AIM In this study, we investigated current knowledge and practice of dietary salt usage in patients treated at Sarajevo University Hospital Center. METHODS In this cross-sectional study, 300 patients were interviewed by use of a questionnaire containing 22 questions. RESULTS One-member and two-member families used mainly 200 grams salt per month, three-member and bigger families used 500 grams salt monthly. Different types of seasoning blend (like Vegeta) were used in quantities of 100 grams in one-member families, and 200-500 grams in bigger families. Considering that a healthy individual takes about 10.0% of salt through natural foods, 75.0% through treated foods and 15.0% by adding salt at the table, we decided to conduct this study by use of a questionnaire. Considering the consumption of salted and smoked meat, there was some variation: 26.0% (mainly one-member families) did not consume this kind of meal at all, whereas 16.6% (six-member families) consumed salted and smoked meat 4 times or more per week; 60.3% of study subjects associated salt with kidney diseases, hypertension, heart diseases, thyroid gland and diabetes. As a food supplement, salt is very important for healthy digestion, regulation of body fluid and nervous system functioning, while as a iodine carrier salt plays an important role in the prevention of goiter. The average quantity of salt for normal population is 6 grams daily, but some authorities suggest less, i.e. 3-4 grams daily. Lower salt means lower risk of hypertension and osteoporosis development. CONCLUSION The average quantity of salt per family member varies and decreases with family growth, but is generally higher than recommended by the WHO. This problem has to be addressed through education, health education and additional research.

Cardiovascular diseases (CVD) are the leading cause of death in developed countries and in most developing countries. They represent an important cause of loss of working ability, invalidity, hospitalization and increase of health care costs. Annually, about 20 million people dies from CVDs, and projections says that by the year 2020 25 million people will be casualties from it. Mortality increase from CVDs will be markedly higher in non-developed than in developed countries, which is due to changes in the population structure, prevalence of risk factor and insufficient preventive activity. Last fifty years morbidity and mortality of CVD in B&H are in increasing and follow trends in countries in transition.

The latter part of the twentieth century has seen an increased concern for the implications of war for civilian populations, and more attention has been given to psychosocial impacts of uprooting and displacement. ‘Loss of place’, acute and chronic trauma, family disruption and problems of family reunification have become issues of concern. The war in Bosnia was characterized by massive displacement, disruption and loss of life, relatives and property. Health and psychosocial well-being were affected in a number of ways. There was an overwhelming loss of perceived power and self-esteem. Over 25% of displaced people, for example, said they no longer felt they were able to play a useful role; even in non-displaced populations approximately 11% of those interviewed said that they had lost a sense of worth. Widespread depression and feelings of fatigue and listlessness were common and may have prevented people from taking steps to improve their situation. Almost a quarter of internally displaced people had a high startle capacity and said they were constantly nervous. Most adverse psychosocial responses increased with age and in a population that includes many elderly people this poses serious problems. The findings point to major challenges with respect to repatriation and reconstruction. They highlight the importance of family reunification and the facilitating of decision-making by affected people themselves. The findings also shed light on potential problems associated with over-dependence on external assistance and hence the need for people to be given the means of using their skills and knowledge to control their day-to-day lives.

UNLABELLED Sudden Cardiac Death (SCD), although all the technical medical developments in diagnostics and therapy is one of the biggest health problems in BH and the world. Incidence rates of SCD ranging between 0.36 to 1.28 per 1000 inhabitants in the general population in Western countries and 1/1000/year in the world. AIM Considering of the incidence SCD in Mostar in 2003 and causes here events. METHODS AND RESULTS With the standard methods of statistics and data regarding of Federal statistical office, the hospitals protocols and Emergency medical services of Mostar, and results of studies in the preventive actions SCD in BH of Association of Cardiologist of Bosnia and Herzegovina and Public Health office of BH made correlation and considered that the incidence SCD in Mostar is 0.42% in the general population or 50.8% all the natural death. The biggest is at people aged after 60 in 82.74%, more in men to women (53.36%). In the 30 deaths of the infarct myocardiac in Clinical Hospital of Mostar in 2003, 16 is sudden death, with 53.33%. Hospital sudden death is most in the women 62.5%. CONCLUSION High incidence of sudden death in Mostar in 4.2/1000/year is results the multifactorial risc factors of coronary artery disease and beggest stress in Mostar in the postwar period especially with administrative regulation of the city.

UNLABELLED: Sudden Cardiac Death (SCD), although all the technical medical developments in diagnostics and therapy is one of the biggest health problems in BH and the world. Incidence rates of SCD ranging between 0.36 to 1.28 per 1000 inhabitants in the general population in Western countries and 1/1000/year in the world. AIM: Considering of the incidence SCD in Mostar in 2003 and causes here events. METHODS AND RESULTS: With the standard methods of statistics and data regarding of Federal statistical office, the hospitals protocols and Emergency medical services of Mostar, and results of studies in the preventive actions SCD in BH of Association of Cardiologist of Bosnia and Herzegovina and Public Health office of BH made correlation and considered that the incidence SCD in Mostar is 0.42% in the general population or 50.8% all the natural death. The biggest is at people aged after 60 in 82.74%, more in men to women (53.36%). In the 30 deaths of the infarct myocardiac in Clinical Hospital of Mostar in 2003, 16 is sudden death, with 53.33%. Hospital sudden death is most in the women 62.5%. CONCLUSION: High incidence of sudden death in Mostar in 4.2/1000/year is results the multifactorial risc factors of coronary artery disease and beggest stress in Mostar in the postwar period especially with administrative regulation of the city.

In the last twenty years, the European office of WHO with its expert groups designated CVD as a problem of top priority in European health policy. The documents of WHO related to CVD, and their directives to member countries, are illustrated in this paper. The authors emphasize that according to available data, CVDs are cause of 40% of total mortality among the European population above the age of 75. In Bosnia and Herzegovina, CVDs are the leading cause of mortality in the last few years. The difference in incidence and prevalence of CVD among European countries is emphasized in the paper. According to the available data of WHO, the greatest incidence and prevalence of these diseases is in East European and Central European countries and the lowest in Mediterranean countries, with the exception of Bosnia and Herzegovina. The evaluation of the present state of frequency of CVD in Europe and the projection of their trends in some countries until 2020 is given in the paper. An alternative projection of the trends of CVD in Bosnia and Herzegovina, including a variant of application of organized preventive programs, is presented in the paper. Illustrative examples of the effects of preventive programs in some European countries, and possibilities of their application in Bosnia and Herzegovina are presented in this paper. Cost analysis of the application of preventive programs and their effects on the reduction of number of people affected by CVD in the short period until 2010 and 2020 is also elaborated in this paper.

The war in Bosnia and Herzegovina, caused by the aggression of neighbouring countries, besides biological destruction and poverty halted every scientific and technological development in all areas, and in medicine, too. This paper presents vital events in population, forced migrations and violent deaths also. A comparative review and state level of medical technology for particular specialist disciplines in B&H is shown for 1995 and 1990. The criteria for the assessment of lagging in technology and health development is the number and structure of specialized staff, state of premises and medical equipment, bioinformatics, etc, with personal estimation of selected number of leading experts in various medical disciplines (Delfy method) about working conditions. The paper presents the assessment of technological lagging in health sector in B&H (average rate of 40.4%) due to the war, related to 1990.

The spontaneous development of the organization and practice of emergency medicine created a number of types of emergency medicine units. Long time, these units were developed in out-hospital institutions such as health centres. Together with these services, all acute hospitals have had full day,s emergency services for definite care of urgent conditions. The authors give principles of this activity organization in the light of expected incidence and severity of urgent conditions related to the number of population which gravitate to particular hospital or other health services. Starting from the assumption that expected frequency of urgent conditions per 100 persons in 24 hours is between 0.50-0.75, the authors present the model of health care organization of such cases including family doctor, health station, health centre, hospital.

The objective of this study was to investigate the impact of almost 3 years of war on glycaemic control and blood pressure in Sarajevans with non-insulln-dependent diabetes mellitus (NIDDM). Fifty-five patients with NIDDM were randomly selected from a register of 279. Data from pre-war records were retrieved and the same measurements were repeated using a similar methodology. These included blood glucose levels, ghycosylated haemoglobin Ale (HbAlc), serum cholesterol and triglycerides. Other measurements included weight, height and systolic and diastolic blood pressure. Information was collected on the prescribed therapy, the availability of drugs and access to medical facilities. Weight was significantly reduced by 11.7 ± 8.2 kg. Sixty per cent of the sample were obese (body mass index (BMI) >30) before the war compared with only 18% afterwards. The percentage of patients with NIDDM with acceptable blood glucose values Increased from 15 to 35%. The values of HbA1c improved significantly but no differences in the total serum cholesterol or in the trigiyceride levels were found. Twenty-five of the participants were hypertensive (BP > 140/90 mmHg) before the war compared with only 14 in 1994–1995. The number of patients controlled without any anti-diabetic medication increased from 3 to 13. The reduction in anti-diabetic drugs and blood pressure probably occurred as a result of the significant weight loss. It can be concluded that glycaemic control and the level of hypertension improved in patients with NIDDM in Sarajevo during the war. These findings have major implications for future policies related to public health.

COLIN SANDERSON, BO J. A. HAGLUND, PER TILLGREN, LEIF SVANSTROM, CLAES-GORAN OSTENSON, LARS-ERIK HOLM, HENRIK ULLEN and ARIF SMAJKIC Health Services Research Unit, Department of Public Health &Policy, London School of Hygiene & Tropical Medicine, London, UK, Department of International Health &Social Medicine, Karolinska Institute, Stockholm, Sweden, Department of Endocrinology, Karolinska Institute, Stockholm, Sweden,Swedish National Public Health Institute, Stockholm, Sweden, Department of Oncology, Karolinska Institute, Stockholm, Sweden and Institute for Social Medicine, University of Sarajevo, Sarajevo, Former Yugoslavia