Abstract
Dear Editor, I recently searched medical databases for the treatment of postpartum hemorrhage (PPH) in order to update the second edition of the textbook on the issue, Obstetric Operations, for which I am Editor-in-Chief. In addition to the existing articles, I also found numerous novel methods for compression hemostatic procedures. Among these, I came across a paper categorized as Commentaries, by Ghezzi et al., published in BJOG: An International Journal of Obstetrics & Gynaecology in 2007, describing the Hayman technique as a simple method in the management of PPH (1).

Abstract
Background: In contemporary society, media and social networks promote youth and physical beauty as ideals, while ageing is often stigmatised. The growing use of aesthetic procedures like Botox and fillers reflects the influence of the beauty industry. In contrast, Christian anthropology views the body as a temple of the Holy Spirit and ageing as a path to wisdom, raising questions about how religious youth navigate these opposing values.

Aim: To explore how religious young people in Croatia interpret contemporary beauty norms, aesthetic surgery, and ageing.

Methods: A qualitative design based on semi-structured individual interviews was employed, following COREQ guidelines. Using snowball sampling, seven participants (aged 18–30, self-identified as religious and active in church communities) were recruited. Interviews took place in April–May 2024 at the parish of St. Anthony of Padua in Zagreb. Ethical approval was granted by the Catholic University of Croatia; all participants provided informed consent. Data were analysed using thematic analysis, progressing through open, axial, and selective coding.

Results: Participants identified media and social networks as key promoters of unrealistic beauty ideals. In response, they emphasised natural embodiment, spiritual balance, and healthy living. Attitudes toward aesthetic surgery were ambivalent—though not viewed as religiously forbidden, most supported bodily integrity and accepted interventions only for health or functional reasons. Ageing was seen positively, associated with maturity, wisdom, and respect for older adults.

Conclusion: Religious beliefs shaped how young participants interpreted cultural norms of beauty and ageing, promoting natural embodiment and viewing ageing as a stage of personal and spiritual growth. Findings highlight the role of religiosity in youth culture and call for further interdisciplinary research on embodiment, beauty, and ageing within contemporary society.

Keywords: aesthetic surgery, ageing, beauty, Croatia, religiosity, young people

Abstract
Background: Dilated cardiomyopathy (DCM) is the most common type of cardiomyopathy, usually of multifactorial aetiology, characterised by ventricular dilation and impaired systolic function leading to congestive heart failure.

Aim: To present a case of idiopathic ischemic stroke in a young patient with dilated cardiomyopathy and to emphasise the importance of early recognition and prompt management of neurological complications in heart failure.

Case description: A 36-year-old male was admitted to the Coronary Unit with severe heart failure due to dilated cardiomyopathy (EF 25%) and elevated NT-proBNP levels. Major risk factors included obesity, hypertension, smoking, and dyslipidaemia. On the second day of hospitalisation, the patient developed acute neurological symptoms, and a brain CT confirmed ischemic stroke. Intravenous thrombolytic therapy was administered within the recommended time frame, resulting in complete neurological recovery. Coronary angiography and thrombophilia screening were unremarkable, and the patient was discharged hemodynamically stable on optimal medical therapy.

Conclusion: This case highlights the high morbidity of dilated cardiomyopathy and its potential neurological complications. Early recognition, prompt treatment, and effective risk factor management are essential for better outcomes.

Keywords: heart failure, dilated cardiomyopathy, risk factors

Abstract
Background: Venipuncture is a common paediatric procedure often associated with pain and fear. Inadequate pain management can cause distress, poor cooperation, and avoidance of future medical procedures. Topical anaesthetics such as EMLA cream offer a simple, non-invasive method of pain relief.

Aim: To evaluate the effect of topical EMLA cream on children’s pain and fear during venipuncture.

Methods: This single-centre, prospective, non-randomised comparative study was conducted at the Children’s Hospital Srebrnjak, Zagreb, Croatia, from October to December 2024. A total of 104 children aged 7–10 years requiring venipuncture were included. Participants were assigned to either the intervention group (n = 52) or the control group (n = 52) based on parental consent for topical anaesthetic use. Pain intensity after venipuncture was assessed using the Visual Analogue Scale (VAS, 0–10), and fear was self-rated before the procedure on a numerical scale from 0 to 10. Data were analysed using the Mann–Whitney U test and Spearman’s correlation, with significance set at p < 0.05.

Results: Children who received EMLA reported significantly lower pain scores (mean VAS 2.1 ± 1.2) compared with controls (4.8 ± 1.5, p < 0.001). Pre-procedural fear showed a moderate positive correlation with pain intensity (ρ = 0.45, p < 0.01). No significant sex differences were found.

Conclusions: Topical EMLA cream effectively reduces procedural pain in children during venipuncture. Addressing both pain and fear is essential for a comprehensive and compassionate approach to paediatric care.

Keywords: venipuncture, children, pain, EMLA, local anaesthetic, non-randomised comparative study

Abstract
Prenatal diagnostics is one of the most dynamic areas of modern medicine. Its application provides invaluable benefits through early detection of fetal malformations, timely planning of delivery, and the possibility of intrauterine therapeutic interventions. At the same time, it opens a series of ethical challenges related to maternal autonomy, the dignity of the unborn child, the responsibility of physicians, and the role of society.

The article presents the fundamental principles of medical ethics – autonomy, beneficence, non-maleficence, and justice – as key guidelines in decision-making. Special attention is devoted to the dangers of test commercialization, the risk of false-positive results, and the possibility of discrimination based on sex or disability. Emphasis is placed on the importance of trust and quality communication between the physician and the family, as well as the need for equal access to modern methods regardless of socioeconomic status.

Future developments in prenatal diagnostics, including the application of artificial intelligence and genomic analysis, raise new questions about the boundary between medically justified procedures and covert eugenics. Therefore, prenatal diagnostics cannot be viewed merely as a medical procedure but also as a socio-ethical process in which personal decisions, legal frameworks, and cultural values intertwine.

In conclusion, prenatal diagnostics justifies its place in modern medicine only if it remains focused on the protection of life and respect for human dignity. This requires ongoing dialogue between medicine, ethics, and society, as well as strong social support for families with children with disabilities, since their integration and acceptance represent a measure of the humanity and maturity of the community.

Keywords: prenatal diagnostics; medical ethics; autonomy; beneficence; non-maleficence; justice; fetal anomalies

Abstract
Background: Beauchamp and Childress’ principle of respect for autonomy has been criticised by scholars for privileging individualism due to its Anglo-American (‘Western’) origin and orientation. Consequently, researchers in clinical ethics need to consider alternative normative models and culturally diverse approaches to autonomy.

Aim: Guided by philosophical inquiry, this paper seeks to re-envision the concept of autonomy in biomedical contexts by focusing on the contributions of Confucian perspectives to its understanding and application in clinical contexts.

Methods: The research methodology is philosophical inquiry based on a textual analysis of the Analects (Lunyu), which records the teachings and conduct of Confucius. The research methodology of philosophical inquiry comprises philosophical retrieval and philosophical reconstruction. Philosophical retrieval aims to review, shed light on, and analyse key concepts, theories, and presuppositions with respect to one or more classical texts. Philosophical reconstruction, on the other hand, is geared towards applying ancient intellectual ideas and practices to contemporary issues and challenges.

Results: The textual analysis of the Analects reveals that Confucius’ notion of autonomy is relational, embodied, and authentic. Rather than ‘self-rule’, Confucius’ interpretation of autonomy advocates ‘selves-rule’ by harmonising interdependence, mind-body integration, and moral self-cultivation. What makes Confucius’ relational autonomy unique is its emphasis on morality, particularly the all-encompassing virtue of ren (an achieved state of humanity).

Conclusion: A major implication of Confucian ideas in clinical settings is the need to respect and consider the consent of patients as well as that of their family members based on the value of ren (an achieved state of humanity). Confronted with complex ethical dilemmas, especially in clinical scenarios, medical professionals need to recognise that the autonomy of an individual is intrinsically tied to that of their family and inseparable from pre-existing ethical commitments. In other words, medical professionals should be mindful of the relational, embodied, and authentic aspects of autonomy by giving balanced recognition to both patient autonomy and shared decision-making, which contributes to the realisation of ren. Confucian bioethics converges with Christian bioethics by underscoring the relational dimension of autonomy, especially in settings involving family, healthcare professionals, and the patient.

Keywords: autonomy, Confucius, interdependence, mind-body integration, ren, self-cultivation