INTRODUCTION Most COVID-19 cases are mild, but some require hospitalization due to pneumonia, with symptoms like hypoxia and dyspnea. This has led to speculation about erythrocyte involvement in the infection. This study aimed to examine the differences in the presence of dysmorphic erythrocytes in COVID-19 patients upon admission compared to healthy subjects, as well as to assess these differences in relation to the severity of the clinical presentation of COVID-19. METHODOLOGY This study included 150 participants: 100 COVID-19 patients and 50 healthy subjects who formed the control group. The COVID-19 positive participants were divided into two groups based on the deterioration or improvement of their health conditions during hospitalization. Hematological parameters were analyzed, and peripheral blood smears were prepared to observe morphological changes in erythrocytes. RESULTS The morphological changes observed in hospitalized COVID-19 patients included spiculated red blood cells (RBCs), spherocytes, stomatocytes, schistocytes, knizocytes, keratocytes, as well as mushroom- and cup-shaped RBCs. At admission, spiculated RBCs and spherocytes were more prevalent in patients showing improvement. Conversely, stomatocytes, knizocytes, keratocytes, and mushroom-shaped RBCs were more frequent in patients experiencing deterioration. Additionally, spiculated RBCs were more common in patients with improvement, while stomatocytes, schistocytes, knizocytes, keratocytes, mushroom-, and cup-shaped RBCs were more prevalent in deteriorating patients. CONCLUSIONS The complete blood count and the examination of peripheral blood smears in hospitalized patients may serve as fundamental tools to assist clinicians in differentiating disease severity and improving treatment decision-making.

Introduction. Chronic kidney insufficiency presents a progressive decline in renal function. Long-term hemodialysis treatments lead to biochemical parameter imbalances like an altered level of homocysteine (Hcy). Hcy can contribute to oxidative stress and endothelial damage, which promotes the accumulation of low-density lipoprotein (LDL) cholesterol and the development of atherosclerosis. It can also affect lipoprotein metabolism and trigger inflammatory processes that alter the lipid profile, especially increasing triglycerides and lowering high-density lipoprotein (HDL) cholesterol. Methods. This cross-sectional, clinical and descriptive-analytical study included 83 patients, 40 patients on hemodialysis, and 43 subjects in healthy control group. Results. The hemodialysis group had significantly higher Hcy values compared to the control group of seemingly healthy subjects (p<0.05). The control group had significantly higher values of total cholesterol, LDL and very low-density lipoprotein (VLDL) compared to the hemodialysis patients (p<0.05). There was non significant correlation between Hcy and lipid parameters in the hemodialysis group, neither in the control group. Conclusion. Patients undergoing hemodialysis had significantly higher total homocysteine levels compared to the control group. However, total homocysteine did not demonstrate an association with lipid status parameters in either the hemodialysis patients or the healthy subjects. Keywords: homocysteine, hemodialysis, cholesterol, triglycerides, metabolism.

In our letter, we presented the challenges within medical biochemistry in a tertiary hospital in a measles outbreak. The letter somewhat shows the current situation in the first part. In the remaining part, the challenges in the work of the medical biochemical laboratory are listed and the significance of the most common biochemical and hematological analyzes for these patients is explained. This letter is an important clinical-epidemiological overview of the current situation that arose as a result of the measles outbreak.

Introduction Chatbots like ChatGPT have attracted a lot of interest lately due to their ability to generate human-like responses. Their reliability and accuracy are still questionable, and they are the topic of many studies in different fields. Therefore, the aim of this study was to examine the knowledge of two versions of chatbots regarding laboratory enzymology and to compare it with the average knowledge of students for the purpose of considering the use of ChatGPT in providing answers in this field. Material and methods An exam with 110 questions covering four topics was answered by students and ChatGPT-3.5 and ChatGPT-4.0. The accuracy of the answers of 52 students and ChatGPT was evaluated. The accuracy of answers between students and artificial intelligence was compared, and the percentage of passing the exam was 60%. All responses were reviewed by two authors with full interrater agreement. Results Total scores for students, ChatGPT-3.5, and ChatGPT-4.0 were 85.46%, 52.73%, and 74.55% (p < 0.05), whereby ChatGPT-4.0 achieved better results compared to the other chatbot. ChatGPT-3.5 and ChatGPT-4.0 achieved the best results on questions about enzymes in metabolism. The lowest scores for both chatbots were observed in the laboratory analysis of enzymes. Conclusion ChatGPT showed average results in the Laboratory Enzymology exam and scored lower than students. This proved that chatbots could be a potential tool for learning and eventual implementation in higher and/or medical education with extensive optimization but still cannot replace a human.

Background: To gain insight into the role and relevance of inflammatory and immunological markers in the comprehensive assessment of a patient's immune response to surgical procedures. This study focused on investigating preoperative and postoperative serum levels dynamics of SAA, CRP and proportion of HLA-DR CD14 monocytes, CD14 monocytes, and pro-inflammatory monocytes CD16 T CD14 T in patients who underwent heart surgery using extracorporeal circulation (on-pump). Methods: An observational, prospective study was conducted at the Heart Center of the Clinical Center of the University of Sarajevo on 53 patients divided into 3 age groups: 50-59, 60-69, and 70-80. The serum levels of CRP and SAA were quantitatively determined by immunonephelometry. At the same time, flow cytometry technology was applied to measure the proportion of CD14 monocytes, HLA-DR CD14 monocytes, and pro-inflammatory CD16 CD14 monocytes. Results: Measured values of CRP; SAA, proportion of monocytes CD14, and proportion of pro-inflammatory monocytes CD16 CD14 are significantly increased postoperatively compared to the preoperative values (p < 0.05). The proportion of HLA-DR CD14 monocytes is lower postoperatively compared to preoperative values (p < 0.001). Furthermore, there are no significant gender differences in the preoperative or postoperative parameters (p > 0.05), with the notable exception of the preoperative proportion of CD14 monocytes (p < 0.05). The analysis of age-related differences indicates no significant changes in the observed preoperative and postoperative parameters among the defined age groups (p >0.05). Conclusions: Early monitoring of inflammatory and immunological markers in the postoperative phase could be valuable for healthcare professionals to implement prompt interventions to mitigate negative outcomes.

Background: The oncogenic potential of HPV remains a major global public health challenge and various natural therapeutics are being investigated to prevent cancer. The natural components of the Alchemilla vulgaris plant have various anti-inflammatory, antioxidant, antiviral, and anticancer effects. Objective: Therefore, the aim of this study was to bioinformatically examine the potential inhibitory effect of A. vulgaris compounds on the HPV target protein. Methods: The structures of quercetin, catechin, apigenin, luteolin, caffeic and gallic acid were taken from the PubChem database, and the protein structure of the target HPV 16 E6 oncoprotein (PDB ID: 4XR8) from the Protein Data Bank. Virtual screening and docking analysis were performed in AutoDock Vina. Protein-ligand complexes were visualized using Discovery Studio. The molecular dynamics simulation of 4XR8 in complex with quercetin was performed using Desmond. Results: Docking analysis showed that quercetin has the strongest binding affinity with 4XR8 (quercetin -8.9 kcal/mol, apigenin -8.7 kcal/mol, luteolin -8.7 kcal/mol, catechin -8.4 kcal/mol, caffeic acid -7.3 kcal/mol, gallic acid -6.8 kcal/mol). The molecular dynamics simulation results reinforce the stability and strong binding affinity of quercetin within the HPV 16 E6 oncoprotein. Conclusion: Natural components of Alchemilla vulgaris, especially quercetin, have shown promising potential for the treatment of HPV infection and additional in vitro and in vivo studies are needed for their further research.

Background: T Measles is a viral, highly contagious disease from the group of rash fevers, which mainly affects children. Persons suffering from measles are considered contagious four days before and four days during the period of the appearance of measles, which favors its faster spread. Clinical observation and laboratory diagnostics are essential for monitoring the course of the disease in order to prevent complications. Objective: Our study aimed to analyze the significance and usefulness of laboratory tests on admission to hospital in pediatric patients with measles. Methods: This prospective study included children with confirmed measles infection who came accompanied by parents to the Infectious Disease Clinic of the Clinical Center of the University of Sarajevo during nine months. Data on age, sex, symptoms and results of laboratory analyzes (biochemical, hematological and coagulation) were recorded. Results: The study included a total of 302 subjects, including 122 healthy controls and 180 measles patients. Significantly lower values observed for aPTT, absolute number of eosinophils and basophils, RBC, hemoglobin, hematocrit, MCV, MCH, MCHC in measles patients. Significantly higher values were observed for fibrinogen, D-dimer, WBC, neutrophils, lymphocytes, monocytes, RDW and MPV in measles patients in contrast to controls. Significantly higher values were also observed for serum chloride, glucose, CRP, AST, ALT and LDH values. AST/ALT, NLR, PLR, NPR, LMR, LCR, SII and AISI also showed significant differences in measles patients compared to controls. Conclusion: The results of our study showed that laboratory tests have great significance and potential in measles in pediatric patients admitted to the hospital. Lymphocyte/C-reactive protein ratio also showed good diagnostic potential.

Breast cancer is one of the most common types of cancer among women worldwide, therefore an early and precise process of diagnostics plays an important role in improving the prognosis and outcome of treatment. The application of artificial intelligence (AI) allows faster and more precise analysis of medical imaging, which contributes to the early detection of tumors and lowers the number of false-negative results. This review article analyzed 60 scientific papers and using the most recent findings about this topic, searched for AI implementation in breast cancer research and how AI may improve overall survival outcomes for breast cancer patients.

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Introduction: Breast cancer (BC) is a malignant disease that predominantly affects women, with known genetic components such as mutations in tumor suppressor genes BRCA1 and BRCA2. Other risk factors include unhealthy lifestyles, lack of physical activity, and consumption of alcohol and cigarettes. Aging also plays a role in BC development, with hormonal influences such as estrogen and progesterone promoting cancer growth. Material and Methods: Research was conducted using data collection tools for risk factors and tumor markers from primary healthcare unit records. The sample comprised 200 women, divided into two groups based on BC diagnosis, with complete medical documentation. Male BC cases were excluded. Results: Statistical significance was found between genetic components, family history, aging, obesity, alcohol and cigarette consumption, longer hormone exposure, and female BC development using the Chi-Square test, confirmed by Fisher's Exact test. Tumor markers CA 15-3, CEA, CA 19-9, and CA 125 were useful for BC screening and metastasis detection, as determined by the One Sample T-test. In Sarajevo Canton, invasive ductal BC was the most common type among women, while lobular carcinoma in situ was the least common. Conclusion: Correlations between risk factors, including aging, unhealthy lifestyles, and hormone exposure, and increased BC risk were confirmed. Tumor markers CA 15-3, CEA, CA 19-9, and CA 125 were effective in diagnosis, screening, and metastasis detection in females, with sensitivity for regression detection at 81.8% and specificity at 100%.