PURPOSE It is estimated that 10-20 % patients on hemodialysis therapy have hepatitis C virus infection with big geographic and individual variability in HCV prevalence between different hemodialysis centers. OBJECTIVES To determine prevalence of HCV infection among hemodialysis patients in Hemodialysis Unit of General Hospital Gracanica and to make epidemiological, clinical, biochemical and virusological analysis in anti-HCV positive patients. WORK METHODS: 58 patients that were hemodialyse during 2000 year in Hemodialysis Unit Gracanica were included in this study. All patients were tested on anti-HCV antibody and further planed analyses were done. WORK RESULTS Prevalence HCV infection in Dialysis Unit Gracanica was 46.5 %. The most number of HCV positive patients were in age of 40-49 years 40.7 % or (11/27 patients). The more often HCV positive patients were male 59.3 % or (16/27 patients). In group of anti-HCV positive patients, in 85 % (23/27) have detected HCV RNA. It means that 39.60 % patients in Hemodialysis Unit Gracanica have chronic HCV infection, but 6.80 % patients had past infection. Receiving of blood transfusion, as risk factor, for HCV infection were more often found in group anti HCV + patients (81.5 %) than in group anti-HCV negative patients (51.6 % patients). The length of dialysis therapy were longer in group anti HCV + patients and it was 6.8 years than in group of anti-HCV negative patients that was 1.6 years. HCV infection was not associated with significant biochemical parameters of liver lesion or with manifested clinical symptoms in the time of this study. CONCLUSION The observed Unit for Hemodialysis can be concerned as unit with high prevalence of HCV infection. It is courage fact that there was no new registered HCV seroconversion since beginning of work this unit until time of this study. Implementation of general and specific measures for prevention of HCV infection and introduction of regular control can decrease risks for HCV infection inside hemodialysis unit.

UNLABELLED Meningococcal disease is the most significant cause of morbidity and mortality even in the most developed socio-economic surroundings. Meningococcal sepsis and meningitis are caused by Neisseria meningitidis (NM), which is surrounded by polysaharide capsule, which is the main factor of virulence. THE GOAL OF THE WORK was to confirm the frequency and characteristics of meningococcal disease as well as the justification of introducing vaccination. Through retrospective analysis of the history of the disease, a total of 87 patients with meningococcal sepsis hospitalized at the hospital for infectious in Tuzla in the period 1995 to 2004. diseases were included. Out of 87 hospitalized patients, 34 patients (39%) had meningococcal sepsis, meningococcal sepsis and meningitis had 50 patients (57.6%), and only 3 patients (3.4%) had only meningitis. The diseases most frequently appears in males, 54 patients (62.0%), and in females, 33 patients (38.0%). The largest number of diseased is in the period 0-12 months, 39 patients (44.8%), and then in the period from 13-24 months, 19 diseased (21.8%), from 3-6 years of age 12 patients (13.8%), after sixth year of age meningococcal disease appears in a smaller percent. The youngest patient was 3 and a half months old, and the oldest was 23 years old. Diagnosis was established based on the history of the disease, clinical examination, lab researches, biochemical and bacteriological search of liquid. Etiological cause was proved through liquor culture in 24 cases (27.5%), hemoculture in two cases (2.29%). Death was the result in eight cases (9.1%), one patient (1.1%) resulted in the amputation of a finger, and the rest of 78 patient (89.6%) are cured without sequel. Patients are treated with the Penicillin G, Ampicillin, and in a case of the resistance, were treated with cephalospores of third generation. CONCLUSION the meningococcal disease, and especially its form of Waterhause-Friderichsen syndrome represents a hard disease which in 50% of cases has a death as the result.

The adults died more frequents from the diseases that could be prevented by vaccinae. To data from WHO HBV infection numbers the nineth place on the list for causes of death. The paper from 1980 proved that chronic HBV carriers have 5-100 folds higher risk for liver carcinoma than noninfected persons lived in the same areas and had the same occupations. In the group of higher risks for HBV infection the medical employees are on the first place. The aim of our paper was to show the high risk of HBV diseased at the Clinic of infectious Diseases and to point HBV vaccina in relation to prevention of HBV infection and HBV chronical carriers. During 2002 we've tested on markers of HBV et HCV all employees of the Clinical Center and among them 84 persons of the Clinic of Infectious Diseases in Tuzla. Tests were done by ELISA in the Department of Transfusiology in University Clinical Center in Tuzla. From total 84 persons 41 (56.9%) were vaccinated before and at 17 (23.6%) the seroconversion weren't done. They most receive 1 booster-dosis. The others with negative markers of HBV were 30 (35.7%) vaccinated by "Engerix B" vaccina (GlaxoSmithKline), that we're had in the beginning of our project. 27 persons (32.0%) have been in contact with HBV virus during the long term duty in the Clinic. They've had HBs antibodies. At 3 (4.1%) members of medical employees that were recovered from severe HBV diseases after accidental injury by winkles the seroconversion HBsAg to HBs antibodies were happened. Among the to have been in contact with HBV virus proved the true of high risk of diseased from hepatitis in the Clinic of Infectious Diseases.

INTRODUCTION Acute infectious diarrhea is a global health problem especially in infants and children, and is a leading cause of morbidity and mortality. The ethiology of acute infectious diarrhea and also biochemical, epidemiological and clinical characteristics of children dying with infectious diarrhea are investigated in this study. METHODS 201 children, aged from 6 months to 14 years, with acute infectious diarrhea admitted to the Infectious Diseases Clinic in Tuzla in the period from 21st December 1999 to 21st December 2000 were included in the study. RESULTS Enteropathogens were identified in stool samples in 103 (51.3%) of 201 examined children. Viruses were identified in 51 (25.4%) cases, bacteria in 44 (21.9%), fungi in 3 (1.5%), and parasites in 2 (1%). Rotavirus, a frequent pathogen, was detected in 48 cases (23.9%), followed by Salmonella species in 20 (10%), EPEC in 10 (4.9%), and Shigella species in 9 (4.5%) cases. In this study the authors noticed that the highest morbidity was recorded in children in the first 2 years of life (70.5%), and among rural community (68.4%). The detection of rotavirus decreased with increasing age of cases and peaked in winter and autumn. Blood in stool was most common in children with shigellosis (22.2%). CONCLUSIONS High percentage of infants and children dying with acute infectious diarrhea presents a serious socio-economic and medical problem in Tuzla region of Bosnia and Herzegovina. Rotavirus is the single most common pathogen in children with infectious diarrhea.

Early transition from parenteral to oral antibiotic therapy switch therapy play a major role in treatment because of adverse reactions of long parenteral therapy. In the prospective, comparative and randomized clinical study the efficacy of two treatment regimens were analyzed: XICLAV (amoxicillin + clavulanic acid): parenteral regiment with early transition to oral therapy and parenteral regimen in patients with bacterial infections without transition to the oral dosage form, on the other hand. In our study we've analyzed 240 hospitalized patients in the Clinic of infectious Diseases in Tuzla and Sarajevo too, so in the Institution for infectious diseases in Zenica. The mean age of our patients was 39.6 years, 70.8% females. The major (50.5%) patients had urinary or respiratory tract infectious (bacterial pneumonia 38.8%) but several patients have had skin infections and sepsis. The first 120 patients were initially treated by Xiclav administered parenterally i.v. (adults at a dose of 3 x 1.2 gr i.v.; the children at a dose of 3 x 30 mg/kg) with early oral switch therapy (adults at a dose of 3 x 625 mg per os; the children at a dose of 3 x 25-50 mg/kg); whereas the others (120 patients) were treated parenterally by the regimen mentioned above. The mean length of i.v. therapy and hospitalization in the i.v. group was 4.12/10.21 days respectively (p > 0.05). The clinical efficacy switch of both therapeutic regimens was comparable. The resolution of all clinical symptoms and laboratory signs of infections was noted at 69% patients of both groups, with significant improvements at noted at 69% patients of both groups, with significant improvements at 21% patients and at 10% patients showed clinical failure. The tolerability of Xiclav was very good. The adverse reactions during treatment were observed at 5.2% patients. This study noticed satisfied clinical and bacterial efficacy so did tolerability of Xiclav in the treatment of bacteriological infections. Xiclav apply early transition from parenteral to oral therapy.