Introduction Alcoholic liver disease represents a growing global pandemic, particularly among younger men, and is one of the leading causes of premature death worldwide. Observing complications during the decompensation stage and monitoring disease progression dynamics using scoring systems are particularly important. Materials and methods This retrospective-prospective, descriptive, and analytical study included 123 male patients with a confirmed diagnosis of alcoholic liver cirrhosis, hospitalized at the Internal Medicine Clinic, University Clinical Centre of the Republic of Srpska in Banja Luka, Department of Gastroenterology and Hepatology. The study period spanned from January 2023 to January 2025, with the note that patient selection and monitoring began much earlier, in June 2021. After hospitalization, patients were followed monthly through a program of outpatient control examinations, with disease outcomes recorded. The study included all male patients over 18 years of age with a confirmed diagnosis of alcoholic liver cirrhosis and signed informed consent. Female patients and those with cirrhosis or other etiologies were excluded. For statistical data analysis, the Statistical Package for the Social Sciences (SPSS) version 29 (IBM Corp., Armonk, NY, USA) was used. The statistical analyses performed included median, standard deviation, analysis of variance, Student's t-test, chi-square test, and survival analysis. Results The mean age of the patients was 59.09±9.316 years. Most of them had anemia: 113 patients (91.86%) with decreased erythrocytes and 109 patients (88.62%) with decreased hemoglobin. Thrombocytopenia was observed in 104 patients (84.55%), while an increased mean corpuscular volume (MCV) was recorded in 68 patients (55.28%). Among biochemical parameters, the most common findings were increased bilirubin in 98 patients (79.67%), aspartate aminotransferase (AST) in 111 patients (90.24%), gamma-glutamyl transferase (GGT) in 109 patients (88.61%), and D-dimer in 110 patients (89.44%), while albumin levels were decreased in 107 patients (87.00%). Hyponatremia (decreased sodium) was observed in 63 patients (51.21%), and hypercalcemia (increased calcium) in 116 patients (94.30%). Jaundice was the most common external sign, present in 98 patients (79.67%), while ascites were noted in 86 patients (69.91%). Death during the first decompensation occurred in 31 patients (25.20%), of whom 17 (54.83%) died in the hospital. The leading cause of mortality is bleeding from esophageal varices. Conclusion Although a healthy liver performs over 200 distinct functions in the human body, a cirrhotic liver leads, one might say, to an even greater number of dysfunctions. This pathology is extremely complex, characterized by numerous complications and high treatment costs, which, despite all applied measures, do not ensure a favorable long-term prognosis without liver transplantation.

<p><strong>Introduction. </strong>Tibial bone defects, particularly those caused by infections, represent one of the most complex challenges in orthopedics. Given the severity of complications such as limb function loss or even amputation, the need for innovative and reliable treatment methods is crucial. Medial fibular transport using the Ilizarov apparatus offers a successful solution to these problems, preserving limb functionality and integrity.<br /><strong>Case report.</strong> This paper presents the case of a 76-year-old patient with chronic osteomyelitis and infected tibial pseudarthrosis. Following radical debridement and sequestrum removal, a significant partial bone defect measuring 8 cm remained. Treatment was performed using medial fibular transport with the Ilizarov apparatus. The reconstruction process lasted eight months, after which complete bone consolidation, infection elimination, and restoration of limb function were achieved.<br /><strong>Conclusion. </strong>The medial fibular transport technique has proven to be an effective and safe method for treating large tibial defects associated with infection, enabling limb preservation and significantly improving patients&rsquo; quality of life.</p>

<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>

Introduction. Cardiac magnetic resonance imaging (CMR) is considered the reference diagnostic method for quantifying right ventricular size and function, and pulmonary regurgitation in patients with tetralogy of Fallot surgery. The aim of this paper is to confirm the importance of magnetic resonance continuous postoperative monitoring of right and left heart function parameters as a diagnostic method that provides the most precise and accurate assessment. Methods. The prospective observational study included subjects with TOF surgery who were diagnosed with residual morphological and/or functional disorders on control postoperative echocardiographic examinations. All subjects underwent magnetic resonance imaging of the heart on a 1.5 T scanner with dedicated coils for the heart surface according to the standard protocol for a period of one year from the beginning of the study. Criteria for exclusion from the study were: significant residual pulmonary stenosis, condition after pulmonary valve replacement, existence of residual shunt lesions, contraindications for cardiac magnetic resonance imaging (pacemaker, ICD, claustrophobia). Depending on the time elapsed since the tetralogy of Fallot surgery, the subjects were divided into groups: more than 15 years, 11-15 years, 6-10 years, less than 5 years. Results. The study included 131 subjects with an average age of 24.18 ± 11.57 years with complete correction of TOF. Intergroup differences in values of right ventricular end-diastolic volume, right ventricular ejection fraction, and left ventricular ejection fraction were demonstrated, but there was no statistically significant intergroup difference in values of pulmonary regurgitation fraction. The negative interaction of the right and left ventricles intensifies during the years of follow-up of patients after TOF surgery, which is especially true fifteen years after surgery. Conclusion. CMR has the most significant role in research efforts aimed at improving the outcomes of operated patients with tetralogy of Fallot.

This study was undertaken to determine the effects of humic acid on the growth seedling of two tomato cultivars CeylandoF1 and RallyF1, under greenhouse conditions. Treatment with „Humistar“ was started in the two-leaf stage of the plant. One level of humic acid of 20 ml l-1 was applied to the seedling growing media and each seedling of the species was treated every ten days until transplanting directly into the soil in greenhouse.The higest growth rate: leaf (weight), stem (diameter and weight) and root (weight and lenght) growth were optained in cultivar RallyF1 as compared to the control and leaf, stem and root weight compared to Ceylando F1 cultivar.General, the results showed that humic acid influenced better root development in both examined tomato cultivars.

Introduction/Objective. The aim of the study was to examine the progression of diabetic nephropathy (DN) in a prospective three-year period as well as to establish the risk factors for DN progression. Methods. The study involved 45 patients with type 2 diabetes and DN (26 males, aged 18?62 years) followed up for three years. All the patients underwent physical examination and laboratory analysis at each visit. Laboratory analyses included complete blood count, serum glucose, urea, creatinine, protein, lipid concentration, glycosylated hemoglobin (HbA1c) and urine protein, albumin and creatinine concentration. Glomerular filtration rate (GFR) was calculated using Modification of Diet in Renal Disease formula. Kidney length and parenchymal thickness were measured by ultrasound. Results. Fasting serum glucose concentration (12.0 ? 2.79 vs. 9.50 ? 2.22, p < 0.001) and HbA1c (7.99 ? 1.43 vs. 7.49 ? 1.29, p < 0.031) were decreased over the three years. Albuminuria increased (43.75 ? 10.83 vs. 144.44 ? 52.70 mg/l, p < 0.001) and GFR (63 vs. 58.3 ml/min/1.73 m2) decreased significantly during the study, but serum lipid concentration remained unchanged. Mean kidney length and parenchymal thickness decreased during the three years. Linear regression analysis found systolic blood pressure, fasting glycemia, HbA1c as positive and kidney length and parenchymal thickness as negative predictors of proteinuria increase, but proteinuria as negative and serum iron and albumin concentrations as positive predictors of annual change in GFR. Conclusion High blood pressure and high HbA1c are selected as significant risk factors for increasing proteinuria, which is a significant predictor of GFR decreasing in patients with DN.

Progress in diagnosis and treatment has led to a significant improvement in the fate of children born with tetralogy of Fallot, with the perioperative mortality of 2-3% and a 30-year survival rate of 90%. However, the majority of these patients have residual postoperative morphological and hemodynamic disorders, as well as heart rhythm disorders, primarily due to the volume loading of the right ventricle caused by chronic pulmonary regurgitation. Improved surgical techniques have reduced early mortality to less than 3%, but the annual mortality rate has increased 20-30 years after initial surgical remediation, mainly due to unwanted cardiac events. In longitudinal monitoring of patients after repair of tetralogy of Fallot, early detection of morphological and hemodynamic residual disorders both in asymptomatic and symptomatic patients is of great importance. The purpose of this is a timely identification of new therapeutic measures (e.g. pulmonary valve replacement) in order to improve the course and outcome of treatment. Cardiovascular magnetic resonance imaging is a diagnostic method that provides the most precise and accurate estimation of individual parameters of cardiac dysfunction and poor outcomes. Furthermore, it plays a significant role in defining the predictive ability of individual parameters. Previous research has shown that the increase in mortality risk coincides with progressive dilation and right ventricular dysfunction, by means of ventriculo-ventricular interaction and left ventricular dysfunction. Identification of parameters that can predict the high-risk patients for future unwanted cardiac events such as ventricular tachycardia and cardiac insufficiency can assist the customization of a therapeutic approach leading to improvement in quality of life and patient's survival rate.

Introduction. The aim of the study was to determine the frequency and risk factors for diabetic nephropathy (DN) in patients with type 2 diabetes as well as the factors related to kidney function decrease over a three-year period. Methods. The study involved 81 patients with type 2 diabetes, initially classified into two groups: the first group was comprised of 41 patients with DN (27 males; 62.03 ± 7.73 years) while the second one included 40 patients without DN (17 males, 61.73 ± 11.55 years). All of them were subjected to history taking, objective examination as well as laboratory examination. Based on the results of the study lasting for three years, the patients of both groups were divided into subgroups with stable kidney function and subgroups with impaired kidney function, defined as an increase in proteinuria level and/or decrease in estimated glomerular filtration rate (eGFR) by more than 25%. Results. In both groups, high incidence rates of known risk factors for diabetes and DN were recorded at the beginning of the study. The multivariate logistic analysis identified the female sex and the duration of diabetes as significant predictors of DN. After three-year period, kidney function declined in approximately 50% of patients with and without DN. Furthermore, the values of fasting glycemia and HbA1c were statistically higher in the groups with impaired kidney function compared to the ones with stable eGFR. The linear regression analysis revealed that, during three-year period, the change in eGFR was significantly associated with patient age, the duration of diabetes, systolic blood pressure, the difference in diastolic readings and proteinuria. The change in proteinuria was strongly associated with systolic blood pressure, the difference in diastolic readings, as well as with HbA1 and eGFR at the end of the study. Conclusion. In patients with type 2 diabetes, female sex and longer duration of diabetes were identified as significant risk factors for DN, while patient age, the duration of diabetes, elevated blood pressure and poor glucoregulation were identified as risk factors for kidney function decrease.

Introduction: During the course and development of diverse cardiological diseases different central nervous system complications may develop. These are most frequently related to the nature of the cardiovascular entity itself. Aim: To evaluate the association between atherogenesis factors and border zones strokes within the cerebral medial artery vascularization territories. Methods: In total 30 patients were enrolled in the study. Stroke diagnosis was based according to clinical and neurological examination and brain CT findings. The study analyzed risk factors correspondingly to World Health Organization criteria. Results: In majority of patients (18; 60%) arterial hypertension was diagnosed. Additionally, following condition and risk factors were identified: cardiological diseases (17; 23.3%), cigarette smoking (13, 43.3%), hypercholeterolaemia (9; 30%) and diabetes (7; 23.3%). In the group with cardiological diseases most frequent was myocardial infarction (9; 56.2%), AV block II and III (5, 29.4%), atrial fibrillation with slow ventricular response (3; 17.6%). Conclusion: Results of the study point to conclusion that myocardial infarction, AV block II and III, atrial fibrillation with slow ventricular response, iatrogenic hypertension and traditional risk factors for atherogenesis significantly influences presentation of the border zone strokes within the cerebral medial artery vascularization territories.