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1.  A retrospective study of 572 patients with hand burns treated at the Department of Plastic Surgery Kosovo during the period 2000-2010 
Hands participate in everyday human activities and they are the most vulnerable parts of a human body. The objective of this study is to understand the common causes of hand burns, the methods of surgical interventions, duration of hospitalization and distribution of hand burns in 11 year period regarding the age. This is a retrospective study that included 572 patients with hand burns treated at the Department of Plastic Surgery Kosovo during the period 2000-2010. The data were collected and analyzed from the archives and protocols of the University Clinical Center of Kosovo. Data processing was done with the statistical package InStat 3. From statistical parameters were calculated structural index, arithmetic median and standard deviation. Data testing is done with X 2 test and the difference is significant if P<0.05. The Ministry of Health of our country should make efforts to organize training for health workers about treatment for minor burns in order to reduce the number of referral patients from other primary (Familiar Medicine) and secondary centers (regional Hospitals).
PMCID: PMC3945823  PMID: 24624309
Hand burns; human activities; thermal injuries
2.  Synthesis and Antioxidant Activities of Novel 5-Chlorocurcumin, Complemented by Semiempirical Calculations 
The novel curcumin derivative (1E,4Z,6E)-5-chloro-1,7-bis(4-hydroxy-3-methoxyphenyl)hepta-1,4,6-trien-3-one (5-chlorocurcumin) was prepared from natural curcumin. The newly synthesised compound was characterised by spectral studies (IR, 1H NMR, and 13C NMR). The free radical scavenging activity of 5-chlorocurcumin has been determined by measuring interaction with the stable free radical DPPH, and 5-chlorocurcumin has shown encouraging antioxidant activities. Theory calculations of the synthesised 5-chlorocurcumin were performed using molecular structures with optimised geometries. Molecular orbital calculations provided a detailed description of the orbitals, including spatial characteristics, nodal patterns, and the contributions of individual atoms.
PMCID: PMC3793294  PMID: 24170994
4.  First-trimester bleeding characteristics associate with increased risk of preterm birth: data from a prospective pregnancy cohort 
Prior evidence linking first-trimester bleeding with preterm birth (PTB, <37 weeks gestation) risk has been inconsistent and may be biased by subject selection and/or incomplete documentation of bleeding episodes for all participants. Prior studies have not carefully examined the role of bleeding characteristics in PTB risk. In the present study, we estimate the association between first-trimester bleeding and PTB in a non-clinical prospective cohort and test whether bleeding characteristics better predict risk.
Women were enrolled in Right from the Start (2000–2009), a prospective pregnancy cohort. Data about bleeding and bleeding characteristics were examined with logistic regression to assess association with PTB.
Among 3978 pregnancies 344 were PTB and 3634 term. Bleeding was reported by 986 (26%) participants. After screening candidate confounders, only multiple gestations remained in the model. Bleeding associated with PTB [odds ratio (OR)adjusted = 1.40, 95% confidence interval (CI) 1.09–1.80]. Risk did not vary by race/ethnicity. Compared with non-bleeders, PTB risk was higher for bleeding with red color (ORadjusted = 1.92, 95% CI, 1.32–2.82), for heavy episodes (ORadjusted = 2.40, 95% CI 1.18–4.88) and long duration (ORadjusted = 1.67, 95% CI 1.17–2.38).
Bleeding associated with PTB was not confounded by common risk factors for bleeding or PTB. PTB risk was greatest for women with heavy bleeding episodes with long duration and red color and would suggest that combining women with different bleeding characteristics may affect the accuracy of risk assessment. These data suggest a candidate etiologic pathway for PTB and warrant further investigation of the biologic mechanisms.
PMCID: PMC3241603  PMID: 22052384
epidemiology; first-trimester; pregnancy; preterm birth; vaginal bleeding
5.  Genetic regulation of the ramA locus and its expression in clinical isolates of Klebsiella pneumoniae 
Tigecycline resistance has been attributed to ramA overexpression and subsequent acrA upregulation. The ramA locus, originally identified in Klebsiella pneumoniae, has homologues in Enterobacter and Salmonella spp. In this study, we identify in silico that the ramR binding site is also present in Citrobacter spp. and that Enterobacter, Citrobacter and Klebsiella spp. share key regulatory elements in the control of the romA–ramA locus. RACE (rapid amplification of cDNA ends) mapping indicated that there are two promoters from which romA–ramA expression can be regulated in K. pneumoniae. Correspondingly, electrophoretic binding studies clearly showed that purified RamA and RamR proteins bind to both of these promoters. Hence, there appear to be two RamR binding sites within the Klebsiella romA–ramA locus. Like MarA, RamA binds the promoter region, implying that it might be subject to autoregulation. We have identified changes within ramR in geographically distinct clinical isolates of K. pneumoniae. Intriguingly, levels of romA and ramA expression were not uniformly affected by changes within the ramR gene, thereby supporting the dual promoter finding. Furthermore, a subset of strains sustained no changes within the ramR gene but which still overexpressed the romA–ramA genes, strongly suggesting that a secondary regulator may control ramA expression.
PMCID: PMC3117140  PMID: 21514798
Klebsiella pneumoniae; romA; ramA; ramR; acrA; Tigecycline
6.  Cementless bipolar hemiarthroplasty in femoral neck fractures in elderly 
Indian Journal of Orthopaedics  2011;45(3):236-242.
Cemented hip arthroplasty is an established treatment for femoral neck fracture in the mobile elderly. Cement pressurization raises intramedullary pressure and may lead to fat embolization, resulting in fatal bone cement implantation syndrome, particularly in patients with multiple comorbidities. The cementless stem technique may reduce this mortality risk but it is technically demanding and needs precise planning and execution. We report the perioperative mortality and morbidity of cementless bipolar hemiarthroplasty in a series of mobile elderly patients (age >70 years) with femoral neck fractures.
Materials and Methods:
Twenty-nine elderly patients with mean age of 83 years (range:71-102 years) with femoral neck fractures (23 neck of femur and 6 intertrochanteric) were operated over a 2-year period (Nov 2005–Oct 2007). All were treated with cementless bipolar hemiarthroplasty. Clinical and radiological follow-up was done at 3 months, 6 months, 12 months, and then yearly.
The average follow-up was 36 months (range 26-49 months). The average duration of surgery and blood loss was 28 min from skin to skin (range, 20–50 min) and 260 ml (range, 95–535 ml), respectively. Average blood transfusion was 1.4 units (range, 0 to 4 units) Mean duration of hospital stay was 11.9 days (7–26 days). We had no perioperative mortality or serious morbidity.
We lost two patients to follow-up after 12 months, while three others died due to medical conditions (10–16 months post surgery). Twenty-four patients were followed to final follow-up (average 36 months; range: 26–49 months). All were ambulatory and had painless hips; the mean Harris hip score was 85 (range: 69–96).
Cementless bipolar hemiarthroplasty for femoral neck fractures in the very elderly permits early return to premorbid life and is not associated with any untoward cardiac event in the perioperative period. It can be considered a treatment option in this select group.
PMCID: PMC3087225  PMID: 21559103
Cementless bipolar; femoral neck fractures; comorbidities; elderly
7.  Water pipe (shisha) smoking among male students of medical colleges in the eastern region of Saudi Arabia 
Annals of Saudi Medicine  2010;30(3):222-226.
Shisha smoking, one of the commonest methods of smoking tobacco among Arabs, increases the risk of cardiovascular and respiratory diseases. The objective of this study was to determine the prevalence of shisha smoking among male students of three colleges and to identify factors associated with shisha smoking.
This cross-sectional study included 500 male students of three colleges (medicine, applied medical sciences and dentistry). Data were collected from 371 students using a self-administered questionnaire.
The overall prevalence of shisha smoking was 12.6% (8.6% shisha only and 4.0% both shisha and cigarettes). Thirty students (63.8%) started shisha smoking at ages of 16 to 18 years. Seven students (15%) smoked shisha daily. Cafés or restaurants were the favorite places for smoking (70.2% of students). There was a high prevalence of shisha smoking among students whose mothers had a secondary (19.1%) and higher (53.3%) education.
There was a high prevalence of shisha smoking among university students. The majority of students started shisha smoking at a young age. Public health measures, including the banning of smoking in public places are recommended.
PMCID: PMC2886873  PMID: 20427939
8.  Validation of four different risk stratification systems in patients undergoing off-pump coronary artery bypass surgery: a UK multicentre analysis of 2223 patients 
Heart  2003;89(4):432-435.
Background: Various risk stratification systems have been developed in coronary artery bypass graft surgery (CABG), based mainly on patients undergoing procedures with cardiopulmonary bypass.
Objective: To assess the validity and applicability of the Parsonnet score, the EuroSCORE, the American College of Cardiology/American Heart Association (ACC/AHA) system, and the UK CABG Bayes model in patients undergoing off-pump coronary artery bypass surgery (OPCAB) in the UK.
Methods: Data on 2223 patients who underwent OPCAB in eight cardiac surgical centres were collected. Predicted mortality risk scores were calculated using the four systems and compared with observed mortality. Calibration was assessed by the Hosmer–Lemeshow (HL) test. Discrimination was assessed using the receiver operating characteristic (ROC) curve area.
Results: 30 of 2223 patients (1.3%) died in hospital. For the Parsonnet score the HL test was significant (p < 0.001) and the receiver operating characteristic curve (ROC) area was 0.74. For the EuroSCORE the HL test was also significant (p = 0.008) and the ROC area was 0.75. For the ACC/AHA system the HL test was non-significant (p = 0.7) and the ROC area was 0.75. For the UK CABG Bayes model the HL test was also non-significant (p = 0.3) and the ROC area was 0.81.
Conclusions: The UK CABG Bayes model is reasonably well calibrated and provides good discrimination when applied to OPCAB patients in the UK. Among the other three systems, the ACC/AHA system is well calibrated but its discrimination power was less than for the UK CABG Bayes model. These data suggest that the UK CABG Bayes model could be an appropriate risk stratification system to use for patients undergoing OPCAB in the UK.
PMCID: PMC1769277  PMID: 12639875
risk stratification; coronary artery bypass graft surgery
9.  A regional survey of chest drains: evidence-based practice? 
Postgraduate Medical Journal  1999;75(886):471-474.
Although the use of chest drains is common in medicine, there appear to be wide variations in practice. A survey was therefore conducted to establish the current status of chest drain management in the Northwest region. A questionnaire targeted consultants practising in the specialties of chest medicine, general surgery, accident & emergency and cardiothoracic surgery. The questionnaire consisted of five sections encompassing aspects of the insertion, day-to-day care and removal of chest drains. With an overall response rate of 75.3% (110/146), important variations in every major aspect of the practice of chest drains were found between the specialties and to a large extent within each specialty. We have made a number of recommendations which aim to encourage good practice and reduce unnecessary complications, including the adoption of standardised protocols for inserting and managing chest drains.

Keywords: chest drains; clinical audit
PMCID: PMC1741334  PMID: 10646026
11.  Antigen-coated latex particles as a model system for probing monocyte responses in leprosy. 
Infection and Immunity  1993;61(9):3724-3729.
To study responses to Mycobacterium leprae antigens, we developed an in vitro model system in which latex particles coated with M. leprae sonic extract (MLSON) antigen were presented to monocytes. Uptake and oxidative response as measured by superoxide production to these antigens were investigated. Phagocytosis of MLSON-coated particles was greater than that of control particles in monocytes from both leprosy patients and controls from leprosy-endemic areas; uptake of MLSON-coated particles was higher in monocytes from lepromatous leprosy patients than in cells from tuberculoid leprosy patients and controls. In both patients and controls, uptake of latex particles coated with leprosy antigens triggered very little reduction of nitroblue tetrazolium although the cells were capable of mounting a respiratory burst. Antigen-coated latex particles can therefore be used as a tool to investigate monocyte responses to M. leprae and individual recombinant antigens.
PMCID: PMC281070  PMID: 8395470
12.  T-cell recognition of the 18-kilodalton antigen of Mycobacterium leprae. 
Infection and Immunity  1989;57(7):1979-1983.
The 18-kilodalton (kDa) antigen of Mycobacterium leprae was expressed as a fusion protein with a 2-kDa leader peptide and used in proliferation assays with peripheral blood cells. Fifty percent of untreated tuberculoid leprosy patients and 93% of long-term leprosy contacts responded to the recombinant protein in lymphocyte transformation tests. Comparison of the stimulation indices in the two groups showed that the contacts responded more strongly than the tuberculoid leprosy patients. Seventy percent of Mycobacterium bovis BCG-vaccinated European donors responded, although with low stimulation indices. The isolation of 18-kDa antigen-responsive T-cell lines from a BCG-vaccinated British donor confirmed that the 18-kDa antigen contains at least one cross-reactive epitope. These results indicate that the 18-kDa protein is an important antigen in the immune response to leprosy.
PMCID: PMC313830  PMID: 2659530

Results 1-12 (12)