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Background: The triglyceride/high-density lipoprotein (TG/HDL) ratio emerges as a promising marker for cardiovascular risk. However, the relationship between overall serum lipid levels and hemorrhagic stroke (HS) remains uncertain. Therefore, our study aims to explore the association between this novel index and mortality in HS patients., Methods: Utilizing a retrospective-prospective framework from January 2020 to August 2023, we scrutinized data from 104 hospitalized patients diagnosed with HS, with particular attention to their medical backgrounds and lipid profiles., Results: Age (odds ratio [OR], 1.078; 95% confidence interval [CI], 1.032-1.125; P = 0.001), atrial fibrillation (OR, 0.237; 95% CI, 0.074-0.760; P = 0.015), glucose level (OR, 1.121; 95% CI, 1.007-1.247; P = 0.037), and TG/HDL index (OR, 0.368; 95% CI, 0.173-0.863; P = 0.020) emerged as independent predictors for in-hospital mortality, as determined by both univariable and multivariable logistic regression analyses., Conclusion: Our results add weight to the growing evidence backing the utility of the TG/HDL index in assessing cardiovascular risk among HS patients. They emphasize the necessity of adopting a comprehensive risk assessment and management strategy that incorporates both traditional markers and novel indicators., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Family Medicine and Primary Care.)

Aim To investigate the serum value of brain derived neurotrophic factor (BDNF), proteins S-100, NSE, IL-6 in normal pressure patients (NPH) compared to control (healthy) group and also a possible correlation with radiological findings in NPH patients. Methods Study patients were included during the period of 2020- 2022. All NPH patients met the diagnostic criteria for probability of NPH. Control patients group included patients without known brain disorder, without clinical symptoms of NPH. Blood samples were taken before planned surgery for NPH. BDNF serum concentrations were assessed by a sensitive ELISA kit, and serum concentrations of S-100, NSE and IL-6 were assessed by using ECLIA technology for immunoassay detection. Results Among 15 patients who were included, seven NPH patients were compared to eight control patients. Non-significant decrease in BDNF serum concentrations, an increase of protein S-100 serum concentrations, a decrease of NSE serum concentrations, as well as an increase of IL-6 serum concentrations in NPH patients compared to healthy controls was found. Strong positive correlation between BNDF and Evans index was observed (p=0.0295). Conclusion We did not find a significant difference of BDNF, protein S-100, IL-6 and NSE between serum concentration in NPH and healthy patients. More future research is needed to find the role of BDNF in NPH patients., (Copyright© by the Medical Assotiation of Zenica-Doboj Canton.)

Circulation of the Omicron variant with the reemergence of the N501Y mutation along with many others in the spike protein has once again stirred the academic community. Interestingly, tracing the genetic diversity of SARS-CoV-2 shed light on a less frequent N501Y + Delta variant which has been in the global circulation for some time before the Omicron appearance. This paper aims to present the molecular characteristics of the SARS-CoV-2 Spike_N501Y + Delta variant detected in Bosnia and Herzegovina. The study was conducted during November and December 2021. All patients were tested using real-time RT-PCR for detection of SARS-CoV-2. A representative number of SARS-CoV-2 positive samples was pre-screened using VirSNiP SARS-CoV-2 Spike N501Y kit. The characterization of the viruses was carried out with Illumina RNA Prep with enrichment and the Respiratory Virus Oligo Panel kit. Among the analyzed sequences, we found two isolates of the Delta variant that differ from their most related clade- GK AY.4.3 in additional mutations N501Y and L54F. In this study, we described the presence of a rare form of Delta variant with Spike_N501Y mutation in the shadow of the Omicron emergence. Despite the set of mutations in the Spike protein, this form of Delta variant does not indicate the large-scale consequences for the general population. Further functional studies of this form could provide more information about its antigenicity and infectivity., Competing Interests: The authors declare no competing interests., (© 2022 The Author(s).)

The coexistence of humans and dogs, in addition to all positive effects, can result in negative effects on human health. A particular risk is posed by a population of stray dogs, that is, dogs without owners and veterinary supervision. A contact with dogs in addition to bites, carries the risk of viral, bacterial and parasitic zoonoses, and can also cause psychological trauma. Children, the elderly and pregnant women are the categories most susceptible to the negative effects of dogs. The aim of the paper was to make an interdisciplinary analysis of the negative effects of dogs on humans. Dog bites cause wounds and dysfunction of damaged tissue, and often lead to various infections. The risks of rabies and tetanus are particularly significant if proper and timely treatment is not performed. Ongoing training for dog owners can significantly reduce the number of bites inflicted by owned dogs, but stray dogs remain a serious social problem and pose potential health risks of some zoonosis. Timely and adequate management of bite wounds and the use of rabies-post-exposure prophylaxis as well as psycho-therapy, where indicated, significantly reduce possible adverse health effects for patients who have been bitten by dogs., (Copyright© by the Medical Assotiation of Zenica-Doboj Canton.)

Objective: The objective of our study was to investigate the effects of carbamazepine (CBZ) and lamotrigine (LTG) treatment on bone metabolism in epileptic patients., Patients and Methods: A cross-sectional study was performed on normal controls (N=30) and 100 patients with symptomatic epilepsy caused by a primary brain tumor, divided into two groups according to the treatment: LTG monotherapy group (N=50) and CBZ monotherapy group (N=50). For each participant serum levels of 25-OHD and osteocalcin (OCLN) were measured, and bone mineral density (BMD) was evaluated by the dual-energy X-ray absorptiometry method., Results: There was no statistically significant difference in the average values of vitamin D in serum between the CBZ and LTG groups (Vitamin D CBZ 17.03±12.86 vs. Vitamin D LTG 17.97±9.15; F=0.171, P=0.680). There was no statistically significant difference in the average values of OCLN between the CBZ and LTG groups (OCLN CBZ 26.06±10.87 vs. OCLN LTG 27.87±28.45; F=0.171, P=0.674). The BMD value was lower in both groups using antiepileptic agents compared to the controls, but when comparing the CBZ group to the LTG group, a statistically significant difference was only observed for the Z score (T-score CBZ: 0.08± 1.38 vs. T-score LTG: 0.37± 1.02; F=1.495, P=0.224; Z score CBZ: -0.05±1.17 vs. Z. score CBZ: 0.38±0.96; F=4.069, P=0.046) (Table 3)., Conclusion: The choice of antiepileptic agents for treating seizures in patients with brain tumors should be carefully evaluated in relation to their impact on bone health. These patients could benefit from supplementation and regular measurement of biochemical markers of bone turnover and BMD., (Copyright © 2020 by Academy of Sciences and Arts of Bosnia and Herzegovina.)

Introduction: Interictal depression as a co morbid disorder can be seen among more than 40% of patients with epilepsy. Epilepsy duration as well as selected antiepileptic drugs can be suitable for the development of depressive disorder in many aspects., Aim: To test relation between depressive disorder in patients with epilepsy, duration of illness and type of antiepileptic therapy., Patients and Methods: Prospectively, by random selection, we have tested 300 patients with epilepsy, with or without depressive affective disorder at the Outpatient Department for Epilepsies in the Clinical Center of Sarajevo University. All patients answered Beck and Hamilton depression scales., Results: This research involved male patients which made 54% of baseline at the average age of 37.7 years SD = 12.86, as well as female patients at average age of 32.83 years SD = 12.26. Depressive disorder according to the results at the Beck scale was present in 34%, and according to the Hamilton scale in 38.9% of patients. Carbamazepin as monotherapy was applied for more than a half of the baseline, Phenobarbital as monotherapy and combined with Carbamazepin significantly more frequently among men's (p < 0.0001). Duration of illnesses longer than 20 years had 56% women with the expressed depressive disorder, compared to the 42% men's with depression (p < 0.01)., Conclusion: Depressive disorder occurs significantly more frequently among women with the longer epilepsy duration, as well as among male patients who had Phenobarbital as single or add on therapy.

Schizophrenia is a chronic progressive illness characterized with frequent relapses and requiring long-term treatment. In spite of the fact that this disorder belongs among ten leading causes of disability worldwide, the consequences and difficulties associated with schizophrenia are frequently underestimated. The course of the illness is further characterized by a high percentage of suicides and attempted suicides, decline in cognitive functions and frequent relapses. The results of numerous studies indicate that early treatment with antipsychotics leads to better long-term outcomes compared with control groups. In the process of deciding about treatment we must bear in mind the importance of individual approach to schizophrenic patients because there are significant differences in the type of disorder, symptoms, co-morbidity, course of disorder (first episode or chronic course), as well as the differences in treatment response and treatment adherence. When choosing an antipsychotic agent we should try to find the drug capable of addressing all aspects of the illness that is safe and well tolerated in long-term treatment; we should start the treatment as early as possible, reduce the psychotic symptoms and avoid negative effects on functioning, whilst avoiding adverse effects and establishing a trusting and productive therapeutic alliance with the patient. Existing evidence strongly suggests the use of adequate doses of antipsychotics as early as in prodromal psychosis. Evidence shows that schizophrenic patients remain longer in treatment with atypical antipsychotics particularly when they are applied as depot injections, because the efficacy of treatment is higher, drug concentration stable and long-lasting, there are fewer adverse effects, and the co-operation with the service provider is better. In this way, the atypical antipsychotics provide us with the opportunity to establish long-term control of the psychotic symptoms, and reduce relapse rate and the number of hospitalizations while improving the quality of life of schizophrenic patients and establishing optimal therapeutic alliance.

Seizures are influenced by the physiologic variation in sex hormone secretion during the menstrual cycle and throughout the reproductive life of women with epilepsy. Catamenial epilepsy is defined as the occurrence of seizures around menses or an increase in seizures in relationto the menstrual cycle. The incidence of catamenial epilepsy varies from 10% to 78%, largely because of methodological differences among studies. Variation in concentracion of antiepileptic drugs across the menstrual cycle may also contribute to increased seizure susceptibility. It is important for the physician to work closely with the patient to determine whether her seizures are indeed catamenial and to design an appropriate treatment plan.

Botulinum toxin (BTX) is a powerful neurotoxin which blocks cholinergic transmission at the neuromuscular junction. Judiciously applied it can reduce local muscle over activity while maintaining the strength in other muscles. For focal or segmental dystony it has been a medication of choice. Refined botullinum toxin A being applied in affected groups of muscles weaker power of contraction. Basic mechanism which weaker contraction remands the same. Controlled trials have provided evidence of the effectiveness of BTX both in reducing spasticity itself and in achieving functional gain. The guidance given here to clinicians involved in the management of spasticity covers the types of patient suitable for treatment using BTX, the appropriate dosage, and the necessary follow-up procedures and documentation.

Epilepsies are one of the most common neurological disorders. Men and women are almost equally affected. Women bear specific features because of their natural characteristics and changes in hormonal status, which can affect the clinical presentation and the course of the disease as well as the comorbidity of various disorders. By this, we have in mind a mutual influence of steroid hormones and antiepileptic drugs, calcium and phosphorus transport disorder, insulin and lipid metabolism, adverse cosmetic effects, sexual dysfunctions, pregnancy, teratogenity and the delay in fetal development and bone diseases.

This paper gives examples of the measurement bioelectrical signals in the diagnosis procedure and therapy of patients treated at the Center for Medical Health of the Clinical Center of the University of Sarajevo. The emphasis of the paper is put on the following methods: electromyography, electroneurography, potentials evoked by hearing, potentials evoked by sight, somatosensory potentials. Each of these methods mentioned calls for the application of modern information technology based on conversion of analog data into digital data and its interpretation during the identification of timely and correct diagnosis.

The epidemiological parameters of the migraene headaches with the occurrence in the most productive life age with the subjective intensive experience of the characteristic pain in migraene headaches are the reason of interest for migraene as the headache "sui generis" from the pathological and therapeutic aspect. The diagnosis of migraene is put according the criteria for migraene headaches. In persons who suffer from migraene it is certainly, that besides the family anamnesis and the solalled precipiting factors there are also the tresh hold for migraene attack to which the basic change in serotonin generator in the brain branch. In the therapeutic approach are used the profilacted and therapeutic measures. The agents which act as agonists 5-HT 1 receptors have simptomatic effects in migraena, while antagonists of 5-HT 2 recetors are-successful in the prophilaxis. Selective agonist 5-HT 1 receptor is sumatrypane and has broken the more year sterotipy in the treatment of the migraene, while the more recent agonists receptors 5-HT 1D alfa and 5-HT D1berta receptor rizatriptan, zolmitriptan, naratriptan show clearly the therapeutic aim of the treatment or migraene influence on the serotoenergic generator of the brain branch and the consecutive change of the cerebral circulation.