<p><strong>Aim </strong>To determine the outcome of pregnancies in women whose pregnancies resulted from in vitro fertilisatio (IVF) procedure.</p> <p><strong>Methods </strong>This a retrospective cohort study was conducted at the Clinic for Gynecology and Obstetrics, University Clinical Center Tuzla, Bosnia and Herzegovina. Data from the delivery protocol were analyzed over a five-year period, from January 1, 2019, to December 31, 2023. A total of 257 deliveries from IVF pregnancies were analyzed, constituting the study group, while the control group consisted of an equal number of women with spontaneously conceived pregnancies. The following data were analyzed: baseline obstetrics and neonatal characteristics, and presence of complications during pregnancy and delivery.</p> <p><strong>Results </strong>The average age of pregnant women was higher in the study compared to the control group (p=0.001). The average body weight and body length at birth were lower in the study group (p=0.001). The twin pregnancies were more frequent in the study group (p=0.0001). In the study group it was recorded largest number of primiparous women (p=0.0001). It was found higher number of newborns with Apgar scores <7 at the first and fifth minutes in the study group (p=0.0001). There were higher prevalence of preterm births and cesarean section in the study group (p=0.0001). Fetal asphyxia and breech presentation were more prevalent in the study group (p=0.008 and p<0.0001).</p> <p><strong>Consclusion </strong>Pregnancies resulting from IVF were still riskier than those resulting spontaneously.</p>
<p><strong>Aim:</strong> To investigate the impact of three-dimensional (3D) printing technology on vascular surgery, focusing on its role in preoperative planning and surgical training.</p> <p><strong>Methods:</strong> A systematic review was conducted of studies published between 2017 and 2024 that evaluated 3D printing in vascular surgery. Databases searched included MEDLINE and CENTRAL. Eligible studies reported applications of 3D printing in preoperative planning, simulation, or surgical education.</p> <p><strong>Results:</strong> Analysis of relevant studies revealed that 3D-printed vascular models improved surgical precision, reduced fluoroscopy time, enhanced technical skill acquisition, and increased trainees’ confidence. Models based on computed-tomography angiography data provided accurate, patient-specific anatomy for classic or endovascular aortic aneurysm repair and other vascular procedures.</p> <p><strong>Conclusion:</strong> 3D printing significantly enhances vascular-surgery training and preoperative preparation by providing realistic, patient-specific simulations that improve both technical competence and surgical outcomes.</p> <p> </p>
<p><strong>Aim T</strong>o describe the clinical picture and laboratory findings, as well as to examine the significance of novel hemogram-derived inflammatory indices in adult patients with measles admitted to a tertiary hospital.</p> <p><strong>Methods </strong>This prospective, descriptive, and analytical study included adult patients over 18 years of age with clinical signs of measles, admitted at the Clinic for Infectious Diseases, Clinical Center of Sarajevo. Upon admission, medical history, physical examination, and laboratory analyses were conducted from February 2024 to 31 December 2024.</p> <p><strong>Results </strong>The study included 124 patients, 52 men and 72 were women with a mean age of 38.33±13.18 years. The most common symptoms in most patients were rash (95.97%) and cough (69.36%). Neutrophilia (63.7%) and lymphopenia (74.19%) were the main hematological features along with elevated C-reactive protein (CRP) (95.17%) and transaminase (75%) in the vast majority of patients. The results of laboratory analyzes also indicated hyponatremia and hypokalemia, with elevated values of the enzymes creatine kinase (CK) and lactate dehydrogenase (LDH). The CRP, as the most commonly elevated laboratory parameter, showed positive, significant correlation with Neutrophil/Lymphocyte ratio (NLR), Systemic Inflammation Response Index (SIRI) (p<0.05) and Systemic immune-inflammation index (SII) and Aggregate Index of Systemic Inflammation (AISI) (p<0.01).</p> <p><strong>Conclusion </strong>Adult measles was associated with significant inflammation, hematologic changes, and organ involvement, with CRP showing strong correlations with hemogram-derived indices. These findings suggesting that they may be useful in diagnostics of measles.</p>
Irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO) share symptoms such as abdominal pain, bloating, and altered bowel habits. Both are linked to dysbiosis and gut–brain axis dysfunction. IBS is a multifactorial disorder characterized by abnormal motility, visceral hypersensitivity, low-grade inflammation, and alterations in the microbiota. In contrast, SIBO is defined by excessive bacterial colonization of the small intestine that can mimic or worsen IBS symptoms. Gut microbes and their metabolites influence motility, immune activation, barrier integrity, and gas production; methanogen overgrowth is associated with constipation-predominant presentations, while hydrogen- and hydrogen sulfide-related pathways may contribute to diarrhea and bloating. Because recurrent or empiric antibiotic use is common—particularly in suspected SIBO—yet carries risks of resistance, microbiome disruption, and relapse, there is a strong rationale to prioritize effective non-antibiotic strategies. Accordingly, this review synthesizes current evidence on IBS/SIBO pathophysiology and microbiota interactions. It evaluates non-pharmacological interventions including dietary approaches, probiotics/prebiotics, herbal therapies, and mind–body treatments (e.g., cognitive behavioral therapy and gut-directed hypnotherapy). We emphasize an integrative framework that supports symptom control and quality of life while helping reduce unnecessary antibiotic exposure.
<p><strong>Aim</strong> Many studies have demonstrated that over half of the World's population is infected with <em>Helicobacter pylori (H. pylori)</em>. To evaluate the current <em>H. pylori</em> seroprevalence in Bosnia and Herzegovina (B&H), <em>H. pylori </em>antibodies (immunoglobulin G, IgG) from patients with suspected presence were analyzed.</p> <p><strong>Methods </strong>In total, 201/471 (42.7%) males and 270/471 (57.3%) females were enrolled between June 2024 and July 2024. They were tested using the enzyme-linked immunosorbent assay (ELISA) method.</p> <p><strong>Results</strong> The overall seroprevalence of <em>H. pylori</em> infection was 214 (out of 471; 45.4%) and did not differ in relation to sex. The seroprevalence rate of <em>H. pylori</em> was highest in the 50–69 age group, 81 (out of 137; 59.1%; 95% CI: 2.2–5.6), followed by the ≥70 age group, 17 (out of 31; 54.8%; CI: 2.0–6.7), and the 30–49 age group, 101 (out of 219; 46.1%; 95% CI: 1.7–4.3). The lowest seroprevalence rate was in the younger age group (≤29) with 15 (out of 84; 17.8%). Older age groups were more likely to be <em>H. pylori</em> positive and equivocal, while younger age groups negative for <em>H. pylori</em> infection.</p> <p><strong>Conclusion </strong>This single-center study is the first study providing information on the <em>H. pylori</em> seroprevalence in the B&H population and investigating its association with age and sex. Further research is needed to explore other risk factors and to develop effective ways to reduce the burden of this infection.</p>
<p><strong>Aim </strong>To identify predictors of all-cause mortality and 6-month rehospitalisation in patients with hypertensive crisis, focusing on inflammatory indices, metabolic markers measured at admission, and antihypertensive treatment profiles.</p> <p><strong>Methods </strong>This prospective observational study included 210 adult patients with hypertensive crisis. Demographic, clinical, and therapeutic data were collected, including data on comorbidities, antihypertensive drug use, and treatment adherence. Laboratory parameters obtained at admission included neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), homocysteine, and uric acid. Patients were followed for 12 months. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were conducted to identify independent predictors.</p> <p><strong>Results </strong>Mortality occurred in 10.9% of patients, and 27.1% were rehospitalised within 6 months. Deceased patients exhibited significantly higher levels of PLR (p=0.0329), SII (p=0.0355), homocysteine (p=0.0488), and uric acid (p=0.021). In multivariate analysis, homocysteine (OR=3.55; p<0.001), uric acid (OR=1.03; p=0.007), PLR (OR=1.04; p=0.047), and SII (OR=1.01; p=0.030) remained independently associated with mortality. Chronic kidney disease (OR=2.15, p=0.012) and poor treatment adherence (OR=1.92; p=0.017) were also significant predictors. ROC analysis demonstrated moderate discriminative power, with AUC values of 0.68 for PLR, 0.66 for SII, 0.65 for homocysteine, and 0.63 for uric acid.</p> <p><strong>Conclusion</strong> Elevated inflammatory indices and metabolic markers, particularly homocysteine and uric acid, were independently associated with increased mortality risk. Additionally, chronic kidney disease and suboptimal adherence to antihypertensive therapy significantly contributed to adverse outcomes. These findings underscore the importance of comprehensive risk assessment and personalised management in this high-risk population.</p>
<p>Aim:</p> <p>To assess the impact of cognitive impairments on various domains of quality of life in patients with multiple sclerosis (MS).</p> <p>Methods:</p> <p>This prospective study included 135 MS patients and 50 healthy controls. Participants were divided into three groups: patients with MS for more than one year (n=85), newly diagnosed MS patients (n=50), and healthy individuals (n=50). Neurocognitive assessments included the Mini-Mental State Examination, Wechsler Intelligence Scale, Revised Beta Test, Raven's Coloured Progressive Matrices, Wechsler Memory Scale, Rey-Osterrieth Complex Figure Test, Verbal Fluency Test, Audio-Verbal Learning Test, and the SF-36 Quality of Life Scale.</p> <p>Results:</p> <p>Cognitive impairments were present in 40–60% of MS patients, with memory dysfunctions being the most prominent (30–60%). Longer disease duration was associated with poorer visuospatial, visuoconstructive, and attention-related abilities. Patients also showed reduced logical and working memory. Quality of life was significantly lower in MS groups compared to controls, with a notable correlation between cognitive impairment and decreased MMSE scores.</p> <p>Conclusion:</p> <p>Cognitive impairments in MS patients, particularly those affecting memory, executive functioning, and attention, significantly reduce quality of life. Cognitive testing should be considered essential in assessing disease severity and treatment planning.</p> <p style="text-align: justify; text-justify: inter-ideograph; line-height: 150%;"><strong> </strong></p>
<p><strong>Aim:</strong>Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal neoplasm of intermediate biological potential, characterized by spindle cell proliferation and significant inflammatory component. This study aimed to determine the clinicopathologic characteristics, the clinical outcomes of inflammatory myofibroblastic tumor cases in the low-volume pediatric surgery service in a developing country.</p> <p><strong>Materials and methods: </strong>The study included data from all IMTcases diagnosed and operated from 2010 to 2024 at the Clinic of Pediatric Surgery, Clinical Center University of Sarajevo. <strong>Results:</strong> Three pediatric patients (two females, one male) diagnosed with IMT were analyzed for demographic, clinical, histopathological, immunohistochemical, and outcome parameters. All tumors were located in the abdominal or abdominopelvic region, with a median patient age of 4 years. Clinical manifestations included non-specific gastrointestinal symptoms (n=2) and systemic signs such as fever (n=2), weight loss and weakness (n=1). Complete surgical resection was conducted in all patients, and all experienced complete remission without recurrence. Histopathological analysis revealed consistent presence of spindle cells within a prominent inflammatory milieu, rich in plasma cells and lymphocytes. Immunohistochemically, all tumors were positive for vimentin, ALK, and SMA, while ALK-FISH analysis (performed in one case) was negative. No significant nuclear atypia or mitotic activity was observed.</p> <p><strong>Conclusion:</strong> Our study showed the constant of its heterogeneous morphology, and significance of IMTs immunophenotype, particularly in older children, where the inflammatory component is more pronounced. ALK gene alterations are commonly associated with IMT, as well as with other types of pediatric neoplasms, however, favorable outcomes in our cohort study, raise question regarding further need to clarify the prognostic significance of molecular findings and their potential therapeutic implications.</p>
<p><strong>ABSTRACT</strong></p> <p><strong>Aim </strong>To examine the association between metabolic parameters and novel cardiometabolic indices with the coronary artery calcium score (CACS).</p> <p><strong>Methods: </strong>This retrospective cross-sectional study included 130 patients who underwent coronary computed tomography angiography (CCTA) at the Radiology Clinic of the Clinical Centre of the University of Sarajevo between January and June 2024.<strong> </strong>Patients were classified into two groups: those with CACS ≤100 and those with CACS >100.<strong> </strong>Platelet count, mean platelet volume (MPV), estimated glomerular filtration rate (eGFR), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), uric acid (UA), and novel cardiometabolic indices, including Castelli risk index I and II (CRI-I and CRI-II), non-high-density lipoprotein cholesterol (non-HDL-C), were compared between the groups.</p> <p><strong>Results </strong>Patients with CACS >100 had significantly higher MPV, TC, LDL-C, UA, non-HDL-C, CRI-I, CRI-II, and the UA/eGFR ratio. Older age, increased platelet activity, dyslipidemia, hyperuricemia, and the higher UA/eGFR ratio correlated positively with CACS, whereas eGFR correlated negatively. In multivariate regression analysis, the UA/eGFR ratio emerged as an independent predictor of higher CACS (OR = 2.37; 95% CI 1.18–4.78; p=0.017).</p> <p><strong>Conclusion </strong>Elevated UA levels and adverse cardiometabolic indices are associated with greater coronary artery calcification. The UA/eGFR ratio independently predicts higher CACS, highlighting its potential prognostic value.</p> <p><strong>Keywords: </strong>coronary angiography, glomerular filtration rate, uric acid, vascular calcification</p>
Understanding and comparing tumor evolutionary histories is fundamental to cancer genomics. Clonal trees, used to model tumor progression, are rooted, unordered trees in which each node represents a subclone labeled by a set of distinct mutations. To compare two clonal trees, we introduce omlta, the optimal multi-label tree alignment, which removes the minimum number of mutation labels from the trees, so that the remaining trees are isomorphic. Computing omlta is NP-hard. Here, we present an algorithm to compute the omlta, with a running time of where L ≥ 1 is the total number of mutation labels occurring in the input trees and k is the minimum possible number of mutation labels that need to be removed for the alignment. Our implementation (https://github.com/algo-cancer/omlta) is the first computational tool for determining the optimal alignment between clonal trees. We applied omlta to 126 cases from the TRACERx study on non-small cell lung cancers and some melanoma single-cell data.
<p><strong>Aim</strong> Vaccine hesitancy challenges global public health, with parental attitudes significantly impacting childhood immunization. This study examined parental perceptions of vaccine safety, effectiveness, and decision-making factors in Bosnia and Herzegovina.</p> <p><strong>Methods</strong> A cross-sectional survey was conducted in March 2025 with 233 parents at a Primary Healthcare Center in Gračanica. A structured questionnaire based on the Parent Attitude about Childhood Vaccines (PACV) assessed sociodemographic data, vaccination experiences, information sources, and attitudes toward vaccines using a Likert scale.</p> <p><strong>Results </strong>Among 233 participants, 195 (83.7%) fully vaccinated their children, 30 (12.9%) practiced selective vaccination, and eight (3.4%) refused all vaccines. Vaccine hesitancy was significantly associated with lower education, (26.3% vs. 5.1%; p<0.001), rural residence (76.3% vs. 48.2%; p=0.002), and having three or more children (34.2% vs. 12.3%; p=0.01). Trust in healthcare professionals strongly influenced behavior, with 178 (91.3%) of parents who fully trusted doctors adhering to the immunization schedule. Concerns about autism were reported by 14 (36.8%) of hesitant parents and were significantly associated with delayed or refused vaccination (p<0.001).</p> <p><strong>Conclusion</strong> Although overall confidence was high, vaccine hesitancy persisted due to perceived risks. Strengthening healthcare communication and addressing misinformation, particularly autism concerns, may help improve vaccine uptake.</p> <p><strong>Keywords</strong><strong>: </strong>health knowledge, immunization program, public health, vaccination coverage</p>
<p><strong>Introduction.</strong> Ruptured abdominal aortic aneurysm (RAAA) is a life-threatening emergency with high mortality. While conventional risk factors are well recognized, emerging evidence suggests environmental temperature may also influence rupture risk. This relationship has not been studied in Bosnia and Herzegovina. The aim of this study is to investigate the association between ambient temperature and RAAA incidence.</p> <p><strong>Methods:</strong> A retrospective observational study was conducted at the Clinical Center of the University of Sarajevo between January 2021 and February 2025. Data from 105 RAAA patients were analyzed using demographic, clinical, and temperature data, with time series analysis assessing patterns around rupture events.</p> <p><strong>Results:</strong> The mean patient age was 71.5 ± 7.6 years; 86.7% were male. The average aneurysm diameter was 85.1 ± 17.7 mm. Hypertension (68.6%), smoking (55.2%), and diabetes (37.7%) were the most prevalent comorbidities. The mortality rate was 38.7%. Most ruptures occurred during colder months, with a peak in January (16.1%) and a low in August, March, and February (each 4.7%). The mean ambient temperature during the 10 days before rupture was 11.41 ± 6.16 °C, not significantly different from the temperature on the rupture day (p = 0.991). However, minimum daily temperature was significantly lower than the mean daily temperature on rupture days (6.48 ± 5.92 °C vs. 11.42 ± 17.61 °C; p < 0.001).</p> <p><strong>Conclusion:</strong> A seasonal RAAA pattern with winter clustering was observed, but no consistent short-term link to ambient temperature was found, warranting further study with advanced models.</p>
<p><strong>Aim</strong> To assess the level of knowledge about risk factors and prevention of lung cancer among medical students, and to identify differences in knowledge based on the year of study and previous secondary education background.</p> <p><strong>Methods</strong> The study was conducted among 223 students of the School of Medicine, University of Zenica, and the School of Medicine, University Clinical Center Tuzla using an anonymous online survey via the Google Forms platform. The collected data were analyzed using descriptive statistics and the χ2 test to assess statistical significance.</p> <p><strong>Results</strong> The majority of students identified smoking as the main risk factor for lung cancer, while air pollution was rated as the most overlooked risk factor. There were significant differences in the perception of neglected risk factors between years of study (p<0.05). Most students from Zenica acquire their knowledge through formal education, while students from Tuzla more often rely on the internet and media (p<0.05). Additionally, 82.5% of students believe that passive smoking is equally harmful as active smoking, with no significant differences between groups.</p> <p><strong>Conclusion</strong> Medical students demonstrate a good level of awareness regarding risk factors and prevention of lung cancer; however, there is a need for greater emphasis on environmental risks and passive smoking in their education. The results highlight the importance of continuous education to ensure that future healthcare professionals are equipped to effectively promote health and prevent this disease.</p>
<p><strong>Introduction:</strong> Environmental factors may influence postoperative outcomes and quality of life following total hip replacement (THR). This study investigated the impact of the geographical location of the surgical site, as well as the patient’s place of birth and residence, on treatment outcomes in individuals with artificial hips.</p> <p><strong>Methods:</strong> A prospective study was conducted involving 280 patients (both genderes; mean age 62 ± 8.8 years) who underwent THR due to primary or secondary hip osteoarthritis. Patients were divided into two groups: Group A (n = 64) included individuals who were not operated on in their place of birth and residence, while Group B (n = 216) consisted of those who were born, resided, and underwent surgery in the same geographical location. Outcomes were assessed using the EQ-5D questionnaire (covering mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), the Visual Analogue Scale (VAS) for pain, and a VAS-based treatment satisfaction scale, administered preoperatively and one year postoperatively. Statistical analysis was performed using Fisher’s exact test (p < 0.05).</p> <p><strong>Results:</strong> Only 22.9% of all patients underwent surgery in their place of birth and residence, mostly for primary hip osteoarthritis. Preoperatively, Group A reported significantly greater limitations in self-care (p < 0.05). One year postoperatively, Group B showed significantly higher VAS scores for treatment satisfaction (p < 0.05).</p> <p><strong>Conclusion:</strong> Patients who underwent total hip replacement in their place of birth and residence demonstrated better postoperative outcomes compared to those who had relocated.</p> <p> </p> <p><strong>Keywords</strong>: arthroplasty; immigrants; quality of life</p> <p> </p>
<p><strong>Aim </strong>Mild traumatic brain injury (mTBI) presents diagnostic challenges, with head computed tomography (head CT) often overutilized in emergency settings. Blood biomarkers such as glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) have shown promise in early injury detection. Aim of this study was to evaluate the diagnostic utility of GFAP and UCH-L1 in identifying intracranial injuries early and potential reduction in unnecessary head CT scans in mTBI patients.</p> <p><strong>Methods </strong>A prospective study was conducted on 102 adult patients with mTBI. Serum levels of GFAP and UCH-L1 were measured within 12 hours post-injury and compared with head CT findings using appropriate statistical analyses.</p> <p><strong>Results </strong>Both biomarkers demonstrated 100% sensitivity and moderate specificity, with high negative predictive value (NPV), supporting their utility in ruling out injuries detectable on CT.</p> <p><strong>Conclusion </strong>GFAP and UCH-L1 are effective early biomarkers for excluding significant intracranial injuries and may help optimize head CT scan utilization in the acute management of mTBI.</p>
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