Background: COVID-19 affects all organ systems, including the visual organs. Clinical manifestations encompass all segments of the eye. Neuro-ophthalmic manifestations are rare and can occur during the acute phase of the illness, during recovery, or in the course of Long COVID. These clinical manifestations include optic neuritis and various forms of encephalomyelitis. Optic neuritis more commonly occurs during the recovery phase from the acute form or during Long COVID. Family physicians are in a position to first diagnose optic neuritis in the early stages. Objective: The aim of this paper is to present a case of optic neuritis occurring in the early stages of the disease, diagnosed in the prehospital period in a family medicine practice with consultations from ophthalmologists, infectologists, and neurologists. Such close collaboration enabled the early administration of corticosteroid therapy. Case report: A case of a 28-year-old woman is presented, who exhibited symptoms of COVID-19 with a confirmed positive antigen for the SARS-CoV-2 virus (PCR nasopharyngeal swab). On the fourth day of illness, sudden loss of vision in the right eye occurred along with headache. Early diagnosis and early administration of corticosteroid therapy led to significant improvement in vision. Conclusion: Clinical manifestations of eye diseases can occur in the early stages of COVID-19 as a direct consequence of viral infection. Ophthalmologist and neurologist examinations are necessary in the early stages of the disease for timely diagnosis of various ophthalmologic and neurologic disorders and adequate therapy.
Background: Prior to 2012, the mesentery was perceived as a fragmented structure, lacking distinct functional and anatomical characteristics, and was merely considered part of other digestive organs. Dr. J. Calvin Coffey's in 2012 in his study redefined the mesentery as a distinct organ with a clearly defined anatomical and histological structure, although its specific function remains under investigation. The continuous structure and unique tissue properties of the mesentery classify it as the 78th independent organ in the human body. Insights into mesenteric adipose tissue have enhanced our understanding of normal metabolic processes and disease etiology, impacting health significantly. Experimental and clinical research highlights the vital roles of visceral adipose tissue, influencing neighboring organ function. The interaction within the brain-gut-liver axis is illuminated by the newfound functions of mesenteric adipose tissue, emphasizing its independent organ status. Objective: This study aims to evaluate the latest findings on the structure and function of the mesentery, focusing on visceral-mesenteric adipose tissue, and assess its role as a new organ in the brain-gut-liver axis. Methods: A comprehensive analysis of clinical and experimental studies on the mesentery's structure and function was conducted, focusing on recent discoveries regarding mesenteric adipose tissue and its role in the brain-gut-liver axis. Results and Discussion: Recent research has revealed the mesentery's unique functions, particularly in mesenteric adipose tissue. Mesenteric adipose tissue plays a crucial role in metabolic functions and influences disease onset. It acts as a vital link in the brain-gut-liver axis, directly influencing hepatic metabolism and disorders such as metabolic syndrome. Conclusion: Scientific evidence confirms the mesentery's anatomical and functional specificities, solidifying its status as the 78th independent organ in the human body. It serves as a crucial link in the brain-mesentery-small intestine-liver axis, impacting health and disease. Ongoing research holds promise for advancing our understanding of pathophysiological mechanisms and treatment approaches for metabolic syndrome and other chronic diseases.
Background: In December of 2019, SARS-CoV-2, a new type of coronavirus, appeared, and it turned into an international epidemic. The consequences of the pandemic, especially the isolation measures, fear of infection and bad economic trends, as a result of the crisis, threaten people's basic psychological needs. Objective: The objective of this research was to assess the impact of the COVID-19 pandemic on mental health and perceived social support of persons with disabilities in Bosnia and Herzegovina. Methods: The research included a total sample of 232 respondents with different types of disabilities. The Symptom Checklist (SCL-90) was used to verify the research objective, which assessed three dimensions: somatization, depression and anxiety. Also, in order to verify the research objective, the Multidimensional Scale of Perceived Social Support was applied, which consists of 12 statements that measure the perceived social support of family, friends and other people. The research data was processed with descriptive and inferential statistics. The basic statistical parameters were calculated, while the t-test was used for an independent sample of respondents to verify the set objective. Results: The results of the research showed that persons with disabilities, who were infected with the SARS-Cov-2 virus, had a significantly higher level of somatization, anxiety and depression compared to those who were not infected with the virus. The results in relation to social support did not prove to be statistically significant. Conclusion: The obtained results lead to the conclusion that, in the future, interventions by experts of various profiles must be planned to preserve the mental health of persons with disabilities, which is why it is important to invest in the emotional, psychological, social, physical and spiritual well-being of the individual.
Background: Thromboembolic complications are a frequent occurrence during COVID-19. This report presents a patient with signs of subclavian steal syndrome (SSS) caused by a thrombus in the initial part of the right subclavian artery. Pathological occlusive changes, such as thrombosis, are four times more common on the left subclavian. Thrombosis of the subclavian artery occurs in about 1% of the population, but atherosclerotic changes are common and usually asymptomatic. Objective: The aim of this report is to present a patient with signs of subclavian steal syndrome (SSS) caused by a thrombus in the initial part of the right subclavian artery associated with symptoms of COVID-19. Case report: A 56-year-old female patient presented with tremor, numbness and prickling in the right hand, tinnitus, blurred vision, vertigo, syncope, trismus and headaches. The formation of a thrombus caused neurological symptoms in the right hand with a stronger pronounced tremor, headache and syncopal episodes. Routine CT with angiography did not reveal significant subocclusions of the neck arteries or significant ischemic changes in the brain. The patient was treated as Parkinsonismus (disease) with syncopal and collapsing episodes. Due to worsening subjective complaints, CT angiography of the neck and head blood vessels was repeated with iterative 3D reconstruction. The examination, as mentioned above, revealed atherosclerotic changes with thrombosis and stronger subocclusion of the right subclavian artery (RSA) proximal to the origin of the arteria vertebralis. Both vertebral arteries, as well as arteria basilaris, had a normal appearance. During physical exertion of the right arm doppler examination of neck blood vessels revealed the presence of reverse blood flow in the right vertebral artery. Haematological tests and high D-dimer also confirmed the diagnosis. After anticoagulant therapy, the thrombotic mass on the mural calcified RSA plaque disappeared. With the reduced physical strain on the right hand and a lifestyle change, syncopal conditions and headaches stopped. There was a reduction in tremors and tingling in the right hand as well. Conclusion: We reported a case of subclavian steal syndrome caused by thrombosis associated with OVID-19. Thromboembolic complications are common in the course of this disease. The diagnosis was confirmed with advanced diagnostic tools (CTA with 3D reconstruction), laboratory tests (D-dimer) and doppler ultrasound. When routine CT angiography is not completely clear, 3D reconstruction is necessary.
The decision of the citation database to include or not include a journal is not subject to the control of another entity, or the professional public, and there are no internationally established ethical standards that the citation database would have to apply. As a consequence of the absence of control, the already mentioned offensive reviews and arbitrary interpretation of the criteria for journal inclusion appear. Given that a journal’s entry into the citation database is a condition for its long-term survival, people who make decisions in the citation databases gain the power to shut down or revive certain journals based on personal preferences. Any power that is not controlled is eventually abused. Therefore, our proposal is to urgently establish the principles of ethical behavior of citation databases at the global level and find ways to ensure compliance with such principles.
In the hilly Balkans, a folk proverb has been circulating for a long time, „It is most difficult to be a prophet in one‘s own village“, which reflects the age-old mistrust of the population towards new ideas. This is not surprising in the least, because since the written history of the peoples of the Balkans has existed, a continuous series of conquerors and local rulers who subjugated the common folks and imposed their world view can be traced. Nevertheless, from time to time, people with great strength appear who not only break the shackles imposed by the powerful, but through their actions find a way to the souls of their compatriots and gain their unreserved trust. One of such spontaneous creators is professor Izet Mašić, who achieved a miracle of medical publishing in his Sarajevo and Bosnia and Herzegovina and traced the path of medical science. There may be thousands of medical journals in the world, more or less reputable, and researchers from the Balkans can publish their work in them, but only domestic medical journals can initiate and direct domestic medical research, and educate young researchers in the right way. Professor Mašić made it possible for authors from Bosnia and Herzegovina and other Balkan countries to present their results to the world and receive an incentive from impartial experts to continue their work and progress more and more by editing and publishing three domestic journals at once, which are visible in the most important world bases,. The progress in research then translated into improving medical practice and health care of the population. The following details from Professor Mašić‘s biography tell us how this miracle happened. This year, academician Izet Mašić, Editor-in-Chief of a few biomedical journals, including Acta Informatica Medica journal, celebrates his 70th birthday and also 45 years of his academic and scientific work.
The recently emerged novel coronavirus, “severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2),” caused a highly contagious disease called coronavirus disease 2019 (COVID‐19). It has severely damaged the world's most developed countries and has turned into a major threat for low‐ and middle‐income countries. Since its emergence in late 2019, medical interventions have been substantial, and most countries relied on public health measures collectively known as nonpharmaceutical interventions (NPIs). We aimed to centralize the accumulative knowledge of NPIs against COVID‐19 for each country under one worldwide consortium. International COVID‐19 Research Network collaborators developed a cross‐sectional online survey to assess the implications of NPIs and sanitary supply on the incidence and mortality of COVID‐19. The survey was conducted between January 1 and February 1, 2021, and participants from 92 countries/territories completed it. The association between NPIs, sanitation supplies, and incidence and mortality were examined by multivariate regression, with the log‐transformed value of population as an offset value. The majority of countries/territories applied several preventive strategies, including social distancing (100.0%), quarantine (100.0%), isolation (98.9%), and school closure (97.8%). Individual‐level preventive measures such as personal hygiene (100.0%) and wearing facial masks (94.6% at hospitals; 93.5% at mass transportation; 91.3% in mass gathering facilities) were also frequently applied. Quarantine at a designated place was negatively associated with incidence and mortality compared to home quarantine. Isolation at a designated place was also associated with reduced mortality compared to home isolation. Recommendations to use sanitizer for personal hygiene reduced incidence compared to the recommendation to use soap. Deprivation of masks was associated with increased incidence. Higher incidence and mortality were found in countries/territories with higher economic levels. Mask deprivation was pervasive regardless of economic level. NPIs against COVID‐19 such as using sanitizer, quarantine, and isolation can decrease the incidence and mortality of COVID‐19.
Background: We could say that traditional healing is a way of healing that has been common since ancient times. It has been passed down from generation to generation for many centuries. Magic medicine, although not approved by any of the monotheistic religions present in Bosnia and Herzegovina, and strictly prohibited by Islam, in the form of various magical acts and spells, exists among the people. Some of these magical practices have their roots in the pre-Christian Slavic period and earlier. Objective: The aim of this article was to provide the review of the traditional medicine during the history and today in Bosnia and Herzegovina. Methods: Review of the available literature, personal contacts and personal experience in contact with the traditional medcine. Discussion: Some of these magical practices have their roots in the pre-Christian Slavic period and earlier. Since the cause of the disease was usually associated with evil beings of supernatural powers, a deity or God’s will or punishment, it is understandable that priests have long been engaged in healing. Especially in the mentally ill, there seemed to be a certain divine or demonic origin of the disease. Muslim folk medicine divides diseases into two groups; in fevers and obsessions with unclean spirits. Folk medicine knows the healing properties of herbs and other substances of animal or mineral origin. The medicinal properties of simple foods that can be found in every home are also widely used, such as: milk, honey, vinegar, oil, onion, and garlic. Prescription books, known as “ljekaruše”, were created by collecting and writing down folk remedies. They were written mostly by Catholic priests. “Witch doctors” or “healers” have been preserved in Orthodox monasteries. Conclusion: Traditional medicine is important for history of medicine, ethnology, anthropology, and abounds in folklore elements. It is an area that leads to knowing, understanding or feeling the very nucleus of a nation.
It is very well known that science is world activity and that there is no good and bad work in the field of scientific research. Nowadays scientific productivity of the individuals, learned societies on regional or state level are measurable parameters. In most of the systems it does include the number of original scientifi papers, quality of journals measured by impact factor and scientific citation index (1-4). There are also additional measurable parameters but for the purpose of this meeting we will avoid discussion about them. New field of scientometrics using the help of impartial and ruthless machines (computers) do help very significantly in evaluation of scientific productivity anywhere in the world. Unfortunately, there are many misused conclusions and interpretation on the data offered by computers. It is clear that some vital important changes are urgently needed. Today’s conference should use rare opportunity having together experts in the field to discuss the problems visible now. This author intends to discuss facts and doubts in writing review articles and chapters in the book (5). Some important flexibility in citation, in particular self citation, should be analyzed. An illustrative examples from author’s own experience will be shown and discussed at the meeting.
Background: The new coronavirus SARS-CoV-2 caused a pandemic that threatened all aspects of life and health while worsening the socio-economic situation of the entire population. COVID-19 affects all organs and organ systems. The symptoms of the affected organs can last for a long time after the acute infection. About 1/3 of patients develop neuropsychiatric signs in the clinical course of the disease. The most common symptoms are mental fog, headache, cognitive changes, behavior changes, muscle weakness, anosmia and ageusia. These symptoms may develop due to a direct effect of the virus on the neurons or hyper reactive immune response. Objective: The aim of this article is to describe 2 young adults who developed neuropsychiatric symptoms in the course of Long COVID-19 syndrome. Ischemic vasculitis was proved using CT imaging. Case report: We collected data of two younger females who had previously recovered from the acute form of COVID-19 without respiratory complications. They developed in the next 1-2 months a clinical picture of a brain disorder. In both cases, CT and angiography scans of the brain showed signs of ischemic vasculitis. Neurological therapy has led to an improvement of the neuropsychiatric symptoms. Conclusion: Neuropsychiatric disorders in Long Covid syndrome are common and diverse. Two cases of young adults who developed signs of neurological disorder in the post COVID-19 period were presented, and CT scans of the brain showed signs of ischemic vasculitis.
Background: Haematochesia (Lower Gastrointestinal Bleeding (LGIB) is the most common reason for endoscopic examination. Generaly it is caused by hemorrhoids and diverticular disease, but other anorectal conditions can also lead to LGIB. Recurrent bleeding may result in secondary iron deficiency anemia. Colonoscopy is the primary diagnostic option for establishing a diagnosis of colonic bleeding. Objective: This study aimed to analyze symptoms and endoscopic finding (specialy hemorrhoids) who may be sources of LGIB.Second goal of this study is to estimate time from onset of symptoms to performance of a colonoscopy. Methods: A retrospective study included 603 adult patients who underwent colonoscopy in General Hospital “Sv. Apostol Luka“, Doboj, Bosnia and Herzegovina, between 1.1.2020 and 31.12.2020. Results: Average age of the examined population was 62±13,3years. According to the gender they were mostly men. To be exact,by percentage it was 53.7% of men and 46,3% of women, or by number: 324 men and 279 women. The most common indications for colonoscopy were LGIB (48,8%), abdominal pain and irregular stool. Most frequent endoscopic findings were hemorrhoids 42%. Normal findings had almost one third of all examinated patients. Combined findings-presence of more clinical entities in one patient were presented in 95 cases. In the group with hemorrhoids were almost two thirds of males, but there was no gender difference noted in between group with LGIB and without LGIB. More than half patients were older than 61 years. Anemia was presented in almost 20% of cases. Significantly it is higher frequency of abdominal pain, irregular stool and weight loss observed on the group without LGIB. Also, significantly more frequently patients with LGIB underwent colonoscopy in 0-30 days when compared with patients without LGIB (p=0,016). Conclusion: In patients with haematochezia, taking a careful medical history is mandatory. Hemorrhoids, diverticular disease and colorectal cancers are the most common causes of bleeding. Patients with LGIB and abdominal pain were previously examined with colonoscopy. Completely colonoscopy is advocated to detect probable proximal lesions.
Background: Previous pandemic and catastrophic events significantly changed the life of every human being, bringing him/her into a state of stress and the need to quickly adapt to new ways of daily activity. COVID-19 has a negative impact on all elements of health: social, physical and mental. Pharmacotherapy, as well as protective measures (isolation, wearing masks and maintaining physical distance) did not give the expected results. Vaccination has not yet led to herd immunity, so it is still jeopardizing every aspect of human health (1, 2). Non-pharmacological methods, such as stress and sleep control, physical activity and contact with nature are of great importance since they can significantly contribute to staying healthy during a pandemic. Objectives: The aim of this paper is to evaluate the impact of non-pharmacological measures such as stress and sleep control (with different measures against the negative effects of anxiety and depression on mental state) and the possible positive impact of “forest bathing” on improving the immune response to the virus and its consequences. Methods: Available evidence-based studies on ways to com- bat stress and the effect of the proposed measures on human mental health and the im- mune system were analyzed. From the mentioned studies, recommended measures have been registered, which refer to stress and sleep control, diet and eating habits, contact with nature (“forest bathing”, gardening), virtual communication and meditation (mindfulness practice). Results and Discussion: The combined results of these studies indicate that COVID-19 has a chronic course and complications that significantly affect the physical, mental and emotional state of the patient. Proven positive effects of non-pharmacological measures can be applied in the daily practice of primary health care in the comprehensive fight against the COVID-19 pandemic. Conclusion: Non-pharmacological measures such as stress and sleep control, spending time in nature, healthy diet, and physical activity may improve the immune response to COVID-19. These measures, with their positive effects on all aspects of health, can make a major contribution to controlling and improving the quality of life during the COVID-19 pandemic.
Background: The corona virus is transmitted in three ways: by direct contact with an infected person, by droplets, and by air. Transmission control according to official guidelines can be prevented by keeping a distance, wearing a mask and washing hands. Sharing a space with several members of the immediate or extended family increases the risk of transmission in all three ways. In Traditional Bosnian families two or three generations live in one household. The family doctor is informed with living conditions of the residents and has the opportunity to monitor the rate of secondary transmission from the index case, and then recommend additional preventative and treatment measures. Objective: The aim of the study was to determine the first occurrence of the symptoms and to monitor possible intrafamilial transmission of the disease through clinical examinations and microbiological-serological tests. Methods: The study was conducted in a family medicine clinic in the region of northeastern Bosnia and Herzegovina from March to December 2020. Patients with symptoms that could indicate the presence of COVID-19 disease were registered. If COVID-19 was proven, the patient became an index case. The other members of the family would be monitored for the secondary transmission via laboratory (PCA SARS-CoV-2 and IgM and IgG antibodies) and clinical parameters. Results: Characteristics of 25 index cases were analyzed. All 25 of them were middle-aged men that worked outside the home. In 25 households, there was a total of 123 members that shared a home with the index patient. Secondary transmission developed in 76 out of 123 family members (61.8%). Only one patient had a severe form of the disease and was hospitalized. 2 patients died. Conclusion: Intrafamiliar transmission of Covid-19 in households of Bosnia and Herzegovina is high. The secondary attack rate of SARS- CoV-2 in households is 61,8%. In the surveyed households, family members use common rooms with an infected patient, and the customs of family gatherings are maintained, without the implementation of protective measures. The family medicine team has the opportunity to apply appropriate preventive action, education and early prehospital treatment as well as adequate selection for the hospital admission.
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