A cross-sectional study of online learning during the COVID-19 pandemic: Student perceptions.

Background: Severe acute respiratory syndrome coronavirus 2 caused an unprecedented pandemic for more than 2 years, affecting the lifestyle health, and education systems at the global level. During this long pandemic period, online learning was considered the only secure learning alternative. Multiple studies have demonstrated positive or negative perceptions related to online teaching. Aim: Through this study, we identified the perceptions and different challenges that online learning brought to the education of the students of Alexander Xhuvani University, Elbasan, focusing on their achievements. Method: This cross-sectional study was conducted by Alexander Xhuvani University from March to May 2021. A questionnaire that assessed students' perceptions related to the effectiveness of distance learning was used for this study. This questionnaire had a Cronbach α value of 0.760. Students from two faculties were welcomed to be part of this survey and to fill out the questionnaire on the Google platform. The data of the online questionnaire was made in Excel format and then analyzed using the statistical program SPSS version 20.0. Results: Overall, 350 students were included in the study about 268 (76.6%) belong to the female gender, and most students 239 (68.3%) belong to the age group of 18-20 years. It is worth mentioning that 271 (77.4%) had a negative perception related to e-learning. Approximately, 201 (57.4%) of students encountered difficulties with the internet, 49 (14%) of cases reported a lack of technological equipment, and 111 (31.7%) encountered distraction while using the phone to listen to the online lesson. Problems with visual images and audio were also reported. As advantages, we mention freer time and greater flexibility in the learning process. Changes in health and management of online learning were observed in 123 (35.1%) of students, where loss of time and lack of concentration to learn, sleep problems, stress, anxiety, and fear were encountered the most. Conclusions: This is the first study in university education to assess students' perceptions and results achieved by online learning during our country's pandemic. Our study's findings show that 271 (77.4%) of participants have a negative perception of online learning. The most common challenges among students were Internet speed, a lack of technological equipment, and Internet disconnection. In terms of expectation fulfillment during online learning and assessment results, 245 (70%) of students' expectations were unsatisfied and unmet. These findings will address the gaps in the literature and may influence future online learning design in our country.

Anxiety and depression in geriatric hemodialysis patients: factors that influence the border of diseases.

Introduction: The two main psychological issues that people with end-stage renal disease (ESRD) experience are depression and anxiety. We conducted this study to determine both the prevalence of depression and anxiety, and the factors associated with them, among hemodialysis patients. Methods: Patients aged 18 years or older, who had received hemodialysis in a hemodialysis center in Elbasan, for at least 3 months were included in this study. Beck Anxiety Inventory and Beck Depression Inventory Instruments were used to assess hemodialysis patients levels of depression and anxiety. Results: Overall, 107 hemodialysis patients (men 65.4%) with a mean age of 57 ± 8.9 years were enrolled in the study. The prevalence of anxiety and depression resulted to be 85.98, and 84.11%, respectively. We found a significant difference in depression and anxiety scores in patients age groups of 61-70 years old (OR = 1.8; 95% CI [0.7-3.7]; p = 0.041), in non-smoking patients (OR 3.4; 95% CI [1.09-8.2]; p = 0.04), in diabetic patients (OR 3.4; 95% CI [1.09-8.2]; p = 0.04), and in patients with a time in dialysis of 6-10 years and >11 years, respectively, (OR 3.4; 95% [1.5-9.0]; p = 0.01), (OR1.3; 95% CI [0.4-3.6]; p = 0.04). Conclusion: Our study shows that the prevalence of mental disorders (depression and anxiety) is high among patients with ESRD on maintenance hemodialysis. We recommend a routine screening and referral to psychological health specialists to evaluate the mental health disorders among hemodialysis patients with the primary aim of improving their quality of life.

Trends of recreational water quality in Albania's coastal during 2016-2020.

Water quality impairment is a substantial environmental hazard which impacts a wide variety of stakeholders and interests, particularly those who participate in outdoor water-based recreational activities. Recreational bathing water qualities are highly vulnerable to microbial pollution from municipal sewage, industrial effluents, agriculture run-off and river discharges. Fecal contamination impairs water quality and potentiates human health risks. The aim of this study was to see the 5-year trend of microbiological quality of recreational bathing waters in Albania. Every year we collected 1,071 samples taken 30 centimeters below the water's surface at least one meter deep. Assessment of bacterial load of the coastal waters was done nine times for every point, for the Escherichia coli and Intestinal enterococci, according to the methods ISO 7899-1 and ISO 9308-3. Bathing water assessment is to be classified according the categories indicated in the Directive 2006/7/EC and recommendations of WHO/UNEP-2010. Microbial Water Quality Assessment Category (cfu/100 ml water) done in 119 monitoring points were: During 2016, Excellent 53%, Sufficient 23%, Good 9% and Poor 15%. In 2017, Excellent 68%, Sufficient 15%, Good 6% and Poor 10%. During 2018, Excellent 82.4%, Sufficient 13%, Good 0.9% and Poor 3.7%. During 2019, Excellent 89%, Sufficient 2.5%, Good 6% and Poor 2.5%. During 2020 Excellent 89.9%, Sufficient 5%, Good 0.9%, and Poor 4.2%. Based on the above assessment, it is noticed a significant increase of microbial quality of recreational bathing waters in Albania due to investments in the sewerage system and better waste water treatment.

A case with high bilirubinemia and hemolytic anemia during leptospirosis and a short review of similar cases.

BACKGROUND: Leptospirosis is characterized by very diverse clinical manifestations, which may range from flu-like subclinical forms to very severe presentations characterized by multi-organ failure, or to atypical presentations. One of its most aggressive presentations is Weil's disease, characterized by jaundice, hemorrhagic phenomena and renal failure. Cases with high bilirubinemia over 30mg/dL are not communes in human leptospirosis. Our aims are to present an atypical case presentation of human leptospirosis, characterized by jaundice and hemolytic anemia, and to make a short review in PubMed for similar cases. At the same time we want to emphasize the diversity of the clinical presentation of human leptospirosis. METHODS: A 54-year-old man presents at the emergency department of the infectious medicine with severe fatigue, nausea, vomiting, and generalized weakness. On exam, he was alert and well oriented; blood pressure was 80/50 mmHg and icteric. First blood examinations confirmed high bilirubinemia, thrombocytopenia and acute renal failure. RESULTS: Based on anamnestic and clinical evaluations, blood and serology examinations, the patient resulted with leptospirosis. The bilirubin reached 73.4mg/dL. At the same time on PubMed research we found only limited cases with leptospirosis associated with bilirubinemia over 30mg/dL and over less with hemolytic anemia. CONCLUSION: Based on our clinical experience, as well as literature data, we suggest that clinicians should have a high index of suspicion in cases of jaundice with exposure possibilities for infectious diseases. Connection of high bilirubinemi over then 30mg/dL and hemolytic anemia in human leptospirosis is an unical case report.

Circumaortic right renal vein with multiple vascular anomalies.

Circumaortic right renal vein is an extremely rare finding and to our knowledge only 1 case has been reported in the literature so far. Its rareness, in contrast to left renal vein anomalies, is thought to be due to a relatively simple embryologic development of right renal vein compared with left renal vein. On the other hand, association of Circumaortic right renal vein with inferior vena cava agenesis and aortic coarctation is an extremely rare occurrence. Our aim is to introduce a case of Circumaortic right renal vein in a 3-month-old child with inferior vena cava agenesis and aortic coarctation. Discussion on the underlying embryology of Circumaortic right renal vein, its clinical importance and the association with other vascular anomalies, will be on our focus as well. Precise understanding of renal vein anomalies is important when planning retroperitoneal surgery or interventional vascular procedures. Awareness of such anomaly implies crucial knowledge for radiologists who should include it in the medical reports to aid future patient's management.

The role of gender in the prevalence of human leptospirosis in Albania.

INTRODUCTION: Leptospirosis is a zoonotic spirochetal disease with global importance, which continues to have a major impact on public health in developing countries. The prevalence of the disease is much higher in males. The objectives of this study were: to give some data and to share our experience with human leptospirosis in Albania; to describe the prevalence regarding to the role of gender in the prevalence of human leptospirosis; to make a gender specific analysis of the clinical manifestations in patients diagnosed and treated for leptospirosis in our service and to make a review of literature related to this hypothesis. METHODOLOGY: We reviewed the epidemiologic data, risk factors and differences in clinical presentation between males and females' patients with leptospirosis. These data are analysed from hospitalized patients. Diagnosis of leptospirosis was established based on clinical presentation, epidemiological data and subsequently confirmed serologically by Anti-Leptospira IgM antibodies through ELISA test. RESULTS: Between 2005-2016, 233 cases of confirmed leptospirosis were analysed. Males were 208 (89.27%) and 25 of patients (10.72%) were females in ratio 9:1 p < 0.001. The highest prevalence was observed in the 45-64 age groups. Overall mortality was found to be 8.58%, 19 were males and one female p < 0.001. CONCLUSIONS: There is a much higher prevalence of leptospirosis in middle aged men. Mortality rate seems to be similar in males and females. While the difference in prevalence may be related to exposure to risk factors, further investigation is necessary to study gender-based genetic and immunological predisposition.

Ocular and cutaneous manifestation of leptospirosis acquired in Albania: A retrospective analysis with implications for travel medicine.

UNLABELLED: Albania is an attractive tourism destination with an increasing volume of travel. As a Mediterranean country some tropical infectious diseases are present in certain areas of Albania, including leptospirosis, which is a zoonotic infectious disease prevalent around the world. The goal of this retrospective study is to describe the ocular and cutaneous manifestations of leptospirosis in Albanian patients and raise awareness to travelers travelling in and out of the country. METHODS: We retrospectively studied 107 cases of leptospirosis, treated at "Mother Teresa" University Hospital Center, in Tirana, Albania between January 2009 and December 2014. All cases included in the analysis had a clinical and epidemiological presentation suggestive of leptospirosis, confirmed with ELISA (enzyme linked immunoassay) positive for IgM antibodies against Leptospira. RESULTS: There were 89.7% males (n = 96) and 10.2% females (n = 11). Mean age at the time of diagnoses was 43.7 ± 17.8 years old (range 17-78). All patients were native and residents of Albania. Conjunctival suffusion was present in 81.3% of the cases, whereas subconjunctival hemorrhage was seen in 12 patients (11.2%). Uveitis was seen in 38.3% of the cases and all patients with uveitis presented a severe systemic disease. A cutaneous rash was present in 58.8% of patients. Other cutaneous manifestations include jaundice in 62.6% and intense pruritus in 5.6% of cases. CONCLUSIONS: Ocular and cutaneous involvement happens more frequently in patients with Leptospirosis, than it was thought to be. Therefore the clinician should be more careful in his systemic evaluation of the disease.