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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

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.

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

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

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

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

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

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

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