Faculty of Medicine
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Item type:Publication, Pediatric Echinococcosis: diagnosis, urgent surgical intervention, and treatment – case report(Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2024-11); ; ; Racaj, AnilaEchinococcus tapeworms cause human echinococcosis, which causes hydatid cysts, most commonly in the liver and lungs but also in other organs. Delays in symptom onset can lead to diagnostic issues, especially in children. Pediatric cases are rare and often lead to unintentional diagnoses. Living in a rural area increases risk. Imaging and serological testing are essential for diagnosis. This case is rare since it involves pediatric echinococcosis. Children rarely get echinococcosis, and symptoms are often vague; thus, diagnosis is mainly by accident. Case report: A 10-year-old female child developed symptoms and signs such as tachycardia, fever, and facial urticaria. On the first clinical examination, classic signs of an acute abdomen were present, indicating a possible abdominal emergency. Laboratory results showed significantly high levels of inflammatory markers, including CRP and WBC, indicating an active inflammatory process, most likely caused by infection or tissue injury. Imaging examinations, particularly a contrast CT scan of the abdomen, revealed two burst liver cysts in the peritoneal cavity, confirming the diagnosis of echinococcal cysts in the liver. We undertook an urgent surgical intervention to address the burst cysts and avert potential complications like peritonitis or sepsis. Post-operative treatment included constant monitoring of the patient's condition, antibiotic and antihelminthic medication to control infection, pain management, and supportive measures to help with recovery. Echinococcosis in children manifests as nonspecific symptoms, which often leads to a rare suspicion and coincidental diagnosis. Echinococcosis is often considered a possible cause of stomach discomfort. The standard treatment for echinococcosis usually involves a combination of antiparasitic medication and surgical removal of the cyst. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The Effect of Rectus Sheath Block as a Supplement of General Anesthesia on Postoperative Analgesia in Adult Patient Undergoing Umbilical Hernia Repair(Walter de Gruyter GmbH, 2017-12-01); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, MASTERING THE LEARNING CURVE SIGNIFICANTLY REDUCES OPERATIVE TIME FOR LAPAROSCOPIC TREATMENT OF COMPLICATED APPENDICITIS(INSTITUTE OF PUBLIC HEALTH OF REPUBLIC OF NORTH MACEDONIA, 2021-08-30); ; Laparoscopic appendectomy is the preferred operative method for acute appendicitis treatment. In terms of complicated appendicitis it can be effective in hands of an experienced laparoscopist that overwhelmed the learning curve for the method. Aim: Тhis retrospective study examines whether the operative time for laparoscopic appendectomy for complicated appendicitis is shortened after mastering the learning curve. Material and methods: A total number of 196 patients were operated for the diagnosis of acute appendicitis, of whom 77 were diagnosed with complicated appendicitis. They were subsequently divided in two groups (laparoscopic and open). Operative time in both groups was measured and the conversion and postoperative complications were noted. Results: Conversion rate was 2.3%. Operative time was shorter in the laparoscopic group (67.4 ± 22.9 vs. 77.9 ± 17.9 minutes; p = 0.033). Overall postoperative morbidity was 25.97% with wound infection present only in the open group (p = 0.018). Intraabdominal abscess occurred in one patient from the laparoscopic group (0.38%). Length of hospital stay was shorter in the laparoscopic group (4.3 ± 2.2 vs. 5.7 ± 2.1, p = 0.0052).