bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of statin administration on IL-6 and IL-1b expression in peripheral blood mononuclear cells of a hypertensive patient with SARS-CoV-2 spike protein stimulation
Authors: Andrianto Andrianto , Pikir Budi Susetyo , Amalia Rizki , Yusriza Teuku , Alzahra Fatimah , Qurota A’yun Maya , Jonatan Michael
Published: April 2024

Aim
The infection of the SARS-CoV-2 virus potentially causes a cytokine storm with elevated IL-6 and IL-1β levels. Statin therapy was common among COVID-19 patients due to their cardiovascular comorbidities. However, the effect of statins on COVID-19 infection is unclear. The aim of this study was to evaluate the impact of statin administration on IL-6 and IL-1β level in peripheral blood mononuclear cells (PBMCs) after SARS-CoV-2 spike protein stimulation.
Methods
The PBMCs were isolated from a hypertensive patient and stimulated by the SARS-CoV-2 subunit S1 spike protein. The
PBMCs were then divided into four treatment groups and treated with simvastatin at various doses (10 µM, 25 µM, 50 µM,
and control). IL-6 and IL-1β were measured from the supernatant using the ELISA method.
Results
The stimulation of SARS-CoV-2 spike protein in PBMC cell culture statistically increased IL-6 and IL1β expression of 5.2
and 35.07 fold, respectively (p<0.05). The expressions of IL-6 and IL-1β were not statistically significant among three simvastatin doses and control.
Conclusion
Statin administration did not have significant effect on IL-6 and IL-1β levels in PBMCs after SARS-CoV-2 spike protein stimulation in this study, a further study is needed.
Assessment of postoperative cosmetic outcomes of distal form hypospadias repair with the Hypospadias Objective Scoring Evaluation (HOSE)Assessment of postoperative cosmetic outcomes of distal form hypospadias repair with the Hypospadias Objective Scoring
Authors: Jonuzi Asmir , Zvizdić Zlatan , Milišić Emir , Kulovac Benjamin , Mešić Amira , Vranić Semir
Published: April 2024

Aim
A standardized assessment for the optimal repair of hypospadias remains elusive. The aim of this study was to assess a postoperative cosmetic outcome of hypospadias repair using a validated questionnaire, Hypospadias Objective Scoring Evaluation (HOSE).
Methods
During the period between January 2016 and May 2019, 40 patients who underwent hypospadias repair were identified and they agreed to a follow-up using the HOSE. Distal hypospadias repairs underwent a cross-sectional assessment of the cosmetic outcome. Cosmetic assessment was performed by an independent physician using the HOSE scoring system.
Results
The native meatus was coronal in 10 (25%), subcoronal in eight (20%), and distal penile in 22 (55%) patients. Mean followup was 35.90 months (SD ±29.58) postoperatively (range 12–162 months). Complications occurred in one (2.5%) patient. Out of 40 uncomplicated repairs, 39 (97.5%) were satisfactory. A vertical slit-like meatus located at the distal glans was created in 33 (82.5%) boys, and at the proximal glans in seven (17.5%). The urinary stream was single and straight in 39 and spray in one patient. A straight erection was observed in 39 (97.5%) boys. The median HOSE score was 16 (range 12–16). One patient had a small, single coronal fistula. The technique used included tubularised incised plate urethroplasty.
Conclusion
The HOSE score is simple, easy, non-invasive and non-expensive tool for objective assessment of long-term outcomes of hypospadias repair.
The efficacy and safety of electrolyzed water against Covid-19 as an alternative hand sanitizer
Authors: Hidayat Rachmat , Wulandari Patricia
Published: April 2024

Aim
To investigate the efficacy of electrolyzed water against viruses and its safety to the skin.
Methods
Virus culture was carried out at level-3 Bio-Safety (BSL3) facilities. The test material was prepared at room temperature
mixed with one part virus suspension and one organic load. As an antiseptic and disinfectant control, 0.7% formaldehyde was used. Cytotoxic effects of electrolyzed water were performed on Vero cells. In order to assess the safety of electrolyzed water, a skin sensitivity test was conducted for electrolyzed water exposure.
Results
Electrolyzed water has a higher value of reduction factor than antiseptic and disinfectant control, formaldehyde, and it
was statistically different from control. Cytotoxicity test results on Vero cells showed that electrolyzed water demonstrated safety in Vero cell viability. As many as 58 participants who met the inclusion criteria took electrolyzed water sensitivity test to the skin. The sensitivity test showed that participants with reactions to electrolyzed water were all female, with a mean age of 32.6 years. The patch-test was positive in 3 of 4 participants who reacted to the product.
Conclusion
Electrolyzed water is effective as a new antiseptic and disinfectant against viruses and safe for human skin.
Adherence to preventive behaviours and risk of COVID-19 infection: a case-control study
Authors: Hosseinabadi Reza , Biranvand Shoorangiz , Anbari Khatereh
Published: April 2024

Aim
To investigate the relationship between adherence to preventive behaviors and risk of COVID-19 infection.
Methods
In this case-control study, 491 participants were selected through convenience sampling. First, the samples of the case
group (COVID-19 patients) were selected, and then the control group was matched with the case group based on age, gender, and occupation. The criteria for diagnosing COVID-19 for the case group were self-reported positive PCR test or lung involvement on a chest CT scan. Descriptive statistics were used to summarize the results, and an odds ratio was calculated to quantify the magnitude of the association using a 95% confidence interval (CI) and a p<0.05.
Results
The results showed that, compared to those who always wear a mask, the risk of contracting SARS-CoV-2 was 3.153 times higher in those who used no masks (95% CI: 0.953-10.434) and 3.779 times higher in those who used masks occasionally (95% CI:1.929-7.37). The participants who never observed physical distancing and handwashing were 2.25 times more likely to get COVID-19 than those who always observed (95% CI:1.719-4.954; OR=2.258).
Conclusion
Participants who fail in following the protective measures, especially wearing a mask regardless of its type, had
a higher risk of COVID-19 infection. Therefore, it is recommended to use a mask consistently, especially during the peak of COVID-19 waves.
Mid-term outcomes in the treatment of retroperitoneal sarcomas: a 12-year single-institution experience
Authors: Verras Georgios-Ioannis , Mulita Francesk , Bouchagier Konstantinos , Bousis Dimitrios , Kehagias Dimitrios , Liolis Elias , Perdikaris Ioannis , Filis Dimitrios , Perdikaris Panagiotis , Panagiotopoulos Ioannis , Maroulis Ioannis , Benetatos Nikolaos
Published: April 2024

Aim
To present the experience from collective data regarding patients with retroperitoneal sarcomas that have been operated in and followed up by the University General Hospital of Patras in Rion, Greece, between 2009 and 2020.
Methods A retrospective analysis of adult patients treated at our hospital with a diagnosis of primary retroperitoneal sarcoma who underwent tumour resection.
Results
Data from 29 patients were analysed. The mean age at diagnosis was 56.1 years; 55.2% of patients were male (n=16). Liposarcomas (on histology) were identified in 19 (65.5%) patients, leiomyosarcoma six (20.7%), and other histologic subtypes in four (13.8%) patients. Tumours >5cm were presented in 27 (93.1%) patients. Negative margins were attained in 13 (44.8%) of all patients who underwent surgical resection. Five (17.2%) patients received neoadjuvant radiation, four (13.8%) postoperative radiation, and three (10.3%) patients received both chemotherapy and radiation
prior to surgery with the rest of the patients being treated with surgical excision alone. A 3-year follow-up was successful in 21 (72.4%) patients; five (23.8%) patients died. In total, 16 (55.2%) patients were found to have a local recurrence, with no significant difference in patients' age, gender, tumour size, histology, negative surgical margin (Ro) resection, neoadjuvant chemotherapy, or radiation therapy. There was a significant difference in the 3-year survival rate between patients having positive or negative surgical margins (p=0.027).
Conclusion
The higher 3-year survival rate in patients with retroperitoneal sarcomas when achieving Ro resection warrant further
investigation with a larger sample size across different institutions. 
Vascular comorbidities in patients with multiple sclerosis and their impact on physical disability
Authors: Tadić Daliborka , Grgić Sanja , Dominović-Kovačević Aleksandra , Nazalević-Bursać Majda , Mavija Srđan , Đajić Vlado
Published: April 2024

Aim
Given the impact of vascular comorbidities (VC) on the diagnosis, treatment, and outcome of multiple sclerosis (MS), we
examined the incidence and correlation of VC and risk factors for vascular disease in people with MS (PwMS) compared to the general population, and the impact on the physical disability of patients.
Methods
Cross-sectional study involved 100 patients with MS and 50 healthy people from the general population, matched by
sex and age. The values of demographic, biochemical, and anthropometric parameters, the presence of VC and risk factors for vascular diseases in both groups, and clinical parameters in PwMS were analysed. Statistical analysis included methods of descriptive statistics, χ2 test, Student's t-test, analysis of variance, correlation
and regression analysis.
Results
Groups differed by a higher frequency of transient ischemic attack in the control group (p=0.024), and the treatment of
hypertension (p=0.038) and smoking frequency (p=0.044) in the MS group. Normal triglycerides levels were statistically significantly more prevalent in the MS group (p=0.000). Total body weight and BMI were statistically significantly higher in the control group (p=0.000). The increase in Expanded Disability Status Scale (EDSS) score was associated with higher levels of total (p=0.001) and low-density lipoprotein (LDL) cholesterol (p=0.003), and activated partial thromboplastin time APTT (p=0.002).
Conclusion
In PwMS it is necessary to pay attention to the higher frequency of smoking than in general population, and the impact
of total cholesterol, LDL and APTT levels as significant parameters that affect physical disability.
Impact of COVID-19 vaccine on clinical characteristics and outcome of hospitalized COVID-19 patients during the fourth wave of the pandemic in Tuzla Canton, Bosnia and Herzegovina
Authors: Porobić-Jahić Humera , Piljić Dilista , Jahić Rahima , Mujić Medina , Trnačević Alma , Petrović Jasminka , Mustafić Sehveta , Jahić Nedim , Tihić Nijaz
Published: April 2024

Aim
To evaluate clinical and epidemiological characteristics and outcome of patients with COVID-19, and impact of vaccine against COVID-19 on them.
Methods
This retrospective study included 225 patients treated from COVID-19 in the period from 1 to 30 September 2021 at the
Clinic for Infectious Diseases, University Clinical Centre Tuzla (UCC Tuzla). For the diagnosis confirmation of Covid-19, RTPCR was used. Patients were divided in two groups: fully vaccinated with two doses of vaccine, and non-vaccinated or partially vaccinated.
Results
Of 225 patients, 120 (53.3%) were females, and 105 (46.7%) males. Mean age was 65.6 years. There were 26 (11.6%)
fully vaccinated patients. Most common symptoms in unvaccinated patients were fatigue (70.9%), cough (70.4%) and fever (69.8%), and in vaccinated fever (76.9%), fatigue (69.2%) and cough (46.2%). Cough was more common in unvaccinated patients (p=0.013). Fatal outcome happened in 84 (37.3%) patients. Transfer to the Intensive Care Unit (ICU) and older age had a higher risk of death (p<0.001). Older age patients were more likely to have comorbidities like atrial fibrillation (p=0.017), hypertension (p<001) and diabetes mellitus (p=0.002). Atrial fibrillation (p<0.001), hypertension (p<0.001), diabetes mellitus (p=0.009) and history of stroke (p=0.026), were related to fatal outcome in unvaccinated patients, also did a shorter duration of illness prior to hospitalization (p<0.001) and shorter length of hospitalization
(p=0.002).
Conclusion
Older patients with comorbidities, as well as those who were not vaccinated against COVID-19, were at higher risk
for severe form of the disease and poor outcome. 
Prognostic value of colour Doppler brain sonography for the neurodevelopmental outcome in term neonates with hypoxic ischaemic encephalopathy
Authors: Hadžimuratović Emina , Branković Suada , Hadžimuratović Admir , Bukvić Melika
Published: April 2024

Aim
To determine a prognostic value of cerebral blood flow parameters for the development of neurological sequelae in term neonates with hypoxic ischaemic encephalopathy (HIE).
Methods
We reviewed medical records of 47 term neonates with HIE who survived until the age of 12 months of life. According to
the Sarnat and Sarnat clinical score, neonates were divided into 3 groups: mild HIE, moderate HIE and severe HIE. All included neonates had the colour Doppler brain sonography performed in the first 24 hours of life. The neurological assessment was done at the age of 12 months of life by using the Denver Developmental Screening Test (DDST). Logic regression analysis was performed using the colour doppler brain sonography parameters with the development of neurological impairment as the primary outcome.
Results
Out of 47 neonates, 19 (40.4%) were with mild, 17 (36.2%) with moderate and 11 (23.4%) with severe HIE. The values of cerebral blood flow parameters and resistance index (RI) significantly correlated with the neurological impairment at the age of 12 months of life (p<0.001). The limit value of RI indicating the poor neurodevelopmental outcome was 0.81, sensitivity 80%, specificity 85.3%, positive predictive value 52.2% and negative predictive value 95.2%.
Conclusion
The cerebral blood flow parameters measured with colour doppler brain sonography are good indicators of the severity of HIE and later neurodevelopmetal outcome. 
Post-traumatic instability of the first metatarsophalangeal joint: a novel surgical technique of capsular reconstruction in a young kickboxer
Authors: Caizzi Gianni , Coviello Michele , Franchini Andrea , Riefoli Flavia , Palmiotto Florianna , Moretti Biagio
Published: April 2024

Aim
 To report a novel surgical technique of capsular reconstruction of post-traumatic instability of the first metatarsophalangeal joint (MTPJ).
Methods
The clinical case is related to a 24-year-old male athlete whose clinical symptoms began with pain and spontaneous dislocation of the left first MTPJ during a kickboxing fight. He received conservative treatment (cryotherapy and rest) at first. Afterwards, he referred persistent hallux instability associated with moderate pain, despite normal anatomic alignment with no evidence of first ray deformity. Plain traditional x-rays of the left foot, magnetic resonance imaging (MRI), static and dynamic ultrasonography (US) and clinical tests were performed in order to diagnose capsular ligamentous structure lesions. Results
The plain x-rays showed hallux abductus angle of 3°. The MRI and US demonstrated a rupture of the lateral capsular ligamentous structures and detachment of the abductor tendon. The pull out medium-lateral of the capsule with the abductor suture was performed as a treatment for dynamic hallux varus deformity. At six-month follow up, the patient walked without lameness with complete active and passive range of motion and with a stable first MTPJ. Conclusion
The patient presented with the post traumatic instability of the first metatarsophalangeal joint treated with a novel surgical technique of capsular reconstruction. The patient returned to the full weight-bearing in only 2 months of rehab. To the best of our knowledge, the surgical correction proposed has not been previously described.
Minimally invasive mini-thoracotomy access as a surgical method in state-of-the-art treatment of single-vessel coronary heart disease
Authors: Kabil Edin , Granov Nermir , Haxibeqiri-Karabdić Ilirijana , Grabovica Sanja , Mujičić Ermina , Štraus Slavenka , Banjanović Bedrudin , Djedović Muhamed
Published: April 2024

Aim
To compare outcomes of two different surgical techniques of coronary artery bypass grafting (CABG) for treating isolated left anterior descending (LAD) coronary artery disease by full median sternotomy technique vs. minimally invasive approach via left anterior mini-thoracotomy.
Methods
This retrospective, observational study, which included 61 elective patients, was conducted at the Clinic for Cardiovascular Surgery of the Clinical Centre of the University of Sarajevo in the period from June 2019 to January 2022. Patients were divided in two groups according to the operative technique used, the sternotomy CABG group of 30 patients where the access considered full median sternotomy, and the minimally invasive CABG group where left anterior mini-thoracotomy was performed. The groups were compared by previously defined primary and secondary clinical postoperative outcomes.
Results
Out of 61 patients, the majority was males, 50 (82%). The analysis of the outcomes of the minimally invasive CABG surgery showed significantly shorter operative times (p=0.001), less postoperative drainage (p=0.001) and transfusion requirements, shorter mechanical ventilation duration (p=0.0001), low major adverse cardiac and cerebrovascular events rates, as well as shorter Intensive Care Unit stay days with mean of 3.3±1.442 days (p=0.025), but no total hospital stay days with mean of 6.7±1.832 days (p=0.075) compared to sternotomy CABG group.
Conclusion
Minimally invasive approach for CABG surgery in treating isolated single vessel LAD disease, together with the fasttrack protocol, offers a reasonable alternative to full median sternotomy, leading to faster patients’ overall recovery and improving the quality of life. 
Spinal cord stimulation in chronic pain treatment – first experiences in Bosnia and Herzegovina
Authors: Bućma Tatjana , Savić Ostoja , Boškić Tatjana , Arambašić Topić Lena , Sladojević Igor , Novaković Bursać Snježana
Published: April 2024

Aim
To describe results of spinal cord stimulation technique when the conventional multidisciplinary treatment of neuropathic or
mixed pain failed.
Methods
The research was conducted at the Institute for Physical Medicine and Rehabilitation “Dr. Miroslav Zotović”, Banjaluka.
Ten patients, who had chronic pain resistant to other therapeutic options and a failed back surgery, were sent for an evaluation. Each patient underwent a 4-week evaluation by a team of medical specialists, phychologist and social workers. Additional diagnostic methods (MRI of the lumbosacral spine, electromyoneurography of lower extermities, congnitive assessment tests) were also performed to establish a proper indication for implantation of the system for spinal cord stimulation. Leads of a system for spinal cord stimulation were implanted percutaneously or surgically at
the epidural space. Functional outcome measures (visual analogue scale, Oswestry index, anxiety and depression scales) were taken before the implantation of the system and on several followups.
Results
Four patients did not meet critea for the inclusion in the study (two were not ready, two showed psychopathological symptoms). One patient had a percutaneous lead implant, but it was removed after six months due to paresthesia. The remaining five had surgicaly implanted epidural leads and showed significant improvement in pain control, Oswestry index had lower values, and all except one patient had improvement registered by anxiety and depression scales.
Conclusion
Short-term and long-term follow up showed a long lasting pain reduction and improvement of functionality in all patients.
Can laboratory and clinical parameters predict the occurrence of acute arterial occlusion in COVID-19 patients?
Authors: Karlović Kristian , Bogdan Gojko , Rastović Pejana , Kajić Martin
Published: April 2024

Aim
To determine radiologic, clinic and laboratory characteristics of COVID-19 positive patients with acute arterial occlusion and compare them with post COVID-19 and non-COVID-19 patients.
Methods
In this retrospective study, 53 patients with acute occlusion of peripheral arteries admitted to the University Clinical
Hospital Mostar in the period between 29 February 2020 and 30 September 2021 were involved. The first group was made of COVID-19 positive patients, the second group were post COVID-19 patients and a control group were non-COVID-19 patients.
Results
Most patients were males, 37 (69.8%). The average age of COVID positive patients was 66.09±11.25 years, post COVID-19 patients 71.33±5.22 years and COVID-19 negative patients 69.82±1.99 years. Lower extremities were most affected, 38 (71.6%), without significant alteration in the coagulogram. Acute arterial occlusion occurred about 2 weeks after the beginning of COVID-19 or at the time of the first appearance of symptoms.
Conclusion
We have to take special care about patients with risk factors for developing acute arterial occlusion due to thromboembolism or thrombosis 10 days after the beginning of the disease. We also recommend the use of low molecular weight heparin
(LMWH) and monitoring coagulation state due to anti Xa and thromboelastometry.
Comparative analysis of the effects of dalteparin and reviparin on perioperative blood loss in patients with extracapsular hip fractures treated with intramedullary nailing
Authors: Sivro Mirza , Lazović Faruk , Omerović Ðemil , Kapidžić Tarik , Papović Adnan , Omerčević Mirza , Selimović Harun
Published: April 2024

Aim
To determine differences between reviparin and dalteparin treatment in patients with extracapsular hip fractures treated with intramedullary nailing and their effects on perioperative blood loss and early postoperative recovery.
Methods
Retrospective comparative study included 68 patients with extracapsular hip fracture who were divided into dalteparin
and reviparin group. Medical records were used to obtain demographic data, laboratory parameters, haemoglobin and haematocrit levels, platelet count, mortality rate and medical complications.
Results
Out of total 68 patients, 31 were in reviparin and 37 in dalteparin group. Mean age of patients was 70.5 (±14.4) and
76.8 (±8.4) years in reviparin and dalteparin group, respectively (p=0.071). Median values of haemoglobin levels on the first postoperative day were lower in dalteparin group compared to reviparin group (p=0.012). On the first postoperative day haematocrit values were also lower in dalteparin than in reviparin group (p=0.015).
Both groups showed an increase in platelet count on the first postoperative day, but without significant difference (p=0.084). There was no statistically significant difference in intrahospital mortality between the groups (6.4% vs. 2.7%; p=0.588). One case of pulmonary embolism was detected in the dalteparin group.
Conclusion
Low-molecular-weight heparin is the drug of choice in patients with hip fractures for thromboprophylaxis. Due to
non-antithrombin-mediated actions, reviparin and dalteparin could have different effects on perioperative blood loss. Both dalteparin and reviparin are safe and effective agents for thromboprophylaxis in patients with proximal femur fractures.
Clitorea ternatea flower extract induces platelet-derived growth factor (PDGF) and GPx gene overexpression in ultraviolet (UV) B irradiationinduced collagen loss
Authors: Sofyanti Putri Rizka , Putra Agung , Chodidjah Dr , Masyitah Darlan Dewi , Trisnadi Setyo , Thomas Siti , Amalina Nur Dina , Candra Irawan Rizky
Published: April 2024

Aim
To determine the effect of Clitorea ternatea flower extract (CTFE) in the gel dosage form on the expression of GPx and platelet-derived growth factor (PDGF) in ultraviolet (UV) - B irradiation-induced collagen loss rat model.
Methods
This is experimental research with post-test control group design. Twenty healthy male Wistar rats were divided into
four treatment groups: a sham group, UVB control group, two treatment groups with gel of CTFE 5% and gel of CTFE 10%,
respectively. Each group was treated with UVB at 302 nm with a MED of 160 mJ/cm2 for 5 days, whereas the sham group did not receive UVB. In the treatment groups CTFE 5% and CTFE 10% gel were given on the 6th to the 14th day. On day 14 all treatment groups were terminated, and GPx and PDGF gene expression were analysed using qRT-PCR.
Results
In the group of gel of CTFE 10%, there was a significant increase in GPx gene expression (9.51±1.83) and PDGF
(4.36±1.18) compared to the UVB control group which had GPx and PDGF gene expression of 4.90±1.64) and 0.032±0.01, respectively.
Conclusion
The administration of CTFE gel showed an increase of the expression of GPx and PDGF genes on UVB irradiationinduced collagen loss rat model.
Comparison of dexmedetomidine alone or with other sedatives for paediatric sedation during magnetic resonance imaging: a systematic review
Authors: Vitraludyono Rudy , Utariani Arie , Hanindito Elizeus
Published: April 2024

Aim
To compare the outcome of sole dexmedetomidine or with other sedative drugs in paediatric patients during magnetic resonance imaging (MRI).
Methods
Literature was obtained from PubMed and ScienceDirect from 2010-2020 using key words: sedation, paediatric,
dexmedetomidine, ambulatory, MRI, ketamine, propofol, midazolam. The literature selection was based on Participant, Intervention, Comparators, Outcomes (PICO) analysis. All English full-text and peer-reviewed articles were included. The primary outcome was hemodynamic stability, respiratory compromise, and recovery time. The risk of bias analysis was assessed using Cochrane collaboration Risk of Bias (RoB 2.0).
Result
Of 106 studies, 17 studies were included with a total 3.430 paediatric patients undergoing MRI. Dexmedetomidine alone provides a more stable hemodynamic but longer recovery time than ketamine, propofol or midazolam. The combination of dexmedetomidine and ketamine provides more stable hemodynamics, especially in the incidence of hypotension and bradycardia, and does not significantly reduce airway configuration more than sole dexmedetomidine or ketamine. Intranasal dexmedetomidine is more recommended than its combination with midazolam. Combining dexmedetomidine with ketamine, propofol or midazolam provides a shorter recovery time.
Conclusion
A combination of dexmedetomidine with other sedatives such as ketamine, propofol and midazolam is better than sole
dexmedetomidine for paediatric sedation during magnetic resonance imaging.
Hypoxic secretome mesenchymal stem cells inhibiting interleukin-6 expression prevent oxidative stress in type 1 diabetes mellitus
Authors: Utami Ayuningtyas , Putra Agung , Wibowo Joko Wahyu , Nur Dina Amalina , Satria Irawan Risky Chandra
Published: April 2024

Aim
Type 1 diabetes mellitus (T1DM) is an autoimmune disease characterized by the chronic inflammation of the pancreatic islets of Langerhans. Hyperglycaemia leads to suppressed antioxidant enzyme and increased inflammation in the pancreatic cell, resulting in pancreatic cell death. Hypoxic secretome mesenchymal stem cells (HS-MSCs) are soluble molecules secreted by MSCS that have the antiinflammation ability by secreting various cytokines including IL-10 and TGF-β which potent as a promising therapeutic modality for T1DM. This study aims to investigate the role of HS-MSCs in regulating superoxide dismutase (SOD) and caspase-3 gene expression in T1DM model.
Methods
Twenty male Wistar rats (6 to 8 weeks old) were randomly divided into four groups (sham, control, HS-MSCs 0.5 mL
and HS-MSCs 1 mL intraperitoneal treatment group). Streptozotocin (STZ) 60mg/kgBB was conducted once on day 1, HS-MSCs 0.5mL (T1) and HS-MSCs 1 mL (T2) were administrated intraperitoneally on day 7, 14, and 21 after STZ administration. The rats were sacrificed on day 28; the gene expression of SOD and IL-6
was analysed by qRT-PCR.
Results
This study showed that the ratio of SOD significantly increased in HS-MSCs treatment associated with suppression of
IL-6 gene expression.
Conclusion
HS-MSCs administration suppresses oxidative stress and inflammation by up regulating SOD and inhibiting IL-6 to
control T1DM. 
Relation between thyroid hormonal status, neutrophillymphocyte ratio and left ventricular systolic function in patients with acute coronary syndrome
Authors: Halilčević Mirela , Begić Edin , Džubur Amela , Džubur Alen , Aziri Buena , Durak-Nalbantić Azra , Begić Alden , Brkić Ammar , Gogić Ena , Lepara Orhan
Published: April 2024

Aim
To examine a relation of thyroid function, neutrophil-lymphocyte ratio (NLR) with left ventricular function measured through the left ventricular ejection fraction (LVEF) in patients with acute myocardial infarction treated with percutaneous coronary
intervention (PCI).
Methods
This prospective research involved 160 consecutive patients with acute myocardial infarction. Patients were divided into
those with normal thyroid hormone status (n=80) and those with hypothyroidism (newly diagnosed) (n=80). Inflammatory parameters and parameters of hormonal status were taken for analysis: thyroid-stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), free thyroxine (FT4), and free triiodothyronine (FT3). All patients underwent transthoracic echocardiographic examination (TTE) five days upon admission, and left ventricular ejection fraction (LVEF) was analysed.
Results
Significant difference between the two groups was verified in values of T3, T4, erythrocytes, haemoglobin, haematocrit,
neutrophil, lymphocytes, NLR, C-reactive protein (CRP) and sedimentation rate. Patients with euthyroidism had a higher frequency of coronary single-vessel disease (p=0.035) and a significantly lower frequency of triple vessel disease (p=0.046), as well as a higher median value of LVEF (p=0.003). There was a significant correlation between LVEF with haemoglobin values (p=0.002), NLR (p=0.001), and CRP (p=001).
Conclusion
The altered status of the thyroid gland in acute myocardial infarction is associated with the severity of the coronary blood vessel lesion, LVEF and correlates with inflammatory response.
CT advantages of potential use of polymer plastic clips in neurocranium
Authors: Delibegović Samir , Delibegović Mirela , Katica Muhamed , Obhodžaš Muamer , Ođuz Muhamed
Published: April 2024

Aim
Clips in neurosurgery are made of titanium alloys, which reduce artifacts on computed tomography (CT). The radiological advantage of plastic clips on the CT image was demonstrated when they were placed in an inter-hemispherical position at an angle of 90º. The aim of this study was to investigate the behaviour of the clip placed at different angles.
Methods
Sixty heads of domestic pigs were divided into two groups, in group 1 a titanium clip was placed to the interhemispheric
position at an angle of 90º, 45º, 0º, ten heads for each angle. In group 2 a plastic clip was placed in the same way. CT scan of the brain was performed for each angle. The size of the density and possible artifact were measured on CT.
Results
The size of the titanium clip ranged from 17.05 mm at an angle of 0º in the axial plane to 91.47 mm at an angle of 0º in the
sagittal plane. The average size of the plastic clip ranged from 6.4 mm at an angle of 0º in the axial plane to 23.22 mm in an angle of 90º in the sagittal plane. Artifacts were observed only in the titanium clip.
Conclusion
Plastic clips have shown radiological advantages over titanium clips in the CT image. The average density size of
the plastic clip in all planes and all angles was smaller than the titanium clip. 
Computer-assisted navigation for intramedullary nailing of intertrochanteric femur fractures: a preliminary result
Authors: Coviello Michele , Ippolito Francesco , Abate Antonella , Zavattini Giacomo , Zaccari Domenico , Leone Andrea , Noia Giovanni , Caiaffa Vincenzo , Maccagnano Giuseppe
Published: April 2024

Aim
To demonstrate a reduction of risk factors ray-depending in proximal femur nailing of intertrochanteric femur fractures,
comparing standard technique with computer-assisted navigation system.
Methods
One hundred patients hospitalised between October 2021 and June 2022 with intertrochanteric femur fractures type 31-A1
and 31-A2 were prospectively enrolled and divided randomly into two groups. A study group was treated with computer-assisted navigation system ATLAS (Masmec Biomed, Modugno, Bari, Italy) (20 patients), while a control group received the standard nailing technique. The same intertrochanteric nail was implanted by a single senior surgeon, Endovis BA 2 (EBA2, Citieffe, Calderara di Reno, Bologna, Italy). The following data were recorded: the setup time of operating room (STOR; minutes); surgical time (ST; minutes); radiation exposure time (ETIR; seconds) and dose area
product (DAP; cGy·cm2).
Results
Patients underwent femur nailing with computer-assisted navigation system reported more set-up time of operating room
(24.87±4.58; p<0.01), less surgical time (26.15±5.80; p<0.01), less time of radiant exposure (4.84±2.07; p<0.01) and lower dose area product (16.26±2.91; p<0.01).
Conclusion
The preliminary study demonstrated that computerassisted navigation allowed a better surgical technique standardization, significantly reduced exposure to ionizing radiation, including a reduction in surgical time. The ATLAS system could also
play a key role in residents improving learning curve.
Effects of direct acting antiviral therapy on liver stiffness measured by using fibro scan in Egyptian patients with chronic hepatitis C
Authors: Abdel Naser Abdel Atty Gadallah , Abdullah Abdulaziz Bahnasi , Waleed Abdelfattah , Mousa Dr , Mohammed Shafiek Mohammed Elsayaad , Hany Abdelbary Abdelaziz Elbasyouni
Published: April 2024

Aim
Egypt has the highest incidence of hepatitis C virus (HCV) infection in the world. Fibrosis development is common in HCV
cases, and it is important in disease prediction. The aim of this study was to demonstrate the role of fibro scan in assessment of changes in hepatic stiffness in patients with chronic HCV infection following direct acting antiviral treatment (DAAT).
Methods
This prospective observational research included 120 patients with compensated HCV infection. All patients were subjected to fibro scan before and after receiving DAAT. Patients’ history, clinical examination, laboratory parameters (red – RBCs, and white blood cells - WBCs, hepatic function test, renal function test, coagulation profile, HBsAg, AFP - alpha feto protein, HbA1C, HCVAb) and fibro scan were done for all patients.
Results
Stiffness may differentiate F0-2 minimal fibrosis from F3-4 massive fibrosis using ROC-curve analysis, with 77.5% sensitivity, 90% specificity, 88.57% positive predictive value (PPV), and 80% negative predictive value (NPV). With sensitivity, specificity, PPV, and NPV of 71.4%, 44.5%, 43.48%, and 71.43%, respectively, the APRI-score can discriminate F0-2 from F3-4 at cutoff of 0.314. At a cutoff of 1.18, Fib4 calculation can discriminate F0-2 from F3-4, with sensitivity, specificity, PPV, and NPV of 78.6%, 64.1%, 63.04%, and 78.57%, respectively.
Conclusion
Hepatic fibrosis measurements such as fibro scan and non-invasive fibrosis scores (FIB-4) and aspartate aminotransferase (AST) to platelet ratio index (APRI) showed a significant improvement after direct-acting antiviral therapy. Improvements in hepatic function tests, serum creatinine level, and platelet count
are also seen. 
Correlation between signal transducer and activator of transcription 1 (STAT 1), vascular endothelial growth factor (VEGF), and signal to noise ratio (SNR) value in otoacoustic emission (OAE) examination on organ of Corti cochlea due to cisplatin
Authors: Lubis Nelfi Disya Amalia , Siti Hajar Haryuna Tengku , Khalid Khalisanni , Zainul Rahadian
Published: April 2024

Aim
To assess the cochlear damage caused by cisplatin in the rat cochlea based on decreased signal to noise ratio (SNR) values on otoacoustic emission (OAE) examination and increased expression of signal transducer and activator of transcription 1 (STAT 1) and vascular endothelial growth factor (VEGF) on immunohistochemical examination.
Methods
Twenty-four Rattus norvegicus were divided into 4 groups and injected with 8 mg/kgBW of cisplatin intraperitoneally except for control group. The SNR on OAE examination were checked before the treatment and on day 3, 4, and 7 after
the treatment. The cochleas were stained immunohistochemically, followed by assessment of the cochlear organ of Corti damage based on STAT 1 and VEGF expression.
Results
A decrease in the mean of SNR value was found in accordance with the length of cisplatin exposure. The STAT 1 and
VEGF expression increased with duration of cisplatin exposure. A correlation was found between SNR values, STAT 1, and also VEGF expression (p<0.05).
Conclusion
An increase of STAT 1 and VEGF expression influences cochlear damage due to cisplatin administration. There was
a correlation between STAT 1 and VEGF expression with SNR values in the cochlear organ of Corti of Rattus norvegicus exposed to cisplatin. 
Association of HLA-B27 antigen with clinical and laboratory parameters in patients with juvenile idiopathic arthritis
Authors: Čengić Adisa , Selmanović Velma , Hasanbegović Sniježana , Begić Nedim , Karčić Emina , Fejzić Elma
Published: April 2024

Aim
To analyse the association of human leukocyte antigen B27 with clinical and laboratory parameters in patients with juvenile
idiopathic arthritis (JIA) at the disease onset.
Methods
A retrospective review of medical records of 25 HLAB27 positive and 25 HLA-B27 negative JIA patients was performed. The diagnosis of JIA was based on the 1997-2001 International League Against Rheumatism (ILAR) criteria. Collected data:
age, sex, HLA- B27 antigen presence, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid-factor (RF), antinuclear antibody (ANA), fever, rash, uveitis, enthesitis, inflamed joints and subtype of JIA.
Results
HLA- B27 positive study group had more boys (p=0.01), higher erythrocyte sedimentation rate (p=0.038), higher presence
of fever (p= 0.025) and enthesitis (p=0.024). Any significant difference in age of the disease onset, CRP, ANA, RF, rash, uveitis, inflamed joint and dactylitis was not noticed. The most common subtype of JIA in the HLA-B27 positive patients was ERA (60%).
Conclusion
This study showed that the presence of HLA- B27 antigen plays a significant role in determining the presenting clinical
and laboratory characteristics in JIA patients.
Outcomes of acute kidney injury in critically ill children who need renal replacement therapy
Authors: Pokrajac Danka , Hadžimuratović Admir , Kalkan Ismeta , Begić Nedim , Hadžimuratović Emina , Mišanović Verica , Anić Duško , Mustajbegović-Pripoljac Aida
Published: April 2024

Aim
To determine an outcome of acute kidney injury (AKI) in critically ill children (CIC) who needed renal replacement therapy
(RRT) and were admitted to the Paediatric and Neonatal Intensive Care Unit (PICU and NICU) at the Paediatric Clinic, University Clinical Centre Sarajevo (UCCS).
Methods
 The research included 81 children with AKI. The Kidney Disease: Improving Global Outcomes (KDIGO) criteria to define
AKI was used. Other laboratory findings and imaging tests were made depending on children’s primary disease that led to the AKI.
Results
Among 81 children with AKI, 38 were girls and 43 boys. A total of 39 (48.1%) patients died; the death was due to the nature of the primary disease and multiple organ failure syndromes. Out of the total of 81 patients the highest mortality rate was found in children in the first year of life, 22 (56.4%), while 17 (43.6%) patients died after the first year of life.
Conclusion
Without an accurate diagnosis at the right time, due to the lack of adequate biomarkers for AKI screening, the heterogeneity of AKI, comorbidities often lead to unfavourable outcomes of the disease, among CIC, especially in infants with low birth
weight and extreme immaturity. Some causes of AKI are preventable and can be reduced by a better organization of primary and secondary health care.
Molecular-genetics analysis of 15 STR loci in sibship testing in isolated rural Bosnian population – the use of the grey zone
Authors: Mušanović Jasmin , Metović Azra , Pepić Esad , Lujinović Almira , Fojnica Adnan , Husremović Faruk , Šečić Damir , Marjanović Damir , Šutković Jasmin
Published: April 2024

Aim
Examination of the effectiveness of STR loci in proving sibship of the Bosnian-Herzegovinian village of Orahovica and
the formation of a “grey zone“.
Methods
The probability of sibship was determined by calculating the likelihood ratio (LR) parameter for each of the 15 observed
STR loci and for each of the pairs of relatives and non-relatives. Cumulative sibship index (CSI) was calculated for each of the pairs by multiplying the LR values of all 15 loci and obtained values are used as CSI limit for separating relatives from non-relatives. By creating a grey zone for local populations, an attempt was made to obtain a line of demarcation between siblings and non-siblings.
Results
An analysis of the origin of the respondents' relatives was performed, up to the level of sibship in the third generation. The
results of the CSI for pairs of relatives from the village of Orahovica showed that the highest CSI value, and therefore the sibship probability was recorded among relatives from the village of Orahovica (CSI=534211727.203;SP=99.999999812%). On the contrary, incredibly low CSI value was recorded among non-relatives,
ranging from CSI=0.0000001 to 0.5261434 (SP=0.000009999% to 34.475357951%).
Conclusion
For the threshold value CSI=1 and for CSI=3, this method determined sibship in 100% of pairs of relatives and the
absence of biological sibship in 100% of pairs of non-relatives in the village of Orahovica. The STR system is proved to be a successful method in determining sibship or absence of sibship in small local populations.
Minimally invasive coronary artery bypass (MICS CABG) in Bosnia and Herzegovina: a single centre, single surgeon cohort experience
Authors: Granov Nermir , Šljivo Armin , Mujičić Ermina , Rebić Damir , Džubur Alen , Begić Edin , Selimović Tarik , Zvizdić Zlatan , Fajkić Almir , Jonuzi Asmir , Kabil Edin , Štraus Slavenka
Published: April 2024

Aim
This is the first research in Bosnia and Herzegovina presenting minimally invasive coronary artery bypass grafting surgery
(MICS CABG) experience, advantages, and outcomes as compared to conventional surgery (OPEN CABG).
Methods
This retrospective cross-sectional study was conducted between January 2019 and November 2022 and included patients
with indication for surgical revascularization.
Results
Among 237 patients, males predominated, 182 (76.7%), with a mean body mass index (BMI) of 28.4±3.9, median The Society of Thoracic Surgery Risk (STS) score of 1.55 (0.8, 4.0), short term STS score of 11.2 (6.8, 23.7), mean age of 64.8±8.7 (ranging 41-83) years, 122 (51.4%) underwent OPEN CABG and 115 (48.6%) MICS CABG. MICS CABG took less time (p<0.001; OPEN 3.5±0.8h; MICS 2.8±0.8h) and needed less mechanical ventilation (p<0.001, OPEN 17.3±11.9h; MICS 13.0±12.5h) than OPEN CABG. Even though there was no difference in hospitalization length between groups (OPEN (7.5±3.2), MICS (7.1±4.0)), patients receiving MICS (2.9±1.5) spent less time in the ICU (p=0.0013) than OPEN CABG (3.6±2.8). OPEN CABG used also more blood derivatives, red blood cells (OPEN 292 vs MICS 55), plasma (OPEN 270 vs MICS 86) and platelets (OPEN 71 vs MICS 28).
Conclusion
Patients undergoing MICS CABG in Bosnia and Herzegovina had less mechanical ventilation hours and less ICU duration compared to OPEN CABG even though the hospitalization duration was very similar. MICS CABG takes less time to be conducted, has fewer CPRs postoperatively, uses less blood derivatives including red blood cells, plasma and platelets.
Relationship between brain-derived neurotrophic factor serum levels with the severity of melasma
Authors: Novianti Nazli Putri Astrid , Yosi Ariyati , Nasution Khairina
Published: April 2024

Aim
To determine the relationship between brain-derived neurotrophic factor (BDNF) levels and the severity of melasma.
Methods
This cross-sectional analytic study included consecutive patients from the Dermatology and Venereology Polyclinic
at Prof. dr. Chairuddin Panusunan Lubis Universitas Sumatera Utara (Prof. dr. CPL USU) Hospital Medan from May to December 2022. Serum BDNF levels and the severity of melasma were analysed using the Kruskal-Wallis test.
Results
Of the total of 30 patients enrolled in the study, the majority were in the age group of 36–45 (average of 44) years and work
as housewives. The highest risk factor was sun exposure. The melasma pattern was dominated by centrofacial patterns, majority of melasma types were epidermal, and the most severe degree was moderate. A moderate negative correlation between BDNF levels and the duration of melasma was found (p=0.007; r= -0.485). There was no significant relationship between BDNF levels and the severity of melasma (p=0.387).
Conclusion
No significant relationship between BDNF levels and the severity of melasma indicates that the causes of melasma are
multifactorial, such as sun exposure, genetic, hormonal, and other factors (drugs, neural and psychological, and lipid metabolism).
In vitro effectiveness of the avocado peel extract (Persea americana Mill) as an antifungal against Trichophyton rubrum, the cause of dermatophytosis
Authors: Yosi Ariyati , Armayanti Ira , Wardani Meidina K.
Published: April 2024

Aim
To determine the effectiveness of avocado peel extract (Persea americana Mill) as an antifungal against T. rubrum, which
causes dermatophytosis.
Methods
In vitro laboratory experimental study using a post-testonly control group design analysed active compounds of avocado
peel and continued with the antifungal activity test. In each group divided according to the concentration of 0% (negative control), 12.5%, 25%, 37.5%, 50%, 62.5%, 75%, and positive control (2% ketoconazole) antifungal activity test was carried out using the fungus T. rubrum ATCC 28188 for five repetitions.
Results
The avocado peel extract contained phenolic compounds, flavonoids, tannins, saponins, alkaloids, terpenoids, and glycosides. Antifungal activity test showed a significant difference with the highest mean inhibition zone diameter of T. rubrum, which was demonstrated at a concentration of 75%.
Conclusion
Avocado peel extract is useful to inhibit growth of Trichophyton rubrum in dose dependent.
Bone healing during electrostimulation
Authors: Bezsmertnyi Yurii , Shevchuk Viktor , Jiang Yankai , Shevchuk Olena
Published: April 2024

Aim
To investigate the effect of direct epineural electrical stimulation of the nerve on the nature of reparative processes in the bone stump.
Methods
Three series of experiments were carried out with amputation of the thigh in the middle third and muscle plasty. In the 1st
and 2nd experimental series a perineural catheter was brought to the stump of the sciatic nerve, through which mechanical irritation of the nerve was performed for 20 days daily for 20 minutes. In the 2nd series, an electrode was added to the nerve and epineural electrical stimulation was performed daily for 20 days. Animals of the 3rd series served as control. The observation periods were 1, 3, 6 months. Histological research method with filling vessels with ink-gelatin mixture was applied.
Results
In the 1st series, there was a sharp distortion of the reparative process, which consisted of a violation of microcirculation, changes in shape, resorption of the cortical diaphyseal plate, fractures, deformations. In most experiments of the 2nd series, organotypic stumps were formed with normalization of microcirculation. In the 3rd series, results of the formation of the stump were better than in the 1st, but worse than in the 2nd series.
Conclusions
Painful nerve irritation after amputation leads to a significant disturbance of microcirculation and reparative regeneration at the end of the bone stump with the development of pathological restructuring of bone tissue. Electrostimulation of the
nerve improves microcirculation and reparative regeneration of the bone tissue.