Introduction: Neural tube defects (NTDs) are multifactorial congenital anomalies of the central nervous system that results from failed neural tube closure between the 3rd and 4th weeks of embryonic development. Numerous clinical and experimental studies indicate that supplementation with folic acid before and during early pregnancy reduces the development of these anomalies. The present study examined the incidence and risk factors for NTDs and evaluated the effects of folic acid supplementation.Methods: This cross-sectional study included all children with NTDs who were hospitalized at the Pediatric Clinic, Clinical Centre University of Sarajevo during the period from January 01, 2008 to December 31, 2012. Data were collected retrospectively from the medical histories of hospitalized children. The study included children in pediatric clinics from four cantons (Sarajevo, Zenica–Doboj, Unsko–Sanski, and Central Bosnia) of the Federation of Bosnia and Herzegovina. The number of live births for the specified period in each of the four cantons was taken from a report by the Cantonal Ministry of Health.Results: Among the 69,096 live births recorded during the study period, 39 children had verified NTDs, with an overall incidence of 0.56:1,000 (or 5.6:10,000) in all four cantons. The most common NTDs were myelomeningocele with hydrocephalus (22/39, 56.4%), followed by isolated myelomeningocele (9/39, 23.1%), spina bifida occulta (7/39, 17.9%), and occipitocele (1/39, 2.6%). A total of 33.3% (13/39) of mothers took folic acid, but only one began supplementation prior to pregnancy, while 67.7% (26/39) of mothers did not take folic acid during pregnancy. NTDs were found more frequently in primiparas (53.8%), women with low education (basic school, 64.1%), and unemployed women (82.1%).Conclusion: It is important to make national recommendations for folic acid supplementation for women of reproductive age, but also change the public health policy that includes mandatory fortification of basic foods as this is the best measure for primary prevention of NTDs in the whole population regardless of employment and education status. Additional comprehensive studies are required to assess the incidence and risk factors throughout Bosnia and Herzegovina.

Introduction: Neural tube defects (NTDs) are multifactorial congenital anomalies of the central nervous system that results from failed neural tube closure between the 3rd and 4th weeks of embryonic development. Numerous clinical and experimental studies indicate that supplementation with folic acid before and during early pregnancy reduces the development of these anomalies. The present study examined the incidence and risk factors for NTDs and evaluated the effects of folic acid supplementation.Methods: This cross-sectional study included all children with NTDs who were hospitalized at the Pediatric Clinic, Clinical Centre University of Sarajevo during the period from January 01, 2008 to December 31, 2012. Data were collected retrospectively from the medical histories of hospitalized children. The study included children in pediatric clinics from four cantons (Sarajevo, Zenica–Doboj, Unsko–Sanski, and Central Bosnia) of the Federation of Bosnia and Herzegovina. The number of live births for the specified period in each of the four cantons was taken from a report by the Cantonal Ministry of Health.Results: Among the 69,096 live births recorded during the study period, 39 children had verified NTDs, with an overall incidence of 0.56:1,000 (or 5.6:10,000) in all four cantons. The most common NTDs were myelomeningocele with hydrocephalus (22/39, 56.4%), followed by isolated myelomeningocele (9/39, 23.1%), spina bifida occulta (7/39, 17.9%), and occipitocele (1/39, 2.6%). A total of 33.3% (13/39) of mothers took folic acid, but only one began supplementation prior to pregnancy, while 67.7% (26/39) of mothers did not take folic acid during pregnancy. NTDs were found more frequently in primiparas (53.8%), women with low education (basic school, 64.1%), and unemployed women (82.1%).Conclusion: It is important to make national recommendations for folic acid supplementation for women of reproductive age, but also change the public health policy that includes mandatory fortification of basic foods as this is the best measure for primary prevention of NTDs in the whole population regardless of employment and education status. Additional comprehensive studies are required to assess the incidence and risk factors throughout Bosnia and Herzegovina.

Introduction: This study is the fi rst study about the distribution ABO blood types at children with acute leukemia in Federation of Bosnia and Herzegovina. The aim of the study is to point out distribution of blood type groups at children with acute leukemia (AL)Methods: The number of children in this study was the following: 145 children with acute leukemia and 27 of children with acute myeloblastic leukemia (AML). All of the children were treated at Hemato- Oncology Unitof Pediatric Clinic in Sarajevo, in the period January 2000 until December 2010. Age of children was between 1 month and 15 years.Results: The results showed that different blood types were registered in 93. 1% of children who got ill and treated from acute leukemia for the mentioned period. At 6. 9 % of children, none of the blood types wereregistered. It was noticed that 40.9 % children who have registered blood type O, 37% blood type A,16% blood type B and 6.5% blood type AB had AL, too. It has been observed that children with following bloodtypes had AML: O, 47.8%, A, 47.7% and AB, 30.4%.Conclusion: Signifi cance ABO types distribution was confi rmed for children with ALL, p<0, 05. The analysis of the distribution of ABO types based on gender showed that signifi cance was confi rmed at females with both ALL and AML (p<0.05).

The aim of this paper was to investigate the incidence of acute lymhoblast leukemia (ALL) among children aged 0 to 15 years in the Federation of Bosnia and Herzegovina in the period from 1997 to 2004. The data for this paper were obtained by retrospective analysis of 139 case histories of children who were treated at the Haematology-Oncology Department of the Pediatrics Clinic of University Clinic Centre in Sarajevo in the period from 1 January, 1997 to 31 December, 2004 but also by analysis of the data provided by Cantonal health institutions in the Federation of Bosnia and Herzegovina. The above indicated data were complemented by those of the children who had been sent for treatment to the Clinic-Hospital Centre “Salata” in Zagreb and the Clinic Centre in Split (the Republic of Croatia) at their parents’ request. The data on population samples were taken from the yearly statistical reports of the Federal Statistical Institute. In the area of the Federation of Bosnia and Herzegovina it was recorded that 119 children (83 boys (69,7%) and 36 girls (30,3%) suffered with ALL in the period from 1 January, 1997 to 31 December, 2004.The total ALL incidence rate in children of either sex in the observed period was 3.2/100.000 (95%CI 2.6-3.8). In Posavina Canton the incidence rate was highest, amounting to 6.4/100.000 (95%CI 1.7-16.4), while in Herzeg Bosnia Canton the rate was lowest and it amounted to 0.77/100.000 (95%CI 0.7-4.3). In other Cantons the incidence rate was fairly uniform. Poisson regression indicates that the rates do not differ significantly between the cantons (likelihood ratio χ2 test =14.88, df=9, P=0.09). The results of our investigation indicate that the average incidence rate of ALL in the area of Federation of B&H, in comparison with similar studies conducted in other countries, does not show statistically significant differences.

UNLABELLED Treatment of acute leukemia is based on the general measures and specific treatment in accordance to the protocols. In the Europe and in Bosnia and Herzegovina BFM protocols are used, and they were developed by German pediatricians- hematologist. Protocols are based on the combination of the medicines (corticosteroids and some citostatics, which are given to the patient according to the exact scheme. These protocols use classification of the diseased according to the risk group diseased belong to. AIM OF THE WORK The aim of this work is to establish which of the protocols, protocol BFM 90 or protocol BFM 95, have more influence in the treatment of the diseased children with lymphoblast leukemia. PATIENT AND METHODS Patient which were examined were children with ALL and treated on the pediatric clinic in Sarajevo in accordance to the protocols BFM 90 and 95 in the period between 1997 and year 2004. Method used in this study was descriptive analyses based on the inside we had into the available documentation. RESULTS AND CONCLUSIONS In the study there were 117 children with ALL included. 54 (46,1%) of the children were treated in accordance to the protocol BFM 90, and 63 (53,85 %) of the children were treated in accordance to the protocol BFM 95. There was noticed significant difference of the survival of the diseased children, based on the statistical testing. Children treated in accordance to the protocol BFM 90 there were 24 % of the children who died, and 12,6 % of the children who were treated in accordance to the protocol 95 died.

INTRODUCTION Neutropenia febriles are the most frequent complications during the hospital treatment of children who are ill of malignant. It is urgent state end each of feverish should be treated as infection, until it is proved as opposite. It is necessary immediately to begin with antibiotical therapy according to the algoritham for therapy of neutropenia febriles. Neutropenia febriles is caused by virus, bacteria and fungus infection. RESULTS It were 83 leukemia treated children on Hematooncology department of pediatrical Clinic in Sarajevo in period from 01.01.1997 until 31.12.2002. Neutropenia febriles were seen at 41 of children (49.4%). Between all of neutropenia febriles the causes were isolated at 27 children (65%). The most of them had sepsis, and at 40% of children had positive hemo-cultures. In the hemo-cultures the gr. positive causes were isolated at the 55% of children, gr. negative causes were isolated at 25% of children, and fungus were isolated at 20%. Between the other cultures urino-cultures were positive at 18.5% of children. RTG pulmo was isolated at 18.5%, smear pharyngs was isolated at 11%. CONCLUSION In such state of patient it should be thought about the possibility of contamination of patient and protect him/her from superinfection, by him/her in isolation box and staff should take care about sepsis and antisepsis.

UNLABELLED We report a case of mumps virus (VM) caused secondary autoimmune hemolytic anemia (AIHA). A 12-year-old boy was hospitalized at Paediatric Clinic of Sarajevo because of haemolytic anaemia followed by disturbed consciousness. Idiopathic hemolytic anemia was diagnosed on the basis of anamnesis, detailed clinical examination and laboratory analysis. The boy responded well to the therapy (corticosteroides, immunoglobulines, transfusions of red blood cells without buffy coat) with improvement of general condition and clinical aspect. Ninth day since the beginning of illness, firstly one than another parotide gland were enlarged, painful, followed by swallow problem and erythema of Stensen's duct. Epidemic parotitis were diagnosed on the basis of high amylasa in serum and urine. CONCLUSION AIHA could be seen as primary disease. But, in paediatric population it is more often only one manifestation of underlying disease which we should search for.

UNLABELLED Datas about frequency of congenital anomalies in the world are different because of the difference in ecological variations, socioeconomical differences, geographical differences and other conditions. Datas about incidence prevalence and mortality of the congenital anomalies during the infant period are insufficient in region Sarajevo. Goal of this study is to show frequency of congenital anomalies in region Sarajevo. Patients During the period from 01.01.1990-31.12.1999 in Sarajevo region was done the retrospective analysis of children who were born alive and dead, then the analysis of mortality of infants because of congenital anomalies, and children with anomalies. RESULTS During the same period there were 47980 children born. There were 269 (5.6%) dead born children were 269 (5.6%). Incidence of mortality in infantil period was 120/10,000, and incidence of the children with congenital anomalies was 286/10,000 and was higher every year. There is no datas about mortality of congenital anomalies. CONCLUSION This study shows that congenital anomalies in Sarajevo region are getting higher from year to year, and it is necessary to make a registry of congenital anomalies like these in the world.

UNLABELLED The aim of the study is to analyze the frequency of the congenital anomalies of the digestive tract in the period of 1993-1998. The patients and methods: Our group included 67 patients (47 males and 20 females; age range 1-12 months) suspected of digestive tract anomalies. First, all of them have been examined by pediatric surgeon. At the first place, we used the most conventional radiological procedures for digestive tract examination. They were followed by US in cases with suspicion on hypertrophic pyloric stenosis and biliary atresia (bile-duct atresia). CT and MR were performed in patients with anorectal anomalies. In cases with suspected associated anomalies of other organs, intravenous urography and chest radiography were used. RESULTS Congenital anomalies and abnormalities of the digestive tract were diagnosed in 25 patients. The most frequent anomaly was hypertrophic pyloric stenosis (n = 14), followed by invagination (n = 12) and megacolon congenitum (n = 9), all predominant in male sex. All radiological findings we confirmed at surgery (100%). CONCLUSION Conventional radiology is still extremely useful in the diagnosis of the digestive tract anomalies; also US revealed to be essential in the diagnosis of the hypertrophic pyloric stenosis and the intestinal invagination. Recognition of the associated anomalies should lead to application of the other examination techniques like CT and MR. MR might be useful in the anorectal malformations and hepatobiliary tract anomalies, but we have no experience in that field, till now.