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Volume 53, Issue 4, 2025

Online ISSN: 2560-3310

ISSN: 0350-8773

Volume 53 , Issue 4, (2025)

Published: 30.06.2025.

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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

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

Assessment of neutrophil-lymphocyte and platelet-lymphocyte ratio in patients with hashimoto's thyroiditis

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.

Sanja Gašić, Milica Perić, Tamara Matić, Teodora Jorgaćević, Slađana Ilić

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

Obesity and consequent changes in the body

Obesity is one of the most common chronic, non-infectious diseases in the world and our country, and it is characterized by excessive accumulation of fat tissue in the body and an increase in body weight. The increase in the number of obese people is an important global health problem. Obesity is associated with cardiometabolic and psychosocial comorbidities, and may also affect years of healthy life and reduce life expectancy. Numerous factors, such as biological predisposition, socioeconomic factors and environmental factors, interact and influence the development and maintenance of obesity. Excess adipose tissue in the body and its dysfunction is associated with inflammation and increased risk of metabolic, mechanical and mental complications. It is very important to monitor the incidence of obesity and its impact on the development of chronic non-communicable diseases and life expectancy due to the development and implementation of strategies to prevent the increase in the number of obese people.

Bojana Kisić, Dragana Puhalo-Sladoje, Dijana Mirić, Dragiša Rašić, Tatjana Novaković

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

Cor triatriatum sinister as an incidental finding in elderly woman

Cor triatriatum is a rare condition. It comprises around 0.1% to 0.4% of all congenital heart malformations. There are two types of this anomaly: cor triatriatum sinister (CTS), which is more common and accounts for 92% of all cases, and cor triatriatum dexter (CTD). This condition usually presents at an early age and is diagnosed mainly during early childhood. In some patients, who have less severe cases of CTS, diagnosis could be made in adulthood. We report an unusual case of a 78-year-old woman who was diagnosed with CTS for the first time. The patient was admitted to the cardiology department with symptoms of chest pain and dyspnoea. Physical examination revealed diffusely diminished breath sounds, with focal wheezing, and irregular heart rate, with no murmurs, while blood pressure was 140/90 mmHg. A transthoracic echocardiogram revealed an accessory membrane in the left atria suggestive of CTS.

Dalila Šačić, Mirza Šačić, Mirsad Šačić

01.12.2021.

Professional paper

Fructose metabolism: The pathogenic potential of a little molecule

In recent decades, the use of fructose in diet has increased worldwide, and coincided with increase of obesity, metabolic syndrome, diabetes, and non-alcoholic liver disease. This review presents molecular aspects of fructose metabolism, its characteristics and contemporary knowledge about control mechanisms in order to answer how this small molecule can exert pathogenic effects. When present in small, physiological amounts, fructose actually exerts protective glycoregulatory effects. However, long-term exposure to supraphysiological amounts of fructose creates conditions for the development of certain pathological states. In such conditions, lipogenesis is intensified causing dyslipidemia, gluconeogenesis is also intensified leading to hyperglycemia and compensatory hyperinsulinemia, while insulin signaling through IP3K/Akt is blocked. Moreover, exposure to high fructose levels can induce inflammation, redox balance disruption and a decline in energy synthesis. It is most likely that the ability of the liver to metabolize large amounts of fructose and the absence of autoregulatory and hormonal control mechanisms are responsible for pathogenic potential of fructose.

Dijana Mirić, Bojana Kisić, Dragana Pavlović, Ilija Dragojević, Sladoje Puhalo

01.12.2021.

Professional paper

Analysis of the characteristics of traffic trauma

Introduction: It is estimated that an average of 1,308 people die in traffic accidents in the world every day. Traffic accidents are caused by factors of the road, vehicles and the human factor, which occur alone or in combination with other factors in over 90% of cases. Material and methods: The retrospective systematic research included all cases of traffic trauma that were brought to the admission surgical outpatient clinic in the Clinical Hospital Center Kosovska Mitrovica in the period from January 2020 to December 2022. Results: In the observed period, 126 patients were registered. The age of the respondents differs statistically according to gender (p=0.030), and the highest frequency is male (81.8%) in the working population (18-59 years). The age of the subjects showed no statistical association with the types of injuries in traffic trauma (p=0.151). Friday and Saturday are the days with the highest risk (25.3% of injuries), and Sunday is the day with the least number of injuries (3.6%). The lowest number of injuries was recorded from January to May (n=12, 9.5%), and the highest was in the period August to October (n=54, 42.9%). A male patient, 20 years old, an alcoholic, required urgent surgical treatment (splenectomy) due to abdominal injuries. Alcoholism and the age of the subjects did not show statistical significance (p=0.495), and 24.6% of patients had a diagnosis of alcoholism. The age of the subjects showed a statistical association with hospitalization (p=0.004), male gender and age between 18-59 years. Only 2 patients required transport to a highly specialized facility. The fatal outcome showed a statistically significant correlation with the age of the respondent (p=0.016), there was only one patient (between 12-18 hours), a female, 85 years old as a passenger of a motor vehicle. Conclusion: The results of our study indicate a statistically significantly more frequent injury and hospitalization of male patients, that Friday and Saturday are the days of greatest risk and that the fatal outcome occurs in extremely elderly patients. Our findings favour the need to raise public awareness through the media, public actions and forums.

Nikola Miljković, Gojko Igrutinović, Milica Milentijević, Aleksandra Milenković, Mladen Kasalović, Aleksandar Jakovljević

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

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