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H. Pandza, I. Masic, Z. Knezević

Internet is more and more involved in medical education in many countries including Bosnia and Herzegovina. Not only medical student but also physicians are using Internet to find out the latest information in specific field of medicine. Some sites are specially designed to be used for medical education. Information about some programs or courses of medical education can be found here. Improvements of network resources and multimedia technologies have made it possible to satisfy needs for medical Education. Multimedia approach offer possibility to show text, picture, sound or movie considering specific need. All of that is available on Internet. Many search engine are available in the world and student can use all of them when they have access to Internet. The more precise search can be done on specific sites that include information about medical conditions and medical education. The most important is MEDLINE. MEDLINE is bibliographic database of National Library Of Medicine in USA. This database can be explored from several sites. All relevant information about article can be find here including abstract and service to obtain full text of specific article. Database can be searched using specific keywords that can be find in text or in MESH thesaurus. Data about authors, their addresses and title of article can be found, too. The possibility of using Internet in medical education are considered in this article. Some of Internet sites are described, too.

B. Prnjavorac, E. Ajanović, I. Masic, B. Rakić-Prnjavorac, K. Kahvić, S. Kahvić, M. Smailbegović

Use of medical information in everyday practice has been described in this paper. Importance of systematic collection, analysis and use, including correct "data management" is noticed. Information system is formed of every noted information, not only in computing form. Use of databases allows us connection to many information, but rational use should allow us to select only these in number an quality which are necessary for decision making.

I. Masic, Z. Ridanović, H. Pandza

Expert systems are software systems that can successfully compare to human experts. Their purpose is mostly advisory. Besides, they give explanation and advices to human experts when performing certain tasks. They are intelligent information systems, and are capable to explain and justify their conclusions. Knowledge systems are smaller software systems, and are usually less successful than human experts. Main reasons for expert systems development in medicine are: need for justification of decisions, need for enhancing performances in many uncertain relations; need for explaining of decision making process++ etc. One of the reasons of developing knowledge-based systems was that conventional statistic formalisms have not provided satisfactory solutions in medical decision making (MDM). Also, today, the relations between cases and conclusions are not universally valid. So, few causes can provide the same conclusion. Besides, data are not necessarily absolutely accurate. The area of applying expert systems is very wide: diagnosis, prognosis, education, managing etc. Basic structure of expert system consists of: knowledge, data base, inferring mechanism, explaining mechanism and user-interface. In this paper we presented several expert systems which are actually used in practice, especially in internal disciplines: Internist, Mycin, Onkocyn, DXplain.

M. Beganović, B. Lagerkvist, I. Masic, M. Mujić, I. Cerić, D. Pecar

The number of war victims in need of physical rehabilitation in Bosnia and Hercegovina is not exactly known but less than one per cent of the population. Anyhow physical rehabilitation services needs to be reorganized in the community taking care of about 70-80% of the patients. The rest are partly in need of institutional care, which is also important for training and research purposes. The reorganization of services for the mentally ill is aimed at both war victims and others and reorganized at Community Mental Health Centers. The number of mentally ill war victims is definitely exceeding the number of physically injured from the war.

D. Nikšić, I. Masic

In this research paper we gave a model with a scale for assessment of health services quality in the primary health care. The model of assessment of quality is based on elements of quality--structure, process and outcome of health care. For every quality element defined indicators and variables with numeric values are shown. The proposed model was tested on the sample of hundred check ups of children aged from 0 to 1 year. The source of data was the health record, and data were collected through questionnaire for assessment of medicine team procedures. The outcome is measured through questionnaire about parents' satisfaction with services delivered. The results of research showed that the health record is only partly suitable to obtain data about contents of doctors work. Total quality of health care is estimated as lower values. The reason lies in the lower level of the content and quantity of check ups, and insufficient education of health professionals. The suggested model and evaluation scale are suitable for implementation in our health care system. The assessment of quality of work is compulsory in further evaluation of the system, regarding the obtained results.

D. Nikšić, I. Masic, I. Jokić, H. Pandza

Medical education, especially continuous one, is considered as a very important strategy in assuring health care quality. It represents the most dynamic structural element of the health care quality. In this presentation we used the structural approach to quality assurance, through examination of medical literature utilisation trends from a number of health professionals and students of biomedical schools. In the research we used questionnaires which contained the questions related to the motivation of the subjects to use the medical literature and its availability to them. 34 students of biomedical schools were interviewed through questionnaires, 45 students of high nursery school and 32 medical doctors. The results showed that motivation of the subjects in the survey, both students and medical doctors to use medical literature is significant. However the possibility to use professional literature in their libraries is very limited because of the lack of new literature. Only 3% of interviewed medical doctors and students use Internet in their education. Technological delay in the process of education in Bosnia and Herzegovina caused by the war will significantly influence the level of health care quality in our country in the next period.

I. Masic, N. Alispahić, M. Dover, D. Nikšić

This paper presents a comparative review of the quality control methods in the industry and health care system with emphasis placed on hospitals. These standards were applied for the first time in the medical sector in 1995 in German hospital, which then was given the quality certificate. According to experience the application of standards ISO 9000, 9001 and 9002 in the hospital requires certain modification because the quality control in the health care is targeted on the process of production and not only on the outcome of the provided service. Unfortunately in the countries of former Yugoslavia there is no greater interest yet.

Z. Sabanovic, I. Masic

Improvement of the efficiency and effectivity of health care system is a task of high priority for social system because it is one of its crucial components. Health care system spends significantly great part of social budget. That is why its quality--directly or indirectly--influences other segments of social system. After five years of either total or partial destruction of health care capacities, facilities, resources, lack of human resources, as well due to total collapse of the economy in our country, the consequences of the aggression on Bosnia and Herzegovina require radical changes in respect of the organisation and structure of the health care system in Bosnia and Herzegovina. Concerning the fact that hospital system in Bosnia and Herzegovina is one of the most expensive segments of health care system, future reforms in health care system should be implemented primarily in this field. These reforms should consist of establishing of DRG system for control, evaluation, updating, financing and management of health care system to desired direction and way of development. In that regard, it is necessary to: improve actual computer capacities by application of new technologies; develop DRG and CASEMIX classification systems, following experiences of highly developed countries, and adapt it to our health care system; change financing system by following CASEMIX, and adapt CASEMIX step-by-step to implementation i.e.: department by department; hospital by hospital; in the last phase-to connect CASEMIX with network of integral information system of Sarajevo Canton and, later, with network of all other cantons in BiH. to educate medical staff about the implementation and use of DRG and CASEMIX in practice.

Z. Hadziahmetovic, J. Krasni, I. Masic

The results of healing by osteosynthesis at dogs' bones fractures are presented in this paper. The importance of drainages is emphasised in the healing process. In Cantonal veterinary station in Sarajevo in the period January 1995-January 1998, 14 dogs with osteosynthesis were selected. We observed the following parameters: wound's healing, functional status, X-ray examination. In respect of the incidence of complications in the final results of healing there were no evident differences between these two groups with active drainage A and passive drainage B.

History is a witness of the great importance and influence of islamic science from the period of "Golden Age of Arabic Civilisation". A famous scientist said: "Sciences has no country, it is international; we all share in fruits of investigations of people from different traditions and all ages." Scientists from the early period of islamic era had set fire of a stream of man's thought and progress, observation, experiments and tradition, that have become a weapon of modern science. All of that was based upon Quran and Hadiths, that have been their guidelines when setting free human mind from taboos. Medieval Arabian scientists have followed the words of Holly Prophet Mohammad s.a.v.s., saying that searching for knowledge have had to be the most important task for people, and that ink more saint than blood of the saints. These attitudes of Holly Prophet have awaken desire for studying with muslim scientists. The result of that desire became a key of scientific progress. There are many worldwide famous arabian scientists: El-Kindi, Er-Razi, Ibn Sina, El-Biruni, Ibu Hajsem, Ez-Zahravi, El-Farabi, Ibn Zuhr, Ibn Ruzd etc. These names, among several hundreds of arabian physicians, attribute "Golden Age" of islamic science. That period was characterised by movements, reprocessing of ideas. That reprocessing of ideas has gained the great minds together, and that process is continuous. That is why we have to be grateful to them. Famous Muslim physicians defined medicine as skill that dealt in keeping good health, coped with ills and health recovering. They have also modified many Greek writings and established basic principles of the art of medicine. What is significant is that, regardless of historical past and modern technical and technological presence, these principles are still accurate for understanding of medical science. These principles are what the author is discussing in detail in this paper about.

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