In this manuscript we report one pediatric surgeon's experience in childhood inguinal hernia repair. From 2005 to 2008, 402 children with inguinal hernias were operated on by one surgeon. A retrospective survey of their charts was carried out to evaluate the demographics and clinical aspects of these patients. The ages ranged from 20 days to 16 years with a maleto-female ratio of 2.5:1. 64.9% right, 27.1% left, and 7.9% bilateral hernias. Hydroceles were present in 6.2% assosiated hernias. Incarceration occurred in 8.7% of children. An opposite-side hernia developed in 5.7%. 5.3 percent of patients with a hernia repair on the right side later developed a hernia on the left side, and 8.2% of patients with a hernia repair on the left side later developed one on the right side. 4.5 percent of all male patients in this series and 8.6% of female patients developed an opposite-side hernia. While overall recurrence rate was 1.2%, our recurrence rate was 0.25%. There was a 0.24% wound infection rate, and 1 (0.24%) testicle was atrophic at followup. In this study, in the recurrence of childhood hernia, the general surgeon's intervention was the prominent cause. It is suggested by the study that inguinal hernias on the contralateral side becomes symptomatic within the first six months following initial operation.Therefor, close observation is needed in that time. U period od 2010. do 2014. godine, na odeljenu dečije hirurgije Z Novi Pazar operisano je 401 dece od preponske kile od strane tri dečija hirurga. Retrospektiva analiza njihovih grafikona i tabela je sprovedena radi procene kliničkih aspekta operisanih pacijenata. U starosti se kretale od 20 dana do 15 godina sa muško-to-ženska odnosu 2,5: 1. 64,9% u pravu, 27.1% levo, a 7,9% bilateralni kile. Hidroceles bili prisutni u 6.2% assosiated kile. Zatvaranje desilo u 8,7% dece.Suprotnoj strani hernija razvijen u 5,7%. 5.3 odsto pacijenata sa kile na desnoj strani kasnije razvio kilu na levoj strani, a 8,2% pacijenata sa kile na levoj strani kasnije razvio jedan na desnoj strani. 4.5 odsto svih muškaraca obolelih u ovoj seriji i 8,6% od pacijentkinja razvio naprotiv-side kilu. Dok ukupna stopa recidiva je 1,2%, naša stopa recidiva je 0,25%. Bilo je infekcija stopa 0,24%, a 1 (0.24%) testis je atrofični na praćenje. U ovoj studiji, smo pokazali da u odnosu na druge studije jako je važno da pedijatrijske pacijente operisu iskljucivo pedijatrijski hirurzi jer je broj postoperativnih komplikacija i recidiva kile jako mali. Obzirom da se recidivi i pojave kile na kontralateralnoj strain javljaju najviše u prvih 6 meseci nakon operacije, bitno je češće decu kontrolisati u tom periodu.Ključne reči: Dečja ingvinalna kila, recidiv, procesus vaginalis, operacija UvodPreponski kila je najčešća indikacija za operaciju u pedijatrijskoj starosnoj grupi i učestalost preponske kile u tim mlađi od 18 godina varira od 0,8 do 4,4% 1 . Svi pedijatrijski ingvinalni kile zahtevaju operativno lečenje da bi se sprečio razvoj komplikacija, kao što su inkarceracijia , ili strangulacija 2...

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Objective: The aim of study was determining the relation between the quality of metabolic control, anthropometric parameters and ultrasound measurement of fat accumulation and carotid atherosclerotic plaques vulnerability in patients with type 2 diabetes. Methods:The study included 51 patients with type 2 diabetes mellitus and 50 healthy individuals. The assessment of plaque vulnerability relies on quantitative and qualitative plaque ultrasound analysis. The thickness of intraabdominal adipose tissue was measured as a distance between the frontal wall of abdominal aorta and the dorsal wall of rectus abdominis muscles; the measurements are performed by placing transducer 5 cm above the umbilicus.Results: Atherosclerotic plaque was found in all of diabetic patients, comparing to 28.12% in the control group; among those, 47.06% with diabetes and 25.6% of control patients had vulnerable plaque. The vulnerability of atherosclerotic plaque was significantly related to age, duration of diabetes, glycaemia, waist circumference, waist / hip ratio, intra-abdominal adipose tissue thickness, intra-abdominal/subcutaneous fat ratio, dyslipidemia and hypertension.Conclusions: Carotid atherosclerotic plaques, particularly vulnerable ones, are far more prevalent in diabetic patients. Advanced age, poor glycemic control, obesity and the intra-abdominal fat accumulation contribute to carotid atherosclerotic plaques vulnerability. Despite the significant correlations with metabolic/anthropometric measurements, none of the predisposing factors could be identified as the independent risk factor; obviously, the increased vulnerability of has been the result of the synergistic effects of multiple pathogenic mechanisms. Moreover, ultrasound measurements of intra-abdominal fat did not show a decisive advantage over the classical anthropometric measurements in estimating atherosclerotic and metabolic risk.

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The primary histopathological feature of diabetic vascular complications is the formation of atherosclerotic plaques.Ultrasound examination provides not only a quantitative analysis of the plaque, but also the qualitative analysis of plaque vulnerability.Body fat distribution highly correlates with certain pathologies and an evaluation of this distribution is essential in the estimation of health risks. Waist circumference and WHR index (Waist-Hip Ratio) are highly useful methods in both adipose tissue distribution and cardiovascular and metabolic risk assessment in individual patients, as well as populationwide.The aim of our study was the assessment of incidence, distribution and vulnerability of carotid atherosclerotic plaques in patients with type 2 diabetes versus healthy controls, and their relation to adipose tissue distribution.The study involved 101 persons -51 type 2 diabetics and 50 control patients. Atherosclerotic plaques were present in 100% of diabetics vs. 28.12% of control subjects. Vulnerable plaques were found in 47.06% of type 2 diabetes patients and in 25.6% of controls. The results of Mann-Whitney's test show a higly significant difference in the incidence of plaques and plaque instability between the two groups.The mean waist circumference was significantly higher in type 2 diabetic patients compared to controls (96.53 ± 11.51 cm vs. 87.97 ± 12.15 cm, p <0.01).The mean waist/hip ratio was significantly higher (p <0.01) in patients with type 2 diabetes (0.93 ± 0.08). The waist circumference and waist/hip ratio significantly correlated with the athe-rosclerotic plaque instability (p = 0.54, p <0.0001). Acta Medica Medianae 2017;56(4):31-37.