Sasa Raicevic

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting reproductive, metabolic, and psychological health in women of reproductive age. Conventional therapies for PCOS often focus on symptom management but are associated with side effects, leading many women to explore complementary approaches. This review aims to evaluate the clinical efficacy and safety of herbal medicines in the management of PCOS, based on data from clinical trials and preclinical models. An extensive literature search was conducted using databases such as PubMed, ScienceDirect, Scopus, and Cochrane Library, covering studies published from 1995 to 2025. Inclusion criteria encompassed clinical trials and randomized controlled trials on herbal interventions for PCOS, as well as relevant preclinical in vivo and in vitro studies. Key outcomes analyzed were hormonal regulation, insulin sensitivity, ovarian function, and anti-inflammatory effects. Numerous herbs demonstrated therapeutic potential in PCOS management, including. Nigella sativa L., Ranunculaceae; Vitex agnus-castus L., Lamiaceae; Trigonella foenum-graecum L., Fabaceae and Cinnamomum verum J.Presl, Lauraceae These herbs exhibited diverse mechanisms such as modulation of insulin signaling pathways, reduction of oxidative stress, hormonal normalization, and anti-androgenic effects. Clinical trials reported improvements in menstrual regularity, insulin resistance, and hirsutism with favorable safety profiles. Herbal medicine represents a promising adjunctive or alternative strategy for managing PCOS. While existing evidence supports their efficacy, variability in study design, dosage, and outcome measures limits definitive conclusions. Future standardized, high-quality clinical trials are needed to confirm therapeutic benefits and ensure safety.

Background: The pathophysiological mechanism underlying pregnancy complications is not entirely known. Although it is currently impossible to predict the occurrence of redox imbalance, it is possible to identify women with a high or medium risk of developing this disease prior to a negative outcome by non-invasive diagnostic methods. The Aim: This study aimed to examine the possible role of the parameter of oxidative stress (OS) measured in early pregnancy in the screening/treatment of obesity and its complications during pregnancy. Methods: This research was designed as a prospective observational cross-sectional clinical study which included 40 non-obese and 31 obese pregnant women between 11 and 13 g.w. who were managed in the Department of Obstetrics, University Clinical Center Kragujevac in Serbia. We collected anthropometric and clinical indicators, maternal and pregnancy factors, and measured prooxidative parameters from blood samples. Results: We observed significantly increased levels of the superoxide anion radical, hydrogen peroxide and the index of lipid peroxidation in the Obese group in comparison with the Non-Obese group and significantly decreased bioavailability of nitrites in the Obese group in comparison with the Non-Obese group. Conclusions: The determination of systemic parameters of OS in early pregnancy could be a good methodological approach in the screening/treatment of obesity during pregnancy and this approach should be followed for the screening of endothelial dysfunction in pregnancy which needs further monitoring and/or treatment.

Interprofessional cooperation and teamwork among health professionals in the health care system are crucial for improving patient satisfaction and quality of health services. The aim of the research is to examine the satisfaction of patients with interpersonal cooperation and health services provided at the level of primary and secondary health care. The research was done as a cross-sectional study and was conducted at the Niksic General Hospital and two health centers in Podgorica. The sample consisted of 154 respondents, both sexes. The research used a questionnaire for health care users designed for the purposes of this research. The questionnaire consists of a general and a specific part. Descriptive statistics measures and x2 test were used for statistical data processing. The results of the research show that there is a statistically significant correlation between gender and patient satisfaction with services χ² (2, N = 154) = 104.117, p = 0.000, as well as between age and patient satisfaction with services χ² (6, N = 154) = 139.294, p = 0.000. Understanding interpersonal cooperation is important for improving the efficiency of health care, its organization and customer satisfaction.

Maternal mental health may be considered a determining factor influencing fetal and child development. An essential factor with potentially negative consequences for a child’s psychophysiological development is the presence of maternal distress during pregnancy and the postpartum period. The review is organized and presented to explore and describe the effects of anxiety, stress, and depression in pregnancy and the postpartum period on adverse child developmental outcomes. The neurobiology of maternal distress and the transmission mechanisms at the molecular level to the fetus and child are noted. In addition, the paper discusses the findings of longitudinal studies in which early child development is monitored concerning the presence of maternal distress in pregnancy and the postpartum period. This topic gained importance in the COVID-19 pandemic context, during which a higher frequency of maternal psychological disorders was observed. The need for further interdisciplinary research on the relationship between maternal mental health and fetal/child development was highlighted, especially on the biological mechanisms underlying the transmission of maternal distress to the (unborn) child, to achieve positive developmental outcomes and improve maternal and child well-being.

Ovarian fibromas are benign tumors that consist of spindle cells in bundles or storiformly arranged with collagen fibers in the stroma. Thecomas resemble theca interna ovarian cells, and there is lipid material in their cytoplasm. There is an overlap in histological and immunohistochemical characteristics of these two benign tumors, and the term “fibrothecoma” was coined to describe such cases. Their incidence is extremely rare in adolescents. The subject of our study is a 15-year-old, unmarried, virgo intacta patient who was referred to us due to profuse vaginal bleeding and the loss of consciousness. A right ovary ultrasound examination exposed the formation of a hyperechoic tumor with a diameter of 41.2 mm × 29.5 mm. Findings of cancer antigen 125 (CA 125) in the amounts of 621.1 U/mL and 142.87 mIU/mL of the B-human chorionic gonadotropin (B-hCG) serum were determined. After preoperative preparation, we operated on the patient to remove a tumor with a diameter of 37 mm × 30 mm × 22 mm, smooth outer surface, solid cross-section, and yellowish white color. The diagnosis of fibrothecoma was made based on pathohistological examination. An unusual finding of fibrothecoma in a virgo intacta adolescent with profuse vaginal bleeding and increased levels of CA 125 and B-hCG may serve as a basis for broader thinking about the pathology of juvenile bleeding.

Polycystic ovary syndrome (PCOS) represents the most common endocrinopathy among childbearing-age women, with oxidative stress (OS) underlying its etiopathogenesis. Metformin (MET) represents a frequently used agent in PCOS. However, weak results encourage alternative treatments. We aimed to investigate isolated and synergistic effects of Standardized Aronia melanocarpa extract (SEA) and MET for alleviating reproductive and metabolic PCOS abnormalities. PCOS induction was followed by 28-day treatment with MET, SAE, or MET + SEA. Bodyweight (BW), cyclicity, histological, and ultrasonographical ovarian analyses were performed. Hormonal, glycemic, and lipid profiles were accessed, as well as systemic and ovarian oxidative status; BW, cyclicity, ovarian histomorphology, ovarian volume, testosterone and progesterone levels, as well as LDL, triglycerides, and total cholesterol levels were aggravated after PCOS-induction and improved after MET, SEA, and MET + SEA treatment. MET + SEA had the greatest impact on glycoregulation. Alterations in OS parameters (TBARS, O₂⁻, H₂O₂, catalase, superoxide dismutase, and reduced glutathione) could be responsible for observed differences; (4) Conclusions: Our findings confirmed that SAE alone or along with MET was capable of ameliorating reproductive and metabolic disturbances in the PCOS rat model, with the restoration of OS parameters. SAE alone did not alter the protective effects of MET in PCOS.

Introduction: Chorioangiomas are benign, nontrophoblastic tumors of the placenta. Giant chorioangiomas (larger 5 cm) are infrequent and have unfavorable outcomes due to their strong association with maternal and fetal complications. We describe a case of a giant chorioangioma that had a good outcome without complications. Case report: A 27-year-old woman, primipara, with a regularly monitored pregnancy was admitted to the hospital at 37 + 5 weeks of gestation due to pain in the lower half of the abdomen, rupture of the amniotic sac and accumulation of thick, green, amniotic fluid. Ultrasonography performed at 33 weeks of gestation indicated the presence of a tumor mass 12.5 × 7.7 cm in diameter that was localized near the chorionic surface. Cardiotocography indicated variable decelerations, which necessitated an emergency cesarean section. A live, healthy, male child was born without complications via Dorfler’s cesarean section. The encapsulated tumor mass was manually removed from the uterus, and angiomatous chorioangioma of the placenta was diagnosed by pathohistological examination. Conclusion: Ultrasonographic monitoring is the choice method for the accurate diagnosis and intervention of chorioangioma, but only pathohistological examination can confirm the diagnosis. This case report demonstrates that giant placental chorioangioma may have a favorable outcome without any medical intervention.

Introduction/Objective. The increased presence of lipid particles in blood is one of most common reasons that transfusion units are unusable. The risk factors for lipemic plasma in donated blood are not completely known. The aim of this study is to identify the factors that influence plasma to be fatty so that we can prevent further storage costs and eliminate unusable transfusion units. Methods. This case?control study was conducted in 2017, and 1552 respondents were included in the study. The control group included 1502 subjects whose blood was not lipemic, while 50 patients with lipemic blood were selected for the case group. The presence of lipemic blood was assessed by inspection, while data were collected by clinical laboratory tests and a questionnaire. Results. Our findings show that multiple blood donors with lipemic blood were significantly older (p < 0.0005) and have higher systolic and diastolic pressure (p < 0.0005), high triglyceride levels (p < 0.0005), and lower levels of hemoglobin (p < 0.0005). Additionally, the presence of lipemic plasma was associated with female sex (p = 0.002), blood type (p = 0.016), heart disease (p < 0.0005), smoking (p < 0.005), diabetes (p = 0.001), lipid intake prior to blood donation (p < 0.005) and venipuncture therapy (p < 0.0005). Systolic pressure is a reliable predictor of lipemic blood (AUROC = 0.901, p < 0.0005). Conclusion. Our study provided a rational explanation and identified some of the risk factors that may help identify potential donors with lipemic blood.

Several Serratia species are widely distributed in nature, but Serratia marcescens is the only species frequently isolated in hospitals. This pathogen is mainly responsible for nosocomial infection, mostly in immunocompromised hosts. A 26-year-old woman with a twin pregnancy, regularly controlled, was hospitalized at 24 + 5 weeks of gestation due to scant vaginal bleeding, lower abdominal pain, and body temperature up to 37.5°C. Gynecological examination revealed bleeding accompanied by dilatation of the cervix. The laboratory analyses revealed leukocytosis with elevated C-reactive protein (CRP). Treatment was initiated with intravenous antibiotic administration. After admission, fetal membranes spontaneously ruptured, and an extremely preterm dichorionic female twin birth occurred at 25 + 0 weeks of gestation. Both infants died two days after labor. Pathological and microbiological analyses revealed chorioamnionitis caused by S. marcescens. According to the antibiogram, antibiotic treatment was continued for the next 7 days. The examination of cervical and vaginal discharge samples was negative three days and two weeks after therapy. S. marcescens may cause spontaneous miscarriages and, in this important case, caused loss of discordant twins in an extremely preterm birth by an immunocompetent patient. Infection by S. marcescens cannot be excluded as a cause of discordant growth and needs to be confirmed by further research.

Preeclampsia is one of the leading causes of maternal and perinatal morbidity and mortality, usually characterized by hypertension and proteinuria. Despite high incidence of preeclampsia the pathophysiological basis of preeclampsia is still not clear and there are a number of mechanisms and signaling pathways that intertwine. It is very important to develop specific and reliable predictive algorithms in order to enable early initiation of therapy due to facts that incidence of preeclampsia has upward trend and that cause adverse maternal and fetal outcome. Some of the most commonly used methods for prediction of preeclampsia include uterine artery Doppler velocimetry, determination of some microRNA, such as miR-210, and assessment of various pro-angiogenic and anti-angiogenic factors from blood. Angiogenic factors that possibly have most important role in pathogenesis of preeclampsia are vascular endothelial growth factor (VEGF) and placental growth factor (PlGF), which promote angiogenesis, and soluble fms-like tyrosine kinase-1 (sFlt1) and soluble form of endoglin (s-Eng), which exhibit anti-angiogenic properties. Aggravating circumstance is that preeclampsia has heterogeneous origin, and due to this fact, the value of individual markers can vary significantly. There is a constant tendency for creating comprehensive algorithm for prediction of preeclampsia which would be sufficiently specific and sensitive, and in the same time cheap and available. In that sense, new clinical studies are needed to show the most effective combination of parameters in the predeclampsia prediction.