Faculty of Medicine
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Item type:Publication, HEPATITIS B IMMUNIZATION IN THE MATERNITY WARD OF THE UNIVERSITY CLINIC FOR GYNECOLOGY AND OBSTETRICS IN R. N. MACEDONIA(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2024-05); Duvlis, SotirijaIntroduction: The beginning of the fight against infectious diseases is marked by receiving the first dose of Hepatitis B (HepB) vaccine in the maternity ward. It is a recombinant viral vaccine that stimulates active immunity. Unfortunately, on a global level, there is a decline in vaccination coverage of children for all vaccines. Our study aims to assess the coverage of the first dose of vaccine against the HepB among newborns in our hospital during 2023. Material and Methods: This is a retrospective study and it included data for HepB vaccination from all newborns born at the University Clinic for Gynecology and Obstetrics from 01.01.2023 to 31.12.2023. Results: There were 3,917 live births in total in our maternity hospital in the year 2023. 3,235 (82.6%) of the newborns were vaccinated against the HepB virus, while 682 (17.4%) of the newborns remained unvaccinated. In the first 24 hours after the birth and the first 7 days, 2,912 and 323 newborns were vaccinated respectively. Out of the 682 unvaccinated, 30 have been transferred to another health facility, 8 were unvaccinated due to the written consent from the parents for postponing vaccination, and 644 newborns remained to be vaccinated in the vaccination dispensary, where individual calendars for immunization would be created. Conclusion: In order not to lose the battle with infectious diseases at a time of intensive technical- technological development, it is necessary to be more active and to continuously participate in the process of immunization at all levels of the health care. Immunization of newborns with HepB vaccine is an effective measure to control HepB infection and prevent liver cirrhosis and hepatocellular carcinoma. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, RELATIONSHIPS AMONG BIOCHEMICAL MARKERS IN EARLY NEONATATAL INFECTIONS(2014); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, HYDROCEPHALUS WITH VENTRICULOPERITONEAL SHUNT IN INFANTS: OUR EXPERIENCES AND CLINICAL OUTCOMES(Macedonian Association of Anatomists, 2022-12); ; ; Mica Kimovska-HristovAbstractHydrocephalus is a condition resulting from disorder in absorption and circulation of the cerebrospinal fluid (CSF). It leads toaprogressive ventricular dilatation and need of ventriculoperitoneal shunt (VP)placement. The aim of our study wasto present our experience withinfantswith hydrocephalus,ventriculoperitoneal shunt placement, and earlypostoperative follow-up.A retrospective study was conducted comprising infantswith hydrocephalus born between January 2019-January 2022with ventriculoperitoneal shunt placement performedatthe University Clinic for Neurosurgery in Skopje,Macedonia. Demographic and clinical characteristics, complications and the need for ventriculoperitoneal shunt were documented.Of twenty-three infantswith hydrocephalus,14 (60.8%) were preterm infants (median birth weight 2120g; mean gestational age 33.1weeks), 9(39.1%) were term infants(mean birth weight 3600g; mean gestational age 38.4 weeks). The etiology of hydrocephalus was:congenital hydrocephalusin 5infants(21.7%),prematurityin 6 infants(26.08%), spina bifida in 2 infants(8.7%),systemic infection in 4 infants(17.3%), and intraventricular hemorrhage in 6 infants(26.08%).Ventriculoperitoneal shunt was placed inall 23infants, at the mean age of 33.5(30-43) days.Postoperative complicationsas a result of ventriculoperitoneal shuntplacement were:ventriculitismanifested in3 preterm (13%) infants,of which 2(8.6%) died;fiveterm infants(21.7%) had postoperativeseizures, of which2 infants(8.6%) died. Nineteeninfants(82.6%) were discharged and transferredto the neonatology department. Ventriculoperitoneal shunt placementis atreatment of choice for infantswith hydrocephalus, although postoperative complications in preterm infantsincrease the percentageof morbidity and mortality. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, THE ROLE OF RISK OF RENAL FAILURE, INJURY TO THE KIDNEY, FAILURE OF KIDNEY FUNCTION, LOSS OF KIDNEY FUNCTION AND ENDSTAGE RENAL FAILURE (RIFLE) CLASSIFICATION IN IDENTIFICATION AND PREDICTION SEVERITY OF THE KIDNEY INJURY IN NEWBORNS(SHMSHM / AAMD, 2021); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, RELATIONSHIP OF SERUM PROCALCITONIN LEVELS AND C-REACTIVE PROTEIN LEVELS IN NEWBORNS WITH SEPSIS IN DIFFERENT TYPES OF RESPIRATORY SUPPORT IN INTENSIVE CARE UNIT(Institute of Public Health of the Republic of North Macedonia, 2021); ; ; ; Elizabeta ShuperliskaSepsis in newborns with RDSy and asphyxia is essential; it is a life-threatening condition and still represents an important cause of mortality and morbidity. The aim of this study was to evaluate the predictive values of procalcitonin (PCT) as an early diagnostic and prognostic biochemical marker for sepsis in newborns with RDS and asphyxia. Material and methods: The study was designed as prospective and we examined 110 newborns with proven sepsis admitted in the Intensive Care Unit at the University Clinic of Pediatrics – Skopje in the period between December 2018 and Јanuary 2021. Procalcitonin levels were measured by using the immunoassay system Vidas based on the ELFA principles. The newborns with proven sepsis were divided into two groups. The first group comprised 55 newborns with RDS and proven sepsis and the second group included 55 newborns with asphyxia and proven sepsis. The statistical analysis confirmed significantly different values of PCT in the analyzed time period in first group of newborns with RDS and proven sepsis, p<0.001. The highest average values (40.37±53.79) were measured on admission with a high level of peak compared to the second group of newborns with asphyxia and proven sepsis. The statistical analysis confirmed significantly different values of PCT in the analyzed time period in the first group of newborns with RDS and proven sepsis with mechanical ventilation (MV) and bubble continuous positive airway pressure (BCPAP) compared to the second group of newborns with asphyxia and proven sepsis, p<0.001. PCT is a promising sepsis marker in newborns with RDSy, capable of complementing clinical signs and routine laboratory parameters suggestive of severe infection at the time of ICU admission. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, NEONATAL ACUTE KIDNEY INJURY IN INTENSIVE CARE UNIT(2017); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, EARLY DIAGNOSTIC OF SEPSIS IN NEWBORNS WITH RESPIRATORY DISTRESS SYNDROME(SHMSHM / AAMD, 2020); ; ; Avdi MurtezaniObjective: Early diagnosis of sepsis in newborns with RDS is essential for life-threatening condition, for reducing severe sepsis and septic shock in the Intensive care Unit at the University Children’s Hospital in Skopje.Methods: In this prospective study, we included 100 (M:F=59:41) newborns with Respiratory distress syndrome (RDS) suspected for sepsis admitted in the Intensive Care Unit in period of December 2019 till 31 May 2020 y. Procalcitonin levels were measured by using a immunoassay system Vidas based on the ELFA principles. Results: The newborns with RDS suspected for sepsis have been divided into two groups The first group included 50 newborns with RDS and positive blood culture and the second group included 50 newborns with RDS and negative blood culture. Тhe average gestational age of the newborn with RDS and positive blood culture was 36,01± 3,1 weeks and the newborn with RDS and negative blood culture 36,26± 3,2 weeks. Preterm newborns in both groups dominated (64,2% and 58,2%). Тhe average birth weight of the newborn with RDS and positive blood culture was 2490,5 ±791,6 grams, and the newborn with RDS and negative blood culture was 2690,2±788,5grams. There is statistically significant difference in average PCT between the two groups overtime (p<0.05). There is statistically significant difference in average PCT between the two groups overtime procedure (MV , BCPAP, OXYGEN MASK) (p<0.05).Conclusions: PCT is promising sepsis markers in newborns with RDS, capable of complementing clinical signs and routine lab parameters suggestive of severe infection at the time of ICU admission - Some of the metrics are blocked by yourconsent settings
Item type:Publication, NEONATAL ACUTE KIDNEY INJURY ASSOCIATED WITH COMORBID CONDITIONS(Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2015)Acute kidney injury (AKI) is a common clinical problem in neonatal intensive care units. Predisposing factors are perinatal asphyxia, prematurity, sepsis, and congestive heart failure. The aim of this study was to determine the contributung conditions associated with neonatal acute kidney injury.Materials and methods. In a clinical prospective sudy we evaluated neonates with acute kidney injury who had been hospitalized in the NICU at University Childrens Hospitals in Skopje, Republic of Macedonia. We studied medical records of neonates with a diagnosis of acute kidney injury in the period 2013-2014. Results. Out of 450 hospitalized neonates, 29(6.4%) with a documented acute kudney injury were analyzed in the study. The male to female ratio was 2.6:1. Most of the neonates involved in the study were term neonates (66%). Prerenal AKI was evaluated in 80% of cases. Perinatal asphyxia was the most common predisposing factor for kidney injury in our study and was evaluated in 56% cases with predomination of term infants and male. Sepsis was present in 44% of cases, prematurity in 34%, and congenital malformations in 27% of cases. Mortality rate was 26% and it was significantly higher in patients with assisted ventilation and sepsis (p<0.05). Conslusion. Early recognition of risk factors and rapid effective tratment of contributing conditions will reduce acute kudney injury in neonatal period. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Effect of lipid parameters on foetal growth in gestational diabetes mellitus pregnancies(MANU / Walter de Gruyter GmbH, 2014-12-01); ; ; Vladimir SerafimoskiIntroduction: Women with gestational diabetes mellitus (GDM) often deliver newborns large for their gestational age (LGA). The aim of the study was to evaluate the effect of lipid parameters in the second half of pregnancy on foetal growth in GDM pregnancies. Material and methods: In two hundred consecutive women with GDM the age, body mass index before pregnancy, body mass index before delivery, gestational week of GDM diagnosis, lipid parameters after 24 weeks of pregnancy, fasting glycaemia, HbA1c in the second and third trimester of pregnancy, gestational age at delivery, mode of delivery, and baby birth weight were analyzed. Results: Of the 200 GDM pregnancies, 50 (25%) women delivered LGA newborns, 135 (67.5%) women delivered newborns appropriate for gestational age (AGA), and 15 (7.5%) women delivered newborns small for gestational age (SGA). Maternal triglyceride levels and HbA1c in the second trimester were higher, and HDL-C was significantly lower, in the LGA group than in the AGA group (3.8 ± 1.8 vs. 3.1 ± 1.1 mmol/L, 6.1 ± 1.1 vs. 5.5 ± 0.8%, and 1.3 ± 0.4 vs. 1.6 ± 0.4 mmol/L, p < 0.05). Also, maternal triglyceride levels and HbA1c in the second trimester were significantly higher in the SGA group than in the AGA group (3.8 ± 1.9 vs. 3.1 ± 1.1 mmol/L and 6.8 ± 0.8 vs. 5.5 ± 0.8%, p < 0.05). Maternal triglycerides were independent predictors for delivering LGA newborns in GDM women. Conclusion: In GDM pregnancies, maternal triglycerides in the second half of pregnancy may identify women who will deliver LGA newborns. Thus, with good regulation of lipid profile, we can avoid macrosomia from GDM pregnancies.