Sveži prelomi u ortopedskoj hirurgiji i traumatologiji, dovode do hemodinamske nestabilnosti celokupnog organizma. Kod otvorenih preloma, stepen
 hemodinamske nestabilnosti organizma je značajno veći. Prioritet u lečenju svežih preloma ima DAMAGE CONTROL IN ORTHOPEDIC (DCO). DCO je
 invazivna procedura koja ima ulogu kako u stabilizaciji preloma, tako i u kontroli krvarenja. Prelomi dugih kostiju kao i prelom karlice su apsolutna
 indikacija za DCO. Slobodno možemo reći da ova procedura prestavlja prioritet u lečenju svežih preloma. Procedura je individualizovana u zavisnosti
 od težine povrede kao i  hemodinamskog statusa povređenog pacijenta. U ortopedskoj hirurgiji i traumatologiji kao standardna procedura u DCO
 koristi se spoljašnji fiksator po Mitkoviću. Ortopedski hirurzi moraju biti jako prisebni i obazrivi kod pregledapacijenata sa politraumom i da
 prepoznaju tkzv. trougao smrti. Trougao smrti čine: acidoza, hipotermija i koagulopatija. Svaka karika je medjusobno povezana jedna sa drugom
 dovode do ireverzibilnih promena u organizmu što za posledicu ima smrtni ishod. DCO se sprovodi u tri faze: 1) podrazumeva kontrolu kvarenja,
 smanjenje kontaminacija bakterijama, kao i privremenu fiksaciju preloma. Sve ovo je neophodno uraditi u roku od 1-2h.; 2)  obuhvata stabilizaciju
 vitalnih parametara u JIN-e kao i reanimacija pacijenta ordiniranjem neophodne terapije, krvi i krvnih derivata.; 3) podrazumeva definitivna metoda
 lečenja u smislu nastavka lečenja preloma spoljasnjim fiksatorom ili konverzija u neku drugu metodu lečenja.

 Ruptura potkožne tetive ekstenzora policis longusa (EPL) je jedna od najčešćih povreda tetiva ekstenzora šake. Ova vrsta povrede može biti posledica
 trauma ručnog zgloba. Češće se javlja kao posledica degenerativne ili inflamatorne bolesti. Ponekad se to dešava bez predisponirajućeg stanja, zbog
 kontinuiranih pokreta savijanja i opružanja palca šake.
 Ruptura tetive EPL-a se obično dešava u predelu Listerove kvrge gde su trenja najveća. Kontinuirano ponavljanje mikrotrauma može da uzrokuje
 rupturu. Engkvist i Lundborg [1] su postavili hipotezu o patogenezi mehanizama ove povrede.  Smatrali su da nakon trauma ili zapaljenja formiran
 hematom unutar omotača tetive dovodi do povećanja pritiska u neelastičnom prostoru. Povećanje pritiska može izazvati promene u snabdevanju krvi i
 može dovesti do nekroze i rupture struktura tetiva. Nakon prekida kontinuiteta tetive EPL-a, retrakcija proksimalnog okrajka je praćena
 degenerativnim procesima koji ugrožavaju direktnu suturu.
 Predloženi su mnogi tretmani, artrodeza interfalangealnog (IP) zgloba palca ili transpozicija tetive ekstenzor indicis proprius (EIP) koju je razvio
 Mensch 1925. god. [1].
 Transpozicija tetive šake je hirurška procedura која uključuje repozicioniranje funkcionalne tetive како bi se obnovila funkcija oštećene tetive šake.
 Ova operacija ima za cilj da vrati pokret, funkciju i snagu šake.
 U ovom radu prenosimo naše iskustvo u lečenja traumatske rupture tetive EPL-a metodom transpozicije tetive EIP-a. Opisujemo operativnu tehniku
 transfera tetive EIP-a na tetivu EPL.
 Ključne reči: trasnpozicija tetive, ekstenzor policis longus, ekstenzor indicis proprius, funkcija.

 Uvod: Kognitivni pojačivači (KP) poboljšavaju kognitivne funkcije putem neurotransmitera CNS-a. Čine raznorodnu grupu supstanci koje se
 svakodnevno uzimaju kao napici nalik kafi, biljni lekovi i dijetetski suplementi (“meki pojačivači”) ili lekovi koji se koriste u lečenju bolesti
 (nootropici). Upotreba i zloupotreba su česte u studentskoj populaciji sa brojnim etičkim pitanjima.  
Cilj: Utvrđivanje informisanosti studenata medicine, njihovih stavova o upotrebi i stepenu rizika od neželjenog delovanja KP, na osnovu pretpostavke
 da je upotreba ovih supstanci redovna.
 Materijal I metode: Studija preseka je sprovedena po tipu anonimnog anketnog istraživanja na Medicinskom fakultetu Priština sa privremenim
 sedištem u Kosovskoj Mitrovici. U ispitivanju su dobrovoljno učestvovali studenti medicine prve tri godine integrisanih studija koji nisu položili ispit iz
 predmeta Farmakologija sa toksikologijom. Upitnik je obuhvatio socio-demografske podatke, podatke o koncentraciji i navikama u učenju, stepen
 informisanosti, procenu upotrebe i procenu rizika korišćenja KP. Stratifikacija uzorka je izvršena prema polu studenata, a Likert-ova skala je poslužila
 za rangiranje stavova ispitanika.
 Rezultati: Od ukupnog broja anketiranih (n=249) u konačnu statističku analizu podataka uključeno je 169 anketnih upitnika (M 32,5 %, Ž 67,5%).
 Najviše studenata je bilo sa druge godine studija (40%), dok je najviše studentkinja bilo sa prve godine (48,2%). Uočena je statistički značajna razlika
 između ispitivanih grupa u odnosu na godinu studiranja (p=0,009).  Informacije o KP su novina za 40,2% ispitanika (M 49,1%, Ž 36%). Da je o njihovoj
 primeni dovoljno informisano smatra 23,7 % ispitanika (M 20%, Ž 25,4%). Postoji statistički značajna razlika u upotrebi internet baza za informisanje o
 KP (p<0,001).Najveći broj studenata (71,6%) koristi internet za informisanje o KP, pri čemu je korišćenje internet baza bilo statistički značajno veće
 kod žena u odnosu na muškarce (M 56,4 %,Ž 78,9 %; p=0,002). Više od polovine ispitanika (50,3%) koristi Mediately bazu kao pouzdanu bazu podataka o
 lekovima. Od ukupnog broja studenata 40,8% upotrebljava neki od navedenih KP (M 43,6%, Ž 39,5%). Najčešći razlozi za upotrebu kod obe grupe
 ispitanika su poboljšanje koncentracije (M 27,3%, Ž 28,9%) i uspešnije polaganje ispita (M 25,5%, Ž 15,8%). Oba pola najviše koriste ginko bilobu (M
 29,1%, Ž 32,5%) i metilksantine (M 29,1%, Ž 17,5%). Studenti znatno češće upotrebljavaju kreatin u odnosu na studentkinje (M 20%; Ž 2,6%; p=0,003).
 Obe grupe studenata su prema medijani i interkvartilnom opsegu (25-75%) uočenog rizika od neželjenih reakcija rangirale kokain (M 9,0; Ž 9,0),
 metamfetamin (M 8,0; Ž 8,0) i amfetamin (M 8,0; Ž 7,0) kao najopasnije, dok je ginko biloba procenjena kao najbezbedniji KP (M 3,0; Ž 3,0). 
Zaključak: Većina studenata nije dovoljno informisana o kognitivnim pojačivačima, iako ih koriste samoinicijativno, radi postizanja boljih rezultata na
 studijama. Neophodno je studente uputiti na adekvatne izvore informisanja i organizovati vannastavne tribine i predavanja o bezbednosti i efikasnosti
 KP pre upotrebe. U skladu sa trendovima u svetu, može se očekivati porast zloupotrebe nootropika na univerzitetima i u našoj zemlji. Smatramo da bi
 trebalo ponoviti ili organizovati slično ispitivanje kroz par godina, po mogućstvu u većem obimu.
 Ključne reči: kognitivni pojačivači, informisanost studenata, stavovi studenata

Introduction. Hypothyroidism can be accompanied by various neuropsychiatric manifestations ranging from mild depression and anxiety to psychosis. Objective. The study aimed to determine the presence of depression in patients with hypothyroidism (clinical and subclinical). Methods. The survey was conducted over twenty-four months, from 01. 07. 2017. to 01. 07. 2019., at the Health Center Krupa na Uni. The cross-sectional study included 160 persons, two groups of 80 persons each. The first group included those with newly diagnosed hypothyroidism, while the control group consisted of people with neat, thyroid function. In addition to the general questionnaire, the study used Beck's Depression Inventory and laboratory analyzes (enzymatic assays to determine thyroid stimulating hormone and thyroxine). The chi-square test was used in the statistical analysis. Results. The first group consisted of 62 (38.7%) subjects with subclinical hypothyroidism and 18 (11.3%) with clinical hypothyroidism, 51 (63.7%) women and 29 (36.3%) men with a mean age of 52±6.9 years. The control group consisted of 42 (52.5%) women and 38 (47.5%) men, with a mean age of 51±4.3 years. Mild depression was verified in 50 (31.2%), moderately severe in 43 (26.9%), and severe depression in 3 (1.9%). The study found the existence of statistically significantly moderate-severe depression in participants with subclinical hypothyroidism (p<0.05). Conclusion. The results of our study indicate a statistically significantly presence of moderately severe depression in patients with subclinical hypothyroidism. Early detection and adequate therapeutic intervention of thyroid gland disorders in patients with depression. Our findings favor the need for early and routine screening for hypothyroidism and depression.

IIntroduction: Fractures of the lower leg are frequent fractures of long bones that are of great importance in traumatology. The role of external fixation (SF) as a type of surgical treatment is significant and widely applied. There are 3 methods of using SF to treat tibial fractures: SF as primary and definitive treatment, SF combined with internal fixation, and conversion of SF to internal fixation. Objective: To show the possibilities of SF as a definitive way of treating lower leg fractures. Methods: In our paper, we analyzed 254 lower leg fractures treated with SF according to Mitković M20, which were treated at the Department of Orthopedics and Traumatology of CHC Kosovska Mitrovica. This series included 172 men or 68% of the total number of patients, and 83 or 32% women. Results: The average age of patients treated with this method is between the third and fourth decades of life. Falling on the leg with twisting of the table or the entire lower part of the leg is the most common type and cause of injuries in 69%. A closed lower leg fracture was diagnosed in 220 patients (A AO 59.%, B AO 26% and C AO 15%). Adequate position of the bone fragments was achieved by the closed reposition method in 190 (%), the average healing time was 18.4 weeks. In 93% of patients, we achieved bone union. Conclusion: The simple placement technique, the simplicity of the instrumentation, the wide range of indications where SF can be used, have led to the fact that it is a type of surgical treatment of great importance for lower leg fractures in small areas.

INTRODUCTION Chronic non-contagious diseases: heart and blood vessel diseases, malignant tumors, diabetes, obstructive pulmonary disease, injuries and poisoning, mental health disorders and others, have dominated the world and our national pathology for decades. Arterial hypertension is one of the most common diseases of the present, which affects in more than 60% of people over the age of 60, and represents a risk factor for infarction, insult, chronic heart failure, renal insufficiency, progressive atherosclerosis and dementia, indicating the importance of hypertension frequency testing in the geriatric population in our country and in the world. OBJECTIVE is to point out the specificity, the high frequency and the risk of hypertension in the geriatric population in our country and in the world. METHODS We analyzed the data and literature in the field of geriatrics, internal medicine, neurology, public health, social medicine and health statistics in the part dealing with the protection of the health of the elderly in our country and in the world. The research was conducted through the analysis of previous scientific research obtained from the literature and the search of electronic databases in accordance with the areas defined in the aim of the work. Using the analytical observational method, all necessary data on this topic were collected, recorded and analyzed. A systematic review of the literature in the researched area was carried out, with the aim of reviewing the methodological characteristics of published studies in the mentioned area. Relevant papers based on this search were collected in full text. Data were extracted from such works, analyzed and presented in this paper. RESULTS AND DISCUSSION Cardiovascular disease is the primary cause of elderly mortality, and it is believed that by removing it in people over the age of 65, the life expectancy would be prolonged for 16 years. The results of some studies show that a third of patients over the age of 65 have isolated systolic hypertension, which is a significant risk factor for apoplexy. In developed countries, the geriatric population is on the rise and reaches more than 30% of the general population, and cardiovascular disease is one of the most common diseases and causes of mortality in this population. Studies have shown that the incidence of myocardial infarction and cerebrovascular events is doubled in patients over 65 years of life with hypertension. Only two groups of diseases, heart and blood vessels diseases and malignant tumors, account for over half of all causes of death. In the Republic of Serbia, in 2021 the population aged 65 and over accounted for 21.28% of the population, while the percentage representation of very old people, over 85 years of age, is constantly increasing. Observed since 2002, more than 100,000 people die annually in Serbia from all causes of death, and almost every second resident of Serbia dies from diseases of the heart and blood vessels. The burden of diseases of the circulatory system or diseases of the heart and blood vessels is on the rise globally, and in recent years in Serbia, on average, 55% of people who have died are victims of one of the diseases from this group. The most common diagnosis within the group of diseases of the cardiovascular system is essential arterial hypertension. The most common causes of death in 2021 belong to the following groups of diseases (according to ICD-10 - International Classification of Diseases of the World Health Organization): Diseases of the circulatory system 41.4%; Tumors 15.1%; Diseases of the respiratory system 5.3%; Diseases of glands with internal secretion, nutrition and metabolism 2.6%. Diseases of the heart, blood vessels and malignant tumors accounted for over half (55.7%) of all causes of death in 2021 in Serbia. As many as 41.4% of all deaths were the result of dying from diseases of the circulatory system, and every sixth person who died (15.1%) was a victim of a malignant tumor. Studies have shown that in patients over 65 years of age with hypertension, the frequency of myocardial infarction and cerebrovascular events is twice as high. CONCLUSION Hypertension is very common in elderly and is a growing problem for them, their family and entire community, as it significantly affects the quality of their lives. The number of elderly in general population is increasing and a growing number of them is with hypertension. Successful prevention can significantly affect the reduction in the incidence of this disease in the population of elderly, which would certainly be one of the priority tasks in improving their health and quality of life.

INTRODUCTION: The ratio of neutrophils-lymphocytes (NLR) and platelet-lymphocytes (PLR) is a new parameter in the assessment of patients with Hashimoto's thyroiditis OBJECTIVE: The aim of this study was to investigate the effect of NLR and PLR in patients with Hashimoto's thyroiditis MATERIALS AND METHODS: In this cross-sectional study, subjects were subjected to tests of thyroid gland function, antithyroid antibodies, as well as laboratory analyzes of blood count with determination of NLR and PLR. The respondents were grouped into two groups. The first group was patients with Hashimoto's thyroiditis (HT), while the second group consisted of healthy individuals who represented the control group. RESULTS: NLR was statistically significantly higher in patients with HT compared to the control group (2.62±0.8 and 2.43±0.8, respectively; p=0.02), while PLR was higher in people with HT compared to the control group, but without statistical significance significance (169±42.5; 159±40.3; p=0.08). Among the examined patients with HT, the group with hypothyroidism showed statistically higher NLR values compared to the group of patients with euthyroid status (2.7±0.9 ; 2.31±0.7 p=0.03). Among the examined patients with HT, the group with hypothyroidism showed statistically higher PLR values compared to the group of patients with euthyroid status, as well as the group with subclinical hypothyroidism (177.8±48.2; 148.3±39.3; 155.5±42.5 p=0.04). NLR and PLR show a statistically significant positive correlation with the level of TSH, Anti TPO and TG At in the group with HT. CONCLUSION: NLR and PLR can serve as practical and valuable markers of the clinical course of the disease, but also markers of autoimmune diseases that progress with chronic inflammation.

INTRODUCTION: The corona virus desease has led to numerous changes in all aspects of our lives. The educational system through numerous innovative learning methods managed the smooth conduct of distance learning. OBJECTIVE: The aim of our study is to examine the attitudes of medical and dental students about quality and effectiveness of online versus traditional teaching, in the course of Hystology and Embriology during the duration of the COVID-19 pandemic. METHODS: The research was conducted online, with the help of a questionnaire designed on the Google Forms platform. The cross-sectional study included second-year students of medicine and dentistry at the Faculty of Medicine in Priština -Kosovska Mitrovica, who during the 2020/21 academic year followed online and classical classes in the subject Histology and Embryology. The results were processed using descriptive statistical methods and appropriate tests for testing the hypothesis about the significance of the difference between two, three or more samples. RESULTS: Out of the total number of surveyed students (n=60), 95% of students attended traditional classes, 88.3% of students attended classes via Zoom platform, while 85% of respondents used Moodle platform. The highest percentage of very satisfied (38.3%) and satisfied (51.6%) students was with traditional teaching. The percentage of available lecturers during online classes is 73.3%, and 76.7% during tradicional teaching. 75% of students believe that tradicional teaching can not be replaced by online teaching method. 68% of students used the literature and available presentations on the Moodle platform to prepare for the exam. A significant correlation was found in the case of satisfaction with the grade and the achieved success in the exam (p=0,001). CONCLUSION: The results of our research show that students preferred traditional over online teaching, which makes traditional teaching a primary and irreplaceable form of education.

Aortic dissection (AD) and pulmonary embolism (PE) are both serious and life-threatening conditions that rarely occur concomitantly. We report a case of a male patient with chronic aortic dissection, pulmonary embolism and decompensated cardiomyopathy with focus on the usage of computed tomography (CT) to ensure timely diagnosis and improve patient management. Case report: Aortic dissection (AD) and pulmonary embolism (PE) are both serious and life-threatening conditions that rarely occur concomitantly. We report a case of a 55-year-old man who was admitted to Coronary care unit due to pulmonary embolism and aortic dissection of abdominal aorta. Conclusion: This case highlights the importance of correct aortic dissection diagnosis and management, as well as the rare but possible association between aortic dissection and pulmonary embolism.