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: 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%.

Introduction: The diagnosis of coronavirus disease 2019 (COVID-19) disease is necessary for the further treatment of patients with the present symptoms, and molecular diagnostics is considered the gold standard. However, it is already known that patients with symptoms of the disease can have a negative test due to various factors. The purpose of this study is to evaluate the laboratory parameters in patients with symptoms of COVID-19 infection who have both positive and negative test results. Methods: The study included 101 samples from patients who tested positive for COVID-19 and 101 samples from patients who tested negative, both groups presenting symptoms of COVID-19. Data on the complete blood count, the absolute values of the differential blood count, and the D-dimer values were collected from the samples that were taken. Using blood count data, neutrophil-to-lymphocyte ratios, platelet-to-lymphocyte ratios, and systemic immune-inflammatory index (SII) were calculated. Results: Based on the examination and research, a significant increase and change in the values of inflammatory indices and D-dimer were determined. In addition to the increase of these values above the reference value, a positive correlation was confirmed between the inflammation index value and the D-dimer value. Conclusion: COVID-19-negative patients with characteristic symptoms of COVID-19 had higher values of lymphocytes and the determination of platelets and SII in these patients can be added to the diagnostic algorithm.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has caused a worldwide emergency. The disease is characterized primarily by symptoms of the respiratory system, but also by systemic inflammation. Since the onset of the disease, there has been a need for biomarkers to predict the severity of the clinical picture and the outcome of the disease. The aim of this study is to evaluate systemic inflammatory markers for predicting severity of COVID-19. Methods: The study was conducted at the Sarajevo Canton Health Center on a total of 170 adults suffering from COVID-19. 70 subjects had mild clinical picture, while the control group consisted of 100 subjects with moderate clinical picture. The results of complete and differential blood counts, C-reactive protein (CRP), and systemic inflammatory indexes (SII) (neutrophil/lymphocyte ratio [NLR], derived NLR [dNLR], platelet/lymphocyte ratio [PLR], and SII) were used to compare the groups. IBM SPSS Ver. 23 was used for statistical analysis and data processing. Results: The proportion of male patients in the group with a milder clinical picture was higher than the proportion of male patients with a moderate clinical picture, p = 0.016. The values of leukocytes and neutrophils were higher in patients with a moderate clinical picture (p = 0.006 and p < 0.001, respectively). The values of all inflammatory indexes (NLR, dNLR, PLR and SII) were higher in patients with a moderate clinical picture of COVID-19 than in patients with a mild clinical picture (p < 0.001 for NLR, dNLR, and SII; p = 0.023 for PLR). In the research, patient age showed no correlation and CRP showed no correlation with SII. Conclusion: SII show higher values in patients with a moderate compared with a mild clinical picture of COVID-19. These parameters can be cost-effective and useful indicators in patient classification, diagnosis, and probably in monitoring patients with COVID-19.