trunk (LMT) and its branches, the anterior interventricular branch (LAD) and the circumflex branch (CX), and their possible relationship with the LMT length. Methods A total of 29 cadaveric hearts were used. The left coronary artery and its branches were dissected. The hearts were then classified according to the number of branches. The LMT length was measured with a digital gauge, and the LAD-CX angle, LMTLAD angle and LMT-CX angle with a manual goniometer. Results The average value of the LMT length was 9.0 mm (6.0-13.5). In 20 (68.97%) samples, the LMT was divided into two terminal branches. There was no statistically significant difference (p=0.321) in LMT length between the hearts with a bifurcation and without it. The average value of the LAD-CX angle was 89.0⁰ (74.5-93.0), with a statistically significant difference (p=0.020) comparing to hearts with trifurcation. The mean value of the LMT-LAD angle was 30.83±9.23⁰ and it was significantly lower (p=0.006) in the group of hearts with bifurcation compared to the group with trifurcation of the main trunk. Conclusion The LMT length shows great variability and is not related to the LAD-CX, LMT-LAD or the LMT-CX angle. Knowledge of the left coronary variation is essential in order to avoid misinterpretation of arteriogram.

Background: Zearalenone is a widely spread mycotoxin, contaminant of most cereal grains. It has uterotropic, estrogenic and anabolic activity in farm animals. The results are hormonal disbalances as hyperestrogenism, Zearalenone inhibits follicle-stimulating hormone production, thus supressing ovarian follicle development and ovulation. Also, it induces oxidative stress. Melatonin acts as a potent natural antioxidant and regulates the reproductive function by modification of steroidogenesis. Objective: The present study was conducted to provide detailed qualitative histological analysis of uterus of female rats treated with zearalenone and melatonin and contribute to better understanding of the topic. Methods: Forty adult, female Wistar rats were equally divided into five groups: Z group – zearalenone, 0,3 mg/kg, i.g.; M group – melatonin, 10 mg/kg, i.p.; ZM group –concomitant application of zearalenone and melatonin in the same dosing regimen, VZ group–zearalenone vehiculum/sunflower oil, i.g. and MZ group–melatonin vehiculum/5% ethanol in Ringer, i.p. Animals were treated daily for 28 consecutive days. After that period, all animals were sacrificed to obtain samples for qualitative histological analysis using the light microscope. Results: Zearalenone led to the alterations of the uterine structures, predominantly in the endometrium that were characterized by metaplasia and hypertrophy of the epithelial cells and hypercellularity of the stroma. In the myometrium, zearalenone induced hypertrophy and hyperplasia of the myocytes. Conclusion: Melatonin, when applied together with zearalenone, blocked the adverse effects of the zearalenone.

Objective. The aim of this study was to learn about the morphological characteristics of the supraorbital foramen and to determine its precise position in relation to the surrounding anatomical landmarks in the adult population of Bosnia and Herzegovina. Material and Methods. For this purpose, 60 skulls from the Bosnia and Herzegovina population of known sex (32 males and 28 females), taken from the osteological collection of the Department of Human Anatomy of the Medical Faculty in Sarajevo, were subjected to morphological and morphometric analysis. Morphometric measurements were performed using a digital vernier caliper (Mitutoyo Corporation, Japan). Results. The study showed that most supraorbital nerves exit the orbit through the supraorbital notch (73.8%) and the rest through the foramen (26.2%). Of this number, bilateral supraorbital notches were recorded in 58.33% of cases, a bilateral supraorbital foramen in 18.34% of cases, while in 23.33% of cases a notch was recorded on one side and a foramen on the contralateral side. Morphometric measurements performed to determine the exact position of the supraorbital foramen relative to the surrounding landmarks showed different values in males and females. An accessory foramen was also observed on the examined skulls in 16.67% of cases. Conclusion. Detailed knowledge of anatomical variations of the supraorbital foramen is required for safe and successful administration of regional anesthesia, in order to avoid iatrogenic nerve injuries during orbitofacial region surgery.

Eldan Kapur, Alma Voljevica, Maida Šahinović, Adis Šahinović, Armin Arapović

Objective. The objective of this study was to study the morphometry of the styloid process of the temporal bone and the prevalence of an elongated styloid process in relation to side and gender. Material and Method. The present study included 200 human skulls which were procured from the rich osteological collections of the Department of Anatomy, Faculty of Medicine, University of Sarajevo. The styloid process was observed macroscopically on both sides of all the skulls and elongations, if any, were noted. The lengths of the styloid processes were measured using digital vernier calipers. The measurements were taken from the point of emergence of the process (base) up to the tip. Results. Out of 200 specimens, only 14 cases (7%) exhibited an elongated styloid process. The mean length of the styloid process was 25.8±4.68 mm and 24.2±4.54 mm for the right and left sides, respectively. The size of the styloid process did not different significantly between the two sides (P=0.724). The mean length of the styloid process was 24.05±3.54 mm in females and 25.95±5.68 mm in males, and the difference was statistically significant (P=0.023). Conclusion. The study and knowledge of the anatomical variations of the styloid process in the Bosnian population may help clinicians to diagnose Eagle’s syndrome. Knowledge of this disorder can prevent the worsening of the painful symptoms related to an elongated styloid process.

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