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.

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.

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: Echosonography of the appendix is the primary method in the diagnostic algorithm of acute appendicitis, after clinical and laboratory examination. Non-invasiveness, availability and easy performance are the advantages of this method in detecting acute appendicitis. Aim: The research aimed to determine the morphological characteristics of the appendix, as well as to evaluate the role of echo sonography in the exploration and visualization of pathological changes in the appendix in acute appendicitis. Material and methods: The cross-sectional study included 59 people who underwent appendectomy and echosonographic examination of the abdomen and pelvis within the Department of Radiological Diagnostics of UHC "Dr Dragisa Misovic-Dedinje" in Belgrade. Results: In 48 out of a total of 59 people (81.4%), there were echosonographic signs of acute appendicitis, of which incompressibility of the wall was present in 40 people (83%), diameter of the appendix over 6mm in 38 (79%), wall thickness over 3mm in 45 (94%), target sign in 33 (69%), hypervascularization of the wall in 28 (58%), as well as the presence of fecoliths with nonhomogeneous content intraluminally in 15 (31.2%) persons. The sensitivity of echosonographic examination for obtaining positive results in persons with acute appendicitis was 86.5%. The specificity of the echosonographic examination to obtain negative results in persons who do not have acute inflammation of the appendix was 57.1%. The positive predictive value (PPV) was 93.7%. The negative predictive value (NPV) was 36.4%. The accuracy of the method was 83.1%. Conclusion: Based on the high sensitivity values of the tests tested in this cross-sectional study, we estimate that echosonographic examination has a primary role in the diagnostic algorithm of a person with suspected acute appendicitis.

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.

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.

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.

Introduction:Subconjunctival hemorrhage or suffusion is bleeding that occurs between the conjunctiva and episclera. It has a distinctive look and often frightens patients. The causes can be varied. Objective: The research was undertaken in order to determine the characteristics of patients within whomsubconjunctival hemorrhage occur. Methods: Retrospective analysis of patients of the Eye Department of the Health Center in KosovskaMitrovica, during 6 months. Results were analyzed SPSS ver 22, i GraphPad INSTAT software package. Results: The change was observed in 63 patients. Male gender was significantly more frequent. The age of patients was diverse-between 5 and 86 years. The causes and conditions associated with subconjunctival hemorrhages are usually eye trauma, in young,and arterial hypertension in elderly patients. Conclusion: Subconjunctival hemorrhage is a relatively common diagnosis in ophthalmology. The change is benign and spontaneously disappears during one to two weeks. It is important to note that the subconjunctival hemorrhage occur in patients with certain risk factors.

The ectopic spleen (ES) is a rare variation occurred depend on the absence or laxity of the suspensory ligaments. The ES is a rarely diagnosed clinical condition. Less than 500 symptomatic patients have been reported. Less than 0.25% of splenectomies are performed on the ES. Patients are usually asymptomatic. It's diagnosed incidentally in general. The incidence is not clear. ES incidence is reported less than 0.5%. However, this rate covers all of the relocations. The spleen can be found anywhere in the abdomen or pelvis, depends on the length of the vascular pedicle. The pelvic ES is a rarely encountered situation. Knowing this anomaly is essential for early diagnosis and prevention serious problems such as torsion, infarction and acute abdomen. A 21 years old female patient with ES was presented on pelvic magnetic resonance imaging.

Introduction: Children with low body weight for gestational age are five times more likely to die in the neonatal period and 4.7 times more likely to die in the first years of life compared to children born at term. The aim To analyze early adaptation to extrauterine life of low body weight for gestational age. Material and methods: Retrospective study with the observation period January-September 2018. The data were obtained by reviewing the medical histories of newborns. As parameters of early adaptation, we observed the Apgar score in the 1st and 5th minute as well as the presence of polycythemia at birth. Results: Out of a total of 405 newborns, 52 had low body weight for gestational age. Apgar score in the 1st and 5th minute was statistically significantly lower in children small for gestational age compared to children with normal body weight for gestational age (p <0.05). Polycythemia is a mechanism of adaptation statistically significantly more often present in children of small body weight for gestational age (p <0.05). Conclusion: Children of low body weight for gestational age have a lower Apgar score in the first and fifth minutes as well as more frequent polycythemia compared to children with normal body weight and we can take them as good indicators of adaptation to early extrauterine life.