Introduction: Upper gastrointestinal bleeding can be a life-threatening condition and requires careful evaluation from the very first episode in order to reduce the risk of rebleeding, hemorrhagic shock and death. The outcome of a patient with upper gastrointestinal bleeding depends on resuscitation measures taken during admission to the hospital and an adequate assessment of the patient’s risk level. Aim: The aim of the study is to compare Glasgow Blatchford score and Rockall score and to identify the most accurate score used in predicting unfavorable outcomes and the need for intervention. Methods: This study involves 237 patients with upper gastrointestinal bleeding. The accuracy of the scoring systems was assessed by plotting receiver-operating characteristic curves (ROC curves) and was calculated for GBS and RS with 95% confidence interval (CI). Results: As for mortality prediction, RS was superior to GBS (AUC 0.806 vs. 0.750). The GBS had a higher accuracy in detecting patients who needed transfusion units and was superior to the RS (AUC 0.810 vs.0.675). In predicting the need for intervention, RS was superior to GBS (AUC 0.707 vs. 0.636. Conclusion: GBS and RS are developed to help clinicians to triage patients appropriately in order to assess endoscopic therapy within a suitable time frame, as well as identify low risk patients for possible outpatient management. High accuracy of the GBS in predicting a need for transfusion represents an important endpoint to assess. RS was superior to GBS in predicting a need for intervention as well as mortality. Currently, a combination of these scoring systems is the best way for proper assessment.

Background: Recent research has closely linked adipocytokines to progression of liver inflammation and fibrosis in patients with non-alcoholic liver disease. The aim of this study was to determine the relationship ofserum adiponectin and resistin levels with the severity of liver fibrosis in patients with chronic hepatitis B (CHB), depending on the duration of antiviral therapy. Methods: The cross-sectional studyincluded75 patients with CHB divided into two groups: T1 group(on antiviral therapy for up to 2 years) and T2 group (on antiviral therapy over 2 years). Control group consisted of 40 healthy persons. Serum concentrations of adiponectin and resistin were estimated with ELISA method, while degree of liver fibrosis was determined using FIB-4and APRIscore. Results:The higher values of serum resistin concentration were verified in patients with CHBcompared to healthy controls. The mean level of serum resistin concentration was significantly higher in group of patients with higher FIB-4 score (9.12±3.39 vs. 5.58±3.36 ng/mL, p = 0.001), as well as APRI score (17.45 ± 3.96ng/mL vs.4.82 ± 1.11 ng/mL, p = 0.001). Positive correlation was found between serum resistin levels and degree of liver fibrosis (p < 0.001). There was no significant difference between mean serum adiponectin levels according to the values of FIB-4 and APRI scores. Conclusions:Serum resistin concentration could be a potential noninvasive biomarker of the severity of liver fibrosis in patients with chronic hepatitis B on antiviral therapy.

Introduction: The COVID-19 pandemic and the restrictions from routine life habits had a tremendous impact on psychological and physical health of youth. It is known that stress, anxiety and depression can be associated with the development of gastrointestinal (GI) symptoms and known to exacerbate present GI symptoms. The pandemic has forced many changes in the behavior of student population such as the studying in an asocial environment. The aim of this study was to examine and quantify the influence of stress onto the quality of life and GI symptoms in the student population in Bosnia and Herzegovina (B&H), before and during the pandemic lockdown. Methods: A total of 279 students from B&H were assessed for their GI and emotional status in pre-COVID period and during the COVID period using validated instruments: GI symptom rating scale (GSRS), Visceral Sensitivity Index, and the Patient Health Questionnaire 15-item Somatic Symptom Severity Scale. Results: The results showed that moderate and severe GI symptoms were more frequently present among student population at the time of the pandemic than in period before pandemic. The most pronounced symptoms were bloating syndrome and abdominal pain syndrome according to the GSRS. Conclusions: We concluded that concern for one’s health and changed way of life are directly related to a worsening of the symptoms of GI disorders in the student population. Further research should go in the direction of early prevention of GI disorders that take root in early youth and later develop into chronic forms.

<p><strong>Objective</strong>. The aim of our study was to determine the etiological factors, treatment and outcome of patients with non-variceal bleeding from upper gastrointestinal tract.</p><p><strong>Materials and Methods</strong>. This study enrolled 200 patients admitted to Sarajevo University Clinical Center with signs and symptoms of upper gastrointestinal bleeding, from January 2019 to July 2020. All patients had undergone gastroscopy, confirming the cause of gastrointestinal bleeding. Clinical and laboratory data were collected retrospectively, including previous non-steroid antiinflammatory drugs (NSAIDs) and anticoagulant therapy, comorbidities, risk factors, as well as endoscopic findings, laboratory findings, treatment and clinical follow-up.</p><p><strong>Results</strong>. The majority of patients were men (59%) with an average age of 53±6 years. Duodenal and gastric ulcers were the most common cause, followed by other etiologies. In our study, previous NSAIDs therapy had been registered in 29.5% of patients, anticoagulants in 8%, and proton pump inhibitors (PPI) in 2.9% of patients. Endoscopic intervention was required in 34% of patients. The need for transfusion occurred in 44.5% of cases. Rebleeding during hospitalization was observed in 7.5% of patients, mortality in 1.5% and surgery in 3% of patients.</p><p><strong>Conclusion</strong>. The patients admitted to our hospital with symptoms of acute nonvariceal upper gastrointestinal bleeding were elderly, predominantly males, with significant comorbidities and a higher incidence of NSAID use. Gastroprotection is underutilized during NSAID treatment in patients with other coexisting risk factors,with a low rate of concomitant use of PPI during NSAIDs therapy. Endoscopic therapy, together with PPI, significantly reduces rebleeding rates, mortality and the number of emergency surgical interventions.</p>

&lt;p&gt;&lt;strong&gt;Aim&lt;/strong&gt; &lt;br /&gt;To evaluate the pattern of indications and a spectrum of colonic pathology, and to determine appropriateness of indications for colonoscopy in order to improve patient selection for colonoscopy.&lt;br /&gt;&lt;strong&gt;Methods &lt;br /&gt;&lt;/strong&gt;This retrospective study includes 294 patients who were referred to the Gastroenterology Department from a primary care&lt;br /&gt;physician in order to approach endoscopic examination. Study data included patients&amp;rsquo; anamnestic data (comorbidities, positive family history, performed radiological examinations) an indication for the procedure, and colonoscopy findings.&lt;br /&gt;&lt;strong&gt;Results&lt;/strong&gt; &lt;br /&gt;Haematochezia was confirmed in 186 (63.26%), positive radiologic finding in183 (62.24%) and anaemia in 157 (53.40%)&lt;br /&gt;patients. Adenoma and colorectal carcinoma were detected in 40 (13.6%) and 53 (18%) patients, respectively. A significant association between haematochezia and colorectal neoplasm was confirmed (p=0.019), haematochezia and inflammatory bowel disease (p=0.027), and between radiological finding and colorectal neoplasm (p=0.018). There was no significant association between anaemia and any of the colonoscopic findings. According to EPAGE II criteria indications were appropriate in 187 (63.6%), uncertain in 67 (22.8%) and inappropriate in 40 (13.6%) patients.&lt;br /&gt;&lt;strong&gt;Conclusion &lt;br /&gt;&lt;/strong&gt;This study confirmed a slightly larger number of uncertain and inappropriate indications for colonoscopy compared&lt;br /&gt;to other studies that examined indications for colonoscopy, which can be attributed to a high number of patients with functional bowel disorders.&amp;nbsp;&lt;/p&gt;