Background Surgical site infections (SSI) are a common complication after a cesarean section (C-section) and mainly responsible for increased maternal mortality and morbidity, dissatisfaction of patients, longer hospital stays as well as higher treatment costs. The aim of this study is to determine the incidence rate and risk factors of surgical site infections in women undergoing caesarean section at the University Clinical Center of Kosovo (UCCK), in the Clinic for Obstetrics and Gynecology. Methods We conducted a prospective observational cohort study involving 325 women who underwent labor and scheduled C-sections from January, 2018 to September, 2018 at the University Clinical Center of Kosovo, Clinic for Obstetrics and Gynecology. Each woman was followed for 30-postoperative days. Data analysis included descriptive statistics, univariate and multivariate logistic regression analysis. Culture-based microbiological methods were used to identify causal agents in postoperative wounds. Results Overall the SSI rate was 9.85% and the median time to SSI was the 7th postoperative day. The mean age of the patients was 31.3 ± 5.5 years (range from 17 to 46 years). The average length of stay was 4.2 ± 3.4 days. Several factors reduced the risk of SSI. These included: age less than 35 years (RR 0.25; 95% CI; 0.199–0.906 and P = 0.027) preoperative use of antibiotics (RR 0.232; 95% CI; 0.107–0.502 and P = 0.000) and duration of the operation less than 1 h (RR 0.135; 95% CI; 0.054–0.338 and P = 0.000). Previous cesarean section and one or more co-morbidity were associated with 7.4 fold and 8 fold increased risk of SSI, respectively. We found a statistically significant association between SSI and co-morbidity, preoperative antibiotic use, duration of operation, age and history of previous cesarean section ( P = 0.000; 0.000; 0.0001; 0.023; 0.000; respectively using chi-square test). Multivariable logistic regression analysis confirmed that one or more co-morbidity, previous C-section, preoperative antibiotics and duration of the surgery < 1 h are predictors of SSI. Conclusion The high incidence rate of SSIs after C-sections in this study highlight the need for prioritizing SSI control and surveillance. Patient demographics, procedures utilized and surgical factors must be incorporated in programs to reduce the infection rate. Additionally, an effort must be given to decrease number of the C-sections performed for the first time through assuring optimal care for the mother and child. The National Committee for Prevention and Control of Nosocomial infection in Kosovo should provide updated guidelines for control and prevention of the nosocomial infections.

The problem of retained surgical bodies (RSB) after surgery is an issue for surgeons, hospitals and the entire medical team. They have potentially harmful consequences for the patient as they can be life threatening and usually, a further operation is necessary. The incidence of RSB is between 0.3 to 1.0 per 1,000 abdominal operations, and they occur due to a lack of organisation and communication between surgical staff during the process. Typically, the RSB are surgical sponges and instruments located in the abdomen, retroperitoneum and pelvis.

Background Recurrent pregnancy loss (RPL) presents one of the main problems in the field of reproductive medicine, due to the unknown etiology in 50% of cases, as well as limited evidence-based diagnostic and therapeutic modalities. Recent studies indicate that systemic and placental oxidative stress (OS) represents an essential factor in the etiopathogenesis of RPL. This article is a comprehensive narrative synthesis of previously published studies concerning the role of oxidative stress in the etiology of recurrent pregnancy loss. Methods We conducted literature search of published studies in the English language focusing on oxidative stress and its association with recurrent pregnancy loss (RPL) utilizing the Medline and Cochrane databases from 2000 through January 2021. The keywords used were “recurrent pregnancy loss” “oxidative stress and recurrent pregnancy loss” and “oxidative stress biomarkers and recurrent pregnancy loss”. Results The search yielded 1116 publications, of which 92 were included in the final analysis. Reactive oxygen species (ROS) and reactive nitrogen species (RNS) at basal levels have various physiological functions whereas deviation from redox window is associated with different pathologies including early pregnancy loss. The currently available studies support the concept that increased oxidative stress (OS) and deficient antioxidant protection is implicated in the etiology of recurrent pregnancy loss (RPL) but underlying mechanisms through which OS affects pregnancy outcome remains largely indefinable. Conclusions Future research in this field can provide new insights regarding the OS-mediated damage in recurrent pregnancy loss as well as potential applications of antioxidant therapy in this group of patients.

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Telomerase Reverse Transcriptase (TERT) is the main catalytic sub-unit of telomerase, a reverse transcriptase enzyme. Telomerase expression is regulated at many levels, with numerous studies suggesting that up-regulation of human TERT gene (hTERT) at transcriptional level results in immortal cell phenotype associated with cancer. The aim of this study is to determine the correlation between hTERT expression and different cervical precursor lesions, as well as with cervical cancer in patients with confirmed Human papillomavirus (HPV) infection. The study included molecular analyzes on cervical samples from 214 women and matched Papanicolaou (Pap) test results. HPV detection and genotyping was performed by polymerase chain reaction (PCR) and genotyping. Quantitative real-time PCR (qRT-PCR) was performed using TaqMan probes and were calculated relative to the reference gene. Results showed significantly increased hTERT mRNA expression levels in high-grade and low-grade lesions compared to normal control samples (p<0.01) associated with 6.31 fold higher risk for developing ASC-US and 9.20 for LSIL. Strong correlation between HPV infection and hTERT expression in the high-grade lesions and cervical cancer was also observed. hTERT relative expression values showed 98% specificity and 100 % sensitivity as indicator of cervical lesions particularly for the ACS-H, HSIL and cervical cancer. In conclusion, hTERT expression correlate with the cytological grade of the cervical lesions and HPV infection and has a potential to be used as a diagnostic and prognostic marker.