Aim This study aimed to assess the impact of forced repeated swimming stress on serum adiponectin and endothelin-1 levels in Wistar rats, comparing the effects between those fed a standard diet and those on a high-fat diet. Methods Twenty adult male Wistar rats were divided into two dietary groups: a standard food diet group (NFD, n=10) and a high-fat diet group (HFD, n=10). Both groups underwent daily forced swimming stress for six days, with durations increasing from 5 to 30 minutes. The protocol finished in an acute bout of swimming exercise on the seventh day with a duration of 40 minutes. Adherence to ethical guidelines was strictly maintained, and serum adiponectin and endothelin-1 levels were measured pre- and post-exercise using the ELISA method. Results Before swimming, the mean adiponectin levels were 4.30±1.50 ng/mL in the NFD group and 3.53±0.70 ng/mL in the HFD group. Post-exercise, these levels significantly decreased to 2.4±0.84 ng/mL (p=0.003) and 1.58±0.23 ng/mL (p=0.001), respectively. Endothelin-1 levels also showed significant decreases from 0.86 pg/mL (0.74-0.87) to 0.49 pg/mL (0.43-0.62) (p=0.003) in the NFD group, and from 0.89 pg/mL (0.86-0.93) to 0.69 pg/mL (0.60-0.75) (p=0.027) in the HFD group after swimming. Conclusion The study highlighted the significant effects of forced swimming stress on lowering serum adiponectin and endothelin-1 levels in Wistar rats, with more pronounced decreases observed in rats on a high-fat diet. The results of the study suggest the potential of exercise as a crucial component of strategies aimed at managing obesity and improving cardiovascular health, emphasizing the interaction between physical stress and dietary factors on metabolic and cardiovascular biomarkers.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common chronic liver condition. Due to pathophysiological processes, MASLD's relation to type 2 diabetes mellitus (T2DM) is still unclear, especially when the role of adipocytokines is taken into consideration. Objective: This study aims to examine the potential predictive value of adiponectin and resistin for MASLD in T2DM. Patients and methods: In a two-year study, 71 T2DM patients were categorized into MASLD-T2DM and non-MASLD-T2DM groups according to MASLD development. Serum samples were tested for resistin, adiponectin, high-density lipoprotein cholesterol, fasting glucose, and triglycerides. An appropriate equation is used to calculate the adiponectin/resistin (A/R) index. The optimal cut-off values for differentiating MASLD patients from non-MASLD patients were determined using receiver operating characteristic (ROC) curves and the corresponding areas under the curve (AUC). To predict the onset of MASLD in patients with T2DM, a logistic regression analysis was performed. Results: There were significant differences in adiponectin (p<0.001), resistin (p<0.001), and A/R index (p<0.001) between T2DM individuals with and without MASLD. The ROC curve for resistin produced an AUC of 0.997 (p<0.001) with a sensitivity of 96.1% and a specificity of 100% for the cut-off point of 253.15. Adiponectin (OR, 0.054; 95% CI, 0.011-0.268; p<0.001) and resistin (OR, 1.745; 95% CI, 1.195-2,548; p=0.004) were found to be independent predictors for MASLD by logistic regression analysis. Conclusion: This study confirms the potential of adiponectin and resistin as predictors of MASLD development in T2DM.

Introduction Serological detection of SARS-CoV-2-specific immunoglobulins G (IgG) and M (IgM) antibodies is becoming increasingly important in the management of the COVID-19 pandemic. Methods We report the first results of COVID-19 serological testing in Bosnia and Herzegovina on 2841 samples collected and analysed in 2 medical institutions in Sarajevo. Antibody detection was performed using commercially available kits. Results In the first cohort, 43 IgM-positive/IgG-negative and 16 IgM-positive/IgG-positive individuals were detected, corresponding to 3.41% of participants having developed antibodies. In the second cohort, 4.28% participants were found to be IgM-negative/IgG-positive. Conclusions Our results suggest the need for population-wide serological surveying in Bosnia and Herzegovina.

AN IMPACT OF DIABETES DURATION ON SERUM ASYMMETRIC DIMETHYLARGININE CONCENTRATION

AIM To assess the utility of gamma-glutamyl transferase (GGT) and C-reactive protein (CRP) in predicting troponin elevation in patients with acute coronary syndrome. PATIENTS The total of 119 patients were divided into troponin-positive (n = 61) and troponin-negative (n = 58) patients. RESULTS CRP cut-off value ≥13.4 mg/l had the sensitivity of 68.1% and specificity of 62.5%, while the GGT cut-off value ≥61.5 IU/l had the sensitivity of 66.0% and specificity of 62.0% and combined use of both CRP and GGT had 71.4% sensitivity and 69.6% specificity in predicting troponin increase in acute coronary syndrome patients. CONCLUSION GGT might be used as an adjuvant marker for risk assessment patients who present with chest pain and are suspected to have acute coronary syndrome.

Aim To investigate total homocysteine (tHcy) serum concentration in patients with probable vascular dementia (VD) and in agematched controls, as well as to determine an association between tHcy serum concentration and cognitive impairment in patients with probable VD. Methods Serum concentration of tHcy was determined by the Fluorescence Polarization Immunoassay on the AxSYM System. Cognitive impairment was tested by the Mini Mental Status Examination (MMSE) score. Body mass index (BMI) was calculated for each subject included in the study. Results Age, systolic, diastolic blood pressure and BMI did not differ significantly between the two groups. Mean serum tHcy concentration in the control group of subjects was 13.35 µmol/L, while in patients with probable VD it was significantly higher, 19.45 µmol/L (p=0.002). A negative but insignificant association between serum tHcy concentration and cognitive impairment in patients with probable VD was found. Conclusion Increased tHcy concentration in patients with probable VD suggests the possible independent role of Hcy in the pathogenesis of VD.

Abstract Background: The ε2, ε3 and ε4 alleles of APOE gene have been associated with several diseases in different populations. Data on the frequency of alleles are used in both a clinical and evolutionary context. Although the data on frequency of these alleles are numerous, there are no reports for the population of Bosnia and Herzegovina. Aim: To estimate the frequency of APOE alleles in a healthy Bosnian population and compare it to data for other European populations. Subjects and Methods: Overall, 170 unrelated Bosnian subjects (108 female and 62 male), aged 53.0 (±5.0) years were included in this study. Genotypes were determined by real-time PCR. Results: In our group the prevalence of heterozygotes E2/E3, E2/E4 and E3/E4 was 20.6%, 3.5% and 12.9%, respectively, while the prevalence of homozygotes E2/E2, E3/E3, E4/E4 was 0.6%, 61.2% and 1.2%, respectively, with a mean frequency of ε2, ε3 and ε4 alleles of 12.6%, 78.0% and 9.4%, respectively. Conclusions: In studied European populations we observed a linear, gradually increasing trend in the frequency of ε4 allele from South to North (Pearson’s test 0,7656, p value <0.00001), and the Bosnian population fits into this pattern perfectly.

Introduction Leptin is a cytokine-like hormone which has a complex role in inflammation. However, the importance of leptin in the pathogenesis of rheumatoid arthritis (RA) is far from being fully elucidated. The aim of the study was to determine serum leptin levels in RA patients and to evaluate whether there is an association between disease activity, anthropometric indices and leptin levels. Material and methods This hypothesis-generating study included 55 RA patients and 25 matched healthy subjects. The serum leptin concentration was determined by enzyme-linked immunosorbent assay (ELISA). Results Median serum leptin level in RA patients of 27.4 ng/ml (14.5–54.9 ng/ml) was statistically significantly higher (p = 0.03) compared with the median leptin value of 16.3 ng/ml (9.6–38.8 ng/ml) determined in healthy controls. The serum leptin level in the high disease activity group was significantly higher (p < 0.0005) than that in the low disease activity group and in healthy controls. A significant difference (p = 0.001) in serum leptin level was also found when the high disease activity group was compared with the moderate disease activity group. In the RA group a statistically significant positive correlation (rho = 0.390; p = 0.003) was observed between serum leptin level and disease activity score (DAS28). Conclusions The present results show that serum leptin levels are increased and significantly associated with disease activity in patients with RA and may have a valuable role in the inflammatory reactions and pathogenesis of RA.

Objectives: The aim was to examine whether plasma coagulation factors activities are increased in patients with diabetes mellitus type 2 (DM2). Also, we aimed to assess whether any association exists between plasma coagulation factors and cardiometabolic risk factors in these patients. Methods: This cross-sectional study included 30 DM2 patients and 30 healthy subjects as control group. Plasma fibrinogen concentration and activities of coagulation factors II, V, VII, IX, X, XI and XII were measured. Results: The activities of coagulation factors IX (145.51±5.27 % of norm; p <0.0005) and XI (136.38±5.08 % of norm; p=0.001) and fibrinogen concentration [10.5 (9.3-13.25) mmol/L; p=0.001] were significantly higher in DM2 patients compared to control (IX - 116.44±3.86 % of norm; XI - 109,27±5,95 % of norm; fibrinogen – 8.8  (7.9-10.2) mmol/L). Plasma activities of factors II, V, VII and X were higher, whereas factor XII activity was lower in diabetic patients than in control subjects, but not statistically significant. A significant positive correlation between fasting blood glucose and factors IX, X and XI, was observed in DM2 patients. In the same group significant positive correlation was determined between factors II, VII, IX, X and triglycerides and between factor II and total cholesterol. Conclusion: Procoagulant state in DM2 as evidenced by enhanced activation of coagulation factors IX and XI and elevated fibrinogen concentration, may contribute to the increased risk of thrombosis and vascular complications in DM2 patients. Furthermore, in the prevention of thrombotic complications in patients with diabetes mellitus it is necessery to keep blood glucose and lipids under control. Key words: coagulation factors, patients with DM2, thrombosis, lipids

Objectives: We hypothesized that serum heart fatty acid binding protein (HFABP) levels could be affected by hypertension in addition to renal impairment in patients on hemodialysis. The aim was to find out possible association between serum HFABP and hypertension in patients treated by hemodialysis. Methods: The cross-sectional study included 72 patients, both gender, age 18-78 years who were recruited from Clinic for Hemodialysis, University Clinical Center Sarajevo. According to Kidney Disease Outcomes Quality Initiative criteria for hypertension, patients were distributed into 2 groups: normotensive (HD-N) and hypertensive (HD-H) group. The cardiac biomarker HFABP was measured using ELISA kit Human FABP3 (Elabscience Biotechnology Co.,Ltd), on immunoanalyzer STAT FAX 2100, USA. The kidney functional biomarkers were measured spectrophotometrically using automated analyzer. Results: Serum HFABP level was lower in HD-H group (3.02(1.96-4.13) ng/mL) compared to serum HFABP in HD-N group (3.38(1.98-5.37) ng/mL)(p=0.359). Patients in HD-N group were older and treated by hemodialysis for a longer time than those in HD-H group (p<0.001 and p=0.029, respectively). Conclusion: Serum HFABP level in normotensive patients on hemodialysis is not significantly different compared to hypertensive patients suggesting that heart type fatty acid binding protein might not be significantly affected by hypertension in hemodialysis patients. Keywords: HFABP, hemodialysis, blood pressure, cardiovascular risk

On Saturday, 19th November 2016th Faculty of Medicine, University of Sarajevo celebrated 70th anniversary of continuous work with Gala ceremony that was held at the National Theater in Sarajevo. Distinguished representatives of the academic community participated in the ceremony – Rector of the University of Sarajevo, Prof. Dr. Rifat Skrijelj, members of the Senate and the Governing Board of the University of Sarajevo, students of the Faculty of Medicine University of Sarajevo, Sarajevo Canton Prime Minister Mr. Elmedin Konakovic, members of the diplomatic corps - the Ambassador of the Kingdom of Saudi Arabia H.E. HANI A. Mominah, Ambassador of the Arab Republic of Egypt H.E. Yasser El Atawi, Representatives of the Embassy of Kuwait, Ambassador of the Austria H.E. Mr. Martin Pammer, Ambassador of the Republic of Croatia H.E. John Del Vecchio, First Counselor of the Embassy of Montenegro, Mr. Predrag Arsovic, Deputy Chief of Mission at the US Embassy in BiH Mr. Paul Horowitz, Head of the Mission of BiH to NATO, Ambassador Almir Džuvo, ECON officer of the US Embassy in BH, Ms. Lillian Wahl-Tuco, Regional Medical Officer at the US Embassy in Sarajevo and Member of Bosnian-Herzegovinan American Academy of Arts and Sciences (BHAAAS) Board of Directors Dr. Eldina Vajzovic-Nizamic, Rector of the University of Mostar, Prof. Dr. Ljerka Ostojic, Rector of the University of Zenica Prof. Dr. Dževad Zecic, General Secretary of the AMSE ( Association of Medical Schools in Europe) and Dean of Faculty of Medicine University of Ljubljana Prof. Dr. Dusan Suput, Deans and Representatives of the Medical Faculty, Universites of Rijeka, Zagreb, Osijek, Skoplje, Tuzla, Split, Mostar, Podgorica, Banja Luka, Foca, Pomeranian Medical University of Szczecin, Poland, Representative of the Faculty of Kinesiology, University of Zagreb, world-widely known plastic surgeon, Prof. Dr. Milomir Ninkovic, Federal and Cantonal Institutions Representatives –Secretary of the Federal Ministry of Health Ms Snježana Bodnaruk, Municipality Center Mayor, Prof. Dr. Nedžad Ajnadžic, Parliament of the Federation of Bosnia and Herzegovina representatives, Representatives of the Companies BH Telecom, and BOSNALIJEK, Director of the Cantonal Hospital ‘’Dr. Irfan Ljubijankic’’ in Bihac, Representatives of Medical Chamber of Sarajevo Canton, Director of HEA Agency for Development of Higher Education and Quality Assurance, as well as many other distinguished representatives of the academic, political, cultural, economic and public life of Bosnia and Herzegovina. The celebration was opened with welcoming speech held by the Dean of the Faculty of Medicine University of Sarajevo, Prof. Dr. Almira Hadžovic-Džuvo. Guests were addressed by Prof. Dr Rifat Skrijelj, Rector of the University of Sarajevo, Mr. Elmedin Konakovic, Sarajevo Canton Prime Minister, Dr Eldina Vajzovic- Nizamic, Regional Medical Officer at the US Embassy in Sarajevo and Member of BHAAAS Board of Director Prof. Dr. Dusan Suput, General Secretary of the AMSE and Dean of Faculty of Medicine University of Ljubljana and Ms Zenaida Hasic, Representative of the main sponsor of the event - Bosnalijek. The program continued with the screening of the film about Faculty of Medicine University of Sarajevo, and a musical work ‘’Bosnian Pastorale’’ composed by Milan Prebanda, performed by the Symphony Orchestra of the Music Academy of the University of Sarajevo. The awards were being presented at the celebration event of 70 years of existence and continuous work of Faculty of Medicine University of Sarajevo. Special Award, ‘’Lifetime Achievement Award, Faculty of Medicine, University of Sarajevo’’, was posthumously given to Prof. Dr. Mira Winterhalter-Jadric and Prof. Dr. Osman Duric. Special award, ‘Great plaque with Charter of Faculty of Medicine, University of Sarajevo’’ was awarded to Prof.dr Bakir Mehic, Prof.Dr. Vjekoslav Gerc, and deserving Institutions of the Clinical Center of the University of Sarajevo, Federal Ministry of Health, and Government of the Sarajevo Canton. Award, ‘’Plaque with Charter of Faculty of Medicine, University of Sarajevo’’ was awarded to Prof.Dr. Nermina Obralic, Prof. Dr. Muzafer Mujic and Prof. Dr. Milomir Ninkovic as well as to Foundation ‘’Dr. Nedžad Beganovic’’. Prize winners and family members of the deceased laureate thanked with warm words to Faculty of Medicine University of Sarajevo for the recognition. The program continued with the screening of the film, which was made entirely by students of Faculty of Medicine University of Sarajevo (direction and acting). The official part of the program ended in tunes of tango, “Libertango” composed by Astor Piazzolla, performed by the Symphony Orchestra of the Music Academy of the University of Sarajevo. Prof. dr. Almira Hadžovic-Džuvo Editor-In-Chief

The Faculty of Medicine University of Sarajevo celebrates its 70th anniversary this 2015/16 academic year. From the historical point of view, 70 years might not be a long period, but taking into account the results achieved in the field of education and scientific research, we can proudly say that this is an Institution that can boast with established tradition. During its 70 years long tradition, the Faculty of Medicine has educated 8701 medical doctors, 1060 masters of medical sciences and 632 doctors of medical sciences. This Faculty has not only produced medical doctors, but was also involved in education of dentistry and pharmacy students as well as other health care professionals. Faculty of Medicine in Sarajevo is older than the University of Sarajevo and was established in 1944, closed 1945 and reopened 1946 and thereby represents one of the oldest higher education institutions in B&H, serving as a cradle from where many medical schools have spawned, not only in Sarajevo, but also Tuzla and Banja Luka. The Faculty has lived through a long journey since its establishment. Many lessons learnt can be identified as a learning experience and taken further to grow faster. The Curriculum renewal was continually undertaken in order to improve quality. The Faculty of Medicine has been revising and renewing the medical education curriculum throughout the years. Major reform was undertaken in 2007 when the medical curriculum was harmonized with the curriculum of medical schools in neighboring countries adopting the principles of Bologna declaration and again in 2015 when the curriculum was revised after careful analysis by students, teacher and management and harmonized with the European Union directives on medical professions. We are also proud to point out that the Faculty of Medicine, University of Sarajevo has successfully completed the „Medical Studies in English” program opened for the first time last academic year. Various achievements today are contributed by many people and therefore we sincerely appreciate the hard work of our predecessors, the seniors, former deans and teachers, support staff, students and alumni for their support and assistance in striving for innovations and excellence, whilst dedicating themselves to the interest of the nation and humanity. As we explore and commemorate our past at the celebration ceremony which will be held 19th November this year, we will toast our present and plan our future. The one thing that hasn’t changed is our purpose as we remain dedicated to advancing health through teaching, research and patient care.