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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

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

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

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

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

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

01.12.2020.

Professional paper

Prevalence, etiology and treatment of psychogenic aphonia in children: A case report

Introduction. Emotions are one of the most important psychological processes, with a decisive influence on a person's voice. Faced with the great challenges and changes that primary and secondary socialization agents impose in the process of growing up, children consequently experience a spectrum of various unpleasant feelings: anxiety, fear, anger, frustration and sadness. Due to the fast-paced lifestyle, it often happens that the child ignores unpleasant feelings, which further worsens the condition in which he finds himself. Among other conditions, psychogenic aphonia in children has become more frequent in recent years. The current case report aims to determine the frequency of psychogenic aphonia in children, to identify the most common causes that lead to psychogenic aphonia and highlight the methods of vocal treatment that give the best results during rehabilitation. Case report. The current paper presents the results collected in a two-year period at the Clinic for Ear, Throat and Nose of the Clinical Hospital Center "Zvezdara". In the period from March 2017 to May 2019, psychogenic aphonia was diagnosed in 31 patients, which is an evident increase compared to the previous ten-year period in which psychogenic aphonia was diagnosed in 38 younger patients. Analyzing heteroanamnestic data obtained from parents, the most common answer about the cause of psychogenic aphonia is dissatisfaction with school success. After successful diagnostics by an otorhinolaryngologist, psychiatrist and vocal pathologist, in the process of rehabilitation of psychogenic aphonia, methods of digital manipulation of the larynx, methods of restoring the voice with cough reflex and methods of turning out the feedback system were applied. In this particular case, the method of digital manipulation of the larynx gave the best results. Conclusion. Optimal evaluation of patients with voice disorders requires the joint efforts of experts from different disciplines. Having in mind the tendency of recurrence of psychogenic aphonia, these findings suggest that the integration of the interventions of a vocal pathologist and a psychiatrist could give effective results in the process of rehabilitation voice.

Mirjana Petrović-Lazić, Ivana Ilić-Savić

01.12.2020.

Professional paper

Suconjunctval hemorrhages

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.

Jana Mirković, Isidora Mrkić, Olivera Đokić

01.12.2020.

Professional paper

Piriformis: Sparing approach, is it better?

Hip fractures as well as coxarthrosis are conditions that are becoming more common in everyday orthopedic practice. With the aging of the world's population, there is an increasing need for partial (HA) or total hip arthroplasty (THA). No elective procedure is as important to quality of life as total hip arthroplasty, and partial hip arthroplasty is a method of treatment in elder population who suffered fracture of the femoral neck. There are several hip approaches that can be used for arthroplasty. Hip dislocation is a serious complication after hip arthroplasty and occurs somewhat more frequently when the posterior hip approach is used. The aim of this study is to show that the piriformis sparing technique gives better results in terms of reducing the frequency of dislocations in the early postoperative period (one year). We operated od 249 patients, and after follow-up that lasted from 13 to 22 months we had four dislocations, three in patient with THA(0.021) and one after HA(0.009). Preservation of the piriformis tendon is a minor modification in the operative technique that can lead to a great benefit in the quality of treatment and a reduced risk of complications.

Korica Stefan, Ivana Glišović-Jovanović, Uroš Moljević, Dejan Tabaković, Dejan Virijević, Slađana Matić, Marko Kadija

01.12.2020.

Professional paper

Why anatomical terminology in Serbian languange?

In article is discussed, from the viewpoint of anatomist, the absence of a "standard" anatomical terminology in Serbian language and the consequences of this fact. After a short overview of the history of the anatomical terminology in the world, the importance of standard anatomical terminology in communication and accurate data exchange in medicine are highlighted. Brief history and the difficulties in the development of anatomical terminology in the Serbian language are presented, and the important role of linguists in its preparation is emphasized. Finally, the reasons why it is necessary to establish a standard anatomical terminology in the Serbian language are given. These reasons are: 1. During the study of anatomy, students encounter new concepts for the first time, which are best explained to beginners in Serbian language; 2. in order to facilitate learning, it is important that texts in anatomy textbooks and from various branches of medicine do not contain different names for the same structures; 3. for entering data into the computers that are now widely used, it is very often necessary to enter the specific terms correctly; 4. general literacy and standardization of professional language should not be neglected, while preserving traditional expressions that patients should also understand; 5. creating a unique terminology avoids arbitrary creation and use of names; 6. finally, the future anatomical terminology in the Serbian language can also serve as an aid to translators in translating to and from Serbian.

Slobodan Malobabić

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