Injuries caused by pressure activated explosive devices are very complex medical and social problem in Bosnia and Herzegovina. Hindfoot injuries are also a big challenge for orthopedic surgeons concerning all forthcoming physical assessment of the patients and the fact that the forefoot and midfoot remain preserved. The study included 60 patients with amputation that followed such an injury, and 60 patients treated with reconstructive procedures. The gait of the patients was assessed in the period of 4 years. In 20 patients, destroyed tissues were sent referred for pathohistologic examination, which revealed typical signs of a damage caused by high kinetic energy devices. The gait was analyzed objectively by the examiner and subjectively by the patients, which was the main indicator of successful treatment. Infection analysis and plantogram were also taken into account. The study showed that in a number of cases primary reconstruction of the hindfoot injuries caused by pressure activated explosive devices was possible with satisfactory results, thus foot amputation having strict indication. Indications for amputation have been limited and foot preservation has become more real in the majority of patients.

The most common and dangerous operative complication after procedure hip joint replacement in orthopaedic surgery is plumonary embolysm. In our work we compare frequency of tromboembolic complications in group which was under suggested profilaxa and in other group with no such profilaxa. Importance of this work is not in a reducing of such complications but also in accepting of unique, wide excepted and scientific based protocol of postoperative tromboembolic profilaxa in ou country.

BACKGROUND Recent vascular studies suggests that patients with arterial occlusive disease (AOD) and with elevated score of multiple risk factors (MRF), especially diabetes mellitus, have an increased prevalence of critical limb ischaemia, increased incidence of lower limb amputations, and an overall poor outcome of their AOD. The aim of this study is to evaluate an overall outcome of AOD, Fontaine stage III and IV, and to correlate their outcome with score of MRF. METHODS We enrolled a group of 136 patients (99 males and 37 females), with an average of 63.7 yrs and SD 12.2 all with AOD, Fontaine stage III and IV. We divided pts in three groups--pts on medicament treatment--MT group, pts for lower limb amputation--AMP group, and pts for vascular surgery. According to their clinical stage we had group in Fontaine stage III (n-48), and Fontaine IV (n-88). We followed 9 clinical variables: age, gender, tobacco, arterial hypertension, diabetes mellitus, hyperlipidaemia, level of fibrinogen, coronary ischaemic disease and cerebrovascular disease. RESULTS In MT group we had n-91 (66.9%) with MRF score of 3.42. In Fontaine stage III we had 37 pts with MRF score of 3.89, and in Fontaine stage IV we had 54 pts with MRF score of 3.37. In AMP group we had n-23 pts (16.9%) with MRF score of 3.39, and all pts were in F IV stage. In VH group we had n-22 pts (16.1%) with MRF score of 3.1. In VH group 50% of pts were in F IV stage. In overall group (n-136) we had a significant number of Fontaine IV stage pts, p < 0.01. CONCLUSIONS We had a high risk group of patients, with mean MRF score of 3.42, 23 pts (16.9%) were referred for lower limb amputation, and 23 pts (16.9%) for vascular surgery. MRF score correlate with overall outcome of AOD, r = 0.72, p < 0.001.

In this paper is presented modality of emergency medical transport by air. Here are a lot of examples of this way of organisation in developed countries as Europe and USA. This way of transport is very effective system of air transport, and it will be very practically in the future in countries in transition as B&H.

We shall present a case of the patient with inferior paraplegia and developed bed-sore. Complications of necrotic lumbar fascitis in femoral and gluteal region have occurred but the fast and radical surgical approach together with medicaments support lead to cure.

: In siege and blocked Sarajevo, in 40 months, in primary care unit and than in Emergency Department 42,075 injured and ill persons have got the first aid. Out of that, 37% were injures 16% acute surgical conditions, 23% internal urgent conditions (since October 1994). There were 24% non-urgent cases from the surgical field. In this period of time 107,453 patients were treated hospitably, with an average of 2.108 hospital beds. In 1996, the primary care was given in 21,708 urgent cases, or 60% of 36,312 hospitably treated persons in total. There were 29% injuries, 24% of acute surgical cases, and 47% of internal medicine cases. Urgent centre received 53% individual paints who came by themselves without any medical aid; 25% from health centres where they have bog a primary care, and 22% came after received first aid of primary care in the Emergency department. By applying war surgical doctrine and general medical doctrine, with appropriate services for prompt diagnostics and treatment, with qualified specialists and consultancy services, a good quality of adequate treatment and care has been achieved, the mortality has been reduced, the hospitalisation has been rationalised, and treatment length has been reduced. Analysis demonstrates the reasons for existence of such medical centres in large hospitals. We have recognised the problems we are facing with, and which have to be solved progressively, as well as those concerning the functioning health services in Sarajevo Canton, and Federation of B&H. On the basis of all these knowledge's we believe that a well organised urgent medicine implemented in practice has great importance in the overall treatment. Basic objectives for establishing the urgent medicine as a system are: The first priority is to organise a modern system of urgent medicine, based on the principles of general medical doctrine and complementing with health care system. Urgent medicine programme should be incorporated in the process of medical education of the medical staff, giving a priority to the activities in practice. Provide modern equipment and adequate working space. Develop already developed co-operation with institutions and professionals from Europe and USA. Improve the low level of the first aid training of the population through the first aid courses.

Fasting (arabic-savm) was proclaimed through islam, and thus it is an obligation for Holly Prophet Muhammad s.a.v.s.-Peace be to Him-in the second year after Hijra (in 624 after Milad-born of Isa a.s.). There is a month of fasting-Ramadan-each lunar (hijra) year. So, it was 1415th fasting this year. Former Prophets have brought obligative messages on fasting to their people; so there are also certain forms of fasting with other religions i.e. with Catholics, Jews, Orthodox. These kinds of fasting above differ from muslim fasting, but they also appear obligative. All revelations have brought fasting as obligative. From medical point of view, fasting has two basical components: psychical and physical. Psychical sphere correlate closely with its fundamental ideological message. Allah dz.s. says in Quran: "... Fasting is obligative for you, as it was obligative to your precedents, as to avoid sins; during very few days (II, II, 183 & 184)." Will strength, control of passions, effort and self-discipline makes a pure faithfull person, who purify its mind and body through fasting. Thinking about The Creator is more intensive, character is more solid; and spirit and will get stronger. We will mention the hadith saying: "Essaihune humus saimun!" That means: "Travellers at the Earth are fasters (of my ummet)." The commentary of this hadith, in the Collection of 1001 hadiths (Bin bir hadis), number 485, says: "There are no travelling dervishs or monks in islam; thus there is no such a kind of relligousity in islam. In stead, it is changed by fasting and constant attending of mosque. That was proclaimed as obligation, although there were few cases of travelling in the name of relligousity, like travelling dervishs and sheichs." In this paper, the author discusses medical aspects of fasting and its positive characteristics in the respect of healthy life style and prevention of many sicks. The author mentions positive influence of fasting to certain system and organs of human body. According the author, o basic messages of fasting could be a Roman poet's saying:" Mens sana in corpora sanum."