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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: Surgical site infections (SSIs) pose a global health concern. While various pathogenic microorganisms can cause SSIs, a predominant causative agent is Staphylococcus aureus, particularly its methicillin-resistant strain (MRSA). MRSA, known for its resistance to multiple antibiotics, significantly complicates treatment options, leading to increased morbidity. In some cases, particularly among patients with pre-existing comorbidities, MRSA infections can prove fatal. Moreover, eradicating MRSA from hospital settings presents a formidable challenge. This study aims to report on two young, otherwise healthy patients who developed MRSA infections in their surgical wounds during hospitalization. Case Descriptions: A 22-year-old female patient developed an MRSA infection following an appendectomy and a 12-year-old male patient exhibited similar complications post-orchiopexy. In both cases, MRSA presence was confirmed through microbiological cultures a few days post-surgery. Repeated cultures indicated successful MRSA eradication after isolation and initiation of targeted antibiotic therapy based on antibiograms. Once their general health stabilized, the patients were discharged and continued outpatient antibiotic treatment for a prescribed duration. Conclusion: These cases emphasize that MRSA infections, typically associated with elderly patients or those with underlying health conditions, can also occur in younger, healthier individuals. Eradicating these infections remains a significant challenge for healthcare facilities encountering MRSA. Keywords: Staphylococcus aureus, Methicillin-resistant, young patients, Surgical site infections.

The rule of law operates in accordance with the law, focusing on the equality of citizens before the law and the prohibition of the arbitrary power of the executive (Government). Justice reform is a mechanism that made it possible for citizens to increase their trust in justice. Justice reform was a mechanism that we had not heard before and it is important in this paper to mention the causes and consequences of justice reform by balancing them to understand its positive and negative sides. Judicial reform has mostly affected judges and prosecutors, but also lawyers in court cases as well and the public had an important role to denounce any judge or prosecutor who had given court decisions in violation of the law but also cases of corruption of judges or prosecutors. In this paper it is very important to address two very important principles sanctioned by the European Convention on Human Rights. the second is a trial within a reasonable time by analyzing court decisions and the importance of respecting deadlines by the courts for a speedy and effective justice. A new innovation taken from the countries of the European Union was the new court map that does not brought a few debates in our country and how the new court map will affect the economy of Albanians given that Albania is a developing country.

Human papilloma virus (HPV) is known as the main cause of cervical cancer. Data also indicate its role in head–neck cancer, especially oropharyngeal cancer. The correlation between high-risk HPV and oral cancer is still controversial. HPV-related lesions of the oral cavity are frequent and, in most cases, benign. The primary aim of this study was to establish if there is a different follow-up necessity between HPV-positive compared to HPV-negative oral lesions. The secondary aim was to evaluate the recurrence of HPV-related lesions. All patients who underwent a surgical procedure of oral biopsy between 2018 and 2022, with ulterior histopathological examination and HPV typing, were examined. A total of 230 patients were included: 75 received traumatic fibroma as diagnosis, 131 HPV-related lesions, 9 proliferative verrucous leukoplakia, and 15 leukoplakia. The frequency and period of follow-up varied in relation to HPV positivity and diagnosis. This study confirms what has already been reported by other authors regarding the absence of recommendations of follow-up necessity in patients with oral mucosal lesions. However, the data demonstrate that there was a statistically significant difference in the sample analyzed regarding the follow-up of HPV-positive vs. HPV-negative patients. It also confirms the low recurrence frequency of HPV-related oral lesions.

Women who have experienced conflict‐related sexual violence report significant long‐term effects, including posttraumatic stress disorder (PTSD), depression and relationship difficulties. Research has demonstrated that maternal trauma is associated with children's behavioural difficulties and challenges in family functioning, such as impaired communication and harsh parenting. This pilot study is aimed at evaluating the preliminary effectiveness of family therapy for Kosovar mothers who experienced conflict‐related sexual violence in 1998–1999 and later developed PTSD and their children in improving family functioning and reducing behavioural difficulties in postwar times. Sixty‐four mothers were randomised to an intervention group or a waitlist control group. Data was collected during a screening phase, at baseline before intervention initiation, after the intervention group completed family therapy and once the waitlist control group received the intervention. Generalised linear mixed models were used to analyse group differences in family functioning and children's behaviours over time. At follow‐up, mothers in the intervention group reported improved family functioning. However, mothers in the waitlist control group reported significantly fewer behavioural difficulties than mothers in the intervention group before the control group had started family therapy. There was no significant interaction between group condition and time for child‐rated family functioning. Overall, this pilot study suggests that family therapy could be effective in reducing the effects of intergenerational trauma related to PTSD and conflict‐related sexual violence. Future research should evaluate the long‐term effects of family therapy to assess if immediate effects were maintained. [ABSTRACT FROM AUTHOR]

After a three-year quarantine from the deadliest global pandemic of the last century, ASTES is organizing to gather all health professionals in Tirana, The 6th Albanian Congress of Trauma and Emergency Surgery (ACTES 2022) on 11-12 November 2022, with the topic Trauma & Emergency Surgery and not only...with the aim of providing high quality, the best standards, and the best results, for our patients ... ACTES 2022 is the largest event that ASTES (Albanian Society for Trauma and Emergency Surgery) has organized so far with 230 presentations, and 67 foreign lecturers with enviable geography, making it the largest national and wider scientific event. The scientific program is as strong as ever, thanks to the inclusiveness, where all the participants with a mix of foreign and local lecturers, select the best of the moment in medical science, innovation, and observation. The scientific committee has selected all the presentations so that the participants of each medical discipline will have something to learn, discuss, debate, and agree with updated methods, techniques, and protocols. I hope you will join us on Friday morning, and continue the journey of our two-day event together.

The main objective of this paper is to examine the knowledge and level of awareness of Occupational Safety and Health (OSH) in North Macedonia, to improve the effectiveness of trainings and analyze how the choice of training type affects the quality of knowledge. In order to collect the necessary data, in the last 5 years (2019-2023), more than 90 trainings on safety at work in many companies from three different sectors in North Macedonia (construction, garment industry and public administration), were carried out. As part of these trainings, which are a legal obligation for every company, questionnaires were filled out to test knowledge about OSH. The conducted survey covers a sample of 180 respondents. Despite the fact that 89% of surveyed in construction know that they perform high-risk work, 52% do not think that they must constantly wear personal protective equipment (PPE) during work. As many as 94% don't know for the right to refuse the work if they are not trained. Employees in garment industry (46%) are not aware that the employer must provide them with not only functional, but also ergonomic equipment. Also, 17% of employees in the public sector did not consider about risks of injuries in administrative work. Creating guidelines for early detection of potential causes of injuries instead of remedying the consequences of accidents at work, is the essence of OSH concept. [ABSTRACT FROM AUTHOR]

Human papilloma virus (HPV) is known as the main cause of cervical cancer. Data also indicate its role in head–neck cancer, especially oropharyngeal cancer. The correlation between high-risk HPV and oral cancer is still controversial. HPV-related lesions of the oral cavity are frequent and, in most cases, benign. The primary aim of this study was to establish if there is a different follow-up necessity between HPV-positive compared to HPV-negative oral lesions. The secondary aim was to evaluate the recurrence of HPV-related lesions. All patients who underwent a surgical procedure of oral biopsy between 2018 and 2022, with ulterior histopathological examination and HPV typing, were examined. A total of 230 patients were included: 75 received traumatic fibroma as diagnosis, 131 HPV-related lesions, 9 proliferative verrucous leukoplakia, and 15 leukoplakia. The frequency and period of follow-up varied in relation to HPV positivity and diagnosis. This study confirms what has already been reported by other authors regarding the absence of recommendations of follow-up necessity in patients with oral mucosal lesions. However, the data demonstrate that there was a statistically significant difference in the sample analyzed regarding the follow-up of HPV-positive vs. HPV-negative patients. It also confirms the low recurrence frequency of HPV-related oral lesions. [ABSTRACT FROM AUTHOR]

Introduction: ALPPS (Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy), is a recently developed procedure, first performed by HJ Schlitt in Regensburg, Germany. The technique developed two stages of hepatectomy. The ALPPS procedure has been introduced to increase the volume of future liver remnant, much more than the other technique, such as PVE (portal vein embolization). The first ALPPS in our country was introduced and performed by our team on May 15th, 2018. Results: The 60-year-old patient was previously operated on for rectal cancer in 2017 at another institution. The operation was performed with anterior resection and the patient was in long term adjuvant chemotherapy. One year after surgery, the patient has multiple bilobar liver metastases and increased tumor markers that led to instant admission to our institution for liver resection. In the first stage, we performed four metastasectomies on the left lobe with right portal vein ligation and transection on the Cantlie line. The second stage was performed after a CT evaluation on the eighth day, with significant hypertrophy on the left lobe. Pathological findings reported ten metastases on the right lobe with a diameter 1-3 cm. The patient was on the long-term chemotherapy, and after one year he had other MS in the IVa segment of the liver. We also performed a metastasectomy. The patient died 32 months after ALPPS. Conclusion: ALPPS is a safe and feasible procedure for the treatment of bilobar liver metastasis from colorectal cancer. It could provide long-term survival for patients. [ABSTRACT FROM AUTHOR]

A well-developed management structure is the backbone for the successful operation of any enterprise. The underrepresentation of women in managerial positions has been a persistent concern in the context of gender equality and economic development. This paper investigates the percentage participation of women managers in European countries and its potential connection to GDP per capita. Utilizing a comprehensive dataset comprising various European countries, we conduct a comparative analysis of the proportion of women in managerial roles across different economies with a special reference to North Macedonia. Additionally, GDP per capita data is incorporated to explore potential correlations between women's representation in management and economic prosperity. The analysis covers the following regions: Scandinavia, Nordic region, as well as Eastern, Western and Southern Europe. The analysis refers to two consecutive years, 2020 and 2021. The results indicate that the percentage participation of women managers and GDP per capita are inversely proportional in the Scandinavian region, the Nordic region, as well as Eastern and Western Europe, while the opposite conclusion applies to the countries of Southern Europe. [ABSTRACT FROM AUTHOR]

A large number of international researches indicate that the level of cognitive skills and self-esteem have a great importance in the implementation of quality leadership. Cognitive abilities and self-esteem are the two psychological attributes useful in predicting trends of emerging quality leadership. The aim of the research was to examine the correlation between cognitive skills and self-esteem. The general hypothesis of this paper is that cognitive skills and self-esteem are very important correlates which determines the quality of leadership. The sample consists of 370 Albanian students from Kosovo/Macedonia (Mage = 19.57, SD = 2.91). In order to collect the data applied were questionnaires: Cognitive Reflection Test (CRT), Rosenberg Self-esteem Scale (RSES) and Youth Leadership Test (YLT). Results showed that 79.7 % evaluated themselves as well-rounded leader; 30.1 % scored as low in self-esteem and 70.3 % scored on low group of cognitive abilities. Group with higher cognitive abilities showed no-significant higher YLT scores, but significantly higher scores on self-esteem (X2 =6.215, p=.045). YLT scores were significantly predicted only by self-esteem (β=.257, p

Background: Retroperitoneal sarcomas are neoplasm that are only 0,3-3% of all solid tumors. Liposarcomas is most freguent soft tissue sarcomas in adults. Symptoms would only be detected if the liposarcoma presses on the surrounding organs. Case presentation: A 58-year-old woman presented with complaint of progressive abdominal distension, loss of appetite, malaise, constipation and weight loss of about 7 kg. Abdominal CT scanning showed the presence of a retroperitoneal tumor that occupies almost the entire right part of abdominal cavity. 16 months earlier, the patient was operated in another surgical facility due to liposarcom, derived from retroperitoneum (Histopathological finding: Poorly differentiated (G3) liposarcoma pleomorphic cell type). The patient was operated under the diagnosis of retroperitoneal liposarcoma. Conclusions: Treatment of choice is radical surgical procedure including elimination of all the structures and organs involved by the tumour process - RO resection as a basic principle of surgical treatment.

In general the problematic of diagnosing basic and specific motor movement information of the basketball game in found in the works of a considerable number of world authors. In this work a youth population of an age group between 13-14 years old will be treated. The total number of participants is defined to an amount of 100 of young basketball players, members of two different basketball academies. In this experiment, the subjects will conduct tests in 5 basic motor skills variables such as: 1. Steady Jump in length, 2 steady jump in height 3.20 meters run from a steady start, 4. Medicine Ball Throw and 5. Agility Test. While from specific motor movement skills are included: 1.20 Meters run with ball, 2. Basketball shooting for 30 seconds round-trip,3. Anaerobic durability with and without ball (kamikaze) 4. Intensive Basketball shots-Change of direction and 5. Basketball shots from five positions. Subject to the number of subjects that will be treated in this study, their age and the amount of variables tested, the main objectives of this study, will be limited to achieving the goals. On the basis of test results, it can be concluded that there are no significant differences in the basic motor parameters between the two groups G1 and G2, mostly due to systematic practice effects rather than academy belonging itself.In the other hand, differences between the two groups in the specific basketball motor skills can be clearly identified, in typical basketball movement situations.In addition, comparing the test results of the individuals tested for the purpose if this diagnosis, a much more advanced level of motor skills compared to the normal population of the same group age that don’t engage in basketball activities can be identified. This experimental study carried out in the youth in the age group of 13(-+ 6 months) years old that continuously in a systematic manner attend basketball academies in two different basketball schools, with sustainable arguments can show the importance of systematic valuation in order to solve many arising problems such as: planning, programming, developing and controlling the effects of training work. Specifically, it is of utmost importance to continously monitor the development of motor skills in the youth.

The approach and the objective of this experiment are consistent with the determination of changes of blood parameters after the stay of the students at an altitude of 1800-2300 meters, for a ten-day long ski course. In this paper are included a total of 64 students of the Faculty of Sport Sciences in Prishtina, of the age group of 19-25 (the average age is 21). All students previously have undergone a medical check for TA, arterial pulse and respiratory rate. In particular, the health situation is of subjects was examined, then, all students, at the same time, gave blood for analysis. In this experiment, three main hematologic parameters were taken in consideration: such as hemoglobin, hematocrit and red blood cells. The same analyses were carried out after the 10-day stay at a high altitude. The results of the experiment have shown significant changes after the ten-day stay at high altitude, despite the previous results that show changes only after the twenty-day stay in such elevations.

The Balanced Scorecard (BSC) has over the last two and a half decades received much attention as a management model for both private and public sector organizations. However, the BSC concept’s use and application in local governments and municipalities remains relatively understudied. This is particularly the case for the Norwegian context. Therefore, the aim of this article is to conduct a descriptive analysis of the diffusion and implementation of the BSC in the Norwegian municipality sector. The article draws on two sources of data: (1) an electronic survey sent to all 428 municipalities in Norway, yielding a response rate of 26%, and (2) follow-up interviews with representatives from 15 municipalities. In the empirical analysis, the article first provides an overall overview of patterns related to the diffusion and implementation of the BSC in the Norwegian municipality sector. With respect to BSC diffusion and implementation, the data show that the BSC is still widely used among Norwegian municipalities and has not yet entered a clear downturn phase. With respect to adoption and implementation, a more fine-grained analysis of five categories of respondents (non-adopters, planners, implementers, current users, ex-users) is also carried out, focusing on the motives, perceptions and applications of the concept. The analysis reveals considerable variation when it comes to perceptions and experiences associated with BSC adoption and implementation.