Medical Biography of Isak Samokovlija: The Famous Bosnian-Herzegovinian Writer.

The purpose of this paper is to shed light on the biographical, professional, and health-educational works of Dr. Isak Samakovlija, who was better known as a writer than a doctor in the country where he was born. He was born in 1889 in Gorazde, the easternmost province in the Austrian-Hungarian monarchy, into a modest Jewish merchant family. He attended high school in Sarajevo and completed his studies in medicine in Vienna in 1917. During the First World War, he served twice in the Austro- Hungarian army. After the end of the First World War in 1918, he completed a medical internship at the National Hospital in Sarajevo. He began his service as a doctor, first in Gorazde and then in Fojnica and Sarajevo. After the establishment of the Independent State of Croatia in May 1941, he was dismissed from his duties in the service without the right to pension or support, and without the right to appeal. In the Independent State of Croatia, he was twice mobilized into the Home Guard and was manager of the clinic in the Alipasin Most refugee camp. After World War II, he was the head of the Health Education Department of the Ministry of Public Health of the People's Republic of Bosnia and Herzegovina in Sarajevo. Together with a group of enthusiastic doctors, he founded and edited the first Bosnian medical journal Zivot i Zdravlje (Life and Health). In that journal, Dr. Samokovlija published 29 articles of health and educational content. In 1949, Dr. Samokovlija left the Ministry of Public Health and continued to edit the literature and art journal Brazda, but he still had a private practice until the end of his life. He died in Sarajevo on January 15, 1955. He was buried with the highest state honors at the Jewish cemetery in Sarajevo. CONCLUSION: Isak Samakovlija (1889-1955) was one of the first medical doctors born in Bosnia and Herzegovina. He made a significant contribution to the improvement of people's health after the First and Second World Wars in the places where he worked. His special contribution are his articles on health education.

Dr. Masa Zivanovic: A Pioneer in Health Care for Women and Children in Bosnia and Herzegovina.

The aim of the article is to present, primarily to the medical world and also the general public, the personality and work of Masa Zivanovic (1890-1960), a pioneer in the health care of children and mothers in Bosnia and Herzegovina (BH), a health educator and one of the leaders of the Yugoslav Women's Rights Movement in the period between the two world wars. She was born in Croatia (then part of the Austro-Hungarian Empire) as Maria Skopszynski, in a family of Polish-Czech origin. After studying at the Temporary Women's Lyceum in Zagreb and passing the matriculation exam at the boy's High School (1909), she obtained the title of Doctor of Medicine in Vienna (1916). Her activity in the Women's Rights Movement has so far generally attracted more attention from researchers than her medical work. However, this work was very important because the general and health education of women, expectant mothers and mothers, after the two World Wars was very poor in BH, and the rates of child morbidity and mortality were high. Masa Zivanovic spent almost her entire working life in Sarajevo. For 30 years, she was the head of the Dispensary for Mothers and the Children, later the Institute for Maternal and Child Health Care, into which the previous institution grew in 1931. She was among the first followers of the new concept of "comprehensive paediatrics", which included social care for children, disease prevention and treatment of the sick. She successfully connected the medical mission with the mission of a women's rights activist, also trying to act as a health educator through articles published in the Women's Movement magazine (Zenski pokret). For a time, she was the president of the Society for the Education of Woman and Protection of her Rights, i.e. the Women's Movement, and a delegate at conferences of international feminist organizations. CONCLUSION: Masa Zivanovic was a physician, a pioneer in the health care of children and mothers in BH, a long-time director of the Institute for Health Care of Mothers and Children in Sarajevo, and one of the leaders of the Yugoslav Women's Rights Movement.

Rosalie Sattler-Feuerstein: An Austro-Hungarian Official Female Physician in Bosnia and Herzegovina, 1914-1919.

This short biography traces the life and medical activities of Rosalie Sattler, née Feuerstein (1883-19??), who was employed as an official female physician at the Austro-Hungarian (AH) provincial public health department in Sarajevo from 1914-1919. Born in 1883 into a Jewish middle-class family in Chernivtsi (then Czernowitz), Ukraine, in Bukovina, the easternmost province in Austria, Feuerstein moved to Vienna in 1904 to study medicine. After earning her MD from Vienna University in 1909, she started her career as an assistant physician at the Kaiser Franz Josef Hospital in Vienna. In spring 1912, Feuerstein moved to Sarajevo to work as an intern at the local provincial hospital (Landeskrankenhaus). In the same year, she married AH district physician Moritz Sattler (1873-1927) in Vienna. In 1914, Sattler-Feuerstein successfully applied to be an AH official female physician in Bosnia. She was an employee of the provincial public health department in Sarajevo and never functioned as an official female physician in the sense of the relevant AH service ordinance. After the collapse of the monarchy, Sattler-Feuerstein continued to be employed as an official female physician of the Kingdom of Serbs, Croats, and Slovenes. She resigned from service in 1919 and established herself as a private general practitioner in Sarajevo with her husband, who had also resigned as an official physician and started to practice privately at that point. Widowed in 1927, she left Sarajevo for an unknown destination, likely in 1938-1939, and vanished from historical records. CONCLUSION: Rosalie Sattler-Feuerstein (1883-19??) came to Bosnia as the eighth AH official female physician and worked as an employee of the AH provincial public health department in Sarajevo from 1914-1919, after which she practiced as a private physician in Sarajevo for more than 25 years.

Kornelija Rakic: A Woman Doctor for Women and Children in Serbia and Bosnia and Herzegovina.

This short biography focuses on the life and medical activities of Kornelija Rakic (1879-1952), a Serbian female pioneer of medicine from the then Hungarian province of Vojvodina, who acquired an MD from the University of Budapest in 1905. Rakic came from a humble background, and a Vojvodina Serbian women's organization enabled her to become a physician and pursue her social medicine mission. After a futile attempt to open a private practice as a "woman doctor for women" in Novi Sad in 1906, she successfully applied to the Austro-Hungarian provincial government in Sarajevo for the position of an official female physician in occupied Bosnia. Rakic began her career as an Austro-Hungarian (AH) official female physician in Bihac (1908-1912) and was transferred to Banja Luka in 1912 and to Mostar in 1917=1918. Kornelija Rakic stayed in Mostar after the monarchy collapsed in 1918 and continued to work as a public health officer in the service of the Kingdom of Serbs, Croats and Slovenes, founded in 1918. Subsequently, she served as the head of the "dispensary for mothers and children" at the Public Health Centre in Mostar, founded in 1929, where she practiced until her retirement in 1949. After World War II, Rakic served as Vice President of the Red Cross Society in Mostar. She received numerous awards and medals from the Austro-Hungarian Empire, the Kingdom of Yugoslavia and the Federal People's Republic of Yugoslavia. Kornelija Rakic died in Mostar in 1952 and was buried at the local Orthodox cemetery of Bjelusine. CONCLUSION: Kornelija Rakic (1879-1952) was the first Serbian female physician in Novi Sad, Vojvodina, and she was employed as an AH official female physician in Bihac (1908-1912), Banja Luka (1912-1917) and Mostar (1917-1918). After World War I, she participated in the establishment and expansion of public health institutions in Mostar and Herzegovina from 1918-1949 against the backdrop of the devastation of the two World Wars.

Jadwiga Olszewska: A Woman Pioneer in Medicine in Serbia and Bosnia and Herzegovina.

This article describes the life and medical activities of Jadwiga Olszewska (1855-1932) in Serbia from 1895-1899, AustroHungarian (AH)-occupied and annexed Bosnia and Herzegovina (BH) from 1899-1918, and the newly founded Kingdom of Yugoslavia, from 1919-1932. In summer 1899, Olszewska replaced Teodora Krajewska as an AH official female physician in Tuzla. Born in Congress Poland, Olszewska had enrolled in 1873 in the medical courses for women in St. Petersburg but had left Russia in 1880 to study medicine in France. She had lived as a student and single parent in Paris since 1883, and she was awarded her Doctorate in Medicine from the University of Paris in 1894. She could not practice medicine in Russian-occupied Poland because of her French diploma, and she could not practice in most Western countries due to her gender. Therefore, she decided to move to Serbia, where she worked as an assistant physician in the district hospitals of Loznica (1895-1897?) and Pozarevac (1897-1899). Driven by the need for a higher income to fund her son's education, she engaged her network of Polish compatriots and procured the position of an AH official female physician of Tuzla in 1899, where she performed her duties in an exemplary manner. After the breakdown of the Austro-Hungarian Empire (AHE) in 1918, Olszewska remained in Tuzla and retired as a Yugoslav official physician in 1923. When she died in Tuzla in 1932, local colleagues had to arrange for a proper funeral because Olszewska did not leave any savings due to her insufficient pension. Olszewska's grave never received a tombstone, and it is untraceable today. CONCLUSION: Jadwiga Olszewska (1855-1932) was a woman pioneer of medicine from Poland, who practiced her profession first as an assistant physician in Serbia (1895-1899) and then as an AH and Yugoslavian official female doctor in Tuzla, BH (1899-1923).

Gisela Januszewska (née Rosenfeld), an Austro-Hungarian 'Woman Doctor for Women' in Banjaluka, 1899-1912.

The focus of this article is on the biography and medical activity of Gisela Januszewska (née Rosenfeld) in Austro-Hungarian (AH) occupied Bosnia and Herzegovina (BH) between 1899 and 1912. Rosenfeld, later Januszewska and then Kuhn(ová) by marriage, was the fifth of a total of nine official female physicians who were employed by the AH administration to improve the health and hygienic conditions among Bosnian and Bosnian Muslim women. In 1893, Gisela Kuhn moved from Brno, Moravia to Switzerland to pursue her medical studies; she was awarded her Doctorate in Medicine (MD) from the University of Zurich in 1898. In the same year, she took up her first position as a local health insurance doctor for women and children in Remscheid but was prohibited from practising in the German Empire. In 1899, she successfully applied to the AH authorities for the newly established position of a female health officer in Banjaluka and began working there in July 1899. She lost her civil service status upon marrying her colleague, Dr Wladislaw Januszewski, in 1900 but carried out her previously officially assigned tasks as a private physician. In 1903, she was employed as a 'woman doctor for women' at the newly established municipal outpatient clinic in Banjaluka. Upon her husband's retirement in 1912, the couple left BH and settled in Graz, Styria. After, World War I Januszewska ran a general medical practice in Graz until 1935 and worked as a health insurance-gynaecologist until 1933. She received several AH and Austrian awards and medals for her merits as a physician and a volunteer for humanitarian organisations. Upon Austria's annexation to Nazi Germany 1938, however, she was classified a Jew and was deported to Theresienstadt concentration camp (Terezín, Bohemia), where she died in 1943. CONCLUSION: Gisela Januszewska, née Rosenfeld (1867-1943) viewed her medical practice as a social medicine mission which she put into practice as a 'woman doctor for woman' in Banjaluka, BH (1899-1912) and Graz, Austria (1919-1935).

Rosa Einhorn (1872-1950): A Woman Pioneer in Medicine between Bosnia (1902-1913), New York, and Palestine.

This short biography details the life and medical activities of Rosa Einhorn, mariée Bloch (1872-1950), who practised as an Austro-Hungarian (AH) official female physician in Travnik in occupied Bosnia and Herzegovina (BH) from 1902 to 1904, and as a semi-official private physician from 1905 to 1912/13. Born in Hrodna district in the Russian Pale of Crescent, Einhorn had qualified and practised as a "feldsheritsa" in Russia and went to Switzerland to study medicine in 1896. Upon receiving her medical doctorate from the University of Lausanne in 1901, she became recommended as a particularly adequate candidate for the not-yet-created position of an AH official female physician in BH. After Einhorn functioned as a general practitioner for women and children in Travnik and the adjacent districts for two years, the AH public health authorities officially dismissed her due to her engagement and marriage to the AH judiciary Sigismund Bloch (1850-1927). However, she obtained a right to private practice in 1905 and was employed as a private physician in AH anti-syphilis campaigning. Struggling for her reinstatement as an official female physician in Travnik, she also strove for the accreditation of her Swiss diploma in Austria, though in vain. After two attempts to emigrate to the United States in 1904 and 1913, Rosa Einhorn finally left Europe to work as a physician in the United States and Mandatory Palestine/Eretz Israel in 1923. She died in New York on May 27, 1950. CONCLUSION: Rosa Einhorn was employed as a provisory official female physician in Travnik in 1903/1904, the AH authorities accepting her only as a local private female physician after her marriage in 1905. Struggling in vain for her reinstatement, she finally left Bosnia in 1913.

Boguslawa Keckova: An Official Female Doctor in Bosnia and Herzegovina, 1893-1911.

The purpose of this paper is to bring to light the biographical details, the professional work and the publishing activities of Boguslawa Keckova (Bohuslava Kecková in Czech and Keck in German), who functioned as an Austro-Hungarian health officer in Mostar from 1893 to 1911 during the period of the Austro-Hungarian occupation of Bosnia and Herzegovina (BH). Keckova, who came from Prague, was the second of nine female physicians to be employed by the Austro-Hungarian authorities between 1892 and 1918. Keckova contributed significantly to the improvement of public health and hygiene in BH, especially by organising the medical treatment of Muslim women. She published a series of popular medical articles, both in Czech and in Bosnian. Her medical articles in the Mostar newspaper, 'Osvit', were among the first in BH to promote public health education and aimed at improving the health of the population. In the Czech Republic, 'Bohuslava Kecková' is renowned for being the first Czech female physician to graduate, who, due to Austria's conservativism and anti-feminism, had been forced to study and practise abroad. After Keckova's efforts to have her Swiss MD degree (1880) recognised in Austria failed in 1882, she acquired an Austrian midwife's diploma and established a maternity home in Prague. In 1892, she accepted the invitation to serve as an Austro-Hungarian female health officer in Mostar, where she initialised and popularised the utilisation of public health among (Muslim) women. CONCLUSION: Boguslawa Keckova's work as a physician, medical writer and health educator, which she continued tirelessly until her death in 1911, was based on gender-specific socialmedical concepts, which were at the core of the contemporary Czech feminist movement.

Dr. Anna Bayerová: The First Official Female Doctor in Bosnia and Herzegovina.

This biographical note details Anna Bayerová's (1853-1924) activities as the first female Austro-Hungarian health officer in 1878 to1918 occupied Bosnia and Herzegovina (BH). Anna Bayerová is known as a heroine of Czech feminism and the 'first Czech female physician', though she only practised in the Czech lands from 1913 to 1916. In 1891, Bayerová was enrolled as the first Austro-Hungarian female health officer and assigned to treat Muslim women in the district of Tuzla, Bosnia. She pursued this mission for the first three months of 1892, had herself transferred to Sarajevo in the summer, and soon thereafter quitted the service. Her biographers point to a series of political and personal motivations to abandon her mission in Bosnia, which, from the viewpoint of Czech feminists, included fulfilling her professional duties in an exemplary way. She spent most of her professional life as a physician in Switzerland and did not request Austrian recognition of her medical degree until 1913. Bayerová died in Prague in 1924. Conclusion. Bayerová, partly for political reasons and partly due to her panic-fuelled fear of catching tuberculosis, quitted her role as the first Austro-Hungarian female health officer in BH soon after her arrival in 1892.

Teodora Krajewska, Official Female Doctor of Tuzla and Sarajevo: Medical Practitioner, Woman of Science, Polish Patriot and Feminist.

A biographical note on Teodora Krajewska (1854-1935) reveals the details of her life and professional activities as an Austro-Hungarian and Yugoslav health officer (Amtsärztin) in Tuzla (1893-1899) and in Sarajevo (1899-1923). Teodora Krajewska, née Kosmowska was the third of nine official female doctors employed by the Austro-Hungarian administration in occupied Bosnia and Herzegovina (BH: 1878-1918) and charged with the special task of popularising public health and hygiene, particularly among Muslim women. A Polish intellectual and fervent patriot from Warsaw, Krajewska had left Congress Poland as a young widow in 1883 to study medicine in Geneva, Switzerland. In 1890, she became the first woman in Europe to be employed as an assistant professor at the medical faculty of the University of Geneva but was forced to resign in 1892. In the same year, she was both awarded her doctorate and appointed to the position of an Austro-Hungarian female health officer in Tuzla. After being nationalised in Austria, she reported for duty in Tuzla in March 1893. In 1899, she accepted her transfer to a newly created position in Sarajevo where she was active as an official physician until 1922/23. She contributed to contemporary medical science through her research on leprosy and osteomalacia in Bosnia. She returned to Warsaw in 1928 and devoted herself to the translation of Serbo-Croatian literature and writing her memoirs on her life and activities in BH.

Medical Journals in Bosnia and Herzegovina from 1878 to 1945.

This paper presents the medical journals published in Bosnia and Herzegovina (BIH) in the period from 1878 to 1945. The first medical journal in BIH may be deemed to be Jahrbuch des Bosnisch-Hercegowinischen Landesspittales in Sarajevo (The Yearbook of the National Hospital of Bosnia and Herzegovina in Sarajevo). In a special part of this journal, doctors from Austro-Hungary serving in Sarajevo wrote scholarly articles about their patients' various ailments. Up to 1945 seven more medical journals were published in BIH: Trezvenost - Organ Jugoslavenskog Saveza Trezvenosti (Temperance - the Journal of the Yugoslav Temperance Society), Zdravlje - Lekarske pouke o zdravlju i bolesti (Health, Medical lessons on Health and Disease), Glasnik Lekarske komore za Bosnu, Hercegovinu, Dalmaciju i Crnu Goru (The Journal of the Chamber of Physicians of Bosnia, Herzegovina, Dalmatia and Montenegro), Glasnik Lekarske komore Vrbaske banovine (Journal of the Chamber of Physicians of Vrbaska banovina, Glasnik Lekarske komore Drinske banovine (Journal of the Chamber of Physicians of Drinska banovina), Vjesnik Zavoda za suzbijanje endemijskog sifilisa u Bosni i Hercegovini (Journal of the Institute for Combatting Endemic Syphilis in Bosnia and Herzegovina) and Casopis za medicinu i biologiju (Journal for Medicine and Biology). CONCLUSION: Medical journals published in BIH in the period from 1878 to 1945 were published in times marked by specific political and social circumstances in BIH, in the time when BIH was not independent, and was under the influence of the health culture of the ruling regimes. Most of the authors of the articles published in these journals were citizens of the occupying authorities, although the papers published were mainly the result of research undertaken in BIH.

Bacterial sepsis in neonates: Single centre study in a Neonatal intensive care unit in Bosnia and Herzegovina.

OBJECTIVE: The aim of the study was to evaluate the incidence, mortality, risk factors, aetiology and the susceptibility to antibiotics of the bacteria responsible for sepsis. MATERIAL AND METHODS: A single centre, prospective, observational study, involving 200 neonates admitted over 12 months to the NICU of the University Children's Hospital, Tuzla, Bosnia and Herzegovina. RESULTS: The crude incidence of all neonatal sepsis was 68.0% (136/200) and that of late-onset sepsis (LOS) was 48.5% (97/200), yelding an incidence density of LOS of 41.6/1000 patient days. LOS represented the most frequent infection and was significantly more frequent than early-onset sepsis (EOS) (71.3% versus 28.7% p<0.001). The overall mortality was 14.0%, and 18.4% among infected neonates. Risk factors associated with LOS were: mechanical ventilation, intravascular catheter, surgical procedures, birth weight ≤1500 g, gestational age ≤ 28 weeks and Apgar score ≤ 3 at 5 minutes. Culture proven sepsis developed in 43.4% of neonates. Klebsiella pneumoniae and Enterococcus faecalis were the predominant bacteria. Gram-negative bacteria were susceptible to amikacin, imipenem and meropenem; gram-positive bacteria to vancomycin and amikacin. CONCLUSION: Neonatal sepsis in our NICU showed a high incidence rate, and gram-negative bacteria were predominant. Low gestational age, mechanical ventilation and an intra-vascular catheter were significantly associated with sepsis. It is necessary to develop a multidisciplinary approach for routine surveillance of nosocomial infections, to improve the asepsis of therapeutic procedures, and to implement the more appropriate use of antibiotics.

Marijuana smoking among school-aged adolescents in the Brcko District of Bosnia and Herzegovina: A cross-sectional study.

OBJECTIVE: The aim was to determine the prevalence of marijuana smoking among school-aged adolescents in the Brcko District of Bosnia and Herzegovina, with particular regard to their gender, age and residence, and the frequency of marijuana smoking in the past thirty days in relation to their peers in the rest of Bosnia and Herzegovina, the Republic of Croatia and the Republic of Serbia. SUBJECTS AND METHODS: This research, designed as a cross-sectional study and based on the ESPAD (European School Survey Project on Alcohol and Other Drugs) questionnaire, adjusted to this research, encompassed 4,188 adolescents from elementary and secondary schools. The data were collected by means of questionnaires tailored to each respondent. RESULTS: A significantly lower number of adolescents smoke marijuana in comparison to those who do not smoke, but male adolescents smoke more often than female adolescents (p<0.001), as well as urban youth in comparison to rural youth (p=0.04). Every fourth adolescent, regardless of gender, who smoked marijuana, used it before the age of thirteen (p<0.001), male adolescents more often than females (p=0.002). In the previous thirty days a higher percentage of all the respondents from the Brcko District had smoked marijuana than those from the Republika Srpska and the RS (p<0.001), and there is no difference between them and their peers from the Federation of Bosnia and Herzegovina and the RC (p=0.382 and p=0.608). CONCLUSION: Smoking marijuana in the Brcko District is a major public health problem. Male adolescents smoke marijuana more often than female adolescents, and urban youth more in comparison to rural youth. In the previous thirty days adolescents from the Brcko District smoked more often than their peers from the Republic of Serbia and the Republika Srpska, and with the same intensity but less frequently compared to adolescents from the Republic of Croatia and the Federation of Bosnia and Herzegovina.

Postal censorship of Bosnian public health institutions during the Second World War: The Independent State of Croatia versus Dr. Stanko Sielski.

This study aims to present evidence of censorship during World War II by the Independent State of Croatia of one of its public health officials, Dr. Stanko Sielski who was a physician trained in epidemiology and public health. During World War II, he directed the Institute for Combating Endemic Syphilis in the Bosnian town Banja Luka. The staff under his direction consisted solely of Jewish physicians. We analyzed two groups of envelopes either sent by or to Dr. Stanko Sielski during the War and found evidence of censorship only in communications with a Jewish physician dated towards the end of the War. Dr. Stanko Sielski would be posthumously recognized for his efforts to shield his Jewish colleagues. CONCLUSION: The newly available, but still limited data, which we present indicates efforts to censor Dr. Stanko Sielski's postal communications towards the War's end. The censors targeted specifically Dr. Stanko Sielski's correspondences with the Jewish physicians he was protecting. This material highlights the many challenges his public health service experienced during the time of armed conflict.

Health-related quality of life in children and adolescents with type 1 diabetes mellitus from Montenegro: relationship to metabolic control.

BACKGROUND: The aim of this study was to evaluate health-related quality of life (HRQOL) in children and adolescents with type 1 diabetes (TIDM) in Montenegro compared with healthy controls and to estimate the effect of metabolic control on perceptions of HRQOL. METHODS: This study involved children and adolescents with T1DM, age- and gender-matched healthy children and their parents. Children and adolescents with T1DM and their parents completed Peds QL 4.0 Generic Core Scales (GCS) and PedsQL 3.0 Diabetes Module. Healthy children and their parents completed self- and proxy-report of Peds QL 4.0 GCS. RESULTS: Our study (self- and proxy-report) showed that children and adolescents with T1DM had lower HRQOL on domain "Psychosocial health" and "School functioning" compared with healthy population (p=0.008; p≤0.001). Lower glycosylated hemoglobin (HbAlc) values were associated with fewer worries, and better health perception by diabetic children and their parents. We did not find notable differences between boys and girls on health perception. Different age groups reported similar QOL. Parents reported that the illness has a greater impact on children's lives than the children reported themselves. CONCLUSIONS: Compared with the healthy children, the HRQOL was lower among children and adolescents with T1DM. Lower HbA1c was associated with better quality of life.

[CIGARETTE SMOKING AMONG SCHOOL ADOLESCENTS IN THE BRCKO DISTRICT OF BOSNIA AND HERZEGOVINA: A CROSS-SECTIONAL STUDY]. / PUSENJE CIGARETA MEDU ADOLESCENTIMA U DISTRIKTU BRCKO U BOSNI I HERCEGOVINI: PRESJECNA STUDIJA.

Objective: The objective of the study was to determine the prevalence of cigarette smoking in adolescents in public schools of the Brcko District of B&H in relation to their gender, age and place of residence. Participants and ­Methods: A cross-sectional study, based on the ESPAD (European School Survey Project on Alcohol and Other Drugs) questionnaire adapted to this research comprised 4,188 respondents who attended primary and secondary schools. Data were collected using a questionnaire prepared for each respondent. Results: Significantly fewer respondents smoke cigarettes compared to those who do not (p < 0.001), while in relation to gender male adolescents smoke more often than female adolescents (p = 0.012). In relation to their place of residence it is established that a significantly higher number of respondents from rural areas smoke cigarettes compared to those from the city (p < 0.001). More than half of the respondents, who smoke regardless of their gender, had their first cigarette before the age of 13. Male adolescents often begin smoking before the age of thirteen compared to female adolescents (p < 0.001), while female adolescents often begin smoking between the ages of 15 and 16 in relation to male adolescents (p <0.001). Every second respondent who smokes cigarettes irrespective of his/her place of residence did so at the age of 13. However, the respondents from rural areas smoke more often (p < 0.0001). Out of 895 respondents who smoked during the last month, 259 of or 30.3 % smoked only one cigarette a week, 162 or 18.1 % smoked 1-5 cigarettes a day, 168 or 18.8 % of the respondents smoked 6-10 cigarettes a day, 146 or 16.3 % smoked 11 to 20 cigarettes a day, and 160 or 17.9 % of the respondents smoked every day. Conclusion: Although 42.8 % of the respondents who had ever smoked cigarettes is significantly less compared to 57.2 % of the respondents who do not smoke, that number is disturbing since we talk about the vulnerable population group and the fact that every second adolescent started smoking at the age to 13.

Neonatal bacterial meningitis: Results from a cross-sectional hospital based study.

OBJECTIVE: The aim of the study was to determine the epidemiological characteristics of bacterial meningitis observed in neonates born in the Department of Gynaecology and Obstetrics, University Clinical Centre Tuzla, Bosnia and Herzegovina, admitted to Intensive care unit (NICU) or readmitted, because of suspected infection, after discharge from the nursery. SUBJECTS AND METHODS: This study was carried out from July 1, 2012 to June 30, 2013. During this period 4136 neonates were born. All neonates admitted to the Intensive care unit with signs and symptoms of systemic infections, and neonates readmitted to the Intensive care unit, after discharge from the nursery for sepsis work up were included in the study. RESULTS: Eighteen of 200 neonates (9%) admitted or readmitted to the NICU developed meningitis. 61% cases were late onset meningitis. The overall incidence was 4.4/1000 live births. The mortality rate was 11.1%. The mean age of symptom presentation was 8.7 days. The most common clinical features were: fever, respiratory distress and jaundice. Significant risk factors for acquiring meningitis were: male gender, Caesarean delivery, stained amniotic fluid. Positive CSF finding were detected in 6/18 (33.3%) of cases. Gram-positive bacteria were more frequently responsible for confirmed meningitis. In all neonates with meningitis blood culture was examined and 5 (50%) yielded Gram-negative bacteria. CONCLUSION: The high rates of neonatal meningitis with predominant late onset may suggest nosocomial origin. Measures to improve antenatal, intrapartum and delivery care and measures during NICU hospitalisation are necessary to lower the risk of nosocomial infections.