This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Background: Antibiotics remain among the most prescribed drugs in primary healthcare, contributin... more Background: Antibiotics remain among the most prescribed drugs in primary healthcare, contributing to increased antibiotic resistance in the community and prevailing as an emerging global health concern. We aimed to quantify the prevalence and quality of antibiotic prescription in primary healthcare settings in the Municipality of Prishtina to identify targets for quality improvement. Methods and Results: This study represents a population-based, retrospective cohort, including data from eight randomly selected family medical centers in the Municipality of Prishtina. Each 150th patient on medical records was assessed for demographic data, diagnosis (ICD-10), antibiotic prescription, antibiotic class, and antibiotic form. In total, the study included 1614 cases reviewed. The antibiotic prescription rate was 16%. The health condition for which most of the cases received antibiotics was J18-Pneumonia, unspecified organism (67%), followed by J03-Acute tonsillitis (54%), J42-Unspecified chronic bronchitis (46%), and N39-Other disorders of the urinary system (43%). Broad-spectrum antibiotics, such as co-amoxiclav (17.7%), amoxicillin (16.5%), and ceftriaxone (12.6%), featured among the most routinely prescribed antibiotics. The antibiotic prescription rate was the highest for cases in the 3-5 age group, of whom 27% received an antibiotic prescription. In 73% of cases, oral antibiotics were prescribed, 69% of which belong to the WHO AWaRe (Access, Watch, Reserve) essential medicines list. Only 18% of antibiotics were prescribed with their generic names. Conclusion: The prevalence of antibiotic prescription in primary healthcare settings in Prishtina is moderately low. These data cannot be extrapolated to other municipalities in Kosovo or other countries due to different organizational levels. High antibiotic prescription rates for young age groups, prescription of broad-spectrum antibiotics, and high rates of parenteral antibiotics were identified as targets for quality improvement.
BackgroundHealth literacy includes cognitive and social skills which help patients to access, und... more BackgroundHealth literacy includes cognitive and social skills which help patients to access, understand and use medical information in ways that promote and maintain good health. Recently health literacy emerged as an important topic for public health and health policy makers.ObjectivesThis study was designed to evaluate health literacy level among patients of primary care centers in Prishtina and its association with socioeconomic status, education level, hospitalization rates, self-perception on health and frequency of visits to the doctor.MethodsShort Test of Functional Health Literacy in Adults was used to collect the data. S-TOFHLA administration criteria were strictly followed. 557 questionnaires were collected, filled by patients around Prishtina visiting primary healthcare centers, and further analyzed with SPSS.ParticipantsEvery third patient, older than 15 years old, who entered doctor’s office, was asked to fulfill the test totaling 557 patients.ResultsFrom 557 surveyed ...
Introduction The Q Aspiration catheter design has shown increased aspiration force in bench studi... more Introduction The Q Aspiration catheter design has shown increased aspiration force in bench studies 1. The objective of this first clinical study was to assess safety and performance of the Q™ Catheter in a real-world setting. The study was a multi-center, observational, post market study utilizing the Q Catheter as first-line therapy during mechanical thrombectomy in Spain. Methods Patients with AIS treated with Q as first line therapy between March 2019 and January 2020 were identified at four centers in Spain. Inclusion criteria included 18-85 years of age, anterior or posterior LVO, ASPECTs 6-10 and within 8 hours of onset/last known well. Baseline demographics, procedural data, post procedure neuroimaging, and clinical outcomes were reported. A follow up visit was conducted to assess mRS. Results There were 45 patients included. Average age at presentation was 72.4 and 53.3% were male. Thrombolytic therapy was given in 46.7% (21/45) and NIHSS was 14.4 (range 1-26). Final mTICI 2b-3 was achieved in 93% of patients (42/45). First pass success of mTICI 2b-3 with only a Q Catheter was achieved in 49% (21/43), increasing to 56% (24/43) when a stent retriever was used as an anchor. Overall successful revascularization using the Q Catheter was 77% (33/43). ENT was 2% (1), sICH rate was 2% (1), and mortality during the study period was 13% (6). At follow-up, 55.5% of subjects had a mRS of 0-2. Conclusion The Q Catheter showed good deliverability and revascularization rates in this real-world setting with no safety concerns.
<sec> <title>UNSTRUCTURED</title> <p>Abstract -Objectives This review rep... more <sec> <title>UNSTRUCTURED</title> <p>Abstract -Objectives This review represents a critical and constructive analysis of literature in the content of toxicology testing of new medicines for children. The review is generated through summary, classification, analysis and comparison of already existing material and researches on field. -Materials and methods Databases as Scopus, PubMed, Medline and Web of Science were used to extract data for the review. Search terms like "juvenile toxicity studies", "children toxicology", "testing of new drugs" were used. Out of 150 research articles screened, 25 most relevant studies are included in this review. -Results Whether juvenile animal toxicology studies are truly useful or necessary to support pediatric drug development is still doubtful. The current knowledge on cross-species functional and kinetic differences is not reliable, meaning that extrapolation of any toxicology study finding to an immature human may not be relevant, especially if performed at the wrong time and in the wrong species. -Conclusion Even though, great improvements and regulatory initiatives regarding juvenile toxicity studies have been accomplished, unfortunately testing new drugs in children still remains on its initial stage and lags behind to other scientific developments. In order to narrow down the juvenile toxicity studies loophole, we need to improve compliance by drug companies and research sponsors with pediatric trial obligations.</p> </sec>
Aneurysms represent bulging of the weakened blood vessel area, as a result of cystic medial degen... more Aneurysms represent bulging of the weakened blood vessel area, as a result of cystic medial degeneration. Aneurysms chance of rupturing increases over time, resulting in bleeding and death. Therefore, patients with aortic aneurysms require frequent monitoring with magnetic resonance and computed tomography angiography, as well as undergoing open repair surgery and endovascular aneurysm repair. We present a case of ruptured thoracic aortic aneurysm in conjunction with bilateral superficial femoral occlusion, as incidental findings in Covid-19 positive patient. The patient, a 62-years-old female, presented with cough, shortness of breath, fever and leg claudication. Doppler ultrasonography of the lower limbs was conducted to rule out thromboembolism, revealing bilateral superficial femoral arteries occlusion. The patient was administered high doses of parenteral anticoagulants. Hemoptysis ensued, prompting an MSCT scan, that showed right pleural effusion, atelectasis, and right active perihilar infiltrates with inter-lobar pleurisy. Due to inflammatory changes on the lung parenchyma, the patient got tested for Sars-Cov-2, and resulted positive. Contrast-enhanced MSCT also revealed thoracic-abdominal aortic aneurysm with its highest diameter measuring 10 cm, and massive per-aortal thrombus and/or hematoma of 5 cm, which was further ruptured and patient died untreated in the fourth day of hospitalization. Questions arise whether Covid-19 was the primary cause of bilateral superficial femoral artery occlusion and whether high doses of parenteral anticoagulants were the primary cause of thoracic aortic aneurysm rupture. Thus, a careful balance must be made between the detrimental and protective contributions of anticoagulants in the patients presenting with Covid-19 and thoracic-abdominal aortic aneurysm.
Spinal tuberculosis (Pott's disease) is a frequent manifestation of Mycobacterium tuberculosi... more Spinal tuberculosis (Pott's disease) is a frequent manifestation of Mycobacterium tuberculosis infection. It manifests as destruction of 2 or more adjacent vertebral bodies followed with destruction of the intervertebral disc, leading to a condition known as spondylodiscitis. Tuberculous spondylodiscitis represents with back pain, fever, joint stiffness, loss of spinal mobility, neurological symptoms, vertebral body collapse, gibbus formation and kyphosis. Persistent Pott's disease might lead to soft tissues abscesses, frequently involving iliopsoas muscle. We, herein, present a 20 years long follow-up case of a Pott's disease patient. The patient got diagnosed as tuberculous spondylodiscitis, almost 10 years after first symptoms onset. She underwent frequent computed tomography and magnetic resonance scanning, with spinal spondylodiscitis being its only significant finding, while lung parenchyma and other organs were not infected. Patient got treated with multidrug anti-tubercular regimen for 18 months in 2 different periods of time; nonetheless she complicated with iliopsoas muscle abscess and percutaneous fistula. Early diagnosis and treatment of spinal tuberculosis (TB) are of great importance in ensuring a good clinical outcome. Delaying the diagnosis and proper management can lead to spinal cord compression, deformity and irreversible neurological complications. Thus, multidrug anti-tubercular therapy must be started timely and the duration of anti-tubercular therapy needs to be individualized. The decision to terminate anti-tubercular therapy should be based on clinical, radiological, pathological and microbiological indices, rather than being based on specific guidelines.
Indian Journal of Forensic Medicine & Toxicology, 2021
Background: This review represents a critical and constructive analysis of literature in the cont... more Background: This review represents a critical and constructive analysis of literature in the content of Bisphenol A in amniotic fluid of pregnant women and its adverse health outcomes. The review is generated through summary, classification, analysis and comparison of already existing material and researches on field. Methods : Databases as Scopus, PubMed, Medline, Web of Science, Global Health, were used to extract data for the review. Search terms like "Bisphenol A", "pregnancy", "amniotic fluid", "endocrine disruptors" were used. Out of 200 research articles screened, 70 most relevant studies are included in this review. Conclusions: This review highlights the correlation between Bisphenol A and its endocrine disrupting potential, impacting especially fragile categories as pregnant women and their fetuses through its toxicokinetic features and its metabolites. Thus, BPA distorts important physiological processes necessary for fetal development and disease progression later in life. We can conclude that human exposure to BPA, as one of the leading environmental contaminants, represents a major global issue and its adverse health outcomes can be debilitating for human health. Further research on field considering BPA distribution, varying exposure rates, racial disparities, inter-species differences and EDCs cumulative effects, should be conducted. Finding safer alternatives for replacing BPA in market must remain a priority.
Open Access Macedonian Journal of Medical Sciences, 2021
BACKGROUND: Pneumothorax is a severe medical condition characterized by the collection of air in ... more BACKGROUND: Pneumothorax is a severe medical condition characterized by the collection of air in one or several spaces of the pleura. A rare subtype of pneumothorax where air is restricted in interlobar pleural space, mostly due to the previous fibrous pleural adhesions, is known as interlobar pneumothorax. CASE PRESENTATION: We present a rare case of a 58-year-old female admitted to the emergency department due to difficulty on breathing, hemoptysis, and discomfort in the right anterior axillary line, which worsened with inspiration and was associated with breathlessness during physical activity. The diagnosis was confirmed by thoracic multi slice computed tomography (MSCT), showing that air was located between the middle and lower lobes of the right lung , measuring 7 × 5 × 2.5 cm (transversal × oblique cranio-caudal × antero-posterior), representing interlobar pneumothorax. DISCUSSION: Cases of interlobar pneumothorax need to be carefully differentiated and evaluated, while skin ...
BackgroundHealth literacy includes cognitive and social skills which help patients to access, und... more BackgroundHealth literacy includes cognitive and social skills which help patients to access, understand and use medical information in ways that promote and maintain good health. Recently health literacy emerged as an important topic for public health and health policy makers.ObjectivesThis study was designed to evaluate health literacy level among patients of primary care centers in Prishtina and its association with socioeconomic status, education level, hospitalization rates, self-perception on health and frequency of visits to the doctor.MethodsShort Test of Functional Health Literacy in Adults was used to collect the data. S-TOFHLA administration criteria were strictly followed. 557 questionnaires were collected, filled by patients around Prishtina visiting primary healthcare centers, and further analyzed with SPSS.ParticipantsEvery third patient, older than 15 years old, who entered doctor’s office, was asked to fulfill the test totaling 557 patients.ResultsFrom 557 surveyed ...
We report the case of a 55-year-old male patient with concomitant pulmonary mucinous adenocarcino... more We report the case of a 55-year-old male patient with concomitant pulmonary mucinous adenocarcinoma and reactivated tuberculosis, documented with multiple MSCT (multi-slice computed tomography) changes. The patient initially presented with productive cough, sluggishness, fatigue, voice hoarseness and tuberculosis changes in MSCT. Later, he was diagnosed with pulmonary mucinous adenocarcinoma, which was confirmed by sputum cytology and transthoracic biopsy. Therefore, clinicians should always evaluate the likelihood of simultaneous lung cancer in patients whose MSCT images suggest TB alterations in the lungs, and swiftly decide on the correct treatment and management approach.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Background: Antibiotics remain among the most prescribed drugs in primary healthcare, contributin... more Background: Antibiotics remain among the most prescribed drugs in primary healthcare, contributing to increased antibiotic resistance in the community and prevailing as an emerging global health concern. We aimed to quantify the prevalence and quality of antibiotic prescription in primary healthcare settings in the Municipality of Prishtina to identify targets for quality improvement. Methods and Results: This study represents a population-based, retrospective cohort, including data from eight randomly selected family medical centers in the Municipality of Prishtina. Each 150th patient on medical records was assessed for demographic data, diagnosis (ICD-10), antibiotic prescription, antibiotic class, and antibiotic form. In total, the study included 1614 cases reviewed. The antibiotic prescription rate was 16%. The health condition for which most of the cases received antibiotics was J18-Pneumonia, unspecified organism (67%), followed by J03-Acute tonsillitis (54%), J42-Unspecified chronic bronchitis (46%), and N39-Other disorders of the urinary system (43%). Broad-spectrum antibiotics, such as co-amoxiclav (17.7%), amoxicillin (16.5%), and ceftriaxone (12.6%), featured among the most routinely prescribed antibiotics. The antibiotic prescription rate was the highest for cases in the 3-5 age group, of whom 27% received an antibiotic prescription. In 73% of cases, oral antibiotics were prescribed, 69% of which belong to the WHO AWaRe (Access, Watch, Reserve) essential medicines list. Only 18% of antibiotics were prescribed with their generic names. Conclusion: The prevalence of antibiotic prescription in primary healthcare settings in Prishtina is moderately low. These data cannot be extrapolated to other municipalities in Kosovo or other countries due to different organizational levels. High antibiotic prescription rates for young age groups, prescription of broad-spectrum antibiotics, and high rates of parenteral antibiotics were identified as targets for quality improvement.
BackgroundHealth literacy includes cognitive and social skills which help patients to access, und... more BackgroundHealth literacy includes cognitive and social skills which help patients to access, understand and use medical information in ways that promote and maintain good health. Recently health literacy emerged as an important topic for public health and health policy makers.ObjectivesThis study was designed to evaluate health literacy level among patients of primary care centers in Prishtina and its association with socioeconomic status, education level, hospitalization rates, self-perception on health and frequency of visits to the doctor.MethodsShort Test of Functional Health Literacy in Adults was used to collect the data. S-TOFHLA administration criteria were strictly followed. 557 questionnaires were collected, filled by patients around Prishtina visiting primary healthcare centers, and further analyzed with SPSS.ParticipantsEvery third patient, older than 15 years old, who entered doctor’s office, was asked to fulfill the test totaling 557 patients.ResultsFrom 557 surveyed ...
Introduction The Q Aspiration catheter design has shown increased aspiration force in bench studi... more Introduction The Q Aspiration catheter design has shown increased aspiration force in bench studies 1. The objective of this first clinical study was to assess safety and performance of the Q™ Catheter in a real-world setting. The study was a multi-center, observational, post market study utilizing the Q Catheter as first-line therapy during mechanical thrombectomy in Spain. Methods Patients with AIS treated with Q as first line therapy between March 2019 and January 2020 were identified at four centers in Spain. Inclusion criteria included 18-85 years of age, anterior or posterior LVO, ASPECTs 6-10 and within 8 hours of onset/last known well. Baseline demographics, procedural data, post procedure neuroimaging, and clinical outcomes were reported. A follow up visit was conducted to assess mRS. Results There were 45 patients included. Average age at presentation was 72.4 and 53.3% were male. Thrombolytic therapy was given in 46.7% (21/45) and NIHSS was 14.4 (range 1-26). Final mTICI 2b-3 was achieved in 93% of patients (42/45). First pass success of mTICI 2b-3 with only a Q Catheter was achieved in 49% (21/43), increasing to 56% (24/43) when a stent retriever was used as an anchor. Overall successful revascularization using the Q Catheter was 77% (33/43). ENT was 2% (1), sICH rate was 2% (1), and mortality during the study period was 13% (6). At follow-up, 55.5% of subjects had a mRS of 0-2. Conclusion The Q Catheter showed good deliverability and revascularization rates in this real-world setting with no safety concerns.
<sec> <title>UNSTRUCTURED</title> <p>Abstract -Objectives This review rep... more <sec> <title>UNSTRUCTURED</title> <p>Abstract -Objectives This review represents a critical and constructive analysis of literature in the content of toxicology testing of new medicines for children. The review is generated through summary, classification, analysis and comparison of already existing material and researches on field. -Materials and methods Databases as Scopus, PubMed, Medline and Web of Science were used to extract data for the review. Search terms like "juvenile toxicity studies", "children toxicology", "testing of new drugs" were used. Out of 150 research articles screened, 25 most relevant studies are included in this review. -Results Whether juvenile animal toxicology studies are truly useful or necessary to support pediatric drug development is still doubtful. The current knowledge on cross-species functional and kinetic differences is not reliable, meaning that extrapolation of any toxicology study finding to an immature human may not be relevant, especially if performed at the wrong time and in the wrong species. -Conclusion Even though, great improvements and regulatory initiatives regarding juvenile toxicity studies have been accomplished, unfortunately testing new drugs in children still remains on its initial stage and lags behind to other scientific developments. In order to narrow down the juvenile toxicity studies loophole, we need to improve compliance by drug companies and research sponsors with pediatric trial obligations.</p> </sec>
Aneurysms represent bulging of the weakened blood vessel area, as a result of cystic medial degen... more Aneurysms represent bulging of the weakened blood vessel area, as a result of cystic medial degeneration. Aneurysms chance of rupturing increases over time, resulting in bleeding and death. Therefore, patients with aortic aneurysms require frequent monitoring with magnetic resonance and computed tomography angiography, as well as undergoing open repair surgery and endovascular aneurysm repair. We present a case of ruptured thoracic aortic aneurysm in conjunction with bilateral superficial femoral occlusion, as incidental findings in Covid-19 positive patient. The patient, a 62-years-old female, presented with cough, shortness of breath, fever and leg claudication. Doppler ultrasonography of the lower limbs was conducted to rule out thromboembolism, revealing bilateral superficial femoral arteries occlusion. The patient was administered high doses of parenteral anticoagulants. Hemoptysis ensued, prompting an MSCT scan, that showed right pleural effusion, atelectasis, and right active perihilar infiltrates with inter-lobar pleurisy. Due to inflammatory changes on the lung parenchyma, the patient got tested for Sars-Cov-2, and resulted positive. Contrast-enhanced MSCT also revealed thoracic-abdominal aortic aneurysm with its highest diameter measuring 10 cm, and massive per-aortal thrombus and/or hematoma of 5 cm, which was further ruptured and patient died untreated in the fourth day of hospitalization. Questions arise whether Covid-19 was the primary cause of bilateral superficial femoral artery occlusion and whether high doses of parenteral anticoagulants were the primary cause of thoracic aortic aneurysm rupture. Thus, a careful balance must be made between the detrimental and protective contributions of anticoagulants in the patients presenting with Covid-19 and thoracic-abdominal aortic aneurysm.
Spinal tuberculosis (Pott's disease) is a frequent manifestation of Mycobacterium tuberculosi... more Spinal tuberculosis (Pott's disease) is a frequent manifestation of Mycobacterium tuberculosis infection. It manifests as destruction of 2 or more adjacent vertebral bodies followed with destruction of the intervertebral disc, leading to a condition known as spondylodiscitis. Tuberculous spondylodiscitis represents with back pain, fever, joint stiffness, loss of spinal mobility, neurological symptoms, vertebral body collapse, gibbus formation and kyphosis. Persistent Pott's disease might lead to soft tissues abscesses, frequently involving iliopsoas muscle. We, herein, present a 20 years long follow-up case of a Pott's disease patient. The patient got diagnosed as tuberculous spondylodiscitis, almost 10 years after first symptoms onset. She underwent frequent computed tomography and magnetic resonance scanning, with spinal spondylodiscitis being its only significant finding, while lung parenchyma and other organs were not infected. Patient got treated with multidrug anti-tubercular regimen for 18 months in 2 different periods of time; nonetheless she complicated with iliopsoas muscle abscess and percutaneous fistula. Early diagnosis and treatment of spinal tuberculosis (TB) are of great importance in ensuring a good clinical outcome. Delaying the diagnosis and proper management can lead to spinal cord compression, deformity and irreversible neurological complications. Thus, multidrug anti-tubercular therapy must be started timely and the duration of anti-tubercular therapy needs to be individualized. The decision to terminate anti-tubercular therapy should be based on clinical, radiological, pathological and microbiological indices, rather than being based on specific guidelines.
Indian Journal of Forensic Medicine & Toxicology, 2021
Background: This review represents a critical and constructive analysis of literature in the cont... more Background: This review represents a critical and constructive analysis of literature in the content of Bisphenol A in amniotic fluid of pregnant women and its adverse health outcomes. The review is generated through summary, classification, analysis and comparison of already existing material and researches on field. Methods : Databases as Scopus, PubMed, Medline, Web of Science, Global Health, were used to extract data for the review. Search terms like "Bisphenol A", "pregnancy", "amniotic fluid", "endocrine disruptors" were used. Out of 200 research articles screened, 70 most relevant studies are included in this review. Conclusions: This review highlights the correlation between Bisphenol A and its endocrine disrupting potential, impacting especially fragile categories as pregnant women and their fetuses through its toxicokinetic features and its metabolites. Thus, BPA distorts important physiological processes necessary for fetal development and disease progression later in life. We can conclude that human exposure to BPA, as one of the leading environmental contaminants, represents a major global issue and its adverse health outcomes can be debilitating for human health. Further research on field considering BPA distribution, varying exposure rates, racial disparities, inter-species differences and EDCs cumulative effects, should be conducted. Finding safer alternatives for replacing BPA in market must remain a priority.
Open Access Macedonian Journal of Medical Sciences, 2021
BACKGROUND: Pneumothorax is a severe medical condition characterized by the collection of air in ... more BACKGROUND: Pneumothorax is a severe medical condition characterized by the collection of air in one or several spaces of the pleura. A rare subtype of pneumothorax where air is restricted in interlobar pleural space, mostly due to the previous fibrous pleural adhesions, is known as interlobar pneumothorax. CASE PRESENTATION: We present a rare case of a 58-year-old female admitted to the emergency department due to difficulty on breathing, hemoptysis, and discomfort in the right anterior axillary line, which worsened with inspiration and was associated with breathlessness during physical activity. The diagnosis was confirmed by thoracic multi slice computed tomography (MSCT), showing that air was located between the middle and lower lobes of the right lung , measuring 7 × 5 × 2.5 cm (transversal × oblique cranio-caudal × antero-posterior), representing interlobar pneumothorax. DISCUSSION: Cases of interlobar pneumothorax need to be carefully differentiated and evaluated, while skin ...
BackgroundHealth literacy includes cognitive and social skills which help patients to access, und... more BackgroundHealth literacy includes cognitive and social skills which help patients to access, understand and use medical information in ways that promote and maintain good health. Recently health literacy emerged as an important topic for public health and health policy makers.ObjectivesThis study was designed to evaluate health literacy level among patients of primary care centers in Prishtina and its association with socioeconomic status, education level, hospitalization rates, self-perception on health and frequency of visits to the doctor.MethodsShort Test of Functional Health Literacy in Adults was used to collect the data. S-TOFHLA administration criteria were strictly followed. 557 questionnaires were collected, filled by patients around Prishtina visiting primary healthcare centers, and further analyzed with SPSS.ParticipantsEvery third patient, older than 15 years old, who entered doctor’s office, was asked to fulfill the test totaling 557 patients.ResultsFrom 557 surveyed ...
We report the case of a 55-year-old male patient with concomitant pulmonary mucinous adenocarcino... more We report the case of a 55-year-old male patient with concomitant pulmonary mucinous adenocarcinoma and reactivated tuberculosis, documented with multiple MSCT (multi-slice computed tomography) changes. The patient initially presented with productive cough, sluggishness, fatigue, voice hoarseness and tuberculosis changes in MSCT. Later, he was diagnosed with pulmonary mucinous adenocarcinoma, which was confirmed by sputum cytology and transthoracic biopsy. Therefore, clinicians should always evaluate the likelihood of simultaneous lung cancer in patients whose MSCT images suggest TB alterations in the lungs, and swiftly decide on the correct treatment and management approach.
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