bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of Zhu’s acupuncture techniques to improve muscle strength of motion limbs in stroke patients
Authors: Seta Septadina Indri , Bahar Erial
Published: April 2024

Aim
To investigate the efficacy of Zhu acupuncture in motoric ability improvement of stroke patients. This research is a preliminary study in an effort to test the efficacy of Zhu's acupuncture technique in motor improvement in stroke patients.
Methods
This quasi-experimental study, with the pretest and posttest approach without control group design was conducted from
June to December 2019 at Holistica Medical Centre Complementary Clinic Palembang, Indonesia. Manual Muscle Testing (MMT) was used before and after the intervention. Zhu’s acupuncture was given five times a week for four weeks.
Results
Eight patients (four males and four females), who were in the recovery phase (within a period of recovery less than 1 year)
after stroke attack were involved. Seven patients experienced improvements in mild and moderate grades for shoulder joint movement after the intervention. Regarding the elbow joint movement, the majority of patients (seven) experienced mild and moderate improvements. Of the total patients who experienced improvement, the majority had mild grade improvements.
Conclusion
Zhu’s acupuncture technique was effective in improving muscle strength of motion limbs on stroke patients.
Epidemiology of neonatal sepsis caused by multidrug resistant pathogens in a neonatal intensive care unit level 3
Authors: Hadžić Devleta , Skokić Fahrija , Brkić Selmira , Saračević Amina , Softić Delila , Softić Dženana
Published: April 2024

Aim
Steady progress in intensive treatment worldwide has increased the survival of immature neonates, but with multiple invasive procedures, which have increased the risk of infection, thus the bacterial resistance to antibiotics. The aim of this study was to analyse the epidemiology of multidrug resistance pathogens as causative agents of neonatal sepsis in the neonatal intensive care unit.
Methods
A retrospective cohort study conducted at the Intensive care unit of the Paediatric Clinic of Tuzla over a three-year period (2016-2018) analysed epidemiology of neonatal sepsis caused by multidrug resistance pathogens. Statistical analysis applied standard methods, and the research was approved by the Ethics Committee of the institution.
Results
 Of the total of 921 treated neonates, multidrug resistance (MDR) pathogens among causative agents of neonatal sepsis were found in 22 neonates (2.38%) with no gender difference. Prematurity and low birth weight were confirmed as the most significant risk factors. From the maternal risk factors a significant difference was found in the first birth and in vitro fertilization. Clinically, MDR sepsis manifested frequently as late onset sepsis, with longer hospital stay and higher mortality. The findings of leukopenia, thrombocytopenia and coagulation disorders were significant. Gram negative bacteria were frequently isolated, in particular Acinetobacter, which showed the greatest resistance to antibiotics.
Conclusion
 Neonatal MDR sepsis is a threat to life, it complicates the treatment, increases costs and mortality. Outcomes can be improved by preventive strategies, earlier and more accurate diagnosis and rational use of antibiotics.
Interleukin 6 concentration elevation as a risk of carotid intimamedia thickness in chronic kidney disease patients with dialysis
Authors: Muzasti Riri Andri , Hariman Herman , Rahmi Daulay Elvita
Published: April 2024

Aim
To investigate the relationship between IL-6 concentration and the risk of carotid artery calcification in chronic kidney disease patients with dialysis (CKD-5D).
Methods
 This analytic observational cross-sectional study includes 95 clinically stable patients who underwent regular haemodialysis for at least three months at Rasyida Renal Hospital Medan, Indonesia. Serum IL-6 level was measured using the enzyme-linked immunosorbent assay (ELISA). Carotid artery calcification was determined by measuring Carotid Intima-Media Thickness (CIMT) using Real-Time B-mode ultrasound.
Results
 There were 53 males (55.8%) of the total samples with the mean duration of haemodialysis of 81.28±67.40 months. Ultrasound examination showed that 28 samples (29.5%) had carotid artery calcification. Statistical test significantly showed that patients with IL-6 ≥81.1 pg/mL were more likely to have carotid artery calcification with an increased risk of 12.92 times (95% CI: 5.54-30.12) compared to the group of patients who had IL-6 level <81.1 pg/mL (p <0.001).
Conclusion
This study proves that a high level of IL-6 can increase the risk of carotid artery calcification in CKD-5D patients.
Endothelin-1 level as a predictor of hepatopulmonary syndrome in liver cirrhosis
Authors: Darmadi Dr , Habriel Ruslie Riska
Published: April 2024

Aim
 To determine the role of endothelin (ET)-1 in predicting hepatopulmonary syndrome (HPS) in patients with liver cirrhosis. Methods
 A cross sectional study involving 80 liver cirrhosis patients aged 18 years or older was conducted in Adam Malik General Hospital Medan, Indonesia between July 2017 and June 2018. HPS diagnosis was confirmed from the presence of liver cirrhosis, abnormal oxygenation, and intrapulmonary vascular dilatations (IPVD). ET-1 level was measured from serum sample using ELI-SA method. Patients with coexisting primary pulmonary pathology and intrinsic heart disease were active smokers, and those who declined to participate were excluded. Statistical analysis was conducted at 95% confidence interval. p<0.05 was considered significant.
Results
 Majority the patients were male (56.3%) and had higher educational background (62.5%). Mean age of the patients was 51.3 (SD=12.6) years. The prevalence of HPS was 21.2%. The patients with HPS had higher ET-1 level compared to those without HPS (p<0.001). The patients with hepatic encephalopathy had 2.917 times higher risk for suffering from HPS, while the patients with Child Pugh score A had lower risk (0.738 times) for having HPS compared to subjects with Child Pugh score B and C. ET-1 level >187.5 mg/L had sensitivity and specificity for predicting HPS in subjects with liver cirrhosis of 82.35% and 81.25%, respectively.
Conclusion
 ET-1 could be used as a promising marker for HPS in patients with liver cirrhosis. ET-1 level of >187.5 mg/l had a good accuracy in predicting HPS in liver cirrhosis patient.
An ethanol extract of Senduduk fruit (Melastoma malabathricum L) inhibits the expression of vascular endothelial growth factor and tumour necrosis factor alpha in HeLa cells
Authors: Edianto Deri , Lelo Aznan , Ilyas Syafruddin , Nainggolan Marline
Published: April 2024

Aim
 Senduduk fruit (Melastoma malabathricum L) is native to Indomalaya and is believed to possess anticancer activity. This study investigated antiangiogenic and anti-inflammation effects of an ethanolic extract of Senduduk fruit (EESF) on HeLa cells.
Methods
 Cytotoxicity was assayed in HeLa cell cultures exposed to a concentration series of 500-7.8 µg/mL of EESF. IC 50 was determined with a methylthiazol-tetrazolium (MTT) cell viability assay. Antiangiogenic and anti-inflammation activity was evaluated by an immunocytochemical assay of vascular endothelial growth factor (VEGF) and tumour necrosis factor alpha (TNF-α) expression in HeLa cells cultured with 1× or 2× IC 50 or as a control without EESF.
Results
 IC 50 of the EESF was 956 µg/mL. The intensity of VEGF staining indicated moderate expression in HeLa cells in response to IC 50 , weak expression in response to 2×IC 50 , and strong expression in the absence of the EESF. While the intensity of TNF-α staining indicated moderate expression in HeLa cells in response to IC 50 and to the absence of EESF, and weak expression in response to 2× IC 50.
Conclusion
Senduduk fruit extract inhibited VEGF and TNF-α expression in HeLa cells in a concentration-dependent manner.
In vitro regulation of IL-6 and TGF-ß by mesenchymal stem cells in systemic lupus erythematosus patients
Authors: Masyithah Darlan Dewi , Munir Delfitri , Karmila Jusuf Nelva , Putra Agung , Ikhsan Riyadh , Alif Iffan
Published: April 2024

Aim
 To analyse the ability of mesenchymal stem cells (MSCs) to regulate interleukin 6 (IL-6) and transforming growth factor (TGF-β) expression in vitro under co-culture conditions in human systemic lupus erythematosus (SLE).
Method
This study used a post-test group design that used peripheral blood mononuclear cells (PBMCs) from SLE patients at Kariadi Hospital, Semarang, Indonesia, and MSCs from a human umbilical cord. The cells were divided into two groups. The control group of PBMCs was treated with a standard medium, and the treatment group was co-cultured with the MSCs at a 1:40 ratio. Following 24 h incubation, the levels of IL-6 and TGF-β released in the culture medium were measured using a specific ELISA assay.
Results
 This study showed a significant decrease in IL-6 level (p< 0.05) and a significant increase in TGF-β level (p<0.001) following 24 h of co-culture incubation of human SLE PBMCs cells and MSCs.
Conclusion
 The PBMCs-to-MSCs ratio of 1:40 can regulate the IL-6 and TGF-β levels in human SLE PBMCs.
Left to right shunt congenital heart disease as a risk factor of recurrent pneumonia in under five-year-old children: a single centre experience in Bandung Indonesia
Authors: Rahayuningsih Sri Endah , Budi Kuswiyanto Rahmat , Reviyani Suryaningrat Filla , Nataprawira Heda Melinda , Sukadi Abdurachman
Published: April 2024

Aim
Children with congenital heart diseases are at the greater risk of respiratory tract infection such as pneumonia. Recurrent pneumonia is one of the most major challenge for paediatric physicians. The aim of this study is to investigate risk factors of congenital heart diseases to recurrent pneumonia children.
Methods
This was a retrospective study of under five-year-old children hospitalized in Hasan Sadikin General Hospital Bandung
Indonesia from 2015 to 2018. Congenital heart diseases and pneumonia, as well as recurrent pneumonia, were identified. Congenital heart diseases diagnosis with and without pneumonia were reviewed.
Results
Of 6997 hospitalized children, in 1258 (18.0%) congenital heart diseases were found, of which 232 (18.4%) had recurrent
pneumonia. Most of those had left to right (L to R) shunt, 213 (91.8%). Congenital heart diseases in children aged under 1 year, 144 (62%) were more preponderant than in those aged 1–5 years. More than a half, 119 (51.3%) were males. Left to right shunt was documented as having recurrent pneumonia, of which patent ductus arteriosus and ventricular septal defect were the most common type in congenital heart diseases. Ventricular septal defect had a possibility for recurrent pneumonia by 1.551 times, and malnutrition 2.591 times.
Conclusion
Ventricular septal defect and malnutrition were identified as risk factors for recurrent pneumonia. Those patients require
multidisciplinary approach to prevent respiratory complications.
ABO groups as a risk factor for myocardial infarction in the population of Bosnia and Herzegovina
Authors: Mujičić Ermina , Granov Nermir , Šljivo Armin , Selimović Amina
Published: April 2024

Aim
To investigate the association of ABO blood types and appearance of myocardial infarction (MI) among the population in Bosnia and Herzegovina.
Methods
This was a cross sectional study conducted at the Department for Cardiovascular Surgery at the Clinical Centre of the University of Sarajevo from January 1 st to December 31 st 2019. Patients were divided into two groups, defined by their blood type, A (N=91) and non-A (N=109). ABO blood groups were determined using standard agglutination techniques. Information regarding history of MI was taken from their medical documentation during the preparation for surgery.
Results
 In total 200 patients were involved in this study. The study sample consisted of 151 (74.5%) males and 49 (25.5%) females. Mean age was 62.98 ± 7.73. Various risk factors associated with myocardial infarction were tobacco 92 (46.0%) and alcohol 54 (27.0%) consumption, obesity 77 (38.5%), diabetes mellitus 47 (23.5%) and hypertension 91 (45.3%). Being A blood type (OR=3.308; 95% Cl 1.317-8.311; p=0.011) and being male and having hypertension (OR=3.086; 95% Cl 1.262-7.545; p=0.013) significantly increased the risk for the development of MI among young adults. Patients with A blood type were significantly younger [median 58.0 vs. 63.0; U = 2738.5; p =0.027] when they developed MI compared to non-A blood type. Conclusion
 The age of myocardial infarction occurrence in the population of Bosnia and Herzegovina is lower in patients with blood group A compared to non-A blood types.
Preoperative tumour size as a predictor of the presence of lymphovascular invasion in lung adenocarcinoma
Authors: Grbić Kemal , Mehić Bakir , Udovičić-Gagula Dalma , Valjevac Amina , Ćemerlić Adem , Krupić Ferid
Published: April 2024

Aim
 To examine whether preoperative tumour size may serve as a biomarker for the occurrence of lymphovascular invasion (LVI) in centrally and peripherally located lung adenocarcinoma.
Method
 The study included 261 patients surgically treated for diagnosed lung adenocarcinoma. A ROC curve was used to determine the biomarker potential of tumour size relative to the occurrence of LVI. Binary logistic regression was used to show changes of tumour size impact on the status of LVI.
Result
 Tumour prevalence according to localization had no statistical significance (p=0.464), while the presence of LVI in central, as well as peripheral positions, was statistically significantly different (p<0.001). The area under the curve of 0.978 highlights the fact that tumour size is an excellent marker of the presence of LVI in centrally located adenocarcinomas of the lung. A similar finding was confirmed in peripherally located lung adenocarcinomas with an area below the curve of 0.943. Binary logistical regression showed that in centrally localized adenocarcinomas of the lung, each additional centimetre of tumour growth represents an increase in the likelihood of LVI+ by 17.14 times. In peripherally located adenocarcinomas of the lung, this increase in likelihood of LVI for each centimetre of growth was 5.46 times.
Conclusion
 With a high degree of sensitivity and specificity, preoperative tumour size may serve as an important biomarker and positive predictor of the presence of LVI in lung adenocarcinoma of any location.
Correlation between numerical and categorical immunohistochemical score of Ki-67 and HER2 with clinicopathological parameters of breast cancer
Authors: Dorić Mirsad , Kuskunović-Vlahovljak Suada , Lazović Salčin Edina , Radović Svjetlana , Čamdžić Nina , Babić Mirsad , Čampara Haris
Published: April 2024

Aim
To evaluate the relationship between numerical and categorical immunohistochemical score of Ki-67 and human epidermal growth factor of receptor 2 (HER2) with clinicopathological parameters of breast cancer (BC).
Methods
The study included 311 patients with invasive BC diagnosed at the Department of Pathology, School of Medicine in
Sarajevo, Bosnia and Herzegovina, during the period 2015-2019. The expression level of Ki-67 and HER2 was detected by immunohistochemical analysis.
Results
The expression of Ki-67, as a numerical variable correlated significantly with tumour grade (p=0.025), progesterone receptor (PR) (p=0.034) and categorical score of HER2 (p=0.028). When Ki-67 was categorized into high (>14%) and low (≤14%) level groups, a statistically significant association was found between Ki-67 level groups and HER2 status (categorical and numerical) (p=0.001 and p=0.043, respectively), as well as significant negative linear correlation with PR (p=0.037). The expression of HER2, as a numerical variable, showed a statistically significant correlation with tumour grade (p=0.038), PR (p=0.025) and categorical Ki-67 (p=0.043). Categorical score of HER2 correlated significantly with age (p=0.025), histologic type (p=0.039), tumour grade (p=0.016), estrogen receptor (ER), (p=0.002) progesterone
receptor (PR) (p=0.0001), and categorical and numerical value of Ki-67 (p=0.0001 and p=0.0001, respectively).
Conclusion
The results demonstrated that the categorical immunohistochemical score of HER2 provided a greater association
with clinicopathological parameters than numerical score of BC. Furthermore, a slightly better correlation with clinicopathological parameters was shown by the numerical value than by the categorical score of Ki-67 by applying a cut-off value of 14%
Serum total prostate-specific antigen (tPSA): correlation with diagnosis and grading of prostate cancer in core needle biopsy
Authors: Čamdžić Nina , Kuskunović-Vlahovljak Suada , Dorić Mirsad , Radović Svjetlana , Lazović Salčin Edina , Babić Mirsad
Published: April 2024

Aim
To investigate the impact of pre-treatment serum total prostate-specific antigen (PSA) level on prevalence of prostate carcinoma detection in prostate core needle biopsy, and its correlation with established prognostic factors.
Methods
Prostate needle biopsy samples of 115 patients with available pre-treatment serum total PSA (tPSA) level were analysed.
For all cases where morphology alone was insufficient, immunohistochemistry was performed using p63, CKHMW and AMACR antibody panel in order to confirm or exclude the existence of prostate carcinoma.
Results
Statistically significant positive correlation between serum total PSA values and prevalence of finding prostate carcinoma
in needle biopsy specimens was found (p=0.011), as well as in the case when the patients were classified into groups according to tPSA levels (p=0.028). Serum total PSA values and levels (level groups) showed significant positive correlation with Gleason score (p=0.029 and p=0.036, respectively) and Grade Group of prostate carcinomas (p=0.044 and p=0.046, respectively). Sensitivity of the screening test by using 4 ng/mL as cut off value for tPSA was
94.12% (CI: 80.32-99.28%), specificity 8.64% (CI: 3.55-17.00%), positive predictive value 30.19% (CI: 21.65-39.87%) and negative predictive value 77.78% (CI: 39.99-97.19%).
Conclusion
The increase of serum tPSA value increases the likelihood of finding prostate cancer on needle biopsy specimens. Due
to such findings and its positive correlation with a grade of prostate cancer, our study indicates that tPSA can still be considered as a useful tool both in detecting and predicting aggressiveness of prostate cancer. 
Phenotypic and genotypic detection of ESBL-producing E. coli isolates from chicken skin in Bosnia and Herzegovina
Authors: Hadžić-Hasanović Vildana , Jerković-Mujkić Anesa , Hasanović Ermin , Bačić Azra , Hukić Mirsada
Published: April 2024

Aim
 To identify E. coli from chicken meat, establish their antibiotic resistance profiles and to confirm ESBL isolates with real time PCR, as well as to identify risk factors and farming practice associated with the antimicrobial resistance E. coli.
Methods
 The study included 100 chicken skin samples collected randomly from retail supermarkets, butcheries and slaughterhouses. Disk susceptibility testing was performed using the Kirby-Bauer method. Detection of ESBL-producing isolates was performed with double disk synergy test. Molecular analysis of phenotypic ESBL-producing Escherichia coli strains was performed at 7500 real time PCR System. Molecular-genetic analysis included detection of CTX-M 1, 2, and 9 gene families and mutations in the TEM and SHV encoding extended spectrum β-lactamases.
Results
 Prevalence of the phenotypic ESBL-producing E. coli isolates was 29%, and they exhibited remarkable sensitivity to carbapenems (100%) as well as to amikacin (93.10%). All ESBL-producing strains were multidrug resistant. Molecular analysis was performed as the final confirmation of the production of extended spectrum β-lactamases for 24 isolates out of 29 phenotypicaly ESBL-producing E. coli isolates.
Conclusion
 It is important to pay attention to people's awareness of bacterial antimicrobial resistance in food chain, as well as to understand its effects on human health and the environment. Phenotypic and molecular analysis demonstrated the presence of ESBL-producing E. coli isolates from chicken skin samples.
The effect of bay leaf extract (Syzygium polyanthum) on vascular endothelial growth factor (VEGF) and CD31 (PECAM-1) expression in acute coronary syndrome
Authors: Hasan Refli , Gontar Alamsyah Siregar , Lindarto Dharma
Published: April 2024

Aim
 To investigate effect of bay leaf extract in endothelial integrity, observed by vascular endothelial growth factor (VEGF) level, VEGF and CD31 expression.
Methods
 Thirty-two acute coronary syndrome surgery-induced Wistar Rats (Rattus novergicus) were divided into 16 bay leaf extract (treatment) groups and 16 control groups, sacrificed on day 1, 4, 7, and 14 after the induction. Serum VEGF level was determined by ELISA and expression of VEGFR-2 and CD31 were detected on immunohistochemistry.
Results
 This study showed increased expression of serum VEGF level, and VEGFR-2 expression was found significantly on day 7 and 14 in the treatment group compared to the control group. CD31 expression was significantly different compared to the control groups on day 4, 7, and 14 of administration.
Conclusion
The potential effect of bay leaf extract on angiogenesis in acute coronary syndrome (ACS) as adjuvant for the treatment. Bay leaf extract has been shown to support angiogenesis and maintain endothelial integrity that leads to better prognosis for reperfusion on ischemic tissue.
Anti-fibrotic effect of intravenous umbilical cord-derived mesenchymal stem cells (UC-MSCs) injection in experimental rats induced liver fibrosis
Authors: Sungkar Taufik , Putra Agung , Lindarto Dharma , Juwita Sembiring Rosita
Published: April 2024

Aim
To investigate the effect of umbilical cord-derived mesenchymal stem cells (UC-MSCs) administration among liver
fibrosis experimental rat model via the regulation of angiotensin II type 1 receptor (AT1R) and platelet-derived growth factor-β (PDGF-β) due to their therapeutic potential to replace liver transplantation for advanced liver fibrosis. Yet the mechanism of action has been questionably associated with UC-MSCs fibrosis regression properties.
Methods
Sprague-Dawley (SD) rats (n=18) were separated into three groups (control, untreated liver fibrosis, and UC-MSCs treated group). Serum PDGF-β level was determined by enzymelinked immunosorbent assay (ELISA) following 14 days of UCMSCs injection. Meanwhile, AT1R expression was interpreted based on immunoreactive score (IRS) stained using polyclonal antibody and liver fibrosis stained with hematoxylin & eosin was graded using the METAVIR score.
Results
UC-MSCs were isolated successfully from rat umbilical cord. Liver fibrosis was observed following 14 weeks of CCl4
injection concurrent with higher serum level of PDGF-β, but the UC-MSCs-treated group had lower level (980.08 ±289.41 and 606.42±109.85 for untreated liver fibrosis and UC-MSCs treated group, respectively; p=0.004). There was also a high expression of AT1R among untreated liver fibrosis group, as well as highgrade liver fibrosis versus localized fibrosis and low level of AT1R expression among UC-MSCs treated-group (p=0.001).
Conclusion
 UC-MSCs administration could ameliorate liver fibrosis by reducing the AT1R expression and PDGF-β serum levels, and intervention through this signaling pathway could be alternative evidence for the causative of positive outcome.
A novel flavivirus strain detected in phlebotomine sandflies in Bosnia and Herzegovina
Authors: Hukić Mirsada , Avdihodžić Halida , Kurolt Ivan-Christian , Markotić Alemka , Hanjalić Jasna , Kapur-Pojskić Lejla , Mahmuljin Irma , Avdić Monia , Salimović-Bešić Irma , Smajlović-Skenderagić Lejla
Published: April 2024

Aim
Phlebotominae sandflies are primary vectors of phleboviruses, causing the sandfly fever disease. The aim of this study was to detect and report the presence of flaviviruses in Phlebotominae sandflies captured in Bosnia and Herzegovina.
Methods
After a microscopic and morphometric analysis, the final identification of collected Phlebotomus specimens was confirmed by PCR, using a hemi-nested polymerase chain reaction on extracted and reversely transcribed RNA.
Results
 We obtained a 155 nt long fragment of the viral non-structural protein 5 (NS5) gene (GenBank accession no. MN090154). The acquired nucleotide sequence, provisionally named as Drežnica, showed a maximum of 70-80% identity in 70-88% (110-137 nucleotides) of the query coverage with several Anopheles, Sabethes, Calbertado and Culex flaviviruses. Maximum likelihood phylogenetic analysis showed that the new flavivirus Drežnica clusters together with the flavivirus isolated from Culiseta annulata mosquitos.
Conclusion
 We report the presence of flavivirus in Phlebotominae sandflies, captured in Drežnica, Herzegovina for the first time. The next phase of research will be directed towards virus cultivation, obtaining a longer or complete virus sequence and clarifying the medical and epidemiological importance of the Drežnica virus.
Effects of semi-refined carrageenan (food additive E407a) on cell membranes of leukocytes assessed in vivo and in vitro
Authors: Tkachenko Anton , Onishchenko Anatolii , Roshal Alexander , Nakonechna Oksana , Chumachenko Tetyana , Posokhov Yevgen
Published: April 2024

Aim
To assess the impact of semi-refined carrageenan (E407a) on hydrophobic regions of phosphololipid bilayer in cell membranes of leukocytes collected from rats orally administered this food additive and white blood cells incubated with E407a.
Methods
Fluorescent probes (ortho-hydroxy derivatives of 2,5-diaryl-1,3-oxazole) were used to estimate the state of lipid bilayer in leukocytes obtained from rats orally exposed to the food additive E407a and in white blood cells incubated with E407a.
Results
No noticeable changes in the physico-chemical properties were observed in the lipid membranes of leukocytes in the region where the probes locate in response to oral intake of semi-refined carrageenan. Incubation of leukocytes with E407a solutions resulted in a decrease in polarity and proton-donor ability of leukocytes in the area of carbonyl groups of phospholipids and in the area of hydrocarbon chains of phospholipids near the polar region of the bilayer.
Conclusion
Membrane fluidity abnormalities found in cells exposed to E407a are similar to those observed in patients with IBD
suggesting that contribution of carrageenan to IBD development may be partially explained by leukocyte membrane modifications. 
The importance of plasma ferritin values in blood donors for the evaluation of body iron store in a five-month period
Authors: Ćatović-Baralija Elma , Ahmetović-Karić Gorana , Hasić Sabaheta , Avdagić Nesina , Babić Nermina
Published: April 2024

Aim
To present haemoglobin and ferritin parameters in donors to highlight the importance of serum ferritin testing for the purpose of evaluating iron depots in order to make recommendations for preserving a population of blood donors.
Method
A prospective study was conducted on 80 blood donors divided in two groups: group I (regular donors, n =40) and group II
(irregular donors, n=40). Haemoglobin and ferritin were measured twice every 45 days, before two consecutive blood donations.
Results
By measuring haemoglobin and ferritin values before donation in both groups, a decrease of initial ferritin value in Group I
relative to Group II was observed (without statistical significance). A significant decrease was found between repeated measurements for both parameters in both groups, indicating equal intensity of the decline in value regardless of a donor status. Measurement of ferritin before and after donation revealed statistically significant loss of ferritin in all examinees (p=0.011). The decline in haemoglobin after donation, although significant, did not fall below the reference value for donation in either women or men.
Conclusion
Results indicate the need for periodic monitoring of the plasma value of ferritin in voluntary donors who donate blood
more than twice a year and the possible oral supplementation with iron.
Comparison of analgesic efficacy of acetaminophen monotherapy versus acetaminophen combinations with either pethidine or parecoxib in patients undergoing laparoscopic cholecystectomy: a randomized prospective study
Authors: Mulita Francesk , Karpetas Georgios , Liolis Elias , Vailas Michail , Tchabashvili Levan , Maroulis Ioannis
Published: April 2024

Aim
To investigate analgesic effect of three different regimens of combination of analgesics administered to patients undergoing laparoscopic cholecystectomy.
Methods
Patients undergoing laparoscopic cholecystectomy were randomly allocated to one of three groups on admission, depending of a prescribed post-operative analgesic regimen. Patients allocated to the group A received a combination of intravenous (IV) acetaminophen and intramuscular (IM) pethidine, patients in the group B received a combination of IV acetaminophen and IV parecoxib, and the patients of the group C received IV acetaminophen monotherapy. Analgesic therapy was administered at regular intervals. Pain was evaluated utilizing the numeric rating scale (NRS) at 5 time points: the first assessment was done at 45 minutes, the second, third, fourth and fifth at 2, 6, 12, and 24 hours
post-administration, respectively. Postoperative pain intensity was measured by NRS within the groups and between the groups at each time they analysed using one-way repeat measured ANOVA and Post Hoc Test-Bonferroni Correlation.
Results
A total of 316 patients were enrolled. The analgesic regimens of groups A and B (combination regimens consisting of IV acetaminophen and intramuscular pethidine and IV acetaminophen and IV parecoxib, respectively) were found to be of equivalent efficacy (p=1.000). In contrast, patients in group C (acetaminophen monotherapy) had higher NRS scores, compared to both patients in groups A (p<0.01) and B (p<0.01).
Conclusion
This study confirms the notion of a significant opioid-sparing effect of parecoxib in postoperative pain management
after laparoscopic cholecystectomy.
Efficacy and safety of three plant extracts based formulations of vagitories in the treatment of vaginitis: a randomized controlled trial
Authors: Durić Kemal , Kovčić Hadžiabdić Selma , Durić Mahira , Nikšić Haris , Uzunović Alija , Džudžević Čančar Hurija
Published: April 2024

Aim
There are more and more herbal preparations that are used for the purpose of treatment and improvement of the clinical manifestation of vaginitis not only by patients themselves, but also by healthcare professionals. Plant species, St. John’s wort, chamomile, calendula, yarrow, shepherd’s purse and tea tree oil are all well known for their anti-inflammatory, antimicrobial and wound healing activity. This paper presents the results of a clinical study in which three herbal formulations/vagitories, based on extracts of St. John’s wort, chamomile, calendula, yarrow, shepherd’s purse and tea tree
oil, were investigated for their effectiveness on vaginitis.
Methods
This was a randomized controlled clinical study that included 210 women with diagnosed vaginitis. Patients were divided into two basic groups, women in reproductive period and postmenopausal period. Three subgroups including 30 patients
each received one of the three vagitorie formulations for 5 days, after which the effects on subjective and objective symptoms were monitored.
Results
Three types of vagitories based on plant extracts had a positive effect in the treatment of vaginitis. Vagitories based on tea
tree oil showed better efficiency compared to vagitories with St. John’s wort and vagitories based on extracts of five plants. Women in postmenopausal group reported better tolerability of St. John’s wort-based and five herbs-based vagitories compared to tea tree oil based vagitories.
Conclusion
Investigated vagitories showed a positive effect on both objective and subjective symptoms of vagitnis. No serious
side effects were reported.
Balneogynaecology in the 21st century: increasingly recommended primary and complementary treatment of chronic gynaecological diseases
Authors: Habek Dubravko , Cerovac Anis , Kamerić Lejla , Nevačinović Enida , Šerak Adnan
Published: April 2024

Balneo-gynaecological treatment methods include external bath hydrotherapy, sedentary baths and topical dressings/cataplasm, and internal (intravaginal or intrarectal use of peloids and mineral water). Hyperosmolar thermal spas have been very popular in the treatment of infertility due to the improvement of symptoms of chronic pelvic pain, endometriosis, chronic vascular and inflammatory pelvic diseases. Acute pelvic inflammatory syndrome is a contraindication for balneo-hydrotherapy while hyperthermal hydrotherapy is contraindicated in endometriosis and neurovegetative dystonia due to the stimulation of hyperemia, which worsens the clinical picture. Balneo-hydrotherapy is not recommended in metrorrhagia and malignancies. Balneogynaecological treatment certainly has its own primary but also complementary role in the treatment of chronic gynaecological diseases and is increasingly recommended today.
Characterization and clonal representation of MRSA strains in Tuzla Canton, Bosnia and Herzegovina, from 2009 to 2017
Authors: Numanović Fatima , Dermota Urška , Smajlović Jasmina , Janežič Sandra , Tihić Nijaz , Delibegović Zineta , Bećirović Amela , Muratović Edina , Gegić Merima
Published: April 2024

Aim
To characterize methicillin-resistant S. aureus (MRSA) strains phenotypically and genotypically and to determine their clonal affiliation, representation and antibiotic resistance profile.
Methods
 A total of 62 randomly selected MRSA isolates of different clinical samples collected from 2009 to 2017 were phenotypically and genotypically analysed. Phenotypic analyses were performed by standard microbiological procedures, and using VITEK 2/AES instrument as well as MALDI-TOF (matrix-assisted laser desorption/ionization) technology. Genotypic characterization included spa, MLST (multilocus sequence typing) and SCCmec typing, and detection of the Panton-Valentine leukocidin (PVL) and other enterotoxin encoding genes.
Results
The largest number of isolates, 21 (33.87%) belonged to ST228-MRSA-I, spa type t041, t1003 and t001. Other major
clones were: ST239-MRSA-III, spa type t037 and t030 (27.41%); ST8-MRSA-IV, spa type t008 and t121 (12.9%); ST247-MRSA-I, spa type t051 (4.83%). PVL was detected in 10 isolates (SCCmec IV/V). During 2009 and 2010 the most frequent MRSA strain was South German clone, ST228-MRSA-I (80% and 90%, respectively), while in later years it was replaced with Brazilian-Hungarian clone ST239-MRSA-III (75% in 2015 and 2016). The South German clone, spa type t041 in 90.48% of cases was resistant to clindamycin, ciprofloxacin, erythromycin, cefoxitin, gentamicin, kanamycin, tobramycin and penicillin, while 70.58% samples of the Brazilian-Hungarian clone spa type t037 were additionally resistant to tetracycline and rifampicin.
Conclusion
This research can supplement the existing knowledge about the clonal distribution of MRSA in Bosnia and Herzegovina
and their sensitivity to antibiotics in order to improve the national control of these infections
Prevalence of Cryptosporidium spp. and Blastocystis hominis in faecal samples among diarrheic HIV patients in Medan, Indonesia
Authors: Yulfi Hemma , Fakhrur Rozi Muhammad , Andriyani Yunilda , Masyithah Darlan Dewi
Published: April 2024

Aim
To investigate the prevalence of Cryptosporidium sp. and B. hominis among human immunodeficiency virus (HIV) positive patients in two different outpatient clinics, Haji Adam Malik General Hospital and Primary Care Centre of Padang Bulan, Medan, Indonesia, between two interval periods.
Method
 Cryptosporidium spp. microscopic examination, as well as Jones’ medium for B. hominis, were conducted in the Parasitology Laboratory, enzyme-linked immunosorbent assay (ELISA) was done in the Multidisciplinary Laboratory, Faculty of Medicine, Universitas Sumatera Utara. This was a cross-sectional study, involving 54 diarrheic HIV positive patients (44 males, 10 females). The data were analysed by Spearmen rank correlation, interrater agreement, and 2 tests.
Results Infection rate for Cryptosporidium spp. and B. hominis was 24% (13 patients) and 9% (five patients), respectively. The prevalence of CD4 cell count below 200 cell/mm3 was relatively high, 29.6% (16 patients). There was a significant relationship between cryptosporidiosis and CD4 cell count (p=0.01; OR 1.57; 95% CI 1.25-1.99). Microscopic examination was superior over ELISA, whose diagnostic value for sensitivity and specificity was 46.15% and 100.0%, respectively, and Kappa (K) coefficient of 0.56.
Conclusion
The prevalence of cryptosporidiosis among HIV patients was still relatively high. CD4 count showed a significant
relationship with Cryptosporidium spp. infection, but not with Blastocystic hominis. Microscopic examination is still the most
reliable technique to diagnose the parasites in faecal samples.
Key factors influencing clinical and functional outcomes in extracapsular proximal femur fractures: the role of early weightbearing - one-year follow-up cohort of 495 patients
Authors: Sanchez-Munoz Enrique , Lozano-Hernanz Beatriz , Velarde-Garrido Daniel Vicente , Alarma-Barcia Leticia , Sanchez-Mayoral Victor Trivino , Romera-Olivera Paula , Lopez Palacios Cristina
Published: April 2024

Aim
To establish a correlation between immediate post-surgical weight bearing in extracapsular hip fractures and final functional outcome as well as to study the correlation between immediate post-surgical weight bearing and morbidity and mortality during the first year.
Methods
Retrospective observational cohort study including 495 consecutive patients ≥75 years old operated of extracapsular proximal femur fracture. Medical records were reviewed and information of demographic data, radiological evolution, time to weight-bearing, mortality rate, medical and surgical complications and final ambulation status were recorded.
Results
Patients’ mean age was 87 years; 378 (76.4%) were females. One-year mortality rate was 21.2%. Immediate weight bearing was associated with: decreased hospital stays (7.5 days vs. 9.2 days; p=0.001) and decreased medical complications (78.3% vs. 82.3 %; p=0.02). Surgical complications prevalence was comparable (4.4% vs. 7.8 %; p=0.43) within the groups. Despite mortality rate was lower in patients with immediate weight bearing (21%) compared with delayed weight bearing (21.4%), the difference was not statistically significant (p=0.9).
Conclusion
Immediate weight bearing was associated with shorter hospital stay and fewer medical complications, improving functional outcome. Also, no correlation was found between immediate weight bearing and increased surgical complications or mortality rate during first year after surgery.
Rare and uncommon diseases of the hip: arthroscopic treatment
Authors: Rigon Alberto , De Marchi Wondi , Innocenti Matteo , Meccariello Luigi , Innocenti Massimo , Carulli Christian , Schiavo Alberto
Published: April 2024

Aim
Uncommon and rare hip diseases are sources of pain and functional limitation particularly in young patients. Some of these conditions may be nowadays treated by arthroscopy due to the expertise and technical tips that high-volume hip arthroscopies have achieved during the last decades ensuring a wider range of indications for such a procedure. The aim of this study was to evaluate clinical results of arthroscopy in treating uncommon or rare diseases of the hip at a single Institution.
Methods
Thirteen patients affected by several types of diseases were treated by a hip arthroscopy and retrospectively evaluated.
All patients were operated by the same surgeon, instrumentation and technique, but postoperative rehabilitative protocol was tailored on each patient and his disease. Each patient underwent a specific imaging, consisting of dedicated x-rays and arthro-MRI. Modified Harris Hip score (mHHS) and Non-Arthritic Hip score (NAHS) were used before and after surgery to clinically assess the outcome.
Results
All patients reported satisfaction, pain relief, and a good functional recovery at the latest follow-up visit. Only one patient
affected by chondromatosis reported a recurrence of synovitis and needed a further arthroscopy 25 months after the index operation. No complications were reported at the latest follow-up. The NAHS and mHHS showed good improvements and all patients referred high satisfaction.
Conclusion
Hip arthroscopy performed by expert and high-volume surgeons may ensure good results in patients affected by uncommon and rare hip diseases.
Scrotal trauma: interest of preoperative ultrasound in the prediction of the rupture of the tunica albuginea
Authors: Manno Stefano , Cicione Antonio , Bagalà Lorenzo , Catricalà Antonio , Ronchi Piero , Tiburzi Simona , Giannace Carolina , Dell’Atti Lucio
Published: April 2024

Aim
Scrotal bruises are quite frequent injuries affecting young subjects, with psychological repercussions on body image and fertility. The interest of ultrasound in the context of the emergency remains controversial. The aim of our study was to investigate clinical, ultrasonographic and operative features of scrotal contusions, and to evaluate the contribution of ultrasound in the description of traumatic lesions.
Methods
In this retrospective and descriptive study 71 scrotal contusions operated from December 2015 to April 2020 were collected. We retrospectively analysed 26 patients (aged between 14 and 79 years) of 71 who sustained a scrotal ultrasound, where the latter was positive. The primary endpoint was albuginea rupture, whose concordance between ultrasound and surgery was assessed using the Kappa method. Positive and negative predictive values, sensitivity and specificity for the presence of albuginea rupture were evaluated for a set of ultrasound data: scrotal haematoma, haematocele, regularity of testicular contours, testicular fracture (specificity (93%), testicular haematoma, and Doppler signal intensity.
Results
Surgical treatment was necessary in 26 (37%) patients; only six orchiectomy were performed. Surgical exploration should
be performed if haematocele is found in the genital examination without any ultrasound complement.
Conclusion
The ultrasonography is useful, detailed and accurate when the haematocele is not clinically evident. 
A new prognostic pelvic injury outcome score
Authors: Meccariello Luigi , Razzano Cristina , De Dominicis Cristina , Herrera-Molpeceres Juan Antonio , Liuzza Francesco , Erasmo Rocco , Rocca Guido , Bisaccia Michele , Pagliarulo Enzo , Cirfeda Pietro , Gómez Garrido David , Pica Giuseppe , Rollo Giuseppe
Published: April 2024

Aim
To propose a new prognostic classification system for pelvic injuries based on a new detailed and all-encompassing evaluation of the injury pelvic outcome score and to check the prognostic value of this classification and evaluate its reliability and reproducibility.
Methods
From January 2017 to June 2020 from 156 pelvic fractures treated at our hospitals, 98 patients with pelvic fractures were
recruited according to inclusion and exclusion criteria. All patients compiled three scores (New Score System, Majeed Score, SF-12) sessions two times during the hospital stay to evaluate the endpoint before the trauma and two years after the trauma. All patients carried out three tests independently. The evaluation of three scores included a pelvic and general complication after the surgery, the times needed to compile three score system. For reliability of the new score systems we evaluated the inter-observer or intraobserver agreement, the prediction strength of each score, and a prognostic value.
Results
A total of 98 patients were enrolled (74 were males and 24 females) with mean age of 43.6 (±18.6) (range 16-75) years. Tau B Kendall value was 0.827 for the new score system, 0.673 for the Majeed score, 0.746 for SF-12, there was p<0.05 for the new score system.
Conclusion
The new score system is prognostic, reliable, reproducible and can become a useful instrument to adequately correlate
the long-term outcomes of pelvic injury fractures. Also, it provides a better evaluation of pain, work, sexual possibilities and satisfaction, balance-sitting-walking and psychological status.
Brainstem haemorrhage as a rare complication of burr hole craniostomy
Authors: Corinaldesi Rodolfo , Castrioto Corrado Filippo , Barbieri Francesca Romana , Mastronardi Luciano , Ripani Umberto
Published: April 2024

Aim
Evacuation through burr hole craniostomy is the most common type of chronic subdural hematoma surgical treatment,
with a morbidity rate of 0-9%.
Methods
 Here we present a case of 66-year-old Caucasian woman with bilateral hemispheric chronic subdural hematoma and
left transtentorial uncal herniation. Bilateral burr hole craniostomy with gradual and simultaneous evacuation was performed and subdural drains were placed with daily strict monitoring of drained fluid.
Results
Despite immediate prompt neurological improvement, on the second postoperative day bilateral ptosis and left medial rectus weakness occurred, with no signs of consciousness deterioration. Radiological exams revealed a 9 x 6 mm haemorrhage of the tegmentum mesencephali. In the next day progressive neurological improvement occurred and a follow-up at 1 month revealed persistence of bilateral ptosis with almost complete regression of the left medial rectus weakness.
Conclusion
Although burr hole craniostomy is considered a minor procedure, rare but fatal complications like brainstem haemorrhage may occur. Bilateral simultaneous and gradual drainage, strict monitoring of drained fluid and blood pressure in the perioperative period and frequent neurological with prompt radiological assessment in case of clinical worsening, should be the mainstay of a correct management of chronic subdural hematoma (particularly if bilateral) in order to avoid potentially fatal complications. 
Radiographic and functional outcome of complex acetabular fractures: implications of open reduction in spinopelvic balance, gait and quality of life
Authors: Muzii Vitaliano F. , Rollo Giuseppe , Rocca Guido , Erasmo Rocco , Falzarano Gabriele , Liuzza Francesco , Bisaccia Michele , Pica Giuseppe , Franzese Raffaele , Meccariello Luigi
Published: April 2024

Aim
To investigate the effects of surgical reduction of complex acetabular fractures on spine balance, postural stability and quality of life.
Methods
Twenty-six patients with acetabular fractures surgically treated by open reduction and internal fixation were divided into
two groups according to the amount of reduction. Group A consisted of 18 patients with satisfactory reduction (≤2 mm), and group B of eight patients with incomplete reduction (>2 mm). Functional outcome was measured with Harris Hip Score (HHS), Oswestry Disability Index (ODI), and Short Form (12) Health Survey (SF12). Radiological parameters were assessed with standing whole spine, pelvis and hip X-rays, including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and sagittal vertical axis (SVA). Follow-up intervals were 1, 3, 6 and 12 months and annually thereafter. Gait analysis and baropodometry were performed after 24 months of operation.
Results
Mean HHS, ODI, and SF-12 was improved during the first postoperative year in both groups. After two years average scores kept improving for group A, but worsened for group B. Mean PI, PT, and SS increased in both groups during the first postoperative year, with further increase after two years only in group B. After two years, 16 (89%) patients in group A and four (50%) in group B had a balanced spine (SVA <50 mm). Gait analysis and baropodometry showed greater imbalance and overload for group B compared to group A.
Conclusion
In the long term, incomplete reduction of associated acetabular fractures may lead to poor outcome because of secondary spinopelvic imbalance, with posture and gait impairment.