Despite the discovery and application of many parenteral (unfractionated and low-molecular-weight heparins) and oral anticoagulant vitamin K antagonist (VKA) drugs, the prevention and treatment of venous and arterial thrombotic phenomena remain major medical challenges. Furthermore, VKAs are the only oral anticoagulants used during the past 60 years. The main objective of this study is to present recent data on non-vitamin K antagonist oral anticoagulants (NOACs) and to analyze their advantages and disadvantages compared with those of VKAs based on a large number of recent studies. NOACs are novel direct-acting medications that are selective for one specific coagulation factor, either thrombin (IIa) or activated factor X (Xa). Several NOACs, such as dabigatran (a direct inhibitor of FIIa) and rivaroxaban, apixaban and edoxaban (direct inhibitors of factor Xa), have been used for at least 5 years but possibly 10 years. Unlike traditional VKAs, which prevent the coagulation process by suppressing the synthesis of vitamin K-dependent factors, NOACs directly inhibit key proteases (factors IIa and Xa). The important indications of these drugs are the prevention and treatment of deep vein thrombosis and pulmonary embolisms, and the prevention of atherothrombotic events in the heart and brain of patients with acute coronary syndrome and atrial fibrillation. They are not fixed, and dose-various strengths are available. Most studies have reported that more advantages than disadvantages for NOACs when compared with VKAs, with the most important advantages of NOACs including safety issues (ie, a lower incidence of major bleeding), convenience of use, minor drug and food interactions, a wide therapeutic window, and no need for laboratory monitoring. Nonetheless, there are some conditions for which VKAs remain the drug of choice. Based on the available data, we can conclude that NOACs have greater advantages and fewer disadvantages compared with VKAs. New studies are required to further assess the efficacy of NOACs.

Traumatic injuries of the peripheral nerves are very common. Surgical repair of the damaged nerve is often complicated by scar tissue formation around the damaged nerve itself. The main objective of this study is to present the recent data from animal experimental studies where pharmacological topical agents are used at the site of peripheral nerve repair. Some of the most commonly topical agents used are tacrolimus (FK506), hyaluronic acid and its derivatives, and melatonin, whereas methylprednisolone and vitamin B12 have been used less. These studies have shown that the abovementioned substances have neuroprotective and neuroregenerative properties though different mechanisms. The successes of the regenerative process of the nerve repair in experimental research, using topical agents, can be evaluated using variety of methods such as morphological, electrophysiologic, and functional evaluation. However, most authors agree that despite good microsurgical repair and topical application of these substances, full regeneration and functional recovery of the nerve injured are almost never achieved.

Based on our findings, topical application of HA and FK506 exhibits equally positive effects, preventing perineural scar formation and enhancing nerve regeneration after peripheral nerve repair.

Facial burns are generally considered severe. This is due to the possibility of respiratory complications. First responders check the nostrils for singed hairs. In severe cases there may be soot around the nose and mouth and coughing may produce phlegm that includes ash. Facial and inhalational burns compromise airways. They pose difficulties in pre-hospital resuscitation and are challenge to clinicians managing surviving burn victims in the intensive care setting. Management problems – resuscitation, airway maintenance and clinical treatment of facial injuries are compounded if the victim is child. Inhalational burns reduce survivability, certainly in adult victim. In our retrospective study we found that facial burns dominated in male gender, liquids and scalds are the most common causes of facial burns in children whereas the flame and electricity were the most common causes of facial burns in adults. We came to the conclusion in our study that surgical treatment minimizes complications and duration of recovery.

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.