We describe a case of excessive lingual tonsil hyperplasia in adult despite previous tonsillectomy which required initial tracheostomy to complete removal of lymphoid tissue. We discuss intubation difficulties in evaluation of airway.

Investing in the health of mother and child during pregnancy and postpartum reduces inequality of achieving health care. Maternal and child health indicates health of the population, society as a whole and the effectiveness of health care. Since people in our area knows little and doesn’t talk about the postpartum depression, we tried to identify information how many maternal knows about the postpartum depression, mood disorder, which basis is not only biological, but also the psycho-social nature. Furthermore, we examined the relationship between being informed about postpartum depression and sociodemographic characteristicss and the level of the self-esteem.Instruments used in the study were a questionnaire on sociodemographic characteristics and Rosenberg’s self-esteem scale.The results of our study show that 68% of women don’t know what is postpartum depression, and that the knowledge of postpartum depression is associated with women’s education and employment. Correlation of being informed about postpartum depression and selfesteem is not determined.On the basis of these results, we believe that it is necessary that the institutions, experts from different areas and the future mothers learn more about postpartum depression, symptoms, treatment, causes and possible risks because the concern about the health of mothers and babies has to be primary concern of healthy society.

The incidence of diabetes is on a boom in the world. Coronary heart disease is the most common macrovascular complications of diabetes. Strict control of blood glucose levels contribute to the betterment of the patient and reduce the cost of treatment. The aim is to show the influence and significance of diabetes in the five-year outcomes in patients who underwent percutaneous coronary intervention Initially in the study included 800 patients who underwent percutaneous coronary angioplasty index. After the indexing procedure clinical monitoring is completed for 720 patients (90%) whose data after the completion of the follow-up period subjected to statistical analysis, which included descriptive statistics, a mutual comparison of the examined groups were used methods for testing the significance of differences numeric-factor analysis of variance (ANOVA) student’s t test, rank sum test (Mann-Whitney U test) hi-square test. They were monitored and analyzed the parameters of cardiac status obtained on outpatient examinations, and data obtained by telephone contact with the patient. Patients involved in the study had a very good glycoregulation, therefore there were no statistically significant differences in the five-year outcomes after percutaneous coronary intervention. The study showed approximately equal distribution of the sexes patients who are suffering from diabetes, those with diabetes mellitus type 1 patients with type 2 diabetes. There is no significance in survival, no matter what the patient is suffering from diabetes, has no significance because of the small number of deaths. It is similar to myocardial infarction, no statistically significant differences between patients with diabetes and patients who do not suffer from diabetes in terms of myocardial infarction.

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.

Parathyroid gland adenoma belongs to the benign tumor group and is the commonest originator of the primary hyperthyroidism which emerges owing to the both increased and uncontrolled secretion of parathyroid hormone due to the one or more parathyroid glands hyperfunction. The paper outlines the woman case, who was at the prison sentence enduring, and as a result of the supraventricular tachycardia and hemodynamic instability she was hospitalized at the Clinical centre, Kragujevac. The obduction diagnosed atherosclerosis of severe degree, left ventricle hypertrophy, nephrolithiasis, whereas the organs’ cut-outs pathohistological examination showed parathyroid gland adenoma. The cause of death of the particular patient was the myocardial infarction. Parathyroid adenoma of the patient was not detected in time because of the state of neglect and her way of life. The primary hyperthyroidism has significantly speeded up the myocardial damage and the blood vessel atherosclerotic changes.

Laryngeal lipomas are a rare form of a benign mesenchymal tumour containing fatty tissue. They can occur at any subcutaneous location part of the body, particularly in the trunk and lower and upper limbs where fat tissue is more abundant. We present the case of a 66-year-old man complaining of long lasting (3 years) discomphort in his throat, with no breathing or glutition problems. CT scans showed a 3.0-cm fat-containing mass involving the left aryepiglottic fold. The patient was taken to the operating room for excision of the mass using a laryngofissure approach. The final pathologic diagnosis was lipoma. We describe a case of large laryngeal lipoma removed through an external surgical approach in order to prevent any possible recurrence or malignant alteration.

Za postavljanje dijagnoze sepse, najpouzdanije je određivanje PSP u kombinaciji sa drugim markerima sistemske infekcije. Pojedinačno merenje je često bez značaja, tako da je kontinuirano merenje u vremenu, sa trendovima pada ili porasta nivoa markera sistemske infekcije, daleko informativnije. Nivo PSP značajno zavisi od GFR. Kod obolelih od ABI, PSP je solidan pokazatelj sistemske infekcije do težih i prologiranih stadijuma ABI. Kod obolelih od HBI, tumačenje vrednosti PSP je veoma spekulativno, te postoji potreba za definisanjem novihcut-off vrednosti za PSP kod ovih bolesnika. Kod oblelih pod tretmanom HD, pokazan je različit klirens PSP sa različitim dijaliznim membranama. Svakako, nivo PSP se po HD vraća na pređašnji nivo, koji je inače povišen.

The aim of this paper is to analyze the method of term and preterm deliveries of twin pregnancies and vitality of twins at birth. The development of two fetuses in the uterine cavity at the same time is considered a twin pregnancy. Today, due to more often examination and proper treatment, 50% of twin pregnancies end in preterm delivery. We used retrospective study to analyze the delivery method and vitality of twins born term and preterm at Gynecology and Obstetrics Department of General hospital Novi Pazar in the five-year period, from 2009 to 2013. There were 10.489 deliveries in the said five-year period. Out of this number, 118 pregnancies were twin pregnancies and they amount to 1.12% of all deliveries which is in line with world’s standards. About 73% of deliveries were term and 27% were preterm twin deliveries. The analysis of twin vitality showed that first-born twins at both term and preterm deliveries are more vital and in better condition. Second-born twins are generally born with lower Apgar score. Due to liberalization for caesarean section indication, a great number of twin deliveries end in caesarean section.

In this manuscript we report one pediatric surgeon’s experience in childhood inguinal hernia repair. From 2005 to 2008, 402 children with inguinal hernias were operated on by one surgeon. A retrospective survey of their charts was carried out to evaluate the demographics and clinical aspects of these patients. The ages ranged from 20 days to 16 years with a maleto-female ratio of 2.5:1. 64.9% right, 27.1% left, and 7.9% bilateral hernias. Hydroceles were present in 6.2% assosiated hernias. Incarceration occurred in 8.7% of children. An opposite-side hernia developed in 5.7%. 5.3 percent of patients with a hernia repair on the right side later developed a hernia on the left side, and 8.2% of patients with a hernia repair on the left side later developed one on the right side. 4.5 percent of all male patients in this series and 8.6% of female patients developed an opposite-side hernia. While overall recurrence rate was 1.2%, our recurrence rate was 0.25%. There was a 0.24% wound infection rate, and 1 (0.24%) testicle was atrophic at followup. In this study, in the recurrence of childhood hernia, the general surgeon’s intervention was the prominent cause. It is suggested by the study that inguinal hernias on the contralateral side becomes symptomatic within the first six months following initial operation.Therefor, close observation is needed in that time.

Aktuelna metoda za uklanjanje dobroćudnih lezija glasnica na našem odeljenju je mikrolaringoskopija u opštoj endotrahealnoj anesteziji. Ova tehnika obezbeđuje odlično uveličanje pomoću operacionog mikroskopa i omogućava hirurgu da istovremeno operiše sa obe ruke. Ipak, u nekim slučajevima se kao alternativa može koristiti i indirektna laringoskopska hirurgija u lokalnoj epimukoznoj anesteziji. U ovom članku ćemo napraviti kratak istorijski osvrt na proceduru, indikacije i opis same hirurške tehnike, kao i njene prednosti i ograničenja. Imajući u vidu da ova tehnika nije široko prihvaćena od strane otorinolaringologa, autor će navesti i neka lična zapažanja u vezi sa ovom relativno jednostavnom tehnikom.

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.

This article presents a case of patient with acute and complicated dyslipidaemic pancreatitis, managed by team, consisted of the endocrinologists, gastroenterologists and transfusiologists. Dyslipidaemia, predominantly type IV, is a common cause of acute pancreatitis in young patients, especially in the cases of poor compliance (irregular taking of recommended fibrates and failure to comply with the dietary regime). The treatment of acute pancreatitis, regardless of the aetiology, is due to the severity of the condition, the complexity of the treatment, and the monitoring of patients, in the Intensive Care Units. In cases where dyslipidaemia is the cause of acute pancreatitis, in the context of acute care, a therapeutic plasma exchange is often performed. It rapidly and significantly corrects lipid levels, primarily triglycerides. Therapeutic plasma exchange requires the activity of transfusiology team, which are often unavailable in smaller hospitals.

U okviru ovog rada prikazan je slučaj bolesnika sa komplikovanim akutnim dislipidemijskim pankreatitisom u čijem je zbrinjavanju učestvovao tim, koji su činili endokrinolozi, gastroenterolozi i transfuziolozi. Dislipidemija, prevashodno tip IV dislipidemije, predstavlja čest uzrok nastanka akutnog pankreatitisa u populaciji mladih ljudi, posebno u slučajevima nezadovoljavajuće komplijanse (neredovno uzimanje preporučenih fibrata i nepridržavanje higijensko-dijetetskog režima). Tretman akutnog pankreatitisa se nezavisno od etiologije, zbog težine stanja, kompleksnosti lečenja i monitoringa bolesnika, sprovodi u Jedinicama intenzivnog lečenja. U slučajevima kada je dislipidemija uzrok akutnog pankreatitisa, često se u sklopu akutnog zbrinjavanja sprovodi i terapijska izmena plazme, kojom se brzo i značajno koriguju nivoi lipida, prevashodno triglicerida. Terapijska izmena plazme zahteva aktivnost transfuzioloških ekipa, koje su u manjim centrima, često nedostupne.

We present the case of a 46-year-old patient diagnosed with a large solid tumor localized in the right mesentery, and due to the mesenteric position and tumor structure, diagnostic suspicion of GIST was proposal as the most frequent tumor lesion of this localization. After a few days, the patient was discharged from the hospital without postoperative complication, in further follow-up without relapse.

We present the case of a 46-year-old patient diagnosed with a large solid tumor localized in the right mesentery, and due to the mesenteric position and tumor structure, diagnostic suspicion of GIST was proposal as the most frequent tumor lesion of this localization. After a few days, the patient was discharged from the hospital without postoperative complication, in further follow-up without relapse.

Stvaranje aneurizme leve komore je komplikacija koja može nastati kao posledica infarkta miokarda. Najčešće zahvata apikalni ili anterolateralni zid leve komore (85%) i prati okluziju prednje descedentne grane leve koronarne arterije. Zid prave aneurizme sadrži endokard, epikard i fibrozno ožiljno tkivo. Funkcionalno može biti akinetičan i diskinetičan. Ukoliko kod pacijenta postoje simptomi, kao što su srčana slabost, anginozni bolovi ili komorske aritmije, indikovana je elektivna operacija. Od operativnih tehnika najčešće se koristi Dorova procedura. Od materijala najčešće se koristi politetrafluoroetilen ili perikardno tkivo. Njihova mana je podlžznost kalcifikaciji i retrakciji. Cormatrix je tkivni pač sastavljen od decelularizovane submukoze svinjskog tankog creva. Bogat je kolagenom, glikozaminoglikanima i faktorima rasta. Eksperimentalne studije, sprovođene na životinjama pokazale su da implantacija ekstracelularnog matriksa u područije infarkta srca dovodi do pojave kontraktilnih elemenata, kao i do promene u prirodnom formiranju ožiljnog tkiva

A left ventricular aneurysm is a complication that occurs after a myocardial infarction. It usually involves apical or anterolateral wall of the left ventricle (85%) and most often follows left anterior descending coronary artery occlusion. The wall of the true aneurysm contains endocardium, epicardium and fibrous scar tissue. It can be functionally akinetic or diskynetic. If patients present with symptoms such as heart failure, angina or ventricular arrhythmias, elective surgery is indicated. Surgical approach that is used most often is endoventricular circular ventriculoplasty described by Dor et al. Materials most commonly used for endoventricular repair are pericardial and polytetrafluoroethylene patches, but they are prone to calcification and retraction. CorMatrix is a tissue scaffold made from decellularized porcine small intestinal submucosa. It is rich in collagen, glycosaminoglycans and growth factors. Experimental studies performed on animals showed that implantation of extracellular matrix in the infracted area of the heart was followed by the appearance of contractile elements and altering typical scar tissue formation.

Opisujemo slučaj prekomerne hipersplazije lingvalne tonzila kod odraslih uprkos prethodnoj tonzilektektomiji koja je zahtevala inicijalnu traheostomiju da bi se kompletno uklonilo limfoidno tkivo. Raspravljamo o poteškoćama u intubaciji u proceni disajnih puteva.

Za postavljanje dijagnoze sepse, najpouzdanije je određivanje PSP u kombinaciji sa drugim markerima sistemske infekcije. Pojedinačno merenje je često bez značaja, tako da je kontinuirano merenje u vremenu, sa trendovima pada ili porasta nivoa markera sistemske infekcije, daleko informativnije. Nivo PSP značajno zavisi od GFR. Kod obolelih od ABI, PSP je solidan pokazatelj sistemske infekcije do težih i prologiranih stadijuma ABI. Kod obolelih od HBI, tumačenje vrednosti PSP je veoma spekulativno, te postoji potreba za definisanjem novihcut-off vrednosti za PSP kod ovih bolesnika. Kod oblelih pod tretmanom HD, pokazan je različit klirens PSP sa različitim dijaliznim membranama. Svakako, nivo PSP se po HD vraća na pređašnji nivo, koji je inače povišen.

Za postavljanje dijagnoze sepse, najpouzdanije je određivanje PSP u kombinaciji sa drugim markerima sistemske infekcije. Pojedinačno merenje je često bez značaja, tako da je kontinuirano merenje u vremenu, sa trendovima pada ili porasta nivoa markera sistemske infekcije, daleko informativnije. Nivo PSP značajno zavisi od GFR. Kod obolelih od ABI, PSP je solidan pokazatelj sistemske infekcije do težih i prologiranih stadijuma ABI. Kod obolelih od HBI, tumačenje vrednosti PSP je veoma spekulativno, te postoji potreba za definisanjem novihcut-off vrednosti za PSP kod ovih bolesnika. Kod oblelih pod tretmanom HD, pokazan je različit klirens PSP sa različitim dijaliznim membranama. Svakako, nivo PSP se po HD vraća na pređašnji nivo, koji je inače povišen