Aim To assess whether the quality of diabetes care provided by a family medicine team changed over the course of four years and to identify potential gaps in our practice in order to improve it in the future. Methods An audit was carried out for randomly selected 120 medical records (MC) from the Diabetes Registry of patients with type 1 or 2 diabetes mellitus treated by one family medicine team for four consecutive years, from 2013 to 2016. We examined demographic data (gender, age, diabetes type, family history), annual examinations (glycated haemoglobin, blood glucose, lipid profile, neurological examination, urinalysis, foot care, ocular fundus and body mass index), prescribed insulin or other drugs and patients' education. Results Over the years females dominated with the maximum of 63% in 2013. In most years type 2 diabetes occurred in 93% of patients. The acceptable level of monitoring included examination of ocular fundus, lipid profile or total cholesterol, blood pressure, fasting and postprandial blood glucose with more than 80% annually. A low level of monitoring complications of diabetes was found on monofilament test, 26% in 2016, urinalysis, 20% in 2016 and examination of feet with the maximum of 46% in 2013. Outcome measurement showed satisfactory levels of glycated haemoglobin of 60% in 2014, blood pressure 76% in 2014, fast 56% and postprandial blood glucose of 73% in 2013. Conclusion We still need to find effective interventions that will lead to improvement of care for patients with diabetes in family medicine.

Aim To establish the presence of two risk factors, smoking and alcohol use, for non-communicable diseases among students at the University of Zenica. Methods The research was conducted at eight schools of the University of Zenica in the academic year 2016/2017 during the period from 1 December 2016 to 15 February 2017. The study involved 600 students 19-29 years of age (all years of study). The research was carried out with a standardized and validated questionnaire, the STEPS non-communicable Disease Risk Factors survey, developed by the World Health Organization. Results Tobacco was used by 145 (24.2%) students, 68 (46.9%) of them being males and 77 (53.1%) females (p<0.05). Males smoked 15.62 and females 13 cigarettes per day (p<0.05). On average, male participants were 16.56 years old, and female participants 16.71 when they started consuming cigarettes (p<0.05). A total of 289 (48.1%) students consumed alcohol, of whom 135 (70.2%) were males and 154 (37.7%) females (p<0.05). Conclusion There is evidence of high prevalence of smoking and alcohol usage as the risk factors for non-communicable diseases. Two levels of the prevention measures should be applied in order to reduce the prevalence of such risk factors: strategic level with a definition of the population, actors, activities, target population and anticipated results, and tactic level which will show contingency activities at the University.

Aim To investigate epidemiological characteristics of the measles epidemic (risk factors and reasons for its emergence) in order to establish better control and prevention of future epidemics as well as to determine an influence of poor collective immunization of children against measles on appearance of epidemic disease. Methods An open retrospective epidemiological study of measles infection was conducted during the epidemic in Zenica-Doboj Canton (ZDC) in the period 2014-2015. Disease reports, Disease Reporting Forms for measles and rubella cases and the Bulletin of the Institute for Health and Food Safety Zenica were used for data collection. Results A total of 325 patients with the diagnosis of measles were registered, 262 (80.61%) in 2014 and 63 (19.39%) in 2015 resulting in overall incidence of 81.25/100.000. The majority of patients were aged 0-6 (p<0.05). Of the total number of patients, only 13 (4.73%) were orderly vaccinated (p <0.05). In the period 2009- 2015 in ZDC 25.444 (83.34%) children (p <0.05) were vaccinated with measles, mumps, rubella (MMR) vaccine. Conclusion Results of the study show that the low level of vaccination of children continues to a risk of the emergence of epidemics of measles and other infectious diseases. Therefore, in order to prevent the disease there is a need for a better vaccination campaign.

Aim To determine most common factors making patients with high blood pressure seek professionally unacceptable treatment of hypertension at the Emergency Department. Methods The survey was conducted at the Emergency Department of the Primary Health Care in Gradačac on randomly selected 207 patients who requested medical help because of high blood pressure. For all patients arterial blood pressure and body mass index (BMI) were measured. A survey about knowledge and attitudes regarding habits that affect high blood pressure as well as the socio-economic conditions was made. Results Prevalence of 10.3% was found with regard to visits to emergency care by patients due to high blood pressure. Most patients, 127(61.4 %), were overweight and 36(17.4%) were obese. Patients who rarely controlled their blood pressure were more frequent visitors of emergency medical services. Stressful situation occurs as a factor in a variety of forms. The survey showed that 76 (36.7%) patients sought medical help even though they had no blood pressure values that required emergency care. Conclusion Poorly organized health care system with no continuous and comprehensive preventive promotional programs caused by inappropriate use of resources in health care. The reorganization of primary care with full implementation of family medicine and greater integration of family medicine with other levels of the health care system should provide a better control and treatment of other diseases such as hypertension.

Introduction: Aim of article was to present perspectives of telemedicine in the field of cardiology in Bosnia and Herzegovina. Material and methods: Article has descriptive character and present review of literature. Results: Information technology can have the application in the education of students, starting from basic medical sciences up to clinical subjects. Information technologies are used for ECG analysis, 24h ECG Holter monitoring, which detects different rhythm disorders. By developing software packages for electrocardiogram analysis, which can be divided and interpreted by mobile phones, and complete the whole of the patient in the ambulance, specialist, experienced specialists, or even consultations in various illnesses and cities. Image segmentation algorithms have significance in the quantization and diagnostics of anatomic and pathological structures, and 3D representation has an important role in education, topography and clinical anatomy, radiology, pathology, as well as in clinical cardiology itself, especially in the sphere of coronary arteries identification in the multislice computerized angiography of coronary arteries. Interactive video consultations with subspecialists from the state and the region in adult cardiology, adult interventional cardiology, cardiovascular surgery, pediatric invasive and non-invasive cardiology enable better access to heart specialists and subspecialist, accurate diagnosis, better treatment, reduction of mortality, and a significant reduction in costs. Conclusion: Telemedicine by slow steps in entering the soil of Bosnia and Herzegovina, but the potential exists. It is necessary to educate the medical staff, as well as to provide a tempting environment for software engineers. Investing in infrastructure and equipment is imperative, as well as a positive climate for the its implementation.

Introduction: Alimentary toxoinfections represent a significant public health problem. Globalization of the market and food production, significant impoverishment of a large part of the population, and traditional approach with food preparation and consumption, cause a significant increase in the rates of population infections around the world. The epidemiological surveillance of the illness occurrence plays a significant role in monitoring and controlling the population’s burden of diseases caused by unhygienically prepared and stored food. Aim: The aim of the article is to determine the rates and trends of food related diseases in the Federation of Bosnia and Herzegovina. Results: The results of the analysis have shown that the rate of illness in the Federation of Bosnia and Herzegovina is declining but is still significantly higher than in developed western countries. Particularly great burden is on the population of the Zenica-Doboj Canton (ZDC), which can be due to the traditional relation to the preparation and storage of food, as well as to the relatively poorer economic situation in ZDC. Conclusion: We can conclude that the strengthening of the monitoring system, laboratory capacities, the availability of monitoring guides will enable responsible FBiH/Bosnia and Herzegovina institutions to better control and implement safer food practice.

The time interval from the 9th to the 13th century remained known as the “Golden period of the Arab science”, and a significant place among the taught sciences are occupied by Medicine and Pharmacy. In the history of medicine, Islamic medicine, also known as Arabic medicine, refers to the science of medicine developed in the Islamic Golden Age, and written in Arabic Arabs were able to use their cultural and natural resources and trade links to contribute to the strong development of pharmacy. After the collapse of the Arab rule, the Arab territorial expanses and cultural heritage were taken over by the Turks. Although scientific progress in the Turkish period slowed down due to numerous unfavorable political-economic and other circumstances, thanks to the Turks, Arab culture and useful Islamic principles expanded to the territory of our homeland of Bosnia and Herzegovina. Significant role in the transfer of Arabic medical and pharmaceutical knowledge was also attributed to the Sephardic Jews who, with their arrival, continued to perform their attar activities, which were largely based on Arab achievements. However, insufficiently elaborated, rich funds of oriental medical and pharmaceutical handwriting testify that Oriental science has nurtured in these areas as well, and that the Arab component in a specific way was intertwined with other cultures and traditions of Bosnia and Herzegovina.

BiH nursing education is still developing toward the EU directive on regulated professions. At present, there are two large projects dealing with the reform of nursing curricula in Bosnia and Herzegovina; one of them is the Tempus CCNURCA (Competency-based Curriculum Reform in Nursing and Caring in Western Balkan Universities) project and the other is the ProSES (Strengthening Nursing in Bosnia and Herzegovina) project. Both projects have a shared goal to reform nursing curricula and education in general toward the EU directive dealing with regulated professions. This study performed a deep analysis about the current nursing education situation in BiH. The findings were very interesting because there were a lot of different information from different schools, all of which is important to improving nursing education. The methodology used for this research was analytic, comparative, descriptive, and prospective. Three nursing faculties were analyzed: the Faculty of Health in Zenica, the Faculty of Health Sciences in Mostar, and the Nursing Study Program at the University of East Sarajevo. It is important that the Tempus CCNURCA project also be implemented in Albania and Montenegro with EU partners from Belgium, Slovakia, and the Netherlands. Our findings showed important differences between the BiH and EU nursing approaches. The number of nursing staff employed, medical orientation of the curricula, practice versus theory, and usage of different teaching and assessment methodologies are some of the major differences between BiH and EU approaches in nursing education. These will be the starting and leading points for BiH nursing schools as they reform and introduce proper nursing education recommended by WHO standards for nursing education and EU directive 2005/13 on regulated professions. In conclusion, a deep analysis of the current situation was a major precondition for the successful improvement of nursing education in BiH in accordance with EU standards.

AIM In hemodialysis patients renal disease may cause an impairment of central and peripheral nervous system. In most cases of the peripheral nervous system polyneuropathy is reported. The aim of this study was to evaluate the function of small A-delta nerve fibres, whose function is often overlooked. METHODS The function of large diameter nerve fibers was performed by standard routine neurophysiological examination. Cutaneous silent period (CSP) was elicited by single electrical stimulations at the tip of digit II by the bipolar electrodes. The superficial electrodes were placed on the muscle belly of m. abductor pollicis brevis. The onset latency (L1) was recorded at the beginning of voluntary muscle activity suppression, the late latency (L2) at the start of new muscle activity. The difference between two latencies indicates the duration of CSP. RESULTS The study included 38 consecutive patients (male/female - 21/17, median age 56.6±10.9 years) treated with hemodialysis (one month to 30 years) and 35 healthy subjects (male/female 23/17, age 47.4±10.1 years). The results of the conduction study demonstrated a significant prolongation of F-waves of the median and ulnar nerves, decreased motor and sensory velocities of both nervesin patients on hemodialysis (p less than 0.001). In patients with A-V fistulas a significant prolongation of the onset CSP latency L1 was obtained (p less than 0.001), whereas duration of CSP was not changed. CONCLUSION In hemodialysis patients the significant impairment of small nerve fibers was recorded. The evaluation of small nerve fibers contributes to the assessment of the whole peripheral nerve function.

Introduction: Meningococcal meningitis now represents a significant public health problem, not only in developing countries but also in developed ones. The disease usually occurs sporadically, and much less in smaller epidemics. Material and methods: We retrospectively analyzed the epidemiological characteristics of meningococcal meningitis in the area of Zenica-Doboj Canton in the five-year period from 2008 to 2012th. In total there were 38 reported and hospitalized patients, with an average of 7-8 patients per year. Results: Most commonly disease occurred in infants and young children (28.9%). The highest number was recorded in 2011, 10 cases or (26.3%). Most patients in the monitored period were registered in the municipality of Zenica–12 cases (31.6%) and Zepce 8 cases (21.1%). All hospitalized patients were sporadic cases, there has never been an epidemic in the observed period. Conclusions: Epidemic Meningitis is a very serious disease and a significant public health problem that requires a serious medical scientific approach for its resolution, primarily in finding adequate vaccine and its administration.