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Translations of instruments for measuring quality of life developed in certain, mostly more developed, parts of the world usually do not cover regionally specific aspects of health-related quality of life, even after transcultural validation. The aim of this study was to develop and validate a reliable questionnaire in Serbian, Croatian, Bosnian, and Montenegrin languages suitable for measuring health-related quality of life in adults.

Aim To investigate the serum value of brain derived neurotrophic factor (BDNF), proteins S-100, NSE, IL-6 in normal pressure patients (NPH) compared to control (healthy) group and also a possible correlation with radiological findings in NPH patients. Methods Study patients were included during the period of 2020- 2022. All NPH patients met the diagnostic criteria for probability of NPH. Control patients group included patients without known brain disorder, without clinical symptoms of NPH. Blood samples were taken before planned surgery for NPH. BDNF serum concentrations were assessed by a sensitive ELISA kit, and serum concentrations of S-100, NSE and IL-6 were assessed by using ECLIA technology for immunoassay detection. Results Among 15 patients who were included, seven NPH patients were compared to eight control patients. Non-significant decrease in BDNF serum concentrations, an increase of protein S-100 serum concentrations, a decrease of NSE serum concentrations, as well as an increase of IL-6 serum concentrations in NPH patients compared to healthy controls was found. Strong positive correlation between BNDF and Evans index was observed (p=0.0295). Conclusion We did not find a significant difference of BDNF, protein S-100, IL-6 and NSE between serum concentration in NPH and healthy patients. More future research is needed to find the role of BDNF in NPH patients. [ABSTRACT FROM AUTHOR]

Introduction: maternal cigarette smoking is an important public health issue recognized by the World Health Organization (WHO) as one of the most serious, preventable risk factors for developing a series of pregnancy pathologies. Aim: to determinate association between maternalcigarette smoking and rates of placental expulsion in the study of the efficacy of intra - umbilical vein administration of carboprost versus oxytocin in the management of retained placenta. Materials and methods: this prospective clinical study was conducted at the Clinic of Obstetrics and Gynecology of the Clinical Center University of Sarajevo, in the period from 2013 to 2015 and it included 200 pregnant women. Examinees were randomized in subgroups, by risk factors and interventions. The main outcome variable was expulsion of retained placenta and second outcome variables were: duration of time from intra-umbilical vein administration of drug to expulsion of RR cord diameter, manual removal of placenta, the number of cases who required blood transfusion, anesthetics and antibiotics, by smoking status. Results: history of cigarette smoking was more likely in pregnant women with high schooldiploma (81.6% vs. 66.7%; p<0.05). The pregnant women with positive history of cigarette smoking had statistically significant lower rates of placental expulsion compared with non-smokers (64.6% vs. 80.7%, respectively; p=0.0l3). The cord diameter <2.0 cm was more frequently in the pregnant women with positive history of cigarette smoking, compared with non-smokers, but there was not statistically significant differences (10.8% vs. 5.9%, respectively, p>0.05). Conclusion: cigarette smoking among women of reproductive age is associated with lower rates of placental expulsion. [ABSTRACT FROM AUTHOR]

Introduction: artificial abortion is an abortion in which a pregnancy is intentionally, violently and artificially terminated. Termination of pregnancy older than 10 weeks will be allowed if there are certain reasons. These indications are: medical - the existence of a disease that could seriously threaten the health and life of the woman; ethical indications are pregnancy caused by rape or rape of a weak or minor person, rape by abuse of official position, incest, poor financial condition, large number of children, pregnancy out of wedlock; eugenics refer to the existence of biological-genetic factors that damage the fetus, the mother's disease in the first trimester of pregnancy from rubella, the use of tetracycline, incompatibility of blood groups. Aim: to analyze reasons of women for artificial abortion. Materials and methods: the research was conducted with the questionnaire which was conducted by the authors of Ratovoson and others (2020) was used in a study approved by the Ethics Committee of the Ministry of Public Health of Madagascar. The respondents consisted of 60 women who reported to the Clinic of Gynecology and Obstetrics of the Clinical Center Universty of Sarajevo (CCUS). The research is descriptive on a representative sample. The results were processed in Excell and frequencies and percentages were used, as well as statistical significance testing via chi-square. Spearman's correlation test and ANOVA test were also used. Results: the average age of the surveyed women was from 18 to 45 years. The largest number of surveyed women cited education/career (40%) and age (30%) as the reason for artificial abortion. Their socioeconomic position was average. A history of abortion was significantly more common among younger women (< 20 years compared to 35+ years). The proportion of women who used misoprostol alone (oral, vaginal or both) at 50.0%, while 25.0% were on contraceptive pills. The surveyed women did not do prenatal tests during pregnancy (95%). Conclusion: the most common reasons given by women for artificial abortion in the sample of women who came to the CCUS were education, that is, career and age, and socio-economic status. [ABSTRACT FROM AUTHOR]

Introduction: epilepsy is a common chronic disorder that affects approximately more than one million women of reproductive age. Reproductive function can be adversely affected in women with epilepsy by reducing fertility, increasing the risk of polycystic ovary syndrome, abnormal menstrual cycles, and altering antiepileptic drug (AED) metabolism. Most epileptic seizures during pregnancy occur in women with pre-existing epilepsy. Aim: to investigate and present the clinical characteristics and outcomes of epilepsy during pregnancy. Materials and methods: the research included the clinical characteristics of 26 women with epilepsy who were pregnant at the Clinic of Gynecology and Obstetrics of the Clinical Center University of Sarajevo, in the period from 2020 to 2022. Results: the average age at which seizures occurred was 21.90±2.42 years. All of their first seizures occurred in pregnancy, specifically 16 (61.50%) in the first trimester, 7 (27.00%) in the second trimester, and 3 (11.50%) in the third trimester. The largest number of patients had a focal attack (11/26, 42.30%). Regarding the frequency of seizures in female patients, sporadic seizures were found in the majority of patients (17/26, 65.40%). CSE was found in 4 patients (15.40%), who did not take therapy regularly. The patients were advised to start antiepileptic drug (AED) therapy, while all 26 of them took AED (levetiracetam in 4, carbamazepine in 15 and intravenous diazepam in 7 CSE) during pregnancy. Conclusion: t he conducted study showed that epileptic seizures in the largest number of pregnant women occurred in the first trimester, including focal seizures. Sporadic seizures were found in most pregnant women. The patients were advised to take antiepileptic drug therapy, and all examined pregnant women took it. [ABSTRACT FROM AUTHOR]

Introduction: retained placenta is one of the major causes of primary and secondary post-partum hemorrhage (PPH) and active management of the third stage of labor reduces the risk of PPH. Aim: to compare the efficacy of intra-umbilical vein injection of carboprost versus oxytocin by different medication doses and surgical and non - surgical risk factors in the management of retained placenta. Materials and methods: this prospective clinical study was conducted at the Clinic of Obstetrics and Gynecology of the Clinical Center University of Sarajevo, in the two-year period. Patients were randomized in 4 groups and 8 subgroups, respectively: A1(n=25) (carboprost, surgical risk factors, 1 amp. a 0.5 mg in 30 ml of 0.9%NaCl); A2(n=25) (carboprost, surgical risk factors, 1 amp. a 1.0 mg in 30 ml of 0.9%NaCl);B1(n=25) (oksytocin, surgical risk-factors, 10 UI in 20 ml of 0.9% NaCl); B2(n=25)(oksytocin, surgical risk-factors, 20 UI in 20 ml of 0.9% NaCl); C1(n=25) (carboprost, non-surgical risk factors, 1 amp. a 0.5 mg in 30 ml of 0.9%NaCl); C2(n=25) (carboprost, nonsurgical risk factors, 1 amp. a 1.0 mg in 30 ml of 0.9%NaC l); D1(n=25) (oksytocin, non-surgical risk-factors, 10 UI in 20 ml of 0.9% NaCl); D2(n=25) (oksytocin, non-surgical risk-factors, 20 UI in 20 ml of 0.9% NaCl). The main outcome variable was expulsion of retained placenta and second outcome variables were: duration of time from intra-umbilical vein administration of drug to expulsion of retained placenta, the number of cases who required blood transfusion and antibiotics, postpartum hemoglobin after 24h. Results: the group B2 (UVI oxytocin 20 IU in 20 mL saline, surgical risk factors) and the group D2 (UVI oxytocin 20 IU in 20 mL saline, non-surgical risk factors) had shorter expulsion time (minutes) (Me=5; IQR=4 to 5; Me=5; IQR=4.3 to 6, respectively) compared with other groups (p<0.001). The success rates of total expulsion of the placenta by groups were not statistically significant (70% vs. 82% vs. 72% vs. 78%, respectively; p=0.483). Post-intervention hemoglobin concentrations was statistically significantly greater in the group B (117.3±1.3) vs. the group A (112.1±1.3), (p =0.028). Conclusion: there is no difference in the rates of the total expulsion of the placenta comparing IUV injection of carboprost versus oxytocin in the management of retained placenta. The time for placental expulsion was significantly shorter and postpartum hemoglobin (117.3±1.3) was significantly higher in the intra-umbilical oxytocin groups than in the carboprost groups. [ABSTRACT FROM AUTHOR]

Introduction: retained placenta (RP) affects 0.5% to 3% of women following delivery and it is a major cause of maternal death due to postpartum hemorrhage. Active management of third stage of labor using utero tonics drugs could play an important role in reducing maternal mortality and morbidity. Aim: to compare the hemodynamic parameters and efficacy of the intra-umbilical vein administration of carboprost versus oxytocin in the management of retained placenta by risk factors and doses. Materials and methods: this prospective clinical study with quasi-experimental design (risk factors by medication by doses) was conducted in the period from 2014 to 2016 year at Clinic of Obstetrics and Gynecology, Clinical Center University of Sarajevo. Patients were randomized in 4 groups and 8 subgroups by different medication doses and risk factors. The main outcome variable was expulsion of retained placenta and second outcome variables were: hemodynamic parameters measured 30 minutes after administration of medication and body temperature after expulsion of the placenta, after 12h and 24h. Statistical significance was accepted for p-values, <0.05. Results: the time for placental expulsion was significantly shorter in the intraumbilical oxytocin groups than in the carboprost groups ( p< 0.001). The success rates of total expulsion of the placenta by groups were not statistically significant (70% vs. 82% vs. 72% vs. 78%, respectively; p=0.483). Oxytocin has a hypotensive effect, and in particular, systolic and diastolic blood pressure were significantly lower in the intra-umbilical oxytocin groups than in carboprost groups at 30 min. after injection (p<0.001). Conclusion: oxytocin has a hypotensive effect and carboprost can be used as alternative medication in the management of retained placenta. The success rates of the total expulsion of the placenta are similarly effective comparing intraumbilical vein administration of carboprost versus oxytocin in the management of retained placenta. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Croatica is the property of Croatian Academy of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cardiologia Croatica is the property of Croatian Cardiac Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim To investigate biosynthesis in nitric oxide (NO) during normal pregnancy and in pregnancies complicated by preeclampsia. Methods This prospective cross-sectional study included 80 patients hospitalized at the Department of Women's Health, Neonatology and Perinatology Cantonal Hospital in Zenica. Serum NO concentration in 20 non-pregnant women, 40 healthy pregnant women and 20 pregnant women with preeclampsia aged 17-40 years were measured. The group of healthy pregnant women were divided into 4 subgroups by gestational age. For each woman with preeclampsia, a healthy pregnant control was matched for age, parity and gestational age. Serum NO concentrations were determined after reduction of nitrates to nitrites using the Griess reaction. Results NO concentrations during second trimester of pregnancy (37.2±1.7μM; p<0.05) and third trimester of pregnancy (40.9±2.8μM; p<0.05) were significantly higher in healthy pregnant women than in non-pregnant women (29.3±1.7μM). Serum NO concentrations were lower in preeclamptic women (30.7±1.8μM) compared to matched healthy pregnant women of the third and the late third trimester (35.1±2.2μM), without significant differences. Mean NO concentrations in pre-eclamptic women was positively correlated with systolic blood pressure (r=0.58; p<0.01), diastolic blood pressure (r=0.45; p<0.05), creatinine clearance (r=0.48; p<0.05), uric acid (r=0.49; p<0.05), and negatively correlated with platelet count (r=-0.57; p<0.05). Conclusion NO production was increased with gestational age during normal pregnancy and slightly decreased in preeclampsia suggesting that NO may modulate the cardiovascular changes during normal pregnancy and pregnancy complicated by preeclampsia. [ABSTRACT FROM AUTHOR]

Ovarian cancer occurs in one or both ovaries, mostly in postmenopausal women. Despite the fact that it represents only about 4% of all malignant tumors in women, it is the most common cause of death among all cancers of the female genital organs. Endometriosis is characterized by ectopic endometrial localization in the organism of women, and localization beyond the inner surface of the uterus. It is mostly localized in the ovaries. Nowadays tumor marker CA-125 is used as a diagnostic tool in the diagnosis of ovarian diseases. It is also used for the differentiation of endometrial from non-endometrial benign ovarian cysts. The aim of this study is to demonstrate the degree of reliability of CA 125 for differentiating benign tumors type endometrioma from malignant adnexal tumors. Materials and methods: the study included the analysis of medical records of 120 patients with recorded tumor changes in the ovaries who were surgically treated at the Clinic of Gynecology and Obstetrics of the University Clinical Center Sarajevo and General Hospital "Prim. Dr. Abdulah Nakaš" in a three-year period. In the pre-operative preparation, all patients were tested for level of tumor marker CA 125, and underwent additional subspecialist examinations including ultrasound, CT and MRI of the pelvis. The study included 120 subjects. Group "A" consists of patients with PHD verified malignant ovarian tumors, and group "B" consists of patients with PHD verified benign ovarian disease type endometrioma. Results: the average age was higher in patients with malignant diseases. The subjects in the subgroup under 40 years of age had an average of 34.13 ± 3.28 years in malignant disease and 31.23 ± 4.98 years in benign disease. In the subgroup of subjects aged over 40 examinees had an average of 57.83 ± 8.12 years in malignant disease and 49.96 ± 5.81 years in benign disease. Average value of CA 125 in women with ovarian malignancies amounted to 800.9 ± 116 U/mL, and in patients with benign diseases 112.1 ± 108 U/mL. There was a significant dierence in the average values of CA 125 in the tested groups, and women with malignant diseases had statistically higher values of CA 125, F=20.59; p=0.001. Conclusion: the method of determining the CA-125 is a simple and accessible, making it easier to monitor operational, conservative or combined therapy of ovarian cancer. [ABSTRACT FROM AUTHOR]

There are numerous comparative studies about ways and methods of inducing labor, their efficacy, safety and dosage of drugs recommended for induction. Nevertheless, this topic is still a matter of debate. Inducing labor and successfully completing it vaginally is often a major challenge for obstetricians. Efficacy of induction depends on two factors; knowledge and obstetrician's experience as well as on use of appropriate methods with respect to obstetric findings. It takes a lot of knowledge, experience and patience for successful induction of labor in order to complete it spontaneously and avoid it's completion insurgicalway. The aim of this study is to determine, by retrospective analysis, efficacy of use of Prepidilintracervical gel (Dinoproiston) at a dose of 0.05mg and the possibility of reducing completion of delivery by cesarean section. At Clinic of Gynecology and Obstetrics, Clinical Center University of Sarajevo, in the first half of 2012, 1501 women was delivered, of which the number of induced births by Prepidil gel was 134. Results of this study showed that the percentage of completion induced birth by caesarean section was 33%, in comparison to its total number. The main reason for this lies in fact that the level of maturity of cervix during applications of Prepidil gel was lower, and the child in danger. The most common indication for completing induced labor is cephalopelvic disproportion in 32.6% and threatening fetal asphyxia in 44.2%. Analysis of induced births, compared to the value of the modified Bishop score, revealed that time from application of Prepidil gel until delivery is shorter in patients with higher Bishop score, and in those with Bishop score <5 who gave birth vaginally it was necessary 12.2h in average, with score 5-8 averaged 12.1h, while in patients with cervical maturity >8 in modified Bishop score average 9.5h. Bishop score average 9.5h. Schneider and his colleagues found when using intracervical prostaglandin gel average duration of delivery is 12.8 h in primiparas and 10.9 hours in multiparas from the moment of its application. The use of local products of prostaglandins (Prepidil gel) in the induction of labor with immature or relatively immature cervix in all aspects of labor (the success of vaginal birth, the length of labor, and acceptance by patients) is a successful method that in large percentage reduces completion by caesarean section. [ABSTRACT FROM AUTHOR]

Pregnant women with chronic kidney disease have a poor adaptation to gestational increase in blood flow through the kidneys, which accelerates the decline in renal function and leads to poor pregnancy outcomes. Women who get pregnant with the values of serum creatinine above 124 mmol / L have an increased risk of accelerated decline in renal function and poor pregnancy outcomes. This paper presents a patient with advanced pregnancies (29 gestational weeks) in the fifth stage of chronic kidney disease (creatininemia - 623 nmol / l) before dialysis. This pregnancy on hemodialysis is the first case from 1972, when hemodialysis was introduced in Bosnia and Herzegovina. Hemodialysis treatment lasted 4 weeks and was uneventful; but preeclampsia occurred, so it was decided to perform a cesarean section. A male child, weighing 1,400 kg, was born and died five days later. Pregnancy is indeed a real challenge for women with kidney disease, especially for patients who are treated by dialysis. However, impressive improvements in maternal-fetal care and continuous improvements in the effectiveness of dialysis, with frequent hemodialysis and improved therapy enabled the realization of goals, which sometimes were unattainable. [ABSTRACT FROM AUTHOR]

Myoma accounts for nearly 95% of all benign tumors of female genital organs and is the most common neoplasm of female genital tract. Along with thorough history and gynecologic examination, ultrasound study is of utmost importance in the diagnosis of myoma; magnetic resonance (MR) study may also be required in rare cases. A number of therapeutic options are available for the management of myoma, ranging from medicamentous therapy through operative procedures (e.g., total or supracervical hysterectomy or myoma enucleation) and novel non-operative procedures (e.g., embolization of uterine artery (EUA) and magnetic resonance guided focused ultrasound (MRgFUS). Discomforts caused by a myoma are an absolute indication for treatment. Therapeutic option to be chosen is determined by the number, size and location of myomas, and the patient's preferences. Therapeutic choice should rely on the patient's decision for or against treatment, sparing the uterus. An individualized treatment protocol should be tailored for each patient.

Cervical carcinoma is on second place of all tumors related deaths in the world. Cervical carcinomas affects around 500000 of women in the world, out of which 350000 dies every year. It is determined that HPV infection is the cause of cervical carcinoma. For primary prevention of cervical carcinoma there are currently two vaccines. They are suitable for use against HPV types 16 and 18 and additionally against type 6 and 11. Clinical studies till now showed great safety, immunogenity and 100% efficiency against HPV infections and dysplasia. Besides, the vaccine proved to be partially effective against HPV types 45 and 31. The primarily goal of prophylaxis is targeted towards the young girls between age 9 and 17 years. If the vaccine is effective in young males still needs to be determined.

This retrospective study conducted on the basis of 2002 -2005 history of disease protocol of the delivery room aiming to present a vitality of newborns with breech presentation with regards to the manner of completing deliveries as well as number of mother's previous deliveries. In a two year period, there was a total of 7017 deliveries, out of which 245 (3.49%) were breech presentation cases. Out of these 245 deliveries, 9 pregnant women were admitted with foetus mortus in utero, therefore, for the purpose of further observation we used the figure of 236 pregnant women with breech presentation. Out of that number, 129 pregnancies (54.66%) were delivered by operation, whereas 107 (45.33%) pregnancies were vaginal, supported manually. Vaginal deliveries with some kind of manual support (Bracht, Veit-Smellie-Muller were presented with total of 107 pregnant women of which 50 (46.72%) were cases of first delivery, 44 (41.12%) were second delivery, 6 (5.6%) were third delivery, 2 (1.86%) were fourth delivery, 3 (2.8%) fifth delivery, 1 (0.93%) was sixth delivery and 1 (0.93%) was seventh delivery.

This retrospective study analysed the way of completing a breech delivery. The period between 2002-2005 at GAK Sarajevo was observed. The number of deliveries in this period was 7017, and out of total there were 245 breech presentation cases, making up 3,49 % of total deliveries. T'Ihe goal was to examine breech presentations in pregnant women with at least 37 weeks of gestation, our testing group consisted of 123 patients which makes up half the total number of breech presentations. We also observed occurence of patological conditions in pregnancy (EPH gestosis, RVP, dysproportio, oligo i polihydramnion), mother's diseses history (ST post SC, ST post conisationem, uterine malformations, luxatio coxae, epilepsy), as well as mother's age and number of previous deliveries. Out of 123 pregnancies, 79 (64,22 %) were completed by SC, 43 (34,95 %) were vaginal - manually assisted: Bracht-Veit-Smellie 24 (55,8 %) and Muller-Veit-Smellie 18 (41,8 %). Out of total number of pregnant women observed, 73 (59,34 %) had first delivery, 41 (33,33 %) second delivery, 4 (3,5 %) had third delivery, 1 (0,81 %) had fourth delivery, 2 (1,62 %) fifth delivery, 1 (0,81 %) sixt delivery and 1 (0.81 %) seventh delivery.

In the last couple of years operative hysteroscopy has become a very popular surgical method. It provides us with the possibility to visualize the uterine cavity and explore it with absolute accuracy. In the majority of world centers, it is performed in ambulance. This is a very simple and financially acceptable method, for it does not require special pre and post operative treatments. Of course, simplicity of the procedure, the result, as well as the possibility of complications, depends on the surgeon as well as the preceeding diagnostics. In the period from September of 1997, to September of 1998., 320 operative hysteroscopies were performed in the Clinic for Gynaecology and Obstetrics in Sarajevo. All 320 patients were submitted for infertility. Detailed anamnesis was taken for each patient (HSG, diagnostic laparoscopy, operative laparoscopy, IVF). Each patient in our program was also subject to transvaginal Color Doppler diagnostics before the operation. This form of diagnostics turned out to be highly sensitive and highly specific. We used "Stortz" equipment, including an 8 mm resectoscope and OTV endocamera. Uterine distension was achieved through constant flow of "Purisol" solution. Prior to hysteroscope introduction, we dilated the cervical tube using Hegar metal dilatator. All patients were in general ET anesthesia. We divided complications in two groups: early and late complications. Depending on the sort of complication, patients were hospitalized from 1 to 7 days. Early complications occurred in 7 patients: unsuccessful cervical dilatation--2 patients; uterus perforation--1 patient; uterine bleeding--3 patients; intravasation--1 patient. Impossibility to finish the operation was also considered a complication: impossibility of septum incision--1 patient; incomplete myoma enucleation--1 patient; impossibility to reconstruct womb in the whole--1 patient. Late complications are those that appeared 12-24 hours after the operation: post-operative bleeding--2 patients; increased body temperature--2 patients; pain in lower abdomen--4 patients.