Aim: To evaluate and compare the effects of topically applied diclofenac, ketoprofen, and piroxicam on key inflammatory mediators, including interleukin-17 (IL-17), prostaglandin E2 (PGE2), and signal transducer and activator of transcription 3 (STAT3), in a rat model of collagen-induced arthritis (CIA). Methods: Thirty male Wistar rats were assigned to five groups: three experimental groups receiving topical diclofenac, ketoprofen, or piroxicam, respectively, a positive control group receiving a placebo patch, and a negative control group without collagen injection. CIA was induced using bovine type II collagen and incomplete Freund’s adjuvant, with arthritis severity assessed through macroscopic scoring. NSAID patches were applied to the right hind paw for 6 hours daily over 5 days. Immunological parameters were quantified via enzyme-linked immunosorbent assay (ELISA). Statistical analysis included ANOVA, Kruskal-Wallis, and mixed-effects models to evaluate drug effects over time. Results: A significant difference was observed in tissue PGE₂ levels (F(4,25)=4.235; p=0.009; η²=0.404), with diclofenac showing significantly lower values compared to the negative control and ketoprofen groups, while no significant differences were found for IL-17 or STAT3. Conclusion: Topical NSAIDs demonstrated selective anti-inflammatory effects, primarily through significant suppression of tissue PGE₂, confirming effective local COX pathway inhibition. The absence of significant changes in IL-17 and STAT3 suggests that short-term topical therapy mainly targets prostaglandin-mediated inflammation rather than upstream cytokine or transcriptional pathways involved in rheumatoid arthritis pathogenesis, warranting further investigation into their long-term therapeutic benefits.

Abstract Introduction Rheumatic connective tissue diseases (RCTDs) are chronic systemic autoimmune disorders frequently complicated by cardiovascular involvement, which represents a major cause of morbidity and mortality. Subclinical cardiac manifestations may remain unrecognized and may be associated with systemic inflammation and laboratory abnormalities. Objective To evaluate the prevalence and characteristics of cardiac manifestations in patients with RCTDs and to assess their association with serological status and selected hematological and biochemical parameters. Methods This observational study included 110 adult patients hospitalized and treated for rheumatic connective tissue diseases over a one-year period. Patients were classified into seropositive and seronegative groups based on autoantibody profiles. All participants underwent clinical evaluation, electrocardiography, and transthoracic echocardiography. Hematological, inflammatory, biochemical, electrolyte, enzyme, and serum protein parameters were analyzed. Results Cardiac involvement was more frequently observed in seropositive patients and increased significantly with age. Ventricular hypertrophy and atrioventricular or intraventricular conduction disturbances were the most common abnormalities in this group. Seropositive patients showed significantly lower hematocrit, hemoglobin, calcium, and albumin levels, as well as higher erythrocyte sedimentation rate, fibrinogen, triglycerides, lactate dehydrogenase, and serum urea levels. In the seropositive group, demonstrated significant negative correlations with hematocrit, hemoglobin, albumin, and calcium. Conclusion Seropositive rheumatic connective tissue diseases are associated with a higher prevalence of subclinical cardiac involvement and distinct laboratory abnormalities reflecting chronic inflammation and myocardial remodeling. Integrated cardiovascular assessment combined with laboratory evaluation may facilitate early detection of cardiac involvement in this patient population.

Abstract Objective: To investigate the clinical and pathological features of a rare benign primary cardiac tumour. Methods: A retrospective analysis was conducted on 13 patients diagnosed with cardiac myxoma (CM) over a six-year period. Patient data including demographics, clinical presentation, imaging, laboratory, echocardiographic, histopathological characteristics, surgical intervention details, and postoperative outcomes were reviewed. Results: The mean age of patients included in the study was 57,69±13,47 (range 29 to 80 years), with a female predominance. The most common location of the tumour was left atrium (69.2%), followed by the right atrium (23.1%) and the left ventricle (7.7%). The most common clinical presentation included a combination of dyspnea, angina, fatigue and palpitations (76.9%). Followed by a syncope (15.4%), while one patient was asymptomatic. There was significant association with left ventricular location of CM and the presence of arrhythmia (p=0.004). Besides usually observed histological findings, glandular structures with mucin forming glands were present in 30.8% of cases and calcifications in 15.4%. All patients underwent surgical resection with favorable short-term outcomes. Conclusion: Cardiac myxoma is a rare but clinically significant neoplasm requiring prompt diagnosis and surgical management. Echocardiography remains essential for detection, and histopathology reveals a spectrum of features. Despite the study’s small sample size, findings highlight the importance of early recognition and support the need for larger multicentric studies to better define its prevalence and behavior.

Abstract Introduction: Apocrine hidrocystoma (AH) is a rare, benign cystic tumour of apocrine glands, typically occurring in adults between 30 and 70 years of age without gender predilection. It most frequently affects the head and neck region, while genital localization, particularly in the scrotum, is exceedingly uncommon. To the best of our knowledge, this is the first reported case of giant scrotal apocrine hidrocystoma in an adult patient. Case presentation: A 65-year-old male presented with a painless, translucent cystic nodule in the scrotal region gradually enlarging over several months. The lesion measured 45x30x25 mm and was surgically excised. Histopathological examination revealed a well-circumscribed, unencapsulated cystic lesion within the dermis, lined by two cell layers: an inner layer of apocrine cells exhibiting decapitation-type secretion and an outer myoepithelial layer. Immunohistochemical staining demonstrated AE1/AE3 positivity in luminal cells, and p63 expression in myoepithelial cells, confirming the diagnosis of AH. Conclusion: Apocrine hydrocystoma of the scrotum is an extremely rare benign lesion and therefore represents a diagnostic challenge. Awareness of this entity is essential to avoid misdiagnosis with other cystic or adnexal lesions.

Aim to investigate the prevalence of cervical cytology abnormalities over five years and to correlate it with patient’s age and presence/absence of HPV infection. Methods Pap findings of 614 women with documented cervical abnormalities and Pap findings of HPV-positive women (regardless of whether the Pap test showed an intraepithelial abnormality) were included in this study. Results The majority of women included in the study (36.5%) were aged 30-39 years. The most common abnormalities included atypical squamous cells-ASC (47.4%) and low-grade intraepithelial lesions (LSIL)-15.1%. Out of 614 women, 270 (43.9%) were positive for HPV. HR HPV positivity was found in 256 (41.7%). The proportion of HPV infection positivity decreases with age, especially in the two oldest age groups (women older than 60), p=0.03. The analysis showed a higher ratio of Pap smear abnormalities in groups of patients older than 40 years of age (p=0.02). The youngest age group (patients younger than 20 years of age) showed no other lesions than ASC, while women younger than 40 had no SCC on Pap smear. (p<0.01). Out of 256 HR HPV- positive women 42.2% (n=108) showed Pap abnormalities. HR HPV-positive women more commonly had HSIL lesions, but without statistical significance (p>0.05). Conclusion The results obtained contribute to the knowledge about HPV prevalence and the incidence of squamous cell abnormalities and confirm the necessity for further implementation of HPV vaccination and organized cervical cancer screening program on national level. Keywords: cervical dysplasia, Pap smear, screening.

<p style="font-size: 11pt; color: #000000; font-weight: 400;"><strong>Aim </strong>to investigate the prevalence of cervical cytology abnormalities over five years and to correlate it with patient&rsquo;s age and presence/absence of HPV infection.</p> <p style="font-size: 11pt; color: #000000; font-weight: 400;"><strong>Methods</strong> Pap findings of 614 women with documented cervical abnormalities and Pap findings of HPV-positive women (regardless of whether the Pap test showed an intraepithelial abnormality) were included in this study.</p> <p style="font-size: 11pt; color: #000000; font-weight: 400;"><strong>Results </strong>The majority of women included in the study (36.5%) were aged 30-39 years. The most common abnormalities included atypical squamous cells-ASC (47.4%) and low-grade intraepithelial lesions (LSIL)-15.1%. Out of 614 women, 270 (43.9%) were positive for HPV. HR HPV positivity was found in 256 (41.7%). The proportion of HPV infection positivity decreases with age, especially in the two oldest age groups (women older than 60), <em>p</em>=0.03. The analysis showed a higher ratio of Pap smear abnormalities in groups of patients older than 40 years of age (<em>p</em>=0.02). The youngest age group (patients younger than 20 years of age) showed no other lesions than ASC, while women younger than 40 had no SCC on Pap smear. (<em>p</em>&lt;0.01). Out of 256 HR HPV- positive women 42.2% (n=108) showed Pap abnormalities. HR HPV-positive women more commonly had HSIL lesions, but without statistical significance (<em>p</em>&gt;0.05).</p> <p style="font-size: 11pt; color: #000000; font-weight: 400;"><strong>Conclusion</strong> The results obtained contribute to the knowledge about HPV prevalence and the incidence of squamous cell abnormalities and confirm the necessity for further implementation of HPV vaccination and organized cervical cancer screening program on national level.</p> <p style="font-size: 11pt; color: #000000; font-weight: 400;"><strong>Keywords:</strong> cervical dysplasia, Pap smear, screening</p>

Hypothermia-related deaths present significant diagnostic challenges due to non-specific and often inconsistent autopsy findings. This study investigated the histological and immunohistochemical alterations associated with primary and secondary hypothermia in an experimental Rattus norvegicus model, focusing on the effects of benzodiazepine and alcohol ingestion. Twenty-one male rats were divided into three groups: control (K), benzodiazepine-treated (B), and alcohol-treated (A). After two weeks of substance administration, hypothermia was induced and multiple organ samples were analyzed. Histologically, renal tissue showed hydropic and vacuolar degeneration, congestion, and acute tubular injury across all groups, with no significant differences in E-cadherin expression. Lung samples revealed congestion, emphysema, and hemorrhage, with more pronounced vascular congestion in the alcohol and benzodiazepine groups. Cardiac tissue exhibited vacuolar degeneration and protein denaturation, particularly in substance-exposed animals. The spleen showed preserved architecture but increased erythrocyte infiltration and significantly elevated myeloperoxidase (MPO)-positive granulocytes in the intoxicated groups. Liver samples demonstrated congestion, focal necrosis, and subcapsular hemorrhage, especially in the alcohol group. Immunohistochemical analysis revealed statistically significant differences in MPO expression in both lung and spleen tissues, with the highest levels observed in the benzodiazepine group. Similarly, CK7 and CK20 expression in the gastroesophageal junction was significantly elevated in both alcohol- and benzodiazepine-treated animals compared to the controls. In contrast, E-cadherin expression in the kidney did not differ significantly among the groups. These findings suggest that specific histological and immunohistochemical patterns, particularly involving pulmonary, cardiac, hepatic, and splenic tissues, may help differentiate primary hypothermia from substance-related secondary hypothermia. The study underscores the value of integrating toxicological, histological, and molecular analyses to enhance the forensic assessment of hypothermia-related fatalities. Future research should aim to validate these markers in human autopsy series and explore additional molecular indicators to refine diagnostic accuracy in forensic pathology.

Microscopic signs indicative of drowning are not specific to drowning but also to any other form of suffocation where mechanical obstruction is involved. Our study aimed to evaluate both macroscopic and microscopic findings across different groups sharing a common mechanism of death but differing causes and to compare the diatom test with pathohistological examination.Twenty-nine adult Wistar rats, weighing within recommended ranges, were divided into four groups (L1-L4). The diatom test followed established guidelines for diatoms in water from the Bosna River. Microscopic examination revealed diatoms in the lungs of rats in L3 and L4 groups. Pathohistological findings showed varying degrees of changes including consolidation and inflammatory cell infiltration, dominated by lymphocytes and macrophages, with some samples also showing eosinophilic leukocytes.Significant differences were observed between animals whose cause of death was mechanical asphyxia (suffocatio) and those that were submersed for1 hour versus those that were submersed for 72 hours after death. Diatoms identified in group L4 samples 3, 4, and 5 included Navicula sp. (U3 and U6) and Ulnaria ulna (U4).Our findings suggest combining the diatom test with pathohistological analysis to support a drowning diagnosis. Further examination of other organs could enhance result reliability.

Background: There is no specified diagnostic procedure that can help in determining the cause of death and the diagnosis of drowning because the pathohistological signs are almost identical and non-specified. Aim: Our study aims to recognize and prove diatom appearance in organs from a forensic aspect in Bosnia and Herzegovina, and to examine which is the more specific method in the diagnosis of drowning, the diatom test or the pathohistological finding. Methods: Rats of the recommended body weight were divided into four groups: G1 (n = 8; mechanism of death—asphyxia; cause of death—suffocation, submerged 1 hour after death); G2 (n = 8: mechanism of death-asphyxia; cause of death-suffocation, immersed 72 hours after death); G3 (n = 8: mechanism of death-asphyxia; cause of death-drowning, autopsy immediately after death), and G4 (n = 8: mechanism of death-asphyxia; cause of death-drowning, post mortem 24 hours after death). Results: During the diatom analysis, four species of diatoms, Diatoma vulgaris, Melosira varians, Epithemia adnata, and Cymbella sp, were successfully recovered from the stomach. Microscopic analysis did not detect diatoms in the kidneys and brains of rats, while the pathohistological changes were relatively uniform. Conclusion: Our results propose that the diatom test is a sustainable tool for supporting the diagnosis of drowning in the forensic pathology analysis of the cause of death. This experimental study is a starting point toward the optimization of tests and sampling in cases of unexplained etiology.

Abstract Introduction: Melkersson Rosenthal syndrome (MRS) is a disease of multifactorial origin typically presented with a triad of symptoms including peripheral facial nerve paralysis, plicated tongue and orofacial edema. Diagnosing MRS requires the exclusion of other granulomatous diseases and the correlation of clinical with histopathological finding. Case presentation: We present the case of a 56-year-old female with a four-month history of lower lip and right mandible angle swelling together with a plicated tongue that appeared during COVID-19 infection. The patient was successfully treated with intralesional Triamcinolone Acetonide at a dose of 40 mg. Conclusion: The presented case is specific by its late onset since the patient experienced their first symptoms in fifties, which differs from the majority of cases where the diagnosis is usually established in young adults. Infectious factors are established as possible etiologic factors of MRS, but few cases are described to be triggered or worsened by COVID-19 infection.