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Introduction. Spontaneous bilateral ectopic pregnancy is a rare condition easily overlooked or misdiagnosed. We present a case of spontaneous bilateral tubal ectopic pregnancy and discuss the difficulties in diagnosing and treating such patients. Case outline. A 39-years-old patient with a history of irregular and abundant menstrual cycles complained of pelvic pain and light bleeding after 55 days of amenorrhea. Ultrasound revealed enlarged uterus with a myoma and a heterogenic formation with echogenic ring sign beside the left ovary. Free fluid with clots was present in the pelvis. As the patient was hemodynamically unstable and ectopic pregnancy was suspected, emergency laparotomy was performed. During the surgery we found that both tubes were significantly edematous, dilated, and livid in their ampullary regions. On the left tube anterior wall rupture 15 × 8 mm was noticeable, while right tube was intact with bleeding from its abdominal ostium. Even though the patient was not informed about the possibility of bilateral salpingectomy, after thorough consideration and due to the extent of tubal damage bilateral salpingectomy was eventually performed. Histopathological analysis confirmed the presence of decidua, partially viable and partially necrotic chorionic villi, and trophoblastic tissue in both right and left tubes. Conclusions. Careful preoperative and intraoperative examination of both Fallopian tubes as well as the whole abdominal and pelvic cavity should be mandatory during every assessment of patients with ectopic pregnancy.

Lumpy skin disease (LSD) is among a number of vector-borne diseases (VBDs) threatening the Balkans and therefore, preventing feeding of insects on cattle would reduce the spread of VBDs. In order to test the efficiency of Livestock Protective Fences (LPF) in the protection of dairy cattle from insect bites, a case-control study was conducted, in the districts of Nišava, Pirot and Pčinja, Southern Serbia. It consisted in comparing the number of biting flies collected within time, between 10 farms protected with LPF and 10 non protected ones. The insects were collected using two types of traps; the monoconical Vavoua trap set outside in between forested areas or rivers and the actual farm, and the BGsentinel trap baited with CO2, placed in proximity of the cattle but outside the stable. Vectors were collected every 15 days for 48 hours from May to October 2018 and kept in vials containing 70% of ethanol. Catches per trap were separately stored and for each trap, insects were classified according to species and sex and then counted. Data on milk parameters were analyzed separately, on data collected within protected farms, before and after the LPF deployment, and on data without protection at all. It was not possible to detect a direct impact of LPF on vector densities but the number of bacteria colonies (CFU) values were reduced. Some corrections/adaption in the methodology used may lead to better impact.

Background and Objectives: Mutations in succinate dehydrogenase (SDH) and fumarate hydratase (FH) give rise to various familial cancer syndromes, with these alterations being characteristic of certain types of histomorphologically specific leiomyomas that hold significant predictive value. Materials and Methods: This study presents two cases of uterine leiomyomas exhibiting rare histomorphological and genetic characteristics, which are crucial for prognosis and further treatment. Results: Distinct histopathological features such as marked nuclear atypia, intracellular eosinophilic globules, and abnormal intratumoral vessels raise suspicion for specific leiomyoma subtypes, which carry predictive significance for additional hereditary cancer syndromes. Immunohistochemical analysis confirmed FH/SDH deficiency in both patients, who underwent careful follow-up. Conclusions: This study describes two cases involving unusual leiomyomas, the histopathological characteristics of which may easily go unrecognized. These features hold predictive significance because their specific mutations point to additional hereditary cancer syndromes, highlighting the need for further examinations. [ABSTRACT FROM AUTHOR]

Introduction. Since the coronavirus disease 2019 outbreak was declared a pandemic by the World Health Organization on March 11, 2020, it has become the greatest public health threat worldwide. People with chronic diseases were identified as the group at risk for fatal outcome. The purpose of this research is to estimate the mental health of patients with chronic diseases during the coronavirus disease 2019 pandemic. Material and Methods. A total of 463 individuals (50.8% female), with the average age of 46.63 years (SD = 14.29, ranging from 20 to 75 years of age) participated in the research. The subjects were divided into two groups, based on the existence of at least one chronic disease. The Depression, Anxiety and Stress Scale-21 was used to assess the mental health of the participants. The research was conducted in August 2020. The impact of chronic illness on depression, anxiety, and stress levels was assessed using linear regression models. Results. The prevalence of chronic diseases among the participants was 44.3%. The participants with chronic diseases presented with higher levels of depression (p < 0.05), anxiety (p < 0.001), and stress (p < 0.001) compared to healthy participants. The presence of chronic illness remains a significant predictor of all the dependent variables, even after the inclusion of multiple variables in the final regression model: depression (Beta [β] 0.37; 95% confidence interval: 2.67 – 4.42; p < 0.01), anxiety (Beta [β] 0.19; 95% confidence interval: 0.80 – 2.55; p < 0.01), and stress (Beta [β] 0.09; 95% confidence interval: 0.01 – 2.13; p < 0.05). Conclusion. About five months after the coronavirus disease 2019 pandemic was declared, the investigation of mental health of chronically ill adults in Serbia shows an increased amount of stress, anxiety, and depression in this subpopulation. [ABSTRACT FROM AUTHOR]