Correlation Between Carotid Stenosis and Pulsatile Index Measured by Transcranial Doppler.

Background: Carotid atherosclerosis is often mentioned as one of the main causes of stroke. Currently, embolization is considered the most common mechanism that causes ischemic strokes due to atherosclerotic lesions in the carotid artery. Transcranial Doppler (TCD) ultrasound provides relatively inexpensive, noninvasive, real-time measurement of blood flow characteristics and cerebrovascular hemodynamics within brain arteries. The pulsatile index measured by transcranial Doppler is a parameter that indicates the degree of elasticity of the blood vessels of the brain. Objective: The aim of this study is to determine the relationship between the value of the pulsatile index of the middle cerebral artery and the basilar artery in patients with carotid stenosis using transcranial Doppler and the value of the pulsatile index in relation to the degree of carotid stenosis. Methods: The study involved a total of 140 patients examined at the Color Doppler and Transcranial Doppler Department of the Neurology Department of the General Hospital "Prim Dr. Abdulah Nakas" Sarajevo The patients were divided into two groups. The research was conducted in the General Hospital "Prim. dr. Abdulah Nakas" in Sarajevo at the Department for Color Doppler and Transcranial Doppler of the Department of Neurology and included patients examined in the period from February 2022 to December 2022. All patients underwent extracranial Doppler of the carotid arteries and transcranial Doppler of the middle cerebral artery and basilar artery. Results: The mean values of PI in ACM in the total sample were statistically significantly lower in patients with stenosis up to 50% compared to the average in patients with stenosis over 50%. Average values of PI in AB in the total sample were statistically significantly lower in patients with stenosis up to 50% compared to the mean values in patients with stenosis over 50%. Conclusion: Transcranial Doppler findings showed an increased pulsatile index in patients who had carotid stenosis greater than 50% compared to patients with mild carotid stenosis. The study showed that in clinical work it would be necessary to introduce the pulsatile index as an indispensable neurosonological parameter that would be included in the findings of the transcranial Doppler and thus objectify the potential risk of a cerebrovascular ischemic event.

Favorite colors of patients with drug-resistant epilepsy: pilot study.

OBJECTIVE: To evaluate the favorite colors of patients with drug-resistant epilepsy. METHODS: Following examination, 50 patients were diagnosed in accordance with the 2005 proposal of the International League Against Epilepsy and the definition of drugresistant epilepsy since 2010. The favorite color examination used a six-color tape and Trycolors, an online color mixing tool. The patients' color preferences were compared with those of 50 individuals without epilepsy. RESULTS: Patients with drug-resistant epilepsy preferred the color blue the most (30%), significantly more yellow (p = 0.0001), and significantly less green (p < 0.0001) compared to individuals without epilepsy. By mixing these colors at a certain percentage, we obtained the Go Ben color. SIGNIFICANCE: This information on preferred colors can help to improve compliance and can be utilized in designing medications and environments for patients with epilepsy.

The Efficacy and Tolerability of a Fixed Combination of Perindopril and Indapamide in the Treatment of Unregulated Essential Hypertension - a Postmarketing Study.

OBJECTIVE: The objective of this non-interventional post-marketing clinical trial was to analyze the antihypertensive effect and safety of a fixed combination of perindopril and indapamide in the treatment of unregulated essential hypertension. PATIENTS AND METHODS: The prospective clinical trial included patients aged 20 to 75 years with essential hypertension and blood pressure values ≥ 140/90 mmHg at baseline. On the basis of the investigator's decision, patients received 2 mg perindopril + 0.625 mg indapamide (group 2+0.625) or 4 mg perindopril + 1.25 mg indapamide (group 4+1.25). RESULTS: The study included 1173 patients (426 patients in group 2+0.625 and 747 patients in group 4+1.25) at 27 investigational centers in Bosnia and Herzegovina. Mean blood pressure values at baseline and visits after nine months were significantly higher in the 4+1.25 group compared to the 2+0.625 group. There was a significant drop in systolic and diastolic blood pressure in both groups. The target values of systolic and diastolic blood pressure, according to the European Society of Cardiology (2018), were reached after nine months of therapy by more than 80% of patients in the 2+0.625 group, and this number was significantly higher compared to the 4+1.25 group where more than 60% of patients reached target values. Newly diagnosed patients had a better response to therapy. The percentage of patients receiving additional antihypertensive therapy decreased by the end of the study. Age, gender and the existence of diabetes mellitus were identified as negative predictors of target blood pressure achievement. The therapy showed a good safety profile. CONCLUSION: A fixed combination of perindopril and indapamide was effective and safe in the treatment of unregulated essential hypertension.

Management and Invasive Cardiological Review by Comparison of Percutaneous Coronary Intervention in Left Anterior Descending Artery with Drug Eluting and Bare Metal Stents.

INTRODUCTION: The dominant global public health challenge are non-communicable diseases. According to World Health Organization (WHO) data. The fifth leading causes of death in FB&H are diseases of the heart and coronary arteries: stroke, acute myocardial infarction, cardiac arrest, cardiomyopathy and essential hypertension. The prevention of these diseases has great importance in improving health in B&H. OBJECTIVE: The aim of this study is in estimation of one-year survival and left heart systolic function after the treatment. After the data collection and evidence of their statistical value, the results of the research point to the profile of patients with a LAD disease in one-vessel coronary artery disease that should be subjected to PCI DES LAD and PCI BMS LAD, respectively, or creating guidelines for a better and more effective LAD treatment. MATERIAL AND METHODS: The study was performed as retrospective/ prospective, clinically controlled for a period of three years. In this study was included 60 patients, which was followed in 12 months period. With the PCI BMS method was treated 63.3% and 36.7% of subjects were treated with the PCI DES in LAD. CONCLUSION: The number of complications in patients with one-vessel LAD coronary heart disease, treated with PCI DES and PCI BMS was statistically significant. One possible complication (4 patients) is due to the spread of the disease to other blood vessels. Due to possible complications in the treated or LAD with repeated stenosis, the complication in terms of restenosis of the previously placed stent in 75% are with BM stents justifying the use of drug eluting stent, while the progression of disease in patients (2 patients) indicates the need for detection and prevention of risk factors.

Follow-up of Vasospasm by Transcranial Doppler Sonography (TCD) in Subarachnoid Hemorrhage (SAH).

INTRODUCTION: Subarachnoid hemorrhage (SAH)represents hemorrhage in the space between arachnoidea and pia mater, due to aneurysm burst, spontaneously or as a consequence of trauma. It is condition that occurs more common in women than men, and its most common complications are rebleeding and vazospasm. As a result of vasospasm, develops ischemia in the portion of brain tissue that can cause additional neurological deficit. Transcranial Doppler Sonography (TCD) is a noninvasive ultrasound diagnostic method that allows monitoring of the state of intracerebral hemodynamics. GOAL: The goal is to follow the occurrence of vasospasm after SAH, by the TCD method. MATERIAL AND METHODS: We have analyzed 47 patients with SAH, by analyzing the presence of aneurysm, hypertension and smoking, and by the TCD method monitor the state of intracerebral hemodynamics during the first four days, then in the second and third week. RESULTS: SAH was more common in women (61.7%) than men (38.3%), and in the age range from 22 to 64 years. Aneurism was demonstrated in 61.7% of patients, more common in women, with hypertension 68.1% also more common in women and smoking in 87.2% of patients, also more common in women. By TCD method are recorded milder, elevated blood flow velocities at a quarter of patients in the first measurement, during the second measurement at all and it had significantly greater value, and the third measurement also more increased in about a quarter of patients, so that there is a statistically significant difference in the first and second, second and third measurement for each vessel separately, but not between the first and third measurement. CONCLUSION: Predilection factors for SAH are aneurysms, hypertension and smoking. By using TCD method were recorded milder elevated blood flow velocity in the first days of SAH, with about a quarter of patients, significantly greater increase in blood flow velocity during the second week in all patients and also milder increase blood flow velocity in the third week of the start of SAH is a quarter of patients. TCD is the method of choice in the evaluation and management of vasospasm after SAH, which allows the prevention of delayed cerebral ischemia.

A neurophysiological study of large- and small-diameter nerve fibers in the hands of hemodialysis patients.

PURPOSE: Polyneuropathy in patients with advanced clinical kidney disease is a very disabling condition. The aim of this study was to evaluate neurophysiological abnormalities of large- and small-diameter nerve fibers in the hands of hemodialysis patients. METHODS: A total of 38 hemodialysis patients and 38 healthy control subjects underwent a conventional electrophysiological examination. The function of small nerve fibers was assessed using cutaneous silent period (CSP) measurement. RESULTS: Slower median nerve motor conduction velocities were recorded in patients with fistula (p < 0.0001) and without fistula (p < 0.001). Sensory median and ulnar nerve conduction velocities were slower in both patient groups compared with the control group (p = 0.001). Median sensory nerve action potential amplitudes were lower in patients with fistulas (p = 0.009) and without fistulas (p = 0.005) compared with the control group. Significantly prolonged F-wave latencies of the median (p = 0.002) and ulnar nerves (p = 0.023) in patients with fistulas hands were observed. In 12/38 (32 %) patients, the onset latencies of CSPs were significantly delayed (p = 0.001). There was an inverse correlation of ß2-microglobulin and decreased conduction velocities of the median nerves, while Kt/V was associated with improved sensory nerve conduction velocity of the median nerve. An inverse correlation between motor velocity of both nerves and hemodialysis duration was observed in the patient groups. CONCLUSIONS: The measurement of CSPs provides a useful method for assessing small nerve fibers. The role of A-delta fibers is often overlooked.

Gender Differences in Biochemical and Electroneurographic Parameters of Median and Ulnar Nerve.

INTRODUCTION: In this article are demonstrated differences in the aspects of the metabolic syndrome (MSy) between genders, as well as the association of MSy and neuropathy. THE AIM: The aim of our study was that in patients with newly discovered metabolic syndrome of both sexes make comparison of fasting blood glucose levels and after oral glucose tolerance test, as well as neurophysiological parameters of n.medianus and n.ulnaris. PATIENTS AND METHODS: All participants were examined dermatologically. The analysis included the 36 male and 36 female respondents with a newly discovered MSy. RESULTS: The average age of men was 52.75±7.5 (40-65) years and women 52.1±7.7 (38-67) years. The average value of fasting blood glucose in women was 5.86±0.87 (4.5-8) mmol/L, and non significantly higher in men (p=0.0969) as 6.19±0.8 (4.7-8) mmol/L. Average values of blood sugar 120 minutes after oral glucose tolerance test were not significantly different (p=0.7052), and was 5.41±1.63 (3.3-9.7) mmol/L in women and 5.27±1.52 (2.7-9.8) mmol/L in men. Median motor velocity were significantly higher in women for n.medianus on the left (p=0.0024), n.ulnaris on the left (p=0.0081) and n.ulnaris on the right side (p=0.0293), and the median motor terminal latency were significantly longer in n.ulnaris on the left (p=0.0349) and n.ulnaris on the right side (p=0.011). There was no significant difference in the sensory conductivity velocity in n.medianus and n.ulnaris between the groups, but the amplitude with the highest peak of the sensory response was significantly higher in n.medianus on the left (p=0.0269) and n.ulnaris on the left side (p=0.0009) in female patients. CONCLUSION: The results indicate that there are differences in neurophysiological parameters of the investigated nerves between the genders, and that tested nerve structures in the course of MSy are affected slightly more in men. There were no significant differences in skin changes between genders.

Cutaneous silent period in the assessment of small nerve fibers in patients on hemodialysis.

AIM: In hemodialysis patients renal disease may cause an impairment of central and peripheral nervous system. In most cases of the peripheral nervous system polyneuropathy is reported. The aim of this study was to evaluate the function of small A-delta nerve fibres, whose function is often overlooked. METHODS: The function of large diameter nerve fibers was performed by standard routine neurophysiological examination. Cutaneous silent period (CSP) was elicited by single electrical stimulations at the tip of digit II by the bipolar electrodes. The superficial electrodes were placed on the muscle belly of m. abductor pollicis brevis. The onset latency (L1) was recorded at the beginning of voluntary muscle activity suppression, the late latency (L2) at the start of new muscle activity. The difference between two latencies indicates the duration of CSP. RESULTS: The study included 38 consecutive patients (male/female - 21/17, median age 56.6±10.9 years) treated with hemodialysis (one month to 30 years) and 35 healthy subjects (male/female 23/17, age 47.4±10.1 years). The results of the conduction study demonstrated a significant prolongation of F-waves of the median and ulnar nerves, decreased motor and sensory velocities of both nervesin patients on hemodialysis (p less than 0.001). In patients with A-V fistulas a significant prolongation of the onset CSP latency L1 was obtained (p less than 0.001), whereas duration of CSP was not changed. CONCLUSION: In hemodialysis patients the significant impairment of small nerve fibers was recorded. The evaluation of small nerve fibers contributes to the assessment of the whole peripheral nerve function.

Cutaneous silent period in the evaluation of small nerve fibres.

INTRODUCTION: High intensity cutaneous stimulus transiently suppresses tonic voluntary muscle activity resulting in cutaneous silent period (CSP). AIM: The aim of our study was to evaluate the normal values of an onset latency L1, a late latency L2 and a duration of CSP after stimulating sensory fibres of the median nerve. MATERIAL AND METHODS: This prospective study was performed at the Neurology Department, Clinical Center of Sarajevo University in period from January 1st 2013 to December 1st 2013. In our study we examined 61 subjects. The group included our relatives, coworkers and friends. The informed consent from testing subjects was obtained. RESULTS: The origin of silent period is stimulation of small A-delta nerve fibres. The pre-synaptic or post-synaptic interruption of the electrical volley to motor neurons is discussed. Median values of muscle activity suppression in healthy female is 55.0 ms (45.0-74.0) and 59.0 ms (52.0-67) male subjects. There is a correlation between the onset latency L1 and the late L2 latency (p < 0.03). In the on-going study it seems that delay of L1 and shorter muscle activity suppression might provide a sign of small nerve fibres involvement. CONCLUSION: The use of CSP improves the value of neurophysiology examination.

Post stroke depression.

INTRODUCTION: Comorbidity of depression and stroke significantly reduces the quality of life of patients after the stroke. Squeal after stroke also determines the quality of life and have impact on the occurrence of depression after the stroke. In our study we investigated the occurrence of depression in patients after different types and subtypes of stroke measured by the Hamilton scale compared to the level of disability measured by NIHSS scale. GOAL: The goal was to make a comparative analysis of depression after stroke, according to gender and age, side of the lesion and the severity of neurological deficit. MATERIAL AND METHODS: Material for our work are 210 patients with stroke treated at the Neurology Clinic, Clinical Center of Sarajevo University in 2012, 105 male and 105 female. The mean age of the patients was 67.12 +/- 9.5 years. Ischemic stroke was present in 65% cases. There was no statistically significant difference between ischemic and hemorrhagic stroke among genders. In case of hemorrhagic M-56.7%, F-43.3%; ischemic M-48.3%, F-51.7% (chi-square = 6.563, p = 0.082). Depression was more prevalent among younger patients (52-60 years) with 39.2% then in the group of older patients (61-70 years) with 32% of depressed. In relation to gender there was significantly more patients with depression among women compared to men (63.8:27.2%, chi-square = 14.38, p = 0.00019). Depression was more frequent in patients with stroke in the left hemisphere medial localization (63%). NIHSS scale average was 16.07 with the minimum of 11 and maximum of 22, F = 52.56, p = 0.001. CONCLUSIONS: We can conclude that depression after stroke is more frequent in younger patients, female patients, patients with localized stroke in the medial left hemisphere and with higher disability score.

Hyperlipidemia as a risk factor for persons in specific professions.

INTRODUCTION: The increase in lipid levels associated with other risk factors for the occurrence of ischemic heart disease and stroke is one of the most important health problems in the world. Risk for development of changes is greater for people of specific occupations such as police officers. MATERIAL AND METHODS: This prospective study included 300 police officers, 150 as experimental and 150 respondents as a control group. To both groups same methods have been applied: A detailed history, physical examination, complete laboratory evaluation, lipid electrophoresis targeted to hypercholesterolemia, ultrasound of the abdomen and Color Doppler of the neck vascular structures. The results obtained by statistical analysis of the data showed that there was a significant increase in levels of cholesterol and triglyceride levels in experimental compared to the control group. Ultrasound of the abdomen showed fatty infiltrated liver in 16% of respondents from the experimental and 2% of the respondents in the control group 2%. Color Doppler of the neck blood vessels in 14% of respondents from experimental group showed changes in blood vessels, which ranged from mild thickening of the intima of the vessel to a 50% decrease in circulation. For the control group, this percentage was 0.66%. Considering that this study involved young, active working population, hyperlipidemia becomes a bigger problem.

Assessment of diabetic polyneuropathy and plantar pressure in patients with diabetes mellitus in prevention of diabetic foot.

INTRODUCTION: Risk assessment for development foot ulcer in diabetics is a key aspect in any plan and program for prevention of non-traumatic amputation of lower extremities. MATERIAL AND METHODS: In the prospective research to assessed diabetic neuropathy in diabetic patients, to determined the dynamic function of the foot (plantar pressure), by using pedobarography (Group I), and after the use of orthopedic insoles with help of pedobarography, to determined the connection between the risk factors: deformity of the foot, limited joint movements, diabetic polyneuropathy, plantar pressure in effort preventing changes in the diabetic foot. RESULTS: Out of 1806 patients, who are registered in one Team of family medicine examined 100 patients with diabetes mellitus Type 2. The average age of subjects was 59.4, SD11.38. The average HbA1c was 7.78% SD1.58. Combining monofilament and tuning fork tests, the diagnosis of polyneuropathy have 65% of patients. Comparing Test Symptom Score individual parameters between the first and second measurement, using pedobarography, in Group I, statistically significant difference was found for all of the assessed parameters: pain, burning sensation, paresthesia and insensitivity (p<0,05). The measurements of peak pressure, both first and the second measurement, for all of the subjects in Group I(45) show values above 200kPa. That's a level of pressure that needs to be corrected. The study finds correlation between the foot deformation, diabetic polyneuropathy and plantar pressure (p>0,05). CONCLUSION: A detail clinical exam of diabetic food in a family doctor office equipped with pedobarography (plantar pressure measurements), use of orthopedic insoles, significantly reduces clinical symptoms of diabetic polyneuropathy in patients with diabetes.

Occupational overuse syndrome (technological diseases): carpal tunnel syndrome, a mouse shoulder, cervical pain syndrome.

Technological diseases are diseases of the modern era. Some are caused by occupational exposures, and are marked with direct professional relation, or the action of harmful effects in the workplace. Due to the increasing incidence of these diseases on specific workplaces which may be caused by one or more causal factors present in the workplace today, these diseases are considered as professional diseases. Severity of technological disease usually responds to the level and duration of exposure, and usually occurs after many years of exposure to harmful factor. Technological diseases occur due to excessive work at the computer, or excessive use of keyboards and computer mice, especially the non-ergonomic ones. This paper deals with the diseases of the neck, shoulder, elbow and wrist (cervical radiculopathy, mouse shoulder and carpal tunnel syndrome), as is currently the most common diseases of technology in our country and abroad. These three diseases can be caused by long-term load and physical effort, and are tied to specific occupations, such as occupations associated with prolonged sitting, working at the computer and work related to the fixed telephone communication, as well as certain types of sports (tennis, golf and others).

Motor evoked potentials in 43 high risk spine deformities.

INTRODUCTION: Correction of pediatric spine deformities is challenging surgical procedures. This fragile group of patients has many risk factors, therefore prevention of most fearing complication-paraplegia is extremely important. Monitoring of transmission of neurophysiological impulses through motor and sensor pathways of spinal cord gives us an insight into cord's function, and predicts postoperative neurological status. GOAL: Aim of this work is to present our experiences in monitoring of spinal cord motor function - MEP during surgical corrections of the hardest pediatric spine deformities, pointing on the most dangerous aspects. MATERIAL AND METHODS: We analyzed incidence of MEP changes and postoperative neurological status in patients who had major spine correcting surgery in period April '11- April '14 on our Spine department. RESULTS: Two of 43 patients or 4.6% in our group experienced significant MEP changes during their major spine reconstructive surgeries. We promptly reduced distractive forces, and MEP normalized, and there were no neurological deficit. Neuromonitoring is reliable method which allows us to "catch" early signs of neurological deficits, when they are still in reversible phase. Although IONM cannot provide complete protection of neurological deficit (it reduces risk of paraplegia about 75%), it at least afford a comfort to the surgeon being fear free that his patient is neurologically intact during long lasting procedures.

Predilection role diabetes mellitus and dyslipidemia in the onset of ischemic stroke.

INTRODUCTION: Stroke is the third leading cause of mortality, disability and dementia, but leading cause of epileptic manifestations in the elderly. Diabetes mellitus as permanently elevated blood glucose, often accompanied by dyslipidemia, is among the leading causes of atherosclerotic alteration in blood vessels and is also increasing in the world. GOAL: To determine the existence and predilection of diabetes mellitus and dyslipidemia, in the development of ischemic stroke. MATERIAL AND METHODS: During the 2011 are analyzed all people with stroke admitted at the Neurology Clinic. All patients underwent neurological tests and the laboratory test with special emphasis on the value of blood glucose and lipid levels, with brain CT which confirmed the existence of a stroke, EEG and internist examination. RESULTS: During the one-year period the stroke was confirmed in 1184 patients, aged 33-81 years and 37% in the younger age group (up to 50 yrs.). There was 50.67% male and 49.33% female patients. Ischemic stroke was confirmed in 78.0% (56% with thrombotic and 22% with embolic genesis), of which the 32% was lacunar infarcts (up to 1.5 cm) and hemorrhagic in 22% (SAH in 4.8%, and intracerebral hemorrhage in 17.2%). The most frequent risk factors were hypertension 85%, then smoking in 65%, diabetes mellitus in 39.0%, in 27.38% dyslipidemia, previous stroke in 26.69%, in 23.57% arrhythmia In the baseline sample 30.06% of patients had previously diabetes mellitus and in 8.94% the diabetes was diagnosed during hospitalization, while dyslipidemia was known from earlier in 22.0% and in 5.38% cases was detected during the hospitalization. Among treated patients 79.01% survived, while 20.09% have a fatal outcome. CONCLUSIONS: Diabetes mellitus and dyslipidemia, along with hypertension and smoking are the leading risk factors for the occurrence of stroke. By timely detection and treatment can be controlled slow atherosclerotic changes in blood vessels and thus prevent stroke.

Platybasia and Klippel Feil-syndrome: case report.

A case is presented of a 35-year-old woman diagnosed with platybasia associated with Klippel-Feil syndrome type I. She was admitted to University Department of Neurology for clinical examination because of walking difficulties, dizziness, and intermittent vision disturbances. Neurological examination revealed a predominance of cerebellar symptomatology. Relevant diagnostic work-up included craniogram, cervical spine x-ray, computed tomography (CT) of the brain and craniocervical junction, magnetic resonance imaging of the brain, electroencephalography, ophthalmologic examination, urinary tract ultrasonography, laboratory tests, and psychological testing. CT of the craniocervical junction showed platybasia, congenital fusion of the second and third cervical vertebrae, and basilar invagination of dens axis. Platybasia is leveling of the angle between the floor of the anterior cranial fossa and posterior cranial fossa in the area of sella turcica, which is normally at 115-140 degrees. Basilar impression or invagination is moving up of the basis of the occiput and occipital condyles into the cranium, which means that the borders of the foramen magnum, condyles and adjacent bone are invaginated into the posterior fossa. Klippel-Feil syndrome type II is massive fusion of two of seven cervical vertebrae associated with short neck and low hair line.

Neoplasms in the clinical material of neurology clinic, Clinical Center of University of Sarajevo in the period 1990-2009.

INTRODUCTION: Brain tumors are a unique and heterogeneous group of tumors with which face a variety of specialties, mostly oncologists, neurologists and neurosurgeons. Due to their specific location all brain tumors are malignant, regardless of their malignant potential, because any expansion process within the skull, increased intracranial pressure and destruction of surrounding structures, which can cause neurological, quantitative disturbances of consciousness or death. GOAL: The goal of this study was to record neoplastic processes of the central nervous system in patients of Neurology Clinic, Clinical Center of Sarajevo University in the twenty-year period (January 1st 1990-December 31st 2009). The study was partly retrospective and partly prospective determined by three time periods. MATERIAL AND METHODS: We reviewed medical records and documentation of patients treated at Neurology Clinic, which has 102 beds. All patients' data were collected using a specially designed questionnaire for this study. RESULTS AND DISCUSSION: The number of secondary tumor process for the period 2000-2005 is greater than in the period 1990-1999, while in the period 2000-2009 is increasing (17.2%-30.3%). The male-female ratio is 52:48. During the first two monitoring period there were statistically significantly more men, and in the last monitoring period there were more women. The mean patient's age was 60 years. The most common symptom was hemiparesis for all observed periods evaluated with standard diagnostic tests: CT and MRI. CONCLUSION: We can conclude that CNS neoplasms in patients of Neurology Clinic, Clinical Center of Sarajevo University are present in the twenty-year period with total of 1.47%, and showed a decrease of 2.7% (1990-1999) to 0.47% for the period 2006-2009.

Correlation of aggressiveness and anxiety in fighting sports.

INTRODUCTION: in fighting sports there are many opened issues related with levels of aggression and anxiety. MATERIAL AND METHODS: Our study is performed with healthy young athletes: kick boxers, karate fighters, and boxers. Examined group consisted of 55 members (45 male) with average age of 20.2 +/- 3.8 years. In analysis of level of aggression Questionnaire A-87 is used. Its purpose is assessment of aggressive behaviour in provoked situations, or measurement of impulsive aggression. Questionnaire A-87 consists of 15 items of different situations with five possible responses. RESULTS AND DISCUSSION: The possible responses or reactions are the five most frequent forms of aggressive responses: a) verbal manifest aggression (VM); b) physical manifest aggression (PHM); c) indirect aggression (IND); d) verbal latent aggression (VL), and e) physical latent aggression (PHL). In the analysis of anxiety is used Beck Anxiety Inventory, BAI. Average training period was 7.8 +/- 3.6 years. Even 37 athletes during sporting carriers were injured, and most of examiners (precisely 13) experienced 3 injuries. Average value of BAI was 12.7 +/- 8.7. Average value of total aggression was 152.2 +/- 40.9; highest levels were observed in VM (33.9) and VL (30.1). Significant positive correlations of all components of aggression with level of anxiety is observed (p < 0.05), most prominent IND (r = 0.4263; p = 0.0012), and VL (r = 0.4163; p = 0.0016), and also total aggression (r = 0.4822; p = 0.0002). Slightly significant positive correlation of total aggression with age of examiners is also observed (r = 0.2668, p = 0.0489). Positive correlation VM (r = 0.4928; p = 0.0001), PHL (r = 0.2761; p = 0.0413), and total aggression (r = 0.347; p = 0.0094) is observed with number of injuries of examined athletes. Also, positive correlation (r = 0.2927, p = 0.0301) is observed with level of anxiety and number of injuries. Higher level of aggression and anxiety might change attitude of some sports authorities (especially coaches), and additional psychological training of fight sports might be necessary. CONCLUSION: Assessment of basically levels of aggression and anxiety of athletes might be valuable not only in sport activities, but in overall aspects of life.

Betahistine or Cinnarizine for treatment of Meniere's disease.

INTRODUCTION: Meniere's disease is a condition with sudden attacks of vertigo with nausea and vomiting accompanied by loss of hearing and buzzing sensation in the ears, most commonly unilateral. The exact cause of the disease is unknown. Betahistine is the analogue of histamine with weaker agonistic effect on histamine H1 receptors and stronger effect on histamine H3 receptors, while Cinnarizine has more effective effect on H1 receptors. GOAL: The aim is to determine which drug is more effective in the treatment of Meniere's disease Betahistine or Cinnarizine. MATERIAL AND METHODS: This study evaluates the effectiveness of Betahistine in 37 patients with the Meniere's syndrome accompanied by classic triad of symptoms treated in hospital conditions and Cinnarizine effect in 36 patients with a less severe clinical picture, which were treated as outpatients. To all patients were conducted laboratory tests, brain CAT (to exclude possible expansive process, MS or stroke) and TCD in order to eliminate any possible circulatory disturbances in VB basin. Group with classic Meniere's syndrome was treated at a dose of Betahistine of 3 x 16 mg and followed 8 weeks, while the second group was treated with Cinnarizine at a dose of 2 x 75 mg and also followed for 8 weeks. CONCLUSIONS: Already after one month of therapy was noticed better effect in case of Betahistine in terms of symptoms reduction compared to the Cinnarizine effect.

Stress as provoking factor for the first and repeated multiple sclerosis seizures.

INTRODUCTION: Multiple sclerosis is an inflammatory, autoimmune, disease of the white mass of the brain, which sometimes may involve the gray matter (subcortical and ones in the anterior horns of the spinal cord) with the chronic nature and generally with progressive course. As a possible cause of this disease state are listed genetic predisposition, early viral infections and environmental factors, with special effects of stress as a provoking factor in first episode of the disease and relapses because stress leads to modulation of the immune system and immune response to various causes. GOAL: To determine the existence of intense stressful events as a factor in the development of the first episode of illness and worsening of the seizures. MATERIAL AND METHODS: We analyzed all newly discovered cases of multiple sclerosis over a two year period (January 2010 - December 2011) during the first or second hospitalization, and worsening of seizures for previously diagnosed patients in this period. In order to confirm the MS diagnosis are taken history, neurological examination, MRI of the brain, VEP, CSF examination and for those with repeated hospitalization only follow-up of EDSS scores trough neurological examination. RESULTS: During the two year period there were 109 newly diagnosed cases of MS from which 80 F and 29 M (ratio 2.7:1), aged 17-59 years, mean age 32.93±9.69 years and 41 patients (29 F and 12M with seizures worsening in previously diagnosed disease. Disease duration was from 6 months to 17 years. 72.94% had relapsing-remitting course of the disease (RRMS) and 27.1% had secondary progressive type (SPMS). Stress as a provoking factor preceded in 47.44% the first episode of the disease, infections (respiratory) in 18.3%, and the pregnancy with postpartum period in 8.77% women, whereas in the group of patients with previously diagnosed illness relapse (n=41) showed that the infection is most common precipitating factor which preceded relapse in 58.54% of patients, stress in 29.02%) and the pregnancy with postpartum period in 12.5% of patients. CONCLUSION: An intensive stressor is certainly one of the triggers for the development of Multiple Sclerosis, as the first episode and worsening of previously established disease.