Introduction Scott Aarskog syndrome is an X-linked disorder characterised by short stature, hypertelorism, shawl scrotum in boys and brachydactyly. Syndrome is a genetic abnormality and the condition cannot be cured by optimal way. Aims The aim of this paper is to describe an extremely rare syndrome especially with mild mental retardation. Methods In two cases, the twin brothers and cousins girls where genetically established Scott Aarskog syndrome were made IQ tests in relation to the age of the children. Normally at this syndrome is very rare mental retardation. Results Boys with Scott Aarskog syndrome have had a rounded face with a broad forehead, but girls has no had. IQ test results showed that the twins, seven years old had IQ 69 or 71, a girl six years ald girl cousin 78. Affected twin brothers also have an abnormally long groove in the upper lip or philtrum and a broad nasal bridge. Tissue webbing between fingers and joint hypermobility with a pronounced hyperextension, flexion of the interphalangeal joints and brachydactyly in girl and both boys. The major signs of this X-linked condition are short stature. Musculoskeletal anomalies such as cervical vertebral anomalies, discrete spina bifida occulta, mild pectus excavatum, milder genu recurvatum, moderate joint restriction were presented in all three children relatives. Conclusions The prognosis of this disease is very bad with something shorter life, reduced everyday abilities for regular jobs, and in this case less severe retardation with disabilities to attend regular school and obtaining the title of the working capacity. Usually IQ in children is normal so this is a rare case that still occurs in Scott Aarskog syndrome.

Introduction Migration refers to the movement of persons or children from an origin place to a destination place across some pre-defined, political boundary. Since the 1995s after war, Bosnia and Herzegovina has continued being a country of mass children immigration from Sandjak, Kosovo, Serbia, Monte Negro and sporadic immigration from China. Methods The presence of tuberculosis disease in the Immigrants children or foreign-born child should prompt the pediatricians to collect appropriate specimens to recover an organism. We conducted a secondary data analysis focusing on immigrants children sampled in the 1995 through 2010 versions of the National Bosnian Children Health Records Survey. Results The increase in tuberculosis among Gypsy children in Sarajevo coincided with similar increases in immigration into Bosnia and Herzegovina. Medical records were available for review to assess adequately potential missed opportunities to prevent tuberculosis in children from Sandjak in only 1.5% of cases and Gypsies in 33% cases. Most children with drug-resistant tuberculosis were Gypsy (18.1%) or Chinese Asian (11.2%), and 16.4% of children or their parents were from a Bosnia and Herzegovina regions in which tuberculosis is highly endemic as Sarajevo Canton mountain area. Conclusions Pediatricians should be aware of the special health problems as tuberculosis for which immigrant children are at risk. Immigration poses unique stresses on children and families. There were no significance difference between incidence of tuberculosis and resistence on therapy between children from Sandjak and Bosnia but that differences were higher in case of Gypsies children.

Background Examples of semi-contact sports include karate and its benefite influence on asthma in childhood. Specific treatment for asthma will be determined by pediatrician based on children age, overall health, medical history, extent of the disease, tolerance for specific medications, procedures, or therapies and expectations for the course of the disease. Aims A target of this article is showing benefit of karate training in preschool ages on asthma management and course of disease. Methods To verify the efficacy of karate on asthma, a complex psychomotor activity that enhances pulmonary capacity and lungs volume, and breathing regulations, as an intervention for asthma curing, ten children with asthma, ranging in age from five to seven years, and meeting diagnostic criteria for children asthma disorder were studied during two years period 2010–2011. Results A higher prevalence of asthma has been reported in athletes specially in karate clubs for younger children but with better control of asthma. Risk ofasthma decreased with number of years of training (odds ratio 2.02; 95% confidence interval 1.60–3.03; p<0.0001), number of hours per week (odds ratio 1.74; CI 1.11–2.21; p=0.015) and rank, specifically brown green belt versus lower belts (odds ratio 3.53; CI 2.82–6.28; p=0.007). Conclusions Karate is a relatively safe sport for preschool children and younger schoolers when properly taught and optimize for asthma management. These training principles are perhaps most useful early in a children patient’s course when the setting of appropriate expectations is important in minimizing restrictions from treatment and karate activity.

Background The most common illness caused by parvovirus B19 infection is ‘fifth disease’, a mild rash illness that occurs most often in children. The infection often results in no obvious illness. It commonly infects children and typically causes a mild rash that may resemble a “slapped-cheek”. Other symptoms that can occur include joint pain (arthralgia), fever and general flu-like symptoms. Methods Children who are at risk of severe parvovirus complications might benefit from blood tests that can help determine if they’re immune to parvovirus or if they’ve recently become infected. Most cases of slapped cheek syndrome diagnosed by making a visual examination of the distinctive rash. No further testing was usually required in children during three years period 2009–2011 in capital town of Bosnia, Sarajevo. Results Parvovirus infection in children with anemia may stop the production of red blood cells and cause an anemia crisis. Children with severe anemia may need to be hospitalized and receive blood transfusions. Percentage of hospitalized of parvivirus infections in children with anaemia is 19% in Bosnian preschool children, what is only less 1% of complications in this disease. Conclusions Fifth disease can cause fetal anemia, which if undetected can have severe consequences. Several days after the appearance of early symptoms, a distinctive bright red facial rash may appear usually on both cheeks. In most children, parvovirus infection is mild and requires little treatment. Slapped cheek is actually the Parvovirus B19 that only affects humans, especially younger children.

Background Volleyball is a fun sport for children that is easy to learn and can be played in a gym, at the beach, or on grass. Playing volleyball help improve child heart work, flexibility, balance and coordination. Some schools have volleyball teams for boys and girls. Heart rates can improve sports exercise and volleyball can make children stronger and healthier. Objective The purpose of this study was to examine accountability paediatrics systems operating in youth volleyball training sessions and to understand how those systems vary according to the instructional tasks and the nature of the information provided by paediatricians. Design, setting and participants The ECG recording was performed for 5 min at rest in seated, supine or supine with elevated legs body position on different days in girl and boy school volleyball players. Measurements were undertaken in a quiet room, air temperature ranging from 21 to 22°C, after and before volleyball games. The data was analyzed for 40 female and 40 male volleyball players ranging in age from 12 to 16 years, and other equal players and athletes in other sports of the same age and gender. Methods Systematic medical observation strategies were used to describe and analyse paediatric tasks for heart rates presentation and task volleyball players in schools during paediatrics examinations. Statistical analyses were performed using the Sigmastat Programme 3.0 for windows package during period 2005–2009 in school players teams in Bosnia and Herzegovina. Main outcome measurement Young female volleyball players are more vulnerable to sport injuries but similiar heart rates stabilizing works after volleyball games comparing than their boys counterparts. Results Heart rates after volleyball games and exercise were lower and better than other sports groups in both volleyball groups for girls and boys, too, without difference. Conclusions Further research needs to address issues of paediatricians' knowledge and conceptions related to volleyball instruction for heart works improvement. No differences were noted between heart rates after exercise in boys and girls volleyball school players, but better heart rates were observed in older age volleyball players when compared to other athletes such as tennis players and soccer or basketball players.

CONFLICT OF INTEREST: NONE DECLARED Evidence based medicine (EBM) is the conscientious, explicit, judicious and reasonable use of modern, best evidence in making decisions about the care of individual patients. EBM integrates clinical experience and patient values with the best available research information. It is a movement which aims to increase the use of high quality clinical research in clinical decision making. EBM requires new skills of the clinician, including efficient literature-searching, and the application of formal rules of evidence in evaluating the clinical literature. The practice of evidence-based medicine is a process of lifelong, self-directed, problem-based learning in which caring for one’s own patients creates the need for clinically important information about diagnosis, prognosis, therapy and other clinical and health care issues. It is not “cookbook” with recipes, but its good application brings cost-effective and better health care. The key difference between evidence-based medicine and traditional medicine is not that EBM considers the evidence while the latter does not. Both take evidence into account; however, EBM demands better evidence than has traditionally been used. One of the greatest achievements of evidence-based medicine has been the development of systematic reviews and meta-analyses, methods by which researchers identify multiple studies on a topic, separate the best ones and then critically analyze them to come up with a summary of the best available evidence. The EBM-oriented clinicians of tomorrow have three tasks: a) to use evidence summaries in clinical practice; b) to help develop and update selected systematic reviews or evidence-based guidelines in their area of expertise; and c) to enrol patients in studies of treatment, diagnosis and prognosis on which medical practice is based.