ALCOHOL IN DRIVERS FATALLY INJURED IN ROAD ACCIDENTS IN ALBANIA DURING THE YEARS 2010-2012

Aim: To assess the presence of alcohol among Albanian drivers involved in fatal road accidents between 2010 and 2012.Materials and methods: Samples were obtained for 365 drivers involved in road accidents from January 2010 to December 2012. Blood samples have been analyzed foe the presence of ethanol by GC –HS (Gas-Chromatograph Head Space) in the Laboratory of Forensic Toxicology in the Institute of Forensic Medicine in Tirana which is the only authorized institution to perform the toxicological investigation of road accidents that happen in Albania.Results: In the final cohort of 365 persons involved in traffic accidents, alcohol were found in concentrations above the legal limit in samples from 45.2% of subjects. BAC exceeded 0.50 g/l mostly in male subjects (98.8%). There were involved in traffic crashes mostly, car drivers (57.9%) and pedestrian (29.1%), consisting 41.9% of fatally cases each group.Conclusion: Males have the chance to crash 18% more than females. [OD: 1.18; CI95%: 1.01-7.76]. Blood alcohol concentrations (0.2 g/l ≥BAC≤ 0.5 g/l) are not an influence factor in fatal road accidents. Subjects whose blood alcohol concentrations have a alcohol blood level equal to (0.5 g/l ≥BAC≤ 1 g/l) have the chance to be involved in a fatal accident 2.2 times more then subjects whose blood alcohol concentration is below 0.2 g/l [OD = 2.2 ; CI 95%; 1.09-4.55]. Subjects with a blood alcohol concentration over > 1 g/l, have the chance to be involved in a fatal accident approximately two times more than a subject with a BAC <0.2g/l. [OD 1,98; CI 95%; (1.23-3.02)]

COMPARISON OF NONSTEROIDAL ANTI-INFLAMMATORY OF COX-1 AND COX-2 REGARDING SIDE EFFECTS IN THE ASTROINTESTINAL TRACT

Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to treat symptoms caused by rheumatoid arthritis due to their ability to inhibit prostaglandin synthesis by inhibiting cyclooxygenase (COX). The side effects of NSAIDs are also associated with inhibiting prostaglandin production. Consequently, their application is problematic. NSAID selective COX-2 inhibitors give minor gastrointestinal complications. Our study aims to compare nonsteroidal anti-inflammatory inhibitors of COX-1 and COX-2 regarding side effects in the gastrointestinal tract of patients with rheumatoid arthritis.Keywords:  Nonsteroidal anti-infammatory drugs, rheumatoid arthtritis, COX-2, gastrointestinal tract, PPIs

COST-EFFECTIVENESS OF BETA BLOCKERS AND THE SURVIVAL OF THE PATIENTS WITH HEART FAILURE IN THE CARDIOLOGY CENTER IN TIRANA

Objective: To evaluate the survival of the patients with heart failure in the Cardiology Center in Tirana, to evaluate the cost effectiveness of carvedilol versus metoprolol.Methods: 239 patients (pts) suffering chronic heart failure of different aetiologies, on traditional treatment for heart failure (angiotensin-converting enzyme inhibitors, diuretics, digoxin), with ejection fraction<50%, in NYHA class II-IV, were randomised to carvedilol 6.25-25 mg/day, or metoprolol 50-100 mg/day, or nebivolol 5 mg/day or treated only with the traditional treatment for they have contraindications regarding the use of β–blockers, followed for a two-year period.Results: There were included 239 patients of mild, moderate and severe heart failure, NYHA II-IV, with the fraction of ejection<50 hospitalized in the University clinic of cardiology of Tirana, followed for a two-year period; 83 patients (34.7%) were treated with Carvedilol; 70 patients (29.2%) were treated with metoprolol, 21 patients were treated with nebivolol (8.7%), and 65 patients (27.1%) were treated only with the traditional therapy (TTh).Conclusion: The use of carvedilol along with the traditional therapy of heart failure assures a higher survival rate and a lower hospitalization rate but an increase of cost of treatment of 216 €a year compared to metoprolol in addition with traditional therapy.Â

Prevalence and Correlates of Hypertension in A Transitional Southeastern European Population: Results from the Albanian Demographic and Health Survey

Abstract We assessed the prevalence and socioeconomic and behavioural correlates of hypertension in the young to middle-aged population of Albania, a transitional post-communist country in the Western Balkans. We analysed a sample of 2,837 men and 3,580 women aged 15 to 49 from the 2008/2009 Albanian Demographic and Health Survey. Hypertension was defined as SBP≥140 mm Hg, or DBP≥90 mm Hg, or if the subjects were under treatment for hypertension. Data on demographic and socioeconomic characteristics and behavioural factors were also collected. Logistic regression was used to assess the association of hypertension with covariates. Hypertension was significantly higher among men (27.3 %) than women (20.0 %), and significantly increased with age. The harmful effect of excessive weight and obesity on hypertension was stronger among women than among men and this effect increased with age, especially in women. Smoking and alcohol were risk factors for hypertension in men, but not women. Education had a protective effect on hypertension in women but not in men. Sažetak Ovaj rad istražuje prisutnost te socioekonomske i bihevioralne korelate hipertenzije u populaciji Republike Albanije, tranzicijske postkomunističke zemlje na zapadu Balkanskoga poluotoka. Obradili smo uzorak od 2837 muškaraca i 3580 žena u dobi od 15 do 49 godina iz Albanskog demografskog i zdravstvenog istraživanja (2008./2009.). Hipertenzija je definirana kao sistolički tlak >140 mm Hg, ili dijastolički tlak ≥90 mm Hg, ili ako su se ispitanici liječili od hipertenzije. Prikupljeni su i podaci o demografskim i socioekonomskim obilježjima te bihevioralnim čimbenicima. Za procjenu povezanosti hipertenzije i kontrolnih varijabli korištena je logistička regresija. Hipertenzija je bila značajno viša među muškarcima (27,3 %) nego među ženama (20,0 %) i njena se učestalost značajno uvećavala s dobi. Štetni učinak prekomjerne težine i pretilosti na hipertenziju bio je snažniji u žena nego u muškaraca te se također povećavao s dobi, pogotovo u žena. Pušenje i alkohol bili su faktori rizika u muškaraca, ali ne i u žena. Obrazovanje je imalo zaštitni učinak na hipertenziju u žena, ali ne i u muškaraca. Državna tijela trebala bi osmisliti preventivne programe za borbu protiv prekomjerne težine/pretilosti i hipertenzije

Prisutnost i korelati hipertenzije u jednoj tranzicijskoj južnoeuropskoj populaciji: rezultati demografskog i zdravstvenog istraživanja u Albaniji

We assessed the prevalence and socioeconomic and behavioural correlates of hypertension in the young to middle-aged population of Albania, a transitional post-communist country in the Western Balkans. We analysed a sample of 2,837 men and 3,580 women aged 15 to 49 from the 2008/2009 Albanian Demographic and Health Survey. Hypertension was defined as SBP≥140 mm Hg, or DBP≥90 mm Hg, or if the subjects were under treatment for hypertension. Data on demographic and socioeconomic characteristics and behavioural factors were also collected. Logistic regression was used to assess the association of hypertension with covariates. Hypertension was significantly higher among men (27.3 %) than women (20.0 %), and significantly increased with age. The harmful effect of excessive weight and obesity on hypertension was stronger among women than among men and this effect increased with age, especially in women. Smoking and alcohol were risk factors for hypertension in men, but not women. Education had a protective effect on hypertension in women but not in men.Ovaj rad istražuje prisutnost te socioekonomske i bihevioralne korelate hipertenzije u populaciji Republike Albanije, tranzicijske postkomunističke zemlje na zapadu Balkanskoga poluotoka. Obradili smo uzorak od 2837 muškaraca i 3580 žena u dobi od 15 do 49 godina iz Albanskog demografskog i zdravstvenog istraživanja (2008./2009.). Hipertenzija je definirana kao sistolički tlak >140 mm Hg, ili dijastolički tlak ≥90 mm Hg, ili ako su se ispitanici liječili od hipertenzije. Prikupljeni su i podaci o demografskim i socioekonomskim obilježjima te bihevioralnim čimbenicima. Za procjenu povezanosti hipertenzije i kontrolnih varijabli korištena je logistička regresija. Hipertenzija je bila značajno viša među muškarcima (27,3 %) nego među ženama (20,0 %) i njena se učestalost značajno uvećavala s dobi. Štetni učinak prekomjerne težine i pretilosti na hipertenziju bio je snažniji u žena nego u muškaraca te se također povećavao s dobi, pogotovo u žena. Pušenje i alkohol bili su faktori rizika u muškaraca, ali ne i u žena. Obrazovanje je imalo zaštitni učinak na hipertenziju u žena, ali ne i u muškaraca. Državna tijela trebala bi osmisliti preventivne programe za borbu protiv prekomjerne težine/pretilosti i hipertenzije

Incidence and Impact of Patient-Prosthesis Mismatch in Isolated Aortic Valve Surgery

AIM: The mains topics of this work are the incidence of patient-prosthesis mismatch and the influence in the early results of isolated aortic valve surgery.METHODS: In 193 patients isolated aortic valve surgery was performed. The study population was divided in three subgroups: 20 patients with severe, 131 patients with moderate and 42 patients without patient-prosthesis mismatch. The indexed effective orifice area was used to define the subgroups. Operative mortality and perioperative complications were considered the indicators of the early results of aortic valve surgery.RESULTS: The incidence of severe and moderate patient-prosthesis mismatch was respectively 10.3% and 67.8%. Hospital mortality and perioperative complications were: mortality 5% vs. 3.1% vs. 2.4% (p = 0.855), low cardiac output 5% vs. 6.9% vs. 4.8% (p = 0.861); pulmonary complications 5% vs. 3.1 vs. 0.0% (p = 0.430); exploration for bleeding 5% vs. 0.8% vs. 2.4% (p = 0.319); atrial fibrillation 30% vs. 19.8% vs. 11.9% (p = 0.225); wound infection 5% vs. 0.8% vs. 0.00% (p = 0.165), respectively for the group with severe, moderate and without patient-prosthesis mismatch.CONCLUSIONS: Patient-prosthesis mismatch is a common occurrence in aortic valve surgery. This phenomenon does not affect the early results of aortic valve surgery

Vaginal Infections of Albanian women Infected with HPV and their impact in intraepithelial cervical lesions evidenced by Pap test

Background: Cervical cytology is the best single method for large screening of the population in identifying precancerous lesions of the uterine cervix. Aim: To estimate the frequency of human papillomavirus (HPV) positivity in a group of Albanian women, the prevalence of vaginal coinfections, and the relationship of coinfections with HPV, as well as their role in metaplasia or cervical intraepithelial lesions (CIN). Materials and Methods: In this retrospective study, 2075 vaginal smears were examined. The Papanicolaou stain was used for all slides. The New Bethesda System 2001 was used for the interpretations of the smears. Data analysis was completed using the Statistical Package for the Social Sciences version 19.0. Results: Prevalence of HPV positivity was 43.9% with an average age of 35.48 ± 9.27 years. Candida coinfection resulted in 57.8% of HPV positive women with a significant relationship between them. Gardnerella coinfection resulted in 36 (23%), mixed flora in 34 (8%), and Trichomonas vaginalis in 50% of HPV positive woman. Among the women with positive HPV, 19% had CIN, 8% had metaplasia, and 1% had metaplasia and CIN; 9% of the women with HPV had CIN1 and one of the coinfections. Conclusions: There is a strong relationship between CIN1 and HPV positivity as well as between CIN1 and coinfections. HPV infection is a major factor contributing to metaplasia, and bacterial coinfections in HPV positive women have a statistically significant impact in the development of metaplasia

Maternal and Perinatal Outcomes of Pregnant Patients with Coronavirus Disease 2019: Data from a University Hospital Setting in Tirana, Albania, May 2020 to November 2021

Scientific evidence suggests an increased risk of maternal and obstetric complications in pregnant patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study is aimed at evaluating perinatal and maternal outcomes among patients with coronavirus disease 2019 (COVID-19) in a university hospital setting. This was a prospective cohort study of 177 pregnant women with confirmed SARS-CoV-2 infection at a tertiary hospital between May 2020 and November 2021. Both symptomatic and asymptomatic women with a positive reverse transcription-polymerase chain reaction test result at any time during pregnancy were included in this study. For the purpose of this study, we classified COVID-19 cases into two groups: mild and severe cases. The two groups were then compared to predict how the clinical presentation of COVID-19 affected adverse maternal and perinatal outcomes. Gestational age≥20 weeks at the time of infection was significantly associated with the occurrence of severe forms of the disease (relative risk (RR) 3.98, p=0.01). Cesarean section was the preferred mode of delivery, with 95 women (62.1%) undergoing surgery. A total of 149 neonates were delivered to women who had confirmed SARS-CoV-2 infection at any time during the course of pregnancy of which thirty-five (23.5%) were admitted to the neonatal intensive care unit (NICU). Severe forms of COVID-19 increased the risk of premature delivery (RR 6.69, p<0.001), emergency cesarean delivery (RR 9.4, p<0.001), intensive care hospitalization (RR 51, p<0.001), and maternal death (RR 12.3, p=0.02). However, severe forms of SARS-CoV-2 infection are not directly responsible for low birth weight or the need for neonatal resuscitation. Our findings suggest that pregnant women presenting with severe COVID-19 disease are at an increased risk of adverse maternal and perinatal outcomes, such as premature delivery, cesarean section, admission to the ICU, and maternal death. Infection after the 20th week of gestation increases the risk of developing severe forms of the disease