<abstract>
<title style='display:none'>Abstract</title>
Hypoxic-ischemic syndrome (HIS) and Hypoxic-ischemic encephalopathy (HIE) are conditions that affect term and premature babies, with different pathophysiology and different brain disorders. HIE appears in 1-6 / 1000 live births and 26/1000 live births in developing countries. 15-20% die in the early neonatal period, while surviving babies have severe neurological impairment, including cerebral palsy, epilepsy, visual and hearing impairment, cognitive impairment, intellectual, behavioural, and social disorders. The hypoxic-ischemic event occurs before, during or after birth. The reasons may be related to the mother, the way of birth, the placenta, and the newborn. The criteria for diagnosis of HIE include a combination of perinatal factors, the need for resuscitation, standard neurological examinations, neurophysiological monitoring, neuroimaging methods and biochemical markers. The most effective treatment for HIE is hypothermia in combination with pharmacological therapy. HIE and HIS are problem that still persist in developing countries due to inadequate obstetric care, neonatal resuscitation, and hypothermia. Current and emerging research for HIE examines new markers for early recognition, treatment, and appropriate neuroprotection of high-risk term and premature infants.
</abstract>

Hypoxic Ischemic Encephalopathy (HIE) in Term and Preterm Infants

<abstract>
<title style='display:none'>Abstract</title>
<bold>Introduction</bold>: Opioids are the “gold standard” for pain treatment during and after colorectal surgery. They can inhibit cellular and humoral immunity and it is assumed that can promote cancer cell proliferation and metastatic spread. Adequate pain management can be achieved not only with opioids, but also with non-opioid drugs, which can be used together in small doses, i.e., multimodal analgesia, and can lower the need for opioids during and after surgery. Opioid free anesthesia (OFA) is part of multimodal analgesia, where opioids are not used in the intraoperative period.
<bold>Materials and methods</bold>: In this prospective and randomized clinical study 60 patients scheduled for open colorectal surgery were enrolled. They were between the ages of 45 and 70 with the American Association of Anesthesiologists (ASA) classifications 1, 2 and 3, divided in three groups. The first group of patients, or Opioid-based anesthesia group (OBAG), received the following for induction to anesthesia: lidocaine at 1 mg/kg, fentanyl 100 at µgr, propofol at 2mg/kg and rocuronium bromide at 0.6 mg/kg. They intermittently received 50-100 µgr fentanyl intravenously and 0.25 % bupivacaine 2-3 ml every 30-45 minutes, given in the epidural catheter during surgery. The second group of patients, or Low opioid anesthesia group (LOAG), received the following for induction to anesthesia: lidocaine at 1 mg/kg, fentanyl at 100 µgr, propofol at 2mg/kg and rocuronium bromide at 0.6 mg/kg. Prior to surgery, 50 µgr of fentanyl with 5 ml 0.25% bupivacaine was given into the epidural catheter, and the same dose was received at the end of surgery. The third group, or Opioid free anesthesia group (OFAG), received the following before the induction to general anesthesia: dexamethasone at 0.1 mg/kg and 1 gr of paracetamol. Induction to general anesthesia was with lidocaine at 1 mg/kg, propofol at 2mg/kg, ketamine at 0.5 mg/kg and rocuronium bromide at 0.6 mg/kg. After intubation, intravenous continuous infusion with lidocaine was at 2 mg/kg/h, ketamine 0.2 mg/kg/h and magnesium 15 mg/kg/h loaded on and intermittently 0.25 % bupivacaine 2-3 ml every 30-45 minutes given in the epidural catheter during surgery. The primary goal was to measure the patients’ pain after the first 72 postoperative hours in all three groups (2, 6, 12, 24, 36, 48 and 72 hours after surgery). The secondary goal was to measure the total amount of morphine given in the epidural catheter in the postoperative period in all three groups. Other secondary goals were: to compare the total amount of fentanyl given intravenously during surgery in the first and second groups, determine if there was a need to use rescue analgesia in the postoperative period, measure the occurrence of PONV, and to measure the total amount of bupivacaine given in the epidural catheter during operation in all three groups.
<bold>Results</bold>: Visual Analogue Scale (VAS) score comparisons between groups showed patients from the OBA and LOA groups had significantly higher VAS scores, compared to the patients from the OFA group 2, 12, 24 and 48 hours after operation. After 6 hours postoperatively, patients from the LOA group had significantly higher VAS scores, compared to patients from the OBA and OFA groups. After 36 hours postoperatively, patients from the OBA group had significantly higher VAS scores compared to patients from the LOA and OFA groups. At the last follow-up point, 72 hours after the intervention, the patients from the OBA and LOA groups had significantly higher VAS scores compared to the patients from the OFA group. All patients from the OBA and LOA groups, and only 9 from the OFA group received morphine in the postoperative period via epidural catheter. Patients from the Opioid group received significantly higher amounts of fentanyl during surgery. Additional administration of another analgesic drug in the postoperative period was prescribed in 55% of patients in the OBAG, in 50% in the LOAG and in 35% of the OFA group. PONV was registered in 60% of patients from the OBAG and in 40% of patients from the LOAG. In the OFA group did not register PONV in any of the patients. The biggest amount of bupivacaine given during surgery was in the OBAG (26.37 ± 2.6 mg), in LOAG was 25.0 ± 0 and the less in OFAG group (24.50 ± 4.3).
<bold>Conclusion</bold>: Patients from OFA group, compared with patients from OBAG and LOAG, have the lowest pain score in first 72 hours after open colorectal surgery, received fewer opioids via an epidural catheter in the postoperative period, had less need for rescue analgesia, no occurrence of PONV, and less need for bupivacaine via an epidural catheter in the intraoperative period.
</abstract>

Comparation Among Opioid-Based, Low Opioid and Opioid Free Anesthesia in Colorectal Oncologic Surgery

<abstract><title style='display:none'>Abstract</title> Background and aims: Severe neonatal hypoglycemia (HG) leads to neurologic damage, mental retardation, epilepsy, personality disorders, impaired cardiac performance and muscle weakness. We aimed to assess the clinical characteristics of children with hypoglycemia in a random population of newborns.Patients, methods and results: We investigated 84 patients (M:F=35:48) born at the University Clinic for Gynecology and Obstetrics in Skopje (hospitalized in the NICU) who were found to have hypoglycemia. In total 89.25% of the babies were premature. The mean birth weight was 1795.95 +/596.08 grams, the mean birth length was 41.92+/- 4.62 cm, while the mean gestational age was 33.05±3.19 weeks. 32 children (38.08%) were very low birth weight (&lt;1500g), 38 (45.22%) were low birth weight (1500-2500g), while there were 8 children (9.52%) appropriate for age BW and no high BW for age patients (&gt;4000 g).HG duration was 2.42+/-2.41 hours. In the group as a whole, hypoxic-ischemic encephalopathy (HIE) was found in 3 children (3.57%), infections in 22 (26.18%), respiratory distress syndrome (RDS) in 9 patients (10.62%), intracranial haemorrhage in 2 patients (2.38%). There were no inborn errors of metabolism. There were two deaths (2.38%).Conclusion: Neonatal HG is a significant factor in the overall neonatal mortality. HG can also cause severe invalidity. We found that infections, LBW and low gestational age were most commonly associated with neonatal HG. However the Spearman test showed weak direct correlation, without statistical significance. Neonatal HG requires complex and team interaction of prenatal and postnatal approaches to reduce the incidence of seizures, their consequences and the overall mortality. Special consideration is to be taken in measures that avoid neonatal infections, HIE, LBW and low gestational age. Further studies on a larger population are needed to fully understand and prevent the phenomenon of HG in newborns.</abstract>

University Clinic for Gynecology and Obstetrics, Medical Faculty Skopje, Vodnjanska BB, 1000 Skopje,

Macedonia (the former Yugoslav Republic of)

University Clinic for Gynecology and Obstetrics, Medical Faculty Skopje,

Institute for Epidemiology and Statistics, Medical Faculty Skopje,

Neonatal Hypoglycemia: Risk Factors and Outcomes

<abstract><title style='display:none'>Abstract</title>Brachial plexus injuries are still challenging for every surgeon taking part in treating patients with BPI. Injuries of the brachial plexus can be divided into injuries of the upper trunk, extended upper trunk, injuries of the lower trunk and swinging hand where all of the roots are involved in this type of the injury. Brachial plexus can be divided in five anatomical sections from its roots to its terminal branches: roots, trunks, division, cords and terminal branches. Brachial plexus ends up as five terminal branches, responsible for upper limb innervation, musculocutaneous, median nerve, axillary nerve, radial and ulnar nerve. According to the findings from the preoperative investigation combined with clinically found functional deficit, the type of BPI will be confirmed and that is going to determine which surgical procedure, from variety of them (neurolysis, nerve graft, neurotization, arthrodesis, tendon transfer, free muscle transfer, bionic reconstruction) is appropriate for treating the patient.</abstract>

Brachial Plexus Injuries – Review of the Anatomy and the Treatment Options

<abstract>
<title style='display:none'>Abstract</title>
Problematic smartphone use and or addiction is defined as a form of behaviour characterized by the compulsive use of a smartphone that results in various forms of physical, psychological, or social harm. Global popularity in the area of the use of smartphones has raised concerns about the negative effects associated with problematic smartphone use, especially in the younger population.
Having no consensual definition of smartphone addiction (SA), this behavioural addiction is based on the classic addiction symptomology that was included in DSM-5 criteria for compulsive gambling and substance abuse (APA 2013)
This article provides a review of current research related to SA. Articles were found in the PUBMED database using related key words. Statistics confirm the exponential rise of this problem globally, especially in children and adolescents. Therefore, one must make this a high priority among public health issues.
</abstract>

Is Smartphone Addiction in the Younger Population a Public Health Problem?

<abstract><title style='display:none'>Abstract</title>Predicting the outcome of neonatal critical patients remains elusive. The multiple factors of maternal state of health (infections, diabetes, gestosis), the placental situation (premature rupture of membranes) as well as multiple factors from the baby (small for gestational age, low Apgar score, low birth infections, mechanical ventilation, hypoglycaemia hyperglycamiea) render the approach to treatment of each patient individual and the outcome uncertain. Several approaches and scales are developed in order to assess the mortality risk in those rather complicated situations.We used the CRIB-II scale to assess the mortality risk in 80 patients delivered in a large tertiary level hospital with more than 4,000 deliveries yearly. The patients were stratified according to all the neonatal risk factors and comorbidities. The CRIB-II scale identified well the mortality rates, but not the outcomes. A large and well-balanced cohort of patients followed for a longer period is required to discern in detail the importance of CRIB-II scale in predicting outcomes in high-risk new-borns. This could serve as an assistance to personalized approach to severely sick children. In addition, it is a valuable method in comparing outcomes in different NICUs and outcomes in different times in the same NICU, thus rendering possible improvements in the same unit and among several NICU departments.</abstract>

The CRIB II (Clinical Risk Index for Babies II) Score in Prediction of Neonatal Mortality

<abstract><title style='display:none'>Abstract</title>
<sec><title style='display:none'>Introduction:</title>
The use of herbal medicine as a part of the Complementary and Alternative Medicine is increasing worldwide. Herbal remedies are used to better different conditions including gastritis. 
</sec>
<sec><title style='display:none'>Material and Methods:</title>
We conducted a prospective randomized control clinical trial on a total sample of 72 patients with gastritis in order to examine the effects of the commercial herbal product Gastro Protect. After 6 weeks of conventional therapy the patients were divided into two groups with 36 patients each. As a continuation of the treatment, Group 1 received conventional therapy + Gastro Protect and Group 2 received conventional therapy + Placebo.
We analyzed 14 selected gastrointestinal symptoms, five related to digestive problems, and nine related to stool and bowel problems. For assessing the selected symptoms we used seven point gastrointestinal symptom rating scale (GSRS).
</sec>
<sec><title style='display:none'>Results:</title>
The Gastro Protect group had a significantly lower GSRS score (better condition) compared to the Placebo group related to all five selected symptoms of digestive problems as: abdominal pain (p=0.0250), hunger pain (p=0.0276), nausea (p=0.0019), heartburn (p=0.00001), and acid reflux (p=0.0017). The Gastro Protect group, also had a significantly lower GSRS score (better condition) compared to the Placebo group related to three out of nine selected bowel symptoms: rumbling (p=0.0022), abdominal distension (p=0.0029), and gas or flatus (p=0.0039).
</sec>
<sec><title style='display:none'>Conclusion:</title>
Gastro protect was effective in treating gastritis and other gastrointestinal symptoms. It was safe for usage and showed almost no side effects. In our study, Gastro Protect reduced the examined gastric symptoms and related examined intestinal symptoms.
</sec>
</abstract>

Evaluation of the Effects of Gastro Protect as an Alternative Medicine on Gastritis and Other Gastrointestinal Symptoms

<abstract><title style='display:none'>Abstract</title>
<sec><title style='display:none'>Introduction:</title>
Obstructive uropathy encompasses various urinary tract obstructions, leading to changes in urine flow, kidney pressure, and impaired kidney function. Predicting renal recovery from obstructive uropathy, can be challenging and necessitates treatment, as in percutaneous nephrostomy (PNS) drainage. The choice of drainage method depends on patient-specific factors and local expertise. According to the data for the Republic of North Macedonia, in the register of the European Renal Association, in the last few years, there has been an increase in the percentage of patients with obstructive nephropathy from 7.6% to 8.9% who end up on a chronic hemodialysis program. Prompt relief from urinary tract obstruction is essential to preserve renal function and prevent complications.
The aim of this study is to present our initial data analysis of recent experience in the use of nephrostomies as a method for temporary or long-term resolution of obstructive nephropathy, in terms of safety and success in preserving kidney function and reducing the number of patients on hemodialysis.
</sec>
<sec><title style='display:none'>Materials and methods:</title>
This study analyzed the medical records of 24 patients with obstructive uropathy who underwent PNS placement. Data were collected for the type and degree of obstruction from the ultrasonographic examination. A pig tail nephrostomy was used, with a dilator, guided under ultrasound and controlled with contrast and fluoroscope. Obstructive nephropathy was defined as an elevation of the serum creatinine &gt; 109 µmol/L, before the intervention. Glomerular filtration rate (GFR) was calculated according to the formula CKD epi in ml/min. Each placement of the PNS was considered as an individual procedure and the data of 38 placed nephrostomies were analyzed. We compared the laboratory analyses from the day before (D0) PNS placement and on the seventh day (D7) after PNS placement. The reduction of values for red blood cells (RBC) and hemoglobin (Hb) baseline values from D0 to D7 and the need for transfusion after the procedure were defined as a complication-bleeding. The increase in total counts of the white blood cells (WBC) and C-reactive protein (CRP) from the baseline values from D0 to D7 were defined as a complication-infection. Standard statistical methods were used for data processing.
</sec>
<sec><title style='display:none'>Results:</title>
Most patients, 17 (70%), had malignant disease as the cause of obstruction. Unilateral obstruction was more common, detected in 24 (63%) of procedures, with a high degree of hydronephrosis. Obstructive nephropathy, marked by elevated serum creatinine, was observed in 23 (60%) cases before PNS placement. Complications included bleeding and infection but did not result in any fatalities. When comparing the laboratory analysis before PNS placement (D0) and seven days later (D7), a statistically significant decrease in serum creatinine (225±161 vs. 162±145, p=0.005) and an increase in GFR (47±39 vs.59±34, p= 0.005) were observed.
</sec>
<sec><title style='display:none'>Conclusion:</title>
Percutaneous nephrostomy is a safe and effective treatment option for urinary tract obstruction, especially in patients with malignancies. Continuous monitoring is essential to assess long-term complications and the longevity of PNS functionality. This procedure offers a significant benefit in preserving renal function and minimizing the need for hemodialysis in these patients.
</sec>
</abstract>

Percutaneous Nephrostomy as a Procedure in the Treatment of Urinary Tract Obstruction – Experiences in the University Clinic of Urology in Skopje

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>Introduction:</title>
Gonarthrosis is arthrosis of the knee joint, a chronic non-inflammatory disease manifested by progressive destruction of the intra-articular cartilage, accompanied by abnormal formation of the bones form the joint, changes in the synovial membrane and synovial fluid. Gonarthrosis is the most common type of arthrosis. Gonarthrosis can be treated conservatively and operatively. Among well-established surgical options for the treatment of medial gonarthrosis are high tibial osteotomy (HTO), unicompart-mental knee arthroplasty (UKA), and total knee arthroplasty (TKA). Proximal fibular osteotomy (PFO) or superior partial fibulectomy is a relatively recent procedure proposed to reduce knee pain in patients with medial compartment.
</sec>
<sec><title style='display:none'>Aim:</title>
Our study aims to demonstrate an alternative treatment for gonarthrosis with proximal fibular osteotomy and reduced knee pain in patients with medial compartment osteoarthritis of the knee. 
</sec>
<sec><title style='display:none'>Materials and methods:</title>
At the Department of Orthopedics and Traumatology at J.Z.U “Borka Taleski” Prilep in the period from 2018 to 2021, 14 cases were treated, of which 11 were female and 3 were male. All patients were aged between 62 and 82 years with a mean age of 71.3 years. Patients had a severe degree of gonarthrosis (III/IV) according to Kellgren-Lawrence classification. Arthroscopy was performed in 2 patients. The fibula osteotomy was 7 cm away from the fibular head, with 1 cm resected bone fragment from the fibula.
</sec>
<sec><title style='display:none'>Results:</title>
The average duration of the surgery was 30 minutes. Patients were followed up on the 7th day, first month, 3 months and 6 months after surgery. The final evaluation of function was done after 6 months by examining the active and passive movements of the knee joint. In all 14 patients we have excellent results with pain reduction, improvement of movement and quality of life.
</sec>
<sec><title style='display:none'>Conclusion:</title>
Proximal fibular osteotomy is an option for medial compartment osteoarthritis of the knee. Current literature is limited to small case series which report good outcomes in pain reduction, including the correction of varus deformity in medial gonarthrosis. Further studies are needed to determine the place of the PFO in the medial gonarthrosis management algorithm before it can be recommended for routine clinical use.
</sec>
</abstract>

Alternative Treatment of Gonarthrosis: Proximal Fibular Osteotomy

<abstract><title style='display:none'>Abstract</title>
The medical records of 438 patients who underwent myringoplasty followed up for a minimum of one year in the period of 1980 and 2015 were revised. Examination under otomicroscope was done of the ear to be operated. This was carried out with a speculum under the operating microscope to be reliably asses the tympanic membrane, site of perforation, to rule out any other pathology and assess the status of ossicular chain. All the patients submitted primary myringoplasty surgery were operated under <italic>postauricular, endaural and transcanal approach </italic>with <italic>overlay, underlay and inlay methods</italic>. In the study the patients were divided into three groups depending upon the technique utilized to repair the tympanic membrane. When we compared overlay technique group with underlay technique group, it was observed that overlay technique was no statistically significant difference between these three groups in term of age wise distribution, gender wise distribution, duration of disease and cause of disease, due to matching at the time of selection. In this study the outcome in terms of graft uptake rate was slight better in the overlay technique (94%) as compared to the underlay technique (86.2%), though the difference was statistically insignificant, P&gt;0.05. Patients selection may have had a role in the high success rate in the present study as patients presenting with middle ear pathology were excluded. The complications rate in the present study was quite low, no case in inlay group, three cases of graft lateralization in underlay group, and 19 cases in overlay group. In this study, better results were achieved with overlay technique may probably be due to less surgical manipulation and faster healing process.
</abstract>

Myringoplasty – A Rewiev of 438 Cases

<abstract><title style='display:none'>Abstract</title>
The high level of technological growth in contemporary society, beside benefits, provokes different kinds of damages, especially among the worldwide youth population. World statistics have recognized that video and internet game addiction is a growing problem. In this context, it is supposed that 0.3 to 1.0 percent of the general population might be qualified as a potential sufferer of internet gaming disorder. However, youth between 18-34 years are the highest risk population.
New research has shown the need of early identification of at-risk young people for internet addiction. Adverse experience in children of different forms of stress, negative life circumstances and especially negative, hostile parenting can lead to depression, social and cultural problems, together with significant boredom and loneliness levels. These are all confirmed to be related with addictive behaviour.
Some neural correlates are discussed as the possible background of game addiction. Finally, therapeutic possibilities are presented.
</abstract>

Internet/Video Gaming: The Relevance of a New Phenomenon in the Youth

Assessing Outcome Predictors of COVID-19 Requires a Multicentre, Prospective Design and Inclusion of All Determinants

<abstract><title style='display:none'>Abstract</title><bold>Background:</bold> Chronic kidney disease (CKD) is an emerging health problem in both developed and developing countries. Depression, anxiety and sleep disturbances are highly prevalent in patients with chronic disease, but remain undertreated despite significant negative consequences on patients’ health. Assessment of key components of mental health early in disease course will help to identify high risk subjects in whom modifying these predictors will help in providing active and healthy life in CKD patients.<bold>Methods:</bold> We did a cross sectional study in 200 patients of CKD stage III to V-D fulfilling the eligibility criteria who were on follow up in a single tertiary care center in the state of Haryana, India. We assessed the prevalence of anxiety, depression and insomnia and their correlation with demographic variables in these patients. The structured questionnaire used in this study gathered information on respondent demographic and disease characteristics, and information obtained from the HADS and PSQI questionnaire. Factors associated with anxiety, depression and insomnia were examined by a multiple logistic regression analysis.<bold>Results:</bold> The prevalence of anxiety, depression and insomnia were found to be 71%, 69% and 86.5% respectively. As the CKD stage advanced, the prevalence as well as severity of these parameters increased. Anxiety, depression and sleep quality were found to be significantly correlated to unemployment, low income, low education, urban residence and presence of co-morbidities. The anxiety, depression and insomnia scores were found to have a strong negative correlation with eGFR, hemoglobin, serum calcium (p &lt;0.01) and a positive correlation with TLC, blood urea, serum creatinine and serum phosphate (p &lt;0.05).<bold>Conclusion:</bold> We observed a high prevalence of anxiety, depression and insomnia in CKD patients. There is a need to develop strategies to accurately identify “high risk” subjects who may benefit from preventive measures before complications occur. By identifying CKD patients with high risk of developing these mental health related issues, healthcare provider may be better able to ensure the provision of appropriate rehabilitation to this population.</abstract>

Prevalence of Depression, Anxiety and Insomnia in Chronic Kidney Disease Patients and their Co-Relation with the Demographic Variables

<abstract><title style='display:none'>Abstract</title><bold>Introduction</bold>: Opioid-free anesthesia (OFA) is a new anesthesiological technique, where the giving of opioids (fentanyl) is avoided in the intra- and post-operative period. This leads to reduction in the opioid-related side effects and lower pain scores in the postoperative period.<bold>Materials and methods</bold>: In this randomized, single-blind clinical study, 60 patients scheduled for elective laparoscopic cholecystectomy were enrolled. Half of them (30 patients) received general balanced anesthesia with fentanyl (F group-FG), and the half received opioid-free general anesthesia (OFA group-OFAG). In the post-operative period, Visual Analogue Scale (VAS) scores were followed at rest and when coughing 1 hour, 4 hrs, 8 hrs, 12 and 24 hrs after surgery. Both groups were followed by opioid requirements in the postoperative period.<bold>Results</bold>: In the postoperative period, patients in the fentanyl group (FG) have higher pain scores at rest and on coughing in all analyzed timeframes compared to patients from the OFA group, but statistically significant difference was approved 1 and 24 hours after surgery. In the OFA group 24 hours after surgery none of the patients reported pain at rest and when coughing number 7, 8, 9 and 10 according to the VAS pain score. The total opioid requirement in the postoperative period was significantly higher in the fentanyl group (FG) at rest and when coughing, compared to the OFA group.<bold>Conclusion</bold>: Opioid-free anesthesia as a part of multimodal analgesia and a new anesthesiology technique is a safe procedure, where opioid-related negative effects in patients undergoing elective laparoscopic cholecystectomy are avoided..</abstract>

Is Opioid-Free General Anesthesia More Superior for Postoperative Pain Versus Opioid General Anesthesia in Laparoscopic Cholecystectomy?

<abstract><title style='display:none'>Abstract</title>A quality-made dental impression is a prerequisite for successful fixed-prosthodontic fabrication and is directly dependent on the dimensional stability, accuracy and flexibility of the elastomeric impression materials, as well as on the appropriately used impression techniques. The purpose of this paper is to provide a literature review of relevant scientific papers which discuss the use of various silicone impression materials, different impression techniques and to evaluate their impact on the dimensional stability and accuracy of the obtained impressions. Scientific papers and studies were selected according to the materials used, the sample size, impression technique, storage time, type of measurements and use of spacer for the period between 2002 and 2016. In the reviewed literature several factors that influence the dimensional stability and accuracy of silicone impression molds, including the choice of the type of viscosity, impression material thickness, impression technique, retention of the impression material on the tray, storage time before the casting, number of castings, hydrophilicity of the material, release of byproducts, contraction after polymerization, thermal contraction and incomplete elastic recovery were presented. The literature review confirmed the lack of standardization of methodologies applied in the research and their great diversity. All findings point to the superiority of the addition silicone compared to the condensation silicone.</abstract>

Dimensional Stability and Accuracy of Silicone – Based Impression Materials Using Different Impression Techniques – A Literature Review

<abstract><title style='display:none'>Abstract</title>Obesity and excess weight are a pandemic phenomenon in the modern world. Childhood and adolescent obesity often ends up in obesity in adults. The costs of obesity and its consequences are staggering for any society, crippling for countries in development. Childhood obesity is also widespread in Macedonia. Metabolic syndrome, dyslipidemia and carbohydrate intolerance are found in significant numbers. Parents and grandparents are often obese. Some of the children are either dysmorphic, or slightly retarded. We have already described patients with Prader-Willi syndrome, Bardet-Biedl syndrome or WAGR syndrome. A genetic screening for mutations in monogenic obesity in children with early, rapid-onset or severe obesity, severe hyperphagia, hypogonadism, intestinal dysfunction, hypopigmentation of hair and skin, postprandial hypoglycaemia, diabetes insipidus, abnormal leptin level and coexistence of lean and obese siblings in the family discovers many genetic forms of obesity. There are about 30 monogenic forms of obesity. In addition, obesity is different in ethnic groups, and the types of monogenic obesity differ. In brief, an increasing number of genes and genetic mechanisms in children continue to be discovered. This sheds new light on the molecular mechanisms of obesity and potentially gives a target for new forms of treatment.</abstract>

Obesity in Childhood and Adolescence, Genetic Factors

<abstract><title style='display:none'>Abstract</title><italic>Introduction</italic>: This systematic literature review was performed to establish the mechanism, methodology, characteristics, clinical application and opportunities of the T-Scan III System as a diagnostic tool for digital occlusal analysis in different fields of dentistry, precisely in orthodontics.<italic>Methods</italic>: Searching of electronic databases, using MEDLINE and PubMed, hand searching of relevant key journals, and screening of reference lists of included studies with no language restriction was performed. Publications providing statistically examined data were included for systematic review. <italic>Results</italic>: Twenty potentially relevant Randomized Controlled Trials (RCTs) were identified. Only ten met the inclusion criteria. The literature demonstrates that using digital occlusal analysis with T-Scan III System in orthodontics has significant advantage with regard to the capability of measuring occlusal parameters in static positions and during dynamic of the mandible.<italic>Conclusion</italic>: Within the scope of this systematic review, there is evidence to support that T-Scan system is rapid and accurate in identifying the distribution of the tooth contacts and it shows great promise as a clinical diagnostic screening device for occlusion and for improving the occlusion after various dental treatments. Additional clinical studies are required to advance the indication filed of this system. Importance of using digital occlusal T-Scan analysis in orthodontics deserves further investigation.</abstract>

PHO Dental Clinical Center Sv. Pantelejmon, Clinic for Orthodontics, Skopje, R. Macedonia

Faculty of Dental Medicine, University Ss. Ciril and Metodius, Department of Prosthodontics, Skopje, R. Macedonia

Faculty of Dental Medicine, University Ss. Ciril and Metodius, PHO Dental Clinical Centar for Maxillofacial Surgery, Skopje, R. Macedonia

Facultu of Dental Medicine, Department for Prosthodontics, University of Dental Medicine, Sofia, R. Bulgaria

T-Scan III System Diagnostic Tool for Digital Occlusal Analysis in Orthodontics – a Modern Approach

<abstract><title style='display:none'>Abstract</title>Stress, as a kind of emotion, is inevitable in everyday life. In psychosomatic medicine stress represents a powerful link in the pathophysiological chain of disorder. Having evidence about the power of stress on the body, the interest in medicine was how to measure it in appropriate, fast way and with minimal cost. Electrodermal activity seems to be available for this purpose.The galvanic skin response (GSR) is an objective, transient indication of autonomic nervous system arousal in response to a stimulus. It refers to changes in sweat gland activity that are reflective of the intensity of our emotional arousal.In this article we discuss physiological specifics of skin conductance/resistance and how it is measured in practice. The most used application of GSR is in biofeedback methodology. Biofeedback assessment and training exactly uses skin reaction to different stimuli and aims to gain voluntary control over this autonomic response. The aim of this article is to show effectiveness of this method in paediatric practice.</abstract>

Electrodermal Activity and Stress Assessment

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