ObjectiveFentanyl-induced cough is usually mild and transitory, but it can be undesirable in patients with increased intracranial pressure, open wounds of the eye, dissecting aortic aneurism, pneumothorax, and reactive airway disease. The aim of this study is to evaluate the efficacy of lidocaine in suppressing fentanyl-induced cough in children during induction in general anesthesia.MethodsOne hundred and eighty-six children of both sexes, aged between 4–10 years, ASA physical status I and II, and scheduled for elective surgery, were recruited for the study. Patients with a history of bronchial asthma, obstructive pulmonary disease, or infections of the respiratory tract were excluded. Patients were randomly allocated to three equal groups (n = 62) to receive 1.0 mg/kg lidocaine (Group I), 0.5 mg/kg lidocaine (Group II), or placebo (equal volume of 0.9% saline; Group III). Each was administered over 5 s one minute before intravenous (IV) administration of fentanyl 2−3 μg/kg during induction in general anesthesia. The severity of coughing was graded by counting the number of episodes of cough: mild (1−2), moderate (3−4) or severe (5 or more).ResultsDemographic information was comparable between groups. The most frequent coughing was observed in the placebo group (Group III; 43.5%), of whom 4.8% (three patients) were graded with severe cough. In Group II, 22.6% patients had cough, of which 1.6% (one patient) was graded as severe. In Group I, 16.1% patients had cough, none of whom were graded as severe.ConclusionOur results demonstrate that IV lidocaine can markedly suppress fentanyl-induced cough in children, even in doses as low as 0.5 mg/kg.

Our experience is based on 147 patients with thoracic echinococcosis (TE) who underwent surgery. Of these, 131 (89.1%) patients had pulmonary TE, 3 (2.1%) had extra-pulmonary TE, and 13 (8.8%) had pulmohepatic TE Ninety-nine (67.3%) patients had uncomplicated TE, and 48 (32.7%) had complicated TE. All patients underwent surgery. In 129 (87.8%) patients, we performed cystectomy with capitonage and in 18 (12.2%) cases we performed a lung resection (lobectomy or segmentectomy). Postoperative complications occurred in 2 (1.4%) patients, and recurrence in 2 (1.4%) patients who previously had complicated TE. On admission, there was no evidence of allergic reactions in patients with complicated TE. The average time of postoperative treatment was 13 days. The results of surgical treatment were excellent. The conclusion reached is that a cystectomy with capitonage is the treatment of choice for pulmonary echinococcosis, while lung resection may be necessary if lung tissue has been destroyed by prolonged compression or infection.

Necrotising fasciitis (NF) is a destructive invasive infection of skin, subcutaneous tissue and deep fascia. The aim of the study is to determine the causative agents of NF, its localisation, predisposing factors and comorbid conditions, duration of treatment and distribution of NF in different age groups and over the years. We conducted a retrospective study including 22 patients with NF from 2005 to 2010 in the University Clinical Center of Kosovo. The data were collected and analysed from the archives and protocols of the University Clinical Center of Kosovo. The average age of patients was 56·9 years. In eight cases or 36·4% of total patients studied, NF was caused by monobacterial agents with a predominance of Pseudomonas aeruginosa (five cases or 22·7% of total infections). Polybacterial agents were responsible for NF infection in other 14 cases (63·6%). Majority of the patients had other comorbidities like diabetes, trauma and prior history of surgical interventions. Diabetes was present in 17 patients or 77·3%. The remaining five patients (22·7%) had previous trauma and recent surgical intervention. Average length of treatment was 43 days. The hospital mortality rate in our case series was 22·6%. Early identification and diagnosis of NF significantly improves outcome and reduces mortality.

Background:Chronic subdural hematoma (CSDH) is frequent pathology in neurosurgical practice. The aim of this study is to present the first series of patients with CSDH, who got surgically treated in Clinic of Neurosurgery, University Clinical Center of Kosovo.Materials and Methods:This is a retrospective study that included 137 patients with CSDH who had been treated during the period 2008–2012. The data were collected and analyzed from the archives and protocols of the University Clinical Center of Kosovo. Patients were analyzed in many aspects such as age, gender, etiological factors, clinical features, localization, diagnoses, methods of surgical interventions, recurrences and mortality of patients.Results:From 137 patients with CSDH, 106 (77.3%) were males and 31 (22.7%) females. Average age of patients was 62.85 years. Analyzed according to the decades, the highest number of causes with CSDH was between 70 and 79 years (46%). The head trauma has been responsible for CSDH in 88 patients (64.3%), while the main symptom was headache (92 patients or 67.1%). One burr-hole trepanation with closed drainage system has been used in majority of cases (in 101 patients or 73.7%). The recurrence of CSDH was 6.5%, whereas mortality 2.9%.Conclusion:CSDH is more common in elderly patients. The male-female ratio is 3.4:1. Like other authors we also think that treatment with one burr-hole and drainage is a method of choice, because of its simplicity and safety.

Interatrial septal disorders, which include: atrial septal defect, patent foramen ovale and atrial septal aneurysm, are frequent congenital anomalies found in adult patients. Early detection of these anomalies is important to prevent their hemodynamic and/or thromboembolic consequences. The aims of this study were: to assess the association between impulse conduction disorders and anomalies of interatrial septum; to determine the prevalence of different types of interatrial septum abnormalities; to assess anatomic, hemodynamic, and clinical consequences of interatrial septal pathologies. Fifty-three adult patients with impulse conduction disorders and patients without ECG changes but with signs of interatrial septal abnormalities, who were referred to our center for echocardiography, were included in a prospective transesophageal echocardiography study. Interatrial septal anomalies were detected in around 85% of the examined patients. Patent foramen ovale was encountered in 32% of the patients, and in combination with atrial septal aneurysm in an additional 11.3% of cases. Atrial septal aneurysm and atrial septal defect were diagnosed with equal frequency in 20.7% of our study population. Impulse conduction disorders were significantly more suggestive of interatrial septal anomalies than clinical signs and symptoms observed in our patients (84.91% vs 30.19%, P=0.002). Right bundle branch block was the most frequent impulse conduction disorder, found in 41 (77.36%) cases. We conclude that interatrial septal anomalies are highly associated with impulse conduction disorders, particularly with right bundle branch block. Impulse conduction disorders are more indicative of interatrial septal abnormalities in earlier stages than can be understood from the patient’s clinical condition.