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D. Avdić, Amila Jaganjac, Amila Kapetanović, A. Hadžiomerović, A. Pilav, B. Katana, B. Pavlović

Introduction: A number of people with facial injuries after surgical treatment one knee time comes and a violation of the opposite knee. These injuries have a major impact on quality of life if they are not treated properly, but also have consequences and after surgery. The aim of this paper is to analyze the questionnaires used to assess the quality of life after mutual ruptured anterior cruciate ligament, and to make recommendations for optimal use of the same. Our goal is to establish a correlation between the results obtained from questionnaires used descriptive answers to questions descriptive questions about aspects of everyday life, aspects of physical activity as well as aspects of personal perception of the current health and satisfaction with it. Methods: We analyzed questionnaires used to evaluate the quality of life after a bilateral rupture of the anterior cruciate ligament, which are listed in the attached work. In accordance with the subject of research, in this paper were used the following scientific research methods: a method of deduction, analysis, classification, comparison, analysis methods of written documents. Results: By searching the PubMed database for the purpose of this master's thesis under the terms "unilateral rupture ACL" we came across a 2792 articles, while the term "bilateral rupture of the ACL," retrieved only 73 articles, "contralateral ACL rupture" 192 articles, "Quality of life ACL "  41 articles. The most important dates in our study are certainly "Quality of life after bilateral rupture of the anterior cruciate ligament," where we all find only two articles on this topic. Conclusion: The most commonly used questionnaires to be used in assessing the success of treatment and quality of life after a bilateral rupture of the anterior cruciate ligament are: QOL, IKDC, KOOS, HSS, ADL, SF-36, WOMAC. IKDC proved to be most suitable for patients with ACL rupture in this study.

Introduction Disability is one of the factors that can lead to social exclusion and poverty of individuals with hearing and speech impairment. This is due to the fact that individuals with disabilities are often underestimated, in terms of their work and social skills. The employment of people with disabilities represents a powerful mechanism for achieving full participation of the marginalized groups in all spheres of society. Methods The study included a total of 40 people with hearing and speech disabilities, out of which 16 individuals were employed at DES d.o.o. Sarajevo and 24 at SINKRO d.o.o. Sarajevo. A combination of three questionnaires was used for assessing daily activities and their impact on the quality of life (QoL) of the individuals with hearing and speech disabilities. Results In the total sample, there were 35% males and 65% females. Complete deafness was observed in the majority of participants (90%), while the rest had either moderate (7.5%) or mild (2.5%) hearing impairment. A higher number of participants used sign language as the means of communication, compared to manual alphabet. About 17.5% of the participants used a cochlear implant or a hearing aid. Most of the individuals lived with a spouse (70%), 20% lived with their parents, 7.5% lived independently, and 2.5% lived with a guardian. The majority of the participants who were married had a child (57.5%). The average Ferrans and Powers' Quality of Life Index (QLI) was 19.33, and the average value for total daily activities was 11.700 MET. The average value for the level of physical activity in males was M = 13716.5 and in females M = 10613.56 (p > 0.05). Conclusions Overall, we showed that daily activities have a positive effect on the QoL of working individuals with hearing and speech disabilities, i.e., the individuals who had a higher level of physical activity also had a higher QoL.

Emira Švraka, Muris Pecar, Amila Jaganjac, A. Hadžiomerović, Eldad Kaljić, A. Kovačevic

Introduction: Osteoarthritis of the joints (osteoarthritis or arthritis) represents the largest group of rheumatic diseases. Within rheumatic diseases 50% are degenerative rheumatic diseases, 10% inflammatory and 40% extra-articular. Goal: To determine the modalities of physical therapy for elderly with degenerative diseases. Material and methods: The study is retrospective-prospective and descriptive. The survey conducted included 25 patients with degenerative diseases of the musculoskeletal and nervous systems in Gerontology Center in Sarajevo, from May 1, 2014- April 30, 2015. As research instruments were used: Questionnaire for users of physical therapy in Gerontology Center in Sarajevo, self-developed, visual-analog scale to assess pain and patient records. Results: Of the total number of patients with degenerative diseases (25), 10 (40%) were male and 15 (60%) were female. The most common degenerative disease is knee osteoarthritis which had 11 patients (29%), 3 males and 8 females. From physical therapy modalities in the treatment of degenerative diseases at the Gerontology Center in Sarajevo, kinetic therapy was administered to all patients, followed by manual massage and TENS in 15 cases (60%). From twenty-two patients, who completed a questionnaire, 11 (50%, 2 male and 9 female) rated their health as poor. Seven patients (32%, 3 male and 4 female) assessed their health as good. Three patients (14%, 2 male and 1 female) rated their health as very poor, and one patient (4%, 1 male) rated its health as very good. Conclusion: The Research Physical therapy in elderly with degenerative diseases is a pilot project, which highlights the need for: Conducting research for a longer time period, with a larger sample; Quality of keeping health records; Implementation of a continuous evaluation of functional status and; Stricter control for optimal effectiveness of physical therapy in order to improve the quality of life of elderly patients.

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.

Purpose: Quality of life (QOL) is an important area of research in many scientific disciplines, and the findings could help in designing strategies to improve QOL for various clinical conditions. Chronic low back pain is a frequent medical condition that has a detrimental effect on QOL. The goal of this study was to examine the QOL of people with chronic low back pain in Bosnia and Herzegovina (BIH), and to assess the impact of demographic variables such as age and gender on the QOL. Methods: The study sample consisted of 50 people with low back pain, between 19-79 years of age (mean age 51.2, SD- 13.1 years). There were 35 females (70%) and 15 males (30%) in the sample. The instrument used for measuring the QOL was World Health Organisation Quality of Life scale BREF (WHOQOL BREF). Results: The study demonstrated that low back pain has a detrimental effect on QOL. There was a significant effect of age and gender on certain domains of QOL. Conclusions: Older age is a risk factor for lower QOL of people with chronic low back pain. Females are more likely to have lower scores on the psychological domain of QOL,and therefore need effective psychological interventions aimed at improving their QOL.

Introduction: Osteoporosis is a skeletal system disease characterized by decline of bone mass and deterioration of bone microarchitecture, which leads to increased bone fragility and, consequently, a greater risk of fractures. Postmenopausal osteoporosis generally occurs between 51 and 75 years of age following ovarian failure. Our aim was to investigate if specific lifestyle habits, i.e., smoking cigarettes and physical activity, as well as the intake of dietary supplements, affect bone mineral density (BMD) in postmenopausal women.Methods: Ultrasound (US) and dual energy X-ray absorptiometry (DEXA) data, obtained between 2008 and 2009 year, were retrospectively reviewed for 150 women in postmenopause, 50-65 years old, who live in Sarajevo Canton. The women were classified into two groups: Group A (75 postmenopausal women who underwent US of the left heel bone); control group B (75 postmenopausal women who underwent US of the left heel bone and had a DEXA scan of the lumbar spine and left hip).Results: The study included 150 women with the average age of 55.39 years. In the total sample, 24.7% of women took calcium and vitamin D supplements, and no statistically significant difference was observed between the groups. In the total sample, the prevalence of osteoporosis was significantly different between smokers and nonsmokers; i.e., osteoporosis was more frequent in women who smoked cigarettes. On average, women in both groups reported low physical activity; the difference was not statistically significant.Conclusions: Menopause is a known risk for osteoporosis. Our results showed that the length of menopause is closely associated with osteoporosis occurrence.

D. Avdić, Amila Jaganjac, Arzija Pašalić, Fatima Jusupović, Amila Kapetanović

Substantial changes have occurred in the nutritional management of many diseases in the last twenty years. Introduction of standards, clinical review and implementation of evidence based practice led to re-evaluation of some established dietary interventions. The most common form of osteoporosis is the primary osteoporosis, which is the result of the bone loss and deterioration of bone structure, as people age. Bone loss and osteoporosis can be prevented through adequate nutrition, physical activity, and, if necessary, appropriate treatment. This review will focus on nutritional and clinical aspects of bone tissue homeostasis, with references to physiological and pathophysiological processes.

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.

Amila Jaganjac, B. Katana, Samir Bojičić, A. Hadžiomerović, D. Avdić, Emira Švraka, M. Majstorović

Introduction: Rheumatic diseases are nonsurgical diseases of the locomotor system and connective tissue. Rheumatoid arthritis (RA) is a systemic inflammatory disease of connective tissue of unknown cause, with progressive chronic or subacute course. The aim of the research is to determine whether stationary spa treatment leads to improvement of the functional status in patients with rheumatoid arthritis. Methods: We included 35 patients with diagnosis of rheumatoid arthritis, referred for treatment at the spa " Ilidža " Gradacac from February to April 2014. Patients not adhering to treatment protocols were excluded. We used Visual analogue pain scale (VAS), HAQ questionnaire and assessment of the clinical condition before and after the treatment based on the scores 1-5.Results: There were 32 female and 3 male patients. The average age was 62.28±8.31 years. Based on the HAQ, 12 patients had no difficulties, 9 of them perform activities with little difficulties, 10 with many difficulties, and 4 patients cannot perform certain activities. Before treatment VAS was 6.63±2.36, and after treatment the 2.51±2.27. Ratings of clinical condition before treatment was 2.38±0.74, and after the treatment 3.64±0.98. The most frequently used therapies were kinesitherapy, magnetotherapy and interferential electricity. Conclusions: Stationary treatment at the spa „Ilidža“ Gradacac leads to an improvement of the functional status in patients with rheumatoid arthritis.

Complex regional pain syndrome (CRPS), once known as reflex sympathetic dystrophy, Sudeck's dystrophy and causalgia, is a pain syndrome with indistinctive pathophysiology and unpredictable clinical course. CRPS can develop after a limb fracture, injury or damage to the peripheral or central nervous system. The diagnosis of CRPS is based on the signs and symptoms obtained from the medical history and physical examination. The disease is often resistant to treatment, and its course is not always favorable. A brief overview of this clinical entity is presented, and most relevant and up-to-date information is discussed.

S. Branković, Mersa Segalo, Arzija Pašalić, Jasmina Mahmutović, Amila Jaganjac, Amra Čustović-Hadžimuratović, Elisa Vreto

Introduction: Problem of addiction on psychoactive substances is one of the most diffi cult problems in a modern society, which brings serious consequences, both for the individual, his environment and the whole society.Methods: The study included 95 children and adolescents of medical school. Among the respondents, there were 44 subjects of third year of high school and 51 respondent-grader.Results: Students involved in this research as an answer to why young people start using drugs often reported curiosity in over 50% of cases, as well as pressure of friends. For students who use narkotine respondents generally thought they are  reasonable and sufficiently weak and limited personality. Thelargest number of high school students who were involved in the study did not know the individuals who use drugs.Conclusion: Drug addiction is a serious problem all over the country, and the number of addicts is becoming larger. Particularly worrisome is the fact that the consumption of the drug phenomenon is a characteristic of young population, especially high school students

Introduction: Degenerative joint disease, which is standardized in Europe by the name of arthrosis or osteoarthrosis, while in the Anglo-Saxon literature is in use for a long time by the name of osteoarthritis (OA) although this is not a classical inflammation,is the most common joint disease in general and the most common cause of functional damage of the musculoskeletal system. Recently, the term osteoarthritisappears more frequently in domestic literature. Arthroses are degenerative joint diseases with progressive character, also one of the most frequent diseases in orthopedics. The disease fi rst affects the articular cartilage, then the bony edges of the articular surfaces, and then the articular lining.Methods: Retrospective analysis and evaluation of data of treated patients, with the "Praxis" physical treatment during the period of time from 2000 to the end of 2010 on a sample of 79 patients,valorized the efficacy of Praxis treatment. The  correlation of these results, with valorisation of the efficacy of standard physical treatment in clinics D.Z. " Novi Grad " on a sample of 81 patients, during the period of time from 2000 to the end of 2010, a statistical analysis was performed for comparing the effi cacy of the two methods.Results: There is a functional difference after therapy of bilateral gonarthrosis in clinics D.Z. "Novi Grad" and "Praxis" with statistical reliability.Conclusion: A combined approach in the treatment of knee arthrosis has a wider range of treatment procedures, comprehensively approaches to the problem and gives better results, so we can say that this method has priority compared to the standard approach to the knee arthrosis treatment.

Introduction: Cardiovascular diseases by its frequency, epidemic expenditure, socio-medical consequences and with high mortality are becoming the biggest problem of modern medicine. Mortality from cardiovascular diseases declines due to prevention measures in developed countries, in developing countries and countries in transition it increases. The aim of this study was to determine the prevalence of harmful habits and connection as a risk factor for cardiovascular disease in economically active population in the Canton of Sarajevo.Methods: The study was conducted among the active population of Sarajevo Canton. Randomly selected 443 respondents from different groups of workers aged 18-65 years, who voluntarily joined the study. Weperformed a study intersection descriptive method of research. Instrument for conducting research was a set of questionnaires, designed for research purposes.Results: The results study showed that the study group, current smokers occupy 45%, 1.8% occasional smokers who smoke and the rest of nonsmokers. It was shown that subjects who consume alcohol in biggestpercentage 73.4% consumed the same day, while the smallest percentage 2.7% comprise the same subjects who consumed annually.Conclusions: The prevalence of harmful habits as risk factors for cardiovascular disease among subjects in the Sarajevo Canton is evident represented. It is a significant development of the country, because it affects the health promotion strategy, which consequently changes the behavior based on individual needs. Health education and promotion of health can be reduced or completely prevented by a number of risk factors for cardiovascular disease.

Introduction: Community Based Rehabilitation (CBR) is a strategy within community development for rehabilitation, equalizes opportunities and social integration of incapacitated people. This is a comprehensivestrategy of involving people with disabilities in their communities through the development program. CBR system provides for the people with disabilities equal access to treatment and rehabilitation, education, promotes health and healthy living, and also indicates the existence of other features that make these people become full members of society and the community in which they live and is currently used in over 90 countries around the world.Methods: Research was conducted in two CBRs (CBR-Kumrovec and CBR-Saraj Polje) in the department of physical medicine and rehabilitation in the Sarajevo Canton. The study included and statistically treated 97patients during the period from 01.01.2008 to 31.12.2008 year.Results: In a study from the total number of respondents 65% were women, 35% male respondents, and the most represented were respondents of age group from 71-80 years - 40%. Of all diseases, the most represented were respondents with ICV, 43%.Conclusion: This type of treatment in the home conditions is providing necessary medical rehabilitation services by qualified physical therapists through a sufficiently long period for successful medical rehabilitation inthe natural environment of patients (home conditions), and the presence of family members who we can also educate for the enforcement of basic physical procedures and instruct them on the condition of the patientand his perspective.

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