ABSTRACT The aim: of this study was to compare two methods of polypropylene mesh fixation for inguinal hernia repair according to Lichtenstein using fibrin glue and suture fixation. Material and Methods: The study included 60 patients with unilateral inguinal hernia, divided into two groups of 30 patients – Suture fixation and fibrin glue fixation. All patients were analyzed according to: age, gender, body mass index (BMI), indication for surgery–the type, localization and size of the hernia, preoperative level of pain and the type of surgery. Overall postoperative complications and the patient’s ability to return to regular activities were followed for 3 months. Results and discussion: Statistically significant difference in the duration of surgery, pain intensity and complications (p<0.05) were verified between method A, the group of patients whose inguinal hernia was repaired using polypropylene mesh–fibrin glue and method B, where inguinal hernia was repaired with polypropylene mesh using suture fixation. Given the clinical research, this systematic review of existing results on the comparative effectiveness, will help in making important medical decisions about options for surgical treatment of inguinal hernia. Conclusions: The results of this study may impact decision making process for recommendations of methods of treatment by professional associations, making appropriate decisions on hospital procurement of materials, as well as coverage of health funds and insurance.

INTRODUCTION Multiple sclerosis (MS) and Parkinson's disease (PD) are chronic diseases with unpredictable course causing progressive physical disability and cognitive decline, and broadly affecting the patient's life, social interaction, recreational activities and overall life satisfaction. GOALS To examine the quality of life of patients with PD and MS, and investigate the existence of differences between the degree of impairment to the quality of life in PD and MS. METHODS A prospective study was conducted at the Neurology Clinic, University Clinical Center in Tuzla in the period from December 2005 until May 2007. The study included subjects with confirmed diagnosis of MS and PD. We analyzed 50 patients with PD and 50 patients with MS, with disease duration 1-5 years without any or with mild cognitive impairment. Quality of life was assessed using the SF-36 scale comprised of 36 questions in eight health profiles. RESULTS There was no significant difference in gender frequency in our study sample of patients with PD, while in MS group of patients there were a significantly more females. The average age of the PD patients was 63.18 +/- 10.42, and in patients with MS 37.4 +/- 8.65 years. In our study the relative influence of PD and MS on quality of life was similar after controlling the duration of the disease, and there were some differences in relation to the degree for clinical disability. Subjects showed reduced QoL independently of the duration of illness (patients with PD in 88% of cases, and multiple sclerosis in 84% of cases). There are significant differences in the occurrence of poor quality of life in patients with PD were in advanced clinical stages of disease for the physical, mental dimension of the SF 36 and the total score. Respondents in stages III-V of the disease were 5.23 times (23%) likely to experience reduced QoL compared to those with less physical disability. In subjects suffering from MS reduced QoL was not related to the degree of clinical disability in physical, nor the mental dimension of the SF 36 and the total score. These results in MS patients can be partially explained by the small sample size, on the other hand it is possible that patients with MS, although they have greater physical disability seen as a very difficult diagnosis which determines the entire life. CONCLUSIONS Patients who are treated for PD and MS had a high degree (> 80%) of reduction of the overall quality of life, and there were no significant differences in the extent of QoL reduction between these groups of patients. Reduced quality of life in patients with PD is observed during severe stages of the disease, while the QoL does not depent on the degree of clinical disability in MS patients. In both groups of patients the appearance patients reduced QoL does not depend on the duration of the disease.

The aim of the study was to analyze the usefulness and side effects of treatment with interferon beta 1B (Betaferon) in patients with the relapsing-remitting form of multiple sclerosis (RRMS). The study included 32 RRMS patients that had completed two-year therapy with interferon beta 1B or were still receiving this therapy. Every six months, patients were clinically evaluated and scored by the Expanded Disability Status Scale (EDSS). Two-year therapy was completed by 11 (34.3%) of 32 RRMS patients. Relapse was verified in 4 (36.36%) patients. The mean EDSS score was 2.45 +/- 1.03 at the beginning of therapy and 2.54 +/- 0.98 after two-year therapy; the difference was not statistically significant. In 2 (6.25%) patients on therapy for 18 months there was no relapse, and the mean EDSS was 1.75 +/- 0.35 (both at therapy introduction and at 18 months). Five (15.62%) patients were on therapy for one year. The mean EDSS was 1.6 +/- 1.08 at the beginning of therapy and 1.5 +/- 0.70 at one year. One patient experienced relapse. Two patients were on therapy for six months. They had no relapses with the same EDSS at six months as at therapy introduction (2.0). At the beginning of 2008, another 12 patients started therapy with interferon beta 1B. In conclusion, our experience with two-year interferon beta-1B therapy for RRMS is favorable, with a relatively low rate of relapses (36.36%) and without significant worsening on EDSS. The medication side effects were mild and transient.