Sarajevo Canton Research Articles

The importance of nutrition and overweight as a risk factor in family medicine

Improper nutrition leads to changes in the body that are not only an aesthetic problem, but also lead to chronic diseases. The goals of the research are to analyze knowledge, habits and attitudes about nutrition and knowledge about obesity, to determine the body mass index (BMI) of all respondents, to analyze the connection between nutrition, excess body weight and the frequency of chronic non-communicable diseases. The study was cross-sectional epidemiological, descriptive-analytical, was conducted on a sample of 200 respondents of patients Family medicine, Public Health Center of the Sarajevo Canton. The survey was conducted by interviewing respondents using a modified questionnaire, made up of 27 questions. Analyzing the results, it was determined that the respondents' knowledge of nutrition is satisfactory, but that the majority of respondents (121) have a BMI over 25. For men in the age group of 46-55 years, the average BMI is 29.3, and for women in the same age group, it is 27. 5, which shows that they do not apply their own knowledge about nutrition. The majority of respondents (32%) whose BMI is over 25 have one or more chronic non-communicable diseases. Most respondents stated that they get information about proper nutrition through the media, although many of them suffer from some chronic diseases, they do not get information at the health center. In the family doctor's clinic, it is very important to recognize excess body weight, bad eating habits of patients in time, plan a prevention strategy, and prevent the further development of chronic diseases with professional counseling.

7th ERL Conference Links between Beliefs and Language held at the heart of Europe, in Sarajevo, Bosnia and Herzegovina – a report

On 27-28 June 2024, the Association for the Educational Role of Language organized the 7th International Pedagogic and Linguistic Conference entitled Links between Beliefs and Language. The conference was held at International University of Sarajevo (IUS) in Bosnia and Herzegovina, in cooperation with the English Language and Literature program. Around 50 scholars presented 38 topics and discussed links between beliefs and language through sociolinguistic, cultural, literary, semantic, instructional, personal, interpersonal and inter-linguistic lenses. The Conference was a unique event that brought together participants from different countries: Poland, Georgia, Estonia, United Kingdom, the Czech Republic, Italy, Oman, Spain, Bulgaria, Norway, Bosnia and Herzegovina, Serbia, North Macedonia, Slovenia, Romania and Ukraine. The importance of this scientific and academic event was recognized by the local government, with the Ministry of Science, Higher Education and Youth of Sarajevo Canton granting funds and supporting the Conference. The two-day conference was preceded by a pre-conference meeting, during which...

LANDSLIDES IN SARAJEVO CANTON OBSERVED THROUGH VALID REGULATIONS AND COMPETENT INSTITUTIONS, AND THE IMPORTANCE OF ADOPTING A UNIFORM REGULATION ON LANDSLIDES

Landslides, as modern processes on the surface of the terrain, present a challenge in spatial planning, planning and construction of new settlements, and construction of infrastructure facilities. A special challenge is the planning and construction of settlements and infrastructure facilities in hillside areas. The City of Sarajevo, with its four city municipalities, represents the most populated part of Sarajevo Canton. The situation is similar with non-urban municipalities. A special challenge is the illegal settlements created on hillside areas of the four city municipalities. Many hillside settlements were created unplanned, often within the scope of registered landslides and unstable terrain. The construction of such settlements was not accompanied by the construction of the necessary infrastructure (road communications, fecal and storm sewers), which poses a danger of starting new and reactivating calmed landslides. Society's commitment to climate change brings into focus the landslides that occur as a product of climate change. Special attention is paid to unplanned urban areas on the slopes, where the risk of landslides is increased due to climate change. According to official information, about 1,000 landslides have been registered in Sarajevo Canton. The data on the number of landslides in the area of the Sarajevo Canton date back deep into the past and as such have been updated on several occasions. The last addition of data was carried out in the phase of amending the Spatial Plan, in 2010, when the Terrain Stability Map of Sarajevo Canton was updated. In Sarajevo Canton, special attention is paid to the rehabilitation of landslides that endanger people and material goods, and to the stabilization of the terrain during the development of construction land, for which considerable financial resources are allocated from different levels of government (Federation, Canton and municipalities). Aggravating circumstance are regulations that only partially treat landslides. Certain regulations are unclear, some of them set strict requirements for emergency landslide rehabilitation, while certain regulations are in conflict. The institutional approach for the purpose of research, registration, rehabilitation and monitoring of landslides is not fully aligned with the current regulations. Jurisdiction is partially prescribed and as such is often unclear. The mandated competences of individual levels of government are not harmonized. Remedial measures were implemented on many landslides in the past period, but without clear indications of the effects of the remediation. As a solution to the problem, a proposal for the adoption of a single regulation on landslides was initiated. This paper cites the example of the Sarajevo Canton, where the activities for the adoption of a law on landslides were initiated, but ended unsuccessfully several times, with recommendations for further activities.

STORMWATER MANAGEMENT DIRECTIVES AND STRATEGIES IN TEH EUROPEAN UNION

The paper provides an overview of legal regulations, that is, directives and strategies related to new approaches to stormwater management. The goals, recommendations and guidelines for the implementation/application of new approaches are also listed in order to reduce and mitigate the negative consequences of increasingly frequent urban floods. The development of green infrastructure and solutions related to it are emphasized with the aim of reducing rainfall floods in urban areas and mitigating their consequences. Previous examples from practice in the European Union have shown that for the implementation of green infrastructure in urban areas, it is necessary to have appropriate legal regulations as a basis. In the Canton of Sarajevo and the state of Bosnia and Herzegovina, in order to establish new approaches to stormwater management, it is necessary to monitor and harmonize laws and regulations with the Directives and Strategies of the European Union with the ultimate goal of protecting the environment and improving the quality of life and living conditions. This presupposes a contribution to sustainable social economic and environmental improvement.

Flu seasons during the period 2018-2023 in Sarajevo Canton, Bosnia and Herzegovina: possible impact of the SARS-CoV-2 pandemic on the influenza A and B virus circulation.

During the pandemic of severe acute respiratory syndrome corona-virus 2 (SARS-CoV-2), many countries reported a significant decrease in the prevalence of influenza virus cases. The study aimed to characterize the flu seasons from 2018 to 2023 in Sarajevo Canton, Bosnia and Herzegovina (B&H), and to assess the possible impact of the SARS-CoV-2 pandemic on the influenza A and B virus circulation. The CDC Human Influenza Virus Real-Time RT-PCR Diagnostic Panels were used for the detection of influenza virus A and B, and subtyping of influenza virus A (H1pdm09 virus and H3). The data for this registry-based retrospective study were collected at the Clinical Centre of the University of Sarajevo, Unit for Clinical Microbiology (the laboratory that acts as a referral for the detection and characterization of influenza virus and SARS-CoV-2 in Federation B&H). In the 2018/2019 and 2019/2020, an equal percentage of positive cases was recorded (148/410; 36%, and 182/504; 36%, respectively). The absence of the influenza virus was observed in 2020/2021. During 2021/2022, influenza virus was detected among 19/104 (18%) patients and slightly increased in 2022/2023 (45/269; 17%). The switch of the influenza B virus lineage was observed. The SARS-CoV-2 virus had an impact on the prevalence of influenza virus infection among the population of the Sarajevo Canton, B&H. Since the interactions between these two viruses are not entirely clear, awareness of a possible threat to public health is crucial.

Out-of-hospital cardiac arrest (OHCA) in Bosnia and Herzegovina in the period 2018-2022: current trends, usage of automated external defibrillators (AED) and bystanders' involvement.

To investigate out-of-hospital cardiac arrest (OHCA) trend, provided advanced life support (ALS) measures, automated external defibrillator (AEDs) utilization and bystanders' involvement in cardiopulmonary resuscitation (CPR) during OHCA incidents. This cross-sectional study encompassed data pertaining to all OHCA incidents attended to by the Emergency Medical Service of Canton Sarajevo, Bosnia and Herzegovina, covering the period from January 2018 to December 2022. Among a total of 1131 OHCA events, 236 (20.8 %) patients achieved return of spontaneous circulation (ROSC); there were 175 (74.1%) males and 61 (25.9%) females. The OHCA incidence was 54/100,000 inhabitants per year. After a 30-day period post-ROSC, 146 (61.9%) patients fully recovered, while 90 (38.1%) did not survive during this timeframe. Younger age (p<0.05), initial rhythm of ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) (p<0.05), and faster emergency medical team (EMT) response time (p<0.05) were significantly associated with obtaining ROSC. Only 38 (3.3%) OHCA events were assisted by bystanders, who were mostly medical professionals, 25 (65.7%), followed by close family members, 13 (34.3%). There was no report of AED usage. This follow-up study showed less ROSC achievement, similar bystanders' involvement, similar factors associated with achieving ROSC (age, EMT response time), and a decline in OHCA events (especially in year 2021 and 2022) compared to our previous study (2015-2019). There was an extremely low rate of bystander engagement and no AEDs usage. Governments and health organizations must swiftly improve public awareness, promote better practice (basic life support), and actively encourage bystander participation.

Out-of-hospital cardiac arrest (OHCA) in Bosnia and Herzegovina in the period 2018 -2022: current trends, usage of automated external defibrillators (AED) and bystanders’ involvement

&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Aim&amp;lt;/strong&amp;gt; To investigate out-of-hospital cardiac arrest (OHCA) trend, provided advanced life support (ALS) measures, automated external defibrillator (AEDs) utilization and by-standers involvement in cardiopulmonary resuscitation (CPR) during OHCA incidents.&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Methods&amp;lt;/strong&amp;gt; This cross-sectional study encompassed data pertaining to all OHCA incidents attended to by the Emergency Medical Service of Canton Sarajevo, Bosnia and Herzegovina, covering the period from January 2018 to December 2022.&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Results&amp;lt;/strong&amp;gt; Among a total of 1131 OHCA events, 236 (20.8 %) patients achieved return of spontaneous circulation (ROSC); there were 175 (74.1%) males and 61 (25.9%) females. The OHCA incidence was 54/100.000 inhabitants per year. After a 30-day period post-ROSC, 146 (61.9%) patients fully recovered, while 90 (38.1%) did not survive during this timeframe. Younger age (p&amp;amp;lt;0.05), initial rhythm of ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) (p&amp;amp;lt;0.05) and faster emergency medical team (EMT) response time (p&amp;amp;lt;0.05) were significantly associated with obtaining ROSC. Only 38 (3.3%) OHCA events were assisted by bystanders, who were mostly medical professionals, 25 (65.7%), followed by close family members, 13 (34.3%). There was no report of AED usage.&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Conclusion&amp;lt;/strong&amp;gt; This follow-up study showed less ROSC achievement, similar bystanders&amp;amp;rsquo; involvement, similar factors associated with achieving ROSC (age, EMT response time) and a decline in OHCA events (especially in year 2021 and 2022) comparing to our previous study (2015-2019). There was an extremely low rate of bystander engagement and no AEDs usage. Governments and health organizations must swiftly improve public awareness, promote better practice (basic life support), and actively encourage bystander participation.&amp;lt;/p&amp;gt;

The first molecular record of Borrelia afzelii, B. garinii, B. valaisiana, B. burgdorferi s.s. and B. bavariensis in Bosnia and Herzegovina

ABSTRACT Borrelia burgdorferi sensu lato complex comprises 20 species, from which B. afzelii, B. garinii, B. burgdorferi sensu stricto, B. bavariensis, and B. spielmanii are directly associated with Lyme borreliosis, while B. bissettiae, B. lusitaniae, and B. valaisiana were detected in individual cases. Their main vector in Europe is the hard tick species Ixodes ricinus. To date, two species, B. spielmanii and B. lusitaniae, have been molecularly detected in Bosnia and Herzegovina. To test for the presence of other Borrelia species, we performed nested PCR targeting intergenic region rrf (5S) – rrl (23S) on DNA isolates from 49 ticks collected from vegetation by flagging method and 43 removed from humans in The Center for Emergency Medical Assistance of the Sarajevo Canton and The Healthcare Centers of the Sarajevo Canton. Borrelia species were detected by one-directional Sanger sequencing of the amplified region using the same forward primer as in PCR. Out of six Borrelia species detected in the present study, this is the first record of B. afzelii, B. garinii, B. burgdorferi s.s. B. bavariensis, and B. valaisiana in Bosnia and Herzegovina.

Healthcare professionals' views on the response of the primary healthcare system of Sarajevo Canton in the conditions of the COVID-19 pandemic

Uvod: Pandemija COVID-19 pokazala je nedostatke zdravstvenih sustava na globalnoj razini, a najveći utjecaj pandemije doživjeli su zdravstveni profesionalci koji rade u izravnom kontaktu s oboljelim pacijentima. Cilj: Cilj je rada ispitati stavove i mišljenja zdravstvenih profesionalaca koji rade u ruralnim i urbanim područjima Kantona Sarajevo o mjerama zaštite na radnom mjestu, zdravstvenom kadru i organizaciji rada tijekom pandemije COVID-19 od strane nadležnih institucija. Metode: Ispitani su zdravstveni profesionalci koji rade u urbanim i ruralnim područjima u Kantonu Sarajevo koristeći anonimne anketne upitnike čija je osnova bila check lista za provjeru spremnosti zdravstvenih ustanova za pandemiju COVID-19 koju je kreirala Svjetska zdravstvena organizacija. Kriterij za uključivanje u studiju bio je dobrovoljni pristanak ispitanika da sudjeluju u istraživanju. Rezultati: Analiza ustanove i spremnosti sustava na COVID-19 pandemiju ukazala je na mnoge nedostatke zdravstvenog sustava u Kantonu Sarajevo. Utvrđen je umjeren rizik kod odgovora zdravstvenog sustava primarne zdravstvene zaštite na području cijelog Kantona, s tim da je značajno veći rizik utvrđen u urbanim dijelovima Kantona. Utvrđena je značajna statistička razlika u ukupnom riziku (p &amp;lt; 0,001). Na skali od 8 do 40, ukupan rizik u urbanim sredinama iznosio je 21,95 (19 – 25), dok je u ruralnim sredinama iznosio 19,3 (16 – 23). Zaključak: Uvažavanje stavova i mišljenja zdravstvenih profesionalaca koji rade u izravnom kontaktu s pacijentima trebalo bi biti temelj za donošenje odluka u javnoj zdravstvenoj politici. U našoj se studiji, ali i ranije opisanim studijama, uočava pojam adaptabilnosti koji ukazuje na to da se, prema prijašnjim iskustvima, trebaju napraviti korektivne mjere kako bi zdravstveni sustav bio spreman za moguće epidemije i pandemije u budućnosti.

The influence of number of comorbidities on the quality of life of diabetic patients

Introduction: With the continuous aging of the population of Western societies, an increase is expected not only in the number of patients with diabetes but also in the number of patients with comorbidities. Population studies suggest that most patients with diabetes have at least one comorbidity. Comorbidities can profoundly impact a person’s ability to care for himself/herself and can present barriers to adherence to lifestyle changes and compliance with therapy. Methods: The research was conducted in the Public Institution Health Centre of Sarajevo Canton - Health Center Hadžići and Health Center Novi Grad. It included 161 patients diagnosed with diabetes; 96 women and 65 men.The respondents were between 18 and 65 years old (the upper age limit for the working population for both genders). The instruments for conducting the research were a questionnaire on the socio-demographic characteristics of the respondents and Ferrans and Powers index of quality of life, a version for diabetes. Results: The research included 43.48% of respondents with diabetes mellitus (DM) Type II, 31.06% with DM Type I, while even 25.46% of respondents did not know which type of diabetes they suffered from. There were no statistically significant differences in the Total Quality of Life Index (TQLI) (p=0.328) between respondents with different types of diabetes. The average TQLI value in the group with diabetes duration from 1 to 5 years was 22.07 +/- 5.10; in the group from 6 to10 years was 21.23 +/- 6.0; in the group from 11 to 20 years was 21.86 +/- 4.82; in the group from 21 to 30 years was 19.20 +/- 6.81; and in the group with diabetes duration &amp;gt;30 years, was 23.36 +/- 5.46. High blood pressure was present in 60.24% of respondents, followed by elevated blood fats in 51.55% of respondents, and heart/brain blood vessel diseases, in 43.48% of respondents. Neuropathies were present in 38.5%, visual impairment in 26.08%, and malignant diseases were present in a total of 14.28% of respondents. Conclusion: The average value of the quality of life of respondents with 1 comorbidity was 21.30; with 2 comorbidities 20.91; and with 3 comorbidities was 21.94. There was no statistically significant difference in the quality of life of diabetes patients about the presence of one, two, or more comorbidities (p=0.537). The presence of a greater number of comorbidities in patients with diabetes does not contribute to poor quality of life.

THE EFFECTS OF SWIMMING ON BODY POSTURE IN PRESCHOOL AGE CHILDREN

In this study we analyzed the effects of swimming on the posture of preschool children. The sample for this study consisted of 153 preschool boys and girls children aged 4-6 years (standard deviation= 1.1 years) living in Canton Sarajevo and divided into two groups of boys and girls, with one attended swimming school (n=61) and other did not (n=92). In order to evaluate the postural status, we used a reduced Napoleon Wolanski method with eight variables for the observed body parts: assessment of head posture (HPA), assessment of shoulder posture (SPA), assessment of scapular posture (SBPA), assessment of chest posture (CPA), scoliotic posture (SCP), assessment of abdominal posture (APA), assessment of leg posture (LPA), and assessment of foot posture (FPA). The results indicated a great effect of swimming on posture. We concluded the paper with some suggestions on how to incorporate swimming programs into regular school curricula.

A Comparative Analysis of English Language Student and Teacher Training in Inclusive Education and Specific Learning Difficulties in Canton Sarajevo in Bosnia and Herzegovina

The aim of this study was to conduct a comparative analysis of topics on inclusive education and Specific Learning Difficulties (SpLDs) provided in initial and continuing training opportunities for English language students and teachers in Canton Sarajevo in Bosnia and Herzegovina. The study follows a convergent mixed methods design with an explanatory nature. A questionnaire was used to gather both quantitative and qualitative data on student and teacher views about training in inclusive education and SpLDs at the English Department of the University of Sarajevo and the formal English language teacher professional development programs in Canton Sarajevo. The results suggest that teachers are exposed to more topics on inclusion and SpLDs in their professional training compared to students and potential future English language teachers in their initial training, with a focus on strategies of reflective practice to inclusive language teaching and language learning processes of students with SpLDs.

GC-MS profiling of organic pollutants and physicochemical, histological, microbiological analyses of water and fish samples from Canton Sarajevo (Bosnia and Herzegovina) rivers

&lt;p&gt;Continuous monitoring of the water quality in Canton Sarajevo is one of the top priorities necessary for water management, pollution control and conservation efforts in the region. This study presents a comprehensive assessment of water quality in the interconnected river systems of Miljacka and Zeljeznica, employing a multianalytical approach. Water and fish samples were collected at three sites and analysed for the presence of microorganisms, heavy metals and organic pollutants. Physicochemical parameters were examined to understand the rivers’ overall health and ecologic condition. Histopathological analysis of fish species native to these two rivers served as a bioindicator of environmental stressors. In general, there were less anthropogenic pressures found at Site 1 – Kozija ćuprija (river Miljacka – upstream from the city of Sarajevo) and 3 (river Zeljeznica – downstream from the city of Sarajevo). Site 2 – Otoka (river Miljacka, city center) had the highest concentrations of lead, ammonia, orthophosphates and BOD5, as well as total coliform bacteria. This may be linked to the runoff from sewage. The detected histopathological changes are probably associated with the combined microorganisms and organic pollutants, among which plasticizers, emulsifiers, solvents, surfactants and additives were detected by GC-MS.&lt;/p&gt;

Measles outbreak in 2019: a warning for the post-COVID-19 pandemic period.

Introduction. At the end of 2019 and the year before, there was a significant spread of measles in the World Health Organization (WHO) European Region.Gap statement. Among the countries that reported, a measles outbreak was Bosnia and Herzegovina (BiH).Aim. To describe the measles outbreak in BiH (an entity of the Federation of BiH, FBiH) in 2019.Methodology. Confirmatory IgM serology, measles nucleic acid detection by real-time RT-PCR and virus genotyping were done in the WHO-accredited laboratory for measles and rubella at the Clinical Center of the University of Sarajevo, Unit for Clinical Microbiology. Genotype was determined in all measles-RNA-positive cases by sequence analysis of the 450 nt fragment coding the C-terminal of measles virus nucleoprotein (N).Results. From 1 January to 31 December 2019, 1332 measles cases were reported, with the peak observed in April 2019 (413/1332, 31.01 %). Sarajevo Canton had the highest incidence, number of cases and percentage (206.4; 868/1332; 65.17 %) of measles cases. Around four-fifths of infected persons were unvaccinated (1086/1332, 81.53 %), while 4.58 % of the patients (61/1332) were immunized with one dose of measles-containing vaccine. The highest proportion of cases was found in children 0-6 years of age (738/1332, 55.41 %). Measles IgM positivity was determined in 75.88 % (346/456), while virus RNA was detected in 82.46 % (47/57) of the swab samples. All measles virus sequences belonged to genotype B3. SNP (position 216: C=>T) was detected in 1 of the 40 sequences obtained during this outbreak.Conclusion. Due to suboptimal immunization coverage, BiH belongs to countries at a high risk for measles outbreaks. Post-COVID-19 (coronavirus disease 2019) pandemic, targeted and tailored strategies are required to ensure routine vaccination demand and acceptance and broad partner and stakeholder group participation.

DNA polymorphisms detected in MT-ATP6 and MT-ATP8 genes in the residents of Sarajevo Canton

DNA polymorphisms detected in MT-ATP6 and MT-ATP8 genes in the residents of Sarajevo Canton

DIFFERENCES IN THE SOMATIC CHARACTERISTICS OF THE SUCCESSFUL AND LESS SUCCESSFUL GROUPS OF BASKETBALL PLAYERS OF CADET AGE

Abstract The research is based on a sample of 132 cadet basketball players (69 successful cadets and 63 less successful cadets) from 12 participating clubs of the Sarajevo Canton cadet basketball league. The main goal of the research was to determine the structure of the somatic characteristics of young cadet basketball players using a cross-section. The total sample of basketball players divided into two groups of cadet basketball players, divided according to quality, statistically significantly differ in the analyzed somatic parameters. The group of better quality basketball players has better values in all analyzed somatic characteristics. The sample of variables in this research consisted of a set of 14 measuring instruments used to assess the somatic characteristics of young basketball players. After determining, i.e. adjusting the data values to characteristics that are suitable and valid for the use of designed analyzes and providing exact answers to the defined hypotheses, the following procedures were used for data processing and analysis in this paper: - multivariate analysis of variance (Manova) to determine the differences between groups of successful and less successful basketball players by somatic characteristics; - univariate F tests to determine significance for classifying respondents into groups based on the level of their basketball performance. The results of this research can be useful to coaches for better programming of the training process in working with young basketball players, as well as a good basis for scientists for future research on populations of young basketball players. Key words: Multivariate analysis (Manova), cadets, basketball, somatic characteristics

Aspartate Aminotransferase to Platelet Ratio Index (APRI) as a Predictor of Metabolic Syndrome (MetS) Development in Individuals With Type 2 Diabetes Mellitus.

Despite ongoing findings on the relationship between liver fibrosis in nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS), this association in diabetic patients remains unclear. Early diagnosis of liver fibrosis is important due to the easily available diagnostic tools, such as noninvasive indices that combine clinical and laboratory variables, and the possibility of preventing its complications in type 2 diabetes mellitus (T2DM) patients with MetS. This study examines the potential predictive values of non-invasive liver fibrosis indices for MetS in T2DM patients. Over the course of a two-year prospective, observational, clinical study, 80 individuals with T2DMrandomly selected from the Diabetes Counseling Centers of the Public Institution Health Center of Sarajevo Canton were divided into two groups: T2DM-MetS and T2DM-non-MetS, based on the development of MetS. The studyincludedindividuals with T2DM aged30 to 60who were clinically diagnosed without MetS, voluntarily agreed to participate, and provided complete data in the collection forms. Serum samples from the patients were assessed for levels of liver enzymes, platelet counts, total cholesterol, high-density lipoprotein cholesterol, fasting glucose, and triglycerides. Various equations were utilized to calculate liver fibrosis indices, including the Aspartate Aminotransferase to Platelet Ratio Index (APRI), Aspartate Aminotransferase to Gamma-Glutamyl Transferase to Platelet Ratio (AGPR), Aspartate Aminotransferase to Alanine Aminotransferase Ratio to Platelet Ratio Index (AARPRI), Fibrosis-4 (FIB-4) Index, Forns Index, and Gamma-Glutamyl Transpeptidase to Platelet Ratio (GPR). Receiver operating characteristic (ROC) analysis was utilized to determine the usefulness of noninvasive liver fibrosis indices for diagnosing MetS in individuals with T2DM. Logistic regression analysis was used to predict the onset of MetS in T2DM patients. Significant differences in the values of APRI (p<0.001), AGPR (p<0.05), AARPRI (p<0.001), and the FIB-4 index (p=0.001) were observed in T2DM-MetS individuals compared to T2DM-non-MetS. According to ROC analysis, the area under the curve (AUC) was found to be highest for APRI (0.84), followed by FIB-4 (0.783) and AARPRI (0.747). Logistic regression analysis identified APRI as an independent positive predictor of MetS (OR 18.179, 95% CI 6.035-24.58, p=0.015). This research highlights the effectiveness of the APRI index as a reliable predictor of MetS development in individuals with T2DM.

SAFETY MANAGEMENT AT THE WORKPLACE IN PUBLIC AND PRIVATE HEALTHCARE FACILITIES IN THE CANTON OF SARAJEVO

Introduction: Workplace safety means implementing a modern risk assessment method automatically included in the risk management activity. When a risk is discovered, it is necessary to reduce it or eliminate it completely through preventive measures or interventions. Aim: To examine to what extent healthcare organizations care about their workers, to what extent workers are aware of the risks, whether they have adequate working conditions and whether they respect them. Participants and methods: The study was included 144 healthcare professionals employed in public and private healthcare institutions in the Sarajevo Canton. The sample was selected by the method of random selection. The study is descriptive and comparative. Results: The total sample (N=144) included 140 or 97.2% respondents working in public healthcare institutions, and 4 or 2.8% respondents working in private healthcare institutions. Almost ¾ of respondents are familiar with the implementation of risk assessment in the workplace, and in 25.0% of cases they are familiar with some strategic document on risk management and assessment of risky workplaces. The largest number of respondents, 63.9%, state that they respect the protection measures provided by the employer. None of the respondents gave reasons for non-compliance. Conclusion: Respondents confirmed the existence of workplace risks in public and private healthcare institutions and awareness about them, they are fully or partially aware of the risks and partially practice protection against them. A significant number of employees mention illnesses that are potentially caused by a risky workplace.Keywords:workplace safety, management, healthcare institutions.

Assessment and Application of the Hear Score in Remote Emergency Medicine Outposts in Bosnia and Herzegovina.

Background and Objectives. In emergency departments, chest pain is a common concern, highlighting the critical importance of distinguishing between acute coronary syndrome and other potential causes. Our research aimed to introduce and implement the HEAR score, specifically, in remote emergency outposts in Bosnia and Herzegovina. Materials and Methods. This follow-up study conducted a retrospective analysis of a prospective cohort consisting of patients who were admitted to the remote emergency medicine outposts in Canton Sarajevo and Zenica from 1 November to 31 December 2023. Results. This study comprised 103 (12.9%) patients with low-risk HEAR scores and 338 (83.8%) with high-risk HEAR scores, primarily female (221, 56.9%), with a mean age of 63.5 ± 11.2). Patients with low-risk HEAR scores were significantly younger (50.5 ± 15.6 vs. 65.9 ± 12.1), had fewer smokers (p < 0.05), and exhibited a lower incidence of cardiovascular risk factors compared to those with high-risk HEAR scores. Low-risk HEAR score for prediction of AMI had a sensitivity of 97.1% (95% CI 89.9-99.6%); specificity of 27.3% (95% CI 22.8-32.1%); PPV of 19.82% (95% CI 18.67-21.03%), and NPV of 98.08% (95% CI 92.80-99.51%). Within 30 days of the admission to the emergency department outpost, out of all 441 patients, 100 (22.7%) were diagnosed with MACE, with AMI 69 (15.6%), 3 deaths (0.7%), 6 (1.4%) had a CABG, and 22 (4.9%) underwent PCI. A low-risk HEAR score had a sensitivity of 97.0% (95% CI 91.7-99.4%) and specificity of 27.3% (95% CI 22.8-32.1%); PPV of 25.5% (95% CI 25.59-28.37%); NPV of 97.14% (95% CI 91.68-99.06%) for 30-day MACE. Conclusions. In conclusion, the outcomes of this study align with existing research, underscoring the effectiveness of the HEAR score in risk stratification for patients with chest pain. In practical terms, the implementation of the HEAR score in clinical decision-making processes holds significant promise.

Dyslipidemia induced by antipsychotics: di”erences between schizophrenia and bipolar disorder

IntroductionThe introduction of antipsychotics, especialy of newer generation, greatly a”ects the e”ectiveness of the psychiatric treatment of patients with schizophrenia (SCH) and bipolar disorder (BP). Patients su”ering from SCH and BP often have metabolic syndrome (MetSy), as a result of taking antipsychotic therapy, especially in patients with abdominal obesity, there is an atherogenic fat profile that carries a high risk for the development of dyslipidemia.ObjectivesTo investigate frequency and di”erences of somatic diseases in patients with SCH and BD depending on the presence of MetSy.MethodsThis five-year prospective study was conducted in the Psychiatric Hospital of Canton Sarajevo. We followed 135 patients with SCH and 135 patients with BD, aged 30 to 69 years, who were treated with antipsychotics for five years.ResultsDyslipidemia was significantly more common in SCH patients (73.3%), compared to BD (54.1%) and was dominantly presented in women (61.4%). The frequency of dyslipidemia increased with the age of the patient. Associated risk factors in patients with SCH diagnosed with dyslipidemia were 73.5% smokers, 78.7% hypertensive patients, 69.7% patients with elevated BMI and 83.0% with elevated blood glucose values, while slightly lower values were recorded patients with BP. 97.8% of patients with dyslipidemia had elevated CRP.ConclusionsThere are significant di”erences in dyslipidemia in patients su”ering from SCH and BP. Adequate knowledge of the antipsychotic drugs is required in order to provide adequate psychiatric treatment, regarding minimalising adverse e”ects of antipsychotics will be reduced to a minimum. It is important to recognize high-risk patients and educate them about preventive measures.Disclosure of InterestNone Declared