Introduction: Acute kidney injury is characterized by a rapid loss of renal excretory function with the increase of nitrogen compounds in the blood and with different outcome. Objective: Since descriptions of the risk factors and sequelae of acute kidney injury (AKI) remain relatively limited, the objective of this study was to determine etiology and clinical characteristics of AKI, as well as risk factors for adverse outcome of renal function and death in AKI patients. Methods: We retrospectively studied a cohort of 84 adult AKI patients admitted to Nephrology Clinic in University Clinical Centre Sarajevo during period 2012-2014. Demographic, laboratory and clinical parameters were retrieved. The in-hospital and 6 months mortality were recorded. Renal function outcome was defined 3 months following discharge. Results: Majority of patients were older (median age 73.5 years) with great severity of AKI (Stage III in 78.5% of cases) and high burden of comorbidities (mean Charlson comorbidity index, CCI score 6.4±3.05). The most common causes of AKI were acute interstitial nephritis (16.7%), heart failure (15.5%), gastroenterocolitis (13.1%), and sepsis (12%). Renal function recovery was recorded in 48.8% of patients, with prevalence of 10.7% of intrahospital mortality and 37.3% of 6 months mortality. Risk factors for poor outcome of renal function and mortality in AKI patients were increasing age and higher CCI score, while protective factor was higher diuresis. Sepsis proved to be risk factor for death.

Introduction: Pancreatic injuries are not common after blunt and penetrating trauma, but can be challenging to diagnose and manage. Case report: Twenty-three year old man, injured during a fall from a motorcycle two days earlier, was admitted to Department of Surgery, University Clinical Centre Tuzla because of suspicion of pancreatic trauma. Immediately after hospitalization, patient underwent laboratory and radiological tests that revealed the existence of pancreatic trauma, so we opted for urgent surgical treatment. Surgery and early postoperative course were normal and the patient was discharged on the ninth postoperative day. Conclusion: Proper diagnosis and well-selected surgical treatment significantly increases the chances for recovery of these patients.

Although laparoscopic cholecystectomy has become a gold standard in treatment of symptomatic cholelithiasis, it is associated with higher risk of intraoperative lesions and primarily lesions of biliary ducts. In small percentage of cases biliary fistulas occur, most commonly after leakage from cystic duct stump or accessory bile ducts – Luschka’s duct. We report of a patient who had episodes of abdominal pain following routine laparoscopic cholecystectomy for acute calculous gallbladder. Results of conducted diagnostics verify the presence of biliary fistula caused by obstruction of bile pathways by stagnant pus and microcalculi of common bile duct, with development of biloma presumably caused by pressure injection of contrast material during ERCP procedure. Endoscopic sphincterectomy via ERCP enabled healing of formed biliary fistula, whilst continuous percutaneous ultrasound guided drainage of biloma was method of choice in later treatment of our patient. It is important to note that diagnostic evaluation of biliary fistula is very challenging and that timely nonsurgical treatment is of great benefit for patient.

Introduction: Accommodative Convergence/Accommodation (AC/A) ratio is constant at one and the same person in the course of life, i.e. the same ratio accommodative convergence monitor any change in accommodation measured in diopters. Such a perfect relationship is possible if there are no refractive anomalies in both eyes and oculomotor imbalance of eye muscles. Material and methods: We are examined 50 patients with close brain injury, and patients which had problems with near vision, accommodation and convergency were reducted, with loss motor fussion, and preserved stereoscopis vision, and showed us, that disturbances are clear motor and folowed with incapable of patient to hold of superposition view to watching object. Results: The difference in average proximity distance vision and reading time with no fatigue after 6 months a statistically significant, the value of t-test, t = 1873 for p <0.01, r = 0. 718. The value of convergent fusion 6 months after treatment in 30% of the patients was from 0 to16 Pd, S. D. = 18. 6, and χ2 = 7. 22. In 18% of the patients was from 0 to 10 Pd, S. D = 17. 61, and χ2 = 5. 41, at 20% of patients 0 to 22 Pd, SD = 14. 18, χ2 = 6. 84, in 16% of patients 0 to 4 Pd, SD = 16. 41, χ2 t-test = 5. 13 and the remaining 16% of patients the value of convergent fusion is about 1 PD, S. D = 15. 01, χ2 t = 5. 18. All patients showed significant improvement in near vision compared to the value of convergent fusion before treatment where χ2 t-test = 9.41, after 6 months of treatment, there is considerable significance p < 0 01, t–test 0. 914, correlation coefficient r = 0. 881. Conclusion: Disturbances of AC / A ratio should be evaluated only with regard to all symptoms and is only possible by proper rating interference in reading.

Introduction: Traumatic injuries of the eye are the most common cause of loss of visual function. In our study we performed Ocula Trauma Score (OTS). We compared with the values of visual acuity of injury and thus get an accurate model for determining the prognostic value of the final visual acuity before treatment of the patient. This model is a reliable test for both the ophthalmologist and the patient. Aim of study: The aim of this study was to show the socioepidemiological and demographic profile, as well as the most common mechanism in ophthalmic injuries, so to determine the final visual acuity and assessment and evaluation of sensitivity and specificity of ocular trauma score (OTS), and most importantly to determine the prognostic value final visual acuity after eye injuries. Material and Method: We conducted a clinical-epidemiological, retrospective-prospective study at the Department of Ophthalmology, Clinical Centre University in Sarajevo in the period 2009-2011. A sample of 124 patients with diagnosed closed of eye injuries were recruited. We applied Classifying Closed Globe Injury, performed Calculating the OTS and convert of total raw points into % chance of vision outcomes. Results: Comparison of age groups by gender shows that there is no statistically significant (x2 = 5.155; p = 0.2718). Of the total number of closed eye injuries (N = 124) at the admission from groups D and E with the worst vision were 29 patients (23.38%), in group C had low visual acuity of 20 (16.12%), in group B the mean visual acuity 33 (26.61%), and in group A well-preserved visual acuity 42 (33.87%) patients. On the demission patients with well-preserved visual function was 84 (67.74%), with a medium of visual function 10 (80.64%), while the poorer visual function was 4 (3.225%) and 7 (5.645%) patients had a sense of light and projections and 1 (0.8%) patient had lost visual acuity-amaurosis. 18 (14:51%) patients did not take their eyesight due to a fresh post-operative recovery. Conclusion: Data on each patient are based on the possibility of such characteristics of the mechanism of injuries presentation of vision at the beginning of disease, injury and zones relative afferent pupillary defect possibility assumptions what will be with the vision postoperatively.

Introduction: Developmental hip dysplasia represents the most common deformation of locomotor system in children. Developmental modulation of the hip is expressed during first year of life which is important for early diagnosis and treatment. Therefore, in the practice, it is very important to set a diagnosis early with application of simple and convenient methods (ultrasound) in order to achieve fast and efficient therapeutical effect and avoid permanent disability. Aim: The aim of this paper is to point out the increase of prematurely born infants and their survival thanks to the development of Unit for Intensive Neonatal Care at the Pediatric Clinics in Sarajevo. Material and methods: Clinical investigation included 150 infants (77 girls and 73 boys) in whom the developmental hip dysplasia was diagnosed with clinical exam, ultrasound exam and x-ray of the hips. The exams were done in period of January 2012 to August 2014. Results: Two groups of patients were formed. The first one consisted of premature infants, total number of 75 (34 girls and 41 boys), with developmental hip dysplasia that was diagnosed at the first exam at the Ultrasound unit of the Pediatric clinics and at the Intensive Neonatal Care Unit of the Pediatric Clinics in Sarajevo. Second (control) group consistsed of patients-on term infants who had diagnosed one of developmental hip dysplasia, total of 75 (43 girls and 32 boys) during first exam in the Ultrasound unit of the Pediatric clinics in Sarajevo. Conclusion: The frequency of premature birth is between 5 and 10% of all labors and demonstrates increasing trend. We suggest ultrasound examination of hips in each newborn, term or premature, at the age of 6 weeks after birth.

Introduction: Application of a central venous catheter (CVC), as a temporary or permanent vascular access for hemodialysis, has been continuous practice at the Sarajevo Pediatric Clinic, Department of Pediatric Intensive Care. The main goal of the article is to present our experiences with central venous catheters in the treatment of these patients. Material and methods: In the period from January 2009 to December 2014 a total of 41 patients were treated and a total of 56 catheters were placed. Results: The results show the prevalence of the femoral venous catheter (69,64%), with significantly smaller participation of jugular (28,57%) and symbolic participation of subclavian catheters (1,78%). Frequency of infections of 8,92% in our article is lower than the percentage contained in the data of the National Nosocomial Infections Surveillance System, which provided data related to 17% of catheter related infections. The most common agents of the catheter related infections in our patients are gram-negative bacteria from the Klebsiella pneumoniae group. Conclusion: The issue of the higher complication percentage during the treatment is linked with hemostasis related to bleeding into or around the catheters in 28,57% of patients, and to clotting disorder in terms of thrombosis in 10,71% of patients.

Abstract The main goal of this paper is to investigate the behaviour of stock returns in the case of stock markets from Central and Eastern Europe (CEE), focusing on the relationship between returns and conditional volatility. Since there is relatively little empirical research on the volatility of stock returns in underdeveloped stock markets, with even fewer studies on markets in the transitional economies of the CEE region, this paper is designed to shed some light on the econometric modelling of the conditional mean and volatility of stock returns from this region. The results presented in this paper provide confirmatory evidence that ARIMA and GARCH processes provide parsimonious approximations of mean and volatility dynamics in the case of the selected stock markets. There is overwhelming evidence corroborating the existence of a leverage effect, meaning that negative shocks increase volatility more than positive shocks do. Since financial decisions are generally based upon the trade-off between risk and return, the results presented in this paper will provide valuable information in decision making for those who are planning to invest in stock markets from the CEE region.

Aim: The objective of this study was to evaluate prognostic impact of clinical factors on outcome of renal function in septic and non-septic acute kidney injury (AKI) patients. Methods: The prospective, observational, clinical study was performed at Nephrology Clinic and Clinic for Infectious Diseases, University Clinical Centre Sarajevo. One hundred patients with diagnosis of AKI were enrolled in the study, and divided into two groups: septic and non-septic AKI patients. Clinical parameters included causes and type of AKI, pre-existing comorbidities and different treatment modalities. Patients were followed up until discharge or death. Renal function outcome was defined by creatinine clearance values at discharge. Results: Septic AKI patients had significantly longer hospital stay (p=0.03), significantly worse renal function outcome (p<0.001), and higher burden of comorbidities (70.6% vs. 60.6%), compared to non-septic patients. Septic AKI patients were almost three times less likely to receive renal replacement therapy (8.8% vs. 24.4%) and they had significant delay in initiation of dialysis (p=0.03). By multivariate analysis, sepsis (95% CI 0.128-0.967, p=0.043) and hypertension (95% CI 0.114-0.788, p=0.015) were independent predictors of adverse renal function outcome in AKI patients. Postrenal type of AKI was independent predictor of renal function recovery in non-septic AKI patients (95% CI 1.174-92.264, p=0.035), while Failure, as third class of AKI, was independent predictor of non-recovered renal function only in septic AKI patients (95% CI 0.026 to 0.868, p=0.034). Conclusion: Septic AKI patients are clinically distinct compared to non-septic AKI patients with different prognostic factors and poorer renal function outcome.

Background: Hypertension (HT) and renal anaemia (RA) are well-established markers of cardiovascular risk in patients with chronic kidney disease (CKD). They appear to be the stimuli for left ventricular hypertrophy (LVH), who significantly participates in cardiac complications in uremic patients. Hypertension is extremely common after kidney transplantation (KTx) and it has been observed in up to 75% of patients. The prevalence of post-renal transplant anaemia (PTA) is variable (up to 30%) and several factors such as graft function contribute towards its pathophysiology. Aim: The aim of this study was to analyze the impact of blood pressure and anaemia on LV remodelling in first year after transplantation comparing echocardiographic findings before and twelve months after transplantation had done. Methods: In five years retrospective-prospective study we followed up 30 patients with renal allograft in first post-transplant year. During the study values of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), blood hemoglobin (Hgb), serum creatinine and creatinine clearance were monitored monthly. Results: Before transplantation (Tx) 86% of patients had HT, and RA was confirmed in all patients. Normal echocardiographic findings had 33% of patients and 67% of patients had echocardiographic sings of LVH. Before renal transplantation group with LVH had statistically higher the mean values of blood pressure (MBP) (p=0.053) compared to group with diastolic (LVDDF) (p=0.0047) and systolic-diastolic dysfunction (LVSDDF) (p=0.0046). The values of SBP and DBP positively correlated with LV mass index (LVMI) in the group of patients with LVH (p=0.0007 and p=0.0142). The values of Hgb was statistically higher in group with normal LV mass index compared to LVH (p=0.019), with negative correlation between LVMI and values of Hgb in the patients group with LV hypertrophy (p=0.009). After the first year of transplantation, 63% of patients showed normal LV mass index and 37% remained with echocardiographic findings of the LVH. The values of SBP and values of Hgb in both groups, as well as values of DBP in group of LVH were statistically different in compare with data before transplantation (p<0.05). The positive echocardiographic remodelling of LV significantly correlated with the increase of Hgb values (p=0.05), but without significant correlation with the decrease of the mean SBP and DBP. Conclusion: These results confirmed that positive echocardiographic remodelling of left ventricle after successful renal transplantation is complex process depended on many risk factors and elimination of uremia- related factors is a priority.