Aim To investigate the serum value of brain derived neurotrophic factor (BDNF), proteins S-100, NSE, IL-6 in normal pressure patients (NPH) compared to control (healthy) group and also a possible correlation with radiological findings in NPH patients. Methods Study patients were included during the period of 2020- 2022. All NPH patients met the diagnostic criteria for probability of NPH. Control patients group included patients without known brain disorder, without clinical symptoms of NPH. Blood samples were taken before planned surgery for NPH. BDNF serum concentrations were assessed by a sensitive ELISA kit, and serum concentrations of S-100, NSE and IL-6 were assessed by using ECLIA technology for immunoassay detection. Results Among 15 patients who were included, seven NPH patients were compared to eight control patients. Non-significant decrease in BDNF serum concentrations, an increase of protein S-100 serum concentrations, a decrease of NSE serum concentrations, as well as an increase of IL-6 serum concentrations in NPH patients compared to healthy controls was found. Strong positive correlation between BNDF and Evans index was observed (p=0.0295). Conclusion We did not find a significant difference of BDNF, protein S-100, IL-6 and NSE between serum concentration in NPH and healthy patients. More future research is needed to find the role of BDNF in NPH patients.

Background: Retained placenta is one of the major causes of primary and secondary post-partum hemorrhage (PPH) and active management of the third stage of labor reduces the risk of PPH. Objective: The aim of this paper was to compare the efficacy of intra-umbilical vein injection of carboprost versus oxytocin by time and success rates of total expulsion of the placenta. Methods: This prospective clinical study with quasi-experimental design 2x2x2(risk factors by medication by doses) was conducted at Clinic of Obstetrics and Gynecology, Clinical Center of University of Sarajevo in two-year period. Patients were randomized in 4 groups and 8 subgroupsby different medication doses and risk factors. The main outcome variable was expulsion of retained placenta and second outcome variables were: duration of time from intra-umbilical vein administration of drug to expulsion of retained placenta, the number of cases who required blood transfusion and antibiotics, postpartum hemoglobin after 24h. Statistical significance was accepted for p-values < 0.05. Results: The group B2 (UVI oxytocin 20 IU in 20 mL saline, surgical risk factors) and the group D2 (UVI oxytocin 20 IU in 20 mL saline, non-surgical risk factors) had shorter expulsion time (minutes) (Me=5; IQR=4 to 5; Me=5; IQR=4.3 to 6, respectively) compared with other groups (p<0.001). The success rates of total expulsion of the placenta by groups (A,B,C and D) were not statistically significant (70% vs. 82% vs. 72% vs. 78%, respectively; p=0.483). Post-intervention hemoglobin concentrations was statistically significantly greater in the group B(117.3±1.3) vs. the group A (112.1±1.3), (p =0.028). Conclusion: The time for placental expulsion was significantly shorter and postpartum hemoglobin was significantly higher in the intra-umbilical oxytocin groups than in the carboprost groups.

Abstract Background Translations of instruments for measuring quality of life developed in certain, mostly more developed, parts of the world usually do not cover regionally specific aspects of health-related quality of life, even after transcultural validation. The aim of this study was to develop and validate a reliable questionnaire in Serbian, Croatian, Bosnian, and Montenegrin languages suitable for measuring health-related quality of life in adults. Methods The study was of a cross-sectional type, assessing the reliability and validity of a newly developed questionnaire for measuring health-related quality of life (HRQoL) in adults residing in western Balkan states (WB-HRQoL). It was conducted on a sample of 489 adults from Serbia, Croatia, Bosnia & Herzegovina, and Montenegro, with a mean age of 52.2±14.4 years and a male/female ratio of 195/294 (39.9%/60.1%). Result The definitive version of the WB-HRQoL scale with 19 items showed very good reliability, with Cronbach’s alpha 0.905. The scale was temporally stable, and satisfactory results were obtained for divergent and convergent validity tests. Exploratory factorial analysis brought to the surface four domains of health-related quality of life, namely the physical, psychical, social, and environmental. Conclusion The WB-HRQoL scale is a reliable and valid generic instrument for measuring HRQoL that takes into account the cultural specifics of the western Balkan region.

Healthcare risk management began in the 1960s (USA, UK, Australia, New Zealand). It has traditionally been driven by insurance and lawsuits. Today, health risk management is widely accepted through development of appropriate standards and educational programs (1). Risk management within the organization should be recognized as an integral part of good management, or part of organizational culture. Risk management should be included in the organization’s philosophy, practices and business plans, and not treated as a separate program (2). RISK MANAGEMENT IN THE CLINICAL HEALTH CARE PROCESS

During a pandemic, mitigation as well as protection of system-critical or vulnerable institutions requires massive parallel, yet cost effective testing to monitor the spread of agents such as the current SARS-CoV2 virus. Here we present SARSeq, saliva analysis by RNA sequencing, as an approach to monitor presence of SARS-CoV2 and other respiratory viruses performed on tens of thousands of samples in parallel. SARSeq is based on next generation sequencing of multiple amplicons generated in parallel in a multiplexed RT-PCR reaction. It relies on a two-dimensional unique dual indexing strategy using four indices in total for unambiguous and scalable assignment of reads to individual samples. We calibrated this method using dilutions of synthetic RNA and virions to show sensitivity down to few molecules, and applied it to hundreds of patient samples validating robust performance across various sample types. Double blinded benchmarking to gold-standard quantitative RT-PCR performed in a clinical setting and a human diagnostics laboratory showed robust performance up to a Ct of 36. The false positive rate, likely due to cross contamination during sample pipetting, was estimated at 0.04-0.1%. In addition to SARS-CoV2, SARSeq detects Influenza A and B viruses as well as human rhinovirus and can be easily expanded to include detection of other pathogens. In sum, SARSeq is an ideal platform for differential diagnostic of respiratory diseases at a scale, as is required during a pandemic.

Background: Cohort studies are useful in determining how risk factors and outcomes differ among regions, populations and available resources. The aim of this five-year cohort study of premature infants from Bosnia and Herzegovina was to examine the impact of mode of delivery and administration of prenatal corticosteroids on key neonatal outcomes. Methods: This cohort study included 734 infants with gestational age 24 32 weeks, admitted to the neonatal intensive care unit of the Pediatric Hospital in Sarajevo from 1 Jan 2012 to 31 Dec 2016, including both inborn infants and infants transported from the smaller hospitals throughout the country. We also examined the subgroup of 225 infants with gestational age 24 28 weeks for the same outcomes. Results: In the full cohort, cesarean delivery was associated with a lower incidence of severe intraventricular hemorrhage (IVH) [6.5% (cesarean section, CS) vs. 13% (vaginal delivery) OR 0.45, 95% CI: 0.26 0.78 (p < 0.01)], but not with increased survival to discharge. Administration of prenatal corticosteroids was associated with decreased mortality [13% (yes) vs 21% (no) OR 0.53, 95% CI: 0.33 0.84 (p < 0.01)]. In the subgroup of extremely premature infants, CS was associated with a higher incidence of respiratory distress syndrome and surfactant administration, and prenatal steroid administration was associated with a lower mortality rate. Multiple regression analysis showed birth weight to be a significant predictor of survival to discharge and both birth weight and delivery type to be significant predictors of severe IVH. In this model, antenatal steroid administration was not a significant predictor of survival or severe IVH. Conclusion: In this cohort of premature infants born in Bosnia and Herzegovina, survival was not influenced by delivery type. In the full cohort, CS was associated with decreased risk of severe IVH but this association was not seen in the subgroup of more premature infants. We found an association between prenatal corticosteroids and decreased mortality, but this did not remain significant with multiple regression analysis.