The information about prisoners' health in transitional countries including Albania is limited. The aim of our study was to assess the health status and its correlates among adult prisoners in Albania, a post-communist country in Southeast Europe. This was a cross-sectional study conducted in 2013 including 401 prisoners in Albania [290 (72%) males and 111 (28%) females]. All participants were administered an anonymous and structured questionnaire including information on self-perceived health status, health-related problems, lifestyle factors (smoking, alcohol intake and drug use) and demographic and socioeconomic characteristics (age, sex, educational attainment and income level). Binary logistic regression was used to assess the association between self-reported health status and covariates. Overall, 173 (43.1%) of prisoners included in this study reported a poor health status, with a clear predominance of the female gender (P < 0.01). Overall, 28.1% of prisoners reported the presence of at least one disease. The overall prevalence of smoking, excessive alcohol consumption and drug use were 59.1%, 34.9% and 10.2%, respectively. Upon multivariable-adjustment, poor self-perceived health status was positively associated with female gender (OR = 2.01, 95% CI = 1.41-2.96), smoking (OR = 1.58, 95% CI = 1.29-2.04), excessive alcohol consumption (OR = 1.71, 95% CI = 1.38-2.13) and the presence of diseases (OR = 1.86, 95% CI = 1.52-2.87). This study provides important information about the health status among Albanian prisoners. There is an urgent need for Albania to make a significant progress in health services provision for prisoners, which constitute a particularly vulnerable population subgroup.

Knee flexion is one of the main problems of the lower extremities in cerebral palsy patients. Many operative procedures are recommended for contractures of the knee in cerebral palsy patients. We performed simple operation and analyzed the results after operative treatment with nine years follow up. 85 patients with spastic cerebral palsy were treated in period 2001-2010. 40 were ambulatory and 45 non ambulatory with ability to stand with support. All of them underwent same surgical procedure with distal hamstrings lengthening. Tenotomies were performed on m. semitendinosus, m. semimembranosus, m. gracillis and biceps femoris. Only m. semitendinosus was tenotomized completely, other muscles were tenotomized only on tendinous part. The patients had a plaster immobilization for five days after the surgery with the knee extended. All 85 patients had improvement of the popliteal angle pre and post operative respectively. Improvement in the crouch gait was noticed in the period of rehabilitation. We had no complication with the wound. Three of the patients had overcorrection and achieved recurvatum of the knees. We consider this procedure very simple with satisfying improvement of standing, walking and sitting abilities in children with spastic cerebral palsy.

Multiple Sclerosis (MS) is a chronic recurrent neurological disease that affects the Central Nervous System. This study aims to determine epidemiological factors that affect the appearance of MS, such as: incidence, prevalence, mortality, case appearance in accordance with the disease phase RRMS, SPMS, PPMS, gender, age, age group, and EDSS. Deals with analyzing diagnosed and treated patients in the Clinic of Neurology in Prishtina during the period of 2003-2012. The research was conducted through a questionnaire applied in the diagnosed cases of MS. Information on patients was gathered from: history of illness, discharge reports and other relevant documents on MS illness. Clinical and epidemiological-descriptive study methods were used. The acquired results are shown through tables, graphics. Statistical processing was conducted with Microsoft Office Excel. From the total number of doubtful hospitalized cases of demyelinization (644) in the Clinic of Neurology in Prishtina, 412 cases (64%) were diagnosed with MS. For the period of 2003-2012 the prevalence of MS has been 19.6 of patients in 100,000 inhabitants. MS incidence rate was 0.95 of patients in 100,000 inhabitants. MS mortality rate was 0.14 of deceased in 100,000 inhabitants. The ratio female--male is 2.3:1. A larger number of patients fall within the age group of 30-39 years-old. Clinical form trends: RRSM 72.3%, SPSM 22.6%, PPSM 5.1%. The rate of EDSS 78.3% (0-3.5), 14.9% (4-6.5), 6.8% (7-9).

This study aims to analyze body composition in adult male football players and its changes during adulthood. Adult male football players (n = 942, mean age 24.11 +/- 4.69 y), all members of national competitive clubs from Macedonia were included in the study. The absolute and the relative body components were calculated: lean body mass (LBMkg), muscle mass (MMkg; MM%), bone mass (BMkg; BM%) and fat components (FMkg; FM%), using the anthropometric protocol by Matiegka. Mean values of anthropometric measures for all included participants were as follows: height = 178.39 +/- 6.11 cm; weight = 77.02 +/- 7.57; LBM = 65.65 +/- 6.38; MM% = 53.23 +/- 2.78; BM% = 17.05 +/- 1.27; FM% = 14.58 +/- 1.48. Descriptive statistics for these parameters was made for age specific groups. The results obtained could be used as reference values for adult football players in Republic of Macedonia. In the examined age span (18-35 years) a slight increase of absolute values of all three body components has been registered with advancing age. The most significant increase in the absolute values was registered for the muscle component, followed by the fat and bone components, respectively. Regarding the relative values (%), the muscle and the fat components showed an equally slight positive correlation with the age increase of 1 year, whilst the bone component decreased with advancing age.

Antimicrobials are widely used in infectious diseases. Only the timely intervention will contribute to the positive outcome of the disease. Unjustified use of antimicrobial prophylaxis may have adverse effects, i.e., result in bacterial resistance to existing antimicrobials, as well as toxic effects on leukocyte lineage and other parameters of the blood. The goal of this study was to confirm that the antimicrobial therapy of urinary, gynecological and respiratory infections has a toxic effect on leukocyte lineage. Followed by lowered immunity and the emergence of risk for health complications especially in oncology and other immunodeficient patients for whom to apply pharmacotherapy it is necessary to have adequate immunity, or white blood cell count that is greater than 4.0 x 10(9)/L. A prospective-retrospective study was conducted on a sample of 30 patients in a Primary Health Care Center in Gracanica during the period from March 01, 2013 until April 01, 2014. Testing of this sample was conducted by survey on health status and treatment, or on taking of antimicrobial therapy and other treatment regimens, with the referral diagnosis and determination of leukocytes count in by hematology counter SYSMEX. Results of leukocytes below and close to the lower reference values were statistically analyzed by Students t-test. Mean WBC count in the group treated with antimicrobial therapy was 3.687 +/- 0.83 x 10(9)/L, in the group which during repeated infection did not use the antimicrobial therapy 5.09 +/- 1.04 x 10(9)/L, and in the control group of healthy subjects 7.178 +/- 1.038 x 10(9)/L. Statistical analysis with Student's t test indicate highly significant differences between group of patients that used antimicrobial therapy with the group of patient that did not used antimicrobial during repeated infection (t = 6.091; p = 0.0001), as well as significant differences in mean WBC count of both of these groups and the controls (t = 4.984; p = 0.0001, and t = 8.402, p = 0.0001). Use of antimicrobial drugs leads to serious toxic reactions, or leukopenia. Indications for the use of antimicrobial therapy must be strictly followed, because banal, frequent infections are not indication for antimicrobial therapy. It is necessary to know the types of infection causes. Important is the proper and timely selection of antimicrobial therapy. When selecting the drug we should bear in mind its antimicrobial activity, pharmacokinetic and toxic properties, as well as patient health status. Possible is also the application of preventive medicine as well as other manner of solving infection.

Sideropenic anemia is a common pregnancy disorder. Depending on severity, maternal anemia can significantly influence morphometric characteristic of placental tissue, pregnancy course and outcome. to estimate if maternal anemia a) results with significant placental changes; b) influence on newborn weight, length and vitality. Research included 100 women and their newborns, 50 anemic, and 50 women in the control group. Sixty placentas were collected, placental mass and volume was determined, and blood vessels of terminal villi were stereologically analyzed. Newborns mass and body length, and Apgar scores within 1 and 5 minutes after delivery were recorded. Placentas of anemic pregnant women showed significant increase of terminal villi blood vessels (224.18 vs. 197.00 cm3; p < 0.0001), but total placental mass and volume did not differ significantly. Anemic mothers' newborns were significantly shorter (51.76 vs. 55.54 cm; p < 0.0001), smaller body mass (3048.00 vs. 3615.60 g; p < 0.0001) and delivered one week early (38.2 vs. 39.2 GW; p < 0.0001), but not significantly poorer vitality (p > 0.05) comparing with the control group. Sideropenic anemia increase placental maturity, that could be a possible cause of earlier spontaneous delivery among anemic women. The anemic mothers' newborns are shorter and lower body mass, but not poorer vitality index.

Fractures of the proximal femur and hip are relatively common injuries in adults and common source of morbidity and mortality among the elderly. Many methods have been recommended for the treatment of intertrochanteric fractures. We retrospective analyzed all the patients with fractures of the hip treated with proximal femoral nail antirotation (PFNA) at the Clinic of Orthopedic and Traumatology, University Clinical Centre Tuzla from the first of January 2012 to 31 December 2012 years. The study included 63 patients averaged 73.6 +/- 11.9 years (range, 29 to 88 years). Fracture type was classified as intertrochanteric (Arbeitsgemeinschaft für Osteosynthesefragen classification 31.A.1, A.2 and A.3) and subtrochanteric fractures (Seinsheimer classification). The ratio between the genders female-male was 1.6:1. There was statistically significant difference prevalence of female compared to male patients (p = 0.012). There were 31 left and 32 right hip fractured. Low energy trauma was the cause of fractures in 57(90.5%) patients. Averaged waiting time for hospitalization was 3.2 +/- 7.5 days (range, 0 to 32 days). 44 patients were admitted the same day upon injuring. The average waiting time for the treatment was 3.6 +/- 5.7 days. The ratio between with or without co-existent disease was 4.7:1. During the three months postoperatively with ASA score 3 and 4 six patients died. There were no significant differences in deaths from ASA score 1 and 2 (p = 0.52). Reoperation for the treatment of implant or fracture-related complications was required in three (4.7%) patients (infection, reimplantation and extraction). Three patient developed deep vein thrombosis. Statistically significant difference was found in the deaths in the first three months compared to the next three months (p = 0.02). We found statistically significant difference between pre-injury and postoperative mobility score (p = 0.0001). PFNA is an excellent device for osteosynthesis as it can be easily inserted. Moreover, it provides stable fixation, which allows early full weightbearing mobilization of the patient.

Meningococcal meningitis now represents a significant public health problem, not only in developing countries but also in developed ones. The disease usually occurs sporadically, and much less in smaller epidemics. Material and methods: We retrospectively analyzed the epidemiological characteristics of meningococcal meningitis in the area of Zenica-Doboj Canton in the five-year period from 2008 to 2012th. In total there were 38 reported and hospitalized patients, with an average of 7-8 patients per year. Most commonly disease occurred in infants and young children (28.9%). The highest number was recorded in 2011, 10 cases or (26.3%). Most patients in the monitored period were registered in the municipality of Zenica-12 cases (31.6%) and Zepce 8 cases (21.1%). All hospitalized patients were sporadic cases, there has never been an epidemic in the observed period. Epidemic Meningitis is a very serious disease and a significant public health problem that requires a serious medical scientific approach for its resolution, primarily in finding adequate vaccine and its administration.

Various complications occur in patients with advanced stages of liver diseases. Renal dysfunction, a parameter included in the MELD score, is the most important prognostic factor. There is a strong need in clinical practice to estimate the GFR in this patients. The aim of our study was to detect differences in renal function among patients with different stages of chronic liver diseases caused by HBV and HCV, also to determine the impact of viral etiology and gender on the values of eGFR and renal function. This was an observational cross-sectional study performed on patients with HBV and HCV chronic hepatitis, cirrhosis and HCC caused by these viruses hospitalized during period 2009-2014 in the Clinic of Gastroenterohepatology, Clinical Center University of Sarajevo. The estimated GFR (eGFR) was evaluated by the MDRD4 method. For the processing of data spss 21.0 statistical software was used. Statistical methods used in this study where: analysis of variance test (ANOVA test), Student's t-test for independent samples and Pearson coefficient of correlation. The level of significance was p < 0.05. Among this three groups of patients there was a statistically significant difference in eGFR (F = 18.79, p < 0.05), i.e. increase of degree of liver damage was related with increase of renal impairment, as reflected by a significant reduction in estimated glomerular filtration rate. Gender had no significant effect on eGFR and renal function (p > 0.05), except in group of patients with HCC (p < 0.05). Etiology had no significant effect on eGFR and renal (p > 0.05). There was statistically significant inverse correlation between glomerular filtration rate and liver enzymes AST (-.184) and GGT (-.181). By calculation of GFR, we determined the existence of a significant reduction of kidney function through progression of liver damage from HBV and HCV chronic hepatitis, liver cirrhosis to HCC caused by these viruses, which drawing attention to the importance of the assessment of renal function in patients with this liver pathologies. Gender and etiology had no significant effect on eGFR and impairment of renal function. Given the statistically significant inverse correlation between eGFR and AST and GGT this liver enzymes may have important role as marker for both renal and hepatic injury.

The aim of this study was to investigate a relationship between seasonal variation and incidence of type A acute aortic dissection (AAD) and spontaneous abdominal aneurysm rupture (rAAA) in Canton Tuzla, Bosnia and Herzegovina. A total of 81 cases, 41 AAD and 40 of ruptured AAA were identified from one center over a 6-year, from 2008 till 2013. In 2012 were admitted (45.6% or 36 patients). Seasonal analysis showed that 19(23.4%) patients were admitted in spring, 15(18.5) in summer, 26(32%) in autumn and 21 (25.9) in winter. The most frequent period was autumn/winter with 47 or 58% patients. A causal link between atmospheric pressure (AP) and incidence of rAAA and AAD on seasonal and monthly basis was found.