There is an emergence of infections with ESBL-producing micro-organisms recently. They remain poorly characterised in children. We sought to characterise children in a teaching hospital from whom an ESBL-producing organism had been isolated.

Congenital posterior urethral-perinal fistula is a rare anomaly of which there have been reported only one case to date. This report outline the simple clinical presentation, diagnosis and simple technique surgical management. Congenital posterior urethral-perineal fistula is a rare anomaly. This is a rare case in the world literature. There are reported only six cases since 1964. Dr. William C. Brown, Dillon, Heusele has reported one case (diagnosis and new surgical technique). Other authors have reported rare cases: Le Duc has reported one instance ofan urethral-rectal fistula in the absence of any anorectal abnormality. Out of the 7 cases previously reported one is actually an urethral scrotal fistula but it is included since it has a similar embrylogic origin to the rest of the series.

«I have a dream», said Martin Luther King. „Trust your dreams.Have the courage to go after them, „another wise man had said. „Do not allow small minds to convince you that your dreams are too great,“ advised another wise man. It was considered a big dream the idea of creating a new Albanian non-public faculty in the field of medicine and health. In fact it was a dream that was born in the mind of Henri Çili and preserved for many years in his heart. He is one of the most passionate innovators in the field of higher education and our social liberalization in general. He together with three other open-minded inovators created the European University of Tirana (UET), which in the last ten years marked impressive stories of success.

Nowadays the prevalence of obesity especially maternal obesity prevalence has increased substantially and provides a major challenge to public health. Besides that, weight gain during pregnancy may result in negative outcomes for women and neonatal. Objective: We evaluated maternal obesity prevalence and outcomes during and after pregnancy at the Regional Hospital of Ferizaj. Methods: A total of 258 pregnant females who delivered their babies at the Regional Hospital of Ferizaj between March 2018 and March 2020 were included in this study. Based on the body mass index (BMI) of maternal, the patients were divided into groups: underweight, normal weight, overweight, obese I, obese II, and obese III/ morbid obese. The effects of obesity on fetal and maternal outcomes were investigated. Results: Overall 258 pregnant women were included in our study, the average age was 28.7±3.4, with min age of 19 and a max of 41 years old. The prevalence of BMI over the normal weight among pregnant women resulted in 70.5% (182/258). Most of the maternal were overweight at 29.6% (54/182), obese class I at 27.5% (50/182), obese class II at 25.3% (46/182), and obese class III at 17.6% (32/182), with a significant association between them χ2=2.8, p<0.02. Adverse obese maternal effects and perinatal consequences or other problems were significantly more frequent than in normal-weight maternal. Besides that, in this study, the low-birth-weight infant rate was higher in the low BMI pregnant cases with a strong significant association (χ2=37.8 p value < 0.0001). Conclusion: The finding of this study conclude that obesity plays a significant risk factor and it is a strong association with complications in pregnancy and newborns. Further studies are recommended to explore the obesity problems to develop guidelines and strategies and to minimize the adverse effect of this risk for developing maternal and newborn complications.

Pap test is already part of the successful examinations in the early detection of cervical cancer. The objective of this 1-year retrospective study (2019-2020), is to assess the importance of periodic Pap tests, the distribution of squamous and glandular anomalies, as well as determining the predominant categories for each anomaly, in 4123 cases of Hygeia hospital, in Albania. The age group 60- 69 years was with the most anomalies. 72.8% of women included in the study tested negative for intraepithelial lesion or malignancy. There was an increase in the positive percentage of Pap tests with epithelial cell abnormalities with increasing age group up to the age of 70 years (p <0.001). With epithelial cell abnormalities 97.7% of them were of squamous origin (ASC-US 86.2%) and 2.3% of them were of glandular origin. The Pap test should be a routine test for all sexually active young women, for early precancerous detection of the cervix. It is a valid, inexpensive, uncomplicated, noninvasive screening test for the detection of premalignant and malignant lesions of the cervix7 . The American Cancer Society recommends that all women should begin screening for cervical cancer 3 years after the onset of coitus.

Perinatal brain injury is the third leading cause of child mortality globally. Purpose: Evaluation of perinatal risk factors for encephalopathy in neonates in order to prevent deaths and disabilities Method: This is a prospective, case-control study conducted in the Maternity Hospital “K. Gliozheni” during the time period 2012 – 2016. 65 newborns at term ≥37 weeks diagnosed with encephalopathy according to the Thompson classification >5 within 12 hours of birth were compared with a control group, infants without encephalopathy in a 1:1 ratio selected casual and gender-appropriate. Results: Total antepartum risk factors were found in (70.8%) of cases and (18.5%) of controls (p<0.01). Sentinel events were found in 38.5% of cases and in 9.2% of controls. (p<0.01). Acute intrapartum events in total were found in (38.5%) of cases and (9.2%) of controls (p<0.01). 43.1% of babies had a combination of antepartum and intrapartum factors (p<0.01). Significant and independent predictive factors of risk for neonatal encephalopathy resulted: from maternal factors, mother’s age >35 years (p=0.03). Of the intrapartum factors: pregnancy with twins (p<0.01), hypertension/preeclampsia (p<0.01), non-reactive FHR before delivery (p<0.01). MEDICUS No. 6, ISSUE 2/ 2022 103 From intrapartum factors: breech birth (p=0.01), emergency cesarean section (p=0.01), meconial amniotic fluid (p=0.02), prolonged birth (p=0.01). Conclusion: Knowledge of perinatal risk factors associated with neonatal encephalopathy is essential for developing interventions to prevent neonatal death and disability.

Background: Although cancer is the disease for which people need palliative care the most, the number of diseases and conditions requiring palliative care has increased and will continue to grow. Palliative care improves health, reduces unnecessary hospitalization as well as overuse of health services. There are several barriers to palliative care access and the main are those related to the public such as: lack of public awareness of palliative care, on their benefits; cultural and social barriers.

This review’s purpose is to summarize the current state of knowledge on the systemic implication of chronic pulmonary obstructive disease Background: The ‘systemic repercussions’ of COPD are of great importance. These include accidental weight loss, skeletal muscle dysfunction, and a higher risk of cardiovascular disease, osteoporosis, and depression. Frequently affecting the patient’s health and prognosis, these extrapulmonary COPD characteristics demand thorough screening and proper management to give the most effective medical care. Methods: We conducted a search of papers describing COPD as a systematic disease on the MEDLINE database. Discussion: Local and systemic inflammation, oxidative stress, and changes in the neuro-humoral states are some of the likely candidate pathways by which these extrapulmonary complications of COPD are affected, even though the mechanisms for the association of COPD with systemic disorders have not been fully clarified. The processes and mechanisms behind the extrapulmonary symptoms of COPD will likely become more transparent with further research. Conclusion: COPD management should be based on a clear understanding of COPD-related comorbidities and their impact on COPD itself.

Fractal analysis is an objective approach that in oncopathology is one of the important fields of application. In this study is present fractal methodologies at histological level that have been successfully applied to characterize pathological features and able to perform differential diagnosis and prognosis in oncopathology. The basic principles and prospects of fractal geometry in pathology are promising. In particular, fractal analysis is emerging as a powerful tool to perform differential diagnosis and prognosis of the patients in cancer and other malignancies as well to improve the effectiveness and safety of patient care. All fractal objects have Fractal Dimension FDs, commonly calculated with box counting. Morphometry, the measure of shapes of the structures, can be added to every imaging technique in order to obtain objective indexes. In this field, fractal analysis has been applied to histopathology, cytopathology, and electron microscopy with great success. Performing fractal analysis of tissue samples, it’s possible to make differential diagnosis between the early stage of tumors and flogosis, or among the different types of Basal Cell Carcinoma, and different grade of Invasive Bladder Carcinoma, well as to investigate the subtle alterations of the nuclear patterns in human breast tumors, or to evaluate other tumors.

Introduction Colorectal cancer (CRC) is a multi-factorial disease with high malignancy, and the fourth leading cause of cancer death worldwide. This study was performed to assess the epidemiological, patients’ profile and clinic-pathological characteristics of CRC in Regional Hospital, Durres. Methods This is a retrospective study where being included all patients diagnosed with CRC at Surgery ward in Durres hospital from January 2016 to December 2020. A statistical software SPSS version 21.0 was used for data analyze. Results During five years of CRC cases investigation, a total of 136 patients were treated in the regional hospital of Durres city. Of these, 97 (71.3%) patients had cancer of the colon and others patients 39 (28.7%) had rectal cancer. Most of the patients (47%) resulted with left-side tumors and (24.3%) with right-sided tumors. Males with CRC resulted 62.5% and females 37.5% with ratio man versus female 1.66. The commonest symptoms were abdominal pain or discomfort 39.7%, diarrhea or constipation 27.9%, changing in bowel habits 16.9%, rectal bleeding and anemia 15.4%. About the stage of CRC, in stage I resulted 24.3% in stage II 42.6%, stage III 14% and stage IV 19.1%. CRC in descending colon and rectum were commonest in females (22.05%) while in males the ascending colon is the commonest (26%). Conclusion During this retrospective study, the cancer of colon cancer resulted more frequent versus or than rectum cancer. Males were the most predominant gender in this study and left side-tumors more frequently occurred on patients over 60 years old. We have found varied clinical presentation among our patients, but abdominal pain or discomfort and diarrhea or constipation were the commonest symptoms. Patients with CRC on the sate II has a predominance in number compared to patients diagnosed with other stage of tumors.