Medicine and Nursing

The horror experienced by the 30 wounded in Dubrava Prison from 19.05.1999 until release from Pristina Hospital which then continued in Serbian prisons. The study involved 30 patients injured in Dubrava Prison from 19-22 May 1999. Their hospitalization was performed at the Pristina Hospital at the Vascular Surgery Clinic from 26.05.1999-08.06.1999. They stayed in the hospital 1-15 days and then they returned to prison again. Their average age was 32.4 years, The youngest was 17 years old The oldest was 50 years old Two patients had no birthdays in the hospital admission protocol. Of the 30 Albanian wounded, two died during hospitalization and another, after being released from the hospital was then sent in Serbia’s prison where he died after 11 days. Injuries were various: explosive wounds, scapular injuries and injuries from beatings by various means. The aim of this paper is to present the maltreatment, medical and institutional non humanism of the Serb state by violating every human right of the wounded persons in prison as well as those of the patients in hospital.

Pathophysiologies of cancer-associated syndroms such as cachexia are poorly understood and no routine biomarkers have been established, yet. Using shotgun proteomics, known marker molecules including PMEL, CRP, SAA and CSPG4 were found deregulated in patients with metastatic melanoma. Targeted analysis of 58 selected proteins with multiple reaction monitoring was applied for independent data verification. In three patients, two of which suffered from cachexia, a tissue damage signature was determined, consisting of nine proteins, PLTP, CD14, TIMP1, S10A8, S10A9, GP1BA, PTPRJ, CD44 and C4A, as well as increased levels of glycine and asparagine, and decreased levels of polyunsaturated phosphatidylcholine concentrations, as determined by targeted metabolomics. Remarkably, these molecules are known to be involved in key processes of cancer cachexia. Based on these results, we propose a model how metastatic melanoma may lead to reprogramming of organ functions via formation of platelet activating factors from long-chain polyunsaturated phosphatidylcholines under oxidative conditions and via systemic induction of intracellular calcium mobilization. Calcium mobilization in platelets was demonstrated to alterate levels of several of these marker molecules. Additionally, platelets from melanoma patients proved to be in a rather exhausted state, and platelet-derived eicosanoids implicated in tumor growth were found massively increased in blood from three melanoma patients. Platelets were thus identified as important source of serum protein and lipid alterations in late stage melanoma patients. As a result, the proposed model describes the crosstalk between lipolysis of fat tissue and muscle wasting mediated by oxidative stress, resulting in the metabolic deregulations characteristic for cachexia.

NIR spectroscopy provides the spectral signatures (i.e. “fingerprints”) of living human muscles, which represent specific, accurate, and reproducible measures of their overall biological status. We showed that chemometric analysis applied to NIR spectra acquired from the upper limb distinguishes the biceps from the triceps. We acquired muscles reflectance spectra in the Vis-SWIR regions (350-2500 nm), utilizing an ASD FieldSpec 4™ Standard-Res Spectroradiometer with a spectral sampling capability of 1.4 nm at 350-1000 nm and 1.1 nm at 1001-2500 nm. Optical spectroscopy proves effective for studying human muscles in vivo and contribute to non-invasive more thorough evaluation of the muscular system.

It is proved that the Screening of Cervix for neoplasia has decreased the incidence and mortality from the Cancer of Cervix and has raised the scale of healing from the Cervical Cancer. Prevention of the Cervical Cancer throughout Southeastern Europe is barely documented, despite the fact that the Countries of this region are the most affected places in Europe by the Cervical Cancer.

It is estimated that the number of cases with Cervical Cancer and the number of deaths from this malignity in 11 States of Southeastern Europe during the period from 2002-2004 has been around 9000 women affected from the Cervical Cancer and around 4600 deaths from this illness.

Based on the incidence of the surrounding countries, the incidence in Kosova might be 7.8 to 10.1. 2 The standard ways of Screening and Diagnosing are Citology, Colposcopy, Biopsy and Histological confirmation of intraepithelial cervical neoplasia. The “see and do” approach may be applied as an alternative method, during which the decision for treatment is based on the Screening Test and treatment according to the positive test result. The available screening tests include: Testing for Human Papilloma Virus (HPV), Visual Inspection via Acetic Acid (VIA) and Citology (Pap Test). Possible Treatments are: Cryotherapy, Loop Electrosurgical Excision Procedure (LEEP) and Conisation. This guideline offers the recommendations for Screening and Treatment of intraepithelial cervical neoplasia . It is adapted from the existing guidelines of WHO and NCCN, NHS and USPTF.

Methodology Group for the Guideline Adaptation has been appointed by the decision of the Ministry of Health, Republic of Kosova.

Goal and Focus According to the Definition of intraepithelial cervical neoplasia (CIN), intraehelial cervical neoplasia ( CIN), is a premalignant lesion, which can be developed in one of these stages: CIN1, CIN2 or CIN3. If untreated, CIN2 and CIN3 may progress into a Cervical Cancer.

Target Population Guideline recommends applying the Screening from the age 21 (when the Screening should begin) until the age 65.

Dedication of Guideline Guideline is dedicated to the policy-makers, managers of medical institutions and medical professionals who have responsibility to apply the prevention programme of the Cervical Cancer on the Republican and Municipal level.

In the future, from this guideline should be drawn Clinical Protocols for the respective diseases. Key words for literature research: ‘Clinical Guideline’, ‘Clinical Protocol’, ‘Cervical Cancer’,

‘intraepithelial neoplasia‘

Recommendation

Based on the above Guideline, women suffer and die from the Cervical Cancer, hence it is of a particular importance that on the level of UBT to be charted a leaflet which is dedicated to the women, so that they may have the peace of mind knowing that they are able to protect themselves from the Cervical Cancer.

Women of every group-age will understand that:

- Cervical Cancer is a scary disease, but it is one of a few types of cancer that can be prevented.

- What is Cervical Cancer

- When the PAP test should be taken

- Which group-age should check for the HPV virus (Humam Papilloma Virus)

- Which is the connection between the virus HPV and the Cervical Cancer

- How the human gets infected with this virus

- Does it mean that every woman that is infected by this virus will get Cervical Cancer

- Does a simple PAP test detect the HPV virus

- What does the PAP test observe

- What does the HPV test observe

- In which age the women should do the PAP test

- In which age should they do the testing for HPV

- Will Insurance pay for the HPV test

- What do the patients who are suffering or who have suffered from the Cervical Cancer say I strongly believe that the short explanations on these key points about the Cervical Cancer will be an undisputed contribution which will positively influence the consciousness of population. It is not enough to inform professionals and policy-makers alone, but the population,especially the women, who will enjoy the life instead of suffering, must be informed too. For making this leaflet, Faculty of Nursery, respectively the UBT will give an important contribution not only in education of nurses in the Bachelor studies, but also in the education of the population.

Antibiotics are substances that can destroy the bacteria (bactericidal effect) or inhibit their growth and development (bacteriostatic effect). They are of natural, synthetic or semi-synthetic origin. Antibiotics are a good choice for curing bacterial infections, but they do not affect viruses and fungi. Antibiotics were initially used only in hospitals for the treatment of dangerous diseases such as tuberculosis, lung inflammation and meningitis..

Aim: The purpose of this paper is to analyze the knowledge of citizens in Kosovo cities (Ferizaj / Uro Kaevac, Kacanica) on the use of antibiotics with or without criteria, knowledge of their preferred types and the associated side effects. Many antibiotics are circulating in Kosovo and the purpose of this paper is to evaluate the access of citizens (Population and patients to Family Medicine Centers in Ferizaj, Kacanica) to the information on antibiotic intake, which types of antibiotics are most prescribed, preferred by the patients themselves, have they always received a doctor's prescription, have they consulted a pharmacist, knowledge of the side effects.

Material and Methods: We studied and interviewed 280 citizens (among them patients from Family Medical Centers and General Hospital in Ferizaj).

180 respondents were from Ferizaj and 100 citizens from Kacanik

The information was obtained with the assistance of the students of the Faculty of Nursing on campus in Ferizaj in the form of a questionnaire.

Results and discussion: 280 sex-disaggregated citizens participated in the study, 165 males or 58.9%, and 115 females or 41%. The age group for the study was 20-60 years old males and 25-60 years old females

71.5% of respondents did not have sufficient knowledge about antibiotic use, such as differences in doses, names, manufacturers, and prescription antibiotics without a prescription: Ampicillin and Cefallex whereas 28.5% of respondents had good knowledge of antibiotics. Antibiotics starting from their role and importance to the body, the doses allowed and prescribed by medical professionals, the time when antibiotics should be used. The most prescribed and prescribed antibiotics by patients in the town of Ferizaj / Uroizevac were: Caps: Amoxicillin 500 mg, 250 mg, Ciprofloxacin in doses of 500 and 750 mg, Tab. Ospen 1000 mg and 1500 mg. While in the city of Kacanik the antibiotics prescribed were: Caps. Ampicilina 500 mg, Tab. Amoxiclav 625 mg and 1000 mg Cefexime 500 mg

The time intervals for taking antibiotics were not respected, ie 53.5% did not receive antibiotics within 24 hours, 30% consumed the antibiotic as prescribed by the physician, and 16.5% consumed the therapy. with an antibiotic, only the first day and discontinued.

Providing safe water for human consumption is quite challenging and a fundamental human right. On the contrary, contaminated water endangers the physical and social health of all people.

Kosovo is a small country with limited water resources. Underground and accumulated water resources are mainly used. Prizren is the second largest city in the country in terms of population, while providing safe drinking water mainly from underground sources. According to the 2018 estimation, Prizren has 192712 inhabitants, whose concentration is highest in the urban area with about 53%.

In this study was investigated the bacteriological quality of water sources for human consumption in the Prizren during 2018, comparing the source water with the treated water accessible to citizens.

Material and methods: The research was designed and conducted during 2018. The water was sampled at 16 sampling points for Routine 3 examination. Sampling and analysis were done in the laboratory of Prizren RPHC. The research of bacteria in the sampled water was done by the Membrane filter technique.

Results: The analysis of the collected samples was done with the Membrane filter technique investigating four parameters. During 2018, 832 bacteriological samples were sampled and analyzed including Routine 1, 2 and 3. In our research we analyzed 16 samples, of which 8 from water sources for consumption and 8 from water supply sources. We found that out of 8 samples from the sources, 5 of them resulted in the presence of bacteria, such as E. coli, Enterococus, Coliform bacteria and Bacterial colonies at 37C. In none of the water samples sampled at supply points throughout 2018 hasn’t been bacterial growth.

Discussion: Analysis of water samples from Prizren city water supply sources resulted in 62.5% bacterial presence. E. coli has been most present in positive specimens, but also coliforms. Water treatment before use is a very important process for preventing health impacts. This has resulted quite well in our samples collected at springs at citizen supply points, characterized by no bacterial presence. We can conclude that drinking water in the city of Prizren is within the standards for drinking water according to AI 16/2012 and Council Directive 98/83 / EC.

Background - Aortopathy in patients with bicuspid aortic valve (BAV) is increasingly recognized to be a heterogeneous disease entity. Likewise, many studies suggest that the bicuspid valve morphology influences aortic dilatation, but the association of the two is yet to be understood. We therefore, compared, in a meta-analysis, the effect of right-left coronary cusp fusion (RL) and right-non coronary cusp fusion (RN) on the pattern of aortic dilatation.

Methods – Up to November 2017, a systematic search of electronic databases was conducted to identify all studies that compared aortic dimensions in patients with BAV. Raw mean differences in millimeters was analyzed using Comprehensive Meta Analysis software, and data was combined using random-effect model.

Results - Twenty studies reported aortic dimensions for 3854 patients with RL and 1735 patients with RN BAV (with or without raphe). Indexed and non-indexed values were compared at the level of aortic annulus, sinuses of Valsalva, sinotubular junction and ascending aorta. Using indexed values showed only the sinuses of the Valsalva wider in RL BAV patients (mean difference 1.84 (95% CI: 0.46–3.23), p < 0.009, I2 = 90.4%). Using non-indexed values showed the annulus (mean difference 1.38 (95% CI: 0.62–2.13), p < 0.000, I2 = 84%), sinuses of Valsalva (mean difference 2.94 (95% CI: 1.75–4.12), p < 0.000, I2 = 88.2%), and sinotubular junction (mean difference 1.28 (95% CI: 0.27–2.29), p < 0.013, I2 = 76.8%) wider in RL BAV patients but similar ascending aorta diameter (mean difference 0.14 (95% CI: -1.16–1.44), p < 0.83, I2 = 87.4%).

Conclusions – The meta-analysis found wider aortic diameters in RL BAV compared to RN BAV patients. This might suggest a contributing effect of the transvalvular flow direction and its relationship with the aortic wall. However, it does not necessarily exclude differences of development style and tissue composition. Thus, categorizing BAV subtypes may serve as a clinical tool for optimum follow-up strategies in order to provide optimum evidence based management.

Community score card was first used in Lipjan Municipality as an instrument for measuring patient satisfaction with health services, and evaluation of PHC services by providers of these services, focusing on type 1 and type 2 diabetes mellitus patients. This activity was developed in support of AQH, through the NGO POLIS and the workers of the PHC-Lipjan The purpose of this research was to identify community needs and opportunities to solve these problems, Involvement of the community in decision-making and monitoring of services in PHC, Relevance of findings by CSC and current internal management and Ministry of Health level.

Methodology of work: Organizing information meetings about CSC with citizens and health workers. In the informative sessions with 207 citizens, there were 139 men and 68 women in the gender ratio, in the ethnic ratio 200 Albanian, 6 RAE and 1 Croat.

Total Health Worker 76, in the gender ratio Men 28, Women 48 in the ethnic ratio 71 Albanian, 5 Serb, based on residence and place of work 50 City, and 26 Village. Then focus group meetings: Within the Community Focus Groups, 15 out of the 15 meetings were attended by 120 participants. Since turning it into average participation, it turns out that 8 people have participated in each focus group.

Indicators evaluation visit Following the completion of the third focus group meetings where the consolidated indicators and sub-indicators were assessed by these groups, the field evaluation process was developed. Thus, the evaluation team was divided into two groups of 4 persons each. Each observer group had one POLIS employee, two community members, and one health worker

Interface Meeting The latest activity under the Community Score Card is the joint meeting between health care providers and the community, who have largely been patients with diabetes. This meeting was held on 01 November 2018.

Conclusions These activities served first to confront the evaluations of both groups that they gave during the scoring of the indicators, and then to find a consensus between the two groups on the final grade of each of the indicators and sub-indicators. Following this confrontation and consolidation, work has been done in groups to develop an action plan for three indicators that have been assessed by stakeholders at this meeting as needing to be improved. Thus, the working groups have outlined all the activities that need to be included in the action plan in order to improve these services.

Curriculum is defined as, "All the learning which is planned and guided by the school, whether it is carried on in groups or individually, inside or outside of school” To develop or revise medical curriculum is a difficult task and requires a thorough knowledge of the curriculum development process. The faculty and curriculum committee members need a proper direction right from planning, implementation and monitoring of the curricular exercise. The curriculum development reflects the future of medical education, changing trends in healthcare system and expectation of stake holders. The medical faculties involved in curriculum development process spend a lot of time in thinking how to analyze and organize in writing a new curriculum. The pathway to curriculum revision and development still remains as an unknown lane. The Professional Qualifications Directive; 2005/36/EC, came into force in 2007 and aims at facilitating the mobility of skilled workers to other EU countries and making the European labour market more flexible. The Professional Qualifications Directive regulates issues of skilled workers who wish to exercise their profession outside their home country or the country they received their education from. The Directive provides for:

• A special scheme for temporary mobility of skilled professionals
• Regulations for professionals who want to settle and work permanently in another EU country
• A system of recognition of language skills
• A system for the recognition of professional and academic titles across the European Union
• The Directive clarifies three different types of recognition of qualifications:
• Automatic recognition for professions whose training conditions have been harmonized by all Member States (this applies to health professionals, veterinary surgeons and architects)
• General recognition for other regulated professions that fall not under automatic recognition
• A recognition scheme based on professional expertise and working experience
• Actually some Universities has an approach with this directive.

Introduction: Diabetes is a serious, chronic disease that occurs either when the pancreas does not produce enough insulin (a hormone that regulates blood glucose), or when the body cannot effectively use the insulin it produces. Raised blood glucose, a common effect of uncontrolled diabetes, may, over time, lead to serious damage to the heart, blood vessels, eyes, kidneys and nerves. More than 400 million people live with diabetes. Globally, an estimated 422 million adults were living with diabetes in 2014, compared to 108 million in 1980. The global prevalence (age-standardized) of diabetes has nearly doubled since 1980, rising from 4.7% to 8.5% in the adult population.

Aim: The aim of this study is to determine the health needs and fears among the patients with Diabetes Mellitus especially those who use insulin. Moreover, the purpose was to determine the fears experienced by the patients from the time they were diagnosed and self-management problems.

Methodology: The motivation for doing qualitative research, as opposed to quantitative research, comes from the observation that, if there is one thing, which distinguishes humans from the natural world, it is (our) ability to talk. As qualitative research is involved here, generalizations are not intended. Attention focuses on how a phenomenon is unveiled and the surrounding world is questioned. Sixteen (9 women and 7 men) insulin-dependent patients, expressed their fears and health needs. The recruiting took place in a remote area of Kosova (patients asked not to mention the exact area).

Results: The results showed that patients have a different fears and needs associated with the diagnosis, treatment, and everyday life in the self-management of the disease. Most patients express the needs as wishes. They also point out to expect more nurses in helping them to prevent hypoglycemia, and get more health education concerning diabetes.

Conclusion: Type I Diabetes Mellitus patients expressed their worries about being in the dark concerning health education regarding their disease, psychological needs in their everyday life. There is an immediate need for specialized nurses, since because of their expertise, these specialized nurses should not only educate patients but they should also educate other nurses and even doctors. The importance diabetes nurses place on individualized nursing practice should be reflected throughout the nursing care of diabetes patients.

The skull is one of the most important elements which serve to protect the human head, and including other organs with the jaw. With this being said, sometimes the skull is not strong enough such as when a baby is born, therefore a condition such as Encephalocele may appear. Encephalocele is a neural tube defect that may appear in Parietal Lobe, Occipital Lobe, and Anterior meaning the face of an individual. Moreover, the most common case is the Occipital Lobe, which is located in the back of the head, while Parietal in on the top of the head

General Hospitals are rankedas a health institutions, according to the Lawon Health, in the group of secondary leveli nstitutions. Their missionis to take careof the health of the population through hospital services provided in accordance with the highest standards. In recent years, court proceedings have been in itiated by patients, health institutions-specifically hospitals, but also from health care staff, including doctors an dnurses. Civil disagreements, with potential financial implications, really jeopardize the financial sustainability of hospitals-even they may evenlead to bankruptcy. Collateral damage to such processes is badimage, also have financially negative impact on institutions, so a multidimensional researchis of public interest but also in iteres health institutions and patients.The research focuses on the document entitled : Legal Guide, drafted by the Management of General Hospital in Peja.The Legal Guide, conceived as an internal document of the General Hospital in Peja. The Legal Guide, conceived as an internal document of the General Hospital in Peja, partof the file of each employe employed in the Hospital of Peja does not have the meaning of a formal legal document. I am committed to keep ingevery employe eaware of the right sand obligations during the exercise of duty. To notify, sensitize and keep attentive to the obligation to practice the profession with in the legal, ethical and moral regulations as well as to be conscious of his rights. Identification of problems in forensicdis put es and consequently the identification of causes as well as possible ways of reducing cases, the level of real violations, the degree of dissatisfaction, the improvement of the quality of the services and consequently the strengthening of the patient-worker mutual trust health, wouldresult in a general public interest.

Interventions for surgical removal of tonsils in children are frequent, especially in school-age children. Since this intervention is done under general anesthesia, the most common event during anesthesia after tonsils removal is cough. In our research we have analyzed the effect of Propofol on reducing the frequency of cough presentation. Cough is a reflex response to the presence of foreign particles and injuries to the respiratory tract.Method: The study has prospective design, investigating the presence of an adverse anesthetic and post-surgical effect during arousal from anesthesia. The study included 240 children aged 3–15 years, operated by the tonsils, all rated ASA 1. Patients were divided into two equal groups, the experimental group and the control group. The experimental group was administered 0.5mg/kg Propofol and the control group 0.1mg/kg sodium chloride. The influence of age and duration of surgery on cough presentation was observed and recorded.The data processing was done with the In Stat 3 statistical package. From statistical parameters calculated the structure index, arithmetic mean, standard deviation, minimum and maximum values. Testing of qualitative data was done with X2 test and Fisher's exact test, and calculation of quantitative data that did not have normal distribution with Mann-Whitney test The correlation between the two phenomena was made with Spearman's correlation for nonparametric data. Test verification was done with 99.7% confidence level (P <0.01) and 95% confidence level (P <0.05). Results: Out of 120 patients in the study group of 10 or 8.3% presented cough, while from 120 patients of the control group are 23 or 19.2%. With the X2-test we obtained a distinction with the statistical signification of cough by groups presentation. Cough is more common in patients in the control group (X2-test = 5.1, P = 0.024, P <0.05). Conclusion: Administration of the sub-hypnotic dose of Propofol at the end of general anesthesia enables slow waking and few postanesthetic complications such as cough. The age and gender of the surgeons do not affect the incidence of cough presentation while the duration of the surgical intervention is a very important factor

The aim of this study was to discuss the level of progesterone and prolactin during the development of normal pregnancy and determine the report of progesterone and prolactine level with pregnant women and non-pregnant women. Material and methods: In this study are included 60 women with normal pregnancy (group N) and 60 non-pregnant women (groups S). In both groups blood samples were taken from cubital veins and determination of progesterone and prolactin concentration. Group N (n= 60 ) was selected in prospective way by eliminating from the study all the patients with pregnancy pathology. Group S (n= 60) was selected in prospective way by eliminating from the study the pathology of endocrine system. Results: First results showed that the level of progesterone in significant way is raised during the pregnancy (t= t= 2.589, P=o.o406 p< o.o5). Prolactin is raised in significant way during the development of pregnancy. (t= 3.174, p 0.0252, p< 0.05 ). While comparing the progesterone values with pregnant and non-pregnant women, we have ascertained that the level of progesterone in significant way was higher with pregnant women (q= 10.707, p< 0.001). While comparing the prolactin values with pregnant and non-pregnant women, we have ascertained that the level of prolactin in significant way was higher with pregnant women (q=11.451, P < 0.001). Discussion: The level of progesterone is raised due to development of placenta during pregnancy and increase of fetal area of suprarenal gland of fetus. The level of prolactin during pregnancy is raised due to effective stimulated placental steroids, estrogens, and rilizing tiretrop hormone in hypothalamus on one side and due to presence of prolactin decidul during pregnancy. Conclude: We conclude that the level of prolactin and progesterone is raised in significant way during the development of pregnancy. The values of progesterone and prolactin at pregnancy are raised in significant way comparing with non-pregnant women.

Hyperprolactinemia is endocrinology disorder of the hypothalamus-pituitary axis-gonade which manifests with high reproductive menstrual disorders and infertility.The purpose of the paper was to analyze the incidence of menstrual reproductive disorders (amenorrhea, oligomenorrhea, polimenorrhea) and galacthorrhea in to hyperprolactinemia. Material and methods The study included 125 patients. In group N (with hyperprolactinemia) included 35 women with menstrual disorders, galactorrhea and infertility. In group K (with normoprolactinemia) included 90 women with menstrual disorders, galactorrhea and infertility. Results The incidence of hyperprolactinemia N group was 28 % (hyperprolactinemia = 44.77 ng/ml) compared with group K with 72 % incidence (Hyperprolactinemia=8.83 ng/ml), which is statistical significance p <0.0001. Amanorrhea incidence N group was 25.71 % (prolactenemia=74.49 ng/ml) compared to group amanorrhea K values 5.56 % and frequency prolactenemia 14.22 ng/ml is with statistical significance p <0.0001. Oligomenorrhea incidence N group was 20 % compared with the incidence of oligomenorrhea K groups with 7.78 % incidence. Polimenorrhea N group is presented with 11.43 % incidence compared with the group K with 3.33 % incidence. Galactorrhea shown incidence 34.29 % (prolactinemia =64.49 ng/ml) N group compared to the values of K group with the incidence of 3.33 % and (prolactenemia =15.06 ng/ml) that is with statistical signifikanc p <0.0001. Statistical analyses are made through the paired t-test and unpaired t-test. Conclusion Menstrual disorders fertility (amenorrhea, oligomenorhea, polimenorrhea) and galactorrhea are measured with high incidence and statistical signifikance hyperprolactinemia compared with control group (normoprolactinemia).

Hyperprolactinemia is endocrinology disorder of the hypothalamus-pituitary axis-gonade which manifests with high reproductive menstrual disorders and infertility.The purpose of the paper was to analyze the incidence of menstrual reproductive disorders (amenorrhea, oligomenorrhea, polimenorrhea) and galacthorrhea in to hyperprolactinemia. Material and methods The study included 125 patients. In group N (with hyperprolactinemia) included 35 women with menstrual disorders, galactorrhea and infertility. In group K (with normoprolactinemia) included 90 women with menstrual disorders, galactorrhea and infertility. Results The incidence of hyperprolactinemia N group was 28 % (hyperprolactinemia = 44.77 ng/ml) compared with group K with 72 % incidence (Hyperprolactinemia=8.83 ng/ml), which is statistical significance p <0.0001. Amanorrhea incidence N group was 25.71 % (prolactenemia=74.49 ng/ml) compared to group amanorrhea K values 5.56 % and frequency prolactenemia 14.22 ng/ml is with statistical significance p <0.0001. Oligomenorrhea incidence N group was 20 % compared with the incidence of oligomenorrhea K groups with 7.78 % incidence. Polimenorrhea N group is presented with 11.43 % incidence compared with the group K with 3.33 % incidence. Galactorrhea shown incidence 34.29 % (prolactinemia =64.49 ng/ml) N group compared to the values of K group with the incidence of 3.33 % and (prolactenemia =15.06 ng/ml) that is with statistical signifikanc p <0.0001. Statistical analyses are made through the paired t-test and unpaired t-test. Conclusion Menstrual disorders fertility (amenorrhea, oligomenorhea, polimenorrhea) and galactorrhea are measured with high incidence and statistical signifikance hyperprolactinemia compared with control group (normoprolactinemia).

Background Mental health problems among youth are frequent especially in offenders and as such is very important to identify as early as possible.

Objectives To estimate and compare level of some mental health problems between three group of male youths: juvenile offenders in correctional centre, adolescents with conduct problems and university students .

Method It is cross-sectional quantitative study. The sample consisted ofthree male groups : 41offenders placed in one Correctional Centre (Mage = 18.02; SD = 2.20); 41 male students of secondary school with conduct problems (Mage = 16.97; SD = .61) and 42 male university students randomly selected (Mage = 19.7; SD = 1.77). They filled questionaire MAYSI–2 (Grisso & Barnum, 2001).Data processing was done with SPSS 21.0 and Microsoft Excel 2013.

Results Juvenile offenders in correctional centre scored significantly higher than other two groups of youth in Alcohol/Substance abuse subscale (p=.001), Suicidal ideation subscale (p=.048) and Traumatic stress subscale (p=.003) based on Kruskal-Wallis Test. Juvenile offenders in correctional centre scored higher but nonsignificantly in Angry/Irritabile and Depression/Anxyous subscales. Students of secondary school with conduct problems scored higher but nonsignificantly in Thought disturbance and Somatic subscales.

Conclusion Male juvenile offenders have significantly more mental heath difficulties. Mental health needs of youths in Kosovo (especially juvenile offenders) seems to benumerous and is important to be addressed properly.

Background In an effort to fully analyse and understand the HCV situation and its epidemiology in Kosovo, a multilateral collaboration between different local and international institutions resulted in the establishment of an effective second-generation surveillance (SGS) system for HIV/AIDS between 2006 and 2018 in accordance with the published guidelines. The goal of the Integrated Biological and Behavioural Survey 2018 was to gather strategic information regarding Second Generation of HIV surveillance for better advocacy, planning, and design of future prevention programs.

Methods A mapping exercise was initially conducted in 2016 for size estimations of the key populations: people who inject drugs (PWIDs), followed by an Integrated Behavioral and Biological Surveillance in 19 selected cities across Kosovo.

Results A total number of 458 PWID were interviewed from 6 different municipalities during the study period. Following are the key findings:

• · Of the 458 PWIDs who participated in the study, 399 (87%) were males, while only 59 females were interviewed.
• · The average age was 32.7 ± 9.2 years, with approximately half of the PWIDs up to 30 years old.
• · The average monthly income for all PWID was reported to be 299 ± 298 euros.
• · Average age when they started injecting drugs was 21.7 years. Females at a slighter younger age in comparison to males.
• · Nearly half of the PWIDs surveyed (46.5%) reported injecting once daily with no significant differences between males and females.
• · Streets, Homes and shooting galleries were the most common places where participating PWID injected.
• · Less than 20% of PWID reported sharing syringes or any of the injecting equipment; friends being the most common people whom they shared with.
• · Heroine (67.5%) and methadone (71.6%) were the most common drugs injected in the last 6 months.
• · Nearly 90% of the PWID interviewed informed that they injected at least twice a day
• · A high proportion (97.6%) reported use of a new/sterile syringe for the last injection.
• · Thirty-three percent informed that they overdosed themselves with drugs to the point of losing consciousness, while 24% were treated in a hospital/medical centre.
• · Nearly half of the PWID informed that they had been ever treated for drug addiction.
• · Average age at first sexual intercourse was reported to be 16.4 ± 1.9 years.
• · Overall 77% PWID informed that they hadn’t had sex in the last 6 months.
• · Nearly 6% PWID reported having sex with a sex worker in the last 6 months.
• · The average number of sex partners was reported to be 2.0 ±1.7 in the last six months.
• · Only 14.7% always used a condom (lower in female PWID (9.5%), while 43% rarely or never used a condom.
• · Nearly 10% informed that they sold sex for money.
• · A very high proportion of PWIDs had the correct knowledge of sexual transmission and sharp instruments as the routes of HIV transmission however very few knew that used syringes (19%) could spread HIV
• · Nearly 70% knew a place to get tested for HIV, while 63% got tested, and 96% of those who got tested knew their test results.
• · Almost 80% knew of HIV prevention programs and services in their area, while nearly two-thirds actually utilized them.
• · Program Services mostly utilized were free syringes (48%), counselling and education (36.5%) and VCT for HIV (24%).
• · None of the PWID who participated in the study were tested positive for HIV
• · HCV testing showed an overall prevalence of 23.8%, with varying prevalence rates among Municipalities, which ranged between 50% in Mitrovice to 17.3% in Ferizaj. Conclusions Results of HCV testing showed an overall prevalence of 23.8%, with varying prevalence rates among Municipalities, which ranged between 50% in Mitrovice to 17.3% in Ferizaj. The results of HCV testing does hint to the parenteral transmission of HCV which is due to sharing of syringes and injecting equipment.

The styles of learning have a tendency to guide the styles of teaching, counselling and communication in relation teacher-student. The way that students get information from teachers, books, the internet and their interpretation, depends on their preferences which are different.

The purpose: Evaluating Student Opinions and Identifying Diversity to Students regarding their Knowledge and Implementation on the Style of Learning and Learning in the Nursing Study Program at the Faculty of Medicine at the University of Gjakova "FehmiAgani" and at the "FAMA" College in Prishtina.

Methodology: The population of this study was 80 students in the second academic year (40 students per institution) of the aged 20-25, conducted in the january - february 2019.

Results: Approximately half of the students don’t study everyday, 32.5% study a little every week, while 28.7% declared that they study just before the exam. For the memorization of a certain chapter, 43.7% declared that they are not ready to talk on the next day about the chapter. 76.2% that they focus more on the pictures then on the text and they do it only to pass the time. 37.5% declared that they can’t express their knowledge during lesson time because some of the teachers don’t offer that opportunity.

Conclusions:The learning style of students at the two institutions is of an auditive and practical type. Basedon the measurements the studentsbelong to the "concrete" group. Helpingyoungpeople to identify the waystheylearnbetterand be offered them the opportunity to use all the sensesandintelligenceisoneof the challengesofpolicy-makingstrategiesforteaching in educationalinstitutions.

Aspired foreign bodies continue to present a challenge to otorhinolaryngologists, pulmonologists and thoracic surgeons, where you can find a quick diagnosis, speed, and safe respiratory service of foreign bodies. Tracheobronchial foreign bodies are most common in the age group of 1-3 years and are most commonly of plant origin. The most common signs and symptoms from foreign bodies in the tracheobronchial trunk are coughing, difficulty breathing, and decreased airflow to the affected side. Bronchoscopy is recommended in all cases with a history of sudden cough, vague acute respiratory distress, or chronic lung infection. In our clinical case, an unusual flow occurs after penetration of the foreign plant body into the right tracheobronchial trunk of the 5-year-old child and the inflammatory and physical effects on deep structures of the right lung, the creation of bronchocutaneous fistula, and the penetration of the foreign body into the the external environment through the empiema necessitans drained to the chest wall. Empyema necessitans is a long-term complication of a poor or uncontrolled thorax empyema characterized by pus penetration into soft tissues and the skin of the thoracic wall. In our case the same is a direct consequence of the penetration - aspiration of the foreign plant body, part of the plant of the family Poaceae and the species Festuca rubra with body building and propensity for one-way penetration in different structures. The child is admitted to the Regional Hospital of Gjilan / Gnjilane, able to cough with a sudden onset, then persistent as well as respiratory problems, where he is treated as persistent right pleuropneumonia. The child is transferred to the Pediatric Surgery Clinic in Prishtina to accompany the condition with abdominal obstruction. After excluding the possibility of acute surgical disease, the child is transferred to the Pediatric Clinic where he is treated as a right pleuropneumonia until the appearance of a chest wall change and transfer to the Thoracic Surgery Clinic, where he is treated as empyema necessitans and drainage of pus contents. together with aspiring foreign troops.

Hypertensive disorders complicate 10-20% of pregnancies and are the major cause of maternal and fetal morbidity and mortality. Preeclampsia occurs in approximately 5% of all pregnancies, 10% in primiparas, and 20-25% in women with a previous history of arterial hypertension. Eclampsia complicates 1 in 2000 pregnancies.

Purpose of the study It is acquainted with the pathologies of preeclampsia, eclampsia and the assessment of knowledge and skills regarding the management of eclampsia in nurses and midwives at Queen Geraldine Maternity Hospital, Tirana.

Methodology The study is better in two directions in retrospective aspect of preeclampsia where indicators such as Age, city/village; Operate; Duration of stay. Statistics are obtained by the statistics service on Maternity “Queen Geraldine” Tirana (2017-2019). While the second study is cross-sex and you accept nurse and midwife questions. There are more to a question formulated by me with foreign references. Fifty nurses/midwives were asked at the Queen Geraldine Maternity Hospital in Tirana.

Results and discussions There is a predisposition for the city to be the largest, with an average stay of 7-8 days with ages 25-34. Approximately 70% of the terminally ill in surgery due to hypertensive and eclamptic disorders.

About 44% of the interviewed staff indicate the possibility of evaluation.

Conclusions As can be seen, there is a large number of city experiences to display disorders and the level I appear in tire management is low.

Make sure you are involved in training levels and workshops on eclampsia management.

Burn injuries are very frequent in Kosovo, leading to long-lasting physical, functional, aesthetic, psychological and social consequences directly proportional to the time of healing; the longer it takes for the burn wound to heal the more serious are the sequelae. The objectives of the present study are to review the epidemiological, clinical and therapeutic aspects of burn patients presenting with post-burn sequelae treated at the Department of Plastic and Reconstructive Surgery, Pristina, Kosovo, from January 2005 until December 2013.

Matherial and methods. A total number of 275 patients with burns sequelae are included in this study. The following variables were considered: age, sex, anatomical location, pathological types, and surgical procedure.

Results. There were 112 men (40.7%) and 163 women (59.3%), ranging in age from 0 to 67 years (mean age 33.5 years), most of the patients were children 162 (58.9%).Burn contractures were observed in 208(75.6%) patients, hypertrophic scars in 75(27.3%), keloids in 10(3.6%), alopecia in 12(4.4%), syndactily in 18(6.5%), ectropion in 9(3.3%) .

Conclusion. Timely wound closure and the development of an individual programme for surgical treatment of burns sequelae are crucial for optimal outcomes in patients with burns.

The incidence of concomitant pneumoperitoneum in a severed corporal injury (head, neck / thorax / abdomen) with more pronounced thoracic injury is extremely rare and the exact mechanism of its presentation is unknown at this time (it is idiopathic). The dilemma lies in deciding whether or not to have surgical treatment. The case of a 31-year-old injured person who accidentally falls off the stairs and falls downstairs (2.5 - 3 m height) on a grate-reinforced base and being treated after all clinical and imaging tests, and careful observation a week is only done in a conservative (non-surgical) way, bed regimen and empirical therapy: antibiotics and analgesics. Literature is consulted and suggestions are given.

Medicine is a comprehensive profession for the development of this decade, people honored for the use of doctors undoubtedly enter into the informational use respectively digitization of the most effective means and communication between health professionals and patience. Caring for the diversity of diseases face to face and taking proper care to seek out medical staff, health informatics or the digitization of communications for the purpose of delivering it as soon as possible, you are precisely now using the topics of interest to the economy medical in the world. Taking care of the face in your country only has the digitization of communication between the doctor and the nurse so data from both parties have access to each other. This research is qualitative and aims to obtain answers from medical staff (physician, nurse, health technician) and some categories of patients (acute, chronic, and paralyzed), through this work we want to obtain qualitative data where we will explain how the health staff has adapted to the new army and how I mean the tire benefits of this digitization, the challenges it faces, the reduction or creation of health costs. This paper is conducted in the regions of the Republic of Kosovo with the above categories and aims to provide qualitative data, respectively experiences with digitalization of assets.

School and family are key players in maintaining a healthy society. The purpose of this study is to identify the relationship between individual, contextual and parenting factors in reporting atmosphere, psychological well-being, victimization and violence in Tepelena district schools. The study has a mixed design consisting of quantitative, qualitative and observational methodologies. The study methodology involves hierarchically overlapping multiple analyzes. Sampling in school selection was appropriate while classes were selected according to spatial sampling. The self-report questionnaires used are: The California School Climate and Safety Syrvey (CSCSS), Kessler-10 and Scale of Parenting Style (SPS). In addition, the qualitative House-Tree-Person (HTP) test and observation were used. 375 questionnaires were administered in 5 district 9-year schools. The mean age of the sample is (M = 14.2, SD = 1.33) among which 144 are boys (47.7%) and 210 girls (59.3%). SPSS software version 22.0 was used for data analysis. The analysis showed that students reported low levels of violence and forms of victimization. Quality tests and observation did not support these results. Reporting of school risk factors was low while the presence of firearms and drug use was noted. There were statistically significant relationships between the presence of violence, school atmosphere, psychological well-being, school victimization, family atmosphere, and parenting style. Situation and satisfaction in the family are predictors of the school atmosphere. It is noted that student recognition of rules increases with increasing responsiveness and accountability / control by both parents and vice versa and there is a strong relationship between knowledge of rules against violence and maternal accountability. The study recommends organizing meetings and seminars among psychologists, parents, teachers and / or students as well as longitudinal studies to look at changing factors related to school atmosphere, psychological well-being, perceived parenting styles, and violence by experts in the field. The recommendation relates specifically to schools in rural areas.

The aim of the study was to evaluate the incidence and prevalence of GNAPS at our patients with kidney disease, than to evaluate the causes of it, and to monitor clinical signs and laboratory data. Our attention is on finding the causes and conditions that can contribute on occurrence of the disease. We have described the most important clinical signs and laboratory results, in order to draw the conclusions for prevention of the disease and to impact on minimizing the consequences of the disease .

Our patients, 37 of them, have been the children hospitalized in Pediatric clinic of Prishtina – Nephrology ward. The group age of the patient was from 28 days to 18 years during the perid January 2018 – December 2018.

According to the history data, laboratory tests and other additional examination, statistical processing we have achieve these results: Within total number of children with Acute poststreptococcocal glomerulonephritis 67.5% were male and 32.4 % were female which mean 2:1 respectively. The vulnerable age is between 6 to 15 years with 75.6 %. Less vulnerable age is from 15 to 18 years with 8.1 %. The children from the villages are most affected by the disease with 62.1 % while the children from cities with 37.8 % . Regarding the social status of the patient we have found from our study that Acute poststreptococcocal glomerulonephritis is the disease of the families with low incomes. From our study 45.9 % of the patients are with low economic status 18.9 % with middle economic status and 8.1 with high economic status. From the etiological aspects we have concluded that most of the infections are caused by St. beta hemoliticum but the high percentage of Acute poststreptococcocal glomerulonephritis 24.3 % is caused by piodermic infections. Regarding the importance for the clinical signs different authors have made a different separations. We have given the importance to these signs: oliguria, edema and hypertension . With oliguria were 78.3 % , with edema 72.9 % and 40.5 % with hypertension. We have to emphasize that most of the patients were presented with two clinical signs like oliguria and edema and sometimes combined with hypertension . Only a small number of patients were presented with one sign.

According to the laboratory tests 97.2 % of the patients have had microscopic hematuria and 89.1 % proteinuria.

Regarding the hematologic tests we have found 43.2 % of patients with high sedimentation rates from 20 to 40. In many cases (81 %) there has been a decrease of the number of RBC that according to some authors is of dilutional character. Number of leukocites is increased as well (67.5 %).

Biochemical tests like urea and creatinine are within normal ranges. Sometimes they are slightly increased.

Serological tests of Acute poststreptococcocal glomerulonephritis are more significant, 70 % of patients were found with increased level of Antistrptolizin test O.

Most often complications of our patients were Acute Renal Insufficiency and Chronic Renal Insufficiency with equal percentage 6.1 %.

Patients were treated with antibiotics, antihypertensive drugs and very rare with imunossupresant.

Occurrence of the disease is often in winter, late autumn and early spring

Interpretation of radiological examinations in routine everyday practice, everywhere, not just in Kosovo, contains many errors and discrepancies. Fortunately, most of them are low-level errors, or if they are serious, they are mostly found and corrected in a timely manner; obviously, diagnostic errors become critical when misinterpretation or misidentification can significantly delay medical or surgical treatments. Errors can be summarized into three main categories: observation errors, errors in interpretation, and failure to suggest additional appropriate diagnostic procedures. The possibility of misdiagnosis / misinterpretation is increased even in radiologists with experience during work in emergency units and in radiologists that are at the beginning of their professional careers and in particular during residency training. Pathologies that most often constitute neuroradiology pitfalls include calcification, pseudofractures (fake fractures) , expansion of either subarachnoid or epidural space, ventricular system abnormalities, vascular system abnormalities, intracranial lesions or pseudolesions (fake lesions), and in particular neuroradiological emergencies. In order to minimize the possibility of errors, it is important to be aware of various imaging presentations of a certain pathology, to obtin clinical data, to be familiarized with and to apply the latest practical guidelines, to review post-interpretation examinations , to instruct the patient to undergo appropriate additional examination, and finally, to interpret and to communicate important pathological findings properly and at the right to the other members of treatment team.

The continuum of cardiovascular disease represents a chain of events, initiated by a multitude of dependent or independent risk factors, interfering with many physiological processes to reach the final stage of cardiac disease. Despite improvements in the treatment of cardiovascular disease and a reduction in the mortality rate from cardiovascular events, global mortality from cardiovascular disease remains high. It is imperative to act to break the chain links of this continuum of cardiovascular disease. Since the magnitude of this problem is enormous and a challenge for all health care systems, the engagement of nurses as the majority of health professionals is essential. The facts show that: adverse social and environmental conditions promote patterns of adverse behavior that, in turn, contribute to the major risk factors and the cycle of illness, disability and death. The facts also show that interventions to improve social and environmental conditions are manifested by a reduction in cardiovascular mortality and healthy life to death. The contribution of nurses, as the largest group of health professionals, to health promotion, prevention and management of cardiovascular disease is essential to succeed in reducing mortality and morbidity from cardiovascular disease.

Objective: To assess the progress of contact investigation in Kosovo, assess outcomes and effectiveness, and identify performance gaps. METHODS: This was a retrospective descriptive study were routine surveillance data were analyzed to assess contact investigations outcomes implemented during 2016, 2017 and 2018. The coverage of index cases with contact investigation and the yield of contact investigation on TB notification rate were calculated. The treatment outcomes of latent tb infection (LTBI) were assessed. RESULTS: The coverage of index cases with contact investigation procedures increased from 47% in 2016 to 55% in 2018. The number of index cases assessed was 1097, out of them 563 (51.3%) were bacteriologically confirmed. There were 5247 contacts evaluated, the mean number of contacts per index case was 5. The 53% of contacts were female and children from 0-5 constituted 5.3% of contacts. In total, 101 cases were diagnosed with TB, 54% bacteriologically confirmed. The contact investigation yield to TB notification rate was 5%. The total number of LTBI among contacts was 407 and 372 (91.4%) commenced treatment. CONCLUSIONS: Despite increasingly favorable outcomes on coverage of index cases and detection of TB and LTBI cases, there were modest results on follow-up of contacts and poor monitoring of LTBI treatment outcomes. Further improvement of contact investigation should encompass development of contacts follow-up strategy, monitoring of preventive treatment therapy outcomes, and ensuring legal and financial sustainability for contact investigation network.

Work stress as well as burnout have been found in different occupations at different levels. Maslach Burnout Inventory Questionnaires and Self-Report Form of Job Satisfaction were used to investigate the level of stress and burn-out in mental health professionals in Prizren and at the same time their possible causes of stress and burn-out. Participants in the research were (N = 24, Mage = 41.19, SD = 8.03), respondents of both sexes, dominated by female respondents with 16 respondents or 66.7%. High stress level resulted in 66.7% of the sample; emotional exhaustion at 16.7%; depersonalization at 37.5%and 100% resulted in a low level of personal accomplishement. Inadequate payment, lack of security / threats, physical conditions of work, lack of respect by the supervisor (s), lack of gratitude from others for the work done, good rapport with work colleagues etc. are found to be factors with higher levels of stress.This research will contribute, both theoretically and practically, by raising awareness of health institutions in the process of their function, maintaining the health of employees and to improve the quality of services, as well as being useful to managers and leaders of these institutions to identify the impact of stressors on their employees.

Risky behavior is a serious public health problem in EU countries. Most of the illnesses in adolescents are the result of risky behaviors related to drug consumption. Problems that lead to the risk behavior may be required in the poor quality of family life and the inadequate way of upbringing.

Aim: To determine the role of upbringing styles of parents with the habits of consuming psychoactive substances (drugs).

Material and Methods: A study was conducted on a sample of 600 respondents, pupils from primary and secondary schools on the territory of the Polog region. Тhe scale used to estimate the parents' upbringing styles- "Egna Minnen Batraffande Uppfostran" (EMBU) is applied, as well as the UHO (union of health organizations) survey questionnaire from the "Global Health Adolescent Survey". The statistical analysis of the data obtained from the research was made in the statistical program SPSS 17.0.

Results and discussion: The structure of the examinees consisted of 264 (44%) male and 336 (56%) female students. The ethnic structure of the students consisted of 300 Macedonian students and 300 Albanian students, 172 (28.67%) were the ninth grade students, 203 (33.83%) were first year high school students, and 225 (37.5%) were second year high school students. In this group of students, 28 (4.67%) students use drugs, in fact the prevalence of drug consumption was 4.67%. With the increase in the value of the subscale "rejection" of the father for the unit score, the risk of developing risky behavior of children from the aspect of drug use increases by 6.3% (OR: 1,063, 95% CI 1,007 - 1,123). With the increase in the value of the subscale "overprotection" of the father for the unit score, the risk of developing risky behavior among children from the aspect of drug use increases by 8.9% (OR: 1,089, 95% CI 1.020 - 1.163).

Conclusion: The results of the studies have shown that upbringing styles of parents have a significant impact on the risky behavior of adolescents from the aspect of using marijuana drug.

The endoscopic treatment is one of the most common therapy for bleeding peptic ulcer. Administration of PPI after successful injected therapy with epinephrine is of great importance. This study has the aim to show the efficacy of the PPI treatment after endoscopic injected of epinephrine in the patients with bleeding peptic ulcer.

METHODS. In this study are included 102 patients with active bleeding or with nonbleeding visible vessels, after beginner hemostasis with endoscopic injection of epinephrine (1:10 000). These patients are randomized in two groups. The first group with 22 patients were treated with PPI, 40 mg pantoprazole infusion every 6 hours for 3 days and the second group with 80 patients were treated with 50 mg ranitidine infusion every 8 hours for 3 days. All the patients were followed for survey characteristics during 14 days after the first examination.

RESULTS. Episodes of rebleeding were lower in the group of patients treated with PPI every 6 hours, 7.1% (2/28) compared with the group of patients treated with Ranitidine every 8 hours, 15% (12/80). The volume of the transfused blood in the group of patients treated with PPI was lower than in the group of patients treated with ranitidine, 930 ml vs 1540 ml and p<0.001. The days of hospital stay (9 vs 11 , P>0.05) Number of patients who need the surgical intervention (10.7% vs 12.5% , P> 0.05) and mortality rate (3.6% vs 6.25% , P> 0.05) were without statistically significance between two groups.

CONCLUSION. Combination of the endoscopic epinephrine injection and administration of high doses of PPI in infusion was more effective than combination of endoscopic injection with epinephrine and ranitidine in infusion for prevention of the re-bleeding from peptic ulcer with active bleeding or nonbleeding visible vessels.

Overweight and obesity is a well-known public health problem in developed countries. In particular, obesity in children and adolescents is posing a major concern (according to WHO 2001 reports). WHO estimates that in 2007 about 1.6 billion and 400 million individuals over the age of 15 were overweight and obese. The data show that in 2015 these statistics will increase to 2.3 billion for overweight individuals and 700 million for obese unless radical measures are taken to moderate this issue of importance to the population. The data provided shows a high prevalence of overweight and obesity both in developing and developed countries. The prevalence of overweight and obesity is increasing in Kosovo, a country that is moving towards rapid urbanism and nutrition change. Information is limited to overweight and obesity among adolescents in Kosovo. The purpose :of this study is to examine the body weight of adolescents in the population of the Ferizaj Region (14 and 15-year-olds) and to build a national strategy. Methodology: The study included a sample of 240 teenagers (120 female and 120 male) primary and secondary school students in Ferizaj, Kaçanik, and Shtime. The study began in December 2018 and ended in May 2019 with the help of Nursing students from UBT College. Participants in the study were interviewed and examined for weight and height using standardized techniques. Results: Based on the WHO classification for 2008 on BMI score, it results that 4.9% of adolescents were overweight, of whom 37.6% were female and 62.4% males with statistically significant change (p <0.01). An important finding in our study shows that 67.3% of adolescents had normal weight, while 32.7 of adolescents were overweight, with 73.4% males and 26.6% females. Conclusions: Overweight and obesity in the region of Ferizaj begin to present a problem starting with teenagers aged 14 and 15. The prevalence is higher among the male population (boys), while the rest is for the female population who mostly develop an unhealthy style and food disorders (mainly in not realizing permitted daily meals). Recommendation: It is required by public health experts to implement a health promotion strategy to prevent this problem from being initiated in the Ferizaj Region, Republic of Kosovo.

Uromodulin is a glycoprotein which is synthesized in nephron distal tubule epithelial cells.The purpose of this research is to determine the role of uromoduline in the pathogenesis of kidney damage in chronic tubulointerstitial diseases.Of the 101cases with chronic tubulointerstitial disease,48 cases were obstructive pyelonephritis and 53 cases nonobstructive pyelonephritis with vesicoureteral reflux.Uromodulin in the form of interstitial kidney deposition was found in a total of 26 cases(25.7%) of chronic obstructive and nonobstructive tubulointerstitial diseases.Of 26 cases with this interstitial protein,15 cases (58%) were obstructive pyelonephritis,while 11 cases (42%) were non obstructive pyelonephritis.In the largest number of cases with this PAS-positive protein,calcifications were found in the renal interstitium (21 of 26 cases or 81%),whereas in cases with PAS-negative protein these calcifications were found much less (19 of 75 cases or 25%).This difference with x2 test is significant.The largest number of cases with interstitial protein deposition was found in the kidneys with severe injury (16 of 26 cases or 61.5%),while in the kidneys with mild injury only in (3 of 26 cases or 11.5%).Around this protein in the kidney interstitium,lymphoplasmacytic infiltrates and macrophages are observed as an inflammatory reaction to uromodulin.This data indicate that uromodulin plays an important role in the pathogenesis of kidney damage in chronic ,especially obstructive tubulointerstitial diseases.

Hyperprolactinemia is endocrinology disorder of the hypothalamus-pituitary axis- gonade which manifests with high reproductive menstrual disorders and infertility.The purpose of the paper:The purpose of the paper was to analyze the incidence of menstrual reproductive disorders (amenorrhea, oligomenorrhea, polimenorrhea) and galacthorrhea in to hyperprolactinemia. Material and methodsThe study included 125 patients. In group N (with hyperprolactinemia) included 35 women with menstrual disorders, galactorrhea and infertility. In group K (with normoprolactinemia) included 90 women with menstrual disorders, galactorrhea and infertility. Results:The incidence of hyperprolactinemia N group was 28% (hyperprolactinemia = 44.77ng/ml) compared with group K with 72 % incidence (Hyperprolactinemia=8.83 ng/ml), which is statistical significance p<0.0001. Amanorrhea incidence N group was 25.71 % (prolactenemia=74.49ng/ml) compared to group amanorrhea K values 5.56 % and frequency prolactenemia 14.22ng/ml is with statistical significance p <0.0001. Oligomenorrhea incidence N group was 20% compared with the incidence of oligomenorrhea K groups with 7.78 % incidence. Polimenorrhea N group is presented with 11.43% incidence compared with the group K with 3.33 % incidence. Galactorrhea shown incidence 34.29% (prolactinemia =64.49ng/ml) N group compared to the values of K group with the incidence of 3.33% and (prolactenemia =15.06 ng/ml) that is with statistical signifikanc p <0.0001. Statistical analyses are made through the paired t-test and unpaired t- test. Conclusion Menstrual disorders fertility (amenorrhea, oligomenorhea, polimenorrhea) and galactorrhea are measured with high incidence and statistical signifikance hyperprolactinemia compared with control group (normoprolactinemia).

The aim of this study was to discuss the level of progesterone and prolactin during the development of normal pregnancy and determine the report of progesterone and prolactine level with pregnant women and non-pregnant women. Material and methods: In this study are included 60 women with normal pregnancy (group N) and 60 non-pregnant women (groups S). In both groups blood samples were taken from cubital veins and determination of progesterone and prolactin concentration. Group N (n=60) was selected in prospective way by eliminating from the study all the patients with pregnancy pathology. Group S (n=60) was selected in prospective way by eliminating from the study the pathology of endocrine system. Results: First results showed that the level of progesterone in significant way is raised during the pregnancy (t=t=2.589, P=0.0406 p< 0.05). Prolactin is raised in significant way during the development of pregnancy. (t=3.174, p 0.0252, p<0.05 ). While comparing the progesterone values with pregnant and non-pregnant women, we have ascertained that the level of progesterone in significant way was higher with pregnant women (q=10.707, p<0.001). While comparing the prolactin values with pregnant and non-pregnant women, we have ascertained that the level of prolactin in significant way was higher with pregnant women (q=11.451, P < 0.001). Discussion: The level of progesterone is raised due to development of placenta during pregnancy and increase of fetal area of suprarenal gland of fetus. The level of prolactin during pregnancy is raised due to effective stimulated placental steroids, estrogens, and rilizing tiretrop hormone in hypothalamus on one side and due to presence of prolactin decidul during pregnancy. Conclude: We conclude that the level of prolactin and progesterone is raised in significant way during the development of pregnancy. The values of progesterone and prolactin at pregnancy are raised in significant way comparing with non-pregnant women.

Background: Inhalation therapies have found use many centuries ago, but their popularity in recent years has become one of the most controversial medical debates. Aims and objectives: The purpose of this scientific paper was to see how many children were inhaled during the last 6 months of 2018 in the primary health level of the city of Bujanovac and which drug was most prescribed by health professionals.Methods: This retrospective and quantitative study is planned as a descriptive and cross-sectional study. As a tool for data collection were used health protocols obtained at the primary health level of the city of Bujanovac. Results: 58% of the participants in the research are boys, while 42% are girls. The most affected age is 2 years old with 26%. 76% of children are of urban origin, while 24% are rural. 42% of children were inhaled with pulmicort, 37% of children were inhaled with spalmotil and 8% of children with berodual. The most common diagnosis for which children are inhaled, 45% in total, is J20- acute bronchitisConclusions: We finally conclude that acute bronchitis is the most common medical diagnosis in inhaled children, boys are inhaled more often than girls and the most prescribed medication by health professionals are bronchodilators.

The colon is the last part of the human digestive tract. It consists of the colon, rectum and anus which is the most final part that performs defecation or defecation. The task of the colon is to absorb fluids, residual nutrients, pass on fecal materials, and dispose of them. When the colon, rectum, or anus cannot perform this function due to various diseases or traumatic injuries, then another way must be found to eliminate fecal material. The colostomy consists of an opening (stoma) of the colon and its ascent to the abdominal wall, creating a new communication to eliminate gases and feces.The colostomy may be temporary, meaning that after a few weeks or months an operation is performed and it is closed in order to restore the normalization of the intestinal transit, but it can also be permanent. When the colostomy is permanent it means that the patient will no longer be able to defecate from the anus, as it is impossible to restore the normality of the intestinal transit.Purpose: To understand patient self- care and health education needs for patients with colostomy after rectal carcinoma surgery to provide basic information to improve the quality of nursing.In some cases, unfortunately, complications can occur after stoma formation surgery, these are discussed and nursing advice is given. One of the most important ways a nurse can support a patient is to teach the patient his or her stomach care, ensuring independence before discharge and showing empathy and compassion.Methodology: The research was conducted at UCCK, Prishtina leads with more cases of colorectal cancer than other municipalities in Kosovo.The research was used in 20 patients suffering from rectal carcinoma after colostomy. Some patients experienced defecation disturbances and disorder. Only a few patients could achieve self-care for colostomy before leaving the hospital. Patients' first need for health education was to understand how to train up to regular defecation.Results: There were significant results between nursing interventions and different dimensions 1 month and 6 months after surgery. Routine nursing care plus full course intervention can significantly improve patients ’quality and quality of life after colostomy.

The available evidence supporting the treatment of patients with left main coronary artery disease (LMCA) in support of percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) remains unascertained. Current clinical guidelines recommend PCI as an appropriate alternative to the standard treatment with CABG in patients with LMCA and low-to-intermediate anatomical complexity. Randomized clinical trials (RCTs) with long follow-up results have recently been published showing comparable results for the two procedures with more frequent need for repeat revascularization in patients treated with PCI. Additional data are required to overcome the limitation of sample size in individual RCTs, in comparing the primary clinical outcomes endpoints including death, stroke, myocardial infarction and need for revascularization, between the two treatment strategies. Since atherosclerotic disease is progressive in nature, assessment of the outcomes of coronary interventions at long-term follow-up should be highly desirable. The recent our meta-analysis clearly demonstrates comparable long-term clinical outcome for PCI compared with CABG treatment of patients with unprotected LMCA disease. Hard clinical outcomes, including mortality, were not different between the two treatment strategies but the higher need for repeat revascularization with the non-surgical procedure should be considered in the decision-making process. It is expected that with continuous development of better-quality stents, resulting in better arterial stability and tissue compatibility and lower need for repeat revascularization, PCI might become the established treatment for selected patients with LMCA disease.The findings of this meta-analysis, with the longest clinical follow-up currently available, suggest that the MACE rate and long-term survival of patients were comparable in patients receiving PCI or CABG for unprotected left main stem disease. However, the rate of repeat revascularization was higher in patients treated with PCI.

Fingertip injuries with major distal phalangeal amputations and loss of terminal pulp are very frequent in surgical practice. The good available techniques for the repair of these injuries range from the simple procedures, free graft, to reconstruction with flaps, thenar or cross-finger flap.Materials and methods: This retrospective study includes anamnestic, the level of injury in fingers, as well as operative data for all patients underwent surgery, treated for fingertip injuries from January 2005 until 2018 in University Clinic Center of Kosovo, Clinic of Surgery, Department of Plastic Surgery in Pristina.Results: From January 2005 until December 2018, in our department treated 34 patients with fingertip injury. There were 27 men (79.4%) and 7 women (20.6 %) ranging in age from 13 to 59 years (mean age 23 year). From analysis of sort of covering of wound, notice that in 15 cases (44.1%) used thenar flap, and other cases-19 (55.9%) used cross-finger flap. Conclusions: The major indication for thenar flap is amputation of the digits distal to the interphalangeal joint, and this flap providing adequate subcutaneous tissue for pulp restoration, good tissue match for texture, appearance, and recovery of sensibility. For amputations proximal to the DIP joint, cross-finger flap may then be preferable.

Based on the success in physical treatment of patients in the region of Lombardy (Italy), Belgium and some other countries that were heavily affected by COVID-19, we have begun to adapt the same physical treatment protocols to patients at the University Clinical Center of Kosovo (UCCK). In order to adapt an adequate treatment for the patients and consider the safety of the staff, during a one-month research at the Pulmonology and Dermatologic Clinic (adapted for patients with confirmed COVID-19), we have gathered and documented results from patients infected with COVID-19 in acute phase. At the same time we were able to compare the results obtained in both clinics.Methods: The research was conducted based on quantitative research and clinically controlled randomization methods.From ward A at the Pulmonology clinic, 20 patients were examined and treated as a control group, with an average age of 63.2, whereas In Dermatologic Clinic were examined as well 20 patients with an average age of 64 years.Results: After completing the research and processing the results, the role and importance of physical therapy with patients was confirmed. Specifically, a significant difference was observed between the two groups of patients. Overall treatment of patients at the Dermatologic Clinic was more efficient. Treatment with Oxygen therapy was shorter, the number of patients who showed secondary complications due to physical inactivity was smaller and the number of patients who were transferred to the Intensive Care Center was significantly smaller. We have also noticed a small difference in the number of patients who ended up with fatalities.Conclusion: The results of this study gave us a clear vision regarding the treatment of patients with COVID-19. Concretely, we suggest that following procedures such as: positioning patients, drainage of lungs and airways, activation of intercostal muscles in order to increase the inspiratory and spare expiratory volume and activating the upper and lower extremities to prevent thromboembolism should be incorporated in the treatment regimen for Covid-19 patients

Background and Aim: The survival benefit associated with radial access compared with femoral access in patients with ST-elevation myocardial infarction (STEMI) referred for primary percutaneous coronary intervention (PCI) remains controversial. The aim of this meta- analysis was to assess whether there are additional short-term benefits associated with the use radial access in patients undergoing primary PCI for STEMI. Methods: The PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched for randomized controlled trials (RCTs) comparing radial and femoral access for primary PCI in patients presenting with STEMI. We identified 14 RCTs with 11,060 patients, 5,480 underwent radial access and 5,580 femoral access, all were followed up for a minimum of 30 days. Data were pooled by meta- analysis using a fixed-effects or a random-effects model, as appropriate. Random effect odds ratios were used for efficacy and safety outcomes. Results: Compared with femoral access, the radial access was associated with a significantly lower risk for all-cause mortality (odds ratio [OR]: 0.69; 95% confidence interval [CI]: 0.54 to 0.86; p = 0.001), major adverse cardiovascular events (OR: 0.83; 95% CI: 0.70 to 0.98; p = 0.03), major bleeding (OR: 0.49; 95% CI: 0.35 to 0.70; p < 0.0001), and major vascular complications (OR: 0.48; 95% CI: 0.36 to 0.64; p < 0.00001). The frequency of acute myocardial infarction or stroke were not different between the two approaches. Conclusions: In patients with STEMI treated by PCI, the radial access approach is associated with less mortality, MACE, major bleeding and vascular complications compared with femoral access.

Abortion has incited debate in many countries, starting from smaller communities to government levels. States have approved various acts on this issue, yet many have encountered community opposition and reaction. The attitude towards abortion depends on many factors of the community, thus we decided to assess the attitudes towards abortion of Municipality of Ferizaj inhabitants, which represents the purpose of this paper. The methodology used is the non-experimental methodology. The total number includes 200 randomly selected subjects from the total sample of the Ferizaj inhabitants, surveying each subject voluntarily and respecting all ethics and moral norms in maintaining the subjects’ anonymity. The results of non-parametric comparative statistics show that there are statistically significant differences in abortion attitudes according to economic status, as well as statistically significant differences in abortion attitudes according to the number of children in the family. It also was found that there are differences in attitudes towards abortion according to the readiness to undergo an abortion.

Aim of this study is to assess the importance of early program of rehabilitation after Achilles tendon repair.Methods: A prospective study on 20 patients after Achilles tendon repair in Royal Medical Hospital in the period January 2018 - January 2020. The rehabilitation program started from 3 weeks postoperatively. They were made 15-20 therapeutic sessions with each one lasting form 30-60 minutes. For treatment was used the protocol after Achilles tendon repair from “Stone Clinic” in San Francisco. For evaluation was used the average American Orthopedic Foot and Ankle Society score. Results: Post-op 8-12 months follow up there were no re-ruptures. 80 % of patients were able to return to their previous sporting activities by 6-8 months post operation, 20 % were not able to return to their previous sporting activities from fear of re-injury. The average American Orthopedic Foot and Ankle Society score at 6 months was 96 with 16 patients, having excellent and four patients good. The average time to return to work was 28 days.Conclusion: Start of early rehabilitation is a key factor to return in previous work and sporting activities. Fear from re-injury was the main reason of 4 patients that were not able to return in previous sporting activities.

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to a new social order worldwide. The COVID-19 pandemic outbreak has affected many countries causing hundred thousand of deaths all around the world. It did not exercise its influence only on the citizens' health status, but also had a tremendous impact on the economy and financial status of many countries. Nevertheless, all its clinical manifestations are still being elucidated. Together with its spread, proper protective measures, early and accurate detection of the COVID-19 became the most crucial and challenging step. Therefore, facing this global situation and need, Roche Diagnostics responded by launching the most innovative and accurate diagnostic assays towards fast, robust, and accurate detection of SARS-CoV-2. Here we present eight distinct diagnostic approaches covering molecular and serological testing for the evaluation of patient's health condition, infectiousness and their exposure to the virus. All these tests have demonstrated high accuracy and precision with over 99.5% sensitivity and specificity as they were validated throughout a large number of samples.

Benzodiazepines are among the most prescribed psycho tropics in the world and are used to treat some problems such as: anxiety, insomnia, panic, epilepsy, muscle spasms, etc. Benzodiazepines may be helpful in treating short-term insomnia. Their use beyond 2 to 4 weeks is not recommended due to the risk of addiction. It is preferred that benzodiazepines be taken repeatedly and at the lowest effective dose. They improve sleep-related problems by shortening the time spent in bed before falling asleep, prolonging sleep time and, in general, reducing awakening.Purpose: The purpose of this research is to analyze the description of Benzodiazepines in the Main Family Medicine Center in Ferizaj in the six-month period, January-June 2029. To analyze the nature of the description and the most prescribed drug by the group of Benzodiazepines.Material and Methods: For the compilation of this paper, primary and secondary data were used, within these data were included the data that we used to understand the theoretical aspect of the description of benzodiazepines. These data were obtained from the Main Family Medicine Center in Ferizaj (from January 2019 to June 2019, the first half of the year). The information was obtained from the book of protocols with the approval of the Health Directorate in Ferizaj.Result: From the results obtained in QKMF- Ferizaj it is clear that in the first half of 2019 with benzodiazepine tablets or more sedatives were treated middle-aged men. But what is worth noting is that it is clear that we have young people who have used these drugs with a doctor's prescription. This fact is to be worried about because the positive effects of using benzodiazepines are known, but let us not forget the side effects and their dependence. In middle age it is not very disturbing because there are not many adult patients who used these medications. The fact that many young people are unable to cope with their emotional state has also led to the use of these medications. The most prescribed benzodiazepines were Diazepam 5 mg, 10 mg tablets, Bromazepam 3 mg and 6 mg tablets, Lorazepam 3 mg, etc. In percentage we have these ages which were users of benzodiazepines: 18-30 years 16%, 30-40 years 11%, 40-50 years 13%, 50-60 years 20%, 60-70 years 26%, 70- 80 years 12%.Discussion: Benzodiazepine hypnotics shorten the time it takes to sleep and extend the sleep period. The main differences exist in how long they can remain in the body, possibly leading to prolonged side effects. For example, lorazepam has a much shorter duration than diazepam, allowing for faster drug clearance and theoretically fewer side effects. On the other hand, diazepam can remain in the system for days and increase the risk of long-term side effects, especially in the elderly. Benzodiazepines should be used for a short period of time (usually 2 to 4 weeks) for insomnia. Short-acting benzodiazepines are often preferred for insomnia because they theoretically produce less daytime drowsiness, although many patients still experience these effects.Conclusion: The results of the research in the book of protocols and prescriptions at the Main Center of Family Medicine in Ferizaj show that a number of citizens who have concomitant diseases are regular users of Benzodiazepines: Diazepam and Lorazepam. However, citizens need to have more information about the side effects of these drugs, especially young people who use Lorazepam for sleep disorders and acne.Recommendation: to respect the criteria for the prescription of benzodiazepines and to develop a national strategy about the correct prescription of these drugs.

The value of micronucleus (MN) and microscopic changes in lymphocytes of circulating blood presents a good case to study changes of genome directly into organs affected by tumourAim: The aim of this research is to analyse the level of induction of MN and the value of microscopic changes in binuclear lymphocytes of venous circulating blood on patients with oral cancer during treatment with chemotherapy.Material and methodology: The study analyses 21 patients with oral carcinoma (72.2% male) with an average age of 54.7+-9.2. From parameters, we have analysed theeffect of the chemotherapy and microscopic changes in lymphocytes of the circulating blood of patients diagnosed with oral cancer. Results:Changes of degenerations of microscopic cells at patients with oral malign processes in lymphocytes of circulating bloodwere noticed, as after chemotherapy there are significant changes (16.7±27.2 vs. 27.8±33.6, p<0.0001).Also we have defined a significant change regarding all apoptic binuclear lymphocytes (p<0.00001), necrotic lymphocytes (p<0.0002), and lymphocytes with nucleoplasmbridge. Conclusion:Results show that chemotherapeutics have induced cytotoxity of cells but have not induced chromosomal changes or formation of micronucleus formation.

This study addresses issues of the impact of the night shift in the emotional state of nurses at work at the Main Family Medicine Center in Rahovec. We used a linear model that links work role and social factors, anxiety depression, and self-esteem. This research was conducted with 24 nurses, where 12 nurses were interviewed during the night shift and 12 nurses during the day shift. Of these, 6 are male or 25%, and 18 are female or 75%. The lowest age of nurses was 32 years, while the highest was 54 years. This study aims to identify scientific evidence on the occurrence of changes in the emotional state of nurses working on night shifts associated with adverse physical and psychological health outcomes, such as poor quality of work and symptoms of depression, anxiety, and self-esteem. The aim of the study is to compare the quality of work, as well as the symptoms of the emotional state of nurses working in the night shift with those who work in the day shift and to investigate the relationship between work quality and the symptoms of the emotional state of nurses. In addition, we will assess the prevalence and accompanying factors of depression, anxiety, and self-esteem among mental health nurses working at the MFMC in order to identify independent predictors of mental health disorders.

Corona virus (COVID-19) is an acute infectious disease caused by the new Corona virus. The firs cases were registered in China at Wuhan region at the end of December 2019. The disease is characterized by high contagiousness and relatively high mortality compared to other diseases that spread through the respiratory tract. Inadequate knowledge and incorrect attitudes among health care providers can directly influence practices and lead to delayed diagnosis, poor infection control practice and spread of disease.Methods: A prospective research was undertaken on knowledge and attitudes of health providers about Corona virus diseases, at the University Clinical Center of Kosovo in period of time June-August 2020. Data were collected through a self-administered questionnaire. Descriptive and inferential statistics were used to assess the relationships between study variables such as standard deviations, T test, ANOVA and Spearman’s correlation.Results: In this research 97 health workers participated. The vast majority showed good knowledge and a positive attitude about presence of COVID-19 in our country and worldwide (85%). Approximately two thirds of the participants knew the mode of transmission (67%), the isolation period (65.8%), method of treatment (58.4%) and 79% had a positive attitude towards the application of protection measures. There was a negative correlation between knowledge scores and attitude scores (r=0.21, p<0.001). Moreover, media and social media were the main source of information COVID-19 (92%).Conclusion: Most respondents had solid knowledge and showed positive attitudes about COVID-19. However, the expectations were higher as it was believed that health workers should have greater knowledge about the disease as well as confidence in the existence of this disease. In order to raise the level of knowledge and trust, additional education is needed within the institution where they work.

Surgical repair of coarctation of the aorta (CoA) is a safe procedure in children, however the condition is known for its potential recurrence and other related complications. The available evidence shows abnormal intrinsic properties of the aorta in CoA, thus suggesting additional effect, even after CoA repair, on left ventricular (LV) function. Accordingly, we sought to obtain a better understanding of LV myocardial mechanics in very early-corrected CoA using two-dimensional STE. Methods and results: We retrospectively studied 21 patients with corrected CoA at a median age of 9 (2–53) days at three time points: 1) just before intervention, 2) at short-term follow-up (within 3 months after intervention) and 3) at medium-term follow-up after intervention (median 2.3 years) and compared them with normal values. Speckle tracking analysis was conducted via vendor independent software, Tomtec. After intervention, LV function significantly improved (from −12.8 ± 3.9 to −16.7 ± 1.7; p < 0.001), however normal values were not reached even at medium-term follow-up (−18.3 ± 1.7 vs. −20 ± 1.6; p = 0.002). Medium-term longitudinal strain correlated with pre intervention EF (r = 0.58, p = 0.006). Moreover, medium-term subnormal values were more frequently associated with bicuspid aortic valve (33.3% vs. 66.6%; p < 0.05). Conclusion: LV myocardial function in neonates with CoA can be feasibly evaluated and followed up by speckle tracking echocardiography. LV subendocardial dysfunction however, remains in early infancy coarctation long after repair. Long-term follow-up through adulthood using myocardial deformation measurements should shed light on the natural history and consequences of this anomaly.

Childbirth is a joyous event when a woman gives birth to a child she desires. Despite the pain and embarrassment, childbirth is the long-awaited peak of pregnancy and the beginning of a new life. However, childbirth is also a critical time for the health of the mother and her baby. The postpartum phase is an essential period for a mother and her baby. The postpartum period includes a critical transitional time for a woman, her newborn, and her family, on a physiological, emotional, and social level.The postpartum period, or puerperium, begins about an hour after birth and includes the following six weeks. Postpartum nursing care should respond to the needs of mother and baby during this particular phase which includes: prevention and early detection, treatment of complications and diseases, counseling, parental education and breastfeeding services, immunization, maternal nutrition and all other needs which lead to improved quality of maternal and infant health. Problems such as postpartum (hemorrhage, pregnancy-related hypertension, pulmonary embolism and puerperal sepsis, decay of wounds, breast abscess and constipation, and sexual problems) may also be present during this period. Unknown postpartum disorders can lead to physical distress, psychological distress such as postpartum depression, and a poor quality of life for mothers who, if not treated promptly and effectively by nursing staff in collaboration with medical staff, may lead to deteriorating health. Postpartum care indicates the fact that most maternal deaths and disabilities occur during the postpartum period and that early neonatal mortality remains high, therefore home nursing care remains essential during this phase.

Burnout is defined as "a multidimensional construct composed of emotional fatigue, depersonalization, and personal achievement that occurs in people who work any job" (Maslach, 1982). According to the WHO the symptoms of burnout are lack of energy or exhaustion, increased isolation from work, feelings of negativity associated with work and decreased professional effectiveness. The main aim of this research is to identify the risk of burnout, through three components, such as fatigue, depersonalization, and personal achievement to the nurses of the Main Family Medicine Center in Rahovec. In this research 51 nurses of Main Family Medicine Center in Rahovec responded positively to the questionnaire, with an average age of 41.31 years. Of the total number of nurses, 35.3% were male and 64.7% were female. Of the respondents, 72.5% had completed secondary education, 23.5% had university education, while 4.0% had a master's degree. A self-administered questionnaire called Maslach Burnout Inventory (C. Maslach, S. Jackson, 1981) was used to conduct this research. The data were analyzed with the statistical package for social sciences, SPSS, version 21. Based on the descriptive data we can conclude that nurses show no symptoms of burnout, have no loss of sensitivity, and are satisfied with their personal achievements. While by correlation we understand that we have a moderate negative correlation between the level of education and the fatigue component (r = -. 312 *, p = .026). Also, a moderate positive correlation was found between the fatigue component and the ward in which they work (r = .284 *, p = .044).

The aim of this study, was to diagnose breast cancer in women with breast cystic lesions using sonographic features of ultrasound and fine needle aspiration. Materials and methods: We examined 1560 patients with breast lesions, 87 patients had cystic breast masses. Most often symptoms was : a lump, breast pain, nipple discharge. The mean age of the patients was 45 years (range, 18–73 years). Diagnosis was determined with sonography with high frequency transducers 12 MHz and with fine- needle aspiration. Excision was performed for all malignant lesions. Cystic lesions were categorized as simple cysts, clustered cysts, cysts with thin septa, complicated cysts, cystic masses with a thick wall, and complex solid and cystic masses. Sonographic findings were compared with the pathologic results and were classified as benign and malignant masses. Results: Of 87 patients with cystic lesions, 12 (13.8%), were simple cysts, 8 (9.2%) were clustered cysts, 11 (12.6%) were cysts with thin septa, 17(19.5%) complicated cyst. All of cases were pathologically proven to be benign. Of 13 (15%) cases with cystic masses with a thick wall, 3 (23.1%) proved malignant, of 26 (29.9%) cases with complex solid and cystic masses, 11(42.3%) of them proved malignant. Conclusion: In our study sonographically detected and pathologically proved, simple cysts, clustered cysts and cysts with thin septa were all benign, so for this kind of cysts interventional treatment was not needed, just annual routine follow-up with sonography. Symptomatic complicated cysts should be follow-up by sonography and aspiration cytology and treated according to clinical symptoms. Cystic masses with a thick wall and complex solid and cystic masses should be examined by biopsy with pathologic confirmation.

Stress is an inevitable consequence of life, it is the demand for the human being who needs to adapt. The inadequate atmospheres at universities, in students with different socio-cultural backgrounds, can cause more academic failures than elevation, and also create an unfavorable atmosphere for students (Mersha,Bishaw, Asrat & Nigussie 2009).The purpose: Evaluating student opinions about their knowledge of stress, dealing with it, and managing it.Methodology: The study was random, with a population of 428 students (46.7% females and 53.3% males), with some studying in public institutions and others in private, majoring in Psychology, Criminology, Law and Economics. The realization was made during the period November - December 2019.Results: 70.1% of students declare that they feel more tense, tired and less energetic than when they started their studies. 46.7% of students face continuous stress. Concern is the situation where 50.5% of students declare that they do not work. For the individual, family and socio-economic difficulties, 29.9% of the students are declared, which is why 15.9% of them have increased the consumption of alcohol, tobacco and sedatives.Conclusions: Students should continually study and be educated for stress management, improving communication and collaboration with colleagues, pedagogues, and management, and to identify potential factors that enhance motivation and improve their performance. Academic staff should support students to manage situations and regenerative factors during their studies and remove conflicting style with students.

Doctors and nurses in Family Medicine are the "gateway" or first contact of the patient who seeks to find solutions to problems related to his health in general and sexual health in particular. With the increase in the prevalence of cases of sexual disorders in middle-aged and elderly people, the need to manage these problems should be routine in family medicine. The approach and professional skills of GP and nurses are prerequisites for the patient to express themselves freely and talk about something that is very private and somewhat embarrassing.Aim:Emphasizing the importance that doctors and nurses have in Family Medicine Centers in detecting and treating or guiding patients with problems in the field of sexual health is the main goal of this presentation. However, raising awareness of decision-makers and relevant institutions about the possibility of training or other education in this area is a secondary goal.Current situation :Based on the information received from consulting with patients, they have never been asked or examined for sexual disorders during their visit to the family doctor. The situation is almost the same in other countries. Due to the nature of the problem and the unwillingness of both parties, the health staff and the patient, to talk about sexuality a great gap has been created in the discussion and treatment of sexual disorders. One of the main reasons for not discussing these problems is the lack of comfort and fear of dealing with these problems by health personnel. Generally, family physicians have a low level of knowledge about sexual functioning.Conclusions There is a great need for education and training of health personnel on the way of communication and obtaining sexual history. Increasing knowledge about sexual function of their patients can help overcome problems and prevent many consequences, especially those in the cardiovascular system and psychological well-being.

It is proven from the literature that in more than 90% of cases of suicide, individuals have obvious mental disorders. Other identified causes are various circumstances, stress and trauma. Treating people with mental health problems, especially those with suicidal ideation, is a challenge for mental health professionals. PURPOSE of this survey is the presentation of our problems and experiences, during last six years, with the patients who come from the criminal conditions - the procedures of confrontation with the court, the prosecution, the police . Our goal is to present our thoughts on suicide prevention in these conditions. Criminal conditions, even for a normal person, are abnormal, where the person feels guilty, worthless and automatically clings to depressive, nihilistic and suicidal ideas. METHODOLOGY The patients files have been analyzed, especially of the cases that have had the most special treatment, cases which have had auto-aggressive, violent manifestations, self-harm in terms of suicide, which have come for treatment or psychiatric evaluation from prisons in IFPK. These people have swallowed dangerous things, hiding razors, and tablets for suicidal tendencies. FINDINGS We found 19 people with self aggressive behavior. Of this number males 18, females 1. Personality disorders and the use of psychoactive substances have been dominated by male and female 9, female 1, then in turn: bipolar disorder, schizoaffective disorders, disorders of the group of schizophrenia, psychosis and psycho organic disorders. DISCUSSION Among the factors that are most potential for self aggressive manifestations and lead to suicide, are mental disorders, new circumstances, or even submission through proceedings, court hearings, police investigation , etc. Disconnection of family relations, a daily strict routine for some of the people in these conditions are burdensome and without perspective. CONCLUSION However, despite psychosocial and biological treatment, dangerous behaviors in psychiatric patients still remain a phenomenon that will probably never end, as is their etiology. So staying in penal conditions ,or penal condition treatment are always potential for incidents like emotional explosions, injuries, threats, irritations, suicide. Suicide as a phenomenon regardless of where the person is, at home, at work, in criminal conditions, on a plane, in a car, remains a challenge that we will face for a long time.

In this paper, the compatibility of clinical diagnoses with histopathological ones has been analyzed. 418 laparoscopic cholecystectomy with clinical diagnoses were analyzed at the UCCK Laparoscopic Center with histopathological diagnoses performed at the UCCK Pathological Institute. In 173 cases, the clinical diagnoses did not match the histopathological ones. No cases of cholecystitis have been reported. Diagnosis was inconsistent in every 2.41 patients. The female-male ratio was 5: 1. All cholecysts operated on at the Laparoscopic Center were sent for histopathological analysis. Purpose of the paper - To see the compatibility between the clinical diagnoses of cholecystitis and histopathological ones - Examine the rationale for sending each cholecyst for histopathological analysis.

Intravenous infusion is the main mode of administration of anti-cancer drugs for most types of malignant disorders, with a number that exceeds 1 million infusions every day worldwide.Aim: The purpose of this paper is to: Identify complications of intravenous chemotherapy administration in peripheral veins - extravasation, assessment of basic UCCK nursing knowledge regarding these complications, and assessment of the knowledge of patients undergoing chemotherapy in Oncology Clinic related to extravagance.Material and Methods: To carry out this research we are based on the empirical method. Empirical data (nurses 'and patients' experiences) are analyzed quantitatively. Through quantitative research, data was collected from nurses and patients by applying a standardized approach where questionnaires were used, and where nurses and patients represented the sample from the general population.Results: Research findings find that most nurses have clear that all extravagances should not be treated with the same steps and procedures (51%) because there are different forms of this complication. They make it clear that all cytotoxic extravagances can be prevented if proper education is provided.Discussion: In our country, there is no accurate evidence of extravasation due to chemotherapy because they do not register and do not appear. What is the prevalence of extravagance and how much the burden it makes for Kosovo's health is not studied in any work in Kosovo. One of the reasons is also insufficient information on what is, how it is and how to react when this complication occurs.Conclusions: Extravasation is a concern for all health care providers who administer chemotherapy. Extravagance is more common in peripheral administration, but can also occur with central access approaches. Extravasation is the unintentional infiltration of the drug into the surrounding tissues, the consequences of which will depend on the herb that is administered.

Ductal adenocarcinomas account for 85-90% of pancreatic tumors. In 60-70% of cases, the tumor is localized to the head, 5-10% to the body, and 10-15% to the tail. One-year survival of patients with pancreatic cancer is 26%, while 5-year survival is 6%. Endoscopic ultrasound is very sensitive in detecting solid pancreatic lesions.AIM: Introducing the clinicopathological features of our patients with pancreatic tumorsMETHOD: This study included 38 patients [15 females (39.5%) and 23 males (60.5%), with a mean age of 65.10 ± 10.21 years, range 34-78, with solid pancreatic lesions, who were announced in the period January 2018 - July 2019. Endoscopic Ultrasound (EUS) was performed with Pentax EG- 3870UTK Endoscopic Ultrasound. The EUS FNA is made with 22 gauge needles.RESULTS: We had two groups, the group with adenocarcinomas [n = 36 (94.7%)], and the second group with two patients with insulinoma. The main symptom was pain (57.9%). 36.8% of them were with jaundice. Nearly half of these patients were examined with EUS (17 patients). 21% of them used tobacco. Regarding the localization of the solid lesion in 25 patients (65.8%) it was in the head of the pancreas, 8 (21%) in the body and two of them were in the tail and the uncin. Most of the patients were stage IV.CONCLUSIONS: The description of the characteristics of our patients with solid pancreatic tumors is similar to the literature. Most of the patients were in stage IV. Material for histopathological analysis can be obtained with linear EUS. All of these features make EUS the method of choice for patients with pancreatic disease.

The experiences of nursing students in their clinical practice play a key role in terms of nursing education. The main purpose of this study was to investigate the experience of student nurses in relation to their clinical practice, the benefits they receive, and the challenges they face.Methods: For this study, semi-structured interviews with a total of four participants from different public medical and private universities were used, the sample is randomly selected. Outcomes: The results obtained based on the research questions are four topics, two of which talk about the benefits of nursing students and the other two about the challenges they face during clinical experiences.Conclusion: The result of this study shows that clinical mentors help students gain more skills in their work as a nurse and the small number of clinical mentors is presented as a challenge for new students, also the results show that challenges for young students are also lack of tools and workspace.

Health policies, adequate legislation in the field of health and sustainable financing of the health system continue to be serious challenges for countries in transition and especially for the Republic of Kosovo. As a new state, with a health system that has gone through three difficult periods in the last three decades such as political, economic, social and the transition from international administration to an independent and sovereign state, has significantly influenced the reform and advancement of health policies as well as the quality of legislation governing this area.The situation in Kosovar healthcare continues to be critical two decades after the war and 12 years after the declaration of independence. Low level of development of the health sector, lack of political will, inadequate health policies and non-implementation of legislation, unsustainable financing is reflected in poor results, even alarming in terms of public health in Kosovo. The lack of a serious approach to the health sector has led to this sector, of primary importance, to be degraded to alarming proportions at the three levels of Kosovo's health system.The purpose of this paper is to assess the achievements, stagnation, the need for reforms in the health system and to improve the parameters and indicators that make the health system of a stable country, through a qualitative and comparative method, with reviews of Kosovo's health policies and legislation, as well as evaluation reports of relevant international institutions.

Infections received during the provision of health care pose a threat to the safety of the patient, staff and other actors involved and consequently affect the quality of health care. In the concrete situation of Pandemia Covid -19 infection of health personnel, in addition to the negative effects on the health of each individual and other side effects, really risk capacity - human resources of each health institution with direct effect on reducing the main capital in combating pandemics - that of health personnel.Human resources, of course not the only ones, although especially in times of pandemics, and consequently in today's Covid -19, represent the main capital in which any possible action plan to manage the problem. They are carriers of it. all activities. Consequently, being a carrier of activities also risks being infected, with consequences, in addition to endangering health, and the loss of the ability to perform tasks and responsibilities. A plan that would focus on preserving the human capacity of the health institution is an essential obligation.In order to address these issues, the hospital had prepared an Action Plan for the management of human resources during the pandemic at the General Hospital in Peja. The focus of the Hospital's Action Plan was to avoid "close contact."The purpose of this paper is to, through the study of the plan, collection, systematization and analysis of data on the number of infected personnel, by systematizing them according to profession, place of work, measures taken, to highlight the interconnectedness of measures taken with the number of infected staff and eventually specify any practice applied with a positive or negative effect on the possibility of infection, considering in this element also the public interest of this paper.

Hiatal hernia is accidental asymptomatic finding, but may be associated with gastro- oesophageal reflux disease and Cameron ulcer, in large hiatal hernias.Cameron lesions are linear ulcers or erosions in the folds of the gastric mucosa in diaphragm level from secondary mechanical trauma to diaphragmatic contraction by respiratory excursions in combination with impaired gastric acidity and ischemia. The frequency of Cameron ulcer depends on the size of the hiatal hernia and, increases in proportion to the increase in the size of the hernia. The prevalence rate of hiatal hernia ranges from 0.8 to 5.2% in all patients undergoing upper endoscopy. gastrointestinal. It mainly causes anemia due to iron loss as a result of chronic gastrointestinal bleeding and indigestion. Upper gastrointestinal endoscopy is the gold standard of the diagnostic aspect. Treatment is mainly with antisecretory and iron, for anemia. If it is refractory, surgical intervention is the final treatment. We present the case, a 65-year-old woman with retrosternal postprandial pain, especially in lying down immediately after eating, vomiting, dyspnea, weight loss, fatigue and lethargy. E the patient had a history of long-term symptoms of more than 20 years and treatment with antisecretory. He had a cholecystectomy 10 years ago. The endoscope shows a hernia large hiatal and erosions / ulcerations at the level of gastrodiafragmal contact (ulcers Cameron). Laboratory tests showed low Hgb and Fe (85 g / L or 5.4 mmol / L, respectively). and low MCV (60). After the endoscopic examination, the application was completed. After operative treatment, there was significant clinical and laboratory improvement. For further follow-up, barium radiological examination is envisaged, and after six months, upper digestive endoscopy and cardiopulmonary examination. We conclude that hiatal hernia with Cameron lesion is a rare, potentially destructive but still curable cause of refractory sideropenic anemia. Diagnosis is very difficult in developing countries, where iron deficiency anemia is more common. A high index of suspicion, chest x- ray, barium examination, occult blood test and finally, endoscopic and intraoperative findings are the basis for diagnosis. In the best groupings, upper gastrointestinal endoscopy is a gold standard of diagnostic mode.

Mentoring is a professional task of nurses and an important training in nursing education and practice. Mentoring is carried out by an experienced nurse who supports the establishment of a less experienced nurse or a student during university education.Purpose: To assess mentoring of nursing students in the practice environment from the perspective of mentors and students.Materials and methods: 143 nursing students and 65 mentors of nursing students participated in the research. Research data was collected by two questionnaires, one for students and the other for mentors and analyzed with SPSS.Results: The average age of the students participating in the research was 23.4 ± 4 years, while the average age of mentors was 40.4 ± 10.4 years. The results show that there is no statistical significance (p = 0.211) of mentorship knowledge for nursing programs. While there is a statistical significance in practicing nursing skills (p = 0.04).Discussion: The research results have provided answers to the research goals and questions regarding the mentoring of nursing students in the practice environment from the perspective of mentors and students. Both hypotheses are approved by the results of the paper.Conclusions: Mentoring nursing students promotes student learning in the practical environment where they have a mentor who is responsible and helps them in the mentoring phase.

Examining what autism is and being aware of the general symptoms and characteristics that children with autism possess is a professional task of nurses. Informing parents about diagnosing a child with autism and informing them what to do next with them is an important task for us as health professionals. Purpose: The aim is to bring to the readers the problems, symptoms, therapy that accompany the lives of these children, and above all an awareness of society, especially parents, who often times as a result of a negligence or distrust that their child has any problem, they neglect the problem that becom the cause of some irreparable consequences for the whole life of the child. Materials and methods: The research involved 2 private autism associations: '1.Autism Speak-Kosovo', 2. 'National Autism Association in Kosovo', and finally I collected data from the child and adolescent psychiatry clinic (QKUK-Prishtina). Questionnaires were used for data collection, and I received responses from: Principals, Psychologists, Therapists and Psychiatrists who take care for children with autism. Results: The results have shown that the most affected gender is the male gender, the dominant age that these associations have, varies from 3-12 years, and that the most used drug in these children is Risperidone 1 mg ( in 77% of cases ). Discussion: Results in this research have been achievable with what we were looking for in autistic children, we have also gotten the right answers to our awareness research questions for these children. Conclusions: We have come to the conclusion that the number of children with autism is increasing, and we as health professionals need to adapt to them in daily life, in the physical, psychological and social environment. Therefore, the role of all health professionals as well as parents is essential for a positive outcome in these children.

There are two types of keratitis, the one which includes substance loss (ulcer) and the one where the inflammation process develops in deep layers without epithelium damage (keratitis stromalis or parenchimatosa).Common signs for all the types of keratitis are: cular pain that is intensified during the movement of palpebra on cornea. photophobia, it occurs from the painful contraction of the inflamed iris, decrease on sight sharpness, and watering.According to etiology, keratitis is divided in bacterial, viral, mitotic, allergic and trophic keratitis. According to this study, masculine gender is much more affected with 41 cases in total or 68.33%, then comes female gender with 19 cases or 31.67%. In the data regarding age, it is noticed that the most likely groups to be attacked are those of 60-79 years old, with 20 cases in total, 12 males and 8 females. It is also worth mentioning that there were 4 patients with elongated hospitalization, 3 males and 1 female, who stayed in the hospital in the period 29-35 days. In order to have a desirable success, certainly the nurse should have an ethical and professional approach toward the patient. There is a great psychological difference in the patients’ attitude towards their disability regarding with what we are dealing with: whether it is a born or gained disability.

The World Health Organization defines premature birth as a birth that occurs ≥22- 37weeks based on gestational age, or less than 259 days from the first day of the last menstrual cycle. 8-10% of pregnancies result in premature birth. Premature newborns are at risk of Respiratory distress syndrome(RDS), Intracranial Haemorrhage (HIC), Necrotizing enterocolitis (NEC), as well as other renal and neurologic complications. 10% of premature newborns remain handicapped throughout growth, have neurologic disorders, defects in sight and hearing, mental retardation, emotional disorders with social maladaptation as well as slowed intellectual development.Premature birth is a global problem which occurs even in Kosovo. Despite all the treatments premature birth cannot be prevented but only managed. In Kosovo, every year around 2500 births are premature, whereas the survival of the newborns is dependent on the gestational age. Therefore, births before 32 weeks and especially before 28 weeks are more challenging. The Aim.The aim of this study is to investigate premature births in the Obstetrics and Gynecology Clinic in Prishtina. This is a retrospective study in which we have analyzed the peripartal outcome based on maternal and fetal parameters. Material and Methods.This is a retrospective, descriptive, and analytic study of cases with premature births in the Obstetrics and Gynecology Clinic in Prishtina between January 2019 and March 2019. Data has been collected from medical records and evidence in the departament of delivery and operative ward. Cases with premature births have been analyzed according to maternal and fetal parameters. Maternal parameters that we have analyzed are the age, parity, mode of delivery whereas newbon parameters that were analyzed included gestational age, mode of delivery, weight at birth and vitality in the first and fifth minute according to the APGAR score.Excluding criteria: Term birthsResults:In this study, the rate of preterm birth is found to be 9.03%. Preterm birth rate was highest among women in group age between 30-40 (51%), followed by women ages 20-30 (38%), ages 40 years and older (7%) and women under age 20 (4%). Specific prematurity rate was the highest for women 40 and older (16.86%) followed by women under age 20 (12.69%). The highest proportion of premature birth was observed among primiparous women (42%) whereas women in their fourth and more pregnancy had lowest proportion (12%). The proportion of premature birth was 28 % in second pregnancy and 18% in third pregnancy. The highest rate of specific prematurity (10.41) was observed among women in their fourth and more pregnancy followed by nulliparous women (10.20%). Based on the gestational age 12.31% of cases were between 22-28 gestational weeks, 9.7% were between 28-32, 17.24% were between 32-34 and the majority respectively 60.59 were between 34-37 gestational weeks. Cesarean delivery was performed in 59% of the cases compared to vaginal birth which represented 41%. According to newborns weight at birth ,12% were between 500-1000 grams, 9% weighing between 1000-1500 and 17 % between 1500-2000 grams. 31% of premature infants were with birth weight 2000-2500 grams and 31% ≥2500 grams. There were 4% stillbirths, whereas 11% had severe asphyxia and 16% moderate asphyxia.Conclusion Based on our results, premature birth is still a problem due to unfavorable peripartum outcome.Thus, we highly recommend to increase the awareness among women regarding the importance of regular antenatal visits in order to identify women at risk for preterm birth as early as possible and to manage these cases according to the recommendations of the EPC program. since clinical efforts focus mainly on problem-solving rather than prevention.

Pregnancy in most cases complicates the couple's sexual life. Given the level of sexual education of the population as well as the approach of health personnel in terms of sexuality it is expected that any change in a woman's life will inevitably have an impact on her sexuality. In the general population of the globe, 40-50% of women may have sexual dysfunction during their lifetime.The purpose of this research was to describe the possible changes in sexual behavior during pregnancy in couples and to give recommendations that will improve their sexual life. Methodology - For data collection we used the PSRI (Pregnancy Sexual Response Inventory) questionnaire, which was distributed via the Internet to pregnant women of different ages of pregnancy. The research was conducted in May-June 2020. The sample included 184 pregnant women. Results- Most pregnant women (55.4%) were 26-35 years old, in the third trimester were 45.7% of surveyed women, with university education were 64.1%, tobacco and alcohol consumers were less than 10% of them and planned pregnancies have stated 82.6%. The frequency of sexual activity decreased to 65.2% of pregnant women, sex life deteriorated to 45.1%, sexual desire decreased to 51.5% while difficulties in achieving orgasm were reported by 35.3% of women interviewed. As for the partner according to the assessment of the pregnant woman, 40.2% think that they do not have any problems in sexual functioning and 38% think that they have complaints. 86.4% of women interviewed think that their partner has no sexual difficulties.Conclusions - Based on our research, it turns out that most pregnant women have changes in their sex life as a result of pregnancy, and according to pregnant women, the impact of pregnancy on their partner is not very expressed.

Given that we have a steady increase in new cases of breast cancer and it is the second most common disease in women after skin cancer, then we chose to share information on breast building through this topic, changes occurring at different stages of lifelong development, to explain what is breast cancer, risk factors for breast cancer, to determine the initial symptoms, what are the types of treatment, how is the treatment divided according to the stages, what is the role of Nurses in the treatment of patients facing breast cancer, we will explain the assessment methods through which the diagnosis is determined, how we can influence the increase of the level of knowledge in women related to this disease. Purpose: The main purpose of this diploma thesis is precisely to raise awareness to the population of this country, to correctly inform them related to the possibility of prevention, early diagnosis, and treatment of the breast cancer.Materials and methods: Quantitative data were collected by questionnaires containing closed questions, a total of 27 questions. Respondents are ladies treated at the main Family Medicine Center in the municipality of Peja during August. A total of 50 women were surveyed. For the realization of this work, the methods used, in addition to collecting quantitative data from the questionnaire, also include a review of the literature. The literature used to work on this thesis includes Oncology books, various scientific sources from the Internet, and various literature related to thesis. The data of the conducted questionnaire were coded to be analyzed with the VISIO program.Results: This research has been to determine the level of knowledge of women from the age of 40 regarding sympathies, routine screening for prevention or early diagnosis of breast cancer. We have come to the conclusion that there are advantages and disadvantages in our country in terms of the general information that the population in question possesses. The reason why this research is important lies in the fact that it reflects the current situation in our country, through this research, in addition to being informed about the current situation, we are oriented towards determining the possibilities of how to improve it.Discussion: The research results provided answers to the purpose and research questions regarding the level of knowledge of women treated in the primary care of the Municipality of Peja regarding the early diagnosis of breast cancer. The hypothesis has been approved based on the results of the paper.Conclusions: The results of the research clarified that the population in our country needs additional information and advice which will result in improvement of the current situation. Based on the recommendations given by the World Health Organization (WHO) - (http://who.int/) and adapting them to the capacity of our country.

In this paper we present the way of thoraco-lumbar approach to large kidney tumors, with additional, subcostal incisions, giving a better kidney appearance, ie the tumor and making the intervention easier and with fewer complications, you found operational intervention. Material and methods The material was taken from the protocol of the Clinic and the work reveals the work in our Clinic, in a period of five years. subcostal incision. This approach is commonly used for patients with large kidney tumors, with localization mainly in its upper pole and with infiltration of surrounding organs, such as the suprarenal glands, vena cava, and diaphragm. Results From all the cases worked with this approach, we have managed to access the renal hilus more easily, to progress the kidney from the surrounding tissues and not to have accompanying complications. It should be noted that even in cases where there has been a complication, such as crying of the vena cava or diaphragm, they are easily resolved. Conclusion It can be concluded that the thoracolumbar approach with subcostal incision is a very favorable approach for the surgeon and offers a better display of the renal hilus, but also of the organs close to the upper kidney pole, such as the suprarenal glands, diaphragm and vein. cava, which are not uncommon in collision with the tumor and should be treated with special care.

Cardiovascular disease is a national and international problem. They are the leading cause of death worldwide. Among them, 85% of deaths occur due to coronary artery disease and stroke. The aim of the study was to identify by ultrasound the atherosclerotic changes in the carotid arteries in patients with coronary heart disease.Material and methods: A sample of 215 subjects with coronary artery disease underwent ultrasound evaluation of the carotid arteries. They are classified into two groups: Group A, 130 (60.47%) with positive exercise test and Group B 85 (39.53%) with previously experienced myocardial infarction. They were assessed for the thickness of the CIMT, the presence and echographic characteristics of atherosclerotic plaques, and for the presence of significant stenoses (> 50%). Results: The average age of all subjects was 57.05 ± 8.63. In Group A, the thickness of CIMT was 0.78 (± 0.27) mm, while in Group B 0.80 (± 0.11) mm. No significant difference was observed between the groups (p> 0.1). The largest number of atherosclerotic plaques are found in the bulbus of the carotid arteries and in the ACI (53% and 35%), which is significantly higher than in the ACC and ACE (8% and 4%, p <0.01). Sonolucent atherosclerotic plaques were observed more frequently in Group B than in Group A (60.49% vs. 35.29%, p <0.01). With significant stenoses are identified 16.15% of individs in Group A, and in this case the difference was not significant (p> 0.1).Conclusions: Ultrasound evaluation of carotid arteries for CIMT, plaque morphology, and degree of stenosis may provide valuable additional information on preexisting cardiovascular risk and silent coronary artery disease in asymptomatic patients.

This study has a retrospective character and summarizes the imaging and clinical- laboratory data of patients examined at IDC Prima, from the first cases in Kosovo until the end of July.We have analysed and compared the imaging data from our patients with those of the publications of major world institutions, in particular with the European national imaging associations within the ESR, through ongoing regular correspondence and exchange of experiences in this field. First andforemost, the Chinese and Italians sources, who presented studies regarding this problem, hitherto unknown to the world,immediately after the first wave of the epidemic. The vast majority of patients had similar imaging data as the ones in publications from the aforementioned countries; nonetheless, we also found some elements that did not match, such as the presence of thoracic lymph nodes. A total of 52 patients were examined in this study.Conclusions have also been drawn about some consequences or sequences such as the interstitial fibrosis that pass into chronicity and may remain for a long time (this remains to be seen in the future).Particular emphasis was also placed on pulmonary and cerebral thromboembolism. We have considered some patients who have tested positive, for whom we have not found pathological imaging changes, but also patients with negative test results while the imaging showed pathological findings. Ultimately, the imaging findings of Covid-19 with pulmonary implications are sufficient for diagnosis, even in the absence of a positive PCR test. This reflects an extremely high specificity of diagnostic imaging, especially the Computed Tomography.

Preeclampsia results in uteroplacental insufficiency which causes hypoxia to the fetus. Hypoxia causes biochemical changes in the fetal and pregnant liver by altering the concentration of biochemical parameters in maternal and fetal blood. Purpose of the study: to determine the level of aminotransferases (ALT, AST) and lactate dehydrogenase in pregnant and fetal / neonatus blood of normal and preeclamptic pregnancy Material and methods: 80 pregnant women were included in the study, 40 of whom had normal pregnancies and 40 preeclamptic pregnancies with increased retardation (IUGR), in both groups blood was drawn from the cubic vein to determine AST, ALT and LDH in pregnant women and the fetus/neonatus. Pregnancy age is determined by the formula of recent menstruation and fetal biometrics. Results were determined by the Mann-Whitney U test for non-parametric numerical variables destroyed in the independent groups. Results: AST values in pregnant women with preeclampsia are higher compared to physiological pregnancies [U = 521,500, z = 6.717, p <0.001]. ALT values in pregnant women with preeclampsia are higher than in physiological pregnant women [U = 554,000, z = 6,560, p <0.001]. LDH values are higher in preeclamptic pregnancy compared to physiological pregnancy [U = 1131.500, z = 3.509, p <0.001]. The AST values in fetal/neonatus blood with IUGR are higher than normal-growth fetal values [U = 1333,000, z = 2,454, p <0.014]. ALT values in the fetus/neonate with IUGR are higher compared to the fetus with normal growth [U = 908,000, z = 4,698, p <0.001]. LDH values in fetal/neonatus blood with IUGR are higher compared to fetuses with normal growth [U = 1203,000, z = 3.135, p <0.002]. Conclusions: In preeclamptic pregnancy the values of AST, ALT and LDH are higher compared to physiological pregnancy. In fetal/neonatus with IUGR values of AST, ALT, LDH are higher compared to normal-growing fetus/neonatus.

The immunohistochemical method was applied with the aim of determining the localization of the Tamm-Horsfall protein in the intracellular areas of the different parts of the nephron,as well as its localization at the interstitium of the kidneys.Of the 101 cases with chronic tubulointerstitial diseases,48 were chronic obstructive pyelonephritis cases and 53 werw chronic nonobstructive pyelonephritis cases accompanied with a vesico-uretheral reflux.The methods that have been applied:Hematoxilin-eozin,PAS(Periodic Acid Schiff).After that,blocks of paraffin which proved PAS-pozitive were applied the specific immunohistochemical method,carried out with PAP reaction of the specific primary antibody(Tamm-Horsfall anti-beta-2glycoprotein).The immunocytochemical reaction was mainly the shape of(bigger or smaller) granular precipitates of dark on brown or yellow to brown color.Mosaic type reaction dominated all the preparations.The results reached at by the application of the immunohistochemical method show the presence of Tamm-Horsfall protein in the form of diffuse amorphous precipitates in the interstitium and chronic inflammatory infiltrates and macrophages gathering around them.This method also enables us to distinguish the presence of this protein substance,in the granular or mosaic form,in the cytoplasm of the epithelial cells of the distal tubules of nephron,as well in the macrophages seated in the interstitium,mainly around the amorphous precipitates of this protein.In other parts of the nephron the immunocytochemical reaction was negative.

Schwannoma is a neurogenic benign tumour arising from the proliferation of Schwann cells present in the peripheral nerve sheath of myelinated nerves. This proliferation can hypothetically appear in every anatomic region of the human body. In this paper the authors discuss the case of a 49-year-old female who presented to Pulmologic Clinic with problems of mild respiratory difficulties and radiological findings of massive shadow on 4/5 of thoracic cavity. After transthoracic biopsy and nonconclusive diagnosis patient is transferred on Thoracic Clinic for open surgery.The patient underwent electively open left thoracotomy and a single-step surgical excision treatment of the mass which was recognized as a ancient schwannoma at pathological examination. After 12 months of followup, the patient is free of disease and without respiratory difficulties.

In post-war Kosovo, the magnitude of inappropriate use of enzodiazepines is unknown to date. Objective: The aim of this study was to assess the prevalence and correlates of continuation of intake of benzodiazepines beyond prescription (referred to as ‘‘inappropriate use’’) in the adult population of Gjilan region in Kosovo.Method: A cross-sectional study was conducted in Gjilan region in 2015 including a representative sample of 780 individuals attending different pharmacies and reporting use of benzodiazepines (385 men and 395 women; age range 18–87 years; response rate: 90%). A structured questionnaire was administered to all participants inquiring about the use of benzodiazepines and socio-demographic characteristics.Results: Overall, the prevalence of inappropriate use of benzodiazepines was 58%. In multivariable-adjusted models, inappropriate use of benzodiazepines was significantly associated with older age (OR 1.7, 95% CI 1.1–2.7), middle education (OR 1.8, 95% CI 1.2–2.7), daily use (OR 1.4, 95% CI 1.1–2.0) and addiction awareness (OR 2.7, 95% CI 2.0–3.8). Furthermore, there was evidence of a borderline relationship with rural residence (OR 1.2, 95% CI 0.9–1.7).Conclusion: Our study provides novel evidence about the prevalence and selected correlates of inappropriate use of benzodiazepines in Gjilan region of Kosovo. Health professionals and policymakers in Kosovo should be aware of the magnitude and determinants of drug misuse in this transitional society.

Allergic diseases, including asthma, rhinitis and eczema with a clinical burden on the quality of life of those affected, pose a global public health challenge from the growing trend of their spread,The International Study of Asthma and Allergies in Childhood (ISAAC) provided incomparable opportunities to explore tendencies in the prevalence of allergic diseases and their risk factors over time in children. Reports based on the ISAAC study revealed the existence of differences between and within countries in the spread of allergic diseases.Despite advances in understanding the pathophysiology of allergic diseases and the growing number of treatment options, the relationship between the increased prevalence of allergic diseases and the interaction between genetics and environmental factors has been established as the main determinants of this increase.Many studies have shown the role of diet as a major factor influencing immune homeostasis and the development of allergic diseases through a complex interaction between nutrients, their metabolites, and the immune cell population.Purpose: To assess the prevalence of allergic diseases in adolescents in the city of Ferizaj, Kosovo, in 2017 using the questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC), then to compare our results with the prevalence found in the studies conducted of other countries and the analysis of the possibility of the impact of diets as risk factors compared to global data.Methodology: The study included primary school students in the municipality of Ferizaj, a sample of 891 adolescents (487 females and 404 males), the study started in June 2017 to November 2017 and the study activities were carried out by the MCFM Health Education group , Ferizaj.Results ISAAC studies in children aged 13 to 14 years, the 12-month prevalence of eczema, asthma and rhinitis symptoms show ranges from 0.2% to 24.6%, from 3.4% to 31.2%, and from 4.5% to 45.1% between countries globally. Findings in our study show the prevalence for asthma at 2.13%, for allergic rhinitis 29.41% and eczema at 3.03%. Also the analysis of the relationship on a global level between food consumption and the appearance of disease symptoms ,confirmed the protective effect of fruit consumption ≥ 3 times a week (OR 0.87, 95% CI 0.81 to 0.94) and the effect as a risk factor in the occurrence of symptoms of consumption of fast food (OR 1.25, 95% CI 1.18 to 1.33). Analysis of data from our study in terms of risk factor assessment resulted in protective impact of fruit consumption (OR 0.64, 95% CI 0.31 to 0.31) and risk impact for fast food (OR 1.06 (0.91 to 1.08). Conclusions: The findings of our study provided data on the understanding of the epidemiological situation of adolescents in the city of Ferizaj with allergic diseases, explicitly the relationship between them, since in number represents the condition of allergic rhinitis. Analyzing the possibility of the impact of food products in predicting the severity of allergic symptoms, the study provided us with information on the more pronounced negative impact of processed foods (fast food) on the condition of eczema compared to the other two allergic conditions.

Adolescents experience depression in a very similar way to adults, but they can experience their emotions more intensely and with greater instability. Depression in adolescence comes at a time of great personal change - when boys and girls start forming a distinct identity from their parents, they encounter gender and sexuality issues, and begin to make decisions for the first time in their lives. Research shows that online social networks have recently started to get a greater increase in usage among elementary and high school students. They spend a considerable amount of time on social media sites such as Facebook, Twitter and so on, turning them into a daily activitiy in their lives and then starting to exhibit classic symptoms of depression. In order to research the level of depression in “Gjon Buzuku”high school studentsin Prizren, we used Beck's for Depression (Beck's Depression Inventory) as well as the self-report form for the use of social networks. Participants in the research were (N = 47, participants, M mean = 16.7, DS = standard deviation DS = 12.07, respondents of both sexes, where female gender dominated with 27 respondents or 57.45%). For participants' depression the overall score was interpreted as follows: 3% of participants resulted in minimal depression, 40% of participants resulted in mild depression, 49% of participants resulted in moderate depression and 8% in severe depression . This research will contribute both theoretically and practically by raising the awareness of educational institutions in the process of their functioning and in preserving the health of students to increase the quality of teaching. The results of this scientific research can be used for analyzing similar situations in other school institutions in both public and private institutions.

The importance of physiotherapy in antenatal health care provides many benefits for pregnant women where the main goals is to remove back pain, increase physical and psychological preparation for childbirth. Physiotherapeutic health care is very important to practice it during pregnancy. The quality of life during pregnancy and the effectiveness of physiotherapeutic interventions have not been previously studied in Pristina. Aim: Was to investigate the level of awareness about the importance of physiotherapy in antenatal health care and how much pregnant women are guided to physiotherapeutic visits during pregnancy.Methods: The importance of physiotherapy was assessed by 55 pregnant women in a period of 4 months between November 2019 - and February 2020 at Family Medicine Center in Prishtina, using self-administered questionnaires.Data were obtained on demographic characteristics, chronic diseases, low back pain, physical activity as well as their knowledge and perception of the importance of physiotherapy in prenatal care. Results: Among 55 women: 33 were housewives, 17 were working women and 5 were students.Knowledge of the importance of physiotherapy in pregnant women was 34% (n = 55) awareness of physiotherapy interventions in antenatal health care was 25% (n = 55), giving instructions for physiotherapeutic visits by other health professionals there is also a very low percentage of 2% (n = 55), only 16% (n = 55) were following the exercise program through various websites.Conclusions: The importance and role of physiotherapy in antenatal health care among pregnant women is unsatisfactory. Measures should be taken to increase their knowledge and improve their awareness of the role of antenatal physiotherapy, to consult and refer for meetings with the physiotherapist health professional to determine moderate physical activity and to be informed through written materials for the importance and effect of physiotherapy during prenatal and postpartum periods.

With the aging of the population there are a lot of changes, where diseases of the cardiovascular system are among the major causes of death of the population. Changes in cardiovascular physiology result in effects as well as reaction to their treatments. It is very important that we in the future as nurses know as much as possible about the treatment of cardiovascular diseases and the side effects that are present at this age. Purpose: The research was done in order to understand how big the use of β-blocker drugs is in the elderly. In which cases will a drug from the group of β-blockers be prescribed, and which of this description is used more, is it given as monotherapy or in combination with other drugs, at what age does this therapy take more, and most importantly what positive effects and negative can be brought about by the use of these medications. Materials and methods: For the answers to the research questions and the provision of data it was necessary to cooperate with the cardiology clinic - QKUK - Prishtina, where during the all questions asked, a cardiologist answered me, also I had special help from the head nurse of that department. Results: Male gender is the most affected, where in 50 patients, 40 of them use β-blockers, and the most used drug at this age is Metoprolol. β-blockers are mostly combined with a drug called ‘Aspirin’. Discussion: The answers I received have been enough to complete my research and raise our awareness as a health worker in the future. Conclusions: The group of β-blockers had a fairly large use in old age. As health professionals we need to have knowledge about the condition of patients before and after treatment. including: regular check-ups, access to the best possible therapy, maintaining a good diet over food uses, and good physical activity recommendations.