Introduction: Sarajevo is the capital city of Bosnia and Herzegovina, with the population in Canton Sarajevo of 438,443 people. The first cases of COVID-19 in Canton Sarajevo were on 20th March. On that day, we had three positive cases. These days at the beginning of the COVID-19 epidemic in Canton of Sarajevo around 2500 citizens were in self-isolation at home. The aim of this paper is to show the journey of Canton Sarajevo in the fight against COVID-19 infection, the impact of measurements that were taken to stop the infection spreading and to compare pre- and post-lockdown stats.Methods: During the period March-July 2020, we have analyzed daily newly cases and followed them through the period of at least 14 days. All data were analyzed using SPSS 25.0 (IBM Corp. Released in 2019. IBM SPSS Statistics for Windows, NY: IBM Corp.) and MS Office 2019 suite (Excel). For comparison, we have used the Chi-square test.Results: In the period of 10 weeks from the beginning of March to the 25th of May in Canton of Sarajevo, we had a total of 113 cases of COVID-19 infection. The number of conducted tests was 7515. In total, with positive retests, we had only 161 positive tests, which is 2.14% of all analyzed tests. From that number of patients, 58 (51.3%) were male and 55 (48.7%) were female. Regarding age distribution, under 65 years were 91.1% of patients.Conclusion: Choosing the best method to fight against COVID-19 is hard to determine. Staying at home would decrease the infection rate, but in the long term, it is not sustainable. Perhaps the mix of methods that we had in Sarajevo is the best option. Fighting against one epidemic cannot be the source for other epidemics.

Introduction: Although sense of security in mothers is not clearly specified in literature, most important factors that make it up in women that do not have issues in pregnancy are social support, prenatal health care and partner’s support. Psychological factors play a key role in recognizing fear of childbirth, distinguishing anxiety from clinical depression. Recognizing risk factors and adequate intervention support would significantly reduce fear. Aim: to analyze development of mother’s sense of security during the postnatal period and establish the differences between two study groups. Methods: The Cross section study was conducted in 2017 in the Public Institute for Health care Protection of Women and Maternity in Canton Sarajevo. Using random method in the study were included 395 mothers. The research instrument was PPSS-instrument and modified questionnaire. Results: Postnatal sense of security in n=395 of the mothers on average was 49, 61±7, 6. Mothers’ sense of security during the first week after their child’s birth differed significantly (p=0.004) between mothers whose husband actively participated in psychophysical preparation for childbirth. Development of parents sense of security is in direct connection with psycho-physical preparations of pregnant women for labor only when both partners took active part in preparations for labor. Conclusion: Postnatal sense of security in parents is a term that has not been researched enough and it requires further studies. Bachelor degree in health care/graduated nurse/midwife, especially in primary health care field, according to her competencies would be able to independently create and work on promoting prevention programs through holistic approach with individuals and families.

Introduction:Total hip endoprosthesis is one of the most frequent and effective methods that are used in the treatment of progressive degenerative hip changes. After the implantation of total hip endoprosthesis, patients perception on their postoperative improvement and health has big role in their contentment and thus in the success of the surgical procedure. The aim of this survey is to examine whether there are differences in the quality of life of people in third age before and after the implantation of total hip endoprosthesis.Material and methods:The survey included 100 examinees in the third age, above 65 years, of both genders, with the disease of hip joint that had been treated at the Clinics for orthopaedics and traumatology of UKCS by implanting the total endoprosthesis. The examinees were questioned before the surgery and after implanting the total hip endoprosthesis. The survey has covered the period from 1st January 2014 till 31st December 2016. As an instrument tool in the survey well validated SF-36 questionnaire for the estimation of life quality and total health status was used. Results: Evaluating all the elements in SF-36 questionnaire it was determined that statistically significant improvement of all the life quality elements that this questionnaire measured was detected, after the conducted surgery compared to the state before the surgery, p=0.001. Statistically biggest improvement has been detected in limitations that happened because of physical and emotional issues, and then in those that were related to physical and social functioning (p=0.001). Body pains and vitality are also statistically significantly better after the conducted surgery (p=0.001). Conclusion:Out of the results of the survey it derives that the quality of life of the people in third age is significantly better after the surgery of implanting the total hip endoprosthesis.

Introduction: The dietary supplements are defined as vitamins and minerals or herbal products and are typically given in the form of a capsule or tablet. The nonsmokers are more attempted to use dietary supplements than individuals who smoke. Aim: In our investigation, we examined associations between vitamin B, folic acid, multivitamin or mineral intake among the student population and their correlation with smoking prevalence and drinking coffee. Materials and methods: We used a questionnaire to examine the general characteristics of the subjects, age, sex, their lifestyle, cigarette smoking, coffee intake and their use of dietary supplements. Data were collected from participants of the University of Sarajevo and a longitudinal study of 960 men and women aged 18-24 years from 2017 to 2018 was conducted. Results: The results showed that 32% of students took vitamin B supplements and 10% folic acid. In opposite, more than half of students took multivitamins (59.5%) and minerals (60.4%) less than one year. About a quarter or less took multivitamins (23.9%) and minerals (24.3%) for years. Less than 20% of students took multivitamins and minerals within a period of one year. In student population smoking prevalence was estimated at 21.2% and coffee intake in 71.2%. The smoking and use of vitamin B supplements were independent of each other, p = 0.201. The use of folic acid did not depend on smoking p = 0.501. There were no observed correlations between multivitamin and mineral supplement consumption compared to smoking status or drinking coffee. Conclusion: Deficient dietary intake of folic acid and B vitamins from food and supplemental sources appear to be one of the atherosclerosis incidences. Further studies should examine associations between dietary supplements intake and lifestyle of students, as well as smoking status and coffee intake.

Introduction: Dietary supplements are an important source of vitamins and minerals that may help prevent several disease-causing biological pathways involved in one-carbon metabolism, including the suppression of cell proliferation, oxidative stress, nitric oxide synthesis, and angiogenesis. The present study aimed to assess the association between the intake of folate, Vitamin B6, Vitamin B12, and minerals and the consumption of alcohol among university students. Methods: This study was participated by students aged 19-22 years from the University of Sarajevo between 2017 and 2018. Using a questionnaire, we interviewed in a week them to collect information regarding age, socio-economic status, alcohol consumption, and dietary supplement intake. Then, we investigated the association between the baseline intake of folate, B vitamins, and minerals and that of alcohol consumption. Results: Most students consumed Vitamin B supplements (32%) and folic acid (10%). Dietary multivitamins and minerals were less prevalent in more than a year, accounting for 186 (23.9%) and 174 (24.3%) students, respectively, than those in less than a year. In a year, <20% of students consumed multivitamins 129 (16.6%) and minerals 116 (15.3%). Meanwhile, 256 (27.1%) students consumed alcohol. The Chi-square test of independence showed that drinking habits and the intake of such dietary supplements had no association (p > 0.05). Conclusion: An extremely low percentage of the participating students in Canton Sarajevo used dietary supplements of Vitamin B, folate, multivitamins, and minerals. Moreover, alcohol consumption and dietary supplement intake were not associated. Further research is needed to establish the best cost-effective public health system to achieve a sufficient intake of dietary supplements.

Introduction: Shoulder pain is the most common form of extra-articular rheumatism. We aimed to determine the efficiency of the conventional physical treatment of the shoulder pain compared to the conventional treatment plus the Mulligan's joint mobilization technique and acupuncture. Methods: We included a total of 277 patients with the shoulder pain caused by adhesive capsulitis (frozen shoulder), calcific tendinitis, rotator cuff syndrome, or the tendinitis of the biceps muscle. We used clinical and radiological diagnostic criteria to make the diagnosis. Patients were assigned into group treated with conventional physiotherapy treatment during the ten days (CP)(n=148), and the group treated with conventional physiotherapy treatment plus the Mulligan joint mobilization and acupuncture (CP+MA)(n=128). Treatment efficiency was evaluated by assessing the status of the patients before and after the treatment with the Work Abilities and Activities of Daily Living (WAADL) scale as well as the Treatment Success scale. Results: Mean treatment duration was 13.36±5.83 and 10.86±4.55 days in CP and CP+MA group, respectively (p<0.05). Mean WAADL scores after the treatment were 3.98±1.04 and 4.61±1.10 in CP and CP+MA group, respectively (p<0.05). Mean Treatment success score was 3.16±0.74 and 4.35±0.78 in CP and CP+MA group, respectively (p< 0.05). Conclusions: Conventional physical therapy plus the Mulligan's joint mobilization technique and acupuncture resulted in shorter treatment duration and higher WAADL and Treatment success scores in patients with shoulder pain.

Introduction: Unhealthy behavior such as neglecting to brush and floss, using tobacco and alcohol, and inadequate nutrition can adversely affect dental health. The frequency of dental visits is also of great importance in the early detection of different oral disorders. Our aim was to assess oral health behavior and attitudes among students of the 1st year of  two health and non-health oriented studies of University of Sarajevo. Methods: We included 119 students of the 1st year of Faculty of Health Studies and 108 students of the 1st year of Faculty of Architecture of the University of Sarajevo. A self-administered questionnaire was used, comprising demographic data, data on oral hygiene habits, dental attendance pattern, a number of extracted teeth as well as problems with the appearance, comfort, and social life due to teeth problems. Results: Faculty of Architecture students significantly more often visit their dentist (χ2 = 24.174, df = 5, p = 0.00). Faculty of Health Studies students have significantly more extracted teeth (χ2 = 35.54, df = 4, p = 0.001). Dental health habits were significantly better at the students Faculty of Architecture (χ2 = 16.391, df = 2, p = 0.001). No significant difference between the groups about about avoiding encounters due to teeth and dentures problems. Conclusion: Oral health related attitudes may be better in students of non-health oriented studies, however, these results have to be confirmed by more investigations and larger studies.

Introduction: Chronic dermatitis is a major sociomedical issue still being marginalized due to generally accepted view that skin diseases are less of a health problem than is the case with diseases of other organs and organ systems for they are not life-threatening. Measurement of quality of life of persons suffering from psoriasis could become an important factor in assessing the success of treatment and modern aspect of integration of the diseased into the planning of therapeutic procedures, monitoring of their outcomes and improving the quality of treatment. Aim: To determine the quality of life and the degree of depression of persons with psoriasis, as well as to make a correlation between the two. Patients and methods: A descriptive and analytical study of cross-sectional character has been performed. The sample consisted of N = 56 respondents with medically verified diagnosis of psoriasis that was treated at the Clinic for Skin and Venereal Diseases of the Clinical Centre of the University of Sarajevo. Criteria for involvement of participants: respondents are to be over 18 years of age with verified medical diagnosis of psoriasis, and to voluntarily consent for inclusion in the research. The research instruments consisted of standardized questionnaires: the WHO-BREF Quality Questionnaire and the Beck Depression Inventory. Results: Median value of scores relating to quality of life of persons with psoriasis from our sample was highest in the domain of social interaction and amounted to 72 (51.50-81.00); the domain of physical health was 63 (39.50-75.00); the psychological condition was 63 (44.00-75.00); and the environmental domain was 63 (44.00-73.50). Depression of persons with psoriasis showed correlation with domains of quality of life. The depression proved correlated with the respondents’: physical health (rho = -0.793 p = 0.0001); psychological health (rho = -0.842 p = 0.0001); social interactions (rho = -0.598 p = 0.0001); as well as with attitude towards the environment (rho = -0.709 p = 0.0001). Gender, age, education, marital or employment status did not prove statistically significant for influencing occurrence of the depression. Conclusion: Given that median scores of all four domains of the quality of life of persons suffering from psoriasis were in the higher half of classification scale, the quality of their life can be considered as satisfactory. The degree of depression and the domain of quality of life are in negative correlation with psoriasis.

Introduction: Currently, there is a growing interest in alcoholism-related studies among healthcare community. Cigarette smoking is five times more prevalent among adult men compared to women but these gender differences have been decreasing among young people. In developed countries, harmful effects of sedentary lifestyle and physical inactivity have led to increased rates of obesity in young population. The main aim of this study was to explore the lifestyles of students at the University of Sarajevo. We investigated the prevalence of cigarette smoking and alcohol consumption, eating habits, and physical activity in this student population. Methods: Students from Faculty of Health Sciences [FHS], Faculty of Political Science [FPS], and Faculty of Traffic Engineering and Communications [FTEC]) voluntarily participated in this questionnaire-based study. We surveyed a total of 410 students. Results: On average, 21.8% of participants consumed cigarettes (a significantly higher number of those who smoked cigarettes was in FPS group). The highest number of students who reported physical activity (recreational or active sport) was in FTEC group (66.5%), and the difference was statistically significant compared to FHS (48.2%) and FPS (51.9%) groups. Over 60% of participants in all three groups experienced stress occasionally. The majority of students in three groups consumed fast food while at campus. The highest number of students in all three groups reported to drink water compared to other drinks. Conclusions: Our results indicate that the lifestyles of university students in Sarajevo are subject to concern. Frequent alcohol consumption and cigarette smoking are typical examples of behaviour that should be reduced through educative programs and workshops.

Introduction: Dehydration develops when the body fluid losses exceed fluid intake. It may occur during exercise, heat stress, restricted fluid intake, or any combination of these. Marginal dehydration (loss of > 2% body weight) can compromise aerobic exercise performance, particularly in hot weather conditions, and may disturb fluid and electrolyte balance. The aim of the study was to determine the quantity, type and dynamic of fluid intake during athletic performance in endurance sports (football and basketball) in two age categories: juniors (under the age of 18) and seniors (over the age of 18).Methods: Research included 100 athletes playing in Premier League in Bosnia-Herzegovina. We formed groups by sport type (football and basketball) and age (<18 and ≥18 years). Questionnaire with questions about the fluid intake habits was used for data collection.    Results: There were 53 football players and 47 basketball players. All the participants were male. Average age of the participants was 19.3 ± 4.58. Habit of weighing before and after training was present in less than 44% of players among all the groups. Seniors were more frequently measuring their weight compared to junior players (p=0.01). Basketball players and players younger than 18 years were most frequently taking more than 2L of water per day. Most of the players, regardless of sport type or age group were not taking at least ½ L of isotonic fluid before the training. Signs of dehydration were more frequently observed in players under 18 years old, with most frequent sign being dry throat and sudden fatigue.Conclusion: Water and electrolytes intake before, during and after training of the athletes were inadequate regardless of type of sports and the age of athletes.

Introduction: Depression is the most common mental problem in elderly and is often under-recognized or is inadequately treated, thus significantly affecting the quality of life of elderly people. The reasons for the occurrence of depression in the elderly are multiple. The most common are neurobiological and psychosocial risk factors as well as physical illness. The aim of this study is to determine the presence of the most common risk factors related to the degree of depression, determined by the geriatric depression scale.Methods: This is cross-sectional, descriptive and analytical study undertaken on the sample of 150 psychologically and physically capable residents of the "The Gerontology Center" in Sarajevo older than 65 years. The following instruments were used for research: the Geriatric Depression Scale (GDS) and the modified questionnaire on risk factors important in the depression development.Results: Women are more depressed than men (p<0.01). Depression severity increases with age (p=0.008). The marital status of respondents was significant factor affecting the GDS scores (p=0.009). GDS score and education are weakly correlated (p=0.07) and more educated are less depressed. Also, independently mobile elderly are less depressed (p<0.0005). GDS scores and presence of depression in younger age are dependent (p=0.004). Depression and subjective sleep disturbances are dependent (p=0.002).Conclusion: The most common risk factors for depression in elderly are gender, age, marital status, history of depression in younger age and mobility.

Background Many studies throughout the world show that hypertension is not effectively treated and controlled, which continued to pose an important challenge in health systems in the world. Design and methods Population surveys were carried out in 2002 and 2012 in the Federation of Bosnia and Herzegovina (FBIH) on representative sample at the age of 25-64. The surveys used systematic stratified sample. Questionnaires and anthropometric measure protocols were adapted from internationally recommended surveys. Results In the past ten years there has been a slight increase in hypertension prevalence in researched population (41% vs. 42%). Percentage of hypertensive male and female respondents who are not aware of their hypertension actually dropped in the past decade from 54.3% to 51.4%. In 2002 total number of hypertensive respondents aware of their hypertension included 8.1% of male respondents and 10.3% female respondents whose condition was not treated and this rate effectively dropped during the 10-year period. Number of hypertensive, treated, and uncontrolled respondents dropped as reported in the 2012 survey; consequently percentage of hypertensive, treated, and controlled respondents in the 2012 survey increased, in particular in female population. Conclusions Investments in primary health care, improved availability, and improved quality of health care in the FBIH in the past 10 years can explain increased rate of hypertension detection and treatment; however, efforts should be continued to introduce hypertension screening programs and hypertension control programs. Significance for public health In spite of wide knowledge of pathophysiology and epidemiology in development of hypertension, ability to easily diagnose it, availability of efficient medications, hypertension continues to have high prevalence and setting up hypertension controls poses significant public health challenge. Recently conducted cross-sectional population surveys in the Federation of Bosnia and Herzegovina give us opportunity to follow the trend for hypertension and implement public health measures to reduce or eliminate causes of high blood pressure in population and at the same time with implementation of medical treatment.