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Nursing is a profession frequently organized around shift work in order to guarantee the continuity of care throughout the 24 hours. However, working in shifts is coupled with the desynchronization of circadian rhythms and may result in adverse effects on nurses' health. Our previous work has demonstrated the presence of increased stress levels, reduced coping abilities and diminished life enjoyment in shift work nurses in comparison to those working only in accordance with the daily schedule. Here we aimed to appraise the effects of shift work on their overall health status.We used a comparative cross-sectional approach on a sample of 157 hospital nursing professionals at the University Clinical Hospital Mostar. Study subjects were divided into two groups: a total of 51% study subjects were included in a specific type of shift work (i.e., 12-hour day shift / 24 hours off / 12-hour night shift / 48 hours off), while the remaining 49% adhered to the conventional 7-hour daily schedule. The instrument used was a Standard Shiftwork Index (SSI), together with a comprehensive appraisal of participants' socio-demographic characteristics. Descriptive and inferential statistical methods were applied, and statistical significance was set at p≤0.05 (two-sided).The results have shown that nurses in shift work were significantly more burdened with gastrointestinal disturbances (p0.001); more specifically, there was a higher frequency of appetite loss (p=0.003), heartburn (p=0.03), nausea (p0.01) and weight gain (p=0.05) when compared to nursing professionals in the day shift. Conversely, there were no statistically significant differences in cardiovascular health between these two groups. In addition, nurses in shift work more frequently presented with headaches (p=0.001) and varicose veins of lower extremities (p=0.037) in comparison to nurses working only in accordance with the daily schedule.Shift work can adversely influence psychophysical homeostasis, resulting not only in substandard performance of nursing staff, but also potentially hazardous effects on their overall health status. More specifically, we recognized shift work as a substantial risk factor for gastrointestinal and metabolic disorders in nurses; likewise, the increased prevalence of headaches may consequently have a detrimental effect on social and family relationships. All of this should be tackled in a holistic and organized way, together with any additional psychological/sleep issues.

To determine the existence of the toothlessness within the patients in the area of Mostar. The aim is to determine the topography of toothlessness within the population of Mostar, according to Kennedy classification. The aim is to connect measures of socioeconomic status with the appearance of the toothlessness. To develop a model that includes a form of toothlessness and the socioeconomic status of the patients in Mostar.The study was conducted at the Health Center in Mostar and the Regional Medical Center in Mostar. The research was cross-sectional study. It included 800 patients who regularlyoccurred to the dental ambulance because of the toothlessness and because of the prosthodontics treatment. The measurement was conducted by the dentist based on the anonymous research cardboard at the first examination of the patient. The dentist will determine the topography of the toothlessness according to Kennedy classification and the etiology of the toothlessness.In the total sample of respondents, the toothlessness was significantly higher represented (P0.001). The manifestation of thetoothlessness was significantly higher among temporary employees and the retirees (P0.001). In the total sample, toothlessness affected the sociological status of a higher percentage of the respondents (P0.001).In our study, in a total sample of respondents, toothlessness was significantly higher represented (90% of respondents). The influence on the sociological status of the patient is most visible in the groups with the lower material status.

A study of COVID-19 infected patients was conducted regarding to organic and psychological characteristics. The findings of the study indicate that in the period of the pandemic in 2020, a total of 78 infection cases were confirmed in West Herzegovina Canton. Of the total number of infected, 55.1% are women and 44.9% are men. Of the infected population, 16.7% were hospitalized. By monitoring the COVID-19 disease in West Herzegovina Canton, we conclude how all manifestations of the disease were represented, from asymptomatic, through mild respiratory to the most severe clinical picture with fatal outcomes. The mortality rate in West Herzegovina Canton is 5.1%. The study showed that a total of 28.2% of COVID-19 positive patients before infecting with virus, were most likely to suffer from hypertension, diabetes and malignancies. Furthermore, it is important to emphasize that a total of 71.9% of those infected are without underlying diseases. Also, the results indicate that people with COVID-19 in addition to the characteristic symptoms of the disease (fever, fatigue, cough, etc.) had certain mental ailments such as decreased general mood, increased anxiety, panic attacks, acute stress disorder and others.

Approximately 20% of the European labour force is involved in some type of shift work, with nurses being on the forefront. In Bosnia and Herzegovina, a specific work scheme is pervasive in the health care arena, where all nurses involved in shift work are committed to eight night shifts per month - unlike other European countries that restrict the number of night shifts. Accordingly, we aimed to investigate whether such shift work significantly affects psychosocial functioning and the quality of life of hospital nursing personnel in this country.A comparative cross-sectional study design was applied on a total of 157 hospital nursing professionals at the University Clinical Hospital Mostar during 2019. Subjects were divided into two groups: a total of 51% study subjects worked in specific shifts (12-hour day shift / 24 hours off / 12-hour night shift / 48 hours off), while 49% subjects worked in accordance with the regular 7-hour daily schedule. Standard Shiftwork Index (SSI) questionnaire was used, alongside comprehensive socio-demographic and quality of life appraisal. Descriptive and inferential statistical methods were applied, and statistical significance was set at p0.05.This study demonstrated increased amounts of stress, reduced coping abilities and reduced levels of life enjoyment in shift work nurses in comparison to day work nurses. Furthermore, increased anxiety, stress, psychoorganic symptoms and sleep disturbances were significantly more common in shift work hospital nursing staff. In our study, nurses that worked in shifts have experienced negative externalities such as decreased social functioning, as well as reduced family and leisure time. Conversely, significantly higher satisfaction rates with shift work were only shown in regards to compensation.Our results reveal many detrimental effects of shift work and contribute to the field of research that is still laden with gaps in understanding its exact impact on the overall health of nursing personnel. Going forward, prospective (and even interventional) studies will be needed to disentangle the exact interplay between work-related factors in various health care systems and subsequent psychosocial disorders in health personnel.

Izbijanje koronavirusne bolesti (COVID-19) 2019. godine, uzrokovano teškim akutnim respiratornim sindromom (SARS) koronavirusom 2 (SARS-CoV-2), prema dosadašnjim podacima je prouzrokovalo smrt kod preko 250 000 ljudi i zarazilo preko 3,6 milijuna ljudi diljem svijeta. Provedene su sve znane i raspoložive mjere za smanjenje prijenosa COVID-19 infekcije s osobe na osobu, kako bi se virus stavio pod kontrolu širenje. Nebrojeno puta se naglašavalo kako bi posebnu pozornost i napore trebalo dati na zaštiti ili smanjenju prijenosa u osjetljivoj populaciji, uključujući kronične bolesnike, imunokompromitirane osobe, djecu, zdravstvene djelatnike i osobe starije životne dobi. Kao odgovor na brzo rastući broj publikacija o aktualnoj bolesti o kojoj se još uvijek ne zna mnogo, ovim člankom se želi prikazati sveobuhvatni pregled dosadašnjih relevantnih studija.

Introduction: The most common mental disorders in elderly, beside dementia, are depression and anxiety, which are important public health problem, although they are diagnosed and treated in under 20% of the population. Mental health care for elderly is one of the indicators of quality or omissions in the health system of a country. Aim: The aim of the study was to examine the incidence of depression and anxiety among the elderly in the Livno area. Material and methods: Across-sectional study was carried out in the Livno area through June 2017 on a sample of 100 respondents (N=100). Inclusion criteria: age over 65 years. Exclusion criteria: persons with malignancy, persons with psychiatric diagnosis or dementia. Research tools used: Questionnaire on sociodemographic status and Hospital Anxiety and Depression Self Evaluation Scale (HAD). Results: More than 90% of the respondents of both genders were estimated to be borderline depressed or depressed. There was a higher incidence of depression among male respondents, and anxiety among female respondents. Probably and borderline anxiety is recorded in 84% of respondents, which exceed the results of all available literature data. Religious habits have no influence on the occurrence of depression but there is a connection between prayer and anxiety occurrence. Conclusion: This research has established an extremely high incidence of depression and anxiety among the elderly in the Livno area. The results of the available studies indicate significantly lower rates of occurrence than in the tested sample. Socioeconomic status did not prove to be a significant predictor of the occurrence of these disorders.

In the five thousand years of recorded history there is written evidence of various types of addiction. In recent decades scientists focus their attention on addictions without the immediate introduction of psychoactive substances into the organism or the so-called "addictions without drugs". Studies have revealed a number of similarities between drug addictions and addictions without drugs that also carry biological, psychological and social consequences in the form of addictive activity carvings, adrenaline alarm, dopamine and serotonin secretion, tolerance and abstinence syndrome same as classical forms of addiction. Although the physiological effect of addiction without drugs on the brain and nervous system is not yet sufficiently explored, scientists have found equivalent effects on addicts suffering from one or the other type of addiction. These addicts are almost generally dysfunctional persons who become prisoners of their own passions, and the consequences are numerous technological advantages offered by modern times and in some respects a punishment due to the civilization for forgetting the man himself. Considering that most people, so and many psychiatrist, often accept these addictions as a lifestyle and without any delay and awareness of the potential dangers they may pose, we can with certainty say that the so-called "addictions without drugs" are the scourge of the 21

The stigmatization of mentally ill patients has negative labelling, marginalization and exclusion of people simply because they have a mental illness. Stigma has negative consequences for the individual and his family, as well as for psychiatry as a profession and the entire community. Stigma weakens the mentally ill, reinforcing a sense of alienation, which has negative consequences on the course of the illness. The media can inform the public about the treatment of mentally ill patients by conveying correct information, who can then act positively towards improving the quality of treatment. Stigma and self-stigma create a feeling of low self-esteem and fear of rejection, due to which mentally ill people avoid the media and very rarely speak publicly about their illness. The realization of information rights is very delicate and it is reflected through two opposing but substantially equivalent human rights: 1. Right to information, 2. Right to privacy. Which of the two rights will get advantage depends on the circumstances of each case and journalism ethics. The relationship of psychiatry with the media and especially the media with psychiatry must be extremely correct and professional, based on facts, and not on the pursuit of media sensationalism. The media can significantly reduce the current level of stigmatization of the mentally ill by adequate and correct reports, and thereby facilitate their role in family and society. Lack of knowledge and understanding of mental illness contributes to stigmatization. Education of patients, their families and journalists is crucial if we want to better understand people with mental illness and reduce stigma.

Tumor marker CA 125 is found in normal mesothelial lung cells and normal bronchial epithelial cells. If destruction of these cells occurs due to inflammation or tumour, CA 125 will be released, and increased in the serum.From November 2008 to May 2009 a study analysing CA 125 levels in serum samples from patients who are hospitalized at the Pulmology Department of University Hospital Mostar. Standard laboratory tests, X-ray, sputum examination to BK, and tumour marker CA 125 were performed in all patients. Patients were divided into 5 groups. Comparing clinical and laboratory findings of patients and statistical processing of collected data, conclusions were drown about the role of tumor markers Ca 125 in the diagnosis of pulmonary tuberculosis.This analysis is performed on 220 patients, forty with pulmonary tuberculosis. Of the total number of patients included, there is 60% of the negative findings of tumor marker Ca 125 which is statistically significant (P0.05). Further analysis of Ca 125 shows that there is 75% of positive findings in active pulmonary tuberculosis, which is a statistically significant difference (P=0.002). Within the group of patients with lung carcinoma, half of the patients showed positive finding of tumor marker CA 125. Statistical analysis showed that sensitivity of CA 125 was 75%, specificity was (68%) and positive predictive value was 12% in patients with active tuberculosis.The result of this study showed that the increase in serum tumor marker CA 125 is present in active pulmonary tuberculosis as well as in patients with lung cancer.

The continuous progress of science has a very positive effect on health care. Health care in its broader sense has greatly progressed in past decades, and the education of health care professions requires more continuous learning, teaching materials and course duration. It becomes clear that continuous education is not only important for good quality doctors, but all participants of health care are gaining more burdens and their work becomes more complex. There is an increased necessity for team work, division of tasks and specialization. In this battle for health, the Faculty of Health Studies becomes a necessity and has an obligation in education of various health personnel due to acquiring practical and theoretical skills, as well as abilities in providing the best possible health care. The path of knowledge is long and difficult. It has been present at our faculty for 17 years and we carry it out through a variety of undergraduate and graduate programs, and as of this years through our postgraduate program. Besides the education of health care workers we wanted to offer to our current and former students, and their educators the possibility of publishing their work, so in 2015 we launched our electronic journal, "Health Bulletin", whose publisher is the Faculty of Health Studies. In the process of continuous battle for health, prevention and treatment, the role of highly educated health care worker is of increasing importance and he certainly becomes an indispensable link in this process. The goal of our faculty is to educate the best possible health care workers, who will in addition to high quality practical work gradually take over our teaching responsibilities at the university.

Public health is an important area of health care that reflects the readiness of the state and society to provide the welfare of all citizens through the promotion of health and the preservation of a healthy environment - factors that directly affect the health of the population. The field of public health is very broad and its concept is changing over time, being defined in a narrower and wider sense. In short, public health is a science and practice that aims at ensuring the conditions in which people can preserve and improve their health and prevent health damage. The third millennium brings its specifics, needs and priorities according to challenges public health is faced by in the twenty-first century: the economic crisis, rising inequality, population aging, rising rates of chronic diseases, migration, urbanization, ecosystem change, climate change, etc. The role of public health is to protect, improve health, prevent diseases and injuries. Such a public health approach implies a multisectoral work focusing on "wider health determinants", and within this activity experts from various medical and non-medical profiles, whose field of public health is concerned, can be found. The development of inter-departmental co-operation skills contributes to a better understanding of health professionals and professionals of other profiles, and facilitates common, synergistic actions in addressing public health problems in the community. Symposium on Public Health Achievements and Challenges organized by the University of Mostar Faculty of Health Studies is just another indication of the obligation, the need and the desire for professional and scientific contribution to the fight for better health. Our faculty has so far organized other numerous symposia, and the aim of this symposium is to present public health achievements and challenges in our surrounding in order to protect, improve health, prevent diseases and injuries in a modern way.

In recent decades, there is more and more scientific research and evidence that religiosity has a positive impact on quality of life and mental health. The aim this study is to evaluate the impact of religiosity on the quality of life and psychological symptoms of chronic mental patients.The test group was consisted of 100 chronic mental patients at the Clinic for Psychiatry UCH Mostar, and control group was consisted of 80 somatic patients surveyed from the Infirmary of family medicine of the Health Center Mostar. The survey was conducted by the social and demographic questionnaire, a questionnaire on the quality of life of the World Health Organization WHOQOL-BREF, the questionnaire on religiosity and self-assessment questionnaire for psychological symptoms SCL-90For the socio-demographic data we obtained results that chronic mental patients as opposed to chronic somatic patients have significantly higher percent of an average lifestyle habits. There is statistically significant difference in the place of residence, chronic mental patients live in the city as opposed to somatic who live in the countryside. On the question of religiosity we received information that the chronic mental patients in relation to chronic somatic patients significantly more attend public religious gatherings, but however, chronic somatic patients compared to chronic mental significantly more use religiosity for better financial position, social comfort. In self evaluation of psychological symptoms we received information that the chronic mental patients as opposed to chronic somatic patients had significantly more psychotic features. To test the quality of life between the two groups, we received the information that chronic mental patients have significantly better physical and mental health, social relationships and caring for the environment as opposed to chronic somatic patients.Quality of life was significantly better in the chronic mental patients. Also, chronic mental patients significantly more attend public religious gatherings, while chronic somatic patients significantly more use religiosity for a better financial position, social comfort. Finally, chronic mental patients had a significantly more pronounced psychotic features.

Since war activities, the previously mixed population of Mostar, Bosnia and Herzegovina, live in segregated parts of the town based on ethnicity. The aim of this study was to examine differences in health risks and health status between populations of the two parts of the town. Health status of 300 randomly selected primary care patients was evaluated by practicing family physicians in two main primary care centers in West and East Mostar. Each group consisted of 150 patients. Data were collected between December 2013 and May 2014. Patients were evaluated for smoking habit, alcohol consumption, body mass index, blood pressure and laboratory measurement of fasting glycemia. Family physicians provided diagnosis of chronic noninfectious diseases (hypertension, diabetes mellitus, cardiovascular disease, malignant disease, depression, and alcoholism). The two groups differed according to age, income, employment status, and rate of alcoholism and hypertension. Alcoholism (OR= 4.105; 95% CI 2.012-8.374) and hypertension (OR=1.972; 95% CI 1.253-3.976) were associated with inhabitants of West Mostar, adjusted for age, employment and income status on logistic regression. In conclusion, ethnic differences between inhabitants of the two parts of the town might influence health outcomes. These are preliminary data and additional studies with larger samples and more specific questions considering nutrition and cultural issues are needed to detect the potential differences between the groups.

Background The aim of the present study was to explore the differences in serum CRP, IL-6, TNF-α, ACTH and cortisol among patients with major depressive disorder with or without metabolic syndrome (MS) compared to a healthy control group. Subjects and methods The MDD study group consisted of 80 patients (mean age of 50.03±9.55 years). The control group was recruited from the hospital personnel and it consisted of 40 examinees (mean age of 47.20±7.99 years). All patients who participated in the study were diagnosed with depressive disorder using MINI questionnaire, and Hamilton rating scale for depression. Diagnosis of the metabolic syndrome was set by NCEP ATP III criteria. Results Examinees with depression but without MS had significantly more cortisol concentration when compared to the control group. CRP was significantly higher in the MDD group when compared to the control group and in MDD+MS group when compared to the control group. IL6 serum levels were significantly higher in the MDD group when compared to the healthy control group, and in MDD+MS group when compared to the healthy control group. ACTH had significant independent predictive values for abdominal obesity. Levels of TNF-α were statistically significant independent predictors for hyperglycaemia. Statistically significant predictive values for MDD were found for cortisol, and IL-6. Conclusion Results shown here emphasise the importance of neuroendocrine and inflammatory factors in pathogenesis of depressive disorder and MS. Further prospective research is necessary to clarify possible causal relationship between depression and MS. It is necessary to investigate the possibility of a joint biological mechanism in pathogenesis of these two disorders with the special attention given to the disturbances in the immune system.

Aim: To determine the rural–urban differences in primary care practice, hospital inpatient care and total services. Methods: This cross-sectional study used data from Zenica-Doboj Canton in Federation of Bosnia and Herzegovina (FBiH). The overall sample size for the study was 1,995. Individual interviews were conducted in one randomly selected day of the week, except Monday and Friday, on the basis of EUROPEP (European Task Force on Patient Evaluations of General Practice Care) standardized questionnaire. Results: Out of total number (n=1 995), 47.9% was urban population and median of age was 42 years for both populations. The most of urban residents (81.4%) had finished high school or higher education compared with rural residents (58.5%) (p < 0.001). There are significant differences in employment status between rural and urban population (p < 0.001). Rural residents are more likely to travel more than 15 minutes to see their health facilities compared with urban residents (61.7% vs. 24.4%, respectively). Median of distance (kilometers) from residence location to the nearest hospital was statistically significantly higher in rural Me = 8.0 (5.0 do 14.5) km compared to urban population Me = 1.5 (1.0 to 3.0) km (p < 0.001). The rural population was more likely to buy drugs for medical treatment (p < 0.001) and parenteral injections in primary care practice (p < 0.001). Conclusion: There are significant differences in the overall health care assessment of rural populations as compared to urban populations.

Background: Young people and nursing students are prone to stress and psychological consequences of it. The aim of the current study was to assess the associations between psychopathology and religiosity in the group of nursing university students. Subjects and methods: The study included 100 nursing students of the Faculty of Health Studies in Mostar. The participants were assessed with the SLC-90-R and Dimensions of Religiosity Questionnaire. Sociodemographic data were also collected. Results: All SCL-90-R subscales negatively correlated with religiosity showing that the strength of religiosity was associated with better mental health of nursing students. Twenty two percent of potential cases of mental disorder were detected based on the GSI cut-off score. Religiosity was a significant predictor of mental disorder in logistic regression based on the GSI. The year of the study and quality of family relations were associated with students’ religiosity. Gender, socioeconomic status and parents’ education were associated with higher psychopathology scores. Conclusion: Religiosity showed to be important factor of resilience for nursing students. Further studies are needed.

There is a growing quantity of data showing that mental illnesses affect the somatic health. Depression is a complex disease, connected with the disturbances of sleep-cycle, appetite, body weight and level of physical activity, all of which may represent the risk factors for the development of metabolic disturbances. In the depressive patients, there is a number of various physiological mechanisms and psychosocial factors which may influence the development of metabolic syndrome (MS), such as sex, age, smoking, stress levels, nutrition and level of physical activity. It is considered that chronic stress causes depression and the resulting bad life habits may lead to MS and finally KVB. Aim of this study was to investigate the psychosocial and clinical features of depressive patients with the diagnosis of MS. The cross-reference study has been done at the sample of 80 patients diagnosed with MS. Among the diagnostic instruments applied, we have used the structured socio-demographic questionnaire, MINI questionnaire, Hamilton Rating Scale for Depression (HAMD-17) and Clinical Global Impression (CGI). The diagnosis of metabolic syndrome had been established following the NCEP ATP criteria. Among the depressive patients, there were 38.8% who fulfilled the criteria for establishing the diagnosis of MS. There was a greater incidence of suicide among the depressive patients with the diagnosis of MS. The diagnose was more frequently established in depressive women, while an increased intake of carbohydrates represented a significant feature of both depression and MS. Further research is needed to explain the observed gender differences and to determine if the interventions aimed to treating the depression can also contribute to accepting the healthy life habits and as a consequence, indirectly reduce the incidence of MS.

Background: Patients with stable coronary artery disease (CAD) can be evaluated for myocardial viability by examining reverse redistribution of Thallium-201 (201TI) through cardiac scintigraphy. There is limited knowledge about association of a reverse redistribution with favorable cardiac outcomes. In this study, we hypothesized that higher left ventricular ejection fraction (LVEF), lower myocardial necrosis, fewer ischemic events, and less angina will be associated with reverse redistribution of 201TI imaging. Methods: Adult patients with stable CAD included in this study underwent exercise-redistribution Thallium single-photon emission computed tomography (SPECT) and were followed for one year. LVEF and regional wall motion abnormalities were evaluated with echocardiography, exercise duration by bicycle testing, and myocardial ischemia and viability by Thallium SPECT. Results: We studied 159 patients (87 men, 72 women, median age 60 years, range: 38-84) with well-developed collaterals. Those with reverse redistribution on SPECT (n = 61, 38.3%) had significantly better exercise tolerance (⩾85%; P < .001). Subjects with reverse redistribution had better LVEF ( P < .001), wall motion parameters ( P < .001), a lower degree of myocardial necrosis ( P < .05), less angina during follow-up ( P = .02), and fewer ischemic events whether treated with OMT or PCI ( P < .001). Conclusions: Reverse redistribution of 201Tl on scintigraphic images is a predictor of myocardial viability. Evidence from our study suggests that optimally treated chronic CAD patients with reverse redistribution may have lower likelihood of future adverse cardiovascular events and better prognosis.

Retrospective study was conducted in surgical intensive care unit (ICU) in Clinical Hospital Center Zagreb in 2005. The aim of study was to create guidelines for empirical antibiotic therapy of sepsis in ICU for unknown causative agent based on antimicrobial susceptibility of causative bacteria.Thirty-two patients with severe sepsis were included in study and from medical records their clinical and microbiological data were analyzed. Antimicrobial susceptibility of the strains isolated from the blood-culture was tested by disk diffusion method according to CLSI (Clinical Laboratory Standard Institution). We used APACHE II score to predict the severity of illness. Mann-Whitney test and χ2 test were used to test statistical significance difference between results.Acinetobacter baumannii and Pseudomonas aeruginosa were the predominant causative agent. Acinetobacter baumannii was displaying excellent susceptibility to ampicillin+sulbactam and carbapenems, whereas Pseudomonas aeruginosa was showed good susceptibility on ceftazidim and carbapenems. Methicillin-resistant Staphylococcus aureus (MRSA), third predominant causative agent exhibiting good susceptibility to vancomycin and linezolide.The recommended therapy is empirical antibiotic therapy and should cover all important pathogens.

Approximately 94.000 persons were killed or disappeared and about 1.8 million people were forced to flee from their homes during the war in Bosnia and Herzegovina, from April 1992 to December 1995. The Dayton Peace Agreement, signed on November 21, 1995, ended the war. Life and health conditions of the population in BH characterized with severe disorders caused by severe war and post-war traumatic events. The aim of this work is to establish the connection between breast cancer in women and stress caused by traumatic experiences during the war in BH. We performed this study of pairs at the Clinic for Oncology, University Clinical Hospital Mostar, from November 2008 to March 2009. Two hundred women from Herzegovina region participated in this research. The study group consisted of 100 women with diagnosed breast cancer. The control group consisted of 100 women without breast cancer diagnosis, of the same age and living in the same area. We have found that women with breast cancer had statistically considerably more war traumatic experiences and thus more stress than the women in control group (p=0.000). The following conclusions are also noteworthy: 39% of women in the study group were under the ages of 50, when diagnosed breast cancer. Only one woman got psychosocially care within breast cancer treatment. High middle age of physiological loss of period (≥50), longer fertile period, as well as the smoking habit are breast cancer risk factors statistically more present. Women with breast cancer have experienced more stress due to significantly more war traumatic experiences, so that war-related stress considered a risk factor.

Analysis of a cerebro-vascular insult hospitalised cases from West Herzegovina Canton as a retrospective epidemiological study was done in Clinical hospital Mostar for the period from 1998 to 2002. The major source of data was medical documentation of this hospital, the only hospital for the treatment of 88,257 inhabitants from this Canton. The study included a total of 393 cerebro-vascular insult cases from this Canton treated in the Clinical hospital Mostar Among them 189 (48.1%) were male patients, while 204 (51.9%) cases were female. The majority of the cases were above 50 years of life. Majority of treated female patients were older then 65, while among male patients the majority were between 50 and 65 years old. The least number of cases was under 50 years in both groups. During the same period risk factors research for entire FBiH was performed on the sample of 2,750 national insurance holders. Out of them 1.7% was found to suffer of cerebro vascular insult.

To examine the effects of war in Bosnia and Herzegovina on the occurrence of acute coronary syndrome among civilians.The incidences of acute myocardial infarctions (first and recurrent) and unstable angina pectoris were examined among the residents of Mostar and the nine neighboring districts. The study population was the population that lived in the area before the war (182,000 in the 1991 census). Others who immigrated into the area were not taken into consideration. Five consecutive years (1987-1991) before the war and 5 consecutive years (1992-1996) during the war were analyzed.In the 5-year period during the war, 267 men and 161 women suffered from acute myocardial infarctions, compared with 246 men and 119 women in the 5-year period before the war. The wartime increase in acute myocardial infarctions for the combined male-female population was statistically significant (p = 0.025). For women, the wartime increase was statistically significant only for the age group of 60 to 69 years (p = 0.007). The smaller increase among men was not statistically significant (p = 0.354). The increase to a wartime number of 52 cases of recurrent myocardial infarctions from a prewar level of 24 was statistically significant (p = 0.001). The percentage of fatal myocardial infarctions among women, however, was lower during the war (18.6%) than before the war (32.8%) (p = 0.048). During the war, 109 men with unstable angina pectoris were hospitalized, compared with 84 before the war; the cases among women were 76 and 41, respectively. The increase was statistically significant among women (p = 0.001) but not among men (p = 0.072). There was a statistically significant increase (p0.001) in the total number of unstable angina pectoris cases during the war (185 cases, compared with 125 prewar cases).The common population during the war in Bosnia and Herzegovina had increased numbers of acute myocardial infarctions and unstable angina pectoris cases.

Persons serving a prison sentence are identified as a population exposed to a higher risk of HIV/STIs due to a high incidence of risk behaviour, especially intravenous drug misuse. To show results of research on prevalence of HIV/STIs in relation to spread of risk behaviour and other risk factors.Cross-sectional study on a sample of 620 respondents in 10 prisons. A specially structured questionnaire was applied as a research instrument, together with blood sample taking for laboratory analysis of HIV, HBV, HCV and syphilis.Majority of respondents show insufficient knowledge about HIV/AIDS, ways of transmission prevention, especially knowledge on ways of HIV transmission. Every sixth respondent has experience of intravenous drug use, of which 58% exchanged drug injection equipment. Every fifth respondent with a tattoo had their tattoo done in prison. Below 2% of respondents quote being victims of sexual abuse, and having wilful anal sexual intercourse in prison. Test results in this research: HIV (0), HBV (1.5%), HCV (14.3%) syphilis (0.5%).Intravenous drug use presents the strongest risk factor for HCV, and therefore for HIV/ STIs. Other risk factors - tattooing with kit exchange, sexual risk intercourse, abuse, insufficient knowledge and information about HIV/AIDS, ways of transmission and way of protection, and lack of access to measures of prevention and "Harm reduction" programme.

A cross-sectional study in the Primary Care Medical Centre Mostar and Regional Medical Center "Safet Mujić" was conducted. Family physicians randomly surveyed, examined, and analyzed laboratory tests from 300 subjects divided into three age groups from 20-39, 40-54 and 55-65 years, totally 100 subjects. Data for age, sex, smoking status, alcohol consumption, body mass index, blood pressure, blood glucose, triglycerides and cholesterol, and the presence of chronic non-communicable diseases, including diagnosis of depression and the presence of stress were entered in medical records.Levels of cholesterol were significantly higher in rural population as well as among students, and high triglyceride levels most frequently were presented in the student population. A group of farmers had a significantly higher prevalence of hypertension, DM and CVD compared to other investigated groups. The largest number of smokers and people who drink alcohol was present in group with the highest incomes, while obesity was significantly expressed in people with lower incomes. The group of examinees with the highest incomes had the greatest exposure to stress.Socioeconomic processes have an impact on risk behavior of the adult population, and the presence of a number of chronic diseases that are accompanied with increased laboratory blood glucose, cholesterol and triglycerides levels.

Although the connection between body and soul is written in the Bible, research papers haven't given much attention to it until the past few decades. Recently, both here and abroad, there have been more studies that investigate the prevalence of various somatic disorders in psychiatric patients, including metabolic syndrome.The objective of this study was to establish the prevalence of metabolic syndrome and it's components in patients with posttraumatic stress disorder (PTSD).Metabolic syndrome and its components were investigated in 60 patients with chronic PTSD conditioned by the war and in 60 patients treated for somatic problems by their family physician in Mostar.The prevalence of metabolic syndrome was statistically significantly higher in patients with PTSD (48.3%) than in the control group (25%) (P=0.008) and the number of its individual components (test group 2.38±1.30 compared to control group 1.72±1.24) (P=0.005). PTSD patients diagnosed with metabolic syndrome had significantly more frequent hyperglycemia (P=0.010) and abdominal obesity (P=0.044) compared to the control group.The prevalence of metabolic syndrome increased in patients with PTSD compared to the control group.

Immunization is one of the most effective medical interventions in the prevention of the disease and represents the easiest and most cost-effective investment in health. The strategy of controlling contagious diseases that can be prevented through immunization has a long tradition in B&H. Mandatory immunizations are administered against ten diseases. Although the development of new technologies, the efforts of the pharmaceutical industry, the development of new vaccines provides better vaccines in terms of greater safety and effectiveness it should be pointed out that no vaccine is »absolutely effective and safe«, and it will not achieve the immune response in 100% vaccinated, also there are possible side effects and unexpected reactions that could occur. Vaccination is often a media issue because previously unnoticed local, isolated events-side effects and complications of vaccination are now accompanied by media attention as there are now numerous and fast communication channels (internet, e-mail, TV, etc.) and media evolved from being less »controlled« to more »commercial«. Doubt in benefit of vaccination is growing even among health professionals who are expected to provide up-to-date, understandable information, and issue information about immunization benefits and potential risks. It is therefore important for health professionals to be well informed, to be a good source of authoritative, scientific and reasonable advice, and to speak openly about the benefits and risks of vaccination so that consumers fully understand both possible outcomes of vaccination. This takes communication skills, particularly in crisis situations connected with vaccination. Health professionals are thus faced with a changing attitude toward importance of immunization in the social climate where risk is less tolerated than ever before.

The aim of this study was to describe the situation and the development of Croatian Defense Council medical corps during the 1992–1995 war in Bosnia and Herzegovina. The paper provides an overview and describes the main events that lead to development of the medical care in the wartime conditions, with special emphasis on the public health system in Herzegovina region. This included the creation of three distinctive public health system settings: initial, integral and post-war period, all marked by certain specificities in organization and delivery of the public health and overall health care to both military and civilians. The knowledge and skills gathered during this period can be useful in situations that involve the need for fast public health actions, such as various natural disasters and disease outbreaks, and could be used for establishing highly mobile response public health teams. Furthermore, the experiences gathered during these periods may be useful during the planning phases of the health care reforms, all aiming to deliver the best possible health care to the entire population.