Prevalence of HBV and HCV among blood donors in Kosovo

Hepatitis is disease of the liver caused by the infectious and non-infectious agents

Hepatitis B and C in dialysis units in Kosova

<p>Abstract</p> <p>Background</p> <p>Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are important causes of morbidity and mortality of hemodialysis (HD) patients. This study aimed to investigate the epidemiological and clinical features of HCV and HBV infections in six different HD units in Kosova.</p> <p>Five hundred and eighty-three end-stage kidney disease (ESKD) patients on maintenance HD from six HD centers in Kosova (358 female, 225 male, mean age 54,8 years (16–66) were included in this study. Data from databank of the National Blood Bank in Prishtina, as well as the data from the databank of the Transfusion Centers in Regional hospitals in Prizren, Peja, Gjilan, Mitrovica and Gjakova were taken in this study. Clinical data such as age, sex, HBsAg and anti-HCV antibody and primary causes of ESKD were examined.</p> <p>Serological markers for HBV and HCV were determined with immunoenzymatic assay (ELISA).</p> <p>Results</p> <p>The T-test and x²test were used to analyze the significance of the results. Among our HD patients HBsAg and anti-HCV antibody prevalence rate was 12%, respectively 43%. Chronic nephritis was a more frequent cause of ESKD among our HD patients. With unknown etiology were 23, 5% from them.</p> <p>Conclusion</p> <p>HBV and HCV prevalence in our HD patients is still high. These data emphasize the need for stricter adherence to infection control, barrier precaution and preventive behaviors with all patients.</p

Anaphylaxis caused by taking pantoprazole: case series

Introduction: Pantoprazole is one of the most widely used proton pump inhibitors, but anaphylaxis occurs rarely during its use. The purpose of reporting these two cases is to show that pantoprazole is not a drug without problems; it can also cause anaphylactic reactions. Cases description: A 42-year-old woman presented to the emergency department due to dyspeptic complaints. Immediately at the end of the infusion of pantoprazole, there started to be numbness of the tongue, itching all over the body, and difficulty in breathing. Half an hour after taking a pantoprazole 40 mg capsule, a 58-year-old woman started to experience redness of the face, thickening of the tongue, itching, bloating, and dizziness. Arterial pressure was 80/60 mmHg, pulse 150/minute, while saturation had dropped to 88%. In both cases, fluids, adrenaline, antihistamines, methylprednisolone, and calcium were immediately started. After the improvement of their general conditions, both patients were discharged home. Discussion: The first case relates to anaphylaxis after the intravenous administration of pantoprazole, and the second case relates to the appearance of anaphylaxis after its oral administration. Conclusion: Health workers need to be informed about the possibility of anaphylaxis in patients taking both oral and parenteral pantoprazole

Endoscopic ultrasound of solid pancreatic lesions: our clinical experience

Ductal adenocarcinomas account for 85-90% of pancreatic tumors. In 60-70% of cases, the tumor is localized to the head, 5-10% to the body, and 10-15% to the tail. One-year survival of patients with pancreatic cancer is 26%, while 5-year survival is 6%. Endoscopic ultrasound is very sensitive in detecting solid pancreatic lesions.AIM: Introducing the clinicopathological features of our patients with pancreatic tumorsMETHOD: This study included 38 patients [15 females (39.5%) and 23 males (60.5%), with a mean age of 65.10 ± 10.21 years, range 34-78, with solid pancreatic lesions, who were announced in the period January 2018 - July 2019. Endoscopic Ultrasound (EUS) was performed with Pentax EG- 3870UTK Endoscopic Ultrasound. The EUS FNA is made with 22 gauge needles.RESULTS: We had two groups, the group with adenocarcinomas [n = 36 (94.7%)], and the second group with two patients with insulinoma. The main symptom was pain (57.9%). 36.8% of them were with jaundice. Nearly half of these patients were examined with EUS (17 patients). 21% of them used tobacco. Regarding the localization of the solid lesion in 25 patients (65.8%) it was in the head of the pancreas, 8 (21%) in the body and two of them were in the tail and the uncin. Most of the patients were stage IV.CONCLUSIONS: The description of the characteristics of our patients with solid pancreatic tumors is similar to the literature. Most of the patients were in stage IV. Material for histopathological analysis can be obtained with linear EUS. All of these features make EUS the method of choice for patients with pancreatic disease

Hiatal hernia associated chronic cough: two case reports

Chronic cough conventionally defined as a cough persisting for more than 8 weeks, represents both a disabling symptom for the patients and a difficult management problem. Gastroesophageal reflux alone or in combination with other factors such as postnasal drip syndrome and/or asthma is the cause of chronic cough in 10-40 % of adult patients. Reflux related extraoesophageal manifestations are frequent and represent a diagnostic and therapeutic challenge which could involve lungs, upper airways and mouth, presenting with asthma, laryngitis, chronic cough, dental erosions, and non-cardiac chest pain. One common cause of acid reflux disease is a stomach abnormality called a hiatal hernia. Here we present two patients with chronic cough, who had hiatal hernia. The first case is an 81-year-old male, with a cough for the last three years. The patient had been visiting pulmonologists for a long time because of their cough. Finally, he was instructed to consult a gastroenterologist. In the upper endoscopy, in addition to antral gastritis suspicious for an intestinal metaplasia, there was also a 3-4 cm hiatal hernia. Whereas the second case is a 54-year-old lady with chronic cough. She also has been visited many times by doctors. Endoscopy revealed hiatal hernia of 4-5 cm. Despite the prescribed therapies and diet the cough persisted, therefore laparoscopic fundoplication was proposed. At the end of this report, it should be said that in the differential diagnosis of a chronic cough, gastroesophageal reflux disease should also be considered

USE OF ENDOANAL ULTRASOUND IN ANORECTAL DISEASES: OUR CLINICAL EXPERIENCE

INTRODUCTION: Benign anorectal diseases are very common in the general population. Fistula-in-ano obstructed defecation, and fecal incontinence remains a major challenge in surgery. The high rate of surgical failures and the need for repetitive surgical interventions are common experiences for physicians dealing with these pathologies. Endoanal ultrasound is now regarded as the gold standard for evaluating anal sphincter pathology in the investigation of anal incontinence. Endocavitary ultrasound for anal and rectal pathologies was first used in the early 60s for the initial assessment of rectal tumors. The main indications of the endoanal ultrasound are the assessment of anal fistula and the anal sphincter study in patients with fecal incontinence. Endorectal ultrasound is widely used in rectal cancer staging. AIM: The purpose of this paper is to present the results of our work with endoanal ultrasound in our patients with benign and malignant anorectal diseases. METHOD: The study included 65 patients [24 females (36.9%) and 41 males (63.1%), with a mean age of 49.29 ± 16.5 years, range 14-84], with benign and malignant anorectal diseases, who were registered at the “Gastromed - AFM” Ordinance in Pristina during the period March 2018 - January 2020. After taking the history, physical examination, and endoscopy, an endoanal/transrectal ultrasound was performed with a Hitachi EUP-R54AW-19 probe. RESULTS: Based on the indications for endosonographic examination, patients were divided into 5 groups: with anal pain [n = 31 (47.7%)], with fecal incontinence [n = 11 (16.9%)], rectal cancer [n = 4 (6.2%)], constipation [n = 10 (15.4%)], and with perianal fistulas [n = 9 (13.8%)]. As can be seen almost half (47.7%) of the patients were with anal pain. Ten patients had fistulas (out of 5 with intersphincteric and transfincteric fistulas). Endosonography had also revealed four abscesses. Sphincter damage was present in 11 patients (16.9%). The internal anal sphincter was mostly damaged in 8 (12.3%) patients, while the external one was damaged in one patient (1.5%). Both sphincters were damaged in both patients. The anal fissure was the most common cause of anal pain, 17 patients (26.2%). CONCLUSIONS: Endoanal ultrasound is easy to apply, well accepted by the patient, requires simple preparation, is inexpensive, and provides accurate and rapid information on regional anatomy. All these features make endoanal ultrasound to be the method of choice in patients with anorectal diseases

Clostridium difficile infection following standard triple therapy for H. pylori eradication : a report of 3 cases

Introduction/Aim: Even though it is not known how much resistance to clarithromycin is in our country, the therapy of choice for eradicating H. pylori continues to be the clarithromycin-based triple therapy. This 14-day therapy is generally well tolerated, with rare cases of mild side effects. However, although rarely in the literature, there are cases with severe side effects with pseudomembranous colitis. Infection with C. difficile causes a spectrum of diseases ranging from occasional diarrhoea to colitis, toxic megacolon, and death. Here we have presented three cases of C. difficile infection that appeared after eradication therapy with clarithromycin-based triple therapy. After therapy with oral vancomycin, the diarrhoea stopped completely. Presentation of cases: Case 1. A.B. 36-year-old female, reported due to frequent bowel movements, one month after receiving the two-week eradication therapy with clarithromycin, amoxicillin and pantoprazole. Lactose intolerance was suspected, but the genetic test for lactose intolerance was negative. After C. difficile toxin A and B were positive, a 14-day therapy with oral vancomycin 4x125 mg was prescribed. After 10 days, the stools stopped completely. Case 2. B.B. 38-year-old male. Reported due to frequent stools three weeks after completion of eradication therapy with clarithromycin. Oral vancomycin 4x125mg was prescribed for 14 days. On the tenth day, stools stopped, and faeces began to form. Case 3. G.Z. 25-year-old male. Three months after the end of eradication therapy, watery, bloodless stools appeared. Since C. difficile toxin A and B were positive, he was prescribed oral therapy with vancomycin 4x125 mg for 14 days. Towards the seventh day, the diaries left the terrace. In all three cases, control tests for C. difficile toxin A and B were negative. Colonoscopy was not performed on any of the patients, since such a thing is not mandatory. Diagnosis is made only by tests of toxins A and B in faeces and not by culture. Conclusion: These cases suggest that our doctors should have a high index of suspicion for pseudomembranous colitis in patients with diarrhoea after H. pylori eradication

EFFICACY OF PROBIOTICS IN HELICOBACTER PYLORI ERADICATION THERAPY

INTRODUCTION: Development of antibiotic resistance, maladaptation of patients to receiving eradication therapy, side effects of drugs are the main factors influencing the apparent decrease in eradication rates of Helicobacter pylori (H. pylori). In our work on classical eradication therapy of H. pylori, we have added probiotics and evaluated their role in eradication, as well as tried to evaluate the role of probiotics in reducing the occurrence of side effects of antibiotics. METHODS: The study included 114 patients in most cases with dyspeptic complaints and H. pylori from the Gastroenterology Clinic of HUCSK, and the Specialist Clinic Gastromed -AFM in Pristina. The patients were divided into two groups. The first group consisted of 62 patients, who were given the classical therapy with pantoprazole 40 mg, twice a day for half an hour before a meal, amoxicillin 1 g, twice a day after a meal for two weeks, and clarithromycin 500 mg, 2 times a day after meals, for two weeks. The second group consisted of 53 patients, to whom the probiotics Lactobacillus reuteri were added to the classical eradication therapy as well as the combination of three other probiotics Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium lactis, in the form of 3 capsules of Helicobalans, for two weeks. One month after the end of therapy, the condition of H. pylori was assessed with antigen in the feces, urease test, or histopathological analysis. Where H. pylori were negative it was accepted that eradication was successfully performed. RESULTS: H. pylori eradication was achieved in 38 of 62 patients in the first group (61,3%), and in 37 of the 53 patients in the second group (69,8%). Although the eradication rate in the second group was higher, the statistical difference between the two groups was not statistically significant (p = 0.199). Regarding the side effects of prescribed therapies, the first group had side effects in 27 (43.5%) patients, while the second group with probiotics in 17 (32%) patients. However, in terms of the occurrence of side effects from the use of ordinary therapy, there was no statistical difference between these two groups (p = 0.194). CONCLUSIONS: The addition of probiotics to classical H. pylori eradication therapy can reduce the side effects of therapeutic regimens as well as increase the success of H. pylori eradication. There is a need for prospective and randomized work with a larger number of patients