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.

Fear of falling (FOF) is a significant health problem that can be present in the elderly, both in those that had experienced falling and in those that hadn`t. The aim of the study was to establish correlation of FOF with the following characteristics of the participants: sex, age, education, marital status and the number of falls in the previous year. Performed from October to December 2014, the research included 100 participants from general population older than 65 and covered by health visiting service of Dom Zdravlja Nis. The questionnaire for assessment of FOF - Falls Efficacy Scale (FES) and the epidemiological questionnaire were used in all participants. We established that there is statistically significant difference of FES values (hi-kvadrat=7.668, p<0.05) between different age groups. It was found that median value of FES questionnaire is statistically significantly higher in participants living as singles in relation to those living in a community (U=828.0, p<0.05). There is satistically significant medium correlation between FES values and the number of falls in the previous year (r=0.661, p<0.01). This research established that FOF is associated with age and the number of falls in the previous year, that implies the need for prevention of FOF, especially in elder people and in people that experienced one or more falls. Implementation of prevention is also important in people living alone because FOF is excessive in their case.

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.

Quality of life (QoL) is used in the natural and social sciences as a relatively new category which deserves more attention in research. Quality of life related to health is a term commonly used when QoL on health. An increasing number of research studies that are based on an examination of the QoL. This paper analyzes the concept of the QoL, the possibilities of measuring the QoL, a special emphasis is placed on measuring QoL in dermatovenereology. Given that the skin disease are of particular significance for the patient, the said indices are dermatologically quality of life, especially the quality of life of patients dermatological (DLQI).

During the armed conflict in Kosovo and Metohija, and after it, were killed more than 5 000 people, and according to the International Red Cross Committee in March 2001, 3,338 people were still missing. Until the conclusion of this study, the number of missing persons in Kosovo and Metohia for which the trail is about 1700. This list includes people from all ethnic communities. The primary objective of the forensic investigation is to determine the identity of the missing persons and after that their remains returne to the families, in accordance with Geneva protocols. Experts post-mortem examination after the exhumation determine the cause and manner of death, which indicates a violation of human rights and war crimes.Conclusion. We are facing with reasonable fear that with the passage of time, less interest will be devoted to this issue and the activities on finding and identifying missing persons will completely stop.

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: 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

Necrotizing otitis externa, also known as malignant type of the inflammatory process, represents an infection of the skin of external hearing canal, a fast development of tissue necrosis and infection spreading to the surrounding structures. Basic clinical characteristics are: strong earache, leaking from ear, granulation findings at the bottom of the hearing canal, the disorder of hearing function and a potential possibility of complications (paralysis of facial nerve, intracranial infections). Mycrobiologically the most present bacerium is Pseudomonas aeruginosa. Other microorganisms that can be isolated are Aspergillus species, Staphylococcus aureus, Proteus mirabilis, Klebsiella oxytoca, Candida parapsilosis. The disease is more common in patients with general diseases, mostly of metabolic nature (diabetes mellitus). The approach to diagnosis and therapy is usually urgent in order to prevent the development of serious complications. This paper shows the results of the analysis of clinical process of malignant otitis in 25 patients from the Clinic of ORL and MFS KCS according to the type of the cause and the development of potentially severe and life threatening complications.

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.