Introduction: The study of importance of left ventricular contractile reserve presence and changes plasma brain natriuretic peptide levels (BNP) during exercise in patinets with idiopathic dilated cardiomyopathy is very popular today, but these two parametres have rarely been interconnected. The study of response BNP during echocardiography stress tests in patients with idiopathic dilated cardiomyopathy with or without preserved left ventricular contractile reserve. We studied 55 consecutive patients with idiopathic dilated cardiomyopathy (mean age 54.98 ± 9.84, 49 (89.1%) male) treated in the outpatient clinic for heart failure at the Institute of Cardiovascular Diseases "Dedinje". All the patients underwent the echocardiography stress test. Contractile reserve was assessed by measuring of the changes of the left ventricle ejection fraction basally and in the first minute after the strongest stress. Level of BPN was measured at rest, in the first minute and after 20 minutes of maximal exercise stress. Following the kinetics of BNP level during stress testing, we find that in patients with preserved left ventricular contractile reserve BNP level is rising at maximum load achieved (Mediana (IQR) - 59 (22-113) vs. 91 (37-135) vs. 78 (30-159) ng/L, p<0.001), whereas in patients without preserved left ventricular contractile reserve BNP level does not change significantly (Mediana (IQR) – 89 (50-322) vs. 119.5 (61.3-321.8) vs. 136 (72- 281), p=0.102). The increase in BNP in the peak load compared to its value at rest was positively correlated with preserved contractile reserve (r=0.38, p=0.009), better WMSI at rest (r=-0.28, p=0.04), greater difference in the double product (r=0.40, p=0.002), as well as the work accomplished on the test (r = 0.47, p <0.001), and longer duration of the test (r = 0.43, p = 0.001). The increase in BNP during physical exercise in patients with idiopathic dilated cardiomyopathy suggests a preserved contractile reserve of the left ventricle.

Determination of direction of car impact on pedestrian is complex interdisciplinary biomechanical analysis, which sintetize the work of legal medicine and traffic engineering professions. Injury characteristics depends on constitution and position of pedestrian, and type of passenger car. There are different mechanisms of injury arising from sum of effect of complex mechanical forces, from motion and impact on human body. Results are showing that new generation car, with aerodinamic wedge front, favorize occurrence of hyperextensive injuries, while speed presents dominant factor of intensity of injuries. In modern traffic conditions, we found multiple reduction of number of deaths of pedestrians in road traffic accidents.

Introduction: Psychogenic non-epileptic seizures represent a paroxysmal event followed by a sudden change of behavior, cognition or consciousness, mostly of short duration, which resemble or can be understood as epileptic seizures. They occur in persons without epilepsy and in patients with epilepsy. They are not associated with abnormal EEG discharges because their cause is a psychic disorder. Case report: A 20-year-old patient has been suffering of occasional “morning short-lasting jerking hand movements, staring and fainting” since the age of 14 years. Beside a symptomatic anamnesis for epilepsy and non-specifically changed standard EEG, antiepileptic therapy (valproate and lamotrigine) was introduced. Because of non-response to antiepileptic therapy, the patient was forwarded for further clinical examination involving video EEG telemetry, which indicated that this was a case of psychogenic non-epileptic seizures. A successive withdrawal of antiepileptic drugs was initiated, and also, a psychologist and psychiatrist were included into treatment, which resulted in the reduction of seizures and improvement of the patient's general condition. Conclusion: Psychogenic non-epileptic seizures represent a frequent diagnostic problem requiring team's work, while the video EEG telemetry is the method of choice for diagnosis.

The most important characteristic of calcium channels is selective regulation of slow incoming stream of calcium into the cell tissue providing the slow increasement of action potential. Such tissues include smooth muscles of blood vessels, cardiocytes and heart noduses (AV and SA node). Different calcuim antagonists have different effects on previous tissues due to their different chemical formula. Verapamile, Nifedipin and Diltiazem are the most frequently used of all. Their commonest characteristic is blocking the calcium channels causing vasodilatation of blood vessels as well as negative inotropic and chronotropic influence. By blocking the incoming calcium through slow channels of myofibrils of smooth muscles, the antagonists of calcium decrease the quantity of available calcium for contraction which causes vasodilatation. The most famous and most frequently used calcium antagonist is Verapamile. In terms of electrophysiology, Verapamile inhibits action potentials of heart noduses, especially the AV node, where the slow incoming of calcium is the most important for depolarization. Prolongation of the efective refractory period of SA node causes the heart frequency decreasement while prolongation of the effective refractory period of AV node slows down the work of chambers in case of flater and fibrillation of atriums. The molecules of calcium-bonding protein called kalmodulin are located in synaptic endings. Each kalmodulin can bond four calcium ions providing transfer into active calcium-kalmodulin complex which activates the kinase protein. Activated kinase protein starts the exocytosis of neurotransmitters into synaptic gap. Apart from activating kinase protein, calciumkalmodulin complex also starts the activity of calcium pump presynaptic membrane which pumps calcium out of presynaptic ending stopping the further exocytosis of neurotransmitters into synaptic gap. Taking into consideration the fact that opening the calcium channels on membrane of presynaptic ending is necessary to free the neurotransmitter out of the vesicle, the aim of our work is to study whether Verapamile has effects on the membrane of presynaptic endings of sympathetic nervous system checking the level of catecholamine in serum. The experiment was conducted in 6 healthy dogs which were, after 10-minute- infusion (0.9% NaCl), treated with intravenous bolus veramapile injections in three occasions, in every 5 minutes, until the first signs of intoxication had appeared. This caused bradycardia, heart rhythm disorder and blood pressure drop. In order to determine the level of catecholamine, blood was taken sequentially, in every 5 minutes, before the new dose of verapamile was given. Verapamile (given intravenous) significantly decreases the concentration of adrenaline and noradrenaline in the serum of dogs.

The mos Tooth whitening is a procedure that removes stains and various discolorations of tooth surface. Discoloration of teeth may be endogenous and exogenous nature. The aim of this study was to investigate the impact of bleaching combined with daily use of drinks that cause tooth discoloration. Evaluated the changes in surface structure of enamel, and changes in hardness after bleaching. Were 20 extracted teeth. The teeth are marked with longitudinal lines halves (medial vestibular and distal surfaces). Tretitana mesial half of the 16% carbamide peroxide, a distal was left as control. NDT device HL400DL, duroskopskom method of enamel hardness was measured before treatment, after treatment and after remineralization. Olympus inverted microscope GX41 enamel structures were observed in the treated and control half of the tooth. After bleaching there is a difference compared to the untreated surface, that surface is bleached a few shades lighter, but after the use of coffee and soft drinks teeth back to the original dark color. Enamel microhardness after the treatment is somewhat small but not significant. With a magnification of 2000x and see the structural changes in enamel. Tooth whitening, but that the remineralization and the abstinence from prebojenih beverages and tobacco.

Senna (Cassia angustifolia Vahl.) is used in food and pharmaceutical technologies as officinal drugs and natural laxative. The aim of the study was to investigate the effect of toluene and methanol Senna extracts on the viability and proliferation of HeLa cells. The senna leaves were extracted in Soxhlet's extractor and obtained toluene and methanolic extracts were used for determination of effects on viability and proliferation. Cytotoxic effect of different concentrations (0.1%, 0.01%, 0.001% and 0.0001%) extracts was investigated in HeLa cells in vitro. MTT test showed significant cytotoxic activity for toluene extract, especially the concentration of 0.1%, while the tested concentrations metanolic extract did not show cytotoxic activity.

Trachoma is keratoconjunctivitis caused by ocular infection with Chlamydia trachomatis. Endemic trachoma is caused by serovars A, B, Ba and C. Trachoma is probably the third most common cause of blindness worldwide, after cataracta and glaucoma. Active trachoma affects an estimated 84 million people; another 7.6 million have end-stage disease, of which about 1.3 million are blind. Most trachoma programmes use the WHO simplified grading system, by presence or absence of five clinical signs. The World Health Organization is leading a global effort to eliminate blinding trachoma by the year 2020, through the implementation of the SAFE strategy. This involves surgery for trichiasis (S-surgery), antibiotics for infection (A-antibiotic), facial cleanliness (F-face) and environmental improvements to reduce transmission of the organism (Eeducation). Tratment for trachoma includes local and systemic administration of appropriate antibiotics. Surgical correction of trachomatous trichiasis reduces the risk of progressive corneal opacification and blindness.

Introduction: In adults the diagnosis of acute pyelonephritis and glomerulonephritis is primarily based on clinical and laboratory-biochemical testing. In patients where the clinical picture atypical, even if a person does not respond to therapy resorts to radiographic examination. Echotomographic examination is unavoidable in the diagnostic algorithm. Objective: The aim of this study was to establish the individual echotomographic parameters, as well as to determine their diagnostic power in patients with acute infections (pyelonephritis and glomerulonephritis), and comparing them with the appropriate reference tests. Materials and methods: We performed a cross sectional study in the period from October 2014. until May 2015. It included 50 patients with acute inflammation of the kidney which was made echotomographic examination of the abdomen and pelvis, within the Department of Radiological Diagnostics KBC "Dragisa Mišović-Dedinje" in Belgrade. The echotomographic examination of the kidneys included testing of numerous parameters that could indicate the existence of an acute inflammation of the kidney. For the gold standard, we take the findings obtained by CT (computed tomography) imaging of the abdomen and pelvis, as well as histopathological findings obtained by fine needle bio-psy. Results: At 50 patients with acute inflammation of the upper urinary tract, 41 patients (82%) had acute pyelonephritis, and 9 (18%) had acute glomerulonephritis. In 70% of patients with acute pyelonephritis (29 people) were present enlargement of the kidney where the test sensitivity was 79.3% and specificity of 91.7%. The accuracy of the method was 82.9% when the monitored parameters: loss of central echo complex and cortico-medullary differentiation. The sensitivity of the test in which the observed thickening of the pelvic and ureteric wall was 65% and specificity of 90%. The analysis of the presence of calculus in renal parenchyma leads to the values of sensitivity test of 54.8% and specificity of 80%. Hypoechoic focus in the renal parenchyma, enlargement of the kidneys and loss corticomedullar limits are parameters who with great sensitivity and specificity suggest acute glomerulonephritis. Conclusion: On the basis of high values of sensitivity and specificity of the test survey estimates that ultrasound has a required place in the following diagnostics algorithm. The use of echotomography that offer the possibility of high resolutive views, as well as the wide availability and good reproducibility of the method, the low cost of inspection, in favor of the first exploration ultrasound examination. Multidetector CT scan and fine needle biopsy remains the method of choice for the definitive diagnosis.

Acute appendicitis is the most common surgical disease in the pathology of the population. Incidence in the general population is 6%. In the period from 15.01.2002 to 08.16.2014 as any 627 appendix which je12,4% of the 5055 total patients. Prevalent patients males 55.5% compared to 44.5% female. According to the age of the children present in 393 (68.47%) and 181 adults (31.53%). The greatest incidence is in children aged age group of 15-20 years, 131 (23.06%). In the adult group the highest incidence is represented in the third decade of 21-30 years, with 77 (13.4%). The most common disease of acute appendicitis is in the second decade of the 258 cases (44.9%). Intraoperative pathomorphologically highest incidence wearing Appendicitis phlegmonosa with 317 (52.1%). Peritonitis acuta is the most common complication of severe forms of appendicitis acuta 231 (71.96%). Anterograde apendectomia was performed in 532 (87.5%) patients and retrograde in 76 (12.5%). Abdominal drainage procedures were performed in 145 (23.85%) patients. Postoperative complications 6 (4.68%). Surgical wound infection 4. Fistula appendicularis 1 (3.12%). Mortality 1 (0.16%).

Introduction: Toxoplasma gondii is one of the causative agents from the groups of TORCH infections, which are commonly associated with congenital anomalies. Objective: Defining risk factors for infection byToxoplasma gondii of women in reproductive ages in the territory of Kosovska Mitrovica, as well as determination of seroprevalence of infection by Toxoplasma gondii in prenatal screening of pregnant women and women of childbearing age. Materials and Methods: Across sectional study that included 49, pregnant women and women of childbearing age has been conducted. The pregnant women have been monitored on regularly base, or some women have been treated in the Gynecology and Obstetrics Department of the Health Center in Kosovska Mitrovica. Ages, place of residence, education, gynecological history and exposure to the potential risk factors associated with Toxoplasma have been collected by questionnaires. Sera have been tested on the presence of IgM and IgG antibodies to Toxoplasma gondi by ELISA standard manufacturer's protocol (Euroimmun, Luebeck, Germany). Results: Our study shows that 32 (65.3%) women were seronegative, while 17 women (34.7%) were seropositive. Significant seropositivity has been recorded for the women who were in contact with the ground (42.9%), compared to the women who did not have this contact (23.8%). Uses of undercooked meat in the diet did not show any effect to the seropositive status of the respondents, i.e. greater percentage of analyzed patients (75.5%) used inadequately cooked meat. Even 93.3% of respondents deny contact with a cat. It is observed that seropositivity increased with the age. Conclusion: Seroprevalence to Toxoplasma gondii infection of women of childbearing in the territory of northern Kosovska Mitrovica is not high, which implied that there is a higher possibility for acquiring primary toxoplasmosis infection during pregnancy especially for women who come in contact with the ground