Background: Benzodiazepines (BZDs) are very often inappropriately prescribed drugs. The aim of this study is to analyse physicians' prescribing patterns for BZD in Republic of Srpska, and to assess to what extent primary diagnosis determine the dose and the length of use of BZDs. Methods: A retrospective analysis of the physicians' prescription habits based on the database of Family Medicine Information Systems of Republic of Srpska, as well as on data from patient's medical record were performed. Patients' socio-demographic and clinical characteristics, including the data on the type and dose of BZDs prescribed, were recorded and evaluated. Results: BZDs were mostly prescribed for anxiety disorders (30.05%), for depressive disorders (17.54%), and for anxiety-depressive disorders (10.86%). A significant amount of BZDs was prescribed for non-psychiatric diagnoses (23.81%). Patients suffering from psychotic disorders were taking the highest dose of BZD and for the longest periods of time (p<0.001). Longer use of BZDs was in women (r=0.04, p<0.001), elderly (r=0.178, p<0.001), single people (r=0.12, p<0.001), those who live in urban areas (r=0.45, p<0.001) and those who were prescribed higher doses (r=0.213, p<0.001). Conclusion:A significant percentage of patients were using the BZDs for longer period of time than recommended. Strongest positive correlation was found between the dose and the length of use, which implies the addictive potential of BZDs. Since it has been noticed that prolonged use, or abuse is present regardless of the diagnosis, precaution is advised when prescribing BZDs even for acute diseases.

Introduction: Acute coronary syndrome (ACS) is one of the m ost common and most dramatic manifestations of ischaemic h eart disease and distinguishing of ACS from non-cardiac chest pain represents a diagnostic challenge. Objective: Determine the frequency of ACS types: NSTEMI, STEMI and unstable angina pectoris (UAP) and examine the frequency and significance of risk factors and cardiospecific enzymes in patients with ACS. Methods: The analysis included patients who were referred from the prehospital level of the Banja Luka Primary Healthcare Centre (Emergency Department and Family Medicine Department) and treated under the ACS diagnosis in the coronary unit of the Cardiovascular Diseases Clinic of the Banja Luka University Clinical Centre of the Republic of Srpska (UCCRS) in the first 6 months of 2011. The study included patients older than 18, with recorded information on their gender, age, smoking status, hypertension, diabetes, obesity and family burden. Values of cholesterol, triglycerides, serum potassium, creatine kinase (CK), CK-MB, cardiac tro - ponin T (cTnT) were measured. Results: The total of 192 patients were referred under the referral diagnosis of ACS and treated in the coronary unit of the CVD Clinic of the Banja Luka UCCRS. At the same time, ACS was confirmed in 178 cases. STEMI was confirmed in 86 patients (48.31 %), NSTEMI in 55 (30.90 %) and UAP in 37 (20.79 %). ACS was statistically significantly more common in men (112 men and 66 women), in particular younger men (average age for men was 62.7 and 69.2 for men and women, respectively) (U = 2.472 x 103, p < 0.001). Among the risk factors, it was found th at smoking was more often associated with STEMI (p = 0.014) and hypertension with UAP (p = 0.041). Among all param eters, all three examined cardiac biomarkers showed statistical significance (p < 0.001), namely: values at STEMI > NSTEMI > UAP. Conclusion: Half of patients with ACS did not have STEMI (which is presumably easy to diagnose). Third of patients with ACS reported atypical symptoms, which further complicates the early recognition of MI without ST elevation. Precaution is needed in women and in elderly. Determination of cTnT should be available in every examination room.

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Background and Objectives: Benzodiazepines (BZDs) are among the most prescribed psychotropic drugs and significant number of patients use these drugs for longer periods than recommended. The objective of this study was to determine the factors associated with prescribing of BZDs at the primary healthcare level. Materials and Methods: A retrospective analysis of family physicians’ prescriptions from the databases of family medicine teams of the Republic of Srpska was performed. The number of BZDs users, as well as the total number of prescriptions, were determined. Thereafter, it was determined which specific BZD had been prescribed, in which dose, for how long, as well as the specific social and demographic characteristics of patients to whom the drugs were prescribed. Results: The results showed that 38.47% of patients used the BZDs for a period longer than six months. The most frequent BZDs prescribed were the intermediate-acting BZDs, primarily bromazepam (58.69%). Two thirds of patients were women. The average age of the patients was 60, 60.46% of patients were single, and 69.68% lived in urban areas. The longer uses of BZDs were recorded in women, the elderly, single people and those who lived in urban areas, while higher doses of BZDs were prescribed to men, as well as younger and married people. The highest positive correlation was found between the dose and length of use of BZD. Conclusions: A significant percentage of patients used BZDs for a time period longer than recommended. Caution is necessary when prescribing BZDs to women, the elderly, patients that live in urban areas and patients who are single. When prescribing BZDs, family physicians should be aware of their potential interactions and addictive potentials.