Head gunshot injures are usually fatal. Elderly patients may have survived penetrating head injuries, since old bullets with lower velocity produce much less damage to brain tissue. We report a case of elderly male patient with mild head injury due to accidentally fall. Patient died a few hours after admission to Emergency Department. Autopsy finding showed one strayed projectile in the posterior horn of left lateral ventricle and one in the soft tissue of right VIII intercostal space. Later we obtained information that patient suffered multiple gunshot wounds about 35 years earlier. However, the cause of death was deterioration of long-term and severe hypertensive and atherosclerotic heart disease.

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.

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.

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.

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. 

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.