The objective of this paper was to present basic clinical characteristics and outcomes of treating Covid 19 patients during the second wave of the pandemic. In the retrospective study for the period from September 2020 to February 2021 it was analyzed disease history data and radiological lung changes, time from the initial start of the disease until hospitalization, parameters of blood gas analysis, comorbidities, and the outcome. The research covered 409 patients, out of which 263 (64.3%) were males. Average age was 67.07± 12.44 years (min. 20; max. 93). A high comorbidities prevalence (82.9%) was noticed out of which arterial hypertension (69.2%), diabetes mellitus (37.7%) and obesity (24.7%). On the radiological lung scan the most noticed changes were consolidation (46.2%), “ground glass” (41.3%) and interstitial changes (13%). Bilateral lung infiltration was noticed in 91.9% of the patients. Average oxygen saturation was 84.29%±10.28% (min. 35; max. 98; med. 87%). In patients with unilateral lung infiltration, average oxygen saturation was 85.09%±8.60% (med. 89%, min.61% max 98%), while in patients with bilateral lung infiltration average was 84.22%±10.42% (med. 87%, min. 35%, max. 98%). From the total all patients’ death was noticed in 35.7% cases. Morbidity of patients with unilateral lung infiltration was 27.3% and in patients with unilateral infiltration 36.4%. Hospital admission in the first week of the disease indicates the severity of the clinical condition and can be a predictor of poor outcome. Bilateral pulmonary infiltration, obesity and diabetes mellitus are risk factors for high mortality.

Background: Covid-19 primarily manifests itself as a respiratory disease, but also with numerous extrapulmonary symptoms and complications. The clinical form of the disease before hospitalization, has a great influence on the further course and occurrence of complications of the disease. Objective: To analyze the clinical and laboratory characteristics of patients with moderate and severe clinical form of the disease, the complications that developed in these patients during hospitalization and the outcome of the disease. Methods: The retrospective study included 520 patients from the Tuzla Canton, treated in the COVID-19 Hospital at University Clinical Center Tuzla in the period from March 27 to October 1, 2020. The source of data were the medical records of hospitalized patients. The clinical and laboratory characteristics of patients with moderate and severe clinical form of the disease and the complications that developed in these patients during hospitalization were analyzed. Results: The number of hospitalized men was statistically significantly higher, p=0.000. Most patients were in the age group of 60-69 years: 152 (29.3%), then in the age group of 50-59 years: 119 (22.9%). Women <70 years had more often a moderate, and women >70 years more often a severe clinical form of the disease, p<0.01. Patients with hypertension, diabetes mellitus, chronic lung diseases, cardiovascular diseases, hematological diseases and tumors of solid organs, with leukopenia and lymphopenia, elevated LDH, CRP, transaminases and serum ferritin, significantly more often had a clinically severe form of the disease (p<0.01). Patients with a severe clinical form of the disease on admission to the hospital had more frequent complications and death as outcome (p<0.01). Conclusion: Patients who were hospitalized with a severe form of COVID-19 had significantly more frequent disease complications and death as outcome.

ABSTRACT Two cases are presented with coronavirus disease 19 (COVID-19)-related hiccups: one during initial presentation and one 10 days after COVID-19 diagnosis. Hiccups in both patients were resistant to treatment and responded only to chlorpromazine. COVID-19 patients may present with hiccups and also may have hiccups after treatment. Resistant hiccups without any underlying disease other than COVID-19 should be considered in association with COVID-19 and may respond well to chlorpromazine.

Aim: To analyze the rate of mortality in children with foreign body aspiration (FBA). Methods: We outlined a retrospective review of hospital data of patients between 1971 and 2013. FBA occurring in children 0 year to 14 years was considered for inclusion (patient ages ranged from 0.6 to 15 years, with a median age of 2.2 years). The gender structure within the investigated cases was 75.8% males and 24.2% females. During the study period, 772 patients undergoing rigid bronchoscopy with the diagnosis of FBA were included. Deaths on arrival were excluded. Results: Total rate of mortality (for whole investigated period) was 0.785. For last fifteen years of the investigated period the rate of mortality was zero. Conclusion: For prevention of foreign body aspiration in children and its mortality should be taken two strategies: non-medical (alterations in product design and public education campaigns) and medical (education of medical staff and improvement of equipment).

Received: 17.12.2017 Accepted: 25.01.2018 Department of 1Otorhinolaryngology, 2Chest Disease, 3Surgery, 4Radiology, 5Clinic for Microbiology, Tuzla University Clinical Center, Tuzla, Bosnia and Herzegovina, 6Faculty of Education and Rehabilitation. University of Tuzla, Bosnia and Herzegovina Yazışma adresi: Sekib Umihanic, ENT Clinic. UCC Tuzla. Bosnia and Herzegovina e-mail: sekib.umihanic@gmail.com INTRODUCTION

There are different kinds of foreign bodies that people aspirate. It depends on diet and the customs of the community. Almost the largest percent of accidental deaths in children under the age of 5 goes consists of Foreign Body Aspiration (FBA)1. However, a number of adults live with FBA, and foreign body can remain undetected for a long period of time2. A spoon in the bronchus has rarely been described as a FB, and never as a weapon of suicide so far. As an FB, spoon is always taken through oral route, and located in different parts of the digestive tract. When a large foreign body is aspirated, the result can be acute respiratory distress and, sometimes, even death. Also, foreign body aspiration can mimic other illnesses, causing some difficulties in diagnosis, e.g. astma3. The mortality can be reduced if a foreign body is diagnosed and removed early. Otherwise, the complications are serious and sometimes fatal4.

Introduction: Surgical and medical treatments of nasal obstruction are a common parts of otolaryngologist practice. The definitive treatment of deviated nasal septum is septoplasty. Aim: In this study was to evaluate the values of subjective parameters, and active anterior rhinomanometry parameters prior and three months after the septoplasty. Patients and Methods: We analyzed the subjective parameters (“NOSE” scale), the active anterior rhinomanometry parameters according to International Committee on Standardization of Rhinomanometry, on 40 patients. Thirty healthy adult volunteers participated belonged to the control group. None of the patients or healthy volunteers had previous history of nasal surgery or active rhinological disease. Results: The post-operative improvement in symptoms of nasal obstruction obtained in 92,5% patients and improvement parameters of the active anterior rhinomanometry in 42,5% patients. Conclusion: The correlation between the findings with rhinomanometry and subjective sensation of nasal patency remains uncertain. There still seems to be only a limited argument for the use of rhinomanometry for quantifying surgical results. Three months postoperative findings are very early results to interpret the permanent effects.

OBJECTIVES This study aims to report our experience in the management of foreign body (FB) impaction in esophagus in the Ear-Nose-Throat Clinic, University Clinical Center of Tuzla, Bosnia and Herzegovina. PATIENTS AND METHODS Seventy-one patients (44 males, 27 females; mean age 32.99±28.57 years; range 1 to 81 years) who admitted to our clinic between January 2003 and December 2013 with a history of a FB in esophagus were retrospectively analyzed including head and neck examination. All patients were performed rigid esophagoscopy under general anesthesia. RESULTS A total of 32 FBs were detected in children (23 males, 9 females; mean age 4.6 years; range 1 to 11, mod 1) with coins being the most common (56.31%). A total of 39 FBs were detected in adults (21 males, 18 females; mean age 56.2 years; range 16 to 81) with bones and food being the most common (43.6%). Foreign bodies impacted in the upper esophageal sphincter in 87.5% of children and in 66.7% of adults. The duration of localization of FBs in esophagus was between one hour and six months. All procedures were performed without complications; the FBs were completely extracted without the requirement to repeat the procedure. CONCLUSION Our study results suggest that use of rigid endoscope is reliable in removing FBs in the esophagus.

ABSTRACT Introduction: Central Venous Catheters (CVC) are essential in everyday medical practice, especially in treating patients in intensive care units (ICU). The application of these catheters is accompanied with the risk of complications, such as the complications caused during the CVC insertion, infections at the location of the insertion, and complications during the use of the catheter, sepsis and other metastatic infections. Patients and methods: This study is a retrospective-prospective and it was implemented in the period 1st January 2011- 31st December 2012. It included 108 examinees with CVC placed for more than 7 days. Results: The most common complications occurring in more than 2 attempts of CVC applications are: hearth arrhythmias in both groups in 12 cases, 7 in multi-lumen (12.72%) and 5 in mono-lumen ones (9.43%). Artery puncture occurs in both groups in 7 cases, 5 in multi-lumen (9.09%) and 2 in mono-lumen ones (3.77%). Hematoma occurred in both groups in 4 cases, 3 in multi-lumen CVCs (5.45%) and 1 in mono-lumen ones (1.88%). The most common complication in multi-lumen catheters was heart arrhythmia, in 20 cases (36.37%). The most common complications in mono-lumen CVCs was hearth arrhythmias, in 20 cases as extrasystoles and they were registered in 16 catheter insertions (30.18%). Out of total number of catheters of both groups, out of 108 catheters the complications during insertion occurred in 49 catheters (45.40%). The most common complications in both groups were heart arrhythmias, artery punctures and hematomas at the place of catheter insertion.

AIM To determine the efficiency and safety of talc pleurodesis in treating the malignant pleural effusion and recurrent spontaneous pneumothorax. METHODS The study included 54 patients with malignant pleural effusion and recurrent spontaneous pneumothorax, who underwent talc pleurodesis using the "talc slurry" method of pleural talc obliteration. RESULTS Pleurodesis was successful in 52 (96%) patients. The average duration of thoracic drainage was 4.4 days. Procedure complications included higher body temperature, pneumonia and pleural effusion separation. All of the patients had satisfying radiological findings at the point of discharge and three months later. There was no death outcome related to the procedure of pleurodesis itself. CONCLUSION Our study has proved the efficiency and simplicity of talc pleurodesis in treating symptomatic malignant pleural effusions and cases with recurrent spontaneous pneumothorax.Appropriate patient selection and compliance with surgical principles during the procedure make this method safe, efficient and successful in treating pleuropulmonal diseases. Large particle talc should be used for pleurodesis because of the minimum risk of complications.

ABSTRACT Introduction: Lung cancer is most common cause of cancer-related mortality worldwide. Non-small-cell lung carcinoma (NSCLC) is disease with very low 5-year relative survival rate. For patients with non-small cell lung cancer, roles of current treatments are to prolong survival time and to improve quality of life. Aim: The aim of the work was to compare values of Glasgow Prognostic Score (GPS) before application of the chemotherapy medication with response to chemotherapy and toxic side effects associated with chemotherapy in patients treated with cisplatin-etopozid (PE) and cisplatin-gemcitabin (PG) in stages IIIb and IV of NSCLC. Testing role of Glasgow Prognostic Score as a possible predictor of response to therapy and toxic side effects of chemotherapeutic protocol was another aim of this work. Patients and methods: This prospective study included 60 patients in stages IIIb or IV of NSCLC, with ECOG ≤ 2. The patients were divided in two groups. First group contained 30 patients treated with chemotherapeutic protocol using cisplatin-etopozid (PE), and the same number of patients in the second group were treated with cisplatin-gemcitabin (PG). Results: Glasgow Prognostic Score (GPS) evaluation before the chemotherapy inclusion showed values of 1 (43.30:53.30), then 2 (40.00:36.70) and the lowest 0 (16.70:10.00) which supports the pathological values of GPS in developed lung cancer, i.e. most patients had pathological GPS value in both protocols (83.30:90.00). Monitoring of toxic side effects and response to chemotherapy was done after each cycle of treatment. Discussion: Results of this study revealed importance of GPS in selection of patients for treatment with chemotherapy. Patients with lower values of GPS treated using PE chemotherapeutic protocol had weaker response to therapy. Conclusion: Coefficient of correlation for therapy response in both chemotherapeutic protocol, compared with values of GPS before treatment, were not statistically significant, therefore GPS cannot be considered as a predictor of therapeutic on chemotherapy.

Introduction: The aim of this research was to compare specifi city and sensitivity of Color Doppler ultrasonographywith CT angiography.Methods: A total of one hundred patients suffering from carotid artery disease (n=200) were tested in this research in the period from June till October, 2011. Average age of the patients was 61.5 years, and most of the patients were in the age group ranging from 55 to 65 years. The level of carotid artery stenosis is measured according to Standards of the North America Symptomatic Carotid Endarterectomy Trail study,by method of Color Doppler ultrasonography and CT angiography.Results: Stenosis <50% registered by Doppler ultrasonography was found in 62% and by CT angiography in 64% patients. Stenosis from 70 to 79% registered by Doppler ultrasonography was found in 88% and by CT angiography in 82% patients. In patients with level of stenosis 70-79% there was a tendencyof registering the stenosis to be higher by Color Doppler ultrasonography, than by CT angiography. In the case of the occlusion, there was also the similar observation, with variation of 8% carotid arteries.Conclusion: Extracranial Doppler and color duplex ultrasound enable reliable detection of both stenosis and occlusion of carotid arteries and accordingly they occupy an important place in radiological algorithm. When it comes to CT angiography it can be concluded that it can provide accurate and exact information regarding the condition of blood vessels as good as Digital Subtractive Angiography can.