Aim To assess the number of visits to pediatric emergency departments in Croatia and reasons for visiting before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods We reviewed the medical records of pediatric patients visiting emergency departments of four tertiary medical centers between February 25 and April 25, 2018 and 2019, and between February 25 and April 24, 2020. Antimicrobial prescription was analyzed as well. Results There were altogether 46 544 visits – 18218 in 2018, 19699 in 2019, and 8634 in 2020. The overall number of visits in 2020 significantly decreased compared with 2018 and 2019 (52% and 56% reduction, respectively), mostly due to a decreased number of visits due to certain infectious diseases: acute gastroenteritis (89.2%), sepsis/bacteremia (81.2%), urinary tract infections (55.3%), and lower respiratory tract infections (58%). Most visits were self-referrals regardless of the analyzed period, and the majority of patients did not require hospitalization. There were no significant differences in the number of visits requiring urgent medical care, such as those due to seizures and urgent surgery. The most frequently prescribed antibiotic in all periods was amoxicillin, followed by amoxicillin/clavulanate and oral cephalosporins. Conclusion A significant reduction in the number of pediatric emergency department visits and hospital admissions is indirectly related to the COVID-19 pandemic. Most of the reduction was due to a decreased number of infectious disease cases. However, the number of visits requiring urgent medical intervention did not change.

Anatomy of the periorbital region is very complex. Aesthetic problems that occur in that region have to be thoroughly assessed so that the right choice of treatment can be done. Kpodzo et al published a review of current management for malar mounds and festoons. Due to the variable terminology and nonstandardized treatment algorithm, the incidence of malar aesthetic problems is not known. In that article, they suggested the standardized terminology to be as said:Malar edema: fluid that accumulates below the infraorbital rim above the malar eminence, Malar mound: chronic swelling in the same area, Festoons: cascades of lax skin and/or orbicularis muscle over the malar eminence. 1 Newberry et.al. also published a systematic review and have proposed the term "malar bags" that encompasses all previously mentioned malar pathologies. 2 Kikkawa et al first described the upper border of region involved as orbitomalar ligament (it separates the lower eyelid and malar eminence).In its anatomic position orbitomalar ligament is osteocutaneous ligament. 3 Lower border was first described by Furnas as the mid-cheek fold. 4 Pessa and Garza described it as the malar septum and Muzaffar et al and Mendelson et al defined it as the zygomaticocutaneus ligament. [5][6][7] The etiology of this aesthetic problem is still unknown. Furnas hypothesized that gravity with loss of laxity in the orbicularis muscle leads to its sagging and causes skin to stretch. 8 Goldman showed that transient edema in that area can occur after injection of botulinum toxin type A. 9 It led to the conclusion that muscle pump is an important

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