PRIMARY OPEN-ANGLE GLAUCOMA AND FARMACOECONOMICS - REVIEW

Primary open-angle glaucoma (POAG) is defined as a chronic and progressive disease. Date suggested that it is the second most common cause of the blindness in the world. Blindness, as global problem, is partially consequences of poor health insurance, low medical education, etc. The only modifiable risk factor for glaucoma is intraocular pressure. Cost of the antiglaucomatous treatment increased by prescribing and using wide spectrum of antiglaucomatous drugs. If an ophthalmologist is not satisfied with glaucomatous disease control, need for the laser or surgical treatment is appeared. Disease stadium also determines the cost of the treatment. The social and economic burden of glaucoma can be changed by increased life expectancy, older population age and higher per capita GDP. Unique opinion about cost effectiveness cannot be reached, due to nonconforming findings of many studies. Treatment approach must be individualized to every patient, according to the disease's stadium, availability of therapeutic modalities and approaches, life expectancy and the level of GDP. Efficacy, compliance and potential side-effects of prescribed medication also determine the proper treatment choice

Employee and the Self-Employed Job Satisfaction: Similarities and Differences

Research question: This paper investigates if there are differences between employees and the self-employed job satisfaction levels. Motivation: The motive for this research was the desire to determine the validity of the assumption that the self-employed are more satisfied with their jobs than employees, and also to investigate for the first time in Serbia the differences in the self-employed and employee job satisfaction. The paper relies on earlier research works that have all shown that the self-employed are more satisfied with their jobs than employees (Blanchflower, 2004). This is due to the autonomy at work that the self-employed have, while employees experience it in a smaller degree. In addition, the selfemployed also have better opportunities to organize their work so that it can be interesting, a greater flexibility at work and larger income. Idea: In this perspective, the central hypothesis of this study is that in Serbia, and also other researched countries, the self-employed job satisfaction is higher than that of the employees in their firms. Therefore, the research has been directed to determine whether job satisfaction, as a dependent variable, is systematically different depending on the respondents’ status (self-employed – employee), as an independent variable. Data: The research included 127 employees in 15 different business firms run by the self-employed from different parts of Serbia. Of the total number of respondents, 52 were self-employed while 75 were employees. The respondents rated the importance of and their satisfaction with 12 job dimensions. Tools: While calculating the average importance and satisfaction rates of the self-employed and employees, as well as the statistical significance of the differences in their ratings by means of independent sample t test, significant results have been obtained. Findings: Just like in the earlier research, it has been confirmed that the self-employed show a higher level of total job satisfaction in comparison with employees. Statistically significant differences in the job dimensions’ importance exist only in the job dimension “Work that does not require overtime”, which is significantly more important to employees than to the self-employed. With respect to job satisfaction, statistically significant differences exist in 6 out of 12 job dimensions, and in each of them the self-employed are more satisfied than the employees. Unlike in earlier research, the main source of the self-employed satisfaction is not autonomy at work, but personal responsibility in task completion, safe working conditions and friendly atmosphere at work. Contribution: The study has once again shown that the selfemployed are more satisfied with their job in comparison with the employees, and that this also applies in Serbia

Treatment of Multiple Chalazions with Intralesional Kenalog-40 Injections in Juvenile Patient: A Case Report

Aim: To case report the efficacy of subcutaneous steroid injections in the treatment of multiple chalazions and to evaluate the safety of intralesional injection in primary and recurrent chalazions in juvenile patient.Case report: A 25-year-old man noticed lesions which appeared on upper lid during past three months. It was clinically presented with three focal, large and painful nodules in upper right eyelid. Inflammation process began on May the 1st of 2013. After one month in May 30th 2013 was directly administered synthetic steroid, Kenalog-40. Application of triamcinolone acetonide resulted in two satellite lesions, compared to the original, when the same incisions drained during the first surgery in July 5th 2013, with topical antibiotic-steroidal drugs and hot compresses. Second surgery was in July 26th 2013. Third surgery was performed in August 5st 2013 with second application of Kenalog-40. Combined treatment leads to recovery of clinical signs and inflammation of right upper eyelid with regressions of primary and recurrent chalazions.Conclusion: Two steroid subcutaneous injections produced complete resolution of multiple primary and recurrent chalazions. Clinical imperative was that recurrent or unusual refractory chalazions require referral to Hystopathological examination of curetting to exclude malignancy

Autologous Serum Eye Drops for Post-Chemical Injuries and Corneal Epithelial Defects

Aim: To evaluate success rate (efficacy, safety) in treatment of post-chemical injuries and corneal defects using autologous serum eye drops.Material and Methods: Authors reviewed 93 patients (116 eyes) hospitalized in Clinic of ophthalmology from 2010 to 2013, who had post-causoma corneal defects that were nonresponsive to conventional treatment and were treated with serum therapy. Authors correlated time of epithelialization of defects with rate of epithelial healing.Results: Authors investigated 93 patients (52 males, 41 females; aged 18 - 74) for treatment of corneal defects. Application of autologous serum therapy 56 (48.28%) of 116 eyes was healed in an average time of 4 weeks. Among 116 eyes, epithelial defects healed in 4 (3.45%) within 1 week, in additional 17 (14.65%) in 1-2 weeks, totalling 31 (26.72%) within 3 weeks. Five eyes (4.31%) completely healed at 5 week; three eyes (2.59%) had subsequent healing of epithelial defect at 6 week; 56 eyes completely healed within one month, and the remaining eight eyes healed within 1.5 month.Conclusion: Using serum therapy, it was managed to reduce time of healing from eleven weeks, which were necessary just couple years ago (before 2010) to four (maximum six) weeks to complete healing which are necessary today

THE TREATMENT OF ACUTE POISONING IN CLINICAL EMERGENCY CENTER OF KRAGUJEVAC

No abstract availabl

Evaluation of the patients with Grave's ophthalmopathy after the corticosteroids treatment

Background/Aim. Graves' ophthalmopthy is one of the most common causes of exophthalmos as well as the most common manifestation of Graves' disease. The treatment of Graves' ophthalmopathy includes ophthalmological and endocrinological therapy. The aim of this study was to clinically evaluate the patients with Graves' ophthalmopathy treated with corticosteroids. Methods. Evaluation of 21 patients was performed in the Ophthalmology Clinic and Endocrinology Clinic, Clinical Centre Kragujevac, in the period from 2009 to 2010. They were treated with pulse doses of intravenous corticosteroids. They were referred to ophthalmologist by endocrinologist in euthyroid condition in the active phase of Graves' ophthalmopathy (ultrasonography of orbit findings and positive findings of antithyroid stimulating hormone receptor antibody - anti-TSH R Ab). The clinical activity score (CAS) and NO SPECS classification for evaluation of disease severity were used. Ophthalmological examination includes: best corrected visual acuity, slit-lamp exam, Hertels' test, direct ophthalmoscopy and ultrasonography of the orbit. Results. According to our results 76.19% of the patients were female; mean age of the patients was 35.2 ± 5.6 years. According to CAS classification after 6 months of the treatment recovery was shown in 23.81% of the patients, partial amelioration in 47.62% and no clinical amelioration in 28.57% of the patients. We achieved better results with male, young patients with high clinical activity score. Good results were observed after the first dose of corticosteroids, much better CAS after the third dose, which maintained until 6 months after the first treatment. Conclusion. Our results signify that intravenous pulse dose of corticosteroids treatment of the patients with Graves' ophthalmopthy is safe, comfortable, clinically justified and accessible for the clinicians and patients. Positive results are achieved after the first dose with increasing trend up to the third dose, which was maintained for the next three months

A Toxic Hepatitis Caused the Kombucha Tea – Case Report

Background: Toxic hepatitis may clinically manifest as other diseases of the liver, where it must always be considered in differential diagnoses of unexplained liver damage, such as poisoning with kombucha tea.Case report: 47-year old female patient was hospitalized and has consumed daily ounces of kombucha tea. During hospitalization patient was diagnosed with toxic hepatitis and treated with intravenous solutions of hepatic protective and ursodeoxycholic-acid (effective therapy). Conclusion: Examinations showed that kombucha tea has potential to revert the CCl4-induced hepatic toxicity, but used in overdose can induce toxicity himself

PREVENTION OF ADENOVIRAL EYE INFECTION - REVIEW

Epidemic viral conjunctivitis caused by adenovirus is the most common infectious conjunctivitis. The exact incidence of adenoviral conjunctivitis is still poorly known, but there are two well-defined adenoviral keratoconjunctivitis clinical syndromes: epidemic keratoconjunctivitis (EKC) and pharyngoconjunctival fever (PCF). Epidemic keratoconjunctivitis is also the most severe form and presents with watery discharge, hyperemia, chemosis and ipsilateral lymphadenopathy. Diagnosis is mainly clinical, but its etiology can be confirmed using cell cultures, antigen detection, polymerase chain reaction or immune-chromatography. Multiple treatments have been tried for this disease, but none of them seem to be completely effective. Viruses are resistant to desiccation and certain common surface disinfectants. Prevention is the most reliable and recommended strategy to control this epidemic infection. Global epidemic surveillance system definitely needs to be established to monitor and analyze the epidemic conjunctivitis in the future. There is clearly a need for the national and the military public health institutions to work together on guidelines to handle future challenges

DEVELOPMENT OF SERBIAN MEDICINE IN THE 19TH CENTURY

With the fall of the medieval Serbian state under Turkish rule, every culture, including medicine, died out, and the people resorted to folk medicine and self-taught doctors, i.e. empiricists. Serbs began to get educated in Vienna and Pest, and there were Serbian doctors in Novi Sad already at the beginning of the 18th century. At that time, the first doctors with diplomas appeared in Serbia, but mostly as personal doctors of the Belgrade pasha or Knez Miloš, i.e. his brother Jevrem in Šabac. In the fourth decade of the 19th century, the first military doctors set out, and the newly created four military district commands got their doctors. The Serbian Medical Association started the first medical journal, "Serbian Archives" in 1874. Josif Pancic is writing the first textbook in natural sciences, and Dr. Acim Medovic is writing the first textbook on forensic medicine. Before the First Serbian-Turkish War, the civilian ambulance numbered 69 doctors, 10 medical assistants, 26 pharmacists, and five pharmacy assistants, while the military ambulance had 19 doctors, five medical assistants, one pharmacist, and four pharmacy assistants. Health was initiated but also the establishment of the Ministry of Health and the higher education institution of the Medical Faculty in Belgrade. Guided by the oath, expertise, and experience, the doctors of that time made a significant effort to improve and develop medicine in Serbia in the 19th century