Contents
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
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
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
01.12.2019.
Professional paper
Mehanizam kontrakcije i relaksacije miometrijuma, interakcija okcitocina i prostaglandina
Regulation of uterine activity during pregnancy is due to the nature of the loss of humoral sympathetic, holinergical and peptidergic inervation. So far, nothing found that would indicated that the mechanism of premature birth and its pathogenesis different from the normal mechanism of delivery, except for different maturity of the fetus. Since a large number of substances that participate in the contraction and relaxation of miometrium (estrogen, progesterone, cortisol, etc.). Today's modern research has focused on prostaglandins and oxytocin, or their interaction. Accepting oxytocin as substance initiation deliveries it is difficult for two reasons: the level of oxytocin in the blood can not lift before the delivery and release of oxytocin remains constant during pregnancy. Oxytocin probably plays a role in support delivery for decidual cells stimulates the synthesis of uterine PGF2a.
Goran Relić, Vujadin Mujović, Nenad Šulović, Slaviša Minić
01.12.2019.
Professional paper
Frequency and histological-cytological correlation of premalignant and malignant changes in the cervix in women of different ages
Introduction: Cervical cancer is the fourth most common and accounts for about 6.6% of all cancers in women. Aim: The aim was to determine the frequency of premalignant and malignant changes in the cervix, to examine the histological-cytological correlation of premalignant and malignant changes in the cervix and the correlation of the women's age with the stage of cervical disease. Material and Methods: A retrospective study analyzed 186 cervical biopsy specimens and cervical smears (Papanicolau test) at the Institute of Pathology of the Faculty of Medicine in Pristina, based in Kosovska Mitrovica, over a three-year period from 2016 to 2018. Results: Of the 186 subjects, 62 had mild premalignant changes of type LSIL, 22 HSIL, and as many as 20 (10.75%) cervical cancer. There was a statistically significant positive association between histological and cytological findings (r = 0.854; p <0.001). There was a statistically significant difference in the age of the subjects with regard to histological findings (F = 11,327; p <0.001). Subjects with HSIL were significantly older than those diagnosed with cervicitis chronica (p = 0.029). Subjects diagnosed with planocellular carcinoma were significantly older than women with cervicitis chronica (p <0.001) and LSIL (p <0.001). Conclusion: There is an increasing trend of cervical cancer in Northern Kosovo and in the Serbian enclaves in central Kosovo and Metohija. Subjects with cervical cancer were significantly older than subjects with mild premalignant cervical changes. There is a significant histologic-cytological correlation of cervical findings, so we believe that more massive cervical screening, especially in younger women, could reduce the incidence of premalignant and malignant diseases of the cervix.
Dejan Mihajlović, Zoran Bukumirić, Nenad Šulović, Goran Relić, Slaviša Stanišić, Saša Cvetković, Momir Dunjić, Tanja Mirković, Milica Milentijević, Novica Đoković, Mirjana Stojanović-Tasić
01.12.2019.
Professional paper
The frequency of bucal and palatal impaction maxillary canines
Introduction: Maxillary canines are usually impacted teeth the second after third molar. Frequency of impacted maxillary canines is about 1 to 3% of population (in 85% of the cases palataly, and in 15% of the cases bucaly). The aim of this research was to find the frequency of bucal and palatal impacted maxillary canines in relation to sex and position of impacted tooth. Matherial and method: We analyzed three-dimensional computed tomography images (CBCT) of 64 examinees (aged 12 to 33 years) with 80 unerupted maxillary canines to plan the orthodontic therapy. Results: Among 64 examines with impactions, 80 impacted maxillary canines are diagnosed. The average age of all respondents in the survey is 16,3±4,3. Of 64 examinees in research 41(64.1%) were female which is significantly more important than the representation of male examinees whose number was 23(35.9%). Frequency of unilateral impactions of maxillary canines is three times higher 48 (75%) in comparison to bilateral impactions 16 (25%). Of total 80 impacted maxillary canines 19 (23.75%) were bucal impacted, 3 (2.75%) in the middle of alveolus and 58 (72.5%) palatally. With the bucal and palatal impaction usually was represented partially vertical impaction (70%); completely horizontal impaction (10%) was represented only in the palatal impaction. Conclusion: The analysis of CBCT images of maxilla shows a statistically significant frequency of partially vertical, unilateral and paltally localized impacted maxillary canines.
Sanja Simić, Jasna Pavlović, Vladanka Vukićević, Amila Vujačić