Background/Objectives: The COVID-19 pandemic caused over seven million deaths globally as of July 2024. In an attempt to bring the pandemic under control, immunization was implemented as the main preventive strategy. This study aimed to investigate the knowledge, attitudes, and practices (KAP) of hospitalized patients and healthcare workers (HCWs) regarding COVID-19 vaccination, as well as the factors contributing to COVID-19 vaccination rates. Methods: This cross-sectional, survey-based KAP study was conducted between November 2024 and February 2025 in five hospitals across five cities of the Republic of Srpska, Bosnia and Herzegovina. Results: There were 571 respondents, 68% of whom were female, with an average age of 39.17 ± 14.74 years; one-third held a university degree. The study sample consisted of patients and healthcare workers (HCWs) (59% vs. 41%). During the pandemic period, 46.6% of respondents were diagnosed with COVID-19, with a higher prevalence among healthcare workers compared to patients (54.2% vs. 41.2%). Among the 55.2% of respondents who were vaccinated, HCWs were more often vaccinated than patients (70.9% vs. 44.2%) and more likely to know that vaccines protect against severe forms of disease and death (80.8% vs. 68.5%). Patients more often believed that vaccination against COVID-19 may lead to sterility in young patients (11.3% vs. 6%) and were more often afraid of vaccination compared to the occurrence of COVID-19 (35.6% vs. 24.8%). Regression analyses showed that independent predictors of COVID-19 vaccination were older age (p < 0.001), higher education level (p = 0.039), knowledge of vaccine production technology, and the belief that vaccinated individuals have milder symptoms of the disease (p = 0.002). Conversely, the belief that the COVID-19 situation was overblown was negatively associated with vaccination (p = 0.004). Conclusions: HCWs had better knowledge, more positive attitudes, and better vaccination practices against COVID-19 in comparison to patients. However, there are still certain dilemmas and hesitations among HCWs toward COVID-19 vaccination.

Urinary tract infections, as one of the most common infectious diseases, contribute substantially to the global healthcare burden, particularly due to the rising prevalence of resistant bacterial strains such as Klebsiella pneumoniae. Background/Objectives: The aim was to investigate the prevalence of urinary tract infection pathogens among hospitalized patients at Saint Apostol Luka Hospital in Doboj during the period 2021–2023. Methods: This retrospective cross-sectional study was conducted at Saint Apostol Luka Hospital, Doboj, Republic of Srpska, Bosnia and Herzegovina. Data from the Department of Microbiology were analyzed for the period 2021–2023, including patients with positive urine cultures (≥103 CFU/mL) of a single uropathogen. Bacterial identification and susceptibility testing were performed according to EUCAST standards, and statistical analysis was carried out using SPSS v24. Results: Escherichia coli was the most frequent isolate (29.2%), followed by Klebsiella spp. (24.2%) and Enterococcus spp. (19.8%). A significant rise in K. pneumoniae prevalence and resistance to multiple antibiotics—including β-lactams, carbapenems, aminoglycosides, and colistin—was observed during the study period. Conclusions: This study revealed that E. coli and Klebsiella spp. were the leading uropathogens, with notable differences in distribution by sex, age, and hospital department. A marked rise in multidrug resistance, particularly among K. pneumoniae, was observed across the study period. These findings underscore the urgent need for continuous surveillance and stronger antimicrobial stewardship to curb resistance trends.

Background: Undernutrition disorder is a prevalent comorbidity (up to 25%) in type 2 diabetes (T2D) patients which significantly compromises their health. We aimed to assess the association between single nucleotide polymorphysms (SNPs) adiponectin (ADIPOQ) +276 (G/T) and resistin (RETN) −420 (C/G) with the risk of developing T2D and undernutrition in patients with T2D. Methods: The research was conducted as prospective case-control study among 106 patients with T2D and 106 healthy control individuals in the territory of the Bosnia and Herzegovina from Sep 1st 2022 to May 1st 2023. For assessing the nutritional status, the mini nutritional assessment (MNA) was used. DNA analysis was carried out by restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR) method. The data were analyzed using chi-square test, t-test for independent samples and binary multivariate logistic regression. Results: The research included 212 subjects of which 124 (58.5%) were male. The mean age of the subjects was 68.48±4,67 yr. Almost 20% of subjects were undernourished, significantly more T2D patients when compared to controls (33% vs. 6.6%; P<0.001). ADIPOQ +276 GT genotype was identified as significant predictor of T2D (OR: 3.454; 95% CI: 1.400–8.521; P=0.007) and undernutrition disorder (OR: 3.453; 95% CI: 1.331–8.961; P=0.011) in T2D population, while the presence of RETN −420 CG genotype had protective effect against occurrence of T2D (OR: 0.353; 95% CI: 0.144–0.867; P=0.023). However, RETN genotypes were not associated with undernutrition disorder. Conclusion: ADIPOQ +276 gene polymorphism represent a significant predictor for development of T2D and undernutrition disorder in T2D population, while RETN −420 gene polymorphism was identified as a significant factor associated with a reduced risk for T2D, but was not associated with undernutrition.

The aim of the study was to assess the seroprevalence of SARS‐CoV‐2 in the Republika Srpska, Bosnia and Herzegovina, after five waves of COVID‐19 and 1 year after introduction of vaccination to better understand the true extent of the COVID‐19 pandemic in the population of the Republika Srpska and role of vaccination in achieving herd immunity.

<p><strong>Introduction. </strong>The COVID-19 pandemic has had a significant impact on the mental health of individuals with chronic diseases. Contributing factors include limited access to healthcare during lockdowns, fear of infection, and heightened stress due to poorer outcomes of COVID-19 infection in this population. The aim of this study was to examine the presence of depression, anxiety, and stress in the second year of the COVID-19 pandemic among individuals with pre-ex<br />isting cardiovascular, malignant, chronic respiratory diseases, or diabetes mellitus.<br /><strong>Methods. </strong>A cross-sectional study was conducted among the general population of the eastern region of Republic of Srpska during December 2021 and January 2022. Depression, anxiety, and stress were assessed using the DASS-21 scale, while data on comorbidities were collected through a questionnaire from an epidemiological population-genetic study conducted concurrently.&nbsp;<br /><strong>Results.</strong> A total of 1,372 participants from the eastern region of Republic of Srpska were included in the study, consisting of 40.0% males and 60.0% females. Participants were aged 20 years and older, with an average age of 50.6 years. The study found that depression, anxiety, and stress were statistically significantly more prevalent among participants with pre-existing cardiovascular or chronic respiratory diseases compared to those without such conditions. Additionally, participants with a history of malignant diseases or diabetes mellitus were significantly more depressed and anxious than&nbsp;<br />those without these conditions.<br /><strong>Conclusion. </strong>The findings of this study may contribute to the development of policies aimed at improving mental health and preventing mental disorders in individuals with comorbidities.</p>

<p><strong>Introduction. </strong>Antibiotic resistance is a major threat to public health globally. The aim was to examine the impact of the COVID-19 pandemic on the distribution and antimicrobial resistance of pathogenic microorganisms isolated from samples&nbsp;<br />obtained during standard hospital care in one hospital center. &nbsp;<br /><strong>Methods.</strong> Data were obtained retrospectively from a database of the hospital microbiology laboratory. Study sample consisted of 3012 samples tested before the pandemic in 2019 and 3130 samples from the pandemic period in 2021.&nbsp;<br /><strong>Results.</strong> There was no statistically significant difference in the occurrence of agents that were resistant to all antibiotics between the observed years, but there was the difference in the occurrence of those agents between departments, with the highest frequency in the intensive care unit and the COVID-19 department (p&lt;0.001). Isolation of Acinetobacter bacteria increased 2.7 times, and Clostridioides difficile 6.4 times during 2021 compared to 2019. Statistically significant differences were registered in resistance to: imipenem, piperacillin-tazobactam, ceftayidime, cefepime, glycopeptides, aminoglycosides, levofloxacin and ciprofloxacin in 2021 compared to 2019.&nbsp;<br /><strong>Conclusion. </strong>Our results suggest possible influence of COVID-19 on antimicrobial resistance and input a need for a new larger study addressing this issue.</p>

<p><strong>Introduction. </strong>Lyme neuroborreliosis (LNB) can manifest during the early and late stages of Lyme disease (LD). The aim of this study is to determine epidemiology and clinical findings in patients with LNB.&nbsp;<br /><strong>Methods.</strong> The research was conducted in Banja Luka at the University Clinical Center of Republic of Srpska (UCC RS) during a four-year period from 10/2017 to 10/2021. The research included 51 patients admitted to the hospital with some neurological symptoms that could lead to the LNB diagnosis. Patients had lumbar puncture with cytochemical analysis of cerebrospinal fluid (CSF), ELISA anti-Borrelia IgM/IgG in serum and CSF, Immunoblot anti-Borrelia IgM/IgG in serum, and other documentation about epidemiology and clinical findings in LNB. &nbsp;<br /><strong>Results.</strong> A statistically significant (p=0.017) higher proportion of female patients was observed. Most patients were between 50 and 60 years old. Most of them were retirees (31.37%), farmers, medical technicians followed with forestry workers, students etc. Most of examinees did not have information on previous tick bite (64.71%). The largest number (72.55%) did not have data on previous skin changes. The largest number of neurological symptoms at admission related to the feeling of tingling and weakness in the extremities, headache, dizziness and some ophthalmological symptoms. Patients also suffered from consciousness and speech disorder, anxiety, paresis n.VII. The largest number of examinees had some neurological symptoms up to three months prior the admission to the hospital. &nbsp;<br /><strong>Conclusion. </strong>Symptoms of LNB can be quite non-specific or possibly even mimic other neurological diseases. Involvement&nbsp;<br />of peripheral nervous system is dominant in adult patients. It is necessary to work on early diagnosis of LD and it is mandatory to report it to the national epidemiological service.&nbsp;</p>

Background: The COVID-19 pandemic has had a significant impact on the global economy and public health, disrupting various aspects of daily life. Apart from its direct effects on physical health, it has also significantly affected the overall quality of life and mental health. This study employed a path analysis to explore the complex association among multiple factors associated with quality of life, anxiety, and depression in the general population of the Republic of Srpska during the pandemic’s second year. Method: A cross-sectional study was conducted on a nationally representative sample (n = 1382) of the general population (adults aged 20+) during the second year of the COVID-19 pandemic in the Republic of Srpska, Bosnia, and Herzegovina. Assessment tools included the DASS-21 scale for depression, anxiety, and stress, along with the Brief COPE scale, Quality of Life Scale (QOLS), and Oslo Social Support Scale (OSSS-3). Sociodemographic factors and comorbidities were also assessed. Structural equation modeling was used to identify the direct and indirect links of various characteristics to quality of life, anxiety, and depression. Results: This study revealed a considerable prevalence of anxiety and depression symptoms (27.5% and 20.9%, respectively), with quality of life playing a significant mediating role. The constructed path model accounted for 33.1% of moderate to severe depression and 79.5% of anxiety. Negative coping was directly linked to anxiety and indirectly to depression via anxiety, while the absence of positive coping had both direct and indirect paths (through quality of life) on depression. Among variables that directly affected depression, anxiety had the highest effect. However, the bidirectional paths between anxiety and depression were also suggested by the model. Conclusions: Pandemic response strategies should be modified to effectively reduce the adverse effects on public mental health. Further research is necessary to assess the long-term effects of the pandemic on mental health and to analyze the contributing factors of anxiety and depression in the post-COVID period.

<p>Diabetic retinopathy (DR) is a chronic microvascular complication of diabetes. Due to the dramatic increase in the number of diabetes cases, the prevalence of DR has also risen, making it the leading cause of blindness among the working-age population worldwide, despite the availability of screenings and modern therapeutic options. Risk factors for the development and progression of DR (duration of diabetes, hypertension, hyperglycemia, dyslipidemia, and genetic factors) have been investigated in numerous epidemiological studies and clinical researches, but the research results were not consistent. In recent years, there has been considerable interest in the study of dyslipidemia in diabetes as one of the factors that could influence the onset and progression of DR, as well as apolipoproteins as potentially better biomarkers for DR. The results of our research also point in that direction. Identifying the risk factors for DR is crucial for enabling adequate prevention and raising awareness among individuals with diabetes about the importance of taking appropriate measures to prevent this microvascular complication.</p>