Introduction: The paper aims to research how the Covid-19 infection affects BPH patients, whether their PSA, prostate volume, residual urine, and quality of life have changed. Additionally, to examine whether any of these variables are a predictive factor for acute urinary retention (AUR). Methodology: The study comprised 80 patients with clinical manifestations of LUTS, an aggravation of previously diagnosed BPH, and who recovered from COVID-19. IPSS, QoL, PSA, prostate volume, and postmicturition residual urine were studied before and after COVID-19. Results: The IPSS score, PSA, prostate volume, and residual urine were signicantly higher after recovering from COVID-19. Additionally, greater IPSS-QoL scores were discovered. Nine patients (mostly older than 60) suffered acute retention during or after the COVID-19 infection. Residual urine was found to be a signicant predictor of AUR. Conclusion: COVID-19 infection is caused by aggravating LUTS symptoms associated with BPH. Consequently, the increase postmicturition residual urine can be considered a predictive factor for the occurrence of AUR

Aim To investigate the prevalence of burnout syndrome among health care workers in the Federation of Bosnia and Herzegovina (FBiH) during the coronavirus disease 2019 (COVID-19) pandemic. Methods This cross-sectional study was conducted in May and June 2021 using an online survey based on Copenhagen Burnout Inventory. The questionnaire underwent forward and backward translation, preliminary pilot testing, and was assessed for reliability and validity. Personal burnout, work-related burnout, and patient-related burnout were assessed. The survey was sent to the members of the Union of Physicians and Dentists in FBIH, who were asked to forward the link to their medical technicians and nurses. Results A total of 77% of participants experienced some form of burnout. As many as 32% experienced all three forms of burnout. Those actively involved in tackling the COVID-19 pandemic more often experienced burnout. In personal and work-related burnout domains, higher level of burnout was reported among female respondents. Higher work-related and patient-related burnout was reported by physicians compared with medical technicians/nurses. Higher level of patient-related burnout was reported in health care workers aged 30-39 and 50-59 years, among respondents working in primary care, and among physicians. Conclusion The majority of health care workers showed moderate or high levels of personal and work-related burnout, with a lower level of patient-related burnout. There is a need for further research into the causes of burnout, as well as for the implementation of organizational interventions aimed to minimize workplace burnout.

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 aim of this article was to report the long-term results of increased ileocystoplasty in 58 patients with spinal cord injury (SCI) with an impact on overall renal function and quality of life. In a representative number of patients, where we followed individual subjects for more than 20 years, we wanted to determine their quality of life and preservation of renal function after surgery. Material and methods After unsuccessful conservative therapy of urinary incontinence, increased ileocystoplasty was performed. In addition to biochemical analysis, intravenous urography (IVU) was performed preoperatively (urography and/or ultrasound assessment of the upper urinary tract) and urodynamic tests were performed in all patients preoperatively. Results After a follow-up of patients within the group (>20 years), 2 patients reported being incontinent. The median elapsed time of action was 20 (13–24) years. Vesical capacity increased in all cases postoperatively when the median vesical capacity was 420.0 (387.5–460.0) ml (p <0.001). Long-term complications included use of bladder chambers, kidney stones and urosepsis. Creatinine clearance confirmed satisfactory renal function after the elapsed time period from surgery. Conclusions The results confirmed that augmentation ileocystoplasty had excellent long-term outcomes in the definitive therapy of refractory neurogenic detrusor overactivity in patients with SCI.

The number of obese and overweight people around the world rapidly grows and takes on epidemic proportions. The aim of this research is to determine the in�uence of body weight on quality of life and to investigate our patients' consciousness about their body weight and its impact on their quality of life. Methods : The cross-sectional study was conducted by interviewing 1067 respondents, using the WHOQOL-BREF questionnaire. Results : Out of 1067 patients, 684 were females. 65.5 % of patients had BMI ≥ 25 kg/m 2 . 21.7% of 699 patients who had BMI ≥ 25 kg/m 2 think that their increased body weight doesn’t affect their health, 27.9 % of respondents think that their overweight is unrelated to physical activity, 41.8 % of respondents have no problems purchasing the clothes due to their weight and 31.6 % of respondents with BMI ≥ 25 kg/m 2 think that it doesn’t affect their quality of life. Conclusion : Quality of life is signi�cantly better in respondents with BMI <25 kg/m 2 . The alarming result is that slightly less than half of respondents think that overweight doesn’t affect their health and don’t understand the seriousness of the problem.

The number of obese and overweight people around the world rapidly grows and takes on epidemic proportions. The aim of this research is to determine the influence of body weight on quality of life and to investigate our patients' consciousness about their body weight and its impact on their quality of life.Methods : The cross-sectional study was conducted by interviewing 1067 respondents, using the WHOQOL-BREF questionnaire.Results : Out of 1067 patients, 684 were females. 65.5 % of patients had BMI ≥25 kg/m 2 . 21.7% of 699 patients who had BMI ≥25 kg/m 2 think that their increased body weight doesn’t affect their health, 27.9 % of respondents think that their overweight is unrelated to physical activity, 41.8 % of respondents have no problems purchasing the clothes due to their weight and 31.6 % of respondents with BMI ≥25 kg/m 2 think that it doesn’t affect their quality of life.Conclusion : Quality of life is significantly better in respondents with BMI <25 kg/m 2 . The alarming result is that slightly less than half of respondents think that overweight doesn’t affect their health and don’t understand the seriousness of the problem.

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.

Background:The number of obese and overweight people around the world rapidly grows and takes on epidemic proportions. Obesity has become one of the leading causes of death although it can be prevented.The aim of this research is to determine the in�uence of body weight on quality of life and to investigate our patients' consciousness about their body weight and its impact on their quality of life. Methods: The cross-sectional study was conducted by interviewing 1067 respondents, using the WHOQOL-BREF questionnaire. Results: Out of 1067 patients, 684 were females. 65.5 % of patients had BMI ≥ 25 kg/m 2 . 21.7 % of 699 patients who had BMI ≥ 25 kg/m 2 think that their increased body weight doesn’t affect their health, 27.9 % of respondents think that their overweight is unrelated to physical activity, 41.8 % of respondents have no problems purchasing the clothes due to their weight and 31.6 % of respondents with BMI ≥ 25 kg/m 2 think that it doesn’t affect their quality of life. Conclusion: Quality of life is signi�cantly better in respondents with BMI <25 kg/m 2 . The alarming result is that slightly less than half of respondents think that overweight doesn’t affect their health and don’t understand the seriousness of the problem.

Higher education students comprise a particularly vulnerable group for the development of anxiety symptoms and disorders. The aim of our research was to examine the impact of anxiety sensitivity on the success of medical students at the University of Mostar, and to establish the differences between students depending on their sex and the year of study. One hundred students in their first and fifth year of medical school were interviewed using the ASI questionnaire, 7 days prior to their final exams. Here we demonstrate a positive correlation between anxiety sensitivity and academic success. We did not find any significant differences between the first and fifth-year medical students, nor between participants based on their sex. We conclude that anxiety can have a positive impact on the academic achievement of higher education students.

OBJECTIVE The aim of this study was to document the prevalence of degenerative intervertebral disc changes in the patients who previously reported symptoms of neck pain and to determine the influence of education level on degenerative intervertebral disc changes and subsequent chronic neck pain. METHODS One hundred and twelve patients were randomly selected from the University Hospital in Mostar, Bosna and Herzegovina, (aged 48.5±12.7 years) and submitted to magnetic resonance imaging (MRI) of the cervical spine. MRI of 3.0 T (Siemens, Skyrim, Erlangen, Germany) was used to obtain cervical spine images. Patients were separated into two groups based on their education level: low education level (LLE) and high education level (HLE). Pfirrmann classification was used to document intervertebral disc degeneration, while self-reported chronic neck pain was evaluated using the previously validated Oswestry questionnaire. RESULTS The entire logistic regression model containing all predictors was statistically significant, (χ2(3)=12.2, p=0.02), and was able to distinguish between respondents who had chronic neck pain and vice versa. The model explained between 10.0% (Cox-Snell R2) and 13.8% (Nagelkerke R2) of common variance with Pfirrmann classification, and it had the strength to discriminate and correctly classify 69.6% of patients. The probability of a patient being classified in the high or low group of degenerative disc changes according to the Pfirrmann scale was associated with the education level (Wald test: 5.5, p=0.02). Based on the Pfirrmann assessment scale, the HLE group was significantly different from the LLE group in the degree of degenerative changes of the cervical intervertebral discs (U=1,077.5, p=0.001). CONCLUSION A moderate level of intervertebral disc degenerative changes (grade II and III) was equally matched among all patients, while the overall results suggest a higher level of education as a risk factor leading to cervical disc degenerative changes, regardless of age differences among respondents.

Education means: learning, teaching or the process of acquiring skills or behavior modification through various exercises. Traditionally, medical education meant the oral, practical and more passive transferring of knowledge and skills from the educators to students and health professionals. Today the importance of focus on educational quality, particularly in the professions operating in the services required by people is agreed by all involved. The higher educational system shoulders some critical responsibilities in the economic, social, cultural and educational development and growth in the communities. In countries that are in transition it is in charge of educating professional human workforce in every field and if the education is optimal in terms of quality, it is capable of carrying out its responsibilities. It is reason why there is the necessity behind discovering some strategies to uplift the quality of education, especially at university level.. By increasing the courses and establishing universities and higher education centers, the countries around the world have generated more opportunities for learning, especially using modern information technologies. Regarding to evaluating different educational services quality, one of the most important measures should be the way to develop programs to promote quality and also due to the shortage of resources, evaluating the services quality enables the management to allocate the limited financial resources for realization whole educational process. Advances in medicine in recent decades are in significant correlation with the advances in the new models and concepts of medical education supported by information technologies. Modern information technologies have enabled faster, more reliable and comprehensive data collection. These technologies have started to create a large number of irrelevant information, which represents a limiting factor and a real growing gap, between the medical knowledge on one hand, and the ability of students and physicians to follow its growth on the other. Furthermore, in our environment, the term technology is generally reserved for its technical component. This terminology essentially means not only the purchase of the computer and related equipment, but also the technological foresight and technological progress, which are defined as specific combination of fundamental scientific, research and development work that gives a concrete result. The quality of the teaching-learning process at the universities in former Yugoslav countries and abroad, depends mainly of infrastructure that includes an optimal teaching space, personnel and equipment, in accordance with existing standards and norms at the cantonal or entity level, which are required to implement adequately the educational curriculum for students from first to sixth year by Bologna studying concept. For all of this it is necessary to ensure adequate funding. Technologies (medical and information, including communications) have a special role and value in ensuring the quality of medical education at universities and their organizational units (faculties). “Splitska inicijativa” project, which started 6 years ago as simple intention to exchange experiences of application new model of education, based on: Bologna studying concept, and other types of under and postgraduate education, was good idea to improve also theory and practice of it within Family medicine as academic and scientific discipline. This year scope of our scientific meeting held in Sarajevo on 24th and 25th March 2017, was quality assessment of theoretical and practical education and, also, evaluation of knowledge by students exams (a-y).

Objective: The present study aimed to assess the frequency of workplace violence from patients and patients’ relatives and friends experienced by health care workers. Method and Design: A descriptive cross-sectional study included health care workers from hospital departments and family medicine practices. Data were collected during December 2016 using a self-administered, anonymous questionnaire. Out of 163 distributed questionnaires, 138 (84.7%) were returned suitable for analysis. Participants: Respondents were health workers in the Department of Family Medicine of the Health Care Center Mostar, the Department of Gynaecology and Urology at the University Hospital in Mostar, and the Department of Psychiatry at Cantonal Hospital in Mostar. Results: Some form of aggression at work was experienced by 79.7% of respondents. Verbal aggression was more frequent in the Family Medicine Department, while physical violence was more prevalent in hospital settings, specifically in the Psychiatry Department. Physical forms of aggression were significantly more frequently experienced by nurses than by physicians.

Background. Medication nonadherence is a fre- quentprobleminthetreatmentofchronicconditions. Objective. To study the adherence to pharmacologi- cal treatment of chronic nonmalignant pain, as well as factors and patient attitudes related to nonadher- ence in patients aged 65 years. Methods. The cross-sectional study was conducted with a self-administered questionnaire among 100 patients aged 65 years by five family physi- cians at the Health Care Centre Mostar, Bosnia and Herzegovina. Results. According to their own statements, 57% of the patients were nonadherent, while 84% exhi- bited some form of nonadherence on the Morisky scale. The patients reported a mean pain intensity of 6.6 2.2 on a visual analog scale. The most common deviation from the prescribed therapy was self-adjustment of the dose and medical regimen based on the severity of pain. Polymedication cor- related positively with nonadherence. Nonsteroidal anti-inflammatory drugs were the most frequently prescribed medications. The majority of the partici- pants (59%) believed that higher pain intensity indi- cates progression of the disease, and half of the participants believed that one can easily become addicted to pain medications. Nonadherence was associated with patient attitudes about addiction to analgesics and ability of analgesics to control pain. Conclusion. High pain intensity and nonadherence found in this study suggest that physicians should monitor older patients with chronic nonmalig- nant pain more closely and pay more attention to patients' beliefs regarding analgesics to ensure better adherence to pharmacological therapy.