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 The objective of the study was to determine the prevalence of cigarette smoking in adolescents in public schools of the Brčko District of B&H in relation to their gender, age and place of residence. Participants and ­Methods A cross-sectional study, based on the ESPAD (European School Survey Project on Alcohol and Other Drugs) questionnaire adapted to this research comprised 4,188 respondents who attended primary and secondary schools. Data were collected using a questionnaire prepared for each respondent. Results Significantly fewer respondents smoke cigarettes compared to those who do not (p < 0.001), while in relation to gender male adolescents smoke more often than female adolescents (p = 0.012). In relation to their place of residence it is established that a significantly higher number of respondents from rural areas smoke cigarettes compared to those from the city (p < 0.001). More than half of the respondents, who smoke regardless of their gender, had their first cigarette before the age of 13. Male adolescents often begin smoking before the age of thirteen compared to female adolescents (p < 0.001), while female adolescents often begin smoking between the ages of 15 and 16 in relation to male adolescents (p <0.001). Every second respondent who smokes cigarettes irrespective of his/her place of residence did so at the age of 13. However, the respondents from rural areas smoke more often (p < 0.0001). Out of 895 respondents who smoked during the last month, 259 of or 30.3 % smoked only one cigarette a week, 162 or 18.1 % smoked 1-5 cigarettes a day, 168 or 18.8 % of the respondents smoked 6-10 cigarettes a day, 146 or 16.3 % smoked 11 to 20 cigarettes a day, and 160 or 17.9 % of the respondents smoked every day. Conclusion Although 42.8 % of the respondents who had ever smoked cigarettes is significantly less compared to 57.2 % of the respondents who do not smoke, that number is disturbing since we talk about the vulnerable population group and the fact that every second adolescent started smoking at the age to 13.

Abstract Background: The aim of this study was to evaluate health-related quality of life (HRQOL) in children and adolescents with type 1 diabetes (TIDM) in Montenegro compared with healthy controls and to estimate the effect of metabolic control on perceptions of HRQOL. Methods: This study involved children and adolescents with T1DM, age- and gender-matched healthy children and their parents. Children and adolescents with T1DM and their parents completed Peds QL 4.0 Generic Core Scales (GCS) and PedsQL 3.0 Diabetes Module. Healthy children and their parents completed self- and proxy-report of Peds QL 4.0 GCS. Results: Our study (self- and proxy-report) showed that children and adolescents with T1DM had lower HRQOL on domain “Psychosocial health” and “School functioning” compared with healthy population (p=0.008; p≤0.001). Lower glycosylated hemoglobin (HbAlc) values were associated with fewer worries, and better health perception by diabetic children and their parents. We did not find notable differences between boys and girls on health perception. Different age groups reported similar QOL. Parents reported that the illness has a greater impact on children’s lives than the children reported themselves. Conclusions: Compared with the healthy children, the HRQOL was lower among children and adolescents with T1DM. Lower HbA1c was associated with better quality of life.

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.

The Museum of the History of Health Care in Croatia, as the first such museum in the southeastern part of Europe, was established by the Croatian Medical Association in Zagreb in 1944. Beside Vladimir Ćepulić (1891 - 1964) the head of the Croatian Medical Association, epidemiologist Stanko Sielski (1891 - 1958), was one of the most prominent personalities to be credited for realizing this project. He was born in Gracanica into a family of Polish origin. After his graduation in Vienna in 1919, he worked as an epidemiologist in Konjic, Prozor, Glamoc and other places in the area of Bosnia, mostly involved in typhoid fever and variola eradication. At the beginning of the Second World War he was in Banja Luka where he was given the duty of director of the Department of Endemic Syphilis Eradication. During 1942 and 1943 his correspondence took place with Vladimir Ćepulić, which is today preserved in the Section of the History of Medicine of the Croatian Academy of Sciences and Arts in Zagreb. On the basis of this material it was possible to trace the circumstances of the foundation of the Museum of the History of Health Care, how items were collected for its first exhibition, and the role of Stanko Sielski in preserving the medical heritage and dissemination of knowledge of the history of medicine to a broader audience.

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.

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.

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.

UNLABELLED The Postgraduate studies (PS) at the Medical Faculty (MF) of the University of Tuzla (UT) were founded with the aim of training future staff of the MF in scientific research work. The course lasted four semesters. Up to 1986, classes were attended by five generations or 141 postgraduate students, and 57 of them received their Master's degree (MSc's). Classes were held every week on Fridays and Saturdays. One part of the classes was taught at the MF in Szeged (Hungary). Besides teachers from the UT, classes were also taught by teachers from other universities from the former Yugoslavia and abroad. The most important textbooks were: Cell and Molecular Biology by de Robertisa, Mathematics and statistics for use in pharmacy, biology, and chemistry by Saunders & Fleming, and Kako se pišu saopštenja o medicinskim istraživanjima (How to write reports of medical research) by Rajko Igić. Searching the index base Pub Med at the end of 2014, by the surnames and initials of the names of the 57 masters, we found that they had published 14 articles before completing their MSc's and 821 articles after completing their Master of Science. Later, 35 masters received PhDs and were appointed assistant professors, and later they were also appointed to higher ranks. CONCLUSION Looking at the results of the PS, MF of the UT in the above mentioned period, it can be said that the PS was the place where the formation began of the future scientific and teaching staff of the MF in Tuzla.