Treatment of Proliferative Diabetic Retinopathy with Panretinal Photo Coagulation and Anti VEGF Injection, Depending on the Case

Proliferative diabetic retinopathy (PDR) is the most common cause of severe visual loss in people with diabetes. Although panretinal photocoagulation (PRP) remains one of the best treatment, it has many side effects. So other new treatment modalities have emerged. These  can be used to increase the extent of treatment, expedite the effect of laser treatment and provide alternate measures when laser delivery is difficult or impossible, especially in patients with vitreous haemorrhage, or when the patient is at young age.  Currently, most of the research in this field is focussed on inhibitors of vascular endothelial growth factor (VEGF). Although limited by their short-lived effects, anti-VEGF agents are widely available, especially for the treatment of aggressive PDR. We present 2 cases which  had regression of neovascularization within  four weeks of the initial treatments, and  maintained their visual acuity with no evidence of recurrent neovascularization through 12 months after initiating treatment. Intravitreous injections of anti-VEGF therapy may be an alternative treatment option for patients with PDR. We followed  a system of 3 injection q4wk followed by injection q8wk,  depending on gravity of macular edema and it’s regression from anti-VEGF intravitreal injections.  Keywords:  PRP, PDR, VEGF, DME, etc.

The Music of Thomas Simaku

The music of British-Albanian composer Thomas Simaku (b. 1958) bears the hallmarks of both his formative training and working life in Albania, and the widening of musical palette that came with his move to the UK in 1991. In this article the music from the late 1990s to the present day is considered, with particular attention to more recent works. An overview of some stylistic and technical aspects of this music is offered through analytical observations centred on three dualities: simplicity and complexity, the individual and the group, and stasis and movement. This wide-ranging account aims to open the door for further scholarship around this rich and multifaceted music

Factors associated with adverse events following immunization in Albanian children: An analysis of the national database of adverse events after immunization

Background: Adverse events following immunization are a major concern which is influencing vaccination coverage all over the world. It is therefore important to evaluate the reporting of this events and factors associated with their occurrence in order to prevent them. Methods: The national database of adverse events following immunization in Albanian children was de-identified and transferred to the IBM® SPSS version 21. (SPSS Inc, USA). Every medical information was re-entered using the Medical Dictionary for Regulatory Activities (MedDRA) terms. The dose-based reporting rates are calculated always taking in consideration the number of administered vaccines instead of the number of distributed ones, which is an advantage of the Albanian reporting system Results: During a thirteen year period (2003-2015) there have been 307 AEFI cases reported for a total of 7,713,325 doses of vaccines administered. That regarded 106 females and 134 males. Most of the events have been reported during 2004. Most of thecases were non-serious (78,8%). Most of the cases were treated at ambulatory setting (72.55), followed by hospital treatment (24.3%) and no treatment (2.6%). Most of the cases were recorded in infants aged < 4 months. Conclusion: During the 13 year period, there were no severe events. The completeness and accuracy of information in the Albanian vaccine safety surveillance system still need to improve.&nbsp

Syndromic surveillance in early detection of outbreaks of infectious diseases

Aim: Motivated by the threat of infectious diseases and bioterrorism, syndromic surveillance systems are being developed and implemented around the world. The aim of the study was to describe the early warning surveillance system in Albania.Methods: Syndromic surveillance is a primary health care-facility- and emergency room (ER)-based syndromic surveillance system aiming at detecting outbreaks and undertaking public health actions. It is based on weekly notifications of nine syndromes by over 1,600 General Practitioners (GPs) in the 36 districts of Albania. Data is aggregated by district epidemiologists (DE) and centralized by the national Institute of Public Health.Results: A syndrome is “a set of symptoms or conditions that occur together and suggest the presence of a certain disease or an increased chance of developing the disease.” In the context of syndromic surveillance, a syndrome is a set of non-specific pre-diagnosis medical and other information that may indicate the release of a bioterrorism agent or natural disease outbreak.Since its inception, syndromic surveillance has mainly focused on early event detection: gathering and analysing data in advance of diagnostic case confirmation to give early warning of a possible outbreak.Conclusion: The system is useful for detecting and responding to natural disease outbreaks such as seasonal and pandemic flu, and thus they have the potential to significantly advance and modernize the practice of public health surveillance

Syndromic surveillance in early detection of outbreaks of infectious diseases

Aim: Motivated by the threat of infectious diseases and bioterrorism, syndromic surveillance systems are being developed and implemented around the world. The aim of the study was to describe the early warning surveillance system in Albania.   Methods: Syndromic surveillance is a primary health care-facility- and emergency room (ER)-based syndromic surveillance system aiming at detecting outbreaks and undertaking public health actions. It is based on weekly notifications of nine syndromes by over 1,600 General Practitioners (GPs) in the 36 districts of Albania. Data is aggregated by district epidemiologists (DE) and centralized by the national Institute of Public Health. Results: A syndrome is “a set of symptoms or conditions that occur together and suggest the presence of a certain disease or an increased chance of developing the disease.”  In the context of syndromic surveillance, a syndrome is a set of non-specific pre-diagnosis medical and other information that may indicate the release of a bioterrorism agent or natural disease outbreak. Since its inception, syndromic surveillance has mainly focused on early event detection: gathering and analysing data in advance of diagnostic case confirmation to give early warning of a possible outbreak. Conclusion: The system is useful for detecting and responding to natural disease outbreaks such as seasonal and pandemic flu, and thus they have the potential to significantly advance and modernize the practice of public health surveillance

Stargardt's Disease (Fundus Flavimaculatus)

Background: Stargardt’s Disease is included in the group of degenerative macular diseases, which consists of the progressive loss of cones in fovea of both eyes, leading to variable levels of central vision loss. It is symptomatically similar to age-related macular degeneration and it affects approximately one in 10,000 children, in ages between 7 and 12 years old. Case Report: We report a case of a 13 years old boy who presented with severely reduced bilateral visual acuity. He was admitted to handicapped children school since he was suspected of malingering. He had no family history or previous ocular symptoms. His visual acuity was 20/200 s.c à 20/50 in mydriasis. Fluorescein Angiography, with the characteristic aspect of "bull's eye" due to a "window effect" at the level of the peri foveolar depigmentation limit, was very helpful to decide the right diagnosis.Conclusion: Currently, there is no effective treatment for Stargardt's disease, but having the right diagnosis may assist the patient, family members and the society to adapt helpful behaviors. Individuals benefit from the use of low vision aids and orientation and mobility training.Keywords: Stargardt's disease; bilateral visual loss; progressive; children

Enhancement of Aedes albopictus collections by ovitrap and sticky adult trap

Abstract Background: In the last decades, Aedes albopictus has become an increasing public health threat in tropical as well as in more recently invaded temperate areas due to its capacity to transmit several human arboviruses, among which Dengue, Chikungunya and Zika. Enhancing the efficiency of currently used collection approaches, such as ovitraps and sticky traps, is desirable for optimal monitoring of the species abundance, for assessment of the risk of arbovirus transmission and for the optimisation of control activities. Findings: Two sets of 4 × 4 Latin-square experiments were carried out in Tirana (Albania) to test whether modifications in ovitrap shape and size and in oviposition substrate would increase collections of Ae. albopictus eggs and whether hay-infusion would increase adult catches by sticky trap. Generalized Linear Mixed Models with negative binomial error distribution were carried out to analyse the data. Cylindrical ovitraps lined with germination paper yielded significantly higher egg catches than those exploiting either the (commonly used) wooden paddles or floating polystyrene blocks as oviposition substrates. No difference was observed between cylindrical and conical shaped ovitraps. Ovitraps and sticky traps baited with hay infusion yielded significantly higher egg and adult catches than un-baited ones. A significant relationship between ovitrap and sticky trap catches was observed both in the absence and in the presence of attractants, with ovitrap catches increasing more than sticky trap catches at increasing adult female densities. Conclusions: This study provides grounds for optimisation of ovitraps and sticky traps as monitoring tools for Ae. albopictus by (i) supporting use of germination paper as most appropriate oviposition substrate; (ii) suggesting the possible use of stackable conical ovitraps for large scale monitoring; (iii) confirming the use of hay-infusion to increase egg catches in ovitraps, and showing that hay-infusion also significant increases adult catches by sticky traps