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Introduction: Many factors affect the growth and development of the mandible. The most common one is micrognathia; this can pose and neonatal emergency. Early recognition of mandibular and other face anomalies could provide immediate care for these infants, and presence of neonatologist or other doctors in the delivery room. The aim: Aim of this study was to develop normal ranges of the facial markers: mandibular length, jaw index and the facial angle in the fetus using 3D ultrasound. Material and methods: The research was conducted as a cross-sectional study in the second trimester of pregnancy. Fetuses (female n=23 and male n=27) from singleton pregnancy between 29-37 week of gestation were examined by ultrasound. All images were acquired transabdominally, using Voluson E16. Ultrasound was performed by an experienced operator (SM) and measured the values of head circumference, abdominal circumference, biparietal diameter, femur length, body mass. For mandibular length, inferior facial angle, and the jaw index was calculated (Jaw Index =AP mandibular diameter / BPD * 100), the profile images were used (only images in the exact midsagittal plane were used). The characteristics of the fetal profiles were determined by the Schwartz and Ricketts profile analysis using soft tissue landmarks and analysis of the profile photographs. Results: The results show that the jaw index ranged from 25.33 and 34.06 with an average of 26.00 for all examined fetuses. Conclusion: The physiological position of the mandible is retrognathic and that the average physiological length of the mandible in the third trimester is 2.31cm. There is no difference in mandibular length between genders. Corresponding Author: Samra Salga-Nefic Rosenweg 2a, 3125 Toffen, Switzerland, e-mail: samrasalaga@gmail.com A determination of the standards of morphometrics variables of the stomatognathic system of a fetus INTRODUCTION Many factors affect the growth and development of the mandible: genes, irregular cell migration, low growth potential, feeding habits, and other habits acquired by newborns.1 The most common anomalies are microgenia (weak mandible growth) and retrogenia (small mandible growth in the sagittal plane).1 Deviation of physiological mandibular growth and development may incapacitate the essential functions of the stomatognathic system. Fetuses with mandible anomalies are at risk of airway obstruction through retro-positioning of the tongue-base into posterior pharyngeal airway.2 Micrognathia is frequently seen in Pierre Robin sequence, however it can be found in many genetic syndromes.3 Antenatal diagnosis of anomalies by ultrasound is widely used nowadays. The aim of this study was to develop normal ranges of the facial marker: mandibular length, jaw index and the facial angle in the fetus using 3D ultrasound. MATERIAL AND METHODS The research was conducted as a cross-sectional study in the second trimester of pregnancy. Fetuses (female n=23 and male n=27) from singleton pregnancy between 29-37 week of gestation were examined by ultrasound. All images were acquired transabdominally, using ultrasound Voluson E16, GE Healthcare, Austria GmbH & Co OG. Salaga-Nefic S., Mehmedbasic S., Kozadra J., Zukanovic A., Tiro, A., Dzemidzic, V., Nakas E. A determination of the standards of morphometrics variables of the stomatognathic system of a fetus. South Eur J Orthod Dentofac Res. 2019;6(1):6-11. Submitted: July 30, 2018; Revised: March 7, 2019; Published: April 30, 2019 6 South Eur J Orthod Dentofac Res Salaga-Nefic S. et al. Morphometrics variables of the fetus

Introduction: The aim of prenatal diagnosis is to detect fetal structural and genetic abnormalities. Used are different medical methods, procedures, processes and techniques. For this reason we can speak about the prevention and detection of hereditary diseases and congenital anomalies in the unborn fetus. Material and methods: The authors analyzed the results of early amniocentesis tests performed during 2009 in Institute for Gynecology, Infertility and Perinatology “Mehmedbasic” in Sarajevo. Performed is 299 analysis of amniotic fluid after amnion puncture done in the Institute or at the Clinic of Gynecology and Obstetrics (GAK) Sarajevo. Results and Discussion: Indications for the performance of early amniocentesis were: age greater over 35 (84.9%), positive ultrasound markers (1.6%), positive biochemical markers (5.6%) and positive family history for hereditary diseases (7.9%). Detected was 19 pathological cariograms or very high 7% of the total annual number of amniocentesis. An analysis of the distribution of pregnant women in relation to the indication of the result of cytogenetic analysis for each table made positive predictive value (PPV). For indicator age PPV was 0.11, 0.66 for ultrasound markers, for biochemical markers 0.13, for other indications–0.04. The logistic regression model (odds -ratio 11.234 ) indicate a positive ultrasound findings in relation to the year indicates that the risk to gain abnormal fetal karyotype 13 times higher when using only age as an indication for early amniocentesis. Of the 19 pathological cariogram largest number refers to M.Down (10), Sy. Edwards was detected in 2 patients, Sy. Klinefelter in 3, mosaicism in 3 and translocation gene in two of the fetus. Conclusion: The authors would like to acknowledge a very high percentage of pathological cariogram risk groups, the extension of indications for RAC indicate the value of ultrasound markers as a good screening methods and the need for social incentives to perform screening tests and early amniocentesis in B&H in order to prevent genetic abnormalities.

OBJECTIVE This study aimed to demonstrate incidence, symptoms and therapy management of testicular cancer patients. Also we had evaluated significance of testicular tumor markers. PATIENTS AND METHODS The study was retrospective, clinical and manipulative, analytical and descriptive and covers the period from 01.01.2000 to 31.12. 2008 with 58 male patients from 16 years upwards. For each patient, the data were analyzed from ambulance and hospital protocol on the Urology Clinic Sarajevo. RESULTS Incidence of testicular cancer among patients at the Urology Clinic clinical center Sarajevo is on the rise for the last three years (about 20%). Of the 58 patients with testicular cancer, 70% of patients were in age 20-39 years. 47% were patients with right side testicular cancer and 53% were left sided. Walter Reed Hospital tumor classification showed I 50%, IIa 10%, IIb 19% and III 21% of patients. The highest incidence of pathohistological reports showed mixed tumors 46%, seminoma 26%, yolk sack 2%, teratoma 2%, carcinoma embrionale 16%, dysgerminoma 5% and Laydig cell carcinoma 3%. Mixed, seminoma and carcinoma embirionale represents 90% of testicular tumors. betaHCG marker was positive in 53% of patients with seminoma and non seminoma 80%. CEA marker was positive only in 9% of all testicular cancer, LDH showed higher incidence with metastatic seminoma tumor. 27,5% of patients undergone retroperitoneal lymphadenectomy treatment, all patients had radical orchiectomy. CONCLUSION The common therapeutic procedure in the treatment of testicular tumors are surgical methods radical inguinal orchiectomy, chemotherapy (advanced stages of seminoma and all stages of non seminoma tumor and radiotherapy (early stage seminoma). AFP and betaHCG are excellent markers in the evaluation of surgical and oncology treatment of testicular tumor.

Sonographic detection and evaluation of congenital anomalies of the uterus represent an important segment in the additional therapeutic procedure, that is, treatment of patients with congenital anomalies of the uterus. Besides the primary reason that is manifested in the total cure of the patients, the secondary reason represents the decrease of costs of treatment of congenital anomalies of the uterus. Both descriptive and analytical methods were used in this paper. In 1997 Kurjak and Kupesic compared the sensitivity and specificity of transvaginal ultra sound, color Doppler, hysterosonography and three-dimensional ultrasound during diagnosis of the uterus septum. Representation of pathological findings in our paper in comparison to the examined group is: uterus subseptus = 15.38%, double horned uterus = 10.25%. The examined group includes intrauterine abnormalities of the uterus, analyzing, in that process, individual, pathological entities of intrauterine abnormalities. The research is a prospective, target, clinical study. In the examined group, due to the clinical suspicion of intrauterine abnormalities, 78 patients were examined in the following manner: two-dimensional transabdominal and transvaginal black-and-white and color Doppler ultrasound examinations were made and then three-dimensional transabdominal black-and-white and color Doppler ultrasound examinations. This means that in the detection of congenital anomalies of the uterus, the same sonographic techniques were first applied on the conventional and then also on the multidimensional base. Our research showed that three-dimensional technique is a more reliable diagnostic tool than two-dimensional technique. Sensitivity and specificity rate as well as positive predictive value show that this technique is an extraordinary one for assessing the volume, and position of congenital abnormalities.

M. Kurtović, S. Mehmedbasić, K. Drljević, I. Drljević

INTRODUCTION About 75% of adolescent and younger adult women get in contact with human papilloma virus (HPV). Some of them develop clinically manifested changes identified on Pap smear as ASCUS (Atypical Squamous Cells of Undetermined Significance) or SIL (Squamous lntraepithelial Lesion). Infection with high-risk genital HPV is considered to be a pre-condition for the occurrence of precancerous lesions and cancer, while in HPV infections with low-risk types such possibilities are extremely rare. MATERIAL AND METHODS We have analyzed pathological-cytological results of cervical-vaginal smears in the period 1997-2001 and 2001-2005, where HPV typing has been performed. Examinees are divided in two groups--low-risk and high-risk, and are compared with different types of cell abnormalities (ASCUS, SIL, CIN). RESULTS Low-risk HPV is twice more common than the high-risk oncogenic I-IPV. More than 2/3 of abnormal colposcopy results are verified with presence of HPV infection. CONCLUSION HPV infection is most common in women 20-30 years of age and is present in all types of epithelial dysplasias.

K. Drljević, S. Mehmedbasić

This targeted, retrospective, descriptive, controlled and open study comprises the last decade of the 20th Century and all histologically verified malign tumours at the Cantonal Hospital Zenica. By analysing pathohistological findings, 865 malign genital tumours were found; where the most numerous were cervical maligns (70.06%), then corporal (17.34%), ovarian (10.40%), vulvae 1.16%, vaginal 0.69% and tubal 0.35%. Malign frequency curve shows continual decrease till the war year 1993 and continual increase from that period till 2000. The most frequent type of malign tumour is carcinoma with the frequency of over 98% (70.06% carcinoma planocellulare, 27.86 adenocarcinoma), while recently literature shows a bit over 90% of frequency. More than 3/4 of all malign genital tumours were discovered in nullity and first clinical stages. Results show that approximately 9/10 of all malign processes in female genital tract occurred at uterus. The most frequent are malign tumours that are histologically best differentiated, while the least frequent are those that are insufficiently differentiated. Malign diseases, due to cervical cancer, which encumbers more than half of the cases, mostly afflict age group of 35-49, while the age group 50-64 is mostly afflicted by corporal and ovarian malign tumours. Comparing the year 1991 with 1993, 1995, 1997 and 1999, no statistically significant difference was found occurrence of menarha at women who have cervical, corporal and ovarian malign tumours (p>0.05).

S. Mehmedbasić, I. Bukvić

We have researched influence of asthma on pregnancy, fetus and delivery. We have verified asthmatic pregnant women on the basis of the relevant medical documentation (N=42). Control group is made of healthy pregnant women selected under the FIGO criteria (K=100). We followed up influence of asthma on pregnancy by evaluation of 6 variables which are determinants of pregnancy quality (spontanious abortion, missed abortion, hyperemesis gravidarum, EPH gestoses, prematurity and over-carried pregnancy. Authors didn't find any statistical significance in influence of asthma on pregnancy quality although the level of pathological situations in all researched variables was about 25% higher than in control group. In over-carried pregnancy variable statistically significant low level of cases was found in researched group. Influence of asthma on fetus was monitored with the methods of clinical measurements of fetuses biophysical profile, cardiotocographic index and amnioscopy. Significantly higher participation of pathological situations was found in all three monitored variables within researched group of pregnancies (p<0.01). We have monitored influence of asthma on delivery with the methods of clinical measurement ABS pregnant-asthmatic woman, ABS of the new-born baby, body mass of new-born baby and the kind of delivery. A statistically significant fall of pp O2 (p<0.01) was found as well as declination of actual pH of pregnant-asthmatic woman toward acidosis (p<0.01) during the second delivery stage. Kind of delivery is showing statistically high level of participation of surgical termination of delivery in researched group (SC and vacuum extraction)--(p<0.001).

The inability of a male to attain and maintain an erection sufficient to allow vaginal penetration is called erectile dysfunction. It is a part of general male sexual dysfunction called impotence, which also includes libidinal, orgasmic and ejaculatory dysfunction. Erectile dysfunction affects millions of men and although it may not mean a total loss of sexual satisfaction, it often creates a mental stress that affects the man's quality of life. Knowledge of erectile dysfunction has increased remarkably over the past decade. Nowadays, about 50-85% of erectile dysfunction patients can be shown to have a somatic cause by modern methods of examination. Erectile dysfunction may also occur as a result of specific illness or medical treatment, and it is often multifactorial in etiology. Erectile dysfunction increases with age.

Erectile dysfunction (ED)--the consistent or recurrent inability of a man to attain and/or maintain, a penile erection sufficient for sexual performance--is a common health condition among men that is largely untreated. It is estimated that some degree of ED affects more than one half of all men over the age of 40--152 million men worldwide. That is a big problem, that needs appropriate treatment. After diagnostic evaluation of the patient, doctor decides what is the best treatment option for the patient, following his health condition. Choice of treatment options: physio-sexual therapy, oral drug therapy, topical drug therapy, transurethral drug therapy, intracavernosal therapy, hormonal treatment, vacuum devices and surgery. Nowadays the most important contemporary treatments of ED are peroral sildenafil and intracavernosal pharmacotherapy using vasoactive medicines. However, these drugs are not suitable to every patient. More noninvasive methods to treat ED, such as oral medication or locally applicable preparations are needed.

UNLABELLED Color-Doppler sonography (CDS) of the cavernosal arteries has received considerable attention since its description in 1985 by Lue et al. Color and Spectral Doppler analysis, provides a useful noninvasive means of evaluating both morphologic and hemodynamic penile abnormalities. CDS is the best method in diagnostic evaluation of patients with erectile dysfunction. It assesses the integrity of the arterial supply to the penis and provides some useful information on the veno-occlusive mechanism. Because the arterial diameter and flow rate change during the different phases of erection CDS is performed after pharmacostimulation with vasoactive agents. Purpose of this study is diagnostic evaluation patients with erectile dysfunction. PATIENTS AND METHOD We studied 60 patients suspected for vasculogenic ED, and 30 patients suspected for psyhogenic ED, assessing the morphodynamic features of cavernosal arteries by Color-Doppler sonography and their response to contravaernosal injection of prostaglandin E1 (PgE1) and oral dose of Sildenafil citrate. Morphodynamic parameters evaluated by color Doppler sonography included: peak systolic velocity, endodiastolic velocity, inner arterial diameter, index and acceleration of penile blood flow. Patients were divided in the groups: A group (A1--10 patients < 35 years of age, A2--20 patients > 35 years of age) underwent pharmacotest with ICI PgE1; B group (B1--8 patients < 35 years of age, B2--22 patients 35 years age) were tested with oral dose of Sildenafil citrate and C group--30 patients who were also tested with the same drug. CONCLUSION The CDS may be used to evaluate the hemodynamic parameters of the erectile dysfunction. Arterial insufficiency is suspected with poor blood flow, while veno-occlusive dysfunction is inferred in the face of adequate blood flow and poor erectile response.

S. Idrizbegović, I. Bukvić, S. Mehmedbasić, E. Idrizbegović

During the two war years, higher pregnancies were interrupted by 133 patients either for medical, social or ethical causes. To induce abortions, 15 methyl prostaglandin F2 was used. In advance, portions had been prepared (softened) with cervical application of prepidil gel in dose of 0.5 g. Starting eight to ten hours later Prostin 15 M was applied every 3 hours in dose of 250 mg. An average period from gel application to expulsion of ovulum was 30 hours by nullipara and 21 hours by patients who have delivered a child before. Due to strong uterotonic activity of these medicaments side effects like nausea, vomiting, diarrhoea and prostration occurred several times. Serious complications were registered in 4 patients. Three of them suffered cervix rupture due either to insufficient preparation or external orifitium spasm. The fourth one had profuse bleeding due to secondary atonia. Ruptures were sutured and bleeding stopped with standard uterotonic and blood transfusion.

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