Aim To establish the presence of two risk factors, smoking and alcohol use, for non-communicable diseases among students at the University of Zenica. Methods The research was conducted at eight schools of the University of Zenica in the academic year 2016/2017 during the period from 1 December 2016 to 15 February 2017. The study involved 600 students 19-29 years of age (all years of study). The research was carried out with a standardized and validated questionnaire, the STEPS non-communicable Disease Risk Factors survey, developed by the World Health Organization. Results Tobacco was used by 145 (24.2%) students, 68 (46.9%) of them being males and 77 (53.1%) females (p<0.05). Males smoked 15.62 and females 13 cigarettes per day (p<0.05). On average, male participants were 16.56 years old, and female participants 16.71 when they started consuming cigarettes (p<0.05). A total of 289 (48.1%) students consumed alcohol, of whom 135 (70.2%) were males and 154 (37.7%) females (p<0.05). Conclusion There is evidence of high prevalence of smoking and alcohol usage as the risk factors for non-communicable diseases. Two levels of the prevention measures should be applied in order to reduce the prevalence of such risk factors: strategic level with a definition of the population, actors, activities, target population and anticipated results, and tactic level which will show contingency activities at the University.

Aim The aim of the paper is to present the risk of pregnancy for mother and her child in a young patient who had a surgery to repair Tetralogy of Fallot (ToF), who gave a birth to her firstborn by having a cesarean section. Case report 23 years old patient, in 28 weeks of pregnancy was admitted to the clinic due to her medical record. She did not have any subjective complaints. She had two surgeries to repair ToF. After the surgery, she had residual ventricular septal defect (VSD). She had her first surgery 20 years ago (she was 3 years old), and second 7 years ago (she was 16). She had regular check-ups since, and her heart condition was unchanged. Due to her heart surgeries and VSD, a cardiologist indicates that she should deliver by having a c-section when she is 36 weeks pregnant. The patient’s heart condition was stabilized and the patient was sent home. She was recommended to have her cardiologist check up on her as she leaves the hospital and to have a gynecological examination in 6 weeks. Conclusion It can be concluded that team work and prenatal care, in most cases, lead to delivery without complication, both for mother and fetus.

Introduction Diabetes mellitus(DM) is considered an independent cardiovascular risk factor. Having in mind concomitant occurence of diabetes and other cardiovascular risk factors, it is expected that patients with poor glucoregulation will have more cardiovascular risk factors and higher cardiovascular risk than patients with good glucoregulation. Aim To compare cardiovascular risk and cardiovascular risk factors between patients with poorly controlled and patients with well-controlled Diabetes mellitus. Material and Methods Hundered ten patients aged 40-70 years suffering from Diabetes mellitus type 2 were included. Research is designed as a retrospective, descriptive study. Patients with glycosylated hemoglobin (HbA1c) > 7% were considered to have poorly controlled diabetes. The following data and parameters were monitored: age,sex, family history, data on smoking and alcohol consumption, BMI (body mass index), blood pressure, blood glucose, total cholesterol, triglycerides, LDL, HDL, fibrinogen, uric acid. For the assessment of cardiovascular risk, the WHO / ISH (World Health Organization/International Society of hypertension) tables of the 10-year risk were used, and due to the assessment of the risk factors prevalence, the optimal values of individual numerical variables were defined. Results Differences in the mean values of systolic, diastolic blood pressure, fasting glucose, total cholesterol, LDL cholesterol are statistically significant higher in patients with poorly controlled diabetes. Hypertension more frequently occurre in patients with poorly controlled DM. The majority of patients with well-controlled DM belong to the group of low and medium cardiovascular risk, while the majority of patients with poorly controlled DM belong to the group of high and very high cardiovascular risk. In our research, there was a significant difference in cardiovascular risk in relation to the degree of DM regulation, and HbA1c proved to be an important indicator for the emergence of the CVD. Conclusion There are significant differences in certain risk factors between patients with poorly controlled and well controlled DM. Patients with poorly controlled diabetes mellitus have a higher cardiovascular risk than patients with well controlled diabetes. The value of HbA1c should be considered when assessing cardiovascular risk.

Aim To determine most common factors making patients with high blood pressure seek professionally unacceptable treatment of hypertension at the Emergency Department. Methods The survey was conducted at the Emergency Department of the Primary Health Care in Gradačac on randomly selected 207 patients who requested medical help because of high blood pressure. For all patients arterial blood pressure and body mass index (BMI) were measured. A survey about knowledge and attitudes regarding habits that affect high blood pressure as well as the socio-economic conditions was made. Results Prevalence of 10.3% was found with regard to visits to emergency care by patients due to high blood pressure. Most patients, 127(61.4 %), were overweight and 36(17.4%) were obese. Patients who rarely controlled their blood pressure were more frequent visitors of emergency medical services. Stressful situation occurs as a factor in a variety of forms. The survey showed that 76 (36.7%) patients sought medical help even though they had no blood pressure values that required emergency care. Conclusion Poorly organized health care system with no continuous and comprehensive preventive promotional programs caused by inappropriate use of resources in health care. The reorganization of primary care with full implementation of family medicine and greater integration of family medicine with other levels of the health care system should provide a better control and treatment of other diseases such as hypertension.

Aim To investigate epidemiological characteristics of the measles epidemic (risk factors and reasons for its emergence) in order to establish better control and prevention of future epidemics as well as to determine an influence of poor collective immunization of children against measles on appearance of epidemic disease. Methods An open retrospective epidemiological study of measles infection was conducted during the epidemic in Zenica-Doboj Canton (ZDC) in the period 2014-2015. Disease reports, Disease Reporting Forms for measles and rubella cases and the Bulletin of the Institute for Health and Food Safety Zenica were used for data collection. Results A total of 325 patients with the diagnosis of measles were registered, 262 (80.61%) in 2014 and 63 (19.39%) in 2015 resulting in overall incidence of 81.25/100.000. The majority of patients were aged 0-6 (p<0.05). Of the total number of patients, only 13 (4.73%) were orderly vaccinated (p <0.05). In the period 2009- 2015 in ZDC 25.444 (83.34%) children (p <0.05) were vaccinated with measles, mumps, rubella (MMR) vaccine. Conclusion Results of the study show that the low level of vaccination of children continues to a risk of the emergence of epidemics of measles and other infectious diseases. Therefore, in order to prevent the disease there is a need for a better vaccination campaign.