. Background: Computer simulations can be briefly described as the use of computers to represent the dynamic responses of a tested system, by observing the behavior of another, artificial, system modeled on basis of the test system. Physical modeling has been practiced unconsciously since the beginning of the human species, that is, from the moment when the human mind began to understand all the complexity of phenomena and things that surrounded it in nature. Objective : The aim of this paper is to analyze the implementation of computer's simulation and modeling for educational agenda. Methods : This article is a review of the entire to use models, modeling and simulation by using compiters and ICT for teaching system in undergraduate, postgraduate and continuing education using published information, as well as professional papers and publications about this topic. The simulation methodology is based on computer science, statistics, numerical mathematics, operational research and artificial intelligence, but today it is sufficiently coherent and developed that it can rightly be called a separate scientific discipline. The system model represents a simplified and idealized (abstract) image of a real system. In other words, a model is a description of a real system with all its characteristics that are relevant from our point of view. Results and Discussion: Application of computer simulations in science: Different simulations are used to meet specific requirements of the scientific field and the problem such as: Numerical simulation of a differential equation, which cannot be solved analytically. This category includes theories dealing with continuous systems, such as phenomena in physical cosmology, fluid dynamics ; Stochastic simulation, used for discrete systems, where changes occur on the basis of probability, and cannot be explained by equations. These include genetic changes, and biochemical and genetic regulatory processes; Modeling of molecules and their behavior for the purpose of creating drugs; CFD–Computational Fluid Dynamics.–computers are used to perform calculations, which describe the behavior of liquids and gases; Blue Brain project; Cognitive architecture and Movement of parasites in the human body. Conclusion: This paper presents explanations and examples of the application of computer simulations in order to solve everyday problems encountered, both in medicine and all other branches of science. Conclusion: Computer simulations are an invaluable blend of nature and technology, and are one of the main sources of hope for understanding and improving the world we live in.

Introduction: High educational and teaching standards were the main reason why from the begging student satisfaction surveys and assessments of the students’ knowledge, attitudes and opinions were paramount in the educational process at the Cathedra for Medical Informatics at the Medical Faculty University of Sarajevo. Aim: The aim of this study was to evaluate general knowledge of the fourth semester students about informatics and medical informatics and compare it with previous generations. Methods: Students at the beginning of the fourth semester and before second planned lectures receive “Questionnaire for biomedical students about use and knowledge of information technologies”. Collected data was retrospectively used for this study. The scientific study committee of the Cathedra for Medical Informatics reviewed and approved the database for using this study. At the beginning of the survey, all students were informed that their data could be tracked. Also, all students were informed and got lectures on surveys, development and use of questionnaires for the examination of the patient/student satisfactions and how results of the survey and analysis could help continuously improving quality of the teaching process. Discussion and Conclusion: Medical students come to the faculty with significant IT knowledge and skills. It can even be argued that students rank their knowledge in some way lower than we as teachers estimate based on their practical work. They organize groups on social networks where they exchange information about lectures and exams. It is common for each study year to have its own group. Through this group, information and presentations that teachers send to students are exchanged. One of the goals of teaching medical informatics is the method of searching for medical information on the Internet. The skills learned in medical informatics classes complement those learned earlier and provide a solid base for physicians who are able to supplement their knowledge using IT technologies when they need it.

Introduction: Cancelling elective procedures on the day of surgery presents a constant problem in all higher-level medical facilities, and the research of causes, consequences and possible solutions is the duty of every facility in order to enhance the quality of healthcare services. Aim: The aim of the research was to determine the percentage and reasons for cancelling elective procedures and provide adequate measure to reduce this number in the future and to identify ways to improve the patients’ satisfaction level. Material and Methods: This prospective study included all patients that were scheduled for surgery from March 2016 to November 2018 in the operating rooms at our Department of Surgery, including both performed and cancelled cases. Cases by different surgical departments (general surgery, gynecology, orthopedics, urology, plastic surgery, ophthalmology and otorhinolaryngology) were all included. Results: Out of 8201 planned elective procedures from March 2016 to November 2018 at the General Hospital “Abdulah Nakas”, 7825 cases were performed and 376 cases (4.58%) were cancelled on the day of surgery. The most common reasons for cancelling a surgical procedure on the day of surgery were: lack of time to perform surgery (33.51%), surgery cancelled due to medical/anesthetic reasons (31.38%), surgical procedure cancelled by the surgeon on the day of surgery (11.97%). Conclusion: This study has shown that the percentage of elective cases cancelled on the day of surgery at our institution stands at an acceptable 4.58%. The most common reasons for case cancellation on the day of surgery were identified. The majority of reasons for cancellation were avoidable, which means that appropriate steps could contribute to lowering the percentage of cancelled elective cases and an improved quality of healthcare services.

BACKGROUND Laparoscopic surgery causes less pain than traditional surgery; however, to relieve postoperative pain, surgeons frequently apply local anesthetic preemptively. The aim of this study was to assess the effect of different local anesthetics on pain intensity in patients who had undergone a laparoscopic appendectomy (LA), who received the anesthetic preemptively at incision sites and postemptively, intraperitoneally and trocar sites. PATIENTS AND METHODS A total of 120 LA patients (men and women) were randomly assigned to 1 of the 4 groups (N = 30/group): Group 1: no peritoneal or local administration of local anesthetics during LA; Group 2: 5 mL of 1% lidocaine was applied at incision sites and 10 mL 1% lidocaine was injected under direct vision in the right iliac fossa area and around the stump of the appendix and trocar sites at the end of the procedure; Group 3: 5 mL of 0.5% levobupivacaine applied at incision sites +10 mL 0.5% levobupivacaine injected in the same place intraperitoneally and trocar sites at the end of the procedure; Group 4: 5 mL of 0.5% ropivacaine at incision sites +10 mL 0.5% ropivacaine injected in the same place intraperitoneally and trocar sites at the end of the procedure. Postoperative pain was assessed after 2, 6, 24, and 48 hours using a visual analogue scale (VAS). RESULTS By comparing the average values of pain intensity using VAS, we observed significantly different average values of pain intensity in the levobupivacaine and ropivacaine (3 and 4) groups in comparison with the control Group 1 (P < .05) throughout the follow-up period. CONCLUSION We observed a reduction in postoperative pain, nausea, and vomiting in patients with LA who received intraoperative local anesthetic preemptively at the incision sites and postemptively, intraperitoneally. After the application of levobupivacaine the intensity of pain was significantly lower than in any other tested group.

Background: The risk of wound infection after elective inguinal hernia repair depends on several factors. One of the most important factors is the preoperative skin preparation. The use of antisepsis is performed to reduce the risk of surgical site infections (SSIs) and to remove causing organisms. This work compares two different agent forms for preoperative skin preparation to prevent SSIs. Objectives: The objective of the study is comparing the effects of two different agents used for preoperative skin preparation and prevention of SSIs. Material and methods: 100 adult patients were divided and randomized into two groups, each containing 50 patients. Both groups included patients that are scheduled for elective Lichtenstein inguinal hernia repair. The first group includes patients whose skin preparations were done with povidone iodine (PI) only. The second group included patients that are treated with two antiseptics; Alkosol (96% ethanol, isopropanol-30g and ortophenilphenol-0.1g) and povidone iodide. Alkosol is applied before the induction of anesthesia. The povidone iodide is applied after Alkosol has evaporated. The presence of bacterial growth in the wound was determined 24 and 48 hours after operation. Swabs were used to take samples, which were then cultivated to check for bacterial growth. The presence of infection was also determined by the following criteria: pain or tenderness, induration, erythema, local warmth of the wound etc. Results: The surgeon or clinician declared that after 24 hours the wound was infected in 20 patients in the control group and in 22 patients after 48 hours. In the Alkosol (96% ethanol, isopropanol-30g and ortophenilphenol-0.1g) and povidone iodide group infection was declared in only 3 patients after 24 hours. Discussion: Compared to the use of providone only, the use of Alkosol (96% ethanol, isopropanol-30g and ortophenilphenol-0.1g) and povidone iodide has many advantages and was associated with lower rates of SSIs following clean surgery. A larger trial is warranted in order to add definitive and more conclusive data to the current evidence base.

Social network is a social structure made of individuals or organizations associated with one or more types of interdependence (friendship, common interests, work, knowledge, prestige, etc.) which are the “nodes” of the network. Networks can be organized to exchange information, knowledge or financial assistance under the various interest groups in universities, workplaces and associations of citizens. Today the most popular and widely used networks are based on application of the Internet as the main ICT. Depending on the method of connection, their field of activity and expertise of those who participate in certain networks, the network can be classified into the following groups: a) Social Networks with personal physical connectivity (the citizens’ associations, transplant networks, etc.), b) Global social internet network (Facebook, Twitter, Skype), c) specific health internet social network (forums, Health Care Forums, Healthcare Industry Forum), d) The health community internet network of non professionals (DailyStrength, CaringBridge, CarePages, MyFamilyHealth), e) Scientific social internet network (BiomedExperts, ResearchGate, iMedExchange), f) Social internet network which supported professionals (HealthBoards, Spas and Hope Association of Disabled and diabetic Enurgi), g) Scientific medical internet network databases in the system of scientific and technical information (CC, Pubmed/Medline, Excerpta Medica/EMBASE, ISI Web Knowledge, EBSCO, Index Copernicus, Social Science Index, etc.). The information in the network are exchanged in real time and in a way that has until recently been impossible in real life of people in the community. Networks allow tens of thousands of specific groups of people performing a series of social, professional and educational activities in the place of living and housing, place of work or other locations where individuals are. Network provides access to information related to education, health, nutrition, drugs, procedures, etc., which gives a special emphasis on public health aspects of information, especially in the field of medicine and health care. The authors of this paper discuss the role and practical importance of social networks in improving the health and solving of health problems without the physical entrance into the health care system. Social networks have their advantages and disadvantages, benefits and costs, especially when it comes to information which within the network set unprofessional people from unreliable sources, without an adequate selection. The ethical aspect of the norms in this segment is still not adequately regulated, so any sanctions for the unauthorized and malicious use of social networks in private and other purposes in order to obtain personal gain at the expense of individuals or groups (sick or healthy, owners of certain businesses and companies, health organizations and pharmaceutical manufacturers, etc.), for which there is still no global or European codes and standards of conduct. Cyber crime is now one of the mostly present types of crime in modern times, as evidenced by numerous scandals that are happening both globally and locally.

Introduction: Beginning with the late twentieth and early twenty-first century, the Internet was a significant additional tool in the education of teenagers. Later, it takes more and more significant role in educating students and professionals. Goal: The aim of this paper is to investigate, to what extent and how effectively the Internet is used today by students of biomedical faculties in Bosnia and Herzegovina. In addition, more specifically, this paper will research the implications of the well-known social networks in education of students and health professionals in Bosnia and Herzegovina. We compared the ratio of using Social networks by students for spreading medical information as basics for health education at medical faculties at 3 universities in Bosnia and Herzegovina (B&H). Results and discussion: The results showed that only 11.6% of professors use Facebook type of social network, 49.3% of them have a profile on BiomedExperts scientific social network and 79% have available articles in the largest biomedical literature database MEDLINE. Students are also frequent users of general social networks and educational clips from You Tube, which they prefer to utilize considerably more than the other types of professionals. Students rarely use the facilities of professional social networks, because they contain mainly data and information needed for further, postgraduate professional education. Conclusion: In B&H there are decent conditions for the use of online social networks in the education of health professionals. While students enthusiastically embraced these opportunities, this is not so much a case with health care professionals in practice; while scientific health care workers have not shown greater interest in the use of social networks, both for purposes of scientific research and in terms of self-education and training of students.

Advances in medicine in recent decades are in significant correlation with the advances in the information technology. Modern information technologies (IT) have enabled faster, more reliable and comprehensive data collection. These technologies have started to create a large number of irrelevant information, which represents a limiting factor and a real growing gap, between the medical knowledge on one hand, and the ability of doctors to follow its growth on the other. Furthermore, in our environment, the term technology is generally reserved for its technical component. Education means, learning, teaching, or the process of acquiring skills or behavior modification through various exercises. Traditionally, medical education meant the oral, practical and more passive transferring of knowledge and skills from the educators to students and health professionals. For the clinical disciplines, of special importance are the principles, such as, “learning at bedside,” aided by the medical literature. In doing so, these techniques enable students to contact with their teachers, and to refer to the appropriate literature. The disadvantage of these educational methods is in the fact, that teachers often do not have enough time. Additionally they are not very convenient to the horizontal and vertical integration of teaching, create weak or almost no self education, as well as, low skill levels and poor integration of education with a real social environment. In this paper authors describe application of modern IT in medical education – their advantages and disadvantages comparing with traditional ways of education.

INTRODUCTION Laboratory diagnosis of medical biochemistry activity plays a significant role in the Primary Health Care Center (PHCC), dominated by Family medicine and diagnostic services. Medical biochemical diagnosis has a visible place at all levels of health care, which shows the number of requests for laboratory diagnosis, number and type of required laboratory tests. MATERIALS AND METHODS The study included 1000 requests for laboratory tests at the PHCC in Gracanica in primary health care units. We made an analysis of the most common laboratory tests in the requests by doctors from primary health care based on requests for laboratory diagnosis. RESULTS The requests of primary health care units in PHCC laboratory tests are required at all levels of service: urine, WBC, SE, glucose, total bilirubin, ALT, AST, AF, CK, cholesterol, HDL cholesterol, triglycerides, creatinine, urea, uric acid, CRP, fibrinogen, calcium and phosphorus. The following requirements are the most common laboratory tests with 94% representation: urine, WBC, glucose, cholesterol, triglycerides, aminotransferases, creatinine, and urea. In 1000 requires was required total of 5333 laboratory tests. Test requirements of a general practice make 44, 1%; FM doctors account for 40% and the requirements of other specialists (pediatricians, gynecologists and specialists of occupational medicine) are 15, 3%. The doctors in family practice most often required: glucose, urine, WBC, SE, TGL., Chol., ALT, AST, creatinine and urea. General practitioners are demanding more cholesterol and triglycerides, a family medicine doctors are demanding lower cholesterol and triglycerides and higher CRP, fibrinogen, total bilirubin, ALT, AST, and other specialists the most demanded urine and WBC. DISCUSSION Laboratory diagnosis is a common diagnosis, which shows the representation of required number and type of laboratory tests. In requirements of PHC units in PHCC laboratory tests are required at all levels of service: urine, WBC, SE, glucose, bilirubin, ALT, AST, AF, CK, cholesterol, HDLchol., triglycerides, creatinine, urea, uric acid, CRP, fibrinogen, calcium and phosphorus. The following requirements are the most common laboratory tests at the primary level: urine, WBC, glucose, cholesterol, urea, and found the secondary level of triglycerides, index levels and did not clear the number of searches required by the standards and norms of PHC.

BACKGROUND Pain in the lower abdomen is one of the leading reasons that lead the patient in surgery. Although appendicitis is the most common cause in about two thirds of patients the other causes must be taken into account. OBJECTIVES To determine the probabilities which could determine what is an etiological cause of pain. MATERIALS AND METHODS comprised 102 patients hospitalized in general hospital Tesanj because the clinical symptoms dominated by acute pain in the lower abdomen. The study was retrospective prospective clinical study. All data were collected in a special database and statistically analyzed. RESULTS Of all the causes of abdominal pain in the lower abdomen the most common is appendicitis with a total of 62 patients, of which slightly more male patients (36) compared to female patients (26) or (57% male and 43% female patients). If we analyze the time elapsed from pain onset to patient visit of physician we can say that patient with more intense pain will visit physician sooner. Colic and intense pain is a characteristic of colon cancer (15 patients) and Crohn's disease. Dull pain is characteristic of omentum cyst, diverticulitis, and intestinal obstruction and was seen in one fifth of patients with colorectal cancer and one third of patients with acute appendicitis. Palpatory positive pain in Mc Burney's point distinguishes appendicitis from other causes in most cases. DISCUSSION The decision-making in the treatment of abdominal pain is depending of nature of pain, intensity, spreading, and sensitivity to palpation and localization of pain that usually indicates the place where the sick organ transmits the inflammatory process to the parietal peritoneum. Other symptoms that accompany pain and laboratory tests can be of crucial importance.

Problem: Laboratory medicine, medical-biochemical diagnosis in primary health care is much represented. By organization of family medicine medical-biochemical diagnosis is defined as a branch of diagnostic services in primary health care. For these actions is necessary in the morning prior to admission of users and their demands that all jobs are properly prepared. On previous day should be provided and prepared: accessories, reagents and machines. Morning daily routine work of preceding control and calibration equipment, methods and process quality control of work in the laboratory. Only after the fulfillment of the procedures followed overview of search control of samples. After validating the results of daily quality control and after they met the criteria can be analytically examined samples from users. These procedures are not sufficiently familiar to users and doctors, for that are very often necessary the direct telephone communication between them. To make the results of laboratory tests needed are huge material resources. This is evident in the economic analysis where laboratory tests are valued with a score of: search by type and material resources expended for analytical examination. These technical and financial performances of laboratory medicine are not appropriately classified as blatant as that in other industries, technology and other primary health care (PHC) and family medicine (FM). Goal: The overall objective of the research is to define a model of efficiency (or effectiveness) of medical-biochemical diagnosis for users with the requirements of units of family medicine (FM), in a representative sample of patients in the unit for the laboratory diagnosis of the Primary Health Care Center Gracanica. Confirm what is the usefulness of the application of laboratory diagnosis in family medicine. Determine the frequency of the need for laboratory tests in the therapeutic treatment of major diseases. Evaluate the need for using laboratory diagnostics to try to prevent major diseases. Material and methods: The study included a total of 1000 respondents. All subjects were users of primary health care in Primary Health Care Center Gracanica (Tuzla Canton) in primary health care units have received requests for laboratory diagnosis. This paper is an analysis of the representation requirements for the laboratory diagnosis by doctors in primary health care and the most frequent diseases in primary care. An analysis is made of laboratory test results, based on requests for laboratory diagnosis by doctors and illnesses in primary care. Made is analysis of the presence of normal and pathological laboratory test results from the request for the laboratory diagnosis by doctors in primary health care. Made is an analysis of the most common laboratory tests requests, and based on requests for laboratory diagnosis by doctors in primary health care and the most frequent diseases in primary health care. Incorporated is the economic analysis of labor

SUMMARY The development of modern technology and the Internet has enabled the explosive growth of distance learning. distance learning is a process that is increasingly present in the world. This is the field of education focused on educating students who are not physically present in the traditional classrooms or student’s campus. described as a process where the source of information is separated from the students in space and time. If there are situations that require the physical presence of students, such as when a student is required to physically attend the exam, this is called a hybrid form of distance learning. This technology is increasingly used worldwide. The Internet has become the main communication channel for the development of distance learning.

Acute appendicitis is one of the most common causes of acute lower abdominal pain. However, there are other diseases that can cause pain and mimic acute appendicitis. Some of these conditions are treated surgically; however, some of them should be treated conservatively. Therefore, the treatment of diseases associated with a number of decisions made by doctors and patients. The decision making is divided into three levels. At the first level, the patient and his family are to decide that patient should go to visit physician. At the second level is a physician in primary health care, who decides whether a patient deserves conservative or operative treatment. If he think that it is necessary to forward patient to the hospital, the other specialist: surgeons, urologists and gastroenterologists are involved in the decision making process. At the third level are decisions about the future treatment of the patient. The patient can be sent to home treatment, control exam could be appointed, patient cold be operated or observed. For decision making process physicians use information collected from patient’s history, physical examination of patients, laboratory tests and radiological examinations.

One of the most common causes of acute pain in the lower abdomen is appendicitis and covers almost two thirds of the total number of hospitalized patients. The survey included all patients who have pain in lower abdomen and came to the review at the Polyclinic Doboj-South and General Hospital Tesanj during 24 working hours. The sample consisted of 101 patients hospitalized at the General Hospital Tesanj with the clinical picture dominated by acute pain in the lower abdomen. Taken into account are all relevant clinical parameters necessary for establishing rapid etiological diagnosis of acute lower abdominal pain. So we can say that appendicitis has the following characteristics: pain is gradual, increasing in duration from 8 to 16 h, localized in the lower right quadrant, or begins in the epigastrium and is descending into the lower right quadrant and spreading in a large percentage of proximal dorsal and then the inner part of the thigh. Accompanied by nausea, vomiting, with a statistically significant increase in leukocyte levels over 10000 and pathological findings in urine. The difference between rectal and axillary temperature was statistically significant. Palpatory positive painful in Mc Burney spot. Patients are usually younger than 30 years.