During the process of developing herbal drugs with antimicrobial action, one of the most important phases is testing of antimicrobial activity in vitro. The disk-diffusion method is performed in Petri dish, on solid feeding surface. The disks with definite concentrations of antibiotics, pure substances or plant extracts are placed on the top of feeding plates previously inoculated with pure bacterial culture. Growth of the bacterial culture depends on its susceptibility to a tested substance; if the substance has antibacterial effect, a clear zone free of bacteria will form around the disk. Minimal inhibitory concentration (MIC) of the tested substance is determined by extrapolation of the regression line: concentration of the tested substance/radius or surface of area where growth of bacteria was inhibited. This method of testing microbial susceptibility to antibiotics, pure substances or plant extracts is highly sensitive and specific.

Primary psychiatric disorders are frequently associated with electrolyte disorders, which could be caused by medication. We performed a systematic review of the literature in order to discover published cases of electrolyte disorders associated with risperidone use. The databases Medline and Scopus were searched and 317 publications were retrieved containing the following keywords: risperidone, hyponatremia, hypernat remia, hypokalemia, hyperkalemia, hypocalcemia and hypercalcemia. We included in our review the following publication types: the original scientific research, case reports, review of literature and letters to the editor. Case reports and observational studies associating risperidone with hyponatremia or hypokalemia, as well as with hypocalcemia were found. In spite of sporadic case reports of risperidone induced electrolyte disorders, conflicting opinions and results of other studies quest ion the certainty of this association. Further research is necessary to confirm and enlighten the association between risperidone and electrolyte disorders.

Background: Quality of life assessment in patients with Multiple sclerosis (MS) is invaluable for a proper evaluation of disease severity, appropriate choice of therapy and monitoring of its effects. The aim of this study was to assess the quality of life of patients with MS and to identify gender differences in examined outcome. Patients and Methods: A descriptive cross-sectional study was conducted from August 2010 to May 2011. The data were obtained by anonymous survey of 110 patients. Quality of life of the patients was measured by the instrument 'The World Health Organization Quality of Life (WHOQOL) - BREF'. Data on gender and age of patients, type of MS, the number of relapses during the last 2 years, current therapy, dose regimens of certain drugs, and the amount of money the patients spend each month for the purchase of drugs that are not issued at the expense of health insurance fund, were obtained using a distinct structured questionnaire. The collected data were analyzed using simple descriptive statistics and Student's t-test for independent samples. Results: Of the total 110 interviewed patients, 70% (n = 77) were female and 30% (n = 33) male. There were no significant gender differences in the disease duration, number of relapses in the last two years and spending of more than 1000 RSD per month for purchase of drugs that were not issued at the expense of the health insurance fund. Significantly better quality of life was recorded in women than men (p = 0.031), mainly on account of differences in the assessment of the domain of 'Environment' (p = 0.025), as measured by WHOQOL-BREF scale. Conclusion: This study has shown that females tolerate difficulties caused by multiple sclerosis better than men, and also have a better quality of life than men with the same clinical form of the disease and identical symptoms, treated with the same therapy.

High prevalence of metabolic syndrome in children and adolescents is seriuous problem of modern society. In order to prevent development of possible complications (cardiovascular diseases and diabetes mellitus type 2) later in life, early recognition of children at risk for developing metabolic syndrome is of great importance. Previous differences in criteria for diagnosis of metabolic syndrome in children and adolescents have been significantly decreased by new criteria issued by the International Diabetes Federation. From the aspect of prevention, key elements are proper nutrition and regular physical activity. In a view of treatment recommendations, initial steps should be regulation of energy balance in the diet and increase in physical activity; the drug treatment is reserved for patients with high risk of complications.

Congenital anomalies are the cause of 20.0-25.0% of cases of perinatal death, while 3.0% of children are born with malformations of varying size. We examined the predictive values and defined the credibility ratio of the combined test results. Sensitivity of the test is 94.0%, and specificity is 99.0%. The positive likelihood ratio [likelihood ratio test (LR+)] is 94.00; a negative likelihood ratio [likelihood ratio test (LR-)] is 0.06. The pretest probability that pregnant women carry a fetus with chromosomal abnormality is 1:250. Posttest odds after the combined test to discover this abnormality are 0.3760, and probability of the same case is 0.2732 if it happens that the test result is positive. The result of our study confirms the justification of combined test usage in routine clinical practice, since the posttest odds rate in the case of a positive screening increases several times over (almost 90 times); the probability of detecting a chromosomal abnormality was about 70 times.

PIH12 GOLD STAGE AND DURATION OF HOSPITAL ADMISSION DETERMINES SIZE AND STRUCTURE OF COPD RELATED DIRECT MEDICAL COSTS IN ELDERLY Jakovljevic M, Lazic Z, Jankovic S, Verhaeghe N, Annemans L The Medical Faculty University of Kragujevac, Kragujevac, Serbia; Clinical Center Kragujevac, Kragujevac, Serbia; Ghent University, Ghent, Belgium; Ghent University—Brussels University, Ghent, Belgium OBJECTIVES: COPD cost of illness assessment and its dependence on GOLD stage or duration of hospital admission. METHODS: The sample consisted of 186 elderly COPD patients. Chest physicians conducted follow-up and fi nancial data were obtained from administrative registry. Time horizon was one year and Health Insurance Fund perspective was selected. Included clinical endpoints were disease exacerbation and hospital admission. Economic data included all inpatient COPD-related medical goods and services consumption, and outpatient drug utilization. We excluded medical costs which did not arise from COPD. RESULTS: An average elderly COPD patient imposed c1745.41 of costs annually to the national health care budget. Severity grade (GOLD stage) and duration of all hospital admissions were signifi cantly and directly correlated with overall cost. Expenses structure per year was: c14.54 outpatient care, c126.97 inpatient drug consumption, c377.98 hospital admission (Intensive Care Unit admissions and specialist consultations included in daily price), c133.5 imaging diagnostics, c111.43 laboratory analysis, c26.67 therapeutic interventions, c70.32 consumables, c884 outpatient drugs consumption. Most expenses originating from drug acquisition were due to antibiotics prescribed for curing infections and mucolitics and antihistamine drugs consumption. Average number of hospitalizations per person was 1.45 with a duration of 12.84 days. Fifteen persons deceased. Average number of outpatient visits was 2.71 per person. CONCLUSIONS: Overall burden of COPD is mostly driven by outpatient drug consumption and exacerbations leading to hospital admissions. Relative relevance of drug acquisition expenses in our country is higher than in high-income societies, because of still signifi cantly lower human labour wages in the area. Pattern of diagnostic procedures requested and ATC drug classes consumed remains similar and comparable in most countries. More in-depth research of indirect COPD attributable costs e.g. lost productivity, absentism, premature death etc, will be needed in the future.