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BACKGROUND: Rib fractures are one of the most common traumatic injuries and may result in significant morbidity and mortality. Despite growing evidence, technological advances and increasing acceptance, surgical stabilization of rib fractures (SSRF) remains not uniformly considered in trauma centers. Indications, contraindications, appropriate timing, surgical approaches and utilized implants are part of an ongoing debate. The present position paper, which is endorsed by the World Society of Emergency Surgery (WSES), and supported by the Chest Wall Injury Society, aims to provide a review of the literature investigating the use of SSRF in rib fracture management to develop graded position statements, providing an updated guide and reference for SSRF. METHODS: This position paper was developed according to the WSES methodology. A steering committee performed the literature review and drafted the position paper. An international panel of experts then critically revised the manuscript and discussed it in detail, to develop a consensus on the position statements. RESULTS: A total of 287 studies (systematic reviews, randomized clinical trial, prospective and retrospective comparative studies, case series, original articles) have been selected from an initial pool of 9928 studies. Thirty-nine graded position statements were put forward to address eight crucial aspects of SSRF: surgical indications, contraindications, optimal timing of surgery, preoperative imaging evaluation, rib fracture sites for surgical fixation, management of concurrent thoracic injuries, surgical approach, stabilization methods and material selection. CONCLUSION: This consensus document addresses the key focus questions on surgical treatment of rib fractures. The expert recommendations clarify current evidences on SSRF indications, timing, operative planning, approaches and techniques, with the aim to guide clinicians in optimizing the management of rib fractures, to improve patient outcomes and direct future research.

Abstract Background Rib fractures are one of the most common traumatic injuries and may result in significant morbidity and mortality. Despite growing evidence, technological advances and increasing acceptance, surgical stabilization of rib fractures (SSRF) remains not uniformly considered in trauma centers. Indications, contraindications, appropriate timing, surgical approaches and utilized implants are part of an ongoing debate. The present position paper, which is endorsed by the World Society of Emergency Surgery (WSES), and supported by the Chest Wall Injury Society, aims to provide a review of the literature investigating the use of SSRF in rib fracture management to develop graded position statements, providing an updated guide and reference for SSRF. Methods This position paper was developed according to the WSES methodology. A steering committee performed the literature review and drafted the position paper. An international panel of experts then critically revised the manuscript and discussed it in detail, to develop a consensus on the position statements. Results A total of 287 studies (systematic reviews, randomized clinical trial, prospective and retrospective comparative studies, case series, original articles) have been selected from an initial pool of 9928 studies. Thirty-nine graded position statements were put forward to address eight crucial aspects of SSRF: surgical indications, contraindications, optimal timing of surgery, preoperative imaging evaluation, rib fracture sites for surgical fixation, management of concurrent thoracic injuries, surgical approach, stabilization methods and material selection. Conclusion This consensus document addresses the key focus questions on surgical treatment of rib fractures. The expert recommendations clarify current evidences on SSRF indications, timing, operative planning, approaches and techniques, with the aim to guide clinicians in optimizing the management of rib fractures, to improve patient outcomes and direct future research.

Vancomycin-variable enterococci (VVE) are vanA-positive, vancomycin-susceptible enterococci with the ability to revert to a vancomycin-resistant phenotype on exposure to vancomycin. We sought to assess the prevalence of VVE and to determine clinical characteristics of patients infected with VVE. We prospectively collected Enterococcus faecium sterile site isolates from Toronto Invasive Bacterial Diseases Network hospitals from January 2015 to June 2016 and calculated VVE (defined as vanA-positive, vancomycin-susceptible isolates) prevalence among vanA-containing isolates. We performed chart reviews of VVE and vancomycin-resistant E. faecium (VRE) bacteremias identified from January 2012 to June 2016, and on a random sample of patients with bacteremia due to vanA/vanB-negative, vancomycin-susceptible enterococci (VSE) from January 2015 to June 2016. Clinical characteristics were compared and factors associated with mortality assessed. Because of the potential reversion from VVE to VRE, pulsed-field gel electrophoresis (PFGE) was performed for strains causing breakthrough bacteremia in order to identify relatedness among strains with different phenotypic resistance within the same patient. VVE comprised 47% (18/38) of vanA-positive isolates. The charts of 36 VRE, 25 VVE, and 79 VSE patients were reviewed. Central venous catheter associated bacteremia was more common in VVE (44%) and VRE patients (57%) than in VSE patients (28%) (P = 0.01). The Pitt bacteremia (OR 1.3, P = 0.002) and the Charlson score (OR 1.2, P = 0.008) were the only independent mortality predictors. PFGE of strains causing breakthrough bacteremia showed high within-patient clonality, irrespective of vanA-positivity or vancomycin-susceptibility. A substantial proportion of vanA-positive isolates are VVE and are therefore not detected with conventional selective culture methods. Bacteremia sources of patients with VVE are similar to those infected with VRE. We detected no association between VVE and 30-day mortality or breakthrough bacteremia.

The 8th Albanian Congress of Trauma and Emergency Surgery (ACTES 2024) was a dynamic platform for exchanging cutting-edge knowledge, clinical expertise, and innovative trauma and emergency surgery research. This prestigious event will convene leading professionals from Albania and the international medical community, including surgeons, researchers, and healthcare providers. The congress aims to address contemporary challenges and advancements in trauma care, emergency surgical techniques, and interdisciplinary approaches to patient management. Key themes include the role of minimally invasive surgery in trauma, advancements in hemostatic techniques, damage control marks a pivotal event in the medical community, providing a dynamic platform for knowledge exchange, professional collaboration, and advancements in surgical science in Albania. This congress brings together experts, scholars, practitioners, and enthusiasts from trauma and emergency surgery, creating an opportunity for meaningful dialogue and innovation. Hosted in the vibrant city of Tirana, ACTES 2024 features a comprehensive program that addresses a broad spectrum of topics, including abdominal and chest injuries, vascular trauma, emergency surgical procedures, and the evolving challenges in nursing services for the modern era. The congress theme, "Trauma and emergency surgery and not only…” underscores a commitment to innovation, evidence-based practices, and groundbreaking discoveries. The event includes plenary sessions with renowned experts, scientific presentations, panel discussions, poster awards, networking opportunities, industry exhibitions, cultural activities, and Continuing Medical Education (CME) credits. Primary Content: Participants can expect an enriching professional experience complemented by opportunities for personal growth. The congress promotes collaboration, fosters international partnerships, and highlights the vital role of each attendee in advancing surgical knowledge and improving patient care. The ACTES 2024 is a dynamic platform for exchanging cutting-edge knowledge, clinical expertise, and innovative trauma and emergency surgery research. This prestigious event will convene leading professionals from Albania and the international medical community, including surgeons, researchers, and healthcare providers. The congress aims to address contemporary challenges and advancements in trauma care, emergency surgical techniques, and interdisciplinary approaches to patient management. Key themes include the role of minimally invasive surgery in trauma, advancements in hemostatic techniques, damage control resuscitation, the integration of trauma registries, and strategies for improving outcomes in mass casualty incidents. ACTES 2024 also emphasizes the importance of education and collaboration, featuring interactive workshops, live demonstrations, and case-based discussions. These sessions aim to enhance participants' practical skills and foster partnerships among institutions across the region and beyond. Through its comprehensive scientific program, ACTES 2024 underscores its commitment to elevating trauma and emergency surgical care standards, supporting evidence-based practice, and advocating for policy improvements in healthcare systems. This congress represents a unique opportunity to share insights, build networks, and shape the future of trauma and emergency surgery in Albania and the global healthcare community. Conclusion: ACTES 2024 is not just a gathering; it is a movement toward transforming the future of trauma and emergency surgery. Through active participation, the event aims to inspire innovation, encourage global collaboration, and make a lasting impact on surgical care worldwide. The 8th Albanian Congress of Trauma and Emergency Surgery is committed to continuously improving trauma and emergency care standards in Albania and beyond. By creating a space for learning, collaboration, and knowledge exchange, this congress strengthens the foundation for innovation and evidence-based practice. As healthcare professionals unite to share their expertise and insights, ACTES 2024 will undoubtedly impact trauma and emergency surgery trajectories, ultimately improving patient outcomes. Keywords: Trauma care; Emergency surgery; Damage control surgery; Minimally invasive techniquesMinimally invasive techniques; Multidisciplinary care; Acute care medicine; Hemostasis techniques; Mass casualty management; Surgical innovation; Trauma registries; Evidence-based practice; Healthcare systems improvement; Patient outcomes; Surgical education; Regional collaboration; ATLS, Trauma management; trauma education; BAT, PAT, abdominal injury, pelvic injury, acute care surgery, abdomen acute, oncologic surgery, cardiac surgery, AI, bariatric surgery, sleeve resection, chest trauma, lung cancer, vascular surgery, hernia surgery, colorectal cancer, pain, lung diseases, MVC, car accident, emergency medicine; Trauma care, emergency surgery, abdominal injuries, chest trauma, vascular injuries, nursing challenges, surgical innovation, CME credits, international collaboration, evidence-based practices.

Abstract We present here a 3D-printed pressure mapping mat, equipped with customizable architecture sensors, that offers a cost-effective and adaptable solution, overcoming the size constraints and sensing accuracy issues commonly associated with existing commercial pressure mats across various fields, such as healthcare and sports applications. Leveraging a pillar-origami structure, the demonstrated sensor offers multifaceted stiffness properties, effectively filtering skin deformations and enabling capacitive pressure sensing. Notably, the sensor’s detection range can be finely tuned, spanning from 70 to 2500 kPa, with a sensitivity range between 0.01 kPa-1 and 0.0002 kPa-1, and an impressive response time of just 800 milliseconds. Furthermore, the inclusion of a modular sensor array enhances maintenance and allows for greater flexibility in shaping and enhancing the device’s resolution. This technology finds practical applications in wireless foot pressure mapping and sports protection pads, marking a significant milestone in the advancement of flexible and custom-shaped pressure sensor technology.

Introduction: Prehospital emergency medical services (EMS) are essential to emergency medical care. They provide emergency assessment and treatment for seriously ill or injured patients and transport them by ambulance to an emergency department. Adopting triage methods for systematically prioritizing patients according to how urgent patients need care, including Triage of requests for acute medical treatment, is a promising development in our healthcare system. In Kosovo, there is a gap between the effects of prehospital triage systems and the impact of using the same triage system in two or more EMS settings. In this quality improvement study, implementing the TT app intervention was associated with higher rates of inefficient Triage in prehospital settings. However, supporting EMS professionals in their decision-making by calculating the probability of an individual patient needing specialized care at the scene of injury is a new and promising approach to optimize Triage in the field. If we can fully realize the potential of this approach, it could significantly improve the efficiency and effectiveness of our emergency medical care, leading to better patient outcomes. Standards and most health professionals need to be educated and trained in this critical component of EMS. Education, education, and training for the three levels of health care should be an obligatory component to enhance the quality of emergency medical care for children and adults at risk. It is high time to develop and test a conceptual triage scheme or model that will rely on a triage system that responds to the conditions of our health system. Develop clinical guidelines, algorithms, and triage protocols at the three levels of health care. All healthcare professionals must be educated and trained in ongoing coaching, communication courses, BLS AED, Pediatric, PHTLS, Adult Advanced Life Support, ATLS, and International Trauma Life Support. Conclusion: Triage is vital in optimizing patient outcomes in the high-pressure EMS world. It is the process of rapidly assessing a patient's condition to determine the urgency of care and the most appropriate destination for definitive treatment. Done effectively, prehospital Triage ensures that patients receive the right level of care at the right time, maximizing their chances of survival and minimizing long-term complications.

Introduction: Emergency medicine is a dynamic specialty that offers various medical cases and situations. Emergency medicine doctors treat patients from all age groups and with a large spectrum of physical and mental disorders. Emergency medicine is the specialty of treating illnesses or injuries requiring immediate medical attention. Emergency medicine doctors assess and treat patients in the emergency department, regardless of their illness or injury type. Their main focus is to stabilize patients as quickly as possible and determine the best next step in treating many patients simultaneously, with life-threatening conditions being the main priority. Emergency physicians treat all medical conditions of all age groups, such as cardiology, neurological, pulmonological, nephrological, endocrinological, hematological, gastrointestinal, orthopedic, gynecological-obstetrical, dermatological, psychiatric, traumatological, and accidental conditions. Efforts should be made to reduce the accumulation of ED with a solid organizational culture; rather than adopting “generic” approaches, interventions should be selected and implemented to address the unique challenges of each hospital ED. Emergency medicine can potentially improve patient care and outcomes; however, establishing evidence-based protocols and a multidisciplinary approach to patient management are essential. Creating long-term health policies to regulate the referral system through the national plan and document would regulate the three levels of health care to stop the overcrowding of the hospital's ED.

Introduction: Laparoscopic cholecystectomy is the gold standard in the management of symptomatic gallstones. However, it is estimated that there are 2–15 cases of hepatic abscesses per 100,000 people in the U.S., mostly of bacterial etiology, and approximately half of these are caused by cholangitis. Given the infrequency of cholangitis-induced pyogenic hepatic abscesses and the 0.4 % incidence of choledocholithiasis in post-cholecystectomy patients, pyogenic hepatic abscesses secondary to post-cholecystectomy choledocholithiasis comprise a rare entity. A hepatic abscess occurring post-laparoscopic cholecystectomy is a known complication that can manifest months or even years after the surgery. This case involves a 56-year-old female patient who presented with a 10-day history of abdominal pain and discomfort, primarily in the right hypochondrium, accompanied by fever unresponsive to antibiotics and antipyretics. The appropriate treatment approach was chosen based on clinical signs, abscess size, and the patient's overall condition. Conclusion: This case shows the late complications arising from gallstone spillage into the abdominal cavity during laparoscopic cholecystectomy. It underscores the importance of careful laparoscopic exploration, especially in gallbladder perforation and stone spillage cases. Detailed documentation of the operative procedure is crucial, as it aids in the prophylactic and symptomatic treatment of long-term complications such as abscess formation.

Introduction: Infection is a significant cause of posttraumatic morbidity and prolonged hospitalization. Nosocomial infections are a frequent complication of trauma patients admitted to the intensive care unit (ICU). Trauma is predisposed to infections by various mechanisms, while intravascular catheters, endotracheal tubes, and urinary catheters create suitable environments for nosocomial infection during treatment. Following trauma, wound contamination with aerobic and anaerobic bacteria should always be suspected. Material and Methods: In this paper, we want to review the literature regarding the role of infectious disease (ID) specialists in the trauma team and compare it with the situation in our country. Discussion: Infections in trauma are developed because of endogenous bacteremia or as a result of exogenous bacteremia. Since infection significantly prolongs the hospitalization of trauma patients, the infection disease specialist plays a crucial role in preventing and treating infections in collaboration with the surgeon and other trauma team members. The duration of antibiotic treatment is significant. A shorter duration will result in fewer side effects and allergic reactions and reduce long-term antibiotic resistance. Conclusions: The infectious disease specialist is not a standalone figure but an integral part of the trauma team. Their role is not limited to implementing protocols and using appropriate antibiotics before, during, and after surgical procedures. They also closely follow the patients, identifying those with a greater predisposition to develop infections. This collaborative approach is crucial for successfully preventing and managing infections in trauma patients.

Introduction: Ruptured splenic artery aneurysms (SAAs) are rare but life-threatening vascular emergencies. Prompt diagnosis and intervention are crucial for patient survival. We present a case of a 54-year-old male who presented with We describe the case of a 54-year-old male who presented with an acute onset of diffuse abdominal pain radiating to the left shoulder, tachycardia, and hemodynamic stability without signs of hypovolemic shock. The diagnostic process includes imaging examinations such as abdominal echo, AngioCT abdomen, and laboratory examinations. After 12 hours of observation, the head of the general surgery service and vascular surgeons consulted, and the decision was made to perform an exploratory laparotomy. The patient underwent laparotomy, which revealed hemoperitoneum and rupture of the splenic artery aneurysm, requiring Splenectomy. The patient had an uneventful postoperative course and was discharged home on postoperative day 7. Ruptured splenic artery aneurysms represent a challenging clinical scenario requiring prompt recognition and intervention. Surgical management remains the cornerstone of treatment, aiming to prevent life-threatening bleeding and preserve splenic function when feasible. Multidisciplinary collaboration and adherence to evidence-based practices are essential for optimizing patient outcomes in this rare but critical condition. Ongoing research and advancements in surgical techniques continue to refine the approach to splenic artery aneurysms, enhancing the quality of care provided to affected patients. Conclusion: This case report highlights the importance of a high index of suspicion for ruptured SAA in patients with suggestive clinical presentations. Prompt surgical intervention with appropriate technique selection is essential for optimal patient outcomes.

Introduction: Primary pancreatic lymphoma is a rare clinical entity representing

BACKGROUND: Identification of high-risk populations for serious infection due to S. pneumoniae will permit appropriately targeted prevention programs. METHODS: We conducted prospective, population-based surveillance for invasive pneumococcal disease and laboratory confirmed pneumococcal pneumonia in homeless adults in Toronto, a Canadian city with a total population of 2.5 M, from January 1, 2002 to December 31, 2006. RESULTS: We identified 69 cases of invasive pneumococcal disease and 27 cases of laboratory confirmed pneumococcal pneumonia in an estimated population of 5050 homeless adults. The incidence of invasive pneumococcal disease in homeless adults was 273 infections per 100,000 persons per year, compared to 9 per 100,000 persons per year in the general adult population. Homeless persons with invasive pneumococcal disease were younger than other adults (median age 46 years vs 67 years, P

Background and Study Aim. The significance of analyzing statistical indicators is paramount, as they provide valuable insights into the distinguishing performance factors of teams. The purpose of this study: 1) to identify statistically significant differences between relevant performance factors among winning, drawing, and losing teams in the 2022 Football World Cup in Qatar; 2) explore indicators that are most strongly associated with the game results in this tournament. Material and Methods. A total of 64 matches and 32 participating teams were analyzed. The variables included in the research were: total shots, shots on target, shots off target, effectiveness, passes, passes completed, crosses, crosses against, offsides committed, offsides received, fouls received, ball possession, fouls committed, corners, corners against, yellow cards and red cards. The results are extracted from the official FIFA website. The Analysis of Variance (ANOVA) and the ordinal logistic regression with elastic net were used for data calculation. Results. The results indicate that winning teams have statistically significantly higher mean values of variables related to goals scored: total shots (p < 0.05), shots on target (p < 0.01), and effectiveness (p < 0.01). According to the information-based model selection criteria AIC (Akaike information criterion) and BIC (Bayesian information criterion) effectiveness and shots on target are the most important variables regarding game results. They, along with corners, are best associated with successful teams. In contrast, crosses, ball possession, corners against, and yellow cards are associated with less successful teams. Results suggest that teams with high ball possession and large number of crosses, but fewer shots on target, have weaker results than teams with more shots on target and less ball possession. Conclusions. The study underscores the significance of certain performance indicators, such as total shots, shots on target, and effectiveness, in predicting a team's success. These findings provide valuable insights for coaches and teams to focus on specific aspects of their game to enhance their chances of winning. Additionally, understanding the impact of variables like ball possession, crosses, corners, and yellow cards emphasizes the importance of a well-rounded strategy for achieving success in international football tournaments.

Background: Non-contact anterior cruciate ligament (ACL) injury is a common and debilitating injury among athletes, with high recurrence rates and long-term consequences. Identifying individuals at risk of ACL injury can help prevent or reduce the severity of these injuries. The present study aimed to assess the alpha angle (AA) in ACL rupture patients in both the injured (ipsilateral) and non-affected (contralateral) extremities, compared to a control group. Methods and Results: This case-control study included 105 subjects (78.1% male and 21.9% female) aged between 15 and 45 years of both sexes involved in sports. The case group consisted of 54 patients with sport-related, noncontact ACL ruptures identified by MRI. Fifty-one patients, 10(19.6%) of whom were female, with no ACL rupture, were included in the study as a control group. Hip radiographs were taken in all the subjects using the modified Dunn View with the patient in the supine position, hip flexed 45o and abducted 20o. OsiriX software was used to obtain the measurements. Most injuries were caused by football (58.1%), followed by jumping sports (23.8%) and skiing (18.1%). The mean AA was 49.27 o (SD=4.93) for subjects without ACL rupture and 54.84o (SD=6.17) for subjects with ACL rupture, and the difference was statistically significant (P

Background and Study Aim. The aim of the study is to determine the level of fundamental skills which consist of motor competence such as balance, mobility, and stability. Material and Methods. The study has been conducted with people living in the elderly home "Jetimat e Ballkanit" who are representative of these people's category living in Kosovo. 10 women and 10 men aged 50-65 were included in the study on a voluntary basis. The height, body mass, and all body composition, such as Body mass index, Body fat percentage, Body water, Muscle mass, Bones, Kilocalories, and Visceral Fat, were measured with medical scales (Tanita BC 545 N Innerscan Segmental Personal Body Analysis). Functional Movement Screen is composed of the Deep Squat, Hurdle Step, Incline Lunge, Shoulder Mobility, Active Straight-Leg Raise, Trunk Stability Push-Up, Rotary Stability, were applied. The SPSS 26 packet was used in the data analysis. Categorization of the participants with pain, low, average, and high ability were made by using frequency statistics. Differences between genders and right/left extremities were made by using Independent-Samples T-Test. Also, a regression Linear model and the Backward Elimination method were applied. Results. Gender and right/left dominancy analysis of the Functional Movement Screen scores has shown that no statistical differences appear in the data analyzed in the study (p>0.05). The frequency analysis has shown that 11.1-22.2% of the people living in the elderly home have pain while applying the movements. 24.06% of them have shown low ability in the Functional Movement Screen protocol, 30.39% seem to have a normal level of functionality. There are just 37.01% of them who resulted to be in good condition based on the Functional Movement Screen protocol. Conclusions. The analysis of the study concludes that the lacking of functionality in the motor competency level of elderly people may occur from their nutrition. That, is reflected in motor competency level through decreases in muscle mass, bone density, and increases in fat percentage, body mass index, and body weight.

Purpose:. This study examined the leadership development themes that global orthopaedic surgeons in differently resourced countries perceive as essential components and evaluated barriers to attending leadership development programs. Methods:. This multinational, 45-question survey engaged orthopaedic surgeons (one expert per country). The questionnaire collected participants' demographics, perception of effective leadership traits, and valuation of various leadership themes based on importance and interest. Results:. The survey was completed by 110 orthopaedic surgeons worldwide. Respondents most commonly reported holding a leadership position (87%) in hospital settings (62%), clinical settings (47%), and national orthopaedic societies (46%). The greatest proportion of participants reported having never attended a leadership course (42%). Participants regarded “high performing team-building,” “professional ethics,” and “organizational structure and ability to lead” as the most important leadership themes. No significant (P ≤ 0.05) differences were identified among perceived importance or interest in leadership themes between income levels; however, statistically significant differences were identified in the questionnaire; respondents in low- and middle-income countries (LICs/LMICs) demonstrated a stronger interest in attending a leadership course than those in high-income countries (HICs) (98% vs. 79%, P = 0.013), and fewer surgeons in LICs/LMICs had taken personality assessment tests than those in HICs (22% vs. 49%, P = 0.019). The most common barriers to attending leadership courses were lack of opportunities and invitations (57%), difficulty missing work (22%), and cost of course attendance (22%). Conclusions:. These findings can better inform the development of effective curricula and provide a framework for a successful model for the future. Level of Evidence:. V.

Introduction: Diverticulitis represents a relatively common pathology within the gastrointestinal tract. While diverticula can occur throughout the digestive system, their prevalence is notably higher in the left colon, particularly in the sigmoid region. This condition predominantly affects middle-aged and elderly males. The most effective diagnostic methods for this disease are colonoscopy and computed tomography (CT) with contrast. Although severe complications of diverticulitis are infrequent, the optimal classification of these complications has been described by Hinchey. The article aims to show the case of a young patient with complicated diverticulitis with perforation and generalized peritonitis, classified as stage III-IV, according to Hinchey. Case report: A 43-year-old female patient was urgently admitted to the General Surgery Clinic at Tetovo Clinical Hospital, presenting with severe generalized abdominal pain and signs of peritoneal irritation. Comprehensive diagnostic imaging revealed a large retroperitoneal abscess located above the psoas muscle, accompanied by a significant accumulation of free fluid, suspected to be pus, in the abdominal cavity. Following initial resuscitation, surgical intervention was undertaken. Intraoperative findings included advanced inflammatory changes in the sigmoid colon, characterized by thickened fibrotic walls and a partially constricted lumen. A large abscess was also identified in the retroperitoneal space between the spleen and left kidney. Given these findings, resectioning the distal descending colon and most of the sigmoid colon was considered necessary. The retroperitoneal abscess was incised, its contents aspirated, and a thorough cavity debridement was performed. Subsequently, the Hartmann procedure was executed. Postoperatively, due to the patient's deteriorating condition, she was transferred to the intensive care unit for continued treatment. The patient was discharged from the hospital in stable condition on the tenth day following the surgery. Conclusion: While complications from sigmoid diverticula are uncommon, they can occasionally be extremely severe and pose a significant risk to patient survival.

Introduction: Ventral hernia is one of the most common general surgical pathologies. An incisional hernia will develop in 10–15% of patients with an abdominal incision, and the risk increases to up to 23% in those who develop surgical site infections. Ventral hernia repairs are mostly elective (90%) procedures, but the repair methods are highly variable. Popularized in Europe by Rives and Stoppa, the retromuscular technique has proven to be very effective, with a 94.2% probability of having the lowest odds for recurrence and a 77.3% probability of having the lowest odds for SSI. The study aimed to evaluate our experience at a secondary care center performing Rives-Stoppa repair for abdominal ventral and incisional hernias. Materials and Methods: Between April 2019 and August 2021, 46 patients in the practice at a secondary regional hospital, Teni Konomi, Korce, Albania, underwent a Rives-Stoppa incisional hernia repair. Results: There were 14 (31%) males and 32(69%) females (age range 31-75). Most incisional hernias were midline xiphoid-pubic incision and supraumbilical, with several subcostals (2 right and 1 left) hernias.At the time of repair, most incisional hernias were symptomatic and evident on physical exam. In four cases, the hernia sac was incarcerated at the presentation time. Conclusion: The Rives-Stoppa technique has excellent long-term results and low morbidity in patients with large primary or recurrent incisional hernias. It is the gold standard for most surgeons. Keywords: Incisional Hernia, mesh, polypropylene, abdominal wall surgery, rectus muscle

Introduction: Injuries in construction are not a rare occurrence and cause a strain on the health care service. By having education on workplace hazards, trained first aiders, and an effective accident emergency response system, the occurrence of illness/injuries will reduce and hence the number of fatalities. The purpose of this research is the evaluation, epidemiology, management, diagnosis, treatment, systematization, and the results obtained about the construction industry for injury in life-threatening cases with trauma, reducing morbidity, disability, and mortality while increasing survival. Solving problems for severe traumas in the health system of Kosovo, such as with professional staff, doctors and nurses, dedicated spaces, medical equipment, drugs, consumables, poor diagnostics, non-decisional consultations, as well as their timely and timely delivery. seeks political health solutions to solve this problem. Material and Methods; In this retrospective study, we researched and analyzed the data of patients with construction-related injuries in ED treated from January-December 2021 Results; During the study period, we analyzed 75,899 ED patients. Of these, 420 cases, or 0.06% were injured. In the research, 420 cases of injuries were investigated, investigating all age groups arising from construction-related activities for 2021. Conclusion; To reduce workplace injuries an organization must carry out regular risk assessments, conduct physical assessments for demanding roles, provide safety and wellness training regularly, train and appoint first aid marshals, hire qualified workers, hire enough workers, keep workspaces clean and walkways clear, post proper signage, Provide adequate lighting, education and training on staff emergency response systems via courses BLS-D BTLS, PHTLS ATLS.

Introduction: Patients with life-threatening injuries are a significant concern in the emergency department (ED). These injured people require timely care, as their lives depend on it, and a longer wait can result in organ failure, irreversible damage, and poor survival outcomes. The purpose of this research is the evaluation, epidemiology, management, diagnosis, treatment, systematization, and the results obtained for the injured in life-threatening cases with trauma, reducing morbidity, disability, and mortality while increasing survival. Material and Methods. In this retrospective study, we researched and analyzed the data of patients with critical traumatic injuries in DE treated from January-December 2021 Results. During the study period, we analyzed 75,899 ED patients. Of these, 627 cases, or 0.83%, were severely injured and traumatically admitted as a life-threatening traumatic medical emergency in the resuscitation room. Attacked age were males 507 cases or 80.87% and females 120 cases 19.13% and over 16 were 46 cases or 6.67%. The main problem in the admission of the sick was the injured with disorders of consciousness, shock, cardiac, and respiratory failure, as well as issues at the systemic level. Conclusion. During the study period, we analyzed 75,899 ED patients. Of these, 627 cases, or 0.83%, were severely injured and traumatically admitted as a life-threatening traumatic medical emergency in the resuscitation room. Attacked age were males 507 cases or 80.87% and females 120 cases 19.13% and over 16 were 46 cases or 6.67%. The main problem in the admission of the sick was the injured with disorders of consciousness, shock, cardiac, and respiratory failure, as well as issues at the systemic level. Also, these critically injured require structured and well-organized care in the DE in the resuscitation room, with educated medical staff, nurses, and support staff trained with the mandatory BLS, BTLS, PHTLS, and ATLS courses, implementing and developing the algorithms standardized for structured care of the critically injured. Keywords: DE, traumatic, life-threatening medical emergency, CPR. monitoring, management,

Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in hospitals worldwide. The cornerstones of effective treatment of IAIs include early recognition, adequate source control, appropriate antimicrobial therapy, and prompt physiologic stabilization using a critical care environment, combined with an optimal surgical approach. Together, the World Society of Emergency Surgery (WSES), the Global Alliance for Infections in Surgery (GAIS), the Surgical Infection Society-Europe (SIS-E), the World Surgical Infection Society (WSIS), and the American Association for the Surgery of Trauma (AAST) have jointly completed an international multi-society document in order to facilitate clinical management of patients with IAIs worldwide building evidence-based clinical pathways for the most common IAIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting information was shared by an international task force from 46 countries with different clinical backgrounds. The aim of the document is to promote global standards of care in IAIs providing guidance to clinicians by describing reasonable approaches to the management of IAIs.

This study aims to analyze the relationship between political affiliation and vulnerability to disinformation in North Macedonia through the role of psychological and social constraints in shaping how individuals respond to and process information. Research has shown that politically affiliated individuals may be particularly vulnerable to disinformation in part due to confirmation bias or the tendency to accept and seek out information that is consistent with one’s preexisting beliefs and ignore or refute information that is not. Using the quantitative method and cross-matched data from the empirical research, the study has shown that political affiliation affects the way individuals perceive disinformation. Correspondingly, disinformation with a negative connotation from one’s affiliated political party is perceived by a lower percentage as accurate, contrary to disinformation with a negative connotation from the opposing political party, which is perceived by a higher percentage as accurate. The study also found that politically affiliated individuals are more prone to disinformation than those who are not politically affiliated. The results suggest that political affiliation plays a significant role in an individual’s vulnerability to disinformation.

Pregnancy induces significant changes in oral health because of hormonal fluctuations, making it a crucial period for preventive measures. Dental stem cells (DSCs), particularly those derived from the dental pulp and periodontal ligaments, offer promising avenues for regenerative therapies and, possibly, preventive interventions. While the use of DSCs already includes various applications in regenerative dentistry in the general population, their use during pregnancy requires careful consideration. This review explores recent advancements, challenges, and prospects in using DSCs to address oral health issues, possibly during pregnancy. Critical aspects of the responsible use of DSCs in pregnant women are discussed, including safety, ethical issues, regulatory frameworks, and the need for interdisciplinary collaborations. We aimed to provide a comprehensive understanding of leveraging DSCs to improve maternal oral health.

Anterior cruciate ligament (ACL) ruptures are prevalent knee injuries, with approximately 200,000 ruptures annually, and treatment costs exceed USD two billion in the United States alone. Typically, the initial detection of ACL tears and anterior tibial laxity (ATL) involves manual assessments like the Lachman test, which examines anterior knee laxity. Partial ACL tears can go unnoticed if they minimally affect knee laxity; however, they will progress to a complete ACL tear requiring surgical treatment. In this study, a computational finite element model (FEM) of the knee joint was generated to investigate the effect of partial ACL tears under the Lachman test (GNRB® testing system) boundary conditions. The ACL was modeled as a hyperelastic composite structure with a refined representation of collagen bundles. Five different tear types (I–V), classified by location and size, were modeled to predict the relationship between tear size, location, and anterior tibial translation (ATT). The results demonstrated different levels of ATT that could not be manually detected. Type I tears demonstrated an almost linear increase in ATT, with the growth in tear size ranging from 3.7 mm to 4.2 mm, from 25% to 85%, respectively. Type II partial tears showed a less linear incline in ATT (3.85, 4.1, and 4.75 mm for 25%, 55%, and 85% partial tears, respectively). Types III, IV, and V maintained a nonlinear trend, with ATTs of 3.85 mm, 4.2 mm, and 4.95 mm for Type III, 3.85 mm, 4.25 mm, and 5.1 mm for Type IV, and 3.6 mm, 4.25 mm, and 5.3 mm for Type V, for 25%, 55%, and 85% partial tears, respectively. Therefore, for small tears (25%), knee stability was most affected when the tears were located around the center of the ligament. For moderate tears (55%), the effect on knee stability was the greatest for tears at the proximal half of the ACL. However, severe tears (85%) demonstrated considerable growth in knee instability from the distal to the proximal ends of the tissue, with a substantial increase in knee instability around the insertion sites. The proposed model can enhance the characterization of partial ACL tears, leading to more accurate preliminary diagnoses. It can aid in developing new techniques for repairing partially torn ACLs, potentially preventing more severe injuries.

The 30th Albanian Conference of Surgery (ACS 2023) and the 7th Albanian Congress of Trauma and Emergency Surgery (ACTES 2023) represent significant milestones in the medical community. These concurrent events provide a platform for the exchange of knowledge, collaboration, and the advancement of surgical science in Albania. ACS 2023 & ACTES 2023 gather experts, scholars, practitioners, and enthusiasts from the field of surgery, both in traumatic and non-traumatic areas, in the vibrant city of Tirana. The comprehensive program encompasses a diverse range of surgical topics, from abdominal and chest injuries to vascular injuries, emergency surgery, and the challenge of nurse services in the new millennium. The theme of this year's events, "Surgery and not only...," reflects the commitment to innovation, best practices, and groundbreaking discoveries. The programs include plenary sessions with renowned experts, scientific presentations, panel discussions, networking opportunities, an industry exhibition, poster awards, cultural and social activities, and Continuing Medical Education (CME) credits. Participants can expect a professionally enriching experience that also offers personal rewards. ACS 2023 & ACTES 2023 value the role of each attendee in contributing to the advancement of surgical knowledge and patient care. The events promise to chart new horizons in the field of surgery and foster international collaboration. The Event is poised to create lasting memories, and their success hinges on the active participation of every attendee. It is an opportunity to inspire, collaborate, and make a lasting impact on surgical care worldwide.

Rodent tears contain social chemosignals with diverse effects, including blocking male aggression. Human tears also contain a chemosignal that lowers male testosterone, but its behavioral significance was unclear. Because reduced testosterone is associated with reduced aggression, we tested the hypothesis that human tears act like rodent tears to block male aggression. Using a standard behavioral paradigm, we found that sniffing emotional tears with no odor percept reduced human male aggression by 43.7%. To probe the peripheral brain substrates of this effect, we applied tears to 62 human olfactory receptors in vitro. We identified 4 receptors that responded in a dose-dependent manner to this stimulus. Finally, to probe the central brain substrates of this effect, we repeated the experiment concurrent with functional brain imaging. We found that sniffing tears increased functional connectivity between the neural substrates of olfaction and aggression, reducing overall levels of neural activity in the latter. Taken together, our results imply that like in rodents, a human tear-bound chemosignal lowers male aggression, a mechanism that likely relies on the structural and functional overlap in the brain substrates of olfaction and aggression. We suggest that tears are a mammalian-wide mechanism that provides a chemical blanket protecting against aggression.

Introduction Developing an effective trauma care system is an ongoing challenge in Albania, as it is in many countries. Trauma remains a significant cause of morbidity and mortality, particularly among the younger population in Albania. While the need for a structured trauma system has been recognized, several challenges need to be addressed. Lack of a Formalized Trauma System: Albania lacks a formalized and well-structured trauma system that can efficiently manage trauma cases from the scene of the injury to rehabilitation. The absence of such a system can lead to delays in care and suboptimal outcomes. Inconsistent Data Collection and Quality Improvement: Uniform data collection, quality improvement programs, and trauma verification processes are not consistently implemented. This results in fragmented and inconsistent trauma care, making it challenging to track and improve outcomes. Shortage of Specialized Trauma Care Personnel: The scarcity of healthcare professionals with specialized training in trauma care, including trauma surgeons and emergency medicine specialists, presents a significant hurdle. Trauma care requires a multidisciplinary approach with expertise in various aspects of care, from initial resuscitation to surgical intervention. Infrastructure and Resource Limitations: Many healthcare facilities, especially in rural areas, lack the necessary infrastructure, equipment, and resources to provide optimal trauma care. This includes deficiencies in trauma centers, emergency departments, and pre-hospital care. Challenges in Transportation and Prehospital Care: Efficient prehospital care and transportation of trauma patients are critical for improving outcomes. In Albania, challenges related to transportation and the availability of trained paramedics can hinder the timely delivery of care. Public Awareness and Injury Prevention: Raising public awareness about injury prevention and safety measures is essential. Efforts to reduce the incidence of trauma, especially road traffic accidents, can have a significant impact on overall trauma rates. Coordination Among Healthcare Facilities: Effective coordination among healthcare facilities, from local clinics to major hospitals, is crucial for seamless patient transfer and continuity of care. Advocacy and Government Support: Advocacy efforts by healthcare professionals and organizations are needed to emphasize the importance of a formalized trauma system. Government support and funding are essential for building and maintaining a trauma care infrastructure. Conclusion: establishing a comprehensive trauma system in Albania is a multifaceted challenge that requires collaboration among healthcare stakeholders, advocacy, resource allocation, and a commitment to improving trauma care from the moment of injury through rehabilitation. This ongoing challenge is critical for reducing trauma-related morbidity and mortality in the country.

Introduction; Chest trauma, resulting from both blunt and penetrating mechanisms, poses a significant health threat, and its management demands precise strategies and adherence to established guidelines. This presentation introduces a comprehensive presentation on optimizing chest trauma management, delving into essential strategies and guidelines for healthcare professionals. The presentation begins by outlining the various types and mechanisms of chest trauma, such as blunt and penetrating injuries, with a focus on their significance and prevalence in healthcare settings. Subsequently, the initial assessment of chest trauma patients takes center stage. This involves a primary survey encompassing airway assessment and management, breathing assessment and intervention, circulation assessment and resuscitation, disability assessment, and environmental control. It continues with a secondary survey, including history-taking and a detailed physical examination, accompanied by diagnostic modalities like chest X-rays, computed tomography scans, ultrasound, and arterial blood gas analysis. The presentation then proceeds to address specific chest trauma injuries, including rib fractures, flail chest, pneumothorax, hemothorax, cardiac injuries, pulmonary contusion, and tracheobronchial injuries. The various management approaches are discussed, ranging from pain management, oxygen therapy, chest tube placement, surgical interventions, cardiac tamponade management, to controlling massive hemorrhage. Additionally, it highlights complications and outcomes related to chest trauma, including long-term effects, rehabilitation, and follow-up. The critical role of prevention, pre-hospital care, and guidelines and protocols such as Advanced Trauma Life Support (ATLS) and those from the Eastern Association for the Surgery of Trauma (EAST) are emphasized. Real-life case studies are presented to provide practical insights into chest trauma management, ensuring a comprehensive understanding of the topic. In conclusion, the abstract emphasizes the significance of early recognition, appropriate management, and continuous education and training in chest trauma cases to optimize patient outcomes. This presentation offers a holistic perspective on chest trauma management and equips healthcare professionals with the knowledge and tools to enhance the care provided to patients with chest trauma.

Introduction: The initial assessment of trauma patients is a critical and time-sensitive phase in the realm of emergency medicine. This presentation outlines the fundamental components and principles of conducting an effective initial assessment, which is essential for promptly identifying life-threatening injuries and ensuring timely interventions for patient stabilization. The primary objective of the initial assessment is to swiftly detect and address imminent life-threatening conditions. This process adheres to a structured approach, often following established protocols such as Advanced Trauma Life Support (ATLS). Commencing with the evaluation of the patient's airway, breathing, and circulation (ABCs), healthcare providers prioritize the maintenance of a patent airway, adequate respiration, and a stable circulatory system. Any life-threatening issues identified during this phase demand immediate intervention. Simultaneously, healthcare providers perform a concise yet comprehensive patient history and physical examination, gathering information about the injury's mechanism, the patient's medical background, and any pertinent details. This collected data serves as the foundation for subsequent assessments and treatment plans. The secondary survey, a more detailed and systematic examination, follows the initial assessment. This phase involves a thorough head-to-toe evaluation aimed at detecting injuries that may have been initially overlooked. Diagnostic procedures, including imaging studies and laboratory tests, may be initiated during this phase to further assess and diagnose injuries. The initial assessment places specific emphasis on identifying and managing conditions with rapid and potentially lethal deterioration, such as tension pneumothorax, cardiac tamponade, and massive hemorrhage. Throughout the assessment process, effective communication among the trauma team members is paramount to ensure a coordinated and efficient response. This includes making triage decisions and facilitating swift patient transport to the most appropriate care facility, all of which contribute to optimal trauma patient management. In conclusion, the initial assessment in trauma patients is a dynamic and systematic process designed to swiftly identify and address life-threatening injuries. By recognizing these injuries promptly, initiating timely interventions, and gathering critical patient information, healthcare providers and emergency responders play a vital role in ensuring the best possible outcomes for trauma patients. Training in these procedures is essential to equip healthcare teams with the skills and knowledge needed for successful trauma patient management.

Introduction. Urolithiasis is not a simple disease, but it is a group of metabolic and endocrine disorders in the organism, coupled with changes in the urinary tract. Objectives. Research on the etiopathogenesis of urolithiasis; to analyze parathyroid hormones, to determine citrates in urine; their influence on the occurrence of urolithiasis. Research and the role of infection in the occurrence of urolithiasis, clinical symptoms, diagnostic methods, prevention methods and as well as preventive measures. Materials and methods. The research was conducted on our patients at the Urology Clinic, University Clinical Center of Kosovo, in Pristina. The work was prospective; in our research, we included 102 patients. Results. Our research has increased Parathormone in 5, 88% of cases. We had hypocitraturia in 57, 84% of cases. Hypocyturia then affects the creation of conditions for the crystallization and aggregation of stoneforming substances. Urolithiasis includes both sexes, primarily men 66, 7%, and women 33.3%. With X2- test we obtained a significant difference with statistical significance in the number of cases by gender (X2 = 11.3, P = 0.001). The most attacked age group was 40-49 years old. Symptoms are dominated by colic, nephralgia, dysuria, and hematuria. In this research, we have 22.5% of positive results of urine cultures. Conclusion. Therefore, there is still no explanation about the pathogenesis of urolithiasis, and with the knowledge of the etiopathogenesis of urolithiasis, symptoms, clinic, metabolic disorders and pathomorphology of urolithiasis, prophylactic measures can be taken, and urolith recurrence can be prevented.

Rehabilitative dentistry has made enormous progress in recent years, not only due to the advent of new implant-prosthetic methods, but also thanks to new information technologies that support the doctor. This study aims to present a new implant protocol that involves the application of bioengineering methods. With the application of the finite element analysis, it is possible to evaluate the distribution of the forces of a fixture and possible implant rehabilitation on each patient, even before performing the surgery. This protocol provides for the combination of radiographic images and three-dimensional files to obtain predictable results on possible rehabilitation, guiding its planning in the best possible way. Surely, the evolution of machines and computers will enable the surgeon to carry out and maintain these protocols in a chair-side manner, and to carry out safe and predictable rehabilitations.

The Covid'19 Pandemic created a global public health crisis. State measures and protocols created difficulties in effective doctor-patient communication, therefore the psychological assessment of this communication during the Pandemic becomes the object of research on this topic. The purpose of the study is to describe the impact of the Pandemic on the functioning of the doctor-patient relationship in the primary health service. The study was carried out in the District of Lezha, in the cities of Rrëshen, Laç and Lezha. The sample of the study are 6 family doctors and 24 patients, who communicated with the family doctor during the rehabilitation period in home conditions. This study is built on the qualitative approach of scientific research, using as an instrument the in-depth interview focusing on the impact of the Pandemic on doctor-patient communication. The results of the study showed that doctor-patient communication during the Pandemic had barriers and a negative impact on this relationship.

Abstract Background The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was reportedly increased during the COVID-19 pandemic. The aim of the ChoCO-W study was to compare the clinical findings and outcomes of acute cholecystitis in patients who had COVID-19 disease with those who did not. Methods Data were prospectively collected over 6 months (October 1, 2020, to April 30, 2021) with 1-month follow-up. In October 2020, Delta variant of SARS CoV-2 was isolated for the first time. Demographic and clinical data were analyzed and reported according to the STROBE guidelines. Baseline characteristics and clinical outcomes of patients who had COVID-19 were compared with those who did not. Results A total of 2893 patients, from 42 countries, 218 centers, involved, with a median age of 61.3 (SD: 17.39) years were prospectively enrolled in this study; 1481 (51%) patients were males. One hundred and eighty (6.9%) patients were COVID-19 positive, while 2412 (93.1%) were negative. Concomitant preexisting diseases including cardiovascular diseases (p

The Advanced Trauma Life Support (ATLS) course has become an indispensable tool in preparing health care professionals to provide optimal trauma care. This article highlights the impact of the ATLS course on empowering healthcare professionals for excellence in trauma care. By providing a standardized framework, enhancing critical decision-making skills, and promoting interdisciplinary collaboration, the ATLS course equips practitioners with the knowledge and skills necessary to effectively respond to trauma emergencies. Additionally, the course prepares healthcare professionals for the unpredictable nature of trauma care through simulation-based training and fosters a culture of continuous professional growth. Through its emphasis on standardization, critical thinking, and continuing education, the ATLS course plays a vital role in improving patient outcomes and establishing a foundation for excellence in trauma care. Conclusion: The ATLS course stands as a testament to the commitment of healthcare professionals to provide excellent trauma care. It empowers practitioners with the necessary knowledge, skills, and standardized approach to save lives in the critical moments following traumatic events.

Electrical injury is a physiological reaction caused by electric current passing through the body. Electric injuries can be caused by the impact and exposure to electric current or lightning either at home or at work. The injury depends on the density of the current, tissue resistance, and duration of contact. Very small currents may be imperceptible or produce a light tingling sensation. Injuries can range from minor, moderate, to severe, and fatal injuries are just as likely to occur at home as in the workplace, with around 20 Australians dying each year from electric shock. The purpose of this paper is to study how well-trained healthcare professionals in both pre-hospital and hospital settings are in treating patients in the case of electric shock and injuries caused by lightning, including the triage, assessment, monitoring, treatment, and transport with medical care in pre-hospital settings The research was conducted based on data obtained from assessments of health care professionals based on anamnestic data, the status of vital parameters, monitoring, medical procedures, system-level injuries, type of health care delivery, and location. Conclusions; Given the discrepancies found in reporting pathological conditions and injuries pertaining to electrical burn wounds, a standardized system for classifying these pathological conditions is suggested. Although electric shock-related mortality is not the leading cause of death in high-prevalence areas, awareness needs to be raised.

Fournier's gangrene (FG) is a well known often fatal fasziitis of the pelvic floor following ano-rectal, urologic and gynecologic infections. Although rarely it is described as a complication of operative anal procedures and predisposing factors such as diabetes, alcoholism, immune-defects and consumptive diseases. Current literature only briefly mentions the potential risk of FG after such a common surgical procedure. However, devastating complications occur more often than expected. This catastrophic complication without a predisposing factor is discussed along with a review of the literature. The objective of this article is to provide updated and relevant information regarding the recognition, diagnosis and management of FG, from the general surgeon to the emergency department. This article refers to two complicated cases of Fournier's gangrene. The patients underwent emergency surgical intervention with the diagnosis of hemorrhoidal prolapse with rectal bleeding and accompanying anemia… Conclusion; The gold standard for treatment was found to be a combination of surgical debridement, broad-spectrum antibiotics, and the administration of intravenous fluids. Further, patient survival was found to be directly related to the time from diagnosis to treatment when they underwent surgical debridement. The General surgeon must be vigilant for this condition and be aware of risk factors, prognostic indicators, and proper treatment protocols to recognize FG early and initiate appropriate management.

Kosovo during the Ottoman period was characterized by increased activities regarding youths’ upbringing and education. Prishtina, Prizren, Gjakova, Peja, Vushtrri, Gjilan and many other Kosovo kazas [administrative districts] were centers for educating and training children. This fact is confirmed by the number of the first Muslim cadres of educated people who made a name for themselves in the field of literature and poetry of the classical and modern Ottoman periods, as was the case with the poets of the Divan such as Mesihi of Prishtina, Dukagjinzade Ahmet Bey from Dukagjin and Mehmet Akif Ersoj from Peja (d. 1936). Education activity in Kosovo during the Ottoman administration took place in institutions that were observed by the High Council of the Islamic Religion and the Ministry of Education itself. As a result, researchers have the opportunity to trace official data on the educational and cultural activities that were conducted in sanjaks, kazas, and various villages of Kosovo. These activities are very well reflected in the documentation of the time, starting with the Salname of the Vilayet of Kosovo and other documents such as testimonials, student certificates, and various decisions of education directorates at the local level. This paper addresses the certificates of students from the Llashtica, Pidiq, Caravajka, and Remnik Maktabs [schools] for 1902-1903 school year and Pogragja Maktab for 1905-1906 and also provides data from the schools’ rosters regarding the number of students, the names of the müderris [teachers] who served in the Madrasas of Gjilan and Doburçan in the early 20th century.

This article aims to analyze and determine the effects that can be achieved on overall performance in implementing the marketing concept of the commercial banks in the agricultural sector of the Republic of Kosovo. In conducting the analysis of the marketing activities of commercial banks are defined as a factor - drivers and achieved a level of market and financial performance as a resulting factor. The research hypothesis checked for authenticity is that the systematic execution of marketing activities determines the level of market performance of commercial banks in the market segment “Loans and leasing for agribusiness”. The systematic execution of marketing activities has a major impact on the achieved market share of commercial banks in the market segment “Loans and leasing for agribusiness". Commercial banks with greater market share aspire to more systematically apply their marketing concept. These banks set aside a bigger marketing budget for the realization of their marketing concepts.

Countermovement jump (CMJ) is an element of many sports techniques and has an important role in the overall performance, both when performed at maximal and submaximal intensity. This paper aims to investigate changes in biomechanical and neuromuscular variables that are responsible for controlling different submaximal intensities of the CMJ. 8 healthy and uninjured volleyball players from the first league of the Republic of Serbia, average age 21.9 ± 1.9 years, average body height 191.6 ± 9.2 cm, average body weight 83.1 ± 7.1 kg were included in the study. Subjects performed CMJ at three different jump heights (approximately 65%, 80%, and 95% of the maximal height). For the analysis of electromyographic data, the value of root mean square analysis was used separately for the amortization phase and the jump phase, for the following muscles: m. gluteus maximus (GlutM), m. rectus femoris (RF), m. biceps femoris (BF), m. vastus lateralis (VL), m. tibialis anterior (TA) and m. gastrocnemius medialis(GastM).Kinematic and kinetic variableswere monitored: vertical center of mass displacement in the amortization phase [m], the center of mass height at take-off point [m], jump height [m], jump speed [m/s], angular displacement in the ankle, knee and hip joint [rad], maximal vertical ground reaction force [N/ kg], vertical stiffness [kN/m/kg], the torque of the ankle, knee and hip joint [Nm/kg]. The change in jump height (65, 80 and 95%) did not have a significant effect on the change in activation for most muscles (p≥0.05), except for GastM where a tendency towards increase was observed (p=0.066). During jump phase, the activation of VL, BF, GlutM, TA muscles significantly increased compared to the amortization phase (p≤0.05). The torque in the hip joint increased significantly with increasing jump height (65

Key messages Primary healthcare workers have a prevalence of 17.47% for SARS-CoV-2 antibodies Almost half of those surveyed had either tested positive by PCR or had antibodies We did not find a significant association with adherence to protective measures Infected family members significantly increased the odds of seropositivity

Access and emergency medical care for massive or multiple injuries is an comprehensive interdisciplinary challenge. Taking care of the growing causes of emergency care levels as well as cross-sectoral collaboration in the management of multiple incidents, reducing disease, disability, and mortality in the population with multiple disorders. In a disaster or extraordinary situation with mass casualties is a state in which the health care system is overloaded and the ability to provide emergency health care is considerably hindered. The aim of this review is to present the current state of knowledge on what we, the authors, say are the central aspects of trauma management of mass casualty incidents. Emergency planning and methodology are related to accidental states, elementary medical staff disasters, medical equipment, drilling material, concretizing assessment tools, monitoring, mass incident prevention. In terms of implementing a good action plan, effective collaboration between state agencies such as fire departament and law enforcement is necessary in identifying and directing critically ill patients to designated trauma centres. The integration of emergency systems for incident management, through providing resources like, medical equipment, drugs, autoambulances, ongoing education and training. This has the impact of increasing knowledge of medical emergency procedures that would help reduce the risk of consequences of mass incidents. When applied to MCI responses, damage-control principles reduce resource utilization and optimze surge capacity, consequently reducing the rate of mortality.