Introduction: Operation of the Primary health care center and Medical-biochemical laboratories depends on the number of performed laboratory tests. The number of unnecessary tests significantly affect the operation of health institutions. Material and methods: We analyzed the 1000 requests for laboratory tests at the Primary Health Care Centre in Gracanica from primary care units. Based on the requests for laboratory diagnostics advisable diagnoses from primary health care unit in the Primary Health Care Center (PHC) we made an economic analysis of the total required laboratory tests in the requests for laboratory diagnosis. Incorporating the economic analysis of laboratory tests in requests for laboratory diagnosis by doctors in primary health care (PHC) and the economic analysis of laboratory tests by the disease in primary health care. Results: The economic value of 5333 laboratory tests was 84 312 points (1 point is 0.80 KM). Of the total value of the index score requirements of GPs are 44, 1%, the requirement of family doctors account for 40% and requirements of other specialists make up 15, 9%.. Discussion: In the requests of the PHC units for laboratory tests are required all levels of services: urine, CBC, SE, glucose, bilirubine, ALT, AST, AF, CK, cholesterol, HDL chol., triglicerdes, creatinine, urea, uric acid, CRP, fibrinogen, calcium and phosphorus. The following requests are the most common laboratory tests: urine, CBC, blood glucose, cholesterol, triglycerides, aminotransferases, creatinine, urea. The doctors in family practice most often requested: blood glucose, urine, CBC, SE, TGL. , Chol., ALT, AST, creatinine and urea. General practitioners were demanding more cholesterol and triglycerides, and family medicine doctors were demanding less cholesterol and triglycerides and more often CRP, fibrinogen, ALT, AST, what from the level of economic cost analysis rises the issue whether this was justified?

Objectives: To determine the optimal medication for the treatment of renal colic using evidence based medicine (EBM) parameters (RR, ARR, NNT, NNH, ARI, RRI). Sample and Methodology: During 2010, an ITT study was conducted on 400 outpatients of the Sarajevo University Clinical Center Urology Clinic in order to investigate renal colic pain relief drugs. Each group consisting of 100 patients was administered either Metamizol amp. i.v., or Diclofenac amp. i.m., or Butylscopolamine amp. i.v., while 100 patients belonged to the placebo group that was given distilled water (aqua redestilata). All patients completed visual analogue pain scale (VAPS) from 0 to 10 prior to and after the treatment. Results: Using EBM parameters Diclofenac Na and Metamizol were shown to be the most efficient in the treatment of renal colic. In these two groups, relative risk (RR) was 21 and 8,5% respectively; Absolute Risk Reduction (ARR) was 74 and 86% respectively, and Number Needed to Treat (NNT) was 1 for both groups, while chi-squared (X2) test has shown that there is no statistically significant difference between these two drugs when it comes to their effect. In the Butylscopolamine group, RR was 81; ARR 18%, while NNT was 5. With respect to side effects, only in his group it was shown that Relative Risk Increase (RRI) was 84, ARI 83%, while Number Needed to Harm (NNH) was 2. Conclusion: The most optimal medication for the treatment of renal colic according to EBM parameters is Diclofenac Na, followed by Metamizol. Butylscopolamine is not recommended for the treatment of renal colic.

ЗАЧЕСТЕНОСТ НА ПЕЛТЕЧЕЊЕТО КАЈ ДЕЦАТА НА УЧИЛИШНА ВОЗРАСТ СО DOWN-ОВ СИНДРОМ Невзета САЛИХОВИЌ1, Селма ХАСАНБАШИЌ2, Лејла БЕГИЌ1 1 Универзитет во Тузла, Факултет за об­ра­зо­ва­ние и рехабилитација  2 Институт за посебно образование и ре­ха­би­ли­тација на децата со интелектуална попреченост „Mеденица“, Сараево INCIDENCE OF STUTTERING IN SCHOOL-AGE CHILDREN WITH DOWN SYNDROME Nevzeta SALIHOVIC1, Selma HASANBASIC2, Leila BEGIC1 1 University of Tuzla, Faculty of Еducation and Re­habilitation 2 Institute of Special Education and Re­ha­bi­li­ta­ti­on for Children with Intellectual Disabilities "Mjedenica", Sarajevo Примено: 27.09.2011 Прифатено: 16.12.2011 UDK: 159.946.3-056.31-053.2 Recived: 27.09.2011  Accepted: 16.12.2011 Original Article Резиме Abstract Главната цел на ова истражување е да ја ис­пи­та појавата (зачестеноста) и тежината на пел­течењето помеѓу децата на училишна воз­раст со  Down-ов синдром. Примерокот беше сос­тавен од 37 машки и женски деца на училишна возраст кои беа дијагностицирани со Down синдром. Ова истражување беше спро­ведено во следните установи: Институт за посебно образование и рехабилитација на деца со  интелектуална попреченост „Mе­де­ни­ца“; Центар за образование, обука и вра­бо­ту­вање на деца со ментална ретардација, деца со аутизам и целебрална парализа „Вла­ди­мир Назор“ во Сараево; Основно учи­лиш­те за посебно образование „Зеница“; Ос­нов­но училиште „Ковачиќи“ во Сараево; Здру­же­ние на обединетата граѓанска иницијатива ДУГА од Сараево и асоцијацијата „Биди мој при­јател“ од Илијаш. Сите испитаници беа ис­питувани одделно. Резултатите покажаа дека 13,51 % од децата со Down синдром пел­течат, а крајниот резултат на сериозноста на пелтечењето покажа умерено пелтечење. Овие  резултати  покажуваат  дека  децата со Down синдром треба да бидат интензивно вклу­­­чени во терапијата за говор со цел да им се по­могне да го совладаат пелтечењето, да ја по­доб­рат секојдневната комуникација и да се по­ду­­чат како да се справуваат со оваа го­вор­на ма­на. The main purpose of this study was to examine the incidence (frequency) and stuttering severity in the school-age children with Down syndrome. The sample was consisted of 37 school-age children with Down syndrome, both male and female. The study was conducted in the following institutions: Institute of Special Education and Rehabilitation for Children with Intellectual Disabilities "Mjedenica"; Centre for Education, Training and Employment of Mentally Retarded Children, Children with Autism and Cerebral palsy "Vladimir Nazor" in Sarajevo; Primary School of Special Education „Zenica“; Primary school "Kovacici" Sarajevo; "Association of United Civic Actions – DUGA" in Sarajevo; and The Association "Be my friend" in Ilijas. All of the subjects were individually examined. The results showed that 13,51 % of the children with Down syndrome stuttered, and the total result of stuttering severity indicates a moderate stuttering. These results show that children with Down syndrome should be enrolled intensively in speech therapy in order to help them overcome their stuttering, to facilitate their everyday communication and to teach them how to cope with stuttering. Клучни зборови : зачестеност на пелте­че­ње­то, Down синдром, тежина на пелтечењето Key words: incidence of stuttering, Down syndrome, stuttering severity Адреса за кореспонденција: Невзета САЛИХОВИЌ Владимир Назор 8 75 000, Tузла, Босна и Херцеговина  E-пошта:  nevzeta@gmail.com Corresponding address: Nevzeta SALIHOVIC Vladimira Nazora 8 75 000, Tuzla, Bosnia and Herzegovina Email:  nevzeta@gmail.com

Sideritis scardica Griseb., Lamiaceae (ironwort, mountain tea), an endemic plant of the Balkan Peninsula, has been used in traditional medicine in the treatment of antimicrobial infections, gastrointestinal complaints, inflammation and rheumatic disorders. This study reports a comparison between conventional (hydrodistillation HD and solvent extraction SE) and alternative (supercritical carbon dioxide SC CO2) extraction methods regarding the qualitative and quantitative composition of the obtained extracts as analyzed by GC and GC-MS techniques and their anitimicrobial activity. Different types of extracts were tested, the essential oil EO obtained by HD, EO-CO2 and AO-CO2 obtained by SC CO2 at different preasures 10 and 30 MPa, at 40 °C, respectively, and the fractions A, B, C and D obtained by successive solvent extraction (SE) A: ethanol, B: diethyl ether, C: ethyl acetate and D: n-butanol). While EO was characterized by the presence of the high percentage of oxygenated monoterpenes and sesquiterpenes (30.01 and 25.54%, respectively), the rest of the investigated samples were the most abundant in fatty acids and their esters and diterpenes (from 16.72 to 71.07% for fatty acids and their esters, and from 23.30 to 72.76%, for diterpenes). Microbial susceptibility tests revealed the strong to moderate activity of all investigated extracts against the tested microorganisms (MIC from 40 to 2,560 μg/mL). Although differences in the chemical compositions determined by GC and GC-MS analysis were established, the displayed antimicrobial activity was similar for the all investigated extracts.

Material and method: Using the survey data obtained from doctors in Connecticut, we estimate the “true” costs of defensive medicine and medical malpractice awards via litigation in the overall aggregate picture of U.S. national annual health expenditures. Results and discusion: Progressives claim that these costs amount only to approximately 2% of total annual health expenditures, while conservatives claim that these costs are much higher, in the neighborhood of 10%. Conservatives want to reform the current medical malpractice system because the savings could be significant. Progressives claim that this issue is a “red herring” in the overall picture of health care reform and that other factors such as hospital costs, payments to physicians and pharmaceutical prices are the largest contributors to runaway health care costs, currently amounting to 18% of GDP. The health of the national economy, deficit reduction and future prosperity will depend upon the speed and quality of the cost reducing solutions. Conclusion: An in-depth look into cost and profit structure of each provider’s procedure and legislative push for price and quality transparency of the informed and educated constituents are recommended to improve this serious national, socio-economic problem.