Introduction: during the infant development, the organ growth is influenced by genetic factors, diet, hormones and many neuropeptides. The secondary ossification center in the hip joint begins to form around the 4th month of life. Primary dentition begins at the age of 5-6 months with the emergence of the central incisor in the maxilla. At birth, 6 fontanelles are present between the plate bones of the cranium. The largest is the anterior or large fontanelle. Objective of our research is to analyze the development of the secondary ossification center in the femoral head in relation to dentition and closure of the anterior fontanelle closure as well as influence of childrens' birth weight and current weight on these processes. Methodology: The study included 284 infants, male and female, aged 3 to 8 months. Clinical examination of the musculoskeletal system, anthropomentric measurements and ultrasonographic findings of the hip joint were performed at the Pediatric Clinic of the Clinical Hospital Center Pristina in Gracanica. Results: The development of secondary ossification centre correlated with child's age, dentition, anterior fontanelle closure, birth weight and delivery method, as well as actual body weight. Anterior fontanelle size was inversely related to age, body weight and secondary ossification. Conclusions: According to regression analysis, body weight is the only factor that has a direct and independent impact on the onset and progression of ossification process. Every additional kilogram of a child's body weight accelerates secondary ossification by 1.3-3.77 times.

Introduction: Ellis-van Creveld syndrome is a rare genetic disorder characterized by short limb dwarfism, additional fingers and/or toes (polydactyly), abnormal development of fingernails and, in over half of the cases, congenital heart defects. Motor development and intelligence are normal. This disorder is inherited as an autosomal recessive condition. Some boys with this condition have been described with undescended testicles (cryptorchidism) or an abnormally located opening of the urine canal in the penis (epispadias). Abnormalities in the chest wall, spine and respiratory system have also been reported. Case report: The boy, aged two (2) years and eight (8) months, lives with parents and two brothers, in good living conditions. From the perinatal anamnesis, we can see that it is the third child from the third monitored pregnancy, delivered naturally at 39.gestational weeks, with normal birth parameters (3980/51/36), Apgar score 9. Immediately after birth, has been spotted complete postaxial polydactyly on both hands and postaxial poly-syndactyly (3,4,5,6) on the left foot, and ultrasound of the hips in early infancy indicated their unusual morphology and delayed bone maturation, which led to further medical investigation and treatment. Conclusion: Ellis-van Creveld syndrome is an extremely rare disease (this is the first registered case in our country). On the basis of this case, we want to express the importance of early diagnosis in order to improve the prognosis of the disease, and necessity of careful monitoring of these patients.

Although cerebrovascular disease may be a well recognised trigger for diabetic ketoacidosis (DKA), literature data on the precise mechanisms, characteristics, or treatment guidelines are rare. The risk of developing an ischemic stroke is doubled in adults with diabetes compared to people with normal glucose metabolism. It is important to point out that even children with DKA have a significantly increased risk of cerebrovascular insult and that they can have a stroke with a frequency of about 10%. Given the significant overlap of symptoms between these two diseases, it can be assumed that attributing DKA symptoms as a manifestation of stroke is not uncommon, especially in elderly and less communicative patients. In addition, pH, bicarbonate concentration, and anion gap are not routinely measured in all diabetics suffering from stroke, at least not in secondary health institutions.Children who develop cerebrovascular stroke during DKA often at the beginning have a preserved consciousness or only mild confusion or lethargy. After a few hours, with the institution of therapy, however, loss of consciousness may occur accompanied by signs of increased intracranial pressure. It was previously thought that the cause was too fast fluid replacement. Recent data suggest that reperfusion injury may be a more likely mechanism. Although most of these studies relate to younger individuals with ketoacidosis, it is clear that at least some of them may be operative in adult DKA. Literature therapeutic guidelines for adult diabetics with stroke-related diabetic ketoacidosis are almost lacking, although it is clear that they could not be the same as those utilised in population with normal glucose metabolism. In this paper, we have tried to define our treatment guidelines for these particular patients.

Introduction: Puberty is a juvenile developmental period accompanied by intensive growth and acquisition of reproductive ability. The onset of puberty is influenced by many factors: genetics, neuropeptides and glycoproteins, gonadotropins, sex hormones and the child's nutrition status. Premature puberty is defined as the appearance of secondary sexual characteristics in girls before the age of 8, and in boys before the age of 9. The aim of this paper is to analyze the published results on the importance and influence of factors such as birth weight, current weight and BMI on the development of premature puberty. Results: Eating disorders caused by eating high-calorie foods lead a child to obesity, which is accompanied by premature puberty. On the other hand, conditions characterized by reduced nutrition may be accompanied by delayed puberty. According to the results of this study, children with more pronounced manifestations of precocious puberty had a significantly lower birth weight Discussion: Birth weight of less than 2500g, as well as newborns' SGA (small for gestational age), are directly related to earlier pubertal maturation. Five decades ago, Frich et al. found that reaching a body weight of 48 kg in girls is a "critical mass" for development of menarche. Conclusion: The occurrence of secondary sexual characteristics is more frequent in children with increased body weight and correlates inversely with the child's birthweight.

Hypoglycemia is defined asplasma glucose level sufficiently low to result in neurological damage. In the new-born age, the incidence of hypoglycemia ranges from 0.4-11.4%. Etiologically, low levels of plasma glucose can result from the hormonal or metabolic disorders; high doses of insulin, drug poisoning, liver disease or systemic disorders. The most common cause of severe and permanent hypoglycemia in the neonatal age group is congenital hyperinsulinism - the result of pancreatic cells hyperplasia and/or adenoma. Between two and five years of age, the most common form of hypoglycemic state is ketotic hypoglycemia of childhood, caused by limited amount of substrate. Diagnostic criteria include biochemical confirmation of low of glucose and/or high insulin levels, blood hormone testing (epinephrine, cortisol, growth hormone, glucagon levels), as well as metabolic screeningfor gluconeogenesis, glycogenolysis, and lipolysis disorders and disarrangements of fatty acid oxidation. Therapy is directed towards the substrate supplementation and the application of medications and fuels aiming atrapid attainment of normoglycemia (fruit juices, parenterally applied glucose and dextrose, glucagone, corticosteroid therapy); diazoxide and somatostatin therapy is indicated for patients with hyperinsulinemia.

Introduction: Vitamin D Deficiency (VDD) is defined as the level of 25(OH)D in the serum < 30 ng/ml. According to the contemporary research, even the slight vitamin D deficiency can adversely affect our body in many ways. Numerous studies indicate that vitamin D deficiency is very common in children. The study aimed to research the frequency of vitamin D deficiency in infants and toddlers, the connection between VDD and iron deficiency anemia (IDA), as well as the correlation between 25-hydroxycholecalciferol (25(OH)D) and haemoglobin (Hb) in the examinees. Method: The study includes 150 children, 73 (49%) newborns and 77 (51%) infants. Vitamin D status was determined through the amount of 25(OH)D in blood, using the electrochemiluminescence. Results: Vitamin D Deficiency was found in 58% of infants and toddlers (severe vitamin D deficiency was found in 16% of examinees, vitamin D deficiency was found in 23% of examinees, while vitamin D insufficiency was found in 19% of examinees). Vitamin D deficiency (VDD) and anaemia were found in 80% of examined infants and toddlers. VDD was found in 49% of newborns that were not anaemic. We have observed the substantial difference between the examinees suffering from both anaemia and VDD and the examinees suffering from VDD only. Conclusion: The highest level on anaemia was found in the children with severe vitamin D deficiency, while in the examined infants and toddlers, there was a connection between the level of 25(OH)D and Hb in the serum.