Short-term efficacy of vedolizumab in patients with inflammatory bowel disease in real-life settings in Bosnia and Herzegovina.

Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), necessitates effective management strategies. This study aims to evaluate the real-world efficacy of vedolizumab, a newer biological therapy, in treating IBD in Bosnia and Herzegovina. A retrospective observational study was conducted across 6 medical centers, involving 139 IBD patients, 76 with UC and 63 with CD. Patients were assessed for clinical remission and other outcomes at the 26-week mark post vedolizumab treatment initiation. At 26 weeks, clinical remission was achieved in 82.9% of UC patients and 85.7% of CD patients. Mucosal healing was observed in 38.1% of CD patients. The efficacy of vedolizumab did not significantly differ based on prior anti-tumor necrosis factor (TNF) exposure. Notably, the clinical scoring tools for predicting vedolizumab response showed limited applicability in this cohort. Vedolizumab demonstrated high efficacy in treating both UC and CD in a real-world settings in Bosnia and Herzegovina, underscoring its potential as a significant therapeutic option in IBD management.

Personality Traits and Health Related Quality of Life in Patients with Irritable Bowel Sindrome and Inflammatory Bowel Disease.

BACKGROUND: Personality traits as alexithymia and type D personality may impair health related quality of life (HRQoL) in patients with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Aim of this study was to evaluate personality traits in patients with IBS and IBD and their impact on HRQoL. MATERIALS AND METHODS: The subjects (40 patients with IBS, 40 with IBD and 40 health control subjects) completed SF-36 questionnaire, TAS-20 and DS14 scale. RESULTS: Patients with IBS and IBD had higher results on TAS-20 and DS14 scale when compared with healthy controls. Also IBS patients had higher scores than IBD patients. Higher scores on TAS-20 and DS14 scales in IBS and IBD patients correlate with lower HRQoL. HRQoL was poorer in IBS and IBD patients than in healthy control subjects. CONCLUSIONS: Alexithymia and type D personality in IBS and IBD patients are associated with lower HRQoL and psychological interventions should be considered.

Prevalence of Gestational Diabetes Mellitus and Perinatal Outcomes According to the Old Who Criteria and IADPSG Criteria.

BACKGROUND: Gestational diabetes mellitus (GDM) is the most common metabolic disorder in pregnancy. Pregnancies with GDM have worse outcomes compared to pregnancies with normal glucose tolerance. The objectives of the study were to determine the prevalence of GDM and perinatal outcomes according to the old WHO criteria and IADPSG criteria. SUBJECTS AND METHODS: A retrospective study included 2,405 pregnant women who delivered between January 2009 and December 2010. According to the OGTT results, pregnant women were divided into 4 groups. We analyzed the prevalence of GDM, characteristics of pregnant women and their newborns and perinatal outcomes. RESULTS: We found significantly higher prevalence of GDM according to the IADPSG criteria compared to the WHO criteria. Pregnant women with GDM were significantly older, had higher pre-pregnancy BMI, fasting and 2-h plasma glucose. Pregnant women with GDM had worse pregnancy outcomes compared to control group. The overall proportion of overweight and obese pregnant women was the highest in the group of untreated pregnant women with GDM according to the IADPSG criteria. In this group we found significantly higher rate of fetal macrosomia and LGA. The rate of caesarean section was significantly higher in comparison to control group. Pre-eclampsia was significantly more common in groups of pregnant women with GDM compared to control group. CONCLUSION: IADPSG diagnostic criteria reveals more women with hyperglycemic disorders in pregnancy. A group of pregnant women who were normoglycemic according to the WHO criteria, but according to the IADPSG were diagnosed GDM, had adverse pregnancy outcomes. Lower values of glycemia, than those defined for diabetes in pregnancy, are associated with adverse pregnancy outcomes.

Anxiety, Depression and Personality Types in Patients with Inflammatory Bowel Disease: Comparisons with Peptic Ulcer and the General Population.

BACKGROUND: To explore corellation of anxiety, depression ant type of personality in inflammatory bowel disease (IBD) and compare with peptic ulcer (PU). SUBJECTS AND METHODS: In this study, prevalence of anxiety, depression and type of personality was investigated in 362 cases divided into three groups: 112 of IBD patients, 122 of peptic ulcer patients and 128 of control group who didn't have any gastrointestinal or psychic complaints. IBD and peptic ulcer diagnosis were established by standard diagnostic procedures (anamnesis, clinical manifestations, laboratory, endoscopy and biopsy in IBD and upper endoscopy in peptic ulcer). Anxiety and depression were established by Hamilton anxiety rating scale (HAM-A) and Hamilton rating test for depression (HAM-D). Type of A/B personality was established by Bortner scale and D type of personality by Denollet scale (DS14). RESULTS: Anxiety was found in 47 (41.9%) and depression in 44 (38.3%) of a total of 112 IBD cases. In group with peptic ulcer anxiety was found in 40 (32.8%) and depression aalso in 40 (32.8%) of total 122 cases. In control group anxiety was diagnosed in 21 (16.4%) and depression in 20 (15.6%) of total 128 cases. Anxiety and depresson were significantly higher in both groups than in control group but anxiety and depression were significantly higher in IBD group than peptic ulcer group. D type of personality was statistically significant in peptic ulcer group. CONCLUSION: Anxiety and depression in IBD and peptic ulcer cases have a greater prevalence compared to the normal population and surprisingly are higher in IBD than peptic ulcer group. D type of personality is associated with peptic ulcer.

Nutritional Assessment of Patients with Primary Progressive Dementia at the Time of Diagnosis.

BACKGROUND: patients with different types of dementia may experience changes in nutritional status, which are manifested by specific eating habits. The aim of this study was to determine the nutritional status and eating habits of patients at the time of confirmed diagnosis of primary progressive dementia. SUBJECTS AND METHODS: The study included 40 outpatients (63% women) diagnosed with either form of dementia. The mean age at diagnosis was 77±6 years and the mean time between the onset of first symptoms of the disease and diagnosis was 3-36 months. Nutritional assessment was determined at the time of confirmed diagnoses and included dietary habits (non-quantitative modified food frequency questionnaire (FFQ)), anthropometric (body weight and height and body mass index-BMI) and biochemical parameters (serum concentrations of vitamin B12, folic acid and 25-hydroxy vitamin D). Dietary habits were collected over a 12-month period with the help of a spouse or close family member. RESULTS: The results showed that none of the outpatients were malnourished, the largest number of outpatients (43%) were in the normal body mass category followed by 33% in the overweight category. The results of this study confirmed previous findings of higher preference for sweet foods observed in 53% of patients with dementia. Low status of vitamin B12 was observed in 57% of outpatients, folic acid in 24% and 25 (OH) D in 75% of outpatients. Lower frequency of consumption of dark green leafy vegetables and lower consumption of poultry meat, fish and eggs could have an impact on nutrient deficiency. CONCLUSIONS: The poor nutritional status of outpatients with primary progressive dementia is associated with unhealthy dietary habits that may lead to micronutrient deficiencies. Dietary monitoring and intervention should be initiated immediately after the diagnosis of primary progressive dementia with the goal of reducing nutritional deficiencies and preventing further and more severe impairment of cognitive function.

Depression Disorders in Patients with Chronic Hepatitis C.

BACKGROUND: Chronic hepatitis C was until recently treated with a combined therapy of interferon and ribavirin. More recently, direct antiviral agents (DAA), are being introduced. They are more tolerable and have fewer side effects, with better treatment results. In the Federation of Bosnia and Herzegovina we have started using this new therapy, with a limited financial opportunity. Large numbers of patients with chronic hepatitis C are former or current addicts, some of them treat their addiction with methadone or buprenorphine. These patients often formerly have a depression disorder and during treatment of chronic hepatitis need supervision of a psychiatrist, due to one of the side effects of interferon being deterioration of depression. Using this research we wanted to valorize the depression disorder of our patients, to indicate the effects of interferon on depression deterioration and the need for a new therapy protocol. SUBJECTS AND METHODS: Examinees were patients with chronic hepatitis C on interferon therapy, which we divided into three groups: those who were never addicts, then the group of patients who were earlier addicts and have a long abstinence and patients who treat their addiction with a replacement therapy of methadone or buprenorphine. All patients completed Beck's test, which determines the level of depression, before and after interferon therapy. RESULTS: Patients who used to be addicts or were on replacement therapy had mild or moderate depression before interferon treatment in a large number. After interferon therapy, there was a statistically substantial increase of patients with serious depression, which was not noted before the therapy. CONCLUSION: Interferon therapy deteriorates depression in patients with chronic hepatitis C and there should be a strive for new therapies with less side effects in treatment. No patients stopped therapy. That is a result of community work and supervision over patients from both hepatologists and psychiatrists.

Nutritional status and its effect on complications in patients with colorectal cancer.

BACKGROUND: Nutritional status is an important factor for predicting the risk of developing complications after a surgical procedure. Many nutritional assessments are used in clinical practice, but their role in predicting postoperative outcomes is unknown. Therefore, the aim of this study was to assess the utility of nutritional risk factors at the diagnosis of colorectal cancer (CRC) for predicting early postsurgical complications. METHODS: This was a prospective observational study including 127 patients with CRC at diagnosis. Their preoperative nutritional status was analyzed by body mass index (BMI), triceps and subscapular skinfolds and two nutritional scales: the Patient-Generated Subjective Global Assessment (PG-SGA) and the Malnutrition Universal Screening Tool (MUST). The outcome variables, including postoperative complications, length of hospital stay and mortality, were analyzed. RESULTS: Patients identified as malnourished by PG-SGA score had prolonged hospital stays (p = 0.01). The risk of infection was increased in older patients (hazard ratio, HR 1.12; 95% confidence interval, CI 1.04-1.21) but was not associated with nutritional status. Early wound dehiscence was increased in patients with higher BMI (HR 1.15; 95% CI 1.01-1.29), with higher subscapular skinfold thickness and increased age (HR 1.05; 95% CI 1.05-1.10). Postoperative mortality was not significantly associated with nutritional status. CONCLUSION: Malnourished patients, as identified by the PG-SGA score, stayed longer in hospital than patients who were not malnourished, while increased BMI was recognized as a risk factor for wound dehiscence.

Helicobacter pylori in Otorhinolaryngology: Cause or Bystander.

The bacteria Helicobacter pylori (H. pylori) have been identified in the extragastric tissues in the head and neck. The origin and pathogenicity of these bacteria in the head and neck are not known. Gastric reflux and nasal or oral routes are the possible modes of spread. In many sinonasal, pharyngeal, laryngeal, and middle ear disorders, laryngopharyngeal reflux has been identified as a contributing or causative factor. One possible mode by which laryngopharyngeal reflux may contribute is by seeding of the extragastric mucosa with H. pylori. The clinical significance of the discovery of H. pylori in extragastric tissues in the head and neck is unclear. There is no evidence of a pathologic or active role of H. pylori in otorhinolaryngological disorders. The suggestion that the sinonasal cavities and pharynx may serve as a reservoir for H. pylori and that reinfection of the stomach occurs after eradication therapy awaits further studies for confirmation. No connection was observed between H. pylori found in the stomach and H. pylori found in the head and neck. Also, these bacteria, found in the head and neck tissues, may be accidental or innocent bystanders that do not affect the pathways of otolaryngological and gastroduodenal diseases. This review examines the evidence for a possible relationship of H. pylori with otorhinolaryngological diseases.

Medical Hodegetics - Almost Forgotten Art and Science of Upbringing Medical Doctors.

INTRODUCTION: Education in medicine faces a number of challenges and dilemmas and the onus is on Medical hodegetics, an important but almost forgotten discipline, to address them effectively. The task and final goal of education in medicine is to coach students into professionals, effective and ethical practitioners of medicine, giving them the best available knowledge, skills and attitudes and providing them with a professional identity so that they are able to think, speak, act and feel like medical doctors. During the life course human beings organize their experiences into a meaningful narrative that involves their personal, private, public and professional selves. The self can be defined as a distinct principle of identity, as a narrative construction and as an experiential dimension. AIM: The aim of this paper is to address the actuality and vitality of the hodegetic approach in medical education and professionalism. METHODS: By cross-sectional study authors of the paper searched on-line scientific data-bases and analyzed references about Medical hodegetics subject. RESULTS: Drawing on the literature on psychology of self, identity formation and personality styles as well as on own experience in medical education, the authors stress the increasing importance of medical hodegetics, very useful, but almost completely forgotten discipline. Medical hodegetics which involves all evidence-based medicine, values-based medicine, narrative medicine and person-centered medicine can significantly improve the quality of medical education. The identity of any person in any moment reflects its three domains: individual identity, relational identity, and collective identity, all relevant to medical education. The concept of professional identity formation has recently emerged and attracted great attention in literature on medical education and professionalism. Hodegetics, as a discipline that trains it, seems to us that the essential part of life and what every person should follow. CONCLUSION: Medical hodegetics is an important pillar of the triad of medical deontology as well as it could be an important discipline in medical education and professional identity formation.

Liver transplantation and allergy: transplant-acquired food allergy.

Transplant-acquired food allergy is a well known phenomenon especially linked to liver transplants. Risk factors lie both in transplant recipient and transplant donor - age of recipient and the maturity of immune regulatory mechanisms, family history of atopy in recipient, young age of the donor and atopic history in donor. The exact mechanism has not yet been established and there are many different explanations of this pathophysiologic process. Transplanted liver is a large and well perfused organ, rich in pluripotent hematopoietic stem cells and donor's IgE antibodies that can alter immunological response in the host. Some studies suggest that post-transplant immunosuppression with tacrolimus is linked to an increased occurrence of IgE-mediated sensitization and manifestation of allergic disease. Research in the field of transplant-acquired food allergy is not important only for transplant patients and physicians involved but also for understanding the mechanism of food allergy development in general population and potentially reducing this global health concerning issue.

Preoperative Anaesthesiologic Evaluation of Patient with Known Allergy.

Anaphylaxis is an unanticipated systemic hypersensitivity reaction which can produce deleterious effects, even death, if not treated promptly. Preventive approach implies taking a thorough anamnesis with the emphasis on previously diagnosed allergies. If an allergic reaction occurred during previous surgery, a detailed documentation of administered anaesthetic agents and drugs would be crucial for the following anaesthesiologic management. Preoperative planning and avoiding cross-reactivity with drugs commonly used during anaesthesia are the key points to prevent an anaphylaxis. In case of emergency surgery when the exact identification of allergens is not possible, premedication prophylaxis should be considered. General measures for prevention of anaphylaxis could be undertaken as well, such as the choice of anaesthesiologic drugs and techniques in the operating theatre adequately equipped for the management of predictable anaphylaxis.

Area Under the Curve of Finger Photoplethysmography as an Evaluation Measure for Sympathetic Activity During Lumbar Epidural Anaesthesia.

OBJECTIVE: To detect changes in finger photoplethysmography after administration of epidural anaesthesia as a surrogate method for evaluating autonomic nervous system activity. METHODS: We included a total of 46 patients scheduled for elective surgical procedures under lumbar epidural anaesthesia. A Biopac SS4LA pulse plethysmograph transducer was used for photoplethysmography recording, and the device was placed on the first toe of the right leg. The first standard lead of the electrocardiogram was simultaneously measured with the finger photoplethysmography. First measurement was done before the administration of epidural anaesthesia, and second measurement was done 25 minutes post administration of epidural anaesthesia. RESULTS: The area under the curve of the finger photoplethysmography statistically significantly increased 25 minutes after administration of epidural anaesthesia compared with the first measurement (p=0.0001). The amplitude of the finger photoplethysmography as well as the pulse transit time also statistically significantly increased after administration of epidural anaesthesia. CONCLUSION: The area under the curve reflects the changes in sympathetic activity after epidural anaesthesia below the block level. It can be used for the detection of the degree of sympathetic block and, respectively, for epidural block success. Future prospects include detection of sympathetic block cessation as an indicator for discharge from the awakening room and beginning of patient verticalisation.

Prognostic value of vitamin D receptor and insulin-like growth factor receptor 1 expression in triple-negative breast cancer.

AIM: Triple-negative breast cancer (TNBC) is characterised by shorter overall survival and an early peak of distant recurrences with still no specific targeted treatment available. Vitamin D receptor (VDR) and insulin-like growth factor receptor 1 (IGFR) have recently been described as potential new targets for anticancer therapy, yet their roles in TNBCs are still to be explored. In this study we investigated VDR and IGFR expression in patients with TNBC and compared them with clinical and pathological parameters and survival to possibly demonstrate their prognostic and therapeutic relevance. METHODS: The study included 96 patients with TNBC. Clinical and pathological parameters were compared with the immunohistochemical expression of VDR and IGFR. RESULTS: Positive VDR immunostaining was present in 27% of tumours and inversely correlated with higher mitotic score, histological grade and higher proliferation index measured by Ki-67 and related to the increased overall survival (OS). Out of 96 patients with TNBC, 35.5% of tumours were IGFR positive and correlated with higher mitotic score and Ki-67, and strongly correlated with shorter disease-free survival (DFS). Patients with VDR-negative and IGF-positive tumours had significantly lower DFS and OS. CONCLUSION: Approximately one third of TNBCs express VDR and/or IGFR. Their expression is linked with the recurrence of the disease and survival, which make them possible targets for treatment and a prognostic tool for dividing TNBCs into more homogeneous subgroups.

The historical use of medicinal plants in traditional and scientific medicine.

There is a strong connection between man and nature, ever since his first origins, the man discovered the benefits of the plant kingdom, which he used to feed himself, to heal and to survive. Following the use of eatable, medicinal and poisonous plants takes us into the distant past. The man's first knowledge about plants passed from generation to generation. The ancients Chinese, Egyptians, Indians, Greeks, Romans and the Old Slavs knew a large number of medicinal plants. That knowledge was carried over to other nations as well. Thanks to its geographical location and climate condition, our country is abundant and very rich in variety of species of medicinal plants. In the Middle Ages, there were written many herbal manuals that described the use and procedures in healing with medicinal plants. Many plants were known by the oldest civilizations and they were used by the people for thousands of years. Moreover, today's science has confirmed their effectiveness in the treatment of different diseases.

Immunohystochemical Expression of Vitamin D Receptor in Development Stages of Colorectal Carcinoma.

BACKGROUND: Chemo preventive and antitumor role of vitamin D is manifested through genetic and non genetic ways with a powerful antproliferatory and proapopoptic effect, which is proven by numerous epidemiologic studies. The genetic activity of vitamin D is determined through vitamin D receptors (VDR), a member of stero-thyreoidal family of nuclear receptors, which with vitamin D form a cell nucleus complex responsible for the chemo preventive and antitumor effect. VDR in tissue cells is present in the cytoplasm and the nucleus and manifests its genetic activity after transfer from the cytoplasm to the nucleus. The mechanisms for the transport and genetic control of the transport of VDR from cytoplasm to the nucleus in not yet completely understood. SUBJECTS AND METHODS: By using immunohystochemistry we are evaluating the correlation of cytoplasmic and nuclear expression of VDR during different stages of colorectal carcinoma: normal colorectal mucosa, hyperplasic polyp, low grade adenoma (LGD), high grade adenoma (HGD) and colorectal cancer. RESULTS: Our results confirm that the nuclear VDR expression is strongest in normal colorectal mucosa and in hyper plastic polyps, is gradually weakened in low and high grade adenoma while it is extremely weak or absent in colorectal carcinoma. At the same time the expression of cytoplasm VDR is weakest in normal colorectal mucosa and hyper plastic polyps while it grows during the adenoma stage and is most expressed during colorectal carcinoma. CONCLUSION: We conclude that vitamin D has a strong chemo preventive and antitumor effect in normal colorectal mucosa and hyper plastic polyps, while its antitumor and chemopreventive effect is progressively weakened and ultimately absent in colorectal carcinoma.

Activity of the hypothalamic-pituitary-adrenal axis and inflammatory mediators in major depressive disorder with or without metabolic syndrome.

BACKGROUND: The aim of the present study was to explore the differences in serum CRP, IL-6, TNF-α, ACTH and cortisol among patients with major depressive disorder with or without metabolic syndrome (MS) compared to a healthy control group. SUBJECTS AND METHODS: The MDD study group consisted of 80 patients (mean age of 50.03±9.55 years). The control group was recruited from the hospital personnel and it consisted of 40 examinees (mean age of 47.20±7.99 years). All patients who participated in the study were diagnosed with depressive disorder using MINI questionnaire, and Hamilton rating scale for depression. Diagnosis of the metabolic syndrome was set by NCEP ATP III criteria. RESULTS: Examinees with depression but without MS had significantly more cortisol concentration when compared to the control group. CRP was significantly higher in the MDD group when compared to the control group and in MDD+MS group when compared to the control group. IL6 serum levels were significantly higher in the MDD group when compared to the healthy control group, and in MDD+MS group when compared to the healthy control group. ACTH had significant independent predictive values for abdominal obesity. Levels of TNF-α were statistically significant independent predictors for hyperglycaemia. Statistically significant predictive values for MDD were found for cortisol, and IL-6. CONCLUSION: Results shown here emphasise the importance of neuroendocrine and inflammatory factors in pathogenesis of depressive disorder and MS. Further prospective research is necessary to clarify possible causal relationship between depression and MS. It is necessary to investigate the possibility of a joint biological mechanism in pathogenesis of these two disorders with the special attention given to the disturbances in the immune system.

Correlation of clinical and endoscopic indices in IBD patients in University Clinical Hospital Mostar.

BACKGROUND: To explore correlation between clinical and endoscopic indices in inflammatory bowel disease (IBD) patients. SUBJECTS AND METHODS: There were 112 patients with inflammatory bowel disease. All patients with diagnosed IBD was established a degree of clinical and endoscopic disease activity. CDAI (Crohn's disease activity index) was used as clinical and SES-CD (Simplified Endoscopic Crohn Disease Index) as endoscopic index for Crohn's disease. For ulcerative colitis Truelov & Witts index was used as clinical and Baron as endoscopic activity index. Correlation of clinical and endoscopic indices were compared in Crohn disease (CD) and ulcerative colitis (UC). Patients were analyzed by clinical entities - CD and UC, according to sex, age, parameters of anemia, duration of disease and education. RESULTS: In the total of 112 IBD patients there were 69 patients diagnosed as ulcerative colitis (61.6%) and 43 as Crohn's disease (38.4%). There were 58 (51.8%) women and 54 (48.2%) men. Comparison between endoscopic and clinical indices in CD and UC demonstrated no significant differences in ilnness activity. Endoscopic and clinical disease activity was associated with a higher inflammatory parameters (CRP and leucocytes, L) and lower parameters of hemoglobin (Hb) and MCV. CONCLUSION: Our research has established a good correlation between clinical and endoscopic index of disease activity in the CB and UC in inflammation. Clinical indices can be used for monitoring inflammation.

HBV and HCV serological monitoring among injection drugs users in opiate substitution treatment in Bosnia and Herzegovina.

INTRODUCTION: Use of intravenous heroin carries a risk of serious medical conditions, including acquiring blood-borne infections. Therefore, hepatitis B virus (HBV) and hepatitis C virus (HCV) infection represent a threat for people who inject drugs (PWID). The objectives of this study were to determine the extent and characteristics of risk factors for acquiring HBV and HCV infection in PWID included in opiate substitution treatment in the southern part of Bosnia and Herzegovina (B&H). METHODOLOGY: The study included 120 adult PWID of both sexes who participated in opiate substitution treatment. All participants were interviewed, and their blood samples were tested for the presence of the surface hepatitis B virus antigen (HBsAg) and hepatitis C virus antibodies (anti-HCV). Prevalence data were obtained and compared to the serological status. RESULTS: HBsAg prevalence among PWID was 0.8% (1/120), whereas seroprevalence of anti-HCV was 52.5% (63/120). PWID exposed to risk-behavior factors (such as unsafe sexual activity, serving prison sentence, and tattooing) were more frequently anti-HCV positive. Sharing drug paraphernalia was found to be the most significant risk factor. The highest predictive values for acquiring HCV-infection were attributed to PWID who used heroin for more than three years and who were unmarried. CONCLUSIONS: HBsAg prevalence among PWID is rare (0.8%), while HCV-infection (52.5%) presents an important health and social issue among PWID in B&H. Sharing drug paraphernalia and intravenous heroin use longer than three years were the most prominent risk-behavior factors among the patients we investigated.

Prevalence of amebiasis in inflammatory bowel disease in University Clinical Hospital Mostar.

AIM: To explore the prevalence of amebiasis in inflammatory bowel disease (IBD), Crohn's disease and ulcerative colitis, in patients in Clinical hospital Mostar (Bosnia and Herzegovina, region of Herzegovina). METHODS: In this study, Entamoeba histolytica/dispar prevalence was investigated in fresh faeces by native microscopy and immunochromatographic rapid assay "RIDA(®)QUICK Entamoeba test", in 119 cases of new found IBD patients, 84 of ulcerative colitis and 35 of Crohn's disease and in control group who had also 119 patients who didn't have any gastrointestinal complaints. IBD diagnosis was established by standard diagnostic procedures (anamnesis, clinical manifestations, laboratory, endoscopy and biopsy). RESULTS: Entamoeba histolytica/dispar were found in 19 (16.0 %) of a total of 119 cases, 12 (14.3 %) of the 84 patients with ulcerative colitis and 7 (20.0 %) of the 35 patients with Crohn's disease. As for the 119 patients in the control group who had not any gastrointestinal complaints, 2 (1.7 %) patients were found to have E. histolytica/dispar in their faeces. Amoeba prevalence in the patient group was determined to be significantly higher in group with Crohn's disease, ulcerative colitis and IBD total than in the control group (p < 0.001). CONCLUSION: Ameba infections in patients with Crohn's disease and ulcerative colitis, have a greater prevalence compared to the normal population.

Socio-Cultural Effects on Mental Health and Common Chronic Diseases in Primary Care Patients in East and West Mostar, Bosnia and Herzegovina: Preliminary Results.

Since war activities, the previously mixed population of Mostar, Bosnia and Herzegovina, live in segregated parts of the town based on ethnicity. The aim of this study was to examine differences in health risks and health status between populations of the two parts of the town. Health status of 300 randomly selected primary care patients was evaluated by practicing family physicians in two main primary care centers in West and East Mostar. Each group consisted of 150 patients. Data were collected between December 2013 and May 2014. Patients were evaluated for smoking habit, alcohol consumption, body mass index, blood pressure and laboratory measurement of fasting glycemia. Family physicians provided diagnosis of chronic noninfectious diseases (hypertension, diabetes mellitus, cardiovascular disease, malignant disease, depression, and alcoholism). The two groups differed according to age, income, employment status, and rate of alcoholism and hypertension. Alcoholism (OR= 4.105; 95% CI 2.012-8.374) and hypertension (OR=1.972; 95% CI 1.253-3.976) were associated with inhabitants of West Mostar, adjusted for age, employment and income status on logistic regression. In conclusion, ethnic differences between inhabitants of the two parts of the town might influence health outcomes. These are preliminary data and additional studies with larger samples and more specific questions considering nutrition and cultural issues are needed to detect the potential differences between the groups.