Background: Medical deontology rests on two of its pillars. One is medical ethics, and the other is medical law, i.e. legal regulations that regulate work on health protection and improvement. Ethics is of exceptional importance for medicine, due to the specificity of its calling. Objective: The aim of this article was to explaine the role of medical ethics and medical right in the healthcare professional praxis. Methods: The author used important scientific and professional literature regarding medical deontology, medical ethics and medical low published in the books, monographs and papers deposited in the scientific indexed databases PubMed Central, HINARI, Embase, etc. Results and Discussion: The specificity stems, first of all, from the fact that medicine deals with human life and health, which, in itself, carries a great responsibility. The relationships established between medical professionals and patients are also specific. In this relationship, the patient is in a subordinate and dependent position, which creates preconditions for his abuse. Due to the nature of the work, it is difficult to establish external supervision or control in order to prevent these abuses. This in turn emphasizes the importance of internal supervision and control with the help of medical ethics. Medical ethics sensitizes medical professionals to problems of an ethical nature and helps them recognize and solve them. Medical ethics is, in fact, a set of principles or rules of conduct that a medical professional must follow when making decisions about what is right and wrong, what is permitted and prohibited, what is good and bad for the patient, but also for the community. Making these decisions is often not easy. Conclusion: There are ethical principles that can conflict, which leads to ethical dilemmas, which are sometimes difficult to resolve. Take, for example, the obligation of a doctor to take into account the interests of the patient and to maintain his medical confidentiality. At the same time, however, he must also take care of the interests of the community or other persons. There are cases when the health, and even the lives of those other persons, could be endangered without revealing the medical confidentiality. Medical ethics helps resolve such and similar dilemmas.

Introduction The liver is the largest gland in the human body, and serves to store nutrients and neutralize harmful compounds. The liver plays a very important role in a number of metabolic, both catabolic and anabolic processes, and is therefore called the "central laboratory" of the organism. If liver disease occurs, they can affect all its parts-liver cells, bile ducts, blood and lymph vessels. The liver is damaged by various toxins, drugs, infections, disturbances in the blood supply and other disorders. Diet therapy has been a part of the process in the treatment of liver disease for a while. The therapeutic principle is better known as the "liver diet". The liver diet not only means the replenishment of calories and nutrients, but it significantly affects the course of the disease. Aim The aim of the research is to show that diet therapy plays an important role in the treatment of liver disease as a component for faster recovery of the liver and restoration of its normal function, as well as protecting the liver after overcoming the disease. Results Among the respondents, there were 39 men (64%) and 22 women (36%) who had liver disease as a chronic condition. Most respondents are between 51 and 65 years old (28 and 46%, respectively), while the least number of respondents are in the 20 to 30 age group. The largest number of respondents cited alcohol as the cause of the disease, 31 of them (50.8%), while the virus was the cause of the disease in 15 respondents (24.5%). Of the total sample, most respondents answered that they sometimes (45.9%) or often (47.5%) overeat. The results of the questionnaire showed that 85.2% of the respondents were smokers before the diagnosis of the disease. In most respondents, the food they ate before diagnosis was moderately fatty (52.5%). Using chi-square tests, it was found that there are statistically significant differences in the consumption of almost all foods before the diagnosis of the disease and after the obtained dietary recommendations (p<0.05). Conclusions The aim of the research was confirmed that diet therapy plays an important role in the treatment of liver disease as a component for faster recovery of the liver and restoration of its normal function, and after overcoming the disease it still protects the liver. The main purpose of creating a diet therapy program and plan proved to be significant and necessary because more than half of the respondents rated our advice as excellent. As most causes of liver disease can be prevented, it is necessary to work on familiarizing the population with risk factors, promote a healthy lifestyle and proper nutrition, and identify at-risk patients who must enter the monitoring system for early detection of liver disease.

Introduction: The liver is the largest gland in the human body, and serves to store nutrients and neutralize harmful compounds. The liver plays a very important role in a number of metabolic, both catabolic and anabolic processes, and is therefore called the „central laboratory“ of the organism. If liver disease occurs, they can affect all its parts–liver cells, bile ducts, blood and lymph vessels. The liver is damaged by various toxins, drugs, infections, disturbances in the blood supply and other disorders. Diet therapy has been a part of the process in the treatment of liver disease for a while. The therapeutic principle is better known as the „liver diet“. The liver diet not only means the replenishment of calories and nutrients, but it significantly affects the course of the disease. Aim: The aim of the research is to show that diet therapy plays an important role in the treatment of liver disease as a component for faster recovery of the liver and restoration of its normal function, as well as protecting the liver after overcoming the disease. Results: Among the respondents, there were 39 men (64%) and 22 women (36%) who had liver disease as a chronic condition. Most respondents are between 51 and 65 years old (28 and 46%, respectively), while the least number of respondents are in the 20 to 30 age group. The largest number of respondents cited alcohol as the cause of the disease, 31 of them (50.8%), while the virus was the cause of the disease in 15 respondents (24.5%). Of the total sample, most respondents answered that they sometimes (45.9%) or often (47.5%) overeat. The results of the questionnaire showed that 85.2% of the respondents were smokers before the diagnosis of the disease. In most respondents, the food they ate before diagnosis was moderately fatty (52.5%). Using chi-square tests, it was found that there are statistically significant differences in the consumption of almost all foods before the diagnosis of the disease and after the obtained dietary recommendations (p<0.05). Conclusions: The aim of the research was confirmed that diet therapy plays an important role in the treatment of liver disease as a component for faster recovery of the liver and restoration of its normal function, and after overcoming the disease it still protects the liver. The main purpose of creating a diet therapy program and plan proved to be significant and necessary because more than half of the respondents rated our advice as excellent. As most causes of liver disease can be prevented, it is necessary to work on familiarizing the population with risk factors, promote a healthy lifestyle and proper nutrition, and identify at-risk patients who must enter the monitoring system for early detection of liver disease.

Introduction: COVID-19 pandemic suddenly affected all countries and health care systems from different perspectives including severe disruption of chronic disease services including diabetes. Diabetes is a serious condition and highly present in Bosnia and Herzegovina population, so provision of diabetes care is a important part of good control. Countries had different responses to adopt diabetes care under new circumstances as well as Bosnia and Herzegovina. Aim: To investigate and evaluate the impact of the COVID-19 pandemic on the provision of diabetology care in Bosnia and Herzegovina from the perspective of patients and diabetologists. Methods: Online survey for diabetologists and patient organizations have been developed with adopted question for different perspectives. The survey has been conducted online early September 2020. Collected data were analyzed in SPSS software for descriptive statistics. Results: 25 diabetologists and 24 diabetes patient organizations responded. 72% of diabetologists believe that pandemic has partially altered work with patients and 56% believe that the organization of diabetes care has successfully responded to the new circumstances but 80% believe that the diabetes care system should change. 75% of patient organizations thought that the organization of diabetes care did not adequately respond and 87.5% believe system should change. Conclusion: No significant differences found between RS and FBiH when it comes to majority of questions. Both diabetologists and patients consider that system of diabetes care in Bosnia and Herzegovina should be improved in future. It has been also found that diabetologists in Bosnia and Herzegovina responded and adopted their practices similar to other countries.

BackgroundSubstance abuse among adolescents is a major public health and social problem. However, studies rarely investigate the relationships between substance abuse, educational achievement and sport factors. Substance abuse is an even more significant problem in societies that have experienced trauma, such as Bosnia and Herzegovina, which have had recent wars. The aims of this study were to investigate substance abuse among adolescents in Bosnia and Herzegovina and to study the potential gender-specific relationships between a) sport factors (physical activity/exercise/athletic participation) and substance abuse and b) scholastic achievement and substance abuse.MethodsOur sample consisted of 1,032 adolescents who were 17 to 18 years old (435 boys and 597 girls) and who were in the final grade of high school. These subjects were randomly selected from the territory of Herzegovina-Neretva Canton of Bosnia and Herzegovina. Retrospective testing was performed using an extensive self-administered questionnaire. The questionnaire included questions involving topics such as sociodemographic variables, scholastic variables, sport factors, and substance abuse data (smoking habits, drugs consumption and alcohol consumption using the AUDIT questionnaire). Descriptive statistics, frequencies, analyses of the differences and correlational analyses were performed.ResultsOur results found that greater than one-third of the boys and one-fourth of the girls were daily smokers, and almost half of the boys and one-fifth of the girls practiced harmful drinking; other drugs (i.e. heroin, cocaine, amphetamines, etc.) were rarely consumed. Boys dominated in sport factors, whereas girls were more successful in scholastic achievement. Approximately 23% of the boys and 6% of the girls reported that they practiced harmful drinking and smoked simultaneously. Educational failure, which was defined as having one or more negative grades at the end of the last two school years, was identified in 20% of the boys and 9% of the girls. In both genders, substance abuse was negatively correlated with educational achievement, and half of those students who failed educationally reported daily smoking. Among the girls who experienced education failure, 33% were smokers, and 22% practiced harmful drinking. Sport factors were weakly correlated with substance abuse in boys; thus, we could not support the hypothesis that sports are a protective factor against substance abuse among male adolescents. In girls, participation in team sports was related with a higher incidence of smoking, but there was no evidence of sport factors having an influence on the consumption of alcohol.ConclusionIn this study, the incidence of smoking and the consumption of alcohol were alarmingly high. These findings demonstrate the need for intervention programs to address these issues. These problems are particularly important, considering that substance abuse has a negative impact on educational achievement among boys and girls, and sport factors have not been found to be protective factors against substance abuse.

Summary There are four types of responsibilities that arise on the basis of medical errors: a) Disciplinary (Punishment of the competent Association for restriction or revocation of the license); b) Civil liability (compensation); c) Criminal responsibility (protection of individual interests to protect the interests of the society); d) Violation (fine for minor damage) To increase the number of criminal proceedings mostly influenced the lack of compensation system for harm because the injured party considered that after the positive completion of criminal proceedings can easily make a claim. Therefore they do not address the local Association or Ministry of Health to investigate a case, but to the criminal proceedings to try to get compensation. It turned out that this is a dispute that is usually long lasting, with an uncertain outcome, which does not bring satisfaction to the plaintiff, and had a series of negative consequences in the general approach to the treatment of patients known as “defensive medicine”. As a result of the increased number of lawsuits due to medical errors are caused the following negative consequences: a) Great vigilance of physicians in communicating with patients, who must sign a 2-3 statements when entering the hospital, and that sometimes are not really familiar with the nature of illness and required treatment; b) Significant increase in the number of unnecessary tests which are required by doctors to insure themselves from the potential liability, which at a given moment are not really necessary; c) Lack of medical error reporting system allows individuals to avoid their reporting, which affects the course of treatment and prognosis; d) Often avoidance by the doctors to perform some necessary procedures that are risky, with increasingly open refusal to cure a poor prognosis case which they left to the next level of treatment. Disappears so called “heroic approach” to the treatment in the B&H health system known from the war period and gives way to extreme caution, because the doctors expect that their every procedure will be under scrutiny; e) All of these factors create a mode known worldwide as “defensive medicine”, which increases the cost of treatment and lower level of health care; f) Reduced volume of education, because older physicians are reluctant to let residents decide on specific work procedures and operations; g) There is already a critical shortage of some medical specialties, and inevitably follows increase in price from these service areas and increase of the waiting list.

Summary Medicine and the media are two areas important in the life of every man, which are in almost daily contact with each other and in dependence. Their relations in BiH are currently elemental, focused on direct, immediate needs, without defined rules, with a lot of disorientation, incompetence and irresponsibility, often without respect for at least the minimum rules of conduct and respect, often with a lot of conflict and hostility. The goal of our work is based on the analysis of newspaper articles, TV programs and Web sites in the period of one year and was to assess the current situation and suggest solutions. In order to acquire objective insight into the current situation, in the preparation of the symposium “Medicine and Media” in Mostar, we analyzed all stories related to medicine in two daily newspapers, two weekly, three TV stations in the period from September 1st 2008 to August 31st 2009, and the web sites of hospital institutions, Department of Health Insurance in Bosnia and Herzegovina and the Ministries of Health which were available online on 1st and 2nd September 2009. In total we managed to process 402 contents as written content, TV shows or stories in TV shows and 28 web pages, and we believe that our sample is representative. We have found the following characteristics of the current situation in BiH that have to be changed: Topics in the press, web sites or programs on health services should have some kind of certification, i.e. licensing so that is clear that the contents of the announcement is made under control of health care professionals, i.e., licensed or of optional entertainment content; In cases of professional accusation of any specific person, usually a doctor, not to state full name of the before the existence of binding court decisions, or in case of possible litigation not to allow favoring of any party of the dispute; In addition to the interest in the work of health institutions it is necessary to direct media attention towards the work of the Institute and the ministries of health insurance, because very few reports deal with their work and activities; It is necessary to emphasize investigative reporting with good topics covered by professionals and annual prizes awarded to the authors of such content about medicine in BiH should be considered.

One of the most common events in Surgical Ward is admission of patients with biliary tract disease. To evaluate such patients, it is necessary to create appropriate database and define attributes that will be analyzed. The patients should be divided in groups for analysis and data processing. There were 219 patients included in the study. All patients were selected on the basis of ICD-10 codes and then divided into categories according to the code. In order to assess selected patients, the database was created with all relevant questions about anamnesis, diagnostic tests and surgical procedures. The data about patients was entered into the database. It is possible to analyze data about the most frequent disorders of biliary tract. The most common entity was chronic cholecystitis with calculus and most common procedure was laparoscopic cholecystectomy. The other important attributes are also assessed. ICD-10 classification can be used as a basis for aggregation of data of the patients with biliary tract disease. Some of the codes are more frequent than others and some are rarely used.

The treatment of patient with relapse of bleeding after application of minimally invasive treatment of hemorrhoidal disease such as elastic band ligation, cryosurgical treatment Hemorrhoidal Arterial Ligation (HAL) can be presented as serious clinical problem in patients with concomitant diseases that can be contraindication for radical surgical treatment. We compared the Simple Digital Method and standard above mentioned minimally invasive ambulatory treatment. We used special proctoscope with Doppler Flowmeter in order to identify all branches of hemorrhoidal artery in the anal canal creating graphical presentation using specially adapted software. HAL method is then used to perform ligation of hemorrhoidal artery branches. The elastic ligatures (called gummiligatures) are then applied to the piles in which most prominent flow was registered using Doppler Flowmeter. Antibiotic prophylaxis and sedation was administered preoperatively. Special computer program registered all steps. Hemorrhoidal ointments and paracetamol were used after surgical procedure. Average number of identified hemorrhoid arteries branches was six, and total duration of the procedure was in average 28 min. We compared patient treatment with our method and standard methods. In tested group we noticed significantly fewer complications (after eight days the number of complications 11% vs. 74%, p<0.001, after 15 days 3% vs. 11%: p=0.101). One year after procedure, the treatment was successful in 91.4%, or 32 out of 35 patients according to proctoscopy and Doppler Flowmeter exam. There were three patients with relapse of symptoms. In 77% of patients hat were treated with rubber bands ligation relapse occurred. Our method is significantly more successful in comparison to classical methods of ambulatory treatment and can be alternative to radical surgical treatment.