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.

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.

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.

The ageing process is characterized by numerous changes in the body that negatively affect the health, lifestyle and diet of the elderly. An adequate and balanced diet plays a vital role in the quality of life of the elderly, including physical, mental and social health. Physiological decline in food intake in the elderly is a risk factor for certain micronutrient deficiencies such as osteoporosis, anaemia and decreased immunity. To prevent these public health diseases, it is suggested to promote the intake of foods of animal origin (offal, meat) to prevent iron and vitamin B group deficiency. An adequate intake of anthocyanidins, fruits and vegetables with blue-purple pigments is recommended for the prevention of anaemia. Adequate intake is also important, i.e. intake of at least two portions of dairy products per day and fish products per week in combination with physical activity can provide adequate intake of calcium and vitamin D for the prevention of osteoporosis. The intake of fresh or minimally processed foods has played a significant role in ensuring an adequate intake of vitamin C, which, in addition to improving iron absorption and preventing anaemia, also affects the proper functioning of the immune system. For the same reason, it is recommended to take vitamin A from offals or beta-carotene from yellow-brown and orange fruits and vegetables. In general, appropriate nutritional interventions can be effective and financially effective forms of preventing and treating micronutrient deficits, thus improving the overall quality of life of the elderly

INTRODUCTION: Complete appreciation of the cardiac venous system requires an understanding of its embryological basis, its usual patterns of distribution, and its common variations. AIM: The aim of our study was to improve our understanding of the coronary sinus morphometrical and topographical anatomy. METHODS: The investigations were carried out on 25 human hearts (from 11 male and 14 female persons of mean age 59.5; range: 40 to 75 years). The classic anatomical technique of microdissection (using neurosurgical microinstruments) was performed under the stereoscopic microscope on 10 specimens injected with a 10% formaldehyde solution. The arteries and veins of an additional 15 hearts were injected with methylmethacrylate and immersed in a 40% solution of NaOH for corrosion. Following washing out and drying, the obtained vascular casts were examined and measured. RESULTS: Coronary sinus (CS) extends from the opening of the oblique vein of the left atrium into the great cardiac vein, to its empty orifice into the right atrium. The length of CS varied between 22.4 and 41.4 mm (mean 33.0 ± 6.1 mm). The diameter of CS at its beginning was 5.0 - 9.6 mm (mean 6.6 ± 1.3 mm), and its diameter at its atrial mouth varied from 6.6 - 12.0 mm (mean 8.4 ± 1.6 mm). The CS had varied relationships to the branches of the left or right coronary arteries. It extended superficial and above the artery in 16 (64%) hearts, and close superficial to the artery in 9 (36%) cases. Duplication of the superior vena cava associated with an aberrant left hepatic vein was found in one case. The persistent left superior vena cava, which drained into the right atrium via the enlarged coronary sinus, was formed by the persistence of the left anterior cardinal vein. CONCLUSION: Our study shows that the coronary sinus, created in an early stage of embryological development, is an important collecting vessel receiving the main veins of the heart.

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: 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.

Introduction. At the very beginning of the Corona virus epidemic there was not enough data on whether hemodialysis patients have a higher risk for Corona virus infection and which factors may affect the severity of clinical picture. Objective. The aim of the study was to determine the significance of the Modified Early Warning Assessment (MEWS) score for the assessment of coronavirus disease exacerbation. Methods. The research was conducted in COVID dialysis, as a retrospective, descriptive-analytical study, at the University Clinical Center Kragujevac, Serbia, which was organized ad-hoc for treatment of SARS-Cov-2 infection positive patients, which are transfered from Center for Hemodialysis "Ćuprija". They were evaluated routine laboratory findings, demographic and gender structure, arterial blood pressure, presence of comorbidities and residual diuresis, duration of dialysis, radiological evaluation of lungs, determination of MEWS score were the parameters that were monitored. The results were monitored on admission and and in the end of treatment. Results. A statistically significant difference was registered in serum lactate dehydrogenase concentration (486 ± 107.62 vs. 423.7 ± 92.4 U/L); p = 0.022 and absolute monocyte count (0.46 ± 0.15 vs. 0.67 ± 0.34 x 103; p = 0.008). The significant increase in MEWS score was also found (b = 0.017; p = 0.030). There was a positive correlation between increase of MEWS score and age (b = 0.027; p = 0.002) and arterial hypertension as a concomitant comorbidity (b = 0.700; p = 0.033). Conclusion. In the observed period, there was a significant increase in the degree of MEWS score of dialysis patients who had SARS-Cov-2 infection.

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.