Introduction: Serum creatinine is not enough sensitive marker for the evaluation of glomerular filtration rate (GFR). Cockcroft-Gault (CG) formula is often used to assess GFR, but it is necessary to correct original one for body surface area (BSA), adipositas, and the creatinine tubular secretion. The values of the estimated creatinine clearance and GFR are considered to Poggio reference ones according to biological parameters (age and gender). The aim of the study was to determine the difference in renal function estimation between serum creatinine and corrected CG equation according to the Poggio reference values in the arterial hypertension patients. Materials and Methods: The research included 124 patients of both gender with arterial hypertension, excluding ones with the already verified chronic kidney disease. We estimated creatinine clearance and GFR by CG method corrected for the BSA, body mass index (BMI), and the creatinine tubular secretion according to Poggio reference values. Results: There was no significant difference in both age and gender groups among patients with physiological and pathological values of the renal function determined by the serum creatinine and estimated creatinine clearance by CG equation corrected for BMI, BSA. In both age and gender groups there was significant difference among subjects with physiological and pathological values of the renal function determined by serum creatinine and estimated GFR by CG method corrected for BMI, BSA, and creatinine tubular secretion. Conclusion: There is the most striking difference in the assessment of renal function between serum creatinine and estimated GFR by CG method with three corrections (BSA, BMI, the creatinine tubular secretion). Estimated GFR by CG method with three corrections can help in the early diagnosis of renal dysfunction and optimal treatment in patients with arterial hypertension.

: Introduction Th e concept of the quality of healthcare services is constantly evolving and transforming depending on the interest in it and the level of involvement of medical sta ff and patients. Aim To assess patient satisfaction with the quality of health services in private practice condition. Methods 105 (n=105) subjects participated in the study, and it was conducted by an anonymous survey of the clinic which o ff ers medical services, tests, and diagnostic procedures in the fi elds of gynecology, internal medicine, surgery, radiology, urology, and neurology. Th e research was conducted among patients who used the health services of a private practice institution from January to September 2022. Th e patient questionnaire consisted of 14 questions. Five questions related to identifying the sociodemographic characteristics of the respondents, and 9 questions were research questions of the Lickert type. For this purpose, the standardized Laschinger HCAHPS ( Hospital Consumer Assessment of Healthcare Providers and Systems ) questionnaire on patient satisfaction with the quality of healthcare services was used. Di ff erences in numerical variables were tested by Student’s t-test or analysis of variance (ANOVA). All P values are two-sided (p<0.05). Th e statistical program MedCalc Statistical Software version 18.2.1 was used for statistical analysis. Results Th e research was conducted on 105 patients, 28% of whom were male and 72% female. Most patients were in the age group of 61 to 70 years (30%). Patients are satis fi ed with the quality of healthcare services. Th e highest average score for reception and waiting time (4.9), the lowest score for being informed about upcoming interventions and treatments and professional approach (4.68). Conclusion Patients show a high degree of satisfaction with the general services provided.

Aim To determine the effect of the load on the meniscus in relation to a different angle, and to present the impact of force on eventual injury of menisci. Methods Research included 200 males with average height of 178.5 cm, mass 83.5 kg, and average age of 22 years. The simulation of treadmill that was used in the evaluation of ischemic heart disease was made. Effects on the knee were evaluated by measuring at different inclinations (5°70', 6°80', 7°90', 9°10', 10°20', 11°30' and 12°40'). Results With increasing ascent of treadmill the load on the meniscus also increased. Each increase in ascent after 22% (which corresponded to the angle of 12°40' and seventh degree of load according to the Bruce protocol) at given anthropological values was an etiological factor for meniscus injury. Conclusion The seventh degree of load according to the Bruce protocol can lead to the meniscus injury.

Results: After 247 ± 53 seconds (4 minutes and 11 seconds) in average patients developed NSVT, and were referred for coronary angiography. Of total number, 4 had a significant finding on coronary angiography; 3 patients had single-vessel coronary disease (one received a stent on right coronary artery (RCA), two on left anterior descending artery (LAD)), and one had triple-vessel coronary disease (received a stent on circumflex artery (CX) and LAD).

Abstract Objectives The aim of this article was to present a case of premature fetal closure of the ductus arteriosus (DA) of unknown cause. Case presentation A 32-year-old pregnant woman came for the regular prenatal visit at 36 + 1 weeks of gestation (WG) at which oligohydramnios and premature closure of DA were revealed. Use of non-steroidal anti-inflammatory drugs was excluded by the history, although the patient had the symptoms of common cold 2 weeks before the check-up taking more than 1,000 mL of strong chamomile tea daily till the day before the prenatal visit. The patient was hospitalized at 36 + 1 weeks of gestation due to premature closure of DA and oligohydramnios (amniotic fluid index = 4.5/3), which was the indication to deliver the baby by cesarean section at 36 + 6 WG (birth weight was 2,830 g, birth length 49 cm and head circumference 34 cm, Apgar score at 1 and 5 min were 9/9). Postnatal course was uneventful, and postnatal echocardiography at 12 h of life revealed functionally closed DA and mild dysfunction of the right ventricle, which completely resolved after 7 days. The mother and the baby were discharged home healthy, and were doing well 3 months after delivery. Conclusions Although the cause of premature closure of DA in most of the cases will remain undetected, thorough history sometimes with unexpected events should be taken under the consideration as possible causative factor for premature DA closure, as was drinking of high quantities of chamomile tea in our case.

Introduction: Mathematical modeling of coronavirus disease spread and computer simulations are currently one of the main tools in public health that can give important indicators for prevention planning. Based on mathematical projections and daily updates of information, the measures are either tightened or reduced, in order to protect the health of the population. Aim: The aim of this paper is to present a computer system based on an adequate mathematical model that allows frequent execution of various scenarios of spread severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in any period in the future. Also, the aim of this article is to point out the importance of measures for the prevention of coronavirus disease 2019 (COVID-19) in Bosnia and Herzegovina through examples of computer simulation models. Methods: Software solution based on the USLIRD model (Unpopulated - Susceptible - Latent - Infectious - Recovered - Deceased) was developed, with a number of variable parameters ‘reproduction number, delay period, infectivity period, hospital capacity, characteristics of population). By setting these parameters in accordance with the existing and available data, the model is brought to an optimized state with the possibility of a realistic assessment of the course of the infection curve in any future period. Data from the beginning of the pandemic are collected at the Faculty of Mechanical Engineering, University of Sarajevo and updated several times a day. The set of measures is divided into two types. 'Intervention 1' is a measure to close institutions that are at high risk for pandemics, working from home, wearing face mask, enhanced hygiene when entering facilities with a larger number of people. 'Intervention 2' presents restrictive measures that has been introduced as mandatory in Bosnia and Herzegovina. The period 01.03.2020 to 01.09.2020 was observed. Results: Without epidemiological measures, Bosnia and Herzegovina's health system would quickly collapse. Restrictive measures reduce the intensity of the spread of the infection, save human lives and keep the health system functional, but with consequences on other aspects of society - reduction of economic activities, collapse of the service industry and companies and disorders in mental health status of the population. Four different scenarios of the situation were analyzed. Scenario number three is current condition with measures that are currently in Bosnia and Herzegovina. The reintroduction of restrictive measures leads to a decrease in the number of infected population and suppression of the spread of the pandemic, which is shown in scenario 4. Conclusion: Self-discipline, adherence to measures, while trying to avoid restrictive measures should be the way to fight the COVID-19 pandemic. Whatever the consequences, the initiation of restrictive measures to preserve the health of the population should be imperative.

Aim To evaluate a correlation of serum level of neutrophil gelatinase-associated lipocalin (NGAL) to the risk of the occurrence of complications in patients with the early phase of ST-segment elevation myocardical infarction (STEMI) treated with fibrinolytic therapy prior to percutaneous coronary intervention (PCI). Methods A total of 54 patients with the diagnosis of STEMI treated with fibrinolytic therapy (alteplase) prior to PCI were included. Patients were admitted to the Intensive Care Unit (ICU) of Clinic for Heart, Blood Vessel and Rheumatic Diseases in the period January to March 2018. All patients underwent coronary angiography and PCI within the maximum of 48 hours delay after fibrinolysis, according to the hemodynamic and electrical stability and PCI availability. Blood samples were taken immediately after admission prior to fibrinolytic administration. Patients were divided into two groups according to NGAL values (less or more than 134.05 ng/mL). Results Higher values of NGAL have effect on a higher mean systolic and diastolic pressure (p=0.001 and p=0.003, respectively). Patients with higher NGAL values also have higher values of brain natriuretic peptide (p=0.0001) and highly sensitive troponin I (p=0.002). In that group relative risk (RR) for lethal outcome was 6.4 times significantly higher (p=0.002), for the development of heart failure 2.88 times (p=0.0002), for post-myocardial infarction angina pectoris 2.24 times (p=0.0158), and for ventricular rhythm disturbances (ventricular tachycardia, ventricular fibrillation) 1.96 times higher (p=0.0108). Conclusion Increased NGAL value is related to an unfavourable outcome of patients in the early phase of STEMI treated with fibrinolytic therapy prior to PCI.

Long QT syndrome (LQTS) is a rare (1:2500–1:10,000) inherited disorder characterized by the onset of arrhythmogenic syncope, polymorphic ventricular tachycardia, and sudden cardiac death. The aim of this article was to describe an unexpected success with an unusual therapeutic modality of a patient diagnosed with LQTS syndrome (suspected Romano–Ward syndrome) during an 8-year period. A 59-year-old female patient was admitted to the hospital due to chest pain and nausea, and after diagnostic and therapeutical approach, a permanent dual-chamber rate-modulated (DDDR) pacemaker was implanted instead of the implantable cardioverter defibrillator (ICD). During the 8-year period, the patient remained stable, without rhythm disorder. Romano–Ward syndrome as a congenital LQTS carries a high risk of sudden cardiac death and presents an indication for ICD. In this patient, for objective reasons, this could not be performed. Implantation of a DDDR with an appropriate pharmacological therapy, including propranolol, in this case, proved to be a successful therapeutic modality.

The aim of the paper was to examine the effect of noise on the blood flow velocity through a period of three years on workers who work on press machine. It was proven that continuous exposure to noise affects the blood flow velocity through the aorta and increases the diameter of ascending aorta and this, consequently, leads to an increase in cardiovascular risk. Prevention of changes in the cardiovascular system is considered to be imperative, and the limitation of noise levels and the length of exposure to noise must be established as factors that must be planned during the construction of the work environment.