Introduction: Type 2 diabetes mellitus (T2DM) is associated with a high burden of complications, most of which first present to primary care.Objective: To assess the prevalence and predictors of diabetes-related complications among patients seeking primary health care.Methods: This retrospective study analysed records of 1000 patients with T2DM in primary care. Demographic, clinical, and therapeutic variables were examined, and multivariate logistic regression was used to identify independent predictors of complications.Results: Majority of the patients (58.3%) had at least one complication. Neuropathy (41.8%), retinopathy (32.3%), and chronic coronary syndrome (CCS)(22.3%) were most frequent. Independent predictors for complications included older age, longer disease duration and higher HbA1c (p<0.001 for all). Neuropathy was significantly associated with female sex (p=0.016), while myocardial infarction and CCS showed significant association with male sex (p=0.027 and p=0.002 respectively). All complications were strongly associated with hospitalisations (all p<0.001), except for retinopathy. Family history independently predicted retinopathy (p=0.039) and CCS (p=0.014).Conclusion: Diabetes-related complications remain highly prevalent and are strongly linked to glycaemic control, disease duration, and age. Sex, and family history also shape complication patterns, while treatment modality reflects disease severity. These findings highlight the need for early, individualised management and implementation of guideline-based strategies to reduce complication burden and improve outcomes in frontline care.

Objective: To describe patient-reported symptoms of hypothyroidism in a primary care cohort and perform an exploratory assessment of potential gender differences. Methods: This retrospective observational study included 1000 patients with confirmed hypothyroidism treated at the Public Institution Health Care Centre Visoko between January and October 2024. Data were extracted from electronic medical records. Collected variables included age, gender, comorbidities, family history, pregnancy status, and reported symptoms. Descriptive statistics were performed for the entire cohort. Exploratory logistic regression analyses were used to assess potential gender differences in reported symptoms. Results: The cohort comprised 921 (92.1%) female and 79 (7.9%) male patients, with a mean age of 57±14.6 years. The most commonly reported symptoms were hyperhidrosis (97%), fatigue (96.6%), and heart palpitations (83.5%). Male patients showed a higher likelihood of reporting heart palpitations (OR 2.42, p=0.03) and bowel problems (OR 2.03, p=0.01), and a lower likelihood of reporting neck tightness (OR 0.26, p<0.001) and tearfulness (OR 0.045, p<0.001). Conclusion: In this primary care cohort, the reported symptom burden was largely nonspecific and reflects real-world patient-reported complaints rather than classical manifestations of overt hypothyroidism. Exploratory analyses suggested potential gender-related differences; however, the low number of male patients limits firm conclusions. Larger prospective studies are needed to confirm these observations.

ObjectiveTo evaluate the predictive value of LA strain parameters and LASI for AF recurrence following electrical CV, and to compare them to conventional echocardiographic, biochemical, and clinical markers.MethodsIn this prospective, observational pilot study, 31 patients with persistent AF underwent electrical CV and were followed for six months. Echocardiographic evaluation included LA reservoir, conduit, and contractile strain, left atrial stiffness index, left atrial volume index (LAVI), left atrial appendage (LAA) morphology, left ventricular ejection fraction (LVEF), right atrial (RA) area, and right ventricular systolic pressure (RVSP). AF recurrence was assessed at three and six months.ResultsAt three months post-CV, LA reservoir, conduit, and contractile strain values were significantly negatively associated with AF recurrence (p < 0.001), while LASI and E/E' ratios were positively associated (p < 0.001). At six months, only contractile strain retained prognostic significance (p = 0.008). LVEF showed a positive correlation with recurrence at six months (p = 0.003), potentially reflecting the role of diastolic dysfunction.ConclusionLA strain parameters and LASI are valuable tools for predicting AF recurrence after CV, particularly in the early post-procedural period. Contractile strain may serve as a more reliable long-term predictor, emphasizing the importance of longitudinal atrial function assessment in rhythm outcome prediction. However, given the small sample size and single-center design, these results should be considered hypothesis-generating, requiring validation in larger studies.

Introduction. Owing to its high incidence and significant impact on public health, breast cancer represents a major clinical and epidemiological challenge. This study aimed to describe the clinicopathological and immunohistochemical characteristics of newly diagnosed breast cancer cases in Sarajevo. Results. Among 10,547 breast examinations, 165 breast cancers were detected (1.5–1.6% annual incidence). Conclusion. This study highlights the heterogeneity of breast cancer and emphasizes the need for further research to refine diagnostics and treatment. Keywords: Breast cancer, Estrogen Receptors, Progesterone Receptors.

Introduction. Psychiatric disorders frequently co-occur with chronic somatic diseases, trauma, and family psychiatric history. Results. Affective disorders were most prevalent (67%), particularly among women and retirees. Conclusion. Psychiatric diagnoses are closely intertwined with demographic and social factors, trauma, family history, and somatic comorbidities. These findings highlight the need for integrated, multidisciplinary care. Keywords: Age, Comorbidity, Mental Disorders, Sex, Somatic Diseases.

Introduction. Morning stiffness (MS) is the hallmark of rheumatoid arthritis (RA) and it has important implications on daily life of the patients. There are conflicting reports of its association with disease activity. Methods. This observational study included 125 patients with seropositive RA from Health Care Center, Visoko. We obtained data on patient’s gender and age, duration of RA, pain in hands and feet, MS and its duration, hospital admission, blood pressure, laboratory values and treatment modalities. Results. MS lasted up to 30 minutes in 71 (56.8%) patients, 30 to 60 minutes in 40 (32%) patients, and more than 60 minutes in 14 (11.2%) patients. There was no difference in the duration of MS between genders. Patients with longer MS were younger and had a longer duration of illness. Patients with MS longer than 30 minutes had higher blood pressure and cholesterol levels. ESR in the second hour and CRP correlated with a duration of MS. Patients on methotrexate had a longer duration of MS. No significant differences in the duration of MS were observed for leflunomide, corticosteroids and supportive treatment modalities. Conclusion. Duration of MS correlates with RA disease activity and remains an important burden for patients. Usage of newer treatment options, such as biologic disease-modifying antirheumatic drugs (DMARDs), may be required. Keywords: biomarkers, disease activity, rheumatoid arthritis.

Introduction: Calciphylaxis (calcific uremic arteriolopathy), is a condition primarily observed in patients with end-stage renal disease (ESRD). Aim: To increase clinical awareness of calciphylaxis and to consider it a differential diagnosis in the presence of atypical skin nodules or ulcers occurring in patients with chronic kidney disease (CKD), especially in patients on hemodialysis and non-hemodialysis patients with the background of diabetes mellitus and secondary hyperparathyroidism. Case Report: We present the case of a 77-year-old woman with CKD and diabetes mellitus as well as severely painful, firm, indurated plaques on the lower extremities. The plaques progressed to involve larger areas with associated local ulceration and necrosis. Laboratory testing revealed hyperparathyroidism and incisional skin biopsy confirmed calciphylaxis. Conclusion: Each single CKD patient with diabetes mellitus and signs of secondary hyperparathyroidism with extremely painful ischemic cutaneous lesions or painful subcutaneous nodules without skin changes, although at times, pain may precede the development of the lesions, is a candidate for skin biopsy. Calciphylaxis is a rare but serious kidney complication. Keywords: calciphylaxis, chronic kidney disease, prognosis, treatment.

AIM To investigate whether the radiographic progression of rheumatoid arthritis (RA) correlates with inflammatory markers and other laboratory values, and its association with treatment modalities. METHODS This observational study included 125 patients with seropositive RA. Data were obtained from patients' medical records from the year of 2022. Inclusion criteria were patients with seropositive RA who had attended follow-up with a rheumatologist. Basic patient data were collected: gender, age, duration of RA, hospital admission, systolic and diastolic blood pressure, and X-ray stage of RA. Stages of RA are defined by the American College of Rheumatology and they ranged from stage 1, which represents no destructive changes on X-ray, up to stage 4 where bony or fibrous ankylosis is present. RESULTS There were no differences in X-ray stages of RA between genders. Patients with a higher X-ray stage were younger and had a longer duration of illness. Patients in stages III and IV had higher systolic blood pressure (BP), patients in stage IV had higher diastolic BP. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were higher in X-ray stages II-IV compared to stage I. The patients treated with methotrexate had higher radiographic stages. CONCLUSION X-ray changes can be associated with CRP and ESR levels, since structural damage is related to RA disease activity and functional disability. The use of newer treatment modalities may be required to stop the radiographic progression of RA.

Abstract D-dimer and fibrinogen are nonspecific diagnostic biomarkers for venous thromboembolism (VTE). The aim of this article was to present the values of D-dimer and fibrinogen in relation to the anatomical localization of deep vein thrombosis (DVT). This was an observational study, which included 1,142 patients hospitalized from 2010 to 2019 at the Department of Angiology, Clinical Center University of Sarajevo. Data on gender, age, and thrombosis location were collected of all patients. Fibrinogen and D-dimer values were available for 983 and 500 patients, respectively. Thrombosis location was classified as iliofemoral (521–45.6% patients), femoral–popliteal (486–42.6% patients), isolated calf DVT (63–5.5% patients), and upper extremity DVT (UEDVT in 72–6.3% patients). A majority, 448 (89.6%), of patients had high D-dimer (the cutoff is 0.55 mg/L) and 662 (67.3%) patients had high fibrinogen (reference range: 1.8–3.8 g/L). The highest D-dimer was detected in patients with iliofemoral DVT (mean: 10.48 mg/L), χ2 = 50.78, p  = 0.00. The highest fibrinogen was detected in patients with iliofemoral DVT as well (mean 4.87 g/L), χ2 = 11.1, p  = 0.01. D-dimer and fibrinogen values are significantly higher in patients iliofemoral DVT than femoral–popliteal and isolated calf DVT, and D-dimer values are significantly higher in lower extremity DVT than UEDVT, but these biomarkers cannot be used alone to discriminate between thrombosis locations. Further imaging is required.