Model "P" in gender prediction based on the mastoid process.

Aim To determine the degree of accuracy in determining the sex of the skull based on classical morphometric analysis of the mastoid process. Morphometric analysis excluded a subjective approach expressed in osteoscopic analysis. Methods The study was conducted on a sample of 100 macerated skulls of known gender and age from the second half of the 20th century, including the Bosnian population. Of the 100 skulls, 50 (50%) were male and 50 (50%) were female. Male skulls were on average 60 (47-71) years old and female 57 (43-76) years old. At each mastoid process, 3 measurements were made: mastoid length, mastoid width (medio-lateral diameter) ML) and anteroposterior diameter (AP) of the mastoid process. Results Using the univariate method, we found a significant difference between length, width, AP diameter and size of mastoid processes as well as between gender (p <0.05). Multivariate binary logistic regression showed statistically significant differences in AP diameter of the mastoid process (p<0.05). Conclusion The created model "P" ("P"=exp [X]/1+exp [X]) for sex determination based on mastoid process showed sensitivity of 82% correct prediction for female skulls and 65% accurate prediction for male skulls. This discourse with respect of population standards grants most effective anthropological proof and as such may be suggested for forensic expertise based on human skull.

Elevated Serum C-Reactive Protein Level Is not Associated with Serum Nitric Oxide in Patients with Posttraumatic Stress Disorder.

BACKGROUND: The aim of the present study was to evaluate serum nitric oxide (NO) and C reactive protein (CRP) concentration in veterans with and without PTSD. Furthermore, we aimed to assess whether there is a correlation between serum NO and CRP concentrations in tested groups. SUBJECTS AND METHODS: Cross-sectional study included 90 male individuals, with and without experience of direct war combat, divided into three equal groups (n=30): group 1- included war veterans with PTSD, group 2 - included war veterans without PTSD, and control group - 30 apparently healthy volunteers, without experience of direct war combat. The diagnosis of PTSD was assessed according to the guidelines in the 10th revision of the International Classification of Diseases (ICD-10). High-sensitivity CRP was determined by immunonephelometry. The serum NO level was determined by classic colorimetrical Griess reaction. RESULTS: Serum CRP concentration in veterans with (3.54±1.19 mg/L) and without PTSD (3.24±2.04 mg/L), was significantly higher (p<0.05) compared to control group (1.26±1.06 mg/L). Serum NO concentration in veterans with (7.64±4.43 µmol/L) and without PTSD (7.12±2.60 µmol/L) was significantly lower (p<0.05) compared to control group (11.26±7.01 µmol/L). Statistically significant correlation between serum NO and CRP concentration was determined in veterans without PTSD (r=-0.473; p<0.01). No correlation was observed between serum NO and CRP concentration in veterans with PTSD (r=0.118; p=0.534) and in control group (r=-0.067; p=0.727). CONCLUSION: The present study has showed significant increase of serum CRP and significant decrease of serum NO concentrations in veterans with and without PTSD. Furthermore, statistically significant negative correlation between serum NO and CRP concentration was determined only in veterans without PTSD. Obtained results indicate that the complex mechanism of the pathogenesis of PTSD requires further research.

Metabolic Syndrome and Serum Liver Enzymes Level at Patients with Type 2 Diabetes Mellitus.

OBJECTIVES: The aim of this study was to evaluate liver function in patients with type 2 diabetes mellitus (T2DM) with and without metabolic syndrome (MS) by determining serum levels of gamma glutamyltransferase (GGT), alanine aminotransferase (ALT) and aspartate aminotransferase (AST). We also investigated correlation between levels of liver enzymes and some components of MS in both groups of patients. METHODS: This cross-sectional study included 96 patients (age 47-83 years) with T2DM. All patients were divided according to the criteria of the National Cholesterol Education Program (NCEP) in two groups: 50 patients with T2 DM and MS (T2DM-MS) and 46 patients with T2DM without MS (T2DM-Non MS). The analysis included blood pressure monitoring and laboratory tests: fasting blood glucose (FBG), total lipoprotein cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), fibrinogen and liver enzymes: GGT, ALT and AST. T2DM-MS group included patients which had FBG ≥ 6,1 mmol/L, TG ≥ 1,7 mmol/L and blood pressure ≥ 130/85 mm Hg. RESULTS: T2DM-MS patients had significant higher values of systolic blood pressure, diastolic blood pressure and medium arterial pressure compared to T2DM-Non MS patients. Serum levels of TC, TG, LDL-C, VLDL-C and FBG were significantly higher in the T2DM-MS group compared to the T2DM-Non MS group. Serum fibrinogen level and GGT level were significantly higher in patients with T2DM-MS compared to the serum fibrinogen level and GGT level in T2DM-Non MS patients. Mean serum AST and ALT level were higher, but not significantly, in patients with T2DM and MS compared to the patients with T2DM without MS. Significant negative correlations were observed between TC and AST (r= -0,28, p<0,05), as well as between TC and ALT level (r= -0,29, p<0,05) in T2DM-MS group of patients. CONCLUSION: These results suggest that patients with T2DM and MS have markedly elevated liver enzymes. T2DM and MS probably play a role in increasing the risk of liver injury.

Life Satisfaction and Risk-taking Behavior in Secondary Schools Adolescents.

INTRODUCTION: Life satisfaction involves cognitive component that allows evaluation of the life and accomplishments of life, and emotional component that includes an evaluation of emotions and mood that followed these accomplishments. GOAL: To examine the life satisfaction of young people who attend secondary school, examine the level of satisfaction with life according to sex, to academic achievement, the presence of siblings and to examine the relationship between levels of life satisfaction and risk-taking behaviors. RESULTS AND DISCUSSION: The results showed that there was no relationship between life satisfaction and preferences of delinquency, as well as life satisfaction and achieved academic success. The results confirmed the relationship between life satisfaction and sex as well as the relationship between life satisfaction and the presence of siblings in the family.

Correlation between change in air humidity and the incidence of stroke.

INTRODUCTION: According to the World Health Organization estimates annually in the world die due to CVI every sixth women and 10(th) man. This paper is the research of the correlation between changes in relative air humidity and stroke (CVA) in the Sarajevo Canton. Included are patients who experienced an acute stroke in the Canton of Sarajevo and treated in the pre hospital phase by the staff of the Institute for Emergency Medicine. Days with stroke and those without cases of stroke were compared within three years and meteorological data for those days were obtained by the Weather Bureau of Federation of Bosnia and Herzegovina. Meteorological data include measurements of average humidity every day at 7, 14 and 21 o'clock in three years. AIM: To evaluate the significance of the influence of humidity on the incidence of CVI's. Show the trend towards CVI in the reporting period and is it correlated with the trend of change in relative humidity in those days. Correlate the incidence of stroke as determined in relation to gender, age and selected climatic parameter. MATERIAL AND METHODS: This article presents a retrospective study. Subjects were patients of Emergency Medical Care Institute in Sarajevo, which in the period from 2004 to 2006 had a CVI. Included are patients who had a working diagnosis of stroke for the first time or as a repeated stroke. Analysis of cases of stroke was carried out by gender, age, days and seasons by descriptive-analytical epidemiological methods. RESULTS: In total were registered 1930 patients during three years period. According to years of research in 2004-635, 2005-616 and 2006 - 679. It was found that when testing the null hypothesis about the effects of humidity in two months with a maximum stroke in the year and days without CVI and relative humidity only in 2005 had a statistically significant effect on the incidence of stroke, while during the other two years of the study there was no impacts. It turned out that the extreme values of relative humidity of the day whether there was a rapid increase or decrees in humidity increases the incidence of stroke in all three years of research. CONCLUSION: Patients gender had no effect on the incidence of CVI. Seasons had no effect on the incidence of CVI. Most CVI in all three years of research was in relation to the old age and occurred in the older age group 70-79 (41.35%), where it was shown that the age of the patient influences the incidence of CVI. Extremely low relative humidity and extremely high, influence on the increase in the number of CVI. Determined is a slight correlation between the average relative humidity and CVI in single day.

Correlation of barometer pressure and incidence of cerebrovascular insult.

INTRODUCTION: The intention of this work is to research whether the link between the barometer pressure and the cerebrovascular insult (CVI) exists. The stroke is the first cause of non-traumatic disability and third illness by mortality in the majority of available relevant literature. GOALS: Goal of the sudy was to research all the cases of the patients who suffered from the acute stroke in the Canton of Sarajevo and those who were treated in the pre-hospital phase by Emergency Medical Institute staff and their working diagnosis was established as CVI ac. MATERIAL AND METHODS: The criteria in the research were established for inclusion and exclusion of cases. The days with and without CVI cases were compared with the meteorological data obtained from the Hydro-meteorological Institute of Federation of Bosnia and Herzegovina . Since the approval was requested and obtained from the Hydro-meteorological Institute, all the meteorological data could be compared. The meteorological data comprise the barometer pressure measuring every day at 7 h, 14 h and 21 h. RESULTS AND DISCUSSION: In the retrospective study, there will be followed, during three years (2004, 2005 and 2006), the cases of the patients who suffered from the stroke, and, the emergency medical care was offered to them by the side of the Emergency Medical Institute of Canton of Sarajevo staff. All the cases in the Canton of Sarajevo were followed regardless of the place of incidence: whether the help was offered in Institute's outpatient departments, patient's flat or at public place. Due to the extensiveness of data (in the analysis comprising three years, there was the total of 1930 cases), the test of normal distribution was used. Since it was about the pre-hospital research, the acute stroke was looked at generally without division by types. The certain diagnostics by types can only be established in the hospital. CONCLUSION: The results in the research indicate that the extreme values of barometer pressure, regardless of their being increased ones or decreased ones, influence the increase of CVI incidence, while by comparing the average values in the days with CVI and without CVI, they did not have any influence on the CVI incidence.

[Comparison of efficiency and toxicity of two chemotherapy protocols in treatment of advanced non-small cell lung cancer].

INTRODUCTION: This study was aimed at comparing the efficiency and tolerability of two reference protocols Cisplatin and Etoposide and Cisplatin and Vinorelbine in advanced Non-Small Cell Lung Cancer. MATERIAL AND METHODS: A total of 60 patients (two groups consisting of 30 patients) were treated for advanced Non-Small Cell Lung Cancer during the period from January to December 2005 according to the reference protocols (Cisplatin 100 mg/m2 D1; Vinorelbine 30 mg/m2 D1, D8 on 4 weeks) and (Cisplatin 100 mg/m D1; Etoposide 100 mg/m2 D1, D3, D5 on 4 weeks) at the Department of Oncology of KBC "Bezanijska kosa". All patients were analysed for tumour response, progression free survival as well as for toxicity. X2 test, Kaplan Meiers curves and Log rank test were used for statistical analysis. RESULTS: Although the recorded response rates were a bit lower than in previously published trials, they were not significantly different p = 0.485. No statistically significant difference was recorded in either progression free survival or overall survival. The chemotherapeutical Cisplatin/Etoposide protocol proved to be more toxic both in hematologic (3% vs. 10%) and total toxicities (p = 0.047). CONCLUSION: Our study proved both protocols to have equivalent efficacy. However, the Cisplatin, Vinorelbine protocol could be recommended because of its less expressed toxic effects.

[Endometrial cancer associated with an increase of CA 15 3 and CA 125 in tamoxifen treated patients with breast cancer]. / Endometrijalni karcinom povezan s porastom CA15_3 i CA 125 u bolesnice s karcinomom dojke lijecene tamoksifenom.

The study presents a case of endometrial cancer in a breast cancer patient treated with tamoxifen. The disease occured with elevated values of CA 125 and CA 15_3 tumour markers without any other signs. Additional diagnostic analyses were performed showing a "de novo" endometrial cancer rather than metastatic breast cancer. The patient underwent surgery and radiotherapy. Thereafter, the values of tumour markers were in the reference values.

Coagulation factor VIII activity in diabetic patients.

AIM: To examine coagulation factor VIII activity in plasma, as a risk factor for thrombosis, in the patients with diabetes mellitus (DM). Also, to assess its relationship with fibrinogen and fasting blood glucose concentrations and with body mass index. METHODS: The plasma coagulation factor VIII activity, plasma levels of fibrinogen and blood glucose concentrations were measured in 30 patients with DM type 1, 30 patients with DM type 2 and in 30 healthy subjects. Body weight and body height were also measured and BMI was calculated. RESULTS: The plasma factor VIII activity in patients with DM type 1 and patients with DM type 2 was significantly higher than the values measured in healthy subjects. There was no significant difference in the factor VIII activity between patients with DM type 1 and type 2. The concentrations of fibrinogen and blood glucose in both groups of patients were significantly higher than in the group of healthy subjects. Patients with DM type 2 had a significantly higher BMI compared to healthy subjects, as well as compared to patients with DM type 1. There was a significant positive correlation between plasma factor VIII activity and plasma level of fibrinogen and a significant negative correlation between factor VIII activity and BMI in patients with DM type 2. CONCLUSION: Diabetic patients have the elevated plasma coagulation factor VIII activity and increased fibrinogen concentration thus an increased risk of thrombosis and vascular diseases.

Analysis of chemiotherapeutic protocols efficiency in therapy of advanced non small cell lung cancer.

AIM: To confirm the efficiency and toxicity of two chemiotherapeutic protocols- Cisplatin Gemcitabin (CDDP, Gemcitabin) and Cisplatin, Vinorelbin (CDDP, Vinorelbin) in advanced non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: Retrospectively were analyzed and treated a total of 60 patients (two groups with 30 patients) for advanced or metastatic NSCLC during the period from January 2005 to January 2007. The patients were treated with chemiotherapeutic protocols CDDP, Vinorelbin and CDDP, Gemcitabin for four weeks. The chemiotherapy was administered intravenously. RESULTS: Although registered response rates were a bit lower than in previously published trials, they were not significantly different in two arms (26% vs. 15%) (p = 0.485). Statistically different were therapeutic responses in SD (CDDP, Vinorelbin 44% vs. CDDP, Gemcitabin 93,3%) (P < 0.001) and OS (CDDP, Vinorelbin 10.83% vs. CDDP, Gemcitabin 21.00%) (p < 0.05). Cisplatin, Vinorelbin regimen has shown a higher hematologic (9% vs. 7%), and total toxicities (p = 0.0029). CONCLUSION: In this investigation of two groups of patients, Cisplatin, Gemcitabin regimen has shown better efficiency and toxicity profile. Preferred regimen could be Cisplatin, Gemcitabin.

[Acute coronary syndrome at the Institute of Emergency Medicine in Sarajevo]. / Akutni koronarni sindrom u praksi u ZHMP Sarajevo.

The coronary illness is the first cause of death and falling ill in the world. It is considered that, in more than 50% of cases, it is about the illnesses of heart and blood vessels as the cause of death. These results indicate the necessity to prevent and to treat correctly the persons suffering from cardivascular illnesses. The coronary illness represents the ischaemia myocardium as the consequence of reduced blood flow through the coronary arteries (one or more branches). There are more and more young persons suffering from this illness. In the Emergency Medical Institute Sarajevo, a retrospective-prospective analysis of patients with working diagnosis of ACS was carried out for the period of one year (01.01-31.12. 2008). The patients (279) were analyzed by gender, years of age, months (*when ACS occurred), seasons of year and hours of occurrence of ACS, therapy by applying low-molecular heparin and prospectively by symptoms, as well as usual risk factors.

Analysis of the electroencephalogram and pain characteristic in patients before and after carbamazepine treatment.

GOAL OF THE STUDY: To determine the changes of the electroencephalogram and the changes of the quantity in percentage terms of alpha, beta, theta and delta waves in the electroencephalogram in migraine patients after a carbamazepine treatment. Analyze pain characteristics after the carbamazepine treatment of these patients and the efficiency of the carbamazepine treatment in the prevention of new attacks. PATIENTS, METHODS, RESULTS: A retrospective-prospective study has been conducted on 40 persons of approximately 42,9 years of age, with normal cranium CT finding, craniogram and fundus. They were divided in two groups: Group A--21 person who prophylactically took a daily dosage of 400 mg Carbamezepin and during acute pain attacks Naproksen; and group B--19 persons who prophylactically took daily dosage of 400 mg Carbamezepin. EEG test was done twice--before and after the medication, in order to check the concentration of different waves in the EEG in percentages. The T-test doesn't show a statistically significant difference between the alpha (p 0,719), beta 1 (p 0,865), beta 2 (p 0,710), theta (p 0,867) and delta (p 0,272) waves for the group A and for the group B alpha (p 0,996), beta 1 (p 0,920), beta 2 (p 0,826), theta (p 0,324) and delta (p 0,820) waves, on the significance level p 0,05 in the EEG at the beginning and the EEG at the end of the examination. The t-test does show a statistically significant difference between the intensity, frequency, duration and relief of pain at the beginning and at the end of the examination for both test groups. CONCLUSION: Carbamazepin and Paracetamol do not cause changes in the EEG nor in the quantity in percentage terms of concentration of different waves in the control EEG in patients with vascular headaches. Statistically Carbamazepin and Paracetamol significantly change characteristics of pain and can be used for migraine treatment and prophylaxis.

[Electroencephalographic changes in headaches under the influence of pharmaceuticals]. / Elektroencefa ografske promjene u glavoboljama pod uticajem farmaka.

UNLABELLED: Headache can be manifested as primary disorder or it is a secondary symptom of some other illnes. Electroencephalography (EEG) is electrodiagnostic method which registers electric activity of brain cells and by this method therapeutic effect of single medicaments can be followed by comparing of EEG before and after medication. The aim of work was to test if there are changes in EEG in headaches under the influence of naproxen and sumatriptan in the acute attack of headache and during the prevention of often attacks of pain. PATIENTS, METHODS AND RESULTS: The retrospectiveprospective study was conducted on 92 patients, average age of 42.9 with regular CT of cranium, craniogram and fundus. They were divided in two groups based on drugs they were taking for the prevention or treatment of acute attack of pain. Group A 44 patients preventively took naproxen in the daily dose of 550 mg and in acute attack of pain sumatriptan and group B 48 patients in the acute attack of pain took sumatripanin one dose of 50 mg. Two EEG were recorded before and after medication and concentration of certain waves in EEG was followed. Statistics proved that there is no statistic difference in the EEG before and after medication. Hi square test (Hi Sq. = 1.087) does not show statistically important difference within the number of patients divided in groups, significance is on leve p = 0.297. T-test does not show existence of statistically important difference between concentration of Alpha, beta, teta and delta waves in starting EEG and in EEG at the end of testing after taking on Naproxen 550 mg daily for one month for group A and a pill of Sumatriptan in the acute attack for group B. CONCLUSION: It means that naproxen and sumatriptan at patients with headaches do not cause changes in EEG, nor percent concentration of single waves in starting and control EEG and statistically significant reduce pain at tested patients with vascular headaches.

[Hematological-biochemical tests in patient with migraine]. / Analiza hematolosko-biohemijskih pretraga u pacijenata sa migrenom.

Migraine is periodical disorder which is characterized by recurrent headache seizures different in intensity, frequency and duration. Amylases L-1,4 glycol: gluckanohidrolises, (EC.3.2.1.1) are enzymes from hydrolase's group which dissolve starch meaning glycogen. Activity of amylases in serum grows: at acute pancreatitis, at carcinoma of pancreas, heavy necroses of pancreas. Total number of examinees was 92 out of which 45 were male (48.9 %) and 47 female or 51.1 %. Average age of the examines was 42.9. Neuroticism scale which was tested by Cornell scale was 55,03. Out of the total number of examinees 30 or 32,6 were non-smokers while 62 or 67,4 % smoked regularly. The aim of this work is to perform hematological-biochemical test of blood in patients with migraine. In the beginning of this research it was planned for all the patients to have hematological blood test done (sedimentation of erythrocytes, trombocytes, complete blood test and differential blood test) and biochemical blood test (hepatogram, transamynase, amylase, Lactal dehydrogenase, Alkalic phosphatase, ferrum in serum, Glucose, Cholesterol, Calcium and Phosphorus in serum. After reviewing the received values of hematological and biochemical tests, all values were within the borders of normal values. Amylases had higher values at 49 or 53,3 % of patients, and 43 or 46,7 % of patients had normal values of amylases. Normal values of amylases are to 220 U/l measured by I.F.C. at 37 degrees C. Medium value in tested group is 219.09. It means that every second examinee had increased values of amylase in blood; there is no statistics difference of amylase value between sexes.

[Correlation between levels of blood glucose and cerebrospinal fluid glucose and proteins in diabetes mellitus]. / Korelacija nivoa glukoze u krvi i glukoze i proteina u likvoru u toku diabetes mellitusa.

Patient with diabetes mellitus is prone to develop the vascular lesion of blood vessels of all kinds. Microangiopathy and atherosclerosis are progressive during the illness. Also with this study blood brain barrier change in the diabetes mellitus patients was observed. In patients with diabetes mellitus the level of glucose and total proteins increased in the cerebrospinal fluid. During diabetes mellitus the change of permeability blood brain barrier is evident. Blood brain barrier permeability changes in the patients with ICV as well as in the patients without ICV correlate with the values of diabetes mellitus in blood.

Testing of potassium, sodium and chlorine in liquor at the patients with diabetes mellitus.

Patient with diabetes is susceptible to development of vascular lesions of the blood vessels of all sizes. During the discase there is a progressive development of microangiopatys and arterioscleroses. Continuing the works of Stanley I., Rapaport and other rescarches about changes of permeability of hcmatoenchepal barrier in experimental conditions, (according1) the changes of the barrier at patients with diabetes mellitus was examined in this work. At the patients with diabetes mellitus level of sodium in liquor increases, and the level of chlorine and potassium in liquor decreases.

[Permeability of the hematoencephalic barrier by proteins in diabetes mellitus]. / Ispitivanje propustljivosti hematoencefalne barijere za proteine u toku oboljenja diabetes mellitus.

Patient with diabetes mellitus is prone develop vascular lesion of blood vessels of all kinds. Microangiopathy and atherosclerosis are progressive during the illness. Following the study of Stanley I. Rapport the at all scientist on blood brain barrier permeability change in experimental conditions, also with this study blood brain barrier change in the diabetes mellitus patients was observed. In patients with diabetes mellitus the level total proteins increased in the cerebrospinal fluid.