AIM: To study the correlation between waist/hip ratio as measure of obesity and severity of coronary artery disease (CAD) assessed by coronary angiography in Kosovo.METHODS: The study includes 82 patients with suspected or known CAD referred for coronary angiography. All patients were subjected to full history taking, clinical examination including measurement of arterial blood pressure, body weight, height, BMI, waist circumference, hip circumferences, waist/hip ratio and waist/height ratio. Coronary angiography was performed by standard techniques to determine the presence and severity of coronary artery lesion by Gensini score.RESULTS: Among the 82 patients included in the study, in CAD – group (mean age was 66.76 ± 9.12 years) and non-CAD group (mean age was 64.80 ± 8.30 years), patients in CAD group had BMI (mean 28.17 ± 3.32 kg/m2) and in non-CAD group had BMI (mean 28.76 ± 4.68 kg/m2 ). Patients in CAD group had waist/height ratio (mean 1.76 ± 7.56) and in non-CAD group had waist/height ratio (mean 0.57 ± 0.08). Patient in CAD group had waist/hip ratio (mean 0.93 ± 0.06) and in non-CAD group (mean 0.88 ± 0.07). Thirty seven patients (45.1%) had no coronary artery disease (Gensini score = 0), 15 patients (18.3%) had mild disease (Gensini score = 1-32), 14 patients (17.1%) had moderate disease (Gensini score = 32-58), 16 patients (19.5%) had severe disease (Gensini score ≥ 58).CONCLUSION: There is a significant positive correlation between waist/hip ratio and presence and severity of coronary artery disease among Kosovar patients.

Background—Non-communicable diseases (NCDs) affect a growing share of the population in Kosovo. The country faces challenges with NCDs management, specifically detecting, screening, and treating people with NCDs. Objective—To assess the management of NCDs, including the inputs that influence the provision of NCDs and outcomes of NCD management. Eligibility criteria—Studies had to report NCD management in Kosovo. Sources of evidence—We systematically searched Google Scholar, PubMed, Scopus, and Web of Science. Charting methods—The data were charted by two researchers. We extracted data on general study details and design and information on the management and outcomes of NCDs in Kosovo. Synthesis of results—For the mix of studies that were included in the review, thematic narrative synthesis was used. We developed a conceptual framework based on health production core components to analyze the data. Results—Kosovo’s health care system is available to provide basic care for patients with NCDs. However, there are serious limitations in the availability of key inputs providing care, i.e., funding, medicines, supplies, and medical staff. Additionally, in terms of the management of NCDs, there are areas for improvement, such as limited application of clinical pathways and guidelines and issues with referrals of patients among levels and sectors of care. Finally, it is worth noting that there is overall limited information on NCD management and outcomes. Conclusions—Kosovo provides only basic services and treatment of NCDs. The data reporting the existing situation on NCD management are limited. The inputs from this review are helpful for existing policy efforts by the government aimed to enhance NCD care in Kosovo. Funding—This study is part of the research done for a World Bank review of the state of NCDs in Kosovo and was funded through the Access Accelerated Trust Fund (P170638).

Aim: this study aims to evaluate the pain scale during Arteriovenous fistula (AVF) puncture in patients undergoing regular haemodialysis sessions with and without Lidocaine gel 2%. Methods: The study is Cross-Sectional, conducted at the University Clinical Centre of Kosovo - Clinic of Nephrology and Haemodialysis in Pristina, Regional Haemodialysis Centre in Prizren, Regional Haemodialysis Centre in Gjilan and Regional Haemodialysis Centre in Mitrovica, all in Kosovo. In this research, 616 patients were surveyed during AVF puncture and the other group of 232 patients in whom 2% Lidocaine gel was applied before puncture at the fistula puncture site. Results: In the above mentioned centres, the total number of patients who are on dialysis through AVF is 632, of which 324 men and 308 women. 560 patients had created AVF on the left arm and 72 patients on the right arm. In our research, 616 patients were surveyed, of which 312 men and 304 women. The most affected age group was between 60 and 69. The pain scale reported during AVF punctuation was moderate in 304 (49%) patients, severe in 176 patients (29%) and mild in 136 (22%) patients. After the applying of Lidocaine gel 2%, the puncture of AVF was performed, so from the total number of 232 participants, 64 (28%) of them reported moderate pain and 168 (72%) of research participants reported mild pain during puncture of AVF. In order to compare results from both groups, we have chosen a random sample from the first group during AVF punctuation without Lidocaine gel 2% (234 in total from 616 patients) and compared the result with the second group during AVF puncture with Lidocaine gel 2% (232 in total). Conclusions: The average pain scale during AVF puncture without Lidocaine gel 2% was 5.04 while the average pain scale after applied Lidocaine gel 2% was 2.61.

Background: Despite being a frequent presenting complaint in emergency rooms, chest pain’s clinical therapy varies greatly. Our objectives were to identify the traits of people who complain of chest pain and to analyze the value of the HEART (history, electrocardiogram, age, risk factors, and initial troponin) score index for risk assessment. Depending on how bad it is, each abnormality can be given a score of zero, one, or two points. These five factors add up to the HEART score. Methods: Clinical information on 269 individuals with chest pain admitted to the Emergency Room was reviewed: January 2022 until January 2023. A prospective registry was used to record information about patients with nontraumatic chest discomfort who were admitted from the emergency department. Results: Over a 12-month period, patients admitted in emergency department were classified through HEART score. From them 101 patients (37%) belong to the age group older than or equal to 65 years, 134 patients (50%) belong to the age group 45–65 years, and 34 patients (13%) belong to the age group younger than or equal to 45 years. Strong positive correlation between troponin level (HEART score) and hospitalization, also p value 0.043 is typically considered to be statistically significant. According to HEART score classification 43 cases (60%) from the group with 7–10 (high risk) were hospitalized. According to anamnesis (history) on cardiovascular disease in relation to hospitalization, then 48 cases hospitalized (67%) belong to the classification 1-moderately suspicious and 21 cases hospitalized (29%) belong to the classification 2-highly suspicious classification. Conclusion: The HEART score can be used for triage since it is a simple, rapid, and accurate predictor of outcome in patients with chest pain. A medium risk group included about half of the patients who reported chest pain to an emergency room. Hospitalization and troponin level had a strong positive link (HEART score), with a p value of 0.043.

Objective: To assess knowledge, awareness and attitude among hospital physicians from Kosovo toward current situation of Health Care System (HCS) especially Secondary Health Care (SHC) in Kosovo. Methods: In this cross-sectional study, anonymous questionnaire were delivered to three regional hospitals in Kosovo. The main outcome measures were physician’s awareness of the management of secondary health care institutions, awareness and use of new technology for improving health care in second level and their suggestions for further improvement. Results: Results are divided into three main categories: I. Relevant information on the knowledge of the health care system, were respondents had valuable information and insight; II. Relevant information on suggested improvements, in which respondents gave their proposals regarding workplace and inter managerial relations and III. Relevant information on continues education possibilities for medical staff. Conclusions: In conclusion there is a need to prioritize proper cooperation between primary, secondary, and third level of health institutions, in terms of entire health management in order to increase the quality of health services delivery, in line with western standards. Bangladesh Journal of Medical Science Vol.18(2) 2019 p.288-293

The process of patient referral system at the level of health care is a comprehensive institutional framework with responsible, well-defined competencies, as a network of cooperation with the general goal of maintaining health, treatment, stabilization, transport and medical care up to in the complete recovery of the sick. The process of patient referral system in most countries in Europe and in the world is a challenge for most developing and developed countries. The mechanisms of the referral system function at different national, regional and municipal levels based on national laws and policies and work on the basis of efficient lines of communication by creating clear and simple steps and procedures described. The referral system in Kosovo is disorganized, chaotic, the Ministry of Health must have a national document of the referral system for patients at the health level, and before that all health care professionals are educated, trained on the way of the referral system, which cases must be sent from the primary, secondary and tertiary level. At the national level, the National Coordinating Council with a national plan of the patient referral system can convey the quality; help the health care professionals based on the current health legislation, the harmonization of unique standardized protocols with follow-up guidelines. Patients at the country level.