We prove fixed point theorems for mixed-monotone mappings in partially ordered complete metric spaces which satisfy a weaker contraction condition than the classical Banach contraction condition for all points that are related by given ordering. We also give a global attractivity result for all solutions of the difference equation , where satisfies mixed-monotone conditions with respect to the given ordering.

Dietary interventions with protein and salt restriction, good glucose control, smoking cessation, aggressive blood pressure control, good control of cholesterol and triglycerides, use of ACE inhibitors and ARBs can delay the progression of diabetic nephropathy. The aim of this study was to present the effects of aggressive treatment of the multiple risk factors for diabetic nephropathy on proteinuria in patients with type 2 diabetes. In this study we included 15 patients with diabetes type 2 and insufficient regulation of glycaemia. The patients were followed for three months period. Glycated haemoglobin (HbA1c), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), blood pressure, cholesterol and triglycerides and proteinuria were followed prior and after the study. Prior the study patients were treated with premix insulin divided in two daily doses + metformin after the lunch and they had insufficient regulation of glycaemia. During the study patients were treated with one daily dose of basal insulin, three doses of metformin (2550 mg), one daily dose of atorvastatin (20 mg) and one daily dose of ramipril (5 to 10 mg). Doses of insulin were titrated separately for each patients (0,7-1,0 IU/kg). Patients were advised to start with lifestyle modification, increased physical activity and dietary interventions with protein and salt restriction, energy restricted diet and smoking cessation. A total of 20 patients (male 12 and female 8) with diabetes type 2 were studied. The mean age of the subjects was 53+/-5,25 years. The mean diabetes duration was 4,05+/-1,96 years. The mean body mass index decreased from 28,1+/-1,67 kg/m2 to 25,9 +/-1,22 kg/m2 after the study. Mean HbA1c decreased from 8,82 +/- 0,53 % to 7,15 +/- 0,23 % (p<0,05). Mean fasting glycemia decreased from 8,79+/-0,58 mmol/dm3 to 7,03+/-0,18 mmol/dm3 (p < 0,05). Mean postmeal glycemia decreased from 9,93 +/- 0,77 mmol/dm3 to 7,62 +/- 0,42 mmol/dm3 (p<0,05). The mean cholesterol level decreased from 7,99 +/-0,64 mmol/dm3 to 5,93 +/- 0,65 mmol/dm3 (p<0,05). The mean triglicerides level decreased from 4,05 +/- 0,97 mmol/dm3 to 1,96 +/- 0,24 mmol/dm3 (p<0,05). The significant decrease of proteinuria was recorded, prior the study the mean albuminuria was 1,05 +/- 0,31 g/dm3 and after the study was 0,07 +/- 0,145 g/dm3 (p<0,05). Mean blood pressure prior the study was 153+/-8,69/91,5 +/- 3,78 mm Hg (p<0,05), after the study was 125 +/- 6,32/ 79,25+/-3,26 mmHg. Effective control of glycaemia, blood pressure, cholesterol and triglycerides, use of ACE inhibitors, dietary interventions with protein and salt restriction, smoking cessation, can delay the progression of nephropathy in type 2 diabetes.

UNLABELLED We aimed to determine whether the administration of statins to type 2 diabetics without pre-existing CHD reduced the incidence of CHD and their effects on cholesterol and CRP levels. All the participants were carefully interviewed, clinically examined, and laboratory tested to exclude conditions likely to provoke an inflammatory response that was an exclusion criterion. EXCLUSION CRITERIA Serious heart, liver or kidney problems, history of renal transplant, recent history of drug or alcohol abuse, HbA1c>10%, blood pressure >140/90 mmHg, BMI >35 kg/m2, triglycerides >3,0 mmol/dm3. 95 obese diabetics (mean age 60,9 years and BMI=31,59 kg/m2, diabetes duration more than 10 years) without pre-existing CHD, were included in the analysis and were randomized to simvastatin (25 female and 20 male used 40 mg simvastatin daily) or placebo (30 female and 20 male) group. After six months, simvastatin significantly lowered CRP levels by 19%, (p<0,01), cholesterol levels by 18%, TG levels by 8%, LDL levels by 20% and VLDL levels by 17%, whereas there was no change with placebo. After one year the difference sustained between groups. Coronary events were rarely in the simvastatin group (6,6%) than in the placebo group (14%). Coronary revascularizations were 4 in the placebo group and 1 in the simvastatin group. Rate of stroke was more often in the placebo group (18%) than in the simvastatin group (8,8%). So, reduction of acute CHD events is for 7,4% in the simvastatin group. Positive correlation was between CRP and CVD (r=0,29). Statin therapy reduced the risk of coronary heart disease in diabetics without CHD.

The aim of our work is to determine the total number, age, gender of the patients with the symptomatic epileptic seizures associated with brain tumours, tumour location, clinical signs and characteristics of epileptic seizures. We have analyzed medical documentation of the patients with brain tumours hospitalized at the Department of Neurology, University of Sarajevo Clinics Centre. This study is retrospective and includes time period from 1st January 2000 until 31st December 2005. During the observed period at the Department of Neurology in Sarajevo there were in total 9753 hospitalized patients, from which 101 (1,1%) patients with the brain tumour diagnosis. Average patient's age was 62,60 +/- 1,28 years. In one third of the patients (32%) were recorded epileptic seizures, without significant difference between genders. In case of symptomatic epilepsy, significantly more frequent locations of tumours were: in several lobes (28%), parietal lobe (25%), as well as frontal and temporal lobe (18,8% each), while there were no changes in cerebellum and brain stem (chi2 =7,174, p<0,05). The most prominent signs of illness in our sample were hemiparesis with the cranial nerves lesion (56,3%), speech problems (25%). Normal neurologic findings were significantly more frequent among patients with the symptomatic epilepsy (chi2 =6,349, p<0,05). The most often was a single seizure (59%), in 38% of cases there were recorded series of seizures, and only 3% of patients had status epilepticus. In relation to the type of seizures, the most often are simple partial seizures with or without secondary generalization (66%), than generalized convulsive (31%), and the rarest one are complex partial seizures (3%). Symptomatic epilepsy in case of brain tumours occurs in one third of patients, at older age, and in both genders. The lesion usually affects several lobes and cause simple partial seizures with or without secondary generalization. The most often clinical signs in case of all brain tumours are cranial nerves lesion and hemiparesis, while the normal neurologic findings are significantly dominant in the group of patients with the epileptic seizures.

The aim of this paper was to prove the relation between serum lipid values (cholesterol, triglyceride, low density cholesterol, high density cholesterol and primary open -angle glaucoma. The study includes two patient groups: 50 patients with primary open-angle glaucoma and 50 patients without this disease. However, all 100 patients were tested for serum lipid values. The research covered a period of six months (from May to December 2007.). Primary open-angle glaucoma was diagnosed with intraocular pressure values (between 20,1 and 25,6 mm Hg) measured with Schiotz tonometry. The visual field changes were confirmed with Goldmann perimetry. The gonioscopies were done for diagnosis confirmation. The serum lipid values were confirmed with enzymatic colorimetry in vitro method. U-test (Mann-Witney-Wilcox test) and t-test, as nonparametric tests, were used for statistical evaluations. The cholesterol mean value in the test group was 6,14 mol/dm (3) (3,20-8,10 mol/dm (3)) whereas in the control group it was 5,96 mol/dm(3) (2,70-8,80 mol/dm(3)). U-test was with negative ranks (z=-0,83 AS=0,678). The triglyceride mean value in the test group was 2,38 mol/dm (3) (0,84-11,73 mol/m (3)) and in the control group it was 2,04 mol/dm (3) (0,63-5,89 mol/dm(3)). U-test was with positive ranks (z=0,950 AS=0,342). High density cholesterol was average in the test group with 1,45 mol/dm (3) (0,71-3,40 mol/dm (3)) and in the control group 1,40 mol/m (3) (0,80-3,20 mol/dm (3)). Low density cholesterol in the test group was 3,98 mol/m (3) (1,82-6,49 mol/m (3)) and in the control group 4,08 mol/m (3) (2,69-5,69 mol/m (3)). These results had positive ranks according to U-test. Serum lipid values could be one of predictable factors in primary open-angle glaucoma diagnosis. Due to the patient age, cholesterol values, as common factors in primary open-angle glaucoma and atherosclerosis genesis, could be concern in the same aetiology based on dyslipidaemia as well.

Intrahospital infections (IHI) and antibiotics resistance are the problems which exist in virtually all hospitals in the world. The main aim of the present research is establishing of epidemiological surveillance over occurrence of IHI at the Clinic for Gynaecology and Obstetrics at the University Clinical Center Tuzla and thus identifies: types of bacteria which cause IHI, types of infection according to anatomical localization and research resistance organisms causing of IHI on antimicrobial drugs. A study was implemented on all patients admitted to Clinic for Gynaecology and Obstetrics during the period of one year and who subsequently developed infection. Determination of intrahospital infections was done according to criteria defined by the Centres for Disease Control and Prevention from the United States. The results of our work have shown that both urinary tract infections and surgical site infections are the most frequent. As IHI causers the most found are gram-negative organisms (73,7%), such as Escherichia coli (29,8%), right after that Klebsiella pneumoniae (24,6%), Pseudomonas aeruginosa (14%) and Proteus mirabilis (5,3%) (p<0,05). Gram-positive organisms as causers of IHI are registered in 26,3% cases. Out of that Streptococcus species are isolated in 10,5% cases, Staphylococcus aureus (8,8%) and coagulasa negative staphylococci (7%) (p>0,05). High percent resistance of bacteria was evident to beta-lactams, aminoglycosids and cephalosporin's of third generation. Gram-positive organisms were 100% sensitive to vancomycin, while gram-negative organisms manifested the high percent of sensibility to imipenem and cefepime.

HNPCC (Hereditary non-polyposis colorectal cancers) development is caused by mutation of genes included in system of mismatch repair genes. The mutation exists at 60% of patients in hMSH2 gene, 30% in hMLH1 and 10% both in hPMS1and hPMS2 genes. RER+ exists in about 90% in hereditary non-polyposis colorectal cancer and about 15-28% in sporadic cancers. The purpose of the study was to determine highly sensitive microsatellite markers which can be fast and efficient way of microsatellite screening for detection of HNPCC patients. Moreover, we have analysed the loss of heterozygosity of tumour suppressor genes which could have the diagnostic value in detection of HPNCC patients.

Tennis elbow (Epicondylitis humeri radialis) is the most frequent reason that patients with elbow pain report to a physician. The exact cause of elbow pain is still unclear. However, it is certainly causally connected with connective intersection between forearm muscle and bone in the elbow region. In this paper, we analyzed patients that, over the period of 15 years, reported to "Praxis" clinic for elbow pain treatment (Epicondylitis humeri radialis). Of the total number of 228 patients, 126 were male, 101 female while one patient was younger than 14. Initial analysis established that average overall health condition grade was 2,87 at the onset of treatment. Following the treatment completion that grade was 4,48. Of the total number of 223 patients who were treated by combined method of manipulation and local corticosteroid instillation, eight patients received physical therapy as well. Thus, surgical treatment was not necessary in any patient. The patients' treatment included: 1. Application of manipulative methods in order to reestablish mobility in the "blocked" radio-humeral and the upper radio-ulnar joints. 2. Local instillation of corticosteroid depot in order to control inflammation (enthesitis) and thus, eliminate pain and establish physiological conditions for functioning of joint and local structures. Unlike conservative method which includes initial immobilization due to irritation and inflammation development prevention with concomitant analgesic and antirheumatic therapy, initial application of manipulation with reinstatement of joint mobility instead of immobilization with subsequent instillation of steroid preparations achieves functional restitution and fast reinstatement of full working ability, as a rule.

Betulae cortex, Betula pendula Roth., Betulaceae, comprise triterpene substances which are confirmed to posses very important pharmacological activities such as anti-inflammatory, anticancer and antiviral. In this study, extraction of triterpene substances from both, inner and external birch bark was carried out and after that qualitative analysis on betulin, betulinic acid, oleanolic acid and lupeol was performed by method of thin layer chromatography. By this separation method, applying system for development benzene-ethyl acetate-formic acid (36:12:5), is gained a good separation of examined triterpene substances from methanol extracts of inner and external birch bark as well as used standards. From obtained row triterpene mixtures, certain triterpene substances are isolated using method of dry column chromatography. To those substances infrared (IR) spectra were recorded and compared with IR spectra of adequate standards. The study encloses all obtained IR spectra and interpretations on the basis of which can be concluded that triterpene substances, betulin, betulin acid and lupeol isolated from external birch bark give identical characteristic signals and absorbance as referent standards. Method of dry column chromatography has resulted as simple, efficient, repeatable and economical for laboratory conditions. Beside this, a sufficient quantity of examined triterpene substances is also obtained for continuation of their further analytical analysis.

Dissolution rate of two fluoroquinolone antibiotics (ciprofloxacin and moxifloxacin) was analysed in presence/absence of three antacid formulations. Disintegration time and neutralisation capacity of antacid tablets were also checked. Variation in disintegration time indicated the importance of this parameter, and allowed evaluation of the influence of postponed antacid-fluoroquinolone contact. The results obtained in this study showed decreased dissolution rate of fluoroquinolone antibiotics from tablets in simultaneous presence of antacids, regardless of their type and neutralisation capacity.

Sandfly fever viruses (SFV) are endemic in the Mediterranean, Middle East, northern African and western Asian countries. Toscana virus (TOSV), serotype of Sandfly fever Naples virus, is among of the three most prevalent viruses associated with meningitis during the warm seasons in northern Mediterranean countries. The historical data of the sandfly fever (Pappataci fever) indicates its origin in Bosnia and Herzegovina at the end of 19th century. There is a long period of time for which there are no data on research related to the SFV in Bosnia and Herzegovina. The purpose of the study was to investigate the presence of sandfly fever in Bosnia and Herzegovina in recent years. The 68 of serum samples were obtained from February 2006 until September 2008 from a group of patients with febrile illness of unknown etiology. The sera were tested on the presence of IgG and IgM antibodies against TOSV by specific serology test- recomLine Bunyavirus IgG/IgM immuno-line assay. The recent TOSV-infection was confirmed in the patients in each year during the study: 10,71% (3/28) in 2008; 9,38% (3/32) in 2007 and 12,50% (1/8) in 2006. The presence of specific antibodies to TOSV in the sera of the patients in recent years indicates re-emerging character of the disease in this region. It would be necessary to make biological, epidemiological and clinical research on the TOSV and related phleboviruses to elucidate the problem of SFV in Bosnia and Herzegovina.

Cerebrovascular accident is a focal neurological deficiency occurring suddenly and lasting for more than 24 hours. The purpose of our work is to determine the role of the functional electrical simulation (FES) in the rehabilitation of patients with hemiparesis, which occurred as a consequence of a cerebrovascular accident. This study includes the analysis of two groups of 40 patients with hemiparesis (20 patients with deep hemiparesis and 20 patients with light hemiparesis), a control group which was only treated with kinesiotherapy and a tested group which was treated with kinesiotherapy and functional electrical stimulation. Both groups of patients were analyzed in respect to their sex and age. Additional analysis of the walking function was completed in accordance with the BI and RAP index. The analysis of the basic demographical data demonstrated that there is no significant difference between the control and tested group. The patients of both groups are equal in respect of age and sex. After 4 weeks of rehabilitation of patients with deep and light hemiparesis there were no statistically significant differences between the groups after evaluation by the BI index. However, a statistically significant difference was noted between the groups by the RAP index among patients with deep hemiparesis. After 8 weeks of rehabilitation the group of patients who were treated with kinesiotherapy and functional electrical stimulation showed better statistically significant results of rehabilitation in respect to the control group with both the BI index and the RAP index (p<0,001). In conclusion, we can state that the patients in rehabilitation after a cerebrovascular accident require rehabilitation longer than 4 weeks. Walking rehabilitation after stroke is faster and more successful if we used functional electrical stimulation, in combination with kinesiotherapy, in patients with disabled extremities.