Agron Dogjani | Faculty of Medicine, University of Tirana (original) (raw)

Papers by Agron Dogjani

Digestion, 2005

In each case of extraintestinal manifestations of Crohn’s disease, active disease, if present, sh... more In each case of extraintestinal manifestations of Crohn’s disease, active disease, if present, should be treated to induce remission, which may positively influence the course of most concomitant extraintestinal manifestations. For some extraintestinal manifestations, however, a specific treatment should be introduced. This latter part of disease management will be discussed in this chapter, in particular for pyoderma gangrenosum, uveitis, spondylarthropathy – axial arthropathy – and primarysclerosing cholangitis, which have also been described in quiescent Crohn’s disease. Few new drugs for the treatment of extraintestinal manifestations of Crohn’s disease have been developed in the past and only the role of infliximab has increased in Crohn’s disease-related extraintestinal manifestations. Drugs specifically aimed at this treatment, stemming from a few randomized controlled studies or case series, are sulfasalazine, 5-ASA, corticosteroids, azathioprine or 6-mercaptopurine, methotr...

World Journal of Emergency Surgery

Background The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was... more Background The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was reportedly increased during the COVID-19 pandemic. The aim of the ChoCO-W study was to compare the clinical findings and outcomes of acute cholecystitis in patients who had COVID-19 disease with those who did not. Methods Data were prospectively collected over 6 months (October 1, 2020, to April 30, 2021) with 1-month follow-up. In October 2020, Delta variant of SARS CoV-2 was isolated for the first time. Demographic and clinical data were analyzed and reported according to the STROBE guidelines. Baseline characteristics and clinical outcomes of patients who had COVID-19 were compared with those who did not. Results A total of 2893 patients, from 42 countries, 218 centers, involved, with a median age of 61.3 (SD: 17.39) years were prospectively enrolled in this study; 1481 (51%) patients were males. One hundred and eighty (6.9%) patients were COVID-19 positive, while 2412 (93.1%) were n...

Albanian Journal of Trauma and Emergency Surgery

Fournier's gangrene (FG) is a well known often fatal fasziitis of the pelvic floor following ... more Fournier's gangrene (FG) is a well known often fatal fasziitis of the pelvic floor following ano-rectal, urologic and gynecologic infections. Although rarely it is described as a complication of operative anal procedures and predisposing factors such as diabetes, alcoholism, immune-defects and consumptive diseases. Current literature only briefly mentions the potential risk of FG after such a common surgical procedure. However, devastating complications occur more often than expected. This catastrophic complication without a predisposing factor is discussed along with a review of the literature. The objective of this article is to provide updated and relevant information regarding the recognition, diagnosis and management of FG, from the general surgeon to the emergency department. This article refers to two complicated cases of Fournier's gangrene. The patients underwent emergency surgical intervention with the diagnosis of hemorrhoidal prolapse with rectal bleeding and acc...

World Journal of Emergency Surgery

Albanian journal of trauma and emergency surgery, Jan 20, 2023

Access and emergency medical care for massive or multiple injuries is an comprehensive interdisci... more Access and emergency medical care for massive or multiple injuries is an comprehensive interdisciplinary challenge. taking care of the growing causes of emergency care levels as well as cross-sectoral collaboration in the management of multiple incidents, reducing disease, disability, and mortality in the population with multiple disorders. in a disaster or extraordinary situation with mass casualties is a state in which the health care system is overloaded and the ability to provide emergency health care is considerably hindered. the aim of this review is to present the current state of knowledge on what we, the authors, say are the central aspects of trauma management of mass casualty incidents. emergency planning and methodology are related to accidental states, elementary medical staff disasters, medical equipment, drilling material, concretizing assessment tools, monitoring, mass incident prevention. In terms of implementing a good action plan, effective collaboration between state agencies such as fire departament and law enforcement is necessary in identifying and directing critically ill patients to designated trauma centres. the integration of emergency systems for incident management, through providing resources like, medical equipment, drugs, autoambulances, ongoing education and training. this has the impact of increasing knowledge of medical emergency procedures that would help reduce the risk of consequences of mass incidents. when applied to Mci responses, damage-control principles reduce resource utilization and optimze surge capacity, consequently reducing the rate of mortality.

World Journal of Emergency Surgery

Background Shared decision-making (SDM) between clinicians and patients is one of the pillars of ... more Background Shared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in the discipline of trauma and emergency surgery, investigating its interpretation as well as the barriers and facilitators for its implementation among surgeons. Methods Grounding on the literature on the topics of the understanding, barriers, and facilitators of SDM in trauma and emergency surgery, a survey was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was sent to all 917 WSES members, advertised through the society’s website, and shared on the society’s Twitter profile. Results A total of 650 trauma and emergency surgeons from 71 countries in five continents participated in the initiative. Less than half of the surgeons understood SDM, and 30% still saw the value in exclusively engaging multidisciplinary provider teams without involvin...

Zenodo (CERN European Organization for Nuclear Research), Apr 27, 2022

Postoperative nausea and vomiting (PONV) are disturbing and show adverse events in anesthesia and... more Postoperative nausea and vomiting (PONV) are disturbing and show adverse events in anesthesia and surgery. These effects prolong recovery time, delay patient discharge, and increase hospital costs. PONV is one of the 2 main disadvantages of general anesthesia after the surgery in the first 24 hours. The origin of postoperative nausea and vomiting after surgery performed under general anesthesia is not entirely clear, but it is probably multifactorial. PONV is influenced by the patient's own factors (age, gender, obesity, diabetes, pregnancy), preoperative (premedication, anxiety, diet), intraoperative (anesthetics, intubation, aerophagia, intraoperative dehydration, high doses of neostigmine, use of N2O, time of surgery) and using of opiates. The effectiveness of various antiemetics has been studied for the prevention and treatment of PONV in surgical patients. Glucocorticoids are well known for their analgesic, anti-inflammatory, immune-modulating, and antiemetic effects. Ondansetron is the most prophylactic serotonin subtype 3 antagonists in our daily clinical practice for the prevention of PONV after surgery.

Zenodo (CERN European Organization for Nuclear Research), Apr 27, 2022

Urinoma is an accumulation of urine in the retroperitoneal area. It is caused by injuries to the ... more Urinoma is an accumulation of urine in the retroperitoneal area. It is caused by injuries to the kidneys, ureters, urinary bladder, or urethra. They may be confined, encapsulated fluid collections or may manifest as free fluid. Urine leaks have a variety of appearances. This case describes a patient 27 years old, female presented at the emergency room with internal diseases with complaints of bloating and abdominal discomfort. The history of the disease had begun three days before when she presented to the hospital with bloating that came increasing in quantity. She referred that five days ago gave birth to a child through transvaginal delivery. For the woman was the first birth of a child. According to the patient's own referral, her pregnancy was without problems but the birth lasted many hours. There have been no previous health problems (confirmed by laboratory and imaging tests before pregnancy). There was a careful follow-up of the pregnancy. Except for an isolated case of a urinary tract infection, there was no other complication. Further imaging revealed a large fluid in the pelvis and intraperitoneal. Treatment of this rare phenomenon is crucial for the delay in medical care can lead to abscess, hydronephrosis, electrolyte instability. CT cystography and retrograde urethrographic are the diagnostic imaging studies of choice. In the appropriate setting, the use of these management options may reduce urinoma-related complications and limit or totally eliminate the need for urologic surgery.

GLOBAL JOURNAL FOR RESEARCH ANALYSIS

Background; Metastatic breast cancer is a burden on healthcare worldwide. Despite the progress ma... more Background; Metastatic breast cancer is a burden on healthcare worldwide. Despite the progress made in early diagnosis and adjuvant treatment of breast cancer again about 30% of patients develop metastases in the course of their disease. Also, there is a percentage of patients where the disease presents in metastatic stage. Real-world data may provide valuable information on the effectiveness and safety of medicines, which is particularly relevant for clinicians, patients and third-party payers. Materials and methods; We have collected data from 63 patients at Mother Teresa Hospital receiving Palbociclib since June 2016 until October 2019. Patients aged≥18 years, diagnosed with ABC and exposed to Palbociclib plus Fulvestrant. Patients were followed-up until death… Results; A total of 63 patients were included. Median age was 66 years (range 28–78) and 99.05% were female. Median follow-up time was 26.42 months… Conclusion; Palbociclib plus Lulvestrant seems an effective treatment for...

Albanian Journal of Trauma and Emergency Surgery

ASTES has organized an attractive scientific program, in partnership with the Surgical and Medica... more ASTES has organized an attractive scientific program, in partnership with the Surgical and Medical Societies of our country. In addition, we have prepared several special lectures by national and international speakers.The “Frederic Shiroka” lecture will be given by Professor Flamur Tartari, a distinguished surgeon who hasbeen the chief of general surgery service over the years as the father of Albanian modern surgery. He willdeliver his lecture titled “A lifetime with surgical patients”.The pre-conference course for medical personnel (BLS & D) will be available a day before the conference.Finally, we would like to thank all members of the organizing and scientific committees for their hard work in the past few months to ensure that every aspect of the conference is smooth and with the highest standards.Without their hard work and dedication, this conference would not have been possible. Let us express specialthanks to all speakers, particularly to our distinguished international fa...

International Scholarly Research Notices, 2014

Background. Chronic postherniorrhaphy groin pain is defined as pain lasting >6 months after su... more Background. Chronic postherniorrhaphy groin pain is defined as pain lasting >6 months after surgery, which is one of the most important complications occurring after inguinal hernia repair, which occurs with greater frequency than previously thought. Material and Methods. Patients undergoing elective inguinal hernioplasty in Victoria Hospital from November 2011 to May 2013 were included in the study. A total of 227 patients met the inclusion criteria and were available for followup at end of six months. Detailed preoperative, intraoperative, and postoperative details of cases were recorded according to proforma. The postoperative pain and pain at days two and seven and at end of six months were recorded on a VAS scale. Results. Chronic pain at six-month followup was present in 89 patients constituting 39.4% of all patients undergoing hernia repair. It was seen that 26.9% without preoperative pain developed chronic pain whereas 76.7% of patients with preoperative pain developed ch...

Background; “Acute Appendicitis” is one of the most usual causes of emergency hospital admissions... more Background; “Acute Appendicitis” is one of the most usual causes of emergency hospital admissions and appendectomy is one of the most common emergency procedures performed in the contemporary medicine. This study aims to identify the Alvarado Score System as a simplified tool for the emergency doctor in the abdominal emergency in general and for the Acute Appendicitis in particular. Materials and methods; The study is of retrospective character and includes 130 cases presented with abdominal Pain in University Hospital Centre” Mother Theresa” Tirana, Albania, in the period 1 April 2019 - 30 May 2019 from which 100 allegedly suspected with “Appendicitis Acute”. Results; Gender distribution has a slight male predominance. The predominant age group was 14-21 years old. The most frequent clinical data has been the tenderness in right iliac fossa. In our study 3% of cases belonged to the group 1-4 Alvarado points, 17% of the cases belonged to the group 5-6 Alvarado points and 80% of the ...

Albanian Journal of Trauma and Emergency Surgery

The Advanced Trauma Life Support (ATLS) course has become an indispensable tool in preparing heal... more The Advanced Trauma Life Support (ATLS) course has become an indispensable tool in preparing health care professionals to provide optimal trauma care. This article highlights the impact of the ATLS course on empowering healthcare professionals for excellence in trauma care. By providing a standardized framework, enhancing critical decision-making skills, and promoting interdisciplinary collaboration, the ATLS course equips practitioners with the knowledge and skills necessary to effectively respond to trauma emergencies. Additionally, the course prepares healthcare professionals for the unpredictable nature of trauma care through simulation-based training and fosters a culture of continuous professional growth. Through its emphasis on standardization, critical thinking, and continuing education, the ATLS course plays a vital role in improving patient outcomes and establishing a foundation for excellence in trauma care. Conclusion: The ATLS course stands as a testament to the commitm...

Hernia Updates [Working Title]

Among the most frequent pathologies of the abdominal wall are hernias, which are defined as a pro... more Among the most frequent pathologies of the abdominal wall are hernias, which are defined as a protrusion of the abdominal organs through any of the weak points of the abdominal wall. They can be spontaneous appearing in weak points of the abdominal wall or along the site of surgical incisions. Although hernias have been mentioned since ancient times, until after the second half of the 19th century, when the era of modern surgery began, the concept of hernias rarely mentioned incisional ones. After the introduction of anesthesia and antisepsis, abdominal interventions began to become common and with this, the incidence of incisional hernias was significantly increased. Until after the second world war, the correction of incisional hernias was done using simple sutures, transverse overlapping technique, continuous fascial sutures, etc. After this period, different synthetic materials were manufactured for the correction of abdominal hernias. The large variety of prosthetic materials t...

Zenodo (CERN European Organization for Nuclear Research), Sep 13, 2019

Colorectal cancer represents the third most common cause of malignancy and is the most common cau... more Colorectal cancer represents the third most common cause of malignancy and is the most common cause of large bowel obstruction. Purpose: The aim of this study was to present our experience in the management of patients with obstructive colorectal cancer. Material and methods: This is a retrospective which include eight patients study patients that have undergone emergency surgery for large bowel obstruction as a cause of colorectal cancer from January 2016 2018 at the Clinical Hospital of Tetove. Results: there were three male and two females in our study. The average age of patients was 72.5 years (from 52 82 years). patients with complications, respectively one with anastomotic leakage and two with wound infection. Conclusion: Occlusive colorectal cancers represent sometimes a challenge even for experienced surgeons. A radical surgical treatment is indicated whenever it is possible.

Journal of Surgery and Research

Introduction: Emergency medical service for patients in emergency situations is the most importan... more Introduction: Emergency medical service for patients in emergency situations is the most important aspect of all health systems in the world, as this is the first and most delicate point of confrontation of the patient with the health system of a country. All patients seeking urgent medical care, and the slightest delay in access to this service, by the population, is understood as a matter of "life or death" for them, to which they are quite sensitive. While learning or training during the process of exercising said activity combined with actual study data and comparisons with the results of international emergency medical services remains a challenge of the future. Thus the evaluation criteria of performance indicators of the emergency service based on scientific research evidence are unified. Ambulance services were basically just small vehicles, some with two stretchers, without the necessary equipment. Managers working as emergency personnel had only a few hours of limited first aid training which were referred to as "suitable personnel". The duties of the ambulance service personnel were twofold. On the one hand, they transported the sick and planned the so-called regulated ambulance service… Conclusion: The changes and diversity of medical emergencies including increasing trends of traumatic, mortal, and post-traumatic morbidity emergencies constantly put pressure on medical emergency services. All of these improvements will yield results in increasing efficiency by improving the quality of treatment and reducing the cost of medical care.

Sir William Osler* citon: "Ai që studion mjekësi pa libra, lundron në një det të paeksplorua... more Sir William Osler* citon: "Ai që studion mjekësi pa libra, lundron në një det të paeksploruar..." Osler mbrojti rëndësinë e sigurimit të korrelacioneve klinike në mësimin e siguruar nga librat dhe ushtrimin e tyre në praktikë. Vitet e fundit të gjitha shkollat mjekësore kanë kuptuar rëndësinë e korrelacioneve teoriko-praktike dhe edukimi është bërë shumë më i bazuar në problemet e urgjencës mjekësore, duke përdorur rastet e simuluar dhe prezantimet e tyre. Shumica e shkollave mjekësore në Shtetet e Bashkuara kanë rritur ndërveprimet me pacientët, edhe për studentët e vitit të parë dhe të dytë të mjekësisë. Sidoqoftë, autorët dhe redaktorët e librave shkollorë kanë qenë shumë më të ngadaltë për t'u përshtatur me këtë ndryshim. Shumica e librave shkollorë mjekësorë, përfshirë edhe ato në specialitetin e mjekësisë së urgjencës, mbeten të orientuar nga sëmundjet, sesa te pacientët. Si rezultat, shumica e librave shkollorë zënë pozicione të dukshme në raftet me pluhur të li...

Archives of Clinical and Medical Case Reports

Pseudo aneurysms of the right hepatic artery are uncommon, appearing in approximately 1% of hepat... more Pseudo aneurysms of the right hepatic artery are uncommon, appearing in approximately 1% of hepatic trauma cases, and most are extrahepatic (80%) and have a late-onset [1]. Although they are usually asymptomatic, they should always be treated because of the high risk of complications, especially breakage. We present a case of post-traumatic hepatic artery pseudoaneurysm that was successfully treated using this open surgical technique. Intrahepatic pseudoaneurysm (IHPA) following shotgun injury is rarely reported. Timely diagnosis is crucial. We advise keeping in mind the possibility of IHPA, when dealing with high-grade liver injury. CT is recommended before removal of perihepatic packs, as it may pick up a lifethreatening pseudoaneurysm.

Albanian Journal of Trauma and Emergency Surgery

Electrical injury is a physiological reaction caused by electric current passing through the body... more Electrical injury is a physiological reaction caused by electric current passing through the body. Electric injuries can be caused by the impact and exposure to electric current or lightning either at home or at work. The injury depends on the density of the current, tissue resistance, and duration of contact. Very small currents may be imperceptible or produce a light tingling sensation. Injuries can range from minor, moderate, to severe, and fatal injuries are just as likely to occur at home as in the workplace, with around 20 Australians dying each year from electric shock. The purpose of this paper is to study how well-trained healthcare professionals in both pre-hospital and hospital settings are in treating patients in the case of electric shock and injuries caused by lightning, including the triage, assessment, monitoring, treatment, and transport with medical care in pre-hospital settings The research was conducted based on data obtained from assessments of health care prof...

Cureus

Background Treating chronic hepatitis C (CHC) with direct-acting antiviral (DAA) is very effectiv... more Background Treating chronic hepatitis C (CHC) with direct-acting antiviral (DAA) is very effective at clearing the infection. In Albania treatment with DAA is limited to patients with liver stiffness F3-F4, and with other coinfections. The objective of this study was to evaluate the efficacy of DAA in Albanian patients with genotypes 1-5, who mostly suffer from advanced liver fibrosis. Material and Methods This is a retrospective study carried out at the University Hospital Center "Mother Teresa", Tirana, during 2014-2019, including treatment-naïve and treatment-experienced patients with genotypes 1-5. All patients were evaluated with elastography and most of them were F3-F4. The primary endpoint involved the patients achieving SVR-12, or undetectable hepatitis C virus/ribonucleic acid (HCV RNA) 12 weeks after the end of treatment. In patients without a genotype, we have used a pangenotypic regimen. Results This study included 207 patients with a mean age of 48.9 ± 13.1 years, 56% male and 44% female; 152 (73%) were genotype 1, 24 were (11.5%) genotype 2, nine were (4.3%) genotype 3, 14 were (6.7%) genotype 4, one was (0.4%) genotype 5, and seven (3.8%) unassigned genotypes. The sustained virologic response (SVR) percentage according to genotype is discussed in the article. The overall SVR score of all the patients in our study was >93%. According to elastography, 127 (66%) were F3-F4, and 80 (38.6%) were F1-F2. Conclusion Treatment with DAA proved to be very effective in our patients; most of them had advanced liver fibrosis as well as compensated or decompensated liver cirrhosis. The overall SVR score of the patients in our study was >93%. Our country needs to treat all patients with chronic hepatitis C without limitations to attain the WHO objective of eradicating this disease by 2030.

Digestion, 2005

In each case of extraintestinal manifestations of Crohn’s disease, active disease, if present, sh... more In each case of extraintestinal manifestations of Crohn’s disease, active disease, if present, should be treated to induce remission, which may positively influence the course of most concomitant extraintestinal manifestations. For some extraintestinal manifestations, however, a specific treatment should be introduced. This latter part of disease management will be discussed in this chapter, in particular for pyoderma gangrenosum, uveitis, spondylarthropathy – axial arthropathy – and primarysclerosing cholangitis, which have also been described in quiescent Crohn’s disease. Few new drugs for the treatment of extraintestinal manifestations of Crohn’s disease have been developed in the past and only the role of infliximab has increased in Crohn’s disease-related extraintestinal manifestations. Drugs specifically aimed at this treatment, stemming from a few randomized controlled studies or case series, are sulfasalazine, 5-ASA, corticosteroids, azathioprine or 6-mercaptopurine, methotr...

World Journal of Emergency Surgery

Background The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was... more Background The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was reportedly increased during the COVID-19 pandemic. The aim of the ChoCO-W study was to compare the clinical findings and outcomes of acute cholecystitis in patients who had COVID-19 disease with those who did not. Methods Data were prospectively collected over 6 months (October 1, 2020, to April 30, 2021) with 1-month follow-up. In October 2020, Delta variant of SARS CoV-2 was isolated for the first time. Demographic and clinical data were analyzed and reported according to the STROBE guidelines. Baseline characteristics and clinical outcomes of patients who had COVID-19 were compared with those who did not. Results A total of 2893 patients, from 42 countries, 218 centers, involved, with a median age of 61.3 (SD: 17.39) years were prospectively enrolled in this study; 1481 (51%) patients were males. One hundred and eighty (6.9%) patients were COVID-19 positive, while 2412 (93.1%) were n...

Albanian Journal of Trauma and Emergency Surgery

Fournier's gangrene (FG) is a well known often fatal fasziitis of the pelvic floor following ... more Fournier's gangrene (FG) is a well known often fatal fasziitis of the pelvic floor following ano-rectal, urologic and gynecologic infections. Although rarely it is described as a complication of operative anal procedures and predisposing factors such as diabetes, alcoholism, immune-defects and consumptive diseases. Current literature only briefly mentions the potential risk of FG after such a common surgical procedure. However, devastating complications occur more often than expected. This catastrophic complication without a predisposing factor is discussed along with a review of the literature. The objective of this article is to provide updated and relevant information regarding the recognition, diagnosis and management of FG, from the general surgeon to the emergency department. This article refers to two complicated cases of Fournier's gangrene. The patients underwent emergency surgical intervention with the diagnosis of hemorrhoidal prolapse with rectal bleeding and acc...

World Journal of Emergency Surgery

Albanian journal of trauma and emergency surgery, Jan 20, 2023

Access and emergency medical care for massive or multiple injuries is an comprehensive interdisci... more Access and emergency medical care for massive or multiple injuries is an comprehensive interdisciplinary challenge. taking care of the growing causes of emergency care levels as well as cross-sectoral collaboration in the management of multiple incidents, reducing disease, disability, and mortality in the population with multiple disorders. in a disaster or extraordinary situation with mass casualties is a state in which the health care system is overloaded and the ability to provide emergency health care is considerably hindered. the aim of this review is to present the current state of knowledge on what we, the authors, say are the central aspects of trauma management of mass casualty incidents. emergency planning and methodology are related to accidental states, elementary medical staff disasters, medical equipment, drilling material, concretizing assessment tools, monitoring, mass incident prevention. In terms of implementing a good action plan, effective collaboration between state agencies such as fire departament and law enforcement is necessary in identifying and directing critically ill patients to designated trauma centres. the integration of emergency systems for incident management, through providing resources like, medical equipment, drugs, autoambulances, ongoing education and training. this has the impact of increasing knowledge of medical emergency procedures that would help reduce the risk of consequences of mass incidents. when applied to Mci responses, damage-control principles reduce resource utilization and optimze surge capacity, consequently reducing the rate of mortality.

World Journal of Emergency Surgery

Background Shared decision-making (SDM) between clinicians and patients is one of the pillars of ... more Background Shared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in the discipline of trauma and emergency surgery, investigating its interpretation as well as the barriers and facilitators for its implementation among surgeons. Methods Grounding on the literature on the topics of the understanding, barriers, and facilitators of SDM in trauma and emergency surgery, a survey was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was sent to all 917 WSES members, advertised through the society’s website, and shared on the society’s Twitter profile. Results A total of 650 trauma and emergency surgeons from 71 countries in five continents participated in the initiative. Less than half of the surgeons understood SDM, and 30% still saw the value in exclusively engaging multidisciplinary provider teams without involvin...

Zenodo (CERN European Organization for Nuclear Research), Apr 27, 2022

Postoperative nausea and vomiting (PONV) are disturbing and show adverse events in anesthesia and... more Postoperative nausea and vomiting (PONV) are disturbing and show adverse events in anesthesia and surgery. These effects prolong recovery time, delay patient discharge, and increase hospital costs. PONV is one of the 2 main disadvantages of general anesthesia after the surgery in the first 24 hours. The origin of postoperative nausea and vomiting after surgery performed under general anesthesia is not entirely clear, but it is probably multifactorial. PONV is influenced by the patient's own factors (age, gender, obesity, diabetes, pregnancy), preoperative (premedication, anxiety, diet), intraoperative (anesthetics, intubation, aerophagia, intraoperative dehydration, high doses of neostigmine, use of N2O, time of surgery) and using of opiates. The effectiveness of various antiemetics has been studied for the prevention and treatment of PONV in surgical patients. Glucocorticoids are well known for their analgesic, anti-inflammatory, immune-modulating, and antiemetic effects. Ondansetron is the most prophylactic serotonin subtype 3 antagonists in our daily clinical practice for the prevention of PONV after surgery.

Zenodo (CERN European Organization for Nuclear Research), Apr 27, 2022

Urinoma is an accumulation of urine in the retroperitoneal area. It is caused by injuries to the ... more Urinoma is an accumulation of urine in the retroperitoneal area. It is caused by injuries to the kidneys, ureters, urinary bladder, or urethra. They may be confined, encapsulated fluid collections or may manifest as free fluid. Urine leaks have a variety of appearances. This case describes a patient 27 years old, female presented at the emergency room with internal diseases with complaints of bloating and abdominal discomfort. The history of the disease had begun three days before when she presented to the hospital with bloating that came increasing in quantity. She referred that five days ago gave birth to a child through transvaginal delivery. For the woman was the first birth of a child. According to the patient's own referral, her pregnancy was without problems but the birth lasted many hours. There have been no previous health problems (confirmed by laboratory and imaging tests before pregnancy). There was a careful follow-up of the pregnancy. Except for an isolated case of a urinary tract infection, there was no other complication. Further imaging revealed a large fluid in the pelvis and intraperitoneal. Treatment of this rare phenomenon is crucial for the delay in medical care can lead to abscess, hydronephrosis, electrolyte instability. CT cystography and retrograde urethrographic are the diagnostic imaging studies of choice. In the appropriate setting, the use of these management options may reduce urinoma-related complications and limit or totally eliminate the need for urologic surgery.

GLOBAL JOURNAL FOR RESEARCH ANALYSIS

Background; Metastatic breast cancer is a burden on healthcare worldwide. Despite the progress ma... more Background; Metastatic breast cancer is a burden on healthcare worldwide. Despite the progress made in early diagnosis and adjuvant treatment of breast cancer again about 30% of patients develop metastases in the course of their disease. Also, there is a percentage of patients where the disease presents in metastatic stage. Real-world data may provide valuable information on the effectiveness and safety of medicines, which is particularly relevant for clinicians, patients and third-party payers. Materials and methods; We have collected data from 63 patients at Mother Teresa Hospital receiving Palbociclib since June 2016 until October 2019. Patients aged≥18 years, diagnosed with ABC and exposed to Palbociclib plus Fulvestrant. Patients were followed-up until death… Results; A total of 63 patients were included. Median age was 66 years (range 28–78) and 99.05% were female. Median follow-up time was 26.42 months… Conclusion; Palbociclib plus Lulvestrant seems an effective treatment for...

Albanian Journal of Trauma and Emergency Surgery

ASTES has organized an attractive scientific program, in partnership with the Surgical and Medica... more ASTES has organized an attractive scientific program, in partnership with the Surgical and Medical Societies of our country. In addition, we have prepared several special lectures by national and international speakers.The “Frederic Shiroka” lecture will be given by Professor Flamur Tartari, a distinguished surgeon who hasbeen the chief of general surgery service over the years as the father of Albanian modern surgery. He willdeliver his lecture titled “A lifetime with surgical patients”.The pre-conference course for medical personnel (BLS & D) will be available a day before the conference.Finally, we would like to thank all members of the organizing and scientific committees for their hard work in the past few months to ensure that every aspect of the conference is smooth and with the highest standards.Without their hard work and dedication, this conference would not have been possible. Let us express specialthanks to all speakers, particularly to our distinguished international fa...

International Scholarly Research Notices, 2014

Background. Chronic postherniorrhaphy groin pain is defined as pain lasting >6 months after su... more Background. Chronic postherniorrhaphy groin pain is defined as pain lasting >6 months after surgery, which is one of the most important complications occurring after inguinal hernia repair, which occurs with greater frequency than previously thought. Material and Methods. Patients undergoing elective inguinal hernioplasty in Victoria Hospital from November 2011 to May 2013 were included in the study. A total of 227 patients met the inclusion criteria and were available for followup at end of six months. Detailed preoperative, intraoperative, and postoperative details of cases were recorded according to proforma. The postoperative pain and pain at days two and seven and at end of six months were recorded on a VAS scale. Results. Chronic pain at six-month followup was present in 89 patients constituting 39.4% of all patients undergoing hernia repair. It was seen that 26.9% without preoperative pain developed chronic pain whereas 76.7% of patients with preoperative pain developed ch...

Background; “Acute Appendicitis” is one of the most usual causes of emergency hospital admissions... more Background; “Acute Appendicitis” is one of the most usual causes of emergency hospital admissions and appendectomy is one of the most common emergency procedures performed in the contemporary medicine. This study aims to identify the Alvarado Score System as a simplified tool for the emergency doctor in the abdominal emergency in general and for the Acute Appendicitis in particular. Materials and methods; The study is of retrospective character and includes 130 cases presented with abdominal Pain in University Hospital Centre” Mother Theresa” Tirana, Albania, in the period 1 April 2019 - 30 May 2019 from which 100 allegedly suspected with “Appendicitis Acute”. Results; Gender distribution has a slight male predominance. The predominant age group was 14-21 years old. The most frequent clinical data has been the tenderness in right iliac fossa. In our study 3% of cases belonged to the group 1-4 Alvarado points, 17% of the cases belonged to the group 5-6 Alvarado points and 80% of the ...

Albanian Journal of Trauma and Emergency Surgery

The Advanced Trauma Life Support (ATLS) course has become an indispensable tool in preparing heal... more The Advanced Trauma Life Support (ATLS) course has become an indispensable tool in preparing health care professionals to provide optimal trauma care. This article highlights the impact of the ATLS course on empowering healthcare professionals for excellence in trauma care. By providing a standardized framework, enhancing critical decision-making skills, and promoting interdisciplinary collaboration, the ATLS course equips practitioners with the knowledge and skills necessary to effectively respond to trauma emergencies. Additionally, the course prepares healthcare professionals for the unpredictable nature of trauma care through simulation-based training and fosters a culture of continuous professional growth. Through its emphasis on standardization, critical thinking, and continuing education, the ATLS course plays a vital role in improving patient outcomes and establishing a foundation for excellence in trauma care. Conclusion: The ATLS course stands as a testament to the commitm...

Hernia Updates [Working Title]

Among the most frequent pathologies of the abdominal wall are hernias, which are defined as a pro... more Among the most frequent pathologies of the abdominal wall are hernias, which are defined as a protrusion of the abdominal organs through any of the weak points of the abdominal wall. They can be spontaneous appearing in weak points of the abdominal wall or along the site of surgical incisions. Although hernias have been mentioned since ancient times, until after the second half of the 19th century, when the era of modern surgery began, the concept of hernias rarely mentioned incisional ones. After the introduction of anesthesia and antisepsis, abdominal interventions began to become common and with this, the incidence of incisional hernias was significantly increased. Until after the second world war, the correction of incisional hernias was done using simple sutures, transverse overlapping technique, continuous fascial sutures, etc. After this period, different synthetic materials were manufactured for the correction of abdominal hernias. The large variety of prosthetic materials t...

Zenodo (CERN European Organization for Nuclear Research), Sep 13, 2019

Colorectal cancer represents the third most common cause of malignancy and is the most common cau... more Colorectal cancer represents the third most common cause of malignancy and is the most common cause of large bowel obstruction. Purpose: The aim of this study was to present our experience in the management of patients with obstructive colorectal cancer. Material and methods: This is a retrospective which include eight patients study patients that have undergone emergency surgery for large bowel obstruction as a cause of colorectal cancer from January 2016 2018 at the Clinical Hospital of Tetove. Results: there were three male and two females in our study. The average age of patients was 72.5 years (from 52 82 years). patients with complications, respectively one with anastomotic leakage and two with wound infection. Conclusion: Occlusive colorectal cancers represent sometimes a challenge even for experienced surgeons. A radical surgical treatment is indicated whenever it is possible.

Journal of Surgery and Research

Introduction: Emergency medical service for patients in emergency situations is the most importan... more Introduction: Emergency medical service for patients in emergency situations is the most important aspect of all health systems in the world, as this is the first and most delicate point of confrontation of the patient with the health system of a country. All patients seeking urgent medical care, and the slightest delay in access to this service, by the population, is understood as a matter of "life or death" for them, to which they are quite sensitive. While learning or training during the process of exercising said activity combined with actual study data and comparisons with the results of international emergency medical services remains a challenge of the future. Thus the evaluation criteria of performance indicators of the emergency service based on scientific research evidence are unified. Ambulance services were basically just small vehicles, some with two stretchers, without the necessary equipment. Managers working as emergency personnel had only a few hours of limited first aid training which were referred to as "suitable personnel". The duties of the ambulance service personnel were twofold. On the one hand, they transported the sick and planned the so-called regulated ambulance service… Conclusion: The changes and diversity of medical emergencies including increasing trends of traumatic, mortal, and post-traumatic morbidity emergencies constantly put pressure on medical emergency services. All of these improvements will yield results in increasing efficiency by improving the quality of treatment and reducing the cost of medical care.

Sir William Osler* citon: "Ai që studion mjekësi pa libra, lundron në një det të paeksplorua... more Sir William Osler* citon: "Ai që studion mjekësi pa libra, lundron në një det të paeksploruar..." Osler mbrojti rëndësinë e sigurimit të korrelacioneve klinike në mësimin e siguruar nga librat dhe ushtrimin e tyre në praktikë. Vitet e fundit të gjitha shkollat mjekësore kanë kuptuar rëndësinë e korrelacioneve teoriko-praktike dhe edukimi është bërë shumë më i bazuar në problemet e urgjencës mjekësore, duke përdorur rastet e simuluar dhe prezantimet e tyre. Shumica e shkollave mjekësore në Shtetet e Bashkuara kanë rritur ndërveprimet me pacientët, edhe për studentët e vitit të parë dhe të dytë të mjekësisë. Sidoqoftë, autorët dhe redaktorët e librave shkollorë kanë qenë shumë më të ngadaltë për t'u përshtatur me këtë ndryshim. Shumica e librave shkollorë mjekësorë, përfshirë edhe ato në specialitetin e mjekësisë së urgjencës, mbeten të orientuar nga sëmundjet, sesa te pacientët. Si rezultat, shumica e librave shkollorë zënë pozicione të dukshme në raftet me pluhur të li...

Archives of Clinical and Medical Case Reports

Pseudo aneurysms of the right hepatic artery are uncommon, appearing in approximately 1% of hepat... more Pseudo aneurysms of the right hepatic artery are uncommon, appearing in approximately 1% of hepatic trauma cases, and most are extrahepatic (80%) and have a late-onset [1]. Although they are usually asymptomatic, they should always be treated because of the high risk of complications, especially breakage. We present a case of post-traumatic hepatic artery pseudoaneurysm that was successfully treated using this open surgical technique. Intrahepatic pseudoaneurysm (IHPA) following shotgun injury is rarely reported. Timely diagnosis is crucial. We advise keeping in mind the possibility of IHPA, when dealing with high-grade liver injury. CT is recommended before removal of perihepatic packs, as it may pick up a lifethreatening pseudoaneurysm.

Albanian Journal of Trauma and Emergency Surgery

Electrical injury is a physiological reaction caused by electric current passing through the body... more Electrical injury is a physiological reaction caused by electric current passing through the body. Electric injuries can be caused by the impact and exposure to electric current or lightning either at home or at work. The injury depends on the density of the current, tissue resistance, and duration of contact. Very small currents may be imperceptible or produce a light tingling sensation. Injuries can range from minor, moderate, to severe, and fatal injuries are just as likely to occur at home as in the workplace, with around 20 Australians dying each year from electric shock. The purpose of this paper is to study how well-trained healthcare professionals in both pre-hospital and hospital settings are in treating patients in the case of electric shock and injuries caused by lightning, including the triage, assessment, monitoring, treatment, and transport with medical care in pre-hospital settings The research was conducted based on data obtained from assessments of health care prof...

Cureus

Background Treating chronic hepatitis C (CHC) with direct-acting antiviral (DAA) is very effectiv... more Background Treating chronic hepatitis C (CHC) with direct-acting antiviral (DAA) is very effective at clearing the infection. In Albania treatment with DAA is limited to patients with liver stiffness F3-F4, and with other coinfections. The objective of this study was to evaluate the efficacy of DAA in Albanian patients with genotypes 1-5, who mostly suffer from advanced liver fibrosis. Material and Methods This is a retrospective study carried out at the University Hospital Center "Mother Teresa", Tirana, during 2014-2019, including treatment-naïve and treatment-experienced patients with genotypes 1-5. All patients were evaluated with elastography and most of them were F3-F4. The primary endpoint involved the patients achieving SVR-12, or undetectable hepatitis C virus/ribonucleic acid (HCV RNA) 12 weeks after the end of treatment. In patients without a genotype, we have used a pangenotypic regimen. Results This study included 207 patients with a mean age of 48.9 ± 13.1 years, 56% male and 44% female; 152 (73%) were genotype 1, 24 were (11.5%) genotype 2, nine were (4.3%) genotype 3, 14 were (6.7%) genotype 4, one was (0.4%) genotype 5, and seven (3.8%) unassigned genotypes. The sustained virologic response (SVR) percentage according to genotype is discussed in the article. The overall SVR score of all the patients in our study was >93%. According to elastography, 127 (66%) were F3-F4, and 80 (38.6%) were F1-F2. Conclusion Treatment with DAA proved to be very effective in our patients; most of them had advanced liver fibrosis as well as compensated or decompensated liver cirrhosis. The overall SVR score of the patients in our study was >93%. Our country needs to treat all patients with chronic hepatitis C without limitations to attain the WHO objective of eradicating this disease by 2030.