Contents
01.12.2021.
Professional paper
Lower leg fractures treated with an external fixator at the Department of Orthopedics and Traumatology of the Clinical Hospital Center of Kosovska Mitrovica
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.
Saša Jovanović, Z. Elek, P. Denović, N. Miljković, J. Tomašević, D. Petrović
01.12.2021.
Professional paper
Students' attitudes about the quality and effectiveness of online compared to traditional teaching of histology and embryology during the COVID-19 pandemic
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.
Teodora Jorgaćević, Slađana Savić, Jelena Tomašević, Erdin Mehmedi, Milica Perić, Sanja Gašić
01.12.2021.
Professional paper
Frequency of depression in patients affected by subclinical and clinical hypothyroidism: A cross-section study
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.
Marijana Jandrić-Kočić, Snežana Knežević
01.12.2021.
Professional paper
Operative treatment of supracondylar elbow fracture in a child using the percutaneous method
Supracondylar fractures are the most common elbow injuries in children and are associated with prolonged morbidity due to possible complications that can lead to deformity. The decision on the treatment method is made based on Gartland's classification (I, II, III and IV types) and the treatment can be non-operative (I and II type) and operative (III and IV type). When it comes to the percutaneous method, the main dilemma for its implementation is related to pinning from the medial side of the elbow because there is a high possibility of injury to the n. ulnaris which, according to data from the literature, occurs in some 15% of cases. The aim of treatment is pain relief and maintenance of the patient's functional status. The case presented in this paper represents a patient with whom the clinician is most likely to encounter and shows the clinical assessment of the patient's condition, the way of deciding on the treatment method and the outcome of the treatment undertaken. Agirl, 8 years old, was injured when she fell while playing. At the Department of Orthopedic Surgery and Traumatology, Clinical Hospital Center Kosovska Mitrovica, the patient was clinically and radiographically examined, and the injury was defined as a supracondylar fracture type III according to Gartland. After adequate preoperative preparation under general anesthesia, without the use of a drape - Turniquet, with the use of a C-bow, repositioning is performed and after obtaining a satisfactory position of the fragments, they are fixed percutaneously with 3 Kirschner needles, two medially and one laterally. The patient was discharged 3 days after admission with controls performed for 7 days. The Kirschner pins were removed on the 5th week after the operation and physical treatment was started, after which the movements of flexion and extension as well as pronation and supination were fully restored. Similar results are found in the literature. This information can be helpful in advising parents about what to expect after their child's injury. Also, they represent evidence of good clinical practice for orthopedic doctors and physiotherapists.
Đorđe Kadić, A. Bozović, G. Radojević, Lj. Jakšić, M. Milić
01.12.2021.
Professional paper
Ellis-van Creveld syndrome
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.
Danijela Jovanović, Snežana Marković-Jovanović, Ljiljana Vukadinović
01.12.2021.
Professional paper
Lichen planus disseminatus partim vesiculosus after COVID-19 vaccine
Introduction: Lichen planus is an autoimmune inflammatory disease that can be associated with infections, drugs and vaccines. As concerning the potential triggering effect of vaccine, there is evidence a few cases of new-onset lichen planus that appeared after COVID vaccine, particularly the Pfizer/BioNTech vaccine. Case report: This report is a case of a newonset lichen planus triggered by the Pfizer/BioNTech vaccine administration in a healthy young female. Dermatological examination revealed polygonal, itchy, erythematous papules on trunk, upper and lower limbs, that coalesced into brownish plaques in the ankles, flexural wrist and knee. No mucosal involvement was noted. In view of the clinical picture, the timing of the skin eruption with respect to the vaccine and the histopathologic findings, a vaccine-induced lichen planus triggered by the COVID-19 vaccine has been diagnosed. Conclusion: Lichen planus or lichenoid-like eruption as a cutaneous manifestation following COVID-19 vaccines are rare, and the pathogenesis for its development is still unclear. Clinical trials showed that the leading vaccines upregulate Tcell response (Th1) and incrementing inflammatory cytokines involved in the pathogenesis of autoimmune diseases, such as lichen planus. Although we still do not completely understand its pathogenesis, dermatologists should be aware of the possibility and keep an eye out for worsening or debut of this disease after the COVID-19 vaccine. Vaccinated patients should be monitored for skin manifestations, and dermatological evaluation should be offered, when needed.
Dragica Milosavljević, Milijana Relić, Mirjana Stojanović-Tasić
01.12.2021.
Professional paper
Differential diagnosis distinction of nummular headache and Lichen planopilaris
Introduction: Nummular headache is a type of primary headache of chronic character, with a large number of described varieties in the clinical picture, and therefore the differential diagnostic consideration must include a large number of disorders related to changes in epicranial structures. Certain dermatological disorders can also include pain in a limited area of the scalp with itching, burning or burning sensation, such as Lichen Planopilaris. Case report: This is a report of a patient who was initially diagnosed with Lichen planopilaris, but after determining the parameters of the distinction and the necessary additional diagnostic procedures, a diagnosis of Nummular headache was made. Conclusion: In this presentation, we have presented another important differential diagnostic item and we believe that the work is a small contribution to everyday practice, but also to further research.
Snežana Filipović-Danić, Vekoslav Mitrović, Nenad Milošević, Aleksandar Stevanović
01.12.2021.
Professional paper
Factors associated with involuntary hospitalization
In clinical practice, involuntary hospitalization in psychiatry is a procedure that patients with severe mental disorders are subject to due to the inability to make rational treatment decisions.. The prevalence of involuntary hospitalizations varies widely within and between countries. Involuntary admission to a hospital for psychiatric treatment can be life-saving and may be considered beneficial to some people in the long run. However, the experience of involuntary treatment can be traumatic, intimidating, stigmatizing, and lead to long-term avoidance of mental health services and an increased risk of rehospitalization. In this paper, we have considered the risk factors for involuntary hospitalizations and their frequency in the region and Europe.
Emilija Novaković, Ivana Stašević-Karličić, Mirjana Stojanović-Tasić, Tatjana Novaković, Jovana Milošević, Vladan Đorđević
01.12.2021.
Professional paper
Importance of postoperative pain and possibilities of prevention and treatment
The paper presents the importance of acute postoperative pain, the risk factors for its occurrence and intensity, instruments for its measurement and assessment, as well as the possibilities of prevention and treatment. The fact that post-surgical pain represents not only a subjective unpleasant experience for the patient, but also a factor that significantly contributes to complications and unfavorable outcomes of surgical treatment is well known. Despite that, postoperative pain can be seen very often. To successfully prevent and relieve pain, it is necessary to establish a possible cause-and-effect relationship between the occurrence and intensity of postoperative pain, type of surgical intervention, anesthesia technique, demographic characteristics of patients, comorbidities, chronic therapy, and family and socioeconomic factors. Besides the application of recommendations from the current guidelines and protocols for the prevention and treatment of post-surgical pain to achieve positive treatment outcomes, an individual approach to each patient and the application of multimodal analgesia techniques that include the use of different classes of analgesics, co-analgesics, and non-pharmacological measures, based on modern ERAS-protocols aimed at accelerated recovery after surgical intervention should also be employed.
Anka Tošković, Marina Stojanović, Ksenija Jovanović, Jovan Jozić, Milan Jovanović, Nevena Kalezić
01.12.2021.
Professional paper
A rare case of chronic aortic dissection and pulmonary thromboembolism
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.
Dalila Šačić, Jelena Petrović, Branislava Ivanović
