Introduction: Preoperative carbohydrate oral (CHO) drinks attenuate the surgical stress response; however, the effects of CHO supplementation on the neutrophil-to-lymphocyte ratio (NLR) as an inflammatory and immunology-based predictor remain unclear. This study evaluated the effects of preoperative CHO loading on NLR values and complications following open colorectal surgery compared with a conventional fasting protocol. Methods: Sixty eligible participants having planned for routine and open colorectal cancer surgery from May 2020 to January 2022 were prospectively and randomly allocated to either the control (fasting) group, whose members discontinued oral intake beginning the midnight before surgery, or the intervention (CHO) group, whose members consumed a CHO solution the night before surgery and 2 h prior to anaesthesia. NLR was assessed at 06:00 h before surgery (baseline) and at 06:00 h on postoperative days 1, 3, and 5. The incidence and severity of postoperative complications were assessed by Clavien-Dindo Classification up to postoperative day 30. All data were analysed using descriptive statistics. Results: Postoperative NLR and delta NLR values were significantly higher in controls (p < 0.001; p < 0.001). Control group participants also demonstrated grade IV (n = 5; 16.7%, p < 0.01) and grade V (n = 1; 3.3%, p < 0.313) postoperative complications. There were no major postoperative complications in the CHO group. Conclusion: Preoperative CHO consumption reduced postoperative NLR values and the incidence and severity of postoperative complications following open colorectal surgery, compared with a preoperative fasting protocol. Preoperative carbohydrate loading may improve recovery following colorectal cancer surgery.

Aim To compare hospital costs of acute limb ischemia treatment in two periods of time and to show evidence of long-term repercussions on reducing costs during successful treatment. Methods Retrospective analysis of data obtained from 100 patients' medical history in the period 2000-2016 at the Clinic of Vascular Surgery Sarajevo: group A - 60 patients with acute limb ischemia in the period 2005-2016 and group B - 40 patients with acute limb ischemia (ALI) in the period 2000-2005. From 2000 to 2005 conservative treatment method was used, invasive diagnostic and surgical procedures were often delayed for a shorter or longer period of time. During the period from 2005 to 2016, the management model and safe practice included emergency diagnostic procedures, colour-Doppler, arteriography, emergency surgery (embolectomy by Fogharty and if necessary, vascular by-pass). Results Better health service for the patients with acute limb ischemia was offered in the period 2005-2016, which relied on proven medical treatment trends. The largest share of the total costs of each patient included costs of hospital bed with significant difference between the period 2005-2016 and 2000-2005, mean of 1398.71 KM and 2480.45KM, respectively (p<0.0001), indicating rationalization of time that patients spend at the Vascular Clinic. Conclusion This trend of money/fund savings is an example of good practice, effectiveness and efficiency in the treatment of ALI and as such was used in patients with other vascular diseases.

This study aimed to evaluate the effect of preoperative carbohydrate oral (CHO) loading on the postoperative metabolic and inflammatory response, perioperative discomfort and surgical clinical outcomes in open colorectal surgery compared with a conventional fasting protocol. Fifty patients were randomly allocated to either the intervention group (CHO), to receive preoperative oral carbohydrate supplementation, or the control group (FAST), to undergo preoperative fasting. Insulin resistance, insulin sensitivity, the Glasgow Prognostic Score (GPS) and IL-6 levels were analysed at 06 h on the day of surgery (T1), 6 h after surgery (T2) and at 06 h on postoperative day 1 (T3) and postoperative day 2 (T4). Thirst, hunger, dry mouth, weakness, anxiety and pain were assessed using the visual analogue scale (VAS) prior to anaesthesia induction and at 0–4, 4–8, 8–12 and 12–24 h after surgery. Surgical clinical outcomes included the return of gastrointestinal function, time to independent ambulation and postoperative discharge day. Postoperative insulin resistance was 30% lower (p < 0.03) and insulin sensitivity was 15% higher (p < 0.05) in the CHO group than in the FAST group. The GPS was lower in the CHO group at T1 (p < 0.001), T3 (p < 0.01) and T4 (p < 0.004). IL-6 serum levels were lower at the analysed postoperative time points in the CHO group (p < 0.001). The VAS well-being score was lower in the intervention group (p < 0.001); however, the VAS pain score was not significantly different between the groups. The evaluated surgical outcomes appeared earlier in the CHO group (p < 0.001). A preoperative CHO drink reduced the postoperative metabolic and inflammatory response and improved subjective well-being and surgical clinical outcomes but did not diminish the VAS pain score.

Objective – To analyze the clinical and histological characteristics, as well as to evaluate the results of surgical treatment of pediatric neuroepithelial tumors. Patients and methods – A retrospective study was conducted, including 40 pediatric patients surgically treated at the Clinic of Neurosurgery, University Clinical Hospital Tuzla in the period 2002-2012. During the study we formed groups and the analysis was conducted by age, gender, clinical signs, histopathologic types and type of surgical treatment. The results are presented in tables and expressed by relative values. Results – Neuroepithlial tumors are more common in male patients. There was no statistically significant difference in distribution of neuroepithelial tumors (I‡2=0.400; p=0.527) related to supratentorial and infratentorial localization. Infratentorial neuroepithelial tumors are most common at a younger age (F=6.516; p=0.015). Increased intracranial pressure and seizures are the most common initial presentation of neuroepithelial tumors (I‡2=0.022; p=0.882). There was no statistically significant difference between types of surgical resection and localization of the tumor. Usually we performed total resection (I‡2=0.246; p=0.620). There was a statistically significant difference in tumor grade regarding supratentorial and infratentorial localizations (p=0.013). Infratentorial tumors are higher grade (I‡2=5.495; p=0.019). Conclusion – The most common initial presentations of neuroepithelial tumors are increased intracranial pressure and seizures. Infratentorial tumors are higher grade. The most common initial treatment of neuroepithelial tumors is radical surgical resection.

Introduction: Life satisfaction involves cognitive component that allows evaluation of the life and accomplishments of life, and emotional component that includes an evaluation of emotions and mood that followed these accomplishments. Goal: To examine the life satisfaction of young people who attend secondary school, examine the level of satisfaction with life according to sex, to academic achievement, the presence of siblings and to examine the relationship between levels of life satisfaction and risk-taking behaviors. Results and Discussion: The results showed that there was no relationship between life satisfaction and preferences of delinquency, as well as life satisfaction and achieved academic success. The results confirmed the relationship between life satisfaction and sex as well as the relationship between life satisfaction and the presence of siblings in the family.

Introduction: The intention of this work is to research whether the link between the barometer pressure and the cerebrovascular insult (CVI) exists. The stroke is the first cause of non-traumatic disability and third illness by mortality in the majority of available relevant literature. Goals: Goal of the sudy was to research all the cases of the patients who suffered from the acute stroke in the Canton of Sarajevo and those who were treated in the pre-hospital phase by Emergency Medical Institute staff and their working diagnosis was established as CVI ac. Material and methods: The criteria in the research were established for inclusion and exclusion of cases. The days with and without CVI cases were compared with the meteorological data obtained from the Hydro-meteorological Institute of Federation of Bosnia and Herzegovina . Since the approval was requested and obtained from the Hydro-meteorological Institute, all the meteorological data could be compared. The meteorological data comprise the barometer pressure measuring every day at 7 h, 14 h and 21 h. Results and discussion: In the retrospective study, there will be followed, during three years (2004, 2005 and 2006), the cases of the patients who suffered from the stroke, and, the emergency medical care was offered to them by the side of the Emergency Medical Institute of Canton of Sarajevo staff. All the cases in the Canton of Sarajevo were followed regardless of the place of incidence: whether the help was offered in Institute’s outpatient departments, patient’s flat or at public place. Due to the extensiveness of data (in the analysis comprising three years, there was the total of 1930 cases), the test of normal distribution was used. Since it was about the pre-hospital research, the acute stroke was looked at generally without division by types. The certain diagnostics by types can only be established in the hospital. Conclusion: The results in the research indicate that the extreme values of barometer pressure, regardless of their being increased ones or decreased ones, influence the increase of CVI incidence, while by comparing the average values in the days with CVI and without CVI, they did not have any influence on the CVI incidence.