Adult intussusception caused by inverted Meckel diverticulum is infrequent but important clinical entity, presenting with nonspecific symptoms. It may be observed in any age. We report a 26-year-old male patient with intussusception, who was examined several times for abdominal pain accompanied with nausea and vomiting. Basic diagnostics were inconclusive, so the patient was discharged each time with conservative therapy. After the last episode, CT scan showed suspicious intussusception, so the patient was admitted to general surgery ward. The next day there was a complete regression of all difficulties, and he was free of them in the month ahead. Finally, NMR enterography verified the presence of intussusception, and the operative procedure was performed. At laparotomy, ileo-ileal double intussusception was observed and the affected segment was resected with T-T anastomosis. Histopathological examination demonstrated an inverted Meckel diverticulum, measuring 8cm, with ectopic gastric antral type mucosa and ectopic pancreatic tissue. Postoperatively, the patient made an uneventful recovery.

Aim: We present an interesting case of pancreatic ectopic tissue in the gallbladder. Introduction: Ectopic or heterotopic pancreas is defined as the presence of pancreatic tissue outside the boundaries of the pancreas that show no anatomical or vascular connection with the main body of the pancreas. Case report: We present a rare case of ectopic pancreas found in a 38 year-old man s gallbladder. Male patient was admitted to the Surgical Department Clinical Hospital Center Zvezdara, as scheduled for an elective laparoscopic cholecystectomy. One year prior to the surgery he had had abdominal ultrasonography done during a routine hospital check up. Ultrasonographic examination of the whole abdomen had showed no abnormality, except for cholelithiasis. Laparoscopic cholecystectomy was done. On gross examination, the gallbladder measured 9 cm in length and 3.5 cm in circumference, with a wall thickness ranging from 0.2 to 0.4 cm. On cutting open, one yellowish round stone, measuring 0.6 cm in diameter, was noted in the fundus. The mucosa was velvety flattened. A nodule of 1,5 cm in diameter was seen in the neck region, which on microscopic examination, showed a well circumscribed rest of heterotopic pancreatic tissue, composed of lobules of exocrine pancreatic acini and an occasional duct. Islets of Langerhans were also present. Conclusion: Ectopic pancreatic tissue in a gallbladder is a very rare condition which is usually diagnosed incidentally. Up to the presents, only about 30 cases have been reported. The clinical significance of the ectopic pancreas remains unclear and it requires further exploration.

Implementation of IMRT with 4DCT simulation offers possibility to correlate the respiratory movements and position of tumor volume during radiotherapy treatment. The aim of this study is to quantify movements of primary tumor during IMRT treatment in three axes-Z-superoinferiorSI, X-mediolateral ML, Y -anteroposterior AP.This study included 15 patients with lung carcinomareferred to radical radiotherapy. Contouring of GTV was done in the phases FB- GTV FB, phase 0-GTV0, phase 50- GTV 50, and phase MIP-GTV MIP. Comparison was done with GTV FB as basic value. Evaluation was done in three axis-SI, AP, ML. The movements of GTV in relation to X axis were in the range 0.02-0.47 cm, in relation to Y axis in the range from 0.01-0.56 cm, and according to the Z axis in the range of 0.00-0.79 cm. Based on the results of t-test there was a statistically significant difference (p<0.05) related to X axis between the upper and lower lobe. There was no statistically significant difference (p>0.05) between the upper, lower and middle lobes related to Y and Z axis. The test results which were obtained after the 4D CT simulation and planning of IMRT treatment show the importance of high-quality and precise radiation therapy treatment.

Skočni zglob je često izložen povređivanju zbog svoje statičke i dinamičke uloge. Uganuće skočnog zgloba je značajna mišićno-skeletna povreda, kako kod fizički aktivne tako i kod opšte populacije1 , dok prelom gornjeg skočnog zgloba prednjači u povredama koštano-zglobnog sistema2 . Kod velikog broja povređenih osoba (10% do 60%) zabeležena je funkcionalna nestabilnost kao rezidualni problem3 . Većina stručnjaka ukazuje da se nakon povrede skočnog zgloba, naročito uganuća, razvija hronična nestabilnost. Ovo stanje karakteriše osećaj nestabilnosti zgloba, sa periodičnim ponovnim uganućem4 , a često je prisutno ograničenje obima pokreta dorzifleksije, povezano sa sa bolom3 . Povreda skočnog zgloba može biti preduslov za razvoj sindroma vezanih za stopalo i potkolenicu, kao što su plantarna fasciopatija, sindrom iliotibijalne trake, patelofemoralni sindrom, sindrom medijalnog tibijalnog stresa5 . Pored toga, pojava posttraumatskog osteoartritisa skočnog zgloba pronađena je čak kod 78% osoba sa hroničnom nestabilnošću zgloba4 . Kod osoba kod kojih je došlo do pojave kalcifikacija javlja se niz strukturalnih i senzomotornih simptoma6 , usled čega opada nivo fizičke aktivnosti7 i kvalitet života8 .

The aim of the study was to investigate the degree of exposure to the health risk of the user by using a medical prescription reading goggles, which are classified as low risk, and whether the data from the package leaflet are correctly applied. Medical devices are instruments, apparatus, materials and other products intended to be used for humans and which do not achieve its basic purpose on the basis of pharmacological, immunological or metabolic activity, but are used alone or in combination, including the software required for proper use. Depending on the categories to which they belong, medical devices have greater or lesser risk of adverse health effects on patients. Medical devices are classified to classes according to the degree of risk for the user ranging from low risk to high risk. Research was conducted in retail stores: pharmacies, optical stores and facilities for selling consumer goods. The survey questionnaire methodology collected data on habits of customers - users of diopter reading glasses. The survey was conducted among the masters of pharmacies, opticians and retailers in the period from March to June 2019. Twenty-five facilities were included in the survey in the area of Tuzla, Sarajevo and Zenica.Statistical data processing was done in Microsoft Excel. Study showed that 35% of the respondents answered that patients visited ophthalmologists and brought medical report with needed corrective diopter, while significantly larger number of respondents – 65% answered that patients didn’t visit ophthalmologists and didn’t have a medical report with needed corrective diopter. Research has shown that 73.75% of patients don’t read the instructions for use, while only 26.25% of patients read instructions for use.

Aim: We present the case of a woman with endobronchial pulmonary synovial sarcoma. Introduction: Primary pulmonary synovial sarcoma is an extremely rare tumor that has the same histomorphological characteristics and chromosomal translocations as the synovial sarcoma of soft tissue origin. Material and Methods: A woman aged 58 years, the smoker, without the current symptoms of the disease, came to our institution because of the nodus that was seen on the CT chest. The polip (26 mm) was located in the lumen of the lower right lobar bronchus. The mediastinal and hilar lymph nodes were not increased. The radiological examination was done as part of a routine control after the meningeoma surgery three years ago. Right lower lobectomy and resection of regional lymph nodes were performed. Results: By a macroscopic examination, in the lumen of the bronchus for the lower right lobes, a clearly limited, nonencapsulated, grayish-white node of 2.6 x 2.6 x 1 cm was found. Histologically, the tumor was showed interweaving fascicular uniform spindle cell with ovoid, pale staining nuclei, and inconspicuous nucleoli, scant cytoplasm and the cell borders indistinct. Immunohistochemical tumor cells were positive for CD99, bcl2 and vimentin. Surgical margins and regional lymph nodes were not affected. A detailed clinical and radiological examination confirmed the primary lung origin of the diagnosed synovial sarcoma. A year after surgery the patient feels good. Conclusion: Morphological and immunohistochemical analysis with detailed clinical and radiological examination confirms the primary lung origin of synovial sarcoma

Penile tumors are rare neoplasms of the male urogenital tract and represent approximately 1% of all urogenital cancers in men. Squamous cell carcinoma is the most common histological type of these tumors, and is seen in about 95% of the cases. We report a case of a 66 years old male patient presented with large, neglected cancer of the penis, which grew about 6 months, but patient was not motivated for treatment until tumor began to bleed. Patient was operated and tumor was completely removed. The early postoperative course was uneventful and the patient was discharged from hospital Since penile cancers are rare entity, there are counted controversy about the best method of treatment. We believe that the individual approach to each patient relying on existing good clinical practice guidelines is currently the best therapeutic approach.

The current practice for removal of benign vocal fold lesions is microlaryngoscopy under general anaesthesia. The technique provides excellent magnification with use of operating microscope and enables the surgeon to work with both hands at the same time. However, in certain cases the technique of indirect laryngoscopic surgery under local epimucous anaesthesia can be used as an alternative. In this article we will give the brief historic perspective of the procedure, indications and technical description, as well as its advantages and limitations. Given the fact that technique is not widely accepted by otolaryngologists, the author will also share some personal remarks on this relatively simple procedure.