Background Impulsivity, affective instability, and neglect of oneself and other people's safety as symptoms of personality dysfunction are associated with risky behaviors regarding the transmission of infectious diseases either sexually or by intravenous drug abuse. Objective The aim of this study was to analyze the association between hepatitis C virus (HCV) infection and personality dysfunction in opiate addicts on opioid substitution treatment. Methods This was a cross-sectional, observational investigation of patients over 18 years of age who were actively participating in opioid substitution treatment at five centers in Bosnia and Herzegovina. The occurrence of HCV infection was the primary study outcome, and personality functioning, the main independent variable, was assessed using the Severity Indices of Personality Problems (SIPP−118) questionnaire. The association between scores of personality functioning domains items and HCV infection status was determined by binary logistic regression analysis. Results Patients on opioid substitution therapy with HCV infection more frequently had personality disorders (OR 2.168, 95% CI 1.161–4.05) and were treated longer than patients without HCV infection (OR 1.076, 95% CI 1.015–1.14). HCV infection was associated with lower self-respect (OR 0.946, 95% CI 0.906–0.988), decreased capacity to have enduring relationships with other people (OR 0.878, 95% CI 0.797–0.966), and lower capability to cooperate with others (OR 0.933, 95%CI 0.888–0.98). On the other hand, except for self-respect, other elements of the Identity Integration domain (enjoyment, purposefulness, stable self-image, and self-reflexive functioning), when more functional, increased the risk of HCV infection. Conclusions Our study demonstrates that opiate addicts on opioid substitution treatment have a higher risk of HCV infection if their personality is dysfunctional, especially in the aspects of self-respect, enduring relationships, and cooperativity. The risk is even higher in addicts who have an established diagnosis of any kind of personality disorder.

AIM To analyze the problem of gambling games distribution among the students. METHODS The research was done on a sample of 2370 students of secondary schools in the municipalities of Zenica and Kakanj, Bosnia and Herzegovina. The survey research method and theoretical and comparative methods were applied. Sociodemographic data were analyzed, information about parents' knowledge of involvement of their children in gambling games and their approval, whether the students were informed at school about the dangers of gambling games, religiousness of students and their awareness of the phenomenon of gambling games addiction. RESULTS From the total of 2370 examinees, 164 (6.9%) declared that they often played games of chance, 839 (35.4%) played them occasionally and 1367 (57.7%) never played any games of chance. Betting is the game that most students played, 693 (29.2%). The students declared that their friends played some of the games of chance in 932 (39.3%) cases; 1014 (42.8%) students' parents disapproved playing the games of chance. The biggest number of the students, 1143 (48.2%) declared that there was no discussion at school about the danger of playing games of chance. CONCLUSION Gambling games are widely spread among the secondary school students. The problem is largely induced by the social environment, family and school.

AIM To explore psychic and psychological characteristics of patients suffering from non- epileptic seizures and compare them with the patients suffering from epilepsy. METHODS Using medical documentation 40 patients with non epileptic seizures were compared with 40 randomly selected epilepsy patients according to psychiatric and psychological report, and using psychotropic medications. RESULTS Both psychiatric and psychological reports have shown that pathologic changes were more frequently found within the epilepsy group (n = 20 and n=7, respectively) than in non-epileptic fits group (n= 18 and n=4, respectively). Six patients had neurotic disorders within the epilepsy group, versus 3 within the non-epileptic fits group. Conversion disorders were more frequently found within the non-epileptic group (n=6) as compared to epilepsy group (n=2). Disorders due to acute reaction to stress occurred in six patients in the non-epileptic fits group versus three patients in the epilepsy group. Cognitive disorders were found more frequently within the epilepsy group (n=6) as compared to the non-epileptic fits group (n=1). Vulnerable character, adolescence crisis, deficit of social abilities and indifference were more frequently found within the non-epileptic fits group (n=3) in comparison with the epilepsy group (n=1). CONCLUSIONS Psychiatric and psychological reports are most important elements in the diagnostic of psychogenic non-epileptic seizures.

A 29-year-old Chinese woman was admitted following a sudden onset of lower abdominal pain with associated vomiting and dysuria. She denied a history of dizziness, shoulder tip pain, vaginal bleeding or bowel symptoms. She gave a history of 6 weeks amenorrhoea other than a minimal 1 day bleed, 2 weeks prior to admission. She had been trying to conceive and had a positive home pregnancy test. Her medical history included a laparotomy for ectopic pregnancy 8 years previously, in China, then a vaginal delivery after an uncomplicated pregnancy 2 years ago. On examination, she was haemodynamically stable. A midline laparotomy scar was noted. She had lower abdominal tenderness but no peritonism; bilateral adnexal tenderness but no masses or cervical excitation. A urine pregnancy test was positive, serum HCG 3,584 IU/l and haemoglobin 12.6 g/dl. Pelvic ultrasound scan revealed a left adnexal cystic mass measuring 446 416 34 mm with a trace of free fluid in the Pouch of Douglas but no intrauterine pregnancy. The patient was initially managed conservatively. Serum HCG levels doubled every 48 hours rose to 8,970 IU/l, then 13,700 IU/l. Repeat pelvic ultrasound scan continued to show no evidence of an intrauterine pregnancy. The left adnexal mass had increased in size to 726 71662 mm. Serum HCG was now 38,513 IU/l with a haemoglobin of 12.4 g/dl. An exploratory laparotomy was performed for suspected left tubal ectopic pregnancy. Intraoperative findings included a haemoperitoneum of approximately 1 litre. The majority of the left fallopian tube was absent due to a previous ectopic pregnancy, but that portion present was adherent to the ovary which was enlarged to 86 46 3 cm. A site of rupture was identified on the ovary, consistent with a ruptured left ovarian ectopic pregnancy. Left salpingo-oophorectomy was performed. The procedure was complicated by bowel injury; two small serosal tears were repaired following division of dense bowel adhesions. The patient had an uneventful recovery and was discharged on day 4 postoperatively. Serum HCG levels 1 week and 3 weeks postoperatively were 651 IU/l and 39 IU/l, respectively. Histological examination revealed a complete hydatidiform mole in the context of an ovarian ectopic pregnancy. The diagnosis was confirmed by the supra-regional Trophoblastic Disease Centre in Sheffield, where the patient was subsequently followed-up. Urine HCG levels remained negative.

Thirty-two cases of male infertility in patients having leprosy were studied. One case was oligospermic and the remaining 31 cases were azoospermic. Pathologic changes in the testis and epididymis are described and illustrated. An important observation was the presence of obstruction in the tail of the epididymis in five cases and this obstruction was undoubtedly the cause of sterility in these five cases as the head of the epididymis was full of sperm and testicular biopsy was more or less normal. In the remaining 27 cases, the cause of sterility was testicular affection with fibrosis and hyalinization of the seminiferous tubules in most of the cases.