1st International Medical Students' Congress Sarajevo 2015 January 29th February 1st 2015, Sarajevo Bosnia and Herzegovina

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2 1st International Medical Students' Congress Sarajevo 2015 January 29th February 1st 2015, Sarajevo Bosnia and Herzegovina

3 IMPRESSUM: Editor in Chief: Ema Tahto Techical Editor: Anes Jogunčić Language Editor: Adi Kovačević Publisher and owner: Association of students of the Medical Faculty in Sarajevo ASMFS For Publisher: Malik Ejubović Printed by: Eurocopy d.o.o. Adress: Čekaluša 90, Sarajevo, Bosnia and Herzegovina Copies: 250 ISBN: Reviewers: prof. dr Sabaheta Hasić doc. dr Maida Rakanović Todić 2 P a g e

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5 Abstract book, 1 st International Medical Students' Congress Sarajevo 2015 Abstract book published by Association of students of the Medical Faculty in Sarajevo-ASMFS Firstly, we would like to point out the significance of International Medical Students' Congress Sarajevo 2015 taking place. This is unique opportunity to exchange ideas and experiences that aim to support professional and scientific discussions related to medicine. Organizing of such an event could not be possible without engagement of the enthusiastic group of student at Sarajevo University. It was our pleasure to give our contribution in finalization of the Abstract book. Abstract book of the 1 st International Medical Students' Congress in Sarajevo 2015 provides information regarding different forms of activities, such as plenary lectures, workshops, courses and plenary sessions, which will be performed during the Congress. The book is organized in two sections. First one consists of plenary lectures, workshops and courses. Plenary lectures cover different areas of medicine, such as Neurosurgery, Medical Biochemistry, Biology and Genetics, Pharmacy, Industry and their application in medicine. These are presented by acknowledged experts. Furthermore there are five workshops in areas of: Endoscopic Management of Upper and Distal Gastrointestinal System, Wound Management and Suturing, Minimally Invasive Abdominal Surgery, Cardiopulmonary Resuscitation, Delivery and Caesarean section. These are mentored by eminent supervisors, as a guarantee that the congress participants will have the opportunity to improve their skills in everyday medical practice. The second section of the Abstract book consists of eight plenary sessions, covering research topics in Medicine, Dentistry, Pharmacy and Genetics. All submitted abstracts (66) are categorized in appropriate plenary session and placed in one of the following categories: poster or oral presentation. The vast majority of chosen abstracts, summaries the original studies well, indicating broad spectrum of interests and expertise of their authors and mentors. Therefore, the audience have the opportunity to refresh their knowledge and stay up to date with different scientific disciplines in medicine. Accepted papers have shown that students strive for high quality goals. Their dedication and accomplishments instill confidence in good future of medical science and practice in their countries. Lastly, we would like to wish you all the best in presenting the results of your scientific research and are hoping for credible and encouraging discussion to take place. Best regards, Associate Professor Sabaheta Hasić, MD, PhD Assistant Professor Maida Rakanović-Todić, MD, PhD 4 P a g e

6 CONTENT Foreword 5 Congress Organising Committee 9 Honorary and Scientific board: 12 Plenary lectures 13 Workshops and courses 14 Congress programme Plenary Session I Physiology, Anatomy, Preventive medicine 15 Plenary Session II Microbiology, Immunology, Pharmacology, Pharmacy 24 Plenary Session III Histopathology, Histology 31 Plenary Session IV Internal medicine, Oncology 40 Plenary Session V Neurology, Psychiatry, Physical medicine and rehabilitation, Defectology 54 Plenary Session VI Surgery, Otorhinolaryngology, Anesthesiology 63 Plenary Session VII Gynecology, Pediatrics 72 Plenary Session VIII Dentistry 81 Scientific partners and friends 91 About USMF 99 City of Sarajevo 100 Index of Authors P a g e

7 FOREWORD Dear students and colleagues, On behalf of Medical Faculty University of Sarajevo I would like to give all the participants a warm welcome to the 1st International medical students congress organized by the Association of students of the Medical Faculty in Sarajevo. We are proud and delighted to have the opportunity to host 235 young scientists and future doctors from different countries including Indonesia, Europe and South America in Sarajevo, a city, which has been a crossroad between East and West, a meeting place for different cultures and diversity of people and ideas throughout its history. Striving for excellence in medical education and medical profession is about integrating intercultural dimension and global perspectives into the teaching-learning process and research. The Congress will provide international platform where future doctors and scientists can share their research findings and ideas on various themes in the field of medicine. I would like to acknowledge the excellent contributions by the authors whose work will be presented through oral and poster presentations during the Congress. Their work shows us that we have talented students who will become the future leaders of medical science and profession. At last but not least, this Congress will hopefully bring you many new friendships and experiences giving inspiration for future collaborations and exchange of ideas throughout your medical carriers. Wishing you lots of success in your work during the Congress and pleasant stay in Bosnia and Herzegovina and Medical Faculty in Sarajevo. Yours sincerely Professor Almira Hadžović-Džuvo, MD, PhD Dean of Medical Faculty University of Sarajevo 6 P a g e

8 FOREWORD Dear participants, colleagues and friends, It is with great pleasure that we welcome you to the 1st International Medical Students' Congress in Sarajevo SaMED This Congress is an official project of the Association of Students' of the Medical Faculty in Sarajevo. SaMED 2015 was founded by students with the goal of creating a platform for young researchers from various nations, fields, and faculties to connect and share knowledge, experiences, and future concepts. The Congress itself provides an excellent environment for medical students from around a world to interact through various scientific lectures and activities. Medicine is an endless pool of knowledge, and saying that, we will all have something to learn during the congress. It is going to be an amazing opportunity to gain insight into new ideas and concepts, as well as form new friendships between nations, faculties, and students. We hope that we are going to become an annual meeting and that each year the number of foreign and domestic participants will increase. We are delighted to have you here, taking part in this event, and we hope that you will have a great time in Sarajevo! The SaMED 2015 Organizing Committee will do all it can for you in the next four days, and we hope to see you next year in even greater numbers. Best regards. On behalf of the Organising Committee, Ema Tahto, President of the 1st SaMED 7 P a g e

9 FOREWORD The International Medical Students Congress 2015 (SaMED) will be held from 29 th January until 1 st February in Sarajevo, Bosnia and Herzegovina, under the auspices of Faculty of Medicine, University of Sarajevo. During the congress, participants will be informed about achievements, progress and experiences of eminent domestic experts in various fields of medical science and profession. Experts will have the chance to talk about their own accomplishments in their fields of interest in biomedicine and health. Every conference gives participants the chance to exchange ideas, opinions, achievements and future endeavors in both theoretical and practical aspect. However, international health and biomedicine forums that unite students, except the opportunity for exchanging ideas, give them a look into other international and domestic efforts and improve their medical practice and research abilities. The organization of SaMED 2015 is the result of ambition and hard work of all members of both organizing and scientific committee, with special regards to our young power, supported by management of Faculty of Medicine, University of Sarajevo. We hope that congress will satisfy all the participants expectations. We are sure that, by actively taking part in discussions and lectures at different sessions, you will have an amazing chance to exchange experiences and broaden your scientific knowledge. We are convinced that the Olympic city and European Jerusalem Sarajevo, as well as your hosts, will certainly inspire you. Last but not least, we wish you all successful congress, inspiring atmosphere and pleasant stay in our city. Associate Professor Radivoj Jadrić, MD, PhD President of the Scientific Board of the 1 st SaMED 8 P a g e

10 FOREWORD Dear Participants, On behalf of the Association of students of Medical Faculty it is my great pleasure and honor to welcome you to Sarajevo and to the First international congress of medical students and young doctors SaMED Personally, I am very proud to be the President of Association of students of Medical Faculty in this historical moment. After months of hard work, our dream has finally come true. When we had first started with the planning of SaMED, we could not have dreamed that we are going to have Congress with more than 200 participants from 17 countries all across the world. That is honor and privilege, but also an obligation. We have to keep up this way and try to make SaMED even bigger in years to come. This Congress is certainly a special occasion for all participants, to meet, to listen, to discuss, to share information and to plan for the future. Indeed, a congress is an opportunity to discuss key points of scientific and professional policies and strategies, helping us to define how we should encourage responsible conduct in our scientific research and also to establish personal contacts with colleagues from other parts of the world. We hope that you will enjoy the Congress and that your interaction with your colleagues from many different countries will stimulate a creative exchange of ideas and will be personally rewarding. We also hope and trust that you will enjoy your visit to the very beautiful and exciting city of Sarajevo. Yours sincerely Malik Ejubović, President of Association of students of Medical Faculty 9 P a g e

11 CONGRESS ORGANISING COMMITTEE Ema Tahto, President of the 1st SaMED and project coordinator Malik Ejubović, Finance and science team coordinator Najra Nikšić, Finance team coordinator Anes Jogunčić, Technical support coordinator and marketing team coordinator Emina Borovac, PCT coordinator 10 P a g e

12 Jana Kupusović, Social events coordinator Adi Kovačević Hosting team coordinator Malik Galijašević, Student vice dean Faris Kadić Logo designer 11 P a g e

13 OC MEMBERS: Ajan Alen Alimanović Vildan Aruković Nermina Asotić Amina Asotić Denis Avdagić Mevlida Begić Edin Begić Nedim Čokić Emir Drpljanin Edina Dupanović Sabina Duvnjak Sanela Džinović Ena Đozić Ada Eminović Meris Fatić Vildana Gadžo Rusmir Gagula Adnan Gološ Mirza Hadžić Amila Hadžić Sadžida Hadžimuratović Amila Hundur Hamzalija Huskić Vildana Jesenković Džan Ahmed Jusić Lejla Kacila Amra Karamehić Emina Kiseljaković Meliha Kovačević Nina Kruščica Merima Kučinar Merima Merdić Almina Nalbani Elma Omanović Sedina Osmanbegović Esma Pašagić Selma Pidro Aida Risonjić Anita Rovčanin Bekir Selimović Tarik Sikira Hana Smajović Dženita Spahić Adnan Spahić Selma Šabanović Jasmin Škrijelj Venesa Šumar Nina Zoranović Dinko 12 P a g e

14 HONORARY BOARD prof. dr Almira Hadžović-Džuvo prof. dr Rusmir Mesihović prof. dr Mirsad Dorić prof. dr Izet Mašić prof. dr Zakira Mornjaković prof. dr Šukrija Zvizdić prof. dr Senka Mesihović-Dinarević prof. dr Sebija Izetbegović prof. dr Ismet Gavrankapetanović prof. dr Mirza Dilić doc. dr Emina Kiseljaković SCIENTIFIC BOARD prof. dr Radivoj Jadrić prof. dr Amela Kulenović prof. Svjetlana Radović prof. dr Nenad Vanis prof. dr Enra Suljić prof. dr Sabina Vranić Mahmutović doc. dr Amina Valjevac doc. dr Zlatan Zvizdić doc. dr Mirjana Gojkov doc. dr Enita Nakaš dr. sci. med Amel Hadžimehmedagić mr. sci. dr Zijo Begić 13 P a g e

15 PLENARY LECTURES Kemal Dizdarević, MD, PhD Professor of Surgery, Neurosurgery University of Sarajevo, Faculty of Medicine Lecture: "Science And the Living Human Brain: Clinical Exploration And Manipulation of Neural Networks and Structural Lesions" Emina Čengić-Kiseljaković, MD, PhD Assistant Professor at Department of Medical Biochemistry University of Sarajevo, Faculty of Medicine Lecture: "What Do We Know About Respiratory Chain?" Almir Badnjević, dip. ing. el. Verifikacioni laboratorij "VERLAB" d.o.o. Industry expert at Faculty of Electrical Engineering University of Sarajevo Lecturer at International Burch University Lecture: "Classification of Respiratory Diseases Using Integrated Software Suite" Elma Mrehić, MA Biology and genetics Manager for medical affairs at CryoSave - The Family Stem Cell Bank Lecture: "Cryo-Save's State-of-the-Art Processing and Storage of Stem Cells From the Umbilical Cord" Anela Sehic Lihovac MD, Bosnalijek d.d. Lecture: Pharmacological Aspect of Lysozyme in the Composition of the New Unique Oral Antiseptic 14 P a g e

16 WORKSHOPS AND COURSES ENDOSCOPIC MANAGEMENT OF UPPER AND DISTAL GASTROINTESTINAL SYSTEM Supervisor: Nenad Vanis, MD, PhD Clinic for Gastroenterology and Hepatology University Clinical Center of Sarajevo WOUND MANAGEMENT AND SUTURING Supervisor: Malik Jakirlić, MD Clinic for Reconstructive and Plastic Surgery University Clinical Center of Sarajevo MINIMALLY INVASIVE ABDOMINAL SURGERY Supervisor: Nedžad Šehović, MD, PhD Clinic for Glandular and Oncological Surgery University Clinical Center of Sarajevo CARDIOPULMONARY RESUSCITATION Supervisor: Slavenka Štraus, MD, PhD Clinic for Anesthesiology and Reanimatology University Clinical Center of Sarajevo DELIVERY, CESAREAN SECTION Supervisor: Anela Softic Kasumovic, MD Clinic for Gynecology and Obstetrics University Clinical Center of Sarajevo 15 P a g e

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18 Physiology Anatomy Preventive medicine 17 P a g e

19 FREE FATTY ACIDS ARE ALTERED BY ACUTE EXERCISE IN HIGHLY TRAINED MALE WATER POLO PLAYERS Authors: MIRELA VATIĆ 1, Dolika Vasovic 1 Mentor: Marina Đelić, MD 2 1 University of Belgrade, Faculty of Medicine 2 Department of Medical Physiology, Institute Rihard Burijan, Belgrade, Serbia (Poster presentation) INTRODUCTION: The early pioneers in the field of metabolism during exercise pointed that the fat is an important substrate for muscule contraction. Triglycerides, stored in adipose tissue and muscle fibres, are considered to be the main source of free fatty acids (FFA) oxidised during exercise. But there are no details of the fuel for muscle contraction during acute exercise in highly trained male water polo players. AIM: The aim of this study was to investigate is there a difference between metabolism of athletes and physically inactive subjects after single bout of exercise test. MATERIALS AND METHODS: Ten highly trained male water polo players and ten physically inactive subjects (control) underwent performed maximal treadmill test. Blood samples were obtained before, immediately after, and after 30 minutes of recovery. Serum concentrations of glucose and FFA were determined from those samples. RESULTS: The level of glucose in control subjects was significantly higher immediately after the test (p<0.01) and in 30 minutes of recovery (p<0.05) compared to the beginning of the test. The level of FFA in athlets was significantly higher compared to control subjects in 30 minutes of recovery (p<0.05). The level of FFA in athlets was significantly lower immediately after the test (p<0.01) and in 30 minutes of recovery (p<0.05) compared to the beginning of the test. CONCLUSION: The results of this investigation showed that in highly trained subjects metabolism was phisiological changed compared to physically inactive subjects. Precisely, fuel for contraction in athlets obtained from FFA oxidised, during acute physical activity. Keywords: physical activity, glucose, free fatty acids mirela_oskar@yahoo.com 18 P a g e

20 THE RELATIONSHIP BETWEEN PREMENSTRUAL SYNDROME (PMS), BODY MASS INDEX (BMI) AND LIFESTYLE FACTORS Author: AIDA PIDRO 1 Mentor: Amela Dervišević, MD 2 (Oral presentation) 1 University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina, 2 Department of Human Physiology, Faculty of Medicine University of Sarajevo, Sarajevo, Bosnia and Herzegovina INTRODUCTION: Premenstrual syndrome (PMS) is a set of physical and psychological symptoms that affects woman s life in different aspects. Women are not aware of risk factors that can make their symptoms worse which is why it is important to find relationship between these factors and severity of the symptoms. AIM: To determine the relationship between BMI and lifesyle factors with severity of PMS symptoms and to see how these factors affect women s health. Lifestyle factors include physical activity, smoking, drinking alcohol, eating salty food, vitamins and minerals. MATERIALS AND METHODS: A cross-sectional study was conducted on 100 female students of Medical Faculty University of Sarajevo, mean age 23,3±1,97 years (min. 20, max. 28 years). Students fulfilled a questionnaire that contained questions about their age, current weight, height and certain lifestyle habits that are considered to be risk factors for developing severe premenstrual syndrome. The questionnaire also included estimation of physical and psychological symptoms. After collecting data, analysis was done using SPSS 13.0 programme. RESULTS: Results showed that 73% of medical female students had PMS symptoms, of which 49,32% had mild, 35,61% moderate and 15,07% severe symptoms. Average BMI of students with PMS was 22.52±2,76 kg/m2. There was a strong positive correlation between BMI and severity of PMS symptoms (r=0,531; p<0,0005). We found strong positive correlation between physical activity and PMS symptoms severity (r= 0,474 p<0,0005). Eating salty food was the only lifestyle factor that show poor, but statistically significant, positive correlation with PMS (r=0,2, p=0,045). CONCLUSION: According to our study, there is a positive correlation between BMI and symptoms characteristic for PMS. Lifestyle factors that showed positive correlation are eating salty food and not exercising regularly. It is not found that other lifestyle factors were in correlation with severity of PMS symptoms. Keywords: Premenstrual syndrome (PMS), body mass index (BMI), lifestyle factors aida.pidro@gmail.com 19 P a g e

21 THE EFFECT OF NIGHT SHIFT CLINICAL ROTATION TOWARDS ATTENTION AND REFLEXES OF THE RESIDENTS COMPARED WITH PRECLINICAL STUDENTS IN DR. SOETOMO TEACHING HOSPITAL, SURABAYA, INDONESIA (Oral presentation) Authors: MICHAEL JONATAN 1, Amal Arifi Hidayat 1, Firas Farisi Alkaff 1, Mirza Gilangmas Perdana 1 Mentor: Irfiansyah Irwadi, dr., M.Si 2 1 Universitas Airlangga, Faculty of Medicine, Surabaya, East Java, Indonesia 2 Department of Physiology, Universitas Airlangga, Faculty of Medicine, Surabaya, East Java, Indonesia INTRODUCTION: As health workers, attention and reflexes are very important to accomplish better efficiency and effectiveness in emergency situations. There are many factors that affect attention and reflexes, such as stress and fatigue. Reaction Time (RT) is the best parameter for measuring attention and reflexes. AIM: The aim of this study was to explore the effect of night shift clinical rotation towards attention, alertness, and reflexes in residents compared with preclinical students. MATERIALS AND METHODS: We examined 32 subjects (16 male, 16 female), which are divided into 2 groups, 16 residents (R) and 16 preclinical students (PS) in DR. Soetomo Teaching Hospital. The preclinical group slept for 5-7 hours in the last 24 hours; on the other hand the residents of DR. Soetomo Teaching hospital only slept less than 3 hours. We collect the data using Whole Body Reaction Time Type II machine using three methods, which are simple visual, simple auditory, and choice auditory reaction time. Other factors that affect RT are made constant. RESULTS: The age of the subjects was between (mean 21.35). The mean score result for R vs PS reaction time (CI=95%) was: simple visual ± vs ± (p=0.0001). Simple auditory test ± vs ± (p=0.0001), auditory choice reaction test ± vs ± (p=0.015). CONCLUSION: Long hours of night shift clinical rotation (16 hours a day) reduce the attention and reflexes (increase the reaction time) of medical residents compared with preclinical students. Residents are so drained by their schedule, including the clinical rotation that it interferes with their circadian rhythm that they are rarely in the best state of mind to learn and could not do their best in emergency situations, which can lead to human error and malpractice. Keywords: Reaction time, Residents, Attention, Reflex, Clinical rotation michaeljonatan1996@gmail.com 20 P a g e

22 CT INVESTIGATION OF THE RELATIONSHIP OF THE OPTICAL CANAL AND NERVE TO THE SPHENOIDAL SINUS AND POSTERIOR ETHMOIDAL CELLS (Oral presentation) Authors: DŽENAN JAHIĆ 1, Amina Asotić 1, Edin Begić 1, Amir Jahić 1, Nedim Begić 1 Mentor: Prof. Eldan Kapur,MD, PhD 2 1 University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina 2 Department for Anatomy, University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina INTRODUCTION: A CT scan of the orbit and its adjacent structures shows the detailed display of anatomical structures, relationships and variations. AIM: To analyze the relationship of the optical canal and nerve to the sphenoidal sinus and posteriror ethmoidal cells. MATERIAL AND METHODS: 100 scans of patients from Clinics of Radiology (Clinical Center University of Sarajevo) were made on Somatom Art Siemens. Orbits were without pathological process. Data was collected from both sexes in axial and coronal projection, 3mm slices - bone window. RESULTS: In 100 CT scans (200 sides), three types of the relationship were found. In the first type, the optical canal is placed superolateral to the sphenoid sinus. Second type represented the canal that passes exactly through the superolateral part of the sphenoid sinus. Third type represented that the optic canal might be very close to the sphenoid sinus and posterior ethmoidal cells. The first type was shown in 159 cases (out of , 5%). In this type, dehiscence of the bony wall of the optic canal was found in 4 cases, while pneumatization of anterior clinoid process occurred in 6 cases. The second type was found in 10 (5%) cases. The dehiscence and pneumatization were found in all 10 cases. The third type was found in 31 cases (15, 5%). Dehiscence was not present, pneumatization appeared just once. CONCLUSION: The type where optic nerve goes superolateral to the sphenoid sinus was the most common (79,5%). In the second type (5%), optic nerve is vulnerable in surgical procedures and sinusitis very dangerous anatomical variation. In third type (15, 5%), bony wall of optic canal is very thin and approach to ethmoidal and sphenoidal sinus should be done very carefully. Therefore, CT scan is recommended before surgical procedures in this region. Keywords: Optic nerve, optic canal, posterior ethmoidal cells, computed tomography (CT) djahic@gmail.com 21 P a g e

23 THE PREVALENCE OF SMOKING AMONG MEDICAL WORKERS OF HEALTH CARE CENTER IN PODGORICA Authors: DJULA EROVIC 1, Danijela Knezevic 1 Mentor: Ifeta Erovic, MD 2 (Oral presentation) 1 University of Montenegro, Faculty of Medicine 2 Department of Hygiene and Epidemiology, Health Care Center Bijelo Polje, Montenegro INTRODUCTION: The tobacco smoke contains a number of carcinogenic substances and during the years of its consumption, it causes the damage of almost whole body system. Dependence that occurs is a big social problem due to passive smokers. And, the role of the medical workers in quitting smoking is huge. AIM: Our aim was to show how medical workers use tobacco products even though they are aware of its harmful effects. MATERIALS AND METHODS: We had interviewed 48 doctors and 152 nurses through an anonymous poll. Those who were interviewed, were divided in three groups- non-smokers, ex-smokers and smokers. The survey was about the duration of smoking and the number of smoked cigarettes compared to age, occupation and sex.the results were presented in tables and charts. RESULTS: Of the 200 respondents, 48 were physicians (24%) and 152 were nursetechnicians (76%) of different ages. From 48 doctors, 22 (46%) of them were male and 26 (56%) were female. Among 152 persons with high school medical degree, 54 (36%) of them were male and 98 (64%) were female. Almost half of the interviewed medical workers i.e. 45% were smokers. The rest of them, 37 % were non-smokers.while only 18% of them belong to group of ex- smokers. CONCLUSION: The number of smokers among health care workers is unacceptabl high. Even they are aware of harmful effects that tobbaco products cause, they do not take any specific measures. So they are very bad example for the society and according to them, the society relies and justify its actions. Key words: smoking, health workers, the consequences djula-91@hotmail.com 22 P a g e

24 EFFECT OF OCCUPATIONAL EXPOSURE TO COTTON DUST ON RESPIRATORY SYMPTOMS, ATOPIC STATUS AND VENTILATORY FUNCTION (Oral presentation) Authors: BABAČIĆ HARIS 1, Kandić Elma 1, Murtezani Avdi 1, Jovanovska Anamarija 1, Mentor: Prof. Jordan Minov MD, PhD 1 1 Medical Faculty, University St. Cyril and Methodius Skopje, R. Macedonia AIM: To assess the effect of workplace exposure to cotton dust on respiratory symptoms, atopic status and ventilatory function. MATERIALS AND METHODS: We performed a case-control study including 80 cotton spinners (40 male and 40 female, aged yrs, duration of exposure yrs) and an equal number of office workers, matched by sex and age. Respiratory symptoms in the last 12 months (cough, phlegm, dyspnea, wheezing, and chest tightness) were recorded by questionnaire, skin prick tests to standard aeroallergens were performed, and spirometric measurements were carried out. RESULTS: We found non-significantly higher prevalence of respiratory aymptoms in cotton spinners than in office workers (43.2% vs. 31.6%, P > 0.05) with significantly higher frequency of cough (44.4% vs. 18.6%, P < 0.05) and phlegm (20.8% vs. 8.0%, P < 0.05). The prevalence of atopy was non-significantly higher in cotton spinners (29.6% vs. 24.4%, P > 0.05) with highest prevalence of sensitization to Dermatophagoides pteronissynus in both examined groups (17.6 vs. 12.8%, P > 0.05). Mean values of FVC, FEV1, FEV1/FVC%, FEF50, and FEF25 were significantly lower in exposed workers ( % vs %, % vs %, % vs %, % vs %, and % vs %, respectively). CONCLUSION: Our data support the view that workplace exposure to cotton dust leads to respiratory symptoms, immunological changes and airflow limitation. Keywords: respiratory system, cotton dust, workplace exposure haris.babacic@gmail.com 23 P a g e

25 POST-DEFECATION RECTAL HYGIENE CLEANING TOOLS USED IN THE GENERAL WESTERN-EUROPEAN POPULATION BETWEEN THE AGE OF YRS AND THEIR INFLUENCE ON THE PERIANAL REGION Author: ADI YASER (Oral presentation) INTRODUCTION: Todays standard of post-defecation anal hygiene in the western world is limited to cleaning with soft tissue paper, particularly in Germany, it is the common form in the general population. So far, the cutaneous irritation of the anal region, because of fecal particles and enzymes, which leak from the anal part of the rectus, was not investigated in this age-group. However it has been scientifically proven, that fecal matter does cause irritations in the perianal region. AIM: The aim of this case control study is to collect data of comparability by using sample subjects of all four habits such anal cleansing in combination with soft paper wiping, wet wipes wiping as well as just soft paper wiping and anal cleansing. Several symptoms and medical conditions will be taken into consideration, that have been experienced by patients. SUBJECTS AND METHODS: In this study at least 200 Patients will be included, who have been using the soft tissue paper as a cleaning tool as well as at least 200 Patients using the combination of water and soft tissue paper, as well as at least 100 subjects using just water and 100 using only wet wipes after defecation for a continuous time-frame of not less than 6 months. Data will be collected from patients in the study group, who have filled out a standardized questionnaire. Main criterion will be the evaluation of the anal medical condition in all four study groups. Collected data will be statistically evaluated by medical students responsible for the study design and with professional statistical help and tools such as SPSS. EXPECTED RESULTS: Data is expected to show, that most patients using water in addition to soft tissue paper will be experiencing significantly less symptom occurrence. The lesser occurrence of the symptoms will probably be accompanied by an increased healthrelated quality of life. The opposite side is expected to report a significantly higher occurrence in respect to itching, wetting and burning sensation of the skin in the anal and perianal region. yaser_adi@hotmail.com 24 P a g e

26 Microbiology Immunology Pharmacology Pharmacy 25 P a g e

27 MULTIPLE DRUG RESISTANCE-1 GENE (MDR1) POLYMORPHISM IN PATIENTS WITH RENAL TRANSPLANTATION: COMPARATIVE ANALYSIS STUDY OF TWO TACROLIMUS BRAND-NAME DRUGS (PROGRAF AND PANALIMUS) Authors: MARKO PIZUK 1, Andrija Jekic 1 Mentor: prof. dr Vera Pravica 2 (Oral presentation) ¹School of Medicine, University of Belgrade ²Laboratory for Immunology, Institute of Microbiology and Immunology, School of Medicine, University of Belgrade INTRODUCTION: Generic drugs are significantly cheaper than brand-name drugs, but it is important to consider narrow therapeutic index that these drugs have before their use in treating patients. Different formulations of the same drug do not always have the same therapeutic effect in each individual that emphasizes the possibility that there are significant differences in the concentrations of the active substance in the blood. The tested drugs are transported within the body via the P-glycoprotein encoded by the MDR1 gene. Polymorphisms of this gene can lead to differences in the metabolism of these drugs. AIM: The aim of this study is to examine differences in the concentration of drug in the blood in two groups of patients that received different drugs, which have the same amount of active substance and to determine the possible influence of genetic predisposition for these differences. MATERIAL AND METHODS: 66 patients were divided into equal two groups according to whether they received treatment with a generic form (Panalimus) or a brand-name drug (Prograf). Most attention is devoted to monitoring the concentration of the drug in the blood of patients. Detection and analysis of polymorphisms ofmdr1 gene was done by real-time PCR. RESULTS: By following these two groups of patients we found that patients who were treated by Panalimus had significant variation in the concentration of drug in the blood compared to the other group of patients treated by Prograf, while no significant difference in genotype polymorphism ofmdr1 gene was noticed. CONCLUSION: Although generic drugs are cheaper than the brand-name drugs, sometimes their effect is not satisfactory and must be replaced by more expensive alternatives to avoid adverse effects on the patient. The investigated polymorphisms had no influence on drug concentrations results in blood of patients. Keywords: MDR1 gene polymorphysms, generic drugs markopizuk@yahoo.com 26 P a g e

28 MICROBIOLOGICAL DIAGNOSIS OF TUBERCULOSIS IN OSIJEK BARANJA COUNTY DURING A FIVE-YEAR PERIOD Authors: MARIN KUHARIĆ 1, Dragan Janković 1, Igor Jertec 1, Ivan Kotris 2 Mentor: Domagoj Drenjančević, MD, PhD 2 (Poster presentation) 1 Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek 2 Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek Department for Microbiology and Parasitology INTRODUCTION: As a serious infectious disease, tuberculosis is a large global health threat. It manifests itself as a series of clinical and microbiological reactions created as an inflammatory response of the human body to Mycobacterium tuberculosis. AIM: The aim of this study was to examine the distribution and resistance of Mycobacterium tuberculosis isolated from different clinical samples in OsijekBaranja county during a fiveyear period ( ). MATERIALS AND METHODS: As a retrospective study, archival data from a five-year period was obtained and used, which included clinical samples analyzed at the Laboratory for tuberculosis, Microbiology Service of the Public Health Institute of Osijek Baranja County. The largest number of clinical samples was obtained from the respiratory tract (56% sputum, 10% bronchoscopy samples).the data were analyzed using descriptive statistics (Microsoft Office Excel 2010). RESULTS: 1.6% of all examined clinical samples were smear microscopy positive, while in 2.6% Mycobacterium tuberculosis was cultivated and isolated. Of those cultivated samples, 0.3% was resistant to typical antitubercular therapy. During the examined five-year period, tuberculosis incidence showed a continuous downward trend. Lowest recorded incidence was in CONCLUSION: With a continuous downward trend of tuberculosis incidence in Osijek Baranja county during the examined five-year period, current control and prevention measures should continue to be implemented in the future. Key words: tuberculosis, sputum, resistance, distribution marin@kuharic.org 27 P a g e

29 COMMON SYMPTOMS ASSOCIATED WITH ABNORMAL VAGINAL FLORA AMONG WOMEN OF REPRODUCTIVE AGE Authors: DOLIKA VASOVIC 1, Mirela Vatic 1 Mentor: Prof. Slobodanka Djukic, MD, PhD 2 1 University of Belgrade, Faculty of Medicine 2 Department of Microbiology and Immunology (Poster presentation) INTRODUCTION: Bacterial vaginosis (BV) is one of the most frequent disorders of vaginal ecosystem in women during their reproductive life. The main complaints of women with symptomatic BV include vaginal discharge and odour. However, a substantial, but highly variable, percentage of all women are said to be asymptomatic. AIM: The aim of this study was to evaluate symptoms present among women in reproductive age with abnormal vaginal flora and to compare them with those present in group with normal vaginal flora. MATERIALS AND METHODS: 80 women presenting for a routine health care visit were recruited to participate in a longitudinal study of vaginal flora. They underwent a lower genital tract microbiological evaluation and an interview that included detailed questions regarding lower genital tract symptoms. The diagnosis of BV was based on the Nugent scoring system. RESULTS: The results showed statistically significant difference in two symptoms: increased vaginal fluid [BV (65.6%); NF (25.7%); IF (30.8%)] and increased symptoms following sexual activity [BV (46.9%); NF (5.7%); IF (23.1%)]. Statistically significant difference was also seen comparing the frequency of increased vaginal fluid among women with disturbed and normal flora [DF (55.6%); NF (25.7%)] and the frequency of increased symptoms following sexual activity [DF (40%); NF (5.7%)]. There were no asymptomatic women in a group with diagnosed BV, but almost 69% of women with intermediate flora had no symptoms following present changes in vaginal flora. CONCLUSION: The main symptoms in examined women of reproductive age were increased vaginal fluid and increased symptoms following sexual activity. These symptoms were found more frequently among women with disturbed vaginal flora compared with women with normal vaginal flora. Key words: bacterial vaginosis, symptoms, diagnosis dolika.vasovic@gmail.com 28 P a g e

30 RENEW ME Authors: ZEYNEP DAĞLAR 1, Kamile Karabulut 1 Mentor: Hakan Emmez 2 (Oral presentation) 1 Gazi University School of Medicine, Ankara, Turkey. 2 Departments of Neurosurgery, Gazi University School of Medicine, Ankara, Turkey INTRODUCTION: The axolotls also known as a Mexican salamander (Ambystoma mexicanum) or a Mexican walking fish, is a neotenic salamander. Axolotls are unusual among amphibians in that they reach adulthood without undergoing metamorphosis. Instead of developing lungs and taking to land, the adults remain aquatic and gilled. Axolotl are capable of regeneration various parts and organs of the body also they can regenerate their telencephalon. AIM: The aim of this presentation is explore whether this regeneration and what needed. RESULTS AND CONCLUSION: There is this ability of regeneration of axolotl s telencephalon. They use proliferation of endogenous neural progenitor cells throughout the ventricular zone of the brain for this regeneration. New cells produced in the ventricular zone migrate into the surrounding neuronal layer. After migrating from the ventricular zone, the new cells express markers. Telencephalic regeneration does not occur in the brains olfactory bulbectomized animals. Because the proliferative stimulus appears to reside in the olfactory system. Keyword: axolotl, brain regeneration, telencephalon zeynepdaglar92@gmail.com 29 P a g e

31 INVESTIGATION OF THE IN VITRO EFFECTS OF L-ALPHA GLYCERYLPHOSPHORYLCHOLINE UNDER NORMOXIC AND HYPOXIC CONDITIONS Author: MIGUEL OLIAS IBOR 1 Mentors: Anikó Görbe 2, Renáta Gáspár 2, Eszter Tuboly 3 (Oral presentation) 1 University of Szeged, Biochemisty/Surgical Research Institute 2 Cardiovascular Research Group, Department of Biochemistry, University of Szeged, Hungary 3 Institute of Surgical Research, University of Szeged, Hungary INTRODUCTION: It has been shown previously, that L-alpha-glycerylphosphorylcholine (GPC) has protective effects against sodium-azide-induced systemic hypoxic reactions, in rats. Our aims were to investigate the possible mechanisms of GPC on rat liver mitochondria during hypoxic or normoxic conditions. Moreover, we aimed to define the concentrationdependent influences on the viability and proliferative capacity of cardiomyocytes with high mitochondrial density. MATERIALS AND METHODS: The mitochondrial electron-transport chain (METC) of rat liver homogenates were analyzed by highresolution respirometry (Oroboros O2k), with or without mm GPC in normoxic condition and after nitrogen-evoked anoxia. In parallel, the concentration-dependent influences on cell viability and proliferative capacity were tested in 3 days-old primary cardiomyocyte cultures, exposed to short (15 min) and long (3h) GPC treatments in the 1 µm-1m concentration range and normoxia. Viability was determined by calcein staining, while proliferation was detected by the BrDU incorporation assay. RESULTS: GPC treatment (400 mm) significantly ameliorated the in vitro mitochondrial function impaired by oxidative stress (p=0.025), nevertheless, no increase was observed in METC intensity in normoxic conditions (p=0.821). Cell viability showed a tendency to decrease in case of higher concentrations, however, the treatments had no significant influence on the proliferation of cardiomyocytes in the same conditions. CONCLUSION: We have developed a reliable experimental protocol on primary cardiomyocytes culture, in which the effects of test compounds can be studied during simulated ischemia. Exogenously administered GPC might be protective under stress conditions by maintaining the optimal METC function, but it may influence the membranedependent anti-oxidant systems in normoxic states, particularly in high doses. miguelolias@gmail.com 30 P a g e

32 TRANSFER OF AN IN-LINE RAMAN SPECTROSCOPIC METHOD FOR API QUANTIFICATION BETWEEN A MINI AND PILOT-SCALE HOT-MELT EXTRUDER (Oral presentation) Authors: J. VAN RENTERGHEM 1, Y. Vander Heyden 3, C. Vervaet 2, J.P. Remon 2, M. Kondža 4 Mentor: T. De Beer 1 1 Laboratory of Pharmaceutical Process Analytical Technology, Ghent University, Ghent, Belgium 2 Laboratory of Pharmaceutical Technology, Ghent University, Ghent, Belgium 3 Faculty of Medicine and Pharmacy, FABI, Vrije Universiteit Brussel, Jette, Belgium 4 Faculty of Pharmacy, University of Mostar, Mostar, Bosnia and Herzegovina INTRODUCTION: Hot-melt extrusion (HME) is a continuous production technology that is capable of producing formulations which have a higher bioavailability than conventional oral formulations of poorly water soluble drugs. AIM: The aim of this study was to develop an in-line Raman spectroscopic method for the determination of active pharmaceutical ingredient (API) concentration in extrudates produced by a mini hot-melt extruder. MATERIALS AND METHODS: Calibration mixtures from 15 to 35 (%w/w) API (metoprolol tartrate) with 5% increments in Eudragit RSPO and 0.5% (w/w) magnesium stearate were made for the development of the training set. Validation mixtures and 32.5 (%w/w) API in Eudragit RSPO and 0.5% (w/w) magnesium stearate were made for the validation set. Extrudates were made with a mini-extruder (ME) (DSM, pharma micro extruder 5). The hot-melt extrusion process was monitored using the Raman Rxn1 spectrometer from Kaiser with a Dynisco probe mounted in the barrel of the miniextruder. A PLS model was developed with PLS_toolbox 7.8. RESULTS AND DISCUSSION: The developed PLS model for the mini hot-melt extruder with 2 latent variables had a RMSECV of % (w/w) and a RMSEP of % (w/w) after validation with the mini-extruder validation set. The developed PLS model was then used to predict API concentrations from extrusion runs performed on a pilot scale extruder. CONCLUSIONS: The slope/bias corrected predictions for 17.5, 22.5 and 32.5% API fall within the acceptance limit. Calibration transfer between scales shows promising results. Methods can be transferred from a small scale to a larger scale, hence allowing model development for new drugs which have only limited amounts accessible for research purpose. Keywords: Hot-melt extrusion, Raman spectroscopy, active pharmaceutical ingredient mkondza@hotmail.com 31 P a g e

33 Histopathology Histology 32 P a g e

34 A CASE OF SECONDARY BREAST ANGIOSARCOMA Authors: FRANJO CAROVIĆ 1, Lucija Beram 1, Josip Aničić 1, Matea Tomasić 1 Mentor: Elvira Mustać MD, PhD 2 1 University of Rijeka, Faculty of Medicine, Rijeka, Croatia 2Department of Pathology, Faculty of Medicine, University of Rijeka (Poster presentation) INTRODUCTION: Breast-conserving treatment (BCT) with radiotherapy has replaced mastectomy as the standard care for early-stage breast cancer in the last few decades. Radiotherapy is usually administered to the operated area, in some cases with an extra booster the tumor bed. Accordingly, more secondary angiosarcomas have been reported, with a cumulative incidence of 0.9 per 1,000 breast cancer cases over 15 years. CASE PRESENTATION: Case report of a 66-year-old patient with right breast infiltrating ductal carcinoma in December She underwent conservative breast surgery and sentinel lymph node dissection (pt1c pn0). Her postoperative treatment included radiotherapy treatment and endocrine therapy. Eight years after her radiotherapy (2013.), the patient noticed a purplish spot in the skin of the previously irradiated field of the right breast. The histopathology review a diagnosis of angiosarcoma. The development of secondary angiosarcoma has been linked to radiotherapy (RIA) and chronic lymphedema (Stewart Treves syndrome). Secondary angiosarcomas after BCT have an observed median latency period of 4 8 years. Because of their rarity and seemingly harmless presentation, frequently comprising painless and bruise like skin lesions, both patients and doctors often neglect the initial symptoms and diagnosis is delayed. Patients often have localized, but multifocally growing, disease that is confined to the breast at diagnosis. CONCLUSION: The diagnostic criteria for secondary angiosarcoma of the breast include a previous history of radiotherapy with a latency period of several years (five or more), development of sarcoma within a previous irradiated field, and a histology confirmation. tumors. Keywords: BCT, secondary breast angiosarcoma, radiotherapy fcarovic@gmail.com 33 P a g e

35 MOLECULAR DIAGNOSTICS OF SOLID TUMORS AT THE DEPARTMENT OF PATHOLOGY IN RIJEKA Author: MARIJA LIVAJIĆ 1 Mentor: Nives Jonjić MD, PhD 2 1 University of Rijeka, School of Medicine, Rijeka, Croatia 2 Department of Pathology, School of Medicine, University of Rijeka, Croatia (Poster presentation) INTRODUCTION: New aspect in treating cancer is providing the right therapy for the right person at the right time. Major step in the treatment of metastatic colorectal carcinoma (mcrc) and lung adenocarcinoma has been the development of monoclonal antibodies that target and inhibit epidermal growth factor receptors (EGFR) while in melanoma that was the inhibitor of BRAF since it plays a role in regulating the MAP/ERK signaling pathway important for cell division and differentiation. However, there are now consistent data that anti-egfr therapy is ineffective in mcrc with RAS mutation. On the other hand, the therapy is correlated with better response in patients with mutated EGFR gene in lung adenocarcinomas and BRAF V600 mutation in melanoma. AIM: To determine the prevalence of EGFR, RAS and BRAF V600 mutation status among patients with lung adenocarcinomas, mcrc and melanoma, respectively, analysed in MATERIALS AND METHODS: EGFR mutation analyses was performed on 63 cytological samples obtained from bronchial brushing or washing, lymph node fine needle aspirates, transthoracal and transbronchial fine needle aspirates, tumor imprint and pleural infusion, while RAS and BRAF V600 mutation analysis was performed on tumors cells obtained from formalin fixed paraffin embedded tissues from 43 mcrc and 19 melanomas. RESULTS: EGFR mutations/deletions were found in only 4 (6.4%) patients samples among 63 analysed lung adenocarcinomas. Twenty two (51%) patients with mcrc exhibited KRAS mutation. In present study only 20 KRAS non-mutated mcrc were analysed and all tested patients were negative for NRAS mutation. Twelve patients (62%) had wild BRAF gene while 7 (38%) patients presented BRAF V600 mutation. CONCLUSION: Present study confirms the molecular testing as an important part of diagnosis of any patients with cancer. Analysed mutation status which is in accordance with literature data, helps stratify the patients that will have benefit from biological therapy. Keywords: molecular diagnostics, colorectal carcinoma, lung adenocarcinoma, melanoma, personalized therapy marija.livajic@gmail.com 34 P a g e

36 A CASE OF SARCOMA ARISING IN DERMATOFIBROSARCOMA PROTUBERANS IN THE BREAST REGION Authors: JOSIP ANICIC 1, Matea Tomasic 1, Franjo Carovic 1, Lucija Beram 1 Mentor: Gordana Đorđević MD, PhD 2 1 University of Rijeka, Faculty of Medicine, Rijeka, Croatia 2 Department of Pathology, Faculty of Medicine, University of Rijeka (Poster presentation) INTRODUCTION: Soft tissue sarcomas in the breast region are rare, with the exception of phyllodes tumor. It is difficult to determine the relative frequency of the different types of sarcomas in that region due to wide variations within reported series. They are categorized according to the existing histological soft tissue classification. CASE PRESENTATION: 63-year-old man with medical history of long-standing diabetes and hypertension, presented with a rapidly growing left breast mass. Using fine-needle aspiration (FNA) a diagnosis of probable mesenchymal tumor was made. A wide excision of tumor measuring 10.5 cm in the largest diameter was performed. On a frozen section a myxoid mesenchymal lesion was confirmed. Tumor was located deeply within adipose tissue involving pectoral muscle, and did not affect skin or breast gland tissue. Spindle cell morphology with storiform pattern around the subcutaneous fat vacuoles indicated the fibroblastic, histiocytic or neural tumor with areas of prominent myxoid changes. Increased pleomorfism, cellularity and mitotic activity suggested transition to sarcoma. A final diagnosis of sarcoma arising in dermatofibrosarcoma protuberans was made since immunohistochemical analysis showed strong, diffuse positivity for CD34. CONCLUSION: Present case is interesting because it demonstrates that physical examination, ultrasound and cytology are not useful to differentiate a dermal lesion from a primary breast lesion. Moreover, this case represents a diagnostic challenge because of spindle cell myxoid morphology and wide differential diagnosis. Keywords: dermatofibrosarcoma protuberans, breast region, soft tissue sarcomas josip.anicic2@gmail.com 35 P a g e

37 CLINICOPATHOLOGICAL FEATURES OF TWO DIFFERENT HISTOTYPES OF COLORECTAL CANCER: NOS AND MUCINOUS ADENOCARCINOMA Author: NIVES ŽIVKOVIĆ 1 Mentor: Dora Fučkar Čupić MD, PhD 2 (Poster presentation) 1 University of Rijeka, School of Medicine, Rijeka, Croatia 2 University of Rijeka, School of Medicine, Department of Pathology, Rijeka, Croatia INTRODUCTION: Colorectal cancer (CRC) is the most common type of gastrointestinal cancer. It begins in glands, spreads into the colonic wall, regional lymph nodes and distant organs. Adenocarcinoma not otherwise specified (ACNOS) is characterised by gland formation, often with intraluminal necrosis. Mucinous adenocarcinoma (MUC) is composed of >50% of pools of extracellular mucin with malignant acinar structures or individual tumour cells with intracytoplasmic mucin - signet ring cells. AIM: Compare size, depth of invasion and lymph node status of two histotypes of CRC: NOS and mucinous, at the time of diagnosis. MATERIALS AND METHODS: We analysed clinicopathological features of 30 patients with CRC. Informations were provided from database of Pathology Department. Patients' age ranged from 46 to 87 years. We analysed 15 ACNOS and 15 MUC. Tumor size ranged from 2 to 11 cm. Number of isolated lymph nodes ranged from 4 to 44. We used TNM classification from to define depth of tumor invasion as pt and regional lymph node status as pn. Data were statistically analysed. RESULTS: Mean size of ACNOS was 3.8 cm, and MUC 5.2 cm. In stage pt2 were 3 ACNOS and 0 MUC; in pt3 were 9 ACNOS and 9 MUC; in pt4 were 3 ACNOS and 6 MUC. In stage pn0 were 8 ACNOS and 10 MUC; in pn1 were 2 ACNOS and 2 MUC; in pn2 were 5 ACNOS and 3 MUC. Analysing depth od invasion and lymph node status in ACNOS and MUC, there was no statistically significant difference. Regarding size of the tumor, mucinous adenocarcinomas were larger than adenocarcinoma NOS, and the difference in size was statistically significant (p=0.03). CONCLUSION: Even in this small series of colonic adenocarcinomas, there was statistically significant difference in size of two histotypes: mucinous adenocarcinomas were larger than adenocarcinomas NOS at the time of diagnosis. Keywords: colorectal adenocarcinoma, histotype, NOS, mucinous, size, depth of invasion, lymph node status niveszivkovic@hotmail.com 36 P a g e

38 GASTROINTESTINAL STROMAL TUMORS IN REPUBLIC OF MACEDONIA IN 5 YEARS PERIOD Author: STEFAN KRSTEVSKI 1 Mentor: Blagica Dukova, MD 1 (Oral presentation) 1 University Ss. Cyril and Methodius, Medical faculty, Institute of pathology, Skopje, Republic of Macedonia INTRODUCTION: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract. They are specific kit (CD117)-positive mesenchymal tumors many of which have kit mutations. They are believed to originate from interstitial cells of Cajal or related stem cells. They are most common in people aged and are rare in people younger than 40 years old. The most common sites are stomach (60%), small intestine (35%) and >5% occurre in rectum, esophagus, omentum and mesentery. Histologically GISTs vary from spindle cell tumors to epitheloid, subclassified in 8 subtypes. AIM: To determine morphologically and clinicopathologically relevant information on GIST. MATERIALS AND METHODS: We used archive data from Institute of Pathology, Medical Faculty in Skopje in a period of including all patients diagnosed with GIST. The tissue samples were formalin fixed and paraffin embedded followed by routine hematoxylin eosin (HE) stain. Additional immunohistochemical analysis was made with ckit (CD117), CD34, Vimentin, Actin, S-100, Ki-67. RESULTS: There were 42 patients diagnosed with GIST in this period, 17 (40,48%) of which were females and 25 (59,52%) were males. The most common site was stomach in 22 (52,38%) patients. Twenty six cases (61,9%) showed morphologically low malignant potential and 16 (38,1%) were with high malignant potential. All cases showed immunohistochemically positive cells on c-kit, mainly with smooth muscle differentiation. CONCLUSION: Gastrointestinal stromal tumors are c-kit positive mesenchymal tumors. Received morphologic characteristics correspond with those from the literature. Immunohistochemistry is powerfull tool in diagnosing GIST but further mutation testing should be done for revealing the prognosis. Keywords: gastrointestinal stromal tumors, c-kit, immunohistochemical stefan.krstevski@ymail.com 37 P a g e

39 EFFECTS OF VITALPLANT HERBAL MIXTURE ON HYPERLIPIDEMIC RAT MODEL Author: BOJAN RADOVANOVIĆ 1 Mentor: prof. Vladimir Pilija MD, PhD 2 (Oral presentation) 1 University of Novi Sad, Faculty of Medicine Novi Sad, Republic of Serbia 2 Department of Forensic Medicine, University of Novi Sad, Faculty of Medicine Novi Sad, Republic of Serbia INTRODUCTION: "Functional food" or food that has a positive effect on human health with an adequate nutritional effect, is the basis of the development of the modern food industry worldwide. AIM: To examine effects of Vitalplant herb mixture on pathohistological characteristics of organs and its effect on the body weight of rats on high-fat diet. MATERIALS AND METHODS: The experiment included 40 male Wisttar rats that were divided in five groups. Food consumption and weight gain were measured daily. Increase in body weight and faecal mass weight was recorded on a weekly basis. After 2, 6 and 14 weeks of experiment, animals were sacrificed under ether anesthesia. After autopsies, removed organs were prepared for histological processing. Tissue samples were stained using standard hematoxylin-eosin stain. RESULTS: After 14 weeks of the experiment, the body weight gain was significantly higher (p<0.05) in the group III, while food intake was significantly higher in the group I and II (p <0.05). The relative weight of livers were significantly higher in groups III and IV than in the groups I and II (p<0.05). Significant changes were found in livers of animals in groups III, IV and V with pathohistological diagnosis was that of steatohepatitis. Buildup of pigment in the proximal tubules of the kidney was observed. At the root of the aortic arch fibrous cartilage was found in one specimen. Histopathological changes were not present in other organs. CONCLUSION: Vitalplant plant mixture significantly reduced body weight gain in rats fed a high -fat diet. Fat rich diet induced gross and histological changes of liver typical of steatosis and steatohepatitis, without significant resolution following supplementation with the Vitalplant plant mixture. Key words: functional food, hypolipidemic effect, steatosis, plant mixture, pathohistology bojan.radovanovic.bojan@gmail.com 38 P a g e

40 TUMOR MARKERS - ALPHA-FETOPROTEIN, CARCINOEMBRYONIC ANTIGEN AND CARBOHYDRATE ANTIGEN 19-9 IN SERUM OF PATIENTS WITH COLON CANCER Authors: MALIK EJUBOVIĆ 1, Tarik Selimović 1, Jasmin Perviz 1, Vildana Fatić 1 Mentor: Emina Ejubović, MD 2 1 University of Sarajevo, Medical Faculty, Sarajevo, Bosnia and Herzegovina 2 Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (Oral presentation) INTRODUCTION: Colorectal cancer is a disease of unknown etiology, although several risk factors are related with it. The main factors responsible for the development of the cancer are: predisposition to mutagenic effect, fecal mutagens, a greater amount of meat in the diet, bile acids and elevated ph of stool. Colorectal cancer is the fourth most frequent malignancy in the world with a tendency of growth. AIM: To determine the sex and age distribution of patients, the value of tumor markers in serum of patients and to determine whether there is a correlation between the value of tumor markers and gamma-glutamyl transferase (ΓGT) in the serum of patients. PATIENTS AND METHODS: The research was conducted as a two year retrospective study during at the Clinic for Gastroenterology, Clinical Center of the University of Sarajevo. The study included all patients with a diagnosis of colon cancer and complete medical documentation. RESULTS: Patients with complete documentation were selected for this study (67 of total 97 patients). Gender distribution: male-37, female-30. Age structure(f): years-four, years-four, years-7, years-10, years-5. Age structure(m): years-1, years, years-8, years-20. Values of AFP (F): a positive AFP-1, negative AFP-29. AFP values (M): positive-3, negative 34. Values of CEA (F): 15 -positive, negative-15. Values of CEA(M): 21-positive, negative-16. Values of CA 19-9 (F): positive- 8, negative-22. Values of CA 19-9(M): positive 10-, 27-negative. Values of ΓGT (F): 10 - positive, negative-20. Values of ΓGT (M): positive 10, 27-negative. CONCLUSION: Colorectal cancer occurs more frequently in males. It is more frequent in elderly patients. Values of AFP, CA 19-9 and ΓGT in this study did not show as reliable markers in the diagnosis of colon cancer, while the CEA appears to be a partially reliable diagnostic marker. Keywords: colorectal cancer, tumor markers, AFP, CEA, CA mailk_e16@hotmail.com 39 P a g e

41 THE EFFECT OF ZINC ON THE INJURY OF THE SCIATIC NERVE Authors: SENA DEMIR 1, Zehra Aras 1, Zeynep Nur Gülle 1 Mentors: Ilknur Keskin 1, Nilufer Ayturk 1 1 Istanbul Medipol University, Faculty of Medicine, Istanbul, Turkey (Poster presentation) INTRODUCTION: Peripheral nerve injury especially occurred after trauma is a situation that causes physical, physiological and economic problems on people. At the present time, it s not yet possible to achieve precisely the regeneration of peripheral nerve and clinical recovery. However, different studies that have done with zinc show its treatment results against to ischemia-reperfusion injury. AIM: The aim of this study was to explore the effect of zinc on the injury of incision and compression on the rat sciatic nerve. MATERIALS AND METHODS: The study was made by using 6 Wistor Albino type rats which are weighted between 195 and 200 grams. The right sciatic nerve was used for all subjects. In compression groups, the samples are taken 1 cm before bifurcation of sciatic nerve, leaving the compression site on the center. While in incision groups, the samples are taken on both side of the incision area. For staining hematoxylin eosin, masson trichrome and luxol staining was used. RESULTS: In our study, it was seen that there is axonal disorder in compression group. However, the on rat that was given zinc, no axonal disorder was determined. In control and sham groups, histolopathological findings were alike. CONCLUSION: In this study, our aim was to see the repairment and regeneration capacity of periferal nerve by injecting exogenous biological substances into the surrounding damaged tissue. For this purpose, zinc was used for the experiment and curative effect of zinc has been presented histologically. This experiment has aimed to serve as a model for further studies. Keywords: nerve injury, zinc, ischemic reperfusion demirnursena@hotmail.com 40 P a g e

42 Internal Medicine Oncology 41 P a g e

43 ASSESSMENT OF STROKE RISK IN PATIENTS WITH ATRIAL FIBRILLATION - GUIDELINES AND PRACTICE Author: LAMIJA POJSKIĆ 1 (Oral presentation) 1 Cantonal Hospital Zenica, Department for Internal Diseases, Zenica, Bosnia and Herzegovina INTRODUCTION: Atrial fibrillation is a most common rhythm disorder,with incidence of 1% in general population. It increases the risk for ischemic stroke 5 fold and causes at least 15% of all strokes. ESC Guidelines(2012) recommends CHA2DS2-Vasc score (male sex, age, hypertension, previous stroke /TIA/ thromboembolism, history of vascular disease, diabetes mellitus) for stroke-risk stratification in AF. Score of 0 is low risk, one point is intermediate risk and more than one is high risk. Anticoagulant therapy is recommended in high risk group for prevention of thromboembolism. AIM: Aim of this work is to show difficulties in assessment of stroke risk and its prevention in patients(pts) with AF. CASE REPORT: We present three patients with stroke caused by AF, which was not previously diagnosed. Patient 1, male,64 years old, earlier without known diseases. After admission due to CVI, AF and hypertension were diagnosed, CHA2DS2 Vasc was 1. Patient 2, male, 60 years old, previously healthy, CHA2DS2 - Vasc 0, hospitalized because of TIA, and afterwards diagnosed AF. Third patient, male, 63 years, with no previous history of the disease, CHA2DS2 - Vasc 1, hospitalized because of ICV, after which was discovered AF. Considering that all three patients had low - CHA2DS2 Vasc they were not candidates for anticoagulant therapy even if AF was previously diagnosed. In all three cases, the stroke was the first symptom of AF, and all three patients had moderate to severe disability after ICV. CONSLUSION: These three cases had shown that assessment of stroke risk in AF is very complex, and that score, although it includes various risk factors, is not completely accurate, and its eligbility is questionable. Every patient should be treated and observed individually and awareness of risks of atrial fibrillation should be raised in population. Keywords: stroke, atrial fibrillation lamija.pojskic@gmail.com 42 P a g e

44 HSTN AS DIAGNOSTIC AND PROGNOSTIC MARKER OF EJECTION FRACTION IN PATIENTS WITH MYOCARDIAL INFARCTION Authors: MERDIĆ ALMINA 1, Nikšić Najra 1, Osmanbegović Esma 1 Mentor: Nerma Resić, MD 2 1 University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina 2 Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina (Oral presentation) INTRODUCTION: Myocardial infarction is a term that refers to a condition of ischemia, which takes longer and lead to irreversible changes in the myocardium-necrosis. Myocardial tissue contains large amounts of troponin, so the slightest damage makes an increase in his value. Myocardial infarction leads to loss of contractile capability resulting in decreased heart ejection fraction. AIM: Determining the correlation between hstn, hyperlipidemia, hypertension, and left ventricular ejection fraction in patients with myocardial infarction. PATIENTS AND METHODS: The research was conducted as a retrospective study at the Clinic for heart disease and rheumatism Clinical Center University of Sarajevo in the period September-October 2014, based on the history of the diseases. As the major factors of risk for myocardial infarction we followed hyperlipidemia and hypertension, their impact on the reduction of the heart ejection fraction as a consequence of myocardial infarction. RESULTS: 50 patients were included in the paper, 56 % were men and 44 % were women. Age of respondents: 2% under 50 years, 18% years, 30% years, 42% years and 8% of years. 52% of respondents had hyperlipidemia, 74 % had hypertension, and 12 % of respondents didn't have these risk factors. We noticed that ejection fraction has a lower value in patients with risk factor of hyperlipidemia compared to patients with a risk factor of hypertension. In patients without hyperlipidemia and hypertension ejection fraction had a higher value compared to those patients who had mentioned risk factors, but a reduced ejection fraction compared to a healthy heart. Using correlation and regression analysis, we determined that there is a correlation, but not dependence values hstn and ejection fraction. CONCLUSION: This study suggests that all patients with myocardial infarction have higher value of hstn; his presence can help to identify high-risk sub-groups that are facing with short-term prognosis. Keywords: Myocardial infarction, ejection fraction, hstn alminamerdic@yahoo.com 43 P a g e

45 COMPARISON OF CARDIAC RESYNCHRONIZATION THERAPY EFFICIENCY FOR < 70 YEARS AND FOR >70 YEARS PATIENTS Author: EGLĖ SKIAUTERYTĖ 1 Mentors: doc. Vytė Valerija Maneikienė 2, prof. Germanas Marinskis 1,2 (Poster presentation) 1 Vilnius University, Faculty of Medicine, Vilnius, Lithuania 2 Vilnius University Hospital Santariškių clinics, Centre of Cardiology and Angiology, Vilnius, Lithuania INTRODUCION: Main clinical trials related with CRT were analysing <70 years patients but in real world population the most of the patients are elder than 70. AIM: To evaluate and compare efficiency of CRT for <70 and >70 years patients. It would stop or encourage clinicians to perform CRT procedure for elderly patients. MATHERIALS AND METHODS: 398 clinical-histories of patients for whom CRT was performed in were analysed prospectively. 252 patients had auditorial echocardiography data. They were divided into two age groups: <70 years were 172 patients (71%men, 29%women), >70 years were 80 patients (74% men, 26%women). All the patients had ischemic or non-ischemic cardiomyopathy. Clinical data, biochemical blood tests, ECG, echocardiography results were analysed. RESULTS: Elder than 70 years patients had ischemic cardiomyopathy more frequently (p<0.05). New York Heart Association functional class (NYHAFC) before and after CRT was different (p<0.05) between groups. In a younger group improvement of NYHAFC after CRT was statistically significant (p<0.05), in elder group that improvement was also seen (p=0.06). Difference of left ventricle diastolic diameter (LVDD) before and after CRT was significant (p<0.05) between groups but the change of LVDD was not different (p=0.2). Before CRT left ventricle ejection fraction (LVEF) was bigger in elder group (p<0.05), after CRT there were no difference (p=0.024) between groups. There were no significant difference in QRS width, degree of Mitral valve leak, brain natriuretic peptide (BNP) concentration between groups neither before CRT (p>0.05), nor after CRT (p>0.05). The combined clinical scorei was not different between groups (p=0.87). CONCLUSION: For >70 years patients CRT is at least the same effective as for <70 years patients. Age shouldn t be barrier to perform CRT for elderly patients. Keywords: Cardiac resynchronization therapy, CRT, elderly patients, efficiency, combined clinical score. egle.skiauteryte@gmail.com 44 P a g e

46 THE CORRELATION BETWEEN ARTERIAL HYPERTENSION AND ABNORMAL LIPIDS IN PATIENTS WITH CHRONIC RENAL DISEASE (Oral presentation) Authors: MUHAMEDIN RUSHITI 1, Pranvera Ramadani 1, Teuta Emini 1, Elinda Jonuzi 1, Anita Sinani 1, Vegim Zhaku 1 Mentor: Doc.Dr.Sci Lutfi Zulbeari 1,2 1 State University of Tetovo, Faculty of Medical Sciences 2 Clinic Hospital of Tetovo INTRODUCTION: Nowadays the abnormalities of lipids (dislipidemia) serve as important risk factors in developing arterial hypertension (AHT) in patients with chronic renal failure (CRF). During the last years in recent studies it has been proven and documented a very high positive correlation between arterial hypertension (AHT) and dislipidemias. The abnormalities of lipids in patients with chronic renal diseases are present since the early phases of the disease, and if they are associated with arterial hypertension then the rhythm of progressing towards chronic renal failure occurs in a more rapid way. There are documented facts that patients with chronic renal failure beside other abnormalities, a great number of them suffer from arterial hypertension. The importance of determining this correlation in the beginning of the disease is to prevent the rapid damage of renal tissue and to prevent chronic renal failure. MATERIALS AND METHOD: We utilized the patients history that were hospitalized in the Internal Pavion during the period of and all the data from the health documents. The same data were classified concerning gender and age. RESULTS: On the examined patients (total=60, of whom 25 were females and 35 were males, mean age 57.0± 8.20 years) with chronic renal failure and arterial hypertension a significant correlation of LDL-ch and triglycerides (TG) with low values of HDL-ch from the reference values was shown. CONCLUSION: A lot of contemporary studies show a strong association between arterial hypertension and dyslipidemias thus proving that AHT with its oscillations assists in the lipid's profile. Arterial hypertension helps the accumulation of lipids in the blood vessel walls, thus increasing the incidence of cardiovascular and cerebrovascular diseases in these patients. The sum of hypertension of dyslipidemias also significantly reduce the renal functions. Keywords: Arterial Hypertension, Chronic Renal Failure, Triglycerides, High density lipoprotein cholesterol, Low density lipoprotein cholesterol r.muhamedin@gmail.com 45 P a g e

47 INFLUENCE OF THYROID AUTOANTIBODIES ON THE OCCURRENCE OF HYPOTHYROIDISM AFTER RADIOIODINE TREATMENT IN THYROTOXICOSIS (Oral presentation) Authors: MIRNA DZUBUR 1, Azra Bahtic 1, Edin Begic 1, Semir Hrvo 1, Mersiha Bahtagic 1 Mentor: Mirela Dzubur-Aganovic, MD 1 University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina INTRODUCTION: Anti-TSH receptor antibodies (TRAb) (thyroid-stimulating immunoglobulin, thyroid growth immunoglobulin, thyrotropin binding-inhibiting immunoglobulin) are the key factors in the pathogenesis of Graves disease which is also the most common cause of endogenous hyperthyroidism. Genetic predisposition is necessary for the disease development - HLA-B8, HLA-DR3, HLA DR-9 and gene polymorphism for cytotoxic T lymphocyte antigen (CTLA4). Treatment in thyrotoxicosis (Graves disease) involves anti-thyroid drugs (ATDs), surgery and radioactive iodine (I-131) with the purpose of achieving euthyroid state in patients. AIM: The aim of this study was to evaluate the influence of autoantibodies in a higher hypothyroidism occurrence, one year after radioiodine treatment of thyrotoxicosis. MATERIAL AND METHODS: We retrospectively analyzed the medical records of 120 patients who underwent radioiodine treatment between January 2004 and September We analyzed age, gender, the presence of autoantibodies a day before treatment and one year after treatment. RESULTS: 83% of patients were female. Mean age was 55,5 (31-81) years. 19 (15,8%) patients had positive autoantibodies (Graves disease) and 101 (84,2%) had negative autoantibodies (diffuse goiter 23,7%, uninodular toxic goiter 43,5%, multinodular toxic goiter 32,8%). 75% of patients were treated with ATDs, while 15% were thyroidectomized. Hypothyroidism was found in 36 (30%) patients.11 out of 19(57,8%) in Graves disease and 25 out of 101(22,5%) in diseases with no autoantibodies. Hyperthyroidism was present in 4 patients after treatment. There is a statistically significant correlation (RR-2.34, p<0.05) between the occurrence of hypothyroidism after I-131 treatment and the presence of TRAb. CONCLUSION: Early hypothyroidism, one year after radioiodine treatment is more common in patients with Graves disease. Therefore, anti-tsh antibodies can be a valuable prognostic parameter in determining whether the patient will go into hypothyroid state after therapy with radioactive iodine or not. Keywords: hypothyroidism, autoantibodies, Graves disease, radioactive iodine mirna.dzubur@gmail.com 46 P a g e

48 ASSOCIATION OF GENETIC MARKER RS (FTO GENE) AND TYPE 2 DIABETES IN RUSSIAN POPULATION Author: KSENIA A. VAKHROMEEVA 1 Mentor: Prof. Ludmila A. Suplotova 2 1 Tyumen State Medical Academy, Russian Federation 2 Tyumen State Medical Academy, Russian Federation (Oral presentation) INTRODUCTION: Type 2 diabetes (T2D) is a multifactorial disease affected by multiple genetic and environmental factors. Several genetic markers (single nucleotide polymorphismssnp) for T2D risk have been identified in different populations. AIM: The aim of this study was to evaluate associations between genetic markers and T2D in Russian population. MATERIALS AND METHODS: We assessed the associations of 96 SNPs linked with different pathway components of carbohydrate metabolism abnormalities with T2D in 96 Russian patients and 96 normoglycemic controls using Illumina Golden Gate Genotiping Assay (low density DNA chip with 96 SNPs). T2D was defined according to the World Health Organization criteria, Biochemical measurements included a standard 75g Oral Glucose Tolerance Test, HbA1c, Insulin and Cpeptide. Data were analyzed with the free online statistical program named Calculator for confidence intervals ofodds ratio (genexp.ru/calculator_or.php). RESULTS: We detected statistically significant difference between eleven SNPs and T2D. One of them is an association between rs of FTO gene. This gene encodes the adipose tissue and obesityassociated protein, also known as an alfaketoglutaratedependent diogenase gene. The FTO gene expression was found to be significantly unregulated in the hypothalamus after food deprivation and strongly negatively correlated with the expression of orexigenic galaninlike peptide which is involved in the stimulation offood intake. We found association of genotype C/C of rs with lower T2D risk in Russian population (OR=0,45 [0,240,87], p=0,05). CONCLUSION: RS of FTO gene plays role in the T2D development in Russian population. These results led us to the next phase of the study and now we are determining a predisposing role ofdifferent alleles combinations for T2D risk. Keywords: type 2 diabetes, FTO gene, single nucleotide polymorphism, association ksenia.vakhromeeva@gmail.com 47 P a g e

49 CRANIOPHARYNGIOMA PRESENTING WITH INCREASED INTRACRANIAL PRESSURE AND PITUITARY INSUFFICIENCY Authors: NASTASIA ČEKADA 1, Nikolina Benco 1, Ena Sušić 1 Mentor: Tina Dušek, M.D., Ph.D. 2 1 University of Zagreb, School of Medicine, Zagreb, Croatia 2 Department of Endocrinology, University Hospital Center Zagreb, Croatia (Poster presentation) INTRODUCTION: Craniopharyngioma are rare tumors that occur mainly in children. They are usually located in the suprasellar region and can cause symptoms due to the tumor mass effect. Hypopituitarism can be often seen in patients with craniopharyngioma, whereas hydrocephalus is a rare complication of the tumor. AIM: Our aim is to present a 21-year old man who developed signs of increased intracranial pressure and hypopituitarism in the childhood. MATERIALS AND METHODS: After being diagnosed with craniopharyngioma in October 2008, the patient was placed a ventriculo-peritoneal shunt (VP shunt) which drained the excess fluid form the brain allowing the partial resection of the tumor to be made a few days later. In January 2009 the patient underwent stereotactic radiosurgery due to the small residual tumor. Since then he has been doing regular follow ups (MRI, hormone levels).the MRI showed decrease in the size of the tumor residue in the hypothalamic region. He is under replacement therapy with hydrocortisone, levothyroxine and desmopressin. In September 2012., growth hormone was added to the treatment despite the presence of small residual tumor. In February testosteron (125mg every 4 weeks) was introduced into treatment. RESULTS: The usage of growth hormone as a replacement therapy in the treatment of our patient showed positive results. The patient had grown 13,5 centimeters from September 2012 to October At the same time, no increase in the volume of the residual tumor was noted. CONCLUSION: This report shows the efficiency of the replacement therapy in stimulating growth in patients with pituitary insufficiency. Keywords: craniopharyngioma, hypopituitarism, growth hormone nastasia.ce@gmail.com 48 P a g e

50 EXPERIMENTAL INTESTINAL DYSBIOSIS AND BIOCHEMICAL INDICATORS OF THE LIVER STATE Author: N.O. KARNAS 1 Mentor: V.L.Vasiuk, MD, PhD 2 (Oral presentation) 1 Bukovinian State Medical University, Medical Faculty, Chernivtsi, Ukraine 2 Bukovinian State Medical University, Department of Internal Medicine, Chernivtsi, Ukraine INTRODUCTION:It is known that serious abnormalities in bacteria body system, known as dysbiosis are observed at the hepato-biliary pathology, as a rule. AIM: Study of the liver state by intestinal dysbiosis reproduction on rats by means of antibiotic lincomycin, that suppresses probiotic microflora rate (bifido bacterium and lactobacillus). MATERIALS AND METHODS: Two-series experiments were performed: on Wistar s male rats (1month, 75g) and female rats (13months) which were given antibiotic applied with drinking water at a dose of 50-60mg/kg within 5 days. Euthanasia of the animals under thiopentalsodium anaesthesia (20mg/kg) via blood letting from heart was performed on 15th and 21st day of the experiment. Level of liver markers: bilirubin content, activity of alanineaminotransferase and aspartateaminotransferase, was identified in blood serum. RESULTS:It is clear that in 15 days when lincomycin injected, urease activity increases twice and lysozyme decreases times, according to the data. As a result the dysbiosis degree increases 3.5 times. In addition, both inflammation markers (PA,MDA) increase at dysbiosis indicating the progress of inflammatory process in liver and bacteria translocation from intestine into liver. Furthermore, antioxidant catalase enzyme activity decreases and there is essential decrease of liverprotein. Bilirubin decreases more than twice in rats blood serum and the increase of transaminase activity has not been confirmed statistically. CONCLUSION: 1.Inflammatory-dystrophic processes start progressing under reproduction of intestinal dysbiosis in liver. 2.Level of protection systems (antioxidant and non specific immunity) decreases under intestinal dysbiosisin liver. Keywords:intestinal dysbiosis, inflammation markers, euthanasia, bilirubin karnas2011@mail.ru 49 P a g e

51 MANY FACES OF THE COELIAC DISEASE Authors: VALENTINO RAČKI 1, Ivan Jakopčić 1, Mila Prskalo 1 Mentors: Ivana Mikolašević 2, Daniela Petrić 3 (Oral presentation) 1 Faculty of Medicine, University of Rijeka, Rijeka, Croatia 2 Department of nephrology, dialysis and transplantation, Clinic of internal medicine, Clinical hospital centre Rijeka, Rijeka 3 Clinic of psychiatry, Clinical hospital centre Rijeka, Rijeka, Croatia Celiac disease (CD) is a state of heightened immunological responsiveness to ingested gluten in genetically susceptible individuals. CD may affect up to 1% of the population in the western world. Coeliac disease was considered to be a childhood disease for decades, however recent epidemiological and serological studies have shown that the disease can occur in any life period with peak incidence in the 5th or 6th decennium. During the last decades CD has increasingly become recognized as a multi-organ disorder, and has been linked to a number of complications including malignancy, autoimmune disorders and tuberculosis, Clasically, patients with CD present with gastrointestinal symptoms such as diarrhoea, iron deficiency anemia or weight loss. However, more and more patients have been diagnosed without classical intestinal signs, and the extraintestinal manifestations have been recognised as new disease presentation. Because atypical presentations are increasingly found to predominate, CD is now considered a multi-system disorder involving all medical specialities for its diagnosis. In children disease presents itself with chronic bowel disease symptoms (abundant stool, abdomen distension, loss of weight and slower growth), while in adults extraintestinal symptoms are more common. Extra-intestinal symptoms vary from iron deficiency anaemia, bleeding diathesis, osteoporosis, oedemas, paraesthesia, neuropsychiatric symptoms and problems with reproduction. With so many different presentations of the disease, especially in adults, we can truly say it has many faces and is a diagnostic challenge. In this presentation we will talk about coeliac disease in general, the diagnostic procedure, while also presenting one interesting case report to emphasise the diversity of symptoms that patients who suffer from the disease can have. Gastroenterologists are already familiar with the association between CD and immune and non-immune diseases. Therefore, we would like to stress the necessity of an interdisciplinary approach to patients with CD as well as many other conditions. Keywords: coeliac disease, multi-system disorder, autoimmune disease valentino.racki@gmail.com 50 P a g e

52 THE IMPACT OF SALMON DURIE STAGING SYSTEM (CRAB CRITERIA) ON NEWLY DIAGNOSED PATIENTS WITH MULTIPLE MYELOMA IN PROGNOSIS OF ACHIVING REMISSION Authors: SIMONA PATCHEVA 1, Elena Peneva 1 Mentor: Ass. Svetlana Krstevska Balkanov, MD 1 1 University of Ss. Cyril and Methodius, Medical Faculty Skopje, R. Macedonia 2 Clinic of hematology, Skopje (Oral presentation) INTRODUCTION: Multiple myeloma is a cancer, incurable, that forms in a type of white blood cell called a plasma cell. Multiple myeloma causes cancer plasma cells to accumulate in the bone marrow, where they crowd out healthy blood cells, leading to fatigue and an inability to fight infections. Diagnosis of active MM requires elevated Ca level, renal impairment, anemia, lytic lesions, M protein in the serum and/or urine that are defined as diagnostic CRAB criteria by Salmon and Durie. AIM: Impact of implementing initial diagnostic criteria of CRAB to predict prognosis of achieving remission, progression free survival and overall survival. MATERIALS AND METHODS: At the clinic of Hematology Skopje we retrospectively analyzed 46 patients in a one year period, from January 2013 to January Patients were monitored until October RESULTS: Research was conducted in 46 patients, from which 54% men and 46% women. Middle age was years. Signs of anemia had 35 patients, increased Ca level had 11 patients, lytic lesions had 27 patients. In the urine of 20 patients have been detected Bence Jones proteins, and in 30 patients samples paraprotein. From this criteria according to Salmon Durie staging system 45.6% were stage 1, 19.6% stage 2 and 34.8% were stage 3. CONCLUSION: Patients diagnosed in stage I disease who had been exposed to intensive treatment have better prognosis and long term survival after reaching complete remission. Keywords: Multiple myeloma, lytic lesion, anemia, renal impairment, Salmon Durie staging system, complete remission. simona_patceva@yahoo.com 51 P a g e

53 STATE OF HORMONE RECEPTOR STATUS AND HER2 POSITIVE INVASIVE BREAST CARCINOMA: DOES HORMONE RECEPTOR STATUS HAVE IMPACT ON PROGNOSIS OF HER2 POSITIVE CARCINOMA? (Oral presentation) Authors: SKOČILIĆ I 1, Radovčić I 1, Belac-Lovasić I 2, Mihaljević Ferari A 2, Petković M 2, Lovasić F 2, Dobrila Dintinjana R 2 Mentor: Ingrid Belac Lovasić, MD 2 1 School of medicine, University of Rijeka, Rijeka, Croatia 2 University Clinical Hospital Center Rijeka, Rijeka, Croatia INTRODUCTION: HER2 positive breast carcinoma make 20 25% of all invasive breast carcinoma. Until introducing trastuzumab into the treatment of this group of tumors, prognosis of the disease was worse comparing to HER2 negative tumors. AIM: To establish how the state of steroid receptors effects prognosis of disease in HER2 positive invasive breast carcinomas. MATERIALS AND METHODS: Analyzing histories of 106 female patients with HER2 positive tumors treated in Clinical Hospital Center in Rijeka during period we determined correlation of the proliferation index, stage of the disease and the number of involved axillary lymph nodes as the most important prognostic factor, in two groups of patients: one with HER2 positive invasive breast carcinoma and negative steroid receptors and the other with HER2 positive tumor and positive steroid receptors. RESULTS: In the study group 106 patients were 65,1% ER+ (69/106) and 34,9% ER- (37/106) thus 66,98% HR+ (71/106) and 33,02% HR- (71/106). CONCLUSION: In the group of HER2+HR+ proliferation index Ki67 is significantly lower and affection of axillary lymph nodes is less frequent comparing with the group of HER2+HR, which means that prognosis of the disease is better in the group with positive steroid receptors. Received data are matched with the data from the literature, according to which states that the disease free survival and overall survival is better in the HER2+HR+ group comparing to HER2+HR- group. Keywords: breast cancer, HER2, steroid receptors iskocilic@gmail.com 52 P a g e

54 DOES SILYMARIN INCREASE THE GENOTOXIC EFFECTS OF DOXORUBICIN ON BREAST CANCER CELLS? (Oral presentation) Authors: CINAR METE 1, Cansu Unsal 1, Nil Bahar Atasoy 1, Elif Bengisu Bilgin 1, Ahmet Ozan Kaleci 1, Alperen Kutay Yildirim 1 Mentor: Erkan Yurtcu, Assoc. Prof. Dr 2 1 University of Baskent, Faculty of Medicine, Phase II student, Ankara, Turkey 2 University of Baskent, Faculty of Medicine, Department of Medical Biology, Ankara, Turkey INTRODUCTION: Treatment options of breast cancer include surgery, radiation therapy, endocrine therapy and/or chemotherapy. Doxorubicin is one of the most commonly used chemotherapeutic agents. Due to cytotoxic and genotoxic effects of doxorubicin on normal tissue cells, its usage is limited. To increase the effectiveness of doxorubicin, combination with herbal extracts are under investigation. Silymarin is a flavonolignan, extracted from milk thistle (Silybum marianum). Due to its antioxidant effects, it is thought to be a suitable candidate for combination therapies. AIM: The aim of the study is to determine whether silymarin increases the efficiency of doxorubicin on MCF-7 breast cancer cells. MATERIALS AND METHODS: MCF-7 cells were cultured in standard culture conditions. The viability of the cells and IC50 doxorubicin dose were assessed by trypan blue exclusion and XTT methods, respectively. Doxorubicin and Silymarin were applied alone and in combination for 24 and 48 hours. Silymarin was applied as 300 ng/ml. Genotoxic damage was determined by Comet Assay. RESULTS: IC50 dose of doxorubicin were 70 um and 40 um for 24 and 48 hours, respectively. In both 24 and 48 hours, the genotoxic damage significantly increased with combined treatment of doxorubicin and silymarin compared to single doxorubicin treatment (p<0.05). Single silymarin treatment also increased DNA damage for 24 hours ( p<0.05), but not for 48 hours (p>0.05). CONCLUSION: In the present study, we demonstrated that silymarin increased genotoxic effects of doxorubicin on MCF-7 breast cancer cells. We showed that silymarin is a suitable candidate to be used in combined chemotherapeutic regimens. Nevertheless to reveal the true potential of silymarin, more detailed molecular and in vivo studies are required. This study has been partially presented in University of Baskent XVIth Student Symposia, May Keywords: Doxorubicin, Silymarin, Breast Cancer, Genotoxicity cinar_mt@hotmail.com 53 P a g e

55 DEPRESSION IN ONCOLOGY PATIENTS (Oral presentation) Authors: SELMA KULENOVIĆ 1, Merima Kučinar 1, Meis Sammak 1, Mirad Odobašić 1 Mentor: Timur Cerić, MD 2 1 University of Sarajevo, Medical Faculty, Sarajevo, Bosnia and Herzegovina 2 University Clinical Center of Sarajevo, Department of Oncology, Sarajevo, Bosnia and Herzegovina INTRODUCTION: Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Treatment of profound and chronic depression is often very difficult, requiring in most cases intensive psychotherapy to help the patient understand the underlying cause of the depression. Oncology is the field of medicine that is devoted to cancer. Clinical oncology consists of: medical oncology (chemotherapy), surgical and radiation oncology. The American Society of Clinical Oncology (ASCO) recognizes few more types of oncologists including a hematologist-oncologist, which is why we included patients with blood cancer in our research. AIM: The objective of our research is to raise awareness about the importance of complete care, that incorporates the care of mental health in oncological patients, and to introduce changes and improve medical care in this group of patients. MATERIALS AND METHODS: In our research we were using Beck self-reported depression test during the month of November 2014 on patients in Clinical center University of Sarajevo (Oncology department). RESULTS: Fourty patients took part in our research. According to the test, 26 (65 %) of them were female and 14 (35 %) male patients.there were 12 (30%) registered as patients with no depression, 14 (35%) with mild depression, 3 (7,5%) with medium depression and 11 (27,5 %) were registered as deeply depressed. Nine patients (22,5 %) said that they were using antidepressant drugs and six of them (54,5 %) were patients with deep depression. CONCLUSION: As the results showed, 70% of patients studied are depressed. As it is a large percent of people, we must make sure that the treatment of these patients involves concern of mental health, sessions with psychiatrist and possible inclusion of antidepressants in therapy. Keywords: depression, patients, oncology, cancer selma_kulenovic@hotmail.com 54 P a g e

56 THE CORRELATION BETWEEN THE VALUE OF HBA1C WITH THE FOOD INTAKE THAT CONTAINS HIGH GLYCEMIC INDEX Authors: NADIJA GAČO, Morana Šangulin 1 Mentor: Dr.sc. Sanja Klobučar-Majanović, dr. med2 (Oral presentation) 1 University of Rijeka, Faculty of Medicine, Rijeka, Croatia 2 Department of Internal medicine/endocrinology, University Clinical Center of Rijeka, Croatia Glycemic Index (GI) is a measurement carried out on carbohydrate-containing foods and their impact on our blood sugar. GI is a relatively new way of analyzing foods. Previously, most meal plans designed to improve blood sugar analyzed the total amount of carbohydrates (including sugars and starches). GI goes beyond this approach, looking at the impact of foods on our actual blood sugar. In other words, instead of counting the total amount of carbohydrates in foods in their unconsumed state, GI measures the actual impact of these foods on our blood sugar. The purpose of a glycemic index (GI) diet is to eat carbohydratecontaining foods that are less likely to cause large increases in blood sugar levels. The diet is a means to lose weight and prevent chronic diseases related to obesity such as diabetes and cardiovascular disease. The term HbA1c refers to glycated haemoglobin. It develops when haemoglobin, a protein within red blood cells that carries oxygen throughout our body, joins with glucose in the blood, becoming 'glycated'. By measuring glycated haemoglobin (HbA1c), clinicians are able to get an overall picture of what our average blood sugar levels have been over a period of weeks/month. For people with diabetes this is important as the higher the HbA1c, the greater the risk of developing diabetes-related complications. However, fasting glucose tests provide an indication of your current glucose levels only, whereas the HbA1c test serves as an overall marker of what your average levels are over a period of 2-3 months. During this research we tried to establish the correlation between the value of HbA1c with the food intake that contains high glycemic index. We examined our patients about their eating habits, then we tried to connect it with the value of HbA1c in their blood. Keywords: glycemic index, HbA1c, food, glycated haemoglobin, glucose nadijagaco@gmail.com, morana.sangulin@gmail.com 55 P a g e

57 Neurology Psychiatry Physical medicine and rehabilitation Defectology 56 P a g e

58 ATRIAL FIBRILLATION AND MYOCARDIAL INFARCTION AS RISK FACTORS FOR STROKE IN TUZLA CANTON IN THE PERIOD (Oral presentation) Authors: HARIS BEŠIREVIĆ 1, Ismir Kukić 1, Edvina Ibradžić 2, Arzumana Ožegović 1, Samra Pajazetović 1, Semra Pajazetović 1, Sabrina Zulčić 1 Mentor: Osman Sinanović, MD, PhD 3 1 University of Tuzla, Faculty of Medicine 2 University of Tuzla, Faculty of Natural Sciences and Mathematics, Department of Biology 3 Department of neurology, University Clinical Center Tuzla INTRODUCTION: Patients with atrial fibrillation have a risk of 5% each year for the development of stroke. It causes 15% of strokes, and in persons above 80 years 30% of all strokes. The risk is greatest five days after myocardial infarction and half of all strokes in these patients occurs in the first month. AIM: Aim is to show the importance of atrial fibrillation and myocardial infarction to stroke patients hospitalized at the Clinic of Neurology Tuzla in the period PATIENTS AND METHODS: A retrospective study was conducted at the Clinic of Neurology Tuzla for the period year included 900 subjects of both sexes and of all ages who are in this period hospitalized at the clinic. We applied the SPS system (SPSS21.00). RESULTS: The results showed that the correlation between atrial fibrillation and stroke in men was statistically significant (p = 0.972), as well as between atrial fibrillation and ischemic stroke (p = 0.727), while correlation between atrial fibrillation and hemorrhagic stroke was not statistically significant (p = 0.088). It has been shown that the myocardial infarction was in a stronger correlation with ischemic stroke (p = 0.532) than with hemorrhagic stroke (p = 0.130). In women atrial fibrillation was significantly associated with ischemic stroke (p = 0.877), but also with hemorrhagic stroke (p = 0.207), and correlation of myocardial infarction and ischemic stroke was significant (p = 0.267), while between myocardial infarction and hemorrhagic stroke was not (p = 0.065). CONCLUSION: The results showed a significant association of atrial fibrillation and ischemic stroke in both sexes. Myocardial infarction has a significant impact on the occurrence of ischemic stroke in both sexes. Myocardial infarction and atrial fibrillation are risk factors that can be influenced by reducing their frequency, which would reduce the incidence of the stroke. Keywords: atrial fibrillation, myocardial infarction, ischemic stroke, hemorrhagic stroke. besirevic_haris89@msn.com 57 P a g e

59 STATUS DYSTONICUS AS A CONSEQUENCE OF ZOLPIDEM WITHDRAWAL IN PARKINSON'S DISEASE PATIENT Author: KAJA KOLMANČIČ 1, Maja Kojović 2 Mentor: Maja Kojović, M.D., PhD 2 1 University Medical Centre Ljubljana, (on clinical rotation), Slovenia 2 University Medical Centre Ljubljana, Department of Neurology, Slovenia (Oral presentation) INTRODUCTION: Status dystonicus is a rare but potentially fatal disorder, defined as increasingly frequent and devastating episodes of generalised dystonia. It is associated with bulbar, respiratory and metabolical complications and therefore requires immediate and intensive medical assessment. CASE REPORT: 68-year old female patient with advanced Parkinson's disease (PD) associated with mild generalised dystonia (present from early on in the disease course) and with bilateral deep brain stimulation (DBS) from 2009, noticed by chance that zolpidem, which she was taking for sleep problems, was also relieving her PD symptoms. She subsequently on her own took up to 60mg of zolpidem per day, for several years. Without prior medical consultation, she abruptly discountinued with the medication in March Shortly after, continuous generalised spasms, profound sweating and dispnoea appeared and progressed over 1 week, resulting in urgent hospital referral. On admission, severe generalised dystonia, hypoxemia and severe myoglobinuria due to rhabdomyolisis were noted. With supportive treatment and reintroduction of zolpidem in combination with diazepam, the patient recovered. DISCUSSION: Status dystonicus is a life threatening complication of primary or secondary dystonia. Infections and withdrawal of benzodiazepines and anticholinergic drugs are the most common causes. In our patient, the precipitating factor was withdrawal of zolpidem, a non-benzodiazepine hypnotic, widely used to treat insomnia. The drug has also been anecdotally associated with improvement of different movement disorders, including PD and primary dystonia. Status dystonicus caused by zolpidem withdrawal has not been described yet and we would thus like to draw attention to this potentially severe complication. In patients with movement disorders, the use of this commonly prescribed medication should be carefully supervised by a physician. Keywords: status dystonicus, zolpidem, Parkinson's disease kokaja@gmail.com 58 P a g e

60 LIAISON PSYCHIATRY (Oral presentation) Author: DUŠANKA BESLAĆ 1 1 University of Rijeka, Faculty of Medicine, Rijeka, Republic of Croatia Correlation between physical and mental health is certainly significant, and therapeutic success depends on individual and contextual approach to each patient. Liaison psychiatry is a concept in which a psychiatrist is involved in therapy and rehabilitation ofpatients who suffer from physical illnesses. In Croatia psychiatrists perform formal advisory examinations on primary doctor request. However, it is not common for a psychiatrist to be a part of the medical team engaged in treatment ofsomatic medical conditions. Psychiatric consultation is based on review of medical documentation and progress of medical treatment, cooperation with members ofprimary medical team, conversation and development of trustworthy relation with the patient, considerate assessment of somatic and mental state of the patient, and providing recommendation for further treatment. This discussion presents the basic principles of liaison psychiatry, and the role ofpsychiatrist in diverse branches ofmedicine such as oncology, surgery or transplantation medicine. Keywords: lialison, psychiatry, physical and mental health dbeslac26@gmail.com 59 P a g e

61 BURN-OUT SYNDROME IN MEDICAL STUDENTS STUDYING AT MEDICAL FACULTY IN TUZLA AND THEIR WORKLOAD DURING THE STUDY AT THE BOLOGNA PROCESS (Oral presentation) Author: AVDIĆ AZRA¹, Avdić Melisa¹, Frljak Amra¹, Mazić Lejla¹, Nuhbegović Nadina¹, Paočić Dinela¹, Sejdinović Amir¹ Mentor: Alija Sutović MD, PhD² ¹University of Tuzla, Faculty of Medicine, Tuzla, Bosnia and Herzegovina 2 University Clinical Hospital Center Tuzla, Department of Psychiatry, Head of Division for Forensic Psychiatry, Tuzla, Bosnia and Herzegovina INTRODUCTION: Burn out syndrome or the syndrome of combustion is in the classic literature described as a syndrome which is followed by a poor concentration and memory, apathy, insomnia, decreased ability to cope with current problems, the greater tendency of entering into conflicts. This syndrome has been investigated for several decades, and in recent years is increasing. AIM: The objective of this study is more detailed view of burn out syndrome prevalence in medical students studying on the Medical faculty in Tuzla after the introduction of the new system in education, called the Bologna system of study. MATERIALS AND METHODS: For this purpose we used a descriptive study conducted in the form of an anonymous questionnaire answered by randomly selected students. A survey was administered to 150 medical students from different study years, first, third and the final year. 50% of respondents were girls and 50% of them were men. The questionnaires that students filled contained questions which gave us informations on the assessment of the risk of burn-out syndrome. RESULTS: During the first year of studies: from a total of 25 men, 12% of them were in the group of low risk, 64% in the medium risk, 24% in the high risk group for the development of burn-out syndrome. From a total of 25 women: 4% were in the low-risk group, 48% in medium-risk group, 48% in the high risk group. In the third year of studies: from a total of 25 men, 8% were in the low-risk group, 68% in medium-risk group, 24% in the high risk group. From a total of 25 women: 4% were in the low-risk group, 56% in medium-risk group, 40% in the high risk group. At the sixth year of study or the final year: from a total of 25 men 28% were in the low-risk group, 52% in medium-risk group, 20% in the high risk group. From a total of 25 girls, 8% were in the group of low risk, 28% in intermediate risk, 64% in the high risk group. CONCLUSION: Prevalence of the burn out syndrome among students of the Medical Faculty was high. Girls show a high sensitivity to burnout syndrome, which progressively develops during medical education, while in men the prevalence shows no growth, and in the final year of study even falls. Keywords: Burn-out, medical, students, Tuzla azra_a_tz@hotmail.com 60 P a g e

62 MEDICAL ERROR AND INFLUENCE ON PRACTISE AND LAW (Poster presentation) Authors: MAZIĆ LEJLA 1, Avdić Azra 1, Avdić Melisa 1, Frljak Amra 1, Nuhbegović Nadina 1, Paočić Dinela 1, Sejdinović Amir¹ Mentor: Alija Sutović MD, PhD² ¹ University of Tuzla, Faculty of Medicine, Tuzla, Bosnia and Hercegovina 2 University Clinical Hospital Center Tuzla, Department of Psychiatry, Head of Division for Forensic Psychiatry, Tuzla, Bosnia and Hercegovina The main purpose of this work is to show detailed analys of medical error and statistic about it s influence in every-day-practise. From definition medical mistake is every error or mistake commited by health professionals which results in harm to the patient. They include errors in diagnosis, errors in administration, medication errors, error in the performance of surgical procedures, in use of other types of therapy, in use of equipment and in the interpretation of laboratory findings. Medical errors are associated with inexperienced doctors, new procedures, extremes of age and complex of urgent care. Poor communication, improper documentation, illegal prescribing of medicines, illegible handwriting, similary named medications, are also kown to contribute to the problem. Big influence from doctors side have cognitive overload, making wrong prejudice thinking, sleep deprivation- being awake for over 24 hours, depression and burnout. Very often medical mistakes are reasons of bad health care of the patient, it can be cause of death or chronic invalidy. Because of that every country have criminal law about medical mistakes and unresponsible tretament, medical negligence. So, family of the patient have full right to make acussation if they have legal prove about medical mistake and medical negligence. There are many studies about medical mistakes. According to a 2006 study, medication errors harm approximately 1,5 million people in the United States every year. Study 2007 Commonwealth Fund International Health Policy Surney shows that medical mistake is most common in United States and Australia, and lowest frequency is in Germany and United Kingdom. Keywords: Medical mistake, law, study lejla.mazic@hotmail.com 61 P a g e

63 INTERNET ADDICTION TEST AMONG MEDICAL STUDENTS Authors: KANDIĆ ELMA, Jovanovska Anamarija, Murtezani Avdi Mentors: Viktorija Vujovikj MD, PhD; Beti Zafirova-Ivanovska MD, PhD Medical Faculty, University St. Cyril and Methodius Skopje, R. Macedonia (Oral presentation) INTRODUCTION: Internet addiction is a new clinical entity defined as a maladaptive pattern of internet use causing clinically significant impairment or distress to affected individuals. Official diagnostic criteria for internet addiction do not exist yet, however, and the disorder has been considered as either impulse control disorder or behavior addiction. AIM: To investigate the prevalence of Internet addiction among Medical students and to explore the psychological features associated with Internet addiction. METHODS AND RESULTS: The participants were undergraduate students from Medical Faculty of Skopje, University St. Cyril and Methodius, Republic of Macedonia. Study accomplished in April Volunteering students had to sign a written informed consent and complete the questionnaire including demographic data, time spent on the internet, and psychological measures. The final sample was 120 participants. Students were separated in 6 groups by years of study at Faculty. We translated the IAT (Internet Addiction Test) by Dr. Kimberly Young and use it in a psychometric study. In order to estimate the internal consistency of the KIAT, Cronbach's alpha was calculated. We used Pearson's correlation analyses to determine the testretest reliability, concurrent validity, and convergent validity. Principal component analysis with varimax rotation was conducted to determine the factor structure underlying the KIAT items. Analysis of Variance F=0,89 p=0,49 p>0,05. The smallest averaged score of 33.3 ± 16.3 have the students from the five year, highest averaged score of 42.5 ± 15.4 registered in the group of students in the first year. Kruskal-Wallis ANOVA H ( 5, N= 120) =6,18 p =0,29 p>0,05. CONCLUSION: Medical students in diferente study years have no sigunificant diferente average total score of scale. Keywords: addiction, students, internet, IAT elmakandic@gmail.com 62 P a g e

64 BALNEOTHERAPEUTIC SIGNIFICANCE AND THERMOMINERAL WATER RESOURCES IN SPA CENTRES IN BOSNIA AND HERZEGOVINA Authors: EMIR BEĆIROVIĆ 1, Lejla Mazić 1, Senad Softić 2 Mentor: Ešref Bećirović, MD, PhD, prof. emeritus 1 (Poster presentation) 1University of Tuzla, Faculty of Medicine, Tuzla, Bosnia and Herzegovina 2 University of Tuzla, Faculty od Pharmacy, Tuzla, Bosnia and Herzegovina The goal of our paper was to point to the significance, role, and application of the resources as natural benefits from thermo-mineral waters applied in balneology. Throughout history of medicine, balneology has had a pretty different role starting from full denying to the complete confidence (Hipokrat, A.D., Celsius in the first century A.D., Galen A.D., Celius Aurelianus at the end of the second century A.D., etc.) Historians of medicine consider the year of 1878 as a turn thanks to establishment of the Balneology Section of Physicians Society in Berlin when mythical, cultural and religious model in balneology was replaced by a scientific approach. Council of the European Community in 1996, gave the directions for mineral water to be called natural mineral water. They also required that the European directions for the water quality according to the German Law that is most developed in Europe, to be observed, because Germany is the leading country in the number of mineral water wells, it has 471 of the total of 946 registered ones in EU. This paper points to the properties of thermo - mineral waters according to origin, quantity of the dry sediment, temperature, ph-reaction, most important anions, elements in trace and gases, then Quentin classification in 4 groups was presented. Direct effects of different kinds of baths (Sodiumchloride, carbonic-acidic, radioactive-radon, and sulphur baths) were underlined as specificities of balneo-impact on the human organism. The way of application, mechanism of influence, methods of usage, indications and contraindications, as well as balneo-reaction, were presented by means of the recently available data from this field. Possibilities of the mineral and thermo-mineral water exploitation were presented not only in balneology, but in hydro-geothermal energy as a multipurpose resource, what increases economic valorisation of the resources based on the accepted postulates of modern medical balneological doctrine. Bosnia and Herzegovina has 16 SPA centres (sanatoriums) treated as health institutions, 8 drinking mineral waters, and 8 pools where thermo-mineral water is used as free use with no health institutions observation. Keywords: Balneo-therapy, thermo-mineral waters, SPA-centres (sanatoriums). becirovic.emir@live.com 63 P a g e

65 COMMUNICATION OF MEDICAL PERSONNEL WITH HEARING IMPAIRED PERSONS Authors: JOSIPA IŠTUK¹, Danijela Šoše², Tamara Barnjak³ Mentor: Assistant Professor Vesna Varunek, PhD¹ ¹Faculty of Science and Education, Mostar, Bosnia and Herzegovina ²University of Mostar Faculty of Medicine, Mostar, Bosnia and Herzegovina ³Faculty of health studies, Mostar, Bosnia and Herzegovina (Oral presentation) INTRODUCTION: Effective communication between medical personnel and hearing impaired person rarely materializes. Phenomenon behind this research is the need for quality communication between medical personnel and hearing impaired persons. AIM: Explore the quality of communication between medical personnel and hearing impaired persons and examine the need for medical personnel to learn sing language. MATERIALS AND METHODS Qualitative and quantitative paradigmes are applied in this research. Methods are theoretical and empirical (theoretical analysis of the content, survey method and descriptive methods). Applied instruments are Likert scale of attitudes, the protocol for a group interview andobservationprotocol. A sample consists of 50 health professionals University Clinical Hospital Mostar and 50 members of the association Hearing (deaf and hard of hearing) from Mostar. RESULTS: Of 50 surveyed hearing impaired persons and 50 medical personnel, 80% hearing impaired persons agreed that medical personnel do not know how to communicate with them, 20% are undecided. 94% medical personnel agrees with this statement and 6% are undecided.74% hearing imapired persons and 94% medical personnel agree with the statement that the medical personnel should learn how to effectively communicate with hearing impaired persons. The rest are undecided. Both groups completely agree that communication is important for successful treatment. CONCLUSION: In order to enchance the provision of medical care to satisfaction of hearing impaired persons, it would be necessary to educate future health professionals about the specifics of communication with hearing impaired persons and teach them the basics of sing language. Keywords: communication, hearing impaired persons, sing language, medical personnel josipa.istuk@gmail.com 64 P a g e

66 Surgery Otorhinolaryngology Anesthesiology 65 P a g e

67 CASE REPORT OF NEUROCYSTICERCOSIS WITH UNCLEAR RADIOLOGICAL DIAGNOSIS AND AWAKE NEUROSURGERY PROCEDURE Authors: GAŠPER ZUPAN 1, Andrej Vranič 2 Mentor: doc. Andrej Vranič, M.D., PhD 2 1 University of Ljubljana, Faculty of Medicine, Slovenia 2 University Medical Centre Ljubljana, Department of Neurosurgery, Slovenia (Oral presentation) INTRODUCTION: Neurocysticercosis is considered the most common helminthic disease of the central nervous system. It is a consequence of ingestion of fertile eggs which gain access to the bloodstream and the brain through the intestinal wall. Cysticerci develop in the brain tissue and can be found in several developmental stages. Most commonly the foci are seen in brain parenchyma, however subarachnoid, ventricular or spinal lesions can be found. CASE REPORT: A 53-year old woman presented in July 2014 with a grand mal seizure. CT and MRI were promptly made and a contrast enhancing cystic lesion in the left frontal lobe with surrounding edema was found. After dexamethasone the edema resolved. Brain metastasis or low-grade glioma were suspected. Since diagnostic workup revealed no primary tumor elsewhere, the latter was more plausible. Additional fmri studies were conducted and awake surgery was performed. During the procedure, neuromonitoring of language and motor function was utilized. The mass was completely removed and cysticercosis was diagnosed on histopathological examination. Right arm paresis that was found after the surgery gradually improved. Newly arisen partial epileptic seizures were managed with two antiepileptic medications and albendazole was introduced to treat cysticercosis. Secondary history revealed homemade pork salami being frequently consumed. CONCLUSION: Patient presented with an epileptic seizure which is the most common symptom of neurocysticercosis. Travel history was negative, however that is not exclusive of the diagnosis. In our case, the MRI indicated a malignant disease. Generally surgery is performed only if lesions are symptomatic after the induction of anthelmintic drug such as albendazole. The latter acts as a cysticidal drug and has a positive effect on the clinical status of a patient. However, in significant proportion of cases, the relapse of seizures can be expected and therefore a longer anticonvulsive therapy may be needed. Keywords: neurocysticercosis, awake surgery, neuromonitoring gasper.mf@gmail.com 66 P a g e

68 ADRENAL ABSCESS IN NEWBORN (Poster presentation) Authors: LUCIJA BRADIĆ¹, Melita Brajčinović¹ Mentor: Tomislav Luetić, MD, PhD² ¹University of Zagreb, School of Medicine ²Department of Surgery, Division for Children Surgery, University Hospital Centar Zagreb- Rebro INTRODUCTION: Neonatal adrenal abscess is a rare condition. The differential diagnosis of an adrenal cystic mass includes hemorrhage, cystic neuroblastoma or renal dilatation. AIM: We report a case of 2 day old girl with adrenal abscess associated with Serratia ESBL sepsis which was successfully surgically treated. Considering the position and relation to the other organs it was decided that conservative measures weren t recommended. MATERIALS AND METHODS: Female newborn, presented with decreased acceptance of oral feeds, abdominal distension, mild jaundice, irritability and fever. She was born from her mother's second pregnancy, regularly checked but complicated with gestational diabetes. In the second day of life she became restless, pale-gray skin color with an increase in inflammatory parameters. Specimens were taken for Microbiology. Serratia ESBL 1000 was isolated from the urine culture, and Pseudomonas aeruginosa from nasopharyngeal swab. Therapy started with antibiotics. Abdominal ultrasound, MRI and X-ray of the abdomen were performed and found a cystic tumor formation located above the left kidney and spleen, suspected for neuroblastoma. RESULTS: Surgical treatment was indicated. At the day of surgery inflammatory parameters were: CRP 337.5, L22.9, SE60. Abscess was found and drained. Inflammatory mass removed. Intraoperatively taken sample was positive for the multiresistant Serratia ESBL. Patohistological results of the surgical specimen showed inflamated hemorrhagic adrenal pseudocyst. CONCLUSION: Adrenal hemorrhage is not unusual in newborn but complicated by abscess is rare. Despite being rare it should be considered as a differential diagnosis especially in septicemic newborns with a suprarenal mass lesion. Key words: abscess, adrenal gland, newborn lucijabradic@gmail.com 67 P a g e

69 COMPLICATIONS AFTER CEPHALIC DUODENOPANCREATECTOMY PREVENTION AND MANAGEMENT Authors: EMINA PEZIĆ 1, Dženana Softić 1, Delila Softić 1 Menthor: Zijah Rifatbegović, MD, PhD 1,2 (Oral presentation) 1 University of Tuzla, Faculty of Medicine, Tuzla, Bosnia and Herzegovina 2 Department of Surgery, Unirvesity Clinical Center of Tuzla, Bosnia and Herzegovina INTRODUCTION: Over the last 15 years, major pancreatic resections have been performed with increasing frequency. Despite the observed decrease in postoperative mortality, morbidity remains statistically unchanged with most large series reporting 35%- 45% major complication rate. This apparent improvement in postoperative mortality without an observed decrease in morbidity suggests an improved ability to successfully rescue patients who experience significant postoperative complications. Management of complications has shifted from operative reexploration to interventional or endoscopic procedures. AIM: Troughout research we wanted to show how much morbidity and mortality rates have changed, what are todays complications after duodenopancreatectomy, how are they treated, so we could have a feedback on an improved ability to successfully rescue patients. MATERIALS AND METHODS: We examined 22 patiens ( ) who had this procedure. We tracked down number and type of compications, and what kind of therapeutic treatment was used. We also noted the outcome. RESULTS: From 22 patients, 13 (36.1%) had complications; 3 (8.3%) died. Most common complication is fistula (13.8%), then abscess (8.3%). Percutaneous image-guided drainage was therapeutic treatment. Patients who developed delayed gastric emptying (5.5%) were given metoclopramide; with wound infection (5.5%) treated with antibiotics. Patient with hemorrhage had still to go on reexploration. CONCLUSION: Increasing familiarity with the perioperative events has led to earlier detection, intervention and a reduction in the need for reoperation. Percutaneous drainage procedures are now typical approach to postpancreatectomy leak or abscess, and they can be performed with minimal sedation and low morbidity.reasrch shows positive response on new treatment and minimises the need for reoperating our patients. Keywords: duodenopancreatectomy, endoscopic, interventional peza_913@hotmail.com 68 P a g e

70 HIP FRACTURES IN PATIENTS OLDER THAN 65 ANALYSIS OF 2013 Authors: DAMIR ĆAĆIĆ 1, Ana Oljača 1, Ksenija Baždarić 1,PhD Mentor: Prof Tedi Cicvarić, MD, PhD 1,2 (Oral presentation) 1 University of Rijeka, School of Medicine, Rijeka, Republic of Croatia 2 Department of Traumatology, Surgery Clinic, Clinical Hospital Center Rijeka, Rijeka, Republic of Croatia INTRODUCTION: Hip fractures in patients older than 65 are significant issue in trauma and it is estimated that in the future will be required to establish department that would deal only with geriatric trauma patients. AIM: The aim of this retrospective study is to show the number of patients, type of fracture and the type of implants that were operated in 2013 at the Department of Traumatology, Clinical Hospital Center Rijeka. MATERIALS AND METHODS: For preparation of this study we used data from medical records of patients of the Department of Traumatology, CHC Rijeka from 2013 and in total we examined 385 patients with hip fractures. We have selected patients younger than 65 and they were not analyzed in this study. The data were analyzed: age, sex, type of fracture and implant type. RESULTS: Based on the data we used, we have been given an insight into the ratio of male and female patients, most common type of fracture and the most common type of surgery that is performed in the geriatric trauma. Detailed results, analyzed by statistical analysis will be presented at the congress. CONCLUSION: This study shows the number of patients, type of fracture and implant type. Following current trends in traumatology and quantitative data we can see that there is a need to establish a Department of Geriatric trauma. Keywords: geriatric trauma, surgery, hip fracture damir.cacic01@gmail.com 69 P a g e

71 BAROPODOMETRYC ANALYSIS OF WALK IN PATIENTS WITH SEVERE HALLUX-VALGUS DEFORMITY Authors: MARTINA FIŠIĆ 1, Maja Đorđević 1 Mentor: Hari Jurdana, MD, PhD 2 1 University of Rijeka, Faculty of Medicine, Rijeka, Croatia 2 University Orthopaedic Clinic Lovran, Rijeka, Croatia (Poster presentation) INTRODUCTION: The aim of the study was done baropodometrijsku gait analysis in patients with a strong degree of hallux valugus. MATERIALS AND METHODS: We have analysed two groups of examinees age from 65 to 75. Each group was formed by 40 examinees, in the firs group all patients had severe hallux valgus deformity while in the second the patients were without deformity. Plantar load was examined at typical foot zones with dynamic pedobarography. Length and the average load in intervals of 0,1 seconds in each stage of foot load during the walk were measured with the platform for baropodometric analysis Baropodometro Eletronico. RESULTS: The results in the group of examinees with severe hallux valgus deformity show less static load and a shorter load period respectively to the group without deformity. CONCLUSION: This type of reassignment of the foot load proved decreased function of the anterior part of the foot, particularly of the first metatarsophalangeal joint and thumb in the support phase of the walking mechanism in the group of examinees with hallux valgus deformity with reference to the group of examinees without deformity. Keywords: baropodometry, hallux valgus, pedobarography, foot load, walk. ella1703@hotmail.com 70 P a g e

72 EVALUATION OF CHEST TUBE DRAINAGE FOR A PERIOD OF TWO YEARS IN PATIENTS WITH PNEUMOTHORAX Authors: SELMA MILIŠIĆ 1, Amina Selimović 1,2 Mentor: Ademir Hadžismailović, MD, PhD 1,3 (Oral presentation) 1 Faculty of Medicine, University of Sarajevo, Bosnia and Herzegovina 2 Department of Pulmonology, Pediatric Clinic, University Clinical Centre of Sarajevo, Bosnia and Herzegovina 3 Clinic for Chest Surgery, University Clinical Centre of Sarajevo, Bosnia and Herzegovina INTRODUCTION: Pneumothorax (spontaneous, iatrogenic, traumatic) is defined as the presence of air in the pleural space with secondary lung collapse.chest drainage is a procedure that allows one to achieve full lung re-expansion and to normalize relations and cardiopulmonary pressures to return to physiological values. AIM: The main aim of the study is to report our experience with chest tube drainage as a small surgical procedure for the treatment of spontaneous, traumatic and iatrogenic pneumothorax.the study analyzed the average chest tube drainage duration according to the type of pneumothoraces, complications of chest drainage and comorbidity. MATERIALS AND METHODS: The study included 181 patients treated by chest tube drainage between the period from 1 st January 2011 to 21 st December This is a retrospective study conducted at the Department of Chest Surgery,University Clinical Centre in Sarajevo. RESULTS: The average chest tube drainage duration was 6,1±5,4 days.patients who showed complications related with a chest drainage placement had an average chest tube drainage duration 13,4±9,2 days, and those without complications 5,7±3,2 days.patients with the presence of comorbidity had the average chest tube drainage duration 7,6±6,1 days (p <0,05); [t = 6,454; p = 0,0001],whereas in patients without comorbidity had 6,1±4,4 days (p <0,05); [t = 4,618; p = 0,005].According to the type of pneumothorax average chest tube drainage duration was: primary spontaneous 6,1±3,4 days, secondary spontaneous 11,7±8,8 days, traumatic 5,3±2,1 days, iatrogenic 5,2±3,7 days.one chest drain was placed in 148 (81,8%) of patients and two drains were placed in 33 (18,2%) patients, (p<0,005),[χ2= 7,066; p = 0,001]. CONCLUSION: The study shows that males are more at risk than female.most cases of pneumothorax completely resolved with a single chest drain.the chest tube drainage duration in patients with complications of chest drainage and comorbidity was longer compared to healthy patients. Keywords: pneumothorax,chest drainage,spontaneous,traumatic,iatrogenic selmamili.sm@gmail.com 71 P a g e

73 ASSESSMENT OF RHINOPLASTY COMPLICATION Authors: IRINA MEITEL 1, Liana Karapetyan 2 Mentor: Yuriy Rusetckiy, MD, PhD 2 (Oral presentation) 1 I.M. Sechenov First Moscow State Medical University, Center of Innovation Education Program "Future Medicine" 2 I.M. Sechenov First Moscow State Medical University, Chair of otorhinolaryngology INTRODUCTION: Rhinoplasty enjoys greater popularity. To 68% note nasal obstruction after rhinoplasty. Problem of rhinoplasty complication epidemiology remains obscure. AIM: To estimate epidemiology of functional complications after rhinoplasty. MATERIALS AND METHODS: Main group -137 patients who underwent rhinoplasty in I.M. Sechenov First Moscow State Medical University ENT clinic between 2010 and 2014 and 30 healthy participants - control group. There were 57% female and 43% male ones, 28±3 years. Patients responded to the questionnaire - adapt NOSE and underwent objective assessment - anterior rhinoscopy, acoustic rhinometry (AR) and anterior active rhinomanometry (AARM). RESULTS: The results of questionnaire show that all criteria were noted as insignificant problem in patients who had no concerns. Patients with problems after primary surgery noted criteria as expressed problem, but ones after secondary operation noted criteria as insignificant except blockage with exercise. By rhinoscophy - 5 cases of septal deviation, 2 septal perforation, 1 - nasal synechiae. The results of AARM: Cooperative volume streem (CVS) was in referal limits in 72% in group after rhinoplasty without problems, after primary rhinoplasty - insignificant and expressed bellow in 47 and 40%, in group after secondary rhinoplasty better results. The results of AR: Minimal cross-sectional area (MCA) of the nasal cavity was in referal limits in 61% in group without problems. There was insignificant and expressed bellow in 50 and 3% in primary sugery group, and 46 and 1% after secondary sugery. All paramatres in control group were in referal limits. CONCLUSION: 43% of patients note nasal obstruction after rhinoplasty. From % of revision cases during 5-year period in ENT-department. The most frequent complaint was blockage with exercise. Nasal valve dysfunction is the most common funtional rhinoplasty complication, it was diagnosed in group without complaints. Secondary sugery considerably improve nasal breathing as compared with primary results. Keywords: rhinoplasty complication, nasal obstruction, nasal valve dysfunction irina_babaeva@inbox.ru 72 P a g e

74 SELECTION OF ANESTHESIA IN HERNIOPLASTY (Oral presentation) Authors: NEDIM BEGIĆ 1, Edin Begić 1, Amra Dobrača 2, Dženan Jahić 1, Mirna Džubur 1, Amina Asotić 1 Mentor: Senada Begić, MD 3 1 University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina 2 University of Sarajevo, Faculty of Pharmacy, Sarajevo, Bosnia and Herzegovina 3 General Hospital Prim. dr Abdulah Nakaš, Department of Anesthesiology, Sarajevo, Bosnia and Herzegovina INTRODUCTION: Hernias are among the oldest known afflictions of human kind. Inguinal hernia repair can be performed by using a variety of anesthetic techniques such as general anesthesia, regional anaesthesia (spinal, epidural), paravertebral block or local anesthesia. The choice of anaesthesia and advantages of any one over another have been subject of debate. AIM: Show side effects of general and spinal anesthesia and to demonstrate advantages of any tenhnique over another. MATERIAL AND METHODS: Study had retrospective character, and data were processed from patients history (operations were performed during period January to October 2014.). Patients (n=30) were seperated in two groups, patients treated in general (n=15) and in spinal anesthesia (n=15). RESULTS: General anesteshia was performed with combination of Propofol, Sevofluran and N20. Tension value was continuously recorded, and in 2 (13%) patients a decline of tension (systolic blood pressure below 90mmHg) was recorded after 10 minutes patients with cardiac diseases. After 12 hours 2 patients complained about the nausea and vomiting. Spinal anesthesia was performed with 27G needle, with 0.5% bupivacaine (15-20 mg). 2 patients had a decline of tension after 10 minutes. The pulse ranged between bpm (all patients). In 1 (6,6%) patients spinal block wasn t complete. After 12 hours 1 patient complained about the headache and vomiting. At the site of injection in 2 patients appeared redness (without infectious process). CONCLUSION: Although there is no significance difference in appearance of side effects, spinal anesthesia should be method of choice in the treatment of inguinal hernia, in order to avoid contraindications, and to break down prejudices about the "harmfulness" of spinal anesthesia related to technique of execution and local access. Headache is a side effect of spinal anesthesia, and is less risky and more economical process for both, patient and institution. Keywords: hernioplasty, spinal anesthesia, general anesthesia nedim_begic91@hotmail.com 73 P a g e

75 Gynecology Pediatrics 74 P a g e

76 NON-INVASIVE PRENATAL DIAGNOSIS OF SEX OF THE FETUS IN OBSTETRICS Author: ANNA GURINA 1 Mentors: V. A. Melnikov, MD 2 ; A.N. Markelova, MD, PhD 2 1,2 Samara State Medical University, Russia (Oral presentation) INTRODUCTION: There are more than 300 sex-linked genetic diseases and traits, for example, haemophilia, Duchenne muscular dystrophy, X-linked mental retardation and others. Prenatal screening and diagnosis are considered to be important in allowing women to make informed choices about the continuation of pregnancies affected by genetic conditions. Noninvasive prenatal diagnostic (NIPD) is a new direction for Russian science. AIM: The aim of the research is the investigation the possibility to optimize the leading of pregnant women, who have the risk to give birth their children with sex-linked diseases using Russian test-system DNA-sex of child production by the company Gentechnology. This test-system hasn t analogues in Russia. MATERIALS AND METHODS: Multiple studies have shown that both intact fetal cells and cell-free fetal deoxyribonucleic acids (cffdna) cross the placenta and circulate in the maternal bloodstream. The cffdna is around 3 6% of the total cellfree DNA in maternal circulation during pregnancy. Fetal DNA can be detected from the 4th week of gestation. Our research with the help of cffdna for sex - determination used real-time polymerase chain reaction (PCR) to detect genes on the Y chromosome of male fetuses. We used blood samples (the volume is 7 ml) of 250 pregnant women. After the women gave birth to their children, it was possible to evaluate the results of the study. RESULTS: 137 boys and 113 girls were born, that coincided with the results of the PCR analysis. We calculated the sensitivity and specificity of the method with the help of fourfold table, which are 100 percent. The verification of sex of the fetus in early stages of gestation allows to choose the best algorithm for the management of pregnancy. CONCLUSION: The identification of sex-linked pathology in early pregnancy may be a decisive factor in the decision to continue the pregnancy for high genetic risk families. Because the sensitivity and specificity of NIPD are 100%, we can recommend it for introduction into medical practice for doctors. The analysis of cffdna may be used in national antenatal screening programs for different genetic disorders in future. Key words: obstetrics, fetus, non-invasive prenatal diagnosis (NIPD) anna_gurina@rambler.ru 75 P a g e

77 SUGGESTED LABORATORY PREDICTORS OF PRE-ECLAMPSIA IN PREGNANT WOMEN Author: DAIANA BORIS 1 Mentor: Natalia Kahn, MD, PhD 2 1 I.M.Sechenov First Moscow State Medical University 2 National Institution for Obstetrics, Gynecology and Perinatology of Russia (Poster presentation) INTRODUCTION: Pre-eclampsia (PE) is pregnancy disorder. The prevalence of PE is to 35%. Question about early diagnostics of PE by laboratory tests remains obscure. AIM: To find out possible predictors of PE in laboratory tests. MATERIALS AND METHODS: 60 patients with PE (main group) and 147 healthy patients (control group) who underwent treatment in National Institution for Obstetrics of Russia between 2009 and Blood, urine, biochemical blood tests, coagulogram were analysed. RESULTS: Patients were matched according to age and clinical characteristics. Average age was 29±2. We conducted a laboratory study because of the lack of statistical differences in clinical anamnesis. Statistically significant difference of mean values was revealed in the following laboratory data: prothrombin index -111%, Thrombodynamic Potential Index (TPI) 18 c.u., - in the main group and prothrombin index %, TPI 16.9 c.u., in control group. Erythrocytes in urine: not changed - 15, changed - 14 in the visible area in the main group; in control group: not changed - 20, changed -8. The relation of not changed erythrocytes to the changed came to 2 in the main group and 7.46 in control group. Cases of hypercoagulability was nearly 1.5 times higher in the main group 57.4% while in control group this index appeared as 35%. CONCLUSION: In PE women there are revealed disturbances in rheological properties of blood, even in normal level of platelets. It may serve as an additional factor leading to microcirculation violation and development of polyorgan insufficiency on the background of endothelial dysfunction. Established changes in blood coagulabilitycan be interpreted as adverse predictors of PE at women of high risk. These data are not complete, and further investigation in this area is necessary. Keywords: predictors of pre-eclampsia, pregnancy complications. dayana_boris@mail.ru 76 P a g e

78 KNOWLEDGE OF MEDICAL STUDENTS OF UNIVERSITY OF RIJEKA ABOUT SEXUALLY TRANSMITTED DISEASES CROSS SECTIONAL STUDY (Oral presentation) Authors: RADOVČIĆ I 1, Skočilić I 1, Vrljičak M 1, Ćaćić D 1, Salopek I 1, Baždarić K 1 Mentor: Ksenija Baždarić, PhD 1 University of Rijeka, Faculty of Medicine, Rijeka, Croatia INTRODUCTION: Sexually transmitted diseases are an important problem due to the high incidence and possible permanent effects on general and reproductive health. These are infectious diseases that are transmitted from infected to a healthy person, most often by sexual contact. Risk factors are younger age, female sex, large number of partners, unprotected sexual intercourse, sexual intercourse under influence of alcohol or drugs and existence of another sexually transmitted disease. The risk of disease is greatest among young people who engage in early sexual relationships and are prone to changing partners. This population likely is not using condoms, which is the safest way of protection against sexually transmitted diseases and against unwanted pregnancy. AIM: To define the knowledge of medical students about sexually transmitted diseases. MATERIALS AND METHODS: The questionnaire was made in several phases. Review of books and papers was made in search for examples and similar researches of sexual habits. Furthermore, focus groups were formed in order to gain groups of questions in questionnaire so that first version could be made. Target groups of participants were selected, 1 st and 4th year medical students of University of Rijeka, and the research was conducted. RESULTS: The results are expected to be presented on a congress. The student's knowledge will be compared regarding year of study, sex, social status, parent education status and religion. CONCLUSION: It is expected that students of higher year of study will have more knowledge about sexually transmitted diseases, and that knowledge is not under influence of sex, social status, parent education status or religion. Keywords: students, sexually transmitted diseases ivana.radovcic.5@gmail.com 77 P a g e

79 DO WE NEED A SCREENING FOR HYPERTENSION IN HEALTHY CHILDREN? Authors: ANES JOGUNČIĆ 1, Ema Tahto 1 Mentor: Lutvo Sporišević, MD, PhD 2 1 Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina 2 Public Institution Health Center Novi grad, Sarajevo, Bosnia and Herzegovina (Oral presentation) INTRODUCTION: Essential hypertension has origins in childhood, showing a trend of persisting into adulthood and it is essential to timely diagnose hypertension, which is in the child's age usually asymptomatic, in order to reduce cardiovascular morbidity and mortality in adults. AIM: To determine the prevalence of hypertension and evaluate the importance of screening for hypertension in healthy schoolchildren. PATIENTS AND METHODS: The cross-sectional study included 406 healthy children (173/ % of boys and 233/ % girls), mean age 8.7 ± 1.2 years (range 6-10 years). The study included: physical examination, measurement of body weight and height, and determining blood pressure in children calibrated with aneroid sphygmomanometers from Erka company. According to the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents average systolic and / or diastolic blood pressure 95th percentile for age, sex and height was considered for hypertension. RESULTS: Isolated systolic hypertension had 20/406 (4.9%), isolated diastolic hypertension 3/406 (0.7%) and pooled systolic and diastolic hypertension had 3/406 (0.7%) patients. Systolic hypertension was slightly more common in boys (11/ %) compared to girls (9/ %), but the Mann-Whitney test has not proven statistical significance (z = 0.435; p = 0.663). There was no difference in gender distribution of diastolic hypertension in girls (2/ %) and boys (1/ %). Associated systolic and diastolic hypertension was approximately sexually distributed (2/ % of girls and 1/ % of boys). CONCLUSION: Research shows that healthy children may have early cardiovascular risk due to the presence of hypertension. With screening for hypertension in childhood, which should be part of routine pediatric examination, it is possible to promptly determine hypertension, ie. Early cardiovascular risk and prevent premature atherosclerotic cardiovascular clinical expression. Keywords: child, hypertension, cardiovascular risk, screening anesj0710@gmail.com 78 P a g e

80 PULMONARY ARTERIAL HYPERTENSION IN CONGENITAL HEART DISEASE WITH LEFT-TO-RIGHT SHUNT (Oral presentation) Authors: EDIN BEGIĆ 1, Nedim Begić 1, Dženan Jahić 1, Amra Dobrača 2, Ema Tahto 1 Mentor: Zijo Begić, MD 1,3 1 University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina 2 University of Sarajevo, Faculty of Pharmacy, Sarajevo, Bosnia and Herzegovina 3 University Clinical Center of Sarajevo, Pediatric Clinic, Sarajevo, Bosnia and Herzegovina INTRODUCTION: Pulmonary hypertension (PH) is increase of blood pressure at the level of pulmonary vascular resistance or increase of blood flow, through the pulmonary blood vessels. It can be arterial, venous, caused by left heart disease, hypoxic, thromboembolic and caused by diseases that directly affect the pulmonary blood vessels, and PH with unclear mechanisms. Pulmonary arterial hypertension (PAH) is hemodynamically pathophysiological condition defined as increase of secondary pulmonary arterial pressure, at rest over 25, or after effort over 30 mmhg, measured by right heart catheterization. PAHs are classified as primary (5%) and secondary. AIM: The aim was to raise awareness about the problem, to show the importance of early diagnosis and treatment of PAH in CHD LR shunt. MATERIAL AND METHODS: Data of registered patients with CHD LR shunt and PAH were processed from PAH protocols (May to February 2014.) at the Pediatric Clinic CCUS. RESULTS: During mentioned period, PAH was recorded in 48 patients. 18 patients had fixed (irreversible), and 30 patients had non-fixed PAH. Patients with non-fixed PAH were treated surgically (exception of 4 patients) and treated medically with Ca antagonists, diuretics, intermittent O2 therapy, recently with sildenafil, and in 2 occasions with endothelin receptor antagonists. 18 patients are still evaluated with following diagnoses: 9 VSD (2 of them with Down syndrome), 6 AVSD (all associated with Down Syndrome), two patients with complex DORV (one with Down syndrome) and one with AP window. Of these 18 patients, only in 3 PAH wasn't proven with cardiac catheterization. CONCLUSION: Prevention in the form of early detection of PAH, prompt operational correction of CHD with RL shunt, especially of risk groups (chromosomopathies) appears to be the main task of modern pediatric cardiology, with ensuring a specific treatment (prostanoids, endothelin receptor antagonists and inhibitors of phosphodiesterase type-5). Keywords: PAH, LRshunt, catheterization edinbegic90@gmail.com 79 P a g e

81 THE INCIDENCE OF BIRTH ASPHYXIA IN INFANTS AND PRETERM INFANTS CONSIDERING IF DELIVERY WAS INDUCED OR NOT Authors: FARIS KADIĆ 1, Nedim Begić 1, Edin Begić 1 Mentor: Aida Kadić, MD 2 (Oral presentation) 1 University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina 2 Cantonal Hospital "Dr Irfan Ljubijankić", Department of Neonatology, Bihać, Bosnia and Herzegovina INTRODUCTION: Birth asphyxia, perinatal asphyxia or neonatal asphyxia is the medical condition resulting from deprivation ofoxygen to a newborn infant that lasts long enough during the birth process to cause physical harm, usually to the brain. Hypoxic damage can occur to most ofthe infant's organs (heart, lungs, liver, gut, kidneys), but brain damage is ofmost concern and perhaps the least likely to quickly or completely heal. In more pronounced cases, an infant will survive, but with damage to the brain manifested as either mental, such as developmental delay or intellectual disability, or physical, such as spasticity. AIM: Our aim was to find the bond between birth asphyxia in infants and preterm infants considering ifdelivery was induced or not so we can find the way to lower it in future. MATERIALS AND METHODS: This was retrospective study. We used medical histories of the 32 patienys that have been born in 2013 at Cantonal Hospital "Dr Irfan LJubijankić" in Bihać (Bosnia and Herzegovina) and have been diagnosed with birth asphyxia. RESULTS: From 2187 births, 32 were diagnosed with birth asphyxia. 24 of them were infants, which is 75% (21 birth were induced, which is 87.5% and 3 were not, which is 12.5%). 8 of them were preterm infants, which is 25% and no birth were induced. CONCLUSION: Conclusion is that birth asphyxia is more common in induced deliveries in infants. Because of the lack of preterm infants that have been diagnosed with birth asphyxia, we couldn't make some important conclusion. Keywords: Birth asphyxia, Infants, Preterm infants, Delivery, Induced delivery kadicfaris@gmail.com 80 P a g e

82 ALLERGIC REACTIONS ON MACROLIDE ANTIBIOTICS IN CHILDREN Authors: SAŠA ILIĆ 1, Tanja Grahovac 1, Jovana Ivanović 1, Andrija Jekić 1 Mentor: Marina Atanasković-Marković MD, PhD 2 1 University of Belgrade, Faculty of Medicine, Belgrade, Serbia 2 University Children s hospital, Clinical Center of Serbia, Belgrade, Serbia (Oral presentation) INTRODUCTION: Macrolides are group of antibiotics whose mechanism is inhibition of bacterial protein synthesis. It is estimated that only 0,4-3% of macrolide antibiotics lead to hypersensitivity reactions (HSR) in childhood. Macrolide antibiotics can cause early and late HSR (urticaria, angioedema, anaphylaxis, maculopapular/morbilliform rash, erythema multiforme, etc.). Diagnostic standards for the detection of HSR on macrolides have not been fully defined. There are also little data on HSR on macrolides in children in previously published studies. AIM: The aim of study was to determine the incidence of allergic reactions on macrolide antibiotics in childhood. MATERIALS AND METHODS: We examined 100 children, aged 2-18 years, at the University Children s hospital in Belgrade during the period with suspected HSR on macrolides. Children were tested using the ENDA/EAACI principles. Children that had suspected early-type of HSR were tested using skin tests (prick and intradermal test) and drug provocation test (DPT) with increasing concentrations of macrolides. Skin tests were primarily applied and DPT was applied after a negative skin test. Children that had suspected late-type of HSR were tested using patch/intradermal tests and DPT in case of negative skin tests. RESULTS: From tested children there were 59% of boys and 41% of girls. In the examined children 53% had urticaria, 26% had maculopapular rash, 15% had urticaria and angioedema and angioedema had 6%. Suspected HSR on azithromycin was found in 56%, on erythromycin in 33%, and on clarithromycin in 11% of the children. Among possible allergies, we proved that 26,8% (n=15) had HSR on azithromycin. Among the suspected allergies on erythromycin in 36,4% (n=12) was proven HSR. Allergic reaction on clarithromycin was found in 63,6% (n=11). CONCLUSION: Macrolide antibiotics rarely cause allergic reactions in children. According to our research, the most common HSR was on azithromycin, while the most common type was urticaria. Keywords: allergic reaction, macrolides, skin tests sasai1184@gmail.com 81 P a g e

83 THE RELATIONSHIP OF INVASIVE AND NONINVASIVE RESPIRITORY THERAPY TO THE RISK OF DEVELOPING THE RETHINOPATHY OF PREMATURITY (ROP) (Oral presentation) Authors: BOLSHOVA ALINA 1, Krushelnickii Anatoliy 1, Stepanova Ekaterina 1 Mentor: Degtiarev Dmitrii Nicolaeviсh 2, Kirtbaia Anna Revazievna 2, Kan Irina Georgievna 2 1,2 First Moscow State Medical University I.M.Sechenov INTRODUCTION: ROP occurs in 50% of babies weighting less than 1700 g, all cases that have proceeded to the third stage of the disease will cause serious complications or complete blindness. AIM: to evaluate the degree of invasive and noninvasive respiratory therapy effect on the frequency and severity of ROP in the risk group. MATERIALS AND METHODS: retrospective analysis of examination of 217 newborns in the risk group. (In the Russian Federation all children under 35 weeks of gestation or weighting below 2000 g are considered to be in the risk group for ROP). Due to the development of Respiratory Distress Syndrome all children needed respiratory therapy during the first week of living. The patients were divided into 3 groups according to the kind of respiratory therapy received. Group I (n=86) received noninvasive respiratory therapy with Nasal Continuous Airway Pressure, Group II (n=69) noninvasive therapy with Biphasic, and Group III (n=62) invasive respiratory therapy with Artificial Pulmonary Ventilation. RESULTS: In Group I - 0 cases of ROP we observed, in Group II - 3 cases were diagnosed, but all of them had a fast regression afterwards, in Group III 20 children developed ROP, only 15 cases regressed and one child had to undergo coagulation of the retina vessels, due to serious vision problems. CONCLUSIONS: Changing from invasive to noninvasive forms of respiratory therapy may lead to a significant decrease of the risk of ROP. Keywords: retinopathy, prematurity, newborn ksana1@mail.ru 82 P a g e

84 Dentistry 83 P a g e

85 EXPERIMENTAL GROUNDS OF USING OF GUARD MEANS OF PREPARATED SURFACES DURING THE CLINICAL STAGES OF MANUFACTURING OF DENTAL PROTHESIS FOR PATIENTS WITH PATHOLOGICAL DENTAL ABRASION Authors: V.I. STRUK 1, T.M.Zhabiuk 1, Y.I.Zabuga 1 Mentor: V.I. Struk 2 (Oral presentation) 1 Medical Sciences Bukovinian State Medical University, Chernivtsi, Ukraine 2 Department of Operative Dentistry, Medical Sciences Bukovinian State Medical University, Chernivtsi, Ukraine INTRODUCTION:During the treatment of pathological abrasion of hard dental tissues orthopedic constructions are used, and their usage is impossible without preparation of teeth. During the operative interventionin the boundary of dentine, the speed of dental liquid is changing, and that irritates nerval ends of fibers causing ache. To solve this problem, there was invented the array of preparations for the treatment of postoperational sensibility of hard dental tissues desensitizers. AIM: Determination of character of action of different desensitizers on the dentine surface after preparation by orthopedic treatment. MATERIALS AND METHODS: There were studied 60 patterns of extracted teeth and divided into groups. The first (control) group was formed of the patterns, which preparated surface wasn t obturated. The second group was treated with desensitizer Desensital-HG. On the surface of the third group of teeth was brought Desensital O, the fouth Gluftored, the fifth Nanofluor. RESULTS: The results of the conducted electron-microscopic researchcertified that the patterns of the control group on the surface of preparated dentine there are presented the fissures of preparation, the traumatized outgrowths of odontoblasts and lubricated layer of dentine. On the surfaces of the second group of the teeth there was a protective layer with a tight structure, but that didn t provide the full obturation; on the third the thicker crystalized layer; on the fourth and fifth the full obturation. CONCLUSION: Desensitizers form the protective layer that differs by the structure, thickness and obturation degree. Keywords: electron-microscopic research, desensitizers, dentine sensibility taniamily@rambler.ru 84 P a g e

86 MULTIMODALITY THERAPY OF PARODONTITIS AND LICHEN RUBER PLANUS IN PATIENTS WITH DIABETES MELLITUS Author: OLGA MAKOVIYCHUK 1 Mentor: Maria Mytchenok 2 (Oral presentation) 1 Medical Sciences Bukovinian State Medical University, Chernivtsi, Ukraine 2 Department of Operative Dentistry, Medical Sciences Bukovinian State Medical University, Chernivtsi, Ukraine INTRODUCTION: Diabetes mellitus is one of the most spread diseases characterized by macro- and microangiopathy caused by metabolic disorders, morphofunctional changes of the vascular flow, hormonal disorders, imbalance of the immune processes and susceptibility to hypercoagulation. AIM: Treatment of patients with chronic generalized periodontitis with associated lesions of the oral mucous membrane by the elements of lichen ruber planus with underlying diabetes mellitus should be comprehensive. Cold laser therapy (CLT) or low intensity laser therapy should be used to correct the blood flow in this category of patients. MATERIALS AND METHODS: 11 patients with type II diabetes (insulin-independent) and chronic generalized moderate periodontitis and lichen ruber planus of a typical and exudatehyperemic form have been observed. Topical treatment was conducted in two stages. The first one included curettage of periodontal pockets under infiltration anaesthesia and excision of the gingival papillae. Periodontal dressing mixed with the powder of zinc oxide, carotolin and Hyoxizon ointment was applied on the gums. On the second stage nicotinic acid injections under the elements of mucus lesions were given. Carotolin and Hyoxizon ointment were applied on the elements of mucuc lesions and periodontium. RESULTS: Till the end of the course of treatment the condition of patients improved. Papillae on the mucous membrane disappeared. The gums became rosy-pink and did not bleed. The indices of the blood clotting system improved. CONCLUSION: The complex of treatment suggested was effective. A control examination tow months later found a stable condition of the periodontium and absence of the papillae of lichen ruber planus. Keywords: microangiopathy, lichen ruber planus, chronic generalized moderate periodontitis olya.makoviichuk@mail.ru 85 P a g e

87 THE PRINCIPLES OF PHARMACEUTICAL TREATMENT OF PARADONTOSIS AT EARLY STAGES Authors: OLESYA KAVCHUK 1, Yana Palchikova 1 (Oral presentation) 1 Bukovinian State Medical University, Department of Operative Dentistry, Chernivtsi, Ukraine INTRODUCTION: Modern stomatology has a wide range of medicines that are used in treatment of periodontium diseases. Paradontosis is a dystrophic process spreading at all periodontal structures characterized by chronicity.the disease is rather insidious as it doesn t have florid symptoms, at early stages of its development it can be diagnosed with the help of the X-ray only,that is why patients do not resort for help to a doctor. AIM: To analyze remote results of a complex treatment of paradontosis with homeopathic medicines at early stages of development. MATERIALS AND METHODS: 20 patients aged from 40 to 60 with diagnosis of paradontosis of the Ist level were treated.in patients who complained of hypersensitiveness of teeth to different irritantsa plan of measures for paradontosis treatmentwas applied.the patients were also prescribed a complex of hydromassage of gums and electrophoresis with aloe extract. All patients took a course of injections at mucobuccal fold with homeopathic medicinestraumel C and Coenzyme compositum. RESULTS: The term of observation after the performed treatment from 6 months to 1 year. All cases indicated in the investigation were analyzedwith the help of complaint collection and objective assessment and panoramic X-ray. A constant regularity in slowing of dystrophic processes in tissues of periodontium, decrease of teeth hypersensitiveness, decrease of fissures of interdental space, has been found that is supported by the assessment data of X-ray examination. CONCLUSION: Prevention of aggressive microflora acquiring, temporary halt of aging process may be partly achieved with the help of homeopathic medicines. Keywords: paradontosis, hypersensitiveness of teeth, hydromassage, electrophoresis shapka83@ukr.net 86 P a g e

88 ALTERNATIVE MATERIAL BIODENTINE IN CONTEMPORARY DENTISTRY AND COMPARATIVE STUDY OF BIODENTINE AND PRO ROOT MTA (MINERAL TRIOXIDE AGGREGATE) IN APEXIFICATION Author: OLHA KOBA 1 Mentor: Marianna Ostafiychuk 2 (Oral presentation) 1 Bukovinian State Medical University, Faculty of Dentistry, Chernivtsi, Ukraine 2 Bukovinian State Medical University, Faculty of Dentistry, Department of Operative Dentistry, Chernivtsi, Ukraine INTRODUCTION: Biodentine is all- in-one bioactive dentine substitute, based on unique Active Biosilicate Technology. It is a tricalcium silicate material, which has mechanical properties similar to the dentine and can replace it both in the crown and in the root. Apexification is astimulation to form a closed apex in a tooth with necrotic pulp. AIM: To show successful apexification using calcium silicate-based materials and comparison of Biodentine and Pro Root MTA(Mineral Trioxide Aggregate). MATERIALS AND METHODS: Biodentine and Pro Root MTAare used in various clinical cases, such as pulp capping, repair of root, furcation perforations, retrograde fillings and apexification. My research was concentrated on comparing these materials during one-visit apexification. This method describes a treatment of the teeth with an open apex using apical barrier technique. RESULTS:Pro Root MTA is characterized with biocompatibility, regenerative capabilities, and antibacterial properties. Nevertheless, Pro Root MTA has some problems, such as its long setting time, low resistance to compression and possibility of staining of tooth structure. Biodentine, comparing to Pro Root MTA, is better suited to the clinical use, including short setting time (12 minutes),great propertiesandno side effects or disadvantages.advantages of Biodentine: doesn t include monomers, has high biological compatibility, stimulates pulp cells to build reactionary dentine. CONCLUSION: Biodentinerepresents great improvement to other calcium silicate materials. The excellent biocompatibility and shorter setting time ofbiodentinemakes it an alternative material for one-visit apexification. Keywords: Biodentine, Pro Root MTA, calcium silicate materials, apexification. oliakb1994@rambler.ru 87 P a g e

89 ADVANTAGES OF USING VECTOR SYSTEM DURING LOCAL PARODONTITIS (II DEGREE) TREATMENT Author: YULIIA KILMUKHAMETOVA 1 (Oral presentation) 1 Bukovinian State Medical University, Department of Operative Dentistry, Chernivtsi, Ukraine INTRODUCTION: Parodontal diseases take one of the main places among stomatological diseases among dental patients in Ukraine. More than 40 % of population age below 40 years suffer from one or another changes in periodontal tissues, after 40 years this index tends to increase. AIM: To find out the advantages of usage the Vector system among patients with local parodontitisii degreeover ultrasound scaling. MATHERIALS AND METHODS: 83 patients were examined during experiment, 22 of them were deemed healthy, they formed the control group. The rest 61 with pathological changes in parodontal tissues local parodontitis, were divided into two: the first and the second experimental groups. Patients of the first group were treated with ultrasound scaling, parodontalhooks, abrasive pastes and AIR FLOW system. Vector system was used on the patients of the second group. All the patients were given instructions about oral hygiene and medical treatment of the parodontitis. The next visit was appointed in two weeks time. RESULTS: There were no changes with the patients of the control group, aside from better oral hygiene. 21 patients from the first experimental group had gingival swelling, ache and bleeding during eating or brushing their teeth, they suffered from halitosis. There was considerable improvement among patients of the second group: 28 patients had no swelling, bleeding or ache in gingival tissues, examination revealed no concealed subgingival tartar, parodontal pockets decreased in size. CONCLUSION: The usage of Vector system showed better results during local parodontitis II degree treatment, it has better ability to remove subgingival tartar. Keywords: parodontitis, Vector system, ultrasound scaling, parodontal hooks, subgingival tartar. maleccha@mail.ru 88 P a g e

90 CHRONIC GRANULOMATOUS PERIODONTITIS. ETIOLOGY. PATHOGENESIS. THERAPY. Authors: DZVENYSLAVA LEVANDOVSKA 1, Olena Anisova 1 Mentor: Serhiy Palamarchuk, MD 2 (Oral presentation) 1 Bukovinian State Medical University, Stomatological Faculty, Chernivtsi, Ukraine 2 Bukovinian State Medical University, Stomatological Faculty, Departament of operative dentistry, Chernivtsi, Ukraine INTRODUCTION: Chronic granulomatous periodontitis is to be treated either conservatively or by means of surgical treatment removing the granulomas effectively through a probable neoplasty with osteoinductive or osteoconductive materials. The efficiency of treatment and its long-term results depend on the technology of root canals processing and sterilization as well as the method of their subsequent obturation. AIM: To analyze the long-term results of treating chronic granulomatous periodontitis depending on the efficiency of root canals obturation completeness. MATERIALS AND METHODS: 10 patients aged with the diagnosis of chronic granulomatous periodontitis were undergoing treatment in the clinic of therapeutic dentistry of BSMU. The size of granulomas did not exceed 5 mm in diameter. 5 one root teeth of the frontal group in the maxilla and 4 one root teeth of the frontal area in the mandible were subjected to treatment. RESULTS: The observation period after obturation of root canals lasts from 1 to 2 years. There was revealed a regularity confirmed by X-ray examination data: all chronic granulomatous processes in the teeth with not completely filled canals tended to increase in size and were prone to recurrent aggravation. A significant reduction in the size of granulomas up to their total healing was observed in the top area around the teeth with properly obturated canals. We did not observe treatment results depending on the type of material which the root canals had been obturated with. CONCLUSION: The long-term results of chronic granulomatous periodontitis treatment primarily depend on the completeness and efficiency of root canal obturation. Keywords: chronic granulomatous periodontitis, obturation of root canals, X-ray examination dlevandovska@mail.ru 89 P a g e

91 ANTIBACTERIAL ACTION OF PASTE FOR TEMPORARY PLACEMENT INTO ROOT CANALS AND ITS INFLUENCE ON THE EXPERIMENTAL MANDIBLE BONE DEFECT REGENERATION (Oral presentation) Authors: SERHIY PALAMARCHUK 1,2, Anna Prodanchuk 1, Iana Palchikova 1, Dzvenyslava Levandovska 1, Oleksandr Karabulya 1, Marianna Palamarchuk Mentor: Anatoliy Borysenko MD, PhD 2 1 Bukovinian State Medical University, Stomatological Faculty, Departament of operative dentistry, Chernivtsi, Ukraine 2 Bogomolets National Medical University, Stomatological Faculty, Departament of operative dentistry, Kiev, Ukraine INTRODUCTION: The main aim of endodontic treatment of chronic apical periodontitis is the most complete suppression of pathogenic microflora in the system of teeth macro-and microcanals and stimulation effect regeneration of periapical tissues. The paste for temporary placement into root canals during treatment was proposed. It contains: Metronidazole, Enterosgel and Alflutop. AIM: 1) The comparative microbiological study of the antibacterial properties of the proposed medicamental composition. 2) The histologic investigation of influence of the proposed medicamental composition on the experimental mandible bone defect regeneration in rats. MATERIALS AND METHODS: The antibacterial properties of the mendicamental composition were determined by the degree of stunting test strains of microorganisms using the agar diffusion method. The investigation of stimulation effect of proposed medicamental composition on the regeneration of bone tissue the experiments on rats were conducted. The drug Collapan, was used as a comparative remedy. The rats were divided into 7 groups. Euthanasia in all rats group was implemented. RESULTS: The medicamental composition possesses varying degrees of severity antibacterial properties on test strains of microflora. In the histological specimens of the mandible bone defects of 2nd group rats (without treatment 10 th day) the zones of bone tissue in a state of fragmentation were revealed. In the histological specimens of the mandible bone defect of the 4 group rats (was filled with the proposed composition) in 30 th day period the signs of reparation expressed in the formation of big number of new form blood vessels were observed. Moreover, connective tissues formations were closely attached to the bone tissue. The results were similar to action of Collapan. CONCLUSION: The proposed medicamental composition suppresses the test strains of microflora reliably and histological investigation had proved the osteoregenerative abilities similar to those of the material used as a control Collapan. Keywords: test strains of microorganism, metronidazole, enterosgel, alflutop, histological investigation. serhiydentist@gmail.com 90 P a g e

92 REMOTE RESULTS OF DEPOPHORESIS METHOD WITH APPLICATION OF COPPER-CALCIUM HYDROXIDE Authors: IVANITSKA O.V. 1, Zhabiuk T.M. 1 Mentor: Struk V.I. (KM) 1 1 Bukovinian State Medical University, Chernivtsi, Ukraine (Oral presentation) INTRODUCTION: Success of endodontic treatment is known to depend upon the quality of dental root sanation. Nowadays there is an opinion that modern instrumental-mechanical endodontia is not able to decide the problems of elimination of dental root infection. AIM: To study and introduce depophoresis method with application of copper-calcium hydroxide (Cupral) in case of chronic periodontitis. MATERIALS AND METHODS: 60 patients aged from 18 to 55 were examined. Depophoresis was indicated for chronic forms of periodontitis with pronounced destruction of the osseous tissue in the apical area. Sanation of dental roots and periapical foci was conducted by the Professor A.Knappvost s method and included three sessions with 8-10 day intervals. RESULTS: The results of treatment were evaluated in 1 and 4 years considering the absence or presence of patient s complaints, results of physical examination and X-ray picture. X-ray examination 1 year after the treatment showed a tendency to restoration of the osseous tissue in the periapical foci in 57 patients (95%). After 4 years of treatment of destructive forms of chronic periodontitis 85% of clinical cases had a positive result. In 8,3% a pronounced reduction process of destructive foci in the periodontal tissues was found. According to the data obtained the treatment failed in 6,6% of cases which proves the efficacy to use depophoresis method with copper-calcium hydroxide application in identical clinical situations. CONCLUSION: In our opinion, nowadays, when there is a big per cent of ineffective endodontic treatment, the method of sanation of dental roots and periapical foci with application of copper-calcium hydroxide is very actual and is worth of notice of dentists. Key words: copper-calcium hydroxide, instrumental-mechanical endodontia, periodontitis, sanation of dental roots somsomik@mail.ru 91 P a g e

93 SCIENTIFIC PARTNERS MAIN PARTNER: BoHeMSA - Sarajevo, Bosnia and Herzegovina BoHeMSA short for Bosnia and Herzegovina Medical Students Association was founded in 1993 as a joint organization for medical students in the whole country. BoHeMSA received full membership to the International Federation of Medical Students Associations IFMSA in BoHeMSA is non-governmental, non-profit organization that gathers medical students from three universities in Bosnia and Herzegovina. It currently has over 35 active members. The main functions of BoHeMSA are cooperation, association, representation and exchange of medical students both nationally and internationally. It is organized through three local committees, i.e. LC Sarajevo, LC Mostar and LC Tuzla. Each year, 40 students from Bosnia and Herzegovina leave for professional and research exchange programs in over 20 countries worldwide, thanks to our organization. Some of the destinations are: Spain, Catalonia, Turkey, Germany, Brazil, Bahrain, Czech Republic, Russia, Poland, etc. Apart from exchanges, we organize over 10 educational and humanitarian projects annually. Village Concept Project is our most important humanitarian project. We choose the village deprived of primary health care institution within 20 kilometer radius. Donations are collected and medication and other medical material are bought. Then, the team of students and internal medicine specialists visit the village and conduct a pro bono examination of patients and donate medication and other medical aids. Teddy Bear Hospital, educational project is held annually at the Kids festival in Sarajevo. The goal is reduce children s aversion towards doctors through simulation of medical examination of a teddy bear. Candle light memorial is an international project organized during third week of May as a way of honoring a memory of people deceased of AIDS. We set up red ribbon encircled with candles. Candles are lit by pedestrians during sunset. International Federation of Medical Students Associations exists since 1953, and we are proud to be full members of IFMSA, the world s largest organization of medical students for 20 years. Expanding the horizons and educating our students is our primary focus, hence organizing this congress is a great honor for us. Website: 92 P a g e

94 1st Conference on Medical and Biological Engineering in Bosnia and Herzegovina, CMBEBiH 2015 The Association of students of the Medical Faculty in Sarajevo (ASMF Sarajevo) is an official partner with the Society of Medical and Biological Engineering in Bosnia and Herzegovina. Dear Colleagues, The First Conference on Medical and Biological Engineering in Bosnia and Herzegovina (CMBEBiH) will take place in Sarajevo, Bosnia and Herzegovina, in the period March 13-15, It will be a remarkable event as it is the first time that Bosnia and Herzegovina will host a conference on Biomedical Engineering. The general theme of the Conference is "Expand your horizons through the Biomedical Engineering", where researchers from academia, biomedical institutions and industry will have unique opportunity to exchange ideas and present their latest developments in all areas within the field of biomedical engineering. The scope of the conference is to focus on the fields of medical and biological engineering: biomedical signal processing, imaging and image processing, health informatics, e-health and telemedicine, biosensors and bioinstrumentation, biomaterials, biomechanics, robotics and minimally invasive surgery, cardiovascular, respiratory and endocrine systems engineering, molecular, cellular and tissue engineering, clinical engineering and health technology assessment, biomedical engineering education. CMBEBIH 2015 is endorsed by IFMBE and EAMBES. All information about CMBEBiH, including topics, deadlines, manuscript templates etc, can be found at Conference webpage: 93 P a g e

95 MEDICUS - Tuzla, Bosnia and Herzegovina Student's association of Medical Faculty in Tuzla MEDICUS was founded in as a unprofitable, non-political, non-governmental association and unique representative body of all students of the Medical Faculty University of Tuzla, which is a full member of the Student Union University of Tuzla. Over the past year, MEDICUS proved to be a very important factor in the preservation and protection of student rights and interests,but also as an association has conducted many campaigns and projects. Also, Association has taken part in number of projects that are aimed at marking important days in health care and health promotion in general. It's very successful on the field issues and problems of students, active membership in the Council, the Senate, and many commissions and committees of the University of Tuzla.One of the biggest projects are certainly re-editing and publishing the Journal of Medical students' PULSUS after over 20 years of stagnation, the first participation in the competition biomedical faculty Humanijada 2013th and maintain the first brain week in Bosnia and Herzegovina called Tuzla Brain Week - TBW. Website: 94 P a g e

96 NeuRi Rijeka, Croatia 5th NeuRi - Student Congress of Neuroscience will be organized in 2015! The first four congresses were marked by establishing of NeuRi as well as creating neuroscientific recognition of Rijeka and setting our place among student congresses. Upon completion of the last, we are proud to be able to point out that NeuRi has been fully established as a must go "end of April" event for students who reflect on the whole range of functions of the most remarkable and mysterious human organ - the brain.in past few years we have witnessed the launch of two important brain research incentives. On one hand, The Human Brain Project (HBP) as an initiative of the "old continent", and on the other, the American response to the HBP in a form of the Brain Initiative (Brain Research through Advancing Innovative Neurotechnologies). If someone has so far doubted in motto of XXI. century as the century of the mind, these and many other projects that will follow will surely confirm direction of the focus of modern science. Science that will, I believe, provide answers to a number of unknowns, especially those which concern brain pathology: neurological or psychiatric in nature. Thus, neuroscientific breakthroughs will change clinical practice, making us able to treat more successfully but also prevent diseases, improve the quality of life and ultimately make the world a happier place to live in! We hope that NeuRi - Student Congress of Neuroscience gives its quite small, but certainly a decent contribution to this global goal. Under the motto Education & Experience" we want to raise the awareness of young enthusiasts of neuroscience about the importance of brain research and provide them an opportunity to meet with colleagues who share similar interests, expand their knowledge as well as learn and gain memorable experience of congress participation. So we're using this opportunity to warmly welcome you to the 5th Student Congress of Neuroscience - NeuRi We have prepared three days filled with scientific and social programs at the Faculty of Medicine, University of Rijeka as well as the in the town Rijeka (or as call by its inhabitants, "the city that flows") and the Kvarner paradise - the island of Rab with wonderful hosts at the Psychiatric Hospital Rab. Dear students, even this year dozens of your colleagues, as well as many scientists and teachers will be working hard to try to prepare the best atmosphere for a student scientific congress, which you will, we promise, remember for a lifetime! So: welcome to Rijeka and Rab at NeuRi 2015! Website: 95 P a g e

97 GSC Belgrade - Belgrade, Serbia From 2nd to 5th October 2014, the first Global Students Conference of Biomedical Sciences is going to take place in Belgrade, the capital of Serbia. Medical education in scientific research and as well as the acquisition of scientific working skills are of great importance to academic institutions of biomedical sciences on the globe. Place: Deanery of Faculty of Medicine University of Belgrade Website: IMSRC - Istanbul, Turkey Student Scientific Research Club, which was established in 1988, is one of the most active student organisation in Cerrahpasa Medical Faculty and in Istanbul. SSRC has announced its name worldwide by organising various organisations such as national and international congresses, career days and seminars. Our biennially congress(imsrc) is one of the most important and most extensive activities of our club. IMSRC aims to bring medical students from all around the world in order to present their research, share their experiences, learn most current developments, interact with other students and enjoy the beauty of Istanbul. Throughout the conference, delegates will have the opportunity to Exchange knowledge, discuss their work and gain different aspects on medical subjects Hundreds of participants from all over the world improve their skills by participating in workshops. We also award students to encourage them. The 5th edition of the IMSRC will be held on May 15-17th in Participants can present their research in an area of their choice.istanbul University Cerrahpaşa Medical Faculty Students Scientific Research Club is continuing to light up the future with its biennial and now traditional IMSRC. For further information please visit our website: 96 P a g e

98 ZIMS - Zagreb, Croatia ZIMS is a medical congress that brings together medical students and young doctors worldwide For 13 times in a row, looking forward to 14th, ZIMS is a place of constant exchange of experience, presentation of scientific papers and acquisition of new knowledge from colleagues and invited professors in medical science. Further on, general idea of ZIMS is to promote city of Zagreb as a cultural and youth centre, and therefore city sightseeing, workshops and evening gatherings are important part of agenda. It is important to mention that ZIMS is the only conference where young students and not yet affirmed scientist have access to the world of publishing, thus becoming the only conference in Europe where the book of abstracts is published as a supplement to a prestigious medical journal, 'Liječnički vjesnik', which is indexed in EMBASE/Index Medicus. Moreover, the best works are published as full texts. Consequently, the highest quality of an abstract, which goes through strict criteria process, is mandatory. As we know how important presentation of a project is, we expect you to represent your work either orally or as a poster. This medical summit is organized by students from School of Medicine at University of Zagreb, members of EMSA Zagreb and Students Section of Croatian Medical Association. Website: MoMSIC - Podgorica, Montenegro MoMSIC is a voluntary non-government organization. We are working according to the Medical Faculty in Podgorica, University of Montenegro. MoMSIC deals with medical students exchanges, problems of public and reproductive health and human rights. MoMSIC (Montenegrin Medical Students International Committee) is a member of the IFMSA (International Federation Medical Students Association) and for the seven years we can say with pride that we have sent over 350 students on exchanges from our faculty, hosted over 400 students from all around the world, organized numerous activities related to public health and the fight against AIDS.This year MoMSIC was main organizer and ambassador of the National campaign for Breast Cancer Awareness Month in Montenegro. Visit us on our web site: 97 P a g e

99 Sveuciliste u Mostaru - Medicinski fakultet - Studentski zbor The Faculty of Medicine in Mostar was founded April 18, 1997 and is the youngest faculty of the University of Mostar. It annualy enrolles 50 students, and classes from the first day of organized bloc. Dean, Faculty of Medicine in Mostar and instructional spaces for the first three years of study are located on Bijeli Brijeg in the Clinical Hospital Mostar, 4.5 and 6 years of study will be held on wards KB Mostar. The current dean is prof.dr.sc.milenko Bevanda. Student Association is the highest representative body of the students of the University of Mostar. It was founded in The realization of the fundamental tasks of the Quorum of students funded by payment of 10 KM in enrollment academic year. In addition to its main task, representing student interests to the authorities of the University and other organizations of importance to students, Student Council is actively working a variety of student projects. 98 P a g e

100 23. International Medical Students Conference, Kraków 2015 Poland 23. International Medical Students Conference, Kraków 2015 (IMSC) organized by Students Scientific Society of Jagiellonian Univeristy Medical College takes place from the 16th to the 18th of April in Kraków. The Conference is a great opportunity for medical students from all over the world to present their research work in front of international audience. The Conference is at the same time the competition for the best students papers. The aim of the IMSC is popularisation of science among medical students and encouragement to developing their interests, making their first steps on the way of scientific career. Attending interesting workshops participants gain a certain advantage for the practical work of the future medical profession. The social program of the Conference gives the possibility to get new friends and make you feel the magic atmosphere of Kraków, which according to many is the most beautiful city in Poland! Visit us on our web site: Medical Youth- Scientific journal for students and young researchers Medical Youth is an international, peer-reviewed, proffessional and scientific journal run by the students of University of Belgrade School of Medicine. The first issue of the journal was published in 1949, making it one of the oldest scientific journals in South-East Europe. Since then, Medical Youth has been motivating medical students to do research, as well as informing them on latest discoveries in the field of biomedical sciences. The paper can be published in English or Serbian, as preferred. For further information, please contact us via medicinskipodmladak@med.bg.ac.rsor facebook page: medicinskipodmladak 99 P a g e

101 ABOUT ASMF Association of Students of the Medical Faculty (ASMF) in Sarajevo was founded in 2000th year, as a single representative body of all students of the Medical Faculty. Over the past years, ASMF proved to be a very important factor in the preservation and protection of students rights and interests at the Faculty. Of course, ASMF is unprofitable, non-political and non-governmental association which is a full member of the Student Parliament of the University of Sarajevo, where students of our faculty have traditionally governed the Department of Health. Association is headed by President of the Association, and the management structure consists of the President of the Assembly, Board of Directors, the General Secretary of the Association, and the Supervisory Board, which aims to control the finances and Association in general. Over the past years we have managed to achieve an outstanding level of democracy, so that today the Assembly is made of an equal number of delegates from each academic year, and the Assembly itself makes all decisions concerning the association. An important part of the Association consists of departments, in our case Department of International Cooperation, Department of Sport and Department of scientific research. Each of these sectors has achieved remarkable results since the founding of the Association to date. Our students, in collaboration with the faculty are part of LIONS exchange program with Austria. Also, the plan is to achieve full membership in some of the international student associations and it should be resolved in the next academic year. Also, our students participate in many sports competitions of medical faculties in the region, and the culmination of that was the organization Humanijada 2013th. Department for scientific research, since it was founded, worked to help our students with writing scientific papers and going to international conferences. Thanks to these activities, our students have won several prestigious awards at regional conferences. The most important project in the history of Association is planned precisely in the area of scientific research. At the beginning of 2015, international congress of medical students is scheduled and it will take place in Sarajevo, and we hope it will eventually grow into one of the largest student conferences in this part of Europe. Also, Association has in recent years taken part in number of projects that are aimed at marking important days in health care and health promotion in general.perhaps the most important part of the Association consists of representatives of years. Each academic year has two representatives who make the representative body. The specificity of our faculty is that one representative from each year is a full-fledged member of the Teachers' Council with voting rights, which has the right to participate in all decisions at the University. This is why, Faculty of Medicine at the University is special because it is the only faculty where every year is entitled to vote at the Council of Teachers. In addition to membership in the Council, the medical students are full members of all of the governing bodies of the Faculty, as well as the Ethics Committee, Disciplinary Committee, the Committee for Quality Assurance. We hope that during the next years we will keep on going on the path of protecion of students's rights, and that we will further improve our Association for future generations. 100 P a g e

102 CITY OF SARAJEVO Sarajevo is the capital and largest city of Bosnia and Herzegovina and serves as its administrative, economic, university and cultural center. Many archaeological findings testify to the fact that the area of Sarajevo was inhabited even during the Neolithic period. Nonetheless, the name Sarajevo comes from the Turkish words, saray = palace and ovasi = field, and this certainly points to the fact that it was founded by the Ottomans, when the Turkish governor, Isa Bey Ishaković, founded Sarajevo in the 15th century as the seat of Ottoman power for this region. Those who take a stroll through Sarajevo will notice four distinct types of architecture, which reflect the city s different historical periods. The foundations of Sarajevo were laid during the first 150 years of Turkish rule and it was during this time that many architectural jewels were constructed, such as Gazi Husrev Bey s Mosque, the Emperor s Mosque, the Old Orthodox Church and Baščaršija, which was once a grand marketplace. At the beginning of the 17th century, Sarajevo grew into a vibrant community of craftsmen which served as a major trading center and later became one of the most important cities in the European part of the Ottoman Empire. Another period that saw architecture flourish began with Austro-Hungarian occupation at the end of the 19th century and lasted until the First World War started in The modernization of Sarajevo included the installation of a public transport system and the first telephone line. Also, many cultural and educational institutions were founded in that period. Sarajevo s development came to a halt on June 28, 1914, with the assasination of Franz Ferdinand, the Austro-Hungarian heir to the throne, and his wife Sophie. This set of series of unfortunate events eventually led to the outbreak of World War I. At the end of the First World War, Sarajevo became part of the newly-formed Kingdom of Serbs, Croats and Slovenes and it remained part of this state, which was later re-named the Kingdom of Yugoslavia, until the beginning of the Second World War, when it became part of the new Socialist Federal Republic of Yugoslavia. Sarajevo experienced massive damage during the Second World War so it didn t simply undergo major reconstruction during the post-war years, but also enjoyed tremendous growth. By 1984, when it hosted the 14th Winter Olympic Games, Sarajevo had become a modern city with a population of more than 500,000. Sadly, the Olympic flame burned only too briefly. Only eight years after hosting the Olympics, Sarajevo found itself caught in another flame, when the fire of war broke out in BiH in 1992, leaving destruction in its wake until The fourth architectural period is represented by the modern, post-war era. In recent years, the metropolitan area of Sarajevo has experienced rapid development. For its inhabitants, this makes it a better place to live, and for its growing numbers of visitors, it s a better place to visit, the meeting place of East and West. 101 P a g e

103 INDEX OF AUTHORS A ADI YASER 23 ANICIC JOSIP 34 AVDIĆ AZRA 58 B BABAČIĆ HARIS 22 BEĆIROVIĆ EMIR 61 BEGIĆ EDIN 77 BEGIĆ NEDIM 71 BESLAĆ DUŠANKA 57 BEŠIREVIĆ HARIS 55 BOLSHOVA ALINA 80 BORIS DAIANA 74 BRADIĆ LUCIJA 65 C CAROVIĆ FRANJO 32 CINAR METE 52 Č ČEKADA NASTASIA 47 Ć ĆAĆIĆ DAMIR 67 D DAĞLAR ZEYNEP 28 DEMIR SENA 39 DŽ DŽUBUR MIRNA 45 E EJUBOVIĆ MALIK 38 EROVIC DJULA 21 F FIŠIĆ MARTINA 68 G GAČO NADIJA 54 GURINA ANNA 73 I ILIĆ SAŠA 79 IŠTUK JOSIPA 62 IVANITSKA O.V 89 J JAHIĆ DŽENAN 20 JOGUNČIĆ ANES 76 K KADIĆ FARIS 78 KANDIĆ ELMA 60 KARNAS N.O. 48 KAVCHUK OLESYA 84 KILMUKHAMETOVA YULIIA 86 KOBA OLHA 85 KOLMANČIČ KAJA 56 KRSTEVSKI STEFAN 36 KUHARIĆ MARIN 26 KULENOVIĆ SELMA 53 L LEVANDOVSKA DZVENYSLAVA 87 LIVAJIĆ MARIJA 33 M MAKOVIYCHUK OLGA 83 MAZIĆ LEJLA 59 MEITEL IRINA 70 MERDIĆ ALMINA 42 MICHAEL JONATAN 19 MILIŠIĆ SELMA 69 O OLIAS IBOR MIGUEL 29 P PALAMARCHUK SERHIY 88 PATCHEVA SIMONA 50 PEZIĆ EMINA 66 PIDRO AIDA 18 PIZUK MARKO 25 POJSKIĆ LAMIJA 41 R RAČKI VALENTINO 49 RADOVANOVIĆ BOJAN 37 RADOVČIĆ I 75 RUSHITI MUHAMEDIN 44 S SKIAUTERYTĖ EGLĖ 43 SKOČILIĆ I. 51 STRUK V.I P a g e

104 V VAKHROMEEVA A. KSENIA 46 VAN RENTERGHEM J. 30 VASOVIC DOLIKA 27 VATIĆ MIRELA 17 Z ZUPAN GAŠPER 64 Ž ŽIVKOVIĆ NIVES P a g e

105