Biomedical subjects
Publications and source records attributed to D Kecmanović.
Plantago ovata is a high fibre bulk forming laxative. It absorbs water and expands to provide increased bulk and moisture content to the stool. The increased bulk encourages normal peristalsis and bowel motility. Clinical Indications: Constipation, Fecal Incontinence, Hemorrhoids, Ulcerative Colitis, Appetite, Hyperlipidemia, Diabetes mellitus.
The aim of this study is to describe a role of diosmine in the management of bleeding nonprolapsed hemorrhoids. From November 2003 to January 2004, 60 patients were treated with Phlebodia (diosmine). Total colonoscopy was performed at the discretion of the authors according to the age, symptoms and genetic factors of the patient. Patients were treated with Phlebodia (diosmine, 3x1, 5 days) and in addition a bulk agent (3,26 g plantago ovata sachet, twice daily, for the period of next three months). Hemorrhoidal bleeding stopped after 3,2 days. Diosmine, used with fiber supplements, rapidly and safely stops bleeding from nonprolapsed hemorrhoids.
The aim of this prospective randomized study is to describe the effects of laxative plantago ovata after open hemorrhoidectomy (Milligan-Morgan). Sixty patients divided into 2 equal groups were included in this study. The first group was treated postoperatively with 2 sachets of bulk agent Laxomucil (3.26 g plantago ovata), twice daily, for a period of twenty days, while the control group was treated with glycerin oil. The p.ovata group patients had a statistically significant shorter postoperative length of hospital stay (2.9 v.s. 4.1 days). Pain after stool was statistically significant more tolerable in the p.ovata group. In conclusion, the application of bulk agent plantago ovata after hemorrhoidectomy shortens the mean postoperative hospital stay, expedites digestive function recovery and lessens the pain after stool.
The aim of the study is detection of the abdominal infective foci using 99mTc-ciprofloxacin, radiopharmaceutical supposed to distinguish inflammation from infection. Twenty-one patient was investigated. There were 11 true positive findings, 7 true negative, two were false negative, while 1 was false positive. Sensitivity of the method was 79% and specificity 91%. According to our results, scintigraphy with infection is a useful method for detection and assessment of exact localization of deep seated bacterial infections, which might be useful for (differential) diagnosis, surgical treatment in due time as well as monitoring of the treatment of conservative therapy.
The aim of this work is to present existence of the lateral lymphatic spread of metastases in patients with Dukes C low rectal carcinoma (60% of all patients), located at or bellow peritoneal reflexion. Prospective clinical investigation analyzed the group of 64 patients (32 underwent lateral lymphadenectomy and 32 didn't), all treated at Ist Surgical Clinic, Clinical Center of Serbia. Lateral lymphatic spread of metastases was proven by frozen section in 8 cases, so extensive lateral lymphadenectomy was performed. In the group of patients who underwent lateral lymphadenectomy, positive lymph nodes were registered in 18 patients (56.2%); in group of patients operated without lateral lymphadenectomy, metastatic lymph nodes were registered in 12 patients (37.5%). According to results of this investigation, method of lateral lymphadenectomy, as well as extensive lateral lymphadenectomy, is significant for exact determination of postoperative stage of the disease. Also, there is a significant increase in number of patients with Dukes C stage of the disease. In those patients, mesorectectomy alone is not sufficient.
Female patient, 68, hospitalized due to vaginal bleeding, anaemia and defecation disorder. We have done examinations as follows: clinical and laboratory exams, which confirmed severe anaemia. Explorative curretage of uterus--PH findings: malignant tissue. Rectoscopy: extraluminal compression at lo cm from the anal verge. Irigography: spasticity and extraluminal compression to proximal third of rectum and distal sigmoid colon. Ultrasound of abdomen: solid lobular formation 10 x 7 cm in diameter, on the left side of the urinary bladder, surrounded by thin layer of ascites. Ultrasound of liver: without signs of malignant disease. CT-scan of pelvis and abdomen: metastatic lymph nodes, up to 40 mm in diameter, alongside abdominal aorta; solid-lobular tumor, 10 x 7 cm, on the left side of urinary bladder, which fills the central portion of pelvic cavum. Secundary malignant deposits on the pelvic parietal peritoneum with minimal quantity of ascites (peritoneal carcinomatosis). Intraoperative findings confirmed malignant deposits on the right colon serosa, so we performed right hemicolectomy with ileo-colo anastomosis, omentectomy, hysterectomy, bilateral adnexectomy, low anterior resection of the rectum, peritonectomy of pelvis and reconstruction of digestive tubus by colo-rectal anastomosis with circular stapler ILS 33. Duration of operation was 6:45 hours, blood loss was 1100 ml. Intraoperatively was intraperitonealy applicated Adriamycin. One month after the operation, systemic chemotherapy consisting of Endoxan and Karboblastin was administered, for the duration of 6 months, once monthly. Twelve months after the operation NMR showed normal findings, patient was without evidents of recurrent disease.
Pelvic exenteresis (total, anterior and posterior) is operative procedure reserved for the local advanced malignancies of the pelvis. In the period 1995-2001, we have treated 54 patients (20 male, 34 female) by this procedures. By anterior pelvic exenteresis we have treated 6 females for: Ca vesicae urinary (4 pts). Ca PVU after irradiation therapy (1 patient), Ca urethrae (1 patient). By posterior pelvic exenteresis we have treated 2 females for primary advanced Ca of the rectum. By total pelvic exenteresis we have treated 46 pts (20 male, 26 female): Ca PVU after irradiation therapy (10 females), recidivant Ca PVU (8 females), primary advanced Ca of the rectum (7 male, 1 female), recidivant Ca of the rectum (10 male, 7 female), recidivant Schwanoma (1 male), recidivant Sa stromae endometrii (1 female), recidivant Ca vesicae urinary (1 female). The median survival time of all 54 patients was 24 months. Early postoperative mortality was 18% (10 pts). Twenty patients died with median survival of 18 months (range 4-48 months). Twenty one patients are alive without evidence of disease with median follow up period of 41 months (range 6-60 months). Three patients were lost from follow up. Exenteresis pelvis is very complicate operative procedure and it should be limited to perform only in couple surgical centers.
Intestinal duplication is a rare congenital anomaly. It appears through out entire gastrointestinal tract, specially in the ileum. Gastric duplication cyst in adults is extremely rare. Diagnosis is often missed, often established at operation. Preoperative diagnosis may be suspected on CT or MRI with contrast given oraly as well as on EUS. Management of symptomatic gastric duplications is surgical. Recommended management is complete exscision of the duplication without major violation of the gastric lumen. In most cases giant cyst does not allow smaller resection but partial gastrectomy. In this report a rare case of gastric duplicatione cyst of the proximal stomach is presented. Diagnostic finding and surgical therapy are discussed.
During the last four decades, parallel to the strategic and practical innovations that have occurred in social psychiatry, the concepts of the normal and the pathological have changed. As the normal and the pathological are determined and recognisable in both the spatial and the temporal framework, a change in these concepts can be assessed by tracing the shifts in their above mentioned fundamental dimensions. The spreading of the ideas and the practice of the community-centred psychiatry has brought about the greatest difficulties in defining the normal and the pathological.
In Yugoslavia a special commission evaluates the working abilities of insured ill people. In the last 14 years the number of people referred to this commission has increased. For people assessed as being unable to work the most frequent diagnoses have been psychiatric and cardiovascular diseases. All individual requests for retirement on partial or full pension based on mental disorder (n = 1563) made in 1982 in Bosna and Herzegovina were studied. People who were awarded pensions were also followed up. The results obtained indicated that the willingness to retire is widespread among insured people, quite often regardless of the actual impairment of their working abilities. Data are interpreted in the light of the severe socioeconomic crisis Yugoslavia has been experiencing through the last decade.
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