Faculty of Medicine
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Item type:Publication, THE IMPACT OF MATERNAL OBESITY ON PREGNANCY – A REVIEW ARTICLE(Macedonian Association of Anatomists and Morphologists, 2025-11)Maternal obesity has been estimated as a global epidemic, affecting 40% of pregnant women in developed nations. The weight of females that are pregnant has become one of the most concerning points in the modern obstetrics. For this matter after consulting the most accurate literature from academic books in the field and from internet sources from the year 2020 until the year 2025 available on PubMed, Scopus, Data of Science, Google Scholar, ResearchGate, Academia and others we have created a review article that takes in consideration the impact of maternal obesity on the pregnancy itself. Women may have been obese before becoming pregnant or they may have rapidly gained weight during pregnancy and the types of maternal obesity have their challenges for the pregnancy outcome. The maternal obesity must be carefully treated since it is directly responsible for the impact on gestational diabetes mellitus (GDM), hypertensive disorders, and various perinatal complications. By analyzing the types of maternal obesity and complications that occur during pregnancy we take care not only for the current health of the pregnant mothers and their babies but also of their future to take preventive measures, lifestyle changes and thus to improve their health and the health of their babies. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Trend of Kidney Replacement Therapy in North Macedonia from the Years 2015 Through 2020(Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2024-11-01); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Diabetes and arterial stiffness, our experiences(Македонско лекарско друштво = Macedonian medical association, 2021); ; Introduction. The incidence and prevalence of diabetes mellitus (DM) has increased worldwide but also in the Republic of Macedonia, Diabetes is a high-ranking a cause of death, primarily as a cause of cardiovascular death. In the United States, 42% of diabetic patients have diabetic nephropathy, with a 20-fold increased risk of cardiovascular mortality. Arterial rigidity is another independent risk factor for CV death, which is a degenerative process of remodeling the large arteries wall. There is increased arterial rigidity in both: diabetic patients and in patients with arterial hypertension, but studies that address these issues do not have consistency in the results, which was our motive for this study. Methods. This was a cross-sectional study that comprised 62 patients with diabetes mellitus type 2, aged over 38 years, followed at the University Clinic for Nephrology for diagnosis of, or already diagnosed hypertension. The control group consisted of 22 healthy subjects who had not been diagnosed with either DM type 2 or arterial hypertension. We examined pulse wave velocity, and analyzed hypertension with data obtained from 24-hour ambulatory blood pressure monitoring. The obtained data were statistically processed. Results. The results were displayed in tables. Conclusion. Arterial stiffness (measured by PWV) was higher in patients with DM compared to the control group of healthy subjects. In our study HgA1c had impact on PWV which can serve as a tool for assessing CV risk and arterial rigidity. Keywords: diabetes mellitus, arterial hypertension, arterial rigidity, pulse wave velocity - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Rare Case Of Deep Neck Infection(2020-11-10); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, VASCULAR COMPLICATIONS IN PATIENTS WITH DIABETES MELLITUS TYPE 2 AND CORRELATION WITH ELEVATED HOMOCYSTEINE LEVELS AS A RISK FACTOR(2020-01); ; Background Elevated homocysteine levels (tHcy), oxidative stress and prolonged hyperglycemia are considered as potential factors for vascular endothelial damage. Correlation between elevated plasma homocysteine and microvascular or macrovascular complications of diabetes mellitus patients, and its possible role as an early predictor for endothelial imparement, is a scientific challenge up to date.Methods diabetes mellitus type 2 more than 12 months, glycosylated haemoglobin HbA1c ≥ 7,5%, BMI ≤ 40 kg/m2 and prescribed oral antidiabetic drugs (OAD) and / or insulin therapy, divided into two groups: 50 patients diagnosed with vascular complications and 30 patients without vascular complications. Complete haemogram, glycemic profile. HbA1c, lipid prorenal function tests, plasma tHcy levels, ultrasound, doppler sonography, blood preasure measurements, oftalmoscopy and urine test for microalbuminuria were performed in each patient. ResultsElevated levels of homocysteine within 16,05 ± 0,83 μmol/l were detected in the group of diabetic subjects with microvascular and macrovascular complications compared to the group where no complications were diagnosed and levels of homocysteine were 10,44 ± 0,24 μmol/l. Elevated homocisteine levels represent an additional risk factor for endothelial imparement in patients with diabetes Conclusion mellitus type 2. However, further research would provide clear evidence of the impact on endothelial vascular damage and long-term vascular complications - Some of the metrics are blocked by yourconsent settings
Item type:Publication, THE EFFECT OF METHYLPREDNISOLONE VERSUS DEXAMETHASONE IN INCREASING THE DIABETOGENIC EFFECT OF SARS-CoV-2 INFECTION AND THE DEVELOPMENT OF A NEW-ONSET DIABETES MELLITUS(Macedonian Association of Anatomists, 2022); ; ; Milenkovski, MarijanSARS-CoV-2 causes predominantly lung disease, but by way of binding to the angiotensinconverting enzyme 2 (ACE2) receptors, it can attack key metabolic organs and may lead to alterations of glucose metabolism. The aim of the study was to examine the effect of methylprednisolone compared with dexamethasone on the glycaemic control as well as the development of new-onset diabetes in patients who were hospitalized due toCOVID-19 pneumonia. We reviewed the records of 203 consecutive patients who were hospitalized with a clinical presentation of COVID-19 pneumonia in the modular hospital at the University Clinic for Infectious Diseases and Febrile Conditions in Skopje, from December 2020until May 2021. We identified 65 patients with diabetes (32,0%), 49 patients (75%) of whichwith pre-existing diabetes, and 16 (25%) with newly diagnosed diabetes. Impaired glycoregulation was recorded in 19,2% of patients, of whom 5,5% did not receive any corticosteroid-therapy, 22,4% were treated with methylprednisolone – pulse doses,and 21,4% were treated with dexamethasone. Patients with diabetes had a 1,9 times (CI 0,9-3,9) higher mortality rate than nondiabetic patients. We suggest that, if corticosteroid therapy is necessary during the treatment of COVID-19 pneumonia, it is safer to administer dexamethasone than methylprednisolone, especially in patients who have pre-existingdiabetes or are at risk ofdeveloping diabetes. Deterioration of glycoregulation and the need to replace oral antidiabetic therapy with insulin are common. New-onset diabetes often persists even after recovering from Covid-19 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Are diabetes mellitus and lipoprotein(a) independently or causally associated with an increased cardiovascular risk?(Kare (Turkey), 2017-03-17)Serum Lp(a) and diabetes mellitus increase the risk of cardiovascular diseases (CVD). However, the relationship between serum Lp(a) and diabetes is poorly characterized, and it is a subject of debate as to whether they are independently or causally associated (1). One of the atherogenic mechanisms in hyperglycemia is based on enhanced inflammation. Diabetes is associated with increased vascular production of reactive oxygen species (ROS), which causes premature cell apoptosis via reduction of endothelial nitric oxide (NO), resulting in decreased smooth muscle relaxation and antiatherogenic properties, including decreased platelet aggregation and adhesion inhibition (1). - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Newly Diagnosed Diabetes and Stress Glycaemia and Its' Association with Acute Coronary Syndrome(Scientific Foundation SPIROSKI, 2015-12-15); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Carotid ultrasound, blood lipids and waist determination can predict a future coronary revascularisation in the type 2 diabetic cohort(Macedonian Academy of Science and Art (MANU), 2007-12-28); ; ; The aim of the study was to identify incremental values of carotid ultrasound measurements (carotid plaques and stenosis) on the prediction of future coronary revascularization among type 2 diabetic patients. The second objective was to determine the predictive value of the assessment of blood lipids, BMI, abdominal obesity and the ankle-brachial index (ABI). Three hundred and thirty three (333) patients with type 2 diabetes and manifested coronary artery disease were randomly selected in a cohort prospective study. Univariate and multivariate logistic regression analyses were conducted to identify variables predictive of the need for future revascularization: percutaneus coronary interventions (PCI) or coronary bypass surgery (CABG) followed 24 months after the study starting point. The presence of arterial hypertension, hyperlipidemia, physical inactivity, intermittent claudication, the value of systolic pressure, BMI, waist and hip measurement, glycemia and blood lipid fraction (total cholesterol, HDL, LDL, non-HDL, triglycerides) were entered in a model. Ultrasound measurements: carotid IMT, presence of carotid plaques and stenosis, and ABI were also included in the analysis. Based on the univariate and multivariate findings, the presence of internal carotid artery (ICA) stenosis (OR 4,562, 95% CI 1,327-15,687), carotid plaque (OR 1,465, 95% CI 0,829-2,591), and increased waist measurement (OR 1,371, 95% CI 0,757-2,483) were found as significant independent predictors of future PCI. LDL and non HDL cholesterol were found to be factors independently associated with the need for future CABG by univariate analysis, which was not confirmed by multivariate analysis. In conclusion, the current study has provided an identification of predisposing factors for the future need of coronary revascularization among type 2 diabetic patients that permits risk stratification and may facilitate improved patient selection or optimization. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, DEPRESSION AND DIABETES(Institute of Knowledge Management, 2020);