Background: The Organized health care during Ottoman Empire was poor, and the population of Bosnia looked to the clergy of all denominations, among which the Franciscans play a significant role, for a cure for their ailments, both mental and physical. The Franciscan motto of living, not only for yourself but also for others was, also, reflected in the Bosnian Franciscans’ provision of medical services to people. Objective: The aim of this article was to show, based on the available literature, the development of medicine and pharmacy in Bosnia and Herzegovina from the medieval period until the Second World War with description methods of treatment, medicinal forms and preparations that were used in the mentioned period. Methods: The subject of this study was the development of medicine and pharmacy in the areas of Bosnia and Herzegovina from the 14th century until the Second World War. In order to achieve the set goals, a) Retreival of professional and scientific literature and b) Search of scientific databases and web pages on the Internet that offer adequate and relevant data and historical facts related to the subject of studies were carried out. Most of the facts are covered in previously published articles by the author and deposited in the PubMed and PubMed Central databases, as well as in books and monographs by the author of this text. Results and Discussion: In the Middle Ages, folk medicine was present, in which herbalists looked for medicines in certain plant and animal species. In the 13th century, Bosnia was settled by the Franciscans, who permanently marked the development of medicine and pharmacy. They are educated at prestigious universities abroad, from where they bring their knowledge, skills and recipes and write them in books, which are called ljekaruse (medicine books). Every historical period brought some changes for medicine and pharmacy, so the Ottoman Empire brought customs of frequent cleaning, public fountains and hammams were built. During the reign of the Austro-Hungarian Monarchy, the first hospitals and pharmacies were established, and laws on pharmacy activity were introduced. Written documents on the history of the medicine and pharmacy development in Bosnia and Herzegovina are mostly found in the libraries of monasteries, and a significant number of them are also in the libraries of madrasas, and the National and University Librarie in Sarajevo and the former Institute of Hygiene in Sarajevo. Conclusion: In connection with the medical and pharmacy practice of the Bosnian Franciscans, the question of the various medical records that they created, which helped them in their health efforts, stands out. First of all, we are talking about numerous medicinal books, so called ”ljekaruse”. On the soil of Bosnia and Herzegovina, there were many such “ljekarusa” who mostly grew up at the sources of national experience. In those books, the recipes are mostly based on the use of medicinal herbs. Historians of medicine believe that these medicinal books represent the cultural and historical significance of our regions

Background: A laboratory professional concerned with the quality of work in medical-biochemical laboratories ensures the accuracy and precision of laboratory analyses through the implementation of international and European guidelines for working with hazardous substances, through the availability and implementation of Standard Operating Procedures (SOPs). Laboratory hazards that affect the concentration and safety of workers arise from laboratory deficiencies such as: lack of preventive measures, knowledge and skills implemented through SOPs and good laboratory practice. Biophysical hazards in medical laboratories are manifested by needles and sharp objects, infectious materials, noise, vibration, radiation, poor air quality, temperature inversions. Objective: The aim of the research was to raise awareness of the quality of work in medical-biochemical laboratories in order to ensure the safety of workers. Methods: A cross-sectional questionnaire-based study was conducted among 100 laboratory professionals from Bosnia and Herzegovina (BiH) and Croatia. The research was conducted over a period of three months. Results: A higher percentage of exposure to infectious agents and needles and sharp objects was found among respondents from BiH compared to CRO (p=0.018 and p=0.001, respectively). We found that respondents employed in accredited laboratories are aware of exposure to hazards in a high percentage related to infectious agents, toxins (p=0.0012 and p=0.0046, respectively). A significant statistical difference was found between respondents with BiH and respondents with CRO in terms of knowledge of accreditation standards of medical-biochemical laboratories (p=0.0155). Respondents who have standard operating procedures available are aware of the hazards of infectious agents (p=0.0001), toxins (p=0.0466), needles and sharp objects (p=0.0052), noise (p=0.0030), vibration (p=0.0007) and extreme temperatures (p=0.0014). Conclusion: Efficient implementation and continuous compliance with the ISO 15189: 2018 standard requires constant commitment and active participation of laboratory staff. Laboratories must have standard operating procedures in place and actively monitor their use.

Introduction: COVID-19 is an infectious disease caused by the severe acute respiratory syndrom coronavirus 2 and causes a series of respiratory symptoms. Considering the appearance and development of symptoms, the course of COVID-19 can go from mild to severe. Depending on the course of COVID-19, the laboratory parameters change a lot, trying to defend the organism against the foreign pathogen and all the changes it causes. Therefore, the aim of this study is to observe the differences between biochemical, hematological and coagulation parameters depending on the disease stage of COVID-19 patients. Material and methods: We conducted cross-sectional study which included 160 COVID-19 patients from Sarajevo, Bosnia and Herzegovina. Biochemical, hematological and coagulation analyzes were performed. Results: COVID-19 patients with a severe clinical course have higher average values of fibrinogen (6.53±4.47,p<0.001), D-dimer (6.89±7.81, p<0.001), APTT (32.05±5.96, p=0.002), eosinophil (0.66±0.09, p=0.002) and CRP (93.42±75.86, p= 0.023), and lower values of lymphocytes (1.04±0.98, p<0.001), monocytes (0.45±0.3, p<0.001), compared to COVID-19 patients with a mild clinical course. COVID-19 patients with a severe clinical course had higher average values of neutrophils (10.12±5.80, p=0.002) and lower values of reactive lymphocytes (0.02±0.03, p<0.001) compared to COVID-19 patients with a mild clinical course. Conclusion: Biochemical, hematological and coagulation parameters can be a sensitive and specific biomarker for distinction of mild and severe COVID-19.

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The most significant characteristic of the investment interventions that are the subject of this paper is that their activation periods are one year and that their cash inflows are one-time. If there are several independent operations of this type, all those with a positive net present value, and therefore an internal rate of return that is higher than the actualization rate, will be accepted. In the case of competing operations (at certain rates of actualization), especially those whose exploitation periods are different, we may have the case that one of them is better from the aspect of net present value, and the other from the aspect of internal rate of return. The decision on their proper ranking must be based on determining the net present value for exploitation periods that are mutually equal. In the paper, we analyzed two ways of equalizing exploitation periods, the method of reciprocal interventions and the method of replacement, and obtained relevant information for their ranking, which was also confirmed by the annuity method.

Rheumatic heart disease (RHD) is the leading cause of valvular heart disease in underdeveloped nations. It remains a significant public health issue in Sub-Saharan African countries. This study aimed to determine the pattern, severity, and complications of RHD in Somalia. This was a retrospective cross-sectional study of all patients diagnosed with rheumatic heart disease. A total of 8526 echocardiographic examinations were done in our center over a two-year study period from January 2020 to December 2021. Patients with congenital cardiac disease, post-operative cases, myxomatous and old age degenerative disease were all excluded. Of 433 patients, 286 (66.1%) were female, and the mean age was 46.5 ± 20.3. The isolated mitral valve (MV) affected 222 (51.3%). Dual involvement of mitral and aortic valve (AV) was present in 190 (44%). Overall isolated or combined valve involvement, mitral regurgitation (MR) was the most common valve lesion 345 (79.7%), followed by mitral stenosis (MS) 160 (37%). According to the severity of lesions, severe MR was 230 (53.1%) patients, followed by severe MS (n=129, 29.8%). The most common complication of RHD depicted in our study were secondary pulmonary hypertension and enlarged left atrium, 23.8% (n=103) and 19.6% (n=85), respectively. In conclusion, in our study majority of RHD patients were females. Both isolated and in combination, MV was the most commonly affected, and mitral regurgitation was the most common valvular lesion. In our study high percentage of patients already had complications at the time of diagnosis.

Background: The association between diabetes mellitus type 2 (T2DM) and pulmonary embolism (PE) is still unclear. Objective: The aim of this study was to determine the prognostic value of prothrombotic, proinflammatory markers, and troponin for pulmonary embolism and its complications in patients with type 2 diabetes mellitus. Methods: The retrospective cohort study included 294 patients with type 2 diabetes mellitus divided into two groups: (a) the first group with pulmonary embolism (n=165); (b) the control group without pulmonary embolism (n=129). The data were collected from May 2018 to May 2023. In all patients we analyzed: anthropometric parameters, laboratory parameters (troponin, D-dimer, CRP, fibrinogen, uric acid, glucose, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides), arterial blood pressure, antiphospholipid antibodies, HOMA-IR index, CT angiography of the pulmonary artery, rate of adverse clinical events in pulmonary embolism (need for inotropic catecholamine support, fibrinolysis, cardiopulmonary resuscitation) and rate of intrahospital mortality from pulmonary embolism. Results: Troponin levels were significantly higher in the PE group compared to the non-PE group (p = 0.002). D-dimer, CRP, uric acid, fibrinogen and HOMA- IR were significantly elevated in the PE group compared to the non-PE group (p < 0.001). Patients with pulmonary embolism in T2DM proved to have significantly more in-hospital death within 10 days of hospital admission (p<0.001), compared to patients with T2DM, without pulmonary embolism. Conclusion : Prothrombotic, proinflammatory markers, and troponin have good prognostic value for short-term outcomes in PE among patients with T2DM.

Background: Lyme disease (Lyme disease-LD) is a disease of humans and animals that is transmitted by hematophagous insects, especially ticks. The causative agent is the spirochete Borrelia burgdorferi, a bacterium with a complex structure and a slow biorhythm, which has the ability to coat the host's organism with mucus - create a biofilm - or turn into a cyst, and the host does not recognize it and does not create antibodies. This is the reason why, in 10-60% of cases, Borrelia tests are negative, even though it is present. The diagnosis of LD is made clinically, and it is confirmed serologically and microbiologically by isolation and/or detection of the causative agent by the PCR method from tissue samples and body fluids. Lyme disease stage II and III is called „the great imitator“ because its symptoms resemble those of other diseases, so diagnostic errors are often made. Objective: In this article we presented a case of stubborn urticaria in a 28-year-old saleswoman. Case presentation: Mother of two children, who was ruled out by clinical examination for autoimmune diseases and allergies to available allergens. We subsequently confirmed the diagnosis of chronic borreliosis, caused by five types of borrelia, serologically, after advanced intermittent antibiotic therapy, and after acquired food intolerance was discovered. In the available literature, we did not find information that chronic generalized urticaria was caused by Borrelia in combination with food intolerance. Conclusion: The presented case of a patient with chronic urticaria indicates that similar cases with urticaria, as well as all skin changes with intermittent walking symptomatology, should: Undergo clinical treatment, rule out immunological diseases and drug allergies, then test for Borrelia (ELISA+ immunoblot with Borrelia protein sequences!). Take into account the duration of the disease, the possibility of the disappearance of antibodies created in early childhood or a false-negative finding of antibodies, and in case of a negative finding, do not give up ex-yuvantibus therapy.

Introduction. Acute appendicitis is the most common cause of the acute abdomen. Based on the idea that appendicitis is a progressive disease eventually leading to perforation, removal of the appendix is the gold standard of treatment. Material and Methods. The objective of the study is to determine if there is any difference in the occurrence of postoperative complications, and if hospitalization differs depending on the appendicitis surgery method used with the patients. A retrospective analysis was made using the data from the hospital sample of patients admitted to the University Hospital in Foca in the period from January 2019 to December 2021. Results. In the period that was retrospectively analyzed, 107 patients diagnosed with acute appendicitis were operated on. There was no statistically significant difference between the treated groups in relation to the degree of appendicitis, type and duration of symptoms, diagnostic procedures and the time that had elapsed from admission to surgery. The Alverado Score in the probable appendicitis group was 41.1%. The most common symptoms were palpation sensitivity in the inguinal region (84.1%), and pain in the right lower quadrant (69.1%), intraoperative findings of uncomplicated appendicitis 58%, and 25.2% intraoperative findings inconsistent with the pathohistological ones. Conclusion. Acute appendicitis is one of the most common emergency surgical conditions, which requires surgical intervention if not treated in time, and causes life-threatening consequences. Surgical treatment with selected techniques for faster establishment of the gastrointestinal tract function, shorter stay in the hospital, faster recovery and return to daily activities.