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The aim of this study was to show how different coping mechanisms influence the prevalence of anxiety and depression in people suffering from multiple sclerosis. We also aimed at showing how different coping mechanisms contribute to subjective prosperity of the patients emphasizing general health, cognitive functions and fatigue. A questionnaire was given to attendants of the VI Symposium of Patients Suffering From Multiple Sclerosis. Scales were taken from Multiple Sclerosis Quality of Life Inventory (MSQLI), Hospital Anxiety and Depression Scale (HADS) and COPE inventory. A total of 68 anonymous questionnaires were handed in. A total of 57.9% of examinees had symptoms of depression, and 63.2% suffered from symptoms of anxiety. However, majority of the examinees suffered from the combination of these entities. Hypothesis about impact of various coping factors on depression, anxiety, fatigue was validated except an impact on physical state was not proven significant. Predictors improving these states were positive reinterpretation, social emotional support and humor, Predictors worsening these states were planning, acceptance, focus on emotional ventilation and denial. Psychiatric comorbidity has a high prevalence in people suffering from MS. Different coping mechanisms can help in improvement of everyday life.

The interrelation between chronic stress and multiple sclerosis (MS) has always been known, but the biological foundation for this phenomenon has not yet been proven. Our case-study of 5 patients, both diagnosed with multiple sclerosis and PTSD, attempts to demonstrate various dimensions of interrelation between these two diseases. We have also tried to point out the problems and possible complications doctors might encounter during the treatment of an MS patient who is suffering from chronic stress. Our findings show the need for a multidisciplinary approach in the treatment of patients with chronic PTSD and co morbid multiple sclerosis, which will optimize treatment and result in more cost-effective care. Appropriate identification and optimal pharmacological interventions for both disorders might modify further chronicity of these disorders and thus achieve better outcome.

The patients with rheumatoid arthritis of the fourth grade have used the whole basic therapy and, of course, antirheumatic therapy with all their positive and negative effects. We have applied and analysed the application of analgetic physical therapy with TENS (Transcutaneous Electrical Nerve Stimulation). TENS appeared to be a perfect substitution for nonsteroid antirheumatics and analgetics. Its easy application, the possibility of using at home and practically non-existent contraindications give him the priority at pain relief for rheumatoid arthritis of the fourth grade.

Caustics are products which produces necrosis on contact place with chemical affinity to organic substance. Destroying intensity depend of types, concentration and quantity of product ingested. Poisons could be accidental and suicidal. Concentrated caustics rapidly produces necrosis, strong pain and severe general reaction on acute trauma, shock. Except the fact that acute burns with caustics products require an immediate diagnostic and therapeutic approach, this problem remains controversial. A retrospective analysis of 97 cases in last five years, including the war, in our ENT clinic done. Sex, age types and frequency of product ingested. Accidental, suicidal and the most often month it is happened analyzed. The acute diagnostic procedure in caustics ingestion are primarily directed toward the recognition of life-threatening complication such as shock, airway obstruction, perforation of inner organs and in severe acid ingestion, metabolic acidosis. esophagoscopy and endoscopy is accurate in predicting degree of esophageal injury. The aim of therapeutic procedures is to preserve homeostatic balance, to prevent shock and complication of acute hemorrhage or perforations as well as in the development of scar tissue and nepotistic strictures over time. The aim is to preserve the patients own esophagus. During long time experience treatment with diet, cortisone, antibiotics was successful in the prevention in the development of scar tissue and neoplastic strictures over time from esophageal II and III grade lesions.

The first ENT Department in Bosnia and Herzegovina was established in Sarajevo by Dr. Zarko Prastalo in 1923, as a part of the Surgery Clinic, with 10 beds. The next year (1924) ENT got its own operation theatre, 30 beds more and a new localization. In that period there was only one ENT specialist, Dr. Zarko Prastalo. Three years after some new doctors started the specialization in ENT. By the year 1946 the ENT Department became a University clinic with 7 doctors on duty, the Clinic became an educational centre. To the year 1992, 112 ENT specialists were educated in the ENT Clinic in Sarajevo. Later in time, after Dr. Zarko Prastalo, Dr. Ivo Herlinger, Dr. Josip Gerc and Dr. Emilija Bac became known ENT specialists. The new scientific and operation techniques came to the ENT Clinic, the first chelognapalato schisis was in 1936, done by Dr. Josip Gerc. The first ear operation using operation microscope and microinstruments was performed in 1962, while the first laryngo-micro-operation in 1971. Since 1965 th worked with the Maxilofacial Surgery, together, but in 1972 they moved to the stomatologic Clinic, With the development of the clinic, 10 our patient departments (ambulances) were established in Sarajevo. As for now, during the war, there are 101 beds, 13 ENT specialists. Dr. Sejo Sebić was killed in 1992 by the aggressor.

The paper analyzed our experiences with repairing the skin defects in 120 wounded patients in the first war year. After primarily surgical observations patients were hospitalized in the ORL clinic for a further care. Most of wounds were by artillery projectiles. Extensivity, intensivity and primary contamination are three characteristics of war wounds that makes problems in definitely repairing of defects. This is because of the secondary repair 67.80% defects. Spontaneous reepithelization is noticed in 14.80% defects. By direct sutures we closed 16.00%, free skin tissues grafts 23.26%, used various techniques of rotation and transposition flaps 46.52% defects. Correct plastic reconstructive planning and active physical-chemical preoperative treatment eliminated big postoperative complications.

Since the beginning of the war, during the last year, we have examined 255 patients who were exposed to shelling of different origin and caliber. Our pilot study included 197 of patients. We have excluded patients having serious head and brain injuries, as well as cases previously having chronic ear infection, hearing damage and disturbances of vestibulary functions. Patients over 55 years of age were also not included in our study. Our paper presents the consequences of blast injuries to the ear, as well as type and degree of hearing damage. Acquired data are based on anamnesis, ENT examinations, functional hearing tests, examinations of vestibulary function and patient follow-up. Our examinations have pointed out that the majority of the examined patients had sensory neural hearing damage. On the basis of that, we can conclude that the blast had a greater effect on the sensory structures of the inner ear than the middle ear.

Prominent position of nose and paranasal sinuses (nose complex) is one of the most percentage of war injuries (37.00% of ORL region). Unfortunately, these wounds are badly observed. So late we have big functional and aesthetical disorders. Using simple methods like inspection, palpation, rhinoscopy and some radiologic examination we could have a good information about kind and lesion extension. It is very important in operating planning. This paper is retrospective analyses of nose complex war injuries in a first 12 months of aggression. They are open nonpenetrans in less than a half cases and high percent of isolated injuries (42.60%). Most of them are from artillery projectiles.

In this paper we presented 83 patients with war injuries of the temporal area. They have got injuries directly with gun shoots or with blunt force. These patients were observed during the last war year from the 01. 04. 1992 to the 01. 04. 1993. The methods used in this observation were: anamnesis, inspection, palpitation, X-ray diagnosis, following vital signs, and a local status (otoscopy). Acute trauma of the head looking for the presents of ENT specialist, because of the exact diagnosis of the polytraumatized patient and because of prevention some complications.