INTRODUCTION Acute bacterial meningitis (ABM) is a serious infectious disease and medical emergency. Given the fact of its high mortality and morbidity, detecting prognostic factors is potentially useful in improving treatment strategies. This paper aims to determine prognostic factors of short-term outcomes of patients with ABM in a developing country - Bosnia and Herzegovina, measured by the Modified Rankin Scale (MRS) at discharge. METHODOLOGY In this retrospective cohort study, 56 patients treated at the Clinic of Infectious Diseases, Clinical Center University of Sarajevo, for 11 years (2012-2022) were included. Statistical analysis was performed using IBM SPSS Statistics version 29.0.1.0. RESULTS The subjects' average age was 31.6 ± 27.7 years, with the youngest patient being 4 months and the oldest 75 years old. Among those, 31 were male and 25 were female. Unfavorable outcomes had 16 (28.6%) patients, including fatal outcomes in four patients and severe disabilities in 12 patients (MRS: 2-6), while 40 (71.4%) patients had favorable outcomes (MRS: 0-1). In the multivariate analysis, predictors of unfavorable outcomes included age older than 60 years, duration of symptoms longer than 24 hours, presence of neurological defects at admission, impaired consciousness, respiratory distress, and no corticosteroid use during treatment. CONCLUSIONS There is certainly a window of opportunity for patients with ABM: The shorter the time between disease onset and treatment initiation, the better the disease outcome.

Background: COVID-19 is a respiratory disease caused by a novel coronavirus, with a high mortality, especially in patients with underlying diseases. Patients with COVID-19 pneumonia may express an immune response such as cytokine storm or macrophage activation syndrome, which can lead to organ failure and death.Some studies suggest that corticosteroid and tocilizumab can improve the respiratory status and clinical outcome of patients with COVID-19 pneumonia. Aim: The aim of the study was to determine the potential effect of the use of tocilizumab and corticosteroids in patients with concomitant cardiovascular diseases on the clinical course and outcome during COVID-19 infection. Methods: We performed an observational retrospective study of adult patients admitted to “Travnik” and “Jajce” Hospital, Bosnia and Herzegovina, between 01.03.2020 and 01.12.2022 with confirmed COVID-19 and underlying cardiovascular disease (CVD). Results: The majority of patients (110 or 60.4%) had previously reported cardiomyopathy, and other cardiovascular disease included earlier myocardial infarction, stroke, cardiac arrhythmias, cardiac surgery, compensated cardial disease, and acute myocardial infarction. Total of 159 (87.4%) patients received corticosteroids during treatment. Tocilizumab has been used in 16 patients; nine survived and seven died. Conclusion: Even some studies proved that it might improve clinical presentation and prevent lethal outcomes; in our study there were no significant results to confirm this thesis.             Peer Review History: Received 28 September 2024;   Reviewed 15 November; Accepted 21 December; Available online 15 January 2025 Academic Editor: Dr. DANIYAN Oluwatoyin Michael, Obafemi Awolowo University, ILE-IFE, Nigeria, toyinpharm@gmail.com Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.5/10

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has underscored the significant role of cardiovascular risk factors in determining the severity and outcomes of the disease. Pre-existing conditions such as hypertension, diabetes, obesity, and cardiovascular diseases have emerged as key contributors to increased susceptibility to severe forms of COVID-19, influencing both short-term and long-term health outcomes. This review examines the complex interplay between these risk factors and the virus’s direct impact on the cardiovascular system. Key findings suggest that conditions like hypertension, diabetes, and obesity not only predispose individuals to more severe disease but also exacerbate complications such as myocardial injury, arrhythmias, and heart failure. Furthermore, the long-term cardiovascular effects of COVID-19, including myocarditis and pericarditis, are of growing concern, particularly in patients with pre-existing cardiovascular conditions. The virus’s ability to induce myocardial damage through mechanisms involving ACE2 receptor binding and inflammatory cytokine storms has been well-documented. The pandemic has also highlighted significant cardiovascular complications, including left and right ventricular dysfunction, myocardial injury, and elevated pulmonary arterial pressure, with the right ventricle being particularly affected due to pulmonary damage. Imaging modalities such as echocardiography and cardiac magnetic resonance have proven valuable for diagnosing myocardial injury and complications, although accessibility may be limited in routine clinical practice. Survivors of severe COVID-19, especially those with pre-existing cardiovascular conditions, face an elevated risk of major adverse cardiovascular events for up to two years post-infection. Evaluation of post-COVID patients includes ECGs, laboratory tests, echocardiography, and cardiac MRI, which provide critical insights into myocardial injury and complications. Preventive measures, including vaccination, regular monitoring of cardiovascular health, and lifestyle modifications, play a crucial role in reducing the long-term risk of cardiovascular complications. The role of vaccination in mitigating the risk of severe disease and cardiovascular complications is well-established, despite rare cases of vaccine-related myocarditis. Understanding these interactions is essential for developing targeted management strategies, improving patient outcomes in both acute and long-term COVID-19 effects, and addressing the broader challenges posed by COVID-19’s impact on cardiovascular health.

Background: Acute nasopharyngitis is often treated with hypertonic saline that can be combined with additional compounds, such as lysozyme. The aim of this study was to compare efficacy and safety of hypertonic saline solution with or without lysozyme in the treatment of acute nasopharyngitis. Methods: Non-interventional, prospective, multicentre, observational, parallel study was conducted on adult subjects with symptoms of acute nasopharyngitis. Subjects were divided into hypertonic saline or lysozyme group (receiving slightly hypertonic nasal spray with addition of lysozyme). Time until the patency of both nasal passages was measured after the first application of therapy. The congestion severity was assessed by using a visual analogue scale before the therapy application, after 30 minutes, and after seven days. Adverse reactions were monitored and evaluated.   Results: The total number of included subjects was 252 (60 in the hypertonic saline group and 192 in the lysozyme group). In both groups, a significantly better assessment of the severity of the nasal passages’ obstruction was recorded after 30 minutes and seven days from therapy start (for all compared time intervals p<0.001). The lysozyme group had a significantly lower nasal congestion score compared to hypertonic saline 30 minutes after therapy (p<0.001) and seven days from the therapy start (p=0.001). In the hypertonic saline group, a significantly shorter time was observed to establish the patency of the nasal passages after the first therapy application (p<0.001). All adverse events were mild. Conclusions: Addition of lysozyme to slightly hypertonic nasal spray brings added value in the pharmacotherapy of acute nasopharyngitis.

Introduction. The development of the coronavirus disease 2019 (COVID-19) vaccine marked the beginning of the end of the pandemic and the understanding of the disease as something that is part of clinical practice. The aim of this study was to investigate, assess, and demonstrate the signifi cance of vaccination on the outcome of severely ill patients treated in intensive care units. Methods. A retrospective study was conducted on a sample of patients hospitalized at the Clinic for Infectious Diseases of the Clinical Center of the University of Sarajevo during 2022. Results. Participants who were vaccinated against COVID-19 had a lower mortality rate and a higher chance of survival compared to unvaccinated participants. Additionally, disease outcomes were signifi cantly infl uenced by oxygen saturation and platelet count at admission. Conclusion. COVID-19 vaccination signifi cantly reduced the mortality rate, with vaccinated par-ticipants having a higher chance of survival compared to unvaccinated participants.

During the COVID pandemic, research has shown an increase in candidemia cases following severe COVID infection and the identification of risk factors associated with candidemia. However, there is a lack of studies that specifically explore clinical outcomes and mortality rates related to candidemia after COVID infection.

Background: Autoimmune limbic encephalitis (ALE) is an inflammatory brain process involving a group of diseases with antibodies against neuronal synaptic and cellular antigens. Diagnosis is based on clinical examination, neurological functional tests, cerebrospinal fluid analysis, immunological testing, and radiological findings. Objective: This case report aims to present the case of a 68-year-old patient initially hospitalized for intermittent neurological deficits in the form of cognitive disorders of consciousness, which was initially declared as dementia without physical neurological deficit. Case presentation: Initial brain MRI (SIEMENS Magnetom Avanto, 1.5 T, Erlangen, Germany) showed changes differentially diagnosed characterised as glial neoplasm of mixed-grade astrocytoma or inflammatory process of unilateral autoimmune encephalitis. Since the neurosurgical opinion suggested a higher-grade glioma with proposed surgical treatment, the patient was referred for repeated MRI with MR spectroscopy in order to exhaust all diagnostic possibilities before surgery. MRI with MR spectroscopy (SIEMENS Magnetom Lumina, 3 T, Erlangen, Germany) revealed radiologically altered findings, in the right hippocampus and parahippocampal gyrus, which primarily corresponded to changes due to unilateral autoimmune encephalitis,due to its morphology characteristics and spectroscopy profile, making the primary glial neoplasm of lower grade less likely. Since the neurological mosaic IIFT result showed a positive LGI1 antibody finding, therapy for autoimmune encephalitis was initiated, leading to significant improvement in cognitive functions and the return of short-term memory. Conclusion: Although the detection of antibodies against onconeural, cellular, and synaptic proteins represents a significant advancement in diagnosing autoimmune limbic encephalitis, the role of conventional diagnostic tools such as MRI, EEG, and cerebrospinal fluid analysis should not be overlooked, where the application of new functional imaging techniques such as MR spectroscopy can be beneficial and should be considered.