Frequency of Urinary Tract Infection When Diagnosing Vesico Uretheral Reflux in Children in Tuzla Canton.

Background: Vesicoureteral reflux (VUR) represents the return of urine from the bladder into the ureter and the renal canal system. Reflux can occur only on one or both kidneys. VUR most often occurs due to an incompetent ureterovesical junction, which consequently leads to hydronephrosis and dysfunction of the lower parts of the urinary system. Objective: The aim of the study was to determine the frequency of urinary infection when diagnosing vesicouretheral reflux in children in the Tuzla Canton, in the five-year period from 01.01.2016 to 01.01.2021. Methods: Through a retrospective study, we analyzed data from 256 children with vesiocouretheral reflux (VUR), examined in the Nephrology Outpatient Clinic, Clinic for Children's Diseases, University Clinical Center Tuzla, in the period from 01.01.2016 to 01.01.2021, from early neonatal to 15 years of age. The age and gender of children, the most common symptoms of urinary tract infections during the detection of VUR, and the degree of VUR were analyzed. Results: From 256 children with VUR, 54% were male and 46% female. The highest prevalence of VUR was in the age group 0-2 years, and the lowest in the age of children > 15 years. There was no statistically significant difference between the groups of our respondents in relation to age groups, nor in relation to the gender of the children. Statistically significantly more children were without nonspecific symptoms and with asymptomatic bacteriuria in the group without UTI symptoms in children with VUR compared to the group with UTI symptoms in children with VUR. Pathological urine culture between the groups was without a statistically significant difference. Conclusion: Although urinary tract infection in children is common, the possibility of permanent consequences should always be kept in mind if VUR is not diagnosed and treated in time.

Posterior reversible encephalopathy syndrome (PRES) as a complication of immunosuppressive therapy in renal transplantation in children.

Although kidney transplantation is by far the best method of renal replacement therapy, organ receiver is still not spared of eventual toxic consequences of drugs that are in charge of keeping the transplanted kidney functional. Both calcineurin inhibitors, of which tacrolimus more often, occasionally lead to neurotoxic side effects, mostly mild and reversible and dose-dependent in nature, but they can also be very severe or even fatal. It is very important to be aware of possible neurotoxic effects, to confirm them radiologically, and to prevent or reduce drug effects on nervous system. Sometimes the reduction of dose or substitution with another drug with similar mechanism effect is sufficient to terminate the neurotoxic effects of the drug and still not jeopardize the function of transplanted organ.

Posterior Reversible Encephalopathy Syndrome (PRES) as a Complication of Immunosuppressive Therapy in Renal Transplantation in Children.

Although kidney transplantation is by far the best method of renal replacement therapy, organ receiver is still not spared of eventual toxic consequences of drugs that are in charge of keeping the transplanted kidney functional. Both calcineurin inhibitors, of which tacrolimus more often, occasionally lead to neurotoxic side effects, mostly mild and reversible and dose-dependent in nature, but they can also be very severe or even fatal. It is very important to be aware of possible neurotoxic effects, to confirm them radiologically, and to prevent or reduce drug effects on nervous system. Sometimes the reduction of dose or substitution with another drug with similar mechanism effect is sufficient to terminate the neurotoxic effects of the drug and still not jeopardize the function of transplanted organ.

[Infant feeding in respiratory and gastrointestinal infections during the first six months of life]. / Ishrana i obolijevanje dojenceta od respiratornih i gastrointestinalnih infekcija u prvih sest mjeseci zivota.

OBJECTIVE: To investigate the effect of the method of feeding on respiratory and gastrointestinal illnesses during the first six months of life. METHODS: Observational study of infants feeding practice and respiratory and gastrointestinal illnesses in first six months who were born in Gynecology-Obstetric department in period from May-September 2004, who weighed 2500 gm or more and at least 37 gestation weeks. In that period was born 1838 babies. Dates were collected by means of answered questionnaires. RESULTS: We sent 612 questionnaires and 518 (85%) were answered. From 493 eligible questionnaires 395 (80.1%) infants were breastfed, and 98 (20%) formula fed. A total of 279 episodes of illnesses were observed in 493 infants. These infants had on average 1.76 episodes of illnesses. The crude incidence density ratio (IDR) revealed a protective effect of breastfeeding on respiratory illnesses (IDR = 059; 95% confidence interval (CI), 0.44-0.79), for gastrointestinal illnesses (IDR = 0.50; CI, 0.24-0.86) and on all illnesses (IDR = 0.58; CI 0.45-0.86). The IDR adjusted in turn for infant's age, mother's age, socioeconomic status and cigarette consumption in family were similar to the crude IDR. CONCLUSION: the results of this study suggest a protective effect of breastfeeding against respiratory and gastrointestinal illnesses.

[Infants feeding practice in first six month in Tuzla canton]. / Ishrana dojencadi u prvih sest mjeseci zivota u Tuzlanskom kantonu.

OBJECTIVE: To investigate the infants feeding practice in first six months in Tuzla canton. METHODS: Observations of feeding practices in first six months of infants life, born in Obstetrics and Gynecology Department in Tuzla in period May-September 2004 who weighted more than 2500 gm and over 37 weeks gestation age. Dates were collected by standardized questionnaire mailed to 493 mothers from 13 regions in Tuzla canton. With questionnaire we mailed the explanatory letter with investigations detail. RESULTS: Exclusive breast feeding at first 3 month was very high reaching from 74.4% in 1 month, 62.3% in 2 month and 50.9% in 3 month of life. After third month exclusive breast feeding was decreasing and reached 12% at sixth month. Predominant breast feeding was reaching from 13.2% at first month, 27.6% at fourth month and 20.7% at sixth month. Breast feeding and complementary feeding before six month was very low, 1% in first month reaching 47.7% in sixth month. Bottle feeding rate was 11.4% in first month and 20% in sixth month of infant life. CONCLUSION: Infants feeding practice in first 6 months was inadequate according to WHO recommendation, exclusive breast feeding for first six months. Breast feeding initiation rate was high but lack of mothers support after discharge and many barriers discourage exclusive breast feeding of infants in first six months in Tuzla canton.

Epidemiological and clinical aspects of congenital heart disease in children in Tuzla Canton, Bosnia-Herzegovina.

UNLABELLED: Congenital heart disease (CHD) is among the most frequent of all congenital anomalies. The purpose of this study was to present the results of an initial registration of children with CHD from January 1994 to December 1999 in Tuzla Canton, Bosnia-Herzegovina. The population studied consisted of all 39,699 live-born children in this area. Diagnosis of CHD was made by clinical findings, electrocardiography, chest X-ray, echocardiography, catheterisation or autopsy. In the 6-year period, 243 children were found to have CHD, i.e. a prevalence of 6.12 per 1000 live-born. Critical CHD was present in 58 of them, or 1.46 children per 1000 live-born. The average age at diagnosis was 1.47 years. There were 132 boys (54.3%) and 111 girls. The most frequent anomaly was ventricular septum defect with a prevalence of 2.49 per 1000 live-born, representing 40.7 % of the total anomalies. Of the total group, 46 (18.9%) had extracardiac anomalies related to syndromes. Cardiac surgery was indicated in 98 patients (40.3%) but could only be carried out in 42 (17.3%). A total of 63 (25.9%) patients died, 54 of whom within the 1st month of life. CONCLUSION: congenital heart disease is a very significant health problem in Tuzla Canton. It requires urgent measures in terms of organisation of early diagnosis and proper management.