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Introduction: Risk assessment for development foot ulcer in diabetics is a key aspect in any plan and program for prevention of non-traumatic amputation of lower extremities. Material and methods: In the prospective research to assessed diabetic neuropathy in diabetic patients, to determined the dynamic function of the foot (plantar pressure), by using pedobarography (Group I), and after the use of orthopedic insoles with help of pedobarography, to determined the connection between the risk factors: deformity of the foot, limited joint movements, diabetic polyneuropathy, plantar pressure in effort preventing changes in the diabetic foot. Results: Out of 1806 patients, who are registered in one Team of family medicine examined 100 patients with diabetes mellitus Type 2. The average age of subjects was 59.4, SD11.38. The average HbA1c was 7.78% SD1.58. Combining monofilament and tuning fork tests, the diagnosis of polyneuropathy have 65% of patients. Comparing Test Symptom Score individual parameters between the first and second measurement, using pedobarography, in Group I, statistically significant difference was found for all of the assessed parameters: pain, burning sensation, paresthesia and insensitivity (p<0,05). The measurements of peak pressure, both first and the second measurement, for all of the subjects in Group I(45) show values above 200kPa. That’s a level of pressure that needs to be corrected. The study finds correlation between the foot deformation, diabetic polyneuropathy and plantar pressure (p>0,05). Conclusion: A detail clinical exam of diabetic food in a family doctor office equipped with pedobarography (plantar pressure measurements), use of orthopedic insoles, significantly reduces clinical symptoms of diabetic polyneuropathy in patients with diabetes.

I. Masic, Miran Hadžiahmetović, D. Donev, Azis Pollhozani, Naser Ramadani, A. Skopljak, Almir Pasagić, E. Roshi et al.

Introduction: Family medicine as a part of the primary health care is devoted to provide continuous and comprehensive health care to the individuals and families regardless of age, gender, types of diseases and affected system or part of the body. Special emphasis in such holistic approach is given to the prevention of diseases and health promotion. Family Medicine is the first step/link between doctors and patients within patients care as well as regular inspections/examinations and follow-up of the health status of healthy people. Most countries aspire to join the European Union and therefore adopting new regulations that are applied in the European Union. Aim: The aim of this study is to present the role and importance of family medicine, or where family medicine is today in 21 Century from the beginning of development in these countries. The study is designed as a descriptive epidemiological study with data from 10 countries of the former Communist bloc, Slovenia, Croatia, Bosnia and Herzegovina, Serbia, Montenegro, Macedonia, Kosovo, Albania, Bulgaria, Romania, Czech Republic, Slovakia and Hungary, just about half of them are members of the EU. We examined the following variables: socio-organizational indicators, health and educational indicators and health indicators. The data used refer to 2002 and as a source of data are used official data from reference WebPages of family medicine doctors associations, WONCA website (EURACT, EQuiP, EGPRN), WebPages of Bureau of Statistics of the countries where the research was conducted as well as the Ministries of Health. Results: Results indicates that the failures and shortcomings of health care organizations in Southeast Europe. Lack of money hinders the implementation of health care reform in all mentioned countries, the most of them that is more oriented to Bismarck financing system. Problems in the political, legal and economic levels are obstacles for efficient a problem reconstructing health care system toward family medicine and primary prevention interventions. The population is not enough educated for complicated enforcement for and prevention of diseases that have a heavy burden on the budget. Health insurance and payment of health services is often a problem, because the patients must be treated regardless of their insurance coverage and financial situation. The decrease in production and economic growth, as well as low gross national income in the countries with economic crisis, lead to the inability of treatment for a large number of the population. Such situation a system leads to additional debts and loans to healthcare system. Measures implemented for provision of acute curative care largely did not lead to improvements in the health status of the population. Educational and preventive measures, as well as higher standards for quality and accessibility of health care services for entire population in each country, especially those struggling are bound to joining the European Union and their implementation must start. The most A large number of medical institutions are is inefficient in health education and health promotion and must work to educate patients and families and increase the quality of preventive health services. Modernization of health care delivery and joining the European Union by increasing overall economic stability of countries is one of the primary goals of all countries in Southeast Europe.

Objective: The aim of this study is to confirm the effect of one month dietary treatment on the level serum lipids (cholesterol and tryglicerides) and aminotransferases in overweight patients aged over 50 years. Methods: In agreement with the respondents we requested that they immediately only reduce consumption and that in the reporting period use only food without the use of pharmacotherapy (fat lowering agents and lipid lowering medications). The reason for this assumption is that there is physiological variation for biochemical and hematological examinations by number of internal and external influences determine the size of physiological changes, as well as the necessity of the necessary concentration of certain nutrients for basal metabolism, and function of the body–cells or metabolites. These same subjects, we monitored the frequency of the results, the results of blood glucose, cholesterol, triglycerides, aminotransferase, acidum uricum creatinine after 1 month. The study was carried out on a targeted sample of 10 respondents in the Primary health care center in Gracanica for a period of 30 days. The tests on this sample were conducted survey on health status and nutrition, HIV treatment and diagnosis. Findings: Thee results show that there is an increased number of obese subjects. The paper analyzes the results of biochemical tests in subjects aged over 50 years. On the target medical and biochemical laboratory diagnostic examinations in 10 subjects of both sexes were observed: elevated results of blood glucose, cholesterol, triglycerides, aminotransferase, uric acid and creatinine. It was also observed the fact that most patients was with increased body mass (BMI = and> 25). It has been observed continuous decline or normalization of laboratory test results after one month. Conclusion: There is a growing number of people who are overweight (BMI 25-30) and obese (BMI> 30) due to poor habits, which is dominated by excessive calorie intake. Due to the increased supply of food nutrients: glucose and/or triglyceride, cholesterol, protein in the body, there is increase in the metabolism of carbohydrates, proteins, nonprotein compounds, purine and lipid, with an intense oxidative processes in the mitochondria in particular fat cells and liver disorder utilization of glucose, lipids, purine. As a consequence, the pathological results: higher levels of glucose in the blood, cholesterol, triglycerides, uric acid, creatinine and aminotransferase were observed.

Introduction: Antimicrobials are widely used in infectious diseases. Only the timely intervention will contribute to the positive outcome of the disease. Unjustified use of antimicrobial prophylaxis may have adverse effects, i.e., result in bacterial resistance to existing antimicrobials, as well as toxic effects on leukocyte lineage and other parameters of the blood. Goal: The goal of this study was to confirm that the antimicrobial therapy of urinary, gynecological and respiratory infections has a toxic effect on leukocyte lineage. Followed by lowered immunity and the emergence of risk for health complications especially in oncology and other immunodeficient patients for whom to apply pharmacotherapy it is necessary to have adequate immunity, or white blood cell count that is greater than 4.0x109/L. Material and methods: A prospective-retrospective study was conducted on a sample of 30 patients in a Primary Health Care Center in Gracanica during the period from March 01, 2013 until April 01, 2014. Testing of this sample was conducted by survey on health status and treatment, or on taking of antimicrobial therapy and other treatment regimens, with the referral diagnosis and determination of leukocytes count in by hematology counter SYSMEX. Results of leukocytes below and close to the lower reference values were statistically analyzed by Students t-test. Results: Mean WBC count in the group treated with antimicrobial therapy was 3.687±0.83 x109/L, in the group which during repeated infection did not use the antimicrobial therapy 5.09±1.04 x109/L, and in the control group of healthy subjects 7.178±1.038 x109/L. Statistical analysis with Student’s t test indicate highly significant differences between group of patients that used antimicrobial therapy with the group of patient that did not used antimicrobial during repeated infection (t=6.091; p=0.0001), as well as significant differences in mean WBC count of both of these groups and the controls (t=4.984; p=0.0001, and t=8.402, p=0.0001). Conclusion: Use of antimicrobial drugs leads to serious toxic reactions, or leukopenia. Indications for the use of antimicrobial therapy must be strictly followed, because banal, frequent infections are not indication for antimicrobial therapy. It is necessary to know the types of infection causes. Important is the proper and timely selection of antimicrobial therapy. When selecting the drug we should bear in mind its antimicrobial activity, pharmacokinetic and toxic properties, as well as patient health status. Possible is also the application of preventive medicine as well as other manner of solving infection.

Introduction: Drug addiction is one of the most prominent problems in many countries in transition, including Bosnia and Herzegovina. Age limit of drug addiction is shifted to the younger age groups, especially is troubling the increase in number of injection drug users. Our study was aimed to investigate the habits, attitudes and practices related to drug use among young people from the area of Sarajevo city. We can still feel the effects of the war, among which are the most important life without closest relatives, banishment and various types of war and post-war trauma. Goals: To determine the frequency of substance abuse among adolescents; Identify potentially relevant biological, psychological and socio economic characteristics of the adolescents; To explore adolescents attitudes towards drug use; Examine the general level of knowledge of adolescents about drugs and their effects. Material and Methods: The study was conducted on randomized sample of 502 students in two primary and three secondary schools in Sarajevo and Gracanica. To study used survey method. Survey instrument was a self-made questionnaire with the research variables. The obtained data were processed by a computer and statistically correlated. The study is of combined, retrospective, prospective and transversal type. Results: To the question “How many times have you consumed cannabis in the last 30 days” about 6% of the respondents have tried once or twice, while 1.5% use it daily, ecstasy have tried one or two times 2.25%, while 0.5% have daily use. Based on the obtained results it can be concluded that students at schools in Sarajevo consumed drugs 50% more than the children in Gracanica. Analyzing the age at which the subjects consumed the drug for the first time, we came to the conclusion that in the third year of high school only 8% of adolescents have tried any drugs before they turned 15 years. This percentage among eighth graders is about three times higher. Conclusion: Presented research results clearly suggest a strong contamination of the living environment of young people with different types of psychoactive substances. Offer of drugs is extensive and distribution network covers all the places where young people visits, including schools. It is clear that today’s teenagers sooner or later hear about drugs, see, get in touch with a “junkie” and have a chance to take the drugs if they want to. From our research, we found that the following factors: Marital status of parents, employment of parents, the number of family members, type of school and satisfaction with oneself are not crucial for the eventual drug use among young people. While, the biological status of the parents, educational status of parents, financial status of parents, the tendency of parents tobacco and alcohol use, adolescents’ attitude to parents, the harmony of relationships between parents, school performance, positive attitude toward the so-called light drugs, represent significant risk factors for adolescent populations.

A. Bajraktarević, S. Putica, S. Trninic, A. Skopljak, N. D. Kreso, B. Djukic, A. Hadzimuratović, E. Selimovic et al.

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