Abstract Introduction During Covid-19 many staff members were redeployed to the Intensive Care Unit (ICU) with little opportunity to train in the new skills they would require. One such skill was the transfer of a critically ill, and contagious, patient from ICU; a risky and complicated procedure which requires planning, preparation, risk assessment, situational awareness and, ideally, experience. To assist our colleagues in this skill an existing ICU transfer course has been adapted to cover the Covid-19 situation, or any similar contagious pandemic, in patient transfer. Methods An in-situ simulation method was chosen as the most realistic method of immersing our participants into the environment of ICU and to highlight real-life complexities and issues they may face. A multidisciplinary training session was devised so that novice anaesthetists, ACCPs and nurses could learn together, reflective of the usual team. Human factors such as communication, team leadership, task management and situational awareness are the focus of the post-simulation debrief, and human factors sheets have been created to guide the participants in analysing these skills. Pre- and post-simulation confidence, knowledge and attitudes will be assessed using validated appraisal tools and questionnaires to gather both quantitative and qualitative data about the experience. Discussion Multidisciplinary training is often difficult to arrange, due to the different requirements, processes, and procedures each department demands. A hidden blessing of Covid-19 is the realisation that this barrier can be broken, for the benefit of our patients and colleagues alike, and training sessions like this implemented.

Polygonum aviculare and Persicaria amphibia (subfam. Polygonoideae) are used in traditional cuisines and folk medicine in various cultures. Previous studies indicated that phytochemicals obtained from Polygonoideae plants could sensitize chemoresistant cancer cells and enhance the efficacy of some cytostatics. Here, the cytotoxic properties of chemically characterized ethanol extracts obtained from P. aviculare and P. amphibia, individually and in combination with doxorubicin (D), were determined against hepatocarcinoma HepG2 cells. Phenolic composition, cell viability, cell cycle, apoptosis, and the expression of Keap1 and Nrf2 were examined by following methods: LC-MS/MS, LC-DAD-MS, MTT, flow cytometry, and qRT-PCR. Extracts were rich in dietary polyphenolics. Synergistic cytotoxicity was detected for extracts combined with D. The observed synergisms are linked to the interference with apoptosis, cell cycle, and expression of Keap1-Nrf2 genes involved in cytoprotection. The combined approach of extracts and D could emerge as a potential pathway of chemotherapy improvement.

ABSTRACT Two cases are presented with coronavirus disease 19 (COVID-19)-related hiccups: one during initial presentation and one 10 days after COVID-19 diagnosis. Hiccups in both patients were resistant to treatment and responded only to chlorpromazine. COVID-19 patients may present with hiccups and also may have hiccups after treatment. Resistant hiccups without any underlying disease other than COVID-19 should be considered in association with COVID-19 and may respond well to chlorpromazine.

Background: Infantile hemangiomas (IH) are the most common vascular, benign tumors of childhood with a prevalence of 4-5%. Due to intense vasculogenesis, they proliferate during infancy, then involute at an unpredictable rate, extent of involution, and quality of residual tissue. Depending on the location, they may be associated with anomalies of other organ systems (PHACE, PELVIS syndroms). In recent decades, knowledge about hemangiomas has improved, and therefore therapeutic possibilities have improved. Today, the non-selective beta blocker–propranolol is considered the drug of first choice in the treatment of infantile hemangiomas. It is desirable to start treatment in the proliferative phase of hemangioma growth for the best possible effect. The dynamics of drug administration, time interval of dose increase and monitoring of patients during treatment vary from one Institution to another and are still the subject of discussion. Objective: We presented the case of a child with infantile hemangioma of the lumbo-sacral region, treated with combination therapy with systemic propranolol and topical timolol, with satisfactory effect in the end. Conclusion: Propranolol is considered a drug with well-studied side effects and a safety profile. During 6 months of treatment, it leads to complete or almost complete withdrawal of the hemangioma. Treatment should be started in the hemangioma proliferation phase for the best possible therapeutic effect.

Backgroud: Intervertebral disc herniations are caused by rupture of the fibrous ring and migration of one part of the nucleus pulposus towards the spinal canal. The most commonly affected levels are C5-C6 and C6-C7. Surgical treatment of cervicobrachialgia is indicated in the presence of long-term intense pain syndrome with or without radicular sensory-motor deficit and magnetic resonance (MRI) verified disc herniation with a compressive effect. Objective: The most common surgical treatment is anterior lateral microdiscectomy with or without the use of implants. In addition to this method, dorsolateral microsurgical treatment can be used for foraminal hernias. Methods: This retrospective study included 110 (58 / 52.7% male and 52 / 47.3% female) patients with cervical disc herniations who were surgically treated at the Neurosurgery clinic of Clinical Center of Sarajevo University (CCUS) in a five-year period. Stability, postoperative curvature, arthrodesis, implants, and changes in adjacent segments were radiographically analyzed. In the outcome assessment, functional outcome and patient satisfaction were analyzed using the Pain Self-Evaluation Scale (VAS), Prolo functional and economic score, and White’s classification of treatment outcomes. Results: The dominant prevalence of changes was recorded at the levels of C5-C6 (58%) and C4-C5 (28%) with a ventrolateral approach performed in 90% of patients. The largest representation is hard dorsolateral discs (n = 77). In the group of patients with placed implant, hard discs were present in 96 (90%) cases (p <0.001), while soft discs were dominant in patients without implant placement (p <0.001). In the group of subjects with implant, the most common are hard dorsolateral discs and those of mixed localization in 41 of 55 patients (65.5%; p = 0.001). The most common implant is PEEK cage (74.5%). From complications, we had partial vertebral body fractures in 4.5% of patients. Furtehr, the most common are sensory disturbances in 2.73% of respondents. Reduction of symptoms and improvement of preoperative neurological status were observed in over 95% of patients. Conclusion: Surgical treatment of cervical disc herniation is a safe method with a minimal percentage of complications. Microsurgical discectomy significantly contributes to the improvement of the functional status of patients, the reduction of pain, and the improvement of neurological deficit and overall mobility.

A 65-year-old woman with a negative family history of breast cancer presented with a palpable mass in the left breast’s central portion. Mammography revealed an oval heteroechogenic, partly solid, partly cystic, sharply demarcated mass, measuring 100×90 mm in greatest diameter, classified as BI-RADS 4c, according to ACR BI-RADS Atlas Fifth Edition (Figure 1A-B). Breast MRI showed a lobulated mass with smooth margins appearing hypointense on T1WI and high signal intensity on T2WI (Figure 1C-D). A core needle biopsy revealed a cellular neoplasm, composed of small, closely packed tubules with spindle cell intervening stroma without prominent atypia and mitotic activity, classified as B3 category according to the UK National Coordinating Committee for Breast Screening Pathology (Figure 2A). The multidisciplinary tumor board discussed the case and recommended a wide surgical excision. With the patient’s approval, a left mastectomy was recommended and performed. The axillary clearance was not performed. The 100×90 mm tumor was grossly well-circumscribed, grayish-white, and predominantly solid, with a smaller cystic component, without necrosis and hemorrhage (Figure 2B). Histopathologic examination revealed a well-circumscribed tumor with two distinct components (tubular adenoma and phyllodes tumor) with the transition to one another (Figure 2C). The larger portion of the tumor was composed of closely packed small round to oval tubules with little intervening spindle cell stroma consistent with tubular adenoma. The smaller component showed a biphasic fibroepithelial tumor with leaf-like projections with moderately cellular stroma (Figure 2D-E). The stromal cells exhibited mild to moderate atypia, and their mitotic activity was up to six mitoses/10 hpf (Figure 2F). Stromal overgrowth was absent, while the malignant heterologous elements were not observed despite the exhaustive tumor sampling (25 paraffin blocks). The final diagnosis was a complex fibroepithelial tumor composed of borderline phyllodes and tubular adenoma. Clinical Science

Unmanned aerial vehicle (UAV) assisted wireless caching networks (WCN) have been recognized as a promising way to reduce the network load and improve the energy efficiency in the sixth generation (6 G) communication systems. Aiming to improve spectrum efficiency and system capacity, we apply non-orthogonal multiple access (NOMA) in UAV-assisted WCN to serve multiple users on the same spectrum simultaneously and propose the cross-layer resource allocation strategy including the scheduling of UAVs, the grouping of users, and the allocation of power. First, the $\rho$-K-means algorithm is proposed to assign users to multiple clusters and deploy UAVs according to the distance from UAVs to the base station in the UAV deployment layer. Then, the base station broadcasts the popular files to UAVs via NOMA in the content placement layer. Based on the existing fixed power allocation strategy, we propose a statistic quality of service (QoS) based fixed (SQF) power allocation method to take the statistic QoS of the popular files into consideration and improve the energy efficiency through introducing the discount factor. On the basis of SQF, an instantaneous QoS based adaptive (IQA) strategy allocates power according to the instantaneous QoS of the popular files to reduce the file outage probability. Furthermore, we propose an improved method that is a cross-layer based optimal (CLO) power allocation strategy to maximize the system hit probability. Finally, in the content delivery layer, users in each cluster are grouped according to the channel gain from users to UAVs. In addition, each UAV serves two users on the same time-frequency resource block based on the cognitive radio inspired power allocation for the NOMA user pairs. Simulation results confirm that the proposed $\rho$-K-means algorithm and CLO strategy reduce the file outage probability and improve the hit probability.

This year the journal "Medical Archives" celebrates 75 year of existing. "Medicinski Arhiv/Medical Archives" was founded in 1947 as official journal of the Association of Physicians (Sabor ljekara Bosne i Hercegovina) of Bosnia and Herzegovina and the first Editorial board was consisted of academicans: Vladimir Cavka (Professor of Oftalmology), Blagoje Kovacevic (Professor of Surgery), Bogdan Zimonjic (Professor of Internal medicine), and Ibro Brkić (Professor of Internal medicine). Exactly the Medical Archives journal was a key milestone that helped in education of all academic and professional staff that became the foundation of Bosnian and Herzegovinian medicine as a science and health care as a profession. Medicinski Arhiv was included in largest bimedical database Medline in 1947 and till now in that database is deposited more than 7000 papers. Also this journal has highest h-Index in Scopus database ranked by SCImago rank. In Medicinski Arhiv journal authors from more than 60 countries from whole the world published their papers, some of them with very high Scopus h-Index.

The paper addresses and evaluates the currency boards’ policy and assesses whether the economic development of Bosnia and Herzegovina is the function of currency boards, as a form of monetary policy. In this context, a hypothesis that the currency boards provides the foundation for growth and development of a transition economy is being put to the test. To test the hypothesis, the paper compares the movement of economic growth indicators (gross domestic product) among the countries of South Eastern Europe with the primary focus on Bosnia and Herzegovina. By comparing the obtained results, as well as by applying the correlation and regression analysis, by means of simple linear regression, it is proven that the currency boards do not represent an obstacle to economic growth, but is the basis for establishing the stability of the economy and the basis for sustainable growth and development able to adequately respond to shocks.