The rate of development of a primary malignant tumor based on the TNM classification. Depending on the clearly defined criteria, there are several levels of stages and sub-stages. Such a classification also applies when it comes to Breast Carcinoma. Case study

Stage IB of breast cancer with TNM classification as T0N1miM0 cases when it is not found with malignant changes of a primary tumor in the breast, but there is microstasis in a lymph node (usually in the armpit) and stage II A, when cells may not be found. malignant in the tissue of the gland but there are 1-3 lymph nodes attacked with diameter over 2 mm. These cases are not common. The standard of the paper is to produce a discussion on the questions resulting from the case study and previously the findings from the results of the pathohistological analysis after bilateral total mastectomy with axillary lymphadenectomy and the course of the disease as evidenced by the documentation-history of the disease, with a special focus. according to the true nature of the palpated node in the right breast which, in the ultrasound examination, sometimes has a suspicious characteristic of malignancy. /9.7mm, 10/9/7 mm to disappear after 2 years with persistent suspicious lymph nodes). The case study has two peculiarities: In the histopathological examination of the breast gland after mastectomy, no cells with malignant changes are found, not even a single non-proliferative dysplastic change, metastatic malignant changes in only 1 lymph node 2 mm out of a total of 18 excised (IIA classification) Luminal B ( Er +, Her2 , Ke 67 -35%) , cases that are not common. The peculiarity of the case, of the objects of the study, is the fact that at the beginning we had a self-palpated node by the patient and the suspects in the ultrasonography examination in the right breast, behind the areola, which has a suspicious lymph node in the right armpit. After two observation comments, the nodule in the breast recedes-disappears, while the lymph gland subjected to the first biopsy is a node with metastatic carcinoma originating in the breast gland, as well as after bilateral total subcutaneous mastectomy changes with resection of the axilla, the tissue found correctly. non-proliferative dysplastic and left proliferative dysplastic changes. Out of 18 lymph nodes dissected in the axilla, only one lymph node with malignant metastatic changes with high probability from the breast gland (immunohistochemical analysis). The question that comes to my mind and became the driving force of the real study was whether the disappearance of the nodule in the gland could be the result and competent immunological responses of the older patient of the primary malignant process in the breast?! Of course, based on the follow-up procedures during the diagnosis of the patients, the examinations at the beginning when the node was present, based only on the ultrasonographic examination, the malignant nature of the change can be documented. Further results prove, unequivocally, the malignant nature of the lymph gland originating from the breast, since in the PH examination of the two breast glands (after mastectomy) the primary source is not found, in my opinion, it makes the question whether we have it legitimate from a theoretical point of view. do with can understand competent immune, so a functional immune system! Determination of the level of Tumor Infiltrating Lymphocytes (TIL) if it was not important in value, taking into account the classification of the Luminal B subtype (WHO recommendation)?! Through the chronological description of the history of the disease and the commentary on the analyses, diagnostic procedures, therapeutics and results, which is the methodology of punishment, I hope to justify the questions posed and thus this paper

Impact of litigation as a source of forensic disputes, on the performance of hospital institutions in Kosovo Case study General Hospital in Peja

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

Impact of the Close Contact Management Action Plan during the Covid 19 pandemic on the General Hospital in Peja on the number of cases of infected staff at the General Hospital in Peja - case study Period: 18 March - 31 May, 2020

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\u27s 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\u27s 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

Ndikimi i të drejtës së pacientit për të përzgjedhur mjekun në rritjen e numrit të lindjeve me prerje Cesariane në Spitalin e Përgjithshëm në Pejë

Lindjet përmes rrugës operative, e njohur si Sectio Caesarea, nga fillet e saja kur aplikohej vetem kur paraqitej njëri nga 4 indikacione absolute në ditën e sotme aplikohet duke vlersuar rreh 100 indikacione të mundshme përfshirë edhe të drejtën e pacientit për të vendosur nëse do të kryej lindjen më këtë ndërhyrje.Kjo ka bërë që numri i lindjeve të kryera me Sectio të rritet nga viti në vit. Derisa në vitin 2000, në Kosovë, lindjet me prerje cezariane kanë qenë 7.5 %, ky trend është rritur në mbi 33% në vitin 2014 Në Spitalin e Përgjithshëm në Pejë nga 7% në vitin 2000 në 38.2/% në vitin 2020. Ndër faktorët që kanë ndikuar në këtë rritje enorme, përpos faktorëve të mirënjohur si përsosja e teknikës operative, përsosjet e teknikave të anestezionit, kuadri profesional i trajnuar, edukimi shëndetsor, planifikimi i familjes,të drejtat e zgjeruara të pacientit në vendimarrje llogaritet të jetë faktor me ndikim të ndjeshëm. Punimi ka për qëllim të dokumentoj nëse e drejta e pacientit për të përzgjedhur mjekun që do të udhëheqë lindjen është njëri ndër faktorët me ndikim të ndjeshmëm në rritjen e përqindjes se lindjeve me Sectio Caesarea në Spitalin e Përgjithshëm në Pejë. Me qëllim të adresimit të qështjes është përpiluar një pyetësor me 5 pyetje që kanë për qëllim të burojnë të dhëna të besueshme nëse dakordimi i arritur mes pacientit dhe mjekut të përzgjedhur për të përcjellë shtatzaninë dhe lindjen ka rezultuar me numër të madh të lindjeve me Sectio Caesarea. Janë anketuar 160 lehona, që kanë kryer lindjen në Spitalin e Përgjithsëm në Pejë në periudhen Korrik-Gusht 2021. Qëllimi i këtij punimi është që përmes grumbullimit, sistemimit dhe analizës së të dhënave të rezultuara nga punimi të vërtetoj se ndërlidhja e mjekut personal në procesin e lindjes domosdoshmërisht ndikon në rritjen e përqindjes së lindjeve me Sectio Caesarea

Level of prolactin and progesterone at normal pregnancy

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\u3c 0.05). Prolactin is raised in significant way during the development of pregnancy. (t=3.174, p 0.0252, p\u3c0.05 ). 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\u3c0.001). 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 \u3c 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

Incidence reproductive menstrual disorders and gaccthorea hyperprolactinemia

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\u3c0.0001. 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 \u3c0.0001. 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 \u3c0.0001. 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)