Venous leg ulcers (VLUs) account for most lower extremity wounds. Wound management include cleansing, debridement, infection control and applying wound dressing. There exist various types of dressings which can maintain adequate moisture, offer protection, and support the reepithelization of VLUs. The aim of this study is to evaluate the cost-effectiveness of the antimicrobial wound dressing containing ionic silver (Aquacel® Ag+Extra™) in the treatment of VLUs compared to conventional gauze dressing in Serbia. The data regarding the effectiveness and frequency of dressings for both the Aquacel® Ag+Extra™ and conventional dressing were obtained from literature sources. Only direct costs were considered, and values were taken from the published price list of health services or procurement procedures. Sensitivity analyses were performed. The total cost per patient for Aquacel® Ag+Extra™ was 34,178.76 RSD, while the total cost for gauze was 82,800.90 RSD. Besides lower costs, antimicrobial wound dressing shows higher effectiveness than the gauze, implying that Aquacel® Ag+Extra™ is the dominant strategy. The sensitivity analysis supports the robustness of the results. The use of antimicrobial wound dressing containing ionic silver is the preferred option for the treatment of VLUs due to lower costs and the higher curing rate of the wounds.

The college years are critical to students' health as they face various challenges, including social influences and unhealthy lifestyles. Limited access to health services in residence halls increases the risk of unhealthy behaviours. The aim of this study was to investigate students' attitudes towards public health services for primary prevention in dormitories and to make suggestions for improvement. A cross-sectional study was conducted using a questionnaire among students living in halls of residence. The survey explored students' views on healthcare and the availability of preventive services for students living away from home. A total of 996 students participated (response rate 99.1%). Most were unemployed (83.9%). The most frequent preventive visits were to dentists (34.4% twice a year, 24.7% once a year), while 37.7% never visited a gynaecologist/urologist. The majority (68.6%) stated that a pharmacy was necessary in their dormitories. Basic health services include general practitioners (82.3%) and psychologists (21.4%). Attitudes towards health centres varied significantly by place of residence (p<0.001). Primary prevention should be improved by health centres with student-friendly opening hours and additional activities that promote access to healthcare and awareness of prevention.

Customer satisfaction reflects the quality of pharmaceutical services and depends on various factors, such as the quality of services, pharmacists' skills and customer' demographic characteristics. Positive experiences strengthen customer trust and loyalty. Research into user satisfaction is an important tool for improving services. The aim of the work was the analysis of user satisfaction with pharmacy services in Serbia over the last twelve years. Annual reports on user satisfaction in pharmacies from 2013 to 2024 were analyzed. Based on key indicators, a report was prepared comparing satisfaction over the years, taking into account various factors and service quality. With the exception of 2020, public, private and health center pharmacies participated every year. The highest response rate was recorded in 2015. More than 60% of users visit a pharmacy more than five times a year, usually waiting less than five minutes. The highest level of satisfaction with the availability of medicines was recorded in 2021, while overall satisfaction with services peaked in 2022. User satisfaction has remained stable, indicating good availability and quality of pharmaceutical services. The results may contribute to further improvement in practice.

From patients' perspective, the use of antibiotics to treat urinary tract infections (UTIs) in Serbia is unexplored, and therefore the aim of this study is to examine antibiotic use among these patients. An online cross-sectional study using snowball sampling was conducted during the winter of 2020/21 using a validated Google Docs questionnaire. The study included 236 female patients with a mean age of 34.9 ± 14.2 years. Most of the patients perceived UTI symptoms as severe (62.3%) and disruptive for their daily routines (51.3%). The majority of the patients (77.1%) used antibiotics by doctors' prescriptions. Other patients used antibiotics on their own and their selection. Self-treatment with antibiotics was associated with perceived symptom severity (p=0.006) and residence (p=0.017). In total, 17 different antibiotics were reported as being used for UTI treatment and the most frequent were fluoroquinolones (30.3%), cephalosporins (21.2%), and sulfonamides (15.7%). The highest consistency with national and European guidelines in doctors' decisions on antibiotic therapy was observed for treating UTIs in pregnant women (80.0%). These findings emphasize the need for education of healthcare professionals and clinical practice improvement in making rational antibiotic prescribing decisions.

Background: Lyme Borreliosis is a multisystem zoonosis caused by the spirochete Borrelia Burgdorferi and is widespread throughout the world. Borrelia is called the greatest imitator, because it can imitate any disease. The frequent presence of Borrelia in some neurological, dermatological, ophthalmological, cardiology and other patients points to a dilemma: is Borrelia burgdorferii really an imitator or is it the main actor of these diseases. Objective: The aim of this paper is to answer the question: is Borrelia burgdorferi the initiator and main cause of most diseases that are etiologically unexplained. Methods: The paper presents unusual clinical pictures of chronic borreliosis in 10 patients, who recovered on antibiotic therapy, and which are the most striking examples from a group of similarly ill patients. Case study presentation: A total of 10 interesting cases of borreliosis patients were presented. These are the cases: Scleroderma in a 29-year-old patient, generalized lymphadenitis with extreme leukocytosis in a 52-year-old woman, paraparesis in a 24-year-old professional soldier after mild serous meningitis, ALS in a 14-year-old schoolgirl, a case of bilateral migrating optic neuritis in a 13-year-old schoolgirl, retinal ablation in a 32-year-old patient, secondary sterility due to cystic ovaries in a 32-year-old shopkeeper with chronic urticaria, MS in a 20-year-old student, nightmares and moonwalking in a 7.5-year-old pupil complicated with left-sided bartonellosis lymphadenitis of the neck, recurrent syncope with attacks of tachypnea in a 19-year-old patient. All of these patients had normal routine findings, except for the patient with leukocytosis. Infectious disease diagnosis in all patients was made clinically, based on anamnestic data, clinical picture and verified white and/or pink borreliosis striae, and serological confirmation of the presence of the bacterium Borrelia burgdorferi using ELISA, WB and Immunoblot techniques. Conclusion: Based on the presented cases and 12 years of continuous experience with patients with Lyme disease, we conclude that Borrelia burgdorferi is in most cases the cause of the disease of “unknown cause” in neurology, dermatovenerology, ophthalmology, gynecology, internal medicine. The diagnosis of Borrelia is made primarily clinically (extensive anamnesis by organs + finding of new clinical markers on the skin). Serological confirmation of the presence of Borrelia in the body can be done in a small number of cases using the ELISA + WB technique, because these antibodies last for a short time. In older children and adults, it is necessary to use the advanced Immunoblot technique that searches for antibodies to B.B. protein sequences. and additionally search for Borrelia by light microscopy in a native serum preparation.

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According to the WHO, health is not just the absence of disease, but a state of complete physical, social and mental well-being, which is why the main goals of health are aimed at improving physical, mental and spiritual health. Health is one of the fundamental rights of every human being, a precondition for prosperity and quality of life indicator for measuring progress and the basis of steady economic growth. Today, many professions are committed to modernizing the culture of relations with the public, i.e. citizens. This is also essential in healthcare, with the aim of placing the patient’s well-being and rights at the center of attention, i.e. a culture of patient-centeredness. In order to ensure that the rights of every patient are respected, a more efficient system of protecting patients’ rights is needed at all levels, and above all in hospitals, and, patient representatives should be appointed in all hospitals. The health status of our population depends on a rapid changes, such as number of demographic, social, cultural, ethnical, and other characteristics which are for several decades in a very intensive changes, The Jakarta Declaration identified five priorities: a) Promoting social responsibility for the state of health; b) Increasing investments for development of health; c) Development of partnerships for work on health promotion; d) Increasing the capacity of society and training the individual; e) Provision of infrastructure for health promotion. Analyzes of the effectiveness of preventive activities represent a systematic assessment of the impact of public health policies, programs and practices on health outcomes. Based on them, it is possible to create basic recommendations related to public health programs, guidelines for prevention and control, and making decisions about the allocation of available funds.

Background: Depressive disorder is characterized by a persistent low mood (sadness, irritability, or emptiness) or a loss of pleasure, accompanied by other cognitive, behavioral, or neurovegetative symptoms that significantly impair a person's ability to function. Anxiety and fear-related disorders are marked by excessive anxiety and fear, which lead to behavioral disturbances and cause significant distress or impair personal, family, social, educational, occupational, or other key areas of functioning. Objective: The aim of this study was to analyze whether there are differences in the development of depressive symptoms between COVID-19 patients and patients with symptoms of the flu or common cold. Methods: This is a prospective study that included sixty participants: thirty with COVID-19 and thirty without COVID-19. Data were collected from the ambulatory observational records of participants, documenting their symptoms. We analyzed the relationship between variables such as age, sex, education, and the level of potential depression. The participants were divided into two groups: one consisting of individuals with COVID-19 and the other of individuals without COVID-19. All participants were male and female, aged between 40 and 65 years, and had no previous history of depressive disorder. The first group consisted of patients with COVID-19 who were treated at home but were examined at our outpatient clinic and subsequently sent home. Results: Statistical data processing was performed using the Excel program and the R statistical data processing program. Percentages are calculated in relation to 30 respondents in each group.There was no statistically significant correlation between the level of education in Group 1 and the development of depression(Spearman ro=0.007, P=0.972). In Group 1 (Covid ) there is a statistically significant correlation between the age of the subjects and the development of depression (Spearman ro=0.44, P=0.015). A positive value of the Spearman correlation coefficient means that the score increases with the age of the respondent. Three questions with the highest score in group 1 were: Question 2=71, Questions 15 and 16=66, Question 14=65; three questions with the highest score in group 2 were: Question 2=74, Question 1 =50, Question 18=46. Conclusion: COVID-19 can contribute to the development of depression. In our study, 16.7% of patients with COVID-19 showed signs of depression, with 10% experiencing mild depression and 6.7% experiencing moderate depression. Patients in the first group, particularly those of older age, were more likely to develop mild or moderate depression associated with COVID-19. Additionally, no statistically significant correlation was found between the level of education in Group 1 and the development of depression.

The Balkan Peninsula is one of Europe?s major hotspots for plant biodiversity. Although the rich flora of the Balkans has been exten?sively studied from many points of view, genome size studies have received comparatively little attention. This paper contributes to the online available Genome Size Database of Balkan Flora (GeSDaBaF; http://www.pmf.unsa.ba/gesdabaf) and updates this database with new bibliographic data on the C-values for plants in the Balkan region. Additionally, 2C DNA values determined by flow cytometry are reported for 87 accessions, encompassing 82 taxa (70 species, 11 subspecies, and one hybrid taxon, 14 of which are endemic to the Balkans and two with amphi-adriatic distribution) across 63 genera and 31 families. The newly obtained genome size values include the first data for one genus, 25 species, eight subspecies, and one hybrid taxon. These new data represent 9.99% of the 821 taxa for which nuclear DNA content has been assessed in the Balkans to date, highlighting existing knowledge gaps for future research.

Background: Coeliotomy in chelonian species is performed to gain access to the abdominal cavity and requires general anesthesia. In reptile medicine, alfaxalone and propofol are often preferred, although the usage of these drugs is limited by cost and/or vascular access. Furthermore, according to a recent study, propofol produces significant oxidative stress in red-eared sliders (Trachemys scripta elegans), and in such cases, a ketamine and medetomidine combination may provide a better choice. Case description: Three owned red-eared sliders were separately presented with a history of recent lethargy, inappetence, dyspnea, and restlessness. Findings/treatment and outcome: In these three cases of chronic dystocia, a ketamine and medetomidine combination was used to achieve anesthesia induction for surgical treatment. Additionally, intrathecal administration of lidocaine was performed to achieve a potential analgesic effect in deeper intracoelomic reproductive organs. Preoperative changes in blood parameters were observed in one animal, suggesting abnormal kidney function. The same animal showed signs of resedation postoperatively, prolonged recovery, and had a fatal outcome 48 h after the surgery with signs of kidney damage in histopathological evaluation. In the recovery period, none of the surviving animals (n=2) showed neurological or respiratory complications that could be associated with subcarapacial sinus anesthesia administration or intrathecal local anesthesia. Conclusion: According to our observations, intrathecal lidocaine administration provided sufficient analgesia during prefemoral coeliotomy and reproductive organ manipulation. These modes of anesthesia in chelonians require further investigation.

The aim of this study was to analyze the clinical course and outcome of the disease in patients with chronic obstructive pulmonary disease (COPD) who were hospitalized at the Clinic for Infectious Diseases of the University Clinical Center of the Republic of Srpska (UCCRS), in the period from November 30, 2024 to April 1, 2025, due to confirmed influenza. The study included 125 hospitalized patients with microbiologically confirmed influenza. Among them, 20.8% had COPD, of which 48% were male and 52% female, with an average age of 68.6 years and the majority had influenza A (76%), while 24% had influenza B. The mortality rate among patients with COPD was 8%, compared to 32% in patients without COPD. Laboratory findings showed higher levels of C-reactive protein and procalcitonin in patients with COPD, indicating a more pronounced inflammatory response. Additionally, COPD patients had higher levels of D-dimer, suggesting an increased tendency toward thrombosis. Radiological analyses revealed various forms of pneumonia, with 48% of COPD patients showing negative radiological findings despite elevated CRP levels. Oxygen therapy and de-obstructive treatments were more frequently administered in COPD patients, while antibiotics were included in the treatment of all COPD patients. The results suggest the need for a specific therapeutic approach in this group of patients patient group. Also, vaccination against influenza is a key preventive measure that can prevent influenza, reduce the severity of the disease if it occurs, and improve the outcome, especially in patients with COPD, who are more susceptible to more serious complications.

Background: Seasonal flu represents a significant public health challenge and cause of morbidity and mortality, especially among vulnerable populations. The aim of our study is to describe demographic and clinical characteristics of patients hospitalized for laboratory of confirmed influenza during the 2024/2025. season.Methods: The data of patients hospitalized in the Clinic for infectious diseas of the University Clinical Center of the Republic of Srpska from December 2024 to March 2025 were restrospectively analyzed. The diagnosis of influenza was confirmed by PCR testing from a nasopharyngeal swab. Data were collected on age, sex, comorbidities, laboratory findings, therapy, the need for oxygen support and mechanical ventilation, the outcome of treatment.Results: A total of 175 patients, average age 63, were hospitalized. Influenza A was confirmed by PCR test in 78 (44.6%), and Influenza B in 20 patients (11.4%). The most common symptoms on admission were fever, cough and muscle pain. Chronic diseases were present in 155 patients (88.6%), while only 12 patients (6.9%) were vaccinated against influenza. Pneumonia was radiographically diagnosed in 102 patients (58%). Antiviral therapy was used in 160 patients (91.4%). 54 patients (30.9%) required oxygen support, while 7 patients (4%) were on mechanical ventilation. A fatal outcome was recorded in 8 patients (4.6%).Conclusion: Low vaccination rate and high proportion of chronic diseases among the hospitalized indicates to patients the need for stronger vaccination promotion and early intervention in risk groups. Timely diagnosis and adequate therapy remain key factors in prevention of severe forms of disease and reduction of mortality.

Background: Medical deontology rests on two of its pillars. One is medical ethics, and the other is medical law, i.e. legal regulations that regulate work on health protection and improvement. Ethics is of exceptional importance for medicine, due to the specificity of its calling. Objective: The aim of this article was to explaine the role of medical ethics and medical right in the healthcare professional praxis. Methods: The author used important scientific and professional literature regarding medical deontology, medical ethics and medical low published in the books, monographs and papers deposited in the scientific indexed databases PubMed Central, HINARI, Embase, etc. Results and Discussion: The specificity stems, first of all, from the fact that medicine deals with human life and health, which, in itself, carries a great responsibility. The relationships established between medical professionals and patients are also specific. In this relationship, the patient is in a subordinate and dependent position, which creates preconditions for his abuse. Due to the nature of the work, it is difficult to establish external supervision or control in order to prevent these abuses. This in turn emphasizes the importance of internal supervision and control with the help of medical ethics. Medical ethics sensitizes medical professionals to problems of an ethical nature and helps them recognize and solve them. Medical ethics is, in fact, a set of principles or rules of conduct that a medical professional must follow when making decisions about what is right and wrong, what is permitted and prohibited, what is good and bad for the patient, but also for the community. Making these decisions is often not easy. Conclusion: There are ethical principles that can conflict, which leads to ethical dilemmas, which are sometimes difficult to resolve. Take, for example, the obligation of a doctor to take into account the interests of the patient and to maintain his medical confidentiality. At the same time, however, he must also take care of the interests of the community or other persons. There are cases when the health, and even the lives of those other persons, could be endangered without revealing the medical confidentiality. Medical ethics helps resolve such and similar dilemmas.