Aim: The prognostic value of circulating antibodies to oxidized low-density lipoprotein (anti-oxLDL) in patients with coronary heart disease is not completely clear. We aimed to investigate the association between levels of anti-oxLDL in three groups of patients with different grades of severity of coronary heart disease. Patients and methods: The study included 101 patients classified into three groups: one (N=35) with acute myocardial infarction (AMI), a group (N=35) with angiographicallly proven coronary artery disease (APCAD), and a group without angiographicallly proven coronary artery disease (N=31) designated as a control group. Levels of IgG anti-oxLDL antibodies were meausured by enzyme-linked immunosorbent assay. Results: Mean anti-oxLDL value was significantly higher in patients with AMI than in patients with APCAS (1342.1±581.5 mIU/ml vs. 553.0±183.3 mIU/ml, p<0.001), as well as compared with control group (1342.1±581.5 mIU/ml vs. 246.5±114.3, p<0.001). Similarly, significant difference in anti-oxLDL levels was found between the patients with APCAS and control group (p<0.001). Conclusions: The present study showed that elevated levels of anti-oxLDL are positively related with a severity of coronary artery disease. Hence, elevated levels of anti-oxLDL may identify patients with unstable coronary heart disease. Oxidized LDL in circulating plasma could serve as a marker of cardiovascular events.

A test included 40 women in the reproductive age with clinical symptoms of vaginitis and microbiological examination. They were treated by combined therapy of vaginal tablets of nifuratel, 500 mg and nistatin 200 000 i. u. during six days, after which they underwent gynaecological reexamination and repeated microbiological examination of vaginal and cervical smears. An analiysis of vaginal secretion found bacterial flora in 34 smears (65%), fungus (Candida albicans) in 15 (24%) and Trichomonas vaginalis in 7 (11%). Local vaginal therapy in vaginitis caused by Trichomonas vaginalis was successfull in all 7 patients, vaginitis caused by Candida albicans was successly treated in 14 (93%) patients. Bacterial vaginitis was cured in 29 (71%) patients during this tharapy. Local vaginal combined therapy of nifuratel and nistatin is eficient in patients with vaginitis caused by fungi and Trichomonas vaginalis too.

There has never been a case of dirofiliriasis conjunctivae recorded in Bosnia and Herzegovina until now. It is true that German scientists described one case in the woman who stayed in the region of former Yugoslavia, Italy and Spain in 1984 and she might have been infected in one of these countries. The aim of this work is to present the first case of ocular Dirolfiliriasis in a female patient in Tuzla. Patient BD, born in 1946 was admitted to Ophthalmology department in Tuzla on May 10th 2007 with a diagnosis of: Conjunctivitis oc.dex., parasitosis subconjunctivae dex. On May 11th 2007 a parasite was removed, 105.6 mm long, 0.473 wide with cephalic part slightly curved and esophagus length of 15mm. It was concluded that the discovered parasite is the member of Filaridae family and Dirofilaria species. Eoosinophilia with 17% eosinophiles was found in the peripheral blood smear. The presented case indicates that Dirofilariosis can be found in the region of Bosnia Herzegovina.

The natural habitat of Gardnerella vaginalis is a vagina since it could be located among 69% of women who have no signs of vaginal infection and in the vagina of as many as 13.5% girls. G. vaginalis is almost certainly identified among women diagnosed with bacterial vaginosis as well as in the urethra of their sexual partner. The increase in prevalence and concentration of G. vaginalis among patients diagnosed with this syndrome confirms that G. vaginalis plays a significant role in its pathogenesis. In our research, based on Amsel criteria for three or more clinical signs of bacterial vaginosis, it was diagnosed in 20.5% of women with subjective problems of vaginal infection, and in 48.80% of women with subjective symptoms characteristic of this disease. G. vaginalis was isolated from vaginal secretion of women without clinical signs characteristic of bacterial vaginosis. In 2.58% of cases it was solitary, while in 1.28% it was found in combination with other aerobic and anaerobic bacteria and, in 1.28% women combined with Candida albicans. The isolation of G. vaginalis was significantly increased (p<0.05) in the group of women with clinical signs of bacterial vaginosis in comparison to the group of women without these signs. Frequent recurrence of bacterial vaginosis, which is found in 20-30% of women within a three months treatment, is explained as reinfection with other biotype of G. vaginalis, different from a source biotype or as a consequence of wrong treatment. Following Piot biotype scheme, biotypes 2., 3. and 7. G. vaginalis are significantly more often isolated from women who suffer from bacterial vaginosis. Biotype 7. G. vaginalis, isolated from the group of women without clinical signs of bacterial vaginosis, accounted for 2.58% cases. Following Benit biotype scheme, biotypes IVa, IVc and IIc were identified in 12.90% cases, while biotypes IIIa, IIa, Ia, IVb, IIb were found in 6.45% cases. Lipase-positive isolates of G. vaginalis were significantly more frequently accompanied by the syndrome of bacterial vaginosis.

It is generally accepted that inflammation has an important role, not just in the pathogenesis of atherosclerosis, but also in initiation of acute coronary syndrome (ACS). A number of studies showed, that a high concentration of high sensitivity C reactive protein (hsCRP) is an independent risk factor for the development of cardiovascular disease in a healthy person. HsCRP can predict new cardiovascular episodes, including death, in patients with unstable angina and acute myocardial infarction (AMI). Ability of oxidated low densiti lipoprotein (oxLDL) to induce accumulation of holesterol in macrofage was his first described proaterogenic characteristic and it help in hipotesis that oxidation of low densiti lipoprotein (LDL) can be important step in proces of aterogenesis. Framingham study showed that ther is significant corelation between level of total holesterol in blood and coronary artery disease (CAD). Evaluation of bouth hsCRP and LDL levels is superior in detection of CAD. Aims of this study were to determine values of hsCRP in patients with coronary arteries disease verified by coronary angiography (stenosis>70%), and to check if values of hsCRP higher than 3.0 mg/ dL are better predictor of coronary artery disease then lipid status. A prospective study was conducted on 60 patients, who were divided in two groups in compliance with significance of coronary artery disease. All patients have earlier diagnosis of ACS, and from this study excluded patients with acute infection, chronic, systemic or malignant disease. This research shows that patients with significant coronary artery disease, verified by coronary angiography, have higher values of hsCRP than those without disease that have values within the range of the reference values (0-3 mg/dL). Patients with coronary artery disease verified by coronary angiography have values of hsCRP that put them in a group of patients with intermediate to high risk of a future acute cardiovascular event, by classification of American Heart Association. In group of patients with coronary disease there is significant elevation of LDL and total cholesterol. With elevation of HDL values there is reduction in hsCRP values in patients with no significant coronary artery disease.

UNLABELLED Detection of enteroviruses in drinking water poses a very specific problem, since a very small number of particles have to be identified in huge water quantities. Currently, there are a number of methods to identify the concentration of virus particles and RNA templates to carry out RT-PCR, however, no standard method has yet been proposed. AIM The aim of this report is to suggest optimal methods for the preparation of RNA templates to carry out RT-PCR. MATERIAL AND METHODS In this experimental study, two different methods were employed on preparing RNA template. The concentration of virus particles in a large (10 L) and small (1 L) quantity of water was determined by use of the electropositive microporous virology filter (method 1 and method 2). Elution and flocculation of the virals particles were performed by organic extraction (method 1) and inorganic extraction (method 2). The sensitivity of the methods was assessed by testing the artificially contaminated water with 10(1) to 10(5) virus-particles using 1-L and 10-L containers of water. RESULTS Method 1 detected 10(5) and 10(4) virus particles, method 2 10(5), 10(4) and 10(3) virus particles from 10 L and 1 L of water, respectively, yielding a statistically significant difference (p<0.01; chi2 = 6.061). Using two-step RT-PCR with nested PCR method, enteroviruses were detected in 42/100 (42%) samples of surface drinking water and in 83% of the same samples using RT-PCR without nested PCR.

In this study we analyzed microbiology results of tuberculosis in urinary system, in the area of Tuzla canton in period since 1993 to 2005 year. For microbiological diagnosis we tested samples of whole morning urine by method of concentration and homogenization by Petroff and inoculated on Loewenstein culture media. All grown culture was identified biochemical by production of niacin, reduction of nitrate and production of heat labile catalase. In this investigated period we tested 121,945 samples of different biological materials on Mycobacterium tuberculosis: sputum 89,433, gastrolavate 5,122, broncholavate 1,337, pleural exudation 1,356, punctuates 1,711, liquors 179, stools 149, blood 4, urine 22,654 samples. All urine samples were taken from 4,192 patients. Positive culture is found in 358 urine samples or in 1, 58%, or 173 patients or 4, 13%. From total 4,759 microbiologically diagnosed patients with all different types of tuberculosis in this period of time, with pulmonary tuberculosis there was 4,495 or 94, 45% patients and 264 or 5, 55% with extrapulmonal types of tuberculosis. Tuberculosis of urinary system is microbiologically diagnosed in 173 or 3, 63% patients out of total number of diagnosed tuberculosis cases. Tuberculosis of urinary system is diagnosed in 115 women and 58 men. In both sexes it was most often diagnosed in age of 65 to 74 year and in women in age of 45 to 54 year and in man in age 25 to 34 year. Tuberculosis of urinary system is more common in patients from Tuzla then from other town in Tuzla canton. It is also more common in patients that were treated in Clinic then those who were treated ambulatory. We can conclude that distance of place of living from place of microbiology laboratory significantly influence on microbiologically diagnostic of tuberculosis of urinary system.

Normal pH value of vagina from 3.8 to 4.2 has regulatory and protectors mechanisms of vaginal environment. The change in the pH value indicates to presence of disbalance in the ecosystem of vaginal environment. The value of pH above 4.0 is indicator of the decreased number of lactobacillus bacteria and the increased number of other microorganisms in the vaginal environment. This situation is present in the case of developing of bacterial vaginosis. One of the bacteria which is often isolated from vaginal swabs is Enterococcus faecalis. Aims of this study are to examine presence o f Enterococcus faecalis in vagina in healthy women and womenwith signs of bacterial vaginosis, the most often present signs in patients with bacterial vaginosis and isolated Enterococcus faecalis from vaginal swabs, and to determine whether the change of the pH value of vaginal environment could be indicator for bacterial vaginosis associated with Enterococcus faecalis. In this study there were included 90 patients. To all patients there were done: gynecological survey, determined pH of vaginal environment and color of vaginal secret, amino odor test, and taken vaginal swabs for microbiological examination. Enterococcus faecalis was found in the patients with pH 4.0 in 24.05 % cases, but in the patients with signs of bacterial vaginosis it was found in 52.78 %. Positive findings of Enterococcus faecalis was the most often associated with presence of all tree signs of bacterial vaginosis (pH>4.0, changed color of vaginal secret and positive amino odor test) it is in 60.78 6% cases. With two signs of bacterial vaginosis (pH>4.0, changed color of vaginal secret) Enterococcus faecalis was present in 60 % cases. The only presence of change in the pH>4.0 was associated with Enterococcus faecalis in 52.78 %. This study showed that pH change of vaginal environment was associated with Enterococcus faecalis in bacterial vaginosis in high percentage but it can not be used as the sure sign of presence of Enterococcus faecalis in vaginal discharge. Therefore it is necessary to make microbiology examination vaginal discharge.

Aim of this research was to investigate diagnostic value of discovering of antibody on A60 antigen in patients who were tested for presents of Mycobacterium tuberculosis in there biological samples. We tested a samples of sputum, gastric juice, urine, cerebrospinal fluid and punctate from group of 353 patients who were suspected for tuberculosis. In all patients we were looking for antibodies classes A60 antigen. We used immune chromatographic "Hexagon TB" test, Germane company "Human Geselschaft fur Biochemica und Diagnostica". From 353 patients we found 58 (16.43%) patients with positive BK, 79/22,38%) patients with positive Lowenstein culture and 122 (34,55%) patients with antibody in sera on A60 antigen. Patients who were BK and Lowenstein positive, have had antibody in 94,23% cases, Patients who were BK negative and Lowenstein positive have had antibodies in 70,37% cases and patients who were BK negative and Lowenstein negative have had antibody in 19,03% cases. Patients with BK positive and Lowenstein negative results have had antibody in 50,00% cases. Difference between results is significant (p<0,01). From 122 patients with positive antibodies, 52 were BK positive and 68 have had positive Lowenstein cultures. From 231 patients with no antibody, just 6 were BK positive and 11 Lowenstein positive. In 62 patients with positive antibodies, were BK and Lowenstein negative. We confirmed that antibody on A60 antigen in microbiological positive patients are more often then in microbiological negative patients (p<0,001).

This investigation had an aim to establish the incidence of Enterococcus faecalis in vaginal smears and its correlation with antibiotics used for the treatment of genital and extragenital diseases, as well. By this prospective study 300 women in reproductive period have been involved. An average age was 34.5 years and 282 of them are married. They have been divided in 4 groups, 75 in every group. First group consisted women who have not been treated by an antibiotic in last 6 months; second group--women who have been treated due to infections of genital tract; third group--women were treated for unspecific colpitis and last one group were women treated for extragenital infections. A special designated questionnaire has been used to collect data from patients. A vaginal smears for microbiology examination has been taken at the Gynecological Clinic and Clinic for Infective diseases of The University Clinical Center Tuzla from patients of group I, II and IV and at the Outpatient Clinic from patients of group III. Enterococcus faecalis has been found in 112 patients (37.33%); in first group in 13 (17.33%) cases, in second group in 26 (34.66%), in third group 39 (52%), and in last group in 34 (45.33%) patients, which significantly different. Investigation on sensitivity showed a minimal sensitivity on Penicillin and Streptomycin and no resistance on Vancomycin. In conclusion, it could be said that Enterococcus faecalis was found in 17.33% patients who has not been treated by antibiotics and in 44% who used antibiotics, which differ significantly (p<0.01).

Aim of this work is to show the level of prevalence of patients infected with resistant strains Mycobacterium tuberculosis in Canton Tuzla. In the period of 1996-2003 year we tested 87,408 samples of different materials on existence of Mycobacterium tuberculosis. Among all samples there were 66,128 sputum, 14,599 urines, 3,817 gastric juice, 1,174 materials from broncholavage and 547 other samples. Microscopically it was found 4,380 smear-positive samples and 6,365 samples were positive on Loewenstein medium. Positive sputum had 1,917 patients, and positive culture had 3,018 patients. Resistance test was done on streptomycin, isoniazid, rifampicin and ethambutol with standard proportional method for 2,662 patients. Totally sensibile were 2,570 or 96.54%, and restant were 92 or 3.46% patients. Patients infected with mono-drug resistant strains Mycobacterium tuberculosis were 71 or 2.67%, and poli-drugs resitant 21 or 0.78%. There were 16 patients or 0.60% infected with multi-drugs resistant strains. Time of bacteriological negativization for the patients infected with resistant strains was in the average 8.19 months, for the patients infected with mono-drug resistant strains was 2.75 months and for infected with multi-drugs resistant strains was 32 months. It is concluded that region of Canton Tuzla has high level of bacteriological prevalence but low level of prevalence of patients infected with resistant strains Mycobacterium tuberculosis in the this period of time, and it is significantly lower then earlier periods, thanks to national tuberculosis control program and system of directly observed treatment.

The presence of waterborne enteric pathogens (bacteria, viruses and protozoa) in potable water represents a potential danger for people's health. While doing a microbiological examination of potable water on a regular basis, we obtain a constant control of presence of the bacteria that contaminate water. However, the water examination of the enteric viruses is done only when we have some large-scale hydrous epidemics. Finding the bacteria wich point to fecal contamination of drinking water is not a safe indicator of presence of the enteric viruses. After a two step RT/PCR examination on viruses in 84 samples of potable water, the enteroviruses were found in 53 out of 84 samples (63.09%), while the hepatitis A virus was not found after one step RT/PCR examination. In conclusion, we emphasize the need of standardizing the method of potable water viruses detection, in order to legalize the need of its regular application.

: The presence of waterborne enteric pathogens (bacteria, viruses and protozoa) in potable water represents a potential danger for people's health. While doing a microbiological examination of potable water on a regular basis, we obtain a constant control of presence of the bacteria that contaminate water. However, the water examination of the enteric viruses is done only when we have some large-scale hydrous epidemics. Finding the bacteria wich point to fecal contamination of drinking water is not a safe indicator of presence of the enteric viruses. After a two step RT/PCR examination on viruses in 84 samples of potable water, the enteroviruses were found in 53 out of 84 samples (63.09%), while the hepatitis A virus was not found after one step RT/PCR examination. In conclusion, we emphasize the need of standardizing the method of potable water viruses detection, in order to legalize the need of its regular application.

The aim of this study was to made assessment of health effects in 37 workers exposed to gasoline, and its constituents at gasoline stations between 1985 and 1996. Thirty-seven persons who had been exposed to gasoline for more than five years were examined. The evaluation included a medical / occupational history, haematological and biochemical examination, a physical exam, standardized psychological tests, and ultrasound examination of kidneys and liver. The groups were identical in other common parameters including age, gender (all men), and level of education (P<0. 05). The data were compared to two control groups: 61 healthy non-exposed controls and 25 workers at gasoline stations exposed to organic lead for only nine months. Peripheral smear revealed basophilic stippling and reticulocytosis. We found in chronic exposed gasoline workers haematological disorders: mild leukocytosis (7 of 37), lymphocytosis (20 of 37), mild lymhocytopenia (3 of 37), and decrease of red blood cells count (11 of 37). Results indicated that they have suffered from liver disorders: lipoid degeneration of liver (14 of 37), chronic functional damages of liver (3 of 37), cirrhosis (1 of 37). Ultrasound examination indicated chronic kidney damages (8 of 37). These results significantly differed from those of controls (P< 0.05). In 13 out of 37 workers at gasoline stations exposed to gasoline for more than 5 years the symptom of depression and decreased reaction time and motor abilities were identified. The summary of diseases of workers exposed to organic lead and gasoline are discussed.