Metformin is an anti-hyperglycemic agent used for the treatment of type 2 diabetes mellitus. Biguanides lower blood glucose levels primarily by decreasing the amount of glucose produced by the liver. Metformin also helps to lower blood glucose levels by making muscle tissue more sensitive to insulin so glucose can be absorbe. The purpose of the study was to establish the effect of metformin on insulin secretion in obese patients with newly diagnosed diabetes mellitus type 2. We included 40 patients with Type-2 Diabetes Mellitus, who were treated on Department for Internal Disease in Hospital King Milutin Laplje Selo. Patients included in the study were newly diagnosed with diabetes mellitus type 2, glycemia < 12 mmol/L, and hed the Body Mass Index >30 kg/m2. They were treated with metformin, 1000 mg/day. Insulin sensitivity was determined by HOMA IR, insulin secretion by HOMA, lipid status by spectrophotometry. After six months of treatment blood biochemistry tested again. BMI was also established. Metformin significantly lowered BMI (BMI before therapy 31.02 kg/m2, after treatment 28.7 kg/m2) (both p<0,001 vs baseline) waist circumference mean value 98±0.55 cm-93,12 cm. (p<0,001) During the therapy the glycaemia decreased from 11.7 mmol - 6,78 mmol/l, insulinemia mean value 20.141 mlU/l -13.691, HOMA IR elevated in all patients. Among the cholesterol fractions, most significant results were obtained in LDL cholesterol. Mean LDL cholesterol levels 4.51± 2.02 mmol/L. Mean cholesterol level 6.98±2.31 mmol/L. HDL levels -1.32 mmol/L. Serum triglycerides was (mean) 2.63±1.32mmol/L. After six months therapy Metformin produces beneficial changes in lipid states. Metformin may be the first therapeutic option in the diabetes mellitus type 2 with overweight or obesity. Metformin produces beneficial changes in glycemia control, and moderated in weight, lipids and insulinemia. 

Metabolic syndrome is a common metabolic disorder whose primary feature is abdominal obesity, which is associated with a high prevalence of dyslipidemia, hypertension and glucose tolerance disorders. The goal was, determine BMI in subjects with metabolic syndrome and people with normal body weight, take anthropometric parameters (waist and hip circumference, and calculate WHR and WSR index) to assess the average degree of nourishment and body fat distribution. The research was conducted in Gracanica Health House. The study group consisted of 130 subjects that met the criteria for metabolic syndrome. The control group consisted of 40 randomly selected subjects during medical check-ups. The study group was dominated by female with 83. 08%, followed by 16. 92% of male subjects, with the average age of subjects being 56. 32 years. The average BMI index of the study group was 32. 22 kg/m², which indicates first-degree obesity, while the average BMI index of study group subjects was 24. 67 kg/m², which is within the normal nutrition range. By comparing the average values of anthropometric parameters, we established that the study group subjects had statistically significantly higher average body weight parameters (waist-to-hip ratio p<0,001), while the control group subjects had a higher average of body height (p<0,001). In both, study and control group, male subjects had a normal WHR, which is not the case with women. Therefore, there was a statistically significantly higher number of women with pathological WHR (p<0,001) than of men in both groups. The study group had a statistically significantly higher number of subjects with pathological WHR (p<0,001). The average WSR value (waist/BH) is statistically significantly higher in the control group (p<0,001). Obese individuals had significantly higher values of measured anthropometric intraabdominal fat indicators compared to normally nourished people. 

The metabolic syndrome is characterized by a group of metabolic risk factors causing type 2 diabetes (DM2) and cardiovascular diseases. At the heart of this pathogenic disorder is insulin resistance. The metabolic syndrome is often accompanied by diseases of the gallbladder (chronic inflammations and calculosis). The goal of our study was to observe the changes made on the gallbladder with patients diagnosed with the metabolic syndrome, specifically the presence of calculosis and cholecystitis. The study involved 130 patients with the metabolic syndrome and 40 healthy subjects, all of which were subjected to abdominal ultrasonography. Gallbladder calculosis was found in 36,92% subjects of the study group and 12,50% subjects of the control group, resulting in a statistically considerable difference (p<0,001). The results of our study indicate a significant presence of biliary calculosis as one of the manifestations of the metabolic syndrome on the biliary system.

To show the most common causes of bacteriemia in hospitalized patients, as well as their sensitivity to antimicrobial agents. The research data were extracted from official reports produced by Microbiological Laboratory in Clinical Centre Kragujevac. Isolation and identification of the causes were performed with standard microbiological methodology. Sensitivity to antimicrobial medication was tested using disc diffusion. Interpretation and inhibition zones of antibiogram were done in accordance with guidelines of US Clinical and Laboratory Standards Institute (CLSI). A descriptive epidemiological approach was used in the research. The collected data were processed using the appropriate software application. Amongst the processed samples, a significant presence of Staphylococcus spp. was found (coagulase-negative 35,8% and coagulase positive 11,7%). Over 60% of Staphylococcus aureus isolates were resistant to meticillin. Enterococcus spp, isolated in 11,7% of all isolates, in more than 50% of cases was sensitive to ampicillin, with approximate isolate vancomycin sensitivity of 90%. The isolated Klebsiellà spp strains produced high degrees of Extended-Spectrum â-Lactamases (ESBL) and showed resistance to third-generation cephalosporins, aminoglycosides and ciprofloxacin, with 100% sensitivity to carbapenem. Pseudomonas spp and Acinetobacter spp were less represented (5.8% and 5.4%) but these neither pathogens were exempt to antimicrobial resistance.The research indicated that causes of hospital infections should be continuously monitored. 

A characteristic hemodynamic pattern has observed in patients with right ventricular infarction, with frequently accompanies inferior left ventricular infarction or rarely occurs in isolated form. The electrocardiogram may provide the first clue that right ventricular involvement is present in the patient with inferior wall myocardial infarction. Most patients with right ventricular infarction have ST- segment elevation in lead V4R (right precordial lead in V4 position). ST segment elevation of 0,1mV or more in anyone or in combination of leads V4R, V5R, and V6R in patients with the clinical picture of acute myocardial infarction (MI) is highly sensitive and specific for the diagnosis of right ventricular MI.

Sjögren'ssyndrom is autoimmune disorder where cells of immune system afack and destroy eccrine glands which produce tears and spit. We have a patients with following problems: dryness of the bucal lining and conjunctiva, dysphagia of solid food, paint in joints amd muscles, hand sensitivity to coldness.

Pruritus is one of the commonest symptoms of dermatologic appearances in uraemic syndrome and it occurs in 90% of patients on dialysis with different etiology and pathophysiology. The aim of the study was to estimate the frequency of uraemic pruritus and the comparison with clinical and biochemical parameters in 124 patients treated by chronicle haemodialysis at Department of Haemodialysis, Urology and Nephrology Clinic, Clinical Center “Kragujevac”. The routine laboratory analyzes were carried out in examined patients and the concentration of parathyroid hormone was determined. The study was based on data from history of disease and  questionnaire carried out in all patients. Of 124 patients, 65,3% were male and 34,7% were female, mean age of 55,98±12,94 years; the mean time on HD was 55,5 ±50,4 months. 46,8% of examined patients had symptoms of uraemic pruritus. Uraemic syndrome and uraemic complications, manifested by the concentration of urea, 21,57±7,56 vs. 22,93±5,754; p=0,05 and time on dialysis, 67,27±60,07 vs. 43,64±36,84; p=0,02, are the significant parameters of uraemic pruritus. Serum concentration of iron 15,16±8,03 vs. 11,73±6,21; p=0,05 and UIBC 25,12±10,6 vs. 30,45±9,86; p=0,04, as well as hyperglycemia 6,16±2,516 vs. 6,82±2,872; p=0,02 are significantly correlated with uraemic pruritus. There was a statistically significant difference in albumin concentration 35,84±9,09 vs. 37,72± 3,105; p=0,05 but our results were reverse to the data in literature where the reported albumin level was higher in patients with uraemic pruritus. 27,6% of examined patients had itching of all the body what is in correlation with literature. Between the patients with localized itching and patients with generalized itching, there are statistical significance in following: number of erythrocytes 2,4±0,96 vs. 2,7±0,6; p=0,02, concentration of hemoglobin 78,53±31,44 vs. 89,36±19,81; p=0,05, hematocrit 0,23±0,089 vs. 0,26±0,057; p=0,02 and TIBC 29,45±12,01 vs. 34±4,86; p=0,02, as well as concentration of glycemia 5,38±2,52 vs. 6,42±2,12; p=0,01.

Powers was the first scientis who described Varices oesophagei in 1939 (Thomas in 1960) in the 19th century,
th Varices weve considered like consequence of splenies sicknes, was noted like 20 century, portal hypertension, noted like
pathogenesiscal machinery for begining. Varices oesophegei and classification. Oesophagoscopy was vade by 40 patients
because varices were veryfied and a factor of risk, which varices have was measured. Endoscopy morphologycal classification Varices oesophagei was used by Paque in 4 class. Varices in the first class was had 17,5% in the second class 35%, in the second and third class 22,5%, the fourth class 5%. Varices in the third and fourth class have observed like bigs Varices who have very risc and ruinouses for life.