Public Health Services in Herzegovina Region during 1992–1995 War

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

Alimentary Infections during War Conditions: Mostar and Tomislavgrad, Bosnia and Herzegovina, 1992–1995

The aim of this study was to assess the outcome of sanitary and epidemiologic measures undertaken in relation to alimentary infections in the military corps of the Croatian Defense Council (Hrvatsko vije}e obrane) and civilian population in Mostar and Tomislavgrad regions during the 1992–1995 War in Bosnia and Herzegovina. A total of 25 (4.8%) of soldiers and 7 (7.1%) of non-military personnel were not being granted medical clearance to be employed in the food provision services. We recorded a total of 68 alimentary infections cases in military personnel (with an incidence of 536,2 per 100,000 persons), and 436 in civilian population (573,9 per 100,000 person), without significant difference between them (p=0.647).We did not record any alimentary infection outbreak in the military personnel, while two smaller epidemics of the abdominal typhus were recorded among civilian populations, but without lethal outcomes. The results of this study suggest that even the most basic adherence to the principle of standard sanitary and epidemiologic preventive measures may substantially reduce the probability of alimentary infections outbreaks, even in the highly disruptive, warfare environment

Snakebites in Mostar Region, Bosnia and Herzegovina

The aim of this study was to provide an overview of the snakebites in patients hospitalized at the Mostar Clinical Hospital, admitted between 1983 and 2006. A total of 341 patients were recorded, with moderate men predominance (52.8%). Majority of patients were bitten for the first time (99.1%). In 98.8% of patients snakebite occurred to the bare skin, most commonly during June to September period (64.2%). Snakebites were the commonest in agricultural workers (48.1%). Until 2003 all admitted patients were treated according to Russel’s scheme (3-anti). As of 2003 new treatment scheme was applied, resulting in the reduction of antidote and supportive treatment use, causing a reduction in the number of clinically apparent allergic reactions. Serum sickness was recorded in only 2 patients, while lethal outcome was recorded in one (0.3%). Overall results indicate that lethality of snakebite is low, and that patients were often administered treatment without medical indication. High number of tourists as well as the presence of the peace keeping troops and other visiting personnel in this region make the snakebites and awareness on snakes not only a local issue, but also more general concern

Acute Tonsillopharyngitis in a Family Practice in Mostar, Bosnia and Herzegovina

The aim of this study was to examine the characteristics of acute tonsillopharyngitis diagnosis and treatment in the family care physicians in Mostar, Bosnia and Herzegovina. All patients diagnosed with acute tonsillopharyngitis in the Center of Family Medicine in Mostar in 2005 and 2006 were included in this study. Data were collected from medical records, including age and sex, month in which they visited their physician, symptoms and signs that they had (McIsaac’s clinical score was calculated accordingly) and treatment. Results showed that there were no gender differences regarding diagnosis. Mean age was 32.6 ± 16.9 years. The most patients were recorded during the January-March period. Total of 65.6% patients received antibiotic treatment. Phenoxymethylpenicillin, considered as the recommended antibiotic was used in 46.3% cases only. In conclusion, this first critical assessment of the existing family practice records on treating patients with tonsillopharyngitis suggested that physicians have to be more critical when treating patients with this diagnosis and that the knowledge and treatment of patients with pharyngitis need to be continuously improved in general medical practice

Snakebites in Mostar region, Bosnia and Herzegovina [Ugrizi zmija na mostarskom području, Bosna i Hercegovina]

The aim of this study was to provide an overview of the snakebites in patients hospitalized at the Mostar Clinical Hospital, admitted between 1983 and 2006. A total of 341 patients were recorded, with moderate men predominance (52.8%). Majority of patients were bitten for the first time (99.1%). In 98.8% of patients snakebite occurred to the bare skin, most commonly during June to September period (64.2%). Snakebites were the commonest in agricultural workers (48.1%). Until 2003 all admitted patients were treated according to Russel’s scheme (3-anti). As of 2003 new treatment scheme was applied, resulting in the reduction of antidote and supportive treatment use, causing a reduction in the number of clinically apparent allergic reactions. Serum sickness was recorded in only 2 patients, while lethal outcome was recorded in one (0.3%). Overall results indicate that lethality of snakebite is low, and that patients were often administered treatment without medical indication. High number of tourists as well as the presence of the peace keeping troops and other visiting personnel in this region make the snakebites and awareness on snakes not only a local issue, but also more general concern

Prevalence of increased body weight and hypertension in the population of Croatian mainland and Adriatic Islands - are islanders really healthier? [Usporedba prevalencije povećane tjelesne težine i povišenog krvnog tlaka između stanovnika kopnene Hrvatske i Jadranskih otoka - jesu li otočani uistinu zdraviji?]

The aim of this study was to compare the prevalence of the hypertension and the increased body weight (BMI) between Croatian mainland and Adriatic island population. The data from the Croatian Adult Health Survey (N = 9,070) served as an estimate for the mainland Croatian population, while the data from "1001 Dalmatian study" (N = 1,001) were collected from four Adriatic islands; Rab, Vis, Lastovo and Mljet. The prevalence of increased body weight and hypertension was calculated for the four age groups and analyzed using chi-square test. The results indicate that men from the islands less frequently had normal body mass index (P < 0.001), and were more frequently overweight (P < 0.001). The prevalence of overweight and obesity were similar between the island and mainland women. The percent of normotensive respondents in men was significantly lower in islands (P < 0.001), while the prevalence of newly diagnosed hypertension was significantly higher among islanders in both genders (P < 0.001). Despite the traditionally prevalent Mediterranean diet and overall more favorable lifestyle islanders may not be as healthy as previously studies suggested, in terms of cardiovascular risk factors prevalence. This might be related to the poor access to health care and preventive measures or low interest for health care especially among men on the islands, reflected in the higher prevalence of newly diagnosed hypertension. These findings suggest that island populations represent good candidates for disease awareness programs and health promotion interventions

Education in family medicine at the University of Mostar School of Medicine

Department of Family medicine has been formed in academic year2002/2003, few years later after the foundation of the School of Medicine University of Mostar. The formal members of department areprofessor and assistants who lecture and lead seminars. In addition,physicians in rural practices contribute to teaching of family medicine. Clinical teaching of family medicine at Mostar School of Medicine is organized in the summer semester of sixth year of the study. It lasts six weeks and contains lectures, seminars and practices. Every student has right and obligation to evaluate educational process at the end of the course in a form of questionnaire and essay. Family medicine continuously receives high marks by students, especially practices. Evaluation of teaching by students is good way of giving feedback about teaching. We believe that student opinion can revise and improve teaching practice. Our good experience and good marks may prompt the changing our educational curriculum to include family medicine at each study year of medical program

Usporedba prevalencije povećane tjelesne težine i povišenog krvnog tlaka između stanovnika kopnene Hrvatske i Jadranskih otoka - jesu li otočani uistinu zdraviji?

The aim of this study was to compare the prevalence of the hypertension and the increased body weight (BMI) between Croatian mainland and Adriatic island population. The data from the Croatian Adult Health Survey (N = 9,070) served as an estimate for the mainland Croatian population, while the data from "1001 Dalmatian study" (N = 1,001) were collected from four Adriatic islands; Rab, Vis, Lastovo and Mljet. The prevalence of increased body weight and hypertension was calculated for the four age groups and analyzed using chi-square test. The results indicate that men from the islands less frequently had normal body mass index (P < 0.001), and were more frequently overweight (P < 0.001). The prevalence of overweight and obesity were similar between the island and mainland women. The percent of normotensive respondents in men was significantly lower in islands (P < 0.001), while the prevalence of newly diagnosed hypertension was significantly higher among islanders in both genders (P < 0.001). Despite the traditionally prevalent Mediterranean diet and overall more favorable lifestyle islanders may not be as healthy as previously studies suggested, in terms of cardiovascular risk factors prevalence. This might be related to the poor access to health care and preventive measures or low interest for health care especially among men on the islands, reflected in the higher prevalence of newly diagnosed hypertension. These findings suggest that island populations represent good candidates for disease awareness programs and health promotion interventions.Cilj istraživanja bio je usporediti prevalenciju povećane tjelesne težine (ITM) i povišenog krvnog tlaka između stanovnika kopnene Hrvatske i jadranskih otoka. Podaci za studiju dobiveni su iz Hrvatske zdravstvene ankete (N=9.070) kao izvora podataka za kopnenu Hrvatsku, i iz istraživačke studije »1001 Dalmatinac« (N=1.001) kao izvora podataka sa četiri jadranska otoka; Raba, Visa, Lastova i Mljeta. Prevalencije povećane tjelesne težine i povišenog krvnog tlaka izračunate su za četiri dobne skupine i analizirane korištenjem hi-kvadrat testa. Rezultati upućuju na to da muškarci na otocima rjeđe imaju normalnu tjelesnu težinu (P<0,001) i veću prevalenciju povećane tjelesne težine (P<0,001). Među ženama nije zabilježena statistički značajna razlika u prevalenciji povećane tjelesne težine između otočana i stanovnika kopna. Postotak ispitanika s normalnim krvnim tlakom bio je manji na otocima (P<0,001), dok je postotak novodijagnosticiranih ispitanika s povišenim krvnim tlakom kod oba spola bio veći na otocima (P<0,001). Rezultati upućuju da zdravstvena slika otočana nije tako povoljna, unatoč prikladnijem životnom stilu i mediteranskom načinu prehrane, barem u smislu prevalencije čimbenika rizika za nastanak kardiovaskularnih bolesti. Ovakav nalaz bi, osobito među muškarcima, mogao biti posljedica otežanog pristupa zdravstvenoj službi, odnosno manje brige za preventivne preglede i kontrolu zdravlja, što je mogući uzrok većoj pojavnosti novodijagnosticiranih ispitanika s povišenim krvnim tlakom i manjoj prevalenciji ispitanika s prikladno liječenom hipertenzijom. Dobiveni rezultati upućuju na to da su otočne populacije prikladne za javnozdravstvene intervencije i akcije kojima je cilj promicanje zdravlja i prevencija bolesti

Prevalence of Increased Body Weight and Hypertension in the Population of Croatian Mainland and Adriatic Islands – Are Islanders Really Healthier?

The aim of this study was to compare the prevalence of the hypertension and the increased body weight (BMI) between Croatian mainland and Adriatic island population. The data from the Croatian Adult Health Survey (N=9,070) served as an estimate for the mainland Croatian population, while the data from »1001 Dalmatian study« (N=1,001) were collected from four Adriatic islands; Rab, Vis, Lastovo and Mljet. The prevalence of increased body weight and hypertension was calculated for the four age groups and analyzed using chi-square test. The results indicate that men from the islands less frequently had normal body mass index (P<0.001), and were more frequently overweight (P<0.001). The prevalence of overweight and obesity were similar between the island and mainland women. The percent of normotensive respondents in men was significantly lower in islands (P<0.001), while the prevalence of newly diagnosed hypertension was significantly higher among islanders in both genders (P<0.001). Despite the traditionally prevalent Mediterranean diet and overall more favorable lifestyle islanders may not be as healthy as previously studies suggested, in terms of cardiovascular risk factors prevalence. This might be related to the poor access to health care and preventive measures or low interest for health care especially among men on the islands, reflected in the higher prevalence of newly diagnosed hypertension. These findings suggest that island populations represent good candidates for disease awareness programs and health promotion interventions