Trends in frequency of surgical procedures at Department of Otorhinolaryngology and Maxillofacial Surgery of Mostar University Hospital, Bosnia and Herzegovina (2013-2017).

Aim To determine whether there has been a change in frequency of selected otorhinolaryngology - head and neck surgical procedures during a 5-year period. Methods Comparative cross-sectional analyses of surgical candidates and procedures performed at the Department of Otorhinolaryngology and Maxillofacial Surgery during the period 2013‒2017 were done. Data on patients' demographics and cases of selected surgical procedures were extracted from the operating room log books. Patients' average age, male:female ratio, and the percent share of all surgical procedures for each selected surgical procedure for each studied year were calculated. Results In comparison with the year 2013, the year 2017 showed no significant difference in age or sex of patients who underwent selected surgical procedures, increase of the number of all operations and the number of investigated selected operations, increase in the share of tonsil surgery, nasal septum and pyramid surgery, nasal polyposis surgery, parathyroid gland surgery, otoplasty, cochlear implantation, laryngeal surgery, and tracheotomy, and decline in the share of thyroid gland surgery, middle ear microsurgery, neck dissection, surgery of parotid gland, and surgery of neck cysts. Conclusion Our finding of variations in utilization of some studied procedures provides a basis for future discussions, research and provision of health care services. Used data are specific to two studied cantons and do not represent a nationally representative database. The generalisability of the present results to Bosnia and Herzegovina as a whole might be limited. Therefore, similar future investigations conducted in other large hospitals in our country are warranted.

A Rare Case of Recurrent Mucoepidermoid Carcinoma of the Nasal Vestibule.

We report a rare case of a large recurrent mucoepidermoid carcinoma (RMEC) in an 81-year-old female smoker, which has originated in the right nasal vestibule. The recurrent tumour was inadequately treated for 6 years. It was a slow-growing tumour for 3 years and then began to enlarge at a higher pace. In the next three years it has covered a large part of the face. The patient had refused any medical treatment. The tumour caused breathing and swallowing difficulties. Because of the profuse bleeding from the tumour, the patient underwent emergency surgery. Surgical treatment consisted of rhinectomy and resection of the central upper lip and part of the right cheek. The facial defect was reconstructed immediately. Recovery from surgery was fast with no complications. Postoperative Multislice Computed Tomography scan showed no metastases so the patient did not receive any chemotherapy or radiotherapy. During a 2.5 years' follow-up period there was no recurrence of the disease.

Diagnostic value of MPO in patients admitted for suspected acute coronary syndrome--a study of adult in Mostar, Bosnia and Herzegovina.

We assessed the diagnostic efficacy of plasma Myeloperoxidasis (MPO) alone or in combination with cardiac troponin I (cTnI) for detecting ACS in patients presenting with chest pain initiating within 24 h before the hospital admission. In this prospective cohort study were included all respondents who have visited outpatient clinic of internal diseases, University Hospital Mostar because of chest pain and suspected acute coronary syndrome within 24 h of the onset of the period of 6 months and the total sample consisted of 114 patients. Troponin and myeloperoxidase were significantly positively correlated at the beginning of treatment, myeloperoxidase was significantly positively associated with adverse cardiovascular events during hospitalization and myocardial infarction (p < 0.05), with the regression analysis did not show a significant predictor in the development of myocardial infarction (p > 0.05). Sensitivity of myeloperoxidase as a valid test detection of myocardial infarction at baseline was 0.15 and specificity was 0.85, suggesting good diagnostic value usable in the clinical practice.

Benign paroxysmal vertigo in childhood.

The aim of the paper is to describe the clinical picture of benign paroxysmal vertigo (BPV) in childhood. BPV in childhood often goes unrecognized in spite of the fact that vertigo and balance disorders are not uncommon in children. Four cases are described with clinical examination findings between the attacks.

Myoepithelial carcinoma of the parotid gland.

Rare malignant tumor of the salivary gland, a myoepithelial carcinoma, arose de novo in the right parotid gland. The initial tumor was composed predominantly of myoepithelial cells. Subsequently the tumor recurred three times, with infiltration of the bones of the cranial base. Histological examination showed sarcomatoid neoplasm composed of malignant spindle cells with high mitotic rate and perineural invasion. There was no involvement of cervical lymph nodes. Immunohistochemistry demonstrated myoepithelial differentiation: tumor cells were positively stained with vimentin, alpha smooth muscle actin and S-100 protein antibodies, and focal positively was noticed with cytokeratin (AE1/AE3) antibody. Large number of tumor cells nuclei was reactive with the monoclonal anti-p63 antibody, clone 4A4. Myoepithelial carcinomas exhibit a wide spectrum of morphological heterogeneity and for that reason could be confused with many tumors. Cytoarchitectural patterns and immunohistochemical profile are crucial for identification. These tumors are malignant neoplasms with diverse clinical outcomes, sometimes very aggressive.

Tonsillar colonization is unlikely to play important role in Helicobacter pylori infection in children.

OBJECTIVE: To determine (i) seroprevalence of Helicobacter pylori (HP) infection in children undergoing tonsillectomy, (ii) possible HP colonization on tonsils of children and its importance in HP transmission, and (iii) if four examined socio-economic factors are the risk factors for HP transmission and HP colonization on tonsils in children. METHODS: Rapid urease test (RUT) of tonsils, and serologic blood tests for HP were performed in 77 children (aged 4-14 years) in Bosnia and Herzegovina (B-H), undergoing tonsillectomy. RUT positive tonsils were cultured for HP. RUT positive children were tested using (13)Carbon-urea breath test ((13)C-UBT). Information about socio-economic potential risk factors was obtained from the parents. RESULTS: Out of 139 pharyngeal and palatine tonsils, 17 palatine tonsils in 14 children were RUT positive and had negative HP culture. Eight children had positive both RUT and (13)C-UBT. There was no significant difference between children with hypertrophy and those with recurrent tonsillitis comparing their serologic tests results. There was no significant difference between seronegative (n=61) and seropositive (n=16) children comparing their age, sex, parental education level, owning a family courtyard, attending a children's collective, and owning a pet cat. CONCLUSIONS: The results in this prospective study do not support the notion that tonsils are an important reservoir for HP transmission in children in B-H. The examined socio-economic factors did not enhance HP seropositivity rate in children.