Introduction:Metabolic syndrome (METS) represent a simultaneous presence of multiple metabolic disorders in one person. Prevalence is increasing worldwide, which is probably related to increased obesity and sedentary lifestyle. Non-alcoholic steatosis or “fatty liver” is a metabolic disease caused by fat dysfunction. It can be a sign of some other disease, and can often be found in patients with metabolic disorders. Ultrasound is an acceptable method for the identification of fatty steatosis. There is evidence that when turmeric is used as a herbal diet, with its active metabolite of curcumin, can repair fatty acidosis and thus prevent progression of fatty steatosis complications such as cirrhosis and liver cancer. Goal. The aim of the study was to determine the effects of 400 mg curcuminaddition to the nutrition on ultrasound morphological characteristics of the liver in METS patients.Methodology:A prospective cohort study was conducted on 100 subjects with METS, treated in the family medicine practice of the Tuzla Canton, aged 35-70 years. The therapeutic effects of 400 mg curcumin on ultrasound-morphological characteristics of the liver were followed, validated by ultrasound in 50 respondents of experimental groups with METS. The data were processed by the IBM SPSS Statistics 21 statistical analysis program using parametric techniques andStudent’s t-test for paired samples.Results:There were 65% of women in the study. There were no statistically significant differences in the age of respondents within the analyzed groups. The use of 400 mg curcumin per day was statistically significantly improved ultrasound morphological characteristics of the liver in subjects with METS.Conclusion:All respondents with METS who used curcumin had beneficial effects on the morphological characteristics of the liver. Curcumin had stronger effects on subjects with METS and DM type 2 than others.

Out of 376 respondents were significantly more women 242 (64%) compared to 134 men (46%), the decline has been seen 128 (34%) were taking benzodiazepine 216 (57%) of the respondents, the most commonly used benzodiazepine is bromazepam and a positive correlation was found between the use of benzodiazepines and frequency of falls.

Introduction:Cardiovascular diseases (CVD) are the leading death cause in modern world and are the most public health problem. WHO program for CVD contains: prevention, command and follow up of CVD in global level.Aim:Investigate CVD frequency in family medicine team in 2012.year (one year period of time) and qualitative management prevention and clinical services management quality of CVD together with recommended standards.Patients and methods:clinical revision of clinical standard practice patients with CVD was provided in Family medicine team in Public Health Centre Tuzla for the period of time from January 01 2012 - December 31 2012. For quality of realized services, AKAZ standards were based for: chapter 2. Health promotion and diseases prevention 2.5. preventive clinical services; chapter 3. Clinical services, standard 3.1. Coronary diseases and standard 3.2. TIA and Stroke. From CVD register next parameters had been used: age, gender, disease diagnose, therapy, blood pressure values, total cholesterol values, ß blockers therapy, anticoagulant therapy prescription, smoker status, stop smoking recommendation and influenza vaccination recommendation.Statistical approach:All results were taken in Excel program and statistically analyzed. Descriptive standard tests were taken with measurement of central tendency and dispersion. For significant differentials achieved with χ² chances relation was taken (Odds Ratio-OR) with 95% relevant security. All tests were leveled in statistical significant from 95% (p<0,05).Results:Considering total registered habitants number 1448 (males 624 females 824) total diseases of usually CVD in Team 1 family medicine 531 (36,67%). The most frequent disease was hypertension which was presented in 30,31% of registered patients but in total CVD illness was present in 82,67%. In relation with total patients number (531), female prevalence from CVD 345:186 males vs. 65%:35%; P=0,001 and was statistically significantly higher. Almost patients were in age from ≥65 years. Nearly all the standards for chapter 2. Health promotion and diseases prevention and chapter 3. Clinical services, standard 3.1. Coronary diseases and standard 3.2. TIA and Stroke are met in larger percentages than the minimum, however, bad quality signs we have found in total cholesterol control were values of total cholesterol were ≤ 5mmol/l achieved only in 27.58% patients with CVD. Stop smoking recommendation in smokers with TIA and Stroke (total 10 smokers) was registered in 20,00% patients. Indicator was not achieved,(min level 25%).Conclusion:Role of family medicine team is extremely important in patient care who suffer from chronically noncontagious diseases such as CVD, as one of them. Considering that in our country preventive programs for CVD are at small level, results of this study are acceptable. Our plans for personal continuous educations and patient educations about healthy life style are pointed for higher or average of achieved standards and of course everything what have to be done should be written i...

Background: Higher cardiovascular (CV) morbidity and mortality in depressed patient has demonstrated repeatedly. Aim: Determine the degree of occurrence of hypertension, metabolic syndrome (MetS) and depression in the pit miners and the impact of the six-month holistic treatment of all CV risk factors and depression in the overall CV risk in miners with hypertension, MetS and depression. Methods: From 492 pit miners was taken smoking status, measured blood pressure, waist circumference and body mass index. Analysis was done using the concentration of sugar in blood, triglycerides, total cholesterol, HDL, LDL cholesterol and determined total CV risk. All respondents filled self-assessment Beck's depression scale. Prevalence MetS hypertension and depression were determined. Group of 67 patients with joint hypertension, MetS and depression that is treated six months with psychotropic and somatotropin medication, was singled out. After six months, the effect of therapy on the risk factors and total CV was assessed. Results: Among 492 miners 67 (13,61%) of them had hypertension, MetS and depression. After six months treatment, it showed statistically significant reduction in blood pressure (p=0,0001), waist circumference (p=0,0001) ,total (p=0,002), HDL (p=0,007) and LDL cholesterol (p=0,003), smoking (p=0,002), Beck's scale results (p=0,007) and reduction in total CV risk. Conclusion: After six month of combine therapy in respondents has led to reduced CV risk and level of all factors, except BMI and triglycerides.

Significant increase in mortality from coronary heart disease (CHD) has been seen in Bosnia and Herzegovina in the past decade. Little is known about current secondary preventive practices and treatments among patients with CHD in primary health care. The aims of this study were to evaluate the components of secondary prevention for CHD and to detect possible gender differences. This trial included 70 patients, aged 40-70 years, with established CHD from Family Medicine Teaching Center Tuzla. We evaluated components of secondary prevention (serum total cholesterol and blood pressure levels, smoking habits, body mass index, using aspirin, ACE inhibitors and lipid lowering drugs) in all participants. Results showed that significantly more men than women had diagnosis of CHD. 26/70 (37.14%) patients had myocardial infarction, with significantly higher number of men than women, but more women had angina only. Mean systolic blood pressure was 148.09+/-20.22 and diastolic 91.62+/-10.17 mmHg; mean total cholesterol level was 6.23+/-1.33 mmol/l; mean BMI was 27.9+/-3.32 kg/m(2). Blood pressure was managed according to guidelines in 19 (27.14%), and lipid concentrations in 11 (15.71%) patients. 55/70 (78.71%) patients took aspirin, only 18/70 (25.71%) patients took lipid lowering therapy, and 20/23 (86.96%) patients with heart failure took ACE inhibitors. 16/70 (22.86%) patients were current smokers, only 19/70 (27.14%) patients had healthy body mass index, while 21/70 (30%) patients were obese. Results of this study show a suboptimal secondary prevention in primary health care, which indicate more effective public health messages and changes in the healthcare system that promotes preventive strategies.