BACKGROUND: Hepatitis B virus (HBV) is an important global public health problem with significant morbidity and mortality. Chronic HBV infection is a dynamic process with the risk of progression to cirrhosis and hepatic carcinoma (HCC). Although HCC is currently the main concern for diagnosed chronic hepatitis B (CHB), these patients are also considered in high risk for developing B-cell non-Hodgkin lymphoma (B-NHL). The increased risk for B-NHL is well- documented in chronic hepatitis C patients, while in HBV patients are still subject of studies and the most common form of B-NHL reported in these studies is diffuse large B-cell lymphoma (DLBCL). CASE REPORT: We are reporting the case of a patient with chronic HBV infection complicated with a rare type of B-NHL, a splenic marginal zone lymphoma (SMZL) and through a literature review aim to assess the importance of being aware of the increased risk of lymphoproliferative disorders in chronic HBV patients, asses the role of laboratory follow-up for the early diagnose of this complication, and also recommend testing for HBV infection in all patients diagnosed with B-NHL not only in DLBCL forms but also in rare forms like SMZL. CONCLUSION: CHB infection has an increased risk for B-NHL not only for the aggressive DLBCL form which is the most common form encountered but also for SMZL which is a rare indolent form of B-NHL with a better prognosis. Laboratory monitoring has a great value to the early detection of B-cell clonal expansion. In all SMZL, patients are recommended screening for HBV, because treatment with antivirals may regress lymphoma and also prevent reactivation of HBV in case of chemotherapy, especially rituximab.

Aim: To assess the accuracy of simple available laboratory tests (ALT, AST, platelet count, AST /ALT ratio AST to platelet ratio index: APRI) in predicting of liver fibrosis in chronic hepatitis C, in comparison to the predictive accuracy obtained by elastography. Methods: Two hundred and sixty five patients suffering from chronic hepatitis C (CHC) were included in this study. They included patients enrolled from the Hepatology Department of University Hospital Center “Mother Theresa” in Tirana. Fibrosis results obtained from elastography were assigned a score from 0 to 4 score as per METAVIR scoring. Results of serum ALT, AST levels and platelets were expressed as AAR and APRI. Results: One hundred and twenty nine (48.7%) patients showed no evidence of fibrosis on elastography 87 (32.8%) patients showed fibrosis, and 49 (18.5%) as cirrhosis. There was a significant correlation between the degree of fibrosis and AST levels, AST/ALT ratio, platelet count and APRI. The AUROC curve for predicting significant cirrhosis was 0.631 for AST levels, 0.342 for platelets, 0.642 for AAR and 0.668 for APRI (p <0.05). Conclusion: In conclusion, the results of our study demonstrate a diagnostic role of AAR and APRI as a simple non-invasive test for diagnosis of liver cirrhosis.

Daiki old elementary school building is situated in Samoto village in Susami Town, Wakayama Pref. in Japan. The old elementary school building holds more than the essence of spatial identity but memorial history of the village and symbol of community for more than a hundred year. The building was built on 1903 in a wooden structure, once enlarged on 1913, standing on a huge stone retaining wall underneath. But following the decreasing numbers of pupils, the school was closed on 1970 and merged with Samoto elementary school, of the neighboring village. The fact is that the building is the oldest wooden school building in this area and, therefore, deserves preservation, as heritage and legacy, particularly for the villagers. This paper exposition is written on the intermediate report of this engagement for cultural heritage.

Background: Acute Pancreatitis (AP) is an inflammatory pathology with large regional variations in incidence and etiology Aim: The aim of the study was to provide a description of the epidemiologic situation of AP in Albanian population, regarding incidence, etiology and severity of the disease Methods: We have studied all the files of all patients with acute pancreatitis admitted at the UHC ‘Mother Theresa” during an eight year period (2005-2012). The results: We had 964 admissions with the diagnosis acute pancreatitis, making an incidence of 5.64 per 100 000 inhabitants per year. Mean age of patients was 54.5 ± 16.93 years old. Among risk factors, alcohol consumption was found in 382 patients (39.6%), gallstone in 362 patients (37.6%), and others in 220 patients (22.8%). Conclusion: The incidence of acute pancreatitis in Albania ranges from 3.6 – 5.64 new cases per 100 000 inhabitants per year, with an increasing trend during the last years. The incidence of AP among females almost doubles during 2005-2012. Alcohol consumption is the predominating etiologic factor among young males.

Objective of the study: To report on the results of two projects on chronic hepatitis B in Western Balkans lead by Ioannina, Northwest Greece and Tirana, Albania.Methods: In two Prospective projects, HEPAGA I and HEPAGA II which lasted 4 years. In HEPAGA I, serum samples from 410 Albanians were tested for HBV. In HEPAGA II, health care consumption was recorded in hospitalized patients with chronic hepatitis B.Results: HEPAGA I showed that 11.89% of the Albanians was HBsAg(+) and only 21.19% had HBV immunoprotection. HEPAGA II study included 101 patients. There was a significant difference in hospitalization costs per patient between centers. The Greek patients were significantly older (p = 0.027) and there was a significant correlation between age >50 years and hospitalization costs (p=0.035). In Greece, hospitalization costs, number of patients admitted and number of hospitalization days per patient were in a remarkable position compared to other causes of hospitalization.Conclusions: The HEPAGA I study showed a decrease in the prevalence of chronic HBV infection in Albania compared to that of the previous decade. The HEPAGA II study demonstrated that health care consumption due to HBV infection is still an important determinant of the overall health consumption in Western Balkans. (C) 2009 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.