The discovery that sunlight can cure rickets was first scientifically confirmed in 1919. Shortly thereafter, in 1924, it was found that inactive lipids in the diet and skin are converted into antirachitic substances under the influence of UV light. Vitamin D (Vit D), also known as the "sunshine vitamin,"
was first identified in 1931. In recent decades, it has regained the focus of interest among the broader scientific community and dermatologists.
Specifically, certain dermatoses have been associated with low Vit D levels, leading to its supplementation in patients. On the other hand, some
dermatoses worsen with sun exposure, necessitating strict avoidance of sunlight and the therapeutic use of Vit D preparations.We are witnessing a
growing number of cases of melanoma and non-melanoma skin cancers, with excessive sun exposure being the primary etiological factor in most
cases. This paper provides a literature review on the historical discovery of Vit D and presents findings from studies examining Vit D levels not only in
various dermatoses but also in other diseases. The number of studies, as well as the spectrum of diseases in which the role of Vit D is being
investigated, continues to increase.

Introduction/Objective

The objective of this study was to examine the relationship between use of psychoactive substances among University students and diagnosed somatic or mental disorders.

Methods

The cross-sectional study was conducted in a population of 2,000 students of the Belgrade University. Four faculties (Medicine, Geography, Economics, Electrical Engineering) from which the students participating in this research were chosen by the method of random choice (by computer listing), conducted in the period April - June 2010.

Results

We observed that are more numerous students who used psychoactive substances among students with diagnosed somatic illnesses compared to those without them. Statistical significance was found among students who used tobacco (p=0.027), alcohol (p=0.002), sedatives (p<0.001) and cannabis (p=0.021). Mental disorders are also connected to use of psychoactive substances. The statistical significance was achieved for all psychoactive substances except for alcohol.

Conclusion

Use of psychoactive substances is an important issue among University students with diagnosed somatic or mental disorder. Therefore, it is essential to recognize the symptoms and consequences of such behavior, and above all and connection thereof, the importance of prevention which may enhance better solution-seeking via proper education.

Introduction:

Presence mesiodens is not uncommon in clinic practice. It is cause of impacted permanent maxillary central incisors. Diagnosis of the delayed tooth is usually made on the basis of clinical and radiographic findings. The treatment include surgical exposure of the impacted maxillary central incisors and extraction of supernumerary tooth, because it is a direct obstruction for the eruption of maxillary central incisors. Impacted maxillary central incisors is moved into it's proper position with orthodontic traction. The aim is presented surgical-orthodontic treatment of impacted teeth, which is necessary to achieve stability esthetic and functional results.

Case report:

This case report describes a surgical-orthodontic treatment of 9.5-old boy with both impacted permanent maxillary central incisors with supernumerary tooth which disturbs their normal eruption.

Conclusion:

The gnathometric evaluation of spaces in dental arch, the assessment of dental age and radiographic analysis are preconditions of successful therapy. The impacted maxillary central incisors were successfully positioned in the maxillary arch, with an adequate width of attached gingiva. The careful and persuasive treatment planning of an orthodontist, oral surgeon and periodontist are the key to success in resolving such cases.

This article focuses on the sonographic axamination techique for evaluation of intracranial translucencies during the first trimester ultrasound scan. Appropriate knowledge of sonographic landmarks is the most important factor for evaluation normal as well as abnormal brain structure, and this examination may enable detection of open spina bifida and Arnold – Chiari anomaly at an early stage of fetal develpoment.

Pulmonary hypertension (PH) is a hemodynamic condition characterized by a mean pulmonary artery pressure (mPAP) ≥ 25 mmHg at rest, pulmonary arterial wedge pressure (PAWP) ≤ 15 mmHg, and pulmonary vascular resistance (PVR) > 240 dyn·s·cm⁻⁵. The annual incidence of pulmonary arterial hypertension (PAH) is approximately 3–10 new cases per million adults. It is estimated that the prevalence of pulmonary hypertension in individuals over 65 years of age is around 10%.The aim of this study is to present the case of a female patient with progressive dyspnea in whom PAH remained undiagnosed for a prolonged period.A 74-year-old female patient, M.P., was hospitalized in the Coronary Care Unit of the Clinical Center in Kosovska Mitrovica due to symptoms of shortness of breath, choking, fatigue, leg swelling, and weakness. The admission ECG revealed: sinus rhythm, normal axis, high R wave in V2, ST depression, and negative T waves in leads II, III, aVF, and V4–V5. Echocardiography findings showed right ventricular enlargement (2.9 cm), pulmonary artery dilation (3.3 cm), 1–2+ pulmonary regurgitation, and 3+ tricuspid regurgitation, with a systolic pulmonary artery pressure (SPAP) of up to 126 mmHg. The right ventricle measured 5.3 cm in the 4Ch view, with a TAPSE of 1.8 cm. Right heart catheterization revealed the following pressures: PA 78/34/57 mmHg, RV 74/8/10 mmHg, RA 6/6/7 mmHg, CO 4.3 l/min, and LV 99/10/8 mmHg. Although primary pulmonary hypertension is predominantly a disease of younger individuals, it should also be considered in older patients presenting with progressive dyspnea in the absence of structural heart disease.

Introduction: This study highlights the importance of transitioning to a modern approach to outpatient surgery, analyzing the safety and feasibility of this treatment model in patients undergoing hemithyroidectomy or total thyroidectomy, with a focus on postoperative complications.

Materials and Methods: Data were collected from the medical records of 626 patients over a five-year period, from 2011 to 2015, at the Surgery Clinic of the "Dr Dragiša Mišović – Dedinje" in Belgrade. This period allowed for a reliable analysis of the safety and feasibility of outpatientthyroid surgery.

Results: A total of 97 hemithyroidectomies and 529 total thyroidectomies were performed. The average age of hemithyroidectomy patients was 51.24 years, and for total thyroidectomy patients, it was 54.88 years. The most common substrates were benign tumors (over 50%) for hemithyroidectomies and multinodular goiters (almost 50%) for total thyroidectomies. The average hospital stay was 1 day for hemithyroidectomies and 1.48 days for total thyroidectomies. Complications included postoperative bleeding (0.57%), subcutaneous hematoma (1.32%), subcutaneous seroma (2.08%), temporary hypocalcemia or hypoparathyroidism (18.9%), permanent hypocalcemia or hypoparathyroidism (0.76%), temporary vocal cord paralysis (2.65%), permanent vocal cord paralysis (1.89%), bilateral vocal cord paralysis (0.19%), and mortality (0%).

Conclusion: The study confirmed the feasibility and safety of outpatient thyroid surgery, with minimal complications and short hospital stays, especially for hemithyroidectomy, but careful postoperative monitoring is required for patients undergoing total thyroidectomy. 

Introduction: Peptic ulcer is a chronic recurrent disease of the gastrointestinal tract, which most often occurs as gastric or duodenal ulcer. Peptic ulcer is characterized by certain geographical and temporal trends.

Objective: The aim of this study is to determine the frequency of gastric and duodenal ulcers among subjects who underwent esophagogastroduodenoscopy (EGDS) endoscopy due to dyspeptic complaints, as well as to analyze the trend of ulcer disease over a period of 10 years.

Material and Methods: The data of a total of 4074 subjects with an average age of 54.53 ± 15.03 years, both sexes, 1841 men and 2233 women, who underwent EGDS in 2005 and 2015 calendar years were retrospectively analyzed. Results: This study showed that the trend of ulcer disease significantly decreased in the observed ten-year period, accompanied by concomitant decrease in the prevalence of duodenal ulcers, while the frequency of gastric ulcers retained approximately at the same level. The results showed that men were at greater relative risk than women for the development of duodenal ulcers, in both calendar years. In the ten-year period, the average age of patients with ulcer disease increased by about 4 years, especially in the group with duodenal ulcer, and particularly within women with duodenal ulcer. Compared to 2005, the average age of subjects undergoing EGDS in 2015 increased by about 2 years, regardless of whether or not they were diagnosed with ulcer disease.

Conclusions: In the period 2005 - 2015, the age of patients with peptic ulcer tended to increase, whilst the prevalence of ulcer disease, especially duodenal ulcer, has decreased. The relative risk for duodenal ulcer in men was higher than in women. 

Introduction: Syncope is a sudden, short-lived, transient loss of consciousness associated with the inability to maintain postural tone. The aim of this paper is: to determine the frequency of syncope in children and adolescents in our conditions, to analyze the characteristics of syncopal episodes and clinical presentation in order to identify the etiology of seizures, and to provide diagnostic protocols, i.e. guidelines for streamlining clinical trials.

Methodology: The diagnosis of the disease was made clinically on the basis of well-taken anamnestic data and a detailed description of the quality of the attack, physical examination and routine laboratory analyzes: (CBC, glycemia, standard ECG). Additional tests were selectively performed: Holter ECG, ergometry, Tilt table test, Echocardiogram, NMR, EEG.

Results: Out of the total number of examined children in the outpatient Children’s Hospital, Department of Pediatric Cardiology, 139 patients (0.6%) reported due to short-term loss of consciousness. The largest number of children was between 15 and 18 years old. Ninety-two ( 66%) of those 139 were girls, and 47 (34%) were boys (p <0.05). Regarding the cause of syncope, it was found in 117 (84%) patients, and in 22 (16%) children the cause of syncope was unknown (p <0.05). Etiologically spreaking, syncope was divided into 3 groups: autonomic (vasovagal, situational, orthostatic, increased vagus tone in athletes) was the most common, in 88 patients (75%), cardiogenic in 5 (4%) and non-cardiogenic in 24 patients.(21%). There was also a recurrence of the attack. In two children, the syncopal attack was repeated 4 times.

CONCLUSION: Syncope most often occurs in teenagers and is mostly benign. To assess syncope, it is necessary to gather a detailed history of the attack, to conduct a detailed physical examination and routine laboratory analyzes: CBC, glycemia and standard ECG. Supplementary diagnostics should be performed exclusively in patients where there is a reasonable suspicion of heart disease or neurological diseases. 

Kawasaki disease (KD) is an acute, self-limited vasculitis of unknown etiology that occurs predominantly in children under the age of 5 years. In addition to the progress of modern medicine, the cause of KD is currently unknown and specific diagnostic tests for definitive diagnosis does not exist. The differential-diagnostic enigma is the exclusion of other diseases with similar clinical features. The primary treatment in the acute phase of KD is intravenous immunoglobulin (IVIG) and acetylsalicylic acid (ASA/aspirin). There is not a recommendation to a uniform therapeutic approach in refractory KD. The role of corticosteroids is still controversial, but there are studies that support its use as adjuvant treatment. Most patients have a good prognosis. The focus of future research should be the formulation of new algorithms for detection, differential diagnostic triage and treatment of KD. 

Introduction: Paraneoplastic pemphigus is an autoimmune bullous and erosive mucocutaneous syndrome associated with malignancy. First of all, it is associated with lymphoproliferative disorders, but also with solid tumors.

Case report: We present a 73-year-old female patient who developed polymorphic lesions on the skin and mucous membranes after treatment of nonHodgkin's lymphoma. Disseminated pale erythematous macules, exudative papules and plaques, papulovesicles, pustules, targetoid lesions and bullae are present on the skin, mostly with a flaccid roof, some with a hypopyon. Oral mucosal changes included erosions and ulcerations covered by fibrin deposits. Histopathological examination of several biopsies revealed the presence of interface dermatitis, eosinophils, necrotic keratinocytes, as well as intraepidermal cracks with acantholytic cells, dominated by eosinophils. Direct immunofluorescence microscopy of the perilesional skin showed fluorescent intraepidermal reticular IgG deposits, as well as segmental linear IgG deposits along the basement membrane zone. Indirect immunofluorescence microscopy revealed circulating IgG autoantibodies binding to monkey esophagus and rat bladder at a titer of 1:320. Initially, he was treated with systemic corticosteroid therapy, then, in consultation with a hematologist, rituximab therapy was indicated (375 mg/m2, 4 doses once a week). The patient died after the 2nd dose of rituximab.

Conclusion: Considering the different clinical, histopathological and immunological features, paraneoplastic pemphigus presents a challenge for the clinician. Knowledge of different clinical presentations, as well as individualization of therapy with a multidisciplinary approach, are of crucial importance.