Impact of the National Population Register in Improving the Health Information System of Malignant Diseases in Kosova.

INTRODUCTION: Malignant diseases are serious socio-medical problem, being that they cause grave problems in terms of health, social and economic perspective to an individual, in particular, and society in general. A proper reporting and monitoring system enables adequate calculation of indicators and evidence based decision making. AIM: The study aims to examine the appearance of malignancies diagnosed and reported in Kosovo for a three years period: 2012, 2013, and 2014 by its modalities such as by the years of appearance, gender, age, and most frequent types of malignancies. MATERIAL AND METHODS: The study is a retrospective cohort research whereas source data we used are reports of malignant diseases from National Cancer Register (NCR) in the Health Information System (HIS) at the National Institute of Public Health of Kosova (NIPHK). RESULTS AND DISCUSSIONS: In Kosova during years 2012, 2013 and 2014 a total of 7437 cases of malignant diseases were reported; in 2012 were 31%, in 2013 were 24.3%, and during 2014 higher number of cases were reported, 3320 or 44.6%. During the reporting period, the appearance of malignant diseases in both sexes is about equal, with a light predominance of male cases with 50.8% (or 3780 cases), while by age group were represented with the elderly, from ages 50 to 79 years with 5111 cases or 68.8% of total malignancies. CONCLUSION: The highest number of malignant diseases was reported during year 2014 due to better reporting through HIS and NCR. Malignancies attacked both genders equally, whereas the most common types of malignancies were: melanoma and other malignant neoplasms of the skin, malignant diseases of the respiratory and intrathoracic organs, digestive tract, breast and female genital tract. The most affected the older ones.

Smoking Behaviors in Kosova: Results of Steps Survey.

INTRODUCTION: Tobacco use continues to be the leading global cause of preventable death. Most of these deaths occur in low and middle-income countries, and this trend is expected to widen further over the next several decades. The overall objective of the study is to describe and analyse the smoking behaviours of adults in Kosova. METHODS: According to the STEPs methodology, 6,400 respondents, aged 15 - 64 years, are selected randomly within each sex and 10-year age-group. Out of 6,400 participants, 6,117 were selected, which is approximately 95.6%. RESULTS: The prevalence of smoking was higher among males (37.4%) compared with females (19.7%). In all age groups, the prevalence of smoking was higher among males compared with females. Regarding the age group of 15 - 24 years, the prevalence of smoking was 16.0%, but in the age group of 25 - 34 years, it nearly doubled to the rate of 31.9%. We have a smaller increase in the age group of 35 - 44 years, and after the age of 45, it falls gradually. CONCLUSIONS: The prevalence of smoking in Kosova is high compared with other countries in Eastern Europe. In future decades, Kosova will face a high probability of an increased burden of smoking-related diseases.

Knowledge, Attitudes and Practices of Mothers in Kosova About Complementary Feeding for Infant and Children 6-24 Months.

AIM: This cross sectional study assessed knowledge, attitudes and practices regarding complementary feeding among mothers with children between 6-24 months at the national level. METHODS: The sample of 492 mothers with children between 6-24 months, with a confidence level of 95%, the acceptable margin of 5%, the expected prevalence of 50% knowledge and effect of 1.3, were interviewed from all regions, in all Kosovo. Data were analyzed using SPSS version 17.0 and presented using descriptive and inferential statistics such as Chi-square with significance level set at 5%. RESULTS: Overall, 88.4% of respondents had good knowledge of complementary feeding, while only 38.4% of mothers had good practices regarding time for starting complementary feeding. We found association between maternal knowledge and level of education for complementary feeding. CONCLUSION: There is a need to further explore the factors responsible to improving practices for complementary feeding.

PATIENTS' SATISFACTION WITH HEALTH SERVICES AT THE NATIONAL INSTITUTE OF PUBLIC HEALTH OF KOSOVA.

AIM: Purpose of the research is to assess patient satisfaction with the quality of health services provided in National Institute of Public Health of Kosova. METHODS: Study was observational and cross-sectional. Interviews were conducted with 625 clients of IPH. Inclusion criteria for enrollment in the study were patients above 18 years old, with verbally informed consent. RESULTS: In our study, access to IPH, efficacy, patient-provider interpersonal communication, and explanations regarding procedures, readiness to answer to patients need and physical settings and appearance are valued satisfactorily whereas cleanliness was rated with minimal grades. Evaluated 12 quality components, were scored with average mark 3.6. CONCLUSIONS: SWOT analysis, and fishbone diagram should be used on regular bases and a new position for a manager for administrative issues, is opened, complaints box and list of rights and responsibilities of patients were dislocated in a more visible place, and internal staff turnover, is introduced.

Tobacco Smoking Habits Among First Year Medical Students, University of Prishtina, Kosovo: Cross-sectional Study.

INTRODUCTION: Tobacco smoking remains the leading causes of preventable morbidity and mortality in the world, requiring intensified national and international public health response. World Health Organization (WHO) has urged health professional organizations to encourage and support their members to be models for not using tobacco products and promote tobacco-free culture. Healthcare students are the future authority of the health society, they are in a position to play a vital role and have impact on social norms related to smoking. AIM: To determine the prevalence of tobacco smoking among healthcare students of Medical Faculty, University of Prishtina in Kosovo, so that recommendations can be made for its cessation among healthcare providers and thereafter the community. MATERIALS AND METHODS: Descriptive cross-sectional study was conducted using self-administrated questionnaire prepared for this purpose. A total of 284 first year healthcare students of Medical Faculty, University of Prishtina in Kosovo were enrolled in the study. The data were analyzed using SPSS 22. RESULTS: All respondents completed the questionnaire, giving a response rate of 100% (general medicine=180, dentistry = 104). The prevalence of students who have ever smoked was 53.2%. However, only 8.9% (9.1% M vs. 8.7% F) of the general medicine students and 5.8% (4.8% M vs. 6.5% F) of dentistry students declared that smoke tobacco every day. Overall, the research shows that the prevalence of occasional smokers among medical students in Kosova is quite high.

Pediatric burns in University Clinical Center of Kosovo from 2005-2010.

OBJECTIVE: The objective of this study was to determine the incidence and cause of burns in children of our population. METHODS: This was a retrospective study that included 399 patients with burns, younger than 15 years old who were admitted to the Department of Plastic Surgery, University Clinical Center of Kosovo, between 1 January 2005 and 31 December 2010. The patients were categorized into the following three age groups: infants and toddlers (0-2 years), early childhood (3-6 years), and late childhood (7-15 years). Arithmetic median and standard deviation were calculated from statistical parameters for gender and age; the differences between the three age groups were measured with one-way analysis of variance (ANOVA). A p value of <0.05 was considered statistically significant. RESULTS: During the study period 2005-2010, in our population, burns in children were predominant in boys with 257 cases or 64.4%, while 142 patients were girls or 35.5% The difference between the three age groups related to the causes of burns was statistically significant: p<0.000 for electrical burns and p<0.002 for burns caused by pyrotechnic devices. CONCLUSION: A high rate of childhood burns in Kosovo induces hospital admissions and prolonged hospital stays.

Correlation between blood lead level and hemoglobin level in mitrovica children.

INTRODUCTION: Lead toxicity is a serious health threat, especially in developing countries due to environmental pollution. It was thus aimed to investigate correlation between blood lead level and concentration level of hemoglobin in the blood of children involved in research. MATERIAL AND METHODS: The research included 250 children of which 31(12.4%) kindergarten children, 166 (66.4%) of primary school pupils in Mitrovica and 53(21.2%) of primary school pupils in Shtime as control group. From the 250 children included in the survey 129 or 51.6% were female children and 48.4% male children. Children were selected randomly, while tests for concentration of Pb and blood hemoglobin were done at the National Institute of Public Health. RESULTS: The average value of blood lead level of Mitrovica pupils was 2.4 µg/dL (SD±1.9µg/dL), range 0.5 to 16.3µg/dL. The average value of blood lead level of Shtime pupils was 2.3µg/dL (SD±0.7µg/dL), range 1.2 to 5.2 µg/dL with no statistical difference (P = 0.191). The average value of blood lead level in kindergarten children of Mitrovica was 3.8µg/dL (SD±1.3µg/dL), range 2.2 to 7.7µg/dL with significant difference between the average values of blood lead levels of pupils and kindergarten children of Mitrovica (P <0.0001). The average value of hemoglobin in the pupils of Mitrovica was 14.0g/dL(SD± 3.7g/dL), range 9.4 to 25.6 g/dL. The average value of hemoglobin to pupils of Shtime was 11.4g/dl(SD±0.8 g/dl), range 9.2 to 13.0 g/dl with significant difference between mean values of hemoglobin pupils of Mitrovica and Shtime (U '= 6440.0, P <0.0001). With Spearman correlation is found significant correlation of a medium scale (r = -0.305, df = 248, p <0.0001) between blood lead levels and hemoglobin level in the blood.

Causes of infectious acute diarrhea in infants treated at pediatric clinic.

AIM: The aim of this work has been a presentation of causes of acute infectious diarrhea. MATERIAL AND METHODOLOGY: The examinees have been the infants treated at the Pediatric Clinic. The diagnosis has been established on the basis ofanamnesis, physical examination and feces examination on bacteria, viruses, protozoa and fungi. RESULTS: During the period of seven years a number of patients that suffered from acute infectious diarrhea was 1050 (31.82%) out of a total number (3300) with diarrhea. The bacteriological examination proved positive on majority of them or in 655 (62.38%) cases, the viral examination proved positive in 375 (35.72%) cases, whereas fungi examination proved positive in only 3 cases (0.28%). The most frequent bacteria have been Salmonellae species in 255 (38.93%) cases and E. coli in 142 (21.69%) cases, the less frequent have been Yersinia enterocolitica in 16 (2.44%) cases and Bacillus cereus in 4 (0.61%) cases. The most frequent serotypes of Salmonella have been S. Wien in 92 (36.07%) and S. Gloucester in 42 (16.47%) cases. Enteropathogenic E. Coli (most frequent serotypes O111 and O55) has been found in 112 (78.88%) cases. From the group of Shigella the most frequent has been Sh. Flexneri (most frequent serotypes 6 and 4) in 35 (58.33%) cases. The same feces sample of the majority of examinees 501 (76.48%) cases contained only one bacteria (single bacteria), two bacteria (associated bacteria) have been found in 102 (15.17%) cases, three types of bacteria have been found in 17 (2.59%) cases. Rotavirus has been isolated in 271 (72.26%) cases in comparison to adenoviruses that have been isolated in 65 (17.33%) cases. Rotavirus and adenoviruses have been isolated in 39 (10.40%) cases. CONCLUSION: Infectious acute diarrhea appears frequently, and as causes of it usually appear to be pathogenic bacteria in comparison to viruses, protozoa and fungi.

The incidence of caesarean sections in the university clinical center of kosovo.

INTRODUCTION: As in most countries of the world also at Kosovo the rate of Cesarean section from year to year is increasing. AIM: The main purpose of this paper was to present the incidence of births completed by Caesarean section at the Clinic of Gynecology and Obstetrics of University Clinical Center of Kosovo in Prishtinë. MATERIAL AND METHODS: This study is retrospective, namely its made by collecting epidemiological data from patients' histories that completed birth by Caesarean section for the period 2000-2006 in this clinic. RESULTS AND DISCUSSION: During this period, 14 maternal deaths were recorded during or after Caesarean section. Besides this, 14 lethal outcomes, the object of our study was 84 mothers which completed birth by Caesarean section and which are best used as a control group. The average age of mothers who died during or after Caesarean section was 32.1 years (SD ± 4.9). Youngest in this group was 24 years old and oldest 42 years. While the average age of mothers from the control group was 30.6 years (SD ± 5.9). Youngest was 19 and oldest 43 years, without significant difference. Most mothers included in the survey had more than one indication for Caesarean section. The most frequent indication was PIH syndrome with 33.7% and previous Caesarean section in 32.7%. Then with the participation of 12.2% were abruption of the placenta and disproportio feto pelvinea, 11.2% pelvinea and placenta praevia presentation, 10.2% parturiens while other indications were much rarer with less than 10% participation. CONCLUSION: Based on this we can conclude that the risk of the Caesarean section is high.

Rate and time trend of perinatal, infant, maternal mortality, natality and natural population growth in kosovo.

AIM: THE AIM OF WORK HAS BEEN THE PRESENTATION OF THE RATE AND TIME TRENDS OF SOME INDICATORS OF THE HEATH CONDITION OF MOTHERS AND CHILDREN IN KOSOVO: fetal mortality, early neonatal mortality, perinatal mortality, infant mortality, natality, natural growth of population etc. The treated patients were the newborn and infants in the post neonatal period, women during their pregnancy and those 42 days before and after the delivery. METHODS: THE DATA WERE TAKEN FROM: register of the patients treated in the Pediatric Clinic of Prishtina, World Health Organization, Mother and Child Health Care, Reproductive Health Care, Ministry of Health of the Republic of Kosovo, Statistical Department of Kosovo, the National Institute of Public Health and several academic texts in the field of pediatrics. Some indicators were analyzed in a period between year 1945-2010 and 1950-2010, whereas some others were analyzed in a time period between year 2000 and 2011. RESULTS: The perinatal mortality rate in 2000 was 29.1‰, whereas in 2011 it was 18.7‰. The fetal mortality rate was 14.5‰ during the year 2000, whereas in 2011 it was 11.0‰, in 2000 the early neonatal mortality was 14.8‰, in 2011 it was 7.5‰. The infant mortality in Kosovo was 164‰ in 1950, whereas in 2010 it was 20.5‰. The most frequent causes of infant mortality have been: lower respiratory tract infections, acute infective diarrhea, perinatal causes, congenital malformations and unclassified conditions. Maternal death rate varied during this time period. Maternal death in 2000 was 23 whereas in 2010 only two cases were reported. Regarding the natality, in 1950 it reached 46.1 ‰, whereas in 2010 it reached 14‰, natural growth of population rate in Kosovo was 29.1‰ in 1950, whereas in 2011 it was 11.0‰. CONCLUSION: Perinatal mortality rate in Kosovo is still high in comparison with other European countries (Turkey and Kyrgyzstan have the highest perinatal mortality rate), even though it is in a continuous decrease. Infant mortality considerably decreased (from 164‰ in 1950 to 20.5‰ in 2010). The causes of infant mortality have still been tightly related with the causes of the developing countries. Next to this, natality and the natural population growth have experienced a considerably decrease in Kosovo. Even though there have been some improvements within the health care in Kosovo, there is still a lot to be done with the aim of constant improvement of health care in order to promote the health care for mothers and children.

Tuberculous meningoencephalitis.

Tuberculous meningitis is an infection of the the membranes covering the brain and spinal cord (meninges). Tuberculous meningitis is a major global health problem and is the most severe form of extrapulmonary tuberculosis, with high rate mortality. Last years in Kosovo incidence of TB was decreased in less than 1000 cases per year and 10-20 cases per year of TB meningoencephalitis. Still Kosovo has limited numbers of TB. TBM is diagnosed on the basis of clinical features, cerebrospinal fluid (CSF) studies, and radiological findings. Clinical picture, neurological status, anamnestic data, suspect (but not specific) lab tests, and imaging new methods, together can give very valuable help to clinicians for early adequate and successful treatment.

Cases of poisoning with organophosphates treated at the University Clinical Centre of Kosova.

Everywhere today, poisonings present a significant and continuous increase of incidence in illness. Poisonings with organophosphates are more and more often. We do not have accurate statistics for this problem. The aim of this work was to present the clinical characteristics of poisoning with organophosphates, treated in University Clinical Centre in Prishtina. With the retrospective method, 23 patients were analyzed, 18 female and 5 male. Out of these, to (43.5%) have had tentative suicide, while 13 (56%) were accidentally exposed to poison. Poisoning with organophosphates was present in 3.8% of the overall number of poisonings. Organophosphate that was found in the analyzed poisoned patients was malathion (known here as Etiol). Average hospitalization time was 8.8 days (1 - 50 days range), average age of the patients was 27.1 years. Mortality scale was 52.1%. All these patients were treated with atropine. Atropine was given in intravenous way during 4.2 +/- 3.5 days and the average total dose was 82 +/- 61.5 mg. Pralidoxime antidote was not given to any of the patients. In adults, the poisoning was done mainly with the aim of suicide. Poisoned children with Etiol are in larger numbers from rural areas.

Drug abuse in Prishtina region.

Currently the drug abuse has become one of the most serious problems in many countries. The drugs abuse is also widespread in less developed societies. This problem is present in Kosova too with the tendency of rising. The of this research was to show the number of drug abusers in Prishtina region, the type of drugs used, the way of drug administration, then survey of the age, sex, marital status, residence of the drug abusers including their social status (employment, profession and economical status). During the surveyed period the number of hospitalized drug abusers in Neuropsychiatry clinic was 39. 25.5% of them were hospitalized more than ones, with 367 stay days with average treatment period of 7.5 days. Average age of those hospitalized for the first time was 27.9 years of age. 64.1% of them were 25-34 years old. 97.4% of the hospitalized were male. 32 (82.1%) patient were from Prishtina, 5 from Ferizaj and 1 from F. Kosova and Kacanik. During the surveyed period there was no patient hospitalized from other cities of Prishtina Region (Besiana, Drenas, Kastriot, Lipjan, Shtime and Shterpc).

Radiological imaging detection of tumors localized in fossa cranii posterior.

UNLABELLED: Intracranial tumors are characterized by a variety imaging aspects and their detection is always a challenge. Clinical application of Magnetic Resonance Imaging (MRI) and Computerized Tomography has provided an earlier detection and treatment of many CNS pathologies. The aim of this study is to estimate the role of CT and MRI in the determination of posterior fossa tumors. RESULTS: During period 2000-2005 in UCCK-Prishtina, 368 patients were diagnosed with intracranial tumors. Fifty-nine of them were found to have tumor localized in fossa crani posterior (FCP) without any significant difference between genders (50.8% female vs. 49.2% male, chi2 test=0.02 p=0.896). The average age of patients with FCP tumors was 33.1 (SD +/- 22.5, rank 1-70). The most of these patients were registered in 2003 (20.3%) whereas the least in 2000 (11.9%). The most affected age-group was 0-9 (25.4%) and 50-59 (23.7%) whereas the incidences was between 30-39 years of age (3.4%). Tumor types that more often were found in young's individuals were: Astrocytomas with a peak incidence in teenagers (average age was 12-year-old SD +/- 7.5, rank 3-23), next was Medulloblastomas (average age was 11-years-old, SD +/- 2.9, rank 6-16 years) and ependymomas (average age was 6.8-years-old, SD +/- 4.6, rank 1-12). Patients with osseous tumors are characterized by older age than median (61.0, SD +/- 4.2, rank 58-64), then metastases (53.0, SD +/- 5.3, rank 45-60) and meningiomas (50.8, SD +/- 7.7, rank 38-63). The overall average mortality was 0.41 cases per 100,000 inhabitants with variations through years from 0.30-0.50/100,000 inhabitants. CONCLUSION: Comparing with other countries, for some types of FCP tumors, lower morbidity is shown in Kosova, with mean incidence 0.41/100,000. The most frequent tumors in children were medulloblastomas, brainstem gliomas, astrocytomas and ependymomas whereas meningiomas and metastasis were most often found in adults. For FCP tumors detection, MRI had 100% sensitivity, specificity and predictive positive value, whereas brain CT was characterized by 95% sensitivity, 90.4 % specificity and 91% predictive positive value.