Faculty of Medicine
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Item type:Publication, CONTINUOUS INTRAVENOUS NIMODIPINE APPLICATION FOR PREVENTION OF VASOSPASM BEFORE ENDOVASCULAR TREATMENT OF RUPTURED CEREBRAL ANEURISMS(Macedonian Association of Anatomists and Morphologists, 2022) ;Bushinoska, Jasna; ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ASSOCIATION BETWEEN PREMATURITY AND NEONATAL MORTALITY IN OUR MATERIAL(Walter de Gruyter GmbH, 2025-05-02); ;Bushinoska, JasnaJordancho Ivanov - Some of the metrics are blocked by yourconsent settings
Item type:Publication, PREMATURE BIRTH AND COMPLICATIONS OF PREMATURE BIRTH ARE LEADING CAUSES FOR INCREASED NEONATAL MORTALITY(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2025-12-17); ;Bushinoska, JasnaIvanov, JordanchoAbstract Introduction: Neonatal mortality (NNM) is a mortality in newborns in within the first 28 days after birth. Prematurity and the complications from prematurity are the leading cause for higher NNM rates. A premature newborn is born less than 37 gestational weeks of pregnancy. Low birth weight and low gestational age at delivery and their complications are the leading causes of NNM. Aim of the study: The aim of this paper is to present our results gathered from the material of the newborns treated at the Neonatal Intensive Care Unit (NICU) at the University Clinic of Gynecology and Obstetrics in Skopje (UGOC- Skopje), demonstrating that prematurity and complications of prematurity have been the main causes of increased mortality among newborns, in the analyzed period of 9 months. Material and methods: The study is a cross-sectional prospective research that included 445 newborns who were transferred to the NICU for resuscitation, monitoring and treatment after birth, over a period of 9 months or the period from May 1, 2019 to January 31, 2020, at the University Clinic of Gynecological and Obstetric (UGOC) in Skopje. In this paper, we focused on prematurity and complications of prematurity, which had a significant impact on the NNM of newborns in the NICU, in the analyzed period. Results: The study shows that the leading causes for NNM at UGOC- Skopje were prematurity and complications from prematurity: low gestational age at birth, low birth weight, asphyxia, ARDS, NEC, intracranial hemorrhage, sepsis, congenital anomalies etc. Cesarean delivery, prenatal administration of corticosteroids, higher APGAR score in the 1st and 5th minutes, have a significant impact on the survival of newborns and reduction of mortality in newborns. Conclusion: For a long period of time N. Macedonia was a country with one of the highest NNM rates in Europe. Prevention of prematurity and complications from prematurity, improved health and prenatal service, all this reduce the prematurity and NNM. The reasons for higher NNM are preventable and need programs for health care and education of patients, and better public health service. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, DECREASING OF NEONATAL MORTALITY AT UNIVERSITY GYNECOLOGY AND OBSTETRICS CLINIC IN SKOPJE OUR MATERIAL(Macedonian Association of Anatomists and Morphologists, 2026-02-23); ; ;Bushinoska, JasnaIvanov, JordanchoNewborns born after 22 weeks of gestation and with a birth weight greater than 500 g, per thousand live births. For many years, N. Macedonia and the University Gynecology and Obstetrics Clinic in Skopje (UGOC-Skopje), were between leaders inNNMin Europe.From2018, the NNMin Macedonia and on UGOC-Skopje has started to decrease.Aim of the study:The aim of the paper is to present and compare the NNM figures in the Neonatal Intensive Care Unit (NICU) at UGOC-Skopje, in two different periods -the period when the NNM at the clinic was high from 2011-2017 and during 9 months studywhich was madein 2019-2020 on the same clinic, whenthe NNM rate began to fall significantlyon the clinic and in the country.Material and methods:Several previously conducted retrospective studies on NNM at UGOC-Skopje and one prospective study that lasted 9 months from May 2019 to the end of January 2020 were used to obtain and compare the results for NNM rate at the Clinic in this paper.Results:In 9 month,studyin2019-2020, the NNMat the Clinic and in the country,began to record a significant decline.There is a significant decrease in NNM in the group of very premature newborns, bornfrom 28-32 weeks of gestation compared to previous years 2011-2017.NNM rate has significantly decreased and in the group of newborns born with very low birth weight (from 1000-1499 g) and low birth weight (1500-2499 g) compared to previous years.Conclusion:The UGOC-Skopje and N. Macedonia have made progress in the last 5 years in reducing the NNM, which was one of the highest in Europe. This was helped by improved vital statistics, the use of the latest protocols for reducing NNM, and improved technical conditions at NICU - Some of the metrics are blocked by yourconsent settings
Item type:Publication, A CASE OF TWIN PREGNANCY WITH CONJOINED TWINS(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2023-10); ;Ivanov, JordanchoBushinoska, Jasna - Some of the metrics are blocked by yourconsent settings
Item type:Publication, PREGNANCY IN A PATIENT WITH A CONGENITAL UNICORN UTERUS AND CONIZATION DUE TO CERVICAL CANCER(University Ss. Cyril and Methodius in Skopje, 2024); ;Bushinoska, JasnaIvanov, Jordancho - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Effect of intra-arterial Nimodipine on subarachnoid hemorrhage injured brain(Macedonian Association of Anatomists and Morphologists, 2022-08-31) ;Bushinoska, Jasna; ; ; Subarachnoid hemorrhage is a pathological condition of the brain, caused by rupture of intracerebral aneurism or arteriovenous malformation, with high morbidity and mortality rate. SAH may conceive permanent brain damage with persistent disability. Vasospasm isthe most characteristic pathological state of the vasculature, whose development coincides with onset of bleeding with asymptomatic presentation. The critical extend as a risk factor presentswith symptom presentation and indication of brain damage development. Early vasospasm treatment is a priority in prevention of brain ischemia and disability. Existing methods of vasospasm treatment are conservative, endovascular and combined, with simultaneous intraarterial vasodilator application.The aimof this study wasto determine whether intraarterial application of Calcium-blocker Nimodipine will generate immediate vasodilation, facilitating endovascular aneurism treatment, resulting in longterm resolution of the condition.Fifteen patients with SAH receivedendovascular treatment in the first 48 hours of hemorrhage onset, with consequent intraarterialNimodipine application if vasospasm was detected. All patients had ruptured aneurism of anterior circulation. Vessel diameter was measured before and after Nimodipine application. The occurrence and degree of vasodilation, as a difference between both diameters,were considered a confirmation of drug effectiveness.Complete spasm relief occurred in 10patients, residual vasospasm persisted in 4 patients, no VS relief occurred in 1 patient.IntraarterialNimodipine application during endovascular brain aneurism treatment effectively relievesvasospasm. Early coiling reduces complication risks and development of postischemic brain damage. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, MECHANICAL THROMBECTOMY IN STROKE - OUR TEN MONTHS EXPERIENCE(2019-10-24); ; ; ; Bushinoska, JasnaMechanical thrombectomy for stroke patient started in November 2018 in our country. For ten months we have 21 patient with large vessel occlusion. Our center is for now single center that provide mechanical thrombectomy for population of two million people. All stroke patient were with large vessel occlusion on CT and CTA. First patient was directly evaluated and treated in angiography suite on the basis of native CT- hyperdense MCA sign and clinical symptoms. Next patient underwent CT and CTA and one with MR/MRA. Four patient were with T occlusion, two successful recanalization and two failure. Other 17 were M1/M2 occlusion from witch tree tandem lesions ICA and M1. Patients were on age of 25 to 73 years old. We used stent retriever in all patients (solitaire or embotrap) and aspiration together and in most of patient intermediate catheter ( sofia/sofia plus) but we never used balloon guiding catheter. Time window in 18 patient was <6h and 3 of patients with wake up stroke. All patients were with NIHSS >5. TICI 2b was achieved in 8 patients, TICI 3 in 4 patients, TICI 2a in 3 patients, in one patient grade 1 and no reperfusion in 5 patients from witch one with worsening. No major hemorrhage appeared but only 4 patients previously received IV tPA. Till today no national strategy for stroke patient pathway. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Spinal epidural hematoma after lumbar catheter insertion in a patient who underwent TEVAR for an aneurysm of the descending aorta(SciTechnol, 2020-01-29); ; ;Bushinoska, Jasna; Asani, ElmedinaWe present a case of spinal epidural hematoma after Lumbar catheter insertion in a patient who underwent TEVAR for an aneurysm of the descending aorta. Spinal epidural hematoma (SEH) is a relatively rare entity and has been reported to occur in patients who receive anti-coagulant therapy, have bleeding disorders, or after traumatic needle insertion. In our case, the epidural hematoma occurred 4 hours after catheter insertion, in a patient who received anticoagulant and antiplatelet medication. In these cases, early detection of symptoms and rapid diagnosis are an imperative. Our patient’s diagnosis was done 5 hours after symptom development and it consisted of thoracolumbar MRI that showed a spinal hyper-acute epidural hematoma extending from T9-T10 to L4-L5 and the affected segments of the spinal cord and conus medullar showed edema, most significantly at L1-L2 levels. A neurosurgical consult was done immediately after obtaining the results and within six hours after neurosurgical symptoms occurred, the patient underwent spinal decompression, the hematoma was evacuated and the patient regained motor function in her legs. During her stay at the cardiac ICU, the doctors administrated to our patient antiplatelet medication alongside low-molecular-weight heparin (LMWH)–inj. Clexane 40 I.U., against our recommendations. Due to this, our patient developed re-bleeding and we had to perform a second surgery, to do a more extensive spinal decompression and to evacuate the hematoma. Neurologic rehabilitation after the second surgery was difficult, but with extensive physical therapy, we have managed to achieve some improvement, with motor response 2\5 on the left leg and 3\5 on the right leg. Although anticoagulants and\or antiplatelet medication are a must in endovascular procedures and are considered safe to use during epidural analgesia, special attention and care to epidural hematoma should be given, especially in cases when an epidural catheter placement is needed.
