Introduction: This paper compares the David and Yacoub procedures for valve-sparing aortic root replacement, two leading techniques for treating aortic root aneurysms while preserving the native aortic valve. Both methods aim to avoid prosthetic valve replacement and the need for lifelong anticoagulation. Material and Methods: We reviewed the technical nuances, clinical outcomes, and long-term durability of each technique, incorporating findings from recent and historical studies. Also, we'd like to present two case reports from our clinic showing the application of the David procedure. Results: The David procedure involves complete excision of the aortic root and reimplantation of the native aortic valve within a Dacron graft. It offers superior long-term durability and lower reoperation rates, particularly in younger patients and those with connective tissue disorders. In contrast, the Yacoub procedure entails partial root resection and remodeling with preservation of the sinuses of Valsalva, making it a viable option for older patients or those with isolated root dilation. Conclusions: Both the David and Yacoub procedures are advanced techniques for aortic root replacement, each with unique advantages and challenges. The David procedure, with its excellent durability, has consistently delivered successful outcomes. It is especially beneficial for younger patients and those with connective tissue disorders, supporting its role as a preferred approach for long-term outcomes in this population.

Introduction: The surgical management of traumatic injury is an evolving and controversial topic. We present outcomes of laparotomy performed for blunt and penetrating trauma at a level I trauma center over a nearly 10-year period. Material and Methods: Retrospective single-center cohort study of patients who received either damage control laparotomy or definitive laparotomy with fascial closure at the time of index procedure. The primary outcome was in-hospital mortality. Secondary outcomes were length of stay, complications, intensive care requirements, and vasopressor use. Results: Out of 125 included patients, 69 received damage control laparotomy, and 56 received definitive laparotomy. Damage control laparotomy was associated with significantly higher mortality (20.9% vs 1.8%, p=.0015) and length of stay (16.1 vs. 9.3 days, p=.0005) than definitive laparotomy. Complications occurred significantly more frequently among damage control laparotomy patients (53.6% vs. 14.3%, p<.0001). Damage control laparotomy patients were substantially more likely to require intensive care unit admission, mechanical ventilation, and vasopressor support. Conclusion: Patients undergoing damage control laparotomy are at significantly increased risk for adverse outcomes, including increased in-hospital mortality, prolonged length of stay, more significant complication burden, and increased need for mechanical ventilation and pressure support as compared to patients undergoing definitive laparotomy.

Introduction: Urinary infections, while common in intensive care and surgical units, present a unique challenge when fungal pathogens are involved. These fungal urinary infections, known as fungiuria, require a more intricate and prolonged treatment plan involving antifungal medications. This complexity underscores the need for specialized knowledge and skills in managing such cases. This study aims to present two cases of operated pediatric patients who developed urinary fungal infections following Catheterization and simultaneous treatment with two antibiotics. Results: Two pediatric patients, aged 12 and 16, underwent surgical procedures in our clinic. The first patient was treated for gangrenous appendicitis complicated by generalized peritonitis. The second patient was treated for a perforation of the small intestine caused by gangrene in a segment of the bowel, resulting from twisting around intestinal adhesions, also complicated by generalized peritonitis. Both patients, aged 12 and 16, developed urinary symptoms four days after surgery. Microbiological analysis confirmed the presence of fungal infections caused by Candida albicans. However, with the administration of antifungal medications, we were able to successfully eradicate Candida albicans from their urinary tracts, as confirmed by follow-up microbiological cultures after several weeks of therapy. This successful outcome should instill a sense of accomplishment in the audience. Conclusion: Candidiasis, a significant complication in patients undergoing prolonged Catheterization and simultaneous antibiotic therapy, requires vigilant monitoring. The challenging treatment often necessitates long-term administration of antifungal medications for successful eradication. This underscores the importance of vigilance in monitoring fungal infections in catheterized patients and adopting preventive strategies to minimize their occurrence.

Introduction: The emergence of novel pathogens poses a significant and immediate threat to global blood safety, particularly in regions experiencing epidemiological shifts. This study urgently examines the prevalence and impact of newly identified pathogens among blood donors and recipients in Albania, focusing on assessing their implications for public health and transfusion medicine. Results revealed a prevalence of new pathogens among donors and patients, highlighting the potential risk of transmission through blood transfusion. Travel history, socioeconomic status, and urban-rural disparities significantly influenced pathogen prevalence. This study underscores the urgent need for enhanced screening protocols and public health interventions to mitigate the risks associated with emerging pathogens. Our findings contribute to a growing body of evidence emphasizing the crucial role of continuous surveillance and adaptive strategies in transfusion medicine to ensure blood safety and protect vulnerable populations in Albania and beyond. Conclusion: The study highlights the presence of emerging pathogens in blood donors and patients in Albania, underscoring their potential to significantly impact blood safety and public health. The findings emphasize the necessity for improved screening protocols, continuous epidemiological surveillance, and targeted public health interventions to address the risks associated with these pathogens. Adopting adaptive strategies in transfusion medicine is critical to safeguarding the health of donors and recipients in the region.

Introduction: Multiple sclerosis (MS) is a chronic autoimmune disorder of the central nervous system (CNS), marked by inflammation, demyelination, and significant oligodendrocyte injury. This disease arises from a complex interplay of genetic predispositions and environmental triggers that drive immune-mediated damage to oligodendrocytes and myelin proteins. This research paper explores the multifaceted aspects of oligodendrocyte injury in MS, ranging from underlying pathophysiological mechanisms to potential therapeutic interventions and translational implications for clinical practice. Oligodendrocyte damage in MS occurs via multiple mechanisms, including metabolic stress, oxidative damage, and cytokine-induced apoptosis, mainly mediated by interferon-gamma (IFN-γ) signaling. This process exacerbates neuroinflammation and contributes to disease progression. Emerging therapeutic strategies, such as targeting metabolic pathways, reducing oxidative stress, and enhancing autophagy, have demonstrated potential in preclinical studies. Furthermore, stem cell therapies are being explored for their ability to regenerate oligodendrocytes and restore myelin integrity. Conclusions: The intricate interplay among oligodendrocyte injury, demyelination, and neuroinflammation is central to multiple sclerosis (MS) pathogenesis. Oligodendrocytes safeguard myelin in the CNS, facing challenges from immune attacks to metabolic stress. Understanding oligodendrocyte dysfunction is vital for targeted therapies that suppress immune damage and promote remyelination and CNS repair. MS's etiology,

Introduction: Malignant mixed Müllerian tumors (MMMT), also known as carcinosarcomas, are rare and highly aggressive neoplasms of the uterus, accounting for less than 5% of all uterine malignancies. These tumors are biphasic, comprising both carcinomatous (epithelial) and sarcomatous (mesenchymal) components, and are typically associated with poor prognoses due to their rapid progression and high metastatic potential. In this report, we present a unique case of noninvasive polypoid MMMT of the uterus, highlighting its clinical presentation, diagnostic challenges, and management. We also provide a comprehensive literature review, which enriches our understanding of this case within the broader context of uterine carcinosarcomas. Results: This is the first documented case in English literature of a polypoid uterine carcinosarcoma without endometrial infiltration. It is significant because it adds to the limited literature on noninvasive polypoid MMMTs, typically aggressive and diagnosed at advanced stages. Uterine carcinosarcomas are generally aggressive, with most cases diagnosed at advanced stages. Conclusion: Uterine carcinosarcomas are indeed rare, aggressive, and rapidly progressing neoplasms with poor prognoses. It is crucial to include carcinosarcomas in the differential diagnosis of high-grade uterine neoplasms, especially for polypoid tumors. This inclusion is not just essential, but it is the key to ensuring accurate and timely diagnosis, underscoring the significant role of medical professionals in this process.

Introduction: Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is a rare extranodal non-Hodgkin lymphoma strongly linked to Helicobacter pylori infection. It often presents with nonspecific symptoms like dyspepsia, nausea, and epigastric pain and can mimic other gastric pathologies, such as peptic ulcers or gastric cancer. This case report is significant as it highlights the importance of thorough biopsy procedures in diagnosing gastric MALT lymphoma. The patient presented with complaints of dyspepsia, nausea, and epigastralgia and had a giant ulcer on endoscopy. Only after biopsies with a large number of samples (over 10) from both normal and abnormal mucosa the diagnosis of MALT lymphoma was established and reconfirmed after immunohistochemistry. The presence of Helicobacter pylori was detected, and after its eradication treatment, the ulcer was more minor and improved from Forrest II-c to III. This case underscores the potential for a wrong diagnosis (undiagnosed MALT-Lymphoma) if biopsy samples are not comprehensive. It also emphasizes the need for suspicion of gastric MALT-Lymphoma and the necessity of more invasive tissue biopsy, such as EUS-FNA, EMR, and ESD, when suspicion persists. Conclusion: Early diagnosis of gastric MALT lymphoma requires multiple biopsy samples during the initial endoscopy to prevent false negatives. Immunohistochemistry is essential for confirmation, and advanced techniques like EUS-FNA, EMR, or ESD play a significant role when suspicion persists. Timely H. pylori eradication can lead to ulcer healing and better outcomes. Proper endoscopist training is critical to reduce diagnostic delays.

Introduction: In our country, the predominant condition treated in aortic valve surgery in its early stages was aortic valve disease of rheumatic origin, primarily in patients under the age of 60. In recent decades, due to lifestyle changes, increased average lifespan, and a shift in surgical treatment concepts among the elderly, there has been a noticeable trend towards atherosclerotic aortic valve disease treated surgically. This condition poses challenges in selecting the type of prosthesis for surgical replacement—either bioprosthetic or mechanical. The replacement of the aortic valve, aside from its undeniable benefits for patients, also introduces various complications, such as bleeding related to anticoagulation, thromboembolism, prosthetic endocarditis, and structural degeneration of the prosthesis. These complications vary between the two main groups of prostheses: bioprosthetic and mechanical. In this context, we are confronted with the challenge of selecting the type of prosthesis suitable for each patient. This paper presents current issues regarding selecting aortic valve prostheses, considering factors related to the prosthesis and the patient. We will also discuss the trends in prosthesis usage in our country over the past decade. Materials and Methods: We reviewed the types of mechanical and bioprosthetic valves used over the past ten years at our clinic, the Cardiac Surgery Service of the University Hospital Center "Mother Teresa.” We consulted articles, studies, and guidelines for managing heart valve diseases from European and American cardiology associations. Conclusion: The choice of prosthesis for aortic valve replacement remains a current issue, involving considerations of patient-related and prosthesis-related factors. The decision is based on guidelines recommendations, surgical team judgment, and patient preference, following a detailed explanation of the benefits and risks associated with each type of prosthesis.

Introduction: Burn injuries represent a significant public health concern globally, with a substantial impact on morbidity and mortality rates, particularly in low- and middle-income countries. This study provides valuable insights into the epidemiology of burn injuries in Albania. It highlights the critical need for targeted interventions to reduce the incidence and severity of burns in the population. Materials and Methods: This retrospective cohort study examined burn patients at the Department of Burns and Plastic Surgery at Mother Teresa University Hospital Center in Tirana from January 2022 to January 2024. Data were collected from medical records in Tirana, Albania. Formal approval was obtained from the Ethics Committee of Mother Teresa Hospital. The data were recorded in Excel and analyzed using the SPSS statistics program. Results: This retrospective cohort study included 303 burn patients admitted between January 2022 and January 2024. Data on patient demographics, burn causes, total body surface area (TBSA), and burn severity were collected and analyzed using SPSS software. The mean patient age was 36.1 years, with children aged 0-10 most affected, especially 2-year-olds. The youngest patient was seven months old, and the oldest was 89. Male patients comprised 60.7% of the cohort. The leading cause of burns was scalding from hot liquids (39.9%), followed by flames (20.4%) and electrical burns (8.2%). The average TBSA affected was 23.06%. The mortality rate was 7.3%. Conclusion: Burn injuries present significant physical and psychological challenges. Despite advancements in burn care, the importance of preventive measures and public awareness campaigns must be addressed. These remain the most effective strategies to reduce burn incidence and severity. These findings underscore Albania's need for improved burn prevention and public safety initiatives.

Introduction: A traffic accident is when only material damage is caused to the vehicle and track environment, and there are no casualties. RTA represents a significant risk for morbidity and mortality in Kosovo, of which head injury and multiple-site injury increase injury severity. The anatomical site, mechanism of injury, time to reach an initial health facility, time of the day, patient condition at ED, type of treatment given, GCS at admission, and days spent in the hospital were among independent predictors of management outcome. Targeted approaches to improving the care of the injured victims may improve outcomes. Thus, the clinician should consider the clinical presentation of RTA and give due attention to the identified contributing factors in managing it. Law enforcers should also emphasize the identified types and mechanisms of accidents. The PubMed database was utilized for article selection, and papers were obtained and reviewed. The ATLS protocol has been developed to manage trauma patients systematically so as not to miss any condition that may kill the patient. Conclusions: Triage is essential in managing accidental situations and strengthening the primary, secondary, and tertiary health systems. To design clinical guidelines, algorithms, and triage protocols at the three levels of health care, all healthcare professionals should be educated and trained with continuing courses in triage, communication, and Basic Life Support -AED, ACLS, PHTLS, BTLS, and ATLS.