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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

The impact of body weight on the secondary osification centers development and the term of closure of the anterior fontanelle in infants

Introduction: during the infant development, the organ growth is influenced by genetic factors, diet, hormones and many neuropeptides. The secondary ossification center in the hip joint begins to form around the 4th month of life. Primary dentition begins at the age of 5-6 months with the emergence of the central incisor in the maxilla. At birth, 6 fontanelles are present between the plate bones of the cranium. The largest is the anterior or large fontanelle. Objective of our research is to analyze the development of the secondary ossification center in the femoral head in relation to dentition and closure of the anterior fontanelle closure as well as influence of childrens' birth weight and current weight on these processes. Methodology: The study included 284 infants, male and female, aged 3 to 8 months. Clinical examination of the musculoskeletal system, anthropomentric measurements and ultrasonographic findings of the hip joint were performed at the Pediatric Clinic of the Clinical Hospital Center Pristina in Gracanica. Results: The development of secondary ossification centre correlated with child's age, dentition, anterior fontanelle closure, birth weight and delivery method, as well as actual body weight. Anterior fontanelle size was inversely related to age, body weight and secondary ossification. Conclusions: According to regression analysis, body weight is the only factor that has a direct and independent impact on the onset and progression of ossification process. Every additional kilogram of a child's body weight accelerates secondary ossification by 1.3-3.77 times.

Snežana Marković-Jovanović, Aleksandar Jovanović, Radojica Stolić, Milica Popović, Danijela Ivanović

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

Arterial hypertension in geriatric population

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.

Ljiljana Kulić, Vesna Krstović-Spremo

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

Case report of Parkinson's disease and orthostatic hypotension

Introduction: Parkinson's disease is an idiopathic, slow progressive neurodegenerative condition with the loss of dopaminergic neurons in the substantia nigra compacta of the midbrain. Due to cardiovascular dysautonomia and impaired baroreflex function in Parkinson's disease, the development of orthostatic hypotension is most common, along with increased blood pressure variability, supine hypertension, nocturnal hypertension, etc. Orthostatic hypotension in Parkinson's disease increases the risk of developing coronary heart disease, myocardial infarction, and the risk of overall, and cardiovascular mortality. Case report: Orthostatic hypotension in Parkinson's disease is associated with an increased risk of gait disturbances, loss of balance, falls resulting in injuries and limb fractures, and mortality. In this paper, we presented a patient who had previously been treated for arterial hypertension, with the current clinical presentation of symptomatic orthostatic hypotension in Parkinson's disease. After neurological evaluation and the implementation of pharmacological and non-pharmacological therapy for orthostatic hypotension, gradual improvement and stabilization of blood pressure values are achieved, along with a reduction in orthostatic hypotension symptoms and a decrease in subjective discomfort. Conclusion: In the presence of orthostatic hypotension in Parkinson's disease, in addition to pharmacological therapy, nonpharmacological treatment measures are very important for stabilizing blood pressure values and reducing the symptoms of orthostatic hypotension.

Miloš Mijalković, Nikola Vukašinović

01.12.2021.

Professional paper

Fournier 's gangrene: Literature review and case report

Fournier's gangrene is a progressive necrotizing bacterial dermo-hypodermitis of the perineum and external genitalia. It represents a secondary polymicrobial infection with an aerobic and anaerobic group of bacteria, which have a synergistic effect in the development of this disease. Fournier's gangrene is an urgent, potentially life-threatening, medical condition that requires a multimodal approach: surgical debridement of the necrotic tissue, resuscitation of the patient, and the application of a broad spectrum of antibiotic therapy. We present the case of a 45-year-old male, referred to our department due to pain and swelling of the perineal region and scrotum, in the initial stage of Fournier's gangrene. The patient was hospitalized, a surgical incision and drainage of the areas affected by gangrene were made, and he underwent surgical treatment of the wound and intensive suppurative therapy for 23 days. After 23 days of hospitalization, the patient was discharged for home treatment with prior suturing of the incisional wounds, with an orderly local status and good general condition. Timely incision, debridement and application of intensive therapy in a condition such as Fournier's gangrene is of crucial importance. In this way, the possibility of potential complications, the progression of local to systemic disease, as well as the percentage of fatal outcome, is reduced.

Aleksandar Jakovljević, Gojko Igrutinović, Nikola Miljković, Mladen Kasalović, Danijela Vićentijević

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

Understanding wedge resection research productivity with visualization: A scientometric attitude

This research paper presents a scientometric analysis of wedge resection research productivity. The study aims to evaluate the evolution and different types of literature on wedge resection, identify the principal countries, institutions, and sources that have contributed to publications on wedge resection, track the increase of literature on wedge resection citations each year, and determine the most frequently discussed topics in wedge resection research publications. To achieve these objectives, the study utilized a scientometric approach that involved a systematic analysis of existing research on wedge resection and productivity, with a focus on the application of scientometric methods. The results of the analysis provide a comprehensive examination of wedge resection productivity, which can be used to guide future research in the field. The study demonstrates the potential of scientometric methods in examining research output and productivity in various fields, including wedge resection. Overall, this research paper provides valuable insights into wedge resection productivity that can inform future research and decision-making in the field.

Tushar Khachane, Bidhan Dolai

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

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

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