Background: During the last ten years, there has been a dysplosis in the development of digital libraries, which have taken precedence over classical libraries. Objective: With this article, we want to make a kind of comparison of classic and digital libraries, with a description of the pros and cons of both, so we can easily see their advantages and disadvantages. Methods: Authors used as source published papers deposited in indexed databases like PMC, MEDLINE, HINARI, etc. regardsing to appropriate facts about classic and digital libraries in Bosnia and Herzegovina and wordwide. Results and Discussion: Libraries, even a scientific one, must have professionally trained staff and an appropriate technological infrastructure, the main component of which is the Library Information System (BIS). It is a phrase that refers to an integrated library system, which consists of online databases, digital libraries, electronic books, magazines and various multimedia formats on which information sources are stored (hard disks, CDs, USB sticks, DVDs, etc.). In the past, libraries tended to develop means or instruments that would enable access to documentary resources on the spot, i.e. in the library itself - through the catalog. Later, a lot of effort was invested in the development of an automatic version of these local tools - by creating an online catalog for accessing data about library resources from a distance, such as, for example, (www.cobiss.ba) maintained by the National and University Library in Sarajevo (www.nub.ba) with members of the Virtual Library of Bosnia and Herzegovina (ViBBIH) consortium. Thanks to information technology, libraries were able to automate their many functions such as: acquisition, loan, material processing and other work procedures that were previously performed manually. The publishing production of databases has enabled libraries to offer users, through free access or licensing, access to the most diverse contents, Conclusion: Thus, digital libraries have numerous advantages, they are organizations that offer resources for use, include professional staff that select, organize, provide intellectual access, explain, distribute, preserve the integrity and ensure the durability of collections of digital works in such a way that they are ready and economically available for use by one or more communities. However, time steps on us every day, and so does technology, and new inventions, computers, cell phones, so I believe that we should not ignore the beauty when we pick up a book and read it. The historical value of books should not be neglected, both for our sake and for the sake of future generations.
Background: According to laws on health care in Federation of Bosnia and Herzegovina, and AKAZ standards hospital health care includes a set of measures, activities and procedures, which are undertaken with the aim of diagnosing, treating and medically rehabilitating patients in appropriate inpatient health care institutions. Objective: The aim of this study was to explain influence of appropriate helath management standards for hospital healthcare activities and diagnostic services in the praxis. Methods: We used published books and papers with health management standards and also AKAZ standards for our description. Results and Discussion: Acute hospitalization according to the standards of the World Health Organization treats acute disease states or acute exacerbation of chronic diseases with a shorter duration of treatment. This type of hospitalization is carried out in: general, cantonal and clinical hospitals. General hospitals provide basic hospital care in general internal medicine, pediatrics, general surgery, gynecology and obstetrics and diagnostics for this level. Cantonal hospitals provide healthcare services in basic specializations, namely: pediatrics, pneumophthisiology, neurology, psychiatry, infectology, dermatovenerology, internal medicine, medical rehabilitation and physiatry, surgery, urology, orthopedics, otorhinolaryngology, ophthalmology, gynecology and obstetrics. Clinical centers provide services from a wide range of subspecialties, where the most modern diagnostic and therapeutic methods and equipment are used for diagnosis and treatment in these centers, and at the same time, clinical centers are also educational bases for individual clinical disciplines: cardiology, gastroenterology, nephrology, endocrinology, nuclear medicine, pneumophthisiology, hematology, neurology, psychiatry, pediatrics, infectology, dermatovenerology, oncology, angiology, neurosurgery, abdominal surgery, urology, thoracic surgery, orthopedics, reconstructive and plastic surgery, vascular surgery, ophthalmology, otorhinolaryngology, transplantology, cardiac surgery, children\'s surgery, toxicology, gynecology, obstetrics and emergency medicine. Conclusion: Health management aims to fulfill the task of meeting the needs of users of the health system in the process of providing services. The belief that good management is the key to the success of any company, school, development program, or health institution has led to the development of management as a field in recent years
Background: SARS-CoV-2, though primarily a respiratory pathogen, exhibits multi-organ tropism, with the liver among the commonly affected organs. Elevations in liver enzymes are frequent in hospitalized COVID-19 patients, yet acute and pronounced hepatocellular injury in young, clinically stable individuals is uncommon. The underlying mechanisms may include direct viral cytopathic effects mediated by ACE2 receptors, immune-mediated injury, systemic inflammation, and metabolic stress. Notably, hepatic involvement can develop independently of respiratory compromise. Objective: The aim of this case report was to describe three adult patients with serologically confirmed SARS-CoV-2 infection and mild respiratory symptoms who presented with acute liver injury in the absence of other identifiable causes. Case report: During a confirmed COVID-19 wave in Bosnia and Herzegovina, a targeted outpatient study was performed in a family medicine setting. Routine liver testing was conducted for all suspected COVID-19 cases. Laboratory evaluation included liver enzymes, hepatitis serology, autoimmune markers, and inflammatory parameters, with imaging (ultrasound or MRI) to exclude structural pathology. Three previously healthy male patients (aged 25–45) developed acute liver injury during mild febrile illness, all with serologically confirmed SARS-CoV-2 infection (positive IgM and IgG). Retrospective assessment revealed unrecognized metabolic dysfunction-associated steatotic liver disease (MASLD) in all cases. Initial symptoms were fatigue and myalgia without respiratory distress. Laboratory findings demonstrated marked elevations of AST and ALT (>1000 U/L), GGT (>900 U/L), and raised ferritin and D-dimer, while bilirubin remained normal. This biochemical profile - disproportionately elevated transaminases and GGT with preserved bilirubin - was consistent across cases, suggesting SARS-CoV-2–related hepatocellular injury. All patients recovered rapidly with supportive outpatient care, without progression to liver failure. Conclusion: Clinically stable COVID-19 patients may experience acute hepatocellular injury, particularly those with underlying metabolic dysfunction such as MASLD. The recurring biochemical pattern of significantly elevated AST, ALT, GGT, and ferritin with normal bilirubin suggests a distinctive SARS-CoV-2–associated liver injury phenotype. Recognition of this presentation is essential for appropriate evaluation and management. Routine liver function monitoring should be considered in COVID-19 patients, regardless of respiratory symptom severity, especially in those with metabolic risk factors.
Background: The COVID-19 pandemic is likely to have unprecedented and unforeseeable consequences, from those on a worldwide/global level to those at the local level–at the level of local communities and families, and individuals (and not just humans, but all other living beings), of which the future will testify in various ways. Objective: This work presents principles of treatment health care protection of people who has consequences of the colaps of helatcare sytem in Bosnia and Herzegovina (BiH) during Corona pandemic time and proposals how to make it better, with a focus on indications and restrictions for use different methods of education medical staff and how to improve therapeutic modalities by professional staff by education with new ICTs. Methods: System analysis of Public health sector in BiH which has felt down as consequences of great influence of rough political system generaly and at Cantonal and Community levels need to be meta analized by publich health care experts and by most influential health managers who can help to improve distroid current Health Care System at all levels, from Primary to Terciray level of ih heakth care protection. Results: The health system in BiH was unprepared for the COVID-19 pandemic. The unpreparedness of the health system varied in individual areas. The reasons for the unpreparedness of the health system in responding to the pandemic are the organization of the state of BiH by the Dayton Peace Agreement, according to which the health system is fragmented and regulated by law, without the possibility of its harmonization, coordination and interconnection. This pandemic period has clearly shown that “public health” as a medical discipline has been and remains a peripheral concern of society, that is, it has always been put on the back burner. The reason for this is the constant favoring of clinical disciplines, which is not disputed as a need, but this situation has shownhow much public health is needed and called upon when solving such pandemics, which have become a planetary problem. Proof of the previous statement is the very small number of epidemiologists and social medicine specialists in BiH. Conclusion: The response of the health system of BiH as a whole to the outbreak of the Covid-19 pandemic was inadequate, untimely, unprepared, unprofessional, chaotic, misinformed and with a lot of politicking, quasi-leadership and, in the end, it will turn out to be influenced by crime. This led to a high rate of illness and death, led to a great burden on the unprepared health system and setbacks in economic and social terms.
Background: The prevalence of obesity and obesity-related clinical conditions, including metabolic-associated steatotic liver disease (MASLD), sarcopenia, and a wide spectrum of pathological manifestations, is rising globally. According to WHO, BMI is the only anthropometric measure currently used to classify obesity, overweight, and underweight. However, emerging research suggests that obesity is a complex pathological state influenced by multiple etiological factors. Given the limitations of BMI, there is a growing need for a more comprehensive assessment of body composition, particularly fat mass quantity and distribution. Bioelectrical impedance analysis (BIA) provides valuable anthropometric data that can help differentiate obesity phenotypes and guide improved therapeutic approaches. Objective: This study aims to analyze body composition using BIA in a randomly selected sample of adults from primary healthcare settings in Bosnia and Herzegovina. The primary goal is to assess total body weight, fat mass quantity, fat distribution, and obesity types prevalent in this population. Additionally, the study seeks to establish reference values for further diagnostic, preventive, and therapeutic strategies to improve public health outcomes. Methods: A cross-sectional study was conducted on adults (≥18 years) in Gračanica, Bosnia & Herzegovina (B6H), from January 2021 to January 2025. Inclusion criteria required participants to provide signed informed consent, while exclusion criteria included acute systemic diseases, severe dehydration, and fasting for more than 24 hours. Anthropometric parameters measured included age, height, weight, BMI, body fat mass (BFM), fat-free mass (FFM), percent body fat (PBF), waist-hip ratio (WHR), and bone mineral content (BMC). Data were analyzed using SPSS (version 18), with results presented as medians, interquartile ranges, and percentiles (5th, 25th, 50th, 75th, and 95th). Results: A total of 4,628 adults participated in the study, of whom 2,824 (61.0%) were female and 1,804 (39.0%) were male. The median age was 45 years (IQR: 29 years). The findings revealed that over one-quarter of the B&H population is obese, with abdominal obesity being the predominant type. This phenotype is associated with the highest risk for metabolic syndrome and MASLD. Conclusion: Our study highlights a high prevalence of obesity among the examined individuals in primary care settings in B&H, with abdominal obesity being the most common type. This phenotype is strongly associated with metabolic complications. BIA-derived parameters of fat distribution and visceral fat mass may serve as valuable tools for improving obesity classification and developing more effective preventive and therapeutic strategies.
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Background: Urgent surgical treatment of bleeding gastric and duodenal ulcer is indicated in cases where there is no treatment by an interventional gastroenterologist and radiologist readily available, or there is no satisfactory response to the applied interventional procedure. Objective: The aim of our study is to show that there is the still large number of patients with massive bleeding gastric or duodenal ulcers who had to undergo emergency surgery, in order to achieve hemostasis, provide survival analisys, and to present a methode of the surgical procedure which we perfomed. Methods: This study analysed 49 patients in the period of 5 years (2013-2018), who underwent emergency surgery due to bleeding ulcer. All patients had one or more gastroscopies in order to stop the bleeding, which were ineffective. Surgical treatments which are used in managing ulcer bleedings depended on the localization of the lesion and how severe the bleeding is. Indicated treatment is direct compression of a bleeding blood vessel (ulcer niche), truncal vagotomy, pyloroplasty, gastroduodenal artery ligature, ligature of the right gastroepiploic artery. Resection procedures were performed as well: antrectomy, proximal, subtotal and total gastrectomy. All surgical treatments aimed to preserve the patients of gastrointestinal tract where such an approach could be carried out. Results: There were total of 49 patients who underwent surgical treatment of bleeding ulcer of which 31 are male (63,27%) and 18 are female (36,73%). The survival was 38,78% (19 patients); mortality 61,22% (30 patients). The most common surgical treatment was direct suture of a bleeding vessel with a ligature of the gastroduodenal and right gastroepiploic artery. When we observe the results of resection procedures subtotal gastrectomy was most commonly used. Surgical procedure performed were bilateral vagotomy, ligature of gastroduodenal and right gastroepiploic artery if the ulcer is localized in the antral, pyloric or duodenal region and not penetrating showed that there is no need for gastrotomy/duodenotomy and direct suturing of the bleeding vessel significantly reduces operative procedure, and saves the patient from additional surgical trauma and allows the desired hemostasis. In 5-10% of patients with bleeding ulcers, emergency surgery is indicated due to massive bleeding and hemorrhagic shock and then surgery is the only chance of survival. The primary goal of any surgery for bleeding ulcer is to establish bleeding control. massive ulcer bleeding. All these patients did not have the opportunity to avoid surgery and stop the bleeding with the treatment of an interventional gastroenterologist and radiologist. Survival is 38.78%, mortality is still high 61.22% but it is encouraging that without the application of surgical treatment it would be 100% in this group of patients. Conclusion: Regardless of the risk posed by surgical treatment of a bleeding ulcer, it still brings the patient the only chance for life in cases when the interventional radiological and gastroenterological approach has failed or been disabled. Surgical treatment of bleeding ulcer in cases when the gastroenterological and radiological approach is insufficient or disabled - Single center experience.
Background: Prior to 2012, the mesentery was perceived as a fragmented structure, lacking distinct functional and anatomical characteristics, and was merely considered part of other digestive organs. Dr. J. Calvin Coffey's in 2012 in his study redefined the mesentery as a distinct organ with a clearly defined anatomical and histological structure, although its specific function remains under investigation. The continuous structure and unique tissue properties of the mesentery classify it as the 78th independent organ in the human body. Insights into mesenteric adipose tissue have enhanced our understanding of normal metabolic processes and disease etiology, impacting health significantly. Experimental and clinical research highlights the vital roles of visceral adipose tissue, influencing neighboring organ function. The interaction within the brain-gut-liver axis is illuminated by the newfound functions of mesenteric adipose tissue, emphasizing its independent organ status. Objective: This study aims to evaluate the latest findings on the structure and function of the mesentery, focusing on visceral-mesenteric adipose tissue, and assess its role as a new organ in the brain-gut-liver axis. Methods: A comprehensive analysis of clinical and experimental studies on the mesentery's structure and function was conducted, focusing on recent discoveries regarding mesenteric adipose tissue and its role in the brain-gut-liver axis. Results and Discussion: Recent research has revealed the mesentery's unique functions, particularly in mesenteric adipose tissue. Mesenteric adipose tissue plays a crucial role in metabolic functions and influences disease onset. It acts as a vital link in the brain-gut-liver axis, directly influencing hepatic metabolism and disorders such as metabolic syndrome. Conclusion: Scientific evidence confirms the mesentery's anatomical and functional specificities, solidifying its status as the 78th independent organ in the human body. It serves as a crucial link in the brain-mesentery-small intestine-liver axis, impacting health and disease. Ongoing research holds promise for advancing our understanding of pathophysiological mechanisms and treatment approaches for metabolic syndrome and other chronic diseases.
Background: COVID-19 affects all organ systems, including the visual organs. Clinical manifestations encompass all segments of the eye. Neuro-ophthalmic manifestations are rare and can occur during the acute phase of the illness, during recovery, or in the course of Long COVID. These clinical manifestations include optic neuritis and various forms of encephalomyelitis. Optic neuritis more commonly occurs during the recovery phase from the acute form or during Long COVID. Family physicians are in a position to first diagnose optic neuritis in the early stages. Objective: The aim of this paper is to present a case of optic neuritis occurring in the early stages of the disease, diagnosed in the prehospital period in a family medicine practice with consultations from ophthalmologists, infectologists, and neurologists. Such close collaboration enabled the early administration of corticosteroid therapy. Case report: A case of a 28-year-old woman is presented, who exhibited symptoms of COVID-19 with a confirmed positive antigen for the SARS-CoV-2 virus (PCR nasopharyngeal swab). On the fourth day of illness, sudden loss of vision in the right eye occurred along with headache. Early diagnosis and early administration of corticosteroid therapy led to significant improvement in vision. Conclusion: Clinical manifestations of eye diseases can occur in the early stages of COVID-19 as a direct consequence of viral infection. Ophthalmologist and neurologist examinations are necessary in the early stages of the disease for timely diagnosis of various ophthalmologic and neurologic disorders and adequate therapy.
Background: In December of 2019, SARS-CoV-2, a new type of coronavirus, appeared, and it turned into an international epidemic. The consequences of the pandemic, especially the isolation measures, fear of infection and bad economic trends, as a result of the crisis, threaten people's basic psychological needs. Objective: The objective of this research was to assess the impact of the COVID-19 pandemic on mental health and perceived social support of persons with disabilities in Bosnia and Herzegovina. Methods: The research included a total sample of 232 respondents with different types of disabilities. The Symptom Checklist (SCL-90) was used to verify the research objective, which assessed three dimensions: somatization, depression and anxiety. Also, in order to verify the research objective, the Multidimensional Scale of Perceived Social Support was applied, which consists of 12 statements that measure the perceived social support of family, friends and other people. The research data was processed with descriptive and inferential statistics. The basic statistical parameters were calculated, while the t-test was used for an independent sample of respondents to verify the set objective. Results: The results of the research showed that persons with disabilities, who were infected with the SARS-Cov-2 virus, had a significantly higher level of somatization, anxiety and depression compared to those who were not infected with the virus. The results in relation to social support did not prove to be statistically significant. Conclusion: The obtained results lead to the conclusion that, in the future, interventions by experts of various profiles must be planned to preserve the mental health of persons with disabilities, which is why it is important to invest in the emotional, psychological, social, physical and spiritual well-being of the individual.
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