Conclusion about efficacious of some medication can be given based on reducing morbidity and mortality in patients treated with that medication.. Aim of this work was to estimate intrahospital mortality in patients with acute myocardial infarction (AMI), role of myocardial reinfarction in that and side effects of medications in patients who were different treated in initial phase of AMI, based on what they were separated in three different therapeutic groups: group treated with thrombolytic therapy, group treated with beta-blockers and group treated with nitrates. It was shown that intrahospital mortality is highest in patients treated with nitrates but there was not significant difference between thera-peutic groups in frequency of myocardial reinfarction while frequency of complications and side effects were in range as in others similar studies.

Background: Cardiovascular disease is the predominant cause of morbidity and mortality in hemodialysis patients. Left ventricular hypertrophy is a major cardiovascular risk factor in hemodialysis patients.The present study was aimed at assessing the prevalence of left ventricular hypertrophy by doppler echocardiography in hemodialysis patients. Methods: We studied 20 patients on maintenance hemodialysis in Dialysis Centre in Kosovska Mitrovioca. LV mass was measured by both Doppler echocardiography. Left ventricular mass was estimated by the modified formula using measure2 ments obtained in accordance with the Penn convention. Left ventricular mass was divided by body surface area in m to obtain the left ventricular mass index. Results:This clinical observation study involved 20 patients (9 males and 11 females) with end-stage renal diseases undergoing maintenance hemodialysis with a mean age of 55,26 years, mean time on dialysis was 38,74 months. Main causes for developing chronic renal failure was arterials hypertension and polycystic kidney. Arterial hypertension (60%), diabetes mellitus (20%) and hyperholesterolemia (10%), were the most frequent risk factors for cardiovascular disease among the dialysis patients. Left ventricular hypertrophy were detected in 14 (70%) patients. Mean left ventricular mass wass 153,62g/m2 (males), and 142,71 g/m2 (females). To conclude, the present study shows that hemodialysis patients have higher left ventricular mass and higher prevalence of left ventricular hypertrophy.

The most important characteristic of calcium channels is a selective regulation of a slow incoming current of calcium into the tissue cells with tendency of a slow growth of the action potential. Such tissues include smooth muscles of the blood vessels, cardiocities and hearth noduses (AVand SAnode). Different calcium antagonists have different influences on the mentioned tissues, because they also have different chemical components. Verapamil, Nifedipin and Diltiazem have the most common usage. Verapamil is a product of papaverine, nifedipin is a product of dehydroperidine while diltiazem is a product of benzodiazepine. Their common characteristic is blocking the calcium channels which cause blood vessels vasodilatation, negative inotropic and negative chronotropic influence. By blocking calcium to enter through channels spores of miofibrile smooth muscles, calcium antagonists are reducing the amount of available calcium for contraction, which causes vasodilatation. One of the best-known and the commonest calcium antagonist is verapamil. In electrophysiological terms, it inhibits action potential of the heart noduses (especially AV node), where the most important thing for depolarisation, is a slow entrance of calcium. By extending the refractory period of SA node, it reduces the frequency of impulse generation (heart frequency), while by extending the refractory period of AVnode, it slows down the work of chambers in cases of flater and atrium fibrillation. Taking into consideration the fact that verapamil shows cardiodepresive effects, the aim of our work is to study closely its effects on electrocardiogram and hemodynamic parameters. The experiment was conducted on six adult, healthy dogs which were, after 10 minutes 0,9% NaCl infusion, treated with i.v. bolus verapamil injections on every 5 minutes until the appearance of intoxication signs, which causes bradycardia, heart rhythm disorder and the fall of arterial blood pressure. The average verapamil dose was 4 mg per kilogram. After i.v. verapamil administration, heart frequency and middle arterial pressure have a significant fall, while central venous pressure has a significant rise. Larger verapamil doses nd rd can significantly extend T-P and P-R interval with the appearance of AV-block (2 and 3 grade), while the Q-T interval doesn't show any significant change.

The Early Warning Score is a simple physiological scoring system that can be calculated at the patient's bedside, using parameters which are mesured in the majority of unwell patients. Patients suffering in-hospital cardiac arrest often have abnormal clinical observations documented prior to the arrest. Study objestives:This study assesses wheather these patients have less favourable outcome following in-hospital cardiac arrest. Matherials and the methods:For the present study, the patients' hospital charts were reviewed to identify possible abnormal observations within 8 h prior to the arrest. Results: From the total of 100 patients who sufferd in-hospital cardiac arrest, 64 patients had documentation of vital signs and 9 patients had no documentation of vital signs. Of the patients with documented vital signs 27 (29,7%) had normal vital signs and 64 (70,3%) had abnormal observations. Among these 64 patients the distribution was as follows: 17 patients (13,1%) had respiatory rate below 8 or over 20 per min, 40 (30,8%) had puls rate below 40 or over 140 beats per min, 20 patients (15,4%) had systolic arterial blood pressure below 90 or over 200 mmHg, 5 (3,7%) had temperature (˚C) below 36,1 or over 37,9 ˚C, 20 (15,4%) had oxygen saturation below 90%, 14 (10,8%) had decrease in consciousness and 14 (10,8%) had urine output below 50 ml/2hours). Compared with patients whose EWS were 0-2 (ОR 1,2; 95% CI: 0,935-1,507) patients with EWS 3 or more were 6,5 times more likely to die in first 24 hours (OR: 7,8; 95% CI: 1,205-50,205). Conclusions:Patients with documented clinically abnormal observations prior to in-hospital cardiac arrest have a worse outcome than those without. The main implication of these is that these patients need to be identified in time thereby possibly avoiding arrest. This can also be used when assessing the prognosis of in-hospital patients after achieved ROSC.

Echinococcus is a zoonosis, parasitic disease, caused by echinococcus granulosus, E. multilocolaris, E. Vogeli and E. oligarthus. The most frequent at humans is a cystic form of the disease caused by E. granulosus, and rarely the alveolar one caused by E. multilocolaris seu alveolaris. It can affect all the organs and tissues. The most affected ones are: liver (70- 80%) and lungs (10-25%), while rarely, at 5% it can be found in spleen, kidneys, brain, heart, pancreas, mussels and skeleton. The only secure treatment of the primary echinococcosis is the surgical one. It should start immediately after the diagnosis is set in order to avoid complications which follow echinococcosis. Several surgical methods are used in practice for live echinococcus treatment: partial pericystectomia, total cystopericystectomia and liver resection. Aim of the work is to show the importance of the echinococcus cyst of liver and treatment methods. The patient presented in the work is Dj.G., female, register number of the disease history 355/14.05.2007., 61 years old, hospitalized at Surgical Clinic because of the surgery of echinococcus cyst on the left liver lobe. Diagnosis was set by abdomen USG, CT of the abdomen, and laboratory analyses. During the surgery, we found a big echinococcus cyst localized in the second and third segment of liver, so we did a liver resection as a bisegmetectomia with total ekstirpacija of the cyst. Postoperative flow passed normally and the patient
was on the eight postoperative day sent to further home care in a generally and locally good state.

Inhibins are glycoprotein hormones of which there are two molecular forms, inhibin A and inhibin B. Classically, inhibin is known to have a negative feedback effect on pituitary follicle-stimulating hormone secretion. The fetoplacental unit produced inhibin throughout pregnancy. Inhibin Ais the predominant molecular form of inhibin in maternal circulation from 4 week of gestation. Although the precise biological function of inhibin Ain pregnancy is unclear, it is evident from recent studies that inhibin A could be a better marker of placental function than human chorionic gonadotropin because of its shorter half-life. The possible clinical application for the measurement of inhibin Ain early pregnancy could be in predicting miscarriage , Down's syndrome, preeclampsia and fetal growth restriction in the first and/or second trimester before the onset of yhe clinical symptoms. Inaddition, several evidences underline the potential role and the clinical usefulness of their measurements in the diagnosis, prevention,prognosis and follow-up of different gestational pathologies such as:threatened abortion, placental tumors, hypertensive disorders of pregnancy,intrautherine growth restriction,fetal hypoxia.The measurement of inhibin Aand activin Ainto the biological fluids of pregnancy will offer in the future further possibilities in early diagnosis,prediction and monitoring pregnancy diseases.

L-carnitine is assorted with non-vitamin nutritives (metavitamines) on the grounds of importance to the living process, while itb similar to aminoacids in terms of structure. It has multistructural role in functioning of an organism while one of the most important and best investigated roles is the sphere of energizing metabolism because it is needed for the transport of the longchain fatty acids into the mitochondria where they are subject to a β oxidation. It has widespread clinical application in prevention and therapy of: genetic and secondarycarnithine deficiency, cardiovascular disease, lipid metabolism disorder, carbohydrate metabolism disorder, aciduria of organic acids, renal and liver insuficiency, neuropathy, miopathy, as well as the means for improvent of fitness capacites of sportsmen. L-carnitine is crucial part of organism of mamals, therefore it can be applied in relatively big doses whereby it requires no detoxication in liver, on the contrary, it significaty increases its detoxication capacites. Key words: L-carnitine, Physiology, Prevention , Therapy. L-carnitine is assorted with non-vitamin nutritives (metavitamines) on the grounds of importance to the living process, while itb similar to aminoacids in terms of structure. It has multistructural role in functioning of an organism while one of the most important and best investigated rol condarycarnithine deficiency, cardiovascular disease, lipid metabolism disorder, carbohydrate metabolism disorder, aciduria of organic acids, renal and liver insuficiency, neuropathy, miopathy, as well as the means for improvent of fitness capacites of sportsmen. L-carnitine is crucial part of organism of mamals, therefore it can be applied in relatively big doses whereby it requires no detoxication in liver, on the contrary, it significaty increases its detoxication capacites.

Migraine headaches are very frequent and its prevalence rates between 15-18% in women and 5-6% in men (1). Migraine attacks vary very mach in their intensity and frequency from patient to patient, and during the time in same patient. Even 75% of the patients describe attacks as heavy or extremely heavy. Although somatic and neurology exams between attacks reveal regular findings, migraine can have great impact on the patients quality of life (social limitations, complications caused by drugs, psychiatric and somatic morbidity (2) In spite usual believes headaches are very often in children. Before puberty boys safer more frequently than girls. Just the same, in early childhood as well as in adolescence migraine pain could mimic and compromise bringing up the right diagnosis of the other possible somatic causes, most likely one sided headaches. Our case presentation points out one of the possibilities. L.M 15-years old patient hospitalized on the pediatric department of the ,,Kralj Milutin Clinic,, in Laplje Selo on October 2007, under the diagnosis of blanking out and left sided headache. After neurology exam and neurology diagnostic procedures done MR cerebra and MR-angiography, diagnose of aneurism of right the ACM (arteria cerebra media) has been established, and operatively treated. After the intervention, patient stays without intensive headaches , only weak pain on the left side of the head, now and on, without blanks.

Fracture of orbital floor is relatively frequenthly injuries. Fractures can appear same in war or peacefull conditions. War injuries can be bursting, and in many cases is very hard, with fracture, dislocation and defect more of orbit walls. Peacefulls injuries orbital floor appear mostly in car exident, fight, fall on face, and also in sports activity. Regarding specific anatomic structure, sensitive position and content of orbital cavity, even today exists different opinion especially by question of mechanism of originate, same as question of injury treatment.

Many researchers and clinical doctors have realized that spirometric tests, as well as the resistance of airways, could be within the normal limits at people who have clear signs of bronchitis (coughing, expectoration and lighter disphnoe). Very often, especially among smokers, they have found discrepancy between the functional tests' results and clinical symptoms, although they could expect to find minor lungs' diseases within this group of people. Obstructive lesions in small airways are very often present at smokers older than 40 years, whose lungs are macroscopically normal, and who do not show clinical signs of the obstructive lung disease ('asymptomatic smokers'). The aim of the paper was to find which test, among the most often-used tests for the functional research of the respiratory system, represented the best indicator of the initial obstructive changes localized in small airways. The research study included 50 asymptomatic smokers (34 male and 16 female) ranging from 44 to 57 years. The results of the achieved FVC were at normal level, at all examinees. Out of 50 examinees, asymptomatic smokers, there was one examinee (2%) with the lower level of FEV , while at two examinees 1 (4%) lower levels of SRt and MEF were found. Significantly lower levels of the measured MEF were found among 50%FVC 25%FVC 16 asymptomatic smokers (32%). Such a functional result, i.e. a decrease of MEF while the levels of FVC, FEV , Rt, 25%FVC 1 SRt and MEF are normal, accompanied by a long-lasting smoking case-history with less expressed symptoms, points at 50%FVC the existence of the obstructive disorders localized in the periphery parts of the bronchial tree (small airways). The registration of the flow/volume curve and its analysis might be used as a test even more sensitive than spirometry and body pletizmografy; as a test it can be used for a diagnosis of initial obstructive difficulties in small airways, in other words, it could diagnose the small airways disease.