Considering its importance in cell replication and differentiation, programmed cell death, DNA transcription, function of hormones, biological membranes and immunological system, zinc probably has a major role in enabling a proper
function of different tissues, organs and organic system in general. As an essential micronutrient wich is directly involved in metabolizm of insulin, zinc play important role in pathogenesis of diabetes mellitus and its complications. On the other hand, low zinc absorption and hyperzincuria in diabetic animals and humans have indicated that diabetics are more susceptibile to zinc deficiency compared to healthy persons. Inasmuch as zinc plays an important role in syntesis, storage and secretion of insulin as well as conformational integrity of insulin in the hexameric form, zinc deficiency may adversely affect the ability of the islet Numerous studies suggested that urinary zinc excretion was higher in diabetes mellitus, probably as result of hyperglycemia. In contribution, there are findings about correlation between urinary zinc excretion and blood glycosylated hemoglobin (HbA1c) levels in non-insulin dependent diabetic patients. Recent experimental investigations showed that zinc supplementation inhibited NF-kB activation in the pancreas and decreased the expression of inducibile nitric oxide synthase, a downstream target gene of NF-kB. The ability of zinc to modulate NF-kB activation in the diabetogenic pathway may be the key mechanism for zinc's protective effect and important criterion for choosing nutritional strategies for diabetes mellitus prevention.

Diabetes is the most common cause of end-stage renal disease .in United States , Europa and Japan. Approximately 40% of patients with type 1 diabetes and 5-15% of patients with type 2 diabetes eventually develop end-stage renal disease. Risk factors for development of diabetic nephropathy include hyperglycemia, hypertension, positive family history of nephropathy and hypertension, and smoking. Key elements in the primary care of diabetes include glycemic control, blood pressure control, and screening for microalbuminuria. In general, the goal for glycemic control is a blood glucose level as close to normal (HbA C <7%) . Blood pressure control is at least as important as glucose control, especially after the onset of 1 renal damage, and blood pressure should be consistently <130/85. Screening for diabetic nephropathy involves monitoring at least yearly for urinary albumin excretion >30 mg per day. Microalbuminuria is defined as the urinary excretion of 30300 mg of albumin per day. Both glycemic control and rigorous control of blood pressure have significant impact on prevention and progression of diabetic nephropathy. Identification of patients with microalbuminuria selects a population of patients with increased mortality. Microalbuminuria screening should begin at the time of diagnosis. ACE inhibitors should be used when microalbuminuria is present regardless of the presence or absence of hypertension in type 1 diabetes and are widely.
used in normotensive patients with type 2 diabetes, as well.The effect of ACE inhibitors is probably not only via lowered
systemic blood pressure but also via direct effects on intraglomerular hemodynamics. 

The pustula maligna is most often clinical form of antrax. Disease is today a relative Rarity, but its appearance (sporadic or in epidemia) always to be surprised, especially in the biology war. Antrax have a big significant and today, we analyzed clinical findings of pustula maligna and its differential diagnosis. 

Klebsilla pneumoniae is the very rarely cause of osteomyelitis in adults, most commonly in the immunocompromised patients with extra-sceletal infections. Successful therapy of chronic refractory osteomyelitis included different orthopaedic methods of treatment, the long time antibiotics therapy and more and more freaquently treatment with adjuvant hyperbaric oxygenation. We report an uncommon case of patient with chronic postraumatic osteomyelitis cased by dissemination of Klebsilla pneumoniae from urinary tract to place of osteosinthesis of femur. Treatment of this case of chronic refractory Klebsilla osteomyelitis finished successfuly after treatment with hyperbaric oxygenation two years from start of desease. 

Every anesthesiologist can meet during his/her work with the patients who are suffering from rare diseases and had to be treated with surgical procedures. In a large clinical centers availability of the equipment, mentors and continual professional education are factors that are making performances of anesthesiologist's much easier. Regional hospitals, including our own one, are in much disadvantaged position. Health Center Kosovska Mitrovica is providing health treatment from the territory of Kosovo and Metohija. Due to the limited freedom of movement, these patients have to be treated "immediately and at place". Through the presentation of the case of the patient with Guillain-Barre (GBS) syndrome, we would like to underline a need for the establishment of the informational availability system through Point-of-Care Call on Line Electronic Help (OLEH) programme as it would significantly reduce the incidents related to the injuries and death cases caused by anesthesiologist procedures. Presentation of the case: Female, 42 years of age, a neurological patient with a th number of years of diagnosed illness was accepted on 13 February 2006 at the surgical department due to the abdominal pain, constipation and difficult urination. It was identified and diagnosticallv confirmed that uterus cancer spread out towards the colon, jeopardizing the bladder. It was decided that surgical procedure is reouired. Anesthesiology risk management evaluation started from the introduction with GBS. The case reviled acute inflammatory neuropathy with denivelization as the outcome of the antibodies reaction on the peripheral nerves. Chronically occurred types fas it was our easel, could lead to disruptions in breading, weakening of the muscle structure, areflection, pareses of orofaringealy physique, ophtamoplegy, chvadriplegy and chronical lung hearth. Strategy of the anesthesiological approach within the risk management procedures considered safe guidance of the patient through the pre and post anesthesioloqical period. Problem occurred was related to the limited availability of the professional literature and on-place resources related to the holistic experiences in treatment of this kind of problematic cases. The only sure available guideline was related to the avoidance of the depolarizing relaxants, which we have practiced. Within the work, we have described in details pre. peri and post anesthesiological approaches towards this problem. Conclusion: Recognition of the risk factors and multidisciplinary approach showed efficient during the peri and early post operational period. We have to indicate that development of the basic disease could have been much slower if we had assistance in respect to at-hand available and holistic information's on the rare diseases focused on the anesthesiological treatments. Therefore, it is our opinion that more qualitative system of health insurance has to introduce implementation of the hospital services standards, monitoring of the implementation and establishment of the electronic database. Developed countries such are i.e. USA, France, Italy, etc, have already introduced similar practices aimed to reduce morbidity and mortality among the patients

One the of most importante charactersistics of drug is a drug safety. However, there is no absolute safety. Medicines are troughly tested in controlled clinical trials with limiting population and short duration. Experience has shown that much of our knowledge about a medicine becomes available during the subsequent prescribing practice. Therefore there is a need for continued monitoring medicines after granting of product licence for a new drug (phrmacovigilance). WHO international system for drug safety monitoring as maintained by the Upsala Monitoring Centre (UMC) in Sweden, has built up vastedatabase of reports of suspect adverse drug reactions, coming from national centres in 75 countries in all of the world. The international system products valuable information from countries around the world, to support regulatory follow-up and decision-making. Emphasis is on those signals that may remain at the national level, because of small numbers or absence of local reports. The aim of the WHO's international pharmacovigilance program is a safe and rational medicines evrywhere. In Serbia as of 2005. National Medical Devices Agency is acting on behalf of the Ministry of Health as National Centre for Adverse Drug Reactions. The form for reporting adverse effects of medicines, in both pre-marketing and post-marketing phase can be found and downloaded in Word format on the Agency`s web site www.alims.sr.gov.yu.

The birthrate in Serbia has been falling and we are the last country in Europe according the number of newborn children. The aim of this study was to establish the birthrate trend during the period of five years on the territory of Central Kosovo and Metohija, according the data of Gynecology- Obstetrics Clinic/Gracanica, to indicate the importance of an improvement of women's health care, increase the birthrate and population growth rate. There was used a retrospective method of examination of the data from the maternity hospital register in Gracanica. There were also used the data from the death registry in the local community of Donja Gusterica and the records of students enrolled into the first grade of Primary School in Donja Gusterica. During the period from March 2002 to August 2005 there were born 1718 children (912 boys and 806 girls). There is almost no family on this territory with less than three children and there is a significant number of families with four or five children. The number of women who bore six times was 24, seven times was 13 and eight times was 11 while there were two women who born the ninth child and one woman who bore the eleventh child. During the five-year period, on the territory of local community of Donja Gusterica, there died 169 people while, at the same time, the number of students enrolled into the first grade of primary School was 293. An important contribution to growth of natality is an improvement of the women's health care. There was noticed a constant increase in number of newborn children for the mentioned period as well as a significant increase in population growth rate in Central Kosmet

Hypokaliaemia can be cause for beginning cardiac arrhythmias in patients with acute myocardial infarction. The aim of this investigation is to determine correlation between kalium level in serum and cardiac arrhythmias and conveying, to note down in first 24 hours in patients with acute myocardial infarction (AMI). Patients in this study attended in department of Internal medicine(coronary department ) in hospital in Health center in Kosovska Mitrovica.In this prospective study for one years we analyzed 110 patients with diagnosis of acute myocardial infarction. We found that cardiac arrhythmias represented in the most noumber of patients in the first 24 hours from receiving in hospital- 83,63%.The patients have had the more noumber of complex VES(20,91%),SVT(18,18%) than other cardiac arrhythmias in the first 24 hours from their received in the hospital. The low level of kalium have note down in 9,09% patients. The comlex VES have represented in patients with low level of kalium as VF. In the presence of kalium level under the 4,0 the risk for ventricular arrhythmias is higher.SVT have had in 20% patients with acute myocardial infarction,SVB in 10%,SVES in 16%,VF in 7% patients with normal kalium level in serum as branch block and AV-block I, II, III degree. Hypokaliaemia have influence on represence of VES and VF, but have not influence on represence of supraventricular arrhythmias and the disorders of conveying.

Dendritic cells (DCs) are antigen presenting cells which trace origin from bone marrow cells. These cells are discovered and described by Steinman i Cohn (1973) in peripheral lymphoid organs of mice. The cellular membrane of DCs are place of expression of plenty immunoregulatory molecules such as MHC class I and II, co stimulatory, and adhesion molecules, as well as many receptors for different cytokines. Armed on this way, DCs are one of the most effective antigen presenting and immunoregulatory cells. Moreover, role of DCs in development of immune reaction can be crucial due to they are one of the most important cellular “link” between native and adaptive immunity. DCs are engaged in mechanisms of antigen processing and presentation, induction of immune reaction, establishing immune tolerance and immune reaction regulation, balancing the immune reaction between autodestruction and protection of “self” cells. These functions makes that DCs play very important role in development of some pathological conditions and diseases such as autoimmunity, allergies and quality of anti-tumor and anti-microbe defense. Unbalanced immune reaction is hallmark of all cited diseases and immunopatological conditions, so that the function of DCs should be explored on the better way.

Reactive products of oxygen are among the most potent and omnipresent threats faced by the living organism. Intracellular accumulation of reactive oxygen species such as superoxide anion, hydrogen peroxide, hydroxyl radical, and peroxy radical, can arise from toxic insults or normal metabolic processes. These species may perturb the cell's natural antioxidant defence systems, resulting in damage to all of the major classes of biological macromolecules, including nuclear acids, proteins, carbohydrates and lipids. Oxidative stress has been defined as a disturbance in the prooxidant-antioxidant balance, resulting in potential cell damage. It has been implicated in several biological and pathological processes like ageing, inflammation, carcinogenesis, ischemia-reperfusion and in diseases including diabetes mellitus, atherosclerosis, and/or neurodegenerative diseases