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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).)

Objective: This study aimed to determine the intravitreal concentration of VEGF in eyes with PDR and to evaluate the effects of previous PRP on its level. Methods: It was a cross-sectional study performed at the Clinical Centre University. It included 90 eyes surgically treated with PPV, divided into three groups, group A - patients with PDR with previous PRP, group B - patients with PDR without previous PRP, and group C - PPV performed due to the indication unrelated to diabetes. A vitreous sample was obtained during PPV, and the VEGF concentration was determined using an Enzyme-linked immunosorbent assay test (ELISA). Shapiro-Wilk, nonparametric tests Kruskal-Wallis, Mann-Whithney U test, ANOVA and Spearman's correlation test were used. Results: The highest vitreous VEGF concentration was in group B - 972.96 (743.33-1149.13) and was higher than in group A - 69.22 (37.33-225.15) and in group C - 19.93 (1.15-32.17) (p<0.001). There was a positive correlation between VEGF vitreous concentration and glucose level in group A patients (Rho=0.410; p=0.027). Conclusion: As a treatment before PPV surgery, PRP showed to be effective in the reduction of VEGF levels, which also highlighted a decrease in complications during and postoperatively. Abbreviations: DRS = Diabetic Retinopathy Study, PDR = proliferative diabetic retinopathy, VEGF = vascular endothelial growth factor, PRP = pan-retinal photocoagulation, PPV = pars plana vitrectomy, HbA1c = glycosylated hemoglobin, ETDRS = Early treatment diabetic retinopathy study, ESR = erythrocyte sedimentation rate, BCVA = best corrected visual acuity, OCT = optical coherent tomography, ILM = internal limiting membrane, PHACO = phacoemulsification, IOL = intraocular lens, ELISA = Enzyme-linked immunosorbent assay test, AUC = area under the curve, DME = diabetic macular oedema, TDR = tractional retinal detachment, VMT = vitreomacular traction., (© The Authors.Romanian Society of Ophthalmology.)

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.)

Objective: We present a case of relapsing tumefactive demyelination in a young female patient, that posed a real diagnostic challenge, with a heterogeneous clinical picture, atypical for multiple sclerosis (MS) presentation, and neuroradiological manifestations with a high suspicion of neoplastic diseases., Case Report: An 18-year old female patient presented to our Neurosurgical Out-patients' Clinic with symptoms atypical for multiple sclerosis, unremarkable neurological deficit, one tumefactive lesion on MRI, followed by relapse and another two lesions within a period of six months. We decided to perform biopsy of the tumefactive lesion with compressive effect. Serological and clinical data were negative for MS, and the patient did not respond well to corticosteroid therapy. Fresh frozen tumor tissue aroused a strong suspicion of gemistocytic astrocytoma, so total resection was done, but the definitive pathohistological examination confirmed tumefactive demyelination., Conclusion: For clinicians, it is important to consider demyelinating disease in the differential diagnosis of a tumorlike lesion of the central nervous system, in order to avoid invasive and potentially harmful diagnostic procedures, especially in younger patients., (Copyright © 2018 by Academy of Sciences and Arts of Bosnia and Herzegovina.)

- Epithelioid hemangioendothelioma is a rare vascular brain tumor. It develops from endothelial cells, usually in the liver, lung, bone and soft tissue. Primary localization of this tumor in the intracranial space is very uncommon; only 47 cases have been described in the literature. This tumor was initially classified as grade I (benign) in the World Health Organization ( WHO) 2007 classification. In 2016, this tumor was re-classified as grade III (malignant). Herein, the first case report of epithelioid hemangioendothelioma in the cerebellum of a male patient is presented. Complete surgical excision was done. No adjuvant therapy was administered. Magnetic resonance imaging performed 2 years after the surgery continued to show no recurrence of the tumor. To our knowledge, this is the first report of cerebellar location of this rare tumor. In addition, the authors report drastic re-classification of the epithelioid hemangioendothelioma from the benign tumor (WHO 2007) to a malignant one (2016), which significantly changes postoperative management and follow up of this brain neoplasm.

Introduction: Various studies confirm the biocompatibility and efficacy of clips for certain target tissues, but without any comparative analysis of hematological parameters. Therefore, we conducted a study to assess the possible association of the implantation of titanium and plastic clips in the neurocranium with possible morphological changes in the blood cells of experimental animals., Materials and Methods: As a control, the peripheral blood smears were taken before surgery from 12 adult dogs that were divided into two experimental groups. After placing titanium and plastic clips in the neurocranium, the peripheral blood of the first group was analyzed on the seventh postoperative day, while the peripheral blood of the second group was analyzed on the sixtieth day. By microscopy of the blood smears, the following parameters were analyzed: the presence of poikilocytosis of the red blood cells, degenerative changes in the leukocytes and leukogram., Results: There were no statistically significant differences between the mean values of the groups. Monocytosis was detected (first group 22.83 % and second 16.30 %), as well as neutropenia (46.80 %, in the second group). Degenerative changes to neutrophils and the occurrence of atypical lymphocytes were observed in the second experimental group (60 th postoperative day)., Conclusion: A mild adverse effect from the biomaterials present in the neurocranium of dogs was detected, affecting the majority of leukocytic cells. A chronic recurrent inflammatory process was caused by the presence of the plastic and titanium clips in the brain tissue. No adverse effect of biomaterials on erythrocytes in the neurocranium was detected in the dogs studied. Further studies are necessary to explain the occurrence of degenerative changes in the neutrophils and lymphocytes., Competing Interests: • Conflict of interest: the authors declare no conflict of interest.

Aim To examine the presence of morphologic variations of occipital sulci patternsin patients with schizophrenia and migraine headacheregarding gender and laterality using magnetic resonance imaging (MRI). Methods This study included 80 patients and brain scans were performed to analyze interhemispheric symmetry and the sulcal patterns of the occipital region of both hemispheres. Average total volumes of both hemispheres of the healthy population were used for comparison. Results There was statistically significant difference between subjects considering gender (p=0.012)with no difference regarding age(p=0.1821). Parameters of parieto-occipital fissure (p=0.0314), body of the calcarine sulcus (p=0.0213), inferior sagittal sulcus (p=0.0443), and lateral occipital sulcus (p=0.0411) showed statistically significant difference only of left hemisphere in male patients with schizophrenia with shallowerdepth of the sulcus. Conclusion Representation of neuroanatomical structures suggests the existence of structural neuroanatomic disorders with focal brain changes. Comparative analysis of occipital lobe and their morphologic structures (cortical dysmorphology) in patients with schizophreniausing MRI, according to genderindicates a significant cortical reduction in the left hemisphere only in the group of male patients compared to female patients and the control group., (Copyright© by the Medical Assotiation of Zenica-Doboj Canton.)

Aim: To examine the presence of depressive symptoms in patients with multiple sclerosis relapse and its relation to disability and relapse severity., Methods: This study included 120 patients who were assessed during the acute relapse of multiple sclerosis according to Mc Donald criteria. Depression was assessed using Beck Depression Inventory II (BDI-II) calculating both affective and somatic symptom scores. The Expanded Disability Status Scale (EDSS) measured disability. Relapse severity was graded according to the difference between the EDSS score during relapse and EDSS score before the onset of the attack as mild, moderate or severe., Results: There was statistically significant difference between patients with different level of depression considering age (p<0.001), disability (p<0.001), relapse severity (p=0.005) and disease duration (p=0.032). Significant moderate positive correlation of depression with age (rho=0.43) and disability (rho=0.46) was confirmed. There was moderate correlation between disability and somatic symptoms of depression (rho=0.54, p<0.001) with only weak correlation between disability and affective symptoms of depression (rho=0.31, p<0.01). Multiple regression analysis showed that patient's age and relapse severity (p<0.05) were independently related to depression in these patients while disability did not., Conclusion: Correlation between disability and depression was mostly due to somatic symptoms of depression. Although highly correlated, depression during multiple sclerosis relapse was not independently predicted by disability. Depression should be recognized and treated independently from disability treatment, especially in the group of older patients with more severe relapse., (Copyright© by the Medical Assotiation of Zenica-Doboj Canton.)

Background: Fatigue is a common symptom of multiple sclerosis patients that may be present at all stages of the disease. The aim of this study was to determine presence of fatigue in multiple sclerosis patients during relapse and its relation to neurological disability and depression., Subjects and Methods: This cross-sectional study included 120 patients who were assessed during the acute relapse of relapsing-remitting multiple sclerosis. Applied research instruments were: general questionnaire, Expanded Disability Status Scale (EDSS), Beck Depression Inventory-II (BDI-II) and Fatigue Severity Scale (FSS). All patients were examined at the same appointment., Results: 54 (45%) patients were grouped into MS fatigue (MSF) group (FSS≥5) and 48 (40%) as non-fatigue (MSNF) group (FSS≤4). Mean FSS score was 4.83+/-1.49. Difference between MSF and MSNF patients was significant considering age (p<0.001), relapse severity (p=0.044), BDI score (p<0.001) and EDSS score (p<0.001). Positive correlations of fatigue (FSS) with age (rho=0.41, p<0.001), depression (BDI score) (rho=0.61, p<0.001) and neurological disability (EDSS score) (rho=0.55, p<0.001) were confirmed. After adjusting for depression, there was only weak positive correlation between fatigue and neurological disability (rs=0.38; P<0.001), while after adjusting for EDSS score, fatigue continued to correlate moderately with depression (r=0.48; p<0.001). Multiple linear regression analysis showed that BDI score (beta=0.380; p<0.001), EDSS score (beta=0.336, p<0.001) and the age (beta=0.202; p<0.05) are independently related to fatigue severity in this patients., Conclusion: Fatigue is a frequent symptom during multiple sclerosis relapse. Depression and, to a lesser degree, disability but not relapse severity are independently related to the presence of fatigue. Depression and fatigue should be recognized and treated during standard relapse treatment. Further research might focus on other factors influencing fatigue during multiple sclerosis relapse including evaluation of fatigue at the different time points.

Background: Research data from studies of functional neuroanatomy and neurochemistry indicate various dysfunctions in certain areas of the brain in individuals who suffer from chronic Posttraumatic Stress Disorder. These abnormalities are involved in the evolution of symptoms of PTSD, deterioration of cognitive functions and decreased quality of life of the survivors. The intensity of these symptoms is in direct correlation with the degree of dysfunction in the central nervous system. The aim of our study, was to evaluate the subjective perception of the Quality of life in subjects suffering from chronic PTSD and to compare prior to treatment results to results three and six months after receiving therapy, as well as to analyze whether perception of the Quality of life change related to treatment. The study was conducted at the Psychiatric Clinic of the Sarajevo University Clinical Center., Subjects and Methods: The sample consisted of 100 male persons, with war trauma experiences, whose age range was between 35 and 60 years, who were seeking treatment at the Psychiatric Clinic, University of Sarajevo Clinical Center and met the criteria for the diagnosis of chronic PTSD (Posttraumatic Stress Disorder) according to ICD-10. (International Statistical Classification of Diseases and Related Health Problems, 10th Revision). The exclusion criterion was prior psychiatric illness (traumatization before the war) and less than 8 years of education. All subjects received out-patient treatment. Their treatment involved psychopharmacological and psychotherapeutic therapy. The subjects were assessed using the following instruments: Sociodemographic Questionnaire designed by the authors for registering the social and demographic characteristics of the subjects (age, years of education, current employment, and socioeconomic status) and Manchester Quality of Life Scale (MANSA) as a self-report scale. The subjects were assessed prior to treatment, and three and six months after beginning the treatment (follow-up)., Results: There was an increase in the mean values of subjective perception of Quality of Life between the first (3.2352), second (3.4447), and third test (3.6090). Differences between these mean values were not statistically significant between the first and second test, but significant between the second and third test. Also differences between sociodemographic characteristics prior to treatment and during six month follow-up were not statistically significant. A significant increase has been noted in the number of contacts with close friends between the first, second and third test. Also, we recorded a decrease in pertaining aggressive and criminal behavior between the three tests., Conclusion: The results of our study indicate that subjects who are suffering from chronic PTSD have a lower subjective perception of their quality of life. Combined psychopharmacological and psychotherapeutic treatment over a period of six months lead to improvement in the perception of quality of life. This may indicate the need for longer treatment of individuals suffering from chronic PTSD. A significant increase has been noted in the number of contacts with close friends between the first, second and third test, reflecting positive treatment effects on everyday life functioning and coping skills.

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.

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.

Context: Although impunity for those responsible for trauma is widely thought to be associated with psychological problems in survivors of political violence, no study has yet investigated this issue., Objective: To examine the mental health and cognitive effects of war trauma and how appraisal of redress for trauma and beliefs about justice, safety, other people, war cause, and religion relate to posttraumatic stress responses in war survivors., Design, Setting, and Participants: A cross-sectional survey conducted between March 2000 and July 2002 with a population-based sample of 1358 war survivors who had experienced at least 1 war-related stressor (combat, torture, internal displacement, refugee experience, siege, and/or aerial bombardment) from 4 sites in former Yugoslavia, accessed through linkage sampling. Control groups at 2 study sites were matched with survivors on sex, age, and education., Main Outcome Measures: Semi-structured Interview for Survivors of War, Redress for Trauma Survivors Questionnaire, Emotions and Beliefs After War questionnaire, Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)., Results: The mean (SD) age was 39 (12) years, 806 (59%) were men, and 339 (25%) had high school or higher level of education. Participants reported experiencing a mean of 12.6 war-related events, with 292 (22%) and 451 (33%) having current and lifetime posttraumatic stress disorder (PTSD), respectively, and 129 (10%) with current major depression. A total of 1074 (79%) of the survivors reported a sense of injustice in relation to perceived lack of redress for trauma. Perceived impunity for those held responsible for trauma was only one of the factors associated with sense of injustice. Relative to controls, survivors had stronger emotional responses to impunity, greater fear and loss of control over life, less belief in benevolence of people, greater loss of meaning in war cause, stronger faith in God, and higher rates of PTSD and depression. Fear and loss of control over life were associated with PTSD and depression (odds ratio [OR], 2.91; 95% CI, 2.27-3.74 and OR, 2.30; 95% CI, 1.75-3.03, respectively), and emotional responses to impunity showed a relatively weaker association with PTSD (OR, 1.53; 95% CI, 1.16-2.02) and depression (OR, 1.39; 95% CI, 1.02-1.91). Appraisal of redress for trauma was not associated with PTSD or depression., Conclusions: PTSD and depression in war survivors appear to be independent of sense of injustice arising from perceived lack of redress for trauma. Fear of threat to safety and loss of control over life appeared to be the most important mediating factors in PTSD and depression. These findings may have important implications for reconciliation efforts in postwar countries and effective interventions for traumatized war survivors.

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.

Introduction: Correction of anemia in haemodialysed patients by recombinant human erythropoetin (R-Hu Epo) has been reported to improve sexual functions and hormonal disturbances. The purpose of this study was to evaluate how levels of sexual hormones and sexual function differ before and during a 12 month R-Hu Epo therapy., Materials and Methods: Thirty six male patients, mean age 47.5 +/- 12.78 and thirty six female patients, mean age 53.0 +/- 10.14, were included in this study. All patients were dialyzed 3 times per week with haemodialysis mean duration of 4.56 +/- 3.84 years. In order to evaluate sexual activities, the questionnaire was presented to all patients. The levels of prolactin, testosterone, FSH, LH were measured at the beginning of the study and every forth month during the study., Results: During twelve month therapy with Epo, serum hemoglobin significantly increased from 96.0 +/- 13.3 g/dl to 104.0 +/- 17.2 g/dl (p < 0.005), and hematocrit value rose from 0.284 +/- 0.046% to 0.308 +/- 0.052% (p < 0.05). Prolactin was not significantly decreased: at the beginning of the study was 540.3 +/- 302.2 and at the end 537.4 +/- 297.1 microIU/ml. Testosterone concentrations were in normal range in male patients (18.26 +/- 8.61 microIU/ml). There was significant difference in value of LH in female patients which increased from 57.68 +/- 62.58 to 73.79 +/- 68.52 IU/L. Improvement of sexual function was remarkable in female patients. In male patients sexual desire, frequency of sexual intercourse was strengthen after R-Hu epo therapy., Conclusion: Better sexual functions in our patients after treatment with R-Hu Epo did not correlate with hormonal disturbances except changes of LH that increased at the end of the therapy.

The acute polyradiculoneuritis represent acute inflamatory polyneuropathy with unknown cause, frequently induced by prior virus and sometimes bacteria infection. The purpose of this paper is to establish particularities of the clinical course and results of the disease during the war and the post-war time. Within the retrospective study we performed analysis of all patients suffering from the acute polyradiculoneuritis between January 1992 and December 2003 year who during the mentioned period where treated at the Department of Neurology in Sarajevo. In addition to the anamnysis and the clinical examination, diagnostic criteria where laboratory parameters, EKG, cardiological finding, cerebrospinal liquor (LP) and the EMG finding.

Myasthenia gravis is in group of disorders transmission at the motor end-plates is abnormal. Myasthenia gravis is characterised by fluctuating weakness, consisting principally of abnormal fatiguability, with improvement after rest. Since this symptom is subjective the diagnosis is very difficult in the early stages. Lambert Eaton's myasthenic syndrome (LEMS) is characterised by weakness and fatiguability of proximal limb muscles, mainly in legs, with improvement after exercise. Considering the degree of disease, similar symptomatology with a substantially different treatment, we performed this paper to enable the earlier diagnosis and adequate care of these patients.

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.

It is a general rule today, after a relevant diagnostics of an epilepsy, to start a monotherapy treatment, depending on a kind of a seizure, a life age and a general health condition. First line of monotherapy epilepsy drugs remain carbamazapine and sodium valproat. New drugs that are being introduced are: felbamat, gabapentin, lamotrigin, oxcarbazepin, tiagabin, topiramat, vigabatin and zanisamid. These are commonly used as add-on therapy, or as an addition for previously used antiepileptic. Their indicated areas are complex resistant partial seizures with or without generalization. Attention should be paid on proper dosage, interactions and toxicity. Regardless on the new epileptic era, according to reports of International League against epilepsy, most of the patients do not receive the drug that is the most appropriate for them concerning the price (cost-benefit). Neurosurgical methods in epilepsy treatment are: selective amygdalo-hyppocampotomy, temporal lobotomy, subpial resection, hemispherectomy, corpus callosotomy, removal of lesions like tumors or cysts provide encouraging results in reduction of epileptic seizures that can be followed by reduction of drug therapy. N. vagus stimulation is being wider introduced in resident epileptics. Treatment of epilepsy in women requires an approach to sexuality, conception, pregnancy, introduction of medicaments, antiepileptic terratogenity, contraception, motherhood and menopause. A special significance of modern approach to epilepsy is in treatment of elderly who have cerebrovascular and neurodegenerative disease as a cause of seizures. A complex treatment of epilepsy using pharmacological and neurosurgical approach requires supportive psychotherapy, socio-therapy, the work with a family, education about epilepsy and living a life with more quality having one.

Unlabelled: The state of mental confusion is described as an dependent risk factor in development of early and late epileptic-onset seizures following CVI. The aim of this paper is to determine the influence of confused state as possible predictor of symptomatic seizures in the course and following CVI., Material and Methods: The patients who were treated in The Department of Neurology for early and late-onset seizures in the course and following CVI in the period between 1.1.1989 and 31.12.1998., Results: We had total number of 106 patients with symptomatic seizures, 56 in the group of late-onset and 50 in the group of early seizures. 52.8% of the patients have a registered state of mental confusion at the admission to hospital (in the stage of acute CVI), 19.2% of patients had a clear sensorium. Disorder of consciousness of the type of coma was registered in 27.4% of the patients. There was statistically significant increase of the occurrence of mental confusion in the group of patients with late-onset seizures, 62.5% while there was a statistically significant increase of coma in conditions related to type, frequency and outcome of seizures. We can conclude that mental confusion has significant influence of the occurrence of late-onset seizures while it does not influence the type and frequency of seizures.

A seizure is a disturbance of movement, feeling or consciousness occasioned by sudden, inappropriate and excessive electrical discharges in the grey matter of the brain. The most common psychiatric disorder in epilepsy is interictal depression, with lifetime prevalence of 40 to 60%. Particular attention should be paid to suicidal ideations, due to the fact that most of the patients have easy access to potentially lethal when overdosed, antiepileptic drugs. The aim of our paper is to determine the presence of depressive symptoms in epileptic patients according to their treatment protocols (monotherapy or polytherapy), gender, age, social status, age when diagnosed, type and frequency of seizures. Prospective evaluation of monotherapy and polytherapy in 60 subjects, (30 subjects in each group), who were diagnosed with epilepsy. Assessment of depressive symptoms was performed with the use of BDI scale. In both groups there was a similar structure according to gender, mean age was 34 (with an s.d. of 11.06). More than 96 percent of the subjects had low or average socioeconomic status. Average age of first attack was 20.43 (with an s.d. of 11.9). In the group treated with monotherapy there was the biggest number of generalized convulsive seizures, and in the group treated with polyantiepileptic therapy there was the biggest number of partial complex seizures. Symptoms of moderate and severe depression were registered in 33% patients treated with monotherapy and 60% of patients treated with polytherapy (t = 2.198, for p less than 0.05). 16.7 percent of the patients had suicidal ideation. On the basis of our research we can conclude that significantly more frequent and severe depressive symptoms were found in the group of epileptic patients who were treated with polytherapy. In those patients the occurrence of partial complex seizures was the biggest, and their frequency was weekly or even daily.

The facial nerve has predominantly the motoric, and less sensitive function and gets nerved the muscle musculature of the face and its damages, significantly disturbs the function of the series of the muscles of the face. Regarding to this that the parases of the nervus facialis are often in the physician practice, we have written this article with aim to facilitate to the physicians in the practice the early establishing of the diagnosis, and also to give the instructions into the basic physical and rehabilitation procedures which is with success to carry out in patients with the damages of this nerve.

The epileptic seizures occur as the consequence of THE cerebrovascular insult. The morphologic changes at the brain after cerebrovascular insult are responsible for its occurrence. The pathophysioloogic basis of the late epileptic manifestations (after the second week after CVI) are the epyleptic activities of the morphological brain changes which behave according to the type of the "epileptogene focus". The epileptic seizures which occur during CVI are the result of the moleculary changes which occur in ischemia as the primary, and in haemohagia as secondary ones. The aim of our paper is to see the therapeutic aspects of the early and late epileptic seizures during and after cerebrovascular insult. In the course of the retrospective processed treatment of the patients at our clinic, and in the ten years period (01.01.1989-31.12.1998), we treated 7001 patients with the various types and subtypes of CVI. The incidence of the epileptic seizure moved from 0.65% (1994) till 3.14% (1998). In our sample we had 111 patients with late epileptic seizures, and 56 patients with early epileptic seizures. The early epileptic seizures in most cases were treated by Diazemap intravenously, while in the group of the patients with late seizures, most frequently we applied Fenobarbiton, and later diazepam intravenously. After the seizures and admission at the Clinic and in the future treatment most often we recommended and gave diazemap, phenobarbiton and karabo zepine. The therapeutic effects of the applied therapy were statistically significant. It is significant that there were more patients of the applied therapy statistically significantly. It is significant that there were more patients had no later seizures or of whose the seizures were more rarely (Hi2 = 14.209, n = 2, p < 0.01). On the basis of our research we can conclude that the therapeutic principle of the symptomatic epileptic seizures during and after cerebrovascular insult is the principle of the MONOTHERAPY. On the basis of our material we came to the conclusion that kabazepin optimally antiepileptic for this group of symptomatic epileptic seizures.

It is well known that drug abuse is common in early adolescence with almost the same epidemiological characteristics in economical developed and undeveloped countries. Aim of this study is to compare drug abuse among adolescents in the urban and rural areas. Research covers 600 adolescents equal gender and age distribution. Distribution of participants regarding to the rural and urban type of areas, was equal, as well. It was used Q 2000 questionnaires, which was comprehensive tool for all aspects of adolescents life. Results shows that drug abuse is much more common in urban areas (alcohol 62.4%; and cannabis 70.0%; in rural areas alcohol 37.6%; and cannabis 30.0%). Regarding to age, drug abuse is the most common among adolescents aged 15-17. Alcohol is much more related to boys, but regarding to cannabis there is almost no differences.