Journal of Health Sciences 2021-09-16T11:05:26+02:00 Adnan Sehic Open Journal Systems <div style="display: none; text-align: left; padding: 10px 10px 10px 10px; margin: 0px; background-color: #cee3f6; color: #690000; border-radius: 3px; width: 100%;"><strong>ⓘ </strong>Please note that the website of the Journal of Health Sciences will undergo scheduled maintenance on Sunday, 30 May 2021<strong>. </strong></div> <div style="display: none; text-align: left; padding: 10px 10px 10px 10px; margin: 0px; background-color: #ffd7d7; color: #690000; border-radius: 3px; width: 100%;"><strong>ⓘ Notice to readers and authors: </strong>The is a duplicate and fake website of the Journal of Health Sciences, created by a malicious third party, fraudulently offering academicians the opportunity to rapidly publish their research online for a fee. The legitimate website of the Journal of Health Sciences is <strong></strong>. <br />If you have been a victim of the fraudulent website please report it here: <a href="" target="_blank" rel="noopener nofollow"></a></div> <div> <p><strong><em><br />The Journal of Health Sciences</em></strong> is an international, open access, peer-reviewed, and evidence-based scientific journal published by the University of Sarajevo, Faculty of Health Sciences (UNSA FHS; <a href=""> ;</a> <a href="" rel="noopener nofollow"></a>).</p> <p>The Journal's mission is to promote excellence in nursing and a range of disciplines and specialties of <a href="" rel="noopener nofollow">allied health professions</a>. It welcomes submissions from international academic and health professionals community. The Journal publishes evidence-based articles with solid and sound methodology, clinical application, description of best clinical practices, and discussion of relevant professional issues or perspectives. 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Agustini S Grady Krisandi Azza Maryam Imam Rosadi Iis Rosliana Siti Sobariah Wismo Reja Subroto Irsyah Afini Tias Widyastuti Alfida Zakiyah Difky Ernanda Noor Aini Jusryanti . Sulaeha AD Sristin Indah Prestiani Indah Mustika Donna Habibi . Meyla Shinta Mutiara <p><strong>Introduction:</strong> Autologous platelet-rich plasma (PRP) has been a growing trend in the field of medicine due to its broad range of application and is considered safe from bloodborne diseases. Furthermore, various studies have tried to optimize the use of autologous PRP through various preparation protocols, including PRP activation. However, most of the studies available have not evaluated the safety for intravenous delivery of PRP, especially autologous activated PRP (aaPRP). Therefore, this study aimed to evaluate the safety of intravenous delivery of aaPRP.<br /><strong>Methods:</strong> Blood was drawn from each patient and aaPRP was isolated through calcium activation and light irradiation. Each aaPRP was administered intravenously to all patients. Adverse events were documented and analyzed.<br /><strong>Results:</strong> Six hundred eleven patients participated in this study with a total of 4244 aaPRP therapies. Quality control of autologous aaPRP showed no platelets present after both calcium activation and light irradiation. No adverse events such as allergic reaction, infection, and coagulation problems were observed on all patients over the course of the study.<br /><strong>Conclusion:</strong> Our results showed that intravenous administration of autologous aaPRP is safe even in patients with various pathological conditions.</p> 2021-09-16T00:00:00+02:00 Copyright (c) 2021 Karina Karina, Krista Ekaputri, Johannes Albert Biben, Ratna Herawati Purwoko, Tommy Partunggul Sibuea, Sarah Listyo Astuti, Anastasia Maria Loho, Yuliardy Limengka, Nelfidayani, Agustini S, Grady Krisandi, Azza Maryam, Imam Rosadi, Iis Rosliana, Siti Sobariah, Wismo Reja Subroto, Irsyah Afini, Tias Widyastuti, Alfida Zakiyah, Difky Ernanda, Noor Aini, Jusryanti, Sulaeha AD, Sristin Indah Prestiani, Indah Mustika Donna, Habibi, Meyla Shinta Mutiara A comparison of erect weight-bearing and non-weight-bearing radiography of the cervical spine in non-trauma patients 2021-04-22T09:25:48+02:00 Bimali S. Weerakoon Nimali N. Karunaratne Winitha S. Jayasundara <p><strong>Introduction:</strong> Various positioning techniques are utilized to enhance the visualization of lower cervical vertebrae on lateral radiographs. However, the effectiveness of these techniques still remains unclear. This study was conducted to determine the effect of the weight-bearing (WB) technique in visualizing lower cervical vertebrae and cervicothoracic junction (C7-T1) on standing lateral cervical radiographs of adult non-trauma patients. The study was conducted using both computed radiography (CR) and digital radiography (DR) systems.<br /><strong>Methods:</strong> Forty-four CR (29 WB and 15 non-WB – NWB) and 61 DR (26 WB and 35 NWB) lateral C-spine radiographs were prospectively evaluated to assess the visible number of cervical vertebral bodies and C7-T1 junction. The instructions given by the radiographer to the patient for the imaging procedure were also assessed on the Likert scale (very good, good, fair, poor, very poor).<br /><strong>Results:</strong> There was no significant difference (p &gt; 0.05) in the visualization of the number of vertebral bodies between the two techniques of WB and NWB for CR or DR. Further, no significant relationship (p &gt; 0.05) was observed between the WB technique and the visualization of C7-T1 junction in DR systems. However, a significant difference was identified for CR (p = 0.012). The instruction given to the patient significantly correlated with the visibility of the lower C-spine region within each group of WB and NWB in both imaging systems.<br /><strong>Conclusions:</strong> The visibility of the number of vertebral bodies in the lower C-spine region in either CR or DR systems did not demonstrate any enhancement with the WB technique. Regardless of the imaging system or techniques used, adequate instructions given to the patient before and during the imaging procedure of C-spine lateral radiography demonstrated a significant improvement in visualizing the lower C-spine region. In this preliminary study, the application of erect WB radiography technique in evaluating the lower cervical region of adult non-trauma patients gives limited advantage.</p> 2021-09-16T00:00:00+02:00 Copyright (c) 2021 Bimali S. Weerakoon*, Nimali N. Karunaratne, Winitha S. Jayasundara Vestibular bone thickness of the mandible in relation to the mandibular canal in a population from Bosnia and Herzegovina 2021-04-30T22:16:55+02:00 Muhamed Ajanović Selma Tosum Pošković Alma Kamber-Ćesir Edita Redžović Mirsad Kacila Karlo Kožul <p><strong>Introduction:</strong> Dental implantology is the branch of dentistry that is gaining greater significance because a larger number of patients come with requests of implant placements. During dental implant placements, with patients with whom operation is carried out in the mandible, very frequently nervus alveolaris inferior can be injured. The nerve injury may occur during the implant placement, but the nerve may also be injured in case of harvesting of intraoral bone graft. During the bone graft harvesting, but also during any other procedure in the dentistry that entails working on vestibular side of corpus of the mandible, in order not to injure the nervus alveolaris inferior, it is important to familiarize oneself with the distance of the nerve from the outer vestibular cortex of the mandible. The objective of the study was to assess the vestibular bone thickness of the mandible in relation to the mandibular canal with the help of analysis of cone-beam computed tomography (CBCT) images.<br /><strong>Methods:</strong> It was accessed the database of CBCT images taken at the School of Dental Medicine at the University of Sarajevo, where out of 700 reviewed CBCT images, an analysis of 322 CBCT images was conducted that satisfied inclusion criteria of the study. CBCT images were taken using of ORTHOPHOS SLX imaging unit. The measurement was conducted by Sidexis program on cross-section of CBCT image. The measurement of vestibular bone thickness was performed, by measuring the distance from the lateral wall of the mandibular canal to buccal mandibular compact bone, in the region of the second premolar, of the first and the second molar.<br /><strong>Results:</strong> There were statistically significant differences in vestibular bone thickness between men and women on both sides in the region of the second premolar (p &lt; 0.001) and first molar (p = 0.016 right, p = 0.018 left). T-test demonstrated no statistically significant difference in the vestibular bone thickens between men and women on either side in the case of vestibular bone thickness of the center of the second molar (p = 0.397 right, p = 0.743 left).<br /><strong>Conclusion:</strong> Values of vestibular thickness of the mandible are larger with men than with women in all measuring points; however, statistically more significant differences between genders have been detected in the second premolar and center of the first molar.</p> 2021-09-16T00:00:00+02:00 Copyright (c) 2021 Ajanović Muhamed, Selma Tosum Pošković, Alma Kamber-Ćesir, Edita Redžović, Mirsad Kacila, Karlo Kožul Effect of physical therapy in daily life and work activities for people with chronic cervical pain syndrome 2021-04-19T14:27:52+02:00 Eldad Kaljić Edina Hadžipašić Amila Jaganjac Namik Trtak Bakir Katana Muris Pecar <p><strong>Introduction:</strong> Cervical pain syndrome (CPS), or pain in the neck, is defined as a set of symptoms that limit performing movements in the upper part of the back and last more than 1 day. When the mentioned symptoms last for more than 12 weeks, we talk about chronic CPS. It often represents the condition that results from disability. It is associated with poor posture, work in sitting position, stress, and long-lasting and repetitive movements. The aim of the study was to examine the effect of physical therapy on the degree of disability, pain intensity, and daily life and work activities of persons with chronic CPS.<br /><strong>Methods:</strong> The research was conducted in the health spa center “Reumal” Fojnica from June 2020 until July 2020. It included 50 subjects of both genders, more than 18 years old, and of all occupations, treated with physiotherapy procedures (transcutaneous electrical nerve stimulation, magnetotherapy, therapeutic ultrasound, and kinesitherapy in the form of McKenzie exercises). In addition, a pre- and post-treatment study analyzed the condition of the respondents at the first examination and the control examination after completion of treatment.<br /><strong>Results:</strong> By analyzing the results, we established that of the total number of respondents, 74% were female, and the average age was 57.36 years. At the end of the study, the degree of disability caused by neck pain was significantly lower (p &lt; 0.05) than the degree of disability before the therapy. Discomfort caused by symptoms of CPS that occurred and interference with work before the therapy was significantly lower (p &lt; 0.05) after the treatment program. Therapeutic procedures have reduced the pain intensity and improved the activities of everyday life.<br /><strong>Conclusion:</strong> The treatment with physical therapy procedures effectively reduces the degree of disability and pain intensity and improves people’s daily life and work activities with chronic CPS.</p> 2021-09-16T00:00:00+02:00 Copyright (c) 2021 Eldad Kaljić, Edina Hadžipašić, Amila Jaganjac, Namik Trtak, Bakir Katana, Muris Pecar Patients’ trust in the health care system and physiotherapists 2021-05-07T21:48:49+02:00 Anka Vukičević Ranka Ogurlić Miloš Lazić Samire Beqaj Emira Švraka <p><strong>Introduction:</strong> The assessment of the health-care system by its beneficiaries is based on evaluation of the public perception in regards to the performance of healthcare workers, the functioning of the health system, the effectiveness of health policy measures, and a number of other components. The aim of this study was to determine patients’ trust in the work of physiotherapists and the health-care system; determine the quality of communication between the patient and the physiotherapist and determine the quality of cooperation between healthcare workers in the provision of health services.<br /><strong>Methods:</strong> The study is descriptive, conducted in five cities: Banja Luka, Bihać, Herceg Novi, Nikšić, and Podujevo. The confidence in health-care questionnaire developed by Calnan and Sanford (2004) was used as a research instrument, containing six areas of research: Attitude toward the patient, Health policy and patient care, Professionalism and expertise, Quality of health care, Communication and information, and Quality of cooperation.<br /><strong>Results:</strong> The mean age of the subjects was 41 years, 24 females and 26 males. Subjects expressed the greatest satisfaction on subscales I - Attitude toward the patient (27.44 ± 3.59 out of 30) and IV - Quality of health care (36.60 ± 4.19 out of 40), which represents 91.5% of the possible maximum. This is followed by subscale V - Communication and information (20.8 ± 3.17 out of 25) corresponding to 83.2% of the possible maximum, followed by subscale III - Professionalism and expertise (15.68 ± 3.29 out of 20) which represents 78.4% of the possible maximum. Subjects showed the least satisfaction on subscales II - Health policy and patient care (16.94 ± 5.56 out of 25), which represents 67.8% of the possible maximum, and subscales VI - Quality of cooperation (9.94 ± 0.42 out of 15) which corresponds to 66.3% of the possible maximum.<br /><strong>Conclusions:</strong> The research showed a high degree of satisfaction of subjects in various fields, which indicates a high degree of confidence in the work of physiotherapists and the health-care system. Research on a larger sample in needed for creation and implementation of the guidelines in the strategic documents of the countries in the region and for improvement of health policies and patient care.</p> 2021-09-16T00:00:00+02:00 Copyright (c) 2021 Anka Vukičević, Ranka Ogurlić, Miloš Lazić, Samire Beqaj, Emira Švraka Post-coronavirus disease 2019 children in Sarajevo-Lessons learnt? 2021-05-12T17:13:33+02:00 Senka Mesihovic-Dinarevic Timur Šečić <p><strong>Introduction:</strong> A new disease coronavirus disease 2019 (COVID-19) is with insufficiently known epidemiological characteristics and spectrum of clinical expression in childhood. Children have a lower incidence of this disease with a predominance of mild forms but severe clinical forms, such as among others, acute respiratory distress syndrome, and multisystem inflammatory syndrome may occur, according to current findings. In children with atypical symptomatology and positive or suspicious epidemiological survey, practitioners should consider the possibility of COVID-19.<br /><strong>Methods:</strong> This study formed the group of 70 children previously healthy or with no pre-existing heart disease from Sarajevo with positive post-COVID history. Following the history of disease and epidemiological data, establishing the 1st day of disease or contact, a detailed cardiovascular examination was performed, including parameters of body weight, height, oxygen saturation, pulse, blood pressure, 12 leads electrocardiogram (ECG) done on Schiller machine, values of polymerase chain reaction (PCR), or serological test on corona: Immunoglobulin (Ig) G and IgM. Echocardiographic examination was done using M, B mode, color, continuous wave, and pulse wave Doppler in standard views. Laboratory blood tests included: Full blood count, creatinine phosphokinase myofibril, creatinine phosphokinase, lactate dehydrogenase; liver enzymes, D dimer, C reactive protein, and urine.<br /><strong>Results:</strong> Majority of children (64.3%) were asymptomatic. ECG was normal in relation to patients’ age except in eight patients (intermittent palpitations on exertion) who had short PR interval 0.120–0.140 ms, with no delta wave, with heart rate within the normal range according to age, so 24 h ECG Holter was performed without any significant arrhythmias, incomplete right branch block has been documented in 12%, monofocal ventricular ectopic extrasistoly in 15%. Mean IgG, as a marker of infection, showed a statistical significance when compared between age Groups I and II (&lt;5) and older groups: III, IV, and V (&gt;5) (p &lt; 0.05; p = 0.043). PCR test was negative in 9 (70 children), although they showed symptoms, COVID-19 infection clinical data, and positive laboratory findings. Echocardiogram was normal in all patients with normal ejection fraction of the left ventricle.<br /><strong>Conclusion:</strong> The possibility of COVID-19 in children with atypical symptomatology and positive or suspicious epidemiological survey should be in the focus of every pediatrician at primary care institutions nowadays. Cardiovascular assessment should always be an option in post-COVID patients. Immunological assessment is necessary in post-COVID patients in order to gain a further understanding of PTS status. With more serological testing for severe acute respiratory syndrome coronavirus 2 physicians would be able to make a diagnosis of COVID-19 timely and more accurately, as well as to evaluate the role of asymptomatic children in disease transmission and to assess the importance of protective antibodies and the distribution of COVID-19.</p> 2021-09-16T00:00:00+02:00 Copyright (c) 2021 Senka Mesihović-Dinarević, Timur Šečić C – reactive protein in saliva of non-smoking patients with periodontitis (a pilot study) 2021-05-17T16:19:40+02:00 Zerina Hadžić Ivan Puhar <p><strong>Introduction:</strong> C-reactive Protein (CRP) as an inflammatory biomarker can be easily determined in saliva, but the values of salivary CRP in periodontitis are not well-studied. The aim of this study was to analyze and determine the values of salivary CRP in non-smokers with periodontitis stage 3 or 4 before and after supragingival and subgingival full-mouth periodontal therapy.<br /><strong>Methods:</strong> Standard periodontal parameters and saliva samples were collected in 12 non-smoking patients. Patients in the test group (n = 6) underwent supragingival and subgingival full-mouth periodontal therapy, and the control group (n = 6) received only supragingival full-mouth therapy. Both groups received the same oral hygiene instructions in addition to therapy. After 3 months, re-registration of periodontal parameters and re-sampling of saliva for analysis of salivary CRP were done for both groups.<br /><strong>Results:</strong> Statistical analysis revealed large differences in the values of clinical periodontal parameters and CRP levels in the test group after therapy. Values of salivary CRP in the test and control groups were lower 3 months the therapy; however, the results were not statistically significant. The correlation of clinical periodontal parameters and salivary CRP varied in both groups.<br /><strong>Conclusion:</strong> Our pilot study reveals decreased concentrations of salivary C-reactive protein in non-smoking patients following non-surgical periodontal therapy. Further studies are needed to prove the reliability of salivary CRP as a biomarker for periodontitis.</p> 2021-09-16T00:00:00+02:00 Copyright (c) 2021 Zerina Hadžić, Ivan Puhar Relationship between functional capacity and the occurrence of adverse events during healthcare utilization 2021-05-07T11:09:15+02:00 Dijana Babić Danica Železnik Milan Milosević <p><strong>Introduction:</strong> Adverse events, safety incidents, and medical errors in healthcare can be avoided only by understanding the causes of their occurrence, and by applying the knowledge gained from the analysis of similar previous events. Since it is known that most adverse events do not originate from a single cause, most important is timely identification of numerous contributory states that can give us the opportunity to define a number of possible solutions to correct process errors and deficiencies in the system itself. The aim of this paper is to investigate the association between functional capacity of elderly living with cardiovascular diseases and the occurrence of adverse events during use of health-care services.<br /><strong>Methods:</strong> Assessment of functional limitations was done using the Groningen Activity Restriction Scale (GARS). The presence of adverse events was evaluated after interviews with subjects and review of medical records. Differences in continuous numerical values between inpatient and outpatient service users were analyzed by the Mann–Whitney U-test. Spearman’s correlation coefficients of the number of actual adverse events with the presence of restrictions in daily activities were calculated. Fisher’s exact test or Fisher-Freeman-Halton test (in cases of table sizes larger than 2 × 2 format) analyzed the differences in category variables.<br /><strong>Results:</strong> The total number of adverse events was 30 (10.1% of the total number of subjects), while there were 12 actual adverse events (40.0% of the total number of adverse events). No statistically significant correlation was found between the limitations in performing daily activities and the occurrence of actual adverse events (p = 0.173).<br /><strong>Conclusion:</strong> The research conducted in this paper showed that the functional capacity of the elderly with chronic disease is not exclusively related with the occurrence of adverse events associated with health-care utilization.</p> 2021-09-16T00:00:00+02:00 Copyright (c) 2021 Dijana Babić, Danica Železnik, Milan Milošević The level of health literacy of secondary school students in Slovenia 2021-03-29T12:17:13+02:00 Monika Sadar Karmen Erjavec <p><strong>Introduction:</strong> Health literacy of secondary school students is particularly important as they are exposed to higher health risk. Therefore, the aim of the study is to determine the level of basic health literacy, critical and mental health literacy, and numeracy of Slovenian secondary school nursing students using a cross-sectional comparative method.<br /><strong>Methods:</strong> The questionnaire measuring the level of basic numerical, critical, and mental health literacy was completed by 249 secondary school students, divided into a group of secondary school students attending a nursing program and students of others similar secondary schools such as economic technician, chemical technician and preschool education.<br /><strong>Results:</strong> Secondary nursing students were found to have statistically significantly higher levels of basic and mental health literacy than their peers, rather than numerical and critical health literacy. In addition, the results show that there is no statistically significant difference in the level of health literacy between the groups of secondary school students in relation to the environment (rural/urban area).<br /><strong>Conclusion:</strong> Numerical and critical health literacy should be systematically developed in nursing schools, and at least the basic aspects of health literacy should be introduced in all secondary school curricula.</p> 2021-09-16T00:00:00+02:00 Copyright (c) 2021 Monika Sadar, Karmen Erjavec Assessment of functional mobility of persons in the 3rd age of life after programmed therapeutic exercises 2021-06-01T13:35:15+02:00 Bakir Katana Eldad Kaljić Amra Mačak Hadžiomerović Amila Jaganjac Samir Bojičić Namik Trtak <p><strong>Introduction:</strong> Active aging is a process of optimizing of opportunities for health, participation, and safety to improve the quality of life as people age. Therapeutic exercises to strengthen muscles are especially important for the elderly, and the results of such exercises are positive in people with functional limitations. The aim of the study was to assess functional mobility of people in the 3rd age of life after programmed therapeutic exercises.<br /><strong>Methods:</strong> The prospective study included two groups of 130 respondents over the age of 65 who came to the “Centre for Healthy Aging” in Novo Sarajevo in the period from September 1, 2014, until March 1, 2015. Using the time up and go test (TUG), the basic functional mobility was assessed and it represents the minimum time the respondent needs to get up from the armchair, walk a distance of three meters, turn around, and sit back in the armchair. We tested the respondents at the beginning, in the middle, and at the end of the study, which lasted for 6 months.<br /><strong>Results:</strong> Analysis of the gender structure of the control and the test groups, using the Chi-square test, found a statistically significant difference, and in the test group, there were more female subjects than in the control group, χ2 = 50.620; p = 0.001. Analysis of the functional mobility of the respondents of the test groups using the TUG at the end of the study found that the respondents of the test group needed statistically significantly less time to perform the test (8.84 seconds) compared to the control group (9.59 seconds) and test Group B (9.41 seconds), F = 4.711; p = 0.041.<br /><strong>Conclusion:</strong> Programmed therapeutic exercise leads to a significant improvement in functional mobility of persons in the 3rd age of life.</p> 2021-09-16T00:00:00+02:00 Copyright (c) 2021 Bakir Katana, Eldad Kaljić, Amra Mačak Hadžiomerović, Amila Jaganjac, Samir Bojičić, Namik Trtak Short-term effects of carrying a school bag on the distribution of force and plantar pressure during walking of children of different levels of physical activity 2021-06-21T09:06:45+02:00 Dijana Laštro Mirsad Muftić Nenad Ponorac Goran Talic Slavica Janković <p><strong>Introduction:</strong> Carrying a school bag is a dominant activity that a child performs during daily productive activities. The aim of the research is to examine how carrying a school bag of different weights affects the distribution of force and plantar pressure during normal walking on the flat terrain of children of varying levels of physical activity.<br /><strong>Methods:</strong> The pilot study included 124 students aged 11-12 from Banja Luka. According to the protocol, each group of respondents was treated with an intervention-customized school bag and a comparator-school bag that the child only opted for. For the research, the Physical Activity Questionnaire for Older Children, measurement of anthropometric parameters, school bag weight, and Zebris tape (Zebris Medical GmbH, Germany) were used for gait analysis.<br /><strong>Results:</strong> Inactive children achieved the lowest and active children’s highest walking speed during normal walking without a bag, with their customized school bag. When carrying a custom school bag: The highest maximum force is projected on the left heel 330.72 N in inactive children, and the lowest 265.93 N in moderately active children, the highest maximum pressure on the left heel is registered in inactive children, 27.60 N/cm2, and the lowest 21.85 N/cm2 in moderately active children. The maximum force-time of % of standing time on the left foot in the middle part lasted the longest in inactive children, and the shortest active children carried their school bag 40.31% and a custom school bag 39.76%.<br /><strong>Conclusion:</strong> High physical activity and individual adjustment to distribute the burden well allow the child to adequately respond to the loads carried by the weight of the school bag.</p> 2021-09-16T00:00:00+02:00 Copyright (c) 2021 Dijana Laštro, Mirsad Muftić, Nenad Ponorac, Goran Talic, Slavica Janković Subhepatic Appendicitis: A diagnostic conundrum 2021-04-16T10:16:37+02:00 Biji Thomas George Youmna Ayman Hadi Zafar Godfred Menezes <p>One of the most common presentations of acute abdominal pain in the emergency setting is appendicitis. Although it can occur in both genders, when it comes to females with appendicitis, reaching a definite diagnosis can be challenging as it can mimic other diseases such as ovarian cysts/torsions, pelvic inflammatory diseases, endometriosis, and urinary tract infection or physiological reasons like menstrual pain which are exclusive to females and can occur as frequently as appendicitis. Therefore, it is crucial to make an accurate diagnosis as early as possible with the right diagnostic tools to reduce morbidity and mortality in females of child-bearing age. This is a summarized case report of an adolescent female who experienced two atypical attacks of appendicitis 1 year apart. Since the patient had mainly right upper flank pain associated with nausea, vomiting, and fever with a largely non-tender abdomen, various diagnoses such as chronic cholecystitis, biliary colic, peptic ulcer, gastroenteritis, mesenteric lymphadenitis, renal colic, mittelschmerz, and torsion of ovarian cyst were considered and treated for. The patient had no relief and underwent numerous investigative procedures in the 2 years she suffered from her illness. The final diagnosis was only obtained when exploratory laparoscopy was performed. This article aims to remind clinicians to have a high index of suspicion for acute appendicitis in all atypical presentations of acute appendicitis. The latest WSES Jerusalem guidelines for the workup for patients at risk of acute appendicitis should be meticulously followed.</p> 2021-09-16T00:00:00+02:00 Copyright (c) 2021 Biji Thomas George, Youmna Ayman, Hadi Zafar, Godfred Menezes Factor V Leiden homozygous mutation: Recurrent venous thromboembolism during periods of discontinuation of anticoagulant therapy 2021-06-03T11:38:49+02:00 Sabira Šahinović Vildana Huskić Adis Kauković <p>Venous thromboembolism (VTE), also known as deep vein thrombosis and pulmonary thromboembolism, is a medical condition that has a high incidence and a multifactorial pathogenesis. One of the causes is a mutation of the Factor V Leiden (FVL), which is the most common inherited thrombotic disorder. A mutation inherited from both parents is found in about 0.05-0.5% of cases, making our case more medically interesting. We presented the case of a young male patient with recurrent VTE and few risk factors who was admitted to the hospital 4 times with VTE symptoms over a 5-year period. In the background, there was a homozygous FVL mutation and improper use of anticoagulant therapy. We examined the medical data, diagnostics, therapy, and precautions that were and are required.</p> 2021-09-16T00:00:00+02:00 Copyright (c) 2021 Sabira Šahinović, Vildana Huskić, Adis Kauković