Objective Long-standing diabetes mellitus is often associated with cardiovascular complications. We aimed to evaluate the presence, extent and composition of subclinical atherosclerotic plaques in coronary arteries by Computed Tomography in patients with newly diagnosed type 2 diabetes mellitus (NDT2DM), and to identify the predictors. Methods In this study 101 consecutive patients with NDT2DM were included. Patients were categorized into five groups based on their Coronary Artery Calcium Score (CACS) ranging from 0, 0-10, 11-100, 101-400 to >400. All parameters were compared across these groups. Results The average patient age was 54.4 ± 11.6 years and 48 (47.5%) were females. Eight (7.9%) patients had CACS 0, 6.9% CACS 1-10, 42.6% CACS 11-100, 22.8% CACS 101-400 and 19.8% had CACS >400. Multiple regression analysis for the general data identified weight (p = .04) and systolic blood pressure (p = .033) as independent predictors for CACS. Conclusions Asymptomatic patients with NDT2DM in more than 90% of cases may present with calcified atherosclerotic plaques and this may be predicted by: patient weight and the level of systolic arterial pressure. Our study emphasizes the need for comprehensive care and early prevention of cardiovascular complications in individuals with NDT2DM.

Extracranial internal carotid artery aneurysms (EICAAs) can lead to serious medical conditions, such as stroke or compression over cranial nerves. In very few cases, there may be hemorrhagic complications due to the rupture. Although rare, they should be suspected cause in every patient with transitory ischemic attack or stroke, especially in the presence of pain, palpable mass or bruit in the neck.

Takayasu arteritis (TA) is a challenging chronic inflammatory vasculitis of large vessels with unknown etiology. It usually affects the aorta and its main branches and in few cases it affects other arteries like pulmonary and coronary. We report a case of a young woman with transient ischemic attack (TIA) as the initial presentation followed later by ischemic limb syndrome and then ischemic stroke. Lack of specific diagnostic biomarkers for this disease makes early diagnosis and treatment challenging.

The aim of this study is to describe the management and outcome of surgical treatment for post burn contractures in different parts of the upper extremities in children, and provide a final decision algorithm that can be a useful guide for the Resident regarding surgical approach to contracture management. This was a retrospective study conducted in the Clinic of Plastic and Reconstructive Surgery, Pristina-Kosovo, between 2014-2016. All cases continued check ups in the Gentiana-Grelor private clinic in Pristina until 2019. Followups were conducted for no less than 6 months with respect to the viability and healing of the repaired area. Patients of both genders, aged from 0 months to 18 years with post-burn contracture in upper extremity, were included in the study. For the sake of presentation, we divided them anatomically into four main areas: axilla, elbow, wrist and hand. We start with a reconstructive ladder using skin grafts (STSG, FTSG), and local flaps such as advancement flaps, Z-plasties, V-Y or Y-V advancement flap, abdonimal/groin pedicled flap, cross finger flap, radial forearm flap were used. Patients were called for follow-up lasting a minimum of one to up to three years. The study included 144 patients. Their age ranged from 9 months to 18 years, the mean age being 12 years. Ordering them by location, post-burn contracture percentage in upper extremity in children was 68% on the hands, 18% on the elbows, 8% on the axilla and 6% on the wrist. A classification and treatment algorithm aids in achieving significant improvements in both joint motions and aesthetic deformities.

Bezold's abscess is a very rare extracranial complication of acute mastoiditis. Lateral sinus thrombosis is another intracranial complication of acute mastoiditis that can occur, but there are only few reports of concomitant ispilateral Bezold's abscess and lateral sinus thrombosis with favorable outcome. We diagnosed and treated successfully a 14-year-old girl suffering from Streptococcus pneumoniae acute mastoiditis complicated with Bezold's abscess and lateral sinus thrombosis. Surgical treatment included myringotomy, cortical mastoidectomy, and Bezold's abscess incision and drainage. During the course of treatment, we concluded that lateral sinus thrombosis was not caused from mastoiditis by direct spread but from pressure on internal jugular vein caused from Bezold's abscess.

Neuromyelitis optica (NMO), also known as Devic disease is heterogeneous condition consisting of simultaneous inflammation and demyelination distinguished by the combination of Optic Neuritis and myelitis. We report a case of a 54-year-old women, with vision loss and pain on the right eye worsened with eye movement, headache, vertigo, mono paresis of right hand, sphincter dysfunction. Patient met the criteria for diagnosis of NMO by having transverse myelitis, optic neuritis, confirmed by MRI imaging and high level of aquaporin-4-antibodies (AQP4-Ab). Symptoms improved after treatment with low doses of corticosteroids.

Cerebral venous sinus thrombosis is an uncommon cause of stroke presenting with varied presentation patterns. We report a case of a 21-year-old woman with superior sagittal sinus (SSS) thrombosis (SSST) developing after childbirth, presenting with visual hallucinations, severe headache, and tonic-clonic seizures. Time-of-flight magnetic resonance angiography (TOFMRA) demonstrated the presence of thrombus in SSS. She was treated with low molecular weight heparin (LMWH) followed by warfarin. She had excellent recovery a few weeks after admission and was regularly followed up. Although this condition can be presented with different neurological symptoms, it does not typically present with hallucinations. We suggest that CSVT should be suspected even when a patient presents with an atypical picture in a category of patients at higher risk. (Int J Biomed. 2016; 6(4):294-297.)

Brain tumors are a common cause of epilepsy. Tumor type and location are determining factors that significantly influence seizure frequency. The aim of this study was to analyze clinical data of patients diagnosed with brain tumors and epilepsy. Data for this study were obtained from patient medical records over a 6-year period (2000-2005). Patient history and findings obtained by diagnostic methods such as electroencephalography, computerized tomography and magnetic resonance were analyzed. Data were analyzed by appropriate statistical methods and the structure, prevalence, mean and standard deviation were calculated. The significance of results was tested by use of t-test and chi2-test. A total of 15 933 patient charts were analyzed. Out of 15 933 patients, 10.8% were diagnosed with epilepsy and 175 (1.09%) patients had brain tumor, 75 (42.86%) of which were significantly associated with epilepsy (P > 0.05). Almost forty-three percent (42.86%) of tumors were epileptogenic, with no significant sex difference (confidence level of 95%). Fifty-seven (32.5%) brain tumor patients were aged 51-60. The mean age of all patients with brain tumors was 41.6 years. Focal sensorimotor seizures were dominant in 40 (53.3%) cases. Among epilepsy cases with known etiology, 75 (6.8%) patients had epileptogenic tumors. Types of seizures in patients with epilepsy were different from seizures provoked by brain tumors. The most common tumor site was temporal region (43.4%). There was no significant difference according to epileptogenesis. Focal sensorimotor seizures were common in patients with frontal and parietal region tumors.

The results of the research conducted in the Emergency Center during the period 2005 - 2008 are showing an enormous increase in the number of road traffic accidents. In this increase, except reasons mentioned above and among others, the following factors have contributed: enormous increase of number of persons equipped with driving license (5,6), driving speeds above permitted norms are considered a primary cause of road traffic accidents. An important factor that has influenced the cause of accidents was the consumption of alcohol before or during driving the vehicle, non-wearing of seat belts and protective helmets. The worldwide data show that the role of the safety belts enables a reduction of health consequences (1-3). We don't have any precise data from the Kosovo police service in regard to the existing correlation between wearing the safety belt and the degree of damage to the injured, as these data are not taken by the traffic police when an accident happens. The negligence of pedestrians continues to remain a matter of concern and the pedestrians are considered as a vulnerable group (7.8).

vol 17 no 4 DECEMBER 2009 221AIM 2009; 17(4): 221-225SUMMaRY. Introduction: The aim of this study was to, based on the data collected, determine the right time for the application of bone scintigraphy in patients with breast cancer. Discovery of bone metastasis in their initial stages of development, before the occurrences of clinical signs, can completely alter treatment and improve prognosis of patients with breast cancer. Materials and methods: A retrospec-tive study was conducted on three hundred consecutive patients with breast cancer in the period of 2005-2008. Patients without prelimi-nary biochemistry analyses, radiological data and bone scintigraphy, were not included in the study, however, exceptions were made for Computer Aided Tomography and Magnetic Resonance Imaging examinations, because some patients didn’t make them. Bone scin-tigraphy was always performed after clinical examination of all patients, three hours after intravenous administration of 555-740 MBq activity of 99mTc MDP. Results: Two hundred ninety nine (99.67%) were female with breast cancer and only one case (0.33%) was male with breast cancer. Investigation group (IG) included 126 patients (42.0%) with breast can-cer, before surgical treatment (positive clinical signs and laboratory findings for cancer) and in our control group (CG) were included 174 patients (58%) with breast cancer after surgical treatment. Unilateral mastectomy with removal of lymph nodes in the axillae was done in 97 patients (55.74%) whereas in 77 patients (44.26%) only mastectomy. Suspected lesions for bone metastases were found in 30 patients (23.8%) included in the investigation group and 65 patients (37.36%) included in the control group. Suspected bone lesions were found mainly in axial skeletal (vertebrae 57%, ribs 24%, pelvis 12%) and long other extremities (7%). Probability of bone metastases in patients ranged with stage three (III) and four (IV) of disease, was significantly higher (46.6% and 69.6%), in comparison with stage I and II (3.84% and 6.5% respectively), however bone metastases were found also in patients ranged with stage I and II. We noticed 8.7 higher probabilities of bone metastases for patients with lobular invasive breast carcinoma than for patients with invasive ductal breast carcinoma. The sensitivity of bone scintigraphy was 98%, its specificity 95%, resulting in a diag-nostic efficiency of 98%. The positive predictive value was calculated to be 98% as compared to the negative predictive value of 95%. The concentrations of CA 15.3 were significantly higher in patients with bone metastasis than in those without bone metastasis (p<0.01). Conclusion: Our preliminary study results suggest that the application of bone scintigra-phy in primary breast cancer, before surgical intervention is very useful to evaluate initial stage and to perform the follow up examination.