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Gastric cancer represents a major health burden worldwide.The cause of gastric cancer is multifactorial, although infection with Helicobacter pylori is considered to be the primary cause. The early stages of gastric cancer are usually asymptomatic or associated with nonspecific symptoms, such as dyspepsia. Advanced stages and ulcerated tumors may be associated with signs of upper digestive bleeding and hemorrhagic shock. Upper gastrointestinal endoscopy is the first preferred diagnostic procedure. The only chance for cure of gastric cancer is surgical removal of the tumor and the adjacent lymph nodes. Case report: 67 year old male presented with melena and haematemesis. On examination pale, covered with cold sweat, adynamic, hypotensive TA = 60/30 mmHg in hemorrhagic shock. After initial stabilization esophagogastroduodenoscopy was performed and showed irregular and longitudinal ulceration with elevated and subminated edges, necrotic bottom of the lesion with a fixed coagulum. Gastric cancer was suspected and the patient was transferred to Digestive Surgery where a total gastrectomy was performed. The pathohistological finding is in addition to gastric adenocarcinoma.Conclusion: Epidemiologic studies suggest that eating more fresh fruit and vegetables, eating less salted food and eradicating Helicobacter pylori can decrease the risk of gastric adenocarcinoma. The best way for prevention is to carry out an effective screening program in high-risk groups and in high-incidence areas, so that early discovery, early diagnosis and early treatment can be achieved.

Background: Pleuropneumonia takes a prominent place in childhood morbidity. Very often in children it can be manifested with atypical clinical presentation. Objective: To present atypical case of Pleuropneumonia in a seven year old boy. Methods: Seven year old boy with acute onset headache, abdominal pain, vomiting and febrile. On physical examination conscious, febrile (39 C), pale, dehydrated, pharynx hyperemic, abdominal distension and pain on abdominal palpation. Blood test with leucocytosis (Le= 31), elevated infalamotory markers (CRP=221mg/l), abdominal ultrasound with normal findings. Abdominal x ray - Mesohypogastric righ with distended intestinal viscera and with hydroaeric levels in formation. Due to suspicion of an acute abdomen, the child was transferred to the surgical department. After 12 hours of obsrevation still febrile, dehydrated, but with acute appearance of tachidispnea and chest pain on the left hemitorax. On examination febrile 40 C, tachidispnoic. Lung auscultation - vesicular breathing weakened to the left in the middle and basal parts. Chest x ray - Paracardiac basal left with larger zone of non-homogeneous shading in addition to inflammatory consolidation, right with peribronchitic infiltrates and sings of pleural effussion - Left dome of the diaphragm isn’t followed and left frenicocostal sinus is shaded. Pleural ultrasound showed pleural effusion in left frenicocostal sinus. Results: After appropriate antibiotic treatment, oxygen therapy, corticotherapy and inhalation therapy with a complete regression of the auscultatory finding. Control chest x ray and pleural ultrasound with complete regression of inflammatory consolidation and pleural effusion. Conclusion: Very often pleuropneumonia in children can be manifested with atypical clinical picture and it’s a diagnostic and therapeutic problem because it’s often not recognized and not thought of.

Анемија е состојба каде што циркулирачката маса на крв не ги задоволува потребите на ткивата од кислород, т.е концентрацијата на хемоглобинот во крвта е пониска од нормалната, а при тоа бројот на Ер може да биде нормален, помал па и поголем. Долната граница на хемоглобинот е индивидуална и зависи од полот и возраста (возрасен Hgb