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Background: The aim of the study was to find out what happens to erythrocytes and their forms during life and after death as a result of high water temperature.Methods: Heat stress was used on a rat model.to investigate the effects of different temperature intensities (37°C and 44°C) and exposure time (20 min and until the time of death) on erythrocyte morphology. Total of 23 Wistar rats were divided into two groups: 37°C as control group and 44°C as trial groups. The trial groups were classified into antemortem the exposure time of 20 min and postmortem groups exposure time until fatal outcome. The anaesthetised rats were exposed to preheated water using the water bath. May-Grünwald-Giemsa colouring technique was applied on blood samples taken from the abdominal aorta. Results: Exposure of Wistar rats to water temperature in groups KG37 and G44 led to a significant changes in core temperature. In the control group, the thermoregulatory mechanism established normothermia, and in G44 hyperthermia was detected during 20 minutes of exposure. The frequency of heat stroke in group G44 was 43.8%. Target cells and anulocytes were predominant in antemortem group at 44°C, while anulocytes and spherocytes in postmortem groups 44°C, respectively. Dacryocytes with spherocytes were significantly higher in postmortem group 44°C than in antemortem group 44°C (p=0.002, p=0.017, respectively).Conclusions: Poikilocytosis is associated with the exposure length and temperature intensity. Following a fatal outcome dacryocytes with spherocytes at 44°C were significantly more than in corresponding antemortem groups.

L. Sporišević, A. Jogunčić, S. Oručević, S. Musa

Introduction. The beginning of the COVID-19 pandemic led to a lockdown resulting in an 85% reduction in the compulsory immunization of children in 82 countries in May 2020 compared to January and February 2020. The World Health Organization states that during the first four months, for the first time in 28 years, the vaccination coverage of children with the third dose of gout, tetanus, and pertussis vaccines dropped significantly. The objective of the research is to determine the effect of COVID-19 on the implementation of mandatory vaccination of children and youth in the FBiH in 2020 compared to 2019. Subjects and methods: Data for vaccination coverage for children and youth in FBiH were extracted from the official records of the Institute for Public Health of the FBiH, in 2019 and 2020. The percentage of children vaccinated through mandatory vaccination processes was analyzed, expressed as a percentage in primary vaccination and revaccination by FBiH counties in 2020 and 2019 in relation to the planned number of children. Results. The study found a decrease in vaccination with the first doses of vaccine in FBiH, with the exception of the BCG vaccine, which has an increase of 2.3% compared to 2019. In particular, there is a decrease in vaccination with the third dose of the Hepatitis B vaccine and the DTaP-IPV-Hib vaccine third dose. In 2020, in the FBiH, there was a decrease of 26.7% in vaccination with the first dose of MRP vaccine. Conclusion. The research found a significant decline in the vaccination of children and youth for almost all vaccines in all FBiH counties in 2020, which indicates an increased risk for vaccine-preventable diseases.Vaccination improvement activities in the FBiH need to be intensified in order to reduce the risk of vaccine-preventable diseases. © 2022 Hrvatski Lijecnicki Zbor. All rights reserved.

Background: Identifying risk factors for the occurrence of cardiovascular diseases (CVD) is the first step in developing a prevention strategy. Objective: The aim of the study is to investigate the presence of risk factors and assess the overall risk of developing cardiovascular disease. Methods:.This cross sectional and experimental study involved 203 respondents of both sexes from the working population group aged 40 to 65 years. Results: Hypertension was diagnosed in 154 (75,9%) respondents, hyperglycemia in 177 (87,19%) respondents, dyslipidemia in 182 (89,66%) respondents and Diabetes mellitus type 2 was diagnosed in 53 (26,1%) respondents. Excess body mass was observed in 84 (41,4%) respondents, while obesity was noted in 91 (44,8%) respondents, and smoking habit in 117 (57,6%) respondents. Analyzing the above data using Q3 risk assessment for cardiovascular disease occurrence, it was found that the overall Q3 risk was significantly higher in male respondents, 21,8 (12.4-30.6), while female respondents had a median value of 14,7 (14-22,5), with an apparent statistically significant difference of p=0,001. Conclusion: To establish a strategic prevention program to eliminate the existing risk factors can only be achieved through multidisciplinary planning and the involvement of a multidisciplinary team of experts that will help improve the lifestyle of the individual and the entire community. From this work, we can see that the Q3 risk tool is well suited for risk assessment because it incorporates multidisciplinary parameters, whereas lipid indices can only be useful in cardiovascular disease risk assessment by comparing all indices.

Despite many efforts to diagnose and treat preventable cardiovascular diseases (CVD), more specifically to detect known risk factors, these diseases continue to be the leading cause of morbidity and mortality. Bosnia and Herzegovina belongs among the high-risk countries with standardized death rate (SDR) of 385 per 100 000 inhabitants in 2018. Two leading causes of death are acute myocardial infraction, with rate around 90 deaths per 100 000 inhabitants and stroke with the rate around 80 deaths per 100 000 inhabitants in one year. Both incidents are preventable. Digital interventions are necessary for strengthening of the healthcare system. Benefits of eHealth could be seen in transmission of customized health information for different audiences: transmission of health-event alerts to a specified population group; transmission of health information based on health status or demographics; alerts and reminders to clients; transmission of diagnostic results (or of the availability of results) or even notifications and reminders for appointments, medication adherence, or follow-up services. Successful implementation of digital health requires multidisciplinary approaches, from mass dissemination of recommendations through public health education programs directly in the field, to clinical treatments for patients. All this requires the involvement of numerous actors, from the strategic to the operational level of management within the healthcare system in the country.

S. Šegalo, E. Kiseljaković, Lejla Berhamović, Arzija Pašalić, S. M. Vranic, Daniel Maestro, A. Jogunčić, Aleksandra Pašić

Background: Immunization is a key step in preventing the occupational risk of acquiring hepatitis B infection for healthcare workers (HCWs). The aim of the study was determination of hepatitis B vaccine (HepB) coverage rate among HCWs and support staff and immune response 10 years after primary vaccination. Methods: A retrospective study was conducted in the Public Institution Health Centre of Sarajevo Canton in Bosnia and Herzegovina during 2005-2017. Second-generation vaccines Euvax (Sanofi Pasteur, Thailand/LG Life

Aim: Undergraund Farmakology of Black Marked such as are Anabolic steroids wich are irational abused by young recreational bodybuilder are in hidden epidemic connection with fast muscle gain and increased cardiovascular risk. Many young recreational bodybuilders beisides syntetic testestorone derivats, different testosteron esters and supplements search for alternative methods to improve effectes of muscle gain. Effects of Hyperbaric Oxygen Therapy (HBOT) with connection of abuse of stacking anabolic steroids in recreational bodybuilders still stay generally and worldwide unexplored leaving lots of unfilled gaps. Methodology: This study was conducted from beginning of May, 2018 till end of december 2018 at the Clinic of cardiovascular Surgery, department for vascular and endovascular surgery, Clinical Center University of Sarajevo, Special Hospital dr.Solakovic Department for Hyperbaric medicine (BIH) Head of Center for Hyperbaric medicine and chronic wound treatment Banja Luka (BIH), Private Hyperbaric and General Practice Therapy Centar Split and faculty Physical education and Sport Sarajevo included 72 subjects age 20-30 (36 of them went to hyperbaric chamber and used anabolic supplements while, 36 don’t went to hyperbaric chamber only used anabolic steroids). Potential Cardiovascular Side Effects are investigated For the testing of statistical significance of differences between the examined groups parameter tests were used. The difference at a level of p<0,05 was statistically significant. Results: In all tested subjects we investigated increasing potential damage of cardiovascular parameters age 20-30 years after two years study. Analysis shows the no statistically significant influence of recoverry and strength improvment in (HBOT) Treat dacetate group, compared to non Trenbolone acetate abuser group (p<0,005). Conclusion: Anabolic steroid stacking have generally efective potential abusing impact on skeletomuscular system it is unsignificant that oxgen therapy can provide such benefit in strength like anabolic steroids but certainly can improve recovery after hard working effort in a gym.

Daniel Maestro, S. Šegalo, Dinko Remić, Arzija Pašalić, A. Jogunčić

Introduction: Worldwide, COVID-19 pandemic caused millions of infected people and thousands of deaths. Due to enormous pressure on health-care systems and its inadequate preparedness, utter collapse is expected. In the current epidemic response, healthcare workers’ (HCWs) knowledge and practice are crucial, while the impact on their mental health is still unknown.Methods: The cross-sectional study was conducted among HCWs redeployed to COVID points in the Public Institution Health Centre of Sarajevo Canton. According to guidelines and information provided by the World Health Organization and Ministries of Health, a questionnaire was developed. In addition, General Anxiety Disorder-7 as a screening tool for anxiety disorders was used.Results: Of 180 respondents, 26 (14.4%) were in direct contact with the sick patient. In total, 79 (43.9%) respondents consider their personal protective equipment is in accordance with the guidelines of the world health authorities. A total of 72 (39.7%) of respondents used the same mask for several days. In general, the danger from new coronavirus was considered minimal by 59 (32,6%) HCWs. Based on the achieved score for assessing the anxiety disorder, in 63 (35%) subjects, the presence of severe symptoms was detected.Conclusion: This study found that most HCWs do not have enough knowledge about the COVID-19 pandemic. We identified that there are differences in the sources of information and gap in perceptions of the native origin of the virus. Considering the frequency of anxiety symptoms among HCWs, interventions are necessary in order to preserve their mental health.

A. Jogunčić, A. Pilav, Anisa Bajramović, Snežana Bursač-Aranđelović, Aida Pošković-Bajraktarević, Emina Kurtagić-Pepić, Aida Pitić, Zimka Šeremet et al.

Introduction: Sarajevo is the capital city of Bosnia and Herzegovina, with the population in Canton Sarajevo of 438,443 people. The first cases of COVID-19 in Canton Sarajevo were on 20th March. On that day, we had three positive cases. These days at the beginning of the COVID-19 epidemic in Canton of Sarajevo around 2500 citizens were in self-isolation at home. The aim of this paper is to show the journey of Canton Sarajevo in the fight against COVID-19 infection, the impact of measurements that were taken to stop the infection spreading and to compare pre- and post-lockdown stats.Methods: During the period March-July 2020, we have analyzed daily newly cases and followed them through the period of at least 14 days. All data were analyzed using SPSS 25.0 (IBM Corp. Released in 2019. IBM SPSS Statistics for Windows, NY: IBM Corp.) and MS Office 2019 suite (Excel). For comparison, we have used the Chi-square test.Results: In the period of 10 weeks from the beginning of March to the 25th of May in Canton of Sarajevo, we had a total of 113 cases of COVID-19 infection. The number of conducted tests was 7515. In total, with positive retests, we had only 161 positive tests, which is 2.14% of all analyzed tests. From that number of patients, 58 (51.3%) were male and 55 (48.7%) were female. Regarding age distribution, under 65 years were 91.1% of patients.Conclusion: Choosing the best method to fight against COVID-19 is hard to determine. Staying at home would decrease the infection rate, but in the long term, it is not sustainable. Perhaps the mix of methods that we had in Sarajevo is the best option. Fighting against one epidemic cannot be the source for other epidemics.

Coronavirus disease 2019 (COVID 19) is a pandemic disease that is today a global public health problem caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). COVID-19 is a disease of middle and old age, but clinical expression may also be present in childhood. Asymptomatic and mild clinical forms are most often present in persons aged 0-19, but severe clinical forms such as, among others, acute respiratory distress syndrome and multisystem inflammatory syndrome may occur. In addition to presenting the epidemiology, clinical symptomatology of COVID-19, the authors consider certain specifics of COVID-19, that is, possible reasons for the lower incidence of the disease as well as unusual and rare clinical forms of the disease in children. The current activities of health professionals in the supervision of COVID-19 are mainly focused on early detection, isolation and treatment of patients, isolation of contacts, the regular and thorough practice of respiratory hygiene, hand hygiene, and physical distancing. Future efficient and safe vaccination will solve the biggest global medical challenge caused by the new coronavirus in the best possible manner.

S. Šegalo, E. Kiseljaković, Lejla Berhamović, Arzija Pašalić, S. M. Vranic, E. Berhamović, Daniel Maestro, A. Jogunčić et al.

Background: Immunization is a key step in preventing the occupational risk of acquiring hepatitis B infection for healthcare workers (HCWs). Objective: The aim of the study was determination the hepatitis B vaccine (HepB) coverage rate among HCWs and support staff and immune response 10 years after primary vaccination.Methods: A retrospective study was conducted in the Public Institution Health Centre of Sarajevo Canton in Bosnia and Herzegovina. Second-generation vaccines Euvax (Sanofi Pasteur, Thailand/LG Life Sciences Ltd, Korea) and Engerix B (GlaxoSmithKline, Belgium) were applied. A level of ≥ 10 IU/L anti-HBs was set as a cut-off value indicating the presence of protective immunity against new HBV infections and successful vaccination. Results: In total, 1541 (75.80%) were fully vaccinated, out of 1126 (73.07%) were females. The median age of participans was 50.5 ± 9.4 years. Control measurement of the anti-HBs level was performed for 409 (26.54%) HCWs. During the research, 37 booster doses were administered. Of the 23 retested participants, anti-HBs ≥10 IU/L were observed in 19 (82.16%). Three non-reactors subject were revealed.Conclusions: A satisfying HepB coverage rate and a high protective rate against hepatitis B infection among HCWs and support staff was achived. These results indicate the active engagement of the institution in the implementation of preventive measures and the high level of awareness regarding the significance of immunization. Our results demonstrated the effectiveness of booster doses. A low prevalence of non-reactors was revealed. Additional research with a focus on occupational risk factors in dental service is advised.

Introduction: The nasals and hand carriage of Staphylococcus aureus in food handlers (FHs) represent a significant source of Staphylococcal food contamination and food poisoning. Antimicrobial resistance (AMR) is a microorganism’s ability to resist the action of one or more antimicrobial agents. S. aureus has demonstrated the ability to rapidly respond to each new antimicrobial with the development of a resistance mechanism. The aim of the study was to assess the prevalence of nasal carriage rate and AMR pattern of isolated strains S. aureus among FHs in Canton Sarajevo, Bosnia and Herzegovina. Methods: The retrospective study included laboratory results of 11.139 tested subjects between January 2014 and December 2018. The study was conducted in the laboratory of the Institute of Public Health of the Federation of Bosnia and Herzegovina in Sarajevo. Samples of nasal swabs were collected from FHs, employees in companies located in Canton Sarajevo, during sanitary surveillance prescribed by applicable legal standards. S. aureus isolates were identified according to conventional microbiological methods and antimicrobial susceptibility testing was performed by the agar disk diffusion method according to the European Committee on Antimicrobial Susceptibility Testing; 2013 standard. Results: Among the 11.138 subjects, 792 (7.1%) were carriers of S. aureus. Isolated strains were tested on eight different antibiotics, and the resistance to penicillin, ampicillin, and amoxicillin was 788 (99.5%), 776 (97.9%), and 752 (94.9%), retrospectively. In total, 86.36% of isolated strains were multidrug-resistant. Conclusions: The low percentage of S. aureus carriers indicates that preventive measures of carrier control are being actively implemented within the legally prescribed measures. The emergence of numerous isolated strains with multidrug-resistance characteristics is a significant public health problem and consequently limits the range of antibiotics available for therapeutic purposes. The results of this research indicate that AMR has increased in Sarajevo Canton and it is following the trend of global growth.

Sabina Mahmutovic-Vranic, Vanesa Dujso Radaslic, M. Aljičević, Amila Abduzaimović, A. Jogunčić, J. Vraneš

Purpose: Youth represents the most vulnerable population, mainly due to their lifestyle derived from risky sexual behaviours. The aim of the study was to identify specific HPV genotypes correlating with cervical smear cytologic abnormalities, well as sociodemographic/behavioural characteristics and history of sexually transmitted diseases in Bosnian women age up to 30 years. Methods: The longitudinal study was performed at the Department of Microbiology School of Medicine University of Sarajevo and Institute for Public Health dr. Andrija Stampar, Zagreb, Croatia from June 2017 to January 2018. Thirty (30) cervical smears were taken from tested females were screened using COBAS assay for HPV DNA testing. Routine Pap screening was performed in the Public Institution Department for Health Care of Women and Maternity of Sarajevo Canton. A self-administered questionnaire was applied. Results: A total of 30 sexually active women with abnormal cytological reports were enrolled in the study. The mean age was 26 IQR (20.75, 29.0) year. The overall prevalence of HR HPV was 66.7 %. Women age of ≤25 years had a positive association with positive results of HPV testing, OR=1.91. Consummation of alcohol, cigarettes had a strong positive association with positive HPV testing. Conclusions: The data obtained from this study indicate that HPV 16 is the most common HPV type found in the cervical specimens among young Bosnian women, followed by HPV 18. HPV DNA testing using as a screening test should be considered in the development of cervical cancer prevention programs in Bosnia and Herzegovina.

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