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COVID-19, caused by the SARS-CoV-2 virus, has been a major focus of scientific research since late 2019 and early 2020. Due to its enormous societal, economic, and clinical impact worldwide, research efforts aimed, among other questions, to address the effect of host genetics in susceptibility and severity of COVID-19. In this research, we performed next-generation sequencing of coding and regulatory regions of 16 selected human genes, involved in the maintenance of the immune system or encoding the receptors for viral entry into the host cells, in a subset of 60 COVID-19 patients from the General Hospital Tešanj, Bosnia and Herzegovina, classified into three groups of patients with clinical conditions of different severity (“mild”, “moderate”, and “severe” clinical groups). In accordance with previous studies, we found out that the male sex and older age are risk factors for severe clinical picture. We identified 13 variants on seven genes (CD55, IL1B, IL4, IRF7, DDX58, TMPRSS2, and ACE2) with potential functional significance, either as genetic markers of modulated susceptibility to SARS-CoV-2 infection or as modifiers of the course of infection in terms of predicted symptom severity. Our results include variants reported for the first time as potentially associated with COVID-19. Future studies on larger patient cohorts, focused on candidate genes and/or candidate genetic variants, have a potential to answer a range of open questions regarding the effect of host (human) genetic makeup on the expected outcome of COVID-19.

Aim To identify clinical and laboratory parameters on admission and/or during a hospital stay that would predict prolonged hospital stay in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A retrospective cross-sectional study was conducted at the Clinic for Pulmonary Diseases and Tuberculosis, Clinical Centre University of Sarajevo for the period 2019-2021 accounting patients admitted due to AECOPD. The need for hospitalization was evaluated according to the current GOLD criteria and certain clinical parameters. Spirometry testing and laboratory analysis were performed for all patients on the day of admission and on the 10th day of hospital stay. Linear regression was used to show the relationship between multiple independent predictor variables and LOS. Results A total of 50 patients were evaluated during their hospital stay due to AECOPD. Median of LOS was 22.02±1.06, with 90% hospital survival rate. Due to AECOPD the median of LOS in the intensive care unit (ICU) was 4±0.68 days with pH7.35 in 34% of hospitalized patients. According to spirometry classification on the day of admission, 56% of patients were assigned to group 3 and 16% to group 4 with significant improvement identified on spirometry findings on discharge. Platelets on the day of admission were the only statistically significant positive predictors of the length of hospital stay. Conclusion Identifying chronic obstructive pulmonary disease patients at risk of frequent exacerbations and appropriate disease management could reduce the disease burden.

Aim To investigate infl uence of neutrophil-to-lymphocyte ratio (NLR) and proatherogenic risk factors to improve the accuracy of pneumonia severity index (PSI) in the prediction of community acquired pneumonia (CAP) outcome in healthy individuals. Methods A retrospective observational cross-sectional study conducted at the Clinic for Pulmonary Diseases and Tuberculosis "Podhrastovi", University Clinical Centre Sarajevo, included 83 patients with the diagnosis of CAP during the period March 2019-March 2021. Once diagnosed with CAP, PSI score was calculated and according to its value the need for hospital treatment was identifi ed. Patients were divided in two groups: low risk of CAP (PSI90), and high risk of CAP (PSI90). Results The overall average hospital stay was 22.76±10.154 days. In the patients diagnosed with CAP, a positive correlation was established between the following parameters PSI score and age (r=0.670; p0.01), C-reactive protein-CRP (rho=0.287; p0.01), leukocytes (rho=0.406; p0.01), NLR (rho=0.313; p0.01) and platelet to lymphocyte ratio (PLR) (0.296; p0.05). CRP, leukocytes, NLR and PLR were statistically signifi cantly higher in patients with high risk of CAP compared to patients with low risk of CAP. Diastolic blood pressure, lymphocytes, eosinophils were signifi cantly lower in patients with high risk of CAP (p0.05;) compared to patients with low risk of CAP (p0.01). The optimal cut-off value of NLR for CAP patients was 3.089 with an estimated area under curve (AUC) of 0.664. Conclusion Proatherogenic parameters such as age, systolic blood pressure and leukocytes in combination with neutrophil-lymphocyte count ratio could improve accuracy of the pneumonia severity index in community acquired pneumonia outcome.

Background: Pregabalin is a first-line therapy of pain with additional positive effects on the states of depression and anxiety that often occur in patients with chronic pain, thus improving their quality of life. Objective: The aim of this study was to demonstrate the efficacy of pregabalin in reducing neuropathic pain and improving quality of life in patients with peripheral and central chronic neuropathic pain in Bosnia and Herzegovina. Also, the aim was to monitor the safety of therapy with pregabalin. Methods: The study included patients with neuropathic pain lasting more than 3 months. Based on the underlying disease, patients were divided into 5 groups: DM–patients with diabetes mellitus, M–patients after stroke, D–patients with lower back pain, MS–patients with multiple sclerosis, and P group–patients with spinal cord injury. During the baseline visit, the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) was used to assess neuropathic pain. During two follow-up visits (1.5 and 3 months after baseline), the 36-Item Short-Form Health Survey (SF 36) was used to assess the effectiveness of therapy on quality of life. The safety of the treatment was evaluated by monitoring the incidence of adverse drug reactions. Results: The study included 125 patients. During treatment with pregabalin, there was a statistically significant reduction in pain intensity in the DM, M, D and MS groups. In group P, the decrease in pain intensity was not statistically significant (p = 0.070). There was a significant improvement in different parameters of the quality of life in all analyzed groups, with the most prominent effects in the DM group. The effectiveness of treatment was rated as “good” and “very good” in more than 70% of subjects in each group. The expected side effects of treatment were recorded in 27.1% of patients in the DM group, in 20.0% in the M group and in 22.2% in the MS group. Unexpected side effects of treatment were observed in one patient (2.1%) in the DM group. Assessment of tolerability of the applied treatment showed “good” and “very good” response in 68.7% of patients in DM group, 73.3% in M group, 74.5% in D group, 88.9% in MS group and 85.8% in P group. Conclusion: Pregabalin is a safe and effective drug in treatment of neuropathic pain of different etiology.

Caused by the new SARS-CoV-2 coronavirus, COVID-19 (coronavirus disease 2019) evolves with clinical symptoms that vary widely in severity, from mild symptoms to critical conditions, which can even result in the patient’s death. A critical aspect related to an individual response to SARS-CoV-2 infection is the competence of the immune system, and it is well known that several trace elements are essential for an adequate immune response and have anti-inflammatory and antioxidant properties that are of particular importance in fighting infection. Thus, it is widely accepted that adequate trace element status can reduce the risk of SARS-CoV-2 infection and disease severity. In this study, we evaluated the serum levels of Cu, Zn, Se, Fe, I and Mg in pa- tients (n = 210) with clinical conditions of different severity (“mild”, “moderate”, “severe” and “exitus letalis”, i. e., patients who eventually died). The results showed significant differences between the four groups for Cu, Zn, Se and Fe, in particular a significant trend of Zn and Se serum levels to be decreased and Cu to be increased with the severity of symptoms. For Mg and I, no differences were observed, but I levels were shown to be increased in all groups.

Aim To investigate interleukin 6 (IL-6) values depending on duration of diabetes mellitus (DM) and evaluate possible correlation with diabetic polyneuropathy. Methods The research study included 90 patients with DM divided into three groups (30 patients each) according to the duration of DM: group A - patients who had DM for less than 10 years, group B - duration of DM was 10 to 20 years, and group C - patients with DM over 20 years. Control group (K) included 30 healthy participants. Results IL-6 was significantly higher in the healthy control group, 180.318 pg/mL±94.18, than in group A, 47.23pg/ml±34.8, group B, 43.31pg/ml±33.17, and group C, 70.39 pg/ml±59.26 (p=0.0001). All groups had significantly different values of IL-6 between each other (p=0.0001). Level of IL-6 was in correlation with diabetic polyneuropathy in the group A (the youngest participants) (p=0.0001). In other groups there was no significant correlation between IL-6 and diabetic polyneuropathy. Conclusion The level of IL-6 was in correlation with neuropathy among younger patients. A higher level of IL-6 in the control group than in diabetic groups is a sign of stronger inflammatory response among younger and healthy people than in patients with DM.

Background: Patients with diagnosis of COPD suffervery often by bronchiectasis. Cough, expectorate, dyspnea are present in both.Exacerbations of both diseases are mainly provoked by inflammation or upper airways infections. Method: We analyzed 246 patients with COPD hospitalized during 2018 and 2019 year in Department of Pulmonary diseases. Patients were divided in two groups. The first with COPD only, and second one COPD patients with bronchiectasis. Bronchiectasis was diagnosed by High Resolution CT scan. We analyzed three specimen of sputum in COPD patients with or without bronchiectasis. Microbiological specimen was collected in first three days of hospitalization to avoid hospital colonization. Results: Bronchiectasis were found in 88 (36.77 %) cases. Among 158 patients without bronchiectasis sputum was positive in 44 cases (27.84 %). Next bacteria were found: Klebsiella pneumoniae in 18 cases, Acynetobacter species 11 cases, Escherichia coli in 10 cases, Seratia marcescnes 8 cases, Streptococcus pneumoniae in 2 cases, Enterobacter species and Staphylococcus coagulase-negative both one case. Two bacterias were found in 5 cases. In COPD patients with bronchiectasia sputum was positive in 28 cases, as follows: Klebsiella pneumoniae 9, Acinetobacter species 6, Escherichia coli 5, Serratia marcescenes 4, Streptococcus pneumonia 2, Enterobacter, staphylococcus coagulase-negative both in one case. Two bacterias were found in 4 cases. Candida albicans was found in 36 (40.1 %) COPD patients with bronchiectasis and in 52 (16.8%) without.

Summary Background FTO, a gene recently discovered in genomewide associated studies for type 2 diabetes mellitus (T2D), play an important role in the management of energy homeostasis, nucleic acid demethylation and regulation of body fat mass by lipolysis. The aim of this study was to analyze the association of FTO rs8050136 A>C genetic variant with clinical and biochemical parameters of T2D in the population of West Balkan region (Bosnians and Herzegovinians and Kosovars). Methods The study included 638 patients with T2D and prediabetes and 360 healthy controls of both genders, aged from 40 to 65 years. Patients were recruited at the Clinical Centre University of Sarajevo, University Hospital of Clinical Centre in Banja Luka, General Hospital in Tešanj and Health Centre in Prizren. Genotyping of analyzed FTO polymorphism rs8050136 A>C was performed by qPCR allelic discrimination. Results Genotype frequencies of the analyzed polymorphism were comparable between patients with T2D, prediabetic patients, and healthy population. Logistic regression analyses didn’t show significant association of FTO rs8050136 A allele with increased risk of T2D. However, risk A allele was significantly associated with higher levels of HbA1c, insulin, HOMA-IR index, diastolic blood pressure, and inflammatory markers (fibrinogen and leukocytes) as well as showed tendency of association with increased values of obesity markers (BMI, waist and hip circumference). Conclusions Results of our study showed a significant association of FTO genetic variant rs8050136 A>C with the major markers of insulin resistance, obesity and inflammation, opening new avenues for solving many unclear questions in the pathogenesis of T2D.

Introduction: The most appropriate choice of pharmacological treatment of heart rhythm disorders occurring in patients with chronic obstructive pulmonary disease (COPD) and cardiovascular comorbidity is often a topic of debate between pulmonologists and cardiologists in clinical practice, although numerous studies and clinical trials have demonstrated evidence to support the use of selective beta-blockers (BBs) in these patients. Aim: To examine the difference in the number of exacerbations in patients treated with a combination of verapamil and digoxin or BB alone in patients with different COPD stages. Patients and methods: The study included 68 patients (n = 68) diagnosed with COPD who were followed-up during a 12-month period, and the number of exacerbations were analyzed. The patients were divided into two groups according to the stage of COPD: GOLD II (moderate), and GOLD III (severe), and in each group a subdivision was established in relation to the use of either a combination of verapamil and digoxin or the use of BBs alone in pharmacological treatment. The inclusion criteria for patients were defined as following: a) established diagnosis of COPD according to present or deteriorated relevant clinical symptoms and signs, b) the ejection fraction (EF) of a left ventricle (LV) >35%, and c) spirometric cut-points classified as GOLD II (FEV1 / FVC

Despite multistep efforts many asthma patients remain symptomatic. Anti-inflammatory activities of curcumin were shown. Aim was to analyse the add-on therapy with curcumin on inflammatory parameters, lung function, disease control and quality of life in asthma patients. 150 non-smokers with moderate partially controlled asthma were treated during 3 months with stable moderate dose of inhaled glucocorticoids and divided into three groups (n=50): curcumin group (receiving curcumin 500 mg per os twice daily), placebo and control group. Before study, sputum eosinophils (sEo), blood eosinophils (bEo), high sensitive C-reactive protein (hsCRP), predicted forced expiratory volume in first second (FEV1%), Asthma Control Test (ACT) and Asthma Quality of Life Questionnaire (AQLQ) were similar between groups. After study, FEV1%, ACT and AQLQ were improved in all groups, but these improvements were more prominent in curcumin group than in placebo and control. Additionally curcumin group only showed improvement in sEo, bEo and hsCRP. Furthermore, curcumin group showed also more frequent clinically significant improvement in ACT score (change>3) and in AQLQ score (change≥0.5) when compared to placebo and control. However, placebo and control showed similar distribution in FEV1%, ACT, AQLQ, hsCRP, sEo and bEo after study. This is the first placebo controlled and single-blind study to suggest that add-on therapy with curcumin could improve lung function, disease control and quality of life in moderate partially controlled asthma. Future studies may benefit from a larger sample size, longer study duration, double blind design, different dose of curcumin and/or improvements in oral bioavailability.

Sputum eosinophils might predict response to inhaled corticosteroids (ICS) in patients with advanced chronic obstructive pulmonary disease (COPD). Induction of sputum requires expertise and may not always be successful. Aim was to investigate correlation and predictive relationship between peripheral blood eosinophils (bEo) and sputum eosinophils (sEo), and impact of peripheral blood eosinophilia on outcome of COPD exacerbation. 120 current smokers with COPD (GOLD group C) (57.4 ± 0.92 years, M/F ratio 1.4), with no blood (≥7% or >0.43x10 9 /L) nor sputum (≥3%) eosinophilia, were treated with moderate dose of ICS and long-acting bronchodilatator during stable disease, but systemic corticosteroids and antibiotics during exacerbation. According to sputum eosinophilia (≥4%) during exacerbation, patients were divided into eosinophilic (n=45) and non-eosinophilic group (n=75). In stable disease, bEo and sEo were similar in both groups ( p >0.05). During exacerbation, bEo and sEo were significantly higher in eosinophilic group (eosinophilic vs. non-eosinophilic: blood: 1.42 ± 0.39 x10 9 /l vs. 0.23 ± 0.02 x10 9 /l, p

Previous studies reported conflicting results regarding association of insulin receptor substrate 1 (IRS1) gene variation with type 2 diabetes (T2D) and insulin resistance (IR) in different ethnic groups. We examined the association of rs7578326, rs2943641, and rs4675095 in the IRS1 gene with T2D and related traits in a population from Bosnia and Herzegovina, which is one of the European countries with the highest T2D prevalence of 12.5%. Our study included 390 T2D patients and 252 control subjects. Biochemical parameters, including fasting glucose (FG), fasting insulin (FI), homeostasis model assessment insulin resistance index (HOMA-IR), and HbA 1c were measured in all participants. Genotyping analysis was performed by Mass Array Sequenom iPlex platform. Our results demonstrated that rs7578326 and rs4675095 variants were associated with increased FG levels. The rs7578326 was also associated with higher FI, HOMA-IR (B = 0.08, 95% CI [0.01, 0.15], p add = 0.025; B = 0.079, 95% CI [0.006, 0.150], p add = 0.033, respectively) in T2D, and with HbA 1c (B = 0.034, 95% CI [0.003, 0.065], p dom = 0.035) in non-drug-treated T2D. In contrast, rs2943641 C allele was associated with lower FG levels in control subjects (B = -0.17, 95% CI [-0.03, -0.002], p add = 0.030) and HbA 1c (B = 0.03, 95% CI [0.002, 0.06], p dom = 0.040) in non-drug-treated T2D. We report the association between common variants in IRS1 gene with insulin resistance, glucose, and HbA 1c levels in Bosnia and Herzegovina's population.

Introduction: The PhD program represents the biggest step in the education and the PhD itself is the crown of the work of one scientist (1). Each PhD thesis represents the contribution of the author to the development of the area in which he/she is active, and must present something new, unknown or unsufficiently explored until then, with direct implication for the practice. Aim: To present the difference between PhD program during 50 years period, with the presentation of the advantages that development and availability of science brought. Results: When different literature was not available in digital form, writing a PhD thesis after a postgraduate study and a long-term specialist work was the crown of the work of medical professional. Unfortunately, this process was sometimes difficult and was dependent on many parameters and subjective opinions, and was subject of numerous manipulations. In the present age, following the reform of education, and the implementation of Bologna Education System, the number of PhD students has increased and the study started to be held at all Universities in Bosnia and Herzegovina (2). All those who completed the six-year study are able to attend the PhD studies. The main obligation for student and requirement for obtaining PhD degree is article from PhD thesis published in the Current Contents database. This criterion was removed over time and the situation now is that obligation is article that is published in journal thatis in the reference database (without clear definition in which databases). Quantity is achieved but we cannot say that for quality. During the year 2017, in Bosnia and Herzegovina, 11 original articles in the field of clinical medicine were published (indexed in the journals that are in the Current Contents Indexed Publications (journals that belong to CC, SCI and SCI-E base) (3,4). These 11 papers are from the field of gastroenterology, psychiatry and ophthalmology (2,3). If this is the scientific opus of already experienced scientist, the question remains what is expected from young researchers. Conclusion: Which system is better, on this question answer cannot be given, because both systems have shortcommings and advantages. The fact is that there is a gap between generations, which is unlikely to be resolved. It is also a fact that the Bologna system is not ideal, but it is currently our present (5, 6,7). A lot of students are enrolled, and the system must help them, in the process of successfully completing their PhD programs. This help cannot be achieved through the lowering of criteria (publications in science remain the only weapon in evaluation). This step leads to decreasing of quality. Quality is what needs to be taught, quality is the only one that science needs. The results in 2017 for Bosnia and Herzegovina and even the worst experience in the past few years is the red alert and only together, both professors and students, can find a way out of one of the most difficult situations., Introduction: The number of scientific publications in medicine has dramatically increased in recent decades. With the rising tide of publications it has been claimed that publication misconduct, paperism and scientism have become a silent epidemic in our post-truth age of entitlement (1). Many scholars and editors have argued that proper motivation is fundamental to a quality research and promotion of publishing culture. Dissertations and scientific papers became commodities and mass products, the many of them offered little or nothing to scientific progress. Black market in academic papers and predatory publishing is a hot topic. Publishing ethics defines the ethical behavior in writing and submitting a scientific manuscript for publication (3-5). We need more convergence in our thinking on publishing ethics from the perspectives of professional, research, academic and medical ethics, business and political ethics in the light of universal versus particular ethics. Aim: The main goal of this presentation is to address the importance of educational and restorative approach in promoting publishing ethics in order to decrease need for retributive approach to the publication misconduct. The presentation is intended to be thought provoking how to promote epistemophilic publication culture. The method of De Bono’s six thinking hats will be used in order to achieve a joint vision on publication ethics. Results: The scientific studies of motivation to publish are very rare. Motivation to publish may be very different: wish to inform scientific community about own work and get comments and suggestions for further research, to speed career advance, to get or improve funding, to boost own ego, to protect copy right, etc. Recent years have witnessed increased attention for publication misconduct (authorship criteria failure, gift or ghost authorship, duplicate submission, redundant publication, duplicate publication, plagiarism, falsification, and fabrication of data), but much less for motivation for publishing pseudoscientific papers. In general, the issue how to increase proper motivation for publication has been studied very rarely. The career pressure to publish or perish and financial gain and ideology, as a set of ideas that forms one’s goals, expectations, and actions, seem to be strong incentives for publishing pseudoscientific papers. The erosion of the primary scientific interest in publishing by a secondary, commonly non-ethical interest has become a significant problem (5, 6). Publication pressure publish or perish may be associated with job-related burn-out in academic medicine. Conclusion: All clinicians have a professional ethical obligation to follow, understand and share the scientific evidence in a proper way. General purposes for making and publishing a paper should be informing or teaching others, and motivating others for cooperation or the mixture of some or all of these purposes. Common key words of good research and publishing are: integrity, motivation, capacity, understanding, knowledge, experience and creativity. Epistemophilia, the love of knowledge should be the impulse to investigate and publish. Publishing hodegetics and early education for epistemophilic publication culture and reinforcement of proper motivation for publishing is essential to stop falling into pitfall of publishing papers just to have papers to be published because of career and academic promotion and financial gains (4). Proper motivation is an integral component of assurance of scientific quality of published papers as well as scientific progress (6)., Introduction: Ethical issues regarding authorship have been present since antient times (1). Publication is the final affirmation of scholarly accomplishment. Academic advancement, “publish or perish,” as well as prestige, are other important driving forces. Finally, there are many financial benefits (direct and indirect) in publishing such as promotion and further research funding. Many of these forces can lead to ethical lapses, and International Committee of Medical Journal Editors’ (ICMJE) recommended guidelines for authorship are not reflected in current authorship practices within the domain of health sciences in both low-and high-impact-factor journals (1,2). Aim: To present some of ethical issues of authorship in medical scientific publishing. Methods: Article has an analytical character and review of literature. Results and Discussion: A number of studies have reported an increasing trend of papers with multiple authors in every scientific discipline within and across countries. „Significant contribution“ is an important criterion for authorship credit. Many journals currently adhere to the guidelines of the International Committee of Medical Journal Editors (ICMJE), which has established four criteria that each author of a paper should meet: Significant involvement in study conception/design, data collection, or data analysis/interpretation; Involvement in drafting or revising manuscript; Approval of final version of manuscript for publication; and Responsibility for accuracy and integrity of all aspects of research. However it is not enough for avoidance of non-ethical authorships. It has been described several of inappropriate types of authorship: a) guest authorship; b) honorary or gift authorship; c) ghost authorship; d) anonymous authorship; group authorship, etc. Honorary/gift authorship and ghost authorships are two extremes of scholarly malaise. In honorary/gift and ghost authorship, the idea of „significant contribution“ is not reflected in the author list. Someone who has contributed little or nothing gets to be an author. Similarly, a ghost author gets no credit for his/her contribution, as he/she is not on the author list (3). In three peer-reviewed journals in 1996 Flanagin et al. (4) found evidence that 19% and 11% of these papers involved honorary and ghost authorship, respectively. Many others found a similar pattern of honorary and ghost authorships or even more frequency of it. In recent study within the total number of respondents (69 academic workers from medical field) 34.8% of them were added as coauthors, although they did not have any input in the writing process. Even 47.8% of the respondents were under psychological pressure, that they have to add their superiors to the list of authors, though they did not have any contribution at any stage of the article preparation, while 29% of the respondents had a tacit agreement about mutual adding to the author’s list, and 36.2% added their superiors to the author’s list, in order that the first author would get a permission to publish the article in a certain journal (5).There are several ways in which authorship issues, i.e., who should be on the paper as author and who should not and the order of authorship could be solved. For example, the lead or principal author may decide who should be on the author list or cited in the acknowledgment section and who should not be in any of these. However, one still needs to bear in mind that, no matter how articulate the rules and guidelines are, they cannot cover all the contingencies (3). Conclusion: The ethical issue of authorship, although simple at first glance, is an extremely complex issue, and many malversations and violations of ethical principles can be found. Knowledge about formal authorship criteria is highly variable and majority of scientist are not familiar with existing criteria or do not consider formal criteria necessary. Editors could play a more active role in addressing inappropriate authorship by providing clear and unambiguous policies that inform and define deserving authorship and promote research and authorship integrity., Introduction: The biomedical knowledge collection is important for every citizen in a search for health. The amount of published research gives the impression that the right answer for every question is just there. This motivated, together with medical professionals, every individual to get access to what is published and grasp the relevant knowledge needed (1). Aim: The aim of this study was to discuss the possible sources for medical knowledge produced by current research activities, and the value of the knowledge being openly available to public. Results: The understanding of the knowledge in the digital society developed with the help of interdisciplinary and international network, Navigating Knowledge Landscapes (2). The individuals, being lay people or medical professionals, approach the knowledge using the Internet, in a hope to find the latest innovative game-changing knowledge that would apply to the medical issue in question. The most recent medical knowledge is embodied in the academic publishing, which gradually turns to be Open Access, freely available to everyone. In May 2016, the European Union announced “all scientific articles in Europe must be freely accessible as of 2020”. In ideal words,using the digital technologies and Open Access, the knowledge would be available to anybody who wants it. The amount of published articles make the search for the relevant knowledge extremely tedious. Cochrane promotes evidence-informed health decision-making based on sound medical research. To make this research accessible, Cochrane produces up-to-date systematic reviews and other synthesized research evidence to inform health decision making. Subsequently, Cochrane aims to put Cochrane evidence at the heart of health decision-making all over the world (3). The strategies like Open Access and Cochrane in relation to knowledge, and in particular health-related knowledge are indeed very important and should be supported and welcomed. The discussion is opened about the general impact of these activities, and if the availability of the knowledge would be a solution to provide the knowledge to those who need them. Our argument is that the current state of knowledge measured by number of publication is highly over-estimated (4,5). The knowledge is tentative and it changes constantly. Having 11,000 members and over 35,000 supporters from more than 130 countries, and producing a bit less than 8000 systematic reviews, as Cochrane does, is notable, but how this relates to what we do not know is the point of the controversy. Conclusion: Believing in absolute knowledge and the quest to make it available to both professionals and lay public is in opposition to the pluralistic, individual, and incomplete knowledge. The perception of this controversy is a key in providing health-related knowledge to the nowadays society., Introduction: Translation of parts or whole paper from one to another language with the identification of the author(s) is a simple translation, but if the author(s) are different it is called translational plagiarism (1). If the author translates his/her paper into another language and pledges it as another paper, it is called translational self-plagiarism (2). Some of the authors are using monolingual plagiarism, and multilingual plagiarism (3). Back-translation is a new approach using particular tools, when the text in English is taken and translated into another language, then “retranslated” again into the original language, thus hiding their plagiarism. Aim: This study aimed to present a method for verification of the translational plagiarism in the paper written in Macedonian and translated in a foreign language. Methods: Original document (written in Macedonian) was translated with Google Translator; suspected article (published in English pdf file) was converted into Word document and compared both documents with several programs for plagiarism detection (4). Results: It was found that both documents are identical in 71%, 78% and 82%, respectively, depending on the computer program used for plagiarism detection. It was obvious that the original paper was entirely plagiarized including six references from the original paper. System for plagiarism detection and analysis was developed and installed from the Ministry of Education and Science, the Republic of Macedonia. The students and researchers/scientists can easily upload their homework, bachelor’s thesis, master’s thesis, doctoral thesis (dissertation) and other published papers and documents. The system also provides a mechanism for comparing the uploaded documents with all the other documents that are already present in the system and to measure their originality, i.e. to detect if any of the content is already published (5). Unfortunately, the system is robust, language restricted, and the closed database is limited to the documents deposited in the local website only. A very small number of countries uses multilingual plagiarism detection (3,6-8), restricting plagiarism check to one language comparison and presenting false results. Conclusion: Plagiarism of the original papers written in Macedonian and translated in other languages can be verified after computerized translation in other languages. Later on, original and translated documents can be compared with available software for plagiarism detection., Introduction: Outsourcing is a business practice in which a company hires another company or an individual to perform tasks, handle operations or provide services that are either usually executed or had previously been done by the company’s own employees. One way of outsourcing in academic and scientific community is ghostwriting. The word describes a process in which a person or team provide writing services and compilation of finished scientific papers that are officially credited to another person as the author (ordering person). Aim: The aim of this lecture is to present available ghostwriting platforms, make clear distinction between ghost and guest authoring and discuss ethical aspects of ghostwriting. Results: The research of available specialized companies and ghostwriter individuals has been done and specific enquires for production of scientific paper were sent. Offers have varied in price, time needed to compile and potential to fulfill criteria for intended use of scientific paper. Many writer organizations have they own rules for authorship and contribution which have been assessed and compared (1). Different types of ghostwriting have been analyzed (individual publishing, advancement in academic grading, medical and pharmaceutical industry) and ethical responses and criticism from various types of stakeholders (2,3,4). Conclusion: It is difficult to determine how frequently ghostwriting occurs due to its covert nature. It is also very difficult to detect and reveal scientific papers which are compiled by ghostwriters, because they are original piece of scientific work, only credited to another person. Results of research are still work in progress and final conclusions will be presented during the lecture., Introduction: Publishing scientific papers of clinical research in peer-reviewed journals remain a major tool for distributing the medical results and informations to researchers and practitioners (1-3). The ethical issues in publishing of clinical research is always challenging and carries a great responsibility of submitting authors and editors for honesty and avoidance of misconduct as well (4). Aim: The objective of this paper is to explore the ethical principles in publishing of clinical research. Results: The objective of clinical research is to provide knowledge, truth and to avoid any mistake, deviations, unethical issues, fabrication, falsification and plagiarism (FFR). The author’s self-reports contribute to 1,0% in research conduct, while other registered agencies that sponsor research count 0,01% in medical un-ethics. Detection of FRR in publishing still remains the significant issue and requires sometimes a time to discover it. Deviations in reporting the results may be even more difficult to unmask since some authors are not even aware that their action is un-ethical. This may be due to lack of knowledge or to self-motivation. The vast majority of FFR was found in presenting the abstracts at various medical conferences and symposium since there is no strict control of such reports. One of the most frequent un-ethics in this example is ghost authorship. The industry sponsored clinical trials contribute to ghost authorship in a significant manner. Conclusion: Concerning these and other issues in publishing of clinical trials, the peer-reviewing process requires the strict and careful process, the control of statistical analysis, anti-plagiarism software as well as honesty and responsibility of researchers and submitting authors., Introduction: Relations between doctors in everyday clinical practice and pharmaceutical companies are permanent and numerous. If a clinician is involved in publishing, he or she publishes papers in professional journals, then a number of other relationships with pharmaceutical companies are opening up. Participation in clinical research is the third, even more important form of collaboration between clinicians and pharmaceutical companies. And as the fourth and perhaps most important for the pharmaceutical industry, is the involvement of clinicians in the development of clinical guidelines that have the most influential decision in the daily decision-making process in selecting appropriate pharmacotherapy. Aim: To present ethical issues about conflict of interest statement in journals by authors who are involved in promotion of drug. Results: Whether there is a significant conflict of interest, how to quantify it, and whether it needs to be limited. Is the “statement of conflict of interest” itself sufficient enough, which clinicians, and especially medical experts, point to the presentation of their exposure in public presentations? First of all, it is necessary to accept the universal definition of “conflict of interest” as position when it in a sufficiently usable and unavoidable fact in assessing whether it has it and how much it is. The definition of “conflict of interest” is given by the International Committee of Medical Journal Editors as “The state of the presence of a conflict of interest when a professional judgment of a primary interest may be under the influence of a securitized interest” (i.e. when the validation of the patient’s condition will be affected by the financial or other convenience of the judge) (1,2). The “Official Guideline on the Methodology of Conflict of Interest Estimates” is most comprehensive publication Conflict of Interest in Medical Research, Education and Practice, published by the Institute of Medicine, Academies Press, 2009. Is it possible to set up a “red line” enough, which will disable the influence of the situation with the “conflict of interest” on widely-accepted adopted recommendations affecting “decision making”? Is it possible for reviewers of the medical journals to recognize the “conflict of interest” in the text that is being prepared for publication? It is certainly very difficult, even if the authors correctly state the potential conflict of interest. The sponsorship of pharmaceutical companies can also be indirect and do not contain a financial dimension, but there is a significant conflict of interest in all. Conclusion: It is too late to “bring order” to the publishing of medical literature with the intention of reducing the conflict of interest to the minimal impact on making medical decisions. But the “red line” must stand in the process of forming clinical guidelines, which in no way should be sponsored, and should be based on numerous publications in well-controlled and open clinical studies., Introduction: In the past decades, the publication of scientific research has been a very important factor in attracting public funding and support of scientific research. It is also the cornerstone of knowledge dissemination, as well as an essential criterion for academic and scientific evaluation. Hence the great interest in scientific ranking and evaluation of scientific journals, but also in scientific contribution of scientists. Aim: It is very difficult to apply right measures and scientific criteria that can objectively assess the scientific quality of the research and provide precise qualitative and quantitative data on which academic communities and funding agencies could base their decisions. Despite the evident shortcomings in the evaluation of scientific journals it is generally accepted that IF (Web of Science-WoS) and the total number of citations of all articles published in the journal represent a relevant measure of their value and scientific influence. However, the significance of scientists is much more complicated to establish since the relevance of the journals in which their articles are published does not directly reflect their scientific production. Therefore, evaluating the significance of scientists’ accomplishments justifiably involves the application of more sophisticated metric systems rather than just insight into their publication records. Results: A recent focus on scientific productivity leads to the competitive evaluation of scientists, creating incentives to maximize publication numbers, citation counts, and publications in high-impact journals. There are numerous bibliometric databases which are used in biomedical sciences. Most of them, such as Current Contents (section Clinical Medicine but also sections Life Sciences and Social & Behavioral Sciences) Journal Citation Reports (JCR), Index Medicus (Medline, PubMed) and Excerpta Medica (EMBASE), present and rank scientific journals only. Some of scientific databases such as Web of Sciences (including Science Citation Index (SCI), Social Science Citation Index (SSCI), Arts & Humanities Citation Index, and Emerging Sources Citation Index), H-index, Scopus and Scholar evaluate individual scientific contribution of a scientist. Zerem-score (Z-score) represents new criteria for the estimation of scientific merit of individual scientific effect of scientists. According to these criteria the overall scientific score of an author named as Z-score is calculated as the sum of two scores (author score and author citation score). The author score is calculated as the scientific value of the journal in which an article is published and the authors’ specific contribution in this article, whilst the author citation score is calculated as the total number of citations of all articles published by an author. Conclusions: Several authors consider that almost nothing in scientific institution can compare to the importance of publications issued in top scientific journals, claiming that they basically constitute the main source of recognizability. However, it is true that no single metric system is suitable for comprehensive evaluation of scientific research. Based on the long term experience, author is proposing the new criteria (named The Z-score) in order to estimate the scientific effect of scientists and institutions more objectively., Introduction: Approximately about 30% of US health care is inappropriate, or wasteful (overuse). Inly 55% of needed health services is delivered (underuse). Reasons for suboptimal care are the lack of high quality or failure to apply high quality evidence related to the effects of most health care interventions and suboptimal decision-making. Personal decisions are the leading cause of death and 80% of all health care expenditures are affected by physicians’ decisions (1,2,3). Evidence-based clinical practical guidelines (CPGs) as a key approach to improving clinical decision-making (1). Aim: To display the meaning of “Yes” bias in clinical practice. Results: Research included 101 participant from American Society of Hematology (ASH). Results: Data was collected before the meeting of AHS, during and one week after the meeting. The positive, statistically significant relationship between certainty of evidence and strength of recommendations only when the panels voted “FOR” intervention; this association disappeared when the panels voted “AGAINST” intervention (OR=3.6 (95%CI: 2.17 to 6.0; p, Introduction: Perinatal Medicine is a medical subspecialty concerned with the maintenance of health and long-term development of the fetus, neonate, and infant, requiring special knowledge, skills and attitudes for the prevention, diagnosis and management of disorders of this patient population (1). Oral perinatology deals with the influence of poor oral health on the pregnancy outcomes and the fetus. Methods: The first time the term ”oral perinatology”, and ”oral perinatologist” was mentioned in Khartoum in Sudan in 2016, by proposing member of ”Ian Donald Inter-University” Dr. sc. Selma Porović into International Academy of Perinatal Medicine, due to many international lectures and writings in this field. Results: Pediatric dentist, and dentist in general became a member of IAPM in Bucharest in May, 2018. The unfair neglected significance of dentistry as a medical branch is back to the focus of the essence. Oral perinatology becomes a branch that connects many specialties that deal with pregnancy and fetal health, while focusing on oral health and the two-way relationship between poor oral health and the outcome of pregnancy. The analysis of Web of Science, Scopus and PubMed Central, found that Journal of Perinatal Medicine (Official Journal of the World Association of Perinatal Medicine) and The Donald School Journal of Ultrasound in Obstetrics and Gynecology are qualified to deal with this area. Conclusion: As a result of the newly designated field of medicine, we have already started several researches in front of the most prestigious Bosnian Herzegovinian institutions, which undoubtedly enhance the scientific identity of Bosnia and Herzegovina on the world map (2)., Introduction: Correct choice and administration of a statistical test are absolutely essential for meaningful interpretation of research data, yet mistakes are still frequent and could be easily found in published scientific papers or PhD theses (1). Although formally trained in statistics, PhD students are among those who make mistakes (2,3), and they need additional guidance by their mentors in order to avoid misuse of statistical methods and thereafter misinterpretation of the data collected (4, 5). Aim: The aim of this study was to analyze mistakes made by PhD students in statistical analysis of data collected during research within the framework of their thesis. Results: The study was designed as cross-sectional analysis of random sample (n=15) of PhD theses in pre-approval stage at Faculty of Medical Sciences, University of Kragujevac, Serbia. In total 7 (47%) theses had at least one mistake. The most frequent mistakes, found in more than 20% of theses were as the following: insufficient statistical power due to small sample size, non-random sample and use of a statistical test when standard conditions were not met (e.g. use of Chi-square test when one of the frequencies was zero, etc.). Other mistakes found in the sample were: inappropriate choice of non-parametric test for dependent groups, inappropriate validation of a questionnaire (no divergent criterion validation, lack of use of multi-trait, multi-method matrix, etc.) and lack of transparency (measures of variability not presented). Conclusion: Mistakes with statistical analysis made by PhD student are frequent, and lead to misinterpretation of the data. Training course in statistics during PhD studies should be re-evaluated, mentors should invest more effort to review the data and guide students through statistical analysis, and special statistical review board at Faculty or University level may improve the situation (3)., Science is changing the world at an ever-increasing pace. It is hard to imagine medicine, business, education, defense, government or society without revolutionizing achievements of science. It is safe to assume that this march of science will continue (1-4). But, where is it leading? What will the world look like in 10, 20, 50, or 100 years? How will it change lives of individual humans or whole societies? What are the anticipated benefits and challenges? This talk will attempt to answer some of these questions and raise new ones., Introduction: The part “Abstract” of article is the only part of the article that is published in conference proceedings, only part of the article that a potential referee sees when he is invited by an editor to review a manuscript and the only part of the article that readers see when they search through electronic databases such as PubMed (1). It represents a concise overview of the article, understandable and without reading the rest of the content, and can be published independently of it (2-4). Aim: To present the specifics of writing the “Abstract” in the scientific article. Result: There are three types of abstracts: descriptive, informative and structured. The descriptive abstract is specifically used for theoretical, methodological or review articles (150 words or less), informative abstract contains specific information given in the article (150 to 250 words in length) and the structured abstract is essentially an informative abstract with sections labeled with headings (250 to 300 words). A good “Abstract” shows the basic purpose, as well as the research aim, applied methodology, detailed results and important conclusions. It must be written in the language in which the article is written, in a third party and in a passive. Abstract cannot contain something that is not mentioned in the text itself. Conclusion: Abstract is the mirror of the work itself, and its writing requires big effort. It is recommended that each work begins with a temporary abstract and after completion of the full article, a concise abstract is formed. Abstract is the essence of what an author attracts attention to and keeps it until the end of article., Introduction: Current Contents Indexed Publications are publications that are indexed in the most prestigious journals (with the highest impact factors), and they are guide in the daily clinical work of a cardiologist (1). Aim: To present the number of articles from Bosnia and Herzegovina (B&H) in Current Contents database in the field of cardiology in the period 2011-2017. Results: During the seven-year period there are 14 papers in the field of cardiology in the Current Contents database. Out of this number, two are original articles (original research), one is a meta analysis and 11 represent the collaboration of member countries of the European Society of Cardiology (where the representatives of B&H are also), in the writing of guidelines or screening programs presentation. Also, two articles from pediatric cardiology (two original research) were published during mentioned period. Conclusion: Increase in the number of CC articles is an imperative for the new generation of cardiologists in B&H. For new generations of PhD students, the requirement for defending the PhD thesis is a publication of their thesis in the Current Contents Indexed journal. Is this requirement justified, in relation to the mentioned results, it is a question that requires much more analysis., Introduction: Selecting journal title to publish, considering duration of peer review process and the limited time for PhD thesis is a complex step for a young medical researcher. Journals provide information channels for scientific communications (1). The process of selecting a journal requires expertise, which all researchers do not have (2, 3). Aim: To provide a didactic step by step guide in selecting a scientific journal for paper publishing. Results: The first step is to determine aim and scope of the journal, which should match topic of article. Reading previous published journal issues helps in recognizing types of articles that can be published and technical normatives. Finding out Editor main research activity could be in favor to publish similar article. Author should determine what type of article is preferable in the journal of his interests. Journal indexation is very important for young researchers. Web of Science seems to be hard to reach for PhD students. Nevertheless we should try our best to publish in internationally recognized scientific databases (Web of Science, Scopus, Medline, PubMed). The aspiration of every young researcher should be Open Access journals, because that is only way to try to increase visibility of one’s work. The style of writing of scientific information is a scientific style and it does not mean only grammatical and spelling accuracy, but also the way of shaping the contents and sense of article (4-6). Each article should be written in a clear manner and to be accessible not only for professionals but to general population too. Writing an article and publishing requires ethical principles, high English proficiency skills in conversation with Editor and reviewers, because the impression that will be made there could prevail in accepting of our paper. Conclusion: Writing an article requires a lot of time and determination. Getting familiar with aims and scope of targeted journal, technical prerequisites and the length of peer review process is very important., Introduction: The Open Access model of article publishing is regarded as an imperative in contemporary scientific publishing. This model essentially should be free. Open access means providing access to scientific literature to anyone with a computer and an Internet connection, at no charge to the user (1). Scientific authors who pay to publish their articles in open-access publication should be cordially honored for doing so (2). Payment of an open access module is sometimes extremely expensive, and certainly poor countries can rarely afford it (3). This practice puts in difficult position researchers from low-income countries. Journals that are in top quality level often charge enormous amounts for choosing option “Open Access”. Without the Open Access model, every article is essentially meaningless, because every article should be open to readers, and be the basis for future research. Online libraries have great potential in terms of expanding knowledge, but they also present a major problem for many publishers because their rights can be violated (4). Aim: Presentation of online platforms for the archiving of scientific research papers and the presentation of their benefits. Results: Authors can individually manipulate with electronic forms of articles through the platforms (ResearchGate, Academia.edu, Kudos, Mendeley, exoplatform.com, BiomedExperts) which allow the author to individually upload articles, share articles and increase their visibility. The tendency is that every scientist has profile on these online platforms. Which of these platforms is conditionally better, is something, which can be related to personal preferences. With the mentioned platforms authors can manipulate in many ways (ranking on platforms are often questionable). There are also ethical issues in the use of these platforms, because often articles that are not Open Access, if uploaded from an author, become available to the general public. This raises the question of who is the owner of the article, the author or the journal, who is entitled to copyright. There are lot of question, but in the essence everything depends on the ethical policy of the journal or the ethics of author. Regardless of all, the aforementioned platforms represent a great source of knowledge for researchers, as well as the location of the authors’ promotion, as well as the place for creation of collaborations in scientific community. Conclusion: The digital era enabled easy access to knowledge. The fact is that in the future, the issue about these platforms will be getting bigger, and the boundary will have to be set. Which board will set that line is questionable. Until that moment, the mentioned platforms remain a great source of knowledge, for both students and professionals., Introduction: PhD thesis is the final part of the study program and represents the independent and original work of the candidates in the appropriate field, which, for the sake of its originality, is worth publishing (1-3). Aim: The aim of this lecture is to show the peculiarities of writing a doctoral dissertation. Results: PhD thesis should provide evidence that the candidate successfully uses methods in professional and scientific work, in exposing the results of the research, as well as being able to draw conclusions based on the previously set and realized research tasks. The dissertation is quite similar to a scientific article, but it is always more extensive for a number of reasons. For example, an article does not have to contain all the results of a particular research, but only those that are relevant, while the dissertation can also be the results of repetition of the same experiments to see the extent of the research itself. Quite supposedly, a dissertation should be considered and the dissertation should be written as a comprehensive review article with an inescapable description of your research results. It is important to give your personal comment, to reach its point of view, to give its judgment to the results so far, to be critical. As for the article, in the doctoral thesis we have to respect the previously established methodology and draw up a dissertation plan. It will be extremely important to be an Introduction and Discussion for judging the knowledge of the subjects of scientific thinking, while the Material and Methods, and the results will explain how the research was conducted and how the results of the research were presented (1-3). Since the doctoral thesis is a comprehensive scientific work, special attention should be paid to the Summary/abstract, because it will be read first and foremost. In the dissertation we also have an unavoidable chapter on the Rationale of the topic, in which we will clearly explain why we chose this theme and what we want to prove it is ultimately. Considering that the doctoral thesis is a scientific work with limited availability, it is highly desirable but acceptable that the results from the dissertation are published in the original article. Also, extensive dissertations can be the basis for more articles. Conclusion: The results presented in the doctoral dissertation should contribute to the systematization of scientific and professional tasks and existing solutions for a particular area, to solve the current scientific and professional task, set as the goal of work, the application of existing scientific and professional achievements in solving a complex scientific task., Introduction: That title is the most visible and most readable part the entire paper (1). Title appears in original journal and in secondary publications and serves to classify the article in individual scientific disciplines (2). Perhaps the most common grammatical error in defective titles is faulty syntax. An indicative title is recommended, which should be clear; attractive, refer to the hypothesis; indicate the intervention if it is provided; state the structure of the study (3). What is a good title? Day R. define it as the fewest possible words that adequately describe the contents of the paper (1). Aim: The aim of this paper is to show importance of the title, length, abbreviations and jargon, importance of syntax. Results: Title purpose is to attract researchers interested in this field of study, therefore, all words in the title should be chosen with great care (1). Association words with one another must be carefully managed (2). The importance of the title cannot be overstated as it is a major determinant of whether the paper will be read (3). It is the only aspect of the article that appears in many of the databases used for literature searches (3). The title should indicate the content of the work and should contain enough relevant “keywords” to enable readers to find this paper when searching a relevant database (1). Indexing and abstracting services depend heavily on the accuracy of the title (2). There are two types of titles: 1. Descriptive titles, which states the focus of the study, 2. Conclusion titles, which provide the authors’ main conclusion from their study (1). Descriptive title is prefer for research articles because it “lets the data speak for themselves” (1). In some Journal’s Instructions to Authors will specify which style of title to use (2). Often authors are asked to provide a running title. Running title should be chosen with care (2). Titles who are too short, obviously was not very helpful, also long and nonspecific titles are often less meaningful than short ones (2). Most excessively long titles contain “waste” words, right at the start of the title, words such as “Studies on,” “Investigations on,” “Observations on”, „Special approach ...” (3). This words should avoid because every scientific work is investigation, approach, observation (1). A general recommendation for title length is 5-10 words. Titles should almost never contain abbreviations, chemical formulas and jargon (1). Avoiding redundant and unnecessary words in the title will be best achieved if we analyze each written word in terms of assessing whether it is necessary as the key word, or is it the one that points to the essence of a problem without which the reader would not have the problem to be clear (3). Conclusion: What should be checked in the title: accurate, clear, complete, precise, concise, as short as possible? The qualities of good titles are: to be easy to remember, to provoke the reader to think, to attract attention, and to awaken interest. Title “sales” work! (1, 2, 3)., Introduction: The most common mean of sharing results, dilemmas, controversies in field of science is oral presentation (1,2). Presenter is challenged to comprise complicated research in one well delivered speech (3). Aim: This abstract is of descriptive character and aims to present means for preparation of good oral presentation. Results: First step is to identify key message of presentation as a core for developing the logical flow in story. The presentation should contain brief introduction, main results and conclusions. Introduction initiates attention of the audience, but results will keep them interested. Introduce new terms early in presentation because once an audience gets lost in unfamiliar terminology, they stop following. Results should be discussed as they get presented, concisely, clearly and in accordance to the key message. In the conclusion give two or three take home messages of what is improved after this presentation. Presenter must be confident in his words, not speaking too quick nor incomprehensible, adapting words to the target audience. Making an eye contact with an audience gives comfort to the presenter and engages audience with the storyline. Keep the attention of the audience with anecdotes, humorous remarks or pauses between section transition, but don’t digress from the story. Audience attention is the highest in the first 15 minutes. In addition to the oral presentation, there is usually visual aid used to emphasize ones words. Rehearse your presentation in timely manner, using bullet points, but never read from slides or cards. Conclusion: The thought of giving presentation is actually worse than doing it. Preparation and practice can strengthen ones confidence, but presenter-audience dynamic is unpredictable., Introduction: Poster is a visual aid in presenting your research, often starting vibrant discussion and can facilitate collaboration between researchers in common scientific field (1,2). Even though posters are often considered as a consolation prize for rejected oral presentations, good posters can actually improve ones scientific credibility, reputation and are valued as a part of postgraduate scientific work (3,4). The aim of the poster is to grab the attention of the audience which in turn will generate interest in presented area of research. Aim: This abstract is of descriptive character and aims to show the methodology behind designing a memorable poster, including important features which insure high quality end result. Results: Poster should contain the same chapters as a written paper: abstract, introduction, methods, results, discussion, conclusion. Choosing the right format is a key component of successful poster. Guide the audience with arrows and numbers in logical flow. Never use less than 24 point font size, make sure that key components are at eye level and that the title is readable from 3 m distance. The title should be short, sharp and compelling, inviting audience to find out more. Content must be concise and informative, yet encourage the audience to engage in discussions. Graphic elements should be relevant to the subject matter, clear, to the point, and attractive, not less than 13 x 15 cm. Conclusion: In a vast sea of posters, you need to stand out. Most people are more likely to remember the presenter rather than the poster itself. Successful presentation is a soft skill that enables you to sell your work to interested parties in short time. Having handouts given to the audience can help distinguish yourself from others.

Despite intensive treatment, considerable proportion of patients with asthma remains symptomatic. Anti-inflammatory activity of curcumin has been shown. Aim: analyse the impact of add-on therapy with curcumin in asthma patients on inflammatory parameters, lung function and asthma control. During 2 months, 100 non-smokers (46.8±12.4 years, F/M ratio 1.04) with moderate, partially controlled asthma were treated with moderate dose of inhaled glucocorticoids (IGK) with no changes in dose. Patients were divided into two groups (n=50): curcumin group receiving curcumin 500 mg per os twice daily and control group. Before study, sputum and blood eosinophils (Eo), blood neutrophils, high sensitive C-reactive protein (hsCRP), predicted forced expiratory volume in first second (FEV1%), Asthma Control Test (ACT) and Asthma Quality of Life Questionnaire (AQLQ) were similar between groups. After study, in curcumin group blood Eo count and hsCRP decreased, and FEV1, ACT and AQLQ increased significantly (before vs. after study: Eo: 5.9±0.6 vs. 4.1±0.4; hsCRP: 4.2±0.3 vs. 3.4±0.2; FEV1%: 77.7±0.8 vs. 83.9±0.5; ACT: 14.5 (6,19) vs. 18 (14,21); AQLQ: 3.4±0.2 vs. 4.1±0.2). There was no change in the control group. Compared to control curcumin group showed significantly lower blood Eo and hsCRP and higher FEV1% (curcumin vs. control: Eo: 4.1±0.4 vs. 5.4±0.5; hsCRP: 3.4±0.2 vs. 4.0±0.3; FEV1%: 83.9±0.5 vs. 78.3± 0.8), and improved ACT and AQLQ (ACT change>3: 72% vs. 28%; AQLQ change>0.5: 54% vs. 32%) after study. Add-on therapy with curcumin in patients with moderate partially controlled asthma seems to improve response to IGK regarding lung function, asthma control and quality of life. Further placebo controlled trials are needed.

Aim To analyse the long-term impact of altered metabolism on the level of mediators of inflammatory response in female patients with type 2 diabetes. Methods This study included 97 female patients with type 2 diabetes and 107 female, nondiabetic control subjects, who were recruited at the Clinical Centre University of Sarajevo and the General Hospital Tešanj. The effects of glycaemic control on markers of inflammatory response represented by C-reactive protein (CRP), fibrinogen, leukocytes, sedimentation rate, and cytokine IL-6 were tested. All subjects were free of evidence of infections, surgery, thyroid disease, polycystic ovarian syndrome, active liver and kidney damage. All biochemical analyses were performed according to standard International Federation of Clinical Chemistry (IFCC) protocols. Results A significant increase of fibrinogen (p0.001), CRP (p=0.001), interleukin-6 (p=0.013), leukocytes (p0.001) and sedimentation rate (p=0.008) in diabetic female population compared to control subjects was found. A significant correlation between CRP and haemoglobin A1c (p=0.035), interleukin-6 and glucose (p=0.032), IL-6 and body mass index (p=0.007) was found. Conclusion Our data suggest that inflammation plays an important role in the pathogenesis of diabetes in female diabetic population. A more detailed study on a far larger number of subjects is needed if they were to be used effectively as biomarkers in the primary prevention of type 2 diabetes in this population.

Summary Background: Peroxisome proliferator-activated receptor gamma (PPARg) is a key transcription factor in adipogene-sis, and also regulates a number of genes associated with lipid storage and insulin sensitivity. Single nucleotide polymorphisms (SNPs) in the PPARG gene have been associated with obesity and diabetes. In this study, we explored the relationship of three PPARG gene variants with the metabolic syndrome (MetS) and related traits in a population from Bosnia and Herzegovina. Methods: Anthropometric and biochemical parameters were measured in 43 patients with MetS and 43 healthy controls. Subjects were genotyped for Pro12Ala (rs1801282) and 1431C>T (rs3856806) SNPs by classic PCR–restriction fragment length polymorphism analysis, and for-681C>G (rs10865710) variant by real-time PCR. Results: The genotype distributions for the three polymorphisms were not significantly different between MetS patients and controls. The Pro12Ala and 1431C>T variants were associated with lower body mass index in the control subjects (p=0.012 and p=0.049, respectively). In this group, the carriers of Pro12Ala had also lower waist circumference compared to the wild-type homozygotes (p=0.045). Conclusions: Results of our preliminary study indicate a beneficial effect of a common Pro12Ala variant on the metabolic phenotype in healthy non-obese subjects.

Background: Acute respiratory distress syndrome (ARDS) is life treating condition, with intensive general inflammation. Objective: Inflammation can be present with infection or without. Septic embolism, according to our previous experience, is more often multiple, than single. General hypoxia of hall body cause damage of all tissue, and generalinflammationintensifies. A vicious circle was formed and inflammation runs its course in what is very often irrelevant how it was begun.How often pulmonary embolism causes ARDS and what are the main features of this disease, is the goal of the study. Methods: Patients with ARDS, treated in pulmonary intensive care unit were analyzed. Chest X-ray, microbiological analysis of sputum or bronchoalveolar lavage specimen, chest CT scan, blood culture, CRP (mg/dl), deep-dimmer and blood cell count, were performed for all cases. Results: In three years period 53 patients with ARDS were treated. Out of all 19 with septic pulmonary embolism (14 multiple), (CRP 198±28). In only 12 patients origin of venous thrombus was found. Out of all 6 patients have massive non septic embolism (CRP 28±7), 18 heavy pneumonia (CRP 166±28), 4 with interstitial pneumonia (CRP 76±19), 5 with massive TB with caverns (CRP 35±13) and 6 with not well defined cause. Blood culture was positive in 14 cases with septic embolism and in 11 cases with pneumonia. CRP was elevated in all cases but highest was in septic embolism (Mann-Whitney test p=0,024). Conclusion: Septic pulmonary embolism was common cause of ARDS, mostly as multiple, and should be considered even if origin of thrombus was found or not.

The clinical value of eosinophils (Eo) in asthma has been shown, but asthma and obesity association remains unclear. Aim was to analyse the impact of normalising of body mass index (BMI) in obese asthma patients on sputum and blood Eo count and asthma control. 140 obese patients (age:49.94±1.68 years; M/F ratio:0.82, BMI:30.3±0.3) with partially controlled asthma and eosinophilia in sputum and blood were included. Patients were divided in IgE high (≥100 IU/ml) and IgE low ( Before diet, BMI, sputum and blood Eo, predicted forced expiratory volume in first second (FEV1%), Asthma Control Test (ACT) and Asthma Quality of Life Questionnaire(AQLQ) were similar between IgE high and IgE low patients. Sputum Eo count decreased only in IgE low patients (before vs . after diet: 6.8±1.7 vs . 1.2±0.3; p vs . high: FEV1%: 81.9±0.5 vs . 78.9±0.5; p 19: 42% vs . 11%; p vs . 2.3±0.4; p Decreasing of BMI in obese patients with partially controlled asthma improves response to IGK resulting in improved lung function, asthma control and quality of life, particularly in IgE low patients.

Introduction: Cysteine protease are biological catalysts which play a pivotal role in numerous biological reactions in organism. Much of the literature is inscribed to their biochemical significance, distribution and mechanism of action. Many diseases, e.g. Alzheimer’s disease, develop due to enzyme balance disruption. Understanding of cysteine protease’s disbalance is therefor a key to unravel the new possibilities of treatment. Cysteine protease are one of the most important enzymes for protein disruption during programmed cell death. Whether protein disruption is part of cell deaths is not enough clear in any cases. Thereafter, any tissue disruption, including proteolysis, generate more or less inflammation appearance. Review: This review briefly summarizes the current knowledge about pathological mechanism’s that results in AD, with significant reference to the role of cysteine protease in it. Based on the summary, new pharmacological approach and development of novel potent drugs with selective toxicity targeting cysteine protease will be a major challenge in years to come.

Introduction: Several decades of basic science and animal research provided considerable support for significant role of plasma free fatty acids (FFAs) in etiology of Type 2 diabetes mellitus (T2DM). Contradicting data related to signifi cance of elevated FFAs in plasma of patients with Type 2 diabetes prompted us to study concentrations of palmitic acid, stearic acid, and linoleic acid, in patients and healthy controls in an attempt to possibly use them as potential biomarkers in progression of the disease. Since aging is associated withincreased plasma glucose and insulin levels that are consistent with an insulin resistant state, in this study,age differences in the concentration of the above mentioned acids were tested.Methods: Progressive changes in their concentrations were followed through a period 6 months. All subjects included in the study were free of evidence of hepatitis B or C viral infection or active liver and kidney damage. Analysis of glucose and glycated hemoglobin levels were performed on BT PLUS 2000 analyzer using standard IFCC protocols, while concentrations of FFAs were analyzed by gas chromatography.Results: Our data demonstrated signifi cantly higher FFA values in plasma of diabetic patients as compared to healthy controls. There was a trend of correlation of FFAs levels with the blood glucose levels in diabetic patients, which was more prominent in diabetic men than in women.Conclusion: With aging, levels of free fatty acids signifi cantly increased in plasma of diabetic patients, and this effect was also more profound in male than in female diabetics.

INTRODUCTION: The enzyme 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) catalyzes the conversion of the hormonally inactive cortisone to active cortisol, thus facilitating glucocorticoid receptor activation in target tissues. Increased expression of 11beta-HSD1 in adipose tissue has been associated with obesity and insulin resistance. In this study, we investigated the association of two 11beta-HSD1 gene (HSD11B1) polymorphisms with the metabolic syndrome (MetS) and its characteristics in the Bosnian population. MATERIALS AND METHODS: The study included 86 participants: 43 patients diagnosed with MetS and 43 healthy controls. Subjects were genotyped for two HSD11B1 gene polymorphisms: rs846910: G > A and rs45487298: insA, by the high resolution melting curve analysis. Genotype distribution and an influence of genotypes on clinical and biochemical parameters were assessed. RESULTS: There was no significant difference in the mutated allele frequencies for the two HSD11B1 gene polymorphisms between MetS patients and controls. In MetS patients, no significant associations between disease-associated traits and rs45487298: insA were found. Regarding rs846910: G > Avariant, heterozygous patients (G/A) had significantly lower systolic (P = 0.017) and diastolic blood pressure (P = 0.015), lower HOMA-IR index (P = 0.011) and higher LDL-cholesterol levels (P = 0.049), compared to the wild-type homozygotes. In the control group, rs45487298: insA polymorphism was associated with lower fasting plasma insulin levels (P = 0.041), lower homeostasis model assessment insulin resistance (HOMA-IR) index (P = 0.041) and lower diastolic blood pressure (P = 0.048). Significant differences between rs846910: G > A genotypes in controls were not detected. Haplotype analysis confirmed the association of rs45487298: insA with markers of insulin resistance in the control subjects. CONCLUSIONS: Our results indicate that a common rs45487298: insA polymorphism in HSD1181 gene may have a protective effect against insulin resistance.

Aim To determine the lipoprotein proile of voluntary blood donors, and on the basis of parameters to evaluate the risk of atherosclerosis. Methods The study included voluntary blood donors of both sexes. Participants were divided into two groups. The irst group of subjects consisted of men and women in menopause (BD1). Thesecond group consisted of women in reproductive age (BD2). Analysisof concentration of lipoproteins was performed by direct determination of total cholesterol, LDL-C and HDL-C. From the totalserum cholesterol and concentration of lipoproteins ratios of totalcholesterol/ HDL-C ratio and LDL-C/HDL-C were calculated. Results Signiicantly higher concentration of LDL-C was obtained in the serum of BD 1, compared to LDL-C in the serum of BD 2, within the reference range. Mean concentration of HDL-C in the serum of BD 2 group was higher than the values measured in the BD group 1, without signiicant difference. The ratio of total cholesterol / HDL-C showed signiicantly higher values in the BD 1 group compared with results in the BD 2 group. Signiicantly higher values in the BD group 1 were observed for the ratio of LDL-C/HDL-C. Obtained results showed that all voluntary blood donors had a concentration of individual lipoprotein fractions in a lower risk range for atherosclerosis development. Conclusion Female voluntary blood donors in reproductive age have a more favorable lipid status in relation to the voluntary blood donors, men and women in menopause, indicating that this population of women is exposed to lower risk of developing atherosclerosis.

New prognostic factor of lung cancer are being intensively studied currently. A small number of studies compare the importance of molecular makers with so far known functional and clinical prognostic factors. Purpose of this study was to find out whetherp16(ink4) expression is more superior prognostic factor in survival rates in non-small lung cancer (NSCLC) patients than spirometry tests. 100 NSCLC patients (50 squamous and 50 adenocarcinoma) with IIIB and IVA stage and 80 healthy individuals were included. p16(ink4) was immunohistochemicaly detected on formalin-fixed tissues. We measured s pirometry tests : vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in first second (FEV1), Tiffeneau index (FEV1/FVC ratio) and forced expiratory flow 25% to 75%. 2-year progression-free survival (PFS) and overall survival (OS) were observed. Low p16(ink4) expression and impared spirometry parameters correlated with worse 2-year survival outcomes, in both adenocarcinoma and squamous carcinoma. In squamous carcinoma p16(ink4) expression was an independent negative prognostic marker. Severe impairments of spirometry tests had similar prognostic value as low p16(ink4) expression in both NSCLC subtypes. In contrast to p16 (ink4) as a negative molecular prognostic factor, spirometry testings are widely achievable and affordable and could be serviceable prognostic marker in NSCLC patients in advanced NSCLC. Further studies including all clinical stages of NSCLC are needed.

Introduction: Appropriate vitamin D turnover is essential for many physiological function. Knowledge of it’s function was improved in last two decades with enlargement of scientific confirmation and understanding of overall importance. In addition to classical (skeletal) roles of vitamin D, many other function (no classical), out of bone and calcium-phosphate metabolism, are well defined today. Aim: To analyze vitamin D level in the blood in dialysis and pre dialysis patients and evaluate efficacy of supplementation therapy with vitamin D supplements. Methods: Vitamin D3 level in form of 25-hydroxivitamin D3 was measured in dialysis and pre dialysis patients, using combination of enzyme immunoassay competition method with final fluorescent detection (ELFA). Parathormone was measured by ELISA method. Other parameters were measured by colorimetric methods. Statistical analysis was done by nonparametric methods, because of dispersion of results of Vitamin D and parathormone. Results: In group of dialysis patients 38 were analyzed. Among them 35 (92%) presented vitamin D deficiency, whether they took supplementation or not. In only 3 patients vitamin D deficiency was not so severe. Vitamin D form were evaluated in 42 pre dialysis patients. Out of all 19 patients (45 %) have satisfied level, more than 30 ng/ml. Moderate deficiency have 16 patients (38%), 5 of all (12%) have severe deficiency, and two patients (5%) have very severe deficiency, less than 5 ng/ml. Parathormone was within normal range (9.5-75 pg/mL) in 13 patients (34 %), below normal range (2 %) in one subject, and in above normal range in 24 (63 %). Conclusion: Vitamin D3 deficiency was registered in most hemodialysis patients; nevertheless supplemental therapy was given regularly or not. It is to be considered more appropriate supplementation of Vitamin D3 for dialyzed patients as well as for pre dialysis ones. In pre dialysis patient moderate deficiency is shown in half of patients but sever in only two.

To investigate association of two LPIN1 gene variations with main traits of metabolic syndrome (MS) (waist circumference, body mass index, blood pressure, triglycerides, HDL-cholesterol and fasting glucose levels) in population from Bosnia and Herzegovina.This study included 43 patients with metabolic syndrome and 43 healthy controls from General Hospital in Tešanj, Bosnia and Herzegovina. Subjects were genotyped for two LPIN1 gene variations (rs11693809: CT and rs2716610: CT) by real time PCR method.In control subjects LPIN1 polymorphism, rs2716610: CT, was significantly associated with a lower body mass index (BMI) (p=0.008) and waist circumference (p=0.008). The second analyzed rs11693809: CT polymorphism was associated with lower blood HbA1c levels (p=0.048) in a group of MS patients.Results of our study suggest that rs2716610: CT polymorphism of LPIN1 gene could have a protective effect against development of metabolic syndrome, while rs11693809: CT might affect a glucose control in patients with MS.