Interventional Radiology in Treatment of Uterine Fibroids

Uterine fibroids are the most common cause of gynecological intervention in female surgery in general; laparatomy is the most common surgical technique worldwide and in the last decade or so laparoscopy has taken place when the infrastructure in technology and specializes human resources are available. In Albania, the classical surgery like laparatomy is the most common surgical procedure in gynecology intervention for uterine fibroids, however, other techniques available in developed medical systems are available treatment options and perfection of these techniques are promising and cost-effective as well. Uterine fibroid embolization is a non-surgical technique that shrinks fibroids without removing them surgically. The procedure is performed by an interventional radiologist, a medical doctor with certification in radiology and special education and certification in interventional radiology. Patient does not need to be put to sleep, but sedating medications are given in the vein to help relax the patient during one to two hours that procedure takes. A small incision is made in the groin directly over the artery carrying blood to the leg. The interventional radiologist guides a long thin catheter into the blood vessels that supply the uterus while monitoring the process under X-ray. Small plastic particles are pushed through the catheter until they form a blockade to the blood flowing to the uterus. Fibroids have a limited supply of blood vessels, and with the blood flow blocked, the fibroid cells start to die off. The surrounding normal uterine muscle has a better blood supply and is able to survive. Deprived of blood, nutrition, and oxygen, fibroids shrink like prunes for the three to six months following embolization, and the symptoms from the fibroids often lessen as well. Non invasive or less invasive procedures in medicine are taking place worldwide nowadays in clinical practice, so this article brings the need of application of these treatment methods as a treatment option in our patient care service.Keywords: Uterine, fibroid, non-surgical, less invasive procedure, interventional radiology

Safety and Concerns of Diagnostic Imaging Utilisation during Pregnancy

Pregnancy is special situation where human body of pregnant woman undergoes various physiological changes. These changes are complex and involve in a way all anatomical systems. Medical care during pregnancy is interesting and often challenging as it often engages medical management and diagnostic procedures that can place at risk the fetus and the mother as well. Diagnostic imaging modalities are available for diagnostic use during pregnancy. These include X-ray, ultrasonography, magnetic resonance imaging (MRI), and computed tomography (CT), and other modalities as well. Ultrasonography so far is the most common diagnostic imaging modality used during pregnancy; however, other modalities may be required to be employed. Diagnostic X-ray is the most frequent cause of anxiety for obstetricians and patients as well. To a great extent of this concern is secondary to a general belief that any radiation exposure is harmful and will result in an anomalous fetus. This anxiety could lead to inappropriate therapeutic abortion and lawsuit. Actually, most diagnostic radiologic procedures are associated with little, if any, known significant fetal risks. The concern and anxiety among obstetricians, physicians in general and patients as well is present in almost all of them in Albania, though, concerns of this kind exist even in well organised medical systems in developed countries. Having mentioned that, however, in latter one they are isolated cases as physicians are well informed as medical specialists work in close collaboration with interdisciplinary approach of health care delivery as a team. On the other hand, patient education is a great tool in transmitting proper professional information to interested population in regards of this matter. Conclusions: Since according to the American College of Radiology and American College of Obstetricians and Gynecologists, no single diagnostic X-ray procedure results in radiation exposure to a degree that would threaten the well-being of the developing preembryo, embryo, or fetus, Albanian physician must counsel patients appropriately about the potential risks and measures that can reduce diagnostic X-ray exposure.Keywords: Diagnostic imaging modalities, pregnancy, exposure, risk, utilisation, appropriate

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

Varicose Veins during Pregnancy, Diagnosis and Treatment

Varicose veins are enlarged veins that can be blue, red, or flesh-colored. They often look like cords and appear twisted and bulging. They can be swollen and raised above the surface of the skin. Varicose veins are often found on the thighs, backs of the calves, or the inside of the leg. During pregnancy, varicose veins can form around the vagina and buttocks as well. Spider veins are like varicose veins but smaller. They also are closer to the surface of the skin than varicose veins. Often, they are red or blue. They can look like tree branches with their short, jagged lines. They can be found on the legs and face and can cover either a very small or very large area of skin. According to the evidenced based medicine studies, about over 50 percent of women in the United States of America suffer from some type of vein problem. During pregnancy, there is a huge increase in the amount of blood in the body; this can cause veins to enlarge. The growing uterus also puts pressure on the veins. Varicose veins usually improve within 3 months after delivery. More varicose veins and spider veins usually appear with each additional pregnancy. Physical exam and ultrasound examination are important in early diagnosis. Considering that in Albania even though the medical service in general is made of primary, secondary and tertiary care, pregnant women do choose either to follow up their pregnancy at tertiary care centers or neglect the medical care during pregnancy because of lack of awareness of possible complication. This piece of paper will be focused on varicose veins during pregnancy in Albania, early diagnosis and early treatment. Spider veins rarely are a serious health problem, but they may cause uncomfortable feelings in the legs, however, in other cases could have the same symptoms you would have with varicose veins. Varicose veins may not cause any problems, or they may cause aching pain, throbbing, and discomfort. In some cases, varicose veins can lead to more serious health problems if left untreated. In conclusion, since pregnancy is special situation where many physiological changes occur, varicose veins during must be appropriately assessed, diagnosed and early treated in order to minimize the possible serious health problems.Keywords: varicose veins, pregnancy, diagnosing, ultrasound examination, treatment

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