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 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.

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.

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.

Background: A laboratory professional concerned with the quality of work in medical-biochemical laboratories ensures the accuracy and precision of laboratory analyses through the implementation of international and European guidelines for working with hazardous substances, through the availability and implementation of Standard Operating Procedures (SOPs). Laboratory hazards that affect the concentration and safety of workers arise from laboratory deficiencies such as: lack of preventive measures, knowledge and skills implemented through SOPs and good laboratory practice. Biophysical hazards in medical laboratories are manifested by needles and sharp objects, infectious materials, noise, vibration, radiation, poor air quality, temperature inversions. Objective: The aim of the research was to raise awareness of the quality of work in medical-biochemical laboratories in order to ensure the safety of workers. Methods: A cross-sectional questionnaire-based study was conducted among 100 laboratory professionals from Bosnia and Herzegovina (BiH) and Croatia. The research was conducted over a period of three months. Results: A higher percentage of exposure to infectious agents and needles and sharp objects was found among respondents from BiH compared to CRO (p=0.018 and p=0.001, respectively). We found that respondents employed in accredited laboratories are aware of exposure to hazards in a high percentage related to infectious agents, toxins (p=0.0012 and p=0.0046, respectively). A significant statistical difference was found between respondents with BiH and respondents with CRO in terms of knowledge of accreditation standards of medical-biochemical laboratories (p=0.0155). Respondents who have standard operating procedures available are aware of the hazards of infectious agents (p=0.0001), toxins (p=0.0466), needles and sharp objects (p=0.0052), noise (p=0.0030), vibration (p=0.0007) and extreme temperatures (p=0.0014). Conclusion: Efficient implementation and continuous compliance with the ISO 15189: 2018 standard requires constant commitment and active participation of laboratory staff. Laboratories must have standard operating procedures in place and actively monitor their use.

Introduction: COVID-19 is an infectious disease caused by the severe acute respiratory syndrom coronavirus 2 and causes a series of respiratory symptoms. Considering the appearance and development of symptoms, the course of COVID-19 can go from mild to severe. Depending on the course of COVID-19, the laboratory parameters change a lot, trying to defend the organism against the foreign pathogen and all the changes it causes. Therefore, the aim of this study is to observe the differences between biochemical, hematological and coagulation parameters depending on the disease stage of COVID-19 patients. Material and methods: We conducted cross-sectional study which included 160 COVID-19 patients from Sarajevo, Bosnia and Herzegovina. Biochemical, hematological and coagulation analyzes were performed. Results: COVID-19 patients with a severe clinical course have higher average values of fibrinogen (6.53±4.47,p<0.001), D-dimer (6.89±7.81, p<0.001), APTT (32.05±5.96, p=0.002), eosinophil (0.66±0.09, p=0.002) and CRP (93.42±75.86, p= 0.023), and lower values of lymphocytes (1.04±0.98, p<0.001), monocytes (0.45±0.3, p<0.001), compared to COVID-19 patients with a mild clinical course. COVID-19 patients with a severe clinical course had higher average values of neutrophils (10.12±5.80, p=0.002) and lower values of reactive lymphocytes (0.02±0.03, p<0.001) compared to COVID-19 patients with a mild clinical course. Conclusion: Biochemical, hematological and coagulation parameters can be a sensitive and specific biomarker for distinction of mild and severe COVID-19.

Background: A laboratory professional concerned with the quality of work in medical-biochemical laboratories ensures the accuracy and precision of laboratory analyses through the implementation of international and European guidelines for working with hazardous substances, through the availability and implementation of Standard Operating Procedures (SOPs). Laboratory hazards that affect the concentration and safety of workers arise from laboratory deficiencies such as: lack of preventive measures, knowledge and skills implemented through SOPs and good laboratory practice. Biophysical hazards in medical laboratories are manifested by needles and sharp objects, infectious materials, noise, vibration, radiation, poor air quality, temperature inversions. Objective: The aim of the research was to raise awareness of the quality of work in medical-biochemical laboratories in order to ensure the safety of workers. Methods: A cross-sectional questionnaire-based study was conducted among 100 laboratory professionals from Bosnia and Herzegovina (BiH) and Croatia. The research was conducted over a period of three months. Results: A higher percentage of exposure to infectious agents and needles and sharp objects was found among respondents from BiH compared to CRO (p=0.018 and p=0.001, respectively). We found that respondents employed in accredited laboratories are aware of exposure to hazards in a high percentage related to infectious agents, toxins (p=0.0012 and p=0.0046, respectively). A significant statistical difference was found between respondents with BiH and respondents with CRO in terms of knowledge of accreditation standards of medical-biochemical laboratories (p=0.0155). Respondents who have standard operating procedures available are aware of the hazards of infectious agents (p=0.0001), toxins (p=0.0466), needles and sharp objects (p=0.0052), noise (p=0.0030), vibration (p=0.0007) and extreme temperatures (p=0.0014). Conclusion: Efficient implementation and continuous compliance with the ISO 15189: 2018 standard requires constant commitment and active participation of laboratory staff. Laboratories must have standard operating procedures in place and actively monitor their use.

Background and Purpose: Improper distribution of health workers is a worldwide problem, especially in developing countries. The shortage of health personnel has been intensified over the past two decades as a result of the emigration of health workers from developing countries to developed ones and disparities between urban and rural regions. Materials and Methods: This cross-sectional, quantitative, and descriptive study was conducted at the University of Sarajevo, Faculty of Health Studies, for two months. The study included 203 3rd-year and 4th-year undergraduate students of all study programs. The chi-square test was used to examine the difference between students’ attitudes about leaving according to gender, grade point, foreign language learning, and high school graduation, as well as different statements of intention to leave or stay. Results: Of 203 respondents, 49(24.1%) were male and 154(75.9%) were female. Thirty-four students (16.75%) stated their attitude towards the definitive departure. Also, 129 students (63.55%) were thinking about leaving after graduation, while 40 students (19.7%) wanted to continue their life in Bosnia and Herzegovina after their studies. Almost half of the female students (49.26%) and slightly more than half of the male students (14.28%) think about leaving after their studies, with a statistically significant difference between men and women who think about leaving and those who stay. The positive attitudes, which the students who are leaving, for the most part, agreed upon were the acquisition of life experience that their occupation profile was sought in other countries, and career development and professional development. The reasons why most students consider leaving the country after their studies are due to the attitude that their education and degree are more valued in other countries, higher living standards in other fields, and career development and professional development. Conclusion: To prevent the migration of health students, retention policies are needed that target immigrant staff. These policies can be extremely important in preventing the problem of a lack of quality health staff in the near future.