Edin Begic

Usefulness of Total PSA Value in Prostate Diseases Diagnosis

Introduction: Analysis of total value of prostate specific antigen (PSAT), with the unavoidable digital rectal examination (DRE) is the basis of prostate cancer detection. Aim: The aim of this study was to determine the specificity and sensitivity of the total value of PSAT in the diagnosis of prostate cancer. The aim was also to determine the significance of PSAT in diagnosis of benign prostate hyperplasia, precancerous conditions and inflammatory and atrophic changes of the prostate. Material and methods: Data were collected from the “Register of PH biopsy” of Clinic of Urology, CCU Sarajevo. Results: Analysis of correlation between the diagnosis and the PSAT value shows statistically significant negative correlation (r =-0,186; p = 0.006) in the sense that the value of the PSAT is highest in cancer patients, and the lowest in patients with benign prostatic hyperplasia. PSAT increases with age (r = 0.152; p = 0.025). For prostate cancer optimal sensitivity and specificity for PSAT value occurs at cut off value of> 8.6 ng /mL. Values lower than 2 ng/mL and higher than 10 ng/mL are most specific, and PPV increases with increasing value of PSAT. PSAT at values of <2 ng/mL and > 10 ng/mL are at high levels of specificity, and value > 10 ng / mL is also of high sensitivity in the detection of prostate cancer, and in this moment these values represent the optimal mode for the subsequent treatment. Conclusion: PSAT has a relative significance in the detection of prostate cancer, and should not be used as a guideline without DRE.

Pulmonary Hypertension – New Trends of Diagnostic and Therapy -

Pulmonary hypertension is a pathophysiological state hemodynamically defined as the increase of the mean pulmonary arterial pressure above 25, or 30 mmHg at rest, measured by catheterization of the right heart. Laboratory findings usually reveals polycythemia, the ECG right ventricle hypertrophy, and x-ray characteristic of diseased branches (echocardiography and biomarkers such as B-type natriuretic peptide (BNP) and N-terminal pro-BNP hormones are potentially helpful tools in identifying PH). Echocardiography can be found the increase of the right atrium and ventricle, right ventricular hypertrophy, abnormal contraction of the interventricular septum, left ventricular diastolic dysfunction and decreased left ventricular size, with reduced volumes of systole and end diastole. Doppler confirming tricuspid regurgitation. Pharmacological therapy would represent a use: Calcium Channel Blockers, Prostacyclin Analogues, Endothelin Receptor Antagonists and Phosphodiesterase-5 Inhibitors. Alpha adrenergic antagonists, endothelial receptor subtype A (Bosentan, Tracller) with treatment of the underlying disease or anticongestive therapy, are recommended. In case of inadequate response to treatment with a specific drug, guidelines recommend the combined use of drugs from the basic three groups, using their synergism.

Scientometric Analysis of the Journals of the Academy of Medical Sciences in Bosnia and Herzegovina

Introduction: Currently in Bosnia and Herzegovina there are 25 journals in the field of biomedicine, 6 of them are indexed in Medline/PubMed base (Medical Archives, Materia Socio-Medica, Acta Informatica Medica, Acta Medica Academica, Bosnian Journal of Basic Medical Sciences (BJBMS) and Medical Glasnik), and one (BJBMS) is indexed in Science Citation Index Expanded (SCIE)/Web of Science base. Aim: The aim of this study was to show the scope of work of the journals that were published by Academy of Medical Sciences of Bosnia and Herzegovina - Medical Archives, Materia Socio-Medica and Acta Informatica Medica. Material and Methods: The research presents a meta-analysis of three journals, or their issues, during the calendar year 2015 (retrospective and descriptive character). Results: During 2015 calendar year a total of 286 articles were published (in Medical Archives 104 (36.3%), in Materia Socio-Medica 99 (34.6%), and in Acta Informatica Medica 83 (29%)). Original articles are present in the highest number in all three journals (in Medical Archives 80.7%, in Materia Socio Medica 77.7%, and in Acta Informatica Medica 68.6%). In Medical Archives, 90.3% of the articles were related to the field of clinical medicine. In Materia Socio-Medica, the domain of clinical medicine and public health was the most represented. Preclinical areas are most frequent in Acta Informatica Medica. The period of 50-60 days for a decision on the admission of article is most common in all three journals, with trend of shortening of that period. Articles came from 19 countries, mostly from Bosnia and Herzegovina, then from Iran, Kosovo, Saudi Arabia and Greece. Conclusion: In Medical Archives original articles in the field of clinical medicine (usually internal and surgical disciplines) are most often present, and that is the case in last four years. The number of articles in Materia Socio-Medica and Acta Informatica Medica is growing from year to year. In Materia Socio-Medica there is a trend of growth of articles in the field of public health, while the most common articles in Acta Informatica Medica are about medical informatics.

Scientometric Dilemma: Is H-index Adequate for Scientific Validity of Academic’s Work? -

H-index is an index that attempts to measure the productivity and impact of published work of scientists. H-index has several advantages – it combines productivity with echo, is not sensitive to extreme values in terms of articles without citation or to articles with above-average number of citations and directly enables the identification of the most relevant articles with regard to the number of citations received. H-index has great potential in the academic community, but it still has not realistic indicator of the quality of work of one author. Authors described most used indices for scientific assessment.

Software for acid-base status disorders management

Normal acid-base status represents the value of hydrogen ions in extracellular fluid is within pH range of 7.36 (44 nmol/L) and 7.44 (36 nmol/L). Acid-base balance disorders may be a result of enhancement or reduction in amount of hydrogen ions, and include four basic disorders: metabolic and respiratory acidosis, metabolic and respiratory alkalosis. First step implies diagnosing the type of acid-base status disorder. The application input consists of blood analysis data and body weight info. Next step is determining the significance of the disorder and finally recommending future treatment. Software offers the optional functionality of entering mineral level values to improve treatment recommendations. Following the latest trends, along with the aim of increasing availability and mobility of the system, the software is developed for the Android platform using the Java programming language.

Efficiency of Implementation of the Bologna Process at Medical Faculty, University of Sarajevo

Introduction: At the moment at Medical Faculty, University of Sarajevo, simultaneously exist two systems of teaching process, the old (pre-Bologna) and Bologna process. Goal: To show efficiency and justification of use of Bologna process at Medical Faculty, University of Sarajevo, through the prism of actual beneficiaries of this process, students, assessment of quality of medical education, and comparison of results of the teaching process evaluation between students studying according to the Bologna process and the old system. Materials and Methods: The study included period from 2012 to 2014, and had prospective character. Students of final (sixth) year were included, the last three generations of pre-Bologna, and three generations of the Bologna process, which completed their studies successfully. The study included 365 students (177 under the old system and 188 under the Bologna process), who had answered prepared questionnaire. Results: The presence of large number of female students, in both systems is significant. There were significant differences in opinion of students regarding the quality of space for administration and labor administration, informatization of the teaching process, the opinion of the objectivity of teachers in the assessment of the examination, and on-line access to their content. (p <0.05). Discussion: The Bologna process, with all its guidelines, was never to the maximum implemented in the teaching faculties, mostly because of the lack of funds and infrastructure that couldn’t fully comply with all the privileges of the Bologna process. Conclusion: Bologna process on this principle, has brought mediocrity, of which we have tried to escape. New school year, brings, and the new Bologna process, a new curriculum, a large number of new classes, systematization of the material, with simultaneous correction necessary in one hand in teaching, and in other hand in students themselves.

Information technology - a tool for development of the teaching process at the faculty of medicine, university of sarajevo.

Introduction: Information Technologies, taking slow steps, have found its application in the teaching process of Faculty of Medicine, University of Sarajevo. Online availability of the teaching content is mainly intended for users of the Bologna process. Aim: The aim was to present the level of use of information technologies at the Faculty of Medicine, University of Sarajevo, comparing two systems, old system and the Bologna process, and to present new ways of improving the teaching process, using information technology. Material and methods: The study included the period from 2012 to 2014, and included 365 students from the old system and the Bologna Process. Study had prospective character. Results: Students of the old system are older than students of the Bologna process. In both systems higher number of female students is significantly present. All students have their own computers, usually using the Office software package and web browsers. Visits of social networks were the most common reason for which they used computers. On question if they know to work with databases, 14.6% of students of the old system responded positively and 26.2% of students of the Bologna process answered the same. Students feel that working with databases is necessary to work in primary health care. On the question of the degree of computerization at the university, there were significant differences between the two systems (p <0.05). When asked about the possibility of using computers at school, there were no significant differences between the two systems. There has been progress of that opportunity from year to year. Students of Bologna process were more interested in the introduction of information technology, than students of old system. 68.7% of students of the Bologna process of generation 2013-2014, and 71.3% of generation 2014-2015, believed that the subject of Medical Informatics, the same or similar name, should be included in the new reform teaching process of the Faculty of Medicine, University of Sarajevo. Conclusion: Information technologies can help the development of the teaching process, and represent attractive and accessible tool in the process of modernization and progress.

Plasmapheresis in Pediatric Intensive Care Unit.

Introduction: Plasmapheresis also known as a therapeutic plasma exchange (TPE) is extracorporeal procedure by which individual components of plasma that are harmful or blood cells can be removed from organism by using a blood separation technology. Aim: To present the results of the implementation of plasmapheresis in children in the Department of Pediatric Intensive Care of Pediatric Clinic, Clinical center of Sarajevo University, Bosnia and Herzegovina. Patients and methods: Research (period from December 2011 to June 2016) analyzed 66 plasmapheresis (11 patients–6 plasmapheresis per patient). Results: Out of 11 patients, 7 (63.6%) were girls and 4 (36.4%) were boys. The average age of patients was 11.6 ± 3.9 years (the youngest patient had 4 years and 7 months, while the oldest had 16 years and 10 months). Plasmapheresis were significantly more often done in the winter and summer. Underlying disease was in 54.5% of cases of neurological origin. The treatment was in form of receiving IVIG in 7 patients, or the application of mechanical ventilation in 6 patients. The most common complication was hypotension, which occurred in 45.5% of patients, followed by bleeding in 36.3%, hypercoagulability in 27.2% of patients and hematoma in 27.2% of patients. Lethal outcome occurred in 3 (27.2%) patients. Conclusion: Plasmapheresis represents an invasive method due to need for placement of centralized venous catheter that provides adequate blood flow during the procedure. Although complications can be serious, they are rare and are mainly related to the presence of central venous catheter, hemostasis disorders due to use of anticoagulant therapy, and hypotension of the cardiovascular system. It should be noted that for success of plasmapheresis in children multidisciplinary approach is necessary (children’s nephrologist, neuropediatrician, intensive care doctor) as well as well-trained team of doctors and nurses with the acquired knowledge and skills.

Scientometric Analysis of Scientific Validity of Medical Archives Regarding Other Medical Journals in Bosnia and Herzegovina

Introduction: Medical Archives is the oldest medical journal in Bosnia and Herzegovina (B&H) (founded in 1947.). A total of 104 articles were published in Medical Archives during 2015. Analyzing the type of articles, original articles are present in majority during 2015–80.7% (in last seven years, 561 (76%) were original out of 738). In last seven years, 651 (88.2%) articles were from the field of clinical medicine (preclinical disciplines, in the last three years are more represented than in previous years). Collaboration rate in 2015 was 0,92. Articles written in collaboration of five authors (21.1 %) are found to be predominant. From year to year, most often required time for a decision on acceptance or on the revision prior acceptance is between 50 and 60 days (30% of cases in 2015). During 2015, 47.1% of articles were originally from B&H (eleven countries were represented). H index of Medical Archive for 2014 was 12, and does not vary during the last decade. Findings: In 2015 in B&H about twenty-five journals are issued in the field of biomedical and life sciences in general (six are indexed on Medline/PubMed, one is indexed in the Science Citation Index Expanded (SCIE)/Web of Science base). According to GoogleScholar the biggest h5 index has Bosnian Journal of Basic Medical Sciences (BJBMS) and Medical Archives, while the biggest h5 median has BJBMS i Acta Informatica Medica. The highest H-index (13) in B&H has Izet Masic MD, PhD, Enver Zerem MD, PhD and Semir Vranic MD, PhD, while highest g-index (22) has Enver Zerem MD, PhD (analyzed by software package “Publish or Perish”). Conclusion: By comparing the state of medical publishing in B&H with neighboring countries (Croatia, Serbia, Montenegro), we have concluded that B&H is behind Croatia and Serbia by following parameters: Total Documents, Total Cites and H index but in front of Montenegro.

Biomedical Scientific and Professional Social Networks in the Service of the Development of Modern Scientific Publishing

Information technologies have found their application in virtually every branch of health care. In recent years they have demonstrated their potential in the development of online library, where scientists and researchers can share their latest findings. Academia.edu, ResearchGate, Mendeley, Kudos, with the support of platform GoogleScholar, have indeed increased the visibility of scientific work of one author, and enable a much greater availability of the scientific work to the broader audience. Online libraries have allowed free access to the scientific content to the countries that could not follow the economic costs of getting access to certain scientific bases. Especially great benefit occurred in countries in transition and developing countries. Online libraries have great potential in terms of expanding knowledge, but they also present a major problem for many publishers, because their rights can be violated, which are signed by the author when publishing the paper. In the future it will lead to a major conflict of the author, the editorial board and online database, about the right to scientific content This question certainly represents one of the most pressing issues of publishing, whose future in printed form is already in the past, and the future of the online editions will be a problem of large-scale.