The purpose of this paper is to bring to light the biographical details, the professional work and the publishing activities of Bogusławą Keckovą (Bohuslava Kecková in Czech and Keck in German), who functioned as an Austro-Hungarian health officer in Mostar from 1893 to 1911 during the period of the Austro-Hungarian occupation of Bosnia and Herzegovina (BH). Keckovą, who came from Prague, was the second of nine female physicians to be employed by the Austro-Hungarian authorities between 1892 and 1918. Keckovą contributed significantly to the improvement of public health and hygiene in BH, especially by organising the medical treatment of Muslim women. She published a series of popular medical articles, both in Czech and in Bosnian. Her medical articles in the Mostar newspaper, 'Osvit', were among the first in BH to promote public health education and aimed at improving the health of the population. In the Czech Republic, 'Bohuslava Kecková' is renowned for being the first Czech female physician to graduate, who, due to Austria's conservativism and anti-feminism, had been forced to study and practise abroad. After Keckovą's efforts to have her Swiss MD degree (1880) recognised in Austria failed in 1882, she acquired an Austrian midwife's diploma and established a maternity home in Prague. In 1892, she accepted the invitation to serve as an Austro-Hungarian female health officer in Mostar, where she initialised and popularised the utilisation of public health among (Muslim) women. CONCLUSION: Bogusławą Keckovą's work as a physician, medical writer and health educator, which she continued tirelessly until her death in 1911, was based on gender-specific socialmedical concepts, which were at the core of the contemporary Czech feminist movement.

This biographical note details Anna Bayerová's (1853-1924) activities as the first female Austro-Hungarian health officer in 1878 to1918 occupied Bosnia and Herzegovina (BH). Anna Bayerová is known as a heroine of Czech feminism and the 'first Czech female physician', though she only practised in the Czech lands from 1913 to 1916. In 1891, Bayerová was enrolled as the first Austro-Hungarian female health officer and assigned to treat Muslim women in the district of Tuzla, Bosnia. She pursued this mission for the first three months of 1892, had herself transferred to Sarajevo in the summer, and soon thereafter quitted the service. Her biographers point to a series of political and personal motivations to abandon her mission in Bosnia, which, from the viewpoint of Czech feminists, included fulfilling her professional duties in an exemplary way. She spent most of her professional life as a physician in Switzerland and did not request Austrian recognition of her medical degree until 1913. Bayerová died in Prague in 1924. Conclusion. Bayerová, partly for political reasons and partly due to her panic-fuelled fear of catching tuberculosis, quitted her role as the first Austro-Hungarian female health officer in BH soon after her arrival in 1892.

This paper presents the medical journals published in Bosnia and Herzegovina (BIH) in the period from 1878 to 1945. The first medical journal in BIH may be deemed to be Jahrbuch des Bosnisch-Hercegowinischen Landesspittales in Sarajevo (The Yearbook of the National Hospital of Bosnia and Herzegovina in Sarajevo). In a special part of this journal, doctors from Austro-Hungary serving in Sarajevo wrote scholarly articles about their patients' various ailments. Up to 1945 seven more medical journals were published in BIH: Trezvenost - Organ Jugoslavenskog Saveza Trezvenosti (Temperance - the Journal of the Yugoslav Temperance Society), Zdravlje - Lekarske pouke o zdravlju i bolesti (Health, Medical lessons on Health and Disease), Glasnik Lekarske komore za Bosnu, Hercegovinu, Dalmaciju i Crnu Goru (The Journal of the Chamber of Physicians of Bosnia, Herzegovina, Dalmatia and Montenegro), Glasnik Lekarske komore Vrbaske banovine (Journal of the Chamber of Physicians of Vrbaska banovina, Glasnik Lekarske komore Drinske banovine (Journal of the Chamber of Physicians of Drinska banovina), Vjesnik Zavoda za suzbijanje endemijskog sifilisa u Bosni i Hercegovini (Journal of the Institute for Combatting Endemic Syphilis in Bosnia and Herzegovina) and Časopis za medicinu i biologiju (Journal for Medicine and Biology). CONCLUSION Medical journals published in BIH in the period from 1878 to 1945 were published in times marked by specific political and social circumstances in BIH, in the time when BIH was not independent, and was under the influence of the health culture of the ruling regimes. Most of the authors of the articles published in these journals were citizens of the occupying authorities, although the papers published were mainly the result of research undertaken in BIH.

OBJECTIVE The aim was to determine the prevalence of marijuana smoking among school-aged adolescents in the Brčko District of Bosnia and Herzegovina, with particular regard to their gender, age and residence, and the frequency of marijuana smoking in the past thirty days in relation to their peers in the rest of Bosnia and Herzegovina, the Republic of Croatia and the Republic of Serbia. SUBJECTS AND METHODS This research, designed as a cross-sectional study and based on the ESPAD (European School Survey Project on Alcohol and Other Drugs) questionnaire, adjusted to this research, encompassed 4,188 adolescents from elementary and secondary schools. The data were collected by means of questionnaires tailored to each respondent. RESULTS A significantly lower number of adolescents smoke marijuana in comparison to those who do not smoke, but male adolescents smoke more often than female adolescents (p<0.001), as well as urban youth in comparison to rural youth (p=0.04). Every fourth adolescent, regardless of gender, who smoked marijuana, used it before the age of thirteen (p<0.001), male adolescents more often than females (p=0.002). In the previous thirty days a higher percentage of all the respondents from the Brčko District had smoked marijuana than those from the Republika Srpska and the RS (p<0.001), and there is no difference between them and their peers from the Federation of Bosnia and Herzegovina and the RC (p=0.382 and p=0.608). CONCLUSION Smoking marijuana in the Brčko District is a major public health problem. Male adolescents smoke marijuana more often than female adolescents, and urban youth more in comparison to rural youth. In the previous thirty days adolescents from the Brčko District smoked more often than their peers from the Republic of Serbia and the Republika Srpska, and with the same intensity but less frequently compared to adolescents from the Republic of Croatia and the Federation of Bosnia and Herzegovina.

OBJECTIVE The aim of the study was to evaluate the incidence, mortality, risk factors, aetiology and the susceptibility to antibiotics of the bacteria responsible for sepsis. MATERIAL AND METHODS A single centre, prospective, observational study, involving 200 neonates admitted over 12 months to the NICU of the University Children's Hospital, Tuzla, Bosnia and Herzegovina. RESULTS The crude incidence of all neonatal sepsis was 68.0% (136/200) and that of late-onset sepsis (LOS) was 48.5% (97/200), yelding an incidence density of LOS of 41.6/1000 patient days. LOS represented the most frequent infection and was significantly more frequent than early-onset sepsis (EOS) (71.3% versus 28.7% p<0.001). The overall mortality was 14.0%, and 18.4% among infected neonates. Risk factors associated with LOS were: mechanical ventilation, intravascular catheter, surgical procedures, birth weight ≤1500 g, gestational age ≤ 28 weeks and Apgar score ≤ 3 at 5 minutes. Culture proven sepsis developed in 43.4% of neonates. Klebsiella pneumoniae and Enterococcus faecalis were the predominant bacteria. Gram-negative bacteria were susceptible to amikacin, imipenem and meropenem; gram-positive bacteria to vancomycin and amikacin. CONCLUSION Neonatal sepsis in our NICU showed a high incidence rate, and gram-negative bacteria were predominant. Low gestational age, mechanical ventilation and an intra-vascular catheter were significantly associated with sepsis. It is necessary to develop a multidisciplinary approach for routine surveillance of nosocomial infections, to improve the asepsis of therapeutic procedures, and to implement the more appropriate use of antibiotics.

This study aims to present evidence of censorship during World War II by the Independent State of Croatia of one of its public health officials, Dr. Stanko Sielski who was a physician trained in epidemiology and public health. During World War II, he directed the Institute for Combating Endemic Syphilis in the Bosnian town Banja Luka. The staff under his direction consisted solely of Jewish physicians. We analyzed two groups of envelopes either sent by or to Dr. Stanko Sielski during the War and found evidence of censorship only in communications with a Jewish physician dated towards the end of the War. Dr. Stanko Sielski would be posthumously recognized for his efforts to shield his Jewish colleagues. CONCLUSION The newly available, but still limited data, which we present indicates efforts to censor Dr. Stanko Sielski's postal communications towards the War's end. The censors targeted specifically Dr. Stanko Sielski's correspondences with the Jewish physicians he was protecting. This material highlights the many challenges his public health service experienced during the time of armed conflict.

Objective - We aim to emphasize the importance of extensive endocrine workup in cases of pituitary masses. Case report - We report on a case of pituitary thyrotrophic hyperplasia in a 12-year-old girl who was thought to have a pituitary macroadenoma with suprasellar extension. The main complaint was headache, while other symptoms of hypothyroidism were present, but weren't recognised. Hormonal testing revealed low total thyroxine (<12.8 nmol/l) and high TSH (310.5 mIU/l) levels, and hyperprolactinemia (prolactin level at 1680 mIU/l). Based on the clinical history, laboratory data, and MRI, a diagnosis of pituitary hyperplasia secondary to primary hypothyroidism, consequent to chronic autoimmune thyroiditis, was made. Therapy with levothyroxine was initiated at 50 I¼g/day and gradually increased to 75 I¼g daily. After three months of thyroxine replacement, she was clinically and biochemically euthyroid. A follow-up MRI, 4 months after thyroxine replacement was initiated, showed complete resolution of the mass, and normal pituitary gland. Conclusion - Primary hypothyroidism should be considered in the differential diagnosis of pituitary masses. Multidisciplinary assessment in these cases will help to avoid delays in diagnosis and prevent unnecessary surgery.

UNLABELLED This work presents the results of research into the life and work of Dr. Stanko Sielski, related to his professional, scientific and humanitarian work. He was born in Gračanica, Bosnia and Herzegovina (BH) in 1891, to a family of Polish origins. He attended high school in Travnik and completed his studies of medicine in Vienna in 1919. During the First World War he served on the frontlines with the Austro- Hungarian army. He began his service as a doctor in Konjic, Prozor and Glamoč, and then worked in Varcar Vakuf, Zenica, Travnik, Bihać, Banja Luka, Sarajevo and Tuzla. At that time in BH living conditions were very bad, the level of education of the people insufficient, there were many epidemics of infectious diseases, and the mortality of the population was high. Dr. Stanko Sielski made a significant contribution to treating the sick, preventing various diseases and the health education of the people. In the realm of the history of medicine in BA, he researched the life and work of doctors from previous generations, the work of medical institutions, old medical manuscripts written in Arabic, Persian and Turkish, folk beliefs about the origins and treatment of a variety of illnesses, and the role of herbal medicine and amulets in treating the sick. In addition, he undertook research in the fields of archaeology, ethnology and sociology. He published the results of his research in scholarly journals. In the Second World War he saved the lives of many Jewish doctors and their families from persecution in concentration camps, and as a result in 2014 he was posthumously declared "Righteous Among the Nations". CONCLUSION Dr. Stanko Sielski, alongside his work as a doctor, was also involved in a variety of scientific research and publication work, which contributed to the preservation and a better understanding of the material and spiritual heritage of BH.

OBJECTIVE The aim of this study was to determine the effect of psychosocial factors on the age at menarche of girls in Federation of Bosnia and Herzegovina (FBH). SUBJECTS AND METHODS A cross-sectional study was conducted from September 2002 to May 2003 in all Cantons of the FBH. The random stratified sample included 19.803 girls aged 9.0 to 17.5 years. Data were collected using the status quo method. Probit analysis was used to estimate median age at menarche and 95% confidence intervals. RESULTS The present study shows that menarche occurred significantly earlier (p<0.05) in girls from dysfunctional families (median: 12.99 years, 95% confidence interval: 12.93-13.05) than in girls who grew up in intact families (median: 13.04 years, 95% confidence interval: 13.01-13.07). Analyzing separately the impact of each of family stressors on age at menarche, we found that menarcheal age was significantly lower in girls from single-mother families, whose parents are divorced, whose one parent is died and where alcoholism in family is present than in girls from intact families. Maturation was found to be earlier in girls from dysfunctional families then in those from intact families after the influence of place of residence and sibship size was eliminated. CONCLUSION From our research we can conclude that the girls from dysfunctional families reached earlier age at menarche than their peers who grew up in normal families, and that this effect did not disappear after controlling for socioeconomic variables.

OBJECTIVE The aim of the study was to determine the epidemiological characteristics of bacterial meningitis observed in neonates born in the Department of Gynaecology and Obstetrics, University Clinical Centre Tuzla, Bosnia and Herzegovina, admitted to Intensive care unit (NICU) or readmitted, because of suspected infection, after discharge from the nursery. SUBJECTS AND METHODS This study was carried out from July 1, 2012 to June 30, 2013. During this period 4136 neonates were born. All neonates admitted to the Intensive care unit with signs and symptoms of systemic infections, and neonates readmitted to the Intensive care unit, after discharge from the nursery for sepsis work up were included in the study. RESULTS Eighteen of 200 neonates (9%) admitted or readmitted to the NICU developed meningitis. 61% cases were late onset meningitis. The overall incidence was 4.4/1000 live births. The mortality rate was 11.1%. The mean age of symptom presentation was 8.7 days. The most common clinical features were: fever, respiratory distress and jaundice. Significant risk factors for acquiring meningitis were: male gender, Caesarean delivery, stained amniotic fluid. Positive CSF finding were detected in 6/18 (33.3%) of cases. Gram-positive bacteria were more frequently responsible for confirmed meningitis. In all neonates with meningitis blood culture was examined and 5 (50%) yielded Gram-negative bacteria. CONCLUSION The high rates of neonatal meningitis with predominant late onset may suggest nosocomial origin. Measures to improve antenatal, intrapartum and delivery care and measures during NICU hospitalisation are necessary to lower the risk of nosocomial infections.