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.

Prostate cancer (CP) is the most common malignancy in men in America, while it is the second most common in Europe. It is responsible for about 10% of cancer deaths in the same population. It is clinically manifested in various forms, from slow-growing to aggressive forms with pronounced metastatic potential. Diagnosis is made by a well-defined algorithm, which begins with the determination of serum prostate specific antigen values and ends with prostate biopsy as the "gold standard". Pathohistological diagnostic criterias are based on architectural, cytoplasmic, nuclear and characteristics of intraluminal structures, as well as periacinar cleftings, which are deffined as helpfull diagnostic criteria of undoubted importance. Prognostic and predictive parameters are classified into three categories. Some of them are an integral part of routine pathohistologicat report, while others are considered as the diagnostic process progresses. Modern knowledge introduces biomarkers into the everyday practice of personalized medicine, especially when is necessary to treat prostate cancer patients.

Introduction: Health education, as one of the important aspects of preventive dentistry, plays an important role in promoting good oral health. The aim of this study was to determine and define the influence of parents' knowledge about the effects of oral hygiene, proper nutrition and fluoride prophylaxis on oral heath in early childhood. Methods: The survey was conducted in four pedagogical-education institution on Kosovo and Metohia, Serbia. The study included 403 parents of children, aged between 3-6 years. Parents were asked to fill a questionnaire about oral hygiene, nutrition and fluoride prophylaxis. Results: Parents from urban (64.8%) and parents from rural (63.5%) areas were informed that the teeth should be brushed at least twice a day. Only 3.4% parents from urban and 3% parents from rural were informed how often should a child toothbrush be changed. Awareness about nutrition showed that parents from rural areas were better informed than parents from urban areas. Parents from urban (31.4%) and rural (31.7%) areas belived that tooth decay may be caused by prolonged breastfeeding. Awareness about fluoride prophylaxis in preventive and pediatric dentistry was poor. Conclusion: The study showed that parents knowledge about the impact of oral hygiene, nutrition and fluoride on the oral health in early childhood is not good.

Introduction. Jarisch-Herxheimer reaction implies trembling, headache, temperature, rash, meningitis, respiratory problems, liver, kidney and heart dysfunction during antibiotic treatment of Lyme disease. Case outline. A 47-year-old patient in May 2016 had circular redness on the thigh, fatigue, myalgia, nausea and headache. Borrelia Burgdorferi IgM antibodies were positive. She took doxycycline 200 mg/day, four weeks. Western blot IgM and IgG were positive as well. Retreated with Azithromycin, 500 mg/day, three weeks. Next year, there was a sleep and memory disorder, fatigue, dizziness, right leg paresthesia and burning in the soles, muscle weakness, decreased sensitivity and right foot hyperreflexia. Electromyography showed axonal degeneration of the peroneus and the tibialis. Pleocytosis (5 leucocytes/mm³) and intrathecal IgG were found. Magnetic resonance of the head in order. Neuroborreliosis was diagnosed and treatment included ceftriaxone, 2 grams/day, three weeks. After the second dose, trembling, myalgia, headache, nausea, flushed nose, dizziness and nausea started. Temperature 37.8°C. No changes on the skin. The antibiotic was not interrupted, symptomatic therapy was administered, and after two days the symptoms stopped. Neurological disorders have not completely disappeared. Titre antibodies still present. Conclusion. Jarisch-Herxheimer reaction occurs in 7.0-30.0% of patients treated for Lyme disease. Causes are multifactorial. Spirochetes release toxins, hypersensitivity is present, phagocytes destroy agents, complements and cytokines are activated. It is often not recognized. Tremor, fever, myalgia and skin rashes are present before the antibiotic, and the worsening is attributed to the underlying disease or allergy. Doctors should expect it during the treatment of spirochete-related diseases and provide appropriate care.