Introduction:Bosnia and Herzegovina has one of the highest unemployment rates in the Balkan region (43.2%), so unemployment is one of the most serious public concerns in our country.Aim:To analyze the influence of unemployment on mental health of the working age population who attend primary care center.Material and Methods:The study was carried out in the municipality of Bosanska Krupa, which has the highest unemployment rate in the Federation of Bosnia and Herzegovina (56%), and included 510 randomly selected working age patients (aged 23-65 years). We used the General Health Questionnaire-28 (GHQ-28) to evaluate mental health of the working age population.Results:There were significantly more women than men (53.5% vs. 46.5%; p=0.02). The mean age of participants was 51.04±12.84 years. The experimental group included 318 (62.35%) unemployed working age participants: 160 (50.3%) had been unemployed for more than 5 years and had had no work experience, while 158 (49.7%) unemployed participants had had a previous work experience of more than five years. The control group included 192 (37.65%) employed working age participants. Unemployment had a significant influence on mental health of the working age population. The unemployed participants had a significantly poorer mental health compared to the employed (p=0.0003). A predictor of impaired mental health was a job loss. A significantly greater mental health impairment occured in the group of unemployed participants with previous work experience of more than five years compared to the unemployed participants who had had no work experience (p=0.001) and employed (p=0.000).Conclusion:Unemployment has a negative impact and leads to impaired mental health of the working age population in Bosnia and Herzegovina. A job loss has a predictive role. It indicates that social and health policies must be developed in order to improve well-being of the working age population.

AimThe aim of this study was to analyze frequency of embitterment in war veterans with Posttraumatic stress disorder (PTSD).Patients and MethodsIt was analyzed 174 subjects (from Health Center Zivinice/ Mental Health Center) through a survey conducted in the period from March 2015 to June 2016, of witch 87 war veterans with PTSD and control subjects 87 war veterans without PTSD. The primary outcome measure was the Post-Traumatic Embitterment Disorder Self-Rating Scale (PTED Scale) who contains 19 items designed to assess features of embitterment reactions to negative life events. Secondary efficacy measures included the Clinician-Administered PTSD Scale - V (CAPS), the PTSD CheckList (PCL), the Combat Exposure Scale (CES), the Hamilton Depression Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A) and the World Health Organization Quality of Life Scale (WHOQOL-Bref). All subjects were male. The average age of patients in the group war veterans with PTSD was 52·78 ± 5·99. In the control group average age was 51·42 ± 5·98. Statistical data were analyzed in SPSS statistical program.ResultsComparing the results, t tests revealed significant difference between group veterans with PTSD and control group (t=–21·216, p<0·0001). War veterans group with PTSD (X= 51·41 SD= 8·91), war veterans without PTSD (X=14·39, SD=13·61).ConclusionEmbitterment is frequent in war veterans with PTSD.

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.

Objectives:The aim of this study was to evaluate a frequency and clinical presentation of hypertension crises due to age, gender, duration and seriousness at Emergency Medical Service Department of the “Dr Mustafa Šehovic” Health Care Center Tuzla.Methods:The research was conducted in the period between November 2009 and April 2010 and involved 180 examinees of both genders, aging between 30 and 80 years of age with the diagnosis of arterial hypertension. The examinees were divided into two groups: control group consisting of examinees without hypertension crisis (95 examinees) and experimental group consisting of examinees with hypertensive crisis (85 examinees). Descriptive statistical methods were used in the statistical data processing.Results:The research results showed that there had been significantly more female examinees than the male ones (60% vs. 40%; p=0.007). The average age of male examinees was 55.83±11.06 years of age, and the average age of female examinees was 59.41±11.97 years of age. The hypertension crisis frequency was 47.22%, where the hypertensive urgencies were statistically significantly more present than the hypertensive emergencies (16.47%vs.83.53%; p<0.0001). The largest number of experimental group examinees (28.23%) belonged to the age group of 60 to 69 years of age; urgency 26.76% and emergency 35.71%. The largest number of examinees with hypertensive crisis (49.41%) appeared in the period between 6.00 p.m. and 11.59 p.m. The largest number of emergency group examinees (69.01%) had been treated for arterial hypertension for ten years, and the examinees from the emergency group (42.86%) had been treated for 10, 11 and 20 years. The average blood pressure value at the hypertensive crisis examinees was 204.82/126.58 mmHg.Conclusions:The frequency of hypertensive crises in the Emergency Medical Service Department is high and it reaches 47.22%. Hypertensive urgencies were significantly more present in terms of statistics than the hypertensive emergencies (83.53% vs. 16.47%; p<0.0001).

Objectives:The objective of this study is to evaluate the incidence and clinical presentation of hypertensive crises in the Emergency medical services of the Community Health Centre “Dr. Mustafa Šehović” Tuzla in relation to age, sex, duration and severity of hypertension, as well as the prevalence of accompanying symptoms and clinical manifestations.Methods:The study was conducted between November 2009 and April 2010 and included 180 subjects of both sexes, aged 30-80 with a diagnosis of arterial hypertension. All subjects were divided into two groups: a control group, which consisted of subjects without hypertensive crisis (95 subjects) and an experimental group that consisted of subjects with hypertensive crisis (85 subjects).Results:The study results indicate that female subjects were significantly over- represented compared to men (60% vs. 40 %, p=0.007). The average age of the male subjects was 55.83±11.06 years, while the female subjects’ average age was 59.41±11.97 years. The incidence of hypertensive crisis was 47.22%, with hypertensive urgency significantly more represented than emergency (16.47% vs. 83.53%, p<0.0001). The majority of subjects in the experimental group (28.23%) belonged to the age group of 60-69 years of age: 26.76% urgency and 35.71% emergency. The most common accompanying symptoms in hypertensive subjects were headache (75%), chest pain (48.33%), vertigo (44.44%), shortness of breath (38.88%) and nausea (33.89%). The most common symptoms in subjects with hypertensive crisis were headache (74.11%), chest pain and shortness of breath (62.35%), vertigo (49.41%), and nausea and vomiting (41.17%).Conclusions:Chest pain, shortness of breath, nausea and vomiting were significantly over-represented in subjects with hypertensive crisis (p<0.005). Clinical manifestations of hypertensive emergencies in almost all subjects included acute coronary syndrome, and only one subject had acute pulmonary edema.