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One of the first words that is learned in Indonesian is waria. This word is made by combing word wanita which means woman and pria which means man. Warias are one of the most known and visible forms of third gender in Indonesia, this term marks trans-women who has their role in social life throughout Java island. Beside this one there, less visible and researched identity called priawan for trans-men. In the classical epic of Bugis people La Galigo, which is regarded as Memory of the World by UNESCO, there are five distinct genders: bissu, calabai, calalai, makkunrai i oroan?. These genders still exist in south part of Sulawesi Island. Position of other genders, out of binary men and women, which position was installed by abrahamic religion in Indonesia, meaning Sunni Islam and different Christian domination is under threat. This paper aims to deconstruct third gender forms in Indonesia. Decolonization is used in order to better comprehend multigenderism away from Western paradigms. By understanding complex socio-religious environment we can grasp the mechanism of the survival of these marginalized communities besides all circumstances.

Introduction/Objective. The aim of this study is to examine the association of E-cadherin expression and high proliferation index (proIDX) with clinical and pathological indicators of colorectal cancer progression. Methods. The biopsy of 72 patients, obtained by resection of colorectal cancer, was routinely processed at the Institute of Pathology of the Clinical Centre of Montenegro, embedded in paraffin and archived. Based on the archived pathohistological reports, two study groups were formed: the first group (n = 72) consisted of operative biopsies of colorectal cancer, and the control group (n = 72) consisted of biopsies of adjacent non-tumor tissue. Routine hematoxylin-eosin and immunohistochemical avidin-biotin-peroxidase complex method with anti-Ki67 and anti-E-cadherin antibodies was applied on. After quantification of the results for statistical tests, the software package SPSS for Windows (19.0) was used. Results. In colorectal carcinoma, we observed a significant association of proIDX with pT stage, lymph and blood vessel invasion, perineural invasion, lymph node metastases and distant metastases, and Astler?Coller stage tumor disease. We also observed that the absence of E-cadherin was significantly associated with pT stage, lymph and blood vessel invasion, perineural invasion with lymph node metastases, distant metastases, with C2 and D Astler?Coller tumor stage. E-cadherin expression is associated with proIDX with a significantly high, negative correlation coefficient. Conclusion. Our results indicate that it is possible to differentiate patients into groups with a higher or lower risk of developing metastatic disease, based on the expression of Ki67 and E-cadherin.

The objective of the study is to describe QoL in women who have undergone surgical treatment for breast cancer (BC). The focus of the description is the differences in QoL between women treated by modified radical mastectomy (MRM) and women who underwent breast-conserving surgery (BCS) at the Breast and Endocrine Surgery Department of the Clinical Center of Nis, Serbia. From January 1, 2014, until December 31, 2017, 300 patients were treated with BCS and 300 patients with MRM. To assess the QOL, a total of 600 BC patients completed the WHOQOL-BREF questionnaires. The results were analyzed using the t test and chi-square test. WHOQOL produces a quality of life profile. It derives four domain scores: physical health, psychological, social relationships, and environment. Social and demographic factors (age, education, marital status) were collected in both groups. In all four domains, patients treated with conserving surgeries scored higher than patients treated with radical mastectomy. This result was controlled for a set of demographic variables. The differences in QoL scores are present on all levels of controlling variables. According to the results of this study, the QoL in women after an MRM is significantly lower than the QoL in women after BCS. It is especially true for the environment domain. Conserving surgery should be recommended and specific, and patient-centered interventions for increasing QoL of the patients who opted for radical mastectomy should be designed. The intervention should focus on social and environmental domains.

Acute suppurative thyroiditis (AST) leading to thyroid abscess is a rare clinical entity. The aim of this article is to demonstrate a case of severe bilateral pneumonia which originated from a thyroid abscess. The authors report the case of a 57-year-old woman with severe bilateral pneumonia of thyroid origin. The patient had a painful throat and dysphagia for 2 or 3 days. She also had a history of mild fever and hard breathing with a discreet cough 7 days prior to hospital admission. In the past few months, the patient had frequent pneumonias. The patient was treated with a culture-appropriate antibiotic and total thyroidectomy. Primary recommendations for treatment of complicated infections of thyroid origin consider a multidisciplinary approach. Recurrent pneumonia in patients with thyroid nodules may be the result of thyroid inflammation, and, in such patients, neck ultrasound should be conducted as part of the diagnostic workup.

Background/Aim. Incarcerated inguinal hernias surgical treatment represents one of the most frequent surgical treatments in elderly patients. The percentage of incarcerated inguinal hernias urgent surgical treatments is growing exponentially with the age in patients over 50. The aim of the study was to investigate some of the factors that may have impact on the incarcerated inguinal hernias surgical treatment outcome in elderly patients. Methods. The study included 180 patients classified in two groups: the study group (> 65 years of age) and the control group (≤ 65), managed in the period from January 2005 till March 2009 at the General Surgery Clinic, Clinical Center Nis. Results. Most of the patients had right inguinal hernia (52.6%, the study group; 59.1%, the control group). All the study group patients suffered from some of accompanying chronic diseases (100%), opposite to 39 (59%) patients of the control group. Synthetic material was implanted in 124 (68.9%) patients, while the tension technique was performed in 65 (31.1%) patients. The duration of incarceration more than 24 h (p = 0.015), previous abdominal surgery (p = 0.001), the American Society of Anesthesiologists physical status classification system (ASA classification) (p = 0.033) and the presence of chronic diseases (p = 0.01) appeared to be statistically significant risk factors for performing intestinal resection in the study group, while in the control group they represented risk factors, but not at the level of statistical significance (p

Background/Aim. There are a lot of studies aiding to the opinion that the involvement degree of axilla lymph nodes grows depending on increase of breast tumor size, and its histological and nuclear grades. The aim of this study was to assess the risk of axillary lymph nodes involvement, as well as the relation between the tumor size, histological and nuclear grades in a group of female patients who underwent breast cancer surgery, including levels 1-3 axillary dissection. Methods. Investigation covered 900 patients operated on during 2005-2008 who underwent modified radical mastectomy including axillar dissection. We assessed a number of involved lymph nodes, depending on tumor macroscopic size (T), histological grade (HG) and nuclear grade (NG). Results. A total number of examined lymph nodes was 9977. The incidence of involved lymph nodes was from 18.6% with T1 tumor size up to 60.2% with T4 tumor size. Concerning histological grade, the number of involved lymph nodes ranged from 14.2% (HGI) to 45.1% (HGIII); while in terms of nuclear grade, the number of involved lymph nodes ranged from 17.4% (NGI) to 54.5% (NGIV). By using χ2-test for trend and odds ratio (OR), the results showed that the axillary lymph nodes involvement degree was increased with the increase of the tumor size and its histological and nuclear grades. The risk of axillary lymphatic nodes involvement was 1.43 times higher in the group of T2 tumors size compared to the smaller tumors T1 size, and even up to 6.62 times higher in case of T4 tumor size. It was also increasied from 1.79 times for HGII to even 4.98 times for HGIII, and from 1.44 times for NGII to 5.71 times for NGIV. Conclusion. In breast cancer patients, there is a strong correlation between tumor size, its histological and nuclear grades and the risk of axillary lymph nodes involvement.

We report the design, synthesis, and optimization of the first, selective activators of cardiac myosin. Starting with a poorly soluble, nitro-aromatic hit compound (1), potent, selective, and soluble myosin activators were designed culminating in the discovery of omecamtiv mecarbil (24). Compound 24 is currently in clinical trials for the treatment of systolic heart failure.

The study comprises 185 patients who are at the hemodialysis (HD) in the hemodialysis center of the Clinic for Nephrology of the Clinical Center Nis. The factors analyzed in the hemodialytic patients are: duration of the hemodialysis according to which the patients were divided into two groups (shorter and longer than 5 years), age on the basis of which the patients were divided into three groups (younger than 30, subjects of 30 to 60 years of age and older than 60) and gender. In all 185 hemodialytic patients the most frequent symptoms of renal osteodystrophy were examined on the basis of visualization and the use of verbal symptoms score (VSS). For the statistical processing, the student t-test and the Mantzel Haencel tests were used while the differences at the levels p < 0.01 and p

OBJECTIVE: The aim of this study was to investigate the prevalence of hepatitis C virus (HCV) infection in patients with hepatocellular carcinoma (HCC) in our geographic area, and to determine if there is a correlation between HCV genotypes and the development of HCC. METHODS: Thirty-six patients with HCV-related HCC and 35 controls with HCV-associated cirrhosis without HCC were studied. The diagnosis of HCV infection was performed by the enzyme-linked immunosorbent assay test for the detection of anti-HCV antibodies and by reverse transcription-polymerase chain reaction for the detection of HCV-RNA. HCV genotyping was performed by line probe assay-Inno-LIPA HCV II. The diagnosis of underlying disease in the patients with HCC was performed on the basis of clinical, biochemical or histological evidence. RESULTS: Genotype 1b was found in 28 (77.77%) patients with HCC, and in 16 (45.71%) controls. There was significant difference in the prevalence of genotype 1b between the patients with HCC and those with cirrhosis without HCC (P

Objective: In the present study, we compared subtotal thyroidectomy (STT) with total thyroidectomy (TT) in the management of bilateral multinodular goitre. Methods: A total of 204 consecutive patients with bilateral multinodular goitre were assigned to have either TT (n = 73) or STT (n = 131). Demographic details, hospital stay, biochemical findings, indications for operation and complications were noted. Results: There was no significant difference in the age and sex ratio between the two groups (P = 0.695 and P = 0.733). According to thyroid functional status, the majority of patients were euthyroid in both groups (73.28%vs 84.90%). Goitre grades II and III presented the most common indication for STT and TT. Hospital stay for patients who underwent TT was significantly longer compared to STT (P

Background Graves’ disease represents an autoimmune disease of the thyroid gland where surgery has an important role in its treatment. The aim of our paper was to analyze the results of surgical treatment, the frequency of microcarcinoma and carcinoma, as well as to compare surgical complications in relation to the various types of operations performed for Graves’ disease. Methods We analysed 1432 patients (221 male and 1211 female) who underwent surgery for Graves’ disease at the Centre for Endocrine Surgery in Belgrade during 15 years (1996–2010). Average age was 34.8 years. Frequency of surgical complications within the groups was analyzed with nonparametric Fisher’s test. Results Total thyroidectomy (TT) was performed in 974 (68%) patients, and Dunhill operation (D) in 221 (15.4). Carcinoma of thyroid gland was found in 146 patients (10.2%), of which 129 (9%) were a microcarcinoma. Complication rates were higher in the TT group, where there were 31 (3.2%) patients with permanent hypoparathyroidism, 9 (0.9%) patients with unilateral recurrent nerve paralysis and 10 (1.0%) patients with postoperative bleeding. Combined complications, such as permanent hypoparathyroidism with bleeding were more common in the D group where there were 2 patients (0,9%), while unilateral recurrent nerve paralysis with bleeding was more common in the TT group where there were 3 cases (0,3%). Conclusions Frequency of complications were not significantly statistically different in relation to the type of surgical procedure. Total thyroidectomy represents a safe and efficient method for treating patients with Graves’ disease, and it is not followed by a greater frequency of complications in relation to less extensive procedures.

Introduction: A clinically normal-appearing nipple in patients with breast cancer may contain unsuspected neoplastic cells. Preservation of a nipple containing occult malignancy could potentially increase local recurrence rates and affect disease-free survival. Consequently, patients considered for breast conservation operations with nipple preservation must be carefully selected. Methods: Information available on 382 patients diagnosed and treated with breast cancer at the Clinical Center Nis from 2000 to 2003 were retrospectively reviewed. Multivariate hazard analyses was used to assess the association between potential risk factors of cancerous nipple involvement. Results: The frequency of nipple involvement was 12.04%. Nearly half of the patients had disease stage III and IV. Most patients, 29 (63.04%), had a tumor to nipple distance of less then 2 cm. Twenty-five patients (54.34%) had more then four positive axillary nodes. A central/overlap tumor location was present in 28 (60.87%) patients. Cox multivariate analysis of prognostic factors showed that Stage III (RH 4.79 (1.50–14.68, 1.50–14.72); P= 0.008), central/overlap tumor location (RH 3.28 (0.90–11.20); P= 0.078) and nuclear grade III or greater (RH 2.26 (0.79 to 6.65); P= 0.065) had a statistically significant effect on malign nipple involvement. Conclusions: The multivariable model used in this study showed a significant association between stage, centrally located tumors and nuclear grade III or greater in predicting the risk of cancerous nipple involvement. Preoperative magnetic resonance imaging or computed tomography scan examinations are recommended for treatment planning of breast cancer, in particular nipple preserving surgery in patients with central/overlap tumor localization and with a tumor to nipple distance of less than 2 cm.

In most of the cases, breast carcinoma is the primary tumor of the female population. Having in mind a well known fact that the best and most effective way for its terminal eradication is an early treatment upon its localization, tremendous efforts are being made to make an early diagnosis of breast cancer. The sooner the better. The early and precise diagnosis is of crucial importance in the application of adequate therapy, thus achieving more successful outcome with the possibility of complete healing. It is established on the basis of a routine clinical examination and supplementary diagnostic methods. Supplementary diagnostic methods may be noninvasive, minimally invasive and invasive. Noninvasive diagnostic methods are: mammography, xeromammography, ultrasound, thermography, galactography, pneumocystography, computerized mammography, translumination scintigraphy, magnetic resonance and tomography with positive emission.Minimally invasive diagnostic methods are: ductal lavage, aspiration cytology performed with a thin needle and “tru-cut” biopsy.Invasive methods include: biopsy “ex tempore” and “sentinel lymph node” biopsy.Great importance is attributed to the preoperative diagnosis with the help of which we are able to establish the precise and timely diagnosis.

This study considers the usability of Web Portals in terms of their quality of use for specific end users seeking to achieve work goals in particular environments. The method described is particularly aimed at non-experts in the area of user-centered design and evaluation. The objective of this study is to use a weighting approach to determine the relative importance of the usability factors for Web Portals from the perspective of key potential users. Analytical Network Process (ANP) was used to analyze the relative importance of the factors.

Although the number of elderly patients with breast cancer is increasing, knowledge about possible differences in the biology and clinical outcomes of breast cancer according to age is limited. Retrospectively were followed: diagnosis, surgical treatment, stage of disease, histology, and survival of breast cancer treated women at the Surgical and Oncological Clinic in Nis between 1985 and 1990. Patients were divided in two groups: study (=65 years) and control (

By adjusting column temperature and applied electric field, a fast separation in micellar electrokinetic capillary chromatography was developed for the separation of D-lysergic acid diethylamide derivatives. A baseline separation of nine derivatives was accomplished with a run time of less than 12 min by utilizing elevated column temperature (60 degrees C) and an applied electric field of 387 V/cm. The number of plates generated per unit time for the separations completed at elevated temperatures was significantly higher when compared to separations at the same applied electric field but at lower temperatures (20 degrees C).