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Pregnancy is a unique state of the female organism in which occur physiological changes that are necessary to maintain the pregnancy. To be able to respond to the increased metabolic needs of pregnancy and to maintain an adequate level of thyroid hormones in the blood, the thyroid gland responds with changes in its function and anatomy as well. Changes in thyroid function are mainly associated with increased levels of thyroxine-binding globulins in the blood. Their level increases as a result of estrogen stimulation in pregnancy and they are synthesized in the liver. Changes in the physiology of the thyroid gland during pregnancy also occur as a result of stimulation of the TSH receptors of the gland by the human chorionic gonadotropin hormone (hCG) which is secreted by the placental trophoblast. Due to the difference in the physiology of the thyroid gland in and outside of pregnancy, a special interpretation of the results of functional thyroid tests is required. Changes in hormone values are transitory, especially expressed in the first trimester of pregnancy. A healthy pregnant patient without thyroid pathology or disease compensates for those changes and a sufficient amount of thyroid hormones is produced. The presence of thyroid hormones in an optimal concentration in the blood maintains a successful pregnancy and secures normal neurological development of the fetus. Diseases of the thyroid gland lead to a decrease its compensatory ability during pregnancy and the contributes to the inability to respond to the increased metabolic needs that follow. The motive for this paper are the pregnant patients with undiagnosed or unrecognized thyroid gland diseases before pregnancy, where we encounter conditions when the thyroid gland cannot respond to the physiological changes that occur. One of the negative outcomes of this condition can be spontaneous pregnancy loss in the first trimester. Therefore, a special interpretation of the thyroid status in pregnancy is needed and the introduction of constant reference values that will apply only to pregnancy. World recommendations designate reference values for TSH and thyroid hormones respectively for each trimester of pregnancy, the so-called trimester-specific reference values. In case of absence of trimester-specific reference values, there are recommendations regarding the special interpretation of thyroid function tests and reference values; as well as recommendations for using adjusted values according to demographic characteristics that will apply to all trimesters. This review of literature recommendations would help in the management of patients in order to achieve an optimal serum level of thyroid-stimulating hormone and achieve a successful pregnancy, thus imposing the need to introduce recommendations in our laboratories for thyroid analysis values specific to pregnancy, which will differ from those for the non-pregnant population. Keywords: thyroid gland, thyrostimulating hormone, trimester-specific reference values

According to the Traditional Chinese Medicine (TCM) philosophy, the abdominal area is the body's vitality centre and therefore the proper function of the digestive organs is of a great importance. Losing weight without trying, without changing the eating or exercise habits, thus causing gastric pain, should be a cause for concern. Despite the primarily manifestation of corona virus as lung infection presenting with respiratory symptoms and fever, it has manifested significant other complications affecting most organs, including the gastrointestinal tract with gastrointestinal symptoms in 1/3 of the patients. The treated patient is a 39 year old woman, presented with pain and cramps in the stomach and esophagus after sudden weight loss (16 kg in 1 month) after coronavirus infection. The patient had an echo of the abdomen. Liver, bile, spleen, pancreas are without pathological changes. Both the kidney and the bladder are neat without pathological findings. The patient has been receiving medicament therapy for 10 days Reglan 10 mg, but without any effect and changes.After receiving only one fire-needle acupuncture treatment, the pain was gone and didn‟t come back. The treated points are located on the spine on the vertebrae Th5 and Th6. Acupuncture as part of the Traditional Chinese Medicine, is an effective treatment and gives very fast and satisfying results in conditions presented with abdominal pain and discomfort in the stomach and esophagus. KEYWORDS: Stomach, esophagus, pain, acupuncture, traditional Chinese medicine.

Previous studies have observed an association between Varicella Zoster Virus (VZV) infection and stroke. Here we discuss possible causes of Herpes Zoster (HZ) due to COVID-19. Reactivation of VZV caused by decline of cellular immune response has been noted during the convalescent period or after recovery from COVID-19. Whether s troke can be a late sequel of a COVID-19 due to different inflammatory and coagulation mechanisms is currently uncertain. We present the case of a young patient with acute ischemic stroke, two months after mild COVID19 infection associated with subclinical reactivation of VZV infection and discuss possible causes of stroke. Diffusion

Human external ear is a morphologically complex structure and plays a vital role in the collection of sound. The present study would provide the information regarding the shape and size of the various morphological structures of the ear in normal individuals which may help the plastic surgeons to reconstruct the anatomy of the deformed ear and the physical and forensic anthropologists to study variations and establishing its use as a biometrics. The aim of the study was the morphological examination of the ear and its features to investigate the biological variations, sex differences, bilateral variations and further attempt to provide a database of external ears Methodology:The sample for the present study comprises of 60 males and 57 females aged of the 19 years. Darwin’s tubercle is an important structure of the ear which is considered to have some evolutionary significance was examinations. Results: In this study shows the frequency distribution of the various shapes of the Darwin tubercles present on the left and right ears of the subjects. Darwin’s tubercle refers to a congenital prominence usually found on the posterior part of the helix of the ear In the present study, it shows a variety of structures in both the left and right sides in bot h sexes.The trait is usually found on the posterior aspect of the helix; however, in some cases, it was also found on the superior aspect in the present study .The study also shows that the nodosity type Darwin’s tubercle was more often found on the males’ears than the females’ ears. Enlargement and projection form of the Darwin’s tubercle was among the rest of the subject, and in few subjects, the Darwin tubercle was totally absent. Conclusion: The present study shows that the individualistic characteristics of the ear can provide very useful information for personal identification in forensic examinations. Darwin’s tubercle show a variety of structures and individuality. Keywords: Forensic science, Forensic anthropology, Personal identification, Human ear, Morphological variations

Human external ear is a morphologically complex structure and plays a vital role in the collection of sound. The present study would provide the information regarding the shape and size of the various morphological structures of the ear in normal individuals which may help the plastic surgeons to reconstruct the anatomy of the deformed ear and the physical and forensic anthropologists to study variations and establishing its use as a biometrics. The aim of the study was the morphological examination of the ear and its features to investigate the biological variations, sex differences, bilateral variations and further attempt to provide a database of external ears Methodology:The sample for the present study comprises of 80 males and 77 females aged of the 19 years. Thickness, and attachment of the earlobe and shape of the helix were examinations. Results: The earlobe showed different characteristics in different individuals. In nearly half of the cases in both males and females, the earlobe was found to be attached to the face; in many cases, it was free and in some partially attached. The size and shape of the earlobe also showed variations with respect to sides as well as sexes. The shape ofthe helix is highly variable in the individuals showing certain characteristics such as normally rolled helix,concave, flat, and wide covering scapha helix. The other types of the helix such as concave,flat, and wide covering scapha helix were present among rest of the subjects. Conclusion: The database may be useful in the reconstruction of the deformed ears and in the anthropological and forensic research for comparison purposes. Keywords: Forensic science, Forensic anthropology, Personal identification, Human ear, Morphological variations

The interaction between the immune system and cancer cells is complex. Cancer cells can avoid immune destruction by suppressing the immune system. Tumors can create an immunosuppressive microenvoirment and therefore cytotoxic T lymphocytes (CTL) can't lysate them. Avoidance of the immune response is through the inhibitory ligand PD-L1, which is found on the surface of cells of the immune system, mesenchymal, epithelial, and endothelial cells as well as tumor cells. PD-1 is a surface cell receptor, part of the immunoglobulin family. Its ligand PD-L1 is expressed by tumor cells and stromal tumor infiltrating lymphocytes (TIL). This information has been used to increase the therapeutic possibilities for many malignant diseases. Objectives: 1.Optimization of immunohistochemical method (IHH) with antibody staining, anti PD-L1. 2. Optimization of the evaluation method while using different clones of antibodies. Material and methods: In this study are included 44 samples from 3 different types of cancer. 24 triple-negative breast cancers (TNBC), 10 non-small cell lung cancer (NSCLC) and 10 malignant melanoma. Monoclonal mouse primary antibodies have been used by manufacturers Quartett (QR1) and Ventana (SP 142, SP263). To visualize the reaction, an ultraView Universal DAB Detection Kit from Ventana was used on an automated platform for immunohistochemical staining Ventana BenchMark GX. The statistical analysis was done with the statistical package SPSS for Windows Version 22.0. Results: With comparing the sensitivity of two different clones on the same tissue samples from triple-negative breast cancer (TNBC), it can be conclude that the Clone QR1 gives more positive results than the Clone SP142, but there is no statistically significant difference. With comparing the sensitivity of two different clones in the same tissue samples from malignant melanoma, it can be conclude that Clone SP263 gives more positive results than Clone QR1, but there is no statistically significant difference. With comparing the sensitivity of two different clones in the same tissue samples from non- small cell lung cancer, we concluded that Clone QR1 gives more positive results than Clone SP142, but there was no statistically significant difference. Conclusion: Use of any of these clones of the manufacturers Quartett and Ventana give satisfactory results and can be used in the determination and evaluation of PD-L1 status in patients, and thus to determine further therapy and outcome of patients. Keywords: breast cancer, malignant melanoma, non-small cell lung cancer, immunohistochemistry, antibodies

Human papillomavirus (HPV) is the most common sexually transmitted infection globally. Almost all cervical cancers are due to HPV with two types, HPV16 and HPV18, which account for 70% of cases. Myomas are benign growths in different parts and places of the uterus. In this research is presented a case of 32 year old woman diagnosed with uterine myoma and HPV type 16. The myoma was found in September, 2018 and the HPV infection in January, 2020, two years later after the myoma was treated. The myoma was treated with 10 acupuncture treatments, Cordiceps synensis tea capsules 1.5 grams per day and Yunnan Baiyao tea capsules 1 gram per day in a period of 4 months. The HPV treatment included 10 acupuncture treatments and 1.5 gram Cordiceps synensis tea capsules per day in a period of 3 months. The findings after the treatments for the myoma were normal, with no presence of any abnormalities. The two tests for HPV after the treatment were negative too. Acupuncture and herbal treatment as part of the TCM give very good and satisfying results in gynecological disorders and can help in resolving of conditions like HPV and myoma.

Evaluation of the position of mandibular canal and foramen mentale have great significance and it is very important aid in different dental procedures, such as: surgical, dental implant, periodontal, endodontic as well in diagnostic procedures. The main aim of this study was to evaluate the detection of mandibular canal and the mental foramen on classic and digital panoramic radiographs among the population in Macedonia. A total number of 300 panoramic radiographs were evaluated. This investigation was including, the both types of panoramic x-rays, digital or classical. Assessment of the presence of foramen mentale and its relation with the adjacent structures and the mandibular canal was made by five independent examiners. According to the data from this research, in near 60% from the analyzed x-ray images, foramen mentale is positioned between the roots of the first and second lower premolars. Most commonly found position of foramen mentale is between the vertical axis of the second premolar and the line passing between the first and second premolars in the lower jaw in 46.97%. According to the data presented in our research, the mandible canal in about half of cases (more precisely 47.61%) has a descending path through the mandible’s body passing from the second lower molar to the foramen mentale. Most commonly foramen mentale is localized between the first and second lower premolars, while the canalis mandibularis most often possesses a descending path through the mandible’s body passing from the first lower molar to the foramen mentale.

Background: External human ear is considered to be a highly variable structure showing different morphological and individualistic features in The uniqueness of the ear may be useful in establishing the identity of individuals by direct examination, during the examination of CCTV footage or analysis of the ear prints. Considering the forensic significance of the human ear and ear prints encountered at the scene of the crime, the present study is an attempt to evaluate various morphological characteristics of the ear . Methodology: The sample for the present study comprises of 90 males and 87 females aged of the 19 years. characteristics such as overall shape of the ear, size and shape of the tragus. Results: The oval-shaped ear was present among 40% of the males and 44.8% of the females in the study sample. The other types of the ear such as oblique, rectangular, round, and triangular were also found in both sexes. Bilateral asymmetry was observed in the shape of the ear. The shape of the tragus also varied with respect to the left and right sides as well as sexes. Conclusion: The present study shows that the individualistic characteristics of the ear can provide very useful information for personal identification in forensic examinations. The shape of the ear and tragus, show a variety of structures and individuality. The importanceand variability of the human ear may encourage the researchers in conducting further studies and solving the forensic cases pertaining to the investigation of CCTV footage and in examination of dead in airplane crashes, intentional mutilation and dismemberment, explosions, or other mass disasters. Keywords: Forensic science, Forensic anthropology, Personal identification, Human ear, Morphological variations .

Anesthesia for caesarean section can be general and regional. General anesthesia is a state of unconsciousness and loss of protective reflexes as a result of administering one or more anesthetics by intravenous infusion. Regional caesarean section anesthesia can be spinal and epidural. Today with new local anesthetics, spinal anesthesia is an anesthesia of choice for caesarean section. The principle is to apply a local anesthetic to the spinal cord with reversible loss of nerve conduction resulting in muscle relaxation and analgesia. Apgar test is a method of assessing the health of a newborn immediately after birth that is done in the first and fifth minutes after birth and the result is called the Apgar score. The purpose of this paper is to compare the first-minute Apgar score in neonates delivered by caesarean section in terms of the type of anesthesia that has been used, general or spinal. The different types of anesthesia, the possibility for the patient to choose the type of anesthesia or that decision should be left to the anesthesiologist, are just some of the questions that arise at a time when the number of cesarean births is increasing. In this study is used data from the documentation of the Department of Anesthesiology and Resuscitation at PHI Strumica General Hospital on the type of anesthesia applied at each caesarean section and Apgar score of neonates born with these caesarean sections. Data have been collected since 2015, when general anesthesia was more prevalent and 2018, when spinal anesthesia is on the rise. 533 patients were included for 2015 and 496 for 2018. Inclusion Criteria - Indication of caesarean section: fetopelvic disproportion, hypertension, diabetes, preeclampsia, eclampsia, obesity. Exclusion criteria: fetal distress, placental abruption. Of all caesarean deliveries in 2015, 93.06% (496) had general anesthesia, the remaining 6.9% (37) were with spinal anesthesia. First-minute Apgar scores in infants born with caesarean section under general anesthesia were Apgar score -10 at 0.8%, 9 at 44.47%, 8 at 37.22% and lowest notched Apgar score 4 at 0.4%. First-minute Apgar score in infants delivered in spinal anesthesia was 10 in 10.81%, 9 in 70.27% 8 in 13.51%. In 2018, 13.9% (69) of the total number deliveries were done under general anesthesia and 86.08% (427) under spinal anesthesia. In neonates who underwent caesarean section under general anesthesia, the following values for Apgar score were obtained: There is no newborn with 10, 9 was at 20.29%, 8 at 56.52%. In neonates with spinal anesthesia, Apgar score in the first minute after delivery was 10 at 0.47%, 9 at 63.7%, 8 at 25.29% and lowest score- 5 at 0.47%. The improvement of anesthesiology practice, the new local anesthetics and informing the mothers about the safer type of anesthesia are important in the process of choosing the type of anesthesia during a caesarean section. The results only confirm that spinal anesthesia is safer for the mother and plays a role in higher Apgar score in the first minute in the newborn. The choice depends on many factors, and there is also the possibility for the mother to choose the type of anesthesia Keywords: Caesarean section, Spinal Anesthesia, General Anesthesia, Apgar Score

Background: Evaluation of the position of foramen mentale has great significance and it is very important aids in endodontic, oral-surgical, periodontal interventions, as well as diagnostic procedures. Thus, in view of this, the present study was conducted among the population in North Macedonia, to determine the most common location of the mental foramen and to estimate difference in position of foramen mentale in correlation with the second lower premolar teeth. The mental foramen is an opening located on the external surface of the mandible in the region of the mandibular premolars. Radiographically the foramen mentale can be as an oval or round radiolucent zone in the inferior part of corpus mandible on lateral sides, on the left and right side. Panoramic radiographs are the most commonly used extra-oral radiographic aids in dentistry since they provide a rapid and wide picture of mandible and the maxilla in the same time. This technique allows the adequate localization of foramen mentale. The main aim of study is to evaluate the position of the mental foramen and its relationship with mandibular premolars among the population in Republic of North Macedonia Material and method: A total number of 250 panoramic radiographs were evaluated for the positioning of the mental foramen. When assessing the position of the mental foramen, its position is determined in relation with the mandibular premolars and the mandibular median line. All radiographic images in which can not be localized and confirmed the presence of the mental aperture was also excluded from the examination. The examination was performed on a negatoscope if it is classical panoramic x-ray or adequate software used for digital panoramic x-rays. If necessary, magnification was used for magnification of the images. The relationship of foramen mentale with the lower premolars was given according to the following classification: (1) if the position of foramen mentale is distally from the line that passes between the second premolar and the first molar in the lower jaw-first class; (2) if the position of foramen mentale is between the vertical central axis of the second premolar and the passing line between the second premolar and the first molar in the lower jaw- second class; (3) if the position of the foramen mentale is between the vertical axis of the second premolar and the line passing between the first and second premolars in the lower jaw- third class; (4) if the position of foramen mentale is between the line that passes between the first and second premolars in the lower jaw and the vertical central axis of the first premolar-fourth class and if the position of foramen mentale is mesially from the vertical center axis of the first premolar- fifth class. Results: On the basis of the data from our research, it is noted that in near 60%, foramen mentale is positioned between the roots of the first and second lower premolars. The most common position for foramen mentale is the third class (which means that foramen mentale is between the vertical axis of the second premolar and the line passing between the first and second premolars in the lower jaw). Conclusion: In conclusion, the present results showed variations in position of foramen mentale. So it must be noted that local differences in foramen mentale position may occur in a population. This variability should alert the oral surgeons while performing oral surgical and periodontal interventions. If the studies related to variations in the position of foramen mentale are carried out in larger numbers, this data will be reliable for dental medicine clinicians, and with this type of information the possibility of complications will be minimized. Keywords: foramen mentale, mental foramen, Ortopantomogram, panoramic x-ray

Five alfa reductase inhibitors (5ARI) are widely used for treatment of benign prostatic hyperplasia (BPH) as they have a positive impact on the reduction of prostate volume and PSA levels, but also lead to adverse effects: erectile dysfunction, depressed mood and gynecomastia, which make the post 5ARI syndrome. The basis of its occurrence is the inhibition of 5 alpha reductases and blocking the biosynthesis of powerful neurosteroids from their precursor dehydroepiandrosterone and the conversion of testosterone to dihydrotestosterone. The aim of this paper is to show the significance and role of the dehydroepiandrosterone in patients with BPH who are on 5ARI therapy as an important predictor of post-5ARI syndrome. We made a comparative prospective analysis of 222 patients with BPH, of which 110 belong to the control group and were treated with alpha blocker (tamsulosin) and the remaining 112 patients were on combination therapy, alpha blocker and 5 ARI (dutasteride). In both groups of patients in the interval of 6 months over a year, the symptoms of lower urinary tract, erectile function index, and Beck depression index were analyzed with simultaneous monitoring of serum levels of testosterone and dehydroepiandrosterone. We concluded that post-5ARI syndrome, erectile dysfunction, and mood disorders appeared in 20 patients (19%) of the 5-ARI group, while no control group patients showed any such disorders in the control group. They were in correlation (r=89) with initially low levels of dehydroepiandrosterone and testosterone in patients with BPH before initiation of therapy. Keywords: BPH, erectile dysfunction, depression, dehidroepiandrosterone

The purpose of this study was to determine the impact of symptoms and the effects of drug treatment on the quality of life in patients with benign prostatic hyperplasia. We evaluated two groups of patients with the International Prostate Scoring System questionnaire, the Beck depression inventory and an issue/question on quality of life. The first (control) group consisted of patients with benign prostatic hyperplasia who were on alpha-blocker therapy, while the second group of patients (examined) were on combination therapy with alpha blocker and 5-alpha reductase inhibitor. In analyzing the results, we came to the conclusion that patients in the control group had a better quality of life and psychosocial status due to the weaker symptoms of the disease. Patients in the second group had a poorer quality of life due to development of side effects of 5-alpha reductase inhibitors therapy: erectile dysfunction and depression. Modalities in the therapeutic approach enable improvement of the symptoms in the second group and improvement of the quality of life in patients with dual therapy for BPH.

Introduction: Mental foramen (MF) is usually the anterior limit of inferior dental canal, which is located in the body of mandible between the inferior and alveolar margins. The great diffusion of the surgical techniques in jaws surgery and the progress of the radiological imagining procedures expressed many interest in clinical anatomy of MF. The aim of this study was tu determine and compare the position and symmetry of mental foramen in horizontal as well as in vertical plane Methods and Material : One hundred digital panoramic radiographs were selected and studied regarding the location and symmetry of MF The size of MF was recorded using digital caliper and its appearance was determined by visual examination. The collected data were subjected to statistical analysis using paired Student's t-test. Results :The commonest position of MF in horizontal plane was in line with the longitudinal axis of the second premolar (31.0%) while in vertical plane it was found to be located inferior to the apex of second premolar (42.2%). The difference in dimensions on the left and right sides were not statistically significant. Conclusion : MF exists in different locations and possesses many variations. Hence, Individual, gender, age, race and assessing technique largely influence these variations. It suggests that the clinicians should carefully identify these anatomical landmarks, by analyzing all influencing factors, prior to their diagnostic or the other dental, surgical and implant operation.

Медикаментозниот третман на бенигна простатична хиперплазија подразбира користење на главно две групи лекови: селективни алфа блокатори и 5 алфа редуктаза инхибитори. Кај пациентите кои се на двојна терапија, по воведувањето на 5АРИ во лекувањето, може да се појават несакани дејства кои го чинат „пост 5АРИ синдромот" кој опфаќа сексуални нарушувања и Бекова депресија. Целта на оваа студија е да ја истражи појавата на несакани ефекти, сексуална дисфункција и нарушување на расположението со цел полесно надминување на истите. Спроведовме рандомизирана контролирана проспективна фармакоепидемиолошка студија за евалуација на корелацијата на несаканите ефекти од употребата на 5-алфа-редуктаза инхибитори (5АРИ) кај мажи со бенигна простатична хиперплазија (БПХ). Во прилог на оваа анализа испитани се поврзаноста на еректилната дисфункција и депресијата во моментот на започнување на терапијата и во времето на активна употреба на терапијата во два последователни периоди од по 6 месеци, вкупно во тек на 12 месеци. Направивме евалуација на две групи пациенти преку 3 прашалници и тоа: ИПСС (Интернационален простата скор систем) за скорирање на симптомите од бенигната простатична хиперплазија (лесни, средни или тешки), ИИЕФ (Интернационален индекс за еректилна функција) прашалник за еректилна дисфункција (ЕД) и прашалник за Бекова депресија. Првата (контролна) група ја сочинуваат пациенти со БПХ кои се на терапија со алфа блокатор, додека втората група (испитувана) од пациенти се на комбинирана терапија со алфа блокатор и 5 алфа редуктаза инхибитор. Заклучивме дека постои правопропорционална врска помеѓу еректилната дисфункција и депресивното расположение во рамките на пост 5АРИ синдромот кај пациентите со БПХ лекувани со 5АРИ. Клучни зборови: БПХ, еректилна дисфункција, депресија

Aim: To determine the morphological features of mental foramen in population to provide guidelines for forensic scientists and dentists. Methods: 50 adult male and female human mandibles were obtained. Size, incidence, shape,location and number of mental foramina were recorded. Incidence of accessory mental foramina was also noticed. Distance from anatomical landmarks and size was recorded using vernier caliper. Results: Shape of mental foramen was oval in 6% of mandibles and rounded in 94% on the right side and on left it was oval in 13% of mandibles and rounded in 87%. The average size of mental foramen was 2.79 mm on right side and 2.7 mm on the left side. Mental foramen was most commonly found below the apex of second premolar tooth i.e. in 70% of the mandibles. The mean distances of mental foramina from upper border were 1.3 cm and 1.2 cm and from lower border were 1.4cm and 1.5 cm on right and left sides respectively. The average distances from symphysis menti were 2.9cm and 3 cm and 7.2cm and 7.3cm from posterior margin of ramus of mandible on the right and left sides respectively. Conclusion: Comprehensive knowledge of the mental foramen and it’s variations in different population is essential for dental surgeons, anesthetists, anatomists and forensic scientists. Keywords: Mental Foramen, Vernier Caliper, mandibular

Anthropometry means measurement of the human body. For neonatologists, at least four parameters are of great value: birth weight(BW), birth length(BL), head circumference(HC) and chest circumference(CC). For the purpose of this study, we have explored them as means of previous health conditions of the women/fetus. Deviations may indicate congenital developmental disturbances or physical disorders. We restricted our sample to newborns of healthy mothers within the UC for Obs&Gyn in Skopje, Macedonia during 2017. Eligible were newborns of mothers with expected date of birth 37-41completed gestational weeks, assuming that preterm babies might have been exposed in utero to conditions that affect growth and therefore might not represent a “normal” growth standard. Measurement of growth parameters were very precisely performed by validated methods and were completed within 48 hours of birth. Results: the mean value(SD) for the birthweight was 3456.5(411.1)g, female newborns were non-significantly lighter, the mean length, (crown-heel), was 50.3(1.7)cm. The mean HC(SD) was 33.8(1.1)cm and disaggregated related to sex, the females had lower values, statistically significant(p

Undergraduate studies are exposed to many new innovative techniques of teaching. The most specific is teaching and learning Pediatrics, due to many challenges that are posed with the focus of such teaching, i.e. children as patients. More specifically, there is a shift in medical education toward educating physicians who can work as team members, who acquire strong practical experience, who have good communication skills; an ideal medical education would produce physicians who, as part of a health team, practice “patient-centered medicine.” It is well recognized that communicating with children and their families can be challenging for health professionals. A survey of young patients by the Health Commission in 2004 suggested that many children are unhappy with the way in which health workers relate to them whilst they are in hospital. Equipping undergraduate students with the tools for effective communication via specific teaching whilst on clinical placement should therefore be part of the curriculum at all universities. Good clinical communication skills correlate with improved health care outcomes. The recognition that communication skills are a basic clinical skill and the development of practical teaching tools such as training on phantoms, hands-on training, Structured, Clinical, Objective Referenced, Problem-based, Integrated and Organized method of learning, case scenarios and Problem Based Learning, have led to an improvement in acquiring knowledge and communication skills. The complexity of such studies is increased because of the three-way consultation between a child, parent/guardian, and the doctor. Current curricular trends have substantially expanded the opportunities for pediatric departments to achieve full partnership and provide an optimal environment for students to acquire a sound general medical education, preparing them for any specialty and for lifelong learning in an evolving health care system. For the next steps, curriculum leaders in pediatrics can consider each of the following approaches: (1) full partnership with family physicians in the planning and conduct of longitudinal perception, population-based experience, and other integrated ambulatory experiences; (2) active participation as a precepter, small group facilitator, and mentor or role model for case-based educational experiences and small group activities related to acquisition of necessary skills, attitudes, and values for the early clinical experiences; (3) partnership with basic science and other clinical departments to ensure that clinical correlations and case-based opportunities provide balanced and representative exposure to pediatric diseases, maintenance of health, and prevention of illness concepts that are pertinent to adult-onset manifestations of illness; (4) emphasis on developmental and maturational aspects of wellness and of illness, even when age-related or logistical limitations preclude access to a comprehensive age range of infants and children; and (5) full representation of core principles of pediatric health in the curriculum and in performance-based assessments, including biologic and psychosocial development, parental and family support systems, risk behaviors, and environmental risks in children as antecedents of adult-onset morbidity and mortality, social and emotional development and behavior, and relationships between parenting, family dynamics, and maintenance of pediatric health and prevention of adult illnesses. Comprehensive incorporation of the principles of developmental biology, preventive pediatric health care, growth and development, maladaptive environments, and the pediatric origins of major medical and psychological morbidities across all years of medical faculty is more readily attainable in the context of these new curricular trends.

Increasing prevalence of obesity is presenting a critical challenge to healthcare services, and particularly in obstetrics, influencing the perinatal outcome. On the other hand, malnutrition also increases the risk of bad perinatal outcome. Body mass index (BMI) is a measure of body fat based on height and weight that applies to adult men and women and is used as objective parameter for measuring the nutritional status of the pregnant women before the entire pregnancy. The Institute of Medicine classified body mass index (BMI) as underweight (BMI

The aim of the study was to determine the distribution patterns of multiple renal arteries, evaluate how they are affected by gender andbilateral asymmetry and proceed on a systematic review. One hundred and six kidneys from 53 cadavers (27 males and 26 females)were investigated. The number and pattern of multiple renal arteries were determined according to side, gender and level of origin. Thedistances between the main renal and first multiple renal arteries were also measured. Multiple renal arteries were present in 5.6% of thekidneys. No statistically significant difference was found between side and gender (p>0.05). The incidence of multiple renal arteries was43% unilaterally and 6% bilaterally. As regards the multiple renal arteries, a single artery was detected in 43%, two in 6% and three in2.3idin%. In 15.5% (3/12) of the kidneys, there was a short common trunk (

The brain insult is an acute disruption of circulation in the brain, which flows with local and general brain symptoms. It can be ischemic, haemorrhagic or in the form of Transient Ischemic Attack (TIA). Etiologic factors include: atherosclerosis, high blood pressure, heart disease, malformation of brain blood vessels and others. In the acute stage, physical therapy is directed towards the prophylaxis of the complications of the locomotor apparatus (contractures, muscle and tendon retractions, ossifications), the respiratory system (hypostatic pneumonia) and the skin (decubitus). All this is achieved through treatment with a position: a frequent change in the position of the body in the bed, passive exercises performed according to strictly defined rules, breathing exercises, exercises for healthy limbs and intense skin care. The resulting trophic changes of the skin are treated with ultraviolet radiation at the sublimate doses or with high frequency currents at D'Arsonval. After the acute period, physical therapy has a decisive role for the optimal physical recovery of patients, for their adaptation and re-socialization. The leading role in this stage has kinesitherapy through the special methods of Bobath, Brunustrom and Kabat. The choice of a particular kinesitherapy technique is performed individually for every sick person, after a precise kinesiological analysis of the spastic syndrome and a functional assessment. Before starting the kinesitherapy procedure, relaxing procedures are mandatory. In the initial stages of moderate spasticity, soft heat is used (solux and IC light). In strong spasticity, paraffin applications, Kenny compresses, or partial warm baths are used. Of the cryotherapy methods, the most suitable for these conditions is the method of application of frozen towels, three times a minute, with passive relaxation exercises between each application. Proprioceptive Neuromuscular Facilitation Techniques (PNMF) aim to improve the patient's functional ability by facilitating, inhibiting, enhancing and relaxing muscle groups. Techniques use, concentric, eccentric and static muscular contraction. These muscular contractions, with properly dosed resistance and appropriate relief techniques, can be combined and adapted to meet the needs and capabilities of each patient.

The fractures in children are very common, and statistics show that they are usually caused by banal causes on the playground during sports, at home, on the street, during walking or running, in a fall from fences, roofs, trees, stairs and so on. Fractures in boys are twice as common as girls. Also, fractures of the upper limbs are several times more frequent than fractures of the lower limbs. In order to provide proper and timely assistance to the child, knowledge of the characteristics of fractures of the bones in children is necessary. Typically for fractures in childhood is the difficult diagnosis, rapid healing, and spontaneous correction of bone malformation. In the treatment-dominated conservative treatment. Surgery is indicated in only 2% of cases. The duration of immobilization of fractures in childhood is shorter than in adults. In the most common fractures (clavicle, wrist and proximal humerus), immobilization lasts 2-3 weeks. Malpposition of the joints does not require special attention as in adults. The mobility of the joint at normal physiological limits is recovering very quickly. Most fractures in childhood are healed spontaneously, without deformation and without disturbance in bone growth. In fact, the bones of children are not as adults, they contain large amounts of ossein (organic matter), have areas with active bone growth, and periosteum a well supplied with blood, which covers the bones from the outside and gives them elasticity and flexibility. Studies have shown that bone tissue regeneration is closely related to the local blood supply to the traumatic segment. Therefore, early massage after a bone fracture is physiologically based. The optimal conditions for the healing of the broken bone are created, allowing for proper and fast formation of a healthy bone ring.

Nowadays, in the diagnosis of the extensive endocranial processes, major significance is attributed to the dary changes in the skull that appear also in the X-Rays. Despite some successes in the development of the X-anatomy of the skull and in the study of secondary changes, there are major difficulties in reading the X-rays. This is explained by the fact that the variability in the construction of the various parts of the skul I is more frequent, ially at its base and in the area of the great occipital opening. the literature it can hardly be found how the variations in the shape of the great occipital opening are described IKl peculiarities in the construction of its rear end. fn healthy persons, the semi-axial X-rays of the great occipital opening have an oval shape, a clear and smooth back end, surrounded by a solid bone cylinder that passes toward -.Cmidd\e in the vertically set ridge of the occipital bone. When tumors in the posterior cranial fossa are described, many authors note changes in the great occipital opening a the form of osteoporosis, atrophy, and slinging the sku!J at the posterior end of the opening, with local cleavers aid leveling of the corresponding part of the occipital bone, known as the Bapcin symptom. The anatomical variation of the form of the fora men occipital magnum was axsarnioed on 80 ca\varials. With detail malysis we identified three normal variations of the form of the foramen occipital magnum: the oval (48 cases), the IOUlld (21 cases) and the anomalous form ( l l cases). Also the dorsal end and osseous configuration of the occipital m was examined. The importance of this study is it's prognostic and diagnostic application in the clinical and roentgengratic research. (ireatest difficulties arise in the malignant brainstem process, especially when the invasive process goes to the lliddleofthe back of the great occipital opening. Knowledge of foramen occipital magnum variations is important for surgeons in pereforming many procedures and &may help to avoid clinical coplications, especially, during radiological examination .

Diabetes mellitus - type 1, formerly known as insulin-dependent diabetes or juvenile diabetes mellitus occurs in the absence of insulin resulting from the destruction of B cells of Langerhans pancreatic islands which produce insulin. Because in the absence of insulin develop ketoacidosis, external administration of insulin is necessary to maintain homeostasis in patients with Juvenile diabetes. The cases are more common in children and adolescents, but it can occur at any age. The most commonly is diagnosed about 3-6 years of age or in their early teens. By type 1 sufferers around 10% of the total number of patients with diabetes mellitus.

Obesity and cellulite are aesthetic deficiency in women who disrupts the female figure and a very negative impact on their mental and emotional state. The results of research related to weight reduction and cellulite are the source of many contradictions. The main recommendations are: if you want to lose weight, it is necessary to consume fewer calories and exercise more. Most experts recommend physical exercise as a tool to reduce weight gain and cellulite. The experts who study obesity and regulation of body weight, tend to treat the human body as a thermodynamic box: the calories entering on the one hand coming out of other hand, and the difference remains deposited in the body as fat. But from the analysis of the data and the results of various studies can easily notice that there are no scientific evidence to substantiate this. In fact, there are evidence to the contrary.

The coronary arteries supply the heart muscle with blood, if there occurred atherosclerotic plaque or coronary artery diseases their lumen will be reduced and there will not be enough supply of blood, that occur in myocardial ischemia. If over time spraying occurs of the atherosclerotic plaque, material will pour from it and it will lead to full closure of the circulation, there will be no supply of blood and oxygen, and if this condition take longer, part of the myocardial cells will die. This condition will be accompanied by symptoms and visible ECG changes that makes easy for diagnose. To accommodate such a pathological condition of the patient it should be present more risk factors such as: smoking, hyperlipidemу, hypertension, diabetes, obesity, genetics, physical inactivity, psychosocial factors and consumption of alcohol in large quantities. Because of this in primary care should be worked more on this pathology, regularly to share recommendations with the risk categories of citizens in order to act preventively.

Based on 88 matches of 2014/2015 First Croatian football league we established the importance of penalty kicks considering the final outcome of the match and the competition. Using Mann-Whitney test and Pearson correlation coefficient we concluded that penalty kicks as situational efficacy indicators pose a statistically significant difference between the winning and the defeated team (p=0,04), and there is a moderate negative relation to final placement in league system of competition (r=-0,54). These results show that penalty kicks influence the outcome of the match, and if they are repeated, they have a negative effect on final placement.

Introduction: Helicobacter pylori (HP) is a part of the normal gastric flora and is the cause for more than 80% of gastric and 90% of duodenal ulcuses and gastric cancer (1-2 %). Methods: For 5 years we examined 1200 patients with dyspeptic disorders. We used the test for the presence of HP antibodies in serum (IgA and IgG). Results: 690 patients were positive for HP (from which 68 pregnant and 33 nursing women).Depending on the levels of titer of the antibodies and the confirmed diagnosis.the treatement were different.The patients with acute infection were taking the ProHefbis drops as an introductory therapy, 10-15 minutes prior to the triple therapy and after completing it,the patients go on taking ProHerbis three times a day during two months.In case the titer of the antibodies was not decreased after the first check up (45 days), the patients continued taking the drops in the next six months,2-3 times a day 20-30.drops.20-30% of patients after the second check up (90 days) had no decrease of the titer of antibodies and they had the initial suffering because of the resistance to the antibiotics. We administered to these patients the quadruple therapy'and they go on taking ProHerbis drops in the next six months (20-30 drops),2-3 times a day.The nursing and pregnant women with positive HP antibodies were not allowed to take triple therapy were taking 20-30 drops of PtoHerbis in period of 2-3 months. Conclusion: According to the researches performed in Belgrade at the Department of Microbiology of “Dragisa Misovic" Hospital,as well as at the Institute of virusology and immunology “Torlak”, the solution ProHerbis beside increasing the non-specific immunity shows particular bacteriostatical and bactericidal effect upon HP. We confirmed that after 45 days and especially after 90 days of the treatment.

Morfoloske karakteristike tranzitornih lumbosakralnih spojeva. Morfoloske karakteristike renalne arterije kod humanog bubrega. Testiranje dimenzije bubrega kod humanog fetusa za vreme fetalnog perioda.

Cilj istrazivanja bio je analiza duzine, kalibra leve i desne renalne arterije kod humanog bubrega oba pola. Subjekti i metode: Merenja obuhvataju analize renalne arterije kod 30 humanih bubrega i 30 renalne angiografije. Informacije dobijene pri merenju duzine renalne arterije su klasificirane i grupirane a zatim obradjene Studentovim ttest i korelacije. Za potrebe ove analize, za svaku varijablu izracunati su sledeci parameter: Aritmeticka sredine X i standardne devijacije Rezultati: Na nasem ispitivanom materijalu nadjeno je da prosecna duzina desne renalne arterije kod muskog pola iznosi 4.4167 cm, a kod leve 3.3467cm. Dok prosecne duzine desne renalne arterije kod zenskog pola iznosi 4.3667cm, a kod leve 3.2834cm. Kalibar bubrezne arterije meren je 0.2cm od njihovog nastanka. Kod angiografije njihove vrednosti su manje zbog toga sto se kod angiografije vidi samo lumen ovih krvnih sudava a ne i debljina njihovih zidova. Zakljucak: Dimenzije renalne arterije predstavljaju osnovu za pravilnu i brzu dijagnozu brojnih patoloskih i fizioloskih promena bubrega. Kljucne reci: bubreg, renalna arterija, anatomija, dimenzija.

Razvoj ljudskog fetusa, pa i bubrega prolaze kroz niz kontinuiranih i uzajamno zavisnih anatomskih promena, tokom kojih bubrezi dobijaju morfolosku i funkcionalnu zrelost.Ova studija je sprovedena u cilju da se analiziraju anatomske promene dimenzije bubrega tokom fetalnog razvoja od III do X lunamog meseca. Bubrezne dimenzije (duzina i sirina) bili su mereni Vemier-ovim caliperom. Serijska merenja oba bubrega su vrsena kod 300 fetusa oba pola (154 muski pol i 146 zenski pol). Analiza srednjih vrednosti pokazala je statisticki znacajne razlike bubreznih dimenzija u odnosu na lunami mesec. Kljucne reci: fetus, bubrezne dimenzije, fetalni rast i razvoj

Aim - The aim of this work is to present the results of the researched group of patients treated with fire needles and fire cupping in knee osteoarthritis and to explain the methods of the treatment. Methods - Treatments were done in a clinic for TCM and acupuncture in Skopje by a doctor specialist in acupuncture, indoor on a room temperature with duration of 20-30 minutes. In all patients was applied acupuncture treatment with fire needles on certain trigger points - Ashi, with duration of 10-15 minutes and fire cupping with duration of 5-10 minutes at the same points. One specific point which is located on the inside side of the knee was treated in all patients. The research includes 32 patients, of which 21 women and 11 men, on age from 33 to 78. Results - All painful symptoms that patients complained before were gone (pain in the knee, edema, limited motion, numbness, loss of balance, insomnia), therefore the treatments have been effective in all patients. Conclusion - Combined treatment of fire needle acupuncture with fire cupping is one of the most commonly used in knee osteoarthritis and thus gives most satisfactory results in the treated patients so far

Laparoscopic cholecystectomy is a routine operation throughout the world and in our country. It is performed under general anesthesia. The aim of this study is to determine the anatomic variations gall bladder to successfully performed laparoscopic cholecystectomy. The survey was done in Gob "8th September" in Skopje (Republic of Macedonia) 2014. UZ-abdominal gall bladder a totally86 patients, (33 female and 53 male), in age from 35 to 82, were under observation. Normal appearance of the gall bladder is found in 70% of cases, 8% folded, 10% of the double, 15% of left-sided, and in 2% of the gall bladder was missing. In 20% of cases of cystic duct is shorter, which is important because of the connection of the main bile duct, if you need to carry out interventions. Before each laparoscopic cholecystectomy were made with the abdomen-gallbladder. In order to avoid effects at this point as the bleeding, violation of the ductus choledochus, injuries ductus hepaticus dexter.

Myofascial pain syndrome (MPS) has been described as the most common challenge that general physicians, osteopaths, physical and manual therapists face today. Its’s frequency among the patients admitted to chronic pain practices is about 85 % (Han et al. 1997, Skootsky et al. 1989). MPS is characterized by pain originating from the trigger points (TrPs) at muscles and fascia. It is associated with, muscle spasm, tenderness, restricted motion. Although the exact pathology of this phenomenon is still an issue of debate, therapists have developed a lot of empirical treatment approaches. The various treatment techniques that are used for treating TrPs are: TrP release (TrPPR - ischemic pressure applied by finger or some similar tool), ultrasound, TENS, LASER, muscle energy technique (MET), positional release therapy (PRT), strain counter strain technique and integrated neuromuscular inhibitory technique (INIT). The aim of this study is to compare the effectiveness of LASER and TrPPR both combined with MET in reducing pain originating from TrPs. Both approaches resulted in decrease in pain levels and increase in pain threshold. Comparison between the groups showed no advantage to one procedure over the other.

Most definitions describing concept of nanotechnology includes control, understanding, design, imaging, measuring and manipulating matter at dimensions between 1 and 100 nanometers. Nano-structure poses unique physical, chemical and biological properties exclusively due to its nanoscale dimensions, significantly different from the properties of bulk materials and single atoms or molecules. Gravity loses impact and importance, surface tension and Van der Waals constants has more importance in system of nano particles. Extremely small size enables nano particles to enter the human body through usual or unusual routes, pass through cell membranes, cross the blood-brain barrier and access new sites, interact with DNA or small proteins at different levels, in blood or within organs, tissues or cells. Nowadays nanotechnology is being used in a range of applications, with potential to be applied at any stage in food industry: production, processing, packaging, labelling, transporting, tracing, keeping the quality of food product and extend the product shelf-life. The use of nanotechnologies to solve medical problems can dramaticaly improve the quality of life. Nanomedicine has the potential to enable early detection, prevention and significantly improve diagnosis, treatment and follow-up of many diseases. Based on nano (bio) senzors, rapid and sensitive detection of pathogenic bacteria and trace levels of viruses in small sample volumes and lower costs than current in-use technologies are developed. Early detection enables accurate and prompt treatment. Likewise, sensors to detect biofilm formation by bacteria on surfaces are developing Over 70 products are under clinical trials, covering important diseases including cardiovascular, neurodegenerative, musculoskeletal and inflammatory (such as cancer, atherosclerosis, diabetes, eye diseasses, antimicrobial resistance, tissue engineering, Alzheimer disease, arthritis). Nanomedicine delivered over 70 products, including nano-delivery, pharmaceuticals, imaging, diagnostics and biomaterials. Researchers have developed "nano-sponges" that absorb toxins and remove them from the bloodstream, absorb free radicals, monitor the level of nitric oxide (which indicate inflammation, important to monitor inflammatory diseases) in the bloodstream. Nanomedicine is understood to be a key enabling instrument for targeted and regenerative medicine by delivering of drugs (increases efficiency and minimizes side effects), treatments, implantable devices, early diagnosis of cancers, accurate cancer imaging, cancer therapy and drug delivery. Multy drug resistant microorganisms present one of the most serious and increasing global, public health threat. This problem causes approximately 25,000 deaths each year and over 1.5 billion expenses in healthcare and productivity losses in Europe. New strategies to combat MDR are urgently needed and nanomaterials are very promising approach. Metal nanomaterials (silver, gold, copper, titanium, zinc, magnesium, cadmium and alumina) possess unique antimicrobial activities. Silver ions showed strongest bactericidal effect. Regenerative medicine based on tissue engineering is currently a great exciting challenge for science and industry. Nanoparticles are also used to stimulate the body’s innate repair mechanisms, artificial activation and control of adult stem cells and to deliver vaccine, allowing a stronger immune response Nanomedicine provides important new tools to deal with the grand challenge of an ageing population. Future applications of nanomedicine will be based on the ability to build nanorobots. These nanorobots could be programmed to repair specific diseased cells („genetic surgery“), functioning in a similar way to antibodies in our natural healing processes and elimination of bacterial infection. Intense research is going on to make changes in the DNA structure of human beings as it can bring about a way to cure gene-related diseases. Risks of nanotechnology are still unknown and unpredictable. Potential problem with is the lack of knowledge and understanding the impact these products will have on the nanoscale. Initial scientific studies showed negative effects on living organisms and a potential for serious threat to human health in connection with disposal of nanowaste and environmental contamination. Scientists are primarily concerned with toxicity, characterization and exposure pathways. Number of ethical and societal concerns raised, ranging from possible health risks of using or consuming nanoenabled products, intellectual property rights governing them, and the new challenges they may raise. There are concerns that strong economic competition may be taking precedence over scientific prudence when it comes to public health and the potential dangers of nanotechnology. However, currently the benefits of nanomedicine definitely outweigh the risks. Key words: antimicrobial, ions, nanoparticles, nanomedicine, nanotechnology.

Introduction: Fractures are common joint injuries that can occur in any age group. Case report: This case report is a presentation of a mechanical injury in a bicycle fall where the fracture occurs on the head of the right radius in a male person aged 27 years. The patient was admitted to the hospital with pain, swelling and loss of function of the right hand. Reposition and operation were performed by placing osteosynthetic material and plaster immobilization. An osteosynthetic material - a pin was inserted in order to connect the radius with the ulna. The patient was treated with electrotherapy and kinesiotherapy for two months. Electrotherapy with low frequency interference currents and magnetic therapy was also applied. Kynesiotherapy with active and active assisted exercises of moderate dose were used until the metal was removed. Physical therapy continued to be used after the removal of the metal. In addition, the patient was treated with electro-ultrasound in low doses of 0.3 w in cm2, and electrophoresis (EF) with potassium iodide (KI), which is placed on a positive electrode and inserted in the skin and subcutaneous tissue using galvanic current, thus stimulating the creation of callus. The kinesiotherapy with active and active assisted exercises also continued to be used, now with increased resistance. Exercises for strengthening the muscles by using a ball, dumbbells, bands with different resistance were also introduced. The function returned to normal in two months. Conclusion: Physiotherapy, especially kinesiotherapy, is of great importance in restoring the functional status of the patient.

World is heading towards post-antibiotic era and bacterial resistance to antibiotics present a growing concern as a „Major global threat“ to public health. New strategies to combat мulty drug resistant microorganisms (MDR) are urgently needed and nanomaterials looks very promising. Extremelly small size (1-100 nm) enables nanoparticles to enter the human body through cell membranes or cross the blood-brain barrier. Metal nanomaterials (silver, gold, copper, titanium, zinc, magnesium, cadmium, and alumina) possess unique antimicrobial activities. Silver ions showed strongest bactericidal effect, cooper and gold weaker one. Ionic silver is water soluble while metallic silver is not. Inside the human body ionic silver cannot survive, because quickly combines with chloride to form an insoluble silver chloride which is far less reactive than metallic silver nanoparticles which can survive inside the body beacuse they are unaffected by chloride. Silver ions are non-toxic to human cells in low concentrations. Theories and hypothesis about mechanism of antimicrobial action of silver ions includes: - Interaction of electrostatic forces between bacterial cells (negative charge) and silver ions (positively charged), - Oxidation and destruction of bacterial cytoplasm, - Direct influence on DNA, increasing quantity of intracellular free radicals, - Inhibition of the transmembrane transport of Na+ and Ca++ - Inhibition of enzymes of the respiratory chain, - Reaction with Peptidoglycans blocking transfer of oxygen into bacterial cells In our preliminary study of several different compositions of nanoparticle coatings (titanium, inox and silver), we found antimicrobial activity of silver and double composition of titanium and silver against Staphylococcus aureus and Staphylococcus epidermidis, but not against E. coli, Pseudomonas aeruginosa, Listeria monocytogenes and Candida albicans. More extensive studies will follow. Key words: Nanoparticles, silver, ions, antimicrobial, antibiotic, resistance.

Испитаници, идеи и можност на студентите за запазване на достоинството на пациентот како основен принцип на сите медицински дејности. Цел: на испитувањето е да се добијат информации за вниманието, с професионалноста и почитување кон личността на пациентот, за да зголемување на довербата и соработката и како тие принципи се прифакат и толкуват од пациентите.

To describe epidemiological characteristics of tuberculosis in the Republic of Macedonia. The data are taken from annual reports on the work of dispensaries and the health facilities for lung diseases and tuberculosis as well as from the Central Registry for tuberculosis in Macedonia, provided at the Public Health Institution, Institute for Pulmonary Diseases and Tuberculosis, in 2007. Descriptive epidemiological method, statistical processing and data analysis are applied for the realization of the targets.The data are shown by indicators set out in the national tuberculosis program.