Introduction. To compare the diagnostic values of laboratory variables, to present evaluations of the diagnostic test for asymmetric dimethyl arginine (ADMA), rheumatoid factor (RF), C-reactive protein (CRP), and DAS28 index, and to define the effect of untreated rheumatoid arthritis on endothelial function. In order to determine whether ADMA changes depending on the disease evolution, ADMA was used as an indicator for endothelial dysfunction. Methods. Using an ELISA technology of DLD-Diagnostika-GMBH for the detection of ADMA, the samples of serum and urine have been examined in 70 participants (35 RA who were not treated, 35 healthy controls). RF was defined with the test for agglutination (Latex RF test) in the same participants. Results. Out of 35 examined patients with RA, RF appeared in 17 patients (sensitivity of the test, 51.42%). In 20 of the 35 examined patients with RA, we found the presence of ADMA (sensitivity of the test, 57.14%). Anti-CCP antibody was present in 24 examined patients with RA (sensitivity of the test, 68.57%). Conclusion. ADMA has equal or very similar sensitivity and specificity to RF in untreated RA (sensitivity of 57.14% versus 48.57%, specificity of 88.57% versus 91.42%) in the detection of asymptomatic endothelial dysfunction in untreated RA.

Background: The aim of this study was to determine the effect of initial therapy with some disease modifying antirheumatic drugs (DMARDs) (Methotrexate and Ketoprofen) on glomerular and tubular integrity in patients with Rheumatoid arthritis (RA). Objectives: To determine whether there is a change in clinical and laboratory indicators of renal function in course of the follow up of treatment and whether that change correlates with the dynamics of the quantity of enzymes excreted in urine and reactants of the acute phase. Materials and Methods: Using colorimetric method for determination of NAG, samples of 70 participants were examined (35 RA patients treated with Ketoprofen only, 35 RA patients treated with combined use of Methotrexate and Ketoprofen). The follow up was 5 time-intervals in the course of 24 weeks. Results: There was moderate correlation between NAG and microalbuminuria (r=0,34) in the group of patients treated with Ketoprofen only, while statistically significant correlation (r=0,21) was seen in group of patients with combined use of Methotrexate and Ketoprofen. NAG enzymuria in size, number of patients registered, and time of appearance were greater and appears earlier in the group with the combined use of Methotrexate and Ketoprofen compared with the mono-therapy with Ketoprofen. Mean urinary NAG induction was increasing with the concomitant use of Methotrexate and Ketoprofen. Conclusions: Methotrexate is more potent NAG inductor than Ketoprofen and provokes greater tubular enzymuria than Ketoprofen. www.nephropathol.com DOI:10.5812/nephropathol.8989 J Nephropathology. 2013; 2(1): 36-52 Original Article Journal of NephropathologyImplication for health policy/practice/research/medical education: Determination of the urinary N-acetyl-β-D-glucosaminidase together with the urinary creatinine excretion could serve as a more sensitive test for renal lesions in patients suffering from rheumatoid arthritis, as an additional diagnostic tool, and the information for the status of the disease.

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Choanal atresia is a congenital absence of communication between the nasal cavity and nasopharynx. Bilateral Choanal Atresia usually present immediately after birth and in the neonatal period. We report an unusual case who presented at the age of twenty two years. This case was successfully managed by a transnasal approach. Choanal atresia should be considered as a rare diagnostic possibility in any patient who presents with total nasal obstruction and persistent mouth breathing.

In this study, five samples of honey (4 from various beekeepers and 1 from a local supermarket) were analyzed to determine the presence of Pb, Fe, Mn, Al, Cu, Cr, Zn, Cd, As, Ni and Se content using atomic absorption spectrometry. Samples were collected from the following locations: 2 from Skopje, 2 from Kumanovo and 1 from Preshevo, Srbia. HPLC was applied to determine sugars in honey samples. Acid and moisture were also determined. The average values of concentration were from 0.033 to 0.055 mg/kg, 0.610to 2.498 mg/kg, 0.052 to 0.377 mg/kg, 2.133 to 3.474 mg/kg, 0.060 to 1.034 mg/kg, 0.005to 0.019 mg/kg, and 0.067 to 0.085 mg/kg for Pb, Fe, Mn, Al, Cu, Cr, and Zn, respectively. Cadmium was determined in one sample (0.040 mg/kg), while the presence of arsenic, nickel and selenium were not observed. The total amount of reductive sugars was within the standard value of min 60 g/100 g honey. The moisture was from 16.6 to 17.6% (max 20%). The acid content was recorded from 9 to 28mEq/1 kg honey (max 50mEq/1 kg honey). The results were compared with the safety standards established from the Ministry of Agriculture, Forestry and Water Economy. In general, the analyzed parameters are within the standards and honey can serve as good dietary source.