Administration of Systemic Antibiotics for Dental Treatment in Kosovo Major Dental Clinics: A National Survey.

OBJECTIVE: Antibiotics misuse and a high level of antibiotics resistance is observed worldwide, but particularly in developing countries. Kosovo in the last decade is facing challenges regarding antimicrobial resistance. The purpose of the present study was to investigate patterns of antibiotics prescriptions of dentists in Kosovo's major dental clinics. MATERIALS AND METHODS: For Kosovo's prescribing pattern, data collection was obtained from 10 Regional Dental Clinics and a Tertiary Health Center regarding patients who were prescribed antibiotics in the years 2015 to 2019. Data analysis was performed by using descriptive statistics and was processed by using MS Excel. RESULTS: Most prescribed antibiotic during the observed period from 2015 to 2019 in Kosovo was amoxicillin, although a drastic increase of amoxicillin with clavulanic acid-as a broad-spectrum antibiotic-is observed. The trend of antibiotics use in tertiary health institutions is in an overall decrease in Kosovo with an exception in the year 2017. Despite this overall decrease, inconsistency in prescribing is observed when the pattern is analyzed for each region separately. The highest number of patients in health care dental clinics received antibiotics for maxilla-related health conditions and the lowest number of them for oncologic ones. CONCLUSION: The patterns of antibiotics prescriptions by dental practitioners in Kosovo during the years 2015 to 2019 are fluctuating. Compared with the global health care standards, the irrational use of antibiotics in dental health care clinics in Kosovo still exist and this issue should be further addressed by respective actors.

Manifestation of Bronchial Hyperreactivity from Exposure to Heavy and Precious Metal Vapors among the Ore Smeltery Workers of Zveçan, Kosovo.

CONTEXT: Kosovo is a region in the Western Balkans that is rich in minerals and coal, so pollution is a serious public health problem there. Workers in the heavy and precious metal smeltery in Zveqan, Kosovo, were studied with regard to the roles that vapor from the smelting of metals (Pb, Zn, Au, Ag, P, and Cu) and particulate matter play in causing bronchial hyperreactivity. OBJECTIVES: The purpose of the article was to measure the parameters of lung function as determined by body plethysmography, diagnosis of respiratory diseases, and assessment of respiratory function using a histamine bronchoprovocation test. SETTINGS AND DESIGN: The present study was conducted in two groups of participants: A control group, which included 25 healthy persons, and a smeltery worker group, which included 45 mine workers (15 smokers and 30 nonsmokers) holding permanent jobs in the mineral foundry of Zvecan, Kosovo. SUBJECTS AND METHODS: Pulmonary function parameters (specific airway resistance [Raw] and intrathoracic gas volume) were measured and used to calculate the specific resistance (SRaw)and specific conductance (SGaw) of the airways, and a histamine bronchoprovocation test was conducted. STATISTICAL ANALYSIS USED: The data were entered and analyzed using the Microsoft Excel and INSTAT 3 software. RESULTS: Airway specific resistance (SRaw) was significantly higher in the smeltery worker group (P < 0.01) as compared to the control group (P > 0.1). CONCLUSION: These results suggest that occupational exposure to vapors during the metal refining process poses a risk to the workers' health and can cause bronchial hyperreactivity, bronchial asthma, or chronic obstructive pulmonary disease.

In Vitro Action of Meconium on Bronochomotor Tonus of Newborns with Meconium Aspiration Syndrome.

AIM: Here we studied the role of meconium in the respiratory system on live and exited newborns (weight 250-3000 g). Throughout this study is followed the response of tracheal rings in acetylcholine and histamine in different molar concentrations (10-1, 10-2, 10-3, 10-4 mol/dm3). METHODS: To study the smooth tracheal musculature we used 23 tracheal preparations obtained from the newborns exited from meconium aspiration. RESULTS: Based on the functional analysis of the tracheal specimen we have concluded that the meconium aspiration did not change the smooth musculature response on acetylcholine and histamine when compared to control group, exited from lung inflammatory processes (e.g., pneumonia, bronchopneumonia, atelectasis, cerebral hemorrhage), where tracheal smooth musculature response is significant (P for other causes is not significant (P > 0.01). CONCLUSION: The conclusions suggest that meconium did not potentiate the constrictor action of acetylcholine and histamine in the tracheobronchial system and did not cause modulation of bronchomotor tonus in case of his aspiration. Meconium causes mild relaxation of smooth tracheal musculature with a mechanism which is not mediated by cyclooxygenase products, from tracheal epithelium or proteins. Also, direct activity in the smooth musculature of several tested acids seems to have no significant impact in increasing the tonus of respiratory airway of smooth tracheal musculature.

Comparison of Effect of Leukotriene Biosynthesis Blockers and Inhibitors of Phosphodiesterase Enzyme in Patients with Bronchial Hyperreactivity.

AIM: Blocking effect of leukotriene biosynthesis-zileuton and blocking the effect of phosphodiesterase enzyme-diprophylline in the treatment of patients with bronchial asthma and bronchial increased reactivity, and tiotropium bromide as an antagonist of the muscarinic receptor studied in this work. METHODS: Parameters of the lung function are determined with Body plethysmography. The resistance of the airways (Raw) was registered and measured was intrathoracic gas volume (ITGV), and specific resistance (SRaw) was also calculated. For the research, administered was zileuton (tabl. 600 mg) and diprophylline (tabl. 150 mg). RESULTS: Two days after in-house administration of leukotriene biosynthesis blocker-zileuton (4 x 600 mg orally), on the day 3 initial values of patients measured and afterwards administered 1 tablet of zileuton, and again measured was Raw and ITGV, after 60, 90 and 120 min. and calculated was SRaw; (p < 0.01). Diprophylline administered 7 days at home in a dose of (2 x 150 mg orally), on the day 8 to same patients administered 1 tablet of diprophylline, and performed measurements of Raw, ITGV, after 60, 90 and 120 min, and calculated the SRaw (p < 0.05). Treatment of the control group with tiotropium bromide - antagonist of the muscarinic receptor (2 inh. x 0.18 mcg), is effective in removal of the increased bronchomotor tonus, by also causing the significant decrease of the resistance (Raw), respectively of the specific resistance (SRaw), (p < 0.05). CONCLUSION: Effect of zileuton in blocking of leukotriene biosynthesis is not immediate after oral administration, but the effect seen on the third day of cys-LTs' inhibition, and leukotriene B4 (LTB4) and A4 (LTA4) in patients with bronchial reactivity and bronchial asthma, which is expressed with a high significance, (p < 0.01). Blockage of phosphodiesterase enzyme-diprophylline decreases the bronchial reactivity, which is expressed with a moderate significance, (p < 0.05).

Proton pump inhibitor use for 12 months is not associated with changes in serum magnesium levels: a prospective open label comparative study.

BACKGROUND/AIMS: Proton pump inhibitors (PPIs) are a widely used class of drugs because of a generally acceptable safety profile. Among recently raised safety issues of the long-term use of PPIs is the increased risk of developing hypomagnesemia. As there have been very few prospective studies measuring serum magnesium levels before and after PPI therapy, we aimed to prospectively assess the potential association between PPI therapy for 12 months and the risk of hypomagnesemia as well as the incidence of new-onset hypomagnesemia during the study. In addition, the association of PPI therapy with the risk of hypocalcemia was assessed. MATERIALS AND METHODS: The study included 250 patients with normal serum magnesium and total calcium levels, who underwent a long-term PPI treatment. Serum magnesium, total calcium, and parathormone (PTH) levels were measured at baseline and after 12 months. RESULTS: Of the 250 study participants, 209 completed 12 months of treatment and were included in the statistical analysis. The Wilcoxon signed rank test showed no statistically significant differences in serum magnesium levels between measurements at two different time points. However, there were statistically significant differences in serum total calcium and PTH levels in PPI users. CONCLUSION: Stable serum magnesium levels were demonstrated after 12 months and no association between PPI use and risk of hypomagnesemia was shown in the general population. Significant reductions of serum total calcium levels were demonstrated among PPI users; nevertheless, further research is required before recommending any serum calcium and PTH level monitoring in patients initiated on long-term PPI therapy.

Esomeprazole use is independently associated with significant reduction of BMD: 1-year prospective comparative safety study of four proton pump inhibitors.

Because of the efficacy of proton pump inhibitors (PPIs), their the use is increasing dramatically. The risk of adverse effects of short-term PPI therapy is low, but there are important safety concerns for potential adverse effects of prolonged PPI therapy. Findings from studies assessing the association between PPI use and bone mineral density (BMD) and/or fracture risk are contradictory. The aim of this study was to prospectively assess potential association of PPI treatment with the 12-month change in BMD of the lumbar spine, femur neck, and total hip. The study was performed in 200 PPI users and 50 PPI nonusers. Lumbar spine (L1-L4), femur neck, and total hip BMD were measured by dual-energy X-ray absorptiometry at the baseline and at 12 months. A total of 209 subjects completed the entire 12 months of the study and were included in the final analysis. A Wilcoxon signed-rank test showed that at 12 months PPI use was associated with statistically significant reductions in femur neck and total hip T scores (Z = -2.764, p = 0.005 and Z = -3.281, p = 0.001, respectively). A multiple linear regression analysis showed that only esomeprazole added significantly to the prediction of total lumbar spine and femur neck T scores (p = 0.048 and p = 0.037, respectively). Compared with the baseline, 12 months of PPI treatment resulted in lower femur neck and total hip BMD T scores. Among the four PPIs studied, esomeprazole was independently associated with significant reduction of BMD, whereas omeprazole had no effects on BMD. Considering the widespread use of PPIs, BMD screening should be considered in the case of prolonged PPI use.

Impact of the Tamsulosin in Alpha Adrenergic Receptor of Airways at Patients with Increased Bronchial Reactibility.

OBJECTIVE: In this work, effect of tamsulosin as antagonist of alpha1A and alpha1B adrenergic receptor and effect of agonists of beta2 adrenergic receptor-salbutamol in patients with increased bronchial reactibility was studied. METHODS: Parameters of the lung function are determined with Body plethysmography six (6) hours after administration of tamsulosin. Raw and ITGV were registered and specific resistance (SRaw) was calculated as well. Tamsulosin was administered in per os manner as a preparation in the shape of the capsules with a brand name of "Prolosin", produced by Niche Generics Limited, Hitchin, Herts. RESULTS: After six (6) hours of administration of tamsulosin, results gained indicate that blockage of alpha1A and alpha1B-adrenergic receptor (0.8 mg per os) has not changed significantly (p > 0.1) the bronchomotor tonus of tracheobronchial tree in comparison to the check-up that has inhaled salbutamol agonist of adrenergic beta2 receptor (2 inh. x 0.2 mg), (p < 0.05). Blood pressure suffered no significant decrease following administration of the 0.8 mg dose of tamsulosin. CONCLUSION: This suggests that even after six hours of administration of tamsulosin, and determining of lung function parameters, the activity of alpha1A and alpha1B-adrenergic receptor in the smooth bronchial musculature has not changed in patients with increased bronchial reactibility.

Prevalence of Side Effects Treatment with Carbamazepine and Other Antiepileptics in Patients with Epilepsy.

OBJECTIVE: This paper reveals the studies of carbamazepine monitoring in the manifestation of side effects during clinical use. It is important to realize that these ranges are derived statistically, with most patients who have high levels suffering side effects and some with poor control having low levels. Broadly, the newer agents have advantages of lower risk of side effects and less drug interaction. At the presence they are more expensive than the, than "older" agents. Current recommendations and practice are to use newer agents as second line drugs, although in some countries there are gaining favour as potential first line agents. METHODS: In the study 91 patients with epilepsy were involved from which 53 or 58.2% were female and 38 or 41.8% were male with no great significant difference between two genders (X(2)=2.47, P=0.116). However, according to the study results female patients had slightly greater prevalence of epilepsy than man. Average age of epileptic patients was 23.2 years (SD ± 16.4 years), in the range 1-66 years. Patient distribution was present within all age-groups, but 59.4% of all patients were up to 20 years old. The highest prevalence of epilepsy was in the group age 6-15 years old: 33.0%. There were also children 1 - 5 years old with 7 or 7.7% of the patients, and the patients older than 60 years with 4 or 4.4% of the patients. Patient distribution according to the age and gender results with no female patient over 60 year old and more female patients in the age group 1-5 years. However statistically this did not produce a highly significant difference (T-test= 0.72, P=0.437) between average age according to the gender. The average age of the female gender was 22.1 year (SD ± 14.2 years), with the range 2-55 years, while the average age of the male patients was 24.6 year (SD ±19.2 years), with the range 1-66 years. CONCLUSION: Unwanted side effects of antiepileptic drugs analyzed in the study are frequent, but not so severe as to be life threatening. Treatment of epilepsy with these three drugs (carbamazepine, ac.valproic and phenobarbitone) would be the first choice of treatment, with the best safety and efficacy. Application of this therapy is rarely compromised because of the appearance of unwanted side effects. Replacement or termination of therapy may be applied if actual therapy is not adequate for the management of epileptic attacks.

Comparison of Glucocorticoid (Budesonide) and Antileukotriene (Montelukast) Effect in Patients with Bronchial Asthma Determined with Body Plethysmography.

OBJECTIVE: Effect of glucocorticoids-budesonide and antileukotriene-montelukast in patients with bronchial asthma and bronchial increased reactivity was studied in this work. METHODS: Parameters of the lung function are determined with Body plethysmography. Raw and ITGV were registered and specific resistance (SRaw) was also calculated. RESULTS: Results of this research, in patients with bronchial asthma, indicate that glucocorticoids - budesonide (Pulmicort; 2 × 2 mg inh) has significant action (p< 0.01) on reduction of the specific resistance (SRaw) of airways, applied to the same patients 3 days after administration of montelukast, at home (2 × 10 mg). Three days after administration of the montelukast, antileukotriene medicine, at home, on the fourth day same patients administered a capsule of montelukast, 10 mg dose per os, and significantly (p < 0.05) reduced the increased bronchomotor tonus; and the effect of the control with salbutamol (beta2-adrenergic agonist) is effective in removal of the increased bronchomotor tonus, causing significant decrease of the resistance (Raw), respectively of the specific resistance (SRaw), (p < 0, 01). CONCLUSION: This suggests that the bronchodilator effect of glucocorticoids is more powerful than of the leukotriene, because glucocorticoids terminate the early stage of chemical mediator release (prostaglandins PgD2, SRS, and leukotriene LTC4, LTD4, LTE4 and Cytokinins also etc.) as powerful bronchoconstriction substances, whilst antileukotriene substances does not have this feature.

Importance of Alpha-adrenergic Receptor Subtypes in Regulating of Airways Tonus at Patients with Bronchial Asthma.

BACKGROUND: In this work, effect of Tamsulosin hydrochloride as antagonist of alpha1A and alpha1B- adrenergic receptor and effect of Salbutamol as agonist of beta2- adrenergic receptor in patients with bronchial asthma and increased bronchial reactibility was studied. METHODS: Parameters of the lung function are determined by Body plethysmography. Raw and ITGV were registered and specific resistance (SRaw) was also calculated. Tamsulosin was administered in per os way as a preparation in the form of the capsules with a brand name of "Prolosin", producer: Niche Generics Limited, Hitchin, Herts. RESULTS: Results gained from this research show that blockage of alpha1A and alpha1B- adrenergic receptor with Tamsulosin hydrochloride (0.4 mg and 0.8 mg in per os way) has not changed significantly (p > 0.1) the bronchomotor tonus of tracheobronchial tree in comparison to the inhalation of Salbutamol as agonist of beta2- adrenergic receptor (2 inh. x 0.2 mg), (p < 0.05). Arterial blood pressure showed no significant decrease following the administration of the dose of 0.8 mg Tamsulosin. CONCLUSION: This suggests that the activity of alpha1A and alpha1B- adrenergic receptor in the smooth musculature is not a primary mechanism which causes reaction in patients with increased bronchial reactibility, in comparison to agonists of beta2 - adrenergic receptor which emphasizes their significant action in the reduction of specific resistance of airways.

Response of the adrenergic system after provoked bronchoconstriction in patients with bronchial asthma.

OBJECTIVE: In this paper, effect of the Tolazoline as antagonist of the alpha-2 adrenergic receptors in patients with bronchial asthma and chronic obstructive bronchitis was studied, and also the effect of stimulation with Hexoprenaline of beta-2 adrenergic receptor after bronchi-constriction caused with Propranolol, and Acetylcholine. METHODS: Lung function parameters are determined with Body plethysmography. In patients with bronchial asthma and chronic obstructive bronchitis was registered resistance (Raw), was determined the amount of intrathoracic gas volume (ITGV), and specific resistance was calculated as well (SRaw). Aerosolization was done with standard aerosolizing machine-Asema. RESULTS: The study included a total of 21 patients. Two hours after the inhalation of Propranolol, in experimental group, it was applied the blocker of alpha-2 adrenergic receptors (Tolazoline 20 mg / ml with inhalator ways), which did not cause changes in bronchomotor tonus of tracheobronchial system (p > 1.0). Meanwhile, at the same patient, stimulation of beta-2 adrenergic receptor with Hexoprenaline (2 inh x 0.2 mg) is associated with a significant decrease of the specific resistance of airways (SRaw, p < 0.01). Control group results show that after bronchi-constriction caused by Propranolol-aerosol (20 mg / ml) in patients with bronchial asthma and chronic obstructive bronchitis, an increase of specific resistance in airways was caused (SRaw, p < 0.01), which confirms the presence of hyper-reactive bronco-constrictor effects intermediated by vagal ways. Two hours after Propranolol, inhaled Hexorenaline has blocked the action of Propranolol, but not entirely. Furthermore, two hours after acetylcholine-aerosol (1 mg /ml) was applied, inhaled Ipratropium (2 inh x 1 mg) has fully blocked the action of chemical bronchoconstrictor mediators, causing a decline of specific resistance in the airways (SRaw; p < 0.01). CONCLUSION: This suggests that primary mechanism, which would cause reaction in patients with increased bronchial reactibility, is prevalence of the cholinergic system over adrenergic one, and not the relationship in between alpha-2 and beta-2 adrenergic receptors.

Response of smooth bronchial musculature in bronchoconstrictor substances in newborn with lung atelectasis at the respiratory distress syndrome (RDS).

OBJECTIVE: Role of the atelectasis (hypoxia) in the respiratory system of the live and exited newborn (250 up to 3000 g. of body weight), which has died due to different causes was studied in this work. METHODS: Response of tracheal rings to dopamine, serotonine and ethanol in the different molar concentrations (dopamine: 0.05 mg/ml, 0.5 mg/ml, 5 mg/ml; serotonine (5-HT): 10(-4), 10(-3), 10(-2), 10(-1) mol/dm3; ethanol: 0.2 ml, 0.5 ml, 1.0 ml; 96%) was followed up. Study of the smooth tracheal musculature tone (STM) was elaborated in 16 tracheal preparations taken following the newborn death due to different causes. RESULTS: Based on functional researches of tracheal isolated preparations, it was ascertained as follows: atelectasis (cases born with lung hypoxia) has changed the response of STM to dopamine, serotonine and ethanol in a significant manner (p < 0.01) in comparison to cases of controlling group, which has died due to lung inflammatory processes (e.g. pneumonia, bronchopneumonia, cerebral hemorrhage), which have also caused significant response (p < 0.05). CONCLUSION: Results suggest that exited cases from lung atelectasis and cases of controlling group reacts to above mentioned substances by causing significant constrictor action of tracheobronchial system.

Calcium and dairy products consumption and association with total hip bone mineral density in women from kosovo.

BACKGROUND AND OBJECTIVE: There is paucity of evidence in southeastern Europe and Kosovo regarding dairy products consumption and association with bone mineral density (BMD). Therefore, the objective of present study was to assess calcium intake and dairy products consumption and to investigate relationship with total hip BMD in a Kosovo women sample. METHODS: This cross-sectional study included a sample of 185 women divided into respective groups according to total hip BMD. All the study participants completed a food frequency questionnaire and underwent dual-energy X-ray absorptiometry (DEXA) to estimate BMD. Nonparametric tests were performed to compare characteristics of the groups. RESULTS: The average dietary calcium intake was 818.41 mg/day. Only 16.75% of the subjects met calcium recommended dietary reference intakes (DRIs). There were no significant differences between low BMD group and normal BMD group regarding average dietary calcium intake, but it was significantly higher in BMDT3 subgroup than in BMDT2 and BMDT1 subgroups. CONCLUSIONS: The results of this study demonstrate significant relationship of daily dietary calcium intake with upper BMD tertile. Further initiatives are warranted from this study to highlight the importance of nutrition education.

Relationship of weight and body mass index with bone mineral density in adult men from kosovo.

BACKGROUND AND OBJECTIVE: Body weight and body mass index (BMI) are considered strong predictors of osteoporotic fractures, though optimal BMI levels remain unsettled. There are several studies conducted on women about the relationship between BMI and bone mineral density (BMD), and just a few so far on men. Therefore, the objective of current study was to analyze the relationship between weight and BMI and BMD measured in lumbar spine (L1-L4), femur neck and total hip in 64 men from Kosovo. METHODS: This cross-sectional study included a population of 64 men divided into three BMI groups. Dual-energy X-ray absorptiometry (DEXA) measurements were done in all the study participants. RESULTS: Pearson's correlation analysis showed a significant positive correlation between weight and BMI and BMD in femur neck and in total hip, and a significant negative correlation between age and femur neck BMD. Age-adjusted linear regression analysis showed that weight and BMI had a significant positive association with BMD levels. CONCLUSION: Although the results show significant relationship between BMI and BMD, the negative relationship between age and femur neck BMD may serve as guidance to initiate early assessment of the BMD in this region as well as preventive measures of osteoporosis and fractures among ageing men population.

Laser Hemorrhoidoplasty Procedure vs Open Surgical Hemorrhoidectomy: a Trial Comparing 2 Treatments for Hemorrhoids of Third and Fourth Degree.

OBJECTIVE: According to the ''vascular'' theory, arterial overflow in the superior hemorrhoidal arteries would lead to dilatation of the hemorrhoidal venous plexus. Hemorrhoid laser procedure (LHP) is a new laser procedure for outpatient treatment of hemorrhoids in which hemorrhoidal arterial flow feeding the hemorrhoidal plexus is stopped by laser coagulation. AIM: Our aim was to compare the hemorrhoid laser procedure with open surgical procedure for outpatient treatment of symptomatic hemorrhoids. MATERIAL AND METHOD: A comparison trial between hemorrhoid laser procedure or open surgical hemorrhoidectomy was made. This study was conducted at Aloka hospital in Kosovo. Patients with symptomatic grade III or grade IV hemorrhoids with minimal or complete mucosal prolapse were eligible for the study: 20 patients treated with the laser hemorrhoidoplasty, and 20 patients-with open surgery hemorrhoidectomy. Operative time and postoperative pain with visual analog scale, were evaluated. RESULTS: A total number of 40 patients (23 men and 17 women, mean age, 46 years) entered the trial. Significant differences between laser hemorrhoidoplasty and open surgical procedure were observed in operative time and early postoperative pain. There was a statistically significant difference between the two groups regarding the early postoperative period: 1 week, 2 weeks, 3 weeks and 1 month after respective procedure (p<0.01). The procedure time for LHP was 15.94 min vs. 26.76 min for open surgery (p<0.01). CONCLUSION: The laser hemorrhoidoplasty procedure was more effective than open surgical hemorrhoidectomy. Postoperative pain and duration time are only two indicators for this difference between there procedures.

Activity of the adrenergic nerve system in the airways permeability of healthy persons.

OBJECTIVE: In this work, role of the adrenergic nerve system (alpha1 and beta2) in adjustment of the bronchomotor tonus in healthy people was researched. METHODS: Parameters of the lung function are determined by Body plethysmography. Raw and ITGV were registered and SRaw was calculated as well. Aerosolization is done with standard aerosolizing machines - Asema. RESULTS: Results gained shows that following the blockade of beta-2 adrenergic receptor with Propranolol (20 mg-aerosol), stimulation of alpha adrenergic receptor with Oxedrine (120 mg-aerosol) and blockage of these receptors with Tolazoline (20 mg-aerosol), does not change significantly the bronchomotor tonus of the tracheobronchial tree (p > 0.1). Meanwhile, stimulation of the beta-2 adrenergic receptor with Hexoprenaline (2 inh × 0.2 mg) is associated with a significant increase of the peripheral resistance of the airways (p < 0.01). CONCLUSION: This suggests that the activity of the alpha1-adrenergic receptor, unlike the activity of the beta2-adrenergic receptor in the healthy people smooth musculature, is not significant and as such is insufficient to oppose to the tonic activities of the cholinergic system.

Influence of hypoxia in bronchial response to bronchoconstrictor substances at newborn with distress respiratory syndrome (DRS).

OBJECTIVE: In this work, role of hypoxia in respiratory system on live and exited newborns weight 250-3000g.) which have died due to different reasons is studied. METHODS: Response of tracheal rings in acetylcholine and histamine in different molar concentrations (10(-4), 10(-3), 10(-2), 10(-1) mol/dm3) was monitored. Study of the tracheal smooth musculature (TSM) tonus was performed in 12 tracheal preparations obtained from the newborns exited due to different reasons. RESULTS: Based on the functional analysis of the isolated tracheal preparations, we have concluded that the cases born with lung atelectasis have caused significant response ofTSM to Acetylcholine and Histamine (p > 0.01). In cases of control group, which has exited due to different reasons from lung inflammatory processes (e.g.: pneumonia, bronchopneumonia, cerebral hemorrhage), Acetylcholine and Histamine have also caused significant constriction of tracheal smooth musculature. CONCLUSION: Results suggest that exited cases with lung atelectasis (hypoxemia) and cases of lung inflammatory processes have significant constrictor action to Acetylcholine and Histamine in tracheobronchial system.

Importance of the adrenergic nerve system in the response of gases in the arterial blood following the provoked bronchospasm.

INTRODUCTION: This work, partial pressure of the respiratory gases in the capillary blood (pH, PaO2, PaCO2) was studied, following the protective action of the beta2-drenergic stimulator-Hexoprenaline and alpha2-adrenergic blocker-Tolazoline in the bronchoconstriction caused by a beta-blocker-Propranolol. MATERIAL AND METHODS: in patients with increased bronchial reactibility. pH, oxygen partial pressure (PaO2), dioxide carbon partial pressure (PaCO2) in the arterial blood, with the assistance of the analyzer IL, following some minutes of sample taking were defined in all patients. As a standard to verify the accuracy of the measurement, ampoule solutions of pH, PaO2 and PaCO2 were utilized (Acidobasel, Berlin). RESULTS AND DISCUSSION: Following the inhalation of the beta-blocker-Propranolol (20 mg/ml-aerosol), there was an evident decrease (p < 0.05) of pO2 and a non-significant increase (p > 0.1) of pCO2. Beta2-adrenergcic stimulator-Hexoprenaline (2 inh x 0.2 mg), shows an protective effect in the decrease of pO2 (p < 0.05) following the bronchoconstriction being provoked by Propranolol. Alpha2-adrenergic blocker-Tolazoline (20 mg/ml-aerosol), has not shown a protective action in the bronchoconstriction caused with propranolol, therefore significant decrease (p < 0.05) of pO2 and a non-significant increase (p > 0.1) of pCO2 appeared. This shows that stimulation of beta2-adrenergic receptor has protective action in changes of the respiratory gases. Meantime, blocker of the alpha2-adrenergic receptor (Tolazoline) has not shown a protective action in changes of the respiratory gases.

Study of formulation of pharmaceutical solution form of paracetamol in the pediatric clinical practice.

UNLABELLED: AIM of the study was selection of 2 different formulations of paracetamol of 2.5% (125 mg/5 mL) in the Pediatric practice. Paracetamol is widely used in the form of the syrup, with usual percentage of acting ingredient of 125 mg/5 mL. MATERIAL AND METHODS: Both samples of the paracetamol syrup were monitored each day regarding organoleptic features (potential changes in color, smell, transparency, crystallization, etc.), whilst in monthly intervals (1 month, 2 months, 3 months, 4 months and 5 months) content of the paracetamol was analyzed, with the spectrophotometric method (HPLC). RESULTS AND DISCUSSION: Content of the paracetamol in both syrup formulations has not incurred any change even after a period of 6 months of storage, which showed that these two formulations are appropriate ones. From six different formulations of the paracetamol syrup in percentage of 2.5% (125 mg/5 ml) as more appropriate are: fifth formulation which can be considered, without no doubt, as most appropriate one because of its relatively low cost, an stabilized pH, a quite likeable taste and as such also consequently acceptable in the pediatric practice. In some cases, mainly during the winter, the crystallization of the paracetamol in the lid, walls and bottom of the bottle was ascertained also. CONCLUSION: Syrup of paracetamol 2.5% (125 mg/5 mL) as per the formulation 5 experimented by our side can be recommended as most appropriate to be produced in industrial conditions for purposes of pediatric practice.

Study of formulation of mild pharmaceutical forms of paracetamol in medical practice.

INTRODUCTION: Paracetamol is one of the most used antipyretic- analgesic preparation, which can be found in different pharmaceutical forms and in different doses. Due to its wide utilization in the clinical practice, determination of paracetamol in pharmaceutical formulation is of a great importance since that over dosage with paracetamol may cause the hepatic fulminant necroses and other toxic effects. MATERIAL AND METHODS: Study has included two formulations of paracetamol suppositories with doses of 125 mg widely used in the paediatric practice. Suppositories prepared according to these two formulations by the melting method and spilling into forms was subject to the quality control by implementing a series of trials and analyses for that aim, such are: reactions of identification, average mass, disintegration time, and homogeneity whilst quantitative determination was performed by applying two methods of instrumental analyze: spectrophotometry in UV zone and cromatography in liquid phase with high pressure. RESULTS AND DISCUSSION: Results of these analyses, performed immediately following the preparation and 3 months after the preparation, showed that content of paracetamol in both of two formulations is within the norms of Pharmacopoeia. Suppositories of paracetamol in doses of 125 mg prepared as per formulation 1 are to be considered as more appropriate because it contains semi synthetic glycerides as excipient which has better features than other suppository excipients.