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Introduction. Gallstone ileus is a complete or partial mechanical bowel obstruction due to gallstone impaction in the bowel lumen and most commonly occurs after stones migrate through the cholecystoenteric fistula. Case outline. We present a patient with signs of gallstone ileus after stone migration through the cholecystoduodenal fistula into the duodenum with hematemesis as the first symptom. Conservative treatment had been started, to which the patient initially responded well. On the eighth day from the onset of the disease, the condition worsened. Signs of the Rigler triad were identified on computed tomography and magnetic resonance imaging of the abdomen. Enterolithotomy was successfully performed by the open surgical method. Postoperative recovery was orderly, without any biliary problems. Conclusion. Physical examination, upper endoscopy, and radiological diagnostic procedures are complementary and necessary in monitoring the dynamics of stone movement and deciding on when to perform surgery.

Twelve previously synthesized, biologically active 2,6,7-trihydroxyxanthen-3-one derivatives were evaluated in vitro for antiproliferative activity. Compounds were screened against HeLa, SW620, HepG2 and A549 tumor cell lines. Compound with the trifluormethyl group on C-4’ position of the phenyl ring showed the best inhibitory activity towards HeLa and A549 tumor cells with IC50 of 0.7 and 4.1 µmol L−1, resp. Compound with chlorine and fluorine substituents on aryl ring showed the best antiproliferative activity against SW620 with IC50 of 4.1 µmol L–1 and against HepG2 tumor cell line with IC50 of 4.2 µmol L–1. Analyses of cytotoxic and genotoxic potential of the trifluormethyl derivative were performed with cytokinesis-block micronucleus cytome assay in human lymphocyte culture and revealed no genotoxic and cytotoxic effects. The most potent compounds were subjected to molecular docking simulations in order to analyse bindings to molecular targets and, at the same time, further support the results of experimental cytotoxic tests. Docking studies showed sites of importance in forming hydrogen bonds of the most potent compounds with targets of interest.

Introduction: Despite growing progress of perinatal medicine and perinatal care, between 9-19% of preterm infants are born each year. Improvement in survival of infants and the reduction in infant mortality rates is a key role of perinatal quality healthcare. The Aim: To evaluate the perinatal outcome of preterm infants in maternity wards of the Federation of Bosnia and Herzegovina for a period of one year. Material and methods: Of 22 897 live newborns, the research criteria matched 669 (2.9%) preterm infants with complete medical records in ten cantons of the Federation Bosnia and Herzegovina. We analyzed data from maternity wards documentation and discharge letters from tertiary health care centers. Results: Most deliveries were in the Tuzla and Sarajevo Canton with 42.5% of preterm infants. The mean gestational age of preterm infants was 31.4 weeks, with SD ± 5.34, and the mean birth weight 1295 grams, SD ± 234.2. The mean Apgar score was 4.6 ± 2.1, and in the fifth minute 6.6 ± 1.9.Of 669 examinees, there were 345 (51.56%) males and 324 (48.44%) females (51.56 vs 48.44; χ 2 = 1.19; P = 0.27). By analyzing the frequency of preterm infant birth rate according to weight categories, we found a significant difference in some levels of perinatal health institution, between the 1st and 2nd institutions levels (1.76% vs 3.01%; P< 0.0001), also between 2nd and 3rd institutions levels (3.01% vs 3.03%; P < 0.0002), and between 1st and 3rd institutions levels (1.76% vs 3.03%; P < 0.0001). A significant statistical difference in survival of tested newborns was found in institutions of 3rd level χ 2 = 49.25; P < 0.0001 with a low risk for unfavorable outcome [OR = 0.436; 95%CI (0.346-0.550)]. Conclusion: Perinatal outcome of preterm infants in the Federation Bosnia and Herzegovina significantly depends on the level of perinatal health care. Survival rate of infants born in the institutions of the 3rd level was statistically much higher than the survival rate of infants who were born in the 1st and the 2nd level institutions.

Among natural products, essential oils from aromatic plants have been reported to possess potent anticancer properties. In this work, we aimed to perform the cytotoxic concentration range screening and antiproliferative activity screening of chemically characterized Thymus vulgaris L. essential oil. In vivo bioassay was conducted using the brine shrimp lethality test (BSLT). In vitro evaluation of antiproliferative activity was carried out on three human tumor cell lines: breast adenocarcinoma MCF-7, lung carcinoma H460 and acute lymphoblastic leukemia MOLT-4 using MTT assay. Essential oil components thymol (36.7%), p-cymene (30.0%), γ-terpinene (9.0%) and carvacrol (3.6%) were identified by gas chromatography/mass spectrometry. Analyzed essential oil should be considered as toxic/highly toxic with LC 50 60.38 µg/mL in BSLT and moderate/weakly cytotoxic with IC 50 range 52.65-228.78 µg/mL in vitro, according to evaluated cytotoxic criteria. Essential oil induced a dose-dependent inhibition of cell proliferation in all tested tumor cell lines and showed different sensitivity. Dose dependent toxicity observed in bioassay as well as the in vitro assay confirmed that brine shrimp lethality test is an adequate method for preliminary toxicity testing of Thymus vulgaris L. essential oil in tumor cell lines.

Introduction: Hyperuricemia is an independent risk factor for the development of many diseases., Aim: The aim of this paper is to compare the effects of allopurinol and febuxostat on the values of triglycerides and uric acid in hyperuricemic patients., Methods: This was a pharmacological-clinical retrospective-prospective study. The research sample comprised 50 examinees of both genders and different ages who were undergoing allopurinol (100 mg/day) or febuxostat (80 mg/day) therapy. Statistical Product and Service Solutions (SPSS) Software and Microsoft Excel were used for statistical analysis., Results: Examinees who were treated with allopurinol had a statistically significant decrease in uric acid concentrations (by 126.28 ± 20.36 μmol/l) at the end of the observation compared to the initial values (p = 0.006). Examinees who were treated with febuxostat had a statistically significant decrease in uric acid concentrations (by 252.80 ± 94.17 μmol/l) at the end of the observation compared to the initial values (p = 0.001). The initial value of triglycerides was 1.58 ± 0.64 mmol/l in allopurinol-treated examinees, and 1.60 ± 0.52 mmol/l in febuxostat-treated examinees. After three and six months of allopurinol use, there was a statistically significant increase in triglyceride values (p = 0.046 and p = 0.042, respectively). A statistically significant decrease in triglyceride values (by 0.16 ± 0.10 mmol/l) was noted after three months of febuxostat use (p = 0.012)., Conclusion: The results of this research confirmed the previous findings and pointed out the positive pharmacological effects of allopurinol and febuxostat., Competing Interests: The authors declare that there was no conflict of interest., (© 2020 Nermina Ziga-Smajic, Selma Skrbo, Samija Muratovic, Belma Pehlivanovic, Dina Lagumdzija, Naida Omerovic.)

Background: Currently, used oral antiplatelet drugs are both limited and associated with the risk of treatment failure/resistance. Research in this area is hence highly desired. A series of xanthene-3-ones derivatives, we had synthesized, showed us that these derivatives had antiplatelet activity. As far as we know, no research on the effects of xanthen-3-ones in this area has been done., Objective: The aim was to study the antiplatelet potential of a series of synthesised 9-phenylxanthene- 3-ones and to find the ideal structural feature(s) for antiplatelet potential and determine the mechanism of action., Methods: The compounds were synthesized from 1,2,4-triacetoxybenzene and various benzaldehydes. The reaction proceeded smoothly under acidic alcoholic conditions, furnishing the desired products in good yields. The compounds were first screened in whole human blood where platelet aggregation was induced by arachidonic acid. Further analysis was targeted at search of the mechanism of action., Results: Initial screening showed that a majority of the synthesized derivatives had substantial antiplatelet potential. None of the compounds were able to block cyclooxygenase 1 or thromboxane synthase. The mechanism appeared to be based on antagonism of thromboxane effects. The most potent compound 9-(4'-dimethylaminophenyl)-2,6,7-trihydroxy-xanthene-3-one had better potential to block collagen induced platelet aggregation than clinically used acetylsalicylic acid., Conclusion: The last mentioned derivative is promising for further in vivo testing., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.)

Platelet hyperactivity and platelet interaction with endothelial cells contribute to the development and progression of many cardiovascular diseases such as atherosclerosis and thrombosis. The impact of platelet activity with different pharmacological agents, such as acetylsalicylic acid and coumarin derivatives, has been shown to be effective in the prevention of cardiovascular disease. Artemisia dracunculus, L. Asteraceae (Tarragon) is used for centuries in the daily diet in many Middle Eastern countries, and it is well known for its anticoagulant activity. The present study investigates the presence of coumarins in tarragon leaves and subsequently determines the extract with a major amount of coumarin derivatives. The solvents of different polarities and different pH values were used for the purpose of purifying the primary extract in order to obtain fractions with the highest coumarin content. Those extracts and fractions were investigated for their anticoagulant activity by determining prothrombin time (PT) and the international normalized ratio (INR), expressed in relation to the coagulation time of the healthy person. Purified extracts and fractions obtained from plant residue after essential oil distillation, concentrated in coumarin derivatives, showed the best anticoagulant activity, using samples of human blood. INR maximum value (2.34) and consequently the best anticoagulant activity showed the methanol extract at concentration of 5%.  The INR value of normal plasma in testing this extract was 1.05.

Lung agenesis and gastric duplication cysts are both rare congenital anomalies. Gastric duplication cysts can present with nausea, vomiting, hematemesis, or vague abdominal pain. Unilateral pulmonary agenesis can present with respiratory distress which usually occurs due to retention of bronchial secretions and inflammations. We report the unique case of right pulmonary agenesis associated with gastric duplication cyst.