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Mahmud Nurkić

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Aim: The prognostic value of circulating antibodies to oxidized low-density lipoprotein (anti-oxLDL) in patients with coronary heart disease is not completely clear. We aimed to investigate the association between levels of anti-oxLDL in three groups of patients with different grades of severity of coronary heart disease. Patients and methods: The study included 101 patients classified into three groups: one (N=35) with acute myocardial infarction (AMI), a group (N=35) with angiographicallly proven coronary artery disease (APCAD), and a group without angiographicallly proven coronary artery disease (N=31) designated as a control group. Levels of IgG anti-oxLDL antibodies were meausured by enzyme-linked immunosorbent assay. Results: Mean anti-oxLDL value was significantly higher in patients with AMI than in patients with APCAS (1342.1±581.5 mIU/ml vs. 553.0±183.3 mIU/ml, p<0.001), as well as compared with control group (1342.1±581.5 mIU/ml vs. 246.5±114.3, p<0.001). Similarly, significant difference in anti-oxLDL levels was found between the patients with APCAS and control group (p<0.001). Conclusions: The present study showed that elevated levels of anti-oxLDL are positively related with a severity of coronary artery disease. Hence, elevated levels of anti-oxLDL may identify patients with unstable coronary heart disease. Oxidized LDL in circulating plasma could serve as a marker of cardiovascular events.

Mahira Jahić, A. Balić, M. Nurkić, Jasmina Dragović, A. Adžajlić, A. Habibović, Lejla Mešalić, Aza Zigić

M. Nurkić, Dževdet Sarajlić, E. Čičkušić, N. Tihić, F. Numanović, Z. Delibegović, M. Gegić, Ibrahim Pasic, H. Băsić

There has never been a case of dirofiliriasis conjunctivae recorded in Bosnia and Herzegovina until now. It is true that German scientists described one case in the woman who stayed in the region of former Yugoslavia, Italy and Spain in 1984 and she might have been infected in one of these countries. The aim of this work is to present the first case of ocular Dirolfiliriasis in a female patient in Tuzla. Patient BD, born in 1946 was admitted to Ophthalmology department in Tuzla on May 10th 2007 with a diagnosis of: Conjunctivitis oc.dex., parasitosis subconjunctivae dex. On May 11th 2007 a parasite was removed, 105.6 mm long, 0.473 wide with cephalic part slightly curved and esophagus length of 15mm. It was concluded that the discovered parasite is the member of Filaridae family and Dirofilaria species. Eoosinophilia with 17% eosinophiles was found in the peripheral blood smear. The presented case indicates that Dirofilariosis can be found in the region of Bosnia Herzegovina.

F. Numanović, M. Hukić, M. Nurkić, M. Gegić, Z. Delibegović, A. Imamovic, S. Pasić

The natural habitat of Gardnerella vaginalis is a vagina since it could be located among 69% of women who have no signs of vaginal infection and in the vagina of as many as 13.5% girls. G. vaginalis is almost certainly identified among women diagnosed with bacterial vaginosis as well as in the urethra of their sexual partner. The increase in prevalence and concentration of G. vaginalis among patients diagnosed with this syndrome confirms that G. vaginalis plays a significant role in its pathogenesis. In our research, based on Amsel criteria for three or more clinical signs of bacterial vaginosis, it was diagnosed in 20.5% of women with subjective problems of vaginal infection, and in 48.80% of women with subjective symptoms characteristic of this disease. G. vaginalis was isolated from vaginal secretion of women without clinical signs characteristic of bacterial vaginosis. In 2.58% of cases it was solitary, while in 1.28% it was found in combination with other aerobic and anaerobic bacteria and, in 1.28% women combined with Candida albicans. The isolation of G. vaginalis was significantly increased (p<0.05) in the group of women with clinical signs of bacterial vaginosis in comparison to the group of women without these signs. Frequent recurrence of bacterial vaginosis, which is found in 20-30% of women within a three months treatment, is explained as reinfection with other biotype of G. vaginalis, different from a source biotype or as a consequence of wrong treatment. Following Piot biotype scheme, biotypes 2., 3. and 7. G. vaginalis are significantly more often isolated from women who suffer from bacterial vaginosis. Biotype 7. G. vaginalis, isolated from the group of women without clinical signs of bacterial vaginosis, accounted for 2.58% cases. Following Benit biotype scheme, biotypes IVa, IVc and IIc were identified in 12.90% cases, while biotypes IIIa, IIa, Ia, IVb, IIb were found in 6.45% cases. Lipase-positive isolates of G. vaginalis were significantly more frequently accompanied by the syndrome of bacterial vaginosis.

It is generally accepted that inflammation has an important role, not just in the pathogenesis of atherosclerosis, but also in initiation of acute coronary syndrome (ACS). A number of studies showed, that a high concentration of high sensitivity C reactive protein (hsCRP) is an independent risk factor for the development of cardiovascular disease in a healthy person. HsCRP can predict new cardiovascular episodes, including death, in patients with unstable angina and acute myocardial infarction (AMI). Ability of oxidated low densiti lipoprotein (oxLDL) to induce accumulation of holesterol in macrofage was his first described proaterogenic characteristic and it help in hipotesis that oxidation of low densiti lipoprotein (LDL) can be important step in proces of aterogenesis. Framingham study showed that ther is significant corelation between level of total holesterol in blood and coronary artery disease (CAD). Evaluation of bouth hsCRP and LDL levels is superior in detection of CAD. Aims of this study were to determine values of hsCRP in patients with coronary arteries disease verified by coronary angiography (stenosis>70%), and to check if values of hsCRP higher than 3.0 mg/ dL are better predictor of coronary artery disease then lipid status. A prospective study was conducted on 60 patients, who were divided in two groups in compliance with significance of coronary artery disease. All patients have earlier diagnosis of ACS, and from this study excluded patients with acute infection, chronic, systemic or malignant disease. This research shows that patients with significant coronary artery disease, verified by coronary angiography, have higher values of hsCRP than those without disease that have values within the range of the reference values (0-3 mg/dL). Patients with coronary artery disease verified by coronary angiography have values of hsCRP that put them in a group of patients with intermediate to high risk of a future acute cardiovascular event, by classification of American Heart Association. In group of patients with coronary disease there is significant elevation of LDL and total cholesterol. With elevation of HDL values there is reduction in hsCRP values in patients with no significant coronary artery disease.

In this study we analyzed microbiology results of tuberculosis in urinary system, in the area of Tuzla canton in period since 1993 to 2005 year. For microbiological diagnosis we tested samples of whole morning urine by method of concentration and homogenization by Petroff and inoculated on Loewenstein culture media. All grown culture was identified biochemical by production of niacin, reduction of nitrate and production of heat labile catalase. In this investigated period we tested 121,945 samples of different biological materials on Mycobacterium tuberculosis: sputum 89,433, gastrolavate 5,122, broncholavate 1,337, pleural exudation 1,356, punctuates 1,711, liquors 179, stools 149, blood 4, urine 22,654 samples. All urine samples were taken from 4,192 patients. Positive culture is found in 358 urine samples or in 1, 58%, or 173 patients or 4, 13%. From total 4,759 microbiologically diagnosed patients with all different types of tuberculosis in this period of time, with pulmonary tuberculosis there was 4,495 or 94, 45% patients and 264 or 5, 55% with extrapulmonal types of tuberculosis. Tuberculosis of urinary system is microbiologically diagnosed in 173 or 3, 63% patients out of total number of diagnosed tuberculosis cases. Tuberculosis of urinary system is diagnosed in 115 women and 58 men. In both sexes it was most often diagnosed in age of 65 to 74 year and in women in age of 45 to 54 year and in man in age 25 to 34 year. Tuberculosis of urinary system is more common in patients from Tuzla then from other town in Tuzla canton. It is also more common in patients that were treated in Clinic then those who were treated ambulatory. We can conclude that distance of place of living from place of microbiology laboratory significantly influence on microbiologically diagnostic of tuberculosis of urinary system.

M. Nurkić, A. Imamovic, F. Numanović, M. Gegić, M. Osmić, Selma Hadzihafizbegović

Aim of this research was to investigate diagnostic value of discovering of antibody on A60 antigen in patients who were tested for presents of Mycobacterium tuberculosis in there biological samples. We tested a samples of sputum, gastric juice, urine, cerebrospinal fluid and punctate from group of 353 patients who were suspected for tuberculosis. In all patients we were looking for antibodies classes A60 antigen. We used immune chromatographic "Hexagon TB" test, Germane company "Human Geselschaft fur Biochemica und Diagnostica". From 353 patients we found 58 (16.43%) patients with positive BK, 79/22,38%) patients with positive Lowenstein culture and 122 (34,55%) patients with antibody in sera on A60 antigen. Patients who were BK and Lowenstein positive, have had antibody in 94,23% cases, Patients who were BK negative and Lowenstein positive have had antibodies in 70,37% cases and patients who were BK negative and Lowenstein negative have had antibody in 19,03% cases. Patients with BK positive and Lowenstein negative results have had antibody in 50,00% cases. Difference between results is significant (p<0,01). From 122 patients with positive antibodies, 52 were BK positive and 68 have had positive Lowenstein cultures. From 231 patients with no antibody, just 6 were BK positive and 11 Lowenstein positive. In 62 patients with positive antibodies, were BK and Lowenstein negative. We confirmed that antibody on A60 antigen in microbiological positive patients are more often then in microbiological negative patients (p<0,001).

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