AIM To investigate the risk for falls in elderly patients treated in the Primary Health Care Centre Gradiška, Bosnia and Herzegovina. METHODS This study included 500 patients aged 65 and older. They were chosen randomly by 10 family physicians. Data collection took place every Wednesday and Friday, between January 2022 and July 2022. The patients' gait and balance assessment were performed using the Tinetti Gait and Balance Tool to assess the risk of falls. A supplementary questionnaire was created to record data about the patients' age, sex, chronic diseases, and drugs they take. RESULTS Among the included patients there were 266 females (53.2%) and 234 (46.8%) males, with the mean age of 75.25 years. The Tinetti test showed that the risk of falls was high for patients older than 75 years, 111 patients (69.8%), and 48 patients (30.2%) aged 65 to 74 (p=0.000). The risk of falling was higher for female, 93 (35%), than male patients, 66 (28.2%) (p=0.018). Considering chronic diseases, a high risk of falls was found in 32 (2.1%) patients with heart failure (p=0.029) and 19 (11.9%) patients with osteoporosis (p=0.000). Patients who used antihypertensive drugs had the highest risk for falls, 124 (78.0%) (p=0.757). CONCLUSION About two-thirds of the examinees over the age of 75 had a high risk of falls, which indicates that family doctors should be more involved in fall prevention of elderly patients and constantly educate older patients and their families about it.

Lung cancer incidence in Bosnia and Hercegovina is high. The implementation of evidence-based lung cancer screening based on low-dose computed tomography (LDCT) may detect lung cancer early and decrease mortality specific to lung cancer. However, LDCT receipt may be unsatisfactory in Europe due to a low distribution of scanners and radiologists or poor access to care. In this paper, we propose a framework for the implementation of lung cancer screening in primary healthcare of Bosnia and Herzegovina based on the United States Preventative Services Task Force recommendation from 2021 and the American College of Radiology Lung CT Screening Reporting & Data System from 2022.

Background: After the World Health Organization declared the outbreak of a new coronavirus on 30 January 2020 a public health emergency of international importance, health authorities in Bosnia and Herzegovinaas in other countries around the world, have ordered active surveillance, early detection, isolation and management, cases, contact monitoring and prevention of the spread of infection. Objective: The aim of this study was to describe and analyze of the organization of family medicine during COVID-19 pandemic in Canton Sarajevo with its positive and negative aspects. Methods: The case study design provided an ideal framework for systematic research into the organization of primary health care in Sarajevo Canton during the COVID-19 pandemic as it is an empirical study exploring a contemporary phenomenon within its real-life context when the boundaries between phenomenon and context are not clearly visible. Multiple sources of evidence are used. Data were collected in several different ways: analyzing policies, laws, regulations, decisions related to the COVID pandemic, insight into changes in the health information system, collecting data from reports, and through a group interview (Delphi exploratory) with eleven family medicine specialists. Results: Primary care was organized as two parallel systems with family medicine in the center. The first system was COVID-19 primary care and the second was regular care for non-COVID-19 patients. Family medicine physicians despite a numerus setbacks provide health care for 106346 COVID-19 cases. Discussion: Every principal (first contact access, person-centered care, comprehensiveness, continuity of care, community based, coordination of care, and holistic modeling) of family medicine was interrupted with consequences for patients and family physicians. Conclusion: Additional research is needed to examine all facets of the family medicine and primary health care response to the COVID-19 pandemic in Sarajevo Canton.

Introduction: The water pipe is a form of tobacco smoking that recently become very popular among youth in many countries all over the globe. Aim: To highlight recent data collected through Global Youth Tobacco Survey (GYTS) in the Federation of Bosnia and Herzegovina (FBiH) 2019, related to knowledge, attitudes and behavior of school children and youth to water pipe consumption. Methods: The GYTS questionnaire for the Federation of BiH 2019 contained 60 multiple-choice questions. The GYTS 2019 in the Federation of BiH was conducted in a total of 73 of the 75 sampled primary and secondary schools with a school response rate of 97.3%. From the 6,972 sampled students a total of 6,415 participated as eligible students in grades 8-9 of primary and 1st grade of secondary school, with a response rate for students of 92.0%. Results: Survey findings show that almost half (44.1%) of the school children confirm ever smoking the water pipe, while Current smoking of water pipe is confirmed by 16.1% school children. Conclusion: There is a substantial need for implementing of systematic and inter sectorial tobacco control measures that involves a water pipe as new public health challenge among youth.

Introduction: Although during undergraduate study students have a high opinion of family medicine and often praise it, during postgraduate studies they show little interest in this medical specialty. Aim: The study aimed to examine the interest of public medical school students in family medicine as a career choice, to establish whether it changed during the study and if there was a difference in that regard among students studying at medical schools in Bosnia and Herzegovina. Hypotheses: students’ attitudes change with learning about the way a family doctor works. Methods: Descriptive cross-sectional survey. This manuscript presents a nationwide survey (63% response rate) of public medical school students in Bosnia and Herzegovina regarding their likelihood of selecting Family Medicine as a specialty. An anonymous questionnaire was distributed to all medical students on all six state universities in Bosnia and Herzegovina. Data basis of all doctors who have completed specialization programs were taken from ministries of health. Results: In the period from 01/01/08 to 12/31/18, only 8.4% of all completed specializations were family medicine doctors in Bosnia and Herzegovina. Interest in family medicine, as a future career, was shown by 31% of medical students, of which over 75% were female students. The largest interest in family medicine was shown by the sixth-year medical students, stating their extensive knowledge of medicine as a reason. Conclusion: Students’ interest in FM specialization is changing through the years of study. Unfortunately, it is not only the lack of interest, that is the cause of the small number of family medical specialities among students but also poor health policy, which should be subjected to actual reform.

Introduction: It is an undeniable fact that antidepressants can cause side effects. Antidepressants generally have a similar effect but they differ in their application safety, as well as their side effects. Aim: To determine differences in the frequency and intensity of antidepressant induced side effects in patients treated in primary care. Methods: The research was designed as a prospective, cross-sectional study, conducted on a voluntary and anonymous basis, and it included depression patients treated with antidepressant medications during 2013-2015 in Zenica-Doboj Canton using the Hamilton Depression Rating Scale and Toronto Side Effects Scale. Results: The total sample included 508 subjects. As a significant problem, abdominal pain was felt by 14% of subjects, indigestion by 19% of subjects, nausea by 15% of subjects, diarrhea by 9% of subjects, and constipation by 11% of subjects. 29% of subjects suffered from sweating, 20% suffered from a sudden heat stroke, 10% suffered from swelling, and 23% of them reported suffering from dry mouth as a significant problem. The prevalence of side effects in relation to how do they affect life and daily activities of subjects is statistically significant (P <0.000). Statistically significant side effects of SSRI antidepressants correlate with the duration of our subject’s treatment: perception of increased sleep (0.039) as well as decreased sleep (P = 0.009), sweating (P <0.001), sudden heat stroke (P <0.001), being without orgasm (P = 0.004), decreased libido (P <0.001), weight loss (P = 0.045). Conclusion: It is necessary to educate the patients about the nature and features of the depressive disorder, and to notify the patients of the expected course of recovery, as well as the need to adhere to the recommended therapy and the possible side effects of the medication.

Aim To determine the extent and characteristics of incidental injuries, primarily by needles and other medically sharp instruments and to recommend preventative activities to health care professionals. Methods The survey was conducted among 200 healthcare and non-healthcare employees of the Primary Health Care Centre Zenica (48% of the total number of employees). Care workers were surveyed, and the sample was randomly selected in proportion to the number of employees in institutional departments. Respondents answered questions about gender and age, work experience and qualifications; the number and type of exposure to incidents in the past year, number of career incidents, number of reported incidents; information on the manner and cause of the incident. Results The sample consisted mainly of females, 153 (83.2%). An exposure to incident during their work was experienced by 128 (69.6% ) respondents: needle-stick injury, 79 (42.9%), unforeseen patient response, 42 (22.8%), rush to perform the procedure, 34 (18,5%), and negligence, 18 (9.8%). The incidents most frequently occurred in gynaecology department (all respondents experienced an incident event), followed by department of family medicine, 47 (67%). The main reason for these incidents was rush to perform procedures, in 9 (12.5%). Of 128 experienced incident events, 21 (16.4%) were reported. Conclusion The low rate of reporting of exposure to incidents does not provide a realistic basis for risk assessment and preventive action. Primary task for improving safety of work processes at our setting will be to raise employee's awareness of the need to report exposure incidents.

Aim To assess obesity and weekly physical activity among medical students at the University of Banja Luka, Bosnia and Herzegovina, related to gender and years of study profile. Methods This is a prospective, descriptive study conducted among the student population across all six years, comprised of a validated survey instrument Youth Risk Behaviour Survey Questionnaires. The study was approved by the Ethics Committee of the School of Medicine and carried out as an anonymous survey, during the winter semester of the academic year 2017/2018. Results Of the total 601 students, the study included 543 students, 327 (60.2%) females and 216 (39.8%) males. The majority of students 337 (62.1%) had normal weight, and 13 (2.4%) had class 1 obesity. Most female students, 255 (75.7%) had normal weight, while 132 (61.1%) males were overweight. Physical inactivity was found among 349 (64.3%) students; 11 (2%) exercised regularly twice a week and 16 (2.9%) exercised five times a week. Conclusion This study should help better understanding and identifying the onset of obesity among the students of the School of Medicine in Banja Luka and promote awareness of the obesity problem among them that would have benefit for health of this population group.

1Primary Healthcare Center Banja Luka, The Republic of Srpska, Bosnia and Herzegovina 2University of Banja Luka, Faculty of Medicine, Department of Family Medicine, The Republic of Srpska, Bosnia and Herzegovina 3University of Zenica, Faculty of Medicine, Department of Family Medicine, Bosnia and Herzegovina 4University of Banja Luka, Faculty of Medicine, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina