Summary Background HIV infection is characterized by progressive depletion of CD4+ T cells due to their reduced synthesis and increased destruction followed by marked activation and expansion of CD8+ T lymphocytes. CD4/CD8 ratio was traditionally described as a marker of immune system ageing in the general population, but it increasingly appears as a marker of different outcomes in the HIV-infected population. The main objective of this study is to examine the power of CD4/CD8 ratio in predicting the occurrence of metabolic syndrome (MetS) in HIV-positive patients receiving cART therapy. Methods 80 HIV/AIDS subjects were included in a retrospective case-control study. Flow cytometry was used to determine the percentage of CD4+ and CD8+ cells in peripheral blood of these patients. The values of biochemical parameters (triglycerides, HDL, blood sugar, blood counts), immunological parameters (CD4/CD8, PCR), anthropometric measurements and type of cART therapy were evaluated in this study. Results After six months of cART therapy 19 (23.8%) subjects had all the elements necessary for making the diagnosis of MetS. Using multivariate analysis CD4/CD8 ratio was statistically significant (p < 0.05) and had the largest effect on development of MetS (Wald = 9.01; OR = 0.45), followed by cART (Wald = 7.87; OR = 0.10) and triglycerides (Wald = 5.27; OR = 1.7). On the other hand, body weight and waist circumference showed no statistically significant effect on the development of MetS after six months of cART, p > 0.05. Conclusions CD4/CD8 ratio proved to be a significant marker for prediction of metabolic syndrome in HIV/AIDS patients.

Background: HIV infection is characterized by progressive depletion of CD4 + T cells due to their reduced synthesis and increased destruction followed by marked activation and expansion of CD8 + T lymphocytes. CD4/CD8 ratio was traditionally described as a marker of immune system ageing in the general population, but it increasingly appears as a marker of different outcomes in the HIV-infected population. The main objective of this study is to examine the power of CD4/CD8 ratio in predicting the occurrence of metabolic syndrome (MetS) in HIV-positive patients receiving cART therapy. Methods: 80 HIV/AIDS subjects were included in a retro spective case-control study. Flow cytometry was used to determine the percentage of CD4 + and CD8 + cells in peri pheral treated with antiretroviral therapy. Criteria for exclusion from the study were: subjects who at the time of therapy commencement had 3 or more criteria for MetS, an active opportunistic disease or severe infectious disease, acute or chronic inflam matory disease, hypothyroidism, Cushing’s syn drome, acute or chronic kidney disease, acute or body weight and waist circumference showed no statistically significant effect on the development of MetS after six months of cART, p > 0.05. Conclusions: CD4/CD8 ratio proved to be a significant marker for prediction of metabolic syndrome in HIV/AIDS patients.

1University Clinical Centre Sarajevo, Clinic for Infectious Diseases, Sarajevo, Bosnia and Herzegovina 2University Clinical Centre Sarajevo, Department of Immunology, Sarajevo, Bosnia and Herzegovina 3University Clinical Centre Sarajevo, Department of Clinical Biochemistry, Sarajevo, Bosnia and Herzegovina 4University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Infectious Diseases

Background: This cost-of-illness (COI) study provides deep insight in direct and indirect costs of multiple sclerosis (MS) in Bosnia and Herzegovina (BH). Aim: Objective of this study was to analyze the costs and quality of life (QoL) of patients with MS in BH. Patients and methods: We applied the same methodology already used in study conducted across nine European countries. Sixty-two patients participated with EDSS score not higher than 6.5. Costs are collected using a questionnaire quality of life was measured by EQ-5D and MSQOL-54 questionnaires. Results: Mean age of respondents was 39.8 The mean utility measured by EQ-5D-3L was 0.68 at the beginning and 0.63 at the end of the study. QoL measured by MSQoL-54 showed improvement at the end of the trial. Costs are presented from the societal and payer perspective. Cost of MS in Bosnia and Herzegovina annually amount 124.8 million BAM. Cost driver where indirect and DMDs costs, with significant differences among subgroups. Conclusions: This study provides an in-depth analysis of MS costs in BH providing data for health policies development and information for future cost-effectiveness evaluations of new therapeutic options as well as for comparison of MS costs with other countries.

Introduction: Quality of life in patients with acute pharyngitis or tonsillitis is significantly lower than in healthy persons, and it should be taken into account when efficacy of new therapeutic options is investigated. Objective: The aim of this study was to develop and validate a reliable instrument that can measure quality of life in adult outpatients with sore throat caused by acute pharyngitis or acute tonsillitis. Method: The study was of a cross-sectional type, and assessed reliability and validity of newly developed questionnaire for measurement of quality of life in adult outpatients with sore throat (STQoL) caused by acute pharyngitis or acute tonsillitis. It was conducted on a sample of 282 patients, with mean age 39.0 ± 14.8 years, male/female ratio 104/178 (36.9%/63.1%). Results: Final version of the STQoL scale with 21 items showed excellent reliability, with Cronbach’s alpha 0.949. It was temporally stable, and both divergent and convergent validity tests had good results. Factorial analysis revealed three domains, Social/psychic aspects, Physical aspects and Environmental aspects of sore throat related quality of life. Conclusions: The STQoL scale is reliable and valid specific instrument for measuring sore throat related quality of life, which is an important treatment outcome in patients with acute pharyngitis or tonsillitis.

Introduction: The prevalence of allergic asthma are increasing, and the clinical outcome and risk factors of immunotherapy in the treatment of allergy have not been well established. Especially, the impact of viral infection on cytokines in allergic inflammation has yet to be established. This study aimed to determine serum IL-3, IL-11 and IgE levels and blood eosinophil and neutrophil counts during a one-year follow up in patients with allergic asthma on immunotherapy and those on anti-asthmatic drugs only, in the presence of influenza-like illness.

Introduction: The purpose of this study was to validate Bosnian translation of disease specific quality of life measure MSQoL-54 which is widely used in practice. Material and Methods: Previously translated and culturally adopted MSQoL-54 questionnaire used in this study has been provided and licensed by Optum Inc. The questionnaire was validated in 62 MS patients seen at Neurology clinic at University Clinical Center Sarajevo, during April 2016 until May 2016. Internal reliabilities of Bosnian version MSQoL-54 were assessed for multiple item scales by using Cronbach’s alpha coefficient. Clinical validity was assessed comparing means of the two summary MSQoL-54 scores by the EDSS score. Pearson’s (r) correlation coefficient was used to investigate the relationship between the composite scores and the main clinical and demographic variables. Results: Patients’ participation was satisfactory and all scales fulfilled the usual psychometric standards. Highly significant inverse relationship was found between both composite scores and clinical characteristics of the disease and the EDSS. The lowest internal consistency reliability is found on social function scale (0.743), overall quality of life (0.782) and pain (0.833). The highest internal consistency reliability is found on role limitations due to physical problems (0.959), physical health (0.962) and role limitations due to emotional problems (0.966). The mean value of MSQoL-54 PHC (Physical Health Composite) and MHC (Mental Health Composite) were 49.82±18.90 (36.05-61.38) 51.84±22.22 (34.93-70.20) respectively. Our study has shown that the Bosnian version of MSQoL-54 is easy to administer and well accepted by patients and may be useful as clinical outcome measures in patients with MS.

Introduction: Non Hodgkin lymphoma-Diffuse large B cell lymphoma (DLBC) is composed of more varieties of one disease. Analysis and understanding of a wide range of characteristics of the disease, which include: clinical, immunohistochemical, cytogenetic and molecular characteristics may improve treatment results. Aim: achieving the estimated three-year survival and influence of IRF/MUM1 expression to three-year survival. Material and methods: A study was retrospective–prospective, patients were followed for seven years a period of dine. The study included 60 patients de novo DLBCL. Age was 18-72 years old, the average age 45 years, male 31 (51,7%) and female 29 (48.3%). Median follow-up was 47 months (3-91 months). To determine differentiation immunophenotype antibodies those were used anti-CD20, anti-CD10, anti-Bcl-6, IRF-4/MUM1, CD 138. Results: Included the GCB type was 65%. Impact prognostic index IPI>2 GBC vs non GBC p=0,038 X2. Statistically significant difference was confirmed compared to the IPI> 2 to 3 year OS p<0,0005 X2. Significantly longer three-year survival was provided in the group GCB 36 (92,3%) vs. non GCB 8 (38,1%) p=0,003 X2. Clinical and immunohistochemical factors showed a significant impact to three-year survival by univariate: LDH p=0,005, MUM1 p=0,003, while CD10 p=0,069 was confirmed on the level of borderline impact. Using multivariate analysis, expression MUM1 has the greatest impact p<0.0005 OR=0.083 (95% CI 0.23-0.303) on the disease outcome – three-year survival. Conclusion: expression MUM1 >25% has the greatest impact on the disease outcome – three-year survival.

Objectives: The aim of this study was to evaluate visual and refractive outcomes after Veriflex phakic intraocular lenses (pIOL) implantation in moderately myopic eyes as well as postoperative complications. Methods: This prospective clinical study included 40 eyes of 26 patients which underwent implantation of Veriflex for correction of myopia from -6.00 to -14.50 diopters (D) in the Eye Clinic Svjetlost Sarajevo, from January 2011 to January 2014. Uncorrected distance visual acuity (UDVA), manifest residual spherical equivalent (MRSE), intraocular pressure (IOP), endothelial cell (EC) density were evaluated at one, three, six and 12 months. Other complications in postoperative period were evaluated. For statistical analysis SPSS for Windows and Microsoft Excel were used. Results: Out of 26 patients 14 had binocular and 12 monocular procedure, with mean age of 29.8±6.5 years. After 12 months mean UDVA was 0.73±0.20. Mean MRSE was -0.39±0.31D and 90% of eyes had MRSE within ±1D. EC loss was 7.18±4.33%. There was no significant change of IOP by the end of 12 months follow up period. The only intraoperative complication was hyphema and occurred in one eye. Few postoperative complications were: subclinical inflammation in three eyes (7,5%), pigment dispersion in four eyes (10%), ovalisation of papilla in 2 eyes (5%) and decentration of pIOL in 2 eyes (5%). Conclusion: Implantation of iris-claw phakic lenses Veriflex for treating moderately high myopia is a procedure with good visual and refractive results and few postoperative complications.

AIM To evaluate efficacy and safety of iris-supported phakic lenses (Verisyse) for treating moderately high myopia. METHODS This prospective clinical study included 40 eyes from 29 patients, who underwent implantation of Verisyse for correction of myopia from -6.00 to -14.50 diopters (D) in the Eye Clinic ''Svjetlost'', Sarajevo, from January 2011 to January 2014. Uncorrected distance visual acuity (UDVA), manifest residual spherical equivalent(MRSE), postoperative astigmatism, intraocular pressure(IOP), endothelial cell (EC) density were evaluated at one, three, six and twelve months. Corrected visual acuity (CDVA), index of safety and efficacy were evaluated after 12 months. RESULTS Out of 29 patients 15 were males and 14 females, with mean age of 27.9 ± 5.0. After 12 months 77.5% eyes had UDVA ≥ 0.5 and 32.5% had UDVA ≥ 0.8. Mean MRSE was 0.55D ±0.57D and mean postoperative astigmatism -0.86D ± 0.47D. Efficacy index was 1.09 ± 0.19 and safety index 1.18 ± 0.21. One eye(2.5%) lost two Snellen lines and three eyes (7.5%) one line, 11 eyes (27.5%) gained one line, and five eyes (15.5%) gained two lines. EC loss after 12 months was 7.59 ± 3.05%. There was no significant change of IOP after one year follow up. CONCLUSION Implantation of iris-supported phakic lenses (Verisyse) for treating moderately high myopia is an efficient and safe procedure.