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.

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.

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.

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.

Although cerebrovascular disease may be a well recognised trigger for diabetic ketoacidosis (DKA), literature data on the precise mechanisms, characteristics, or treatment guidelines are rare. The risk of developing an ischemic stroke is doubled in adults with diabetes compared to people with normal glucose metabolism. It is important to point out that even children with DKA have a significantly increased risk of cerebrovascular insult and that they can have a stroke with a frequency of about 10%. Given the significant overlap of symptoms between these two diseases, it can be assumed that attributing DKA symptoms as a manifestation of stroke is not uncommon, especially in elderly and less communicative patients. In addition, pH, bicarbonate concentration, and anion gap are not routinely measured in all diabetics suffering from stroke, at least not in secondary health institutions.Children who develop cerebrovascular stroke during DKA often at the beginning have a preserved consciousness or only mild confusion or lethargy. After a few hours, with the institution of therapy, however, loss of consciousness may occur accompanied by signs of increased intracranial pressure. It was previously thought that the cause was too fast fluid replacement. Recent data suggest that reperfusion injury may be a more likely mechanism. Although most of these studies relate to younger individuals with ketoacidosis, it is clear that at least some of them may be operative in adult DKA. Literature therapeutic guidelines for adult diabetics with stroke-related diabetic ketoacidosis are almost lacking, although it is clear that they could not be the same as those utilised in population with normal glucose metabolism. In this paper, we have tried to define our treatment guidelines for these particular patients.

The variety of etiological factors contributing to the development of distal bite various form, as well as the structures that are affected by the disorders determine the deegre of complexity of the malocclusion itself, and thus the choice of therapeutic procedure by which it will be treated. An 11-year-old female patient was diagnosed with this type of malocclusion with a certain degree of presence of other irregularities. After a detailed diagnostic procedure, and determining the type of growth, we approach the therapeutic procedure in two phases. By applying the funcional therapy in the first phase, we correct the vertical growth type, and then in the second phase of therapy using a fixed technique we achieve harmonious intermaxillary relations, an adequate molar and canine Class I relationship as well, thus improving the aesthetics of the patient's face.

Introduction: Cardiovascular diseases (CVD) are leading factor in global mortality and morbidity. It is the cause of 1/3 of total annual mortality, while coronary heart disease (CHD), as one of the CVD entities, is responsible for 85% of deaths worldwide. The aim of the study is to show the importance of the first phase of cardiac rehabilitation (CR) in patients who are going on cardiac surgery, as well as the impact on respiratory function, the occurrence of pulmonary complications and the length of hospitalization. Methods: A sample of 18 patients was included in the randomized observer study. First phase of CR was carried out according to a predefined protocol. We used arterial blood gases (ABG) to evaluate the respiratory function, "two-minute walk test" (2MWT) to assess the functional capacity Data taken from medical documentation are the duration of mechanical ventilation (MV), the length of stay in the ICU, occurrence of the postoperative pulmonary complications and duration of total hospitalization. Results: The test sample consisted of 12 men (60.58 ± 8.33) and 6 women (66.00 ± 6.51). The mean value of CR was 6.15 ± 3.98 days and MV 19,67±11,23 hours. There were no pulmonary complications in 61,11% patients. Using ABG, a statistically significant difference was found in PO2 after extubating and at the last day in ICU (p = 0.01). 2MWT preoperatively significantly correlated with the examined on the last day of hospitalization (r = 0.648 p-value <0.001) well as the length of postoperative hospitalization and duration of mechanical ventilation (r = 0.708 p-value <0.001). Conclusion: The study showed that first phase of cardiac rehabilitation may positively affect the improvement of functional capacity.

Introduction: The most common causes of renal artery disease are stenosis, as a consequence of atherosclerosis and fibromuscular dysplasia. Computed tomographic (CT) angiography is a non-invasive method, which enables visualization of vascular structures and walls of blood vessels, as well as morphology of the renal parenchyma. Objective: To determine the importance of CT angiography in detecting the cause and degree of renal arterial disease. Methods: A total of 45 patients were included in the cross-sectional study conducted from March 2017 to March 2019 in the KBC DR Dragiša Mišović-Dedinje, Belgrade, Serbia. Criteria for inclusion were suspicion of secondary arterial hypertension, patients in preparation for kidney transplantation and in the follow-up period after transplantation, as well as patients with suspected traumatic lesions. We analyzed the causes of the disease, the morphology of the blood vessel wall, the percentage of stenosis, and the renal parenchyma. Results: The most common causes of renal arterial disease are atherosclerosis, which was found in 33 (73%) patients, renal artery aneurysm was found in 5 (11%) subjects, fibromuscular dysplasia in 4 (8.9%) and trauma in 1 (2) , 3%) of the patient. There were 10 (22.2%) patients with a significant (average 80 ± 14.5%) degree of stenosis. The sensitivity of CT angiography in the detection of atherosclerotic changes in the renal arteries was 87.9%, while the sensitivity of CT angiography in the detection of fibromuscular dysplasia was 75%. A statistically significant correlation was found between atherosclerotic stenosis of the renal arteries and a positive CTA finding (p = 0.0002). Conclusion: CT angiography is an important method of visualization and quantification of pathological changes in the renal arteries.

The new pandemic, caused by the corona viral disease 2019 (Covid-19), has brought with it a series of restrictive measures that have drastically altered people's way of life and which restrict freedom of movement, behavior and social engagement. At the time of pandemia, almost all aspects of each individual lifestyle have been impaired, especially in members of vulnerable groups, particularly women in postpartum women. Acute psychological reactions to a pandemia may include insomnia, fear of infection, anxiety, frustration, panic attacks, loneliness, but also depressive episodes. Non-psychotic postpartum mood and anxiety disorders can occur as an inability to adapt to stressful life situations. A comprehensive understanding of the impact of the pandemia on the mental health of women in the postpartum period is needed, in order to devise adequate approaches to recovery from such a major disaster as the Covid-19 pandemic.

Introduction: Postpartum depression negatively affects a woman's quality of life and the development of a relationship with her child, which can have far-reaching consequences on the cognitive, behavioral and emotional development of the child. Etiology includes genetic predisposition, sudden hormonal changes, and sociodemographic factors. Case report: A 28-year-old patient, married, mother of a one-month-old boy. She graduated from the High school of economics, unemployed. She appears in the family medicine clinic due to chronic fatigue and bad mood, at the insistence of her husband, who thinks that she needs professional help. She grew up in a harmonious family. He gets along well with his wife, there are no existential problems. It denies previous illnesses. Neat appearance, inconspicuous posture and behavior, psychomotor diskette slowed down, more sparse spontaneous verbalization, slightly compromised volitional instinctual dynamisms, lowered basic mood. In the laboratory findings, hypothyroidism with elevated thyroid peroxidase antibody and antithyreoglobulin antibodies is detected. The thyroid ultrasound verifies the right lobe of 46x14x15mm, the left lobe of 48x13x12mm, inhomogeneous and easily hypoechoic structure. The Edinburgh Postnatal Depression Scale indicates the presence of depression (total score 18). The patient is referred for a consultative examination by a psychiatrist and a nuclear medicine specialist. Psychiatrist indicates the introduction of Sertralin 50 mg tablets (1x1/2 for the first seven days, then 1x1) and Bromasepam tablets 1,5 mg (2x1/2), nuclear specialist Levotiroskin sodium tablets 50 mcg (1x1/2 for 5 days and 1x1 for 2 days). After six months, withdrawal of the symptoms of the disease and exclusion of therapy by a psychiatrist. Conclusion: Autoimmune thyroid disease is a significant and often unrecognized cause of postpartum depression. Early detection and timely therapeutic intervention of these have a significant role in the prevention and successful treatment of postpartum depression.