Refractive errors in children: analysis among preschool and school children in Tuzla city, Bosnia and Herzegovina.

Aim To establish the prevalence of refractive errors in preschool and school children between 4 and 15 years of age, living in Tuzla, Bosnia and Herzegovina. Methods Children from all elementary schools in the city of Tuzla and as well from eight day-care centres were screened for refractive errors in the period 2015-2019. Any child, who failed to pass the screening examination, was referred to an ophthalmologist for complete ophthalmological evaluation. The obtained data were analysed using non-parametric statistics. Results The highest number of children who were tested after the screening process was during 2015. A total of 7415 children (3790 males and 3625 females), in the age range of 4-15 were screened. In the total sample of children who were completely evaluated (n=145; 290 eyes) the most common refractive error was astigmatism, in 152 (52.4%) eyes. In the preschool children (n=18; 36 eyes), the most common refractive error was astigmatism, in 19 (52.8%) eyes, followed by hyperopia, in 9 (25%) eyes. In the school children (n=127) (254 eyes), the most common refractive error was astigmatism, in 133 (52.4%) eyes, followed by myopia, in 92 (36.2%) eyes. The overall prevalence of refractive errors was 1.95% (145 with refractive error out of 7415 screened). Conclusion Prevalence of refractive errors is high enough to justify a school eye screening programme.

Appropriateness of colonoscopy at a tertiary care centre - are we overdoing gastrointestinal endoscopy?

Aim To evaluate the pattern of indications and a spectrum of colonic pathology, and to determine appropriateness of indications for colonoscopy in order to improve patient selection for colonoscopy. Methods This retrospective study includes 294 patients who were referred to the Gastroenterology Department from a primary care physician in order to approach endoscopic examination. Study data included patients' anamnestic data (comorbidities, positive family history, performed radiological examinations) an indication for the procedure, and colonoscopy findings. Results Haematochezia was confirmed in 186 (63.26%), positive radiologic finding in183 (62.24%) and anaemia in 157 (53.40%) patients. Adenoma and colorectal carcinoma were detected in 40 (13.6%) and 53 (18%) patients, respectively. A significant association between haematochezia and colorectal neoplasm was confirmed (p=0.019), haematochezia and inflammatory bowel disease (p=0.027), and between radiological finding and colorectal neoplasm (p=0.018). There was no significant association between anaemia and any of the colonoscopic findings. According to EPAGE II criteria indications were appropriate in 187 (63.6%), uncertain in 67 (22.8%) and inappropriate in 40 (13.6%) patients. Conclusion This study confirmed a slightly larger number of uncertain and inappropriate indications for colonoscopy compared to other studies that examined indications for colonoscopy, which can be attributed to a high number of patients with functional bowel disorders.

Amblyopia in Children: Analysis Among Preschool and School Children in the City of Tuzla, Bosnia and Herzegovina.

AIM: This study measured the prevalence of amblyopia in preschool and school children between 4 and 15 years of age in Tuzla, Bosnia and Herzegovina and as well and to examine its relations with anisometropia and strabismus. METHODS: Children from eight daycare centers and twenty four elementary schools were screened for amblyopia by volunteer personnel (medical students), any child who failed to pass the screening examination, was referred to the ophthalmologist for complete examination at University Clinic Center Tuzla. The examination included VA, stereopsis, cover testing, refractive retinoscopy, and examination of the red reflex and posterior pole. RESULTS: Total of 7415 children, which included 3790 males and 3625 females, in the age range of 3 to 15 years from 24 schools and 8 preschool were screened. Fifty night children (1.9%) were diagnosed with amblyopia, unilateral in 28 and bilateral in 31. CONCLUSION: Prevalence of significant refractive errors is high enough to justify a school eye screening program solely for this purpose. preschool and school screening program in children in critical period of development of amblyopia must be conducted to find out the ametropias and amblyopia in time; and treat them earlier.