ALBANIAN BANKRUPTCY LAW, WHERE WE STAND, WHERE TO GO

The number of businesses in our country going bankrupt is growing. Businesses that start the procedures of insolvency are increasing, but only few of them are intended to be called legally bankrupt. This is due to the fact that the Albanian bankruptcy law has some shortage that pre vents proper legal regulation of bankrupt businesses. Bankruptcy laws have evolved over time in response to changing economic conditions and the political and economic strength of different interest groups. The Albanian bankruptcy law has been under scrutiny in recent times. The aim of this article is to give an overview of German insolvency law, where we find the German principles under which the law in force is based, and USA insolvency law, in order to highlight the aspect in which the Albanian law requires adjustments

ALBANIAN BANKRUPTCY LAW, WHERE WE STAND, WHERE TO GO

The number of businesses in our country going bankrupt is growing. Businesses that start the procedures of insolvency are increasing, but only few of them are intended to be called legally bankrupt. This is due to the fact that the Albanian bankruptcy law has some shortage that pre vents proper legal regulation of bankrupt businesses. Bankruptcy laws have evolved over time in response to changing economic conditions and the political and economic strength of different interest groups. The Albanian bankruptcy law has been under scrutiny in recent times. The aim of this article is to give an overview of German insolvency law, where we find the German principles under which the law in force is based, and USA insolvency law, in order to highlight the aspect in which the Albanian law requires adjustments

Evaluation of efficacy and effectiveness of live attenuated zoster vaccine

Herpes zoster (HZ) is a viral disease characterized by a dermatologic and neurologic involvement caused by the reactivation of the latent varicella zoster virus (VZV) acquired during primary infection (varicella). HZ incidence increases with age and is related to waning specific cell-mediated immunity (CMI). The most frequent complication of HZ is post-herpetic neuralgia (PHN) characterized by chronic pain lasting at least 30 days, with impact on patientsâ quality of life. Available treatments are quite unsatisfac- tory in reducing pain and length of the disease. The evaluation of the epidemiology, the debilitating complications (PHN), the suboptimal available treatments and the costs related to the diagnosis and clinical/therapeutic management of HZ patients have been the rationale for the search of an adequate preventive measure against this disease. The target of this intervention is to reduce the frequency and severity of HZ and related complications by stimulating CMI. Prevention has recently become possible with the live attenuated vaccine Oka/Merck, with an antigen content at least 10-fold higher than the antigen content of pediatric varicella vaccines. Clinical studies show a good level of efficacy and effectiveness, particularly against the burden of illness and PHN in all age classes. Accordingly to the summary of the characteristics of the product the zoster vaccine is indicated for the prevention of HZ and PHN in individuals 50 years of age or older and is effec- tive and safe in subjects with a positive history of HZ

Characterization of polygalacturonases from fruit spoilage Fusarium oxysporum and Aspergillus tubingensis

We reported the partial purification and characterization of polygalacturonases from fruit spoilage Fusarium oxysporum and Aspergillus tubingensis isolated from banana and peach, respectively. By using diethylaminoethyl (DEAE)-Sepharose column, one and two forms of polygalacturonases were separated from F. oxysporum (PGase) and A. tubingensis (PGaseI and PGaseII), respectively. The polygalacturonases examined had higher affinity toward various polygalacturonic acids and pectins. The apparent Km and Vmax values were reported for the enzymes. Acidic pH optima (4.0 to 6.0) was also reported for the enzymes. Optimal temperature and thermal stability of the enzymes showed a range from 40 to 60°C. The effect of metal cations on the enzymes was studied. The most chemical compounds caused moderate inhibitory effect except benzoic and citric acids which had strong inhibitory effect on the polygalacturonases. The benzoic and citric acids were used as antifungal compounds for F. oxysporum and A. tubingensis. The citric acid was found to be more effective against fungal growth than benzoic acid.Keywords: Fruit, spoilage, Fusarium oxysporum, Aspergillus tubingensis, polygalacturonas

Measles, a re-emerging disease in Albania: Epidemiology and clinical presentations

Aim: Measles is a highly contagious disease caused by the measles virus. Albania is one of many European countries that have successfully interrupted endemic transmission of this disease. However, during the years 2018-2019, an outbreak of measles occurred in Albania. The aim of this study was to describe the clinical features and complications of hospitalized measles patients in Tirana, Albania, as related to age-group and risk factors. Methods: All patients hospitalized for over 24 hours from January 2018 to December 2019 at the Service of Infectious Diseases, University Hospital Centre “Mother Teresa” in Tirana were included in this study. We included patients over 14 years old as this is an Infectious Diseases Service for adult patients only. Clinical and laboratory data were analysed. Results: Of the 318 hospitalized patients (139 females), about 35%, 26%, 17%, 14%, and 7% were 15-24, 25-34, 35-44, 45-54, and over 55 years old, respectively. Females constituted 37% of the total number of patients. The average and median ages were 30.9 years and 28.5 years, respectively. Average time from the first symptom to the hospital presentation was 3.8 days. Contact with other patients with measles was noted in 21% of the patients. Body rashes were identified as maculopapular in 96% of the patients. Pathognomonic enanthema or Koplik spots and conjunctivitis were detected in 62% and 52% of the patients, respectively. Measles-related complications were noted in 53% of the patients; pneumonia/pneumonitis, hepatitis, neurological complications were presented by 24%, 26%, and 3% of the patients, respectively. Average duration of hospitalization was 5.4 days, whereas mortality was 0.3%. Conclusion: This study provides valuable evidence about the distribution and clinical features of measles in Albania. Measles is a highly contagious disease and, as long as the measles virus is circulating, the risk of transmission remains high. &nbsp

Infection prevention and control in healthcare facilities in Albania

  Aim: The objective of this study was to assess the current status regarding Infection Prevention and Control (IPC) in selected healthcare facilities in Albania in light of the ongoing COVID-19 pandemic which continues unabated.     Methods: A cross-sectional study was conducted in April 2021 including a nationwide representative sample of 505 health professionals working mostly in primary health care centres in Albania (84 men and 421 women; response rate: 95%). A structured questionnaire developed by the World Health Organization was administered online to all participants inquiring about a wide range of measures and practices employed at health facility level for an effective IPC approach. Fisher’s exact test was used to assess potential urban-rural differences in the distribution of characteristics regarding IPC aspects reported by survey participants.         Results: About 47% of health facilities did not have a designated focal point for IPC issues; the lack of one patient per bed standard was evident in more than one-third of health facilities (37%); and the lack of an adequate distance between patient beds was reported in a quarter of health facilities (which was twice as high among health facilities in urban areas compared to rural areas). Furthermore, water services were always available only in about two-thirds of health facilities (63%), whereas an adequate number of toilets (at least two) was evident in slightly more than half of the health facilities surveyed (53%). Also, one out of four of the health facilities did not have functional hand hygiene stations and/or sufficient energy/power supply. A completely adequate ventilation was evidenced in slightly more than half of the health facilities (51%). Four out of five health facilities had always available materials for cleaning and about half (49%) had always available personal protective equipment. Functional waste collection containers were available in nine out of ten health facilities, of which, four out of five were correctly labelled.   Conclusion: This study informs about the existing structures, capacities and available resources regarding IPC situation in different health facilities in Albania. Policymakers and decision-makers in Albania and in other countries should prioritize investments regarding IPC aspects in order to meet the basic requirements and adequate standards in health facilities at all levels of care

Therapeutic efficacy of perfloxacin in treatment of ampicillin-resistant typhoid fever in 7 days versus 10 days

AbstractObjective: Typhoid fever is endemic in Albania and is becoming increasingly resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole. Perfloxacin has been shown to have significant activity in vitro against Salmonella species. the authors studied its therapeutic efficacy in patients with typhoid fever.Methods: Thirty patients with ampicillin-resistant typhoid fever, who were admitted to the Infectious Disease Clinic at the University Hospital Center of Tirana, were enrolled in this prospective, nonblinded clinical trial. Patients were treated with oral perfloxacin at 400 mg twice daily. They were randomized to receive treatment for either 7 days (group I) or 10 days (group II).Conclusions: Excellent therapeutic responses were observed in all patients in both groups. In every case, there was significant clinical improvement with defervescence and sterile blood cultures by day 4 and three consecutive negative urine and stool cultures at the end of treatment. Perfloxacin was highly effective in treatment of typhoid fever. Treatment for 7 days appeared to be as effective as treatment for 10 days. In both groups, bile cultures at the end of treatment and at 2 months follow-up were sterile, suggesting that both regimens were effective in preventing a chronic carrier state

Overview on epidemiological and clinical manifestation of COVID-19 in Albanian adults

On March 9, 2020 the first two cases of Sars-Cov-2 were identified and hospitalized in Albania. In this paper we present a retrospective analysis of 3000 consecutive COVID-19 confirmed cases in Albanian adults admitted at the Infectious Diseases Service which includes three tertiary care wards, part of Tirana University Hospital Center “Mother Teresa”. The period included in this analysis is from March 2020 – April 30, 2021. The paper provides a general overview including demographic distribution, symptomatic diversity and clinical signs manifested among cases, as well as the association observed with underlying pathologies. The analysis included 1944 males and 1056 females. Overall, the age groups included range from 15 to 99 years (median 65 years; mean value 63.4±13.4 years). There were no statistically significant age differences between males and females (mean ages were: 63.5±13.1 in females and 63.3±13.5 in males; median ages were: 64 years in females and 65 years in males; P=0.67). There was evidence of a statistically significant difference between sexes regarding the presence of symptoms, which were more predominant in males (P<0.001). On the whole, we observed 19 cases with specific signs and symptoms, most of them (82.9%) among patients who reported the presence of such symptoms 5-14 days before hospitalization. The comorbidities encountered were ranked according to systems and organs, classifying them in 22 categories, among which the most frequent were hypertension (52%) and diabetes mellitus (26.4%). Age was a strong risk factor for severe illness, complications, and death. Analyzing symptom onset with total symptoms and comorbidities, it showed that some patients were affected for many days with few symptoms and few comorbidities. It seems they started as mild cases for many days unpredictably precipitating. There were also a few cases with many comorbidities, but a few symptoms upon hospital admission. &nbsp

Clinical Aspects of Visceral Leishmaniasis in Albanian Adults

Visceral Leishmaniasis is still a public health concern in Albania, a former communist country in Southeast Europe which is undergoing a rapid transition from a rigid centralized system towards a market-oriented economy. VL in Albania has been very widespread and known before World War II, but data were scarce. To the general public the disease is known as "spleen disease". Aim of this study is to evidence clinical manifestation of VL and epidemiological evaluation for referral, early diagnosis and treatment of the diseases. Methods: We analized clinical aspects using descriptive statistics included reporting of minimal and maximal values, ranges, mean values, standard deviations and standard errors. T-test and chi-square tests were employed to compare respectively the mean values or the proportions between groups. Upon hospitalization in our study, the disease was mainly manifested with full signs, which means that generally our cases were hospitalized during the second period of the VL that is the anemic phase, considering late. Results: The study highlighted that clinical manifestation of VL in adults are fever in 100% of cases, pancytopenia in 97.3% , anaemia in 100%, The study showed that VL in adult clinically manifested by fever in 100% of cases, anemia in 100% of cases, 73.9% weight loss, sweating 84.9%, enlargement of the abdomen 89.04%, enlarge the liver and spleen in 100% of cases, phenomena hemorrhagic 21.9%, body weakness 90.4%, paleness 75.3%, oedema 5.4%, lymphadenopathy 24.6%, 27.3%, gastrointestinal disorders, chills 61%.Keywords: V.L. (Visceral Leishmaniasis), Leishmania Donovani, sand fly, Albania