Hidajeta Begić

Epidemiological and clinical aspects of congenital heart disease in children in Tuzla Canton, Bosnia-Herzegovina.

Congenital heart disease (CHD) is among the most frequent of all congenital anomalies. The purpose of this study was to present the results of an initial registration of children with CHD from January 1994 to December 1999 in Tuzla Canton, Bosnia-Herzegovina. The population studied consisted of all 39,699 live-born children in this area. Diagnosis of CHD was made by clinical findings, electrocardiography, chest X-ray, echocardiography, catheterisation or autopsy. In the 6-year period, 243 children were found to have CHD, i.e. a prevalence of 6.12 per 1000 live-born. Critical CHD was present in 58 of them, or 1.46 children per 1000 live-born. The average age at diagnosis was 1.47 years. There were 132 boys (54.3%) and 111 girls. The most frequent anomaly was ventricular septum defect with a prevalence of 2.49 per 1000 live-born, representing 40.7 % of the total anomalies. Of the total group, 46 (18.9%) had extracardiac anomalies related to syndromes. Cardiac surgery was indicated in 98 patients (40.3%) but could only be carried out in 42 (17.3%). A total of 63 (25.9%) patients died, 54 of whom within the 1st month of life. Conclusion: congenital heart disease is a very significant health problem in Tuzla Canton. It requires urgent measures in terms of organisation of early diagnosis and proper management.

Does the severity of congenital heart defects affect disease-specific health-related quality of life in children in Bosnia and Herzegovina?

The aim of this study was to assess whether the severity of congenital heart defects (CHD) affects disease-specific health-related quality of life (HRQOL) in children after open heart surgery. One hundred and fourteen children with CHD and one of their parents participated in the study. HRQOL was evaluated by the PedsQL™ 3.0 Cardiac Module. The children were assigned to one of three groups according to severity of CHD. Children with cyanotic CHD (Group 3) reported that their HRQOL on several domains was lower than that of children with anomalies with the left–right shunt and children with obstructive anomalies. Also, by parent proxy-report, patients with anomalies with the left–right shunt had statistically significant, better HRQOL scores for the heart problems and treatment scales, perceived physical appearance, treatment anxiety, cognitive problems, and communication scales in comparison to the children with cyanotic CHD. By self-report, children of Group 1 reported that they had statistically significant, better HRQOL in the heart problems and treatment scales compared with Group 2. Conclusions: The results of the assessment by the PedsQL™ 3.0 Cardiac Module, a cardiac disease-specific instrument for children with CHD, indicate that HRQOL is poorest in children with complex CHD. Therefore, it is necessary to take the appropriate preventive measures for these patients, which include early (timely) cardiosurgical intervention and active psychological support to limit the negative impact of serious forms of CHD on the quality of life of these children.

The hypertension caused by stenosis of renal arterie.

An otherwise healthy, 12.5-year-old malepresented with sudden onset chest pain, wasadmitted to hospital for elevated blood pres-Panel 1Panel 2Acta Medica Academica 2011;40(1):83DOI 10.5644/ama2006-124.12sure. Physical examination showed systolicheart murmur grade 2/6 in the aortic areawith abdominal vascular murmur and normalperipheral pulses. Blood pressure waselevated: (left arm) 170/110 mmHg, (left leg)185/115 mmHg. The plasma renin activity(6.5 nmol/l/h) was elevated. Renal functionwas normal. Doppler blood flow fromboth renal arteries showed a suspected mildobstruction.

The sudden death of a 6.6 year old girl due to anaphylactic shock caused by nonruptured echinococcal cysts of the left ventricle and the liver

A 6.6-year-old girl presented for leftsided cardiac enlargement on chestradiography (Panel A). Th ree yearsearlier she had undergone a lobectomyof the lower lobe of the leftlung for extraction of an echinococcalcyst.