Technical Challenges on CT Pulmonary Angiogram: Our Data

Purpose: This study aims to evaluate the role of imaging modalities, especially CTPA in diagnosing pulmonary embolism and briefly summarize PE distribution according to age and gender.Material and methods: Data of patients were collected at the "Shefqet Ndroqi" University Hospital, Department of Imaging, Tirana, Albania; during one year period, January 2017 – January 2018.Based on clinical and laboratory data, the study included 300 patients with suspected pulmonary embolisms; 53% were women and 47% were men with an average age of 64.2 years. The patients underwent this diagnostic protocol: physical examination, laboratory examination, and imaging diagnosis (radiography, CTA, MN). Chest X-ray (standing position, PA projection) was performed in all patients included in the study; 98% of patients underwent angio-CT examination, after injection of 50-65 mL of contrast media, Ultravist 370. Nuclear medicine was performed in 2% of patients after injection of 5mCi Tc-99m labeled with MAA.Results: The study shows that pulmonary embolism was found in 17.7 % of the total sample population (54 % of women and 46% of men).  And the group aged 61-70 years old was more affected. CTPA examination data resulted in the final diagnosis and exclusion of PE in 98% of cases: 17.4 % positive for PE; 81.2 % negative for PE and 1.4 % indeterminate due to poor opacification of pulmonary arteries. Perfusion defect was found in two cases.Conclusion: CTPA is the imaging modality of choice in the diagnosis of PE, allowing direct visualization of the thrombus in the vascular lumen by determining the optimal time of pulmonary arteries opacification. Keywords: pulmonary embolism, CTPA, MN, radiography DOI: 10.7176/JHMN/110-03 Publication date:August 31st 202

Gender Prevalence of Urolithiasis in Albania: Our Data

Urolithiasis remain a problematic nosology in many countries and regions, however, there are studies that bring data on this nosology even in location, size and gender as well. We would like to bring in light our data in respect of gender prevalence of urolithiasis on our population study. In our prospective study from 2011 to 2014, of 200 subjects who were admitted to emergency service, respectively City Hospital of Mat, where 122 subjects were diagnosed with urolithiasis, and 67 % of those subjects where males, or in other words 82 subjects, and 33 % were female subjects, or in other words 40 subjects. In many studies there are data on gender and age as well in respect to urolithiasis. Our data, even in modest population would like to present and compare with literature and bring to the respective state authorities’ attention for any future prospects. Keywords: Urolithiasis, prevalence, gender, Albania DOI: 10.7176/ALST/87-01 Publication date: April 30th 2021

Early Diagnosing of Urinary Tract Anomalies

Nowadays, with advanced diagnostic technology and accessibility of patients to qualified physician, many anatomical anomalies are diagnosed in uterine life, including urinary tract anomalies in prenatal period, however, even with advanced of technology, many of such anomalies continue to be diagnosed later on, in early stage of life or even later when a medical problem arise as a consequence of these anomalies. In Albania, nowadays, high technology and high definition diagnostic imaging machines are available; however, we do face lack of qualified and experienced medical specialist, especially in peripheral regions - city hospitals throughout Albania. Early diagnosing of anomalies like urinary tract ones, are possible to be diagnosed since the end of first trimester of pregnancy by 14 weeks, and later on during the anatomic ultrasound examination or otherwise called morphologic fetal ultrasound at 18 – 22 weeks of pregnancy, if examination carried out by a qualified medical specialist, should clearly visualize fetal urinary tract. However, this fetal problems undiagnosed during pregnancy, there are often diagnosed in postnatal period. In some countries, many ultrasound examinations during pregnancy are performed by ultrasound technicians and interpreted by radiologist or perinatologist, however, generally these examination are performed by fetal medicine specialist, or obstetrician and gynecologists. In Albania these examination are performed only by obstetrician and gynecologist, since qe do not have a fetal medicine center. Any urinary problem during early age, it is appropriate to perform a general abdominal ultrasound examination as fast, reliable and cost-effective examination tool with no side effect. Keywords: Diagnostic, early, urinary, anomalies, medical specialist DOI: 10.7176/ALST/87-02 Publication date: April 30th 202

Clinical and Radiological Correlation with Surgery of Third Mandibular Impacted Molars

Overview:Tooth extraction is one of the most common procedures in dentistry and oral maxillofacial medicine. Vigilant investigation of the condition and an accurate preoperative assessment, planning, evaluating indications and contraindications, is needed in all the cases. The objective: The aim of this study is to evaluate the role of radiographic examinations in diagnosis and surgery planning of lower third molar extraction. Materials and methods: Review of literature; on pubmed, medline, embase, sciencedirect, and the Cochrane library, using key words of impacted molars, third molars, mandibula, alveolar, dentistry, oral maxillofacial. Results: During dental and oral maxillofacial daily clinical practice is quite often to face impacted third lower molars, a condition that can lead to a close relation with important anatomical structures. Radiographic examinations are useful in the diagnosis and subsequently in the surgery planning and must submit to principle of justification and optimization. Intraoral radiography and orthopantomography hardly permit to evaluate the buccal or lingual position of the inferior alveolar nerve so to better predict the risk of complications. There are some radiographic signs that suggest the necessity to perform a more accurate radiographic investigation that provides a three-dimensional view of the images. The three-dimensional radiographic methods, by means of sagittal, frontal and axial views, are used to determine anatomical location, proximity, and possible contact of the third molar with the mandibular canal, blood vessels and nerves branches. The beginning of Cone Beam Computed Tomography (CBCT) has reduced the equipment cost but then again above all the radiation exposure for the patients. Conclusions: In the past few years three-dimensional reconstructive technologies were introduced: besides advantages, in addition to the potential benefit in the reduction of complications related to the patient, also resides in the different approach of the surgeon: stress and duration of dental and oral maxillofacial surgical procedures significantly is reduced because the respective medical specialist know exactly the position of anatomical structures. This information will help the surgeon to determine a possible post-operative paresthesia and plan the better surgical technique. Keywords: Impacted molars, third molar, surgery, inferior alveolar nerve, OPT, CBCT DOI: 10.7176/ALST/95-04 Publication date: November 30th 202

Trigeminal Nerve Injuries in Correlation with Daily Dental and Maxillofacial Medicine

Oral and maxillofacial medicine is in close relation with trigeminal nerve, and such daily dental procedures, impacted teeth, dental implants placement, oral and oral maxillofacial medicine including trauma, even injection of local anesthesia can damage trigeminal nerve. Auspiciously, most nerve injuries will undergo natural recovery, with small portion of cases resulting in permanent sensory deficits. Many patents suffering trigeminal nerve problems, present at family medicine doctors as well, or direct to medical specialist like dentist, oral maxillofacial medical specialists, neurologist or neurosurgeons as well.Subsequently, early assessment and diagnosis, often involving multidisciplinary team optimize recovery in respect of time and minimize the complication. Keywords: Trigeminal nerve, oral, maxillofacial, medicine, damage, assessment, recovery DOI: 10.7176/ALST/95-07 Publication date: November 30th 202