Introduction The liver is the largest gland in the human body, and serves to store nutrients and neutralize harmful compounds. The liver plays a very important role in a number of metabolic, both catabolic and anabolic processes, and is therefore called the "central laboratory" of the organism. If liver disease occurs, they can affect all its parts-liver cells, bile ducts, blood and lymph vessels. The liver is damaged by various toxins, drugs, infections, disturbances in the blood supply and other disorders. Diet therapy has been a part of the process in the treatment of liver disease for a while. The therapeutic principle is better known as the "liver diet". The liver diet not only means the replenishment of calories and nutrients, but it significantly affects the course of the disease. Aim The aim of the research is to show that diet therapy plays an important role in the treatment of liver disease as a component for faster recovery of the liver and restoration of its normal function, as well as protecting the liver after overcoming the disease. Results Among the respondents, there were 39 men (64%) and 22 women (36%) who had liver disease as a chronic condition. Most respondents are between 51 and 65 years old (28 and 46%, respectively), while the least number of respondents are in the 20 to 30 age group. The largest number of respondents cited alcohol as the cause of the disease, 31 of them (50.8%), while the virus was the cause of the disease in 15 respondents (24.5%). Of the total sample, most respondents answered that they sometimes (45.9%) or often (47.5%) overeat. The results of the questionnaire showed that 85.2% of the respondents were smokers before the diagnosis of the disease. In most respondents, the food they ate before diagnosis was moderately fatty (52.5%). Using chi-square tests, it was found that there are statistically significant differences in the consumption of almost all foods before the diagnosis of the disease and after the obtained dietary recommendations (p<0.05). Conclusions The aim of the research was confirmed that diet therapy plays an important role in the treatment of liver disease as a component for faster recovery of the liver and restoration of its normal function, and after overcoming the disease it still protects the liver. The main purpose of creating a diet therapy program and plan proved to be significant and necessary because more than half of the respondents rated our advice as excellent. As most causes of liver disease can be prevented, it is necessary to work on familiarizing the population with risk factors, promote a healthy lifestyle and proper nutrition, and identify at-risk patients who must enter the monitoring system for early detection of liver disease.

Introduction: The liver is the largest gland in the human body, and serves to store nutrients and neutralize harmful compounds. The liver plays a very important role in a number of metabolic, both catabolic and anabolic processes, and is therefore called the „central laboratory“ of the organism. If liver disease occurs, they can affect all its parts–liver cells, bile ducts, blood and lymph vessels. The liver is damaged by various toxins, drugs, infections, disturbances in the blood supply and other disorders. Diet therapy has been a part of the process in the treatment of liver disease for a while. The therapeutic principle is better known as the „liver diet“. The liver diet not only means the replenishment of calories and nutrients, but it significantly affects the course of the disease. Aim: The aim of the research is to show that diet therapy plays an important role in the treatment of liver disease as a component for faster recovery of the liver and restoration of its normal function, as well as protecting the liver after overcoming the disease. Results: Among the respondents, there were 39 men (64%) and 22 women (36%) who had liver disease as a chronic condition. Most respondents are between 51 and 65 years old (28 and 46%, respectively), while the least number of respondents are in the 20 to 30 age group. The largest number of respondents cited alcohol as the cause of the disease, 31 of them (50.8%), while the virus was the cause of the disease in 15 respondents (24.5%). Of the total sample, most respondents answered that they sometimes (45.9%) or often (47.5%) overeat. The results of the questionnaire showed that 85.2% of the respondents were smokers before the diagnosis of the disease. In most respondents, the food they ate before diagnosis was moderately fatty (52.5%). Using chi-square tests, it was found that there are statistically significant differences in the consumption of almost all foods before the diagnosis of the disease and after the obtained dietary recommendations (p<0.05). Conclusions: The aim of the research was confirmed that diet therapy plays an important role in the treatment of liver disease as a component for faster recovery of the liver and restoration of its normal function, and after overcoming the disease it still protects the liver. The main purpose of creating a diet therapy program and plan proved to be significant and necessary because more than half of the respondents rated our advice as excellent. As most causes of liver disease can be prevented, it is necessary to work on familiarizing the population with risk factors, promote a healthy lifestyle and proper nutrition, and identify at-risk patients who must enter the monitoring system for early detection of liver disease.

Introduction: COVID-19 pandemic suddenly affected all countries and health care systems from different perspectives including severe disruption of chronic disease services including diabetes. Diabetes is a serious condition and highly present in Bosnia and Herzegovina population, so provision of diabetes care is a important part of good control. Countries had different responses to adopt diabetes care under new circumstances as well as Bosnia and Herzegovina. Aim: To investigate and evaluate the impact of the COVID-19 pandemic on the provision of diabetology care in Bosnia and Herzegovina from the perspective of patients and diabetologists. Methods: Online survey for diabetologists and patient organizations have been developed with adopted question for different perspectives. The survey has been conducted online early September 2020. Collected data were analyzed in SPSS software for descriptive statistics. Results: 25 diabetologists and 24 diabetes patient organizations responded. 72% of diabetologists believe that pandemic has partially altered work with patients and 56% believe that the organization of diabetes care has successfully responded to the new circumstances but 80% believe that the diabetes care system should change. 75% of patient organizations thought that the organization of diabetes care did not adequately respond and 87.5% believe system should change. Conclusion: No significant differences found between RS and FBiH when it comes to majority of questions. Both diabetologists and patients consider that system of diabetes care in Bosnia and Herzegovina should be improved in future. It has been also found that diabetologists in Bosnia and Herzegovina responded and adopted their practices similar to other countries.

Summary There are four types of responsibilities that arise on the basis of medical errors: a) Disciplinary (Punishment of the competent Association for restriction or revocation of the license); b) Civil liability (compensation); c) Criminal responsibility (protection of individual interests to protect the interests of the society); d) Violation (fine for minor damage) To increase the number of criminal proceedings mostly influenced the lack of compensation system for harm because the injured party considered that after the positive completion of criminal proceedings can easily make a claim. Therefore they do not address the local Association or Ministry of Health to investigate a case, but to the criminal proceedings to try to get compensation. It turned out that this is a dispute that is usually long lasting, with an uncertain outcome, which does not bring satisfaction to the plaintiff, and had a series of negative consequences in the general approach to the treatment of patients known as “defensive medicine”. As a result of the increased number of lawsuits due to medical errors are caused the following negative consequences: a) Great vigilance of physicians in communicating with patients, who must sign a 2-3 statements when entering the hospital, and that sometimes are not really familiar with the nature of illness and required treatment; b) Significant increase in the number of unnecessary tests which are required by doctors to insure themselves from the potential liability, which at a given moment are not really necessary; c) Lack of medical error reporting system allows individuals to avoid their reporting, which affects the course of treatment and prognosis; d) Often avoidance by the doctors to perform some necessary procedures that are risky, with increasingly open refusal to cure a poor prognosis case which they left to the next level of treatment. Disappears so called “heroic approach” to the treatment in the B&H health system known from the war period and gives way to extreme caution, because the doctors expect that their every procedure will be under scrutiny; e) All of these factors create a mode known worldwide as “defensive medicine”, which increases the cost of treatment and lower level of health care; f) Reduced volume of education, because older physicians are reluctant to let residents decide on specific work procedures and operations; g) There is already a critical shortage of some medical specialties, and inevitably follows increase in price from these service areas and increase of the waiting list.

Summary Medicine and the media are two areas important in the life of every man, which are in almost daily contact with each other and in dependence. Their relations in BiH are currently elemental, focused on direct, immediate needs, without defined rules, with a lot of disorientation, incompetence and irresponsibility, often without respect for at least the minimum rules of conduct and respect, often with a lot of conflict and hostility. The goal of our work is based on the analysis of newspaper articles, TV programs and Web sites in the period of one year and was to assess the current situation and suggest solutions. In order to acquire objective insight into the current situation, in the preparation of the symposium “Medicine and Media” in Mostar, we analyzed all stories related to medicine in two daily newspapers, two weekly, three TV stations in the period from September 1st 2008 to August 31st 2009, and the web sites of hospital institutions, Department of Health Insurance in Bosnia and Herzegovina and the Ministries of Health which were available online on 1st and 2nd September 2009. In total we managed to process 402 contents as written content, TV shows or stories in TV shows and 28 web pages, and we believe that our sample is representative. We have found the following characteristics of the current situation in BiH that have to be changed: Topics in the press, web sites or programs on health services should have some kind of certification, i.e. licensing so that is clear that the contents of the announcement is made under control of health care professionals, i.e., licensed or of optional entertainment content; In cases of professional accusation of any specific person, usually a doctor, not to state full name of the before the existence of binding court decisions, or in case of possible litigation not to allow favoring of any party of the dispute; In addition to the interest in the work of health institutions it is necessary to direct media attention towards the work of the Institute and the ministries of health insurance, because very few reports deal with their work and activities; It is necessary to emphasize investigative reporting with good topics covered by professionals and annual prizes awarded to the authors of such content about medicine in BiH should be considered.

One of the most common events in Surgical Ward is admission of patients with biliary tract disease. To evaluate such patients, it is necessary to create appropriate database and define attributes that will be analyzed. The patients should be divided in groups for analysis and data processing. There were 219 patients included in the study. All patients were selected on the basis of ICD-10 codes and then divided into categories according to the code. In order to assess selected patients, the database was created with all relevant questions about anamnesis, diagnostic tests and surgical procedures. The data about patients was entered into the database. It is possible to analyze data about the most frequent disorders of biliary tract. The most common entity was chronic cholecystitis with calculus and most common procedure was laparoscopic cholecystectomy. The other important attributes are also assessed. ICD-10 classification can be used as a basis for aggregation of data of the patients with biliary tract disease. Some of the codes are more frequent than others and some are rarely used.

The treatment of patient with relapse of bleeding after application of minimally invasive treatment of hemorrhoidal disease such as elastic band ligation, cryosurgical treatment Hemorrhoidal Arterial Ligation (HAL) can be presented as serious clinical problem in patients with concomitant diseases that can be contraindication for radical surgical treatment. We compared the Simple Digital Method and standard above mentioned minimally invasive ambulatory treatment. We used special proctoscope with Doppler Flowmeter in order to identify all branches of hemorrhoidal artery in the anal canal creating graphical presentation using specially adapted software. HAL method is then used to perform ligation of hemorrhoidal artery branches. The elastic ligatures (called gummiligatures) are then applied to the piles in which most prominent flow was registered using Doppler Flowmeter. Antibiotic prophylaxis and sedation was administered preoperatively. Special computer program registered all steps. Hemorrhoidal ointments and paracetamol were used after surgical procedure. Average number of identified hemorrhoid arteries branches was six, and total duration of the procedure was in average 28 min. We compared patient treatment with our method and standard methods. In tested group we noticed significantly fewer complications (after eight days the number of complications 11% vs. 74%, p<0.001, after 15 days 3% vs. 11%: p=0.101). One year after procedure, the treatment was successful in 91.4%, or 32 out of 35 patients according to proctoscopy and Doppler Flowmeter exam. There were three patients with relapse of symptoms. In 77% of patients hat were treated with rubber bands ligation relapse occurred. Our method is significantly more successful in comparison to classical methods of ambulatory treatment and can be alternative to radical surgical treatment.

Technical systems for endoscopy diagnostics are suitable for application of computer technology. Endoscopic methods can make use of hardware-software packages for the digitalization of images, after which it is possible to store and subsequently analyze, as well as transfer pictures to the local information and communication systems. After installation of these packages follow up of the examination is on the computer monitor, and the examination of patient receives the additional quality and speed. Endoscopic methods enable provision of following functions: Entering basic demographic data about patients, Following use of material, invoice production, etc. Recording video in real time, Review of existing material, image analysis, sequences, Image processing and printing preparation, Creation of own interface, or appearance of doctor’s reports, Data back-up from the software, recording on CD or DVD media,Conversion into any format and recording of data directly on CD or DVD, Easy access to previous patients examinations, Statistical data analysis. analysis and interpretation as basis for writing scientific and professional articles, Networking possibilities with other users. Special advantages for users of these methods are: Safer work for doctors and patients, Application of teleeducation system in process of knowledge transfer to the large number of participants (video conferences, workshops with transfer of “live” image and immediate analysis and comments) Functional dynamic analysis, Possibility for additional consultation or teleconsultation with other experts, Possibility to send image on distance using internet. Imaging views from endoscope, radiological (CT, MRI) or ultrasound obtained during the examination of the patients can be stored on appropriate media. In radiology and gastroenterology used are Pacs / Ris (System for archiving and communicating through images/ Radiology information system) systems. It is a system for work with images, and their purpose is to exclude use of films and start digital data processing. With this project, it is possible to transfer complete series of recordings with modalities such as CT, MRI, and diascopy, endoscopy ultrasound, to a system for archiving and communications, and after that all doctors who are in the network can view the images, give their opinions and seek the opinions of colleagues. This kind of software allows the processing and postprocesing (analysis) of recordings with the help of appropriate tools–zoom, filtering, invert, three-dimensional reconstruction, etc., all with the goal of more accurate diagnosis when viewing recordings. Such analysis is particularly important in the preparation or during the surgeries, and three-dimensional reconstruction of the liver is particularly important in preparation for transplantation. Network access is possible from any networked computer. With this software it is possible to seek via Internet the opinion of radiologists or gastroenterologist from

For the success of surgical treatment of anorectal diseases it is necessary to be familiar with different surgical methods for solving the problem. After examination, a surgeon needs to choose optimal method or a combination of two, in order to achieve the best effect. A correct choice of patients suitable for outpatient treatment is of extreme importance because enforcement of such treatment in patients who are suitable for stationary treatment would compromise the method. In this study we have presented the results of outpatient treatment of anorectal diseases during a two-year period (2000-2001). During this period we have studied 597 cases, out of which 524 patients were successfully treated in an outpatient clinic while for 31 patient (5%) we have concluded that they need a stationary treatment to which they were sent and in whom malignant tumors were found. Methods used in the treatment of different stages of hemorrhoides as being the most frequent disease were Barron's elastic ligature, infrared coagulation, sclerotherapy, HAL (Hemorrhoidal Artery Ligation), with two methods combined most commonly. We achieved excellent or very good results of the treatment in 87% of the patients, and only 2 patients had to be sent for surgical treatment. Beside hemoorhoides, methods that can be performed in local anesthesia in an outpatient institutions can be performed as well in cases of other benign conditions (such as lateral sphincterotomy in cases of anal fissure, fistulotomy and similar). Therefore, we have successfully solved 88% of the cases in out-patient clinic. An increased flow of proetologic lesions that were discovered. During 2-year period, we have solved 90% of anorectal diseases by using minimally invasive surgical methods. Successful and simple treatment of benign anorectal diseases increases the flow of patients having such symptoms, which increases the number of discovered malignant tumors.