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ALMEDICUS
A
ALMEDICUS
ERASMUS
MUNDUS
International Congress of Bio-Medical Sciences, Tirana, 2013
Organized by:
UNIQ UE OPPORT UNITY
FOR AN INTERNATIONAL
RESEARCH CAREER IN
MEDICINE AND THE
HEALTH SCIENCES!
AL MEDICUS
ALMEDICUS
Faculty of Medicine, Tirana, Albania
Partners:
ERA WEB, the European network of leading
European
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post-doctorate students, and also for academic
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for academic exchange between the
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MINISTRIA E ARSIMIT DHE SHKENCËS
Minitry of Education,
Republic of Albania
ERA WEB puts you at the heart of a new era of
LINK UP WITH ERA WEB
WWW .eras MUs- Western
European Union
Erasmus University Medical Center Rotterdam,
the Netherlands
Ludwig-Maximilians-Universität München, Germany
Università Cattolica del Sacro Cuore, Italy
University of Torino, Italy
University for Health Sciences, Medical Informatics and
Technology, Austria
ALMEDICUS Organization
Public Health Institute,
Albania
Student’s Council,
University of Medicine,
Tirana, Albania
Supported by:
Balkans.
eU
Western Balkans
University of Belgrade, Serbia
University of Nis, Serbia
University of Novi Sad, Serbia
University of Sarajevo, Bosnia-Herzegovina
Ss. Cyril and Methodius University in Skopje, Macedonia
University of Tirana, Albania
Association of Public
Health Students in Albania
President of the Congress
Prof. Dr. Bajram HYSA
International Guest Speakers
Chief of Organizing Committee
Prof.Acad. Bashkim RESULI
Director, Division of Surgical Research, McGill University
Chief of Surgical Services, Jewish General Hospital, Canada
Eni Nano
Lady Davis Institute
Department of Experimental Surgery
McGill University, Montreal, QC, Canada
Scientitfic Committee
Prof.Dr. Enver ROSHI
Head of National Institute of Public Health in Albania
Professor in Faculty of Medicine, University of Tirana
Prof.Dr. Genc BURAZERI
Professor in Faculty of Medicine, University of Tirana
Professor in Faculty of Health, Medicine and Life Sciences, Maastricht
University
Ludwig-Maximilians-Universität, Munich, Germany
Abbas Dehghan
Erasmus Medical Center, Netherlands
Altin Stafa
Prof.Dr. Genc SULCEBE
Kita Sallabanda
Professor of Surgery in Faculty of Medicine, University of Tirana
Vice dean of Faculty of Medicine, University of Tirana
Professor in Faculty of Medicine, University of Tirana
Head of Immunology Service in University Hospital Center “Nene
Tereza”
Co-chairs of Organizing Committee
Brigitte Strahwald
Prof. Ass. Xheladin DRACINI
Interventional Neuroradiology, Maggiore Hospital, Bologna Italy
Head of Committee Albania Unit of International Network of the UNESCO
Chair in Bioethics
Neurosurgery Department, Gruppo IMO, Madrid, Spain
Taulant MUKA, MD
Erasmus University,
Netherland
Jana NANO, MD
Ludwig-Maximilians- University,
Germany
Ilir ALIMEHMETI, MD
Medical University of Tirana,
Albania
University Ambassadors
Prof. Ass. Florian TOTI
Medical Doctor in Endocrinology Service in University Hospital Center
“Nene Tereza”
Edvin PRIFTI, M.D, PhD
Head of Cardiovascular Surgery Service in University Hospital Center
“Nene Tereza”
Prof. Dr. Besnik JUCJA
Dean of the Faculty of Pharmacy, University of Medicine, Tirana
Ina MEXHITAJ
Members of Executive Board
National Institute of Neurological Disorders and Stroke
New York, USA
Klodian DHANA
NIHES-Erasmus Medical Center
Rotterdam, Netherlands
Olta GISHTI
Prof. Ass. Ledjan MALAJ
Head of Department of Pharmaceutical Technology, Faculty of Pharmacy,
University of Medicine, Tirana
NIHES-Erasmus Medical Center
Rotterdam, Netherlands
Ervis AGASTRA
Faculty of Medicine, University of Trieste
Trieste, Italy
4 | I nternational C ongress
Organizing Committee
Lawrence Rosenberg, M.D., PhD.
of
B iomedical S ciences
Fjorda Koromani
Medical University of
Tirana, Albania
Eralda ASLLANAJ
Medical University of
Tirana, Albania
Gentjan ASLLANAJ
Medical University of
Tirana, Albania
Enisa SHEVROJA
Medical University of
Tirana, Albania
A bstracts B ook | 5
Prof. Dr. Bajram Hysa
Prof. Dr. Bajram Hysa
President of ICBMS-Albania 2013
Dean of the Faculty of Medicine, University of Medicine, Tirana, Albania
Mirald GINA
University of Granada,
Spain
Pranvera APOSTOLI
Medical University of
Tirana, Albania
Iris HOXHA
Medical University of
Tirana, Albania
Indrit Seferi
Medical University of
Tirana
Fisnik ANXHELA
Medical University,
Albania
Andi RABIAJ
Medical University,
Albania
6 | I nternational C ongress
of
B iomedical S ciences
Arminda AVDULAJ
University of Granada,
Spain
Dea QIRJAQI
University of Granada,
Spain
Evi HOXHA
Medical University of
Tirana, Albania
Naim SKENDERI,
University of Tetovo,
Macedonia
Dear participants, guests and students,
Ladies and gentlemen,
The Faculty of Medicine of Tirana has the pleasure to invite you at the International Congress of Bio-Medical Sciences,
on May 1-4, 2013 in Tirana, Albania. This is the first time that the Faculty of Medicine organizes an international event such
as this in collaboration with the student’s organization Almedicus.
There are expected to be welcomed more than 500 scientists and students from all over the world. These sessions
will not be only on medical topics such as dentistry, pharmacy, medical specialties but they aim to focus on the new data in
the field of bio-technology, biochemistry and biophysics.
As Dean of the Faculty of Medicine, Tirana, Albania , this International Congress is in my absolute focus as part of
the integration process with other European research institutions. ICBMS will not only be just a common congress where
people show their work, but we guarantee you a place where would lay the foundation for new friendships and future
collaborations!
In the heart of the Mediterranean, on the Adriatic and Ionian Seas, Albania is fast becoming one of the world›s most
interesting getaways. Still relatively unspoiled by globalization, you will notice an inspiring mixture of civilizations and
cultures - making this European country truly unique. Nestled in between Greece, Macedonia, Kosovo, and Montenegro,
and across the Adriatic from Italy, Albania boasts blue and turquoise seas, beautiful beaches, snow peaked mountains,
rivers, lakes, and forests. As well as stunning nature, Albanians themselves are famous for their hospitality, and tourists are
welcomed with heart-warming generosity.
Albanian history and culture is fascinating. Butrint, one of the world›s archeological wonders - and a UNESCO World
Heritage site - in the south of Albania provides a glimpse of Mediterranean civilization from the Bronze Age through the
Greek, Roman, Byzantine, Venetian and Ottoman periods - all atop a cliff overlooking Corfu. It›s not to be missed!
Home of both Mother Theresa and the great 15th Century hero Skanderbeg, Albania today offers not only beach and
mountain holidays, but also a vibrant city life, a relaxing outdoor cafe culture and you will see that it›s quickly evolving in a
myriad of directions.
We hope that we will have the pleasure of your presence and, speaking on behalf of the only Faculty of Medicine in
Tirana, we look forward to your active participation in the works of the International Congress of Bio-Medical Sciences,
May 1-4, Tirana, Albania.
Prof. Dr. Bajram Hysa
President of ICBMS-Albania 2013
Dean of the Faculty of Medicine, University of Medicine, Tirana, Albania
ICBMS 2013 CONGRESS AGENDA
9h-18h
11:00-12:30
Prof. Dr. Jera KRUJA
Rector of the University of Medicine, Tirana It is a great pleasure and honor for the University of Medicine, Tirana to host the International
Congress of Bio-Medical Sciences, and on its behalf I warmly welcome all the scientists and
university students from around the world that will be participating in this important event. The borderline between medical and bio-medical sciences constitutes a focal point for the highleveled researches and clinical activities in the congress presentations, and the amalgamation
of this is conducted by well-known young professionals of the academic world whose dynamic
experience offers the possibility to interact between different fields of studies. Comparative
activity may be a kind of bridge between research and current issues, and a good example
for our students in order to develop the best experience in their studies. The event is aimed at researchers, professionals, technicians, students and experts interested
in learning and improving their knowledge in the fields of Medicine, Dentistry, Pharmacy, but
also Bio-technology, Biochemistry and Biophysics on which the talented professionals will
have the opportunity to present their research to the international audience.
We firmly believe in the scientific research and the orientation of this international congress
is a roadmap for the future. It is provided by the new academic spirit of our researchers
and students in order to illustrate the deep involvement and commitment of the University of
Medicine, Tirana to the best international experience.
This is an excellent opportunity for me to thank the leaders of the Student’s Association
“Almedicus”. I also wish to thank the National Scientific Committee and the members of the
steering committee of the conference. I extend special thanks to the University Ambassadors
for their involvement in creating a rich and inspiring program. I also would like to thank the international guest scientists for their participation and the active
support in presenting their experience, and that without them this congress would not be
possible.
Moderators during
the Congress
Prof. Dr. Bajram Hysa, Prof. Dr. Jera Kruja, Prof.Dr. Bashkim Resuli, Prof. Dr. Enver Roshi, Prof.
Dr. Eduard Kakariqi, Prof.Dr. Genc Burazeri, Prof. Asc. Xheladin Dracini, Prof.Dr. Genc Sulcebe,
Prof. Asc. Florian Toti, Edvin Prifti MD, PhD, Prof. Besnik Juca, Prof. As. Ledjan Malaj, Prof.Asc.
Suela Kellici
12:30-13:20
Lawrence ROSENBERG M.D, PhD.
Director of Division of Surgical Research, McGill University, Montreal, Canada. Chief of Surgical Services,
Jewish General Hospital, Canada
Millions saw the apple fall, but Newton asked why
13:20-14:00
Eni NANO PhD Candidate, McGill University, Montreal, Canada
McGill: Leading the way in diabetes research
The role of INGAP in beta cell protection and survival against cytokine induced cell death
Discussion
14:00 -15:00
8 | I nternational C ongress
of
B iomedical S ciences
Lunch Break
15:00 -15:40
Altin STAFA M.D Neuroradiologist, Maggiore Hospital, Bologna, Italy Head of the Albanian Unit of the
International Network of UNESCO Chair in Bioethics
Medical Ethics: A personal choice or a social need?*
15:40 -16:00
Olta GISHTI, M.D Erasmus Medical Center University, Rotterdam, Netherlands Association of adiposity
measures and biomarkers in school age children
16:00 -16:20
Indrit SEFERI, Faculty Of Public Health, University of Medicine, Tirana, Albania
Osteoporosis and Risk Factors in Women in Tirana
16:20 -16:40
Oketa PETRO, M.D Regional Health Agency, Tirana, Albania
Headache: Prevalence and characteristics in Albanian adolescents
16:40 -17:00
Blertina Dyrmishi, M.D Hygeia Hospital, Tirana, Albania
Ovarian Hyperstimulation Syndrome, caused by an FSH-secreting pituitary adenoma, misdiagnosed
as an PRL-secreting pituitary adenoma
17:00 -17:20
Ina Pasho MSc., Faculty of Pharmacy, University of Medicine, Tirana, Albania
Study on the application of phytotherapy in Albania
Thursday 2nd of May 2013
09:00- 10:10
Abbas DEHGHAN, M.D, PhD Erasmus Medical Center, Netherlands
Genome-Wide Association Study: A novel approach to unravel the genetic determinants of
complex disorders
Discussion
Prof. Dr. Jera KRUJA, Rector of the University of Medicine, Tirana Registration
OPENING CEREMONY
10:10 -10:30
Ilir ALIMEHMETI, M.D, PhD candidate Mother Teresa University Hospital, Tirana, Albania
Relation of RDW (red blood cell distribution width) with the presence and severity of coronary stenosis - a
large Albanian Cohort study
A bstracts B ook | 9
10:30 -11:00
Discussion
Coffee Break
Brigitte Strahwald, M.D, MSc, PhD Candidate, Ludwig-Maximilians-Universität, Germany
Risk communication to patients
11:00-11:30
Edvin Prifti,MD, PhD Head of Cardio-thoracic surgery Service, “Mother Tereza” University Hospital,
Tirana, Albania
University of Medicine, Tirana, Albania
11:30-12:00
Prof. AsC. Ledjan Malaj, Faculty of Pharmacy, Tirana, Albania
Hospital pharmacist: key factor in enhancing public hospital services*
11:10-11:50
Brigitte Strahwald, M.D, MSc,PhD Candidate,Ludwig-Maximilians-Universität, Germany
How to present a medical paper
12:00-12:20
Pranvera APOSTOLI,MSc University of Medicine,Tirana, Faculty of Pharmacy
Evidence of gastrointestinal damage related to nsaids in a region of Albania
11:50-12:40
12:20-12:40
Entela Kondo PhD Candidate, Univesity of Barcelona, Spain
European living donor psychosocial follow-up (ELIPSY)
Ina MEXHITAJ, National Institutes of Health, National Institute of Neurological Disorders and Stroke/
Neuroimmunology Branch, Bethesda, United States
Clinical Research: Dynamics of translational reseach: bench to bedside
12:40-13:00
Benjamin T. Gee, Research Fellow, International Virtual e-Hospital Research Fellow, National Telemedicine
Center of AlbaniaImproving patient-physician compliance using web-based technology: Re-thinking diabetes management in
Tirana, Albania
13:00-14:00
LUNCH
12:40-13:40
Lunch
13:40-14:00
Anida GJATA, University of Medicine, Faculty of Medicine
Anemia in chronic heart falure
14:00-14:20
Katina JORGJI, MSc, University of Medicine, Faculty of Pharmacy, Tirana, Albania
Evaluation of the use of Antibiotics without prescription among adults in a Region in Albania
14:50-15:10
Mirjeta GUNI, M.D University of Medicine, Tirana
The Fine Needle Aspiration Biopsy sensitivity in diagnosing thyroid cancer
15:10-15:30
Valdet UKA, PhD Student, Department of Pharmacy, University of Prishtina
The effect of FLT3-kinase inhibitor in combination with a N-glycosilation inhibitor and ER stress inducer on
proliferation, signaling and survival of acute myeloid leukemia cells
15:30-16:00
Coffee Break
10:00-10:40
10:40-11:10
Coffee Break
14:00-14:20
Klejda HUDHRA, University of Tirana, Faculty of Pharmacy
Factors associated with potentially inappropriate medication use in hospitalized elderly identified by STOPSTART criteria. Who is at a higher risk?
14:20-14:40
Malvina HOXHA, Dept. of Pharmacological and Biomolecular Sciences, University of Milan, Italy
Approach to optimize the safety profile of coxibs: Lumiracoxib derivatives with dual cyclooxygenase-2
inhibitor and thromboxane A2-receptor antagonist activity
14:40-15:00
Jetmir ISMAILI, University of Tetovo, Faculty of Pharmacy
Irrational use of antibiotics in the treatment of upper respiratory tract infections in Struga , Republic
of Macedonia
15:00-15:20
Florjana RUSTEMI, M.A- Department of Pharmacy, University of Medicine, Tirana, Albania
Consumption of cardiovascular drugs in Albania from 2008-2011
15:20-15:40
Sani Bajrami, Clinic Hospital of Tetovo, Republic of Macedonia
The role of procalcitonine in the detection of pediatric infections
16:00-16:20
Alida Sina PhD Candidate, Department of Pharmacy, University of Medicine, Tirana, Albania
Comorbidities in chronic obstructive pulmonary disease
16:20-16:40
Blerina RESULAJ, M.D University of Tirana, Faculty of Medicine
The role of physical activity counseling, for better metabolic control and weight reduction in people with Type
2 Diabetes
16:40-17:00
Ermira KRASNIQI,PhD Candidate, Department of Pharmacy,Pristina,Kosovo.
Placebo effect from the application of inert spray without any pharmacological content
15:40-16:10
Coffee Break
Nase Dyrmishi Ph.D Student, Tetovo, Macedonia
Morfological and functional variations of spermatozoids in primary and secondary infertility
16:10-16:30
Emirjona BENDAJ, Phd Student, Department of Pharmaceutical Sciences, University of Urbino, Italy
Corrective Action and Preventive Action Plan in a quality management system in the production of
pharmaceutical active principles
Vinela Refugjati PhD Student
Practical implementation of Integrated Pest Menagement (IPM)in publik restaurants in Albania
16:30-16:50
Arben Boshnjaku, University of Prishtina, Kosovo
Case Report: Treating spondylarthrosis cervicalis with therapeutic combination analgesic muscle relaxant,
tens and kinesiotherapy
16:50-17:10
Alban HASANAJ, MSc. Faculty of Public Health, University of Medicine, Tirana, Albania
Situation assessment nutrition and physical activity in high school students in Tirana
17:10-17:30
Mimoza Shabani, PhD Candidate, University of Prishtina, Kosovo
Cataract, types and clinical manifestion
17:00-17:20
17:20-17:40
Friday 3rd of May 2013
09:00-10:00
Kita SALLABANDA DÍAZ, MD, PhD, Neurooncologyst at Grupo “InstitutoMadrileño de Oncología”
Madrid, Spain
Brain Metastasis Treatment: A giant advance in medicine
10 | I nternational C ongress
of
B iomedical S ciences
A bstracts B ook | 11
Oral presentations
• Adiposity measures and biomarkers in school-aged
children
Olta GISHTI, Romy GAILLARD, Bursa Durmus,
Vincent WV JADDOE MD, PhD
• Cataract, type and clinical manifestation
Mimoza SHABANI, Gani Shabani,Valvita Reçi,
Miranda Selmanaj, Zahir Musa, Ferit Përvetica,
Burim Gashi
• Irrational use of antibiotics in the treatment of upper
respiratory tract infections in Struga (Republic of
Macedonia)
Jetmir ISMAILI, Dehar Rasimi, Zelfirete Limani
• Situation and assessment of nutrition and physical activity
in high school students in Tirana (September-October
2012)
Alban HASANAJ
• Anemia in chronic heart failure
GJATA Anida, Lezha Mimoza, Petrela Ela
• The FNAB sensitivity in diagnosing thyroid cancer
Mirjeta GUNI M.D, Prof.Dr. Agron Ylli,
Prof.Dr. Mehdi Alimehmeti
• Evaluation of use of antibiotics without prescription
among adults in a region of Albania
M.Sc. Katina JORGJI, M.Sc. Ela BEBEÇI and M.Sc.
Pranvera APOSTOLI
• Treatment of diabetic foot ulcers with platelet gel rich in
growth factors
Edlira BORICI
• Treating cervical spondylarthrosis with therapeutic
combination analgesic muscle relaxant, tens and
kinesiotherapy
MSc Pt ARBEN BOSHNJAKU1
Mr.Ph. Ermira Krasniqi PhD cand1,2
• The role of physical activity counseling, for better
metabolic control and weight reduction in people with
type 2 diabetes
Blerina RESULAJ,M.D Prof.Dr.Agron Ylli,
Prof.Ass. Florian Toti
• Ovarian hyperstimulation syndrome caused by an FSHsecreting pituitary adenoma, misdiagnosed as PRLpituitary secreting adenoma
Blertina DYRMISHI. M.D; Taulant Olldashi, M.D;
Prof. Assc Thanas Furreraj; Majlinda Ikonomi M.D;
Vasil Angjeli M.D; Prof. Ass Gentian Vyshka.
• European living donor psychosocial follow-up (ELIPSY)
Martí Manyalich, Ana Menjivar , Ingela FehrmanEkholm, Leonídio Dias, Christian Hiesse, Christina
Papachristou, Niclas Kvarnström, Josep M. Peri,
Xavier Torres, Chloe Ballesté, David Paredes,
Ignacio Revuelta, Fritz Diekmann, Antoni Rimola,
Constantino Fondevila, Levent Yucetin, Entela
Kondo
12 | I nternational C ongress
of
B iomedical S ciences
• Relation of RDW (red blood cell distribution width) with
the presence and severity of coronary stenosis – a large
Albanian cohort study
Alimehmeti I, Siqeca M, Shirka E, Çollaku E, Mijo A,
Seiti J, Aliu Q, Goda A, Ylli A
• Corrective action and preventive action plan (in a quality
management system in the production of pharmaceutical
active principles)
Emirjona BENDAJ
• Placebo effect from the application of inert spray without
any pharmacological content
Mr Ph Ermira KRASNIQI, PhD cand, MSc Pt, Arben
Boshnjaku ,Dr.dent Selda Gjeli
• Consumption of cardiovascular drugs in Albania from
2008-2011
Floriana RUSTEMI
• Study on the application of phytotherapy in Albania
(Tirana area)
Msc.Ina PASHO, Prof. Ass. Vilma Papajani
• Factors associated with potentially inappropriate
medications use in hospitalized elderly identified by
stopp-start criteria. Who is at higher risk?
Klejda HUDHRA, Delina Hudhra, Ela Hoti, Ledjan
Malaj, Besnik Jucja, Aurora Bueno-Cavanillas
• A multitarget approach to optimize the safety profile of
coxibs: lumiracoxib derivatives with dual cyclooxygenase-2
inhibitor-thromboxane a2 receptor antagonist activity
Malvina HOXHA, Valérie Capra, Carola Buccellati,
Angelo Sala, Mohammed Abrar Abdul Gaffar
Shaikh,Clara Cena, Roberta Fruttero, Alberto
Gasco,G. Enrico Rovati,Massimo Bertinaria
• Evidence of gastrointestinal damage related to NSAIDs in
a region of Albania
Pranvera APOSTOLI, Arqile Apostoli, Elizana
Petrela, Suela Këlliçi
• The effect of flt3 kinase inhibitor in combination with
a n-glycosylation inhibitor and er stress inducer on
proliferation, signaling and survival of acute myeloid
leukemia cells
Valdet UKA
• Comorbidities in chronic obstructive pulmonary disease
Alida SINA
• Practical implementation of integrated pest management
(IPM) in public restaurants in Albania, advantages and
challenges
Vinela REFUGJATI, Endri Haxhiraj
• Headache: prevalence and characteristics in Albanian
teenagers
Petro O, Grabova S, Alimehmeti I, Kruja J
• Morphological and functional variations of sperm in cases
with primary and secondary infertility
Ass. MD. Naser DURMISHI, MD. Arian Alili
• Improving patient-physician compliance using web-based
technology: Re-thinking diabetes management in Tirana,
Albania
Benjamin T. Gee
• Osteoporosis and Risk Factors in Women in Tirana
Indrit SEFERI MSc., Prof.Asc.Elizana Petrela.
A bstracts B ook | 13
POSTER PRESENTATIONS
• Relationship of carotid luminal stenosis and neurologic
symptomatology
Altina XHAFERI, Ilirjana ZEKJA, Klodiana POSHI,
Prof. Asc. Astrit Hoxhaj
• Osteoporosis in patients with rheumatoid arthritis
Adela BRAHIMAJ M.D, Ass.Prof.Dr.Teuta BACKA
(ÇIÇO)
• The efficiency of treatment with growth hormone
replacement therapy in children with idiopathic GH
deficiency in Albania
Adela SHKURTI
• Chronic treatment of high blood pressure in Albania
ARSEDA BREGU1 ,Florjana Rustemi 2, Enida Balla3
• Metastatic renal carcinoma to the thyroid gland with 18
f-fdg uptake in the thyroid lodge after total thyroidectomy
Blertina DYRMISHI M.D; Taulant Olldashi M.D; Prof
Ass. Thanas Furreraj; Majlinda Ikonomi M.D; Prof
Ass. Gentian Vyshka; Jolanda Nikolla M.D
• Palliative care in Albania. The experience of EmigliaRomagna Region, Italy
Jana NANO, Prof.Dr. Agim Sallaku
• Assessment of sustainability of primulaacid a by hptlcscanner method in several alcoholic extracts from radix
of Primula veris collected in Albania
Rezarta SHKRELI, Entela Haloçi, Ledjan Cama, Elda
Jano
• BMI impact on neurological diseases
Jora XHAXHO, Ilir Alihmehmeti, Drini DOBI, Jera
KRUJA
• The treatment problems of first permanent molar in
children of University Dental Clinic
Bisela ASLLANAJ, Brovina Diana
• Basal ganglia calcifications secondary to idiopathic
hypoparathyroidism – a similar but different pathology
from the Fahr’s syndrome: Case report
Grabova S, Alimehmeti I, Hoxha V, Zekja I, Bono S,
Papajani M, Ylli A, Kruja J
• In vivo achievable concentrations of idebenone are
unlikely to inhibit oxidative burst of immune cells
Ina Mexhitaj - Simone C. Wuest - Bibiana Bielekova
• Prevalence of chronic complication of diabetes at time of
diagnosis
Taulant MUKA, Florian Toti
• Prescribing pattern of antibiotics in the Pediatric Hospital
of Tetovo, Republic of Macedonia
Edita ALILI-IDRIZI, Ledjan Malaj, Sulltana Asani,
Merita Dauti
• Intensive care aspects of “malignant” toxoplasmosis
MUCO E., Kraja Dh., Pipero P.,Harxhi A., Ndreu A.,
Saro M.,Muhametaj J., Mehmeti J., Gjyzeli M.
• Pharmaceutical control analyses of some paracetamol
sirups registered in Albania
Entela HALOÇI, Stefano Manfredini, Rezarta
Shkreli, Enkeljeda Goci, Ledian Cama
• Chest pain: characteristics and management of patients
in the emergency departmetnt of University Hospital
Center of Tirana
TOPI Geriolda, MD; Zaimi Edmond, MD, DSc
• Interactions between herbal preparations and synthetic
medications, and the role of pharmacists in the prevention
Ela BEBECI, Vilma Papajani
14 | I nternational C ongress
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• The role of pharmacists in healthcare in Republic of
Macedonia compared to the EU countries
Merita DAUTI, Ledjan Malaj, Edita Alili-Idrizi, Sihana
Lika
• Diabetes-related emergencies in Albania – Are the
guidelines being followed?
Keri D, Ylli A, Zaimi E, Alimehmeti I
• Assessment, evaluation, and follow-up of incidentally
discovered adrenal formations by radiologic examination
(incidentalomas): A two-year study
Burda I, Shkurti A, Ylli A, Alimehmeti I
• Comparison between enzyme-linked immunosorbent
assay (ELISA) and enzyme linked fluorescent assay
(ELFA) for the detection of Toxoplasma gondii antibodies
Blerta LAZE¹, Anila Mitre², Blerta Dardha², Hysnela
Marra²
• Comparison of chromosome banding analysis and
interphase FISH in chronic myeloid leukemia patients
treated with Gleevec
D. ROKO, A. Babameto - Laku, V. Mokini, M.
Cikuli
• Variability of parathyroid hormone and other markers of
bone mineral metabolysm in Albania
Merita RUMANO1, Anila MITRE1, Elvisa RUMANO2,
Jotilda JOTI3
• The information about dental instructions in patients with
hemophilia in the Albanian society
Neada HYSENAJ, Florion Tabaku, Xhanina Gavazi
• Patients-perceived family and social support in managing
diabetes
Zeqja Anisa, Keri Denisa, Gee Benjamin, Alimehmeti
Ilir
• Water need assessment in Shkodra
Adrian Hoxha M.D, Odelia Risilia M.D , Petrit Shehu,
BCS. Klejda Risilia, Msc. Genc Dervishi, Msc.
Edjona Bici
• Evaluation of microclimate in the health centre of Bathore
Tirane
Msc. Edjona Bici, Msc. Genc Dervishi, Petrit Shehu
M.D, Adrian Hoxha M.D
• Alloimmunization of Rh-D Negative Pregnant Women in
Albania
Estela MUHO, Irena Seferi, Erind Cafi , Jonida
Pengu
• Alcoholic liver cirrhosis (complications and prognosis)
Resuli Bashkim, Carkanji Anisa
A bstracts B ook | 15
STUDENT’S PRESENTATIONS
Adiposity measures and biomarkers in school-aged children
Olta GISHTI, Romy GAILLARD, Bursa Durmus, Vincent WV JADDOE MD, PhD
• Biliary obstruction treatment
Denisa NAZARKO1, Ledina Mesiti1, Dr.Denis Godaj2,
Prof.Ass. Xheladin Dracini2, Prof.Ass. Arvin Dibra2,
Prof.Dr. Etmont Celiku*
• Thyroid cancer diagnosis and treatment
Frosina SHIRA, Arjana Zerja, Belina Hoxha, Elda
Kadra, Liridona Koloshi,Denis Godaj,
Prof.Ass.Xheladin Dracini, Prof.Dr Etmont Celiku.
• The increasing role of the pharmacist in skin diseases,
drugs use and cosmetic products: What’s more to know?
Joana Mihani, Elona Saqe ,Paola Moni
• Infant mortality in republic of Kosova during 2005-2010
Floran SAHITI, Mergita Ferizi, Jehona Krasniqi,
Shqipërim Aliu
• Treatment of prominent frenulum with 980nm Diode Laser
Dritan Ismailaj
• Nutritional status and dietary habits of students in Tirana,
Berat and Korça
MEÇANI Holta, Xhemollari Lodrina, Cjapi Lysjena,
Hoxha Meri
• Approach to upper gastro intestinal bleeding
Ina SHEHAJ, Etleva Kurti, Denis Godaj, Prof. Asc.
Xheladin Dracini, Prof.Asc. Arvin Dibra, Prof. Dr.
Etmont Celiku
• Surgical treatment of inguinal hernia
Amela HASA, Bora Muhametaj,Erilda Zyka in
collaboration with Prof.Asc.Arvin Dibra
• Clinical, laboratory and ultrasound findings in acute
appendicitis at first surgical clinic – Tirana, University
Hospital Center “Mother Teresa”
Najada STRINGA, Adela Kadaraku, Advin Dibra M.D
• The treatment of ureteral stones with ESWL at urological
clinic during 2010-2012
Aurela MIFTARI, Edip BEZHANI, M.D
• Telling the truth to the patient about the diagnosis and
prognosis and how does this effect on physician-patient’s
collaboration and in the treatment efficiency
Eralda LEKLI, Joana Hankollari, Ritjana Mala, Prof.
Dr. Bardhyl Cipi
• Physical activity, sedentary lifestyle and fitness level
among college students in the University of Medicine in
Albania
Janko M, Xherahu E, Xhavara E, Memia A, Shehi E,
Alimehmeti I, Toti F
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• A two-year retrospective study of risk factors for stroke
among adults under 55 years in Albania
Lekli E1, Hysenaj A1, Ajdini A1, Grabova S2,
Alimehmeti I3, Dobi D2, Kruja J2
• Rheumatoid factors, anti-mcv antibody, anti-jo-1 antibody
levels and mucoproteins in rheumatoid arthritis
Retina ÇAPUNI, Shqipe Bektashi, Petrit Gecaj,
Dashnor Fiska, Steljan Buzo
• Anatomopathological diagnosis: the components that
improve and insure its quality.
Dea MATALLARI, Eneida Karriqi, Romina Zerellari,
Norik Bardhi
Erasmus Medical Center University, Rotterdam, Netherlands
Introduction Worldwide, the prevalence of childhood
obesity is strongly increasing and it is a major public health
problem. (1,2) Childhood obesity is strongly associated with
adverse health outcomes in childhood and adulthood. (6)
Childhood overweight and obesity are usually determined
by using weight and height to calculate body mass
index (BMI) (kg/m2). However, this measure is unable to
distinguish lean body mass from fat mass. A more direct
measurement of fat mass and a better measure of adiposity
is a fully equipped duel-energy x-ray absorptiometry (6)
Previous study, have shown that fat mass assessed by
DXA is strongly associated with cardiovascular risk factors
in adults. (5)
Objective The aim of this study was to assess the crosssectional associations of abdominal adiposity assessed by
ultrasound with childhood gender, age, anthropometrics and
body fat assessed by DXA scanning. We also examined the
associations of abdominal adiposity with lipid profile and
liver enzymes.
Study design This study was embedded in the Generation
R Study, a population-based prospective cohort study from
early fetal life onwards in Rotterdam, the Netherlands. (12)
Mothers were enrolled during pregnancy between 2001
and 2005. Response rate at birth was 61%.Assessment
during pregnancy, were performed in first, second and
third trimester. Between 2008 and 2012, mothers and their
children were invited to our dedicated research centre to
participate in detailed growth and body composition follow
up study measurements. In total 6653 children participated
in the follow up study at the age of 6 years (median, 95%
range)
Covariates Weight and height of the children were
measured in light clothing and without shoes. Body mass
index (kg/m2) was calculated
Total body and regional fat mass was measured using a
Dual-energy X-ray absorptiometry (DXA) scanner (iDXA,
GE-Lunar, 2008, Madison, WI, USA), which analyzed bone,
fat and lean masses (%) with the enCORE software v.12.6.
The specific fat phenotype was measured using android/
gynoid ratio, total body lean mass and total body fat mass
All ultrasound examinations of the study were performed
with an ATL HDI 5000 (WA, Bothell). Preperitoneal and
subcutaneous fat thicknesses were measured with a linear
(L12-5 MHz) transducer according to the method described
by Suzuki et al. in adults (11). The infants were in a supine
position. A linear transducer was placed
Blood samples were drawn by antecubital
venipuncture. Thirty minutes fasting venous blood
samples were obtained from the children and
cholesterol, low density lipoprotein cholesterol,
high density lipoprotein cholesterol, triglycerides,
insulin, alanine-amino transferase and aspartatamino transferase levels were measured in 69%
of the participants by well-trained research nurses.
Statistical analysis First, we assessed gender differences
in childhood anthropometrics measures, total body fat mass
measures and abdominal fat mass measures using Student’s
t-test, as two independent samples. Next, we examined
the correlations between childhood anthropometrics, total
body fat mass measures, abdominal fat measures, lipids
and liver enzymes using Pearson correlation coefficients
and Spearman rank correlation coefficients.
A bstracts B ook | 17
Second, we assessed the associations of childhood
anthropometrics with total body fat mass measures and
abdominal fat measures using linear regression analysis.
We also performed linear regression analysis to assess
the associations of total body fat mass measures with
abdominal adiposity fat mass measures.
Results Table 1 shows the differences in boys and girls
for all measures done at focus at 5 visits in our research
centre. We do see a slightly gender difference, which was
not statistically significant.
We have run the correlation between all our covariates and
we saw a significant and high linear correlation between
abdominal fat measures and total fat mass, measured by
DXA scanning. We can clearly identify high correlation
between BMI and DXA measures. Correlation between BMI
and US measures is also high, but not as high as DXA. So
we can conclude that another good and precise measure
of obesity might be DXA scanning. But this is still to discus,
because of the costs and radiation of DXA. Table 2
Our table 3 shows the association between
anthropometrics measures and obesity measures.
We found the same results as in the correlation
analysis. We can clearly identify that association of
Body mass index is higher among DXA measures
and we can se that our beta coefficient is bigger on
the association of BMI with total fat mass.
Keywords: Children, visceral adipose tissue, subcutaneous
adipose tissue, sonography, DXA scanner, body fat mass
Anemia in chronic heart failure
GJATA Anida, Lezha Mimoza, Petrela Ela
University of Medicine, Faculty of Medicine, Tirana, Albania
Introduction Anemia is common in patients with chronic
heart failure (CHF). It is related to many condictions and on
the other side can influence the prognosis of heart failure
patients.
Objectives The aim of this study was to evaluate the
prevalence of anemia in heart failure patients and to
investigate its relationship with some concomitant factors.
Methods Data were collected on retrospective heart failure
patients wich attended the clinic of cardiology in QSUT
from January to September 2012, in whom hemoglobin
concentration were evaluated. Anemia was defined as
hemoglobin concentration <13 g/dl in males and <12 g/dl
in females. Patients with anemia from other causes were
excluded.
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Results There were an overall of 452 heart failure cases
included in this study. The prevalence of anemia in heart
failure population was 49.1%. Anemia was more common
in males, in older patients, in patients with a severe heart
failure (NYHA-4) and with left heart failure. The ischemic
etiology, hypertension, obtained valvular desease and
idiopatic dilated cardiomyopathy were the most frequented
causes of CHF in anemic patients. Hipertension (HT),
Diabetes Mellitus (DM) and Chronic Kidney Desease
(CKD) were frequently founded in the anemic population.
Anemia was significantly correlated to age (p=0.0007),
sex (p=0.0000), NYHA funxional class (p=0.048), ischemic
etiology (p=0.005), HT (p=0.045), DM (p=0.005), CKD
(p=0.0000), Ejection Fraction (EF) (p=0.002). 69.2% of the
patients with more then one recovery were anemic. 100% of
the dead patient (4 patients) were anemic.
Conclusions Anemia is very common in heart failure
patients. It is significantly associated with several
concomitant desease.
Keywords: Chronic heart failure, Anemia, Haemoglobin,
Prevalence, Association.
The role of physical activity counseling, for better metabolic control and
weight reduction in people with type 2 diabetes
Blerina RESULAJ,M.D Prof.Dr.Agron Ylli, Prof.Ass. Florian Toti
Introduction and aims Physical activity (PA) in people
with type 2 diabetes helps to improve metabolic control,
lipid profile, and to reduce weight. The aim of our study was
to demonstrate the effect of a single session of PA to the
glycemic profile, and the effect of increasing daily physical
activity on the weight and lipid profile.
Methods 50 patients were recruited for a 8 weeks training
session. Every PA session lasted 30 minutes of fast
walking. The number of daily steps was measured through
a pedometer, and all the participants were encouraged to
complete at least 10000 steps/day. All the patients had
completed anthropometric measures, fat body composition
and lipid profile at the beginning and the end of study period.
Results 30 (60%) of the patients completed the 8 weeks
training session, 17 (56.6%) males. Mean age 52.07±11.3
yrs, mean diabetes duration 4.37±2.9 yrs. Mean HbA1c
decreased from 8.43±1.09% to 8.17±1.07% (p=0.07),
mean weight 81.74±20.8kg vs. 79.47±20.11 kg (p<0.05),
mean of daily steps 4535±2590 vs. 11315±2013.6 (p<0.01).
Body fat composition decreased from 33.04±11.8% to
31.09±11.2% (p<0.05). The patients had a slight increase
in HDL cholesterol 54.7±7.65 mg/dl to 59.05±7.29 mg/dl.
Conclusions Physical activity, even in simple everyday
actions, is an important part of diabetes treatment and
weight control. Counseling and encouraging people with
diabetes to increase their daily PA is very important. We
have to assure measurable results to help diabetic patients
to implement and increase PA in their daily life.
Ovarian hyperstimulation syndrome caused by an fsh-secreting pituitary
adenoma, misdiagnosed as prl-pituitary secreting adenoma
Blertina DYRMISHI. M.D; Taulant Olldashi, M.D; Prof. Assc Thanas Furreraj;
Majlinda Ikonomi M.D; Vasil Angjeli M.D; Prof. Ass Gentian Vyshka.
Hygeia Hospital Tirana-Albania
Introduction We report a young woman with ovarian
hyperstimulation syndrome (OHSS), headache, visual
field defects and pituitary macroadenoma. The patient
was misdiagnosed as a pituitary PRL-secreting adenoma.
He was treated with Cabergoline, without evaluation of
FSH, LH and Estradiol values. The prolactin values with
A bstracts B ook | 19
treatment went to normal, but the estradiol remain elevated
even after treatment with Cabergoline and the complication
was OHSS. The biopsy of the ovaries was negative for
malignancy (follicular luteinisation cysts). The case was
treated with GnRH-agonist by the gynecologist, but the
ovaries remained hyperstimulated and the estradiol’s
and FSH’s values very high. A pituitary, FSH-secreting,
macroadenoma was suspected and the patient underwent
surgery.
The laboratory results: B-HCG negative; Prolactin 83 ng/
ml (N 4.3-32.3ng/ml); FSH 103.3 UI/l (N 6.3-22 UI/l); LH 1.9
(N 1.5-8 UI/l); Estradiol >3000 pg/ml (N 38-200). The other
hormones were normal.
MRI of the head: pituitary macroadenoma (the dimensions
35 x 2 x 25 mm) with compression of optic chiasm.
Immunohistochemical staining of the pituitary adenoma
specimen was positive for α subunit, FSHβ subunit and
LHβ subunit; staining was negative for growth hormone,
prolactin, adrenocorticotropic hormone and for TSH.
Conclusions: Surgical resection is the primary and
definitive therapy for OHSS due to gonadotropin-secreting
adenomas. Surgery results in normalisation of gonadotropin
and estradiol levels. Menstrual cycles resume and the
ovaries revert to normal size with cyst remission. In those
with recurrent tumors, radiation therapy may be required.
Keywords: clinically prolactin secreting adenoma;
follicle-stimulating hormone; gonadotrope adenoma;
hypersecretion; ovarian hyperstimulation syndrome.
European living donor psychosocial follow-up (ELIPSY)
Martí Manyalich1, Ana Menjivar2 , Ingela Fehrman-Ekholm3, Leonídio Dias4, Christian Hiesse5,
Christina Papachristou6, Niclas Kvarnström3, Josep M. Peri1, Xavier Torres1, Chloë Ballesté7, David
Paredes1, Ignacio Revuelta1, Fritz Diekmann1, Antoni Rimola1, Constantino Fondevila1, Levent
Yucetin8, ENTELA KONDO1 Hospital Clinic of Barcelona, Barcelona, Spain; 2 Fundació Clínic de Barcelona, Barcelona, Spain; 3 Sahlgrenska
University Hospital, Göteborg, Sweden; 4 Centro Hospitalar do Porto, Porto, Portugal; 5 Hôpital Foch, Paris,
France; 6Charité University Hospital Berlin, Berlin, Germany, 7 Universitat de Barcelona, Barcelona, Spain,
8
Medical Park Antalya Hospital Complex, Antalya, Turkey.
1 Introduction ELIPSY is a project co-funding by EAHC with
the aim to develop a common methodology for all transplant
centres to assess/follow-up the psychosocial sphere of the
Living donor (LD).
This European multicenter study was conducted in 6 different
countries (Germany, Spain, France, Portugal, Sweden, and
Turkey) and examined the psychosocial outcome and the
impact of donation process in LDs. The study concern both
kidney and liver living donors.
Aim To contribute guaranteeing a high quality of living
organ donation programs by creating a follow-up model for
the LD’s psychosocial well-being and quality of life (QOL),
including the impact of the recipient’s outcome on the donor
and the donor’s perception of the donation process.
Methods Working tasks:
Current psychosocial follow-up practices: LD’s assessment/
follow-up methodology among partner’s centers.
Donor follow-up methodology: Evaluate the psychosocial
well-being and the QOL of the donor before and after
donation, as well as the impact of donation process.
Recipient follow-up: Design a recipient follow-up
methodology to correlate the recipient’s outcome with the
LDs psychosocial well-being.
Studies:
Prospective: compare the psychosocial well-being and QOL
of the donors prior to donation and 1 year post-donation,
including the impact of the recipient’s outcome.
20 | I nternational C ongress
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Retrospective: evaluate the long-term impact (up to five
years) through evaluation of psychosocial well-being, QOL
and impact of recipient’s outcome in donors.
Results Survey about current psychosocial assessment/
follow-up practices was conducted in 65 centres from 10
countries. Results show no consensus while performing LD
psychosocial assessment/follow-up practices.
Post donation psychosocial wellbeing of LDs and their
satisfaction one year after donation are linked to their
psychosocial profile before donation. Psychosocial risk
and protective factors for LDs are identified by making
group comparison. Prospective and retrospective study
data analyses suggested a favorable QOL outcome for
most donors as indicated by SF-36 scores felling within the
normal range compared to the general population. Strong
relationship with the recipient before donation influence in a
better post - donation general QOL for the LDs
Conclusions ELIPSY project contributes for the
harmonization of LD psychosocial follow-up among Europe
to guarantee a high quality of LD programs.
Keywords: Living donation, Quality of life, Psychosocial
aspects, Living donor assessment, Kidney transplantation
– Liver transplantation
A bstracts B ook | 21
Cataract, type and clinical manifestation
The FNAB sensitivity in diagnosing thyroid cancer
Mimoza SHABANI*, Gani Shabani**, Valvita Reçi ***, Miranda Selmanaj ***, Zahir Musa**,
Ferit Përvetica ** , Burim Gashi **
Mirjeta GUNI M.D, Prof.Dr. Agron Ylli, Prof.Dr. Mehdi Alimehmeti
“Mother Tereza” University Medical Center, Tirana, Albania
*Department of Ophthalmology ,Mitrovica Hospital and Clinical University Center of Kosova,
**Department of Physiology, University of Prishtina and University of Tirana
Introduction A cataract is a gradual change in the structure
of the lens in an eye, which makes it gradually more and
cloudy.
The lens should normally be clear. But, with cataracts, the
affected lens becomes like frosted glass. A cataract is when
the lens of an eye becomes cloudy and affects to your
vision.
The prevalence of blindness in developing countries is
about 15– 45 times higher than in developed countries.
Methods A focus of our research has been changing of
lens eye by the age 40 further. This study was conducted
in the Hospital of Mitrovica department of Ophthalmology
and Clinical University Center of Kosovo department of
Ophthalmology.
This study was performed on patients` consecutive
examination of males and women.
Examination of eyes was performed by ophthalmologists
and medical doctors (Ophthalmology students),Mitrovica
Hospital and Clinical University center of Kosovo,
department of Ophthalmology.
Results After cataract treatment,most of people (around
95%) will improve vision almost immediately. After cataract
surgery, complications are very rare and patients may feel
mild discomfort for a few days. However, cataract surgery
will not always completely restore your vision.
One person in 1,000 will experience a complication.
Conclusions Cataracts can present with a large variety of
histopathologic changes in lens` eye. Men and women are
equally affected.These cataractous changes can involve
any of the structures of the lens including the nucleus and
the cortex, as well as anterior and posterior subcapsular
areas.
A number of risk factors are associated with cataract like
older age, inheritance, diabetes, hypertension, race,
smoking etc. Often both eyes are affected, but one eye may
be worse than the other..
There are many risk factors and associations for age related
cataract.
Keywords: Cataract, Types, Clinical Manifestation, Surgery
Introduction Ultrasound-guided FNAB (fine needle
aspiration biopsy) is a diagnostic tool characterized by
simplicity, quickness of execution,high sensitivity and low
cost. The sensitivity of FNAB varies in diferent countries.
Four reasons for low sensitivities were identified: tumors
missed at aspiration, microscopic misinterpretations,
diagnoses of cellular atypia and indeterminate diagnoses.
Results In 52 patients diagnosed with thyroid cancer after
histological postoperative examination, 10 (19%) resulted
with benign nodule at FNAB before intervention [8 of them
resulted papillary cancer follicular variant and 2 were
microcarcinomas in multinodular goitres] 12 (23%) of them
resulted suspicious and 30 (57 %) resulted malignant in
FNAB examination. The sensitivity of FNAB resulted 81%.
Aim The objective of our study was the retrospective
evaluation of the FNAB (fine needle aspiration biopsy)
sensitivity in diagnosing thyroid cancer in patients with
malignancy histological results post intervention.
65% of the patients diagnosed with thyroid cancer had a
solitary nodule and 35% had multinodular goitre. In 85%
of the cases predominates female sex and the median age
was 42 years.
Methods In this retrospective study were evaluated 52
patients diagnosed with thyroid cancer after post-operative
histological examination, from the year 2008-2012, in Tirana
Albania. The age of the patients varies from 20-60 years.
These patients underwent thyroidectomy in the department
of surgery at Mother Teresa Hospital. FNAB was performed
before the intervention under ultrasound examination.
In these patients diagnosed with thyroid cancer after
thyroidectomy (performed for seveveral reasons) was
evaluated the FNAB sensitivity.
Papillary cancer is responsible for 90% of the cases, 6%
follicular cancer, no case with medular cancer and 2 patients
resulted with anaplasic thyroid cancer.
Conclusions The FNAB sensitivity in diagnosing thyroid
cancer resulted 81%. The cases with beingn FNAB before
the operation resulted with papillary carcinoma follicular
variant (65%) and microcarcinomas in multinodular goitres
(15%) in post operative histological examination, wich are
the main causes of the reduction of the FNAB sensitivity.
Diagnosis methods, Pre-operative tests:
Refraction,Near and distance visual acuity- LogMAR
scale, Biometry,B-scan ultrasonography, if no fundus
view obtainable,Other optional tests corneal topography,
specular microscopy.
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A bstracts B ook | 23
Relation of RDW (red blood cell distribution width) with the presence and
severity of coronary stenosis – a large Albanian cohort study
Alimehmeti I1, Siqeca M2, Shirka E2, Çollaku E2, Mijo A2, Seiti J2, Aliu Q3, Goda A2, Ylli A1
products, but enables also better recognition of the
most important key-points of this system, allowing so the
improvement of possible defects and the prevention of
possible anomalies that may have a high impact in the
safety and efficacy of the final products.
Conclusions CAPA Plan is a necessary support to improve
the productive process and a very important plan for
reducing the costs of a company.
Keywords CAPA Plan, quality management system, APIs
1 Service of Endocrinology, UHC “Mother Theresa”, Tirana - Albania
2 Service of Cardiology, UHC “Mother Theresa”, Tirana – Albania
3 Service of Internal Medicine, UHC “Mother Theresa”, Tirana – Albania
Introduction RDW measures the variability in red blood cell
size. It has been recently reported as a possible independent
risk marker of various micro and macrovascular pathologies.
Methods 1.251 consecutive patients, who underwent
coronary angiography during 2012, were enrolled in the
study. Presence or absence of coronary artery disease
(CAD) was determined for all the patients. Severity of
coronary stenosis was calculated using the Gensini score.
All known CAD risk factors were also noted. RDW was
analyzed to identify the relationship with CAD and its
severity.
Results Of 1.251 patients, 882 (70.5%) were males and
369 (29.5%) were females. Males were slightly younger
(61.3 vs 61.6 years old) and less overweight (BMI 26.6 vs
27.4 kg/m2), confirming that male gender is an independent
risk factor for CAD. RDW had a positive correlation with the
presence and severity of CAD (OR = 1.28, 95% CI).
Conclusions RDW is a cheap, simple and readily available
clinical laboratory value that may be an independent
predictor for angiographic CAD to be used in future.
Corrective action and preventive action plan (in a quality management
system in the production of pharmaceutical active principles)
Emirjona BENDAJ, Phd Student, Department of Pharmaceutical Sciences, University of Urbino, Italy
Introduction In this article are provided data about
CAPA Plan (Corrective Action and Preventive Action
Plan), its importance and the manner of organization
in a pharmaceutical company that produces active
pharmaceutical ingredients (APIs). This plan is a summary
of all documented measures taken and has the aim to make
a systematic investigation of all deviations that occur in a
quality system of a pharmaceutical company (failure) and
the duty to correct each recurrence (Corrective Action)
or to prevent these deviations (Preventive Action) before
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happening, identifying the vulnerable parts of the system.
Placebo effect from the application of inert spray without any
pharmacological content
Mr Ph Ermira KRASNIQI, PhD cand1,3 MSc Pt, Arben Boshnjaku2 Dr dent Selda Gjeli4
1Pharmaceutical manifacturer TrePharm 2Physiotherapy Clinic Fixoterapia 3University of Medical Sciences
Rezonanca 4Dent-in Dentistry Clinic
Introduction The aim of our research lies on the justification
of high level spray usage as a pharmaceutical form in order
to reduce pain or muscular fatigue, especially in sports.
Methods A number of 50 individuals participated in this
research and each one of them was subjected to a physical
strain after which they self-rated the muscular fatigue/pain.
Then an inert spray (without any pharmacological content)
was thrown on the same muscles and it was requested from
the tested person to re-evaluate the grade of muscular pain/
fatigue, while never been told about the real spray content.
Results On this research Placebo Effect (PE) was
evidenced in 34 out of 50 tested individuals, that means in
68% of the cases. An interesting fact was that PE was more
present at males rather then females (75% to 58.82%),
while a particular importance was given to the presence of
PE between ages during which elder ages were dominant.
This research also compared the presence of PE by living
environment (rural or urban), and the camparison between
the dominant side of individuals, during which the results
were quiet interesting.
Conclusions Subject expectations on pain reduce present
a crucial factor in both treeting/rehabilitation proces and
also during everyday life, therefore we estimate that every
medical care procesional must seriously consider this factor
during treeting and rehabilitation proceses of his patients.
Keywords: Placebo effect, expectation, perception
Methods This study is made during a period of internship
in an Italian pharmaceutical company that produces APIs,
by consulting the relating guidelines, all the archived
documents and preliminary events registered during the
productive process.
Results CAPA Plan serves not only as an efficient valuator
of the quality system in the production of pharmaceutical
A bstracts B ook | 25
Consumption of cardiovascular drugs in Albania from 2008-2011
Study on the application of phytotherapy in Albania (Tirana area)
M.A. Florjana RUSTEMI - Department of Pharmacy, University of Medicine, Tirana, Albania
Msc.Ina PASHO, Prof. Ass. Vilma Papajani
Introduction This study is based on consumption and
prescription of cardiovascular drugs in Albania from 20082011. Information necessary for this study include data from
National Institute of Healthcare (NIH) and from importers
of drugs. These data can be used to identify problems that
merge from drugs use and to improve the standards of care.
Studies on security that have an impact on the healthcare
service are studies of drug consumption according to ATC/
DDD criteria and cost under ABC criteria.
Results The oscillations of DDD between districts are
observed as a result of:
In quantitative terms, the evaluation of prescriptions is given
by the number of recipes prescribed/year for each class of
cardiovascular drugs and through the prescribed number of
recipes/1000 capita/month.
Qualitative aspect of the prescription is estimated through
ratio of DDD group (second level ATC classification) versus
the total number of DDD entire class of cardiovascular
drugs (first level ATC classification) at the district level
and national level. This report reflects the selection profile/
prescription of cardiovascular drugs between groups.
Assessment of consumption of drugs is done through the
prescribed number of DDD/consumed per 1000 inhabitants/
day.
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Misuse or no use of treatment protocols or
guidelines by GPs.
2.
The “prescription only” drugs are often given
without prescription by doctors and pharmacists.
Conclusions
1.
Methods For each drug is calculated prescription/
consumption in terms of DDD, as the sum of its dosage
forms.
1.
2.
In all groups of cardiovascular drugs is observed high
variability in the way of prescription and consumption
between districts and within the same district.
From 2008-2011 the study shows increase in overall
consumption of medicines used to treat cardiovascular
diseases.
3.
Urgent need of use of treatment protocols, treatment
guidelines and continuing medical education for
pharmacists and GPs.
4.
There are statistically significant differences (P <0.05)
in the way of prescription and consumption, for certain
groups of cardiovascular drugs, such as between
districts and between districts and national average
values.
Introduction Phytotherapy is a form of medical treatment
which relies on the use of plants, either the entire plant,
or in the form of a prepared extract. The use of products
of herbal origin with therapeutic purpose is constantly
increasing. In Europe, Germany is the country with the
greatest usage, per capita of the population, of medicinal
plant preparations. This study, as the first quantitative
evaluation on phytotherapy application in our country (area
of ​​
Tirana), aims to study and identify the use of herbal
preparations in Albania.
Methods The study was performed using an anonymous,
structured questionnaire, with the aim to describe the
use and the public opinion regarding the effectiveness of
herbal medicines. Results are based on the questionnaires
collected from May 2011 to May 2012. The questionnaires
were delivered randomly to 200 people, while the results
take in consideration their gender, age, education and the
most common disorders for which herbal medicines are
used for.
Results By gender, herbal preparations have resulted to
be used mainly by women (94.87%); by age, pensioners
(69.2% of them use herbal remedies more than 10 times per
year), followed by 45-59 years group (62.5% of them); while
in terms of education it is more frequently noted in persons
with higher education. In general it appears that selfmedication predominates in the application of phytotherapy.
According to the study, the reliability of the population in
the effectiveness of herbal medicine is 40.1%, almost the
same as the belief in the effectiveness of synthetic drugs.
Herbal medicines have resulted to be more used in the
treatment of these diseases and disorders: respiratory tract
illness (cough, influenza), the treatment of kidney stones,
gastrointestinal tract disorders (constipation, diarrhea,
nausea), sleep disorders, etc.
Conclusions The results of the study show that the use
of medicinal plants and their preparations in preventing
and treatment of a variety of diseases is increasing in our
country.
Keywords:
medicines.
Medicinal
plants,
phytotherapy,
herbal
Keywords: Cardiovascular drugs, consumption,
prescription, ATC/DDD code.
A bstracts B ook | 27
Irrational use of antibiotics in the treatment of upper respiratory tract
infections in Struga (Republic of Macedonia)
Evaluation of use of antibiotics without prescription among adults in a
region of Albania
Jetmir ISMAILI, Dehar Rasimi, Zelfirete Limani
M.Sc. Katina JORGJI, M.Sc. Ela BEBEÇI and M.Sc. Pranvera APOSTOLI
Department of Pharmacy, Faculty of Medicine, University of Tirana, Albania
State University of Tetova, Faculty of Medical Sciences-Study program Pharmacy
Introduction Antibiotics overuse is a global public health
issue influenced by several factors. Antibiotics are drugs
used to treat bacterial infections, but they can cause
more harm than good when not used properly. Irrational
antibiotics use is a major reason for the spread of antibiotic
resistance. Misconceptions about antibiotic use potentially
lead to inappropriate use of antibiotics. This populationbased study was aimed at examining common knowledge,
beliefs, attitude and practice regarding the use of antibiotics
and self medication in the city of Struga, (R.of Macedonia).
Methods In this cross-sectional population-based survey,
800 peoples received a questionnaire. The population of
the study was adults (over 18 years old). The study was
executed between November 2012 to January 2013. A
cluster random sampling technique was applied. Data were
collected using a pre-tested questionnaire and analyzed
using descriptive statistics and correlation.
Results A total of 800 respondents was approached and 621
respondents completed the questionnaire (78% response
rate). Most people in the study have appropriate knowledge
regarding their effectiveness for bacterial infections
(82%). Fewer than half (42%) reported selfmedication
with antibiotics during the previous year, mostly to relieve
sore throat. Almost 39 % of respondents did not complete
their last course of antibiotic, 36% requested antibiotic
prescriptions from clinicians. Further most of participants
(71%) have incorrect knowledge regarding the use of
antibiotics for viral infections. Fewer than half believe that
antibiotics have no side effects (37%).
Conclusions Inappropriate misconceptions and overuse
of antibiotics exists among citizens of Struga. Appropriate
beliefs regarding antibiotic use may lead people becoming
more aware of the disadvantages of using antibiotics
inappropriately. The rational use of antibiotics may be
favored by improving knowledge about these drugs. Based
on the findings of this present study, further studies are
suggested.
Keywords: Antibiotics, Struga, irrational, questionnaire,
knowledge.
Introduction Self medication is defined as the utilization of
drugs to treat self-diagnosed disorders or symptoms, or the
irregular or continuous use of a prescribed drug for chronic
or repeated diseases or symptoms. The chemotherapy of
bacterial infections depends on the isolation of the aberrant
agent, categorization of the agent’s antibiotic susceptibility
and bringing the suitable antibiotic to the site of infection in
adequate quantities to either kill the bacteria (bactericidal)
or modify it to permit the body’s immune response to
eventually kill it.
The main problem with self medication with antimicrobials
is the emergence of pathogenic resistance. Antimicrobial
resistance is an existing problem world-wide, mainly in
developing countries where antibiotics are often obtainable
without prescriptions. The increase in antibiotic resistance
in developing countries is of current public concern as it
results in multiple resistant organisms leading to infections
not easy to treat. The determinants of self medication with
antibiotics in low-income countries mainly include over-thecounter sale of antibiotics, the cost of medical consultation,
lack of agreement with medical practitioners, and
misconception concerning the effectiveness of antibiotics.
Aim
1. To investigate the prevalence of purchase of
antibiotics without prescription and appropriateness
of use among adults.
2. To determine the impact of the education level on
the sensibility level over the use of antibiotics.
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Methods This was a questionnaire based study of 3 month
duration and locus of the study was the population of
Tirana and Fier. After collecting signed Informed Consent,
A pre-validated questionnaire was distributed to 350 people
who visited our pharmacies in Tirana and the Private
Medical Clinic in Fier. Also a part of questionnaires were
distributed by e-mail, to all the people we had contact with
and who had nothing to do with medicine or pharmacy. The
questionnaire consists of specific questions regarding the
knowledge about dose, duration of therapy, adverse effects
of medicine used as self medication and to know the source
of information of medicine used as self medication.
Statistical analysis Statistical analysis was performed
using programs available in the SPSS statistical package
(SPSS 20.0). All variables were tested for normal distribution
of the data. Data are shown as mean ± SD. A chi-square
test was used for categorical variables. P < 0.05 (twotailed)
was considered statistically significant.
Results Use of antibiotics within the past 12 months was
reported by 343 participants (46,7%). 289 individuals
(39,3%) reported that they had received antibiotics
without medical prescription at least one time in the past
12 months. The major source of self-medication was the
pharmacy without prescription (36,40%) followed by their
own experience (28,51%) and leftover medications at home
(18,86%). The most frequently self-medicated antibiotics
were amoxicillin (19.39%), amoxicillin/clavulanic acid
(15.24%), ciprofloxacin (8,86%). Also 6,37% of the patients
wrongly named the antibiotic and 7,76% didn’t even know
A bstracts B ook | 29
the name of the antibiotic that they were treated with. Fever
(29,23%), sore throat (29.06%) and cough (14,19%) were
the most frequent indications for their use.
Finally, 29,05% of the participants reported earlier
discontinuation of antibiotics when symptoms improved.
Discussion The findings from this study highlights the
striking prevalence of self medication among population in
a reagion of Albania, the lack of knowledge and the risks
associated with them. The availability of more complex
drugs groups such as antibiotics without prescriptions is
a source of great concern. Moreover, the practice of self
medication often has many adverse effects and can lead
to many problems, including the global emergence of MultiDrug Resistant pathogens, drug dependence and addiction,
masking of malignant and potentially fatal diseases,hazard
of misdiagnosis, problems relating to over and under
dosaging, drug interactions and tragedies relating to the side
effect profile of specific drugs. The challenge in controlling
the problem of self medication is to achieve the necessary
high level of consumer safety. It may be recommended that
by monitoring usage of self medication, in addition to data
recording and education, safe and effective use of such
medicines can be promoted.
Conclusions Self management of acute, intermittent and
long-term conditions is likely to become more extensive in
the future. A balance needs to be struck between safety and
patient autonomy.
We recommend that a holistic approach must be taken to
prevent this problem from escalating which would involve
awareness and education regarding the implications of self
medication, strategies to prevent the supply of medicines
without prescription by pharmacies and strict rules regarding
pharmaceutical advertising.
Keywords: Antibiotics,
Questionnaire study.
Self
medication,
Misuse,
Factors associated with potentially inappropriate medications use in
hospitalized elderly identified by stopp-start criteria. Who is at higher risk?
Klejda HUDHRA, Delina Hudhra, Ela Hoti, Ledjan Malaj, Besnik Jucja, Aurora Bueno-Cavanillas
Introduction Potentially Inappropriate Medications (PIM) in
the elderly are considered those that do not have evidencebased indication, which have a greater risk for side effects
or are not cost-effective. Various tools that help identify
PIM in elderly patients have been developed such as
explicit methods which focus on the recommendation for
disuse of drugs with an unacceptable risk/benefit profile,
like Beers criteria and STOPP-START criteria (STOPP:
Screening Tool of Older Person’s potentially inappropriate
Prescriptions; START: Screening Tool to Alert doctors to the
Right Treatment). The objective of our study is to identify
the characteristics associated with PIM prescription in
hospitalized elderly patients.
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Methods Cross sectional study conducted during the period
June 2011- July 2012 in the University Hospital of Granada,
Spain. STOPP-START criteria were applied to assess PIM
use in a representative sample of hospitalized patients ≥65
years who fulfilled the inclusion criteria (Charlson index ≥2,
hospitalization in the services of Surgery, Internal Medicine
and Other Medical Services). Stata statistical package
was used for data analysis. We estimated the strength of
association of each variable with the presence of PIM by
OR and 95% CI.
Results No differences were found in the use of PIM
related to sex and age of patients or length of hospital stay,
but they are evident by type of service. In Internal Medicine
PIM frequency is much higher (50.3%) than in Surgery
and Other Medical Services, respectively 31.5% and 35%.
PIM frequency increased with number of drugs, from
24.3% in the group taking 6 or less drugs to a maximum
of 56.7% among patients taking more than 11 drugs, being
significantly important (p<0.01). It was also affected by
Charlson index.
Conclusions The factors that contributed the most to the
frequency of PIM included polypharmacy, polypathology
and being hospitalized in the service of Internal Medicine.
Further studies are required to identify hospitalized patients’
profile with a high risk for PIM use.
Keywords: potentially inappropriate medications, elderly,
STOPP-START criteria
A multitarget approach to optimize the safety profile of coxibs: lumiracoxib
derivatives with dual cyclooxygenase-2 inhibitor-thromboxane a2 receptor
antagonist activity
MALVINA HOXHA,[a] Valérie Capra,[a], Carola Buccellati,[a], Angelo Sala,[a], Mohammed Abrar
Abdul Gaffar Shaikh,[b] Clara Cena,[b] Roberta Fruttero,[b] Alberto Gasco,[b] G. Enrico Rovati, [a]
Massimo Bertinaria,[b]
[a] Dept. of Pharmacological and Biomolecular Sciences, University of Milan, Italy
[b] Dept. of Drug Science and Technology, University of Turin, Italy
Introduction Recently, we found that lumiracoxib, a
cyclooxygenase-2 selective inhibitor (COXIB), displays an
additional mechanism of action, the capacity to antagonize
the thromboxane A2 receptor (TP), however with potency
not sufficient to hypothesize a therapeutic effect. The
possibility of having within the same chemical structure both
the COXIB and the antithrombotic activities prompted us to
design, synthesize and pharmacologically characterize a
series of lumiracoxib derivatives, to identify a balanced dualacting compounds, which might contribute to the rational
design of a new class of cardio-protective anti-inflammatory
agents.
Methods The carboxylic function of the lead was substituted
with non-classical isosteres of acid groups. TP antagonistic
activity was assessed in washed human platelets stimulated
with U-46619. TP receptor binding was studied in HEK293
cells labeled by the specific antagonist [3H]-SQ29,548.
COXIB activity was studied in human lympho-monocytes
and in whole blood preparations.
Results Some of the isosteric substitutions afforded
compounds with improved TP receptor antagonism; of
these a tetrazole derivative showed promising results
with TP antagonistic and COXIB activities within the same
concentration range (IC50 TP/IC50COX-2=1.4).
Conclusions These results highlight that thanks to
structure-activity studies, it is possible to obtain lumiracoxib
derivatives with higher potencies as TP antagonists,
without affecting the COXIB selectivity and the inhibitory
potency of the lead. Keeping all these properties inside a
single molecule will confer obvious pharmacodynamic and
pharmacokinetics benefits. These new compound may lead
to a new class of COXIBs, in which the anti-inflammatory
activity is coupled to the antithrombotic activity, which can
A bstracts B ook | 31
counterbalance the deleterious cardiovascular effects
driven by the prostayclin inhibition observed with COXIBs.
Keywords: Lumiracoxib, cyclooxygenase, thromboxane
A2, inflammation
Abbreviations: COXIB, COX-2 selective inhibitors; TP,
thromboxane A2 receptor; HEK293, human embryonic
kidney cell
Gastrointestinal effects of NSAIDs treatment in Southern Albania population
The effect of flt3 kinase inhibitor in combination with a n-glycosylation
inhibitor and er stress inducer on proliferation, signaling and survival of
acute myeloid leukemia cells
Valdet UKA – PhD student in biomedical research.
Department of Pharmacy, Faculty of Medicine, University of Prishtina, Prishtina, Republic of Kosova.
Pranvera Apostoli1, Arqile Apostoli2, Olta Gishti3, Elizana Petrela4, Suela Këlliçi1
1
University of Tirana, Faculty of Medicine, Pharmaceutical Department, Tirana, Albania
2
Director of Olympus gastroenterology clinic, Fier, Albania
3
Department of Generation R, Erasmus Medical Center, Rotterdam
4
Statistic specialist at Faculty of Medicine, Albania
Introduction: The aim of this article is evaluation of
gastrointestinal effects of NSAIDs treatment and finding a
correlation between NSAIDS effects and gastrointestinal
diagnosis related. This trial assessed whether a policy of not
giving prophylactic gastro protection against NSAIDs was
as effective and safe as a policy of providing prophylaxis.
This is the first time the NSAIDs effects on gastrointestinal
tract are studied in Albanian population during 20 last years
Methods: We conducted this randomized, open-label,
non-inferiority trial at the Olympus clinic in the region of
Fier, Albania with 300 patients. Eligible patients were
persons presented gastrointestinal damage and underwent
randomization for any possible association between NSAIDs
use and gastrointestinal problems. Patients were randomly
assigned to receive, or not to receive, prophylactic gastro
protection against NSAIDs
Results: 42 of 300 patients evolved in this study were
NSAIDs users. From these patients 42,9% are females.
Their age ranged from 21-40 years (23,8%); 41-70 years
(66,6%); over 70 years( 9,5%). The clinical diagnosis
diseases for which they were diagnosed in clinic consisted
mainly in gastritis (including duodenitis, aesofagitis and
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similar): 35.7 %; ulcers (gastric, duodenal and both): 47,7%;
gastrointestinal cancer: 9.5 % and others 9.5%. 14%(42
patients) of the total number of patients used NSAIDs at
least during the last 3 months prior to the visit. 85,7% of
the patients did not performed any gastro protection
while using NSAIDs. Among these patients that used
anti-inflammatory drugs (for their inflammatory conditions:
rheumatic pathologies:73.3%; headache and migraine:
16,7% and post-myocardial infarction:9,5%), all of them
presented gastrointestinal problems not evident prior to the
NSAID medications. There is a strong correlation between
dosage/and period of time during which the NSAIDs drugs
were used. (R/0,876)
Conclusion: NSAIDs use is related to gastrointestinal
damage in the Albanian population. Same results authors
did published for other countries in Europe. There is a close
relationship between gastrointestinal pathologies, especially
gastritis and NSAIDs therapy. By our study resulted giving
prophylactic gastro protection against NSAIDs was as
effective and safe as a policy of providing prophylaxis
Key words: non steroidal anti-inflammatory
gastrointestinal damage, gastro protection.
drugs,
IIntroduction Acute myeloid leukemia (AML) is the
most common type of leukemia in adults. Multiple types
of genetic defects and differentiation states of affected
myeloid progenitor cells give rise to a heterogenous family
of diseases. The most frequent type of genetic lesions in
AML are activating mutations in the gene encoding receptor
tyrosine kinase FMS-like tyrosine kinase 3(FLT3). These
mutations causally contribute to the disease and FLT3 is
therefore explored as therapeutic target. One very potent
FLT3 inhibitor which is currently explored in clinical trials is
named AC220 (Quazartinib). An emerging problem which
is common to all clinical applications of tyrosine kinase
inhibitors, is the development of resistance by appearance
of secondary mutations in the FLT3 receptors. In this study,
we examined whether inhibition of FLT3 N-glycosylation
and stimulation of endoplasmic reticulum (ER) stress by
tunicamycin(TM) enhances quazartinib-induced growth
inhibition in AML cell lines.
Methods We examined the effects of tunicamycin and
AC220 on AC220-sensitive AML cell line. This experiment
was characterized in three different setups in order to have
assessments for three different directions: cell proliferation,
signaling activity and induction of apoptosis.
The cell proliferation was assessed using a proliferation/
viability assay known as MTS assay. This technique can
be used to measure amounts of viable cells based on
conversion of some non-colored reagents to colored
products by metabolic cell activity. Signaling elucidation
was carried out through measuring the activity of
phosphorylated key signaling molecules such are: FLT3
ITD, STAT5, AKT and ERK1/2, using a western blot with
corresponding phosphosite-specific antibodies. And, in the
end we assessed the induction of apoptosis by emplying
the technique of flow cytometry (FACS) with two different
dyes, Anexin V and 7-AAD (7-amino-actinomycin D). All
these experiments were performed in a human AML cell line
called MV4-11, after treatment with above mentioned drugs.
Results Almost in minimal cytotoxic concentrations of
tunicamycin we identified the enhancement of quazartinibinduced antiproliferative effects. Hence, from MTS assay
we gained very promising results. On the other hand,
although we found an aglycosylated form of 130kDa FLT3
ITD, the data we took from imunoblotting exerted just a
mild combination effect between these two inhibitors. This
suggests that downstream signaling pathways such are
RAS-RAF-MEK-ERK pathway and PI3K-AKT pathway are
not involved at all in this process. Interestingly, results taken
by FACS analysis have shown that combination induced
apoptosis.
Conclusions Overall, our data demonstrate that tunicamycin
significantly enhances the susceptibility of Acute Myeloid
Leukemia cells to quazartinib, and that sensitization may
be associated with activation of the ER stress pathway and
with inhibition of FLT3 ITD N-glycosylation.
Keywords: FLT3 ITD, ER stress, Quazartinib, Tunicamycin,
Human AML cells
A bstracts B ook | 33
Situation and assessment of nutrition and physical activity in high school
students in Tirana (September-October 2012)
Alban HASANAJ
Faculty of Public Health, University of Medicine, Tirana, Albania
Introduction The way of feeding is regarded as one of
the causes of the occurrence of heart disease, diabetes,
some forms of tumors, disease that these lasts years has
spread fairly disturbing. The World Health Organization in
its guidelines, highlights the role of a balanced nutrition to
stay healthy and prevent or to treat many diseases.
Aim The purpose of this study is to carry out assessment
of the nutritional situation and ways of feeding among
adolescents in the city of Tirana.
1. Evaluation of customs and the way of nutrition,
smoking and alcohol use.
2. Determining the prevalence of obesity and related
factors in adolescents.
3. Assessment of physical activity.
4. Impact of nutrition and physical activity on obesity.
Methods The study is transversal type (crossectional).
Selected study is descriptive study based on the
collection of data (quantitative or qualitative) through
questionnaires, conducted in September and October
2012. The questionnaire was used to collect data related
to lifestyle, nutrition and physical activity habits. Results
were completed in 400 questionnaires. The questionnaire
was anonymous and selfadministration. The data were
analyzed by SPSS 16.0 statistical package. Categorical
variables are presented in the table with the corresponding
absolute and relative frequencies, were reported OR and
were associated with 95% CI interval assessment. It’s used
x2 test with revision of Yates to assess the association of
variables and non-parametric Spearman correlation to
assess the relationship between variables. Statistical tests
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are two-way, the level of significance was determined for α
= 0.05. Various graphics were used for the visualization of
data.
Definition of study variables. Independent and dependent
variables.
Results We had 400 participants, 39% male and 61%
female. Observed statistically significant difference by
gender (χ2 = 78,737 p <0.01)
Note dominance of pupils with medium economic level in
83.8% of cases; 11.8% refer a higher economic level, while
4.5% of them refer low economic level. The difference is
statistically significant (χ2 = 2058 p <0.01). 4.3% of them
refer that regularly smoke, 5.2% of pupils refer that are
former smokers, while most of the students 90.5% never
smoked. The difference is statistically significant (χ2 =
2625.0 p <0.01) 3.2% refer frequently consumed alcohol,
39.2% students refer that sometimes consumed alcohol,
while most of the students 57.6% of them have never
consumed alcohol. The difference is statistically significant
(χ2 = 821 p <0.01).
In relation to gender, former smoker refer more to men who
are regular smokers compared to women.
OR = 4.6 95% CI 1.5 - 14.1 p <0.01.Is noticed powerful
association agreement and statistically significant of males
with smoking.
Men are 4.5 times more likely than women to be regular
smokers.
Also noticed powerful association agreement and
statistically significant male with alcohol consumption: OR
= 3.1 95% CI 1.5 - 6.1 p <0.01
Men are 3.1 times more likely than women to be frequent
consumer of alcohol .11.9% refer to pupils who usually
consume dinner, 57.3% of students refer to usually consume
lunch, 7.1% students refer to usually consume breakfast,
7.7% students refer to usually consume afternoon, 10.7%
of students refer to consume some of these, while a small
number of students, 5.4% (95% CI 4.4 - 6.5) refer to
consume all meals. The difference between the categories
is statistically significant (χ2 = 2151.3 p <0.01). Food menu
of pupils prevalent use bread, apples, oranges, fruit juice purchased, chicken meat and dessert. 5.5% students refer
that over the past week have not performed any physical
activity, while the majority of students, 94.3% of them refer
that have carried out a physical activity, with statistically
significant difference p <0.01).
Conclusions There is a preponderance of students with
medium economic level, low percentage of students who
smoke and alcohol, of whom the majority are males. Most
pupils have normal weight and make efforts to maintain
their weight. Most students do not have problems with
appetite and often consuming meal is lunch. Food menu
pupils prevalent use of bread, apples and oranges, fruit
juice - purchased, chicken meat and dessert. Students
spend more time before tv and computer. A normal level of
physical activity.
Proposals Exercise of physical activity for at least 30 minutes
per day for obese and overweight persons and moderate
physical activity for other individuals. Avoiding alcohol and
smoking. Daily food diet by balancing ingredients: 25% fat,
55% carbohydrate and vegetables fruits 400gr. Organizing
promotional campaigns to promote healthy lifestyles and
nutrition in the media, distribution of brochures and other
promotional messages. Introducing education curriculum
on nutrition and healthy way of life in high school.
A bstracts B ook | 35
Treatment of diabetic foot ulcers with platelet gel rich in growth factors
Comorbidities in chronic obstructive pulmonary disease
Edlira Borici
Alida SINA
Introduction The normal wound healing process entails
a complex interplay between connective tissue formation,
cellular activity, and growth factor activation. Various growth
factors are involved in the wound healing process and
platelet cells contain a big concentration of these factors.
The most important of them are platelet-derived growth
factor, basic fibroblast growth factor, vascular endothelial
growth factor etc. These factors are used often in form of
a concentrated platelet gel in patients who have diabetic
ulcers.
In this study we bring our experience of using the richplatelet gel in diabetic foot patients aiming to evaluate
the efficacy of a platelet gel rich in growth factors in the
treatment of diabetic wound closure.
Methods In a period of 2 years (2009-2011) at Transfusion
Medicine Service in Hospital of Montecchio, we used the richplatelet gel in 49 patients with diabetic foot ulcers. All these
patients had a wound not closed by previous medications.
Regarding to their age there was a variation from 45 - 83
years old. As protocol, we performed homologous gel.
To prepare the gel, one unit of plasma and one of platelets
donation was used. We centrifuged both units for 10
minutes, 3700 r/min in ambient temperature. From both
units, we mixed together the precipitations until a uniform
mass was obtained. Then under sterile condition we took
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from this unit bag 8 ml and added in a petri dish 0,5 ml
calcium and antibiotic and waited until a gel mass was
formed and from the same unit bag other portions of gel
were obtained separated in petri dishes. We debrided
the wound and we induced the rich-platelets gel in its
surface. Then sterile dressing of the wound was applied.
The procedure was performed twice every week.
Results The patients were followed up and we evaluated
the wounds once a week. 1 week after, 18 of patients had
initialized wound healing with a progress of 0,2cm. At the
2-nd week 45 patients had good response of wound closure.
1 patient had infection of the wound during the 3-rd week
and we interrupted the rich-platelets gel treatment. At the
4-th week 47 patients had good wound closure response
and at the 6-th week 11 of them had wound closure. At 9-th
week only one patient had no response to the treatment and
we directed him to the surgeon specialists, all the others
had total wound closure.
Conclusions The use of rich-platelet gel to treat diabetic
foot ulcers has shown effectiveness in soft tissue
regeneration. We found a clearly faster response and
increased bioavailability as well a much higher percentage
of healing than in the cases previously treated without this
therapy.
Health Insurance Institute, PhD Student
Introduction Chronic obstructive pulmonary disease
(COPD) is a preventable and treatable illness that not only
affects the lungs and airways, but also has a significant
impact on other body systems. As a result comorbidities are
frequent and contribute to poor clinical outcomes in COPD
patients.
Although comorbidities are commonly reported in COPD,
the prevalence of these conditions varies considerably. The
aim of this study is to estimate the frequency of the number
and the prevalence of comorbid diagnoses among Albanian
insured outpatients with COPD during a year.
Methods The presence of comorbidities among 2.598
insured outpatients diagnosed with COPD in 2011, was
obtained retrospectively from Health Insurance Institute
database, using the International Classification of Diseases,
Ninth Revision (ICD-9) codes.
Patient data were analysed to evaluate the frequency of the
number and the prevalence of major comorbidities.
Results Among 2.598 insured outpatients with COPD
only 346 patients (13.3%) didn’t suffer from any other
comorbidities. 52% of the COPD patients had 1 to 2 comorbid
conditions, 24% had 3 to 4 and the rest of the patients
(10.7%) had 5 to 12 comorbidities. Insured outpatients with
COPD had an average of 2.2 (± 1.75) comorbidities in 2011.
The most prevalent comorbid diagnoses were: hypertension
(74% of COPD outpatients), asthma (24%), heart failure
(14%), ischemic heart disease (11.4%), diabetes mellitus
(11%), cardiac dysrhythmias (10.7%), bronchopneumonia
(7%), glaucoma (4.7%), hyperplasia of prostate (4.6%),
atherosclerosis (2.7%) arthritis (2.2%) and peptic ulcer
(2%).
Conclusions COPD is frequently associated with
comorbidities. In this study 86.7% of primary care patients
with COPD have at least one other medical condition. The
most frequent comorbidities are: cardiovascular disease,
asthma and diabetes mellitus. Since the study is focused
only on the data recorded in Health Insurance Institute
database, it can be assumed that patients with COPD may
suffer from a larger number of comorbidities.
Comorbidities should be taken carefully in consideration
and managed appropriately in order to get improved
outcomes in COPD patients.
Keywords COPD, comorbidities, Health Insurance Institute
database, ICD-9, prevalence.
A bstracts B ook | 37
Practical implementation of integrated pest management (IPM) in public
restaurants in Albania, advantages and challenges
Vinela REFUGJATI, Endri Haxhiraj
Introduction Blatta spp are one of the main pest invaders of
public premises from one side and a potential public health
threat from the other. Despite professional and amateur
treatments they are still found worldwide. Food safety
maintenance against Blatta germanica and Blatta orientalis
and other pests are a legal requirement in Albania enforced
from State Health and Food Agencies and standards
(HACCP, ISO ect). Serious references and largest health
agencies recommend the Integrated Pest Control (IPM).
Integrated Pest Management was used to solve the problem.
Through monitor devices upon regular inspection was
possible to evaluate the sustainability of the treatment, costs
and customer satisfaction level of the IPM implementation.
Methods Five restaurants in Tirana located in different
areas but with intensive customer flow were taken in
consideration. In these objects classical treatment was not
efficient after several interventions.
Conclusions Practical recommendations are addressed
to public health policies, public health state inspectors, and
researchers.
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Results IPM is promising in Albania. It can be applied
in public health restaurants but several issues must be
considered. Classical treatment despite its toxicity, work
and customer psychology is a real challenge to IPM.
Keywords: IPM, Blatta subspecies, Public Health, Food
Safety, Monitor
Headache: prevalence and characteristics in Albanian teenagers
Petro O1, Grabova S2, Alimehmeti I3, Kruja J2
1
Regional Health Agency - Tirana, Albania
2
Neurology Service, UHC “Mother Theresa” - Tirana, Albania
3
Endocrinology Service, UHC “Mother Theresa” - Tirana, Albania
Introduction Headache is a common disorder in all age
groups. No study has been carried out to evaluate headache
in Albanian adolescents.
Aim Assessment of headache presence
characteristics in Albanian adolescents.
and
its
Methods 1380 (820 females, 560 males) high school
students aged 16-18 years old (average 17.1) were
interviewed using an eight items questionnaire for headache
evaluation. Classification of headache types was made
using the European Headache Federation (EHF) criteria.
Results 540 students (39.1%) declared headache
episodes, with females reporting more headache suffering
than males. 385 females (47.0%) reported headache
versus 155 males (27.7%). 310 students (57.4%) reported
a generally stable headache pattern over the past months.
Headache for longer than six months was reported by 101
(18.7%) students. 482 (89.3%) declared that headache
somehow interferes with activities of daily living. Most
reported to suffer 5-15 days/month (n 229, 42.4%) or 1-4
days/month (n 193, 35.7%), but importantly 67 (12.4%)
reported 15 days/months to daily headache episodes. If left
untreated, headache would last for 1-4 hours in 275 cases
(50.9%), but in 82 cases (15.2%) it was reported 4-24 hours
of headache lasting. Analgesics were used <1 day/week
by 227 (42.0%), 1-2 days/week by 231 (42.8%), >2 days/
week by 62 (11.5%) and everyday by 20 (3.7%). Changes
in senses immediately before headache start appear in 193
cases (35.7%). Tension-type headache and migraine were
respectively in 27.5% and 7.8% of the adolescents, both
with females-to-male ratio 3:1. 42% of migraine-reporting
adolescents refer aura. Chronic tension-type headache
is reported in 4.9%, and medication overuse headache in
5.9%.
Conclusions In adolescents’ population self-reported
most common headache types are tension-type headache
and migraine. Females are mostly affected. Interference
with activities of daily living were surprisingly very high.
Future studies are warranted to assess if environmental
modifications would lower this worrisome prevalence
among high school students.
A bstracts B ook | 39
Morphological and functional variations of sperm in cases with primary
and secondary infertility
Ass. MD. Naser Durmishi 1, MD. Arian Alili2
The purpose of the paper: The purpose of the paper
was to present interrelation of morphological and
functional variations in sperm as are: normozoospermia,
asthenozoospermia,
oligoasthenozoospermia
and
teratozoospermia with clinical forms of primary and
secondary infertility.
This way, thru studying the possible interconnections to
clarify better etiopathological relations of these states.
Material: Were analysed datas from 32 clinical cases
of primary (21 cases) and secondary (11 cases) of
male infertility, taking in consideration their values ​​
from
macroscopic analysis, native preparations, colorings
for vitality, other cells (leukocytes and round cells),
diagnosis of the spermatogrames and clinical diagnosis
of infertility. Spermatograms are analyzed in the Adrialab
laboratory, Tetovo, and ejaculates are acquired from private
gynecological polyclinics “Gyneco-Medica” Tetovo.
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MSc Pt ARBEN BOSHNJAKU1 Mr Ph Ermira Krasniqi PhD cand1,2
1
Gynecological polyclinics “Gyneco-Medica” Adrialab laboratory, Tetovo
Introduction: A infertility of couples (a reduced fertility)
represent frequent pathology where men’s pathology
takes part in ~ 50% (as an equal component compared to
feminine), but data’s on the participation of male factor are
insufficient.
Already is long time since sperm morphology has been
identified as one of the responsible factors of male infertility.
Variations in the number, mobility and sperm morphology
have identified repercussions in natural fertilization of the
egg cell as at the techniques of assisted human fertilization.
In this regard, we collected and analyzed the first datas in
Tetovo.
Treating cervical spondylarthrosis with therapeutic combination analgesic
muscle relaxant, tens and kinesiotherapy
Method: It is used sperm counting method with chamber
(Burger-Turk), vitality is tested with eosine coloring in optical
microscope, and pH whith indicator.
Processing of results is done in Microsoft Excel 2007, and
presented in tabular and graphical way.
Conclusion: There are recorded significant differences
between the morphological and functional values of
spermatogrames in cases diagnosed with primary infertility
for those with a secondary infertility.
In accordance with collected data from 32 clinical cases, the
group of cases with primary infertility was consisted of 21
cases (66%), the number of cases with normozoospermia
were 5 (24%), with asthenozoospermia 8 (38%) and 8
with oligoasthenozoospermia (38%), what represents a
relatively equal distribution.
Unlike the secondary infertility, which have 11 cases (33%),
the number of cases with normozoospermia is 9 (82%), with
asthenozoospermia 1 (9%) and the oligoasthenozoospermia
1 (9%), which represents an apparently discrepant
distribution where normozoospermia dominates, while
oligoasthenozoospermia and asthenozoospermia are
similarly distributed.
Physiotherapy Clinic Fixoterapia 2Pharmaceutical manifacturer TrePharm
*the case was treated in Physiotherapy Clinic Fixoterapia in Prishtinë, Kosovo
Introduction We did a case report study on a 61 year old
male patient, who’s been working in an office during all his
carrier. His main complains were: neck pain, tingle and
numbness of the left shoulder, hand and fingers, vertigo,
pain on the occipital part of the skull and a significant
reduce of the range of motion (ROM). The symptoms
were gathered during the last couple of years, except
numbness of the fingers that started on the last 2-3
months. On X-ray examination it was seen the narrowing
of intervertebral spaces C6-C7 and C7-Th1, accompanied
with degeneration of vertebrae and the formation of lateral
osteophytes. The diagnosis that was given for this condition
was: Spondylarthrosis Cervicalis.
Methods The patients treating process consisted in:
1.medicament treatment: analgesic and muscle relaxant
(paracetamol 325mg + chlorzoxazone 300mg, two to three
tablets per day during the treatment);
2.physiotherapeutical treatment: Electrostimulation with
TENS (15 minutes of low frequency per session, electrodes
being put on the neck) and Kinesiotherapy (stretching of the
shorted and tensed muscles for the first 6 sessions, articular
mobilization, traction, pressing massage on “trigger points”
and strengthening of the weak muscles after the 6th session
with progressive resistance).
Results Neck ROM in the beginning was: flexion 3cm,
extension 17cm, lateral flexion sinister 17cm, lateral flex
dexter 17cm, rotation sinister 16cm, rotation dexter 15cm. In
the end - after 10 sessions of physiotherapy treatment (with
three day pauses in between: after the second day, fifth and
the eighth day) the results were: complete flexion, extension
22.5cm, lateral flexion sinister 13cm, lateral flexion dexter
13cm, rotation sinister 12.5cm, rotation dexter 12cm.
Conclusions This case of treatment indicates that besides
the obstacles and complications on which Spondylarthrosis
Cervicalis can lead to, the combination of this medicament
treatment (analgesic and muscle relaxant) with this
particular form of physical therapy (Electrotherapy and
Kinesiotherapy) helped the treatment to succeed and
meanwhile made the process very comfortable for the
patient.
Keywords: Spondylarthrosis, TENS, analgesic, muscle
relaxant
Data were calculated from 32 clinical cases diagnosed
with infertility, what enables this limited number of samples
to impact on the representativeness of the results, which
creates space for more voluminous studies in this field.
Key words: Spermatogram, primary and secondary
infertility, normozoospermia, asthenozoospermia,
oligoasthenozoospermia
A bstracts B ook | 41
Improving Patient-Physician Compliance using Web-based technology:
Re-thinking Diabetes Management in Tirana, Albania
Benjamin T. Gee, B.A. International Virtual e-Hospital, Research Fellow National Telemedicine Center of Albania University
Hospital Center ‘’ Nene Tereza ‘’ , Tirana, Albania
Background
Diabetes is a chronic condition that necessitates consistent,
strategic and meticulous management to ensure a
sustained quality of life for the patient. As such, to maintain
an effective, long term treatment regimen will require a
balanced partnership between both the patient and their
provider. However, in developing countries particularly, it
has long been known that rates of patient compliance to
clinical behavioral recommendations are notoriously low,
with patient follow-up equally unsuccessful. In Albania,
this discrepancy has resulted in an emerging public health
crisis, with a nation-wide diabetes penetration rate of 4.8%
(for both Type I and II] and a projected rate of 7.5% by 2025.
Overview of Telediabeti
I. Features
In the current intervention, we have developed TeleDiabeti;
a novel patient-focused, interactive web program that acts
as a centralized management resource for both the patient
and their provider. The main features of TeleDiabeti are
multi-fold; they include a blogging platform that facilitates a
routinized two-way discourse between patient and provider,
allowing the patient to receive personalized feedback on
their reported blood glucose test as well as their every-day
management behaviors; a patient schedule, that lists by
priority the components of a detailed management plan the
patient must participate in, and is organized into a weekly
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format that is easily comprehendable by the patient; a
diabetes education database that provides the patient with
a supplemental set of internationally-reputable electronic
resources, all in Albanian, to enrich their knowledge of
diabetes as a chronic condition, and the self-management
skillsets required to control it.
II. Purpose and Benefits
While the TeleDiabeti intervention is currently undergoing
data collection during its pilot pilot phase, we project the
benefits to be immense for patients who participate in this
program. From a biomedical standpoint, providers will
have access to patient glucose tests that can reveal critical
trends in the patients management and overall health. In
their blog posts, patients are strongly encouraged to provide
information about not only their behavioral characteristics as
they relate to diabetes (diet, physical activity], but also the
everyday social barriers they encounter that may jeapordize
management practices. By more easily understanding the
social and cultural circumstances their patients live in,
providers can tailor personalized management plans that
their patients can easily participate in. Furthermore, our aim
is to empower the patient by improving self-management
techniques, by providing them with an outlet to channel and
express the ups and downs of everyday diabetes care with
not only themselves, but also to their providers who are
willing to listen.
Osteoporosis and Risk Factors in Women in Tirana
Indrit SEFERI MSc., Prof.Asc.Elizana Petrela.
Background: The Study was conducted in 2010-2012.In
this study are included women in the population of Tirana
which are checked for Osteoporosis.For every women is
realized DEXA screening (supported from Hoofman La
Roche Company) and also is filled a standardized and
adapted questionnaire which was well stuctured.
Aim: Evaluation of Osteoporosis Prevalence in women in a
selected sample in Tirana.
Objectives:
• Calculation of Osteoporosis related to age groups.
• Identification of Risk factors (lifestyle) and
associated diseases.
• Relation of Risk Factors with Osteoporosis.
Methodology: For every women is realized DEXA
screening.In every case is filled a standardized and adapted
form which was well stuctured.The database was firstly
put into Excel program for facilitation to transport in other
statistic programs like SPSS 20. Depending to the Score
taken form DEXA, the females are classified: Osteoporosis,
Osteopenia and Normal (as International Classification).
Throw questionnaire was taken the necessary information
related to risk factors. The Analysis of the data was made
by SPSS 20.0 . Random connection between the presence
of osteoporosis and the risk factors were analyzed by
regression analysis.
Results:
• 5% of women were with osteoporosis which have
bigger average age.
• 54.8% were with osteopenia.
• 24% of women in the study had menopause after
the age of 45 and 76% have had menopause after
the age of 50.
•
•
•
•
•
•
•
•
41% of women with osteoporosis were overweight
and 25% obese.
50% of women with osteoporosis had high level of
education.
43.7% of women with osteoporosis consume more
then 2 cups of coffee per day.
20% of women with osteoporosis have had
fractures.
40.6% of women with osteoporosis suffer also
form rheumatoid arthritis.
30% of women with osteoporosis are treated with
vitamin D and 40% are treated with Ca.
50% of women with osteoporosis have feed their
children with breast milk for 9-12 month.
50% of women with osteoporosis have had 3-4
children.
Conclusions: The results ilustrate that there are 5 % of
women with osteoporosis meanwhile mostly of them had
older age compare to the average age of all womenin the
study. 54.8% with osteopenia shows us the high potential
risk for osteoporosis in a later time for this group. It is a
high percentage of women with osteoporosis which are
not treated with vitamin D and Ca. Consuming more then 2
cups of coffee per day and having high education shows an
increased risk for osteoporosis.Having a long time feeding
the children with breast milk and having more than 2
children shows a high level of riskt for osteoporosis. 65% of
women with osteoporosis are overweight maybe related to
small physical activity.The mostly evidenced osteoporosis
associated diseas is rheumatoid arthritis.
Key words: Dexa, osteoporosis, osteopenia
A bstracts B ook | 43
Practical implementation of integrated pest management (IPM) in public
restaurants in Albania, advantages and challenges
Genetic Polimorfism of CYP2C19 in Albanian population
Megi Stafa, Pamela Perri, Supervized by Dr. Shk. Leonard Deda
Faculty of Pharmacy, University of Medicine, Tirana, Albania
Vinela REFUGJATI, Endri Haxhiraj
Introduction Blatta spp are one of the main pest invaders of
public premises from one side and a potential public health
threat from the other. Despite professional and amateur
treatments they are still found worldwide. Food safety
maintenance against Blatta germanica and Blatta orientalis
and other pests are a legal requirement in Albania enforced
from State Health and Food Agencies and standards
(HACCP, ISO ect). Serious references and largest health
agencies recommend the Integrated Pest Control (IPM).
Integrated Pest Management was used to solve the problem.
Through monitor devices upon regular inspection was
possible to evaluate the sustainability of the treatment, costs
and customer satisfaction level of the IPM implementation.
Methods Five restaurants in Tirana located in different
areas but with intensive customer flow were taken in
consideration. In these objects classical treatment was not
efficient after several interventions.
Conclusions Practical recommendations are addressed
to public health policies, public health state inspectors, and
researchers.
Results IPM is promising in Albania. It can be applied
in public health restaurants but several issues must be
considered. Classical treatment despite its toxicity, work
and customer psychology is a real challenge to IPM.
Keywords: IPM, Blatta subspecies, Public Health, Food
Safety, Monitor
Introduction: The scope of this research consist in
determining the phenotypic polimorfism of CYP2C19
in Albanian population. On other words, this research
classifies the individuals in extensive dhe poor metabolizers.
The cytochrome P450, CYP, is a superfamily of cysteineheme enzymes that regulate the oxidative metabolism of
endogenous and exogenous molecules. The CYP enzymes
are classified into families, sub-families and individual
enzymes based on similarities in their amino acid sequence.
polymorphisms in drug-metabolizing enzyme genes
can cause enzyme variants with high, low, or no activity.
CYP2C19 is highly polymorphic and can cause variability
in drug response.
Aims: The purpose of this study is to identify the CYP2C19
phenotype in a sample of Albanian population (n=27) using
omeprazole as a probe.
Methods: After obtaining the signed informed consent, to
27 healthy subjects was given a capsule of omeprazole(20
mg). After a period of three-four hours, a sample of plasma
was collected and analyzed using e validated high-
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performance liquid chromatography method. The ratio
of omeprazole to 5-hydroxyomeprazole was used as an
indicator of CYP2C19 activity.
Results: Mean plasma concentration at 3 h post-dosing
for 5-OH omeprazole and omeprazole were 57.2±35.6
and 318.1±385.5, respectively. For most of subjects
log (concentration 5-OH omeprazole / concentration
omeprazole) was between 0 and 1.0 which is characteristic
for extensive metabolizing phenotype. One subject showing
high plasma concentration of omeprazole (1422,2 ng/ml)
and low plasma concentration of 5 OH omeprazole (40,1
ng/ml) and another showing unmeasurable levels of 5
OH omeprazole (omeprazole concentration was 158,8
ng/ml) were considered poor metabolizer. No ultrarapid
metabolizers were identified.
Conclusion This is the first study aiming to evaluate the
CYP2C19 phenotype in Albanian population. Preliminary
data suggest a prevalence of 7.4% of poor metabolizing
phenotype, which is slightly higher than prevalence reported
for Caucasian populations in other similar studies.
A bstracts B ook | 45
Zoosteriform cutaneous metastases from breast adenocarcinoma. Case
presentation.
POSTER PRESENTATIONS
Eni THAKA,* Keis Gega,* Ina Arizaj ,** Udheheqes M. Nakuci***
*University of Medicine, Tirana, Albania **University “Zoja e Keshillit te Mire”
***Institute of Dermatological Studies
The most common metastatic cancer to the skin is
represented by solitary or multiple dermal or subcutaneous
nodules. There are also atypical lesions like erysipeloides
carcinoma, teleangiectatic metastatic carcinoma, en
cruasse, alopecia neoplastica, erythema annulare
centrifugum-like, etc. From the topographic point of view,
zosteriform cutaneous metastasis are very rare. The
mechanism of cancer cells spread in zosteriform cutaneous
metastasis remain unknown. Different theories are
proposed like neural spread via the dorsal root ganglia etc.
Cutaneous metastasis from breast adenocarcinoma are
considered a bad prognostic sign. We present a woman 58
years old with excised breast adenocarcinoma who within 2
years developed zosteriform and erysipeloid metastasis on
the distribution of T 7 – T 11 neurotomes. A discussion of the
case is made compared with other cases of the literature.
Relationship of carotid luminal stenosis and neurologic symptomatology
Altina XHAFERI1, Ilirjana ZEKJA1, Klodiana POSHI1, Prof. Asc. Astrit Hoxhaj2
1 Faculty of Technical Medical Sciences
CONTACT DERMATITIS LOCALISED AT THE SAME SITE OF AN
FIBROEPITHELIOMA. CASE REPORT
MAJLINDA POÇI*,Edis Sevo*, Joanna Nakuci **, Supervisor M. Nakuci***
*Universiteti Mjekesor i Tiranes
**Universiteti Zoja e Keshillit te Mire
*** Instituti I Studimeve dermatologjike.
Localization of a dermatological condition in the site of another dermatological nosology is rare. Existence of this
phenomenon requires a very careful differential diagnosis,
because coexistence of two nosologies modifies the clinic
of each of them. We are presenting a case of contact dermatitis localized in a fibroepithelioma (achrocordon) site
who required a careful differential diagnosis to exclude a
malignant tumour. The benign tumor was excised with diodic laser at 940 nm and was sent for biopsy, which proved the
synchronous of two nosologies. The existence of another
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nosology on fibroepithelioma is rare. 28 cases are reported
involving 8 nosologies: Basal Cell Carcinoma, Squamous
Cell Carcinoma, Metastatic Melanoma, Verruciform Xanthoma, Verrucous Carcinoma, Fibrous Histiocytoma, Mycosis
Fungoides, Liposarcoma. We present this case with the intention to attract attention due to a rare combination of both
diseases and to emphasize that it is always necessary to
do the biopsy to exclude other nosologies especiallya malignant tumour.
2 Hygeia Hospital – Tirana, Albania
Objective: The purpose of our study was to evaluate
calcified atherosclerotic plaques in the neck carotid arteries
using AngioCT to evaluate the relationship of scores with
luminal stenosis and symptomatology.
Materials and Methods: For a period of 9 months was
measured the calcium plaque volume in 102 neck carotid
arteries (50 patients) using angioCT. In the study are
included 31 asymptomatic patients (mean age, 70.9 ±
8.2 [SD] years; 15 women, 16 men) and 19 patients with
ischemic neurologic symptoms (68.1 ± 12.2 years;8 women,
11 men). At the carotid arteries were 42 high-grade stenotic
(≥ 60% by [NASCET] criteria), 16 moderate-grade stenotic
(30-59%), and 44 mild-grade stenotic or normal (0-29%)
vessels. Volume scores were calculated by summing the
area of calcium in the common and extracranial internal
carotid arteries on axial slices and multiplying by the slice
increment.
Results: We found that scores were significantly related to
the occurrence of symptoms (p = 0.003). The patients with
high-grade stenosis had significantly higher scores than
those without high-grade disease (p = 0.003). Moreover,
quantitative burden was associated with luminal stenosis on
adjusted multivariate analysis (p = 0.034). The specificity
and positive predictive value for high-grade luminal
narrowing were notably lower on individual vessel analysis
than on total score analysis.
Conclusion: Calcium scores in the neck carotid arteries
may represent an marker ( independent one) for luminal
stenosis and ischemic symptoms. A prospective and
longitudinal study examining calcium levels and morbidity
may be justified to examine whether plaque has a role in
risk stratification.
A bstracts B ook | 47
Osteoporosis in patients with rheumatoid arthritis
Adela BRAHIMAJ, M.D 1, Ass.Prof.Dr.Teuta BACKA (ÇIÇO) 2
1. Medical Doctor in training at University Hospital Center `Mother Theresa`, Rheumatology service.
2.Head of Rheumatology service at University Hospital Center `Mother Theresa`.
Aim The identification of osteoporosis risk factors in patients
with RA.
Methods The study was conducted at University Hospital
Center `Mother Theresa`, Rheumatology service in Tirana.
This is a retrospective study, so patients were not followed
in real time. The data were taken from the files of patients
hospitalized in the ward of Rheumatology during the
6-month period January-June 2012. The data were taken
only from the files of patients with rheumatoid arthritis who
had developed osteoporosis.
Results Only 12.9% of patients with RA developed
osteoporosis.
90% were females and 10% males.
95% were classified in the first stage of osteoporosis
(T-score <-2.5 and no fracture), and 5% are classified in
the third stage of osteoporosis (T-score <-2.5 and fracture).
85% belong to the age group 50-70 years.
75% were unemployed and 65% live in the city.
65% were smokers and only 15% alcoholics.
55% had a history of 10-20 years with RA.
50% had a history of 10 years in menopause.
All were treated with glucocorticoids and methotrexate for
years.
Among
associated
diseases
predominate
70%
hypertension, 25% hyperthyroidism, 25% hysterectomy,
2O% osteoartrosis.
From the analysis it was observed that in 80% of cases,PCR
was in high levels.
Serial calcium was found in low levels in 55% of cases and
70% presented respiratory dysfunction in spyrometry.
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Through binary logistic regression analysis were analysed
random connections between osteoporosis (yes / no) and
other factors and found significant links between them:
• Patients with a history of arthritis of 10-20 years
are 12% more likely to make osteoporosis than
those with 10 years.
• Patients with a history of arthritis over 20 years are
49% more likely to make osteoporosis than those
with 10 years.
• Patients with a history of menopause 10-20 years
are 27% more likely to make osteoporosis than
those with a history of menopause 10 years.
• Patients with a history of menopause over 20 years
are 2.3 times more likely to make osteoporosis
than those with a history of menopause 10 years.
• Patients treated with diuretics are 2 times more
likely to make osteoporosis than those who do not
take diuretics.
Conclusions This study identified as risk factors of
osteoporosis in patients with RA:
female sex, early menopause, smoking, urban life, RA
therapy with GC and MTX, associated
diseases as hypertiroidism , hypertension , hysterectomy,
osteoartrosis;
bad economic situation due to the unemployment (lack of
calcium and vitamin D in the diet).
Keywords: osteoporosis, risk factors, rheumatoid arthritis,
University Hospital Center `Mother Theresa` of Tirana
The efficiency of treatment with growth hormone replacement
therapy in children with idiopathic GH deficiency in Albania
ADELA SHKURTI
Introduction The idiopathic growth hormone (GH)
deficiency is defined as the shortest height (-2 DS) without
any further pathologies, including here even a detailed
hormonal, biochemical and radiological evaluation on
behalf of the endocrinologist.
Methods The study is based on the survey of 50 children
of various ages, diagnosed with idiopathic GH deficiency
by the pediatric endocrinology department of ‘Mother
Theresa’ University Hospital Center, excluding those
children diagnosed with Turner Syndrome, chronic renal
disease, GH resistance,children born with SGA and IUGR.
We evaluated the efficiency of the 1st, 2nd, 3rd-year
treatment with somatropin,and measured the height (in cm
and DS),the bone age, the values of GH and IGF-1,while
using the Tanner-Whitehouse and Bayley-Pinneau method
for the forecast of the height.
Results The study involved 50 children, 43 male (86%)
and 7 female (14%), who have showed up at the pediatrics
ward between 2001 and 2009. The median period of the
treatment given was 4.6 years (3-10 yrs). The height at
the moment the patients were first diagnosed was 118.3
±13.1cm; after the 1st year of treatment with somatropin, the
stature reached 129.7 ± 12.6 cm;after the 2nd year 137.8
±12.3 cm and after the 3rd year, the height reached 144.9
±12 cm. Growth velocity in the 1st year of the treatment was
11.4 ± 2.8cm/y, in the 2nd year it was 8.14 ± 2.13cm/y, while
after 3 years of the treatment’s initiation it reached 26.74
±5.4cm/y. The patients appeared to have a differentiation in
height based on the Standard Deviation (SD) -4.6 SD ±1.2.
The first year of the treatment saw an improvement in the
patients’ statures, with a SD of -3.4 ± 1.3 and it was found
the most beneficial.
Conclusions The study found that the first year of the
treatment was the most beneficial for the patients’height
growth, with the GH treatment not resulting in any major
side effects. The termination of the treatment was done
after the closure of bone epiphysis, determined by the lefthand X-rays.
Keywords: Somatropin,idiopathic GH deficiency
Chronic treatment of high blood pressure in Albania
Arseda BREGU1 ,Florjana Rustemi 2, Enida Balla3
1.Community Pharmacy ”EvaFarma”,Tirane
2.Bilim Pharmaceuticals,Tirane
3. University Hospital Center (UHC) “Mother Teresa” of Tirana, Hospital Pharmacy
Introduction In this study is analyzed the manner of
treatment of chronic high blood pressure in patients that are
supported by the insurance system offered by the Albanian
Insurance Institute of Healthcare(ISKSH). This study
helps us to understand the manner of treatment and the
preparations that are used the most in the therapy of high
blood pressure in Albania.
A bstracts B ook | 49
Methods The study analyzes the scheme of therapy of
300 patients in a polyclinic in Tirana. The results can be
generalized because the scheme of therapy are based on
the protocols approved by ISKSH. All the patients are treated
with combined therapy. From the analysis of the cards we
have the number of patients that use every antihypertensive
drug that is part of the refund list. We have calculate the
number of patients that use every drug for the categories :
Betablockers, Diuretics, Calciblockers,Ace-inhibitors,Arb-s
and Inhibitors nervous system. Based on the ISKSH data,
we have calculate the average cost of treatment for every
hypertensive patient.
Results The results that the study produced shows that in
300 patients,103 use diuretics, 150 use ace-inhibitors,201
use beta blockers,194 use calciblockers,102 use ARB and
10 use nervous system inhibitors. The most used diuretic
is Hidrochlortiazid. Enalapril is the only Ace-inhibitor
used.68% of the patient use Atenolol. Amlodipine and
Nifedipine are the most used calciblockers. Losartan is the
most used ARB. Nervous system inhibitors are rarely used.
It is noticed the usage of the combined preparations that are
part of the refund list too. The average cost of the treatment
of high blood pressure for every patient is 8.84 Euro per
month.
Conclusions The refund list is limited in medicines
and need to be enriched in preparations that are part of
pharmaceutical market. The physicians tend to prescribe
the cheapest form-dose despite the compliance of the
patient and the commodity of the usage.The combined
preparations are rarely used because of the high cost.
Metastatic renal carcinoma to the thyroid gland with 18 f-fdg uptake in
the thyroid lodge after total thyroidectomy
Blertina DYRMISHI M.D; Taulant Olldashi M.D; Prof Ass. Thanas Furreraj; Majlinda Ikonomi M.D;
Prof Ass. Gentian Vyshka; Jolanda Nikolla M.D
Hygeia Hospital Tirana
Introduction To examine the presentation and the diagnosis
of clear cell renal carcinoma metastasis to the thyroid gland.
Methods We describe a clinical case of solitary thyroid
metastasis from clear cell renal carcinoma, which was
present eight years after left nephrectomy.
Results Eight years after left nephrectomy for a renal cell
carcinoma at age 34 years, a woman presented with a
mass next to the thyroid gland. FNA of the nodule - cytology
of follicular adenoma.
The patient underwent surgery for total thyroidectomy.
The histopathologic surgical findings were consistent with
a solitary metastasis most compatible with a clear cell
metastatic carcinoma from her previous renal carcinoma
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of the nodule and a chronic lymphocytic (Hashimoto`s)
thyroiditis. The immune-histo-chemical findings were
CD-10 positive; EMA positive; Thyroglobuline negative;
HBME-1 negative. The patient began the treatment with
levothyroxine and 1.5 months after surgery she underwent
a PET-Scan, where focal 18-F-FDG uptake was seen in the
thyroid region with a negative neck ultrasound. Serum TPO
antibodies levels were 90 UI/ml (normal values <70); TSH
6.1 mUI/ml (N 0.25-4.04); Thyroglobuline <0.2 ng/ml (N
0-5); Thyroglobuline antibodies 32.1 UI/ml (n <37).
Metastatic disease from the kidney to the thyroid gland
can occur more than 20 years after nephrectomy with the
average time interval being 7.5 years. 18-F-FDG uptake
was found in the thyroid in the patient who underwent PETscan as the part of cancer’s screening.
Conclusions Metastatic renal carcinoma to the thyroid
should be considered in any patient presenting with a
thyroid mass and a medical history of renal cell carcinoma.
In the case of chronic lymphocytic thyroiditis, sometimes
the uptake in the PET-scan is false positive.
Keywords Metastatic renal carcinoma; nephrectomy;
follicular adenoma; total thyroidectomy; chronic lymphocytic
(Hashimoto`s) thyroiditis; PET-Scan.
Intensive care aspects of “malignant” toxoplasmosis
Muco E., Kraja Dh., Pipero P.,Harxhi A., Ndreu A., Saro M., Muhametaj J., Mehmeti J., Gjyzeli M.
Infectious Diseases Service UHC “Mother Theresa” Tirana.
Introduction Correlation between Toxoplasmosis-Intensive
Care is not a common topic. Achievements in molecular
biodiagnosis and infectious disease practice show that
toxoplasmosis may be subject of management in intensive
care units.
Aim Identification of malignant forms of toxoplasmosis and
the need of management in intensive care units.
Methods Includes review of literature and our studies for this
form of toxoplasmosis.Of our 413 cases with toxoplasmosis
of central nervous system, ocular toxoplasmosis and
toxoplasmic lymphadenopathy we distinguished 15 severe
cases,treated in our intensive care unit.
Results The review of the literature showed that these
clinical forms had the necessity for treatment in intensive
care unit : central nervous system toxoplasmosis, interstitial
pneumonia, fatal toxoplasma myocarditis, severe hepatic
necrosis, severe hemolytic anemia and acute immunemediated thrombocytopenic purpura; disseminated
toxoplasmosis and septic shock due to Toxoplasma gondii;
they are encountered in the immunocompromised subjects
as well as immunocompetent subjects. We saw that 15 out
of 413 cases with toxoplasmosis presented criteria for the
management in the intensive care. They belonged to the
cerebral form and the reasons for the transfer of these cases
in the intensive care unit was association with cerebral
coma. All cases were immunocompromised subjects, with
HIV / AIDS. Mortality resulted 53.33%.
Conclusions Management of toxoplasmosis in the intensive
care unit is an option that might be taken in consideration
especially in immunocompromised patients.
A bstracts B ook | 51
Chest pain: characteristics and management of patients in the emergency
departmetnt of University Hospital Center of Tirana
TOPI GERIOLDA, MD; Zaimi Edmond, MD, DSc
Introduction Chest pain is one of the most common
symptoms of patients presenting in the emergency
department (ED) of University Hospital Center “Mother
Teresa” in Tirana. The aim of this study was to evaluate the
characteristics and management of patients with chest pain.
Methods During the period May – July 2012, we evaluated
217 patients who came to the ED with chest pain as the
main complaint. For each patient a form was filled with
demographic data, risk factors, location, character, spread
and intensity of pain. Laboratory examinations and ECG
done in the ED were also obtained. All the data were
analysed using SPSS.
Results Age varied from 17-98 years old with average
age 58.5 years. 60% were male and 40% female with a
statistically significant difference between gender ( p =
0.013). 22.7% were unemployed, 15.3% laborer, 14.8%
employee, 47.2% retiree; 6% had primary education, 23%
mandatory education, 54% secondary education and 17%
higher education. According to risk factors, 17.5% were
regulary drinkers , 37.3% smokers, 29.5% obese ; 21.7%,
69.6%, 40.1% were respectively prior diagnosed with
diabete mellitus, hypertension and dyslipidemia; 33.6%
had hereditary factors for diabetes and CHD. We found a
statistically significant correlation between diagnosis and
location of pain (r = 0.244, p <0.001) and diagnosis and
charachter of pain (r = 0.222, p = 0.019). No correlation was
found between diagnosis and spread of pain and diagnosis
and intensity of pain.
Conclusions CVD, mainly IHD, are the most frequent
cause of chest pain. It is more frequent in retiree because
of higher risk factors for CVD such as diabetes and
hypertension.Chest pain occurs more in men because high
level of estrogen in women before menopause is protective
for CHD.Location and character of pain correlates with the
cause of chest pain.ECG is the most used examination for
patients with chest pain and is done within few minutes after
arrivel to ED (< 10min).
Keywords: chest pain,
hypertension, ECG.
CVD,
IHD,
ED,
diabetes,
Palliative care in Albania.
The experience of Emiglia-Romagna Region, Italy
Jana Nano Prof.Dr. Agim Sallaku
1
2
Faculty of Medicine, Tirana 2Oncologic Hospital, “Mother Tereza” University Hospital,Tirana, Albania
1
Introduction Palliative care is one of the five components
of the National Plan for Controlling Oncological Diseases
in Albania. During the epidemiological transition of the 90’,
the number of patients with malignant diagnosis raised
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tremendously. Only 33% of patients are able to take
palliative care form the public services and there are only
three Non-Profit Organizations which operate in six cities
throughout the country.
The experience of Emiglia-Romagna Region brings up a
perfect public model of home-assisted service supported
in a successful way with the private and third sector. The
biggest challenge in Albania concerning Palliative Care is
to fulfill the recommendations of WHO for the integration of
Palliative Care in our Health Care System.
Methods The study was conducted in 5 Primary Care
Centers in Tirana. The aim was to evaluate knowledge,
the qualification level, the palliative-offered services
and the identification of the urgent problems of Palliative
Care among the Family Doctors. From May-June 2012,
anonymous questionnaires were conducted to the Primary
Health Care professionals, as the first gate of the system
of terminal ill patients. Semi-structured interviews were
also conducted with professionals working with Non-profit
organizations and other experts of the field.
Results From the results was concluded that Family
Doctors are totally indifferent on giving palliative care to
oncological patients even this is the only gateway through
the system (there are not any other services on the tertiary
system) They were unfamiliar with the principles and models
of Palliative Care and consequently missing competences
ne the application of these principles.
Conclusions The patient’s family remains the only
“institution” of Palliative Care in Albania. There is an urgent
need for developing a long-term plan which can provide
not only medical care, but most of all, global health care.
Other recommendations, rather than the legal policy, are:
implementation of Palliative Care in the curriculum of
Medical Faculty, qualification programs for Family Doctors,
evaluation of the law concerning the narcotics drugs in
Albania, reevaluation of ethic code ect
Keywords palliative care in Albania, family doctors
BMI impact on neurological diseases
Jora XHAXHO, Ilir ALIMEHMETI, Drini DOBI, Jera KRUJA
Faculty of Medicine, University of Medicine, Tirana, Albania
Introduction Body Mass Index is defined as the individual`s
body mass divided by the square of their height. The formulae
universally used in medicine produce a unit of measure of
kg/m2. In neurological practice more with obesity-related
diseases are: stroke, headache, tunnel carpal syndrome,
intracranial hypertension, etc.
Aim To investigate the impact of BMI in some neurological
diseases.
Methods We included in this study 263 persons. 154 of
them were hospitalized in Clinic of Neurology, in University
Hospital Centre “Mother Teresa”, Tirana and 109 as control
group. (They are random persons with the same groupage with admitted persons). For all of them we fulfilled a
form with general data and specific data on risk factors
for several neurological diseases. We classified them
in 4 groups. For every person we calculate the BMI. We
compared BMI of control group with BMI of persons with
neurological diseases.
Results It was found a 1kg/m2 greater in stroke patients
compared with control group and a difference 0,6kg/m2 in
patients with other neurological diagnosis compared with
control group. (z<0,01).BMI was 0,5kg/m2 greater in control
group with Arterial Hypertension compared with patients
with arterial Hypertension with neurological diseases.
BMI was 1,25kg/m2 greater in control group with mellitus
diabetes compared with patients with mellitus diabetes with
neurological diseases. BMI was 2kg/m2 greater in smoker
A bstracts B ook | 53
patients with neurologic diseases compared with control
group.BMI was 2kg/m2 greater in alcoholic persons with
neurologic disease than control group.
Conclusions Obesity is a significant risk factor for
neurological diseases.
Taulant MUKA1, Florian Toti2
Basal ganglia calcifications secondary to idiopathic hypoparathyroidism
– a similar but different pathology from the Fahr’s syndrome: Case report
Grabova S1, Alimehmeti I2, Hoxha V2, Zekja I1, Bono S1, Papajani M1, Ylli A2, Kruja J2
1
Neurology Service, Universitary Hospital Centre “Mother Theresa”, Tirana, Albania
2
Endocrinology Service, Universitary Hospital Centre “Mother Theresa”, Tirana, Albania
Introduction One of the most frequent denominations of
bilateral basal ganglia calcification is Fahr’s syndrome.
In this autosomal dominant or sporadic bilateral basal
ganglia calcinosis there are no known calcium metabolism
abnormalities. Secondary bilateral basal ganglia calcification
is known to occur in several other conditions, including
hypoparathyroidism.
Case report A male patient, 56 years old, presented to
the Endocrinology Service complaining for continous
severe headache, dizziness, memory and concentration
problems, speech and gait difficulties. He was diagnosed
with hypocalcemia 10 years ago and was not properly
treated. The patient refers that he had suffered three TIAlike episodes 2 years ago, for which reason he underwent
to a head computerized tomography exam. The exam
revealed diffuse basal ganglia calcifications and in the graywhite matter interface. One month before presenting to
the Endocrinology Service he was subject to a MRI, which
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Prevalence of chronic complication of diabetes at time of diagnosis
demonstrated diffuse lesions of the periventricular cerebral
and cerebellar white matter, and numerous bilateral basal
ganglia and cerebellar mineralisations. Neurological
examination revealed no neurological deficits, except a
mild bradykinesia. Thyroid and parathyroid ultrasound
exam was normal. No neck trauma, irradiation or surgery
was referred. Parathormone level 0.1 pg/ml (10-65). Total
calcium 4.8 mg/dl (8.5-10.5). Ionized calcium 2 mg/dl (4.85.2). Phosphorus 5.4 mg/dl (2.5-4.5). No autoimmunity
was revealed by blood exams. Eventually, by exclusion,
idiopathic hypoparathyroidism was diagnosed and the
cerebral and cerebellar calcifications were considered
secondary calcifications due to calcium and phosphorus
abnormalities.
Conclusions Fahr’s syndrome must not be incorrectly
diagnosed if calcium and phosphorus abnormalities are
present.
1
Faculty of Medicine, University of Medicine, Tirana, Albania
2
Endocrinology Service, Universitary Hospital Centre “Mother Theresa”, Tirana, Albania
Introduction Chronic complications of diabetes are
the main factors reducing the quality of life and death in
diabetic patients. The purpose of this study was to assess
the prevalence of chronic complications of diabetes at time
of diagnosis and their correlation with some risk factors.
Methods This was a retrospective study. The data were
collected from the files of 53 patients newly diagnosed
with diabetes in the Endocrinology clinic at the University
Hospital “Nene Tereza” from January 2012 till June 2012,
with duration of disease no more than 6 months.
examinations for the diagnosis of retinopathy, nefropathy
and neuropathy. At least one chronic complications was
diagnosed in 21 (39.62%) patients, of whom 17 (32.07%)
had at least one micro vascular complication and 6
(11:32%) a macro vascular complication. Prevalence of
diabetic retinopathy and neuropathy in newly diagnosed
patients with type 2 diabetes was respectively 30.43%
and 41.12%. Prevalence of diabetic foot, nephropathy and
cardiovascular diseases were respectively 5.6%, 11:32%
and 11:32%. Despite high frequency of hyperlipidemia
(64.15%), the treatment was recommended only in 2 cases.
Results In the study were included 53 patients of whom
31 (58.49%) were male. The average age of patients with
type 1 diabetes was 28.7 and in those with diabetes type 2,
55.95. Only in 20.75% of the cases were done all necessary
Conclusions Chronic complications of diabetes have a
high prevalence at time of diagnosis. In the future, remains
as a duty, early detection of diabetes and fulfillment with all
relevant examinations for detection of chronic complications.
Prescribing pattern of antibiotics in the Pediatric Hospital of Tetovo,
Republic of Macedonia
Edita ALILI-IDRIZI, Ledjan Malaj, Sulltana Asani, Merita Dauti
Introduction Antibiotics are commonly prescribed drugs in
pediatrics. Because of lack of uniformity in drug prescribing
and the rise of bacterial antibiotic resistance, monitoring
and control of antibiotic usage is important these days
and strict antibiotic policies should be warranted. Before
such policies can be implemented, detailed knowledge of
antibiotic prescribing practice is important.
Objective The main objective of this study is to analyze the
antibiotic prescription pattern in children taking treatment
in pediatric in-patient department of a pediatric hospital in
Tetovo.
Methods A retrospective study of six month’s duration was
undertaken during 01 January – 30 June of 2012. A total
number of 1563 patients were taken for the study. Drug data
A bstracts B ook | 55
and patient characteristic data were computed using Ms.
Excel.
Results The mean age of pediatric in patients was 3.45 and
male patients were 524 (58.5 %) and female patients were
371 (41.5 %). Among the total number of 1563 patients
analyzed during the period of six months, 895 (57.3 %) of
them were prescribed antibiotics. The majority of patients
given antibiotics were aged 1-3 years (67 %). The most
common diagnosis among all patients prescribed with
antibiotics was chronic bronchitis in 199 (32.5 %) cases
followed by tonsillopharyngitis in 167 (18.7 %) patients.
Parentally administered antibiotics contributed the highest
proportion of the total antibiotics prescribed with 870 (97
%). Cefotaxime was the leading antibiotic prescribed in
Results a) All the samples have the same Rf of which
means that they all have positive paracetamol contents. b)
% of paracetamol contents varies from 94% to 98%. c) two
of them have high level of sugar after ten days d) pH was
different after ten days (acid) because of sugar hydrolysis.
Conclusions Correct diagnosis of the disease and its
management constitute important aspects of patient care
which is even more important in case of pediatric patients.
Physicians must keep a clear understanding of need for
microbiological diagnosis, use of antibiotics and make good
judgment in clinical situations.
Interactions between herbal preparations and synthetic medications,
and the role of pharmacists in the prevention
Keywords: prescription pattern, antibiotic, pediatrics.
Entela HALOÇI1,3, Stefano Manfredini3, Rezarta Shkreli², Enkeljeda Goci1, Ledian Cama2
1-“Aldent” Universtiy Faculty of “Medicinal Sciences” Departament of Pharmacy,Tirane Albania
2-Kristal” Universtiy Faculty of “Pharmacy and Stomatology” Departament of Pharmacy, Tirane Albania
3- Ferrara University, Pharmacy Department, Italy
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Keywords: paracetamol, sirup, analyses
Ela BEBECI, Vilma Papajani
Faculty of Medicine, Department of Pharmacy, University of Tirana, Albania
Pharmaceutical control analyses of some paracetamol
sirups registered in Albania
Introduction There are different generic brands of
paracetamol sirups registered in Albania and most of them
are manufactured by foreign pharmaceutical industries.
To evaluate the acceptability level for a pharmaceutical
product we designed a random study for five brands and
investigated (E.PH. 6-edition) different parameters such as
sugar contents and pH in the first day and the tenth day of
sirup after opening the bottle, identification of paracatamol
Conclusions Both the five samples fulfill the E.PH -6 edition
limits and criterias so we recommend them for normal use.
700 (78 %) cases, followed by Ceftriaxone administered
in 159 (17.8%) of the total patients. Among 895 patients
clinically diagnosed and treated with antibiotics, laboratory
investigations before prescriptions were done in 320 (35.7
%).
through Thin-Layer chromatography, and the quantification
of paracetamol through spectrophotometry methods.
Methods In this study are used europian pharmacopia
methods for analysing paracetamol sirup in which
are included thin-layer chromatography and uv-vis
spectrophotometry.
Introduction There is a general wrong belief by the public
that herbal preparations are safe because they are natural
and used traditionally. When we use herbal preparations for
pharmacological purposes we should take into consideration
the fact that they possess a pharmacotoxicological
profile and may interact with synthetic medications taken
simultaneously with them, increasing or decreasing
their therapeutic effects. Pharmacological interaction
between herbal preparations and synthetic medications
is a phenomenon that is becoming more disturbing by
emphasizing the importance of the development of phytopharmacovigilance in terms of contemporary clinical
toxicological studies.
The role of pharmacist in preventing interactions between
herbs and drugs is vital. In order to ensure that the drugs
that he is dispensing to the patient are safe and will not
cause any interaction, he should ask and inform the patient
about the medications that the patient is taking.
Aim
1. To provide an overview of the clinical data regarding the
interactions between herbal preparations and synthetic
medications.
2. To raise the awareness of pharmacists and physicians
regarding this topic and thus protect the health of the
patients.
Conclusions From multiple data in the scientific literature
based on interactions between herbal preparations and
synthetic medications results that: Ginkgo which is used in
herbalism to treat circulatory disorders it may interact with
some blood thinning medicines or even aspirin increasing
their effect, St. John’s wort another commonly used herb for
depression thanks to its enzymatic induction effect reduces
the level of ciclosporin, digitalis, theophylline, birth control
pills, Ginseng and Garlic can interfere with blood thinners
such as warfarin and increase their effectiveness etc.
Keywords: Herbal preparations. Synthetic medications,
Interactions herbs-drugs, Preventing
A bstracts B ook | 57
The role of pharmacists in healthcare in Republic of
Macedonia compared to the EU countries
Assessment of sustainability of primulaacid a by hptlc-scanner method
in several alcoholic extracts from radix of Primula veris collected in
Albania
Merita DAUTI, Ledjan Malaj, Edita Alili-Idrizi, Sihana Lika
Introduction Within the framework of the healthcare system
in the Republic of Macedonia, a special part is dedicated
to defining the notion “pharmaceutical service”, as a very
important component in the healthcare system.
Aim By using the experiences of the EU member states
as regards the inclusion of pharmacists in the healthcare
system and the prevention of various different illnesses,
the attention towards the necessity of the presence of
pharmacists in the healthcare has to be drawn.
Methods There has been a lot of research carried out
based on international literature, scientific articles, and other
studies that deal with the issue of inclusion of pharmacists in
the healthcare systems. The guidelines of Good Pharmacy
Practice (GPP) have also been used.
Results In the Republic of Macedonia there are 818
registered pharmacies, which is 1 pharmacy per 2500
inhabitants. It can be seen that the number of pharmacies
is much bigger compared to other countries in the region;
however, what has to be noted is that their distribution and
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allocation is totally irrational here. The services provided by
pharmacists usually consist of medicine delivery and sale,
advice and information for patients related to illnesses and
medicine prescriptions.
There is a lack of other services such as measurement
of arterial pressure, glucose in blood, determination of
Body Mass Index, advice about methods of application of
inhalator preparations, which would contribute a lot in the
prevention of certain risk factors, especially those dealing
with cardiovascular diseases.
Conclusions The experiences from the countries included
in this study should serve as a motivation for the Ministry
of Health to start thinking about including pharmacists in
the adopted health care programs. Also, the correctness in
relations between physicians and pharmacists remains as
one of the challenges to be dealt with in the future, since
its final resolution would actually mean better healthcare
services for citizens.
Keywords: Role, pharmaceutical service,
systems
healthcare
Rezarta SHKRELI1, Entela Haloçi2, Ledjan Cama1, Elda Jano1
Department of Pharmacy, Faculty of Medical Sciences, “Kristal” University, Tirana, Albania.
1
Doctoral candidate at the University of Ferrara, Italy
2
Introduction Variety Primula Veris (Primulaceae) is a
herbaceous and perennial plant, it grows shortly. The
flowers are collected without green calix in the period
between March and May, and the roots should be gathered
before flowering, in autumn. Primula rhizome and roots
contain about 5-10% of triterpenic saponins where the
main ingredient is primulaacidi A (with protoprimulagenine
aglycon and a glycosidic range related to aglycon in the
C3 atom) and about 3% phenolic glycozides. Saponins are
used in medicine as expectorant, diuretic, antimicrobial and
antimycotic agents.
Methods The purpose of this study is to determine the
sustainability of the primulasaponine principle in different
storage conditions in extracts obtained with different
methods. Extracts prepared have as digestive alcohol
70% and are extracted in the ratio 1:1 with four methods:
Infusion, Reflux- Condensation, Ultrasound and Magnetic
mixing. Extracts were stored in different temperature, light
and moisture conditions. Assessment of sustainability of
Primulasaponin A in alcoholic extracts was carried out by
the cromathographic method HPTLC-Scaner:
Primulaacid A standard was obtained from Sigma Aldrich
(Standard solution was prepared in the concentration 5.028
± 0.01 mg Primulasaponin / ml).
Stationary phase: etilacetate - formic acid -acetic acid
-water in ratio (50:5.5:5.5:13.5) V/V
HPTLC Camag (Switzerland) with semiautomatic applicator
Camag Linomat IV, Camag CATS 4 software.
Chromatographic development camera 20 x 10.
Hamilton syringe 100 μl.
Analytical scales Mettler H 20 T, Max. 160 mg, d = 0.01 mg
Results Relative changes in the content of the principle in
prepared extracts were:
• Refrigerating conditions: 4.88% in infusion, 4.71%
in reflux-condensation, 7.47% in ultrasound and
8.92% in magnetic mixing method.
• No color packaging environment conditions: 12.8%
in infusion, 13.9% reflux-condensation, 16.6% in
ultrasound and 15% in magnetic mixing method.
• Colored packaging environment conditions: 8.5%
in infusion, 7.7% reflux-condensation, 8.5% in
ultrasound and 10.2% in magnetic mixing method.
Conclusions External environmental factors and the
extraction method affect the stability of Primulaacid A in all
four extracts, the largest relative change in the content of
the active principle was in extract obtained with ultrasound
method and stored at no color packaging environment
conditions and the smaller relative one was in refluxcondensation extract store in refrigerating conditions.
Keywords: Primula Veris, Primulaacid A, HPTLC-Scanner
Method, Sustainability.
A bstracts B ook | 59
The treatment problems of first permanent molar in children of University
Dental Clinic
In vivo achievable concentrations of idebenone are unlikely to
inhibit oxidative burst of immune cells
Asllanaj BISELA *, Brovina Diana
Ina Mexhitaj (1) - Simone C. Wuest (1) - Bibiana Bielekova (1)
Faculty of Medicine, Department of Dentistry,
National Institutes of Health, National Institute of Neurological Disorders and Stroke/
Neuroimmunology Branch, Bethesda, United States (1)
Mother Teresa University Clinic , Tirane, Albania
Introduction Dental decay, also known as dental caries,
is defined as a disease of the hard tissues of the teeth
caused by the action of microorganisms, found in plaque,
on fermentable carbohydrates (principally sugars). At the
individual level, caries is a preventable disease. Given
its dynamic nature the disease, once established, can be
arrested or reversed prior to significant cavitation taking
place. At the level of hydroxyapatite crystals it can be
regarded as a ubiquitous phenomenon.
Aim Our study aimed to analyze the carious status of the
first permanent molar in 442 children aged 6-18 years
randomly presented for examination at Mother Teresa
University Clinic. The second aim was to assess needs the
treatment and suggested a degree of planning for oral
health programs.
Methods An analytical study design was used to determine
the prevalence of dental caries in the FPMs. The sample
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consisted of 93 children total treated for the first permanent
molar aged 6 -18 years in Pedodontic. The study was
statistically analysed.
Results In total 10.7% of the children in the sample had
all four first permanent molar teeth affected by caries.
Prevalence of having all four first permanent molar teeth
affected by caries by age was highest amongst the 13year olds and behind them are ranked the 17 and 18 year
olds while the group of the 6 and 11-year olds had low
prevalence .The number of carious first permanent teeth
increased with age.
Conclusions The prevalence of caries in the FPMs was
high. It increased as the age of the child increased.
Children, who visited Mother Teresa University Clinic
had problems with oral hygiene.
Keywords: Dental caries, prevalence, oral hygiene
Introduction Markers of oxidative stress have been
observed in the pathology studies of brain tissue from the
multiple sclerosis (MS) patients. There are two potential
sources of reactive oxygen species (ROS) in the intrathecal
compartment of MS subjects: 1. Oxidative burst of the
immune cells and 2. Failing mitochondria. Because most
of the mitochondrial defects observed in MS tissue point
towards functional deficiency of electron transport chain
(ETC) complex I, we are currently investigating whether
therapy with idebenone may improve generation of ATP
by mitochondria in demyelinated tissue by bypassing
dysfunctional complex I, as it does in Leber’s hereditary
optic neuropathy. However, idebenone is also considered
an anti-oxidant. Therefore, we wanted to determine if in
vivo achievable concentrations of idebenone can effectively
inhibit oxidative burst of the immune cells.
Methods Fresh whole blood samples from healthy donors,
untreated MS patients and idebenone treated PP-MS
patients participating in IPPOMS clinical trial were subjected
to osmotic lysis of red blood cells. The remaining white blood
cells were pre-treated with 20nM (N=17) or 120nM (N=20)
of idebenone and 10uM diphenylene iodonium (DPI; N=37),
a NADPH oxidase inhibitor, which served as our positive
control. The oxidative burst of granulocytes, monocytes and
lymphocytes was determined by longitudinal measurements
(every 5 min for 30 min) of fluorescence intensity of immunce
cells after addition of Fc-oxyburst reagent, which increases
green fluorescence upon oxidation by H2O2 generated by
oxidative burst.
Results: Neither 20nM, nor 120nM concentration of
idebenone had significant inhibitory effect on oxidative
burst. These concentrations correspond to peak CSF or
peak plasma concentrations of free idebenone achievable
with 2250mg/day dosing. In contrast, DPI significantly
inhibited oxidative burst of all three cellular subtypes.
Conclusions: It is unlikely that in vivo achievable
concentrations of idebenone can significantly inhibit
oxidative burst of immune cells. Therefore, if idebenone
therapy results in the inhibition of intrathecal oxidative
stress, such effect has to be atributed to the inhibition of
ROS formation by failing mitochondria.
Keywords: Primary progressive multiple sclerosis (PPMS), reactive oxigen species (ROS), idebenone, oxidative
burst
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Diabetes-related emergencies in Albania –
Are the guidelines being followed?
Keri D1, Ylli A1, Zaimi E2, Alimehmeti I1
1
Endocrinology Service, UHC “Mother Theresa”, Tirana-Albania
2
Emergency Department, UHC “Mother Theresa”, Tirana-Albania
Introduction Diabetes mellitus is a chronic and progressive
disease known to cause several chronic and acute
complications, some of which are regarded as emergencies
in various international guidelines and require emergent
hospitalization. No study has been carried out yet to assess
guidelines following and criteria fulfillment for diabetesrelated emergency hospitalizations in Albania.
Objective Assessment of diabetes-related emergency
hospitalizations criteriain Albanian routine in confront to
current and updated international and national diabetes
guidelines.
Patients and Methods All patients hospitalized in
the Endocrinology Service and classified as diabetes
emergencies by the Emergency Department between
January and June 2012 were enrolled. Patients only
presenting to the Emergency Department and then
discharged without being hospitalized were ruled out. Clinical
and biochemical data were collected and classification as
diabetes emergency was defined using American Diabetes
Association (ADA) criteria and Albanian national criteria.
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Results During this six-month period 156 patients who
presented at the Emergency Departmentwere hospitalized.
Ketones were measured in only 40 (25.6%) cases, therefore
not assessing 116 patients. Diabetic ketoacidosis (DKA)
was present in 28 (70%) of these patients. Hyperosmolar
hyperglycemic nonketotic syndrome (HHNS) was present in
2 (1.3%) patients. Hypoglycemia was diagnosed in 8 cases,
but hypoglycemic coma was present in only 5 of these
cases (3.2%). Newly diagnosed diabetes was present in 47
(30.1%), of whom 42 (26.9%) had type 2 diabetes and 5
(3.2%) had type 1 diabetes. Importantly, ketones were not
assessed in 31 (66%) cases with newly diagnosed diabetes.
Diabetic foot complication was present in 16 (10.3%) cases,
of whom 2 (12.5%) were newly diagnosed type 2 diabetes
patients. 69 (44.2%) patients presented only hyperglycemia
with no other diabetes-related emergent comorbidity or
complication.
Conclusions Admission from the Emergency Department
is not following any of the international or national
guidelines. Only 35 (22.4%) cases fulfilled ADA criteria for
emergency recovery. National criteria were met in only 71
(45.5%) cases. Effort must be made to respect and follow
such guidelines in order to invest all human and financial
resources in real diabetes-related emergencies.
Assessment, evaluation, and follow-up of incidentally
discovered adrenal formations by radiologic examination
(incidentalomas): A two-year study
Burda I1, Shkurti A1, Ylli A1, Alimehmeti I1
1
- Endocrinology Service, UHC “Mother Theresa”, Tirana-Albania
Introduction Imaging techniques have become a
milestone of the diagnostic evaluation of various
pathologies. Therefore, adrenal incidentalomas are being
discovered much often lately. On autopsy studies adrenal
incidentalomas are refered to be present in between 1.4%
and 9% of the cases. Previous studies report that CT
scans discover adrenal incidentalomas in 0.6-1.3% of the
examinations.
Objective Assessment, evaluation, and 1 year follow-up of
adrenal incidentalomas discovered in a two-year period at
the UHC “Mother Theresa”, Tirana.
Patients and Methods All patients diagnosed with adrenal
incidentalomas between June 2010 and May 2012 were
enrolled. Demographic, laboratory and imaging data were
noted. Patients were followed-up for 1 year. All patients with
functioning adrenal formation were refered to the surgeon.
All removed adrenal formations underwent biopsy.
Results In this two-year period 17 patients presented
with adrenal formations, of whom 10 cases had adrenal
incidentalomas. The other 7 cases had clinical signs
and symptoms orienting towards Cushing disease or
pheochromocytoma, thus were ruled out. Age range
was 22-74 years, with age >55 years dominating (70%).
Female-to-male ratio was 1.4:1. Hormonal evaluation
revealed 3 (30%) pheochromocytomas, 2 (20%) cortisol
secreting adenomas, and 5 (50%) nonfunctioning adrenal
formations. Functioning formations dimensions were 3-6.1
cm. Nonfunctioning formations dimensions were 1.2-7.6
cm. All 5 patients with functioning formations underwent
unilateral adrenalectomy and biopsy examination. Biopsy
confirmed all diagnoses made for pheochromocytomas and
1 (50%) cortisol secreting adenoma. In the remaining case
biopsy could not differentiate between well differentiated
carcinoma diagnosis and adrenal cortex adenoma.
Eventually, all patients with functioning adrenal formations
achieved normal hormonal levels after surgery.
Conclusions The much more frequent use of imaging
diagnostic thecniques is revealing clinically unsuspected
adrenal formations (incidentalomas), of which cases
a relevant percentage is compounded by functioning
adenomas, albeit not excluding the presence of malignancy.
Therefore, not missing adrenal incidentalomas diagnosis
and their careful medical and, if needed, surgical evaluation
and treatment are mandatory.
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Comparison between enzyme-linked immunosorbent assay
(ELISA) AND enzyme linked fluorescent assay (ELFA) for the
detection of Toxoplasma gondii antibodies
BLERTA LAZE¹, Anila Mitre², Blerta Dardha², Hysnela Marra²
“Ismail Qemali” University, Vlorë “Intermedica” Clinic, Tiranë
Introduction Toxoplasma gondii is a parasitic protozoa
which can be transmitted by eating infected meat or from
mother to fetus during the first trimester of pregnancy.
This microscopic parasit can cause fetal infection with
unpredictable consequences in later life. Medical diagnostic
is working to determine the most sensitive techniques for
the detection of T. gondii antibodies, in the framework of
which is developed this scientific work.
Methods An enzyme-linked immunosorbent assay (ELISA,
applied in CHORUS instrument) was compared with an
enzyme-linked fluorescent assay (ELFA, applied in MiniVidas instrument) for the detection of Toxoplasma IgG and
Toxoplasma IgM antibodies. We analyzed 100 patients with
both techniques, out of which 50 for detecting Toxo IgG and
50 for detecting Toxo IgM antibodies.
Results The ELFA technique showed a specificity of 95%;
sensitivity of 97% for Toxo IgG, and specificity of 97%;
sensitivity of 93% for Toxo IgM. While ELISA technique
showed a specificity of 90%; sensitivity of 94% for Toxo
IgG, and specificity of 97%; sensitivity of 92% for Toxo IgM.
Conclusions Although the principle of both tests, based
on the detection of antigen-antibody reactions by means of
a labelled anti-antibody, is the same, each possesses its
own particular technical advantages and disadvantages,
and both require their own expensive equipment for the
reading of the results. The ELFA method was considered
more specific and technically more advantageous than
ELISA. ELISA, which is applied in Chorus instrument, is
recommended for quick examinations but in doubtful cases
it is important for patients to be tested with ELFA technique.
Keywords: ELISA, ELFA, ToxoplasmaIgG, ToxoplasmaIgM.
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Comparison of chromosome banding analysis and interphase FISH
in chronic myeloid leukemia patients treated with Gleevec
D. ROKO¹, A. Babameto - Laku¹, V. Mokini¹, M. Cikuli¹
¹ Service of Medical Genetics, University Hospital Center “Mother Theresa”, Faculty of Medicine,
Tirana, Albania
Introduction Chronic Myeloid Leukemia (CML) is a clonal
disease characterized by balanced translocation between
chromosomes 9 and 22 (Philadelphia chromosome). The
resulting BCR-ABL gene, has tyrosine kinase activity which
stimulates cellular growth. Imatinib mesylate (Gleveec) is a
specific and potent inhibitor of the BCR-ABL tyrosine kinase
which gives hematologic and cytogenetic results in CML
patients during the chronic phase. For the diagnosis of CML
and for monitoring the treatment of response, the detection
of the t(9;22)(q34;q11) or the BCR-ABL rearrangement is
necessary. Chromosome banding analysis (CA) is still the
gold standard but other techniques like fluorescence in situ
hybridization (FISH) are available.
Methods From April 2009 to January 2011, we analyzed
52 CML patients aged 18 -70 years old during the chronic
phase of the disease in parallel with CA and interphaseFISH. All patients were diagnosed at the Haematological
Service in University Hospital Center ¨Mother Theresa¨.
Gleevec was used as initial therapeutic treatment.
Results FISH and CA results were directly compared.
Based on the analyses of > 200 nuclei per patient, FISH
correlated closely with CA. After 12 months therapy, 47
of these patients (90%) had cytogenetic responses, of
which 33 patients or (70%) achieved complete cytogenetic
responses evaluated by chromosome banding analysis. In
5 cases with no Ph+ metaphases in CA, interphase-FISH
detected 2 to 10% BCR-ABL+ rearrangements.
Conclusions CA and interphase-FISH give reliable results
but in our study we confirmed that FISH is a sensitive
technique for the evaluation of molecular response in
patients with CML. Furthermore, FISH probe detected
BCR/ABL rearrangement, which were not visible by CA.
We concluded that FISH reliably detects standard Ph
chromosomes as well as its variant translocations and
accurately quantifies BCR/ABL rearrangements prior and
during cancer treatment in daily routine tumor cytogenetic
diagnostics.
Keywords: Chronic myeloid leukemia, Ph-chromosome,
cytogenetic results, chromosome banding analysis,
fluoresence in situ hybridisation.
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Variability of parathyroid hormone and other markers of bone mineral
metabolysm in Albania
Merita RUMANO1, Anila MITRE1, Elvisa RUMANO2, Jotilda JOTI3
1. Tirana University, Faculty of Natural Sciences, Department of Biology
2. Pharmacy student
3. Biologists, Biocheck Diagnostic Center
Introduction Parathyroid glands play a key role in
the regulation of calcium metabolism. They produce
parathormone, which functions to maintain normal serum
calcium and phosphate concentrations.
Methods For the purpose of this research it has been
analyzed a group of 200 randomly chosen individuals in
the Albanian population aged 20 - 65 years old, a group of
286 individuals suspected for parathyroid problems in the
University Hospital Center “Mother Teresa” in Tirana, as
well as a group of 83 individuals diagnosed with secondary
hyperparathyroidism in the University Hospital Center
“Mother Teresa”. The randomly chosen individuals were
taken under examination to check for the present value of
parathyroid hormone in fasting blood collected in pre-chilled
tubes and all the individuals with a PTH value different from
the reference interval are examined for other parameters,
such as: 25-hydroxyvitamin D, Calcium, Potassium,
Sodium, ALP, AST, Albuminemia and Phosphates, while
the patients of the two other groups are examined for all
the above parameters. PTH and serum concentration of
25(OH) D were measured by Electrochemiluminescence
immunoassay, while total Ca, ALP, AST, albuminemia and
Phosphates were measured by turbidimetry method on
Coobas 6000 system and electrolytes by the electrolytmeter
9180 Electrolyte Analyzer, Roche.
Results The healthy population resulted in 5.5% of
the cases with hyperparathyroidism and in 1.5% of the
cases with hypoparathyroidism. 129 individuals from
the suspected group for parathyroid problems resulted
with primary hyperparathyroidism, 17 individuals with
hypoparathyroidism and 140 resulted normal. A secondary
hyperparathyroidism group, was monitored regularly and it
was noticed that high PTH values ​​in these individuals lead to
significant deficiency of vitamin D, in some cases < 5ng/ml,
hypocalcaemia and very high levels of phosphates in serum
with a mean serum phosphate value of 4.9 mg/dl. The mean
(SD) age for primary hyperparathyroidism patients is 43.5
(14.14) and 53 (12.18) for secondary hyperparathyroidism.
Conclusions According to this study, it is a high biologic
variation of PTH, but further studies are required to confirm
whether the biologic variation of PTH differs at different
intact PTH concentrations, at different times of the day.
Keywords: parathyroid glands, PTH, 25-OH D vitamin,
hypoparathyroidism, hyperparathyroidism
The information about dental instructions in patients with
hemophilia in the Albanian society
Neada HYSENAJ-Dentist in the UNIVERSITY DENTAL CLINIC
Florion Tabaku-Dentist in the TABAKU Dental Clinic
Xhanina Gavazi-UNIVERSITY DENTAL CLINIC
Introduction A proper dental care is important for each
person, but it is especially important for people with
Hemophilia Disease. This study measures the knowledge
of hemophilic patients and the results after the instructions
for oral hygiene in patients related to Albanian Hemophilia
Society.
Methods In this study were examined 40 patients. They were
selected with their wish by the Albanian Hemophilia Society.
A questionnaire was used to point out the information of the
patients before and after oral hygiene instructions. In the
questionnaire were included the actions through which the
patients can prevent oral diseases such as: dental caries,
periodontal diseases, dentures or orthodontic treatments.
After the questionnare a brochure with these informations
was delivered to the patients.
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Conclusions The information of hemophilic patients
about oral hygiene was not at the satisfactory levels.The
awareness of the patients about some factores of oral
hygiene after reading the brochure increased. Althogh it
is required further instructions,especially for this part of
society.
Keywords: Hemophilia,dental instructions, knowledge
Patients-perceived family and social support in managing diabetes
Zeqja Anisa1, Keri Denisa1, Gee Benjamin2, Alimehmeti Ilir1,
1
Service of Endocrinology – UHC “Mother Theresa”, Tirana – Albania
2
International Virtual eHospital, Tirana – Albania
Introduction Family and social support is a very important
element in managing all chronic diseases. Diabetes affects
not only health, but it affects also, among others, lifestyle,
diet, family and social relationships. Different ethnic and
cultural populations rely differently on family and society in
getting support.
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Results The patients who were examined were 30 females
and 10 males.The average age was 23years old.30 patients
were infected with A Type Hemophilia.Most of the patients
had little information about oral hygiene.After the brochure
there were significant changes related to: regular visits
to the dentist,brushing and floosing regularly the teeth
and factors related to bleeding.The other factors had no
significant changes.
Aim Evaluation of family and social support in managing
diabetes as perceived by patients.
Methods 70 inpatients (patients with diabetes recovered
during February-March 2013) with diabetes diagnosed
at least 1 year ago were interviewed on issues regarding
A bstracts B ook | 67
diabetes managing and family and social support.
Demographic and clinical data were recorded too.
Results 36 females (51.4%) and 34 males (48.6%), with
average age 53.4 years (standard deviation 11.1), were
interviewed. Time with diabetes was: 1-3 years in 16
(22.9%), 3-6 years in 12 (17.1%), 6-9 years in 11 (15.7%),
9-12 years in 10 (14.3%), and >12 years in 21 (30%)
patients. Support was considered as good if patients
answered that they agree or totally agree to the relevant
questions. 67 (95.6%) patients affirmed that family was
aware that they have diabetes, against 50 (71.4%) affirming
the same for their friends. 54 (77.2%) patients confirmed
good family support in accommodating their needs,
against 39 (55.7%) confirming good social support. Overall
satisfaction about family support in managing diabetes
was evaluate as good by 64 (91.4%) patients, meanwhile
45 (64.3%) patients referred the same for social support.
Interestingly, only 5 (7.1%) patients answered that they
were calling a family member or a friend with diabetes to
ask diabetes-related questions, against 27 (38.6%) patients
calling an endocrinologist or general physician.
Conclusions Overall family and social support was
perceived as good by most of the patients. Family support
was superior to social support in all diabetes-related fields.
Interestingly, confronted to females, males declared higher
rating for family support and lower rating for social support,
although family support was more rated by both genders.
A possible explanation of this difference between genders
may be that, in most of the families, females are in charge
of family needs. Accordingly, males may get better support
from their partners.
to the septic tanks or the landfill waste , generally 7-8 m
and are closed and have no concrete around the insertion
site. The Buna river water is used for drinking and other
household needs by the Roma community. According to the
qualitative data ,the neighborhood “Guerile” in the informall
area by the Lake of Shkodra and in “Iliria “ in the area where
the Egyptian community lives, water supply is problematic.
In Gruda e Re municipalities, Guci, Bardha and Bleran the
water supply situation has the same characteristics.
Conclusions:Water supply problems in quantity and quality
were observed in neighborhoods and municipalities of the
study, but the study found out drinking water problemalso
in several municipal health centers.
Keywords: drinking water, sanitary aspects, chlorination,
maintenance
Evaluation of microclimate in the health centre of Bathore Tirane
Authors: Msc. Edjona Bici1, Msc. Genc Dervishi1, Petrit Shehu1M.D, Adrian Hoxha1 M.D
National Association of Public Health
1
Water needs assessment in Shkodra
Adrian Hoxha M.D1, 2 Odelia Risilia M.D1. Petrit Shehu1, BCS. Klejda Risilia1,
Msc. Genc Dervishi1, Msc. Edjona Bici1
1
National Association of Public Health 2 Medical University of Tirana
Background: This study is oriented to the assessment
of community needs related to water problems and it was
conducted in Shkodra district in May 2010.The Evaluation is
done in some areas of Shkodra district, neighborhood “Iliria”
and “Guerile”, the municipality Grude, Gucia e Re, Bardhaj
and Bleran. Problems related to water sanitation are vital for
water quantity and quality are important to the community.
Aim: Evaluation of community sanitary hygienic aspects
related to water in order to enhance the quality of life in the
community.
Methodology: A quali-quantitative study. It was elected a
representative sample of N = 224 persons to assess the
needs for water in the district of Shkodra. For quantitative
evaluation it was used a structured questionnaire on
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the impact of low water quality. All data collected by the
questionnaire were analyzed with the Statistical Package for
Social Sciences program (SPSS, version 17). For qualitative
data collection were used the focus group discussions and
individual interviews generated by Haphazard method
and were interviewed 6-12 individuals for each sample.
For this purpose it was used an interview guide based on
the categories of participants and itwas administered a
questionnaire.The Data were coded according the Ground
Theory approach.
Results: Drinking water supply is limited in only 2 hours
a dayand uses the old water pipes. Some of the families
have wells, whose water is not drinkable after the flood,
no analysis are performed to the water and the depth is
limited to 6 m (<10 m in all of the wells). The wells are close
Background: The study was conducted in March-April
2010 for the evaluation of energy efficiency in some health
institutions. Part of this study was to assess the microclimate
in the health centers of Bathore, Tirana. This study is an
attempt to understand the situation of the microclimate in
health institutions and informs on the optimal values of
​​
these parameters allowed.
Aim: Evaluation of the internal environment Bathore’s
Health Centre to increase the quality of service to customers.
Methodology: A point-deskripitv study. Measurement of
microclimate parameters were made such as temperature,
lighting, relative humidity, air movement and also were
monitored indicators that affect these parameters as the
heating system, ventilation, air conditioning HVAC and
lighting Bathore’s Health Centre. The evaluation of these
parameters was based on the optimal values ​​
allowed
adopted by the European Committee. Fo the measurement
were used professional devices in conjunction with the
Occupational Hygiene sector in the Directorate of Public
Health, Tirana.
Results: From the evaluation of these parameters was
observed that the temperature of the internal environment
of Bathore’s Health Centre in all health care settings is from
180 C to 210 C,there is no interior central heating of the
environments, air movements ranges from 0,35 m / s to 0.63
m / s, air relative humidity ranges from 53% - 64%.Lighting
system is carried by luminescent and incandescent lamps
and values ranging
​​
from 149 lux to 1350 lux. A considerable
amount of energy is used for heating evaluated as Eheating =
1050 kWh / month.
Conclusions: There were no significant deviations of
the interior environments microclimate parameters in the
Bathore’s Health Centre. Temperature and relative humidity
in all areas of health care generally fluctuate within the
maximum rates, there was no central heating and sealing
was not guaranteed in all environments equally. Parameters
of air movements present rate fluctuations above the sanitary
permit. Interior lighting system was carried by luminescent
and incandescent lamps. There is no air ventilation system,
and no efficient system of sanitary water preparation.
Key words: temperature, relative humidity, air movement,
lighting system.
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Alloimmunization of Rh-D Negative Pregnant Women in Albania
Alcoholic liver cirrhosis (complications and prognosis)
Estela MUHO, Irena Seferi, Erind Cafi, Jonida Pengu
Resuli Bashkim, Carkanji Anisa
Background
Despite the routine use of Rh D immunoprophylaxis,
clinically significant Anti-D alloantibodies have been found
present in Rh negative women sera during pregnancy.
Early detection of these antibodies is necessary to prevent
harmful effects on the fetus and newborn.
Aims
The aim of this study is to assess the frequency of Rh D
negative among pregnant women referred for testing in
National Blood Transfusion Center and to determine red
cell alloimmunization due to D antigen in Rh-D negative
pregnant women with RhD positive fetus in Albania.
Methods
We analyzed retrospectively data of 3600 pregnant women,
referred to our Center, over a two years period. ABO and
Rh D blood group of the pregnant women was determined
in the first trimester of pregnancy. 828 out of 3600 women
resulted RhD negative. RhD status of the fetus was
determined after delivery. Blood group was identified by
using an DiaMed ID Card ABO/D (DVI+/DVI-)+Reverse
Grouping. Antibody screening was performed to all women,
according to the appropriate protocol in our country. The
presence of red cell alloantibodies was detected using a
three cell screening panel (DiaMed ID DiaCell I-II-III). The
antibodies in the positive sera were identified using 11-Cell
Identification Panel (DiaMed ID DiaPanel).
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Results
The frequency of Rh-D negative among all pregnant women
who were tested was about 23%, while the frequency of
Rh-D negative in Albanian population is about 11%. 67 out
of 828 Rh D negative pregnant women resulted positive to
antibody screening. The immunization rate among these
patients is about 8%. Obstetric history, gestational age
and previous immunizing events were not significantly
associated with the rate of alloimmunization. Anti D was
the most common antibody detected, 91%. It was found in
61 out of 67 alloimmunized pregnant women. In others we
found nonspecific antibodies.
Conclusions
Regardless the implementation of a strategy to prevent the
alloimmunization from D antigen in Rh D negative pregnant
women, Anti-D is still found present in sera in several
cases among these women. More is to be done with the
education of clinicians in our country. Routine testing and
appropriate use of Rh Immune Globulin during pregnancy
and immediately after delivery or termination of pregnancy
can successfully prevent most cases of hemolityc disease
of newborn caused by alloimmunization to the D antigen.
From the results there is a difference in the frequency of
Rh D negative between pregnant women and Albanian
population. This might be due to the reference in NBTC
for antibody screening, mostly of Rh D negative cases.
Since immunization can occur during spontaneous or
induced abortion, ectopic pregnancy, or even during some
procedures like amniocentesis, the clinicians should be
aware to refer every pregnant women for screening in
NBTC.
Introduction
Alcohol is the strongest risk factor for liver diseases,including
liver cirrhosis and hepatocelullar carcinoma.Indeed,the
cirrhosis mortality rate is a good indicator for alcoholic
related mortality.Alcohol consumption in Europe increased
and stabilized at a higher level between 2004 and 2006,with
large variation among European countries.Alcohol is
popular and widely use in Albania.
Aim
To determine the prevalence of major complications of
alcoholic liver cirrhosis and to investigate the short-term
prognosis of the disease
Methods
One hundred sixty eight patients with alcoholic liver cirrhosis,
all man from 28-80 years old (average age 54 years),
consequtively admitted to University service of GastroHepatology (University Hospital Center “M.Theresa”) were
included in this retrospective study from January 2009 to
March 2010. All patients had a history of alcohol abuse of at
least 200 gr of ethanol(daily for several years). We excluded
patients with hepatocelullar carcinoma. MELD score
[MELD=3.8 [ln total bilirubin(mg∕dl)] + 11.2 [ln INR] +9.6 [ln
creatinine(mg∕dl)] was used to evaluate the degree of liver
failure. Student test and Z test were used for comparison
of MELD score points between patients with and without
complications.
Conclusions
1.The most frequent complications of alcoholic liver cirrhosis
was ascites,appearance of esophageal varices,hepatic
encephalopathy,gastrointestinal bleeding, hepato-renal
syndrome and spontaneous bacterial peritonitis respectively
78.9%, 61.7%, 38.1%, 21.4%, 16.3% and 10.1%
2.MELD score must be taken in consideration for adequate
evaluation of end –stage liver disease.MELD score higher
than 20 were strongly related to worse prognosis
STUDENT’S PRESENTATIONS
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A bstracts B ook | 71
A two-year retrospective study of risk factors for stroke among adults
under 55 years in Albania
Etiology
Lekli E1, Hysenaj A1, Ajdini A1, Grabova S2, Alimehmeti I3, Dobi D2, Kruja J2
Number of patients
Percentage
Choledocholithiasis
19
39%
Pancreatic cancer
16
33%
1
Faculty of Medicine, University of Medicine, Tirana-Albania
Cholangiocarcinoma
5
10%
2
Neurology Service - UHC “Mother Theresa”, Tirana-Albania
Ampulloma
2
4%
3
Endocrinology Service - UHC “Mother Theresa”, Tirana-Albania
Others (acute pancreatitis, Courvoisier syndrome,
HCC, iatrogenic jaundice)
7
14%
Introduction Cerebrovascular disease is not a common
health condition in adults younger than 55 years. In Albania,
no study has been carried out to evaluate risk factors for
stroke in this population.
Objective Risk factors evaluation for stroke among adults
aged under 55 years.
Patients and Methods 193 patients presenting with stroke
between 2010-2011 were enrolled in the study. Patients
were evaluated for life style risk behaviors, presence
of dyslipidemia, arterial hypertension, diabetes, atrial
fibrillation and positive familial history for stroke.
Results Of 193 patients, 160 males (82.9%) and 33 females
(17.1%) of average age 48 years (S.D. 7.6), 158 presented
with ischemic stroke (81.87%), 26 with hemorrhagic stroke
(13.5%), 9 with HSA (4.66%). Hypertension was present in
105 (54.4%), diabetes in 44 (22.8%), atrial fibrillation in 7
(3.63%). 45 (23.3%) were both smokers and alcohol users,
18 (9.3%) were smokers, and 10 (5.2%) were alcohol users.
Importantly, a total of 73 (37.8%) had unhealthy behaviors.
Cholesterol level was 211.17 mg/dl (S.D. 67.74 mg/dl), 40%
had hypercholesterolemia (total cholesterol >220 mg/dl).
Triglycerides level was 164.71 mg/dl (S.D. 90.39 mg/dl),
49.6% had hypertriglyceridemia (triglycerides >150 mg/dl).
Only 9 (4.66%) had positive familial history for stroke.
Patients mainly complain of jaundice (100 %), pain in the
right hypochondriac region (90%), nausea/vomiting (59%),
pruritus (35%), weight loss (31%), dark-colored urine (24%).
Biliary obstruction is typically associated with significant
increase in bilirubin levels with an average of 8.6 mg/dl
(±6.8 mg/dl).
39 patients underwent surgery. Surgical treatment depends
on the etiology of biliary obstruction.
1. Choledoco-duodenal anastomosis in 69% of
patients (diagnosed with pancreatic cancer or
choledocholithiasis).
Conclusions Most prominent risk factors were male gender,
age over 45 years, presence of diabetes. Other important
risk factors were hypertension, dyslipidemia, smoking and
alcohol use. Positive familial history for stroke resulted a
non-significant risk factor.
2. Choledocotomy, Kehr’s drain in 10% of patients
(diagnosed with choledocholithiasis).
3. Cholecystectomy, biliary stenting in 8% of patients
(diagnosed with cholangiocarcinoma).
Biliary obstruction treatment
DENISA NAZARKO1, Ledina Mesiti1, Dr.Denis Godaj2, Prof.Ass. Xheladin Dracini2,
Prof.Ass. Arvin Dibra2, Prof.Dr. Etmont Celiku*
1 Third year student, Faculty of Medicine.
2 1 Clinic of General Surgery.*
st Chief, 1 Clinic of General Surgery. st
Introduction The aim of this one year retrospective study
(held in the 1st Clinic of General Surgery) is to describe the
demographic, etiologic, clinical and diagnostic data, and the
treatment of biliary obstruction as well.
Methods We conducted the study in the interval between
01.01.2012 and 31.12.2012. We analyzed 49 clinical charts
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of hospitalized patients diagnosed with biliary obstruction.
Results Demography: 49 patients; 26 males (53%) and 23
females (47%).
Study group’s average age of patients is 64 (±14) years old,
males 63 (±13) and females 66 (±14).
4. Papillectomy, reimplantation of choledochus and
Wirsung’s duct in 8% of patients (diagnosed with
ampulloma).
5. Laparotomy, biopsy in 5% of patients.
Conclusions Biliary obstruction is a common surgical
pathology in our country due to the absence of ERCP
(Endoscopic
Retrograde
Cholangiopancreatography)
in our clinic. This pathology reaches its peak level
around the sixth decade of life and affects both men and
women with an equal frequency. Due to deficiencies
in infrastructure we could not follow closely the
international guidelines suggested in these cases.
Keywords: biliary obstruction, choledoco-duodenal
anastomosis, choledocholithiasis, Kehr’s drain, pancreatic
cancer, bilirubin, jaundice
Infant mortality in republic of Kosova during 2005-2010
FLORAN SAHITI, Mergita Ferizi, Jehona Krasniqi, Shqipërim Aliu
Introduction and aim The aim of this retrospective paper
is evaluation and analysis of infant mortality, presentation of
the main causes and the impact of maternal education level
in infant mortality during 2005-2010 in Kosova.
Methods The data used in this paper were taken from the
annual official publications of Statistical Agency (KSA) for
the period 2005-2010.
The data are related to infant mortality, specifically during
the corresponding years data were taken for the dead
babies by mother’s education level where for the reason
of study only two levels of maternal education will be
analyzed. Descriptive tabulations data are presented and
interpreted. The data derived were tested p=0.05. The trend
of the phenomena is also analyzed.
A bstracts B ook | 73
Results Infant deaths in the Republic of Kosova in the
period 1 January 2005 to 31 December 2010 are in a total
of 2030 cases (this includes dead babies up to 365 days
of age). Within the total, perinatal mortality leads with the
greatest number of 1275 cases or 62.8% . Then we have,
post-neonatal mortality with a total of 492 infant deaths or
24.23% and the third by total is neonatal mortality with 263
infant deaths or 12.95%
In all the above mentioned subdivision noticed a trend of
male domination of approximately 5% for infant deaths.
20% of the total deaths occurred in the first 24 hours of
birth with a total of 407 cases for this time interval that is
approximately 68 deaths in a year in this vital interval .
Conclusions Although the number of infant deaths in
Kosovo has declined in recent years, the country still tops
the list of European countries in infant mortality. - The rate
is still higher than it should be with 17.1 deaths in 1000
births - a huge decrease from 2000, when the number of
deaths was 29 per 1,000 births. A lack of professionalism
and financing in the health care system and other factors
such as poverty and education continues to contribute to
Kosovo’s high infant mortality rate, as well as the deaths
of many mothers during childbirth. It is proven that there is
no significant difference between two levels described of
mother education in infant mortality
Keywords: infant mortality, Kosova, maternal education,
health care, babies
Nutritional status and dietary habits of students in Tirana, Berat and Korça
MEÇANI Holta, Xhemollari Lodrina, Cjapi Lysjena, Hoxha Meri
Faculty of Public Health, University of Medicine, Tirana, Albania
Introduction Nutritional status is crucial for maintenance
of a good health. Students have different eating habits.
Therefore, this study is an effort to understand the
information that students have about healthy eating and to
evaluate their nutritional status.
AIM: Assessment of nutritional status and dietary habits
among students.
aim
▪
▪
To assess nutritional habits among students
To calculate BMI and to compare it between
participants according to the cities.
Methods This is a qualitative-quantitative and crosssectional study, which was carried out from 25th February to
2nd March. The sample involved 200 students, aged 18-30
years old, in universities of Tirana, Korça and Berat. The
questionnaire contained 32 closed questions. Statistical
analysis of the results was conducted using SPPS v.19.0.
Results While analyzing data, we found out that students do
have
healthy
eating practices. Another
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issue we identified was the percentage of overweight
(16.08 %). Only 12.56% of participants were underweight.
After comparing BMI level according to the cities we noticed
that in Tirana there are more overweight students than in
two other cities. In Berat we founded more underweight
students compared to other cities.
Meals skipping,
especially breakfast was another phenomenon we figured
out. Only 10% of participants take 5+ meals/day. 84 % of
students ate less than 5 fruits and vegetables/day.
Conclusions In our study we noticed some phenomenons
like meals skipping, lower intakes of fruits and vegetables
etc. The malnutrition was more or less moderated due to
student’s knowledges on healthy eating. Still malnutrition
remains an important health issue to be considered in
the future studies. Therefore we highlight the necessity
of proper dietary habits and reduction of malnutrition to
improve student’s nutritional status.
Keywords: Nutrition, Nutritional status, students, dietary
habits
Surgical treatment of inguinal hernia
Amela HASA, Bora Muhametaj, Erilda Zyka, Prof.Asc.Arvin Dibra
First Clinic of General Surgery in University Hospital Center Mother Teresa (QSUT), Tirana, Albania
Aim The aim of this study is to determine the current
treatment for Inguinal Hernia in our Hospitals.
Methods We present a prospective randomized study on
patients treated with Inguinal Hernia from December 15th
2012 to March15th 2013, in the First Clinic of General
Surgery in University Hospital Center Mother Teresa
(QSUT). ). During this period, there were treated 64 patients
with Inguinal Hernia .The patients were submitted to a
questionnaire before the surgery, which was completed with
the rest of the details on the first post operatory day.
Results The age range was from 25 years to 84, with an
average of 58 years. 14% of patients were females and
86% were males. In 17% of the cases the hernia was
incarcerated and was treated in emergency and 12% of
the cases the hernia was diagnosed as irreducible.60.9%
of the patients presented a right inguinal hernia, 32.8%
on the left and in 6.3% the disease was presented as
bilateral.74.5% of patients were hospitalized for the first
time for this pathology and 6.4% of them had recidivism.
Looking to the disease history, the 84.6% of the patients
presented pain and prominent buldge as first symptom, and
in 14.5% of them ,vomiting. Time when the first symptoms
occurred goes medially from 1month to 20 years.41% of
the patients, related the hernia with heavy weight lifting,
15.4% with cronical coughing, 5.2% with trauma, 2.6% with
pregnancy, 25,6% shows familiar history of the disease,
and a smaller percentages related it with constipation and
disuric problems. All the patients were treated with open
surgical hernia repair. In 87.5% of the patients was applied
the synthetic prolen mesh according to the Lichtenstein
technique, and in 12.5% of the cases was used the Bassini
technique, mainly because of the lack of mesh in emergency.
After surgery, 90.2% of the patients were treated with
anticoagulants, 100% with antibiotics, and approximately
2.4 lt perfusions each patient. The pain was treated as
follows: 8% of the patients had only NSAIDs, 42 % only
opiats and 50% a combined therapy of them. The average
time after surgery needed from the patients to mobilize was
11 hours. The average hospital stays in monolateral hernia
cases, was 2 days.
Conclusions Inguinal Hernia is a frequent pathology in our
wards/hospitals, with a significant impact, both on morbidity
and limitation of working capacity. The elected therapy is
focused on surgery, if possible, using synthetic protesis
according to the Lichtenstein technique.
The treatment of ureteral stones with ESWL at urological
clinic during 2010-2012
Aurela MIFTARI, Edip BEZHANI, M.D
Faculty of Medicine, University of Medicine, Tirana, Albania
Aim The results of treatment with ESWL for ureteral stones
in patients treated at the department of urology during the
period 2010-2012.
Methods We have studied the records of lithotripsy center
for 186 patients who have been treated with ESWL for
ureteric calculi during 2010-2012 and their progress has
A bstracts B ook | 75
been under surveillance. Statistics show that the risk
of forming ureteric stones is more predominant in men.
Furthermore, some patients are exposed to the risk of
forming stones more often than others (only once in their
lifetime). The purpose of this study was the assessment of
the therapeutic efficiency, complications and limitations of
ESWL in the initial experience. We investigated 640 cases
of stone diseases treated in our hospital, between January,
2010 and October, 2012.In the first procedure were treated
104 patients (56%),in the second procedure were treated
71 patients(26%) and in the third procedure were treated
11 patients(18%).
Results 186 or 29% of cases are with ureteral calculi (86
females, 100 males). Diagnosis work-up included physical
examination, lab test (urine culture, urinalysis, antibiogram)
etc. More severe complication is (renal colic) were noted
(16.7%) or 31 cases. Than the sepsis with 17 cases
(9.1%) Steinstrasse was diagnosed in 11cases (6%).Some
of patients were treated with secondary and adjunctive
procedures 24cases (13%).
-24 or 13% of patients are treated with stent or ureter scope
-162 or 87% of patents had stone expulsion
-Stone localization with i/v contrast before the procedure,
15 cases or 8%
The proximal ureteral stones have higher percentage of
success, 6 hours after the beginning of the renal colic.
Patients underwent the procedure with pain management
and sedation. They received NSAID, opioids following the
procedure. Stone location: CUD with 99 of cases (53.22%)
and CUS with 87cases (46.78%).
The number of procedures:
The first and repeated procedure
The second and adjunctive procedure
Conclusions ESWL can be according to the positive results
of ureteral calculi less than 10mm in the first line of treatment.
In summary, we believe that in situ ESWL provides optimal
first line therapy for distal ureteral calculi Promising new
technical developments are under development, with the
potential to increase the stone-free rate after ESWL. For
optimal results, the refined indications need to be respected
and optimized treatment protocols should be applied.
ESWL procedure seemed to be more effective and safe
than the others. . It has an efficiency rate above 90%, low
procedure time, high safety, good tolerability and minimal
complications.
Telling the truth to the patient about the diagnosis and prognosis and how
does this effect on physician-patient’s collaboration and in the treatment
efficiency
Prof. Dr. Bardhyl Cipi expert of Legal Medicine, The central University Service of Legal Medicine in Tirana,professor of
biothetic and Legal Medicine University of Medicine in Tirana, member of some international bioethics associations
Eralda Lekli Medicine student, University of Medicine in Tirana
Joana Hankollari Medicine student, University of Medicine in Tirana
Ritjana Mala Medicine student, University of Medicine in Tirana
Aim How does it influence in the physician-patient’
collaboration and also in the treatment efficiency, telling
patient the truth about his diagnosis and prognosis .
Which are the main reasons that don’t let the physician
telling patient the truth.
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Methods 100 physicians and residents were surveyed in
Tirana University Hospital Center “Mother Teresa”. They
were asked about the frequency of telling patient the truth,
about situations when they have not been told the truth, so
what have they communicated in these cases, if there have
been any incident when the truth have been revealed and
about the influence of telling truth patient on the physicianpatient collaboration and also in the treatment efficiency.
Results 38% of the surveyed persons usually tell the truth
to the patient,23% of them tell it often and 15% of them
always.
In the cases when the truth is hidden, the main reasons are:
• The relatives asked for it
• Uncertain diagnosis
• They think telling the truth would have a negative
impact on patient’s psychological state.
• Grave prognosis
The two last reasons are more frequent.
In 29% of cases when they haven’t communicated the truth,
they have refered a diagnosis with better prognosis. In 25%
of cases they have only explained them the real condition
without giving any reasons.
Though physicians have acted in this way, 62% of them think
that the truth should absolutely be told. They also think that
the collaboration is always improved when the prognosis is
good and very good. In bad prognosis, 25% of them think
that the truth usually improve the collaboration,21% of
them sometimes and 20% of them always.
Conclusions Most of interviewed think that in good
and very good prognosis the truth always improves the
collaboration; while in bad prognosis 25% of them think that
the truth usually improve the collaboration, for 20% of them
this always improve it and for 21% of them sometimes.
Keywords The truth, the diagnosis, the prognosis, the
physician - patient’s collaboration
Ps.: always = 100% of cases, usually = 75% of cases, often
= 50% of cases, sometimes = 25% of cases, rarly = 10% of
cases, never = 0% of cases
Physical activity, sedentary lifestyle and fitness level among college students
in the university of medicine in Albania
Janko M1, Xherahu E1, Xhavara E1, Memia A1, Shehi E1, Alimehmeti
I2, Toti F2
1
Faculty of Medicine - University of Medicine, Tirana-Albania
2
Endocrinology Service - UHC “Mother Theresa”, Tirana-Albania
Introduction Lack of physical activity is a major risk factor
for overweight and obesity, leading the way to many other
health conditions. Medical students are supposed to be best
informed on this topic. No other study has evaluated actual
physical activity and fitness level in a college students
population in Albania.
Objective Evaluation of physical activity, sedentary lifestyle
and fitness level among college students registered in the
University of Medicine in Tirana.
Methods 301 students (74% females - reflecting the
female-to-male ratio of the total number of students) were
interviewed using a structured questionnaire regarding their
perceived fitness, their physical activity level and beliefs,
and sedentary behaviors. Socio-demographic data were
recorded too. Randomly chosen students were afterwards
instructed to use a pedometer to count the number of daily
steps. BMI was calculated and fat mass was measured
using a hand-to-hand impedance meter.
A bstracts B ook | 77
Results BMI was 21.2 kg/m2 (s.d. 2.49) in females, and
24.5 kg/m2 (s.d. 3.33) in males. Among females 6.8% were
overweight and 0.5% were obese. Among males 37.2%
were overweight, and 6.4% were obese. The opposite was
noted measuring fat mass with females having more fat
mass than males, respectively 28.1% (s.d. 5.76) and 22.2%
(s.d. 2.5). Abdominal perimeter was 72.8 cm (s.d. 6.6) and
88.4 cm (s.d. 11) in males. Average number of steps per
day was 8.214 in females and 10.206 in males. 73% of the
students declared that they were not involved in any kind
of physical activity and 78% confirmed that their physical
activity was not sufficient. 65% were spending >3 hours/day
working or studying in sitting position. 32% were spending
>3 hours/day using the personal computer, but only 9%
declared to watch television >3 hours/day.
Conclusions Although a high level of obesity was not
encountered in this population, a very sedentary lifestyle was
noted with only a small proportion of students approaching
the level of non-sedentary lifestyle (over 10.000 steps/day),
therefore exposing them to weigh gain problems in the next
future. Females were slimmer than males, but they had
higher fat mass percentage and higher level of sedentary
behaviors.
1 Fourth year student, Faculty of Medicine.
2 First Clinic of Digestive Surgery.
* Chief of First Clinic of Digestive Surgery
Results Demography : 84 patients; males (20%) and
females (80%). Average age of patients is 45(±13) years
old, males 50(±14) and females 44(±13). Most of the
patients are residents in Tirana 25 patients, Fier 9 patients ,
Korca 7 patients, Burrel 7 patients.
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Keywords: Radiation exposure, total thyroidectomy,
lymphadenectomy, FNA, radioiodine scan, papillary
carcinoma.
The increasing role of the pharmacist in skin diseases, drugs use and
cosmetic products: What’s more to know?
1
Frosina SHIRA¹,Arjana Zerja¹, Belina Hoxha¹, Elda Kadra¹, Liridona Koloshi¹, Dr.Denis Godaj²,
Prof.Ass.Xheladin Dracini², Prof.Dr Etmont Celiku*.
Methods This is a six year unicentric and retrospective
study, held in the first Clinic of Digestive Surgery. The
study was conducted in the interval between 2006-2011.
We analysed 84 clinical charts of hospitalized patients
diagnosed with thyroid cancer.
diagnostic approach and the management of the patients
have not followed closely the international guidelines.
Joana Mihani1, Elona Saqe1 ,Paola Moni1
Thyroid cancer diagnosis and treatment
Introduction Thyroid cancer is the most common
malignancy of the endocrine system.The pathogenesis
of thyroid cancer is centered on the role of radiation
exposure of the mediastinum,head and neck region which
predisposes to genetic rearrangement. The aim of this study
is to describe the demographic, clinical, diagnostic data and
the experience of the clinic in the treatment of this pathology
as well.
Conclusions Thyroid cancer is a common surgical
pathology in Albania. This pathology affects mostly women
around the 4-5 decade of life and is prevalent mainly
in northeastern and southeastern regions due to iodine
deficiency. The low rate of the patients who have performed
FNA Biopsy and total thyroidectomy reflects the fact that the
Typical clinical symptoms include dyspnea (42%), dysphagia
(35%), profuse sweating (8%),
tachycardia (8%), weight loss (8%), hoarseness (7%),
palpitations (7%), cough (6%). Most of the patients have been
followed-up by the endocrinologist and few of them have
performed the following tests:ORL(otorhinolaryngoscopy)
(17%),FNA(fine-needle aspiration)(22%) and Radioiodine
Scan (18%). The interventions were as below:
1.Lobectomy 31%
2.Subtotal Thyroidectomy 48%
3.Total Thyroidectomy 23%
4.Lymphadenectomy 8%
5.Inoperable 1%
Histopatological diagnosis:
1. Papillary Carcinoma 62%
2. Follicular Carcinoma 29%
3. Anaplastic Carcinoma 7%
4. Medullary Carcinoma 4%
student in the fifth year in the Faculty of Pharmacy , University of Medicine Tirana
Aim The aim of this study is to describe the increasing
role of the pharmacist as an advisor on drugs use in
skin pathologies and cosmetic products. In the Albanian
pharmacies, the space dedicated to these products is
expanding rapidly, but there is also a great need to expand
the knowledge that the pharmacist should have in this area.
Methods This study is based in different literature review
to conclude in the basic knowledge that pharmacists must
have on drugs use in skin diseases and cosmetic products.
Results The pharmacist is a professional, whose role
has radically changed in the latest decades in Albania.
As the awareness of skin problems has increased, even
the role of the pharmacists related to these problems has
changed and developed. In our pharmacies there is a big
number of drugs prescribed by doctors for the treatment of
different skin problems such as acne, eczemas ecc. Due
to this, it is very important to establish a good collaboration
between doctors and pharmacists in order to find the best
treatment for each patient. The discovery of very effective
drugs but highly toxic such as isotretinoine has paved the
way to programs like iPLEDGE, to control its use and in
this area, a good collaboration doctor-pharmacist is highly
recommended. Also, the pharmacist’s role has expanded
in advising patients and helping them find the appropriate
cosmetic product (products that don’t need a medical
prescription). Nowadays, much more people decide with
their pharmacist which is the best product for them. For
example, the pharmacists help people find the best cleanser
for their skin (which can be dry, oily, sensitive or normal).
The pharmacist, having all the knowledge needed for the
different ingredients that these products contain, is the best
qualified person that can help them make the best choice.
Conclusions It is very important for pharmacists to increase
the level of their knowledge upon skin care products.
Some of them are drugs that need a prescription such as
antibiotics, but others can be advised by the pharmacists.
While the parapharmacies areas are expanded, there is
also a real need to increase the pharmacist’s knowledge
over cosmetic products, in order to be able to give people
the appropriate advice in choosing their skin cleansers,
lotions, creams and other cosmetic products, which are
much more present actually in the Albanian pharmacies as
compared with some years ago.
A bstracts B ook | 79
Treatment of prominent frenulum with 980nm Diode Laser
Approach to upper gastro intestinal bleeding
Dritan Ismailaj, Faculty of Dentistry, University of Medicine, Tirana, Albania
Ina SHEHAJ¹, Etleva Kurti¹, Denis Godaj², Prof. Asc. Xheladin Dracini²,
Prof. Asc. Arvin Dibra², Prof. Dr. Etmont Celiku*
Labial frenectomy is a common surgical procedure in
the field of oral surgery. Labial frenectomy is a procedure
generally used for orthodontic and prosthodontic reasons. A
diode laser is a portable, compact, efficient and has a good
bactericide and coagulation properties. A diode laser has a
wavelength between 810 and 980nm.
They can be used in the continuous as well as pulsed mode
with a contact or noncontact handpiece.
The aim of this study was to present the efficacy of using
a diode laser 980nm for treatment of prominent labial
and lingual frenulum and to demonstrate the healing
characteristics after laser surgery.
Materials and methods
Ten patients with prominent labial and lingual frenulum
are included in this report. All patients were treated with
a 980nm diode laser at the Dental University School in
Tirana, Albania. The technique of frenectomy was used
under local anesthesia (lidocaine 2% 1cc). Informed
consent was obtained from all patients. Laser settings were:
fiber optic 300 micrometer, cw, 4 w. The laser fiber was
applied vertically and laterally to the frenulum. All clinical
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participants were exanimated one week, three weeks and
three months after surgery. Postoperative complications,
such as pain, bleeding, swelling scar formation and wound
healing characteristics were evaluated.
Results
No bleeding was observed either during treatment or during
the healing period.
One week after surgery a superficial layer of bibrine was
observed in all clinical cases.
No postoperative pain and swelling were recorded. Three
weeks after surgery oral mucosa was
completely healthy. No scar tissue formation was observed
in any case. In long-term follow-up, the oral mucosa in all
clinical cases looked normal in color and consistence.
Conclusion
The technique of frenectomy is easy, fast and safe to be
performed with a 980nm diode laser. It could be done in
outpatient clinic with local anesthesia, with good degree of
acceptance by the patients and perfect results.
¹ Third year student, Faculty of Medicine.
² 1st Clinic of General Surgery
* Chief, 1st Clinic of General Surgery.
Introduction The aim of this one year retrospective study
(performed in the 1st Clinic of General Surgery) is to describe
the demography, etiology, diagnosis and therapeutic
methods used in Upper Gastro Intestinal Bleeding (UGIB).
Methods Our study is extended on a time interval from
01.01.2012- 31.12.2012. We have gathered data from 168
clinical records of hospitalized patients with UGIB diagnosis.
Results Demography: 168 patients, 132 males (78.6%)
and 36 females (21.4%).
The average age of all patients is 55.7 (± 16.2) years, males
55 (± 17), females 57.8 (± 13.7).
The mortality rate is 1.78% (3 patients).
Patients presented with melena (80%), haematemesis(34%),
haematochezia (48%), fatigue(100%), diffuse abdominal
pain(16%), epigastric pain(12.5%) and syncope(12%).
UGIB is associated with a considerable decrease in
hemoglobin value due to blood loss ~ 8.5 (± 2.87) g/dl.
Endoscopy is used to diagnose the etiology of bleeding in
91% of patients and in 43% to perform sclerotherapy .The
hemostatic therapy consists in injection of Adrenaline
solution added to saline solution. In 7% of the patients
sclerotherapy was repeated twice and in 2% three times.
Number of patients
Percentage
1.Duodenal ulcer
Etiology
69
41%
2.Gastric ulcer
45
26.8%
3.Erosive gastritis
15
8.9%
4.Mixed ulcer
12
7.2%
5.Malignant tumor
12
7.2%
6.Rare conditions(Mallory Weiss, Esophageal Varices, Erosive
Esophagitis,Gastritis)
15
8.9%
15 patients (8.9%) underwent surgery.
1. Ulcer excision was performed in 5.3% of the patients.
2. Gastrectomy in 3.6%.
patients. The percentage of surgical interventions is higher
that the international standard probably due to lack of
alternatives in sclerotherapy.
Conclusions UGIB is a common surgical pathology in
the 1st Clinic of General Surgery. It affects more men
than women. Emergency endoscopy is performed in most
Keywords Upper Gastro Intestinal Bleeding, melena,
haematemesis, endoscopy, hemoglobin, ulcer excision.
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Clinical, laboratory and ultrasound findings in acute appendicitis at
first surgical clinic – Tirana, University Hospital Center “Mother Teresa”
Najada STRINGA Medical student, 4 year, Faculty of Medicine Tirana, Albania
th
Co-author: Adela Karadaku,General Practitioner
Scientific guide: Arvin Dibra M.D
Introduction Acute appendicitis is one of the most common
surgical causes of emergency laparotomy. The aim of this work
was to study the most common findings in patients with acute
appendicitis.
Methods A retrospective observational study with patients
diagnosed with acute appendicitis at First Surgical ClinicUniversity Hospital Center “Mother Teresa” Tirana, during
January-February 2013, was performed .We considered the
following variables: the location of the pain, temperature,
anorexia, nausea, vomiting, the number of leukocytes and the
ultrasound result.
Results Our study included 50 patients with a mean age of
31,8years; 56% of these patients were men and 44% were
women. Regarding the initial location of the pain, it was
epigastric in 38%, located in the right iliac fossa (R.I.F) in
48%, periumbelical in 8% and diffuse in all abdomen in 6%.In
48% of the patients the location of the pain changed from the
initial location into the right iliac fossa. It remained the same in
R.I.F in 48% and it still was diffused in 4%. 14% of the patients
had a normal body temperature, 70% had a slightly elevated
temperature between 37-380C and 16% had a temperature
above 380C. 88% of the patient had anorexia, 70% had nausea
and 56% had vomiting. 76% of the patients had leukocytosis.
The ultrasound confirmed the diagnosis in 70% of the cases.
Conclusions The pain in R.I.F, the leukocyte count, the
ultrasound findings are the most common findings in acute
appendicitis.
Keywords acute appendicitis, ultrasound in appendicitis,
leukocytosis, R.I.F pain.
Rheumatoid factors, anti-mcv antibody, anti-jo-1 antibody levels and
mucoproteins in rheumatoid arthritis
Retina ÇAPUNI, Shqipe Bektashi, Petrit Gecaj, Dashnor Fiska, Steljan Buzo
Number of cases
Mean value
Deviation Standard D.S
Pathologic
interval
Normal
Interval
Percent of
positivity
Rheumatoid
Factors(RF)
20
54 IU/ml
42 IU/ml
12-96 IU/ml
0-10 IU/ml
90%
Anti-MCV
20
68 IU/ml
39 IU/ml
29-107IU/ml
0-20 IU/ml
70%
Mucoproteins
20
66 IU/ml
39 IU/ml
27-105 IU/ml
0-120 IU/ml
10%
Anti-Jo-1
20
4.5 IU/ml
1.24 IU/ml
3.3-5.7 IU/ml
0-20 IU/ml
0%
Introduction In 20 patients with rheumatoid arthritis (RA)
we have observed the relationship between rheumatoid
factor (RF), anti- mutated citrullinated vimentin antibody
levels(anti-MCV), autoantibody directed to histidyltRNA
synthetase (Anti-Jo-1) levels and mucoproteins.
82 | I nternational C ongress
of
B iomedical S ciences
Methods The level of rheumatoid factors were quantified
using the kit Quantia-RF. Quantia-RF is a quantitative
turbidimetric immunoassay for detection of rheumatoid
factors of the IgM class. Serum anti-MCV antibody levels and
serum anti-Jo-1 antibody levels were quantified using Elisa
method, immunoblots technology produced by Orgentec,
Germany. Mucoproteins were quantified with colorimetric
determination of mucoproteins in serum(Winzler’s fraction).
Mucoproteins are separated from other proteins by
precipitation with Perchloric acid and then detected with
Coomassic colouring. We have used a kit produced by
MallincKrodt Baker BV.
Serum was collected from 20 patients with suspected
rheumatoid arthritis. Serum obtained at the time of clinical
evaluation was tested in order to evaluate rheumatoid
factors (RF), anti-MCV antibody, anti-Jo-1 antibody and
mucoproteins. The determinations of anti-MCV and antiJo-1 were quantified in automated system Elisa Alegria.
The determination of RF and mucoproteins was done with a
program photometer BTS 310 Plus.
Results The results of the measurements and simple
statistical analysis are present in the table.
In the above table we describe the results of measurements
of rheumatoid factors, anti-MCV antibody, anti-Jo-1 antibody
and mucoproteins in 20 patients with Rheumatoid arthritis.
Conclusions For the diagnosis of rheumatoid arthritis, the
most specific and sensitive marker is rheumatoid factor
followed by anti-MCV antibodies.
Keywords: rheumatoid factor, anti-MCV antibody, anti-Jo-1
antibody, mucoproteins.
Anatomopathological diagnosis: the components that improve and insure its quality.
Dea Matallari, Eneida Karriqi, Romina Zerellari, Norik Bardhi
Faculty of Medicine, Tirana, Albania
Introduction: The anatomopathological diagnosis is performed
on different tissue sections obtained by using different biopsy
techniques, operator or endoscopic ones. Their diagnostic
accuracy varies based on many factors. Methods: This survey
was carried out studying the archive papers of pathological
anatomy laboratory in “Mother Teresa” Hospital Center.
Respectively for the years 2002 and 2012 there have been
retrospectively revised the diagnoses’ distribution according
to the two categories: final and non-final diagnoses ; the
correlation with the operatory parts and the small parts; the
rate of consultation and the request for extra examination.
There have been inspected 2045 cards for each year and the
operations with the data were made with the SPSS program,
version 15.
Results: In the cards of 2002, there are 1578 final diagnoses in
total, from which 884 correspond to the “Big Biopsy” category.
Regarding non final diagnosis there are 67 diagnoses included
in the “Big biopsy” category and 400 in the “Small Biopsy”
category.
Regarding the rate of consultation, only in 23.5% of the
cases there has been a consultation among the doctors
During year 2012, 1852 diagnoses have been registered
as final, from which 1002 are Big Biopsies. While from the
non-final diagnoses, there are 68 ones categorized as Big
Biopsies and 125 ones as Small Biopsies. In 2012, there is
a decrease in the number of consults among the doctors in
2.2% of the cases. Also, in 2012, there has been need of further
imunohistochemical examinations.
Conclusions: Based on the results, we can conclude:
The percentage of the final diagnoses corresponding the
years 2002 and 2012 has increased to 13.5 %. (from 1578
to 1853 cases). The majority of these diagnoses are from
the category of Big Biopsies. This shows that there has
been an improvement in the methods and techniques
used to extract the biopsy materials and in their rate of
affect in the enhancement of the diagnostic accuracy. There has been a noteworthy decrease from 20% in year 2002
to 6.5% in year 2012 in the number of final diagnoses with Big
Biopsies. Regarding the rate of consultation, there has been
a decrease from 23.5% in year 2002 to 2.2% in year 2012.
This is a result of the use of imunohistochemical techniques
that facilitate the definition of diagnosis. To achieve a higher
diagnostic accuracy, the use of imunohistochemical techniques
must be accompanied by an increase in the rate of consultation.
Key words: diagnosis, biopsy, consult, immunohistochemistry.
A bstracts B ook | 83
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