By, Feim Gashi PT, Cand PhD

Abstract

The Chambers of Health Professionals in the Republic of Kosovo (more…)

By, Olvis PETRE, MD, Irma TASHI (BANI), MD, Jola HASANI, MD, Justi SHESTANI, MD, Silvana BALA, MD, Prof. Dr., Hasan HAFIZI, MD, Prof. Dr.

Abstract

Objective: This review’s purpose is to summarize the current state of knowledge on the systemic implication of chronic pulmonary obstructive disease Background: The ‘systemic repercussions’ of COPD are of great importance. These include accidental weight loss, skeletal muscle dysfunction, and a higher risk of cardiovascular disease, osteoporosis, and depression. Frequently affecting the patient’s health and prognosis, these extrapulmonary COPD characteristics demand thorough screening and proper management to give the most effective medical care. Methods: We conducted a search of papers describing COPD as a systematic disease on the MEDLINE database. Discussion: Local and systemic inflammation, oxidative stress, and changes in the neuro-humoral states are some of the likely candidate pathways by which these extrapulmonary complications of COPD are affected, even though the mechanisms for the association of COPD with systemic disorders have not been fully clarified. The processes and mechanisms behind the extrapulmonary symptoms of COPD will likely become more transparent with further research. Conclusion: COPD management should be based on a clear understanding of COPD-related comorbidities and their impact on COPD itself. How to cite: Petre, O., Tashi (Bani), I., Hasani, J., Shestani, J., Bala, S., & Hafizi, H. (2022). Chronic obstructive pulmonary disease: A view on comorbidity phenotypes. A literature review. Medicus, 6(2), 7–22.

https://doi.org/10.58944/vazq8669

By, Kristi ÇELA, Msc.

Abstract

Introduction: According to Institution of Statistics of Albania 75% of Albanian population lives and is considered a rural population. Based on studies for the general health of the population it is noted that rural and suburban population reports a lower prevalence for good general health compared to the population on urban areas. Even more specifically musculoskeletal issues are seen to have a connection with rural settings but the physiotherapeutic services are missing. Purpose: The purpose of this study is to establish the need of physiotherapeutic services on rural and suburban Albania based on the level of knowledge of this population for the medical services, benefits provided from physiotherapeutic interventions and the level of patients with musculoskeletal issues that have never received such services. Methodology: This study included 490 subjects, 230 males and 260 females from the age of 18 to 80+, all living and receiving medical services on similar settings and backgrounds. Results: 65% of the total population had suffered at least one musculoskeletal issue during the past 3 months. From 320 subjects that had these issues only 6% where recommended to visit a physiotherapist after visiting their local doctor. Only 49% of the whole population knew about physiotherapeutic services .91% of the population preferred to have access of physiotherapeutic services on their local health center and 81% claimed that traveling to urban areas was an extra expense for their health care. Conclusions: Based on the data extracted from the study Albania would benefit from providing public physiotherapeutic services in rural and suburban areas to promote public health for the population. This would give employment opportunities for younger physiotherapists and prevent the higher densities of professionists on a single area. How to cite: Çela, K. (2022). The need for public physiotherapeutic services in rural and suburban Albania. Medicus, 6(2), 23–33.

https://doi.org/10.58944/lvak5140

By, Rezarta STENA, Msc. Klara HYSENAJ, Msc. Armelda TETA, Msc. Esida HOXHA, Msc.

Abstract

Introduction: Scoliosis is a lateral deformation of the spine in the shape of the letter “S” or “C”, which can be located in different segments of it. Idiopathic scoliosis is the most common form encountered in 80% of scoliosis cases. Its nature or cause is not exactly known, so the classification is related to the age at which the deformity is detected. Purpose: Recognition and application of some specific physiotherapeutic methods as part of the international treatment of scoliosis which physiotherapists should include in their practices to improve the conservative management of adolescents with idiopathic scoliosis in Albania. Methodology: The study presents a theoretical-scientific overview, based on evidence. The search in the database PubMed, Google Scholar, Scopus, and guidelines of physiotherapy evidence included the period 2016-2022, using the keywords: ‘scoliosis’, ‘physiotherapy’, ‘Schroth technique’, and ‘Lion method’. Articles that were not in the English language were excluded. The basis for data processing for this study was 8 articles, which met all the criteria. Results: Specific physiotherapeutic methods proved to be very efficient in the latest studies by reducing the scoliotic deformity angle (Kob) by 5-10°, improving the posture with symmetry of the scapular and pelvic circumference, increasing the articular amplitudes of the back and improving the functions respiratory. Conclusion: All physiotherapists in Albania should know these methods from a theoretical-practical point of view and include them in their professional practices to improve the conservative management of adolescents with idiopathic scoliosis. How to cite: Stena, R., Hysenaj, K., Teta, A., & Hoxha, E. (2022). Recognition and evaluation of specific physiotherapeutic techniques in the conservative treatment of adolescents with idiopathic scoliosis. A literature review. Medicus, 6(2), 34–40.

https://doi.org/10.58944/ffzw5771

By, Iva RRUGIA, Msc.Sara ZAVALANI, MD

Abstract

Introduction: Type 1 Diabetes Mellitus (T1DM) is an autoimmune disease caused by an absolute deficiency of insulin because of the destruction of β cells islet of the pancreas. Aerobic exercise and diet are the two main points of diabetes treatment. Methods: The data for this study comes from un online survey of 50 people with health diseases, conducted between June 8 and July 12, 2021. More precisely, the data of our study are un mail-only data, with people selected randomly from a database maintained by B-Sport Plus Project. The database contains questions about physical activities in diabetic patients. Results: Among the 50 interviewers with type 1 diabetes, the largest age group covers those younger than 18 years old. 31% of the patients answered that health conditions limit their daily activity. 47% of them spent 1-2 hours on sports and recreational activities per day. 47% of the patients reported they do multiple sports activities, the others do leisurely walking (walking their dog), bicycling, skating, swimming and curling, gardening and light housework, dancing or other moderate exercise classes, weight training and running, brisk walk. 62% of them reported that they are willing to exercise 1-2 hours per day. 33% of the patients reported they do not participate in sport and recreational activities from lack of time, the others from financial constraints, family and friends influence, lack of self-confidence, illness/injury, problems with transportation. Conclusion Aerobic exercise can improve the sensitivity of Insulin, blood glucose and lipid metabolism, thereby reducing insulin dosage and improving glycemic control. WHO recommends at least 150 minutes of moderate physical activity per week. T1DM patients, physiotherapists or fitness trainer, kinesiologist and endocrinologist need to fully understand how the physical activity effect on metabolism and implement individualized aerobic exercise programs. How to cite: Rrugia, I., & Zavalani, S. (2022). Approach of physical activity in type 1 diabetic patients. Medicus, 6(2), 41–50.

https://doi.org/10.58944/jzyw2858

By, Bardhyl ÇIPI, MD, Prof. Dr.

Abstract

The preservation of secrecy occupies an important place for the respect of freedoms and human rights, which is also foreseen in the Albanian Constitution. In the Albanian Penal Code, several articles have been presented that punish the violation of the confidentiality of correspondence etc. This principle is also very important in medicine. In fact, in the last years, the risk of its violation has become greater due to the development of electronic media, computers, faxes, voice messages etc. Under these conditions, a new medical legislation has begun to be developed in many countries, for these issues. But the field of medical confidentiaity after death is not studied enough. It is important to know the different aspects of this issue in our country, because recently there have been many publications in our country, accompanied by discussions and criticisms, especially regarding the illnesses and deaths of some public figures. In this presentation, among others, some ethical, philosophical and legal data on this issue are analyzed, which are mainly related to the interests of the deceased person, the time that has passed since death, the negative impact of not saving medical data on his memory, followed by the presentation of some well-known cases etc. In conclusion, it is emphasized that medical confidentiality after death, especially that of a public person for our country, is a very delicate issue that requires great care in cases of its announcement. How to cite: Çipi, B. (2022). Medical confidentiality in general and that after the death of the patient. Medicus, 6(2), 51–62.

https://doi.org/10.58944/oqta1952

By, Ismet NIKA, MD, Dr. Sc.

Abstract

Gallbladder perforation occurs very rarely. The most frequent causes of this complication are: acute calculous gangrenous cholecystitis, and acalculous cholecystitis, but very rarely, perforation of the gallbladder may occur without obvious clinical and radiological signs of perforation of the gallbladder. Here I am describing the case of a 76-year-old woman. The patient was presented to the Emergency Department of Durres Regional Hospital with the diagnosis of acute generalized abdomen. The etiological diagnosis was established during the surgical intervention. This clinical case is rare, but it shows that this diagnosis should be taken into consideration by surgeons, in elderly patients who present acute generalized abdomen with unclear etiology in the preoperative period. How to cite: Nika, I. (2022). A case report of spontaneous gallbladder perforation in Durrës Hospital. Medicus, 6(2), 63–67.

https://doi.org/10.58944/hbpz9130

By, Fatjona KAMBERI, Prof. Asoc., Enkeleda SINAJ, Prof. Asoc. Dr. Brunilda SUBASHI, Msc. Glodiana SINANAJ, Dr. Sc.

Abstract 

The COVID-19 pandemic brought the social aspect of the nursing profession into even sharper focus. Nursing discipline is a social virtue that extends beyond only delivering care. Historiography has been impacted by social change. The objectives are to assess how society views professional nurses and to assist in explaining the nursing social component from the perspective of the relevant nurses. The methodology will be based on Grounded Theory, a design framework with sociological roots that is commonly employed in qualitative research. Expected outcomes will help to shape the future of nursing education and profession by identifying variables that define the social component of nursing and determining barriers and other profession-related determinants. How to cite: Kamberi, F., Sinaj, E., Subashi, B., & Sinanaj, G. (2022). Prospective research view on the Methodological Framework and protocol for Social Nursing Components. Medicus, 6(2), 68–80.

https://doi.org/10.58944/hnew5560

By, Dardan BAFTIU, MD, Erjona ABAZAJ, Prof. Asoc.

Abstract

Introduction: Nowadays the prevalence of obesity especially maternal obesity prevalence has increased substantially and provides a major challenge to public health. Besides that, weight gain during pregnancy may result in negative outcomes for women and neonatal. Objective: We evaluated maternal obesity prevalence and outcomes during and after pregnancy at the Regional Hospital of Ferizaj. Methods: A total of 258 pregnant females who delivered their babies at the Regional Hospital of Ferizaj between March 2018 and March 2020 were included in this study. Based on the body mass index (BMI) of maternal, the patients were divided into groups: underweight, normal weight, overweight, obese I, obese II, and obese III/ morbid obese. The effects of obesity on fetal and maternal outcomes were investigated. Results: Overall 258 pregnant women were included in our study, the average age was 28.7±3.4, with min age of 19 and a max of 41 years old. The prevalence of BMI over the normal weight among pregnant women resulted in 70.5% (182/258). Most of the maternal were overweight at 29.6% (54/182), obese class I at 27.5% (50/182), obese class II at 25.3% (46/182), and obese class III at 17.6% (32/182), with a significant association between them χ2=2.8, p<0.02. Adverse obese maternal effects and perinatal consequences or other problems were significantly more frequent than in normal-weight maternal. Besides that, in this study, the low-birth-weight infant rate was higher in the low BMI pregnant cases with a strong significant association (χ2=37.8 p value < 0.0001). Conclusion: The finding of this study conclude that obesity plays a significant risk factor and it is a strong association with complications in pregnancy and newborns. Further studies are recommended to explore the obesity problems to develop guidelines and strategies and to minimize the adverse effect of this risk for developing maternal and newborn complications. How to cite: Baftiu, D., & Abazaj, E. (2022). Assessment of maternal obesity and perinatal consequences. Medicus, 6(2), 81–88.

https://doi.org/10.58944/zwnb9780

By, Eduard KAPAJ, MD, Arben MITRUSHI, MD, Prof. Asoc, Ervin TOÇI, MD, Dr. Sc. Sonila KAPAJ, MD

Abstract

Purpose: Cervical cancer continues to remain a major concern for public health globally. The aim of this study was to determine the positivity level of the Pap test and the prevalence of cervical potentially pre-malignant and malignant lesions in a group of adult women aged 18 years and older in Fier Prefecture in Albania. Material and methods: This cross-sectional study included 1254 women who showed up for a Pap test at the gynecology service at the Fier Regional Hospital during 2013 and 2014. Basic socio-demographic data (age, place of residence, marital status)  as well as data related to women’s gynecological history, including information related to menopause status, current pregnancy, menstrual cycle (regular or irregular), data on previous diseases of the genital tract, previous cytological examinations, and previous biopsies was collected. Adequate cervical smears were interpreted, allowing the calculation of the prevalence of various cervical lesions. Binary logistic regression was used to identify factors associated with a positive Pap test result. Results: The average age of women in our study was 39.8 ± 10.7 years. About two-thirds of women resided in urban area, 99.1% were married at the time of the survey and 17.8% were in menopause. Only 1.8% of women had been subjected to a cytological examination in the past. Among the 1134 adequate cervical smears the level of positive Pap test result was 8.7% and the prevalence of LSIL, HSIL and ASC-US was 4.1%, 1.6% and 3%, respectively. No cases of squamous carcinoma were detected. Age was positively, strongly and significantly associated with a positive Pap result: compared to 21-30 years old women, those aged 31-40, 41-50 and >50 years were significantly 1.98, 6.09 and 14.07 times more likely to have a positive Pap test reading.  There was a tendency for the Pap test positivity to be higher among urban woman, probably due to earlier initiation of sexual activity and more sexual partners compared to rural women. Only 2% of women had had cytological examinations in the past. Conclusions: The prevalence of abnormal Pap test among adult women in Fier prefecture was relatively high even though comparable to national and international studies. There is need to increase the awareness of women about cervical cancer and their participation in cervical cancer screening programs. How to cite: Kapaj, E., Mitrushi, A., Toçi, E., & Kapaj, S. (2022). The level of pap test positivity and the factors associated with it among adult women in Fier, Albania. Medicus, 6(2), 89–101.

https://doi.org/10.58944/crpq4079

By, Ada SIMEONI, MD. Gertiana MULLALLI-BIME, MD, Dr. Sc.

Abstract

Introduction: Perinatal brain injury is the third leading cause of child mortality globally. Purpose: Evaluation of perinatal risk factors for encephalopathy in neonates in order to prevent deaths and disabilities Method: This is a prospective, case-control study conducted in the Maternity Hospital “K. Gliozheni” during the time period 2012 – 2016. 65 newborns at term ≥37 weeks diagnosed with encephalopathy according to the Thompson classification >5 within 12 hours of birth were compared with a control group, infants without encephalopathy in a 1:1 ratio selected casual and gender-appropriate. Results: Total antepartum risk factors were found in (70.8%) of cases and (18.5%) of controls (p<0.01). Sentinel events were found in 38.5% of cases and in 9.2% of controls. (p<0.01). Acute intrapartum events in total were found in (38.5%) of cases and (9.2%) of controls (p<0.01). 43.1% of babies had a combination of antepartum and intrapartum factors (p<0.01). Significant and independent predictive factors of risk for neonatal encephalopathy resulted: from maternal factors, mother’s age >35 years (p=0.03). Of the intrapartum factors: pregnancy with twins (p<0.01), hypertension/preeclampsia (p<0.01), non-reactive FHR before delivery (p<0.01). From intrapartum factors: breech birth (p=0.01), emergency cesarean section (p=0.01), meconial amniotic fluid (p=0.02), prolonged birth (p=0.01). Conclusion: Knowledge of perinatal risk factors associated with neonatal encephalopathy is essential for developing interventions to prevent neonatal death and disability. How to cite: Simeoni, A., & Mullalli-Bime, G. (2022). Neonatal encephalopathy in the term newborn. Medicus, 6(2), 102–111.

https://doi.org/10.58944/ijpm6621

By, Erjona ZOGAJ, Msc. Najada KALLASHI, MD, Dr. Sc. Vidi DEMKO, MD, Dr. Sc. Rushan MUHAMETI, MD. Marsela FERHATI, Msc. Ina TABAKU, Msc.

Abstract

Introduction: CT scan is a very important image modality for examining the patient due to information we receive from it in a very short time. Receiving high quality images is challenging but the evolution of the CT scan has helped the radiology technician a lot. In this article we are going to focus on metal reduction artifacts. In polytrauma hospitals, when orthopedic, neurosurgical, and surgical clinics are mostly with patients that have implant on them, having tools to reduce the artefacts from metals is crucial to not miss anything in regions around. Aims and Objectives: The aim of this article is to show the effectiveness of I-MAR as an important tool to use in patients with implant on, especially in thorax and neck regions. Material and methods: In this article, we are showing 2 study case images from 2 patients who received from our CT scan in radiology department of University Trauma Hospital. Siemens CT go. Top is a 128-slice scan with two beam sources. Conclusion: After comparing the raw dates images and images with I-MAR on, we concluded that I-MAR is a very useful algorithm to reduce artifacts. By using it we can receive more information about soft tissues around implant and the regions nearby affected by artifacts. Using this algorithm helps the technician receive a better quality image. How to cite: Zogaj, E., Kallashi, N., Demko, V., Muhameti, R., Ferhati, M., & Tabaku, I. (2022). The reduction of metal artifacts in Thorac and neck regions in CT Scan. Medicus, 6(2), 112–119.

https://doi.org/10.58944/aflg6610

By, Eneida HOXHA, MD, Somida KUKA, MD, Ledio COLLAKU, MD, Dr. Sc., Elvana RISTA, MD, Dr. Sc., Jorida DJAMANDI, MD, Jona MUSABELLIU, MD, Margarita GJATA, MD, Prof. Dr.

Abstract

Background: Embolic events are frequent and life-threatening complications of infective endocarditis (IE), related to the migration of cardiac vegetations. The risk of embolism is very high in IE, with embolic events occurring in 20-50%of patients. The brain and spleen are the most common sites of embolism in left-sided IE. Stroke is a severe complication and is associated with increased morbidity and mortality rates. Case presentation: A 73-year-old male presented to the Emergency Department, in May 2022 with right hemiparesis, aphasia and fever (38 0C). He reported a history of recurrent fever lasting two days. His pre-existing comorbidities included Diabetes Mellitus, Arterial Hypertension and Atrial Fibrillation on anticoagulation therapy with Acenocoumarole and INR levels within normal range. His past medical history was significant for an Aortic Valve Replacement, in September 2021 and a subsequent hospitalization in January 2022 with Prosthetic Valve Endocarditis. At the time, he presented with a recurrent fever up to 38.8 0C, no significant findings in the transthoracic  echocardiogram (TTE) and positive blood cultures for Enterococcus faecalis. It was started an antibiotic therapy. Laboratory and imaging studies in his latest admission revealed a cardioembolic stroke. Conclusion: Infective endocarditis can present with a wide variety of symptoms and early diagnosis can be challenging. Establishing the diagnosis early in the course of the disease would enable a prompt implementation of empiric antibiotic therapy, potentially preventing serious complications. Keeping a high index of suspicion when evaluating patients at high risk for IE, might lead to more favorable outcomes of major complications associated with it. How to cite: Hoxha, E., Kuka, S., Collaku, L., Rista, E., Djamandi, J., Musabelliu, J., & Gjata, M. (2022). Cardioembolic stroke at prosthetic valve endocarditis. Medicus, 6(2), 120–127.

https://doi.org/10.58944/zaoh3902

EDITORIAL The role and the importance of Kosovo Chamber of Physiotherapy on the improvement of physiotherapy profession …………………………………………………5 Feim Gashi PT, Cand PhD. Chronic Obstructive Pulmonary Disease: A View on Comorbidity Phenotypes. A literature review ……………………………………..7 Olvis PETRE, MD, Irma TASHI (BANI), MD, Jola HASANI, MD, Justi SHESTANI, MD, Silvana BALA, MD, Prof. Dr., Hasan HAFIZI, MD, Prof. Dr. The need for public physiotherapeutic services in rural and suburban Albania …….23 Kristi ÇELA, Msc. Recognition and evaluation of specific physiotherapeutic techniques in the conservative treatment of adolescents with idiopathic scoliosis. A literature review ………………………………………………………………………………………….34 Rezarta STENA, Msc., Klara HYSENAJ, Msc., Armelda TETA, Msc., Esida HOXHA, Msc. Approach of Physical Activity in Type 1 Diabetic Patients …………………………………41 Iva RRUGIA, Msc., Sara ZAVALANI, MD Medical confidentiality in general and that after the death of the patient ……………51 Bardhyl ÇIPI, MD, Prof. Dr. A Case report of Spontaneous Gallbladder Perforation in Durrës Hospital ………….63 Ismet NIKA, MD, Dr. Sc. Prospective research view on the methodological framework and protocol for social nursing components ………………………………………………………68 Fatjona KAMBERI, Prof. Asoc., Enkeleda SINAJ, Prof. Asoc. Dr., Brunilda SUBASHI, Msc., Glodiana SINANAJ, Dr. Sc. Assessment of maternal obesity and perinatal consequences ………………………………81 Dardan BAFTIU, MD, Erjona ABAZAJ, Prof. Asoc. The level of Pap test positivity and the factors associated with it among adult women in Fier, Albania …………………………………………………….89 Eduard KAPAJ, MD, Arben MITRUSHI, MD, Prof. Asoc, Ervin TOÇI, MD, Dr. Sc., Sonila KAPAJ, MD Neonatal Encephalopathy in the Term Newborn ……………………………………………..102 Ada SIMEONI, MD, Gertiana MULLALLI-BIME, MD, Dr. Sc. The Reduction of Metal Artifacts in Thorac and Neck Regions in Ct Scan …………112 Erjona ZOGAJ, Msc., Najada KALLASHI, MD, Dr. Sc., Vidi DEMKO, MD, Dr. Sc., Rushan MUHAMETI, MD, Marsela FERHATI, Msc., Ina TABAKU, Msc. Cardioembolic Stroke at Prosthetic Valve Endocarditis …………………………………….120 Eneida HOXHA, MD, Somida KUKA, MD, Ledio COLLAKU, MD, Dr. Sc., Elvana RISTA, MD, Dr. Sc. Jorida DJAMANDI, MD, Jona MUSABELLIU, MD, Margarita GJATA, MD, Prof. Dr.