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Serbia has a low incidence of tuberculosis (TB), with a decreasing trend in the last decade. The purpose of this manuscript is to describe an outbreak of TB infection that occurred in 2016 among students of a grammar school in Novi Pazar. A 17-year-old girl, third-grade student of a grammar school (the index case), was diagnosed with smear-positive tuberculosis. Contact investigation was conducted, including chest X-ray examinations of over 1100 persons. After the index case was detected, a total of 16 (10 pulmonary and 6 extrapulmonary) tuberculosis patients were newly diagnosed during 2016. Among 11 culture positive cases, MIRU-VNTR method revealed that all Mycobacterium tuberculosis isolates were identical. Diagnostic delay contributed to the transmission of infection.

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PURPOSE: Ovarian cancer (OC) is the most fatal cancer in females. The objective of this paper was to determine the incidence and mortality trends of OC in central Serbia from 1999 to 2003. METHODS: Data about all new cases and deaths of OC were obtained from the Serbian Cancer Registry. Data were analyzed for the central of Serbia which encompasses the territory of Serbia without its northern and southern regions. Data of the female population were obtained from the population censuses in the years 1991, 2002 and 2011. World population was used as a standard. Trend and annual percentage change (APC) of the incidence and mortality rate with corresponding 95% confidence intervals (CI) were calculated by performing jointpoint regression. RESULTS: Jointpoint analysis showed increased incidence trend of annual standardized rate (ASR) for OC from 1999 to 2013 with APC 0.3% (95%CI: 0.3, 0.8). Significantly increased trend in OC mortality was recorded continuously from 1999 to 2007 with APC 2.25% (95% CI: 0.9, 3.6). Decreased mortality trend was observed in the period 2010- 2013 with APC -7.34% (95%CI:-15.8, 2.0). The majority of the new cases of OC were aged 40-74 (78.7%). OC was the sixth most common cancer of all cancers in females and the sixth most common cause of cancer death in females. CONCLUSIONS: During 1999-2013 there was an increasing trend of incidence of OC. In 1999-2007 there was a significant increasing mortality trend and non-significant decrease of the trend from 2010 to 2013 in central Serbia. The incidence and mortality rates of OC in central Serbia were higher than the corresponding rates in neighboring countries.

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Background/Aim: Chronic hepatitis C (CHC) is often associated with injectable drug users and human immunodeficiency virus coinfection for which there is stigmatization in society. The aim of this study was to identify the presence of stigma and discrimination of patients with CHC, as well as the influence of sociodemographic factors on the occurrence of stigmatization. Methods: A cross-sectional study was performed. Patients with CHC and conducted antiviral therapy completed an anonymous structured questionnaire consisting of sociodemographic questions and Hepatitis C stigma scale. Results: Out of 154 patients 61.7% were male and 72.1% from the city; 59.7% have completed secondary school; 61.7% were employed before the disease while 31.8% after the disease; 45.5% were unsatisfactory with financial situation; 54.5% were married; 37.7% lived with a spouse and children; 86.4% in their own house/apartment; 5.2% of the patients were abandoned by their partners, while 35.7% consumed drugs. A statistical significance of the stigma score was found in those who lived in the city (p = 0.018), unmarried (p = 0.005), abandoned by the partners after the diagnosis of CHC (p < 0.001), drug users (p = 0.002) and those living with parents (p = 0.034). Univariate regression analysis singled out as significant: residence (p = 0.018), living with their parents (p = 0.046), abandonment by a partner (p < 0.001) and drug use (p = 0.002). A multivariate regression model of independent variables singled out abandonment by partners (Beta = 5.158, p = 0.007). Men disagree significantly with the two elements inside stigma [not the same as the others (p = 0.035)] and hurt by the reaction of others (p = 0.047)). Conclusion: The presence of stigma in patients with CHC was proven. The results indicate the need to strengthen anti-stigma programs that will reduce their psychological and social problems and reduce stigmatization in society.

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INTRODUCTION/AIM: Pseudomonas aeruginosa (P. aeruginosa) is the most common cause of wound infections, following the disruption of the skin or mucous membranes integrity. The aim of this study was to analyze of the presence P. aeruginosa in wound swabs, antibiotics susceptibility testing, determination of the minimum inhibitory concentrations (MICs) of antibiotics, testing of the metallo-ß-lactamases (MBLs) production, isolates serotyping and analysis of the most common serotypes resistance. METHODS: A total of 90 outpatients and 55 intpatients wound swabs were cultivated. Wound swabs were taken from the patients with wound infections symptoms. Antibiotics susceptibility testing was performed to: meropenem, imipenem, piperacillin-tazobactam, ceftazidime, cefepime, amikacin, gentamicin, netilmicin, of loxacin, ciprofloxacin and colistin (HiMedia). Polyvalent and monovalent antisera for agglutination (Biorad) were used in P. aeruginosa agglutination. RESULTS: P. aeruginosa was isolated from 36.55% wound swabs (36.66% of the inpatients wounds and 36.36% of the outpatients). The analyzed isolates showed the highest degree of sensitivity to colistin (100%) and meropenem (93.44%) and the lowest to cefepime (19.54%). The majority of the inpatients isolates had 12 µg/mL (28.57%) MIC for piperacillin-tazobactam and 16 µg/ml (28.57%) for the outpatients. The most common MICs for ciprofloxacin were 0.19 µg/mL (31.81%) for the nosocomial isolates, and 0.25 µg/mL (28.57%) for the outpatients' ones. The most common ICs for amikacin of the nosocomial isolates were 6 µg/ml (40.90%), and for the outpatients ones 4 µg/mL (33.33%). Five (9.43%) isolates produced MBLs. The most common serotypes were P11 (22.64%), P6 (15.09%) and P1 (11.32%). CONCLUSION: Neither the increased presence of P. aeruginosa was noticed in wounds swabs, nor the antibiotic resistance in the nosocomial isolates compared to those from outpatients. The analyzed isolates had the higest sensitivity to colistin and meropenem, and the lowest to cefepime.

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BACKGROUND/AIM: Pseudomonas aeruginosa (P. aeruginosa) is divided into 20 serotypes on the base of the International Antigenic Typing Scheme. P. aeruginosa serotyping is important because of few reasons but epidemiological is the most important. The aim of the study was serotyping of P. aeruginosa clinical isolates, analysing of single clinical isolates P. aeruginosa present in the particular samples, and analysing of pyocianin and fluorescin production in different isolates of P. aeruginosa. METHODS: A total of 223 isolates of P. aeruginosa, isolated in the microbiological laboratory of the Health Center "Aleksinac", Aleksinac, were examinated. P. aeruginosa isolates were put on the pseudomonas isolation agar, pseudomonas agar base, acetamid agar, asparagin prolin broth, pseudomonas asparagin broth, Bushnnell-Haas agar, cetrimid agar base, King A and King B plates, plates for pyocianin production, plates for fluorescin production and tripticasa soya agar (Himedia). Polyvalent and monovalent serums were used in the agglutination (Biorad). Pigment production was analysed on the bases of growth on the plates for pyocianin and fluorescin production. RESULTS: Serologically, we identificated the serovars as follows: O1, O3, O4, O5, O6, O7, O8, O10, O11 and O12. O1 (38%) was the most often serovar, then O11 (19%) and O6 (8.6%). A total of 18.6% (42) isolates did not agglutinate with any serum, whereas 21 isolates agglutinated only with polyvalent serum. The majority of P. aeruginosa isolates produced fluorescin, 129 (58.54%), 53 (22.94%) produced pyocianin whereas 49 (21.21%) isolates produced both pigments. CONCLUSION: P. aeruginosa was isolated most of the from urine, sputum and other materials. The majority often serovars were O1, O6 and O11. The most of isolates produced fluorescin (58.54%), while 22.94% producted pyocianin and 21.21% both pigments.

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Neonatal tetanus is a severe, often fatal disease caused by the toxin Clostridium tetani. Neonatal tetanus is a generalized tetanus, which occurs in a neonate between 3-28 days of life. The findings indicated that tetanus in a newborn of an unvaccinated mother occurred after the application of non-sterile clay to the umbilical cord. This case was a seven-day-old male baby with progressive difficulty in feeding, trismus, hypertonicity, opisthotonos, and heart murmur. The patient was afebrile and eupneic, and had a history of non-sterile home delivery. In the past, the area of Bujanovac, Medvedja and Presevo had been exposed to mass immigration (especially due to the war in the territory of former Yugoslavia), which caused a serious problem for general practitioners, who had to be vigilant and ensure that all patients registered in their practice were fully immunized. This case has provided a clear indication of the necessity for strategies of both vaccination and ensuring hygienic conditions throughout pregnancy and delivery to prevent neonatal tetanus.

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PURPOSE: Vaccination is the fastest, most efficient and the cheapest measure to prevent communicable diseases. The purpose of the work was to evaluate the results of primary vaccination as well as the first revaccination by DPT,OPV and MMR vaccines. WORK METHOD: Descriptive epidemiological study was used. The investigation was done in the Primary Health Center in Nis and it involved all the children who were born in 2000, 2001, 2006 and 2007. WORK RESULTS: A total number of 1863 vaccination records were examened. In the sample of examened records of children who were born in 2000 and 2001, there were 155 children (12.05%) who were vaccinated with different vaccines and according to the different vaccination schedules. The number of childern born in 2006 and 2007 was slightly higher and it was (14.70%). In the first group (children who were born in 2000 and 2001) there were 43 children (4.51%) who were not vaccinated (3 children haven't been vaccinated by DPT, and other 40 haven't been vaccinated by MMR). Similar situation was in the second group (children who were born in 2006 and 2007) in which 37 children (4.03%) haven't been vaccinated at all (3 of them by DPT and other 34 by MMR). In both observed groups DPT vaccine immunization started out late. 48.25% of children from the first group haven't been vaccinated with the first dose of DPT on time. 58.53% of children born in 2006 and 2007 haven't been vaccinated with the first dose of DPT on time. The first re-vaccination by DPT was also late in children born 2000 and 2001 (16.6% vs 45.36%). It was also delayed the first revaccination by MMR (10.3% vs 22.53%). DISCUSSION: To achieve the expected effects should be vaccinated at least 95% of planned persons but also make timely vaccinations. While the main goal of immunization is to prevent illness and death, the overriding concern of any public health intervention must be "Primum non nocere". CONCLUSION: A small number of post-vaccinal reactions is registered, and there haven't been registered cases of adverse events following immunization or serious reactions that would be contraindications for further immunization.

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BACKGROUND/AIM: Stressful life events present a very important category of psychosocial stress. A few studies have showed that a psychosocial stress represents a very important risk factor for acute myocardial infarction (AMI), but measures of stress may not be suitable for different countries, cultures and ethnic groups. The aim of this study was to investigate the relation of stressful life events with AMI in the period of 1998-2000 in the population of the city of Nis. METHODS: A case-control study included 100 patients with the first MI (in the period 1998-2000) and 100 healthy subjects, matched with respect to sex and age (+/- 2 years) from the city of Nis. The data of stressful life events were obtained by the Scaling of life events by Paykel ES, modified by the authors consistent with the examined population and the period of investigation. The Yates chi2 test, odds ratio - OR and their 99% interval of confidence were used as statistical procedures. RESULTS: The results showed that stressful life events in the period of investigation were very important risk factors for AMI with a statistically significant level (p = 0.000). Huge financial problems (OR = 202.36, Ci = 24.82-4387.58), violation of law (OR = 168.00, Ci = 10.66-6658.96) and serious illness of family members (OR = 159.60, Ci = 19.05- 3514.81) were the highest risk for AMI. The patients who reported that his/her son or other member of family had been gone to the army (or mobilization) before the illness onset, had 138 times higher risk of AMI (Ci = 14.98-3222.47, chi2 = 40.95, p = 0.000), while the patients who had mobilized themselves had 84 times higher risk (Ci = 7.00-2363.06, chi2= 23.87, p = 0.000). Effect of several stressful life events lead to significantly increased risk of AMI andthat significance is larger as the number of life events is more frequent (one life event: OR = 28.41, Ci = 3.73-593.52; chi2 = 17.40, p = 0.000; ? 4: OR = 336.00, Ci = 28.31-9760.28, chi2 = 50,43, p = 0,000). CONCLUSION: These findings indicate that stressful life events are associated with AMI and that they are very important for further epidemiological investigation of the triggering mechanisms and should improve preventive strategies of this serious disorder.

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