In this study, using the methods of spatial autocorrelation in geographic information systems (GIS), an analysis of the spatial distribution of mortality rates in Bosnia and Herzegovina was performed in order to identify high-risk areas with increased mortality and depopulation. Spatial analysis is based on the calculation of global (Global Moran’s I and Getis-Ord General G) and local (Anselin Local Moran’s I and Getis-Ord Gi*) statistical indices of spatial autocorrelation. The values of global statistical indices confirmed a clustering of high mortality values, while local statistical indices confirmed high mortality rates in the municipalities of northwestern and eastern Bosnia and Herzegovina. Conducted research provides an insight into spatial patterns of demographic processes, while results obtained by this research are significant for demographic development and future spatial demographic research in Bosnia and Herzegovina.

The aim of this research is to analyze the spatial distribution of the population ageing in Bosnia and Herzegovina and identify areas of the country that are particularly vulnerable to negative demographic trends. To achieve the goal of the study, data on the ageing coefficient and ageing index for the period 2013-2020 were used. The geospatial analysis of these indicators was performed using global (Global Moran's I and Getis-Ord General G) and local (Anselin Local Moran's I and Getis-Ord G*) indexes of spatial autocorrelation. The research results confirmed the clustering of both indicators. Ageing coefficient values are clustered in municipalities in western, northwestern, Eastern, and central Bosnia and Herzegovina. Ageing index values are clustered in municipalities in central, western, northwestern, and northeastern Bosnia and Herzegovina. This study provides insight into the research methods of spatial demographic trends and phenomena, and its findings can serve as a basis for future demographic research and development in Bosnia and Herzegovina.

The beginning of the 21st century in the Federation of Bosnia and Herzegovina (henceforth referred to as ?the Federation?) has been characterised by a decrease in the primary-school-age population. As such, the main objective of this work is to define and explain the factors that have influenced the decrease in the primary-school-age population in this part of Bosnia and Herzegovina. The research methodology applied in this work is oriented towards defining the degree of influence of demographic factors on the development of the primary-school-age population in the Federation. By using statistical methods and GIS analysis of statistical data, negative demographic trends were confirmed in the Federation at the end of the 20th and the beginning of the 21st century. These trends included intensive migration, a decrease in the total number of inhabitants, a decrease in the birth rate, an increased mortality rate, a decreased rate of natural population change, and the ageing of the population. Due to adverse economic, social, political, and other circumstances after 1995, population emigration has been intensified, most noticeably within the population aged between 20 and 40. The most important result of the research is the fact that the decrease in the natural population dynamics and intensive emigration are the most significant factors influencing the decrease in the primary-school-age population in the Federation. Such negative demographic trends influence the primary education system adversely. In the future, it will be necessary to plan and implement a population-revitalisation process as part of the federation?s overall population policy.

In this paper the age structure and the ageing population process in Bosnia and Herzegovina in the second half of the 20th century and the beginning of the 21st century is analyzed. The main reasons that caused changes in the age composition of the population and the population ageing in Bosnia and Herzegovina have been researched. The main causes of the population ageing in Bosnia and Herzegovina in the second half of the 20th century were primarily trends in fertility rates and secondarily trends in mortality rates. The economic growth of Bosnia and Herzegovina after World War II conditioned changes in the economic and educational structure of the population and with that the changes in the natural increase rates and migration balance. The war was the main cause of negative demographic changes in Bosnia and Herzegovina in the period from 1992 to 1995, and the post-war adverse socioeconomic, political and other circumstances have been the cause of negative demographic trends after 1995. The aim of this paper is to determine the level of population ageing in Bosnia and Herzegovina and the consequences this process could have on the demographic future of this country.

Introduction: Fractures of the proximal femur and hip are relatively common injuries in adults and common source of morbidity and mortality among the elderly. Many methods have been recommended for the treatment of intertrochanteric fractures. Material and methods: We retrospective analyzed all the patients with fractures of the hip treated with proximal femoral nail antirotation (PFNA) at the Clinic of Orthopedic and Traumatology, University Clinical Centre Tuzla from the first of January 2012 to 31 December 2012 years. The study included 63 patients averaged 73.6±11.9 years (range, 29 to 88 years). Fracture type was classified as intertrochanteric (Arbeitsgemeinschaft für Osteosynthesefragen classification 31.A.1, A.2 and A.3) and subtrochanteric fractures (Seinsheimer classification). Results and discussion: The ratio between the genders female-male was 1.6:1. There was statistically significant difference prevalence of female compared to male patients (p=0.012). There were 31 left and 32 right hip fractured. Low energy trauma was the cause of fractures in 57(90.5%) patients. Averaged waiting time for hospitalization was 3.2±7.5 days (range, 0 to 32 days). 44 patients were admitted the same day upon injuring. The average waiting time for the treatment was 3.6±5.7 days. The ratio between with or without co-existent disease was 4.7:1. During the three months postoperatively with ASA score 3 and 4 six patients died. There were no significant differences in deaths from ASA score 1 and 2 (p=0.52). Reoperation for the treatment of implant or fracture-related complications was required in three (4.7%) patients (infection, reimplantation and extraction). Three patient developed deep vein thrombosis. Statistically significant difference was found in the deaths in the first three months compared to the next three months (p=0.02). We found statistically significant difference between pre-injury and postoperative mobility score (p=0.0001). Conclusion: PFNA is an excellent device for osteosynthesis as it can be easily inserted. Moreover, it provides stable fixation, which allows early full weightbearing mobilization of the patient.

ABSTRACT Introduction: Fracture of the femoral shaft is a common fracture encountered in orthopedic practice. In the 1939, Küntscher introduced the concept of intramedullary nailing for stabilization of long bone fractures. Intramedullary nailing has revolutionized the treatment of fractures. Material and methods: The study included 37 male patients and 13 female patients, averaged 39±20,5 years (range, 16 to 76 years). Results and discussion: There were 31 left femurs and 21 right femurs fractured. 46 fractures were the result of blunt trauma. Low energy trauma was the cause of fractures in six patients, of which five in elderly females. 49 fractures were closed. Healing time given in weeks was 19,36 ± 6,1. The overall healing rate was 93,6%. There were three (6,25%) major complications nonunion. There were one (2%) delayed union, one (2%) rotational malunion and no infection. The shortening of 1 cm were in two patients. Antercurvatum of 10 degrees was found in one patient. There was no statistically significant reduction of a motion in the hip and knee (p<0.05). There was statistically significant in the thigh (knee extensors) muscle weakness (p<0.001). Conclusion: Intramedullary nailing is the treatment of choice for femoral shaft fractures.

INTRODUCTION Fractures of the proximal femur and hip are relatively common injuries in adults and common source of morbidity and mortality among the elderly. Many methods have been recommended for the treatment of intertrochanteric fractures. MATERIAL AND METHODS We retrospective analyzed all the patients with fractures of the hip treated with proximal femoral nail antirotation (PFNA) at the Clinic of Orthopedic and Traumatology, University Clinical Centre Tuzla from the first of January 2012 to 31 December 2012 years. The study included 63 patients averaged 73.6 +/- 11.9 years (range, 29 to 88 years). Fracture type was classified as intertrochanteric (Arbeitsgemeinschaft für Osteosynthesefragen classification 31.A.1, A.2 and A.3) and subtrochanteric fractures (Seinsheimer classification). RESULTS AND DISCUSSION The ratio between the genders female-male was 1.6:1. There was statistically significant difference prevalence of female compared to male patients (p = 0.012). There were 31 left and 32 right hip fractured. Low energy trauma was the cause of fractures in 57(90.5%) patients. Averaged waiting time for hospitalization was 3.2 +/- 7.5 days (range, 0 to 32 days). 44 patients were admitted the same day upon injuring. The average waiting time for the treatment was 3.6 +/- 5.7 days. The ratio between with or without co-existent disease was 4.7:1. During the three months postoperatively with ASA score 3 and 4 six patients died. There were no significant differences in deaths from ASA score 1 and 2 (p = 0.52). Reoperation for the treatment of implant or fracture-related complications was required in three (4.7%) patients (infection, reimplantation and extraction). Three patient developed deep vein thrombosis. Statistically significant difference was found in the deaths in the first three months compared to the next three months (p = 0.02). We found statistically significant difference between pre-injury and postoperative mobility score (p = 0.0001). CONCLUSION PFNA is an excellent device for osteosynthesis as it can be easily inserted. Moreover, it provides stable fixation, which allows early full weightbearing mobilization of the patient.

UNLABELLED Supracondylar fractures are the result of a fall on outstretched hand in more than 70% of cases, and more common in the non-dominant arm. Bauman's angle is used to determine the degree of displacement and angulation, and the quality of fracture reduction. Carrying angle is the clinical parameter ofvarus-valgus angulation with elbow fully extended and forearm completely supinated. PATIENTS AND METHODS The study was a retrospective-prospective and there were analyzed children under 14 years of age with supracondylar humerus fracture. They were analyzed by X-ray anteroposterior view of injured elbow, made before and after the surgery, with measuring Bauman's angle. Clinical examination was performed after completing physical therapy, when was measured carrying angle of the injured and healthy elbow using a goniometer. RESULTS AND DISCUSSION The results showed that there is a negative correlation Bauman and carrying angle of injured elbow (r = -0.543, p < 0.0001). Analyzing Bauman's angle deviation from value of 75 degrees and the loss of carrying angle there is noticed significant positive correlation between the Bauman angle deviation and loss of carrying angle. Bauman's angle correlates well with the carrying angle and can be used as an indicator of the potential cosmetic complications. CONCLUSION Carrying angle of uninjured elbow measured when reviewing a child who has suffered supracondylar fracture, can serve as a useful parameter in the assessment of real Bauman's angle, thereby the adequacy of fracture reduction on the injured arm. KEYWORDS supracondylar fracture,

UNLABELLED Assessment of depth of anesthesia is the basis in anesthesiologists work because the occurrence of awareness during general anesthesia is important due to stress, which is caused in the patient at that moment, and due to complications that may arise later. There are subjective and objective methods used to estimate the depth of anesthesia. The aim of this study was to assess the depth of anesthesia based on clinical parameters and on the basis bispectral index, and determine the part of bispectral monitoring in support to clinical assessment. MATERIAL AND METHODS Sixty patients divided into two groups were analyzed in a prospective study. In first group (group 1), the depth of anesthesia was assessed by PRST score, and in the second group (group 2) was assessed by bispectral monitoring with determination PRST score concurrently. In both groups PRST score was assessed in four periods, while bispectral monitoring is used continuously. For analysis were used the BIS index values from the equivalent periods as PRST scores. PRST score value 0-3, and BIS index 40-60 were considered as adequate depth of anesthesia. The results showed that in our study were not waking patients during the surgery. In the group where the depth of anesthesia assessed clinically, we had a few of respondents (13%) for whom at some point were present indicators of light anesthesia. Postoperative interview excluded the possibility of intraoperative awareness. In the second group of patients and objective and clinical assessment indicated at all times to adequate depth of anesthesia. CONCLUSION The use of BIS monitoring with clinical assessment allows anesthesiologists precise decision-making in balancing and dosage of anesthetics and other drugs, as well as treatment in certain situations.