Virtut Velmishi

Hepatology, Gastroenterology, Infectious Diseases

MD
8.00

Publications

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    DESCRIPTION: Abstract Background and aim: Gastric polyps are usually asymptomatic and incidentally discovered during endoscopic procedure. Determination of gastric polyp type is important as the risk for malignant transformation. The polyps behavior and the risk for malignant transformation depends on their histopathological type. To this point, there are no other studies presented in Albania about the gastric polyps. The aim of the study is to assess the prevalence and histological characteristics of gastric polyps in patients underwent endoscopic polypectomy or forceps biopsy. Methods: This study covers the period from January 2008 to December 2013, during which 6985 patients underwent a gastroscopy examination (EGD). During these procedures, 159 gastric polyps were discovered. After excluding from database patients with a history of prior gastrectomy, Crohn’s disease, and treatment over a year with PPI and polyposis syndromes the remaining 89 from them were assessed. Medical history and demographic data were obtained from each patient. Forceps biopsy or polypectomy was performed and the tissue fragments were sent for histopathological evaluation. Results: In this period 159 gastric polyps were discovered and 89 patients were included in the study. Histopathologically, the predominant type of polyps were hyperplastic (69) followed by adenomatous (9), inflammatory (9) and juvenile (2) polyps. Conclusion: This study has shown a significant number of hyperplastic polyps. The number of female patients slightly higher than male patients.
    Full-text · Research · Dec 2015
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    ABSTRACT: Abstract A 5 year old female child presented to pediatric outpatient department with melena and non-specific abdominal pain. She underwent an upper endoscopy which showed a confluent polypoid ulcerative lesion in the duodenum. Histopathology was consistent with non-Hodgkin’s lymphoma. This is a rare neoplasm of duodenum and must be differentiated from other type of malignancies. Keywords : Duodenum, Gastroscopy, Lymphoma, Melena, Non Hodgkins Lymphoma.
    Full-text · Article · Sep 2015
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    ABSTRACT: Background: Crohn's disease, a chronic inflammatory bowel disease (IBD) that was once considered rare in the pediatric population, is currently recognized as one of the most important chronic diseases that affects children and adolescents. Extra-intestinal manifestations rarely can precede IBD leading to a late diagnosis. Case Report: This is a case report of a 13 year old boy admitted for draining abdominal fistulae. The patient refers a six year history of musculoskeletal manifestations with low back pain, recurrent fever and limping. Six months ago he underwent surgery for pelvic abscesses. After surgery he was referred to our service for draining an abdominal fistula. We performed a colonoscopy which shows images and histology compatible with Crohn's disease. We decided to treat the patient with infliximab, 5 mg per kilogram of body weight administered intravenously at weeks 0, 2, and 6. After the second dose of infliximab we noticed the complete closure of the fistula. Conclusion: Infliximab is a good treatment alternative in patients with Crohn's disease preceded by musculoskeletal manifestations and complicated by abdominal fistula.
    Full-text · Article · Jun 2015
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    DESCRIPTION: The reflux disease in children is a well known pathology, which is subject of both surgical and non-surgical approach. The latter is mainly used for children with coexisting diseases. There are two main surgical procedures used to treat this situation; either an open or a less invasive laparoscopic approach. Both have been broadly discussed and compared in the medical literature.
    Full-text · Research · May 2015
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    Virtut Velmishi
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    ABSTRACT: Aim: To evaluate the role of H pylori in peptic ulcer disease in albanian children according to clinical findings, histological data and eradication rate. Methods and patients: We have enrolled in this study all the patients who underwent to FGS for gastrointestinal symptoms during three years. We found 22 patients with peptic ulcer disease 20 of them with duodenal ulcer and 2 with gastric ulcer. For each patient we performed two biopsies (antrum and corpus ) and one more antral biopsy for urease rapid test. After completing the data for 22 patients we have started eradication therapy for Hp positive group. Two months after therapy we have evaluated the eradication rate. For each patient we have included clinical, endoscopic and histological findings. Results: Of the 22 patients with peptic ulcer disease we found 17 patients infected by H pylori and 5 patients negative for H pylori. Range was from 8 years old to 14 years old (mean age was 11,3 years old). In this study with 22 patients there are 18 boys and 4 girls. Hp positive group had 14 boys and 3 girls while Hp negative group had 4 boys and 1 girl. Abdominal pain was equal with GI bleeding while the most frequent histological finding was chronic active gastritis. Of the 17 patients Hp positive 15 of them were negative for Hp two months after triple therapy. Conclusion: H. pylori play an important role in peptic ulcer disease in albanian children . His incidence is approximately 77 %. Male predomination was another interesting finding in our study. Eradication rate of H pylori was 88.2 % Keywords: helicobacter pylori, peptic ulcer disease , fibrogastroduodenoscopy.
    Full-text · Article · Oct 2014
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    ABSTRACT: Case Presentation A three year old girl is presented in our clinic with anorexia, vomiting, irritability, abdominal pain and constipation. She is the first child of an Albanian couple. The pregnancy and delivery were uneventful. She is vaccinated according to Albanian schedule .She has not history of previous diseases or psychiatric problems .According to her parents she has lost 3 kg in the last 2 months presenting symptoms as above mentioned. Initially she was treated in a local hospital but without any improvement (Figure 1). On physical examination this girl presents signs of malnutrition. Her weight was 11 kg (-3DS) and her height was 92 cm (-2DS) .Cardiac sounds were normal. Auscultation of lungs was uneventful. Abdomen was distended but without hepatosplenomegaly. Her behavior was normal for age and neurological evaluation was normal. The laboratory analyses shows: WBC=12 x 10 3 /mm3; RBC=5.08 x 10 6 /mm3; HGB=7.7g/dl; PLT=358; x 10 3 /mm3. Urinalysis and biochemical findings were normal. IgA + IgG antitransglutaminasis was normal. Abdominal ultrasonography and X-ray does not reveal anything Abstract Background: Rapunzel syndrome is an extremely rare
    Full-text · Article · Jul 2014
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    ABSTRACT: The World Gastroenterology Organization recommends developing national guidelines for the diagnosis of Celiac Disease (CD): hence a profile of the diagnosis of CD in each country is required. We aim to describe a cross-sectional picture of the clinical features and diagnostic facilities in 16 countries of the Mediterranean basin. Since a new ESPGHAN diagnostic protocol was recently published, our secondary aim is to estimate how many cases in the same area could be identified without a small intestinal biopsy. By a stratified cross-sectional retrospective study design, we examined clinical, histological and laboratory data from 749 consecutive unselected CD children diagnosed by national referral centers. The vast majority of cases were diagnosed before the age of 10 (median: 5 years), affected by diarrhea, weight loss and food refusal, as expected. Only 59 cases (7.8%) did not suffer of major complaints. Tissue transglutaminase (tTG) assay was available, but one-third of centers reported financial constraints in the regular purchase of the assay kits. 252 cases (33.6%) showed tTG values over 10 times the local normal limit. Endomysial antibodies and HLA typing were routinely available in only half of the centers. CD was mainly diagnosed from small intestinal biopsy, available in all centers. Based on these data, only 154/749 cases (20.5%) would have qualified for a diagnosis of CD without a small intestinal biopsy, according to the new ESPGHAN protocol. This cross-sectional study of CD in the Mediterranean referral centers offers a puzzling picture of the capacities to deal with the emerging epidemic of CD in the area, giving a substantive support to the World Gastroenterology Organization guidelines.
    Full-text · Article · Feb 2014 · BMC Gastroenterology
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    Virtut Velmishi
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    ABSTRACT: Abstract Aim: Gaucher disease is a multisystemic disorder characterized by glucocerebrosidase enzyme deficiency. The aim of this study was to present clinical aspects and diagnostic data of 19 patients (17 type 1, 2 type 3) in our service. Methods: Clinical findings, genetic analysis, laboratory work up, liver and spleen volumes were analyzed for 19 patients. Results: Mean age was 17 years (5-32 years); mean age at diagnosis was 11, 4 years (5-31 years). Most common presenting symptom was splenomegaly (all patients). Most frequent mutation was heterozygous N370S. One patient had severe anemia before the treatment. 16 patients had thrombocytopenia. All patients had high level of chitotriosidase before the treatment (240 times higher than normal value). Conclusion: There is a large variety of clinical signs in Gaucher disease. In our experience a proper investigation of patient followed by further expensive examinations is the cornerstone of diagnostic.
    Full-text · Article · Jul 2013
  • Virtut Velmishi · Ermira Dervishi · Paskal Cullufi

    No preview · Conference Paper · Feb 2013
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    ABSTRACT: Treatment of Hepatitis C in children has a better outcome than in adults, and for this reason the treatment had different views. However, in pediatric age hepatitis C is seen to have an evolution towards chronicity. Today is a normal option to treat chronic hepatitis C as early as possible according to certain criteria. The aim of this study is to show the results of treatment with interferon and ribavirin and the follow-up of children diagnosed with chronic hepatitis C in our service. This is a prospective study which has included children 3 up to 15 years old (13 boys and 4 girls) diagnosed with chronic hepatitis C. All patients underwent a certain protocol, including liver biopsy prior to treatment. Treatment consisted in use for 48 weeks of INF α-2b, 3 MIU/m2 three times a week s/c and ribavirin 15 mg/kg orally divided bid. Two patients were treated with PEGINF α-2b with dose 1.5 mcg/kg once a week s/c and ribavirin 15 mg/kg. After the treatment all patients have stayed under our control for an average period of 24 weeks. At the end of the treatment we detected a patient with HCV-RNA positive. End Treatment Viral Response was 94%. Six months later we found three patients who showed relapse of disease. Sustained Viral Response was approximately 83% The combination therapy of interferon with Ribavirin in treatment of children with chronic hepatitis C provides a higher SVR when treatment is initiated at the earliest stages of hepatic changes. Side effects of therapy are insignificant in comparison with results obtained.
    Full-text · Article · Jan 2012 · Virology Journal

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