AIM Standardization of education process and almost every aspect of life in EU moved the authors of this paper to evaluate medical informatics education at medical schools in Bosnia and Herzegovina. A very complex political structure and existence of two entities, one district and ten cantons in the Federation of Bosnia and Herzegovina caused great differences in the curricula, teaching methods and quality of acquired knowledge among medical schools in the country. Also, on the example of the teaching process at the Medical School, University of Sarajevo, the authors propose a future united and integrated system in the area. METHOD Method of the study is descriptive, comparing education in medical informatics at five B&H medical schools. Over 500 students answered questionnaires designed at medical schools in Sarajevo and Tuzla. The questions tackled the contents of the subject of medical informatics, the possibility of acquiring knowledge from both practical and theoretic lessons, "good" and "bad" sides of the curricula as well as students' computer literacy. RESULTS The subject of medical informatics is being taught in at least 3-4 different ways. Medical schools in Banja Luka and Foca/Srbinje are under a strong influence of the University of Belgrade, Serbia and Montenegro; the teaching staff in Mostar are from Croatia; the University of Tuzla has its own way; and Medical School in Sarajevo maintains high quality values and principles. Things and events that distinguish the Medical School, University of Sarajevo is the fact that it is the only medical school in Bosnia and Herzegovina which has a web site of of the Department of Medical Informatics, organized a number of events including a distance learning course, and has a highly competent teaching staff. Medical School in Sarajevo is the oldest medical school in Bosnia and Herzegovina established in 1944. As a required subject, medical informatics was introduced in the academic year 1992/1993, and it is the only medical school in Bosnia and Herzegovina where medical informatics is taught in two semesters, second and eleventh. DISCUSSION Three important areas are discussed: the quality of education in secondary schools should be improved; the lack of multimedia equipment, good LAN, high-speed connection to Internet and well organized web design, and issues related to maintenance of equipment; and students should have free access to computer rooms to enable them to extend their knowledge in spare time; general information about health system should be available to students to allow them to require the role and importance of medical informatics in "real life". Naturally, we raise the question of unique and systematic medical informatics education in the whole country, irrespective of entities, nationality or religion of students. CONCLUSION Medical informatics education at Medical School, University of Sarajevo, is based on the same concept as on prestigious universities all over the world and in accordance with recommendations of the working groups on education of EFMI and IMIA. Other medical schools in Bosnia and Herzegovina should employ the same methodology and system of work in order to have standardized education in medical informatics and to achieve high quality in education. To enable us to follow the European and global achievements in this area, the power of fact should predominate in the education system as well as in the health system.
The time in which we live is defined by the significant influence of the information technologies on our lives, changes and development of society and the efficacy of all the organization systems. Increase and development of distance learning (DL) technologies over the past decade has exposed the potential and the efficiency of new technologies. Number of events has organized by teaching staff from Cathedrae for Medical Informatics in order to promote distance learning and web based education are very extensive: professional-scientific events, workshops and congresses, first tele-exam at the Medical Faculty, Introducing of Distance learning in curriculum at biomedical faculties, etc. At the University in Sarajevo in year 2003 was opened the e-learning center for the support to the faculties the distance studies by use of the information technology. At Medical Faculty of University of Sarajevo at Cathedrae for Medical Informatics since 2002 is in progress realization of the project named: "Possibilities of introducing distance learning in medical curriculum", approved by the Federal and the Cantonal ministry of science and education. Pilot project was realized during three past school years, theoretical and practical education of subject Medical informatics are adapted to the new concepts of education using world trends of education from the distance. One group of students was included in the project finalized by electronic exam registration and electronic exam on 20 June 2005, publicly, in the Physiology amphitheatre of the Medical Faculty in Sarajevo.
Trauma is number one cause of death in young population in Bosnia & Herzegovina. Department of Neurosurgery, Clinical Center Unversity of Sarajevo (CCUS), as a representative of Bosnia & Herzegovina, participated in the International Research-Treat-Traumatic brain injury project over a span of three years with the main objective to save the lives of patients sustained the traumatic brain injury (TBI) and to improve the quality of life of survivors through research in factors determining the outcome and through changing current clinical practices to provide better care. The scores used to measure the compliance to TBI guidelines at individual patient were developed and tested. The scores were successfully tested on all the patients entered into the database. The patients satisfying the selection criteria were only included into this study. The criteria of severe TBI were used according to the National Traumatic Coma Database established in the US: Glasgow Coma Scale (GCS) score of 8 or less following resuscitation, which may include endotracheal intubation; or GCS score deteriorating to 8 or less within 48 hours of injury. The implementation of Scientific Evidence Based Medicine procedures is followed by a research in efficacy of changed medical practice. This was facilitated by developing a guidelines compliance measurement tool, which evaluates how closely the guidelines are followed in the treatment of individual case. When evaluating the compliance and when discussing the guidelines implementation one of the major problems surfaced is lack of financial support. In the future, we should tend to establish the scientifically basis for dissemination of the Scientific Evidence Based knowledge to all Hospitals in Bosnia& Herzegovina which deal with severe TBI patients. The financial obstacles and misunderstanding could be overcome through creation of public awareness campaign. Reducing mortality of TBI patients, who are youngest and most active part of population, must be priority for our whole community.
This article writes about a 37-year-old patient with Eissemanger's syndrome. The catheterization was done when he when he was 7 years old and was diagnosed as follows: VSD, ASD and pulmonary hypertension. After repeated catheterization when patient was 23 years old the final diagnosis was established: Fenestra aortico pulmonalis, VSD, ASD, aortic stenosis gr II and pulmonary hypertension. The patient has been treating conservatively
This year Medical Faculty University of Tuzla celebrates thirty years of its funding and development. It was second established medical faculty in Bosnia and Herzegovina out of five presently existing. In this paper stated are the most important events and professors, scientists and researchers which in last thirty years with their engagement and contribution have made this Medical faculty respectable scientific institution in Bosnia and Herzegovina and abroad.
: Migraine is periodical disorder which is characterized by recurrent headache seizures different in intensity, frequency and duration. Amylases L-1,4 glycol: gluckanohidrolises, (EC.3.2.1.1) are enzymes from hydrolase's group which dissolve starch meaning glycogen. Activity of amylases in serum grows: at acute pancreatitis, at carcinoma of pancreas, heavy necroses of pancreas. Total number of examinees was 92 out of which 45 were male (48.9 %) and 47 female or 51.1 %. Average age of the examines was 42.9. Neuroticism scale which was tested by Cornell scale was 55,03. Out of the total number of examinees 30 or 32,6 were non-smokers while 62 or 67,4 % smoked regularly. The aim of this work is to perform hematological-biochemical test of blood in patients with migraine. In the beginning of this research it was planned for all the patients to have hematological blood test done (sedimentation of erythrocytes, trombocytes, complete blood test and differential blood test) and biochemical blood test (hepatogram, transamynase, amylase, Lactal dehydrogenase, Alkalic phosphatase, ferrum in serum, Glucose, Cholesterol, Calcium and Phosphorus in serum. After reviewing the received values of hematological and biochemical tests, all values were within the borders of normal values. Amylases had higher values at 49 or 53,3 % of patients, and 43 or 46,7 % of patients had normal values of amylases. Normal values of amylases are to 220 U/l measured by I.F.C. at 37 degrees C. Medium value in tested group is 219.09. It means that every second examinee had increased values of amylase in blood; there is no statistics difference of amylase value between sexes.
Public health in B&H has long tradition. In this article authors presented development of public health in Sarajevo and Bosnia and Herzegovina.
Migraine is periodical disorder which is characterized by recurrent headache seizures different in intensity, frequency and duration. Amylases L-1,4 glycol: gluckanohidrolises, (EC.3.2.1.1) are enzymes from hydrolase's group which dissolve starch meaning glycogen. Activity of amylases in serum grows: at acute pancreatitis, at carcinoma of pancreas, heavy necroses of pancreas. Total number of examinees was 92 out of which 45 were male (48.9 %) and 47 female or 51.1 %. Average age of the examines was 42.9. Neuroticism scale which was tested by Cornell scale was 55,03. Out of the total number of examinees 30 or 32,6 were non-smokers while 62 or 67,4 % smoked regularly. The aim of this work is to perform hematological-biochemical test of blood in patients with migraine. In the beginning of this research it was planned for all the patients to have hematological blood test done (sedimentation of erythrocytes, trombocytes, complete blood test and differential blood test) and biochemical blood test (hepatogram, transamynase, amylase, Lactal dehydrogenase, Alkalic phosphatase, ferrum in serum, Glucose, Cholesterol, Calcium and Phosphorus in serum. After reviewing the received values of hematological and biochemical tests, all values were within the borders of normal values. Amylases had higher values at 49 or 53,3 % of patients, and 43 or 46,7 % of patients had normal values of amylases. Normal values of amylases are to 220 U/l measured by I.F.C. at 37 degrees C. Medium value in tested group is 219.09. It means that every second examinee had increased values of amylase in blood; there is no statistics difference of amylase value between sexes.
INTRODUCTION Measurement of the quality of medical education and assessment of students' satisfaction in today world are necessary and it is of priceless importance. Students' requests are Increased and traditional way of education is insuffcient in the "era of information". New technologies change the way of our perception of the world, how we think, and communicate with others. METHODOLOGY The survey was conducted on the sample of 48 students of the final year of the study of Medical faculty in Sarajevo in June 2006. Questionnaire has 24 process and outcome variables for the purpose of quality assessment of the education at the faculty. RESULTS By measurement of the education quality for the students of final year of Medical faculty in Sarajevo with formatted questionnaires determined was average grade for the quality of lectures which is 3, quality of practical work is 2.9, and quality of the skills gained is 2.8. 77.5 % students attended lectures regularly, 80% are able to give injection in a vein, and 32.5% had training on models for reanimation, model for intubation or model for giving shots, since 92.5% of students have never worked independently ultra-sound examination. The most frequent objection for teachers were that they have not been trying to animate students and because that they do not use audio-visual equipment, assistants of professor very often have other duties during t he practice education and that they are not interested to transfer-their knowledge and experience to students. DISCUSSION AND CONCLUSION Majority of students consider having more practical work, more contacts with patients and that assistants of professor should point out some Interesting clinical cases. Answers on problems during learning and practical exercises majority o f students find on Internet, in not mandatory textbooks and just 7% of students got answers from professors of assistants of professor. Small number o f students in the process of learning use just mandatory textbooks, majority use other textbooks and Internet. Possibility to access professional literature is the largest over Internet. Majority of the student surveyed think that they have solid and good knowledge o fcomputer technology. More of 50 % of students assess that after the study that they will not be able to perform practice independently.
Bosnia and Herzegovina (BiH), as developing country in transition, has to shift from traditional ways of learning to the transformation of the university education in accordance with Bologna process and educational standards in European Union. In the light of these changes authors conducted research at bio-medical faculties in Sarajevo in order to address issues of the education of future physicians and especially role of medical informatics in their under and post graduate studies and continuous medical education. As per given results in this study, current quality of medical education at biomedical faculties, University of Sarajevo, is unsatisfactory due to several reasons and some among others are those traditionally seen as "computer literacy". Problems are determined and recommendations are given for decision makers to support transformation of BiH medical educational system to have physicians, dentists, pharmacists and nurses who possess the knowledge, skills and attitudes required to be competent in medical informatics if they wish to incorporate into their practices systematic approaches for promoting and maintaining the health of defined populations.
This year BIH health celebrates two anniversaries: One hundred and forty years of Turkish civilian and Turkish military hospital in Sarajevo. During Ottoman period in Bosnian pasha region, Oman authorities have founded several military (in each bigger center it has been established military hospital of the Turkish Army) and five civil hospitals, mostly financed from vakuf (Islamic charity) funds. However, first hospital institution in BIH was located in Hadzi Sinan tekija at Mihrivode in Sarajevo, where was located special room for treatment, of mostly physiological patients, using zikr (spiritual ritual). By second half of 19th century civil populations were cured in homes, and wealthy citizens had their own private physicians who used to come with purpose or temporary from Dalmatian or neighboring countries bringing with them appropriate medications. By establishment of mentioned hospitals, other populations were treated by barbers, ranar (specialist for wounds), travar (person who treats patients with grass), and attars who had attar shops with medications purchased from Osman imperia or neighboring western countries. Drugs were prescribed to patients from Ijekarusa (drug prescription book), who were copied from generations and religion books, religion authorities of all confessions or from originals and copies of Arabic medical books which were brought by individuals going to Arabic countries (Mecca, Istanbul, Cairo, etc.). Mentioned hospitals, founded during Osman period (Sarajevo, Tuzla, Mostar, Travnik, Bihac) had key role in the history of BIH health, and they were basis for latter established regional and municipality hospitals founded in the Austria-Hungarian period. In the paper are described Turkish military and Turkish civil hospital established in June 1866 and in October 1866.
Endoscopic ultrasound (EUS) and Magnetic Endoscopic Cholangiopancreatography (MRCP) are important supplementary methods used for endoscopic extraction of common bile duct stones. The technical characteristics of both methods are excellent. If EUS is used for diagnostic purposes in diagnostic of biliary tree disorders there are almost no adverse consequences compared with other indication for this method. Nevertheless, the results are related to experience of physician. Advance of EUS compared to MRCP is its sensitivity and specificity even in cases where stones are small and dilation of biliary tract is minor. The role of EUS and ERCP in reveal of biliary tree stones and disorders is clearly defined. Comparasion of these two methods should be prospective and used in cases where definitive diagnosis is unclear. If EUS reveal stones in biliary tree then ERCP should be done in same session. Beside its role in excluding biliary pancreatitis, EUS can be used for examination of patient with acute and recurrent pancreatitis and is excellent for revealing ductal and parenchymal abnormalities of pancreas.
UNLABELLED Aim of this study is to examinate time period from the beginning of symptoms in acute coronary syndrome to the arrival time in Department of emergency medical service Zivinice where electrocardiogram is only one exact method for diagnosis of the myocardial ischemia. In retrospectively-prospectively study during one year, every patient with symptoms of acute coronary syndrome were taken beside and performed physical survay. We recorded ECG, performed ECG monitoring and/or serial ECG records. We investigated reasons for the lete arrival, sex and age and risk factors. In 167 patients with diagnostic acute coronary syndromes, average time period from beginning symptoms to the arrival time was 8.12 (+/-5,87) hours, significant longer from optimal 2 hours (p=0,001). Average age of these patients was 60,4 years. Male subjects were ill for about 9,2 years earlier than women and 1,6 times higher incidence than female subjects in all age groups. Most important risk and precipitating factors were hypertension, smoking, diabetes, hyperlipidemia, obesity. Leading factors for late arrival was unadequate attributing for importance of the acute chest pain and nonexistance of emergency medical service "on call". CONCLUSIONS It is necessary to informe citizens about risiko factors of acute coronary syndrome development, its symptoms, characteristic and consequences . Necessity is to organize emergency medical service "on call" and establish modern emergency centers. It is necessery to adequately equip stationary emergency medical services and train doctors and other medical staff to point out and adopt the usage of algoritms and protocols for acute coronary syndromes management. To educate members of public services about basic principles of cardiopulmonary reanimation.
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