MediCon 2015. - Abstract book

International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina “MediCon” Tuzla, 30.10. – 01.11.2015.

Abstract Book

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Impressum International congress of students and young doctors of (bio)medicine in Bosnia and Herzegovina „MediCon“ – Tuzla, 30th October- 1st November 2015 Editor-in-chief: Emir Bećirović Editor: Emina Tulumović Graphic design / DTP: Jasmin Jatić / www.jjatic.com Assistant editors: Denisa Kulanić, Aida Omerašević, Majda Bešlagić, Nejra Bećarević, Adnan Mujanović Photographer: Edim Turčinović Publisher: Students' association of Faculty of Medicine Tuzla „MEDICUS“ Address: Faculty of Medicine, Univerzitetska br. 1, 75 000 Tuzla, Bosnia and Herzegovina Tel: + 387 (61) 876-152 (president); + 387 (35) 320-600 (faculty).

Web: www.medicon.us-medicus.ba, www.us-medicus.ba E-mail: medicus.tz@gmail.com Bank account: Students' association of Faculty of Medicine Tuzla „MEDICUS“ Raiffeisen BANK Inc., Bosnia and Herzegovina TRN: 161 025 002 803 0040 ID number: 4209979070005 Print: Off-Set Tuzla 300 copies October, 2015

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

Government of Tuzla Canton will sponsor Congress “Medicon 2015.”

Prime Minister of the Tuzla Canton congratulated our students and expressed his satisfaction with seriousness and enthusiasm shown by the students who have demonstrated their courage by engaging in the organization of such a scientific meeting. „The organization of “MediCon” is a refreshment in our area and the Government of Tuzla Canton will be pleased to accept sponsorship over this project. First of all because it is a project which is implemented by perspective young people, and also because Tuzla and Tuzla Canton, with the University Clinical Centre in Tuzla and the Faculty of Medicine, are flagships of medical profession in Bosnia and Herzegovina, and events such as these confirm this“ said Prime Minister Bego Gutić.

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Contents

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Welcome – President of the Organizing Committee Welcome – Dean of the Medical faculty Welcome – President of the Science Committee Organizing Committee Science and Honoured Committee Congress programme Plenary lectures/ Workshops Students’ plenary lectures Oral presentations Poster presentations Congress organizer Sponsors and patrons Partners and friends Media coverage About the congress About the association

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

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Dear colleagues, young scientists, respected professors and collaborators.

On the behalf of the Medical faculty of University of Tuzla, and Students’ association „Medicus“ I would like to cordially welcome you to the first International congress of students and young doctors of (bio)medicine in Bosnia and Herzegovina „MediCon“.

First of all, I want to thank you for being part of this project and wish you a lot of success in presenting your work. I hope that „MediCon“ will give you an opportunity to be present at interesting sessions, make new acquitances and friends, and at the same time enable you to have a great time. Our wish is to, besides all that, give all participants a chance to get to know Tuzla at its best, and that the Congress evokes some good memories later on.

Scientific-research work needs to represent an part of our lives and our striving towards improvement, and I would like to specially greet the students for whom this is the first time to present a scientific work with hope that the experience you will gain from this congress will encourage you to work hard and take part in such events, with the desire to learn something new and to transfer that knowledge and experience onto others.

I must certainly give accolade to the organizational committee, without whom this congress would be absolutely unthinkable. I hope that the tradition of this congress will continue through years to come, and that all of you will visit us again. A lot of effort and energy has been put into organization, so I am certain that the congress will live up to your expectations and enable that the works which passed the editing will present your faculty, institution, city and state in the best manner.

Welcome to Tuzla!

Emir Bećirović President of SA „MEDICUS“ President of the Organizing Committee of „MediCon 2015.“

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

International Congress of students and young doctors of (bio)medicine in Bosnia and Herzegovina „MediCon“, which is held at the Medical faculty of University of Tuzla from 30th October to 1st November, is a unique opportunity for students of medicine and young doctors to demonstrate their tendency and talent for doing scientific- research work and writing and presenting of personal scientific reports. The theme of this year's Congress is the heart, one of the most significant current fields of professional and scientific-research activity in modern day medicine. Review of current data concerning epidemiology, patogenesis, diagnostics, treatment and prevention of cardio-vascular diseases during the Congress will be presented by reputable experts from compatible fields. Most of the presentations will be held by students and young doctors with the results they found doing the research and display of professional news from different aspects of heart and blood vessels diseases. A large number of organised workshops during the Congress will bring the participants closer to technological-organisational aspects of dealing with cardiovascular medicine, the importance of team work, as well as getting and improving necessary knowledge and skills. Students and young doctors, who are the future of medical profession and science, by using displays of scientific-research and professional work which are the next unit in the Book of abstracts, give their active contribution to improvement of this field of medicine, but also contribute to building of an international network of future/young doctors of (bio)medicine.

We wish you success in your work during the following days of the Congress, as well as that the International Congress of students and young doctors of (bio)medicine in Bosnia and Herzegovina „MediCon“ becomes an opportunity for you to make friends and gain valuable experience.

Dean of the Faculty of Medicine Tuzla Prof. Elmir Čičkušić, MD

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High education, meaning University and the Faculty of Medicine as well, stands on two main pillars: quality education and top scientific-research work of teachers, collaborators, and students. I congratulate the Students’ association of Faculty of Medicine Tuzla „MEDICUS“on the organization of the Congress and I hope that it continues through years and becomes a tradition. Also, I wish a lot of success to all participants of the Congress in their future projects, their participation and scientific-research work has contributed not only to „MediCon 2015“ but has motivated other students to take part in such conferences and take initiative in scientific-research work. I always say that knowledge is power and it pays off in life, and students of Medical faculty of University in Tuzla have demonstrated that they understand it and are moving in the direction which guarantees a successful future. Organizing „MediCon 2015“ is a major contribution to medicine in Tuzla, as well as in all of Bosnia and Herzegovina.

Prof. Farid Ljuca, PhD Prorector for Scientific-research work at the University of Tuzla

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

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Organizing and Scientific Committee

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The Organizing Committee

President of MediCon 2015: Emir Bećirović Honorary President: Prof. Elmir Čičkušić, MD Secretary: Sarija Turkušić Coordinator for technical support: Sejfo Begić Coordinator for International Cooperation: Bahrija Golubović Coordinator for participants: Irma Ramić Coordinator for accommodation: Nermin Alibašić Coordinators for social events: Senad Softić, Velma Suljendić

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Coordinators for the protocol: Denisa Kulanić, Aida Omerašević, Enisa Ahmetović Coordinator for food: Edis Trumić Coordinator for the design: Jasmin Jatić PR: Nedim Ćudić, Adnan Mujanović Photo team: Dario Matić, Ademir Rahimić, Edim Turčinović Members of the Organizing Committee: Nedžib Mujanović, Saliha Redžepovac, Nisveta Prohić, Begajeta Gutić, Lejla Mazić, Ermina Mujanović, Nina Saračević, Dela Kafedžić, Nejra Bećarević, Majda Bešlagić, Belma Brdarević, Arijalda Pjević, Tamara Gavranić, Maida Čajić, Miralem Begić, Emina Tulumović, Adnan Salihović, Mirna Selimbašić, Amar Skakić, Semir Hadžić, Dženeta Brkić, Armin Ramić, Mahir Lapendić, Amila Pjanić.

International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

Scientific committee

President of the Scientific Committee: Prof. Farid Ljuca, MD Members of the Scientific Committee: - Prof. Elmir Čičkušić, MD - Prof. Osman Sinanović, MD - Prof. Šefik Hasukić, MD - Prof. Alija Sutović, MD - Prof. Fahir Baraković, MD - Prof. Fahrija Skokić, MD - Prof. Dženita Ljuca, MD - Prof. Nermina Hadžigrahić, MD - Prof. Senaid Trnačević, MD - Prof. Zumreta Kušljugić, MD - Prof. Muhamed Omerović - Doc. Munevera Bećarević, MD - Elnur Smajić, MD - Mustafa Tabaković, MD Honorary committee

Prof. Enver Halilović, MD Prof. Ešref Bećirović, MD – prof. emeritus Prof. Enver Zerem, MD – academic Prof. Nada Mladina, MD Doc. Nešad Hotić, MD Doc. Maida Mulić, MD Prim. Suad Bijedić, MD

Mr Bego Gutić Mr Jasmin Imamović Mr Sead Džafić Mr Senad Džambić Mr Nedžad Hodžić

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Preliminary congress programme

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Preliminary congress programme FRIDAY (30.10.):

International Congress of Students and

10:00 – 15:00 – REGISTARTION OF THE PARTICIPANTS (Medical faculty) 15:00 – 16:00 – OPENING CEREMONY OF THE CONGRESS /PROMOTION OF THE THIRD

ISSUE OF THE MAGAZINE “PULSUS” 16:00 – 16:15 – GROUP PHOTO (Entrance of the Medical faculty) 16:15 – 16:40 – WELCOME COCKTAIL 16:40 – 17:40 – CENTRAL PLENARY SESSION

(Prof. dr. Emir Kabil – Tuzla, BiH /

Topic: The development of cardiosurgery in Tuzla) 17:40 – 17:55 – STUDENT PLENARY SESSION I

(Emir Bećirović – 3D heart) 17:55 – 18:10 – STUDENT PLENARY SESSION II

(Amar Skakić - Aortic root, aortic arch

and supra-aortic vessels reconstruction) 18:10 – 18:40 – PLENARY SESSION OF OUR SPONSORS BOSNALIJEK 18:40 – 20:00 – DINNER 20:00 – WELCOMING PARTY

SATURDAY (31.10.)

07:00 – 09:00 – 10:00 – 11:00 –

BREAKFAST (Hotel) SESSION I (Medical Faculty– AMF 1)

Amra Meštrić, Zijah Rifatbegović - Dextrocardia associated with situs visceralis inversus Malik Ejubović, Nadija Gačo - Common risk factor among patients with the diagnosis of Myocardial infarction Anis Cerovac, Harun Brkić, Mirza Moranjkić, Mirsad Hodžić - Occlusive carotid disease Vanesa Vujičić, Svetlana Imbrišić, Inga Skopets, Natalya Vezikova - Myxoma of the left atrium as a cause of obstruction of the mitral valve - case report Emir Bećirović, Ermina Mujanović, Nejra Bećarević, Amar Skakić - Rehabilitation of patient suffering from myocardial infarction – the importance of physical training Majda Bešlagić, Emir Bećirović -Stroke prevention in atrial fibrillation patients 11:00 – 11:30 – PLENARY LECTURE (Prof. dr. Haris Huseinagić – Tuzla, BiH / Topic: Vorono´s diagrams in the treatment of giant aneurysms of the basilar artery treated with the technique “waffle cone”) 11:30 – 12:00 – PLENARY LECTURE (Doc. dr. Jasmin Čaluk – Sarajevo, BiH / Topic: The achievements of modern cardiology) 12:00 – 12:30 – 12:30 – 14:30 –

HEALTH MOMENT / COFFEE BREAK SESSIONII, III (AMF 1)

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Ema Tahto, Sabaheta Hasić, Amina Valjevac, Radivoj Jadrić - High-sensitivity troponin in the evaluation of patients with acute coronary syndrome Marta Žutelija, Svetlana Imbrišić, Elena Lyutaya, Evgenija Gribkova, Olga Barysheva, Natalya Vezikova - The cardiorenal syndrome: a case report Skakić Amar, Bećirović Emir - Bloodless off pump coronary artery bypass grafting, treatment of choice for Jehovah’s Witness patients Barbara Dumančić, Marko Galić - Left atrial thrombus and complications Nudžejma Veladžić, Anita Risonjić, Hana Smajlović, Ena Šaranović, Amela Dervišević - Association of ant-cyclic citrullinated peptide antibodies with cardiovascular disease in patients with rheumatoid arthritis Lejla Tufekčić, Majda Bešlagić, Mirzeta Husić - Congenital heart defects in children with Down syndrome Nikolina Nikodinović, Vanja Nežić, Teodora Radulović - Relevance of cytology diagnosis lesions of the thyroid gland Esma Osmanbegović, Šejma Beganović - Three-vessel coronary disease Nermin Alibašić - The impact of physical activity on the cardiovascular system Irma Ramić, Bahrija Golubović - Ductus arteriosus persistens Amila Pjanić - Prevalence of congenital heart defects in University Clinical Center Tuzla Belina Hoxha, Arjana Zerja, Sokol Xhepa - Early and Mid Term Outcome of the Surgical Treatment of the Carotid Artery Occlusive Disease 12:30 – 14:30 –

SESSION III, IV (AMF 2)

Koray Demirci, Mehmet Ali Erkurt, Serdar Şıvgın, Muhammet Maden, Hakan Ismail Sarı - Clinical features and treatment strategies of primary central nervous system lymphoma: a multicenter retrospective study Hamidreza Karimi-Sari, Seyed Jalal Madani, Fariba Araste Fard - Comparison of acid-base and electrolytes imbalance in normal saline and sodium bicarbonate 1.4 % intravenous fluid infusions during cervical and lumbar laminectomy: a pilot double-blinded clinical trial Katarina Badak, Vedran Vizler - Takayasu’s arteritis Cita Zupanc, Maša Bizjak - Attention deficit hyperactivity disorder in adolescents with type 1 diabetes and its impact on metabolic control Piotr Kulesza, Monika Kulig, Bartłomiej Kulesza, Angelika Copija - Elements content in degenerative cervical and lumbar intervertebral discs- is there any difference?

Ismir Kukić, Semra Pajazetović, Arzumana Ožegović, Almedina Terzić, Alija Numanović - Woman’s knowledge about cervical cancer prevention in Tuzla region Nadija Gačo, Malik Ejubović - Thoracic injuries in the patient - a case report Pavle Banović, Ivan Čapo, Matilda Đolai, Dušan Lalošević - Experimental fibrosarcoma in the syrian golden hamster induced by inoculation of cell culture bhk-21/c13 as a model for testing the anti-tumour effect of mebendazole Yaghoob Madmoli, Hamide Mashalchi - Status of associated diseases, blood factors deficiency, splenectomy and bone marrow transplantation in patients with beta thalassemia in dezful in 2015 Semir Hadžić, Delila Bajrić, Emir Bećirović - Abo donor: blood donor management system Boris Baković, Petar Lakić - The incidence of alcohol among high school population in the municipality of Zvornik

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14:30 – 15:50 – LUNCH International Congress of Students and 15:50 – 16:20 – PLENARY LECTURE (Doc. dr. Mario Ivanuša – Zagreb, RH / Topic: Outpatient cardiovascular rehabilitation: the importance of an interdisciplinary approach) 16:20 – 16:50 – PLENARY LECTURE (Doc. dr. Elmir Jahić – Tuzla, BiH / Topic: Trans-radial approach in the treatment of STEMI through primary percutaneous coronary intervention) 16:50 – 17:50 –

SESSIONVI (AMF 1)

Anis Cerovac, Selma Jakupović - Glioblastoma multiforme ten-year survival-case report Mirna Selimbašić, Lejla Mazić, Adnan Salihović, Emir Bećirović, Zihnet Selimbašić - Anorexia nervosa Miroslaw Slawinski, Robert Chudzik, Sylwia Korzeniowska, Emilia Kulak-Janczy, Michal Zarobkiewicz - Bee pollen in medicine Malik Galijašević, Meis Sammak, Selma Kulenović - Serum uric acid level and red cell distribution width in patients with rheumatoid arthritis Burak Isal - New Hope for Leukaemia: Cranberry Kübra Gökçe, Pelin Türker, Maide Kasit - Evaluating Effect of Naringin and Salicyclic Acid on Colon Cancer Cell Culture 16:50 – 17:50 –

SESSION VII (AMF 2)

Ilvana Rabotić, Adnan Kudumović, Haris Beširević, Medina Hasanović, Sejfo Begić - Cervical cancer: What youth know?

Czerżyńska Magdalena, Sawicka Emilia - Pulmonary oedema in the curse of end-stage decompensated renal failure in patient with systemic lupus erythematosus Nnamani Kenechukwu Samuel - Innovative Health Management System Miroslaw Slawinski, Daniel Piatek, Karolina Gasinska, Ewelina Kopcial, Barbara Budzynska, Grazyna Biala - The influence of stress and nicotine on concentration of zinc, copper and iron in animals’ livers Robert Chudzik, Miroslaw Slawinski, Katarzyna Jarosz - Acquired hemophilia is extremely hard to be diagnosed in surgical patients Arjana Zerja, Egzona Sulollari, Berta Sulollari, Julinda Jaho - The effect of interferon therapy on macolopathy in Behҫet panoveitis 18:00 – 21:00 – 21:00 –

FREE TIME PARTY

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SUNDAY (01.11.)

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07:00 – 09:00 – 10:00 – 11:00 –

BREAKFAST (Hotel) POSTER PREZENTATION (Medical faculty)

Ahmed Osmanović, Adnan Fojnica - Genetic predisposition to heart disease Martina Ilinić, Dino Belić, Dunja Degmečić - Comorbidity: cardiovascular diseases among psychiatric patients Emir Bećirović, Majda Bešlagić - Multidisciplinary approach to palliative care of people with ALS Valerija Vukosavljević, Amar Skakić - Cardiopulmonary bypass Majda Bešlagić - Longterm complications of foreign body aspiration Amar Skakić - Aortic root, aortic arch and supra-aortic vessels reconstruction Haris Čampara - Skeletal muscle heart grafting Anita Risonjić, Hana Smajlović, Nudžejma Veladžić, Ena Šaranović, Nesina Avdagić - Evaluation of the effect of body mass index and waist circumferencec on blood pressure in adolescents Bartłomiej Kulesza, Piotr Kulesza, Monika Kulig, Karolina Załuska, Tomasz Sawicki - Impact of the grasping test on women’s cardiovascular systems, and the possibility of replacement from orthostatic tolerance test Kristina Duspara, Mensura Aščerić - Therapeutic options in the treatment of epilepsy Azra Husić, Aida Avdić, Azra Hadžigrahić, Nermina Hadžigrahić - Cutaneus adverse drug reactions: clinical patterns and causative agents in tuzla canton Alma Mudrov - Ecg changes in long-term cannabis smokers Adnan Mujanović - Influence of Iodine-131 from Nevada´s and global nuclear fallout on development of thyroid cancer in local population Lejla Mazić, Arnela Muharemović, Adnan Salihović, Mirna Selimbašić, Hidajet Rahimić - Hypertensive disorders of pregnancy: preeclampsia and eclampsia and neurological complications Mohsen Sadeghi Ghahroudi, Moein Targhi, Seyed Hamid Yousefi - Bleeding after Tooth Extraction in Patients Underwent Coronary Angiography Consuming Dual Anti-coagulantsCompared to Healthy Controls Denisa Kulanić - Fetal circulation Denisa Kulanić - Air pollution and cardiovascular disease Amar Skakić, Emir Bećirović - Prevalence of diverticular disease of colon in Tuzla Canton region 11:00 – 13:00 – 13:00 – 13:30 – 13:30 – 14:30 –

WORKSHOPS (Medical faculty / UKC Tuzla) CLOSING CEREMONY OF THE CONGRESS/ PRICES/ COCKTAIL TOURING AROUND TUZLA WITH A TOURIST TRAIN UNTIL 16:00 o’clock CHECK OUT

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Plenar lectures and workshops

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PLENARY LECTURER Prof. dr. Emir Kabil (General Director of “Heart Center Tuzla” Tuzla) Topic: The development of cardiochirurgie in Tuzla

Prof. dr. Haris Huseinagić (Director of the clinic of Radiology and Nuclear Medicine, University Clinical Center Tuzla) Topic: Vorono´s diagramsin thetreatment of giant aneurysms of thebasilar artery treated with the technique"waffle cone"

Doc. dr. sc. Jasmin Čaluk (Polyclinic Cardio Center Sarajevo) Topic: The achievements of modern cardiology

Doc. prim. dr. sc. Mario Ivanuša, prof. v.š.

(Clinic for Prevention and Rehabilitation of Cardiovascular Diseases "SRČANA" Zagreb) Topic: Outpatient cardiovascular rehabilitation: the importance of an interdisciplinary approach

Doc. dr. sc. Elmir Jahić (Director of the Clinic for Cardiovascular Diseases, University Clinical Center Tuzla) Topic: Trans-radialapproachin the treatment of STEMI through primary percutaneous coronary intervention

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

WORKSHOPS CARDIOPULMONARY REANIMATION Prof. dr. Semir Imamović (Director of the Clinic for Anesthesiology and Reanimation of University Clinical Center Tuzla)

SURGICAL SEWING OF THE WOUND Dr. med. Nail Šehić (Department of Cardiovascular Surgery of University Clinical Center Tuzla)

BASIC LIFE SUPPORT (BLS) AND AUTOMATIC EXTERNAL DEFIBRILLATION (AED) Dr. med. Almir Jagodić (Red Cross of Tuzla Canton/Emergency Department of Health Center Živinice)

SURGICALCARE OF AORTIC DISEASESYMPOSIUM Dr. med. Mustafa Tabaković (Department of Cardiovascular Surgery of University Clinical Center Tuzla)

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Students’ plenar lectures

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3D HEART Emir Bećirović1 Mentor: Elnur Smajić2, MD University of Tuzla, Faculty of Medicine, Tuzla, Bosnia and Herzegovina University Clinic Center Tuzla, Bosnia and Herzegovina

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Abstract Cardiovascular diseases are the most frequent type of diseases in the world and often the cause of death. Golden standard for treating the last stadium of heart disease is heart transplantation.

Considering that the international waiting list is quite long, patients often die because of a lack of donors. For those patients there is not an alternative treatment to believing in new technologies which will enable a different approach to medical treatment. That is why IT is the key resource nowadays. Like matter and energy, every aspect of our everyday life and work depends on it.

Computers in medicine do not have to be strictly used for administrative work only; IT includes a wide range of applications for various utterances. Completely implantable artificial heart which functions without any connection through the skin could be the therapy for many patients.

Based on computer tomography (CT) and magnetic resonance imaging (MRI), regions of interest are segmented by using software which provides a clear image of the heart, blood vessels and precise detection of the problem. Medical information systems have undergone development in the past few decades, especially in the last two. Great technological progress has enabled a complete interpretation and visualisation of cardiological images, including a precise diagnosis and display of areas with pathological changes by using three-dimensional images (3D). Because of a large number of demands, PACS (Picture archiving and Communication System) has been developed, as well as CAD (Computer Aided Detection) by creating a model, and with a more detailed image can accelerate solving the patient’s problem. The main task is to create an anatomic shape of a healthy heart which can be further used for visualisation and as a standard for forming anomalies in patients with a certain cardiological problem.

The aim of the work is to point out the possibility of a new way of treating patients with heart disease, by using various diagnostic methods of modern day medicine in order to create a healthy 3D heart and then transfer onto a “machine” that would improve the quality and prolonged the life of patients.

Key words: 3D heart, CT, MRI, contemporary medical technology, medical software.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

AORTIC ROOT, AORTIC ARCH AND SUPRA-AORTIC VESSELS RECONSTRUCTION Amar Skakić1

Mentor: Mustafa Tabaković2, MD, PhD

University of Tuzla, Faculty of Medicine, Tuzla, Bosnia and Herzegovina University Clinic Center Tuzla, Bosnia and Herzegovina

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Abstract

Female patient, 58 years old, was hospitalized in the Department of Cardiovascular Surgery because of the chest pains, palpitations and dyspnoea. The patient states that symptoms last for last two days. She knew she was suffering from high blood pressure, and admits she was taking prescribed antihypertensive therapy inordinately/rarely. Immediatelly upon reception CT angiography of the entire aorta was made, which showed aneurysm of the aortic root, ascending aorta and proximal part of the aorta arcus as well; with expansion of the aneurysm to the proximal part of the brachiocephalic trunk. Aorta 8,25 cm x 7,43 cm in diameter. CT did not show extravasation of contrast agent. Concentric hypertrophy of the heart muscle with aortic valve insufficiency (AI 3+) and dilatation of aortic annulus is verified by transthoracic echocardiography.

After diagnosing Aneurysm of ascedent aorta, proximal part of aortic arcus and aneurysm of truncus brachiocephalicus with aortic valve insufficiency (AI 3+) and dilatation of aortic annulus we decided to do an operation treatment. Aortic root reconstruction is made according to Bentall, after which the patient is inducted into the hypothermic circulatory arrest. At that point the aneurysmatically modified proximal part of the aortic arch, and aneurysmatically modified brachiocephalic trunk are resected and than reconstructed with the help of dacron graft.

Key words: Aneurysm, aortic root, aortic arch, truncus brachiocephalicus, Aorta, reconstruction, CT angiography, aortic valve insufficiency.

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Oral presentations

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DEXTROCARDIA ASSOCIATED WITH SITUS VISCERALIS INVERSUS Amra Meštrić¹, Zijah Rifatbegović² Mentor: Zijah Rifatbegović, MD, PhD University of Tuzla, Faculty of medicine, Tuzla, Bosnia and Herzegovina University Clinical Hospital Center Tuzla, Clinic of surgery, Bosnia and Herzegovina

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Abstract Dextrocardia, dextroversion, or dextrorotation is term used to describe all forms of malrotation of heart where the heart apex is pointed to the right side of the chest. Estimated incidence is about 1:12000. The most common malformations associated with dextrocardia are situs visceralis inversus and Kartagener`s syndrome. There are three types of dextrocardia described. The exact cause is unknown. Physical examinations of the chest are initial diagnostic instruments, and other sophisticated imaging modalities confirm and classify the diagnosis of dextrocardia.

The aim of the study was to present importance of dextrocardia associated with abnormal position of other abdominal or chest organs, and to estimate the prognosis of congenital and acquired conditions associated with dextrocardia.

There has been made a review of available literature and scientific journals. The study includes reported cases of dextrocardia associated with other abnormalities in children and adults.

In study with retrospective review of 3556 fetal echocardiogram between 2000 and 2011 there has been revealed 39 cases of dextrocardia. Primary fetal dextrocardia was the most common with situs solitus 45,4 %, followed by situs ambiguous 36,3 % and situs inversus totalis in 18,1% of cases. Structural cardiac abnormalities were found in 100 %, 80 %, and 25 % of fetuses with situs ambiguous, solitus and inversus. On the other side there are some acquired conditions which are associated with dextrocardia and there are reports of successful treatment of these conditions.

Dextrocardia with a normal abdominal situs has a high incidence of associated congenital cardiac anomalies. Dextrocardia with situs inversus is associated with a lower incidence of congenital heart disease. Persons having situs inversus with dextrocardia without other congenital anomalies have a normal life expectancy and similar risk of getting acquired disease as that of persons of the same age and sex group.

Key words: Dextrocardia, situs visceralis inversus, congenital cardiac malformations.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

COMMON RISK FACTOR AMONG PATIENTS WITH THE DIAGNOSIS OF MYOCARDIAL INFARCTION Malik Ejubović1, Nadija Gačo2 1 2

University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina University of Rijeka, Faculty of Medicine, Rijeka, Croatia

Abstract Myocardial infarction (MI) commonly known as a heart attack, occurs when blood flow stops to part of the heart causing damage to the heart muscle. Most MIs occur due to coronary artery disease. Risk factors include high blood pressure, smoking, diabetes, lack of exercise, obesity, high cholesterol, poor diet, and excessive alcohol, among others.

To determine the existence of risk factors in patients with a diagnosis of MI with special reference to diabetes mellitus and dyslipidemia, gender and age distribution of patients and to analyze the outcome of the disease.

The study was conducted as a retrospective study at the Cantonal Hospital Zenica. All the patients diagnosed with diagnosis of myocardial infarction were included in the study. Data sources were the patients’ histories in a given period.

The total number of patients diagnosed with MI made 61.46 % (504) of the total number of patients at the Clinic. Male patients were 50.80 % and female 49.20 % of the examinees. There are many risk factors for MI: hypertension 85.32 %, diabetes mellitus 42.46%, dyslipidemia 27.38 %, previous MI 26.59 %, arrhythmias 15.87 %, smoking 14,29 %, previous ICV 11.11%, genetics 7.54 %, angina pectoris 6.35 %, others 9.14 %. 10.91 % of patients have diabetes mellitus and dyslipidemia as a joint risk factor. 75.99 % of the patients survived, while 24.01% did not survive.

Of the survivors, 11.90 % were treated with CABG, 35.12 % of patients were refered to the coronarography and stent placement, while 28.97 % of patients were treated with conservative treatment.

Myocardial infarction is the most common pathology in cardiology. Diabetes mellitus and dyslipidemia, with hypertension are the leading risk factors. Timely and adequate treatment contributes to a better recovery and less complications.

Key words: Myocardial infarction, risk factors, diabetes mellitus, dyslipidemia.

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OCCLUSIVE CAROTID DISEASE Anis Cerovac1, Harun Brkić2, Mirza Moranjkić2, Mirsad Hodžić2 University of Tuzla, Faculty of Medicine, Tuzla, Bosnia and Herzegovina University Clinical Hospital Center Tuzla, Neurosurgical Clinic, Tuzla, Bosnia and Herzegovina

1 2

Abstract The risk of CVA correlates with the degree of stenosis and the presence of ulcerations, and is also increased in hypercoagulable states and with increased blood viscosity. Evaluation included CT angiography, duplex doppler ultrasound B-mode image, magnetic resonance angiography.

Treatment alternatives are primarily between the following; “best medical management”, carotid endarterectomy, endovascular techniques included percutaneous angioplasty and retrograde open balloon angioplasty for carotid stenosis and angioplasty combined with stenting.

The aim of the study was to present preoperative/procedurals symptoms, comorbidities, the metod of diagnosis, degree of stenosis, carotid endarcterectomy and carotid artery stenting methods for the treatment, postoperatively protocol, duration of hospital stay, postoperative evaluation of the patient with occlusive carotid disease (OCD). The retrospective analysis of surgical protocols of the UKC Tuzla included the operational procedures of patients with OCD. In group of carotid artery stenting we analyzed 23 patients, between march 2014. to august 2015. The average age was 66,65 years. Preprocedural most common symptoms such as hemiparesis (11), amaurosis fugax (7), dizzines (7), headaches (5), transient numbness or weakness of the contralateral half of the body (4) and disfasia (3). Comorbidities included high blood pressure (20), elevated blood holesterol/ lipids (15), prewiev insultus cerebrovascularis ( 12), diabetes mellitus (8), cardiac disease (6), other disease (11). The average degree of stenosis is 82,72 %. The average duration of hospital stay is 6,86 days. In group of carotid endarterectomy we analyzed 22 patients, between march 2005. to april 2013. The average age was 59,95 years. We analyzed the preoperative most common symptoms such as TIA (12), amaurosis fugax (7), dizzines (5), disfasia (4) and hemiparesis (3). In four patient the stenosis incidentally detected. Comorbidities included high blood pressure (13), prewiev insultus cerebrovascularis ( 12), diabetes mellitus (8), cardiac disease (9), elevated blood holesterol /lipids (3), other disease. The method of diagnosis for both groups is the color doppler ultrasonography and CT angiography (43), digital subtraction angiography and MR angiography.

The average degree of stenosis is 87,22 %. Postoperative/proceduraly standard protocol for both groups; one day in intensive care unit, measurement aPTT and on the basis of values obtained correction doses of low molecular weight heparin, blood pressure controle, neurological status evaluation. The average duration of hospital stay is 9 days. Postoperative/procedural evaluation in both group of the patient indicates that the patient neurologically stable and no restenosis.

Our research showed the postoperative/procedural improvment of most common symptoms.

Carotid artery stenosis is an important cause of stroke. Carotid endarterectomy remains the established standard for symptomatic stenosis > 70%. Ongoing sudies may demonstrate the role of carotid artery stenting in the treatment of carotid stenosis and prevention of stroke.

Key words: Occlusive carotid disease, carotid endarterectomy, endovascular techniques.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

MYXOMA OF THE LEFT ATRIUM AS A CAUSE OF OBSTRUCTION OF THE MITRAL VALVE - CASE REPORT Vanesa Vujičić1, Svetlana Imbrišić1, Inga Skopets2,3, Natalya Vezikova2,4 University of Rijeka, Faculty of Medicine, Rijeka, Croatia Chair of Hospital therapy, Faculty of medicine, Petrozavodsk State University, Petrozavodsk 3 Department of Cardiology, Republican hospital n.a. V.A. Baranov 4 Department of neurology and acute brain disorders, Republican hospital n.a. V.A. Baranov 1

2

Abstract Myxomas are the most common primary heart tumors. They are benign. 75 % of the myxomas are located in the left atrium. They often grow on a penducule, which allows the bloodstream to move them freely and thus causing an obstruction of the mitral valve. We report a case of a 55year old female patient, who was urgently admitted to the department of cardiology. On day of the admission, she was experiencing dyspnea induced by minimal physical effort. One month before admission, she was subjected to an ultrasound of the heart and a myxoma of the left atrium was found. It was established that the neoplasm occupies more than 50 % of the cavity of the left atrium and protrudes into the cavity of the left ventricle. This condition has caused a significant obstruction of the mitral valve. The obstruction led to the occurrence of heart failure 2A degree of the 4th functional class, occurrence of hemodynamic disorders and the development of acute prerenal kidney failure (oliguria). The treatment of choice is surgical removal of the tumor, so the patient was referred to a heart surgeon. After preoperative preparation, a radical myxomectomy was performed in conditions of artificial blood circulation and hypothermic cardioplegia. Although rare, this cause of heart failure should be borne in mind in all patients with dyspnea. Because of non-specific symptoms that this tumor gives, the diagnosis can be challenging. The clinical presentation depends on the location, size and mobility of the tumor. The performed operation significantly improved her condition, setting a normal left ventricular and kidney function. The patient is being monitored, ultrasound checks are done on a regular basis in order to assess the state of the heart chambers and valves, and in order to enable the timely initiation of the treatment in case of relapse.

Key words: Heart myxoma, mitral valve, obstruction, dyspnea, heart failure.

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REHABILITATION OF PATIENT SUFFERING FROM MYOCARDIAL INFARCTION – THE IMPORTANCE OF PHYSICAL TRAINING Emir Bećirović1, Ermina Mujanović1, Nejra Bećarević1, Amar Skakić1 Mentor: prof. Ešref Bećirović1, MD, PhD 1

University of Tuzla, Faculty of medicine, Tuzla, Bosnia and Herzegovina

Abstract Rehabilitation of patient suffering from myocardial infarction has a goal to recover physical, psychological and social functions up to optimal level. It begins with the first contact with patient and it is conducted continuously till the end of life. Exercise training presents the basic rehabilitation method for cardiovascular patients. When prescribing the Exercise training, must be taken care of: life’s age, gender, muscle-skeletal system integrity, previous physical activity, MI size, ventricular function and functional heart condition obtained from sub maximal ET, as well as medicaments that patient uses. Exercise training in order to lead to good effects, it must be isotonic or aerobic type. It includes the workout of large muscle groups which demands increased lung ventilation, increased minute-volume of the heart and small increasement of artery blood pressure. A certain number of studies have shown that Exercise training can lead to functional capacity increasement even with patients with significant ventricular function disturbances. Increasement of maximal oxygen body cosumption under Exercise training influence is the first of all the consequence of periphery mechanisms adaptation (increasement of artery-vein oxygen difference, sympatic nerve system stabilization with lower levels of heart frequency and blood pressure in calm condition and in effort condition) and it can be archived in situations when improvement of disturbed intrinsic heart frequency is hardly expected.

Key words: Myocardial infarction, exercise training, exercise test, intrahospital rehabilitation, posthospital rehabilitation, prolonged rehabilitation.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

STROKE PREVENTION IN ATRIAL FIBRILLATION PATIENTS Majda Bešlagić¹, Emir Bećirović¹ 1

Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina

Abstract Atrial fibrillation is the most frequent disorder of the heart rhythm. Its prevalence in the total population is 0.4 percent, but increases with aging of the population and reaches 6 percent in people over 80. Atrial fibrillation is often combined with structural heart diseases such as ischemic heart disease, mitral stenosis, in people who suffer from abnormal thyroid function, hypertension and pericarditis, while in 30 percent of all patients organic heart disease cannot be detected.

Hemodynamic disorders and thromboembolic complications increase morbidity, mortality and health insurance expenses. Risk of having an ischemic stroke with these patients is 1.3 percent, and increases up to 10-12 percent if the patients have already had an ischemic stroke or a transient ischemic attack. Aim of this work is to demonstrate the importance of proper oral anticoagulants therapy which decreases the risk of having a stroke by 3 percent per year, while the usage of aspirin is less reliable. Using oral anticoagulants demands a regular monitoring of the patient, keeping INR in a span between 2.0 to 3.0 to reach the maximum therapy effect and minimum risk of bleeding. There needs to be some precaution while using this medication due to a large number of interactions with other medicine and food. Stroke prevention needs to be primary when choosing a therapy for patients with atrial fibrillation because a stroke is an important publichealth problem and only a small number of patients manage to optimally recover their physical, psychological and social functions.

Key words: Atrial fibrillation, prevention, stroke, oral anticoagulants.

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HIGH SENSITIVITY TROPONIN IN THE EVALUATION OF PATIENTS WITH ACUTE CORONARY SYNDROME Ema Tahto, Sabaheta Hasić1, Amina Valjevac2, Radivoj Jadrić1 University of Sarajevo, Faculty of Medicine, Department of Medical Biochemistry, Bosnia and Herzegovina 2 University of Sarajevo, Faculty of Medicine, Department of Physiology, Bosnia and Herzegovina

1

Abstract Previous-generation troponin assays have been used as diagnostic and prognostic markers in acute coronary syndrome (ACS) patients and for risk stratification to guide triage decisions and aid in treatment selection. New, high-sensitivity troponin assays represent an important advance with added sensitivity for cardiac myocyte necrosis, but there remains a need for judicious interpretation with these tests. The aim was to review and discuss levels of high-sensitivity troponin I (hsTnI) in patients with ACS. The study included 100 patients with ACS, divided into two groups: patients with myocardial infarction (MI) (n=50) and patients with unstable angina (UA) (n=50). Patients were hospitalized at Clinic for Cardiology University Clinical Center of Sarajevo. Values of hsTnI were obtained from patients medical histories, and the values measured at the admission were used for analysis. Levels of hsTnI were significantly higher in patients with MI (4092.7 pg/mL) compared to patients with UA (63.9 pg/mL) (p˂0.05). In patients with UA, the hsTnI mean values were higher than the reported reference range (0.0 – 26.2 pg/mL). Great sensitivity of hsTnI enables the detection of microinfarctions in UA patients at admission. Such findings require additional testing to differentiate those patients from AMI patients.

Key words: High-sensitivity troponin I, acute coronary syndrome, myocardial infarction, unstable angina.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

THE CARDIORENAL SYNDROME: A CASE REPORT Marta Žutelija1, Svetlana Imbrišić1, Elena Lyutaya2, Evgenija Gribkova2, Olga Barysheva3,5, Natalya Vezikova4,5 Mentor: Elena Lyutaya, MD University of Rijeka, Faculty of Medicine, Rijeka, Croatia Republican Hospital n. a. V.A. Baranov, Department of nephrology, Petrozavodsk, Russia 3 Republican Hospital n. a. V.A. Baranov, Department of nephrology and hemodyalisis, Petrozavodsk, Russia 4 Republican Hospital n. a. V.A. Baranov, Department of neurology and acute brain disorders, Petrozavodsk, Russia 5 Petrozavodsk State University, Faculty of medicine, Chair of hospital therapy 1 2

Abstract Cardiorenal syndrome is a complex pathophysiological disorder of the heart and kidneys in which an acute or chronic disorder of one organ induces dysfunction in the other. The aim of this study was to demonstrate a patient who developed a chronic cardiorenal syndrome.

We demonstrate a 73-year old female patient who suffered a heart attack 20 years ago and has developed chronic heart failure. She was also diagnosed with diabetes mellitus type 2 and arterial hypertension. During the time, there was constant worsening of dyspnea symptoms and appearance of edema, so the patient was taken to the Kondopoga hospital in September 2014. At the time, the patient had a bilateral hydrothorax and proteinuria (4.0 g/day), so she was diagnosed with chronic kidney disease stage 3. The patient started receiving furosemide, given as a slow intravenous injection, but dyspnea and edema were resistant to applied therapy. Despite of conservative therapy, the patient’s condition wasn’t improving so she was transported to V.A. Baranova hospital in Petrozavodsk in hope to clarify the diagnosis. The thoracic radiograph showed signs of pulmonary venous congestion, and the ultrasound examination showed presence of fluid in the abdomen, pelvis and pleural cavity. Also, the level of brain natriuretic peptide (BNP) was above 35000 pmol/L. Because of reduced ejection fraction (47, 4%), high level of BNP and diuretic resistance it was concluded that edema, ascites and proteinuria were primarily caused by heart failure, so the patient was diagnosed with chronic cardiorenal syndrome. Because of conservative therapy resistance, treatment with the ultrafiltration was started and the patient’s general condition was improved. In future management of cardiorenal syndrome, a close cooperation between cardiologist and nephrologist is needed to improve the outcome of these patients.

Key words: Chronic kidney disease, heart failure, cardiorenal syndrome, diuretic resistance.

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BLOODLESS OFF PUMP CORONARY ARTERY BYPASS GRAFTING, TREATMENT OF CHOICE FOR JEHOVAH’S WITNESS PATIENTS Amar Skakić1, Emir Bećirović1 Mentor: prof. Emir Mujanović, MD, PhD University of Tuzla, Faculty of Medicine, Tuzla, Bosnia and Herzegovina

1

Abstract Jehovah’s witnesses (JW) belong to a religious group refusing to accept blood transfusion. Surgical treatment remains a challenge in this subset of patients. From 1945, JW introduced a ban on accepting blood transfusions, even in life-threatening situations while autologous blood must also be refused if it is predepositedthus excluding preoperative autodonation.

However, autologous blood is acceptable if it is not separated from the patients’ circulation at any time. The invasive nature of coronary artery bypass grafting (CABG), the associated decrease of body temperature and the use of cardiopulmonary bypass (CPB) are major reasons for increased blood loss and high incidence for blood transfusions during and after this procedures. Allogenic blood transfusions are often given and considered necessary in such operations, in spite of increased mortality, morbidity and major adverse outcomes resulting from transfusion. Reduction in the use of blood products should therefore be a general desire for every patient due to the associated risk factors. The evolution of less invasive cardiac surgical approaches, such as CABG without CPB (OPCAB) may contribute to a further reduction of blood transfusion and although these minimally invasive techniques may benefit every patient, they might be particularly valuable for JW. In this report, we present our initial experience in JW patient undergoing OPCAB and the way to use patient blood management for improved surgical outcome in such patient.

Key words: Jehovah’s Witness, coronary artery bypass grafting, without cardiopulmonary bypass.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

LEFT ATRIAL THROMBUS AND COMPLICATIONS Barbara Dumančić1, Marko Galić1 Mentor: Lana Maričić, MD, PhD University J.J Strossmayer, Faculty of Medicine Osijek, Osijek, Croatia

1

Abstract When a new organised mass is found in the heart, we may assume that it is a tumour or thrombus.

Thrombi in the left atrium (LA) are caused by slowed blood flow, mitral valve disease, or LA enlargement. If the atrial appendage is the main localisation site, transesophageal echocardiography (TEE) is required. The aim of our case study was to assess overlapping symptoms of myxoma and thrombus. The medical history of a 66-year-old female patient was analyzed. The patient was admitted to the Department of Cardiology for diagnostic evaluation of a tumour was in the LA, previously detected by transthoracic echocardiography (TTE). Before that, she was treated in an autside hospital for abdominal pain and it was determined left kidney stroke and atrial fibrillation.

Worth mentioning, moreover, was the lack of prior anticoagulant therapy. During hospitalisation, TTE and TEE were performed, and a tumour mass, 18x15mm was confirmed, with concomitant high-grade mitral and tricuspid insufficiency. While preparing for cardiac surgery, the patient suffered cerebrovascular insult. Surgery was delayed and LMWH therapy instituted. A control TTE performed one month later indicated complete resorption of the LA mass, thus indirectly confirming thrombus as the principal diagnosis. Noninvasive cardiac diagnostics in this case played a key role in assessment of the LA tumour mass, leading to the final diagnosis.

Key words: Myxoma, thrombus, atrial fibrillation, cerebrovascular insult.

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ASSOCIATION OF ANT-CYCLIC CITRULLINATED PEPTIDE ANTIBODIES WITH CARDIOVASCULAR DISEASE IN PATIENTS WITH RHEUMATOID ARTHRITIS Nudžejma Veladžić1, Anita Risonjić1, Hana Smajlović1, Ena Šaranović1, Amela Dervišević1 Mentor: Nesina Avdagić, MD, PhD 1

University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina

Abstract Rheumatoid arthritis (RA) is an independent risk factor for adverse cardiovascular events accounting for a significant proportion of mortality among these patients. Anti-CCP antibodies are associated with higher frequency of extra-articular manifestations and poorer outcomes in RA. C-reactive protein (CRP), an acute phase reactant that reflects different inflammation degree, has been indicated as independent risk factor in a variety of cardiovascular disease (CVD). To explore a potential association between anti-CCP antibodies with CVD in RA patients and to evaluate whether such an association is present when duration of RA is taken into account.

This cross-sectional study included 84 subjects, divided into two groups: RA1 group: patients with RA less than 48 months (n=55), and RA2 group: patients with RA more than 48 months (n=29). The serum concentrations of anti-CCP antibodies were determined by an enzyme-linked immunosorbent assay (ELISA). Serum CRP concentration was determined by means of particleenhanced immunonephelometry with the use of BN II analyzer. Serum concentration of anti-CCP antibodies (5.6 U/ml; 2.4-6.8 U/ml) was higher, but not statistically significant in RA2 group compared to serum concentration of anti-CCP antibodies (5.0 U/ml; 2.5-6.2 U/ml) determined in the RA1 group (p=0.410). Patients in RA2 group had significantly higher serum CRP concentration (20.4 mg/L; 10.4-46.3 mg/L) compared to serum CRP concentration in RA1 group of patients (3.2 mg/L; 7.8-29.5 mg/L) (p=0.022). Statistically significant positive correlation was found between concentration of anti-CCP antibodies and CRP in RA2 group (rho=0.511; p=0.005), while positive, although not significant, correlation was observed between these parametres in RA1 group (rho=0.178; p=0.201). RA patients with prolonged disease duration have high titer of anti-CCP antibodies and CRP concentration and therefore should be evaluated for cardiovascular morbidity more meticulously.

Key words: Rheumatoid arthritis (RA), anti-CCP antibodies, C-reactive protein (CRP), cardiovascular disease (CVD).

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

CONGENITAL HEART DEFECTS IN CHILDREN WITH DOWN SYNDROME Lejla Tufekčić¹, Majda Bešlagić¹, Mirzeta Husić2 1 2

University of Tuzla, Faculty of Medicine, Tuzla, Bosnia and Herzegovina University of Tuzla ,Faculty of Education and Rehabilitation, Tuzla, Bosnia and Herzegovina

Abstract Down syndrome is a genetic disorder that refers to the disorder of the 21st chromosome which has three copies of chromosomes instead of two. It represents a group of mental and physical symptoms that are the result of the existence of another copy of the 21st chromosome. Mental retardation is a disability that actually limits the intellectual and social functioning. However, besides that, children with this syndrome often have other health issues such as hearing problems, disorder of the thyroid gland, eyesight problems, dementia and other conditions. They also have an increased risk of developing congenital heart defects in comparison to the general population.

The best evidence is the data that the incidence of having congenital heart defects in the general population 0.8 per cent, while in children with Down syndrome that percent is between 40 and 60. Three leading cardiac abnormalities that appear are: atrioventricular septal defect (60 %), ventricular septal defect (29 %), Fallot tetralogy and persistent ductus arteriosus. Some of these heart defects can be carefully observed and do not require an urgent correction, while some of them demand a surgery at an early age. It is important to state the fact that the life span of people with Down syndrome has increased. Today, they can live up to over 50 years longer; while in the past children with Down syndrome did not live for more than 10 years. This is relevant because an early intervention and treatment of congenital heart defects, and other health problems of children with Down syndrome can make a great difference in gaining functional abilities and melioration of life quality. Specialized programs are available in most countries, which greatly differ, but every one of them include a team of experts who will, depending on the needs of the child, secure medical care and help them to successfully develop their skills.

Key words: Congenital heart defects, Down syndrome, children.

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RELEVANCE OF CYTOLOGY DIAGNOSIS LESIONS OF THE THYROID GLAND Nikolina Nikodinović1, Vanja Nežić1, Teodora Radulović1 Mentor: Radoslav Gajanin, MD, PhD2 University of Banja Luka, Faculty of Medicine, Banja Luka, Bosnia and Herzegovina University Clinical Hospital Center Banja Luka, Department of Pathology, Banja Luka, Bosnia and Herzegovina 1

2

Abstract Thyroid disorders are very common, affecting 750 million people worldwide by recent World Health Organization (WHO) estimates. Thyroid lesions are diagnosed in over 7% of the adult population.

Therefore it is of utter importance to develop safe and accurate tools that distinguish between benign nodules and malignant ones. At present, cytological examination is considered the gold standard diagnostic tool for thyroid lesions. The aim of the research is to use comparative analysis to show correlation between cytological and histopathological examination of the thyroid gland lesions and to determine the sensitivity, specificity, predictive value and diagnostic reliability of this method. In the period from January 2012 to January 2013 cytological and histopathological examination for 24 patients has been completed and they were compared. For histopathological examination for 20 patients was used a sample from completely removed thyroid gland and for 8 patients sample from one of the lobes. The presence of cancer in cytological treated material was diagnosed in 4 patients, which was histologically confirmed. False negative cytological examination was obtained for 2 patients. It was obtained sensitivity 80 %, specificity 100 %, positive predictive value of 100 %, negative predictive value 90 % and diagnostic accuracy of 93 %. The survey confirmed that cytological examination is sensitive, reliable diagnostic method for differentiation of lesions in the thyroid gland. The development of new and more accurate preoperative diagnostic techniques in many cases can eliminate the need of unnecessary diagnostic surgery.

Key words: Cytological diagnosis, histological diagnosis, the salivary glands, sensitivity, specificity.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

THREE-VESSEL CORONARY DISEASE Esma Osmanbegović1, Šejma Beganović2 University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina University of Tuzla, Faculty of Medicine, Tuzla, Bosnia and Herzegovina

1 2

Abstract Depending on pathophysiological mechanism there are two groups of ischemic diseases: chronic coronary disease and acute coronary syndrome (ACS). Asymptomatic coronary disease with myocardial ischemia or so called “mute ischemia” is ischemia of myocardium without angina or chest pain and its equivalent, with presented proof of its existence on electrocardiogram, ergometry, echocardiography or radionuclides methods. It is the most common form of coronary disease and part of more than 75 % of all ischemic events of everyday life. The aim is to show patient with diagnosed three-vessel coronary disease without ACS, with syncope as the only symptom presented. Case report from Clinic for cardiovascular diseases. Patient (male, 57 years old) was treated on in the period from 2nd to 6th July 2014 and from 5th to 7th August 2014 with diagnosis: “Three-vessel coronary disease”. Patient with syncope and attack of ventricular tachycardia was subjected to a treatment of selective coronary angiography, which showed occlusion of left anterior ascending artery (LAD) and right coronary artery (RCA), and treatment of percutaneous coronary intervention (PCI) of RCA with implantation of two stents. Patient was hospitalized for the first time without stenocardial pain with suspected ACS. After examination normal level of troponin was found and ECG was without signs of ACS. Coronary angiography was indicated and it has shown three-vessel coronary disease. Considering the fact that coronary disease is presented as acute and chronic form it is very important to recognize symptoms (changes on coronary vessels as well) and do additional tests as a confirmation of final diagnosis. Absence of anginal pain doesn’t mean that there is no critical stenosis, because collateral circulation is forming. Patients with already before diagnosed coronary disease with no symptoms at the moment are not without risks of progression of disease.

Key words: Syncope, coronary heart disease, mute ischemia.

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THE IMPACT OF PHYSICAL ACTIVITY ON THE CARDIOVASCULAR SYSTEM Nermin Alibašić1 Mentor: Kada Delić – Selimović2 University of Tuzla, Faculty of Medicine Pan-European University “Apeiron” - Faculty of Sports Sciences

1 2

Abstract The positive effect of physical activity on the cardiovascular system is also reflected in the improvement of aerobic capacity and metabolic function, amplification of the lipid profile, insulin sensitivity of immune function, increasing myocardial perfusion and fibrinolytic activity, reduce adherence of platelets due to increased synthesis of prostaglandins PGI2, increasing energy losses, prevention and treatment of obesity and controlling stress. Been demonstrated beneficial effects of physical activity in primary, secondary and tertiary prevention of coronary heart disease and it is generally accepted that physical activity is an important factor in maintaining normal physical and mental health. Physical activity slows degree of atherosclerosis in the coronary arteries in people who are physically active. During physical activity cardiovascular system is going through many changes, such as an increase the cardiac output, which is closely related with the degree of expansion of blood vessels, skeletal muscle, which means the metabolic changes that occur in skeletal muscle during physical activity. There is a reflex activation of the sympathetic nerve in relation to the heart, as well as in relation to resistance and capacitance vessels the systemic circulation. The aim is to stress the importance of physical activity as one of the methods in the prevention of physical, mental and metabolic disorders. For this purpose, they analyzed the active athletes (professionals), recreational and physically inactive. We have done a measure the endurance of the organism of respondents, and Body Mass Index (BMI). After results processing, the proven number of obese people is increasing, and increased the number of risk factors for cardiovascular complications. Active persons, persons who meet the leisure time activities of basic sports (running, swimming, gymnastics), are classified into group of people with a minimum of risk factors for cardiovascular complications. The prevention and reduction of cardiovascular risk, aerobic physical exercises with intensity training of medium load, have a positive effect. The risk of complications during physical activity is negligible, especially if as a form of physical activity practiced walking.

Key words: Exercise, cardiovascular diseases, risk reduction behavior, sport, recreation.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

DUCTUS ARTERIOSUS PERSISTENS Irma Ramić1, Bahrija Golubović1 Mentor: Maida Isabegović, MD, PhD2 1 2

University of Tuzla, Faculty of medicine, Tuzla, Bosnia and Herzegovina University Clinical Center, Tuzla, Bosnia and Herzegovina

Abstract A case study of Ductus arteriosus persistens. The patient has 60 years at present time being, she was diagnosed with ductus arteriosus persistens in her childhood and was recommended surgical treatment, but the patient/her parents refused the operation. At age 45 she was admitted at the hospital with symptoms of dyspnea, cough, leg and abdominal edema and was diagnosed as Vitium mitrale rheumatica decomp. After the patient was stabilized she was released from the hospital with a recommendation for a surgical treatment which was never performed. At age 55 she was admitted at the hospital at the department for cardiology because of oliguria and heart failure. During her stay the following diseases were diagnosed: Dilatatio aortae ascendens, Hypertensio a. pulmonalis, Fibrilatio atriorum permanens, Heart failure NYHA III/IV, Infiltratio pulmonis bas dex, Insuffitientio renalis gr. II, Insuffitientio respiratoria partialis. Dyspneic, with cyanotic lips and extremities, asthenic constitution, auscultatory on both sides near the bases of the lungs the sound is weak, heart rhythm is arrhythmic, tones are clear. Pulse = 130/min. EKG: Atrial fibrillation with ventricular frequency 67/min, electrical heart axis is to the right, depression of ST segment at the inferior and lateral leads. Pulmonary circulation is compromised, hypertrophy of the right ventricle and an incomplete block of the right branch. The Liver is enlarged (17 cm); blood vessels are dilated because of inflammation. Kidney pelvis, calyces and ureters are dilated because of chronic inflammation. Echocardiography has registered persistent ductus arteriosus, with a big possibility of a bidirectional shunt and a pronounced pulmonary hypertension (PAPS 120 mmHg). Latest doctor’s exam heart is arrhythmic, tones are clear, systolic murmur that can be heard best at the ictus cordis. Pulse: 143/min; BP: 160/80. RTG PULMO/COR – heart shadow looks enlarged, left contour is slightly less differentiated. Left, underneath the aortic arch, in the projection of the left hilus continuing in the heart shadow from which it cannot be differentiated, it can be seen around, lobulated and clearly seen contours an inhomogeneous shadow 45mm in diameter with an open etiology.

Key words: Ductus arteriosus persistens, congenital anomaly, surgical treatment.

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PREVALENCE OF CONGENITAL HEART DEFECTS IN UNIVERSITY CLINICAL CENTER TUZLA Amila Pjanić1 Mentor: prof. Adem Balić, MD, PhD University of Tuzla, Faculty of medicine, Tuzla, Bosnia and Herzegovina

1

Abstract Congenital heart defects are the most common fetal anomalies, with incidence from 3 to 10 per 1000 newborn children. Congenital heart defects are diagnosed as isolated or combined with other anomalies or genetic defects. 20 % of children born with congenital heart disease do not live up to second month, 50 % die within first year of life, while rest may have various difficulties in growing and development. Considering that the vast majority of congenital heart defects can be surgically corrected at an early age, it is very important to have them diagnosed at the right time, even before children is born. The goal was to determine the frequency and distribution of congenital heart defects in children born in University Clinical Center Tuzla. We retrospectively analyzed the medical records of the Clinic for children’s diseases, University Clinical Center Tuzla, with focus on children who are suspected to have a heart defect. In the year 2014, 3972 children were born in UKC Tuzla.

89 of them were diagnosed with anomalies; 3 with genetic anomaly (0,75 %), 31 with congenital heart anomaly (7,89 %), 23 with urogenital anomaly (5,79 %), 4 with CNS anomaly (1,00 %), 14 with gastrointestinal anomaly (3,69 %) and 14 with bone anomaly (3,69 %). 34.83% of all anomalies were congenital heart anomalies. One was associated with genetic syndrome, while two were associated with other fetal anomalies. The incidence of congenital heart anomalies in Tuzla Canton in 2014 was 7.8 %, among which ventricular septal defect (VSD) is the most common (51.6 %). It is possible and quite easy to diagnose VSD by ultrasound examination between 19th and 22nd week of pregnancy. It would significantly reduce the morbidity and mortality caused by congenital heart anomalies.

Key words: Congenital heart anomalies.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

EARLY AND MID TERM OUTCOME OF THE SURGICAL TREATMENT OF THE CAROTID ARTERY OCCLUSIVE DISEASE Belina Hoxha¹, Arjana Zerja¹, Sokol Xhepa² 1 2

University of Medicine, Faculty of Medicine, Tirana, Albania.

University Hospital Center “Mother Theresa” Tirana, Albania.

Abstract Treatments for carotid artery disease may include lifestyle changes, medicines and medical procedures. The goals of treatment are to stop the disease from getting worse and prevent a stroke. Your treatment will depend on your symptoms, how severe the disease is and your age and overall health. The aim was to present our experience with carotid artery surgical approach (CASA) in terms of hospital outcome. This is a retrospective study. We included 45 patients who underwent carotid endarterectomy or CEA by the same surgical team in the University Hospital Centre “Mother Theresa”, In Tirana, Albania between February 2011 and July 2014. There was no in-hospital mortality. 15 patients had dexter ICA stenosis, 14 patients had sinister ICA stenosis, 12 patients had bilateral stenosis, 1 patient had dexter CCA and ICA thrombotic aneurysm, 1 patient had dexter ICA thrombosis and 1 patient had CCA sinister stenosis. 30 patients underwent CEA+patch angioplasty, 9 patients CEA+primary closure, 1 patient CEA+CABG, 1 patient CEA+carotis-subclavia artery bypass, 1 patient aneurysm resection +transposition of ECA to ICA, 1 patient CEA shunting+patch angioplasty and 2 patients did not undergo surgery. There were no neurological, pulmonary, infective, renal, gastro-intestinal complications found in any of the patients. None of them experienced multiorgan failure (MOF). CEA can greatly reduce the risk of stroke in people who have carotid artery disease. The surgery is fairly safe when done by surgeons who have experience with it. However serious complications, such as stroke and death, can occur.

Our early and mid term outcome are very promising but there is underdiagnosement of the carotid artery disease in cardiac patients, leading so in undertreatment of such disease.

Key words: CEA, patch angioplasty, primary closure, plaque, TIA, stroke.

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COMPARISON OF ACID-BASE AND ELECTROLYTES IMBALANCE IN NORMAL SALINE AND SODIUM BICARBONATE 1.4 % INTRAVENOUS FLUID INFUSIONS DURING CERVICAL AND LUMBAR LAMINECTOMY: A PILOT DOUBLEBLINDED CLINICAL TRIAL Hamidreza Karimi-Sari1, Seyed Jalal Madani2, Fariba Araste Fard2 Students’ Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR-Iran.

Anesthesiology Department, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR-Iran.

1

2

Abstract Large amounts of saline infused in surgeries of long duration can cause hypercloremic metabolic acidosis. This study was designed to evaluate electrolytes and acid-base imbalance in normal saline and sodium bicarbonate 1.4 % infusions during surgical laminectomy. This double-blind randomized clinical trial was approved by the Ethics Committee of Baqiyatallah University of Medical Sciences with Iranian registry code of clinical trials of IRCT2014061717413N4. Patients who met the inclusion criteria, being 35 to 70 years in age, having ASA physical status class I-II, and candidation for cervical and lumbar laminectomy, were randomly assigned into two groups receiving sodium bicarbonate 1.4% and normal saline intravenous solutions for deficit fluid therapy during the surgery. Hemodynamics, arterial blood gases, and electrolytes levels were measured before and after surgery. Data were compared between the groups by SPSS. Forty patients with a mean age of 49.92 years were evaluated (20 patients in each group). There were no significant differences in demographic data between the two groups. The mean surgery duration and blood loss, urine, and infused fluid volumes did not indicate significant differences between the two groups (P>0.05). The mean PCO2 and HCO3 values significantly increased in the bicarbonate group, whereas they decreased significantly in the normal saline group (3.7 vs. - 3.3 for PCO2 and 2.27 vs. - 3.22 for HCO3). The mean serum lactate increased significantly 0.318 unit in the bicarbonate group while the mean serum Cl- increased significantly 2.8 unit in the normal saline group (P<0.05). Based on the results of this study, it can be concluded that the incidence of acidbase imbalance following lumbar laminectomy surgery significantly decreases by applying sodium bicarbonate 1.4 % serum for deficit fluid therapy. Considering the limited sample size in this pilot study, more clinical trials are needed for confirming its results Key words: Crystalloid solutions, Fluid therapy, Laminectomy, Metabolic acidosis, Sodium bicarbonates, Water-electrolyte balance.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

TAKAYASU’S ARTERITIS Katarina Badak1, Vedran Vizler1 Mentor: dr. sc. Silvija Canecki Varžić, MD2 University J.J Strossmayer, Faculty of Medicine Osijek, Osijek,Croatia University Hospital Center Osijek, Osijek, Croatia

1 2

Abstract Takayasu’s arteritis is a rare disorder that causes blood vessel inflammation primarily damaging pulmonary arteries, aorta’s main branches and the aorta itself. This inflammation leads to thickening, narrowing and scarring that can result in reduced blood flow to vital organs, or to aneurysms that may rupture. It is a very rare disease mostly presenting in females of Asian descent between 15 and 30 years of age. The aim of our case study was to present that nonspecific simptoms of: cough, malaise, dyspnea on exertion, fatigue, subfebrility, night sweatscould also be a sign of a rare syndrome called takayasu’s arteritis. The medical history of a 32­year­old female patient was analyzed. During a period of two years the patient was visiting her family doctor complaining about symptoms of fatigue while performing regular everyday duties (eg. shopping, playing with children), headache, lack of air and difficulties while breathing. After completing all usual tests, the family doctor sent the patient for hospital treatment. Althought, all performed tests showed no abnormal results the patient insisted on further hospitalization. The patient was received on the department of Endocrinology. There the doctors performed CT of head and thorax and found intramural edema, sularingeal left main bronchy stenosis, a. subclavia sin. occlusia, subocclusion of a. Carrotis communis dex. with narrowed latitude of a. subclaviae dex., in the distal area of thoracic aorta was found intramural thrombus. The radiologist placed the suspicion on Takayasu’s arthritis. The diagnosis of athritis was confirmed with an MR angiography and supplementary CDI.If experiencing prolonged difficulties with setting up the right diagnosis one should asses the possibility of rare diseases that are not specific for a certain region.

Key words: Takayasu’s, blood vessel inflammation.

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ATTENTION DEFICIT HYPERACTIVITY DISORDER IN ADOLESCENTS WITH TYPE 1 DIABETES AND ITS IMPACT ON METABOLIC CONTROL Cita Zupanc1,2, Maša Bizjak1,2 University Clinic Center Ljubljana, Ljubljana, Slovenia Pediatric Clinic Ljubljana, Ljubljana, Slovenia

1 1

Abstract Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric diagnoses in childhood. There is a group of adolescents with ADHD who have diabetes mellitus (T1DM).

ADHD may limit their participation in diabetes self-control and insulin administration. The aim of the study was to identify adolescents with T1DM and ADHD and to investigate the affect of ADHD on metabolic control. ADHD treatment was suggested with the goal to improve the management of T1DM and improve the quality of life for these children. The metabolic control of adolescents with T1DM and ADHD is worse than adolescents with T1DM without ADHD. Study was designed as a cross-sectional case-control study in 11 to 17 years old teenage children with T1DM. First adolescents with T1DM and ADHD were identified with the help of the online questionnaire called “Development and Well-Being Assessment” (DAWBA). Then variables of metabolic control were collected from the available medical documentation for the last 12 months. We identified 12 teenage children with T1DM and ADHD and found statistically significant difference (p = 0,044) between the two groups in glycosylated haemoglobin (HbA1c), which is an important indicator of metabolic control in diabetes. The HbA1c was statistically significantly higher (8,6 % versus 8,0 %) in the investigated group. Because ADHD significantly affects the child´s daily functioning, the children and adolescents with T1DM and ADHD have worse metabolic control and require appropriate professional psychological and psychiatric help/treatment.

Key words: ADHD, diabetes, teenagers.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

ELEMENTS CONTENT IN DEGENERATIVE CERVICAL AND LUMBAR INTERVERTEBRAL DISCS- IS THERE ANY DIFFERENCE? Piotr Kulesza, Monika Kulig, BartĹ&#x201A;omiej Kulesza, Angelika Copija Mentor: Jacek Kulesza, MD Medical University of Silesia, Katowice, Poland Medical University of Lublin, Lublin, Poland Abstract Age-related decrease in the concentration of water, nucleic acids and collagen type 2 are factors inducing degenerative processes of the intervertebral discs (IVD). Disorders in the nutrients and metabolites exchange can cause the accumulation of certain substances in IVD, including trace elements (TE). Aim of the study: Investigate and measure the quantity of water and seventeen individual trace elements in cervical (C) and lumbar-sacral (LS) IVD. We analyzed 110 IVD removed from patients with degenerative disease of the IVD in cervical and lumbar-sacral region who underwent surgery in the Department of Neurosurgery in 2009-2012. Assessment of TE was made using ICP-MS technique (Agilent 7500 Cx). The water content of the IVD was computed by subtracting the dry mass from the total disc mass. Patients completed a questionnaire consisted of 13 questions. The average age of patients treated because of symptoms associated with C discs is lower by 4.5 years compared to patients who had removed LS discs. In both groups, the content of Ca, Na and P was highest, Mg and Fe were about 100x lower, while other elements, among them potentially toxic (Pb, Cd, Ni, Zn), were present only in trace amounts. In the lumbar discs, water and two of the assessed elements Cu and Sn, were greater level while the other eight (Li, Al, Mn, Co, Ni, Ga, Cd, Pb) were greater level in the cervical discs. The accumulation of elements along with P and Ca was evaluated: in the cervical discs contents of P and Ca complemented the accumulation of Fe, Zn, Ga, As, Se, Sr, Pd, Ba and Mg, in the lumbar discs Al, Zn, Sr, Pd, and Ba. There was no connection between high levels of some elements and sociodemographic factors. The results are preliminary. They may indicate the accumulation of some of the elements in connection with the P and Ca collection mechanism in the cervical and lumbar discs. C-rings are characterized by significantly higher contents of many trace elements compared with LS-discs, which may be associated with different dynamics and progressing of degeneration process.

Key words: Degeneration, cervical and lumbar intervertebral discs, difference.

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WOMAN’S KNOWLEDGE ABOUT CERVICAL CANCER PREVENTION IN TUZLA REGION Ismir Kukić1, Semra Pajazetović2, Arzumana Ožegović1, Almedina Terzić1, Alija Numanović1 Mentor: prof. Ermina Iljazović3, MD, PhD University of Tuzla, Faculty of Medicine, Tuzla, Bosnia and Herzegovina Health Centre Velika Kladuša, Bosnia and Herzegovina 3 Department of Pathology, University Clinical Centre of Tuzla, Bosnia and Herzegovina 1 2

Abstract Cervical cancer is the second most common cancer in women worldwide, with the majority of cases (~80 %) occurring in developing countries. Human papilloma virus (HPV) has been shown to be the precursor of cervical cancer in over 99 % of these cases. Cervical cancer is preventable, but most women in developing countries do not have access to effective screening programs.

The aim of this study was to evaluate women’s knowledge about cervical cancer, Pap smears, and human papilloma virus in relation to their cervical cancer screening behaviour. We used a simple questionary with five questions regarding cervical cancer prevention, Pap test, HPV, and cervical cancer screening behaviour. We conducted a survey by method of random selection. 265 women were examined. Less than 30 % of them never performed a Pap test, 20 % did it within last 5 years, while 45 % did it within last year. Most of them (71 %) know what is HPV and it role in cervical cancer etiopathogenesis. Almost all women thought that cervical cancer could be prevented through regular gynecological examination. Despite of good knowledge and available screening programs, women in our region prevention.

Key words: Cervical cancer, prevention, HPV, Pap test.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

THORACIC INJURIES IN THE PATIENT - A CASE REPORT Nadija Gačo1, Malik Ejubović2 Mentor: Suad Gačo, MD 1 2

University of Rijeka, Faculty of Medicine, Rijeka, Croatia University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina

Abstract Patient N.N. has been admitted as an emergency case to the Department of Surgery, Cantonal Hospital Bihać during the night. He was a pedestrian hit by a car and he suffered severe chest injuries. Clinical examination revealed paleness, somnolence, difficult communication, lack of orientation and apparent intoxication. An urgent laboratory and chest X-ray were conducted. X-ray revealed the presence of blood and air in the left hemithorax. According to the auscultation finding on the left hemithorax which was silent and the presence of emphysema, the thoracic drainage was indicated. After the drainage, 2.5 l of blood and air were evacuated. Consequently the blood pressure fell under 60 mmHg and the patient collapsed. Emergency surgery treatment was indicated and completed. The surgery revealed a lesion of the left lung, pericardium and the heart muscle with the presence of profuse bleeding. Surgical sutures were applied in order to achieve hemosthasis and a double drainage of the chest was conducted. At the same time, resuscitation and blood compensation were applied. Postoperative recovery went with no complications.

Patient was treated with antibiotics and anticoagulant therapy. 11 days after the surgery he was dismissed from the hospital. Patient’s control was planned periodically after 10 days, 3 and 6 months. Findings showed us that recovery went without any further problems and complications and patient returned to his regular obligations. This case report shows us the importance of timely diagnostics of injuries in order to help a patient as well as the importance of cooperation between surgeons, anesthesiologists and other medical staff.

Key words: Chest, injuries, surgery.

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EXPERIMENTAL FIBROSARCOMA IN THE SYRIAN GOLDEN HAMSTER INDUCED BY INOCULATION OF CELL CULTURE BHK-21/C13 AS A MODEL FOR TESTING THE ANTI-TUMOUR EFFECT OF MEBENDAZOLE Pavle Banović1, Ivan Čapo1, Matilda Đolai1, Dušan Lalošević1 University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia

1

Abstract Cell culture BHK-21/C13 today is used for production vaccines against rabies, because of characteristics like spontaneous tumourogenesis it may present reliable model for research in experimental oncology. Mebendazole has been recently proved to be effective against some types of tumours in vivo as in vitro. The aim of this experiment is studying fibrosarcoma inducted by inoculation of cell culture BHK-21/C13 as a model of local tumour for testing antitumor drugs, and investigating potential antitumor effects of Mebendazole on inducted fibrosarcoma. Adult Syrian golden hamsters were inoculated with a suspension of tumourogenic baby hamster kidney (BHK) cells by subcutaneous injection. On day 5 after inoculation, 30 % of LD50 doses for small rodents of mebendazole were given orally for 6 days, and the same dose of mebendazole suspended in 10 % dimethyl sulfoxide were injected intraperitoneally into the one group of hamsters for 3 days. 19 days after inoculation of BHK cells animals were sacrificed and samples of tumour were excised, processed, described using and analyzed via Student`s t-test, histology and immunohistochemistry techniques. Induced fibrosarcoma has shown 100 % expression and virulence. Experimental groups with oral application of mebendazole were shown regressive changes in tumour volume, tumour cell structure and organization, with high cytochrome C positivity, while named characteristic of experimental group with intraperitoneal application of mebendazole showed smallest differences from tumours in control group. Model of inducted fibrosarcoma has been shown as highly reproducible, with local infiltration and high level of expression and virulence. Mebendazole has showed clear antitumor effect via oral application.

Key words: Syrian golden hamster, mebendazole, BHK-21, fibrosarcoma, tumour.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

STATUS OF ASSOCIATED DISEASES, BLOOD FACTORS DEFICIENCY, SPLENECTOMY AND BONE MARROW TRANSPLANTATION IN PATIENTS WITH BETA THALASSEMIA IN DEZFUL IN 2015 Yaghoob Madmoli1, Hamide Mashalchi1 Mentor: Mansoure Hoghooghi, MD Dezful University of Medical Sciences, Iran

1

Abstract Patients with thalassemia usually died due to diabetes or cardiovascular disease. This study was aimed to assess status of diseases associated, lack of blood factors, Splenectomy and bone marrow transplantation in patients with thalassemia. In this descriptiveâ&#x20AC;&#x201C;analytical study data was collected by reviewing of medical records in thalassemia clinic in Dezful. Data were analyzed using SPSS and descriptive statistics. From 195 patients with thalassemia, 13 patients (6.6 %) had diabetes, 11 patients (5.6 %) with hepatitis C, 5 patients (2.5 %) with hepatitis B, 5 patients with (2.5 %) and 4 patients with heart disease and 4 (2%) had aplastic anaemia. Most deaths (62.5 %) were associated with hepatitis C. 81 (41.5 %) and 40 (20.5 %) had been injected Haemophilus influenza vaccine and HBV vaccine. Most blood factors was lack of factor 8 with 29 (14 %), factor 7 in 10 (5 %), von Willebrand factor with 9 cases (4.6 %). 81 (41 %) of the patients had undergone splenectomy surgery. 2 patients (1 %) also had a bone marrow transplantation. Considering low number of diseases diagnosed associated thalassemia and rate of vaccinations, more accurate tests and complete vaccinations are necessary.

Key words: Beta-thalassemia, blood factors, splenectomy, bone marrow transplantation.

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ABO DONOR: BLOOD DONOR MANAGEMENT SYSTEM Semir Hadžić1, Delila Bajrić1, Emir Bećirović1 Mentor: Šekib Umihanić, MD 1

University of Tuzla, Faculty of Medicine, Tuzla, Bosnia and Herzegovina

Abstract Every two seconds, someone, somewhere in the world needs a blood donation. In a well-organized modern health care system, blood is acquired through blood donation centers from healthy individuals older than 18. In some situations ranging from hot summer weather, severe traffic accidents, earthquakes or even terrorist attacks, it may come to a blood supplies deficit. On the other hand, a dose of blood is also needed for complicated surgical procedures, where every patient needs to bring a donor to donate blood in case something goes wrong during the procedure.

Because of that people are sometimes forced to look for blood donors through social networks like Facebook or even local news portals. By combined use of modern technologies of cloud computing and smartphones we are planning to overcome this issue of blood deficit by connecting potential donors, people in need of blood and medical professionals who work in blood donation centers through a unique, self-made, platform which consists of a smart phone application, donor administration & supervision interface for health care institutions, and social media sites which we are planning to use for promoting blood donating. For purpose of developing this system we used most advanced technologies including PARSE, ANDROID, MySQL, CSS3, HTML5 and etc. Till now, we have received massive support from our local community, media and medical professionals.

AB0 Donor was awarded with second place for development of mobile applications with the aim of improving the healthcare system at Open Ideas for Bosnia and Herzegovina competition organized

by Foundation Dokukino. AB0 Donor was nominated for the World Summit Award as the best and most innovative solution in Health & Environment from Bosnia and Herzegovina. If test phase goes well, and if Ministry of Health approves AB0 Donor, we predict that in about 1-2 years the system will become fully operational and in use.

Key words: Blood donating, Mobile Application, Donor management system.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

THE INCIDENCE OF ALCOHOL AMONG HIGH SCHOOL POPULATION IN THE MUNICIPALITY OF ZVORNIK Boris Baković1, Petar Lakić1 Mentor: Bojan N. Joksimović, MD University of East Sarajevo, Faculty of Medicine – Foča, East Sarajevo, Bosnia and Herzegovina

1

Abstract Adolescence is a period of life in which young people should be integrated into the community.

Because of the high frequency of alcohol consumption today, growing up is often followed by vices, of which alcohol is one of the most common. The aim of this research was to identify the determinants of alcohol consumption among high school population in the municipality of Zvornik.

The research was conducted by cross-sectional study among 80 students, from first to fourth grade of High School, who were surveyed via an anonymous epidemiological questionnaire, in April-May 2015. The majority of respondents (70 %) consume alcohol, where fourth grade students (23,8 %) consume it more often when compared to first grade students (15 %). Of the total number of respondents who consume alcohol, 18,8 % consumes it once a week, 22,5 % once a month, while 28,2 % of respondents consumes alcohol less than once a month. Cafes and bars are marked as places where students most frequently can get alcohol (92,5 %). Forty five percent of respondents said that their parents do not allow them to consume alcohol, 43,8 % consume it with their parents permission only on special occasions, while 11,2 % of respondents consume alcohol whenever they want. Our results indicate that the highest percentages of respondents who consume alcohol are older students. The largest numbers of those who consume alcohol do it less than once a month. The encouraging fact is that 45 % of students are not allowed to consume alcohol in their parents’ homes. When taken into consideration that over 92 % of cafes and bars are marked as places where students get alcohol, tightening of law/legal measures would certainly be the most effective way of prevention.

Key words: Alcohol, students, parents, prevention.

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GLIOBLASTOMA MULTIFORME TEN-YEAR SURVIVAL-CASE REPORT Anis Cerovac1, Selma JakupoviÄ&#x2021;2 University of Tuzla, Faculty of Medicine, Tuzla, Bosnia and Herzegovina University Clinical Hospital Center Tuzla, Neurosurgical Clinic, Tuzla, Bosnia and Herzegovina

1 2

Abstract Glioblastoma multiforme (WHO IV) the most common primary brain tumor, it is also the most malignant astrocytoma. Histological findings associated with GBM: gemistocytic astrocytes, neovascularization with endothelial proliferation, areas of necrosis, pseudopalisading around areas of necrosis. Malignant astrocytomas may develop from low grade astrocytomas via dedifferentiation, however they may also arise de novo. Cytoreductive surgery followed by external beam radiation (60 Gy) given concurently with temzolomid chemoterapy has become the standard. The extent of tumor removal and (in an inverse relationship) the volume of residual tumor on post-op imaging studies have a significant effect on time to tumor progression and median survival. Aproximate survival for GBM is < 1 year. Patient aged 49 years comes with a headache, dizzines, unsteadiness when walk, rapid fatigue and dysphasia. Used cigarettes, no comorbidity, the family were not present malignant disease. The neurological findings present facial nerve paresis, central type and left sided hemiparesis more pronounced on the leg. CT brain commands the right temporoparietal exspansive formation in diametar of 7 cm. Present perifocal edema, mass and compressive effect. 10.11.2005. the surgery was performed and the right-sided TP osteoplastic craniotomy, with a maximim reduction of tumor. The postoperative course was normal, the neurological findings persisted left sided hemiparesis more pronounced at hand. Was administered antiepileptic drugs, consulted a physician and begin the physical treatment. Morfological characteristics of the analyzed tumors respond high malignant glioma infiltration- glioblastoma multiforme. Control CT brain after a month of operation commands to the rest of the tumor. Was administered radiotherapy of 60 Gy in the bed of tumor.

After radiotherapy leads to the development postiradiation dermatitis and conjuctivitis. Control CT brain after radiotherapy of the brain commands to less vascularized tumor lesion rest and gliosis postiradiation etiology. First made MRI brain six years after surgery describes that there is no sign of the presence of safe rest/recurrence tumor lesions. The patient comes to regular check-ups, subjectively felt fine, and left sided hemiparesis in regression regularly used antiepileptic drugs. Last control MRI brain 15.08.2015. describes that there are no signs of recurrence/rest of the tumor process. Although the survival rate for patients suffering from GBM less than 1 year, presented patient alive 10 years after diagnosis GBM with Karnofsky/ ECOG state 70-80/1.

Key words: Glioblastoma multiforme, ten year survival.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

ANOREXIA NERVOSA Mirna Selimbašić1, Lejla Mazić1, Adnan Salihović1, Emir Bećirović1, Zihnet Selimbašić2 1 2

University of Tuzla, Faculty of Medicine, Tuzla, Bosnia and Herzegovina University Clinical Hospital Center Tuzla, Department of Psychiatry, Tuzla, Bosnia and Herzegovina

Abstract Anorexia nervosa (AN) is biopsychosocial disorder which appears as a response to developmental challenges and results with weight loss and many of medical complications. Anorexia nervosa is often an eating disorder with adolescent prevalence 0.5 %, and girls - boys ration is 10-20:1.

The beginning of puberty means the end of childhood, and chronologically means period of early adolescence. Puberty and sexual maturation is the most important and often very traumatical biological event in adolescence for the girls and parents as well. Although it is about normal developmental phenomenon, there are significant individual variations in beginning of the form of sexual maturation. From the biological perspective it is about series of complicated, mutually linked changes of neuroendocrine axis. Somatic changes reflect as more or less sudden changes of physical body dimensions with tissue changes, body composition, and development of secondary sexual characteristics. In this work it is shown the case of girl, 11.5 years old with symptoms of anorexia nervosa, which appeared after negative experience, and diagnosed according ICD-10-R criteria for anorexia nervosa.

Key words: Anorexia nervosa, early adolescence.

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EVALUATING EFFECT OF NARINGIN AND SALICYCLIC ACID ON COLON CANCER CELL CULTURE Kübra Gökçe, Pelin Türker, Maide Kasit Mentor: Oğuzhan Doğanlar School of Medicine, Trakya University, Turkey Abstract Colorectal cancer is the 3rd most common cancer in the world. There were nearly 1.4 million new cases diagnosed in 2012. Flavonoids are natural products belongs to plantae and some fungal organisms that have recently been popular for cancer researchers via strong antioxidant, anticancerogen and anti-tumour activities. Naringin is the special chemical compound of flavonoid groups in grapefruit and useful for its antioxidant and immunostimulatory properties. Salicyclic acid is a stress-specific hormone that also has anti-tumour affects on colorectal cancer. Further studies are necessary to define the most effective does and time period. In this study, it is aimed to evaluate the affect of naringin, salicyclic acid and their mixture on colon cancer cell culture and research the gen expressions profiles of apoptosis genes. In this study, HT29 colon cell culture was incubated in 37 oC and %5 CO2. When the cells grow enough salicyclic acid, naringin and their mixtures were applied on them in 11 different doses starting with 800 µM and going half of the previous. In 24th and 48th hours MTT survival test was performed. To see the effect on apoptosis Gadph, p53, Surviving, bcl-2, bax, p27 gene expressions were searched on 24th and 48th hours by using real time PCR. Naringin, Salicyclic acid and their mixture had decreased the number of cancer cells in both 24th and 48th hours. Results in 48th hours were better. None of those caused an increase in number of cells in any dose we applied. In the qRTPCR analysis, while the individually naringin exposure inhibited apoptosis inhibitor genes (BCL2Survivin), combined applications triggered apoptosis in the colon cancer cell lines. Application of naringin and salicylic acid especially in 100 and 200 µM concentration in cancer cells, an increase significantly expressions of P53,BAX and SOD a death receptor and adaptor protein which help to cause cancerous cell death, were increased. In this study, we found out both salicyclic acid and naringin cause a decrease number of colon cell culture. As for their mixture that was tried by us for the first time in literature, it also worked well. We also found out the most effective dose of our materials. Seeing our materials cause an increase in apoptotic gene expressions was exclusive.

We thought that, naringin, salicyclic acid and especially their mixture can be a promising treatment as a supported applications option for colorectal cancer patients in the future.

Key words: Colon, cancer, colorectal cancer.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

INNOVATIVE HEALTH MANAGEMENT SYSTEM Nnamani Kenechukwu Samuel Mentor: C. Naveen, MD Jiangxi University of Traditional Chinese Medicine, China Abstract After close survey on the health sector in Africa and considering the rate at which patients come to the emergency department for little cases, i decided to come up with a system of health management that will help patients take care of there health at home without coming to the hospital.

This health management system is a system where doctors visit there clients at home every week for a routine checkup no matter the health condition of the patient.

Basically this is trying to assure each patient 24/7 standard health except in case of accidents.

Key words: Health, system, innovative.

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SERUM URIC ACID LEVEL AND RED CELL DISTRIBUTION WIDTH IN PATIENTS WITH RHEUMATOID ARTHRITIS Malik Galijašević1, Meis Sammak1, Selma Kulenović1 Mentor: Amela Dervišević, MD University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina

1

Abstract Rheumatoid Arthritis (RA) is a chronic, multisystem disease with an unknown etymology. Patients with RA are at increased risk for morbidity and mortality from cardiovascular disease (CVD). Elevated serum uric acid (UA) level is associated with systemic inflammation, endothelial dysfunction and CVD in the general population. Clinical studies reported that red cell distribution width (RDW), an index of the routine blood cell count, is a potential predictor of morbidity and mortality in a variety of settings, especially in many CVD. However, the role of serum UA level and RDW in a “high-grade” chronic inflammatory disease, such as RA is still unclear. Analysis of the serum UA level and RDW in RA patients was performed. This cross-sectional study included 67 (63 women, 4 men) patients diagnosed with RA according to the 1988 revised American College of Rheumatology (ACR) criteria and 27 age- and sex-matched apparently healthy controls (23 women, 4 men). Disease activity in RA patients was carried out by the disease activity score (DAS). The biochemical parameters were measured by routine laboratory techniques. Concentration of UA was higher in RA patients (251.0 (211.0- 290.0) µmol/L) than in the control group (249.0 (213.75- 316.5) µmol/L), but the difference did not reach significance level (p=0.668). RDW level was significantly higher in RA group (15.4 (14.4-17.0) %) compared to control group (14.5 (13.85-15.25) %) (p=0.008). In RA patients group, statistically significant positive correlation was determined between the RDW and: DAS (rho=0.316; p=0.009), C-reactive protein (CRP) (rho=285; p=0.036) and erythrocyte.

RDW level was significantly higher in RA group compared to control group and showed significant positive correlation with DAS, CRP and ESR. Key words: Uric acid; red cell distribution width; rheumatoid arthritis; cardiovascular disease.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

NEW HOPE FOR LEUKAEMIA: CRANBERRY Burak Isal1 Mentor: Stephano Rivella, PhD 1

Cerrahpasa Medical Faculty, Istanbul, Turkey

Abstract The North American cranberry (Vaccinium macrocarpon Ait Ericaceae) is receiving attention as “prophylactic” food and source of “orthomolecular medicines”. Cranberry fruit is rich in polyphenolic constituents with flavonols, anthocyanins, and proanthocyanidins (PACs) in particular A-type PACs. In contrast, cocoa, grape and many other plant species have B-type PACs. Iron is essential for normal cell function. Many cancer cells exhibit an increased requirement for iron, because of the increased cellular function rate. Our aim in this study is to identify the most effective compound / fraction / combination of PACs with anti-leukaemia activity, and to understand how these effects are related to iron metabolism and ROS. This is a combined in vitro and in vivo study which is trying to show the best dosage and time of treatment for acute leukaemia cell lines. The treatment includes the Pro Antho Cyanidine (PAC) Type A from natural cranberry powder. In the mechanism of our treatment we are discussing about iron and NFk-B pathways. All the experiments has done in New York Weill Cornell Medical Faculty. In this study we have used four different leukaemia cell lines: K-562(CML), KG-1(AML), MV-4-11(BBML), REH (ALL) and used different combinations of C-18 (has 18 % of PACs), Cysticran-40 (has 40 % of PACs), Lori Trimers, and Piperlongumine, and used different concentrations of DMSO as the solvent of the powders and cell medium solutions. We have incubated the cells for 3,6,12,24 and 48hours for different types of experiments and used MOXI-Z cell counting device to determine the cell numbers and viability of different cell lines with different treatments. Also we have used flow cytometry to show Apoptosis, ROS, and Transferrin receptor (CD-71) ratio changes. In the first flow cytometry experiment, we have incubated the K-562 cell line for 3 hours with 60 and 120 microgram of Trimers. In the second flow cytometry experiment, we have used 500 microgram of Trimers, tetramers and cysticran-40 and incubated the K-562 cell line for 3 and 20 hours. According to the results of Apoptosis, Transferrin receptor-1(CD71), ROS and IL-6 receptor (CD126); the effectiveness of the treatment compounds depends on the dosage and duration of treatment. And when we compare the results of each of the compounds, the most effective compound was the Trimer that we have collected from Cranberries. Although we used an A-PAC trimer from peanuts skins (Cinnamtannin B-1) at the higher concentrations, the trimer from cranberries had similar activity at lower concentrations (the structure of one of the cranberry trimers is identical to Cinnamtannin B-1). For future studies, we aim to compare the effectiveness of A-PAC trimers against other resistant and sensitive leukaemia cell lines.

Key words: Leukaemia, cranberry, cells, experiments.

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CERVICAL CANCER: WHAT YOUTH KNOW? Ilvana Rabotić1, Adnan Kudumović1, Haris Beširević1, Medina Hasanović1, Sejfo Begić1 Mentor: prof. Ermina Iljazović Latifagić, MD, PhD2 University of Tuzla, Faculty of Medicine, Tuzla, Bosnia and Herzegovina University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina

Abstract 1

2

HPV infections are overall present in our population and are considered to be the main cause of cervical cancer (CC).In Bosnia and Herzegovina there are no organized screening programmes for CC, there is an increasing effort to improve the knowledge about CC and STDs. A special target group of the campaign is youth. Determine the knowledge of youth at the University of Tuzla about the causes, diagnosis and prevention of CC and whether there are differences in knowledge between students of Biomedical and Technical/Social Science faculties. A prospective study was conducted at the University of Tuzla in the period from 26.03.-08.05. 2015 it included the faculty of: medicine, pharmacy, technology, agronomy, civil engineering and law. The sample included a total of 318 students aged 19-24 years. For the calculation of statistical significance nonparametric and parametric methods were used. Departure from normality was tested using D’Agostino’s K-squared test. Statistical hypothesis were tested on level of α = 0.05, whereby the groups in the sample were considered significant when p was <0.05 or less. Statistical significance is depicted as: (*) p <0.05 (**) p <0.01 and (***) p <0,001. After the examination, we found out that we had an equal gender representation by faculties (p> 0.05), with an exception of Civil Engineering, where the respondents were mostly male (p <0.0001). Regardless of gender and type of faculty (<0.05), the majority of students (75.5%) at the University believed that CC can be prevented. Respondents from the Civil Engineering Faculty showed the least knowledge about HPV (p <0.0001), followed by the Faculty of Technology (p <0.05), with an overall level of knowledge of 43.1 %. Respondents from the Faculty of Agriculture were less informed (p <0.05) about the possibilities of preventing HPV with barrier contraceptives, while the awareness among other faculties was at 54.5%. Knowledge about Pap test was lower by respondents at the Technical Faculty (p <0.0001), while other faculties were at 80.43%. Knowledge about the prevention of CC was at 75.5% (p> 0.05) and was equally represented among all faculties. Knowledge among students at the University of Tuzla on the cause, the measures of protection and prevention of CC is insufficient, due to lack of adequate education.

Key words: Cervical cancer, HPV, students, Pap test.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

PULMONARY OEDEMA IN THE CURSE OF END-STAGE DECOMPENSATED RENAL FAILURE IN PATIENT WITH SYSTEMIC LUPUS ERYTHEMATOSUS Magdalena Czerżyńska1, Emilia Sawicka1 Mentor: Ptaszyńska-Kopczyńska Katarzyna 1

Medical University of Bialystok, Poland

Abstract Systemic lupus erythematosus (SLE) is an autoimmune disease, of unknown etiology, triggering inflammatory processes of tissues and organs. In the most common cases SLE leads to the deterioration of kidney function (lupus nephropathy- LN), which is unfavorable prognostic factor.

A 51 year-old men with advanced SLE and LN, arterial hypertension, ischemic heart disease (IHD) and chronic kidney failure (peritoneum dialysis) was transferred from the Department of Nephrology because of a lung edema in curse of the elevated blood pleasure (216/110 mmHg) and suspicion of acute coronary syndrome (ACS). On admission patient was conscious, RR 160/100 mmHg, HR 75/min. ECG revealed sinus rhythm and lateral wall ischemic changes that were previously seen. Coronarography performed 4 months earlier revealed IHD. On admission echocardiography showed LV regional contractility abnormalities (EF = 28 %), moderate mitral as well as mild aortic and tricuspid valve regurgitation with moderate pulmonary hypertension.

Biochemical tests showed features of V stage kidney failure. Treatment in Emergency Department included intravenous administration of hypotensive drugs, furosemide and nitroglycerine. After the reduction of dyspnea patient was transferred to Cardiac Intensive Care Unit, where hypotensive and IHD pharmacotherapy was continued. Further analyses excluded exacerbation of IHD. After normalization of blood pressure, mainly caused by acutely decompensated renal failure and stabilization of the general condition, patient returned to the Department of Nephrology for further treatment. Patients with many concomitant diseases present a real challenge. Medical Team and interdisciplinary collaboration is prerequisite to an adequate treatment of the patient.

Key words: Pulmonary oedema, renal failure, lupus erythematosus, coronary syndrome.

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BEE POLLEN IN MEDICINE Miroslaw Slawinski, Robert Chudzik, Sylwia Korzeniowska, Emilia Kulak-Janczy, Michal Zarobkiewicz Mentor: Ewelina Wawryk-Gawda, MD; Barbara Jodlowska Jedrych, MD, PhD Abstract Bee pollen is the dust like substance containing male reproductive cells of flowering plants which enables pollination. It is collected from flowers by bees then it is formed in the ball like masses and transported to the hive. Bee pollen is a source of protein, fat, minerals, hormones, vitamins and organic acids. Medicine and scientific literature gives little attention to its medical benefits. The aim of this paper is to demonstrate the medical benefits of bee pollen and the advantages of using it in medicine. Scientific publications available in PubMed database served as research materials.

Analysis was conducted on ten articles that strictly corresponded to the subject of bee pollen usage in medicine. Dates of publications varied from 1990 to 2013. Contemporary medicine not only gives the possibility of medical treatment but also uses health promotion. Dietary supplements, antibiotics and other medicines are of great importance as it comes to treatment. However, usage of the newest chemical substances in treatment leads to destruction and impairment of the organism. Nowadays, people are more aware of the importance of a healthy life style. Due to this fact, patients approve positively natural supplementation in treatment. Flower pollen, collected by worker bees, contains digestive enzymes from their bodies. As the bee pollen is transported into the hive it is taken out by the bee keeper using sweeper machine. Taking bee pollen has many beneficial effects on oneâ&#x20AC;&#x2122;s health for example it lowers the cholesterol or regenerates the liver. What is more, it also has anti-depressing, antitoxic and antibiotic qualities. The awareness of medical benefits of bee pollen is a crucial achievement in treating 21st century diseases and supporting the treatment of other illnesses. Bee pollen is a source of many nutritious elements that support organism regeneration.

Key words: Bee pollen, treatment, dietary supplements, phytotherapy.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

THE INFLUENCE OF STRESS AND NICOTINE ON CONCENTRATION OF ZINC, COPPER AND IRON IN ANIMALSâ&#x20AC;&#x2122; LIVERS Miroslaw Slawinski1, Daniel Piatek1, Karolina Gasinska1, Ewelina Kopcial2, Barbara Budzynska3, Grazyna Biala3 Mentor: Anna Boguszewska-Czubara1 Department of Medical Chemistry, Lublin, Poland Department of Food and Nutrition, Lublin, Poland 3 Department of Pharmacology with Pharmacodynamics, Medical University of Lublin, Lublin, Poland 1

2

Abstract Stress is an unavoidable life experience, and chronic stress has been related with deregulation of many biological and physical processes. People in stress often smoke more as they feel more relaxed then. It is strictly psychological impression, because in fact nicotine acts to activate biochemical effects of stress hormones on homeostasis of the whole organism. Microelements in tissues play an important role for normal course of physiological reactions. Therefore the aim of our study was to evaluate changes in zinc, copper and iron liver homeostasis in animals subjected to chronic unpredictable stress (CUMS) procedure and administrated nicotine additionally in comparison to unstressed saline treated mice. The experiment was carried out on male Albino Swiss mice, which were divided into mice subjected to CUMS procedure and unstressed mice.

Nicotine at the doses of 0.1 and 0.5 mg/kg b.w. was administered 30 min before CUMS procedure as well as to unstressed control mice for the last seven days of experiment in treatment groups and saline in control groups. Zinc, copper and iron contents in liver of these animals were evaluated using flame atomic absorption spectrometry after sample mineralization by ashing at 450°C in a muffle furnace. The metal content was assayed directly in Thermo Elemental Solaar M5 spectrometer. We have observed decrease in zinc and iron liver content in stressed mice in comparison to unstressed animals and the effect was additionally potentiated by administration of nicotine. In case of copper concentration in liver we observed slight increase in stressed animals versus unstressed mice. Similarly nicotine caused additional increase in the content of copper.

Our studies revealed that stress procedure influences microelements homeostasis in liver. Also nicotine administration caused further imbalance within Zn, Cu and Fe content in liver. Further experiments concerning proper supplementation of the elements during chronic stress situations are required.

Key words: Stress, nicotine, Zinc, Copper, Iron.

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ACQUIRED HEMOPHILIA IS EXTREMELY HARD TO BE DIAGNOSED IN SURGICAL PATIENTS Robert Chudzik1, Miroslaw Slawinski1, Katarzyna Jarosz1 Mentor: Pawel Rybojad, M.D. Ph.D. Habilitated 1 Students Scientific Association at the Department of Thoracic Surgery Medical University of Lublin, Lublin, Poland

Abstract Acquired haemophilia is a very rare haemorrhagic diathesis caused by appearance of antibodies against factor 8th. The possible initiators are: autoimmune diseases, confinement and cancer; however in many cases etiology is idiopathic. Extension of APTT time with normal INR score is a characteristic feature. Surgical patients with previously normal coagulation tests are extremely hard to be diagnosed. Caucasia male aged 54 was admitted to hospital because of complicated pneumonia. CT scans revealed pyothorax and the patient underwent decortication.

Due to ventilation insufficiency patient was transferred to ICU. On the first postoperative day the patient’s state normalized and he was extubated. On the third postoperative day decrease in patient’s blood count was notified. CT revealed hematoma in pleural cavity and patient underwent urgent rethoracotomy. The source of bleeding wasn’t found. Due to problems with controlling of the haemorrhage pleural tamponade with the use of surgical gauze was performed. On the following days bleeding to pleural cavity continued, demanding consecutive gauze packing and blood transfusions. Laboratory tests showed significant increase of APTT time (143,4s) decrease of 8th factor activity (4%) and presence of VIII factor inhibitor (7,5jB), which enabled to diagnose acquired haemophilia. Patient was administered NovoSeven (Novo Nordisk) 90µm/kg every 3 hours and Solumedrol (Pfizer Europe) 160mg/day. The treatment was continued and activity of 8th factor was systematically increasing while count of antibodies decreasing. On the twentieth postoperative day final closer of thoracostomy was performed. After several thoracotomies, blood substitutes’ transfusions, administration of 366mg of Novoseven, the patient finally recovered and was discharged home in fairly good condition. The cause of acquired haemophilia remains uncertain. Patient had medical history of thyroid gland cancer, severe lung inflammation which led to pyothorax, surgery and sepsis and additionally multiple blood substitutes’ transfusions. Surgical, haematological and intensive care treatment enabled the final success.

Key words: Acquired haemophilia, bleeding, thoracostomy.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

THE EFFECT OF INTERFERON THERAPY ON MACOLOPATHY IN BEHҪET PANOVEITIS Arjana Zerja¹, Egzona Sulollari¹, Berta Sulollari1, Julinda Jaho2 Mentor: Ilir Arapi2, MD, MSc, PhD 1 2

University of Medicine, Tirana, Albania Department of Ophtalmology, UHC “Mother Theresa”, Tirana, Albania

Abstract To report a case of Behçet’s panoveitis and bilateral inflammatory maculopathy which was refractory to conventional immunosuppressive therapy but responded well to long-term treatment with the Interferon alpha 2a (IFN-α₂ₐ). Reporting the effect of subcutaneous IFN-α 2a therapy for 26 weeks in a case of Behçet’spanuveitis and bilateral inflammatory maculopathy. The patient’s best corrected visual acuity was monitored, and biomicroscopic and fundus examinations as well as macular thickness map analysis by optical coherence tomography were performed. The resolution of inflammatory signs on biomicroscopic and fundus examinations as well as on optical coherence tomography macular thickness analysis reports. No significant systemic side effects were noted. Long-term therapy of at least 6 months with IFN-α₂ₐ is effective and safe for refractory inflammatory maculopathy in Behçet’s disease. We report this case to contribute to thepreviously reported cases showing the beneficial effect of long-term IFN-α₂ₐ therapy for Behçet’spanuveitis.

In conclusion, early initiation of IFN-α₂ₐ therapy for inflammatory maculopathy in Behçet’s disease preserves and improves visual acuity.

Key words: interferon therapy, macolopathy, Behҫet panoveitis.

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CLINICAL FEATURES AND TREATMENT STRATEGIES OF PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA: A MULTICENTER RETROSPECTIVE STUDY Koray Demirci1, Mehmet Ali Erkurt1, Serdar Şıvgın1, Muhammet Maden1, Hakan Ismail Sarı1 1

Trakya University, Medicine Faculty, Istanbul, Turkey

Abstract Primary central nervous system lymphoma is a rare, highly malignant disease with poor prognosis.

The current knowledge about the disease is mostly gathered from prospective clinical trials and the optimal treatment modality is still a matter of debate. In this study it is aimed to acquire more information about the clinical features and the responses to different treatment modalities.

The archives in centres of Trakya University Hospital, İnönü University Turgut Özal Medical Centre, Pamukkale University Hospital and Erciyes University Hospital researched retrospectively.

Demographic, treatment and survival data were retrieved and their statistical analysis was performed. As descriptive statistics number and percentages, arithmetic mean ± standard deviation, median (maximum-minimum) were used. Survival analysis was performed using Kaplan- Meier method. Median age of patients at diagnosis was 53 and out of 28 patients 15 (53.6 %) of them were male. As the symptoms of the disease 18 (66.7 %) patients presented headache, 15 (53.8 %) presented focal deficit. As initial treatment 26 (92.9 %) patients received chemotherapy, while 19 (67.9 %) patients were treated with surgical resection and the median overall survival time was 7 months. Achieving complete remission as response to the initial treatment is associated with an improved overall survival. Other survival analysis including the impact of all initial treatment methods on overall survival was statistically insignificant.

Key words: Non-Hodgkin Lymphoma, remission, chemotherapy, radiotherapy.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

In the meantime, some interesting facts about MediCon 2015...

First congress of biomedicine in Bosnia and Herzegovina was precisely at the Medical faculty Tuzla...

Around 31.536.000 seconds, 525.600 minutes, 8.760 hours, 365 days, 12 months of active work...

Almost 1000 e-mails...

About 100 meetings...

Even more phone-calls...

Over 30 members of the Organizing Committee...

Have lead to: Over 300 registered participants...

More than 60 works...

From 20 countries...

From 3 continents...

And much more... On our Medical faculty, in our city Tuzla, in our country Bosnia and Herzegovina...

MediCon 2015.

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Poster presentations

International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

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GENETIC PREDISPOSITION TO HEART DISEASE Ahmed Osmanović1, Adnan Fojnica1 Mentor: Damir Marjanović, MD, PhD 1 International Burch University, Department of Genetics and Bioengineering, Sarajevo, Bosnia and Herzegovina

Abstract Heart disease is the leading cause of death and a major cause of disability in the Federation of Bosnia and Herzegovina (FBiH) and situation has become even worse in the post war period. Some reasons for this are: unhealthy diet, obesity, high cholesterol, alcohol usage, smoking etc., and by avoiding these factors we can be able to escape heart disease. Beside these, there are genetic or inherited factors that are causing changes in genes that are passing from generation to generation and from which we cannot escape. The main objective of this small student’s case study is to show that genetic predisposition i.e. increased likelihood of developing a particular heart disease could be based on a person’s genetic makeup. For this purpose, we analyzed 6 families per two and three generations in the FBiH by using pedigree- family tree that shows who has and who does not have the condition of interest. As a result of our small case study we got that most genetic heart conditions could be inherited in an autosomal dominant pattern. The autosomal dominant pattern means that phenotype tends to appear in every generation of pedigree and affected progeny includes both males and females. In the end, our results cannot be validated without more study, but they can be used as basic hypothesis for further research.

Key words: Heart disease, genetic predisposition, pedigree, autosomal dominant pattern.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

COMORBIDITY: CARDIOVASCULAR DISEASES AMONG PSYCHIATRIC PATIENTS Martina Ilinić1, Dino Belić1 MD, PhD, Dunja Degmečić MD1,2 1

University J.J.Strossmayer, Faculty of Medicine, Osijek, Croatia University Department of Psychiatry, University Hospital Centre Osijek, Croatia

2

Abstract Patients with mental illness are more likely to suffer from cardiovascular diseases, while mental status can affect cardiovascular system. Depression and worthlessness as well as anxiety can largely increase risk of a heart attack, and some patients are more likely to ignore their medication plan. Our goal is to determine a proportion of psychiatric patients with cardiovascular comorbidity, isolate the most common cardiovascular and psychiatric disease and most frequently used medications. A retrospective study was conducted at the University Department of Psychiatry, University Hospital Centre Osijek. Among all of the patients hospitalized during 2014, only patients with cardiovascular comorbidity are isolated and divided regarding age, sex, marital status, working status and length of psychiatric treatment. The medication usage, cardiovascular and psychiatric diagnoses are also considered. Out of all the patients hospitalized during 2014 at the University Department of Psychiatry, University Hospital Centre Osijek, 13,08 % of them also have cardiovascular comorbidity. The most common mental disorders are Mood (affective) disorders among 32,88 %, followed by Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders (18,49 %), while the most common cardiovascular disorder is Hypertension in 87,67 % subjects, followed by Varicose veins (2,05 %). The average age of patients is 59,06 years and most of them are retired (56,85 %). More than half of our subjects are men (59,59 %), and 63,69 % are married. The most used medications are antihypertensives and antidepressants, while average length of psychiatric treatment is 10,28 years. The most common diagnoses are Affective disorders and Hypertension. More than half of subjects are men, while the average age is 59 years. The most used medications are antihypertensives and antidepressants.

Key words: Comorbidity, cardiovascular disease, mental illness, retrospective study.

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MULTIDISCIPLINARY APPROACH TO PALLIATIVE CARE OF PEOPLE WITH ALS Emir Bećirović1, Majda Bešlagić1 1

University of Tuzla, Faculty of Medicine, Tuzla, Bosnia and Herzegovina

Abstract Amyotrophic lateral sclerosis (ALS), also known as the Lou Gehrig’s disease, is a progressive neurological illness that affects the central and the peripheral motor neuron. When the impulses cease to reach the muscles due to the decay of the motor neurons, atrophy of muscles appears as a sign of lesion of the central motor neuron and fasciculation of the skeletal muscles due to the lesion of the peripheral neuron. Other symptoms are consequences of these changes and include muscle weakness, cramping, slurred/ nasal speech, and difficulties in swallowing and breathing.

The function of the bulbar musculature and sphincter remains the same, so as the ability to recognize touch, sound, smell, and taste. Mental abilities and consciousness are undamaged. The probability of being diagnosed with this disease is 1-3,9 cases per 100 000 people. Public Health Services Institute of Tuzla Canton does not have the data of the number of those suffering from Amyotrophic lateral sclerosis because the legal record on the level of primary health care places it in the group of secondary diseases of the nervous system. During 2014 on the neurology section of UCC Tuzla eight hospitalizations of ALS patients have been registered. The frequency of the illness rises with aging. The aim of this work is to show the characteristics of the specialist palliative medicine as a comprehensive approach to the illness and the patient with the assistance of a multidisciplinary team. In this work we will point out the deficit of hospital capacity, which means there are only twenty beds in the Center for palliative care and twenty more on the multidisciplinary intensive care section in our Canton*, absence of specialized institutions for quality palliative care, while the existing private capacities are quite often unreachable to most of the families because of the high prices. The conclusion of the work is that the palliative care is the only way in which the patient will have a better life, even though there is a lot of effort put into raising public awareness about this disease and finding a cure for ALS. * The number of accommodating capacities on the Pediatric clinic is shown and it cannot be shown separately Key words: ALS, palliative care, Tuzla Canton, multidisciplinary approach, neurological patients.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

CARDIOPULMONARY BYPASS Valerija Vukosavljević, Amar Skakić Mentor: Almir Osmanović University of Tuzla, Tuzla, Bosnia and Herzegovina Abstract Cardiopulmonary bypass, as a synergetic apparatus, combining the latest trends in mechatronics and cardiology, can be considered as a revolutionary medical appliance that changed and saved countless lives. Continuous development of technology and medicine delivers an exceptional and complex system of mechanical components that act together in order to maintain the function of the heart and the lungs while a cardiac surgical procedure is being performed. This paper will present all the vital components of the cardiopulmonary bypass, the mechanical and medical principles that preside over them and the conduct of the cardiopulmonary bypass: preparations, procedures and management before, during and after the procedure which is being performed.

Key words: Cardiopulmonary Bypass, Cardiac Surgery, Technology, Mechatronics.

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LONGTERM COMPLICATIONS OF FOREIGN BODY ASPIRATION Majda Bešlagić1 1

University of Tuzla, Faculty of medicine, Tuzla, Bosnia and Herzegovina

Abstract Foreign body aspiration can cause a wide spectrum of changes, from slight nuisance to sudden death. Mortality caused by foreign bodies in the respiratory tract is around 1 per cent. Foreign bodies in the bronchi are the most often case with children, and are usually organic: various seeds, bones; theinorganic bodies are rare: metal nails, money, plastic and rubber parts of toys. A good property of metal foreign bodies is that they are projected on the X-ray lung recording, while others remain undetected unless a brochoscopy is done. The body found in the bronchi gives a clinical image of obstruction of those respiratory passages with complications such as emphemysema, atelectasis, bronchopneumonia, and even lung abscess. Chronic foreign body of the bronchi is every foreign body lingering in the bronchi for longer than a month, causing granulation tissue and purulent inflammation, and can cause permanent changes of the bronchi such as stenosis, ulceration and bronchiectasis. Some chronic foreign bodies can be „tolerated“for many years, e.g. coins, while the organic foreign bodies will cause complications quite sooner. Medical treatment implies extraction of the foreign body, usually rigid for children and flexible bronchoscope for adults, while a small percentage of chronic foreign bodies are solved by operation. The aim of this work is to demonstrate that every nontreated long-lasting inflammation of the bronchi, lungs or pleura, is an indication for bronchological examination, because of a suspect foreign body among other things. A case of complications of foreign body aspiration present in the bronchi for almost twenty years is shown. At the age of seven, a boy inhaled grass that was not found via bronchoscopy. After years of recurrent bronchopneumonia, failed treatments and worsening of patient’s state due to chronic inflammated bronchiectasis, a lobectomy of the lower right lobe of the lung is done at the age of twenty-seven. During the histopathological examination, in the lumen of the bronchi dilapidated material is found, i.e. destructed foreign body in which the contours of plant cells can be seen.

Key words: Foreign body, aspiration, bronchoscopy, complications.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

THE MEASUREMENT OF TROPONIN IN PATIENTS WITH DIABETESPREVENTION OF HEART ATTACK Marin Lakić1 1

University of Mostar, Faculty of Medicine, Mostar, Bosnia and Herzegovina

Abstract Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. Myocardial infarction (MI), also known as ˝ heart attack˝ is the irreversible necrosis of heart muscle. DM is considered to be the third most common cause of myocardial infarction, because of the negative effect on the macro and micro circulation. The aim was to show that patients with diabetes, with regular controls and measurement of troponin in the blood can affect, and most importantly, prevent the occurrence of myocardial infarction. The analysis included 160 patients with Type 2 diabetes with stable ischemic heart disease, none of them had an IM, but some of them did revascularization. Patients were divided into two groups: 76 (with successful revascularization) and 84 (without revascularization). We measured troponin levels in both groups of patients. The measurements are not performed in all 160 patients, but we chose 10 patients with approximately equal occlusion of the coronary blood vessels and compared the results with 10 patients who did revascularization. 10 patients (45-60 % occlusion) who have not done revascularization showed the value of troponin between 0.3 and 0.8 µg/L. In the control group, whose patients did revascularization (45 – 60 % occlusion), only one showed the value of troponin over 0.1 µg/L and 9 of them showed values in the normal reference interval (<0.1 µg/L).

While it is expensive to do this research, if all patients suffering from DM (type 2) control their troponin, may prevent the progression of the atherosclerosis and therefore myocardial infarction.

The disadvantages are the short period of time and the expense of research. Although coronary angiography has a great advantage and superiority, I prefer the measurement of troponin as one quick and non-invasive method.

Key words: Diabetes mellitus, Myocardial infarction, troponin.

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SKELETAL MUSCLE HEART GRAFTING Haris Ä&#x152;ampara1 Mentor: Almir FajkiÄ&#x2021;, MD MSc. University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina

1

Abstract The idea behind this paper was to review how far medicine has come in replacing scarred heart muscle tissue with skeletal muscle and having them beat syncronously, either through the surgical transplant or through stem cells injection. As the studies we reviewed happened fifteen years ago, our goal is to review previous accomplishments in this area and to inspire the scientists of today to look into the challenges that could not have been resolved fifteen years ago. The main problem that scientist encountered in the past was inability to entice rhabdomyocytes in the graft to beat syncronously with the heart muscle. Other problems they have encountered were: graft rejection and excessive scarring. We analyzed current accomplishments in this field by methods of analysis and synthesis. We analyzed multiple methods of achieving heart grafting with an auto transplant, skeletal muscle stem cells, and with latest achievement from 2012, by using cardiomyoblasts.

We found that using an auto transplant leads to an excessive graft growth, with an inability of graft to contract. Using the rhabdomyoblasts leads to formation of stable graft with a maximum number of synchronized graft myocytes not exceeding 10 % in adults and 25 % in infants, while using cardiomyoblasts is 100 % effective it is expensive, still experimental and cost inefficient.

Currently using skeletal muscle in heart grafting is improbable, impractical and ineffective. The future research should be focused on finding a way to transfer action potential from heart muscle to every myocyte in the graft. Achieving this would save a lot of patients in decompensated chronic heart failure and lead to significant improvement of their quality of life.

Key words: Heart grafting, rhabdomyoblast grafts, post infarctal heart treatment, heart function restoration.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

EVALUATION OF THE EFFECT OF BODY MASS INDEX AND WAIST CIRCUMFERENCEC ON BLOOD PRESSURE IN ADOLESCENTS Anita Risonjić1, Hana Smajlović1, Nudžejma Veladžić1, Ena Šaranović1, Nesina Avdagić1 Mentor: Amela Dervišević, MD, MSc. 1

University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina

Abstract Obesity is a growing problem in developed countries and is likely a major cause of the increased prevalence of high blood pressure in adolescents. Evaluation of the effect of body mass index (BMI) and waist circumference (WC) on blood pressure (BP) in adolescents. Our study included 61 (26 male; 35 female) randomly selected adolescents, average age 14.9±4.0 years. All of the study participants completed self-reporting questionnaire about their general health and lifestyle habits. Anthropometric parameters such as body weight and height, waist circumference (WC), hip circumference (HC) and waist-to-hip ratio (WHR), were measured for every study participant. Body mass index (BMI) was determined as weight (kg) divided by the square of height in meters (m2).

The prevalence of obesity and overweight was determined on the basis of percentile values of BMI for age and sex. Blood pressure was measured by the auscultatory method. Statistically significant difference in body height, body weight, WC and WHR was recorded between male and female study participants. Most of the adolescents, 52 (85.3 %), had a BMI within the normal range, 1 (1.6 %) adolescent was undernourished, 6 (9.8 %) were overweight, while 2 (3.3 %) adolescents were obese. The average values of BP were 122±14.4 mmHg for systolic and 69±9.5 mmHg for diastolic blood pressure. A significant positive correlation was found between BMI and systolic blood pressure (r=0.50; p<0.001) and also between WC and systolic blood pressure (r=0.31; p=0.015). Results of our study show that adolescents with increased values of BMI and WC have a higher risk of developing hypertension.

Key words: Hypertension, adolescents, obesity, Body mass index (BMI).

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IMPACT OF THE GRASPING TEST ON WOMEN’S CARDIOVASCULAR SYSTEMS, AND THE POSSIBILITY OF REPLACEMENT FROM ORTHOSTATIC TOLERANCE TEST Bartłomiej Kulesza1, Piotr Kulesza1, Monika Kulig1, Karolina Załuska1, Tomasz Sawicki1 Mentor: Adam Nogalski 1

Medical University of Lublin, Lublin, Poland

Abstract Impact of the grasping test on women’s cardiovascular systems, and the possibility of replacement from orthostatic tolerance test. The aim of this study was to test the impact of grasping test on women’s cardiovascular system and possibility of replacing the orthostatic test. 21 volunteer female students were examined, and their physiological parameters - their systolic (SBP) and diastolic blood pressures (DBP), and their heart rates (HR) - were compared. We found that the Orthostatic Tolerance Test (changing the position of the body from recumbent to upright) and the Grasping Test induced meaningful but similar changes in the functioning of the women’s cardiovascular system. The results confirm that there were significant similarities between the cardiovascular system measurements as produced through the Orthostatic Tolerance Test and the Grasping Test. The possibility of introducing the procedure into clinical practice is a crucial factor for continuing our research in the wider population.

Key words: Cardiovascular systems, orthostatic tolerance test, women.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

THERAPEUTIC OPTIONS IN THE TREATMENT OF EPILEPSY Kristina Duspara1, Mensura Aščerić2 University of Tuzla, Faculty od Pharmacy, Tuzla, Bosnia and Herzegovina University of Tuzla, Faculty od Medicine, Tuzla, Bosnia and Herzegovina

1 2

Abstract Epilepsy is a disorder characterized by sudden intermittent and paroxysmal change in motor activity, sensibility and autonomous functions caused by abnormal hyper-synchronized and electro-chemical hyperactivity of the group of neurons. Intracranial causes of epilepsy are: trauma, tumor changes, hereditary diseases, malformations; whereas extracranial causes: electrolyte and metabolic disorders. The misbalance of excitation and inhibition (usually the inhibition decrease or excitation increase) leads to epileptic discharging. The aim is to investigate the commonly used antiepileptic drugs in UKC Tuzla in the period from 1.1.2015. do 31.3.2015. A special emphasis is based on the newer generation antiepiletic drugs due to their efficiency and delicacy during use. In a sample of 60 patients, aged 16 to 68; both sex, the effectiveness of the therapy was assessed on the basis of the number of attacks in the last month before the survey. The data analyzed were obtained by examining the specialist are patients. Under the therapeutic coverage of 43.5 % of patients had a crisis of consciousness (mostly generalized seizures). The percentage of representation of 33.8 % of respondents used the antiepileptic monotherapy, while 66.2 % used a combination therapy. Over a period of a month to the last control 6 patients (10 %) under antiepileptic monotherapy new generation did not have seizures, 3 patients (5 %) out of 17 (28.33 %) the older antiepileptic monotherapy had an epileptic seizure. The most commonly used newer antiepileptic drugs were: lamotrigine (15); levetiracetam (12); oxcarbazepine (12); topiramate (4); gabapentin (1); while 15 patients used valproic acid in combination with newer antiepileptic carbamazepine and 7 patients in the same combination. In 15% of patients diagnosed than epilepsy and other diseases (hypothyroidism, anemia, cancer, Parkinson’s disease, hepatic lesions, subdural fibrin etc.). Based on the data of the residence most patients (60 % women) in the area of ​​the city of Tuzla, at least in the area of ​​Doboj Istok and Gradačac. Using EEG and MRI image with the history it is possible to diagnose epilepsy. Adherence of patients when using AEDs is of crucial importance for the stability of the disease. The new-generation antiepileptic drugs have proven their effectiveness given the absence of seizures when using them.

Key words: Epileptic seizures, hyperactivity of neurons, the new generation antiepileptics, generalized seizures.

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CUTANEUS ADVERSE DRUG REACTIONS: CLINICAL PATTERNS AND CAUSATIVE AGENTS IN TUZLA CANTON Azra Husić1, Aida Avdić1, Azra Hadžigrahić1, Nermina Hadžigrahić1 University of Tuzla, Faculty of Medicine, Tuzla, Bosnia and Herzegovina

1

Abstract Adverse drug reaction (ADR) represent any effect of a drug that is in addition to its intended effect, especially an effect that is harmful or unpleasant when applied in regular therapeutic, diagnostic or profilactic doses. Most common drugs that cause cutaneus ADR are: antibiotics, analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs), antiepileptics, iodine contrasts, anticonvulsants and antithyroid drugs. The aim of this research is to study the different clinical spectrum of cutaneous ADR and to determine the causative drugs. This was a retrospective study looking at all patients who were admitted with a diagnosis of a cutaneous drug eruption at the Dermatovenerology Department, University Clinical Center Tuzla, during the period 2011-2014.

Data included patient demographics, clinical pattern and a detailed drug history. A total of 129 patients with cutaneous ADR were enrolled in the study. The most common types of cutaneous ADR patterns were maculopapular exanthema (57.4 %), urticaria (29.5 %) and erythema multiforme (6.2 %). The drugs most often incriminated for the various cutaneous ADR were antimicrobials (35.7 %), NSAIDs (34.1 %) and anticonvulsants (11.6 %). NSAIDs were implicated in 39.2 % of maculopapular exanthema. Penicilins accounted for 50 % and NSAIDs for 37.5% of erythema multiforme. Urticaria was caused mainly by penicilins (31.6 %) and NSAIDs (23.7 %). Although ADR are often ignored and considered less relevant, it is very important to know that skin is the most common localization of side effects for many different type of drugs. Also, beside harmless reactions, many drugs can cause serious problems and even lead to death.

Key words: Drug, adverse reaction, skin.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

ECG CHANGES IN LONG-TERM CANNABIS SMOKERS Alma Mudrov1 University of Tuzla, Faculty of Pharmacy, Tuzla, Bosnia and Herzegovina 1

Abstract Cannabis (marijuana) is among the most widely used of all psychoactive drugs. Marijuana is known to have various effects on almost every organ system in the body, including the cardiovascular system. Studies have shown that cannabis consumption is associated with acute cardiac events but a lot less is known about its chronic use and long-term effects. Since its use has long been illegal in most countries, large-scale studies have been difficult to manage. Given the expanding use of medicinal marijuana and the fact that legalization of recreational use is rising, lack of information about its side effects raises the potential for concern. The main objective of this work is to study the effects long-term cannabis consumption might have on the heart. Electrocardiogram was performed on thirty-five healthy volunteers aged twenty to twenty-seven. Experimental group consisted of seventeen marijuana smokers. All of them have been smoking marijuana regularly for at least three years. Control group contained eighteen volunteers who never used cannabis in any form. None of the volunteers have used other psychoactive substances nor have they had history of heart disease. Following parameters were compared: rhythm, frequency, P wave height, PQ interval, ventricular activation time, QT interval duration, corrected QT interval duration, T waves, ST segment abnormalities, J point abnormalities. The data retrieved from ECGs was statistically analyzed using chi-square test. The results indicate that there are no statistically significant differences between these two groups. Possible explanation for these results would be that cannabis causes no harmful effects in people who have no history of heart disease, so from this aspect its use could be safe. This finding deserves to be further analyzed using larger groups. There are indicated needs for marijuana treatment, but the harms and the risks are yet to be characterized.

Key words: ECG, cannabis, heart, cardiac effects.

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INFLUENCE OF IODINE-131 FROM NEVADA´S AND GLOBAL NUCLEAR FALLOUT ON DEVELOPMENT OF THYROID CANCER IN LOCAL POPULATION Adnan MujanoviÄ&#x2021;1 University of Tuzla, Faculty of Medicine, Tuzla, Bosnia and Herzegovina

1

Abstract Nevada test site (NTS) was used for surface and above-ground nuclear testing from early 1951 through mid-1962. Thyroid doses were ascribed mainly to consumption of foodstuffs contaminated with iodine-131(I-131). Thyroid doses were estimated as a function of age at exposure, region and dietary habits. Usual thyroid does was estimated to be 0.12 Gy, with a maximum of 1,4 Gy in the area of 300 kilometers from the NTS, including Arizona, New Mexico, Nevada and Utah.

To show how radionuclide I-131, from NTS and global fallout, affected rates of thyroid cancer on the local population and its consequences today. Data review presentation obtained from the professional literature. Relatively little of the information on radiation-related risk comes from studies of population exposed mostly or only to radioactive fallout, because useful dose-response data are difficult to obtain. In 1997 National Cancer Institute (NCI) evaluated the number of thyroid cancer cases from the fallout, measuring the doses of I-131 from NTS and estimated about 49,000 fallout-related cases. Adding global fallout distribution, number of cases rose for 10%, which in total gives us 54,000 cases. Thyroid internal dose from the NTS of I-131 of 5 mGy was much higher than the internal dose from any other radionuclide like Cs-137, Sr-90, Mn-54, I-131, etc and from the external exposure of 0.02 mGy. On the other hand internal thyroid does from the global fallout of I-131 of 0.4 mGy was higher than internal dose of other radionuclides but was smaller than the external dose of 0.7 mGy. With that we can conclude that radiation effects of I-131 from global fallout have an equal effect or at least two-thirds of the effect of internal radiation. Even though fallout occurred 50 to 60 years ago, only about half of the predicted cancers (27,000) from the exposure of I-131 which originated from the NTS and global fallout have expressed so far, half of them being fatal.

Key words: Thyroid cancer, radioactive fallout, iodine-131, Nevada nuclear-bomb tests.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

HYPERTENSIVE DISORDERS OF PREGNANCY: PREECLAMPSIA AND ECLAMPSIA AND NEUROLOGICAL COMPLICATIONS Lejla Mazić¹, Arnela Muharemović¹, Adnan Salihović¹, Mirna Selimbašić¹, Hidajet Rahimić² ¹University of Tuzla, Faculty od Medicine, Tuzla, Bosnia and Hercegovina ² Health Center Živinice, Živinice, Bosnia and Hercegovina Abstract The main purpose of this work is to show detailed analysis of hypertensive disorder of pregnancy and neurological complications that can occur during the preeclampsia or eclampsia. Hypertension is the most common medical problem encountered during pregnancy, complicating 2 - 3 % of pregnancies. Hypertensive disorders during pregnancy are classified into 4 categories: 1.)

Chronic hypertension, 2.) Preeclampsia - eclampsia, 3.) Preeclampsia superimposed on chronic hypertension, 4.) Gestational hypertension. Preeclampsia is multiorgan disease process of unknown etiology characterized by the development of hypertension and proteinuria after 20 weeks of gestation. There are various theories of pathogenesis, but the most popular theory is immunologic theory. Symptoms are: markedly elevated blood pressure measurements taken at least 6 hours apart, proteinuria ≥ 5g/24 hours and manifestations of end - organ disease: oliguria, pulmonary oedema, cyanosis, epigastric pain, thrombocitopenia or fetal growth restriction. Neurological changes are common and include headache, blurred vision, scotoma, hyperreflexia and rarely cortical blinds and the generalized seizures of eclampsia. Eclampsia may occur postpartum when greatest risk of postpartum eclampsia is within the first 48 hours. Eclampsia is the complication of preeclampsia and it includes the development of convulsions in a preexisting preeclampsia or it may appear unexpectedly in a patient with minimally elevated blood pressure and no proteinuria.

The exact cause is unknown but cerebral ischemia, oedema and changes of blood vessels endotel were suggested. Generalized vasculopathy, vasospasm and disseminated intravascular coagulation characterize the disease process outside the brain. Neurological complications of eclampsia are usually transient and cease after the fetus is delivered. The most common symptoms are: generalized epileptic seizures, loss of the consciousness, agitation, headaches or muscle pain. Most common neurological complication is massive cerebral hemorrhage. Preeclampsia and eclampsia can be prevented by regular obstetric examinations, measuring blood pressure, body weight and following laboratory findings of urine proteins.

Key words: Eclampsia, preeclampsia, neurological, disorder.

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BLEEDING AFTER TOOTH EXTRACTION IN PATIENTS UNDERWENT CORONARY ANGIOGRAPHY CONSUMING DUAL ANTICOAGULANTSCOMPARED TO HEALTHY CONTROLS Mohsen Sadeghi Ghahroudi, Moein Targhi, Seyed Hamid Yousefi Shahid Beheshti University of Medical Sciences, Faculty of Medicine, Iran Abstract The risk of perioperative bleeding is high in patients after percutaneous coronary intervention (PCI) taking aspirin and clopidogrel. Decisions about discontinuing these medications have caused a concern for physicians. This study was designed to answer a specific question about continue/ discontinuing aspirin and clopidogrel bisulfate (Plavix) consumption for only one non-surgical tooth extraction. This cohort study was approved by the Ethics Committee of Baqiyatallah University of Medical Sciences. It included 64 patients during the first year after PCI who took aspirin (80 mg) and Plavix TM (75 mg) and 50 healthy control patients who were candidates for one non-surgical tooth extraction at Baqiyatallah polyclinic in 2013-2014.The exclusion criteria were pregnancy and known cases of bleeding disorders. Demographic data, underlying diseases, number of roots, type of tooth, type of hemosthasis, and bleeding immediately, 30 min, and 48-hour after intervention were compared between the two groups using SPSS. A total of 114 patients with the mean age of 56.1 years were evaluated. There were no significant differences in demographic data, underlying diseases, type of tooth, number of roots, and anesthetic dose between the groups.

(P>0.05) There were also no significant differences in bleeding immediately (79.7 % vs. 70%, OR=1.277, 95 % CI: 0.827 â&#x20AC;&#x201C; 1.973) and 30 minutes after intervention between the two groups (23.4 % vs. 14 %, OR=1.280, 95 % CI: 0.908 â&#x20AC;&#x201C; 1.805). Time of consuming aspirin was significantly higher in patients with uncontrolled immediate bleeding and time of consuming the last dose of aspirin correlated with 30-minute hemosthasis (P<0.05). During the 48-hour after intervention, no uncontrolled bleedings and emergency referrals were seen. Based on the results of this study, it can be concluded that using plavix and aspirin simultaneously does not have a significant effect on the risk of bleeding in patients undergoing a single tooth extraction. However, more original research is still needed; it is recommended that each study be designed to answer at least one of those aforementioned questions.

Key words: Aspirin, clopidogrel, tooth extraction, uncontrolled bleeding.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

FETAL CIRCULATION Denisa KulaniÄ&#x2021;1 1

University of Tuzla, Faculty of medicine, Tuzla, Bosnia and Herzegovina

Abstract The circulatory system of an unborn infant, or fetus, functions quite differently from that of a baby after birth. The most significant difference is that, while a baby after birth acquires life-giving oxygen from its lungs, a fetus receives oxygen from its mother through the placenta. Oxygenated blood travels from the placenta to the fetusâ&#x20AC;&#x2122;s heart by way of the umbilical vein. The heart structure of the fetus differs from the normal postnatal heart in that there is an opening in the atrial septum called the foramen ovale. This allows most of the blood that enters the right atrium to flow into the left atrium instead of into the right ventricle. From the left atrium, the oxygenated blood is pumped into the left ventricle and into the aorta, which carries it to the body tissues. From there it returns to the placenta via the umbilical arteries.The second feature of the fetal heart that differs from the postnatal heart is the presence of the ductus arteriosus. This vessel connects the pulmonary artery to the aorta and allows blood to flow from the pulmonary artery into the aorta, which carries it to the placenta for oxygenation. The ductus arteriosus normally closes soon after birth and blood in the pulmonary artery goes to the lungs for oxygenation.At birth, a dramatic change in the circulatory pattern occurs. The lungs inflate, which tends to draw blood into them from the right ventricle. The increase in blood flow into and out of the lungs increases pressure in the left atrium.

This causes a one-way flap on the left side of the foramen ovale, called the septum primum, to press against the opening, effectively separating the two atria. This also increases blood flow to the lungs as blood entering the right atrium can no longer bypass the right ventricle, which pumps it into the pulmonary artery and on to the lungs. Also, within a day or two of birth, the ductus arteriosus closes off, preventing blood from the aorta from entering the pulmonary artery.

Key words: Blood, fetal, ciculation, lungs, air, heart, ductus arteriosus, artery, birth.

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AIR POLLUTION AND CARDIOVASCULAR DISEASE Denisa Kulanić1 1

Pan-european university „ APEIRON“, Sanitary engineering, Bosna i Herzegovina

Abstract Air pollution is a heterogeneous, complex mixture of gases, liquids, and particulate matter.

Epidemiological studies have demonstrated a consistent increased risk for cardiovascular events in relation to both short- and long-term exposure to present-day concentrations of ambient particulate matter. Several plausible mechanistic pathways have been described, including enhanced coagulation/thrombosis, a propensity for arrhythmias, acute arterial vasoconstriction, systemic inflammatory responses, and the chronic promotion of atherosclerosis. Scientists have long known that air pollution causes health problems. Most attention has focused on lung issues like asthma, lung development in children and even lung cancer. It makes sen­se: When air is infused with harmful chemicals like sulfur dioxide, carbon monoxide and hydrocarbons, along with tiny particles of matter, our lungs are going to suffer. Air pollutants come from lots of sources, some natural, likevolcanic eruptions and plants chemical reactions, and some not so natural. Factories and cars that burn fossil fuels send tons of pollutants into the air every day. The manufacturing processes for plastics release chemicals like chlorine, sulfuric acid and (in the case of PVC) vinyl chloride. Spraying aerosol cans, exhaling cigarette smoke and burning trash all decrease the level of our air quality. In fact, medical science has long known that exposure to high levels of air pollution, especially particulate matter, can exacer­bate or even trigger heart disease. But until the last few years, exactly how this happened was a­ bit of a mystery. Now, researchers have uncovered some good evidence of air pollution hurts the heart.

Unfortunately, the heart reacts just as badly to air pollution as our lungs do. While the main causes of heart disease are poor diet, family history, obesity, diabetes and smoking, there’s increasing evidence that heart problems are significantly impacted by pollution. For instance, carbon monoxide from secondhand smoke decreases the amount of oxygen our blood can carry, which can starve the heart muscle of the oxygen it needs to work properly. Particulates in diesel exhaust can cause blood vessels to constrict, limiting blood flow.

Key words: Air pollution, cardiovascular diseases, respiration.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

PREVALENCE OF DIVERTICULAR DISEASE OF COLON IN TUZLA CANTON REGION Amar Skakić1, Emir Bećirović1 Mentor: prof. Ervin Alibegović, MD, PhD University of Tuzla, Faculty of medicine, Tuzla, Bosnia and Herzegovina

1

Abstract According to data from the Federal Statistics Institute Tuzla Canton is covering 13 places where lives around 527000 people. Diverticuls are sac-like pouches that protrude from the normally smooth muscular layer of the colon. They tend to develop where the muscles are weakest, at the places where penetrating vessels cross through the muscles. The great majority of diverticuls develop where the colonis the narrowest, in the sigmoid. We conducted the complete medical examination of 215 patients, aged from 35-85, searching for diverticular disease of colon, and then dynamically monitored these patients for 4 to 6 years (average of 4,5 years). Average age of the patients was 61,6; mostly women (76 %). In the patients with diverticular disease of colon the presence of abdominal pain without clear localization, growing 15-20 minutes after meal, was at 91 % of them and most of them had hypercholesterolemia and CVD related diseases. The frequency and number of patients with diverticular disease increases with age. We revealed about 10 % prevalence in people under the age of 40, and 66 % prevalence in 80 year-old people, with almost equal prevalence in man and woman.

Key words: Diverticulus, colon, abdominal pain, Tuzla canton, sigmoid colon, hypercholesterolemia, CVD.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

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Organized by: Students’ association of Faculty of Medicine in Tuzla „MEDICUS“ Co-organized by: Faculty of Medicine, Tuzla Sponsored by: Government of Tuzla Canton Supported by: University of Tuzla Medical chamber of TC University Clinical Center Tuzla Union of students of the University of Tuzla Institute of Public Health in Tuzla Canton Venue: Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

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International congress of students and young doctors of (bio)medical studies in Bosnia and Herzegovina “MediCon 2015” International congress of students and young doctors of (bio)medical studies in Bosnia and Herzegovina “MediCon 2015” is a project of the Student’s association of Medical Faculty in Tuzla „MEDICUS“ and it was started because of the idea to give students and young doctors a try in writing and presenting their scientific and scientific-research papers.

“MediCon 2015,” will take place at the Faculty of Medicine, University of Tuzla from 30.1001.11.2015. During the 3 days of the Congress, we are expecting interesting lectures of professors from the Tuzla’s Faculty of Medicine, University of Tuzla, and other universities from Bosnia and Herzegovina, as well as from other countries (Croatia, Turkey, Switzerland, Belgium, etc.) which handle the latest issues and developments from the world of medicine. In total there will be 6 sessions which will beside usual lectures, incorporate 5 plenary lecturers and their themed lectures.

Students and young doctors who are actively participating in the congress have the opportunity to compete for the best oral presentation and best poster presentation, and the same will be assessed by the Scientific Committee, and awarded with a special prize. The Congress will be certified by the Medical Association of TC. Besides the scientific part, we have prepared a rich social program, so we can assure you that, in addition to knowledge and skills that you acquire, fun and companionship will not be missed.

Currently we have over 300 applicants from 20 different countries spread throughout Europe, Asia and Africa.

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International Congress of Students and Young Doctors of (bio)medicine in Bosnia and Herzegovina

Student's association of Medical Faculty in Tuzla „MEDICUS“ Student's association of Medical Faculty in Tuzla „MEDICUS“ was founded in 2010. as a nonprofitable, non-political, non-governmental association and unique representative body of all students of the Medical Faculty University of Tuzla, which is a full member of the Student Union University of Tuzla.

Over the past year, „MEDICUS“ proved to be a very important factor in the preservation and protection of student rights and interests,but also as an association has conducted many campaigns and projects. Also, Association has taken part in number of projects that are aimed at marking important days in health care and health promotion in general.

It's very successful on the field issues and problems of students, active membership in the Council, the Senate, and many commissions and committees of the University of Tuzla.One of the biggest projects are certainly re-editing and publishing the Journal of Medical students' „PULSUS“ after over 20 years of stagnation, the first participation in the competition biomedical faculty „Humanijada 2013th“ and maintain the first brain week in Bosnia and Herzegovina called Tuzla Brain Week - TBW.

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