Contents
01.12.2020.
Professional paper
Effectiveness of coronavirus disease-19 vaccination on disease transmission, hospitalization, and clinical outcomes in adults in North India
Background: Covaxin and Covishield vaccines have rapidly rolled out in India to curb the pandemic. We aimed to test the hypothesis that COVID-19 vaccination is clinically effective. Methods: This study was conducted in the Department of Physiology at MGM College, Jaipur, India after approval from the Ethics Committee. Vaccinated and non-vaccinated groups were tested on disease transmission, hospitalization, and clinical outcomes. Researchers collected data using questionnaires circulated through google forms. The association between attributes was tested using the chi-squared test. The significance level was considered at 5%. Results: The vaccination significantly reduced disease transmission of COVID-19 [c2=4.51; p = 0.034]. However, no significant differences were seen in RTPCR positivity, chest CT findings, and hospitalization on vaccination. COVID-related symptoms and their severity were not statistically different between the two groups. Most elderly were vaccinated [c2=41.68; p < 0.001]. Most youths took one dose, while the elderly took two doses of the vaccine [c2=41.77; p < 0.001]. All age groups had similar severity of AEFIs [c2=13.22; p < 0.21]. The vaccination status across gender did not differ significantly. [c2=1.13; p < 0.288] Most males took two doses as compared to females [c2=6,57; p < 0.01]. Adverse effects post-immunization were more severe in females than males [c2=13.10; p < 0.001]. There was no association between the number of vaccine doses and the severity of AEFIs [c2=16.42; p = 0.06]. Conclusion: The present study concludes the beneficial effect of vaccination in reducing disease transmission. However, vaccination has no role in mitigating other COVID-related outcomes.
Kshitij Shah
01.12.2020.
Professional paper
Treatment fracture of the diaphisis humerus with functional plaster
Treatment of humerus fractures is divided into operative and non-operative treatment Fractures of the diaphysis of the humerus heal well. Surgeons today have many opportunities to treat them. The decision on the type of treatment to be applied depends on the location of the fracture, the existence of associated injuries, the age and the general condition of the patient. Non-operative treatment is most often applied, although there are fractures in which surgical intervention is necessary in order to perform healing and prevent complications. Non-operative treatment of fractures of the diaphysis of the humerus gives good results, with little angulation and minimal or no shortening of the arm. Adequate repositioning, appropriate plaster immobilization and regular X-rays heal the fracture within the allotted time. Disciplined early physical therapy in terms of circular movements prevents shoulder contracture and allows later physical therapy to last significantly shorter. Non-operative treatment lasts from 7-11,5 weeks.
Saša Jovanović, N. Miljković, D. Petrović, Lj. Jakšić, G. Radojević, A. Božović
01.12.2020.
Professional paper
The effects of exertional heat stress on some complex cognitive functions
Introduction/Aim: Heat stress represents the important problem in military services. This study investigates the effects of exertional heat stress on complex cognitive functions. Methods: 40 male soldiers performed exertional heat stress test, of which 10 performed the test of the same intensity in cool environment. Cognitive functions were mesured by computerized battery CANTAB, before and immediately after exertional heat stress test. Results: Exertional heat stress led to impairment of some cognitive functions in unacclimatized group: decrease of accuracy in MTS test (from 92,6±4,2% towards 84,5±6,9%, p<0,05) and PSRs (from 85,0±8,0% towards 77,0±9,6%, p<0,05), while similar decreases were recorded in MTS test in passively acclimatized group (from 92,2±5,5% towards 87,7±5,6%, p<0,05) i.e. in PSRs test in actively acclimatized group (from 83,3±6,3% towards 69,4±5,1%, p<0,05). The reaction time was not affected in any group whatsoever. Discussion and conclusion: Exertional heat stress leads to mild impairment of complex cognitive functions, particularly in domain of accuracy. Physical strain itself, however, does not affect cognitive functions. Relatively resistance to heat stress in zoung soldiers may be contributed to their high aerobic level.
Jelena Stojićević, Vanja Jovanović
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
The role of the electrocardiogram in identifying the risk of sudden cardiac death
Introduction: Sudden cardiac death (SCD) represents the unexpected and sudden death of young apparently healthy people. Alarge number of examined cases referred to professional athletes. There is not enough data in the literature related to those who performed sports in a sporadic and recreational manner. In order to prevent SCD, a screening protocol was determined, in which, an ECG performed at rest plays a important role. Based on the established criteria, changes on the ECG can be treated as normal, borderline and abnormal. An abnormal result indicates a risk of SCD. Objective: The aim of this study was to determine the risk of SCD in students who practice physical activity recreationally. Methods: The research involved 500 students (both sexes) of the 1st and 3rd year of study on the University of Pristina situated in Kosovska Mitrovica. As part of the regular systematic examination, an ECG was performed at rest. The risk of SCD was determined by analyzing the changes on the ECG and grouping them based on screening recommendations. Results: The obtained results show that 44% of students had changes on the ECG and that 8% of students had an abnormal result indicated a possible risk of sudden cardiac death. Conclusion: Therefore, timely recognizing and interpreting ECG changes in accordance with screening recommendations is an imperative for identification and possible prevention of SCD.
Biljana Zogović, Miljan Stašević, Ivan Radić
01.12.2019.
Professional paper
Incidence of ectopic thyroid tissue in the adrenal gland
Ectopic thyroid tissue is a rare pathological finding bellow the diaphragm and extremely rare finding is ectopic thyroid tissue in the adrenal gland. Thyroid tissue can be located anywhere along the way of embryological migration pathway of thyroglossal duct. In most cases of ectopic thyroid tissue, it is located in the neck. Pathohistologically ectopic thyroid tissue in all cases was formed of follicular cells that expressed TTF-1, Thyroglobulin, PAX8, and cytokeratin 7, and there was lack expression of calretinin. In the literature we found 15 such cases. Women are much more affected than men (14:1), and it usually presents in the fifth decade (mean age 49). In all cases it was composed of normal follicular cells, and C cells were not found. Review of the literature reveals that adrenal ectopic thyroid tissue is almost always cystic, and has distinctive pathologic features. The most important thing is that ectopic thyroid tissue must be distinguished from metastatic deposits from thyroid gland carcinoma.
Matija Buzejić, Božidar Odalović, Goran Zorić, Branislav Rovčanin, Nikola Slijepčević, Katarina Taušanović, Milan Jovanović, Duška Vučen, Boban Stepanović, Nevena Kalezić, Anka Tošković, Ivan Paunović, Vladan Živaljević
01.12.2019.
Professional paper
Antimicrobial treatment of Acinetobacter neuii invasive infections: A systematic review
Aims: The objectives of this study were to find out whether and to what extent Actinomyces neuii is pathogenic to humans in terms of causing invasive infections and to ascertain the most appropriate and effective antibiotic therapy against this bacterium. Material and method: This study was designed as a systematic review article. MEDLINE, Google Scholar, SCIndex, Cochrane database of published clinical trials - Central and Clinicaltrials.gov databases were systematically searched for primary case reports or case series describing invasive infection with Actinomyces neuii. Results: A literature search identified 23 studies that met the inclusion criteria, describing cases of patients with an invasive infection caused by Actinomyces neuii. It was found that A. neuii could cause endocarditis, endophthalmitis, osteomyelitis, pleural empyema, soft tissue abscesses, neonatal sepsis, ventriculoperitoneal shunt infections and periprosthetic tissue infections. The most prescribed antibiotics for the treatment of Actinomyces neuii infections were amoxicillin and vancomycin (n = 10; 12.3%), followed by penicillin (n =9; 11.1%), gentamicin (n = 6; 7.4%), ampicillin (n = 5; 6.2%) and ceftazidime (n = 4; 4.9%). Antibiotic treatment of infections caused by A. neuii was followed by clinical improvement or complete cure of all patients, with no recorded deaths. Conclusion: A. neuii has a relevant pathogenic potential to cause invasive infections of various organs and tissues, especially in immunocompromised individuals of any age. For the treatment of mild infections caused by this bacterium, the antibiotics of choice are penicillin or amoxicillin, while vancomycin should be used to treat severe infections caused by Actinomyces neuii.
Milica Milentijević, Nataša Katanić, Jelena Aritonović-Pribaković, Aleksandar Kočović, Jovana Milosavljević, Miloš Milosavljević, Srđan Stefanović, Đorđe Ivković
01.12.2019.
Professional paper
Thyroid storm after chest trauma
Thyroid storm is an acute and severe complication of thyrotoxicosis. It is characterized by high fever, sweating, tachycardia, and often heart failure too. The objectives of the paper is to present the case of a patient with thyroid storm developed after the trauma of the chest at previously apparently healthy individuals, diagnosed on the basis of clinical preview and based on the diagnostic criteria according to Burch and Wartofsky. The most common complication is Mb. Graves - Basedow, but often associated with multi-nodose goiter. Thyroid storm is the most severe form of thyrotoxicosis with a mortality rate of 8 to 25 %. Case report. We present an interesting case from our practice: thyroid storm caused after chest trauma in apparently healthy people, but with unrecognized hyperthyroidism and thyroid gland nodule. Conclusion. The objectives of this presentation were to raise awareness of the association between signs and symptoms of thyroid storm that dominate the clinical picture and complicate the initial presentation and the evolution of the situation caused by trauma. The treatment of hyperthyroidism resulted in conversion in sinus rhythm, withdrawal of symptoms and signs heart failure, and normalization of artery pressure.
Tatjana Novaković, Bogdan Dejanović, Zdravko Vitošević, Nenad Milošević, Jovana Milošević, Ljiljana Jovićević, Emilija Novaković, Miloš Mirković, Zlatica Mirković
01.12.2019.
Professional paper
Anatomical variants of circle of Willis
Introduction: The circle of Willis is the major source of collateral blood flow between the carotid and vertebrobasilar system. Its potential depends on the presence and size of arteries that vary greatly among normal individuals and therefore their adequate observation by a radiologist is necessary. Aim: Determine the type of the circle of Willis and their frequency. Determine the type, frequency and localization of anatomical variants of arteries, as well as their average diameter. Compare these variables according to the age and gender of the examinees. Material and methods: A retrospective study was performed at the Center for Radiology of the Clinical Center Nis during 2017. All subjects underwent CT or MR angiography according to a standard endocranial protocol. The anterior and posterior parts of the circle were specially observed, with an emphasis on the presence or absence of anatomical variants of the arteries, with the measurement of their diameter. The obtained data were classified into variants of the front or rear part of the ring as well as the type of ring according to integrity. The frequency of these variables and their comparison by sex and age were measured. Results: The research included 92 examinees. According to the configuration of the Willis arterial ring, the adult type was the most often represented (71.7%). The most common type in terms of integrity was partially complete. The most common anatomical variants obtained in our work was aplasia of AcoA (27.2%) and aplasia of one or both PCoA (21%). PcoA hypoplasia was occured in women with a frequency of 13.5% while in men it was not present. Conclusion: Adequate understanding of the morphology of the circle of Willis by radiological methods is a good guide for neurosurgical and radiological intervention procedures. In this way, potentially significant neurological complications and the risk of morbidity and mortality could be reduced.
Aleksandra Milenković, Slađana Petrović, Simon Nikolić, Branislava Radović, Aleksandra Ilić, Miloš Gašić, Bojan Tomić
01.12.2019.
Professional paper
The frequency of bucal and palatal impaction maxillary canines
Introduction: Maxillary canines are usually impacted teeth the second after third molar. Frequency of impacted maxillary canines is about 1 to 3% of population (in 85% of the cases palataly, and in 15% of the cases bucaly). The aim of this research was to find the frequency of bucal and palatal impacted maxillary canines in relation to sex and position of impacted tooth. Matherial and method: We analyzed three-dimensional computed tomography images (CBCT) of 64 examinees (aged 12 to 33 years) with 80 unerupted maxillary canines to plan the orthodontic therapy. Results: Among 64 examines with impactions, 80 impacted maxillary canines are diagnosed. The average age of all respondents in the survey is 16,3±4,3. Of 64 examinees in research 41(64.1%) were female which is significantly more important than the representation of male examinees whose number was 23(35.9%). Frequency of unilateral impactions of maxillary canines is three times higher 48 (75%) in comparison to bilateral impactions 16 (25%). Of total 80 impacted maxillary canines 19 (23.75%) were bucal impacted, 3 (2.75%) in the middle of alveolus and 58 (72.5%) palatally. With the bucal and palatal impaction usually was represented partially vertical impaction (70%); completely horizontal impaction (10%) was represented only in the palatal impaction. Conclusion: The analysis of CBCT images of maxilla shows a statistically significant frequency of partially vertical, unilateral and paltally localized impacted maxillary canines.
Sanja Simić, Jasna Pavlović, Vladanka Vukićević, Amila Vujačić
