gentian vyshka

The COVID-19 pandemic has brought major psychological issues, such as stress and anxiety, to the global population at large, as well as to specific groups. One such group consists of university students who underwent online teaching and were isolated from physical social contacts for the majority of 2020-2021. However, the impact of stress on university students has not been studied in our country. Stress is influenced by cultural and societal aspects that vary from one country to another but share basic overall features. 

This is a cross-sectional cohort study, using survey methodology, specifically the perceived stress scale-4 (PSS-4). The target population consisted of first-year bachelor nursing students of the Medical University of Tirana during the academic year 2020-2021, who underwent online teaching, as well as the same cohort of students upon their physical return to university. 

Overall stress perception was significantly higher among students in the academic year 2021-2022, Me (IQR)=8 (4), compared to the academic year 2020-2021, Me (IQR)=7 (5) (P<0.001). Also, the level of stress regarding the negative subscale was significantly higher among students in the academic year 2021-2022. 

Overall, the results showed increased stress perception in the academic year 2021-2022 upon students’ physical return to university. We suggest that apart from other important factors, the increased level of stress among second-year students is a direct consequence of the pandemic-imposed measures of college closure and online teaching platforms.

The Yalta Conference of 1945 brought together three of the most influential leaders of the 20th century: Franklin D. Roosevelt, Joseph Stalin and Winston Churchill. Surprisingly, all three leaders would go on to suffer strokes after the conference. This manuscript examines the health status of these leaders during and after the Yalta Conference, the factors that contributed to their strokes (including the role of hypertension), and other modifiable risk factors present in each one of them, and the impact of their declining health on their countries and the world.
Roosevelt's demise, prior to the conclusion of the war, triggered a leadership transition during a critical moment in history, while Churchill and Stalin's passing shaped the early Cold War era. A veil of secrecy shrouded the health conditions of these pivotal leaders. “The Big Three” made considerable efforts to hide their health conditions from both the press and the public at large.
Understanding the health of political leaders is crucial as it can affect their decision-making abilities and the course of history. The fates of Roosevelt, Stalin and Churchill serve as important reminders of the potential consequences of poor health in the highest echelons of political power.

Cannabis abuse has been an issue of major concern for the Albanian society in recent years, following the wide illegal planting of the species. Legal lacunas, weaknesses from the drug-controlling agencies, and the easiness of harvesting Cannabis sativa plants have contributed to the creation of a general negative opinion toward a potential use of its active principles for medical purposes. Professionals of the field and policymakers are largely focused on harm reduction activities, thus bypassing the option of legalizing cannabinoids for clinical conditions that might find relief in their use.The discussion of a case suffering from postherpetic neuralgia shows how this negative opinion is depriving Albanian patients from an otherwise helpful pharmacological option whose efficacy has been confirmed by an important bulk of research. Uncovering the roots of this misperception will help address the issue. Clinicians with expertise need to have their say in the debate, since for the majority of countries where medicinal cannabis is legalized, this was due to consumer-led initiatives. Ensuring patients’ freedom as implied within the principle of autonomy is also a sound ethical support of such legalization.

Chronic alcoholism is a public health issue, and several theoretical frameworks have been proposed to explain its nature. The developmental approach to chronic alcoholism has a double contour, with neurobiological theories counting on several aspects of the deleterious effects exerted from ethanol over neural structures. Psychological and neurobiological theories are not intrinsically contradictory to each other. The importance of early experiences and the potential sensory clues leading to ethanol-self administration are integral parts of the developmental neurobiology of an alcoholic. The developmental theories need to consider any further the accumulative and deleterious effects of ethanol during the nervous system maturation.

Infanticide is a horrendous crime universally condemned from all ethical, juridical and moral standpoints. However, legislation on infanticide foresees mitigating circumstances for infanticidal mothers, with sentences by far dispro-portionate to the severity of the crime. The main justification for this abstaining from severe punishments has been the so-called post puerperal psychosis, whose diagnostic criteria and existence are still very confusing. Psychiatric experts and even jurors show excessive feelings of empathy toward defendant mothers, and fair verdicts under this setting and with this judicial tradition are questionable. Albanian courts have in some cases even denied defendant mothers the unwilling albeit necessary psychiatric treatment, thus exposing them to recidivism and to other social difficulties. Upholding the charge of infanticide in an Albanian court is hereby an impossible enterprise, with high chances for defendants to achieve acquittal on mental insanity grounds. Through describing three cases of infanticide and filicide in recent years of Albanian judicial proceedings, authors raise the concern formulated from other sources regarding the excessive empathy surrounding infanticidal mothers, a deleterious obstacle toward achieving justice.

Patent ductus arteriosus (PDA) is an extremely common in very premature infants. Untreated symptomatic PDA may be associated with chronic lung disease. PDA has a major role in neonatal mortality and morbidity. To compare the efficacy and safety of oral versus intravenous ibuprofen for the pharmacological closure of PDA in low birth weight (LBW) preterm infants. A randomized, single-blinded, controlled study was performed on premature neonates at the neonatal unit, University Hospital for Obstetrics and Gynecology “Koço Gliozheni”, Tirana, Albania from January 2010 to December 2012. The study enrolled 68 preterm infants with a confirmed and significant PDA. The preterm infants received either intravenous or oral ibuprofen randomly as an initial dose of 10 mg/kg, followed by 5 mg/kg at 24 and 48 h. 36 patients were treated with oral ibuprofen and 32 with intravenous ibuprofen during this period. After the first course of the treatment, the PDA closed in 30 (83.3%) of the patients assigned to the oral ibuprofen group versus 23 (71.8%) of those enrolled in the intravenous ibuprofen group (p= 0.355). 15 patiens needed a second treatment course and they were all (100%) with clinical signs of infection and positive bloodculture. There was no reopening of the ductus after the closure. Our data indicate that, for LBW infants, the rate of early ductal closure was comparable and the adverse effects were fewer with oral ibuprofen in comparison to the intravenous route. Association of PDA with perinatal infection has a negative impact in pharmacological closure of the ductus, increasing the need for a second course or for surgery.

The goal of this study was to investigate all the potential routes to Child/Adolescent Psychiatry Clinic-University Hospital Center (CAPC-UHC) in Tirana. The article provides demographic data, as well as further information on the types and amounts of services children/adolescents received during the process of seeking help related to different diagnoses. The study was conducted in CAPC-UHC in Tirana, during September 2006-September 2007. Data were collected from 162 children and their parents using Strengths and Difficulties Questionnaire (SDQ) and Pathways Encounter Form. The sample consisted of 53.1% (86) males and 46.9% (76) females. The mean age was 9.5 + 4.4 years. Out of the total number of cases that sought care to CAPC; 55, 6% were referred by parents themselves, while the rest were referred by others. There was a significant effect of gender to intervals from the onset of problem to the first career (F = 10.803, p=0.001), as well as a significant effect of gender to total time intervals from the onset till the specialist of child mental health problem (F = 6.742, p=0.01). This is the first study investigating the help seeking process to psychiatric care in CAPC Tirana-Albania and may serve as a good start in generating evidence based on child/adolescent mental health service. Further multicentre studies will enhance the values of the findings, since the present study was performed in a single service, and in a setting lacking previous works with similar scope that could have served as references.

Gaucher's disease is a rare genetic disorder that results in the accumulation of cerebrosides in the liver, spleen, kidneys, lungs, brain and bone marrow. The deficiency of the specific lysosomal enzyme glucocerebrosidase is considered as causative factor. The first effective treatment for the disease, the drug Ceredase, approved in 1995, was replaced in 2001 by the drug Cerezyme®. During the period 2004-2009 in our service 11 children were hospitalized and treated for Gaucher's disease: 9 children with type 1, and 2 children with type 3 of the disease. The enzymatic examinations of the biomarker chitotriosidase were performed in Sahlgren's University Hospital, Mölndal Sweden; the DNA analysis was performed in the Children's Hospital & Regional Medical Center, Seattle, USA. We are presenting the biological and genetic molecular data of the children. In our case series, one year after the treatment started, the hemoglobin level was normalized; the platelet count was normalized in 7 patients after one year of treatment, and in 9 patients after two years of treatment. The hemorrhagic syndrome stopped after 6 months of treatment. Chitotriosidase values decreased 10-20 times the initial value, after one year of treatment and in one case the value reached the normal range. The treatment with Cerezyme® has also improved the visceral and biological signs. Anomalies of the oculomotricity were less sensitive to the treatment. According to our experience, Chitotriosidase is a sensitive and specific marker in diagnosing and monitoring Gaucher's disease. The enzyme replacement therapy through Cerezyme® is an effective and safe treatment of Gaucher's disease. Blood signs (anemia, platelet count); visceral signs (splenomegaly, hepatomegaly) as well as bone involvement showed decisive improvement under the therapy.

The apparatus invented by Dr. Luigj Benusi in 1943, in Tirana, was a practical application of the Kowarsky technique and Ambard laws, helping in determining blood urea levels and very important to a variety of diseases, mainly kidney disorders.The apparatus was invented and prepared from very simple laboratory materials, such as glasses, test tubes, corks and volumetric cylinders. Technologically, it was based upon the determination of blood urea through hypobromite, and, among the advantages of the apparatus of Benusi, were its extreme simplicity, the smaller amount of blood needed for producing results (2 milliliters), as well as an easiest way to clean up and to manage the apparatus from a practical point of everyday use.