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Esad Pepić

Društvene mreže:

J. Mušanović, Azra Metović, E. Pepić, Almira Lujinović, Adnan Fojnica, Faruk Husremović, D. Šečić, D. Marjanovic, Jasmin Šutković

Aim Examination of the effectiveness of STR loci in proving sibship of the Bosnian-Herzegovinian village of Orahovica and the formation of a "grey zone". Methods The probability of sibship was determined by calculating the likelihood ratio (LR) parameter for each of the 15 observed STR loci and for each of the pairs of relatives and non-relatives. Cumulative sibship index (CSI) was calculated for each of the pairs by multiplying the LR values of all 15 loci and obtained values are used as CSI limit for separating relatives from non-relatives. By creating a grey zone for local populations, an attempt was made to obtain a line of demarcation between siblings and non-siblings. Results An analysis of the origin of the respondents' relatives was performed, up to the level of sibship in the third generation. The results of the CSI for pairs of relatives from the village of Orahovica showed that the highest CSI value, and therefore the sibship probability was recorded among relatives from the village of Orahovica (CSI=534211727.203;SP=99.999999812%). On the contrary, incredibly low CSI value was recorded among non-relatives,ranging from CSI=0.0000001 to 0.5261434 (SP=0.000009999% to 34.475357951%). Conclusion For the threshold value CSI=1 and for CSI=3, this method determined sibship in 100% of pairs of relatives and the absence of biological sibship in 100% of pairs of non-relatives in the village of Orahovica. The STR system is proved to be a successful method in determining sibship or absence of sibship in small local populations.

Almira Lujinović, L. Dervišević, Zurifa Ajanović, Dina Kapić, Azra Metović, E. Ćosović, Maida Šahinović, J. Mušanović, Jelena Kovačević-Prstojević et al.

Aim To determine the value of angles between the left coronary artery main trunk (LMT) and its branches, the anterior interventricular branch (LAD) and the circumflex branch (CX), and their possible relationship with the LMT length. Methods A total of 29 cadaveric hearts were used. The left coronary artery and its branches were dissected. The hearts were then classified according to the number of branches. The LMT length was measured with a digital gauge, and the LAD-CX angle, LMTLAD angle and LMT-CX angle with a manual goniometer. Results The average value of the LMT length was 9.0 mm (6.0-13.5). In 20 (68.97%) samples, the LMT was divided into two terminal branches. There was no statistically significant difference (p=0.321) in LMT length between the hearts with a bifurcation and without it. The average value of the LAD-CX angle was 89.0⁰ (74.5-93.0), with a statistically significant difference (p=0.020) comparing to hearts with trifurcation. The mean value of the LMT-LAD angle was 30.83±9.23⁰ and it was significantly lower (p=0.006) in the group of hearts with bifurcation compared to the group with trifurcation of the main trunk. Conclusion The LMT length shows great variability and is not related to the LAD-CX, LMT-LAD or the LMT-CX angle. Knowledge of the left coronary variation is essential in order to avoid misinterpretation of arteriogram.

Azra Metović, J. Mušanović, Almira Lujinović, E. Pepić, Jelena Prstojevic-Kovacevic

Background: The genetic structure of each population can be explained according to the frequency of genes and their allelic variants, genotypes, and phenotypes. Objective: To analyze the genetic heterogeneity of the working-age population from the area of Sarajevo Canton based on classic genetic markers. The studied parameters of genetic heterogeneity were assessed by the relative frequency of the recessive allele for static-morphological traits (earlobe shape, chin shape, hairiness of the middle digital phalanx, bending of the distal phalanx of the little finger and digital index) and dynamic-morphological traits (rolling of the tongue into a groove, extensibility of the proximal thumb knuckle, extensibility of the distal thumb knuckle, the way the forearms are crossed, and the way the fists are made). Results: The results of the t-test showed a significant difference in the manifestation of the recessive homozygote for the observed parameters of qualitative variation in the subsamples of men and women. Only for two traits (attached earlobe and hyperextensibility of the distal knuckle of the thumb). The selected sample represent a relatively genetically homogenous population. Conclusion: This study serves as a valuable source of data for future research and the formation of a genetic database in Bosnia and Herzegovina.

Almira Lujinović, L. Dervišević, E. Ćosović, Zurifa Ajanović, Dina Kapić, E. Pepić

Introduction: The human heart is in most cases vascularized by two coronary arteries, the right coronary artery (RCA) and the left coronary artery. The supernumerary coronary artery, which arises independently from the right aortic sinus and passes through sub-epicardial adipose tissue of the pulmonary conus and anterior side of the right ventricle is called the third coronary artery (TCA). Methods: This study consisted of 28 formalin-fixed adult human cadaveric hearts. The presence of the TCA was determined. The position of the orifice of the right and excess arteries in relation to the sinotubular junction was determined, and then also the position of the orifice of the excess arteries “on the o’clock level” in relation to the orifice of the RCA. The radius of these orifices and their distance from the orifice of the RCA were measured. The angle between the aorta and TCA, as well as RCA and conus branch, was measured. Results: A total 11 of specimens had supernumerary arteries. A supernumerary artery was found in two hearts. The angle formed by the aorta with the TCA was 60.09 ± 17.57, while the angle between the aorta and the conus branch had an average value of 89.88 ± 15.92. The orifices of all supernumerary arteries were located below the level of the sinotubular junction. The average diameter of the TCA was 1.49 mm ± 0.41. The average distance between the TCA orifice and the RCA orifice was 2.21 mm ± 1.03. In 45.45% cases, the orifice of TCA was located at the 10 o’clock level. Conclusion: The present study highlights the presence of the TCA. It may constitute a significant collateral circulation contributing to apical and septal perfusion. Interpretation of signs and symptoms of coronary occlusion should therefore include possible contribution of this vascular channel.

Mirsad Panjeta, A. Dervišević, Sanela Hajro, E. Panjeta, Meliha Kovacevic, E. Pepić, Selvedina Duskan

BACKGROUND The pre-analytical phase, which includes all preparatory actions to the analytical procedure, is part of the process during which there is the greatest possibility of laboratory errors. This study was conducted to investigate the frequency and types of laboratory errors during work in the clinical laboratory as well as the frequency and types of laboratory errors in the pre-analytical phase of laboratory work. METHODS The retrospective, descriptive study covered the period from 01/01/2016 to 12/31/2016 within which the presence of 5 different indicators of quality of work, i.e., pre-analytical errors, was monitored: improperly drawn blood, coagulated blood sample, hemolyzed blood sample, improperly marked referral for analysis, and insufficient sample for analysis. RESULTS The most common error in the pre-analytical phase of our study was "coagulated sample", followed by: "improperly drawn blood", "improperly marked referral", "insufficient sample for analysis", and "hemolyzed sample". Using the chi-squared test, a statistically significant difference was found in the frequency of occurrence of certain types of indicators in different departments (p < 0.005). CONCLUSIONS Reduction of these errors can be achieved through analyzing and correcting the reasons for them, education, and by joint action of experts and international organizations, continual training of staff as well as to following the adopted guidelines and standards.

N. Naser, E. Pepić, Sevleta Avdić

Background: Arrhythmias are common problems in hypertensive patients. The presence and complexity of both supraventricular and ventricular arrhythmias may influence morbidity, mortality, as well as the quality of life of patients. Objective: The aim of this study was to assess the diagnostic value of combined 24h BP and ECG Holter monitoring in detection of cardiac arrhythmias in patients with arterial hypertension. Methods: We analyzed the simultaneous records of combined 24h BP and ECG Holter monitoring for 356 adult patients with diagnosed arterial hypertension in the period from January 2017 until January 2021 year. The cardiac arrhythmias were classified in three main groups as following: a) Supraventricular arrhythmias; b) Ventricular arrhythmias; c) Bradyarrhythmia’s. Standard transthoracic echocardiograms were performed in order to evaluate signs of hypertensive or structural heart disease with focus on left ventricle hypertrophy and LV function. Results: Patients had a mean age of 64 ± 11years, 62% male. Average clinic BP was 153.4+18/87.5+14 mmHg. More than 46% of patients displayed a very high-risk profile. In all enrolled patients, cardiac arrhythmia was detected in 302 (84%) patients. The total number of patients with supraventricular arrhythmias was 153 (50,7%). Ventricular arrhythmias were detected in 98 (32,5%) patients. Bradyarrhythmia’s were detected in 51 (16,9%) patients. Elevated resting heart rate in sinus rhythm was detected in 87 (31,6%) of 275 patients with sinus rhythm. Conclusion: Most arrhythmias are related to longstanding arterial hypertension. Effective treatment of arterial hypertension plays important role in preventing structural and functional cardiac abnormalities which will contribute to the reduction of cardiac arrhythmias in hypertensive patients.

D. Šečić, A. Turohan, E. Begić, D. Rebić, E. Pepić, Z. Begić, A. Iglica, N. Begić, Azra Metović et al.

Introduction: Serum creatinine is not enough sensitive marker for the evaluation of glomerular filtration rate (GFR). Cockcroft-Gault (CG) formula is often used to assess GFR, but it is necessary to correct original one for body surface area (BSA), adipositas, and the creatinine tubular secretion. The values of the estimated creatinine clearance and GFR are considered to Poggio reference ones according to biological parameters (age and gender). The aim of the study was to determine the difference in renal function estimation between serum creatinine and corrected CG equation according to the Poggio reference values in the arterial hypertension patients. Materials and Methods: The research included 124 patients of both gender with arterial hypertension, excluding ones with the already verified chronic kidney disease. We estimated creatinine clearance and GFR by CG method corrected for the BSA, body mass index (BMI), and the creatinine tubular secretion according to Poggio reference values. Results: There was no significant difference in both age and gender groups among patients with physiological and pathological values of the renal function determined by the serum creatinine and estimated creatinine clearance by CG equation corrected for BMI, BSA. In both age and gender groups there was significant difference among subjects with physiological and pathological values of the renal function determined by serum creatinine and estimated GFR by CG method corrected for BMI, BSA, and creatinine tubular secretion. Conclusion: There is the most striking difference in the assessment of renal function between serum creatinine and estimated GFR by CG method with three corrections (BSA, BMI, the creatinine tubular secretion). Estimated GFR by CG method with three corrections can help in the early diagnosis of renal dysfunction and optimal treatment in patients with arterial hypertension.

Azra Metović, J. Mušanović, N. Ramic, O. Lepara, D. Šečić, E. Pepić, S. Zec, S. Šljuka

Background: Breast cancer in women is the second most common and accounts for approximately 18% of all malignant tumors in women worldwide. The etiology of breast cancer is not clear enough. Starting from the assumption that the manifestation of breast cancer may have a multifactorial model, this article compares the population-genetic structure of patients (experimental group) with the population-genetic structure of healthy population (control group). Objective: The aim of the study was to examine the possible genetic basis of the Rh factor relationship with selected homozygous-recessive traits of females with breast cancer, and to diagnose the probability (assess the risk) of developing the disease in healthy women by analyzing homozygous-recessive traits (HRT). Methods: This are an anthroposcopic-qualitative study that included two groups of subjects, experimental and control (a total of 80 subjects). An analysis of the percentages within each group was performed using the Chi-square test. The results are presented in tables, and the accepted level of significance is at the level of p <0.05. Results: In the group of Rh+ subjects, the correlation of this type of Rh factor with the breast cancer was proven, given the frequency of the phenotype of homozygous-recessive traits in them. A statistically significant difference was found for 4 traits, and three are also close to the set significance level. In subjects with Rh- factor, a statistically significant difference was found for only one trait (absence of mallets on the phalanges). Conclusion: Although the number of subjects was relatively small, we can conclude that in the experimental group a higher frequency of recessive phenotypes for the examined traits was recorded, which indicates the genetic load of the subjects from this group. Correlation with Rh factor was observed in the case of subjects of the experimental group with Rh+ factor.

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