Faculty of Medicine

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    Item type:Publication,
    Amblyopia Treatment
    (2006)
    ;
    Ivanovska M
    ;
    Antova Velevska M.
    Purpose: to compare patching and atropine as treatments for moderate amblyopia in children 3 to < 7 years old Material and methods: prospective study of two groups of patients treated with patching or atropine (each group of 30 patients). The patients were from 3 to 7 years old and the visual acuity was measured with E test. The groups consisted of patients with strabismic and /or anisometropic amblyopia. The visual acuity of the amblyopic eye was -20/40 to 20/100. The visual acuity of sound eye was ->- 20/40. Inter eye acuity difference >- 3 lines. The visit schedule for the first 6 months was on 5 weeks, 17 weeks, 26 weeks, and afterwards on every 6 months. Results: Patient characteristics: 47% female. Cause of amblyopia: strabismus 38%, anisometropia 37% and combine –mechanism 24%. 26% received previous treatment for amblyopia. The other results of the study will be discussed further in the paper. Conclusions: both patching and atropine are effective treatments for moderate amblyopia in children 3 to 7 years of age. Patching produces more rapid improvement and possibly slightly better outcome. Atropine has easier administration. Both treatments were well tolerated.
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    Pulmonary thrombosis in acute organophosphate poisoning - Case report and literature overview of prothrombotic preconditioning in organophosphate toxicity
    (Elsevier, 2019-06-15)
    ;
    ;
    Niko Bekarovski
    ;
    Irena Jurukov
    ;
    Objective: Acute organophosphate (OP) poisonings are presented with acetylcholine-receptor overstimulation. There have been a few case reports of thrombotic complications in acute OP poisonings, as well as prolonged thrombosis preconditions in patients who survived this type of intoxications. The paper presents a case with pulmonary thrombosis (PT) that develops in the subacute phase of intentional acute OP poisoning, treated only with atropine, as well as a literature overview of OP-induced prothrombotic toxicity. Case report: A middle aged woman was brought to the hospital after ingestion of unknown insecticide with suicidal intentions. She had a history of HTA (arterial hypertension), hyperlipidemia and untreated depression. The clinical features of poisoning were miosis, vomiting, dizziness, abdominal cramps and diarrhea. Soon after admission, she developed difficulties in breathing with decrease of serum pseudocholinesterase (2590...1769...1644...800 U/l), bibasal pulmonary crackles, drop of SpO2 to 84%. Antidote treatment included carbo medicinalis, atropine, and diazepam, without use of oximes. The seventh day pseudocholinesterase, the levels started to rise but the patient’s hyposaturation (SpO2 86-88%) persisted. Chest ultrasound detected hy￾poechoic subpleural lesion to the right. Haemostatic tests showed increased D-Dimmer (2312 ng/ml) with hy￾percoagulability. The CT pulmonary angiography confirmed PT and after the administration of low molecular heparin, her clinical condition improved. Conclusion: Acute organophosphate poisoning treated with atropine showed a potential for inducing pro￾thrombotic coagulation abnormalities, presented with PT. This life-threatening complication may additionally contribute to prolonged morbidity and mortality in OP poisonings, especially in patients with medical history of comorbidites.