Transfusion transmissible infections (TTI) testing is one of the cornerstones of blood safety. Accurate estimation of the prevalence of TTI markers is essential for monitoring of the donor selection/deferral process as well as for the epidemiological situation in the country.
Aim of the study: the aim of this study is to evaluate the seroprevalence of mandatory tested TTI markers (HBV, HCV, HIV and Syphilis) in blood donors and to estimate the demographic characteristics of blood donors with positive TTI markers in the period of 10 years, from 2007 to 2016.
Material and methods: Blood samples were screened for HBsAg, anti-HCV antibodies, anti-HIV (p24 antigen and HIV-1/2 antibodies) and Syphilis (anti-TP) using serological assays (EIA – Enzygnost, Siemens and CMIA – Architect system, Abbott). Repeatedly reactive samples were retested with confirmatory assays: Vidas HBsAg Ultra, Immunoblot Deciscan HCV Plus and RecomLine HCV.Demographic data (sex, age, number of donations andethnicity) of243 donors with positive TTI markers were evaluated using the donor software.
Results: From the total of 269.355 blood units tested, 876 were positive for TTI with the prevalence rate of 0,32%. The number of repeatedly reactive (RR) and confirmed positive (CP) samples was as follows: 831 (0,31%) were HBV RR and 750 (0,28%) were HBV CP; 416 (0,17%) were HCV RR and 122 (0,04%) were HCV CP; 245 (0,10%) were HIV RR and 4 (0,001%) were HIV CP. There were no CP samples for Syphilis in
the analyzed period.The number of confirmatory positive (CP), confirmatory negative (CN) and confirmatory indeterminate (CI) results from the total of 243 HBV and HCV RR donorsin the period from 2013 to 2014 was 149 (61.3%), 84 (34.6%) and 10 (4.1%) respectively. The demographic characteristics of this 243 donors were the fallowing: 103 (69%) first time donors, 128 (86%) male vs. 21 (14%) female, mean age of 34.4 years, mean number of 1.3 donations/donor, 107 (72%) were with Macedonian and 42 (28%) were with Albanian origin.
Conclusion: Blood donation in our country is voluntary, non-remunerated, on regular basis and there are practically no family/replacement donors. Donor selection and deferral criteria are permanently revised. Blood screening and confirmatory testing for TTI is performed according to the standard operating procedures and algorithms which enable deferral and counselling of donors with positive TTI markers. All of this contributes to the low prevalence of TTI markers in our blood donor population as a fundamental to blood safety.
Key words: blood donors, blood safety, transfusion transmitted infections, TTI testing.
Transfusion transmissible infections (TTI) testing is one of the cornerstones of blood safety. Accurate estimation of the prevalence of TTI markers is essential for monitoring of the donor selection/deferral process as well as for the epidemiological situation in the country.
Introduction. The term “risk factors” describes the traits of healthy people connected independently with the recurrent cardiovascular disease morbidity. It includes the lifestyle, biochemical and physiological modified traits, and also the personal unmodified traits such as: age, gender, and family history in the recurrent of cardiovascular disease in younger age (male <55 years of age, female <65 years of age).
In general, the concept of risk factors is a great priority in the improvement of the prevention strategy of the coronary diseases.
Aim. To evaluate the predictive ability of risk factors of cardiovascular disease in long-term prognosis of the patients with recurrent myocardial infarct during 3 years period of the patients after a new event of myocardial infarct in the Elbasan region.
Methodology. It is a 3-year cohort, for a period from 2009-2012 to evaluate the prognostic abilities of the clinical traits in the patients where they were hospitalized in undesired long-term results such as the new recurrent infarct. To see the effect of risk factors for cardiovascular disease in the recurrent or not in another episode of AMI, we used the analysis curve of survival Kaplan Meier. A rate of p<0.05 is considered significant for the statistics.
Results. At the end of the study 16 patients out of 65 had an interest events (death/recurrent infarct) that is significantly lower its non-occurrence (p 0.05). Changes in the survival rate of individuals according to the normal or high levels of cholesterol, presence or not of the diabetes has statistic changes (Log Rank p<0.05).
Conclusions. Knowledge of the risk factors that are also a prognosis factor in the patient performance with AMI helps in defining patients that need to undergo a more specific check up to avoid these undesired results. This is due to the fact that patients who have been smokers, have diabetes, hypercholesterolemia history are at a higher risk to have a reserved prognosis of the disease (recurrence of myocardial infarct or death).
Keywords: risk factors, acute myocardial infarction, the long-term prognosis, survival.
Results: Despite the tremendous efforts made by international governments and organizations to prevent HIV, HBV and HCV (1, 2) 2015 infections, evidence suggests that transmitting infections continue to spread, taking millions of lives in developing countries ( 3, 7).
Introduction Avoiding professional blood exposure is a primary way to prevent the transmission of HBV, HCV, and HIV into health settings PURPOSE OF PUNISHMENT The importance of the study and the new knowledge that will be gained from it. Through this study it is possible to identify the problems that arise after accidents at work in health personnel, considering that through exposure to different biological fluids it is also possible to transmit the serious HIV, HBV and HCV infectious diseases.
Material And Method. In this study were attended by 220 students and professionals of whom 36 Men – M (16%) and 184 Female – F (84%). This study brings new evidence of the risk of infection by the blood, other body fluids, and the knowledge of the workers’ sudents and health workers about post-exposure measures. In this survey are included 3 Annex A – demographic data, B – general knowledge and C – specific data.
Results. The average age of respondents is the new 51% 23 – 25 years old and 33% 36 – 52 year old with a difference of. of 1.52. Statistical processing reflects that, most 45% of respondents think that breast milk is the body fluid that has the highest propensity for transmitting HBV, HCV and HIV. Despite the small difference between those who are often injured at work 42% and those who are seldom at work 39%, there is a high percentage of the group of injured at work compared to those who have never been harmed, increasing the risk virus transmission. In this case, the injury results in a large difference between the injured with age (26%) compared to the injury with other work injury injuries (74%) and the damage was 91% (41%) compared to the PSH damaged in depth 6 (3%). What was seen as high risk and resulted in a high percentage of individuals who do not report the type of contamination, 112 ( 51% ) were compared to individuals who were contaminated with blood contents at No. 54 (25% ) and other biological fluids to a lesser extent. Positive was at a higher percentage
of 49% of individuals reporting that the crushing and disinfection are the first two actions that are being practiced in the event of contamination and the next step was to consult with the infectious. at a higher 48% than in other reporting links. Also, individuals who think that PEPs should be urgently had a higher 49% than individuals reporting at different PEP times. But what matters and increases the risk is the lack of information in the survey.
Conclusions: This study highlights the continuing need to reduce negative attitudes to HIV, HBV and HCV, and to provide the necessary health education between PSHs, particularly focusing on HBV and HCV prevention. Research project findings can be used to develop awareness-raising interventions to report cases of contact with the carrier fluids of these viruses.
Key words: Student, Knowledge Difference, post-exposure prophylaxis, HBV, HCV and HIV.
A high proportion of maternal mortality in developing countries is caused by abortion, especially in such countries with limited abortion laws. The aim of this study was to determine the prevalence of abortion and related factors of abortions in Tetovo population during period of 2012 – 2017 years. This cross-sectional study was carried out in Tetovo province. Data were collected from Clinical Hospitals of Tetovo in Department of Gynecology and Obstetrics. All abortions from 2012 to June 2017 considered as the source population. The risk factors including maternal age, parity, abortion, pregnancy risk factors, maternal nationality, maternity insurance, preterm labor, place of birth, type were compared between normal birth and abortion groups. The data for the research came from 3198 randomly selected pregnant female using structured and questionnaires, data were collected during the period from 201 to June 2017. The results showed that the prevalence of abortion in this study was hight, and there was statistically significant relationship between abortion and maternal age, the higher level of education, socio-economic levels (excluding middle level), the age of marriage, the number of live children. There was no significant relationship between abortion and residence, occupation and type of marriage. Also artificial abortions and missed abortions are in higher rates of induced labour, compare to incomplete, spontaneous abortions and blighted ovum.
Keywords: abortions , prevalence, risk factor.
This paper presents the final data of a four month work (May, June, July, August 2017) on the “Taxonomic Evaluation of Ropalocerofauna in the Suburbs of Kalish Village, Sharr Mountain”. This work coincides with the adult stage of ropalocera. Considering the large gradient of the altitude from the Polog plateau (380m) to the highest peaks, Sharr Mountain (2748m) is represented by almost all vegetative generations. This study for this region is undertaken for the first time by us, which has been overlooked by other local and foreign scholars or has been carried out sporadically. The study is centered on a narrower territory that is very rich in species. Two base stations, one under the village of Kalisht, the other over it, with a distance of 520m to 887m have been described. The collection of the scientific material was made with entomological airspace (Ketscher method) and stored up to the entomological envelopes and mattresses, accompanied by landfill data, date, biotope, collector name, and plant cover notes. During this study, a wealth of material has been picked up by about 400 men and women of ropalocerals. Part of it has been set up for the establishment of a scientific fund at the Biology Research Program of the University of Tetova. From the faunistic analysis so far, it results that we have determined from this material 76 species, included in 44 genres within 5 families. Compared with European (482 species), (Eu-441lloje) known so far, and Macedonian (201 species), that of the Sharri Massif (176 species), this narrow area is visited by 76 species or calculated in% 15.7% at European level, respectively 36.5%, compared to the Sharr Massif and this proves for a generous abundant fortune of ropalocerofauna.
Key words: Ropalocerofauna, species composition, distribution, village Kalisht, Sharr mountain, Macedonia.
Introduction: Presently, there are several scales used for measuring the risk and valuing the outcome in patients with upper GI bleeding. The most frequently used and validated in the clinical practice is the Rocall and Blatchford scale.
Aim: To assess the significance of the GBS /Glasgow-Blatchford scale/ for predicting the clinical outcome and need of therapeutic intervention in patients with acute upper non-variceal GI bleeding /AUNGB/.
Materials and methods:A retrospective monocentric study of 100 patients admitted to our department for AUNGB in 2013 was used. GBS was retrospectively calculated based on the original Blatchford scale. The medical files of all patients were used for creating the study extract. The validity of our study was calculated
using and comparing with the Oliver Blatchford’s study. We created our risk scale basing on the data from the patients files and the clinical examinations – hemoglobin levels, BUN, pulse rate, systolic blood pressure, presence of syncope, melena, liver disease or heart failure during the admission.
Results: In our study we observed 100 patients with AUNGB – 62 males (62 %) and 38 females (38 %). The average age of the population was 63.2 years and the average hospital stay was 4.8 days. Upper endoscopy was performed in all 100 patients. Five (5 %) of the patients needed endoscopic hemostasis, one (1%) underwent surgical operation and 43 (43 %) needed blood transfusion. Ten (10 %) of the patients died. Patients with 3 or less GBS scale points didn’t need any therapeutic intervention.
Conclusion: GBS scale can be clinically used for predicting the need for therapeutic intervention in patients with acute upper non-variceal GI bleeding.
Keywords: acute non-variceal gastro-intestinal bleeding, Glasgow-Blatchford Scale.
Background: Obesity is a well-established risk factor for endometrial cancer.
Aim: The current study is to investigate the relationships of the serum concentration of adiponectin and body mass index with the endometrial cancer in postmenopausal female subjects.
Study Design: Case-control study
Metods: We conducted a case-control study of a total of 210 Bulgarian women to detect the relationships between serum concentrations of adiponectin and body mass index (BMI) in postmenopausal women with endometrial cancer. The study subject constituted 90 cases of endometrial cancer and 120 controls.
Results: Mean serum concentration of adiponectin in endometrial cancer was 2.79 ng/ml as opposed to 7.15 ng/ml in patients without endometrial pathology (p<0.0001). Significantly, low concentrations of adiponectin and higher BMI were noted in the group of patients with endometrial cancer in comparison to controls
(p<0.0001). The regression models establish corelation between serum adiponectin level, BMI and cases with endometrial cancer.
Concluson: The low serum level of adiponectin ratio is independently associated with higher BMI and increased risk for endometrial cancer. Serum adiponectin plays important roles in the development of obesityrelated endometrial cancer and can be used as a predictive marker.
Key words: Obesity, Endometrial cancer, Adiponectin.
Background: Pre-eclampsia is a multisystem disorder of complex origin and prevention of it is not yet possible. Calcium excretion abnormalities have been studied in relation to several factors. However, the role of calcium in pregnant women is still being discussed.
Aims: The aim of this study was to find out the relationship of calciuria levels in mild pre-eclamptic pregnancies compared to normotensive pregnancies in the third trimester (32-35g.w.).
Study Design: Case-control study.
Methods: A study includes 50 primigravida women aged between 20-30 years. The patients were allocated to one of two groups: patients – women with mild pre-eclampsia (n=25) and controls – normotensive women (n=25). The women were asked to come with 24 h urine from 6 a.m. to next day 6 a.m. in a container. Calcium level of urine sample was analysed by the colorimetric method using the semi analyser and was estimated by the OCPC method at 575 nm. Statistical analysis was carried out using the Graph Pad Prism version 7.00 for Mac. Continuous variables were expressed as means; a p-value of <0.05 was considered statistically significant. Results: Pre-eclamptic women excreted significantly less total urine calcium (2.20 ± 0.28 mmol/24 h) than normotensive women (9.72 ± 2.88 mmol/24 h) (p < 0.0001) between 32-35 weeks of gestation. Conclusion: A decrease in 24-hour urinary total calcium between 32-25 weeks' gestation are risk factors for preeclampsia.. This parameter would predict preeclampsia in pregnancy. Keywords: Preeclampsia, Calcium, Hypocalciuria, Pregnancy.
Cholangiocarcinomas are rare neoplasm of biliary tree with a poor prognosis. These tumors are rarely diagnosed in patients younger than 40 years and at the time of diagnosis are usually complicated with obstructive jaundice.
Aim of the study: the aim of these study was to show our experience in the treatment of patients with extrahepatic carcinoma of the bile ducts.
Material and methods: this retrospective study was performed in General Surgery Department of Clinical Hospital of Tetove during a period fom January 2014 until January 2017. Totally six patients aged between 57 and 74 years were subject of this study. Diagnosis was established by ultrasonography, Computed Tomography and endoscopic retrograde cholangiopancreatography (ERCP).
Results: in three patients cholangiocarcinoma was localized in gallbladder, and in three others in common biliary duct (CBD). Radical resection of gallbladder and regional lymphonodectomy was performed in all three patients with gallbladder cholangiocarcionma. One of three patients with cholangiocarcinoma of common bile duct underwent a biliodigestive bypass, one endoscopic palliative therapy with implantation of stent, while the third because of spread and dissemination of the tumors was inoperable.
Conclusion: Cholangiocarcinoma of gallbladder and common biliary duct is a relatively rare malignancy. Early diagnosis of this tumors remains a real challenge and has great impact in the survival rate of patients.
Bronchial Smooth muscle cell is important in Asthma and Bronchial Hyper Reactivity not only for their role in excessive bronchoconstriction, but also for their active participation in inflammation and airway remodeling. Muscle cells are activated from the products of inflammation, but in the other side produce by themselves pro inflammatory mediators. The physiopathology of bronchial smooth muscle cell is important also for the phenotypes of Asthma and the treatment according to the respective phenotype. New techniques like bronchial thermoplastic and new discoveries of drugs are performed or expected to be in the future. Their exact intervention into the correction of the molecular level of muscle dysfunction, like MLCK enzyme higher quantity and higher speed of phosphorylation, or other diverse muscle mediators involved in inflammation or airway remodeling are presented in this review.
Summary: Apolipoprotein E (ApoE) is a major constituent of plasma lipoproteins with many biological actions of great significance. Beyond the known influence of ApoE polymorphisms on serum lipid profile, the pathogenesis of atherosclerosis, and the development of neurodegenerative disorders, ApoE also has a major role in the pathogenesis and progression of a variety of renal diseases, as well as in the atherosclerotic complications associated with them. Briefly, the polymorphisms of ApoE are major determinants of plasma lipid levels in uremic patients. They may affect the risk for cardiovascular disease in this population, predispose to the development of diabetic nephropathy, influence the severity of certain glomerulopathies, and regulate mesangial and glomerular functions locally in the kidney microenvironment. Finally, certain mutations of the ApoE gene are associated with a recently described nephropathy, termed lipoprotein glomerulopathy.The metabolism disorders of apolyproteins, recently are considered as one of the most relevant factors in the appearance of atherosclerotic, cardiovascular and cerebral-vascular diseases at the patients with renal chronic insufficiency (RCI) and those treated with chronic hemodialysis (HD) (1,2). The appearance of the dyslipidemia is noticeable since the early stages of the weakening of kidneys, therefore the examination and etio-pathogenesis
of the apolyproteins, in this concrete case the Apolyprotein – E at these patients, can evidently impact on the prevention of the early cardio–cerebral- vascular and atherosclerosis diseases at the patients with renal chronic terminal insufficiency (RCTI) treated with continual hemodialysis. The apolyprotein – E is a major component of the plasma apoprotein with a large number of biologic actions with a great relevance in the metabolism of lipoproteins. Aside from the known impact of the polymorphism at the apolyprotein-E in the profile of lipids in the premature pathogenesis of atherosclerosis, and the development of neurodegenerative disorders, apo-E, also plays a great role in the ethio-pathogenesis and the acceleration of the renal chronic insufficiency. A large number of studies have verified that the polymorphism of apo-E is and is considered as the main indicator of the levels of plasma lipids at the patients with ESRD treated with HD. Besides that they can influence in the fast progress of the RCI, the development of diabetic nephropathy, the risk from cardiovascular diseases, also influence the degree of the glomerulopathy, and the mesangial and glomerular functions in a local microcells level of the kidneys at the uremic patients. Purpose of the paper:The aim of this research it is to determine the
Apolipoprotein-E concentrations and its effects as well as the impact of Apo-E in the appearance of cardiovascular, cerebrovascular and early artiosclerosis diseases at patients with ESRD treated with repeated hemodialisis. As examination material was used the blood taken from the vein of 1 patients treated with hemodialysis and of the controlling group 1 , taken at the o’clock in the morning, in the room temperature from 19- C, in lying position. The blood for analysis has always been taken before the sessions of hemodialysis (HD) after a hunger condition of 12 hours, with 5 consecutively measurements and without the usage of the hypolipidemic medications. The attained results present the average values obtained from the five measurements in identical conditions. The obtained blood for examination (3ccm serum) with some drops of heparin has been sent for analysis in the Institution of Clinical Biochemistry at the Clinical Center of the Medical Faculty in Skopje. The profile of apolyprotein –E was analyzed at 120 patients from whom 66=males and 54=females cured with continuous hemodialysis over 24 months in the Department of Nephrology with Hemodialysis and the Clinical of Nephrology in the Medical Faculty in Skopje. Results: From the Table 4 all the uremic patients treated with HD manifested high values of apolypoproteine-E and, compared to the control group of the healthy persons (apo-E=3.40± 2.70mg/dl) there was a significant statistic difference with p=0.0001 from all the basic diseases which lead to hemodialysis, but the fact is that patients with diabetes and diabetic neuropathy have shown higher values of apo-E in comparison to other people with basic diseases ( renal polycistose=7.80+-3.70 mg/dl etc.) . Higher values were detected in patients with arterial hypertension(6.50+- 3.10 mg/dl), values that are in a correlation with many studies concerning apo-E.
Keywords: Apolipoproteina-E (Apo-E); Uremia, ESRD.
Summary Central nervous system tumors are a heterogeneous group of neoplasms that include all forms of primary and secondary neoplasms developed within the cranial and vertebral cavity. A total of 1883 cases with CNS tumors were registered during 1993 – 2013, of these 977 cases (49 %) were evaluated and interviewed during the period 2010 -2013. During this study we note the increasing incidence of CNS tumors during years. Interpretation of this increase is complicated greatly from two peaks, in 1995-1996 and 2001-2002, the period corresponding to the addition of diagnostic procedures (CT scan) or improving their ( the introduction of MRI). Age and gender are important risk factors in development of brain tumors, from 55- 80 years old the incidence is higher, and we determined the exclusive predominance of women in meningeoma and a predominance of males in glioma. The impact of improved diagnostic methods was seen particularly in the growth of incidence over the years.
Keywords: Tumors, nervous system, epidemiology, incidence, relative risk.
Benign prostatic hypertrophy (BPH) has several therapeutic options to be treated, including medical and surgical techniques .Among the surgical options , Open Transvesical Prostatectomi (OP) and Trans Urethral Resection of the Prostate (TURP) can be mentioned. We aimed to compare the post operative and short –term complication of OP and TURP. We included all the cases that have undergone surgery in our clinic with OP and TURP from 2006-2015, in total 501 cases. Data were collected during the operation, post operative, hospitalization and when patients referred to the clinic after 1-2 months postoperative. Conclusion: OP and TURP are the two commonest surgeries performed for BP, both of them having their own complications. TURP is a more gentle method for patients, surgeons and hospitals.
Keywords: Open Prostatectomy, Trans Urethral Resection of the Prostate.
Introduction: Neoadjuvant therapy refers to the systemic treatment of breast cancer prior to definitive surgical therapy. The primary objective of neoadjuvant therapy is to improve surgical outcomes in patients for whom a primary surgical approach is technically not feasible and in patients with operable breast cancer who desire breast conservation, but for whom either a mastectomy is required or a partial mastectomy would result in a poor cosmetic outcome. Neoadjuvant therapy also allows for an early evaluation of the effectiveness of systemic therapy. This may permit the clinician to discontinue ineffective treatment. However, identification of effective regimens (for patients who do not respond to the original treatment) continues to be the subject of ongoing research. In addition to these clinical objectives, neoadjuvant therapy gives researchers the opportunity to obtain tumor specimens (both fresh and formalin-fixed) and blood samples prior to and during the preoperative treatment. This enables research aimed at identifying tumor- or patient-specific biomarkers to proceed.
Methods: The aim of this study is to have an evidence of the neoadjuvant treatment of breast cancer in Albania. The data were collected from individual medical records of patients diagnosed with Breast Cancer in Oncological Hospital from 2010 till 2015. We were focused on clinical staging, chemotherapy regimens, downstaging, clinical and pathological response of the mass and axilla. 2128 patients were analyzed.
Results: Data processing showed that 10% (206 patients) of the patients were treated with neoadjuvant chemotherapy, and nearly all of them were presented with locally advanced breast cancer, stage III (T4 N2 M0). 56% had partial clinical response (cPR) and 15% had complete clinical response (cCR). Regarding axilla 44% had cPR, and 24% cCR. Only 30% of them had pCR, and 15% had no metastasis in lymph nodes (pCR), pN0. In total 10 % of patients showed a complete response pT0 N0.
Conclusion: Almost all the patients had a response from neoadjuvant treatment. There is a low percentage of patients who had pathological complete response of the mass and the axilla. A careful pretreatment staging is needed. We have to consider also neoadjuvant therapy for breast conservation.
Key words: Breast cancer; Neoadjuvant treatment; Partial response; Complete response.
Introduction-Ulcers is one of the most common diseases of the gastrointestinal tract, which occurs as a result of factors disrupting the equilibrium between those “aggressive” and defensive. It can be complicated in three forms: bleeding hemorrhagic ulcers, perforated ulcers and stenosis ulcers.
The Purpose of the study-To assess the frequency of three forms of the complicated ulcer (ulcers hemorrhagic, perforated and stenosis) and its connections to gender and age group, of patients with this pathology.
Material and Methods -The type of study is retrospective, which included a 5year period, from 2008-2012. The study involved 527 patients, 434 patients (82%) with hemorrhagic ulcer, 52 patients (10%) with the perforated ulcer, 41 patients (8%) stenosis, hospitalized ulcer, diagnosed and treated at the first and third clinic of surgery, in the service of Gastro-hepatology and reanimation of the University Hospital Center “Mother Teresa”. Patients were grouped by gender, male-female, and by age group.
Results -By statistical analysis of the Che-Square test proved an important statistical link between hemorrhagic ulcer and perforated ulcer by gender of patients (p 0.05). Age of the patients showed a risk factor for the emergence of hemorrhagic ulcers, where the chances of developing this complication increases with the age.
Keywords: Hemorrhagic ulcers, perforated, stenosis, gender, group age.
Antibiotic use and associated resistance has a tendency for escalation in many countries around the world. Kosovo is one of the countries with pronounced antibiotic resistance. One of the factors that influences emergence of antibiotic resistance is their misuse in hospital settings, so the aim of this study was to determine the volume and patterns of antibiotic use in Regional Hospital (RH) Peja.
Data were gathered during June 2015 using Point Prevalence Survey (PPS) methodology developed by ESAC (European Surveillance of Antimicrobial Consumption) and ARPEC (Antibiotic Resistance and Prescribing in European Children). The study included 156 hospitalized patients, with a bed occupancy rate of 43.6%. 88 of all hospitalized patients (56.4%) received at least one antibiotic; adults 55%, children 100% and neonates 16.7%. The most prescribed antibiotic group was other beta-lactam antibiotics (46%), followed by antituberculotic drugs (22.2%) and beta-lactam antibiotics (13.5%). Top 3 prescribed antibiotics were ceftriaxon (38.1%), ampicillin (12.7%) and gentamicin (9.5%). Empiric prescribing was very high (96.9%) compared to targeted treatment (3.1%). Parenteral antibiotics were used in 98.8% of cases.
Data gained from this study will be used to improve the quality of antibiotic prescription in RH Peja and in Kosovo in general.
During infection with bacteria and viruses, under the action of pro inflammatory cytokines TNF-alpha and IL-1beta, it is increased the expression of molecules of adhesion to the endothelium of the capillaries of choroid plexus and in the epithelium of blood-CSF barrier, enabling attachement, secondment, and transendothelial passing of leukocyte to LCS
Objective: Determination and evaluation of the number of leukocytes and their type in the cerebrospinal fluid of patients diagnosed with meningitis.
Materials and methods: In our study we have taken 133 patients over 18 years old, who were presented at the emergency department of the Infectious Diseases Clinic at the “Mother Theresa” University Hospital in Tirana. All patients were presented with clinical signs and symptoms of meningitis, during January 2007 – January 2013. CSF samples were taken within the first three hours of their arrival at the emergency.
Cerebrospinal fluid samples were taken through lumbar puncture by the infectious disease specialist. The samples were then immediately sent to the laboratory to evaluate the leukocyte count using manual method in Burker camera and to determine leukocyte cell types using Giemsa stain. CSF samples were divided into 5 groups according to the number of leukocytes: first group 0-9 leukocytes/mm3, second group 9-200/mm3, third group 200-500/mm3, fourth group 500-1000/mm3, and the fifth group over 1000/mm3. Patients were divided into four groups according to the final diagnosis: first group consists of 50 patients with bacterial meningitis (BM), second group consists of 36 patients with viral meningitis (VM), third group consists of 13 patients with tubercular meningitis (TM), fourth group consists of 34 patients part of control group (CG). Statistical packet SPSS 17.0 was used for the data analysis.
Results:Pleocytosis over 1000/mm3 was found in 92% of patients with BM. Pleocytosis 500-1000/mm3 was found in 6% of BM, 15.3% of TM and 3% of VM. Pleocytosis 200-500/mm3 was found in 47% of VM and 23% of TM. Pleocytosis 9-200/mm3 was found in 50% of VM and 61.5% of TM. The value of leukocytes in patients with bacterial meningitis changes statistically significantly with the value in patients with TM and VM (P 0.5). For the BM with over 1,000 leukocytes/mm3 sensitivity was 94% and specificity 87%.
Conclusion: Neutrophilic pleocytosis with over 1,000 leukocytes/mm3 support diagnosis of BM. Pleocytsis with mononuclear predominance helps us not in differential diagnosis of VM with TM.
Key words: Meningitis, Cerebrospinal Fluid, Pleocytosis.
The aim of the study:Gastroesophageal reflux disease is a common disease with a multifactorialpathogenesis. Our aim is to analyse the role of the gastroesophageal reflux disease questionnaire in the evaluation and diagnosing of reflux disease.
Methods:The questionnaire on the severity of the symptoms related to GERD was used.An evaluation of the distal portion of the esophagus was carried out in all the patients with positive questionnaire results.All mucosal injury was classified by the Los Angeles criteria(LA)
A total of 80 patients were included 15(12%) were females, while males were 65(88%).Mean age of the subjects was 37.5±4.9 years. Majority of the subjects were in 35-44 years of age group. Of the total number of examinees(80 patients) the role of reflux disease questionnaire was important in the predication of the severity of the mucosal damages valuated with upper endoscopy and classified by the Los Angeles criteria(LA)
Our results provide evidence that the questionnaire for the symptoms related to GERD is a viable instrument for assessing symptoms but also the severity of these symptoms is closely related to the severity of mucosal injury of the esophagus.
Key words: Gastroesophageal reflux disease (GERD), Reflux Disease Questionnaire, Upper Endoscopy.
Background: Gastro-esophageal reflux is a normal physiologic reflux experienced intermittently by most people, particularly after eating. Gastro-esophageal reflux disease occurs when the amount of gastric juice that refluxes into the esophagus that exceeds the normal limit, causing symptoms with or without associated esophageal mucosal injury. There are several independent factors that have an interesting role in causing GERD symptoms but also erosive esophagitis.One of them is the role of helicobacter pylori in GERD patients which is still very controversial. Still many studies suggest that there is an elevated incidence of reflux in ulcerous patients after H.pylori eradication and other studies suggest that this infection improves the efficacy of antisecretory treatment in healing esophagitis and maintenance of remission.
Objectives:To determine the prevalence of helicobacter pylori (H.pylori) infection in patients with gastroesophageal reflux disease(GERD)2:to determine the prevalence of helicobacter pylori in GERD patients according to different grades of esophagitis.
Material and methods: A total of 80 patients who presented at the department of Gastro-Enterology at the Military Hospital of Tirana with symptoms of GERD where included and interviewed according to validated GERD questionnaire. It included questions regarding GERD symptoms mostly heartburn and acid regurgitation. Every subject underwent an upper endoscopy for the evaluation of erosive esophagitis and in each case we made a classification of erosive esophagitis based on Los Angeles Classification.
Also H .pylori infection in GERD patients was determined by using an H.Pylori antigen stool test. Subsequently, the percentage of H.Pylori infection was analyzed in the different grades of esophagitis, according to the Loss Angeles Classification.
Results: In this study we determine that the prevalence of the helicobacter pylori in GERD patients is 40%(32/80) .The prevalence of H.Pylori in patients with esophagitis grade A is 58%(10/17), in patients with esophagitis grade B is 27%(6/22),in patients with esophagitis grade C is 22%(4/18) and in patients without esophagitis the prevalence of helicobacter pylori was 52%(12/23).
Conclusions: The prevalence of helicobacter pylori in GERD patients included in this study is 40% and its absence is associated with more severe grades of the disease. These results indicate that H.Pylori plays a protective role against GERD.
Key words: Gastroesophageal reflux,esophagitis,Helicobacter pylori.
Interdiction: The purpose of this paper is that through regular follow up, survey, for thirteen years, on period from 2003 until 2015, of attempted suicide and suicide to determine the curve and pathway of the risk of suicide within Kosovo Prisons. Based on the results of the survey, to review the procedures, to propose adequate professional measures, too decrease the risk.
Material and Methods: Are based on data processing followed by regular protocols for 13 years in prisons in Kosovo. The data are verified, compared and presented as they appear during above mentioned period. The compare of data are performed during the years with number of inmates admitted, number of attempted suicide and performed suicide at Kosovo Prisons.
Results and discussions: During the period for 13 years (2003 – 2015) were admitted 70 173 inmates at overall Kosovo Prisons. At this period 191 (0.27%) inmates attempted to do suicide which was prevented at different ways; from them, 11 (0.016%) inmates achieved to perform suicide.
The curve line of attempted suicide and performed suicide has increasing pathway which presents the concern issue for health and management within a prison system.
The existing protocols, training of the staff and better follow up didn`t become very helpful to decrease the number of attempts and suicides in general.
Conclusions and recommendations: The number of attempts and suicide is lightly increasing permanently. The protocols, procedures and the training have to be reviewed basically and to be certified by the professional improved and implemented with permanently following the results.
The cooperation with public health sector, prison management and multidimensional attitude of the problem has to be immediately implemented.
Keywords: inmates, attempting suicide, suicide, increase, protocols, training, immediately, etc.
Interdiction: The purpose of this paper is that through regular follow up, survey, for six years, on period from 2010 until 2015, of drug use from the inmates of Kosovo Prisons to determine the curve and pathway. Based on the results of the survey, to review the procedures, to propose adequate professional measures, to detect the users, treat them and maintain the treatment.
Material and Methods: Are based on data processing followed by regular protocols for 6 years in prisons in Kosovo. The data are verified, compared and presented as they appear during above mentioned period. The compare of data are performed during the years with number of inmates admitted, experiencing drugs at the prison until drug free units and programs at Kosovo Prisons.
Results and discussions: During the period for 6 years (2010 – 2015) were admitted 25 231 inmates at overall Kosovo Prisons. At this period 1692 (6.87%) inmates were drug users.
The percentage of drug users coming in the prisons was linear with very light increasing curve during this period. The first nine months of the year 2016, the percentage of drug users coming into the prisons of Kosovo achieved 9.59% which is higher than at year 2014 when was the highest rate in general.
Conclusions and recommendations: The number of drug users in Kosovo Prisons was lightly with linear increase, but at the last period this curve is increasing rapidly, from 6.87% for last six years to 9.59 % just at first nine months of the year 2016.
The drug users in general population in Kosovo with Heroine is 0.1%, Cannabis 2.1% and Cocaine 0.3%.
There is necessary to harmonize and combine the plans and strategies of drug prevention and treatment in Kosovo.
The national drug strategy and working plan of Kosovo needs to be reviewed in contest of dividing; reduce of the offer and decrease of the request. The health component (decrease of the request) needs to be managed by Ministry of Health.
Keywords: inmates, drug, increase, reduce of the offer, decrease of the request, etc.
Odonata Pyrrhosoma nymphula and Ischnura pumilio are relatively well investigated. Besides the earlier records, there are many new records for the presence of Ischnura pumilio and Pyrrhosoma nymphula in Macedonia.
According to the latest data species Pyrrhosoma nymphula was identified on 03.06.2008 in the Great River in the village of Klenovec, western Macedonia, and species I. pumillio was identified on 03.06.2008 in Prilep Lake in Prilep and Mountain Galiçica in southwestern Macedonia. However, according to current literature records for the the distribution, biology and phenology of these two species in the region of Lipkovo has never been reported. From our research we managed to confirm the presence of these two species (Pyrrhosoma nymphula and Ischnura pumilio) near the river Vuksan above the village Mateç in Lipkovo region on these dates: 24.05. 2015, 28.06.2015, 29.05.2016 and 26.06.2016.
Keywords: Odonata, Pyrrhosoma nymphula, Ischnura pumilio,region of Lipkovo.
Summary Background. Sexually transmitted disease represent a growing trend. Gonorrhea, tricomoniasa, sifilizi, herpesi, condiloma, candida, garderela vaginalis are the most common sexually transmitted diseases. Objective. To assess the prevalence of STD in Albania.
Material & Methods. Screening includes 24 villages in north-south and east Albania. Female population was recorded in two records voluntarily. It is used Chi-Square and Z test. It was considered significant values of p <0:05 (5%). Results. The prevalence of STD by the tipe of disease -Trichomoniasis: in the first registration 61 cases with prevalence 9.4%, in second registation 31 cases with prevalence 7.3% -Candida urogenitale: in the first registration 111 cases with prevalence 17.2%, in second registation 56 cases with prevalence 13.3% - Bacterial vaginitsi: in the first registration 318 cases with prevalence 49% in second registation 160 cases with prevalence 38% -Mixed infections: in the first registration 84 cases with prevalence 12.9% in second registation 44 cases with prevalence 10.4% -Leukocite: in the first registration 270 cases with prevalence 41.6% in second registation 122 cases with prevalence 10.5%. Prevalence by clinical signs -Leukore: in the first registration 397 cases with prevalence 61.3%, in second registation 202 cases with prevalence 48.0%. -Burnig: in the first registration 106 cases with prevalence 16.4%, in second registation 52 cases with prevalence 12.3%. -Scratching: in the first registration 170 cases with prevalence 26.3%, in second registation 93 cases with prevalence 22.1%. -Dysuria: in the first registration 41 cases with prevalence 6.4%, in second registation 21 cases with prevalence 5%. -Dyspareunia: in the first registration 87 cases with prevalence 13.4%, in second registation 44 cases with prevalence 10.5%. Conclusion. By analyzing data collected was noted that we are dealing with a community health problems. We found insufficient knowledge about STD, poor hygiene and inadequate knowledge, insufficient knowledge about the ways of transmission, insufficiently recognized of the necessity of regular gynecological checkups. Keyword: STD, health education, gynecology checkup.