Introduction: Influenza is an acute, infectious disease of the human respiratory system, caused byinfluenza viruses. Since it is a vaccine-preventable disease, medical students as future health professionals should be involved in programs promoting the importance of flu vaccination.Aim: Compare knowledge, attitude and practice of vaccination against influenza among students of the firstand sixthyear of School of Medicine of University of Mostar.Subjects and methods: The study included a total of81 students of the School of Medicine of the University of Mostar. The data were collected using a questionnaire that consists from demographic data of the respondents andtwenty questions with the offered answers about the knowledge, attitude and practice of vaccination against influenza.Results: Sixth-year students showed greater knowledge about contraindications for vaccination. Both groups of students showed mainly positive attitudes about influenza vaccination. No surveyed student was vaccinated against influenza and many of them reasoned that influenza is not a serious illness.Conclusions: Despite good knowledge and mostly positive attitudes about influenza vaccination, no student who participated in the study was vaccinated against influenza. Therefore, it would be useful for medical students to provide additional information about the importance of illness prevention, because they represent an important part of the future workforce in the health system, that will affect the global attitudes of vaccination.Keywords: influenza, vaccination, knowledge, practice, students

Background: Bloodstream infections (BSI) encountered in hospitals are one of the most complex infections that pose a great challenge. Methicillin-sensitive and Methicillin-resistant Staphylococcus aureus are common causes of severe bloodstreaminfectionsthatareassociatedwithorganfailureandsepticshock.Hence,betterknowledgeoftheincidence ofBSIcausedbyMRSAandMSSAandadequateantibiotictreatmentareimportanttoreducelengthofhospitalstayand improve treatment outcomes.Subjectsandmethods:TheaimofthisstudywastoanalyzethefrequencyofBSIwithMSSAandMRSAinadultpatients whowerehospitalizedatthesametimeandsamedepartmentsoftheUniversityHospitalCentreMostarinthecourseof six years.Results: The incidence of BSI with MSSA and MRSA was shown to be 33,21% and 17,99%, respectively. Averageage of patients infected with MRSA was 61.5 years and with MSSA was 67.5 years. MSSA and MRSA BSI were more commoninmenwithaverageof69,79%and80,77%,respectively.Inbothgroupsofpatients,onethirdhadnoassociated diseases. Patients that had associated chronic disease with mild or moderately severe activity limitations constructed 41,67%withMSSAand46,15%withMRSA.Cardiovasculardiseasesweremostcommonchronicdiseaseinbothgroups, 33.33% for MSSA and 40.38% for MRSA.Treatment of the of subjects with MSSA BSI averaged 15 days and lasted significantlyshorterwhencomparedtoMRSABSItreatmentthataveraged36days.PatientswithMRSABSIweremore treated in middle and/or high-risk departments and with inadequate antibiotic therapy. MRSA BSI patients were more oftenmechanicallyventilated(69,23%),whichcontributestoahighercostoftreatment(averageof8032.5€intotal)and higher drug consumption when compared to the MSSA BSI patients. The death rate was higher in patients treated for MRSA BSI and averaged 67.31%.Conclusions:Theresultsofthisstudyarepromisingsincetheycanbeusedinpracticebycliniciansasaguidelinefor choosing adequate antibiotics, and improve course of treatment, length, outcome and cost.Keywords:Bloodstreaminfections,MSSA,MRSA,antimicrobialtreatment

Abstract Background To examine correlation between elevated levels of thyrotropin with the frequency of miscarriages. Methods A cross-sectional study was conducted on the 380 respondents and it investigated TSH (thyrotropin), thyroid peroxidase antibody(anti-TPO) and free thyroxine (FT4) in pregnant women who had a miscarriage (N = 179) and pregnant women with normal pregnancies (N = 201). Results The incidence of subclinical hypothyroidism in the miscarriages group was higher than in control group (61.4% vrs 15.79% (p < 0.001). In the miscarriages group with hypothyroidism (first trimester) mean value of TSH was significantly higher 4.31 ± 2.55 mIU/L compared to the control group 1.95 ± 0.86mIU/L (p < 0.001). Logistic multivariate regression revealed that TSH and body mass index (BMI) have a significant influence on the miscarriage; TSH level has a higher odds ratio (OR) 1.47 CI (95% 1.22–1.78) than BMI (OR) 1.14 CI (95% 1.06–1.23)) (p < 0.001). The combination of thyroid autoimmunity and TSH > 2.5mIU/L increase the risk of miscarriage (65.75%) compared to positive anti-TPO antibodies and TSH < 2.5mIU/L(14.15%)(p < 0.001). Conclusions Higher TSH levels correspond with obesity during early pregnancy and may be a sign of maternal thyroid dysfunction. Physiological thyroid function in the first trimester of pregnancy is important for perinatal outcome.

Objective: The main objective of this research is to determine the prevalence and characteristics of neurological manifestations in hospitalized patients with SARS-CoV-2 infection. Methods: A cross-sectional study was conducted. 572 hospitalized patients at the COVID Department of Pulmonology of the Mostar University Clinical Hospital in the six-month period from October 31, 2020, to April 30, 2021, were included. We analyzed the incidence of neurological manifestations and the influence of comorbidities and metabolic syndrome on stroke incidence in COVID-19 patients. We analyzed hospital length of stay and mortality in patients with and without neurological manifestations. The research was conducted with respect to all the determinants of the Helsinki Declaration. Results: 572 patients, 351 men (61.4%), and 221 women (38.6%) were included. A fatal outcome was present in a quarter of patients (25.3%). Neurological manifestations were found in 163 patients (28.5%). Myalgia was the most common (16.1%). The following were reported: headache (9.6%), loss of taste (7.34%), loss of smell (6.8%), and vertigo (2.5%). There was a significant difference regarding loss of smell between males and females (p=0.04). The cerebrovascular incident was present in 2.97% of patients and was more frequent in the group of patients with metabolic syndrome. Patients with neurological manifestations had a longer hospital stay, but it was not statistically significant (p=0.9319). The presence of neurological manifestations in general did not influence the mortality rate. Conclusion: Patients with SARS-CoV-2 infection can present with neurologic findings such as myalgia, headache, loss of smell or taste, vertigo, as well as cerebrovascular incidents. Patients with neurological manifestations had longer hospital stays, but the presence of neurological manifestations in general did not influence the mortality rate.

Background : This study conducted at the Clinic for Children’s Diseases of the University Clinical Hospital Mostar, aims to highlight the characteristics, frequency, course, most common complications and treatment outcomes of pregnant women and their late preterm infants according to gestational age. Methods : This study is a retrospective epidemiologic study for the period from 1/1/2018 to 31/12/2021. The study included all the preterm infants who were born at a gestational age from 34 +0/7 to 36 +6/7 weeks and their mothers. Results : In the period under study, a total of 7178 infants were born, of which 253 (3.52%) were late preterm infants. The results show that most mothers were between 30 and 39 years of age, pregnant for the first time with a single pregnancy, delivered by caesarean section, with complications in 53.1% of the pregnancies. All the analyzed pathological conditions were more common in the pregnancies which ended at 34 weeks. Our results indicate that the late preterm babies had a good birth weight (53.8%) and high vitality scores (93%) at birth, but these scores were not confirmed on the first day of life. A significant number of late preterm infants had some pathological condition which was treated in the intensive care units (ICU) ( p < 0.001). Conclusions : The study concludes that half of the pregnant women had risk factors which were the basis for the preterm births and the development of complications in the late preterm infants. Furthermore, despite good birth weight and vitality scores at birth, only one fifth of the late preterm infants were not treated with medications or developed pathological conditions, whereas only one third required no intensive care treatment. It is, therefore, necessary to improve the monitoring and understanding of such pregnancies, implement antenatal corticosteroid therapy, and increase parental awareness to ensure long-term and frequent monitoring of late preterm infants by pediatricians.

Background: The aim of this study was to compare the level of inammatory parameters in 3 different groups of COVID-19 patients depending on severity of clinical manifestations and to dene which inammatory parameter can be used as predictor of clinical severity and outcome. A total of 51 subjects was included in this study by retrospective review of theMethods: documentation at the Clinic for Infectious Diseases of University Clinical Hospital Mostar. The following data were collected: demographic, clinical symptoms, complications, therapy, and the level of inammatory parameters (C-reactive protein at the admission, procalcitonin, leukocytes, relative neutrophils count, relative lymphocyte count). Depending on the value of paO2/O2 patients were separated into 3 groups: mild, moderate and severe group. Data entry into the tables was followed by statistical data processing using IBM SPSS Statistics v.26 and Microsoft Excel 2013. Most frequent symptoms were fever (82% of all subjects), cough (61%), trouble breathing (55%), shortness ofResults: breath (43%), chest pain (27%), muscle pain (25%), diarrhea (20%), vomiting (6%) and headache (6%). The overall mortality of this study was 35%, with a statistically much higher mortality in severe patients. Also C-reactive protein levels were higher in severe patients. Conclusions: Levels of C-reactive protein on admission were signicantly higher in patients who developed a severe clinical manifestations. Also, mortality in severe patients was statistically higher than the remaining 2 groups of patients. CRP is reported as a prognostic factor in the severity of clinical manifestations and mortality of hospitalized COVID-19 patients.

Background: The aim of this study was to show the frequency and epidemiological characteristics of pregnant women who tested positive for SARS-CoV-2 during childbirth as well as the course, mode and outcome of their newborn treatment and diet after discharge. The aim is also to show individual symptoms developed by newborn from pregnant women who test positive for SARS-CoV-2. Method: The study included all the infants born to the pregnant women who tested positive for SARS-CoV-2 on a PCR test 24 hours prior to delivery or, had already been confirmed positive for the infection and had developed symptoms of the virus or had started treatment for SARS-CoV-2 several days prior to delivery. Results: 43/3237 (1.32%) of the pregnant women tested positive for the SARS-CoV-2 virus or had been infected prior to admission and were positive during delivery. A total of 45 newborn infants were transferred to a special room for the care of newborn infants born to SARS-CoV-2-positive mothers at the Department of Neonatology. Specifically, 30/45 (66.7%) of the newborn infants developed symptoms within the first hours of birth which withdrew spontaneously within 24–48 hours after birth. The symptoms referred to are not specific forSARS-CoV-2 infection and are not particularly indicative of infection. Conclusions: The conclusion of this short 21-month study is that prenatal and postnatal duration and outcome in infants is not aggravated by pregnant women who tested positive for SARS-CoV-2. Despite the individual symptoms described above and the pathological states the children developed during hospitalization, all the newborn infants were discharged from hospital in full health, and they were all breastfeeding following discharge in conditions which respected all the epidemiological preventive measures.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has put national health systems under extremely large pressure. Health systems throughout the world demonstrated different levels of preparedness for COVID-19 pandemic. Aim: The aim of the study was to investigate the association of resilience with quality of life and self-esteem in healthcare workers of COVID-19 hospital. Methods: We performed a cross-sectional study between November 2020 and February 2021 in COVID-19 hospital at the University Clinical Hospital Mostar. A socio-demographic questionnaire specifically designed for this study, a CD-RISC25 scale for assessing resilience, a WHOQOL-BREF questionnaire for assessing quality of life, and a RSES scale for assessing self-esteem were used for collecting data. Results: A statistically significant higher resilience was in healthcare workers who felt adequately prepared for work in COVID-19 hospital. Resilience, quality of life and self-esteem statistically significantly positively correlated with one another among healthcare workers. A healthcare worker’s resilience level was statistically significantly affected by psychological domain of the quality of life, gender, and adequate preparation. Conclusion: Resilience is positively related to the quality of life and self-esteem in healthcare workers of COVID-19 hospital at the University Clinical Hospital Mostar.