Retinal changes in febrile seizures in children: a retrospective analysis in Tuzla Canton, Bosnia and Herzegovina.

Aim To evaluate the possibility of retinal haemorrhages or any other retinal pathology caused by febrile seizures alone in children aged between 2 months and 15 years. Methods Children aged between 2 months and 15 years admitted to the hospital following seizures were examined within 48 hours of admission. The seizures were classified by a paediatric neurologist and a detailed ocular examination, including indirect ophthalmoscopy, was performed by an ophthalmologist. Results In the period between May 2019 and May 2020 a total number of 106 children were examined. There were 66 (62.3%) male and 40 (37.7%) female children. The youngest patient was 2 months old and the oldest patient was 15 years old. None of the children was found to have retinal haemorrhages or any other retinal pathology. Conclusion Retinal haemorrhages or any other acute retinal findings in children with febrile seizures are very rare, but we cannot rule out its occurrence. The finding of retinal haemorrhages in a child admitted with a history of seizure should trigger a detailed search for other causes of those haemorrhages, especially shaken baby syndrome. Due to the lack of any manifestations on the retina after febrile seizure, maybe it is time that the current protocol and guidelines, considering obligatory fundus examination, should be re-examined.

Adalimumab in Treatment of Uveitis in Pediatric Behcet's Disease-a Case Report.

INTRODUCTION: Behcet's Disease (BD) is an inflammatory disease characterized by multisystemic involvement and featured by a chronic, relapsing disease course. Recurrent ocular inflammation and macular involvement may lead to severe loss of visual acuity. Prolonged use of local and systemic corticosteroids lead to numerous side effects and complications. Very often other immunosuppressive therapies are needed. Biologic agents are promising for the treatment of Behcet's disease-associated uveitis. AIM: To report successful treatment of paediatric uveitis due to incomplete Behçet's disease with administration of adalimumab, after failing to react to all other modalities of treatment. CASE REPORT: We present the case of a 15-year-old girl who was treated for reccurent uveitis in both eyes with developed complications on anterior and posterior ocular segment. She was earlier treated with topical and systemic steroids for uveitis, laser photocoagulation and methotrexate, however, relapses occurred inspite all treatment modalities. Patient was diagnosed with incomplete Behcet's disease, and adalimumab therapy was initiated. Inflammation was well-controlled by adalimumab administration without need for local or systemic corticosteroids. CONCLUSION: Adalimumab is effective for treating children with Behcet's disease-associated uveitis. Control of ocular inflammation in our case was achieved without need for continuing local or systemic corticosteroids, thus preventing further complications and possible significant vision loss.

Risk factors for post-colectomy adhesive small bowel obstruction.

OBJECTIVE: The purpose of this study was to assess the risk factors for adhesive small bowel obstruction (SBO) following colectomy for colorectal cancer. PATIENTS AND METHODS: In this retrospective study we analyzed 284 patients who underwent surgery for colorectal cancer at the Department of Surgery University Clinical Center Tuzla in the period from 1st January 2009 until 31st December 2014. All patients underwent open colectomy. The length of follow up was from 6 months to 6 years (median follow up 3 years and 6 months). The study included all patients who underwent surgery due to colon cancer. The study excluded patients with postoperative small bowel obstruction after colon cancer surgery with different comorbidities. RESULTS: In the analyzed sample of 284 patients, a small bowel obstruction occurred in 13.7% patients after surgery for colon cancer. The highest correlation of risk factors and the occurrence of postoperative small bowel obstruction after colectomy for colorectal cancer in multivariate regression analysis was found to be for Tumor-Node-Metastasis ≥3 (or =3.680), and postoperative complications (or =30.683). CONCLUSIONS: Postoperative SBO have many causes, but in this study the highest risk factors were the Tumor-Node-Metastasis ≥3, and postoperative complications.

Pediatric cataract in Tuzla Canton, Bosnia and Herzegovina.

AIM: To estimate incidence and to present descriptive epidemiological data on pediatric cataract in Tuzla Canton, Bosnia and Herzegovina. METHODS: Medical records of all patients hospitalized at the Eye Clinic of the University Clinical Center Tuzla over the 8-year period were retrospectively examined. Prevalence, morphology and type of cataract, its possible etiology and existence of other associated ocular and systemic diseases were analyzed. RESULTS: The study included 87 eyes of 58 children. Average age at presentation was 11.12 (SD ± 9.03) years. A total of 34 (58.62%) patients were males and twenty-four (41.38%) females. Twentynine (50%) cataracts were unilateral. Thirty-seven (63.79%) patients had isolated cataracts and 24 (29.31%) patients had other ocular anomalies associated with pediatric cataract. High refractive anomalies, nystagmus and microphthalmus were most commonly associated ocular findings. Strabismus was present in 14 (24.13%) cases. Posterior cortical cataract was present in 29 (32.58%) and nuclear cataract in 28 (31.46%) cases. Estimated incidence of congenital cataract was 2.62 per 10.000 births and incidence of pediatric cataract was 8.6 per 10.000 births. CONCLUSION: Prevalence of pediatric cataract in Tuzla Canton is within the worldwide range. Late presentation of children with cataract remains the problem that needs to be addressed. Improved patient education and public awareness are needed in order to change the course of avoidable childhood visual impairment.

Cyst of the canal of nuck in a two year old girl.

The canal of Nuck is analogous to a patent processus vaginalis in a male, which normally loses its communication to the peritoneal cavity within the first year of life. Failure of obliteration of this tract can result in a hydrocele. We present a rare case of a 2-year-old girl with left-sided groin swelling, diagnosed as inguinal hernia. Patient underwent surgical exploration and establishes definitive diagnosis as cyst of the canal of Nuck.

Unilateral pulmonary agenesis and gastric duplication cyst: a rare association.

Lung agenesis and gastric duplication cysts are both rare congenital anomalies. Gastric duplication cysts can present with nausea, vomiting, hematemesis, or vague abdominal pain. Unilateral pulmonary agenesis can present with respiratory distress which usually occurs due to retention of bronchial secretions and inflammations. We report the unique case of right pulmonary agenesis associated with gastric duplication cyst.

Both-sided large abdominoscrotal hydrocele associated with testicles atrophy.

Abdominoscrtoal hydrocele is unusual condition with large scrotal hydrocele, which communicates through narrow inguinal channel with abdominal component. Abdominoscrotal hydrocele is not a benign condition, because complications such as acute appendicitis, testicular dismorphism, ureterohydronephrosis, paratesticular malignity have been described earlier. This case study describes one year old boy with both-sided abdominoscrotal hydrocele. Abdominal masses connected with hydrocele need to induce a suspicion of this condition. Early diagnosis and existing surgical techniques for treatment of this disorder are the key factors in prevention of complications associated to this disorder.

Association of Low Birth Weight Infants and Maternal Sociodemographic Status in Tuzla Canton during 1992-1995 War Period in Bosnia and Herzegovina.

Objectives. We examined association between incidence rate of low birth weight in liveborn infants and maternal sociodemographic status in Tuzla Canton during 1992-1995 war in Bosnia and Herzegovina. Methods. The present study covers a 22-year period (1988-2009), including the war period (1992-1995), and we retrospectively collected data on a total of 108 316 liveborn infants and their mothers from three different socioeconomic periods: before (1988-1991), during (1992-1995), and after the war (1996-2009). Association between incidence rate of low birth weight in liveborn infants and maternal sociodemographic status were determined for each study period. Results. There were 23 194 live births in the prewar, 18 302 during the war, and 66 820 in the postwar period. Among the liveborn infants born during the war, 1373 (7.5%) had birth weight of <2500 g, which is significantly more in comparison with 851 (3.6%) liveborn infants in this birth weight group born before and 1864 (2.8%) after the war. We found the number of examinations during pregnancy was 1.8 per pregnant woman in the war period, which was low in comparison with the number of examinations before (4.6 per pregnant woman) and after (7.1 per pregnant woman) the war (P<.001 for both). Prewar perinatal mortality LBW infants of 6.2 per 1000 live births increased to 10.8 per 1000 live births during the war (P<.001), but after the war, perinatal mortality LBW infants (5.2‰) and early neonatal mortality (2.4‰) decreased. Conclusions. We found statistically significant association between low-birth-weight and maternal sociodemographic status in Tuzla Canton during 1992-1995 war in Bosnia and Herzegovina.