Contents
01.12.2020.
Professional paper
The impact of neuropsychological assessment in epileptic focus localization
Introduction: Epilepsy that takes place in the temporal lobe is manifested through three symptoms: aura, temporal pseudoabsence and automatisms, while right-sided temporal lobe epilepsy had been also linked with visual or image learning and memory deficits. Case outline: Patient 24 years old in 2020. In July 2020 had complex partial seizures with an unordinary psychomotoric reactions and verbalization, followed by qualitative conscience change in the form of confusion and amnesia. Therapy with paroxetine showed no result. Neuropsychological evaluation showed no other cognitive deficit than severe visuoconstruction dyspraxia and discrete decrease in complex attention. In behavioral aspect prodromal symptoms of tension, anxiety and depression were occurred. Conclusion: Neuropsychological assessment is, along the magnetic resonance imaging and electroencephalographic, the most important method for indicating cognitive deficit in epilepsy and determining the epileptic focus.
Marina Malobabić, Boban Biševac, Vesna Stokanović
01.12.2020.
Professional paper
Respiratory epithelium: Place of entry and / or defense against SARS-CoV-2 virus
Coronavirus Disease (COVID-19) is caused by the RNA virus SARS-CoV-2. The primary receptor for the virus is most likely Angiotensin-converting enzyme 2 (ACE2), and the virus enters the body by infecting epithelial cells of the respiratory tract. Through the activation of Toll Like Receptors (TLRs), epithelial cells begin to synthesize various biologically active molecules. The pathophysiology of the COVID 19 is primarily attributed to the hyperactivation of host's immune system due to direct damage to the cells, with consequent release of proinflammatory substances, but also due to the activation of the innate immune response through the activation of alveolar macrophages and dendrite cells (DC). A strong proinflammatory reaction causes damage to alveolar epithelial cells and vascular endothelium. Respiratory epithelial cells, alveolar macrophages and DC are likely to be the most important cells involved in the innate immune response to the virus, since prolonged and excessive SARS-CoV-2-induced activation of these cells leads to the secretion of cytokines and chemokines that massively attract leukocytes and monocytes to the lungs and cause lung damage.
Snežana Leštarević, Slađana Savić, Leonida Vitković, Predrag Mandić, Milica Mijović, Mirjana Dejanović, Dragan Marjanović, Ivan Rančić, Milan Filipović
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
01.12.2020.
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
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
Dijabetesna ketoacidoza kod bolesnika sa cerebrovaskularnim insultom - uzroci, mehanizmi, dijagnostika i naše smernice za terapiju
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.
Aleksandar Jovanović, Vladan Perić, Snežana Marković-Jovanović, Tatjana Novaković, Slavica Pajović, Saša Sovtić, Srbislava Milinić
01.12.2020.
Professional paper
Intramedular fixation after breaking of the femoral plate
Any fracture of the femoral shaft presents a challenge to the orthopedic surgeon. Femoral fractures most often occur within polytrauma, by forces of high intensity as is the case with traffic accidents. There are two methods to treat with internal fracture fixation, intra and extra medullary fixation. Both treatments have their advantages and disadvantages and it is necessary to make a good preoperative plan. We present the case of a 23-year-old man who suffered a femoral shaft fracture as a driver in a car accident. He was initially surgically treated with orthopedic repositioning and internal, extramedullary fixation. After 18 months, bending of the osteosynthetic material and dislocation of the fragments with varus and recurvatum were verified. Oligotrophic pseudoarthrosis was also present. Reintervention and fixation with interlocking nail was performed. The weight bearing is allowed after two weeks. After 3 months, patient has full range of motion and there is no palpatory painful sensitivity. Intramedullary fixation is the method of choice for fractures of the femur, especially when there is no comminution and in cases of open fractures of the first and second degree. Rotation of fragments is locked, physical rehabilitation is faster and there is less risk of mal union.
Stefan Korica, Dejan Virijević, Ivana Glišović-Jovanović, Dejan Tabaković, Marko Kadija
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
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
