Faculty of Medicine

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Non-ampullary mucinous adenocarcinoma of the small intestine unmasked by persistent anemia: A Case Report
(Liga-Inform, Ltd., 2026-02-23)
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Jankoski, D.
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Kutanoski, D.
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Kostovska Irena
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Perforatedsolitarymid-rectaldiverticulumdiagnosedwith colonoscopy:acasereportandliterature review
(Oxford University Press (OUP), 2026-01-27)
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Avramoski, Vladimir
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Gjinoska, Klaudia
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Kostovska, Irena
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Stoicovski, Emil
Rectal diverticulum is an exceedingly rare clinical entity, typically occurring as a solitary lesion or, less frequently, as up to three diverticula. Its development is often associated with underlying conditions such as obstructive defecation syndrome, rectal malignancy, pelvic floor weakness, chronic rectal impaction, obesity, or infection-related muscular atrophy. Although uncommon, rectal diverticulitis represents a surgical emergency requiring timely recognition and management. In this case, a female patient presented with rectal bleeding and secondary anemia. During the clinical course, the patient developed pelvic sepsis secondary to rectal diverticulitis. Appropriate surgical intervention, combined with antimicrobial therapy and supportive management, led to a favorable outcome. Rectal diverticulitis is a rare but potentially life-threatening condition. Awareness of this entity and early diagnosis are essential to prevent severe complications such as perforation and pelvic sepsis. This case highlights the importance of considering rectal diverticulum in the differential diagnosis of lower gastrointestinal bleeding and pelvic infections.
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Antihypertensive Medication Use and Biochemical Outcomes in Primary Care Patients: A Multicenter Study in Kosovo
(Oriental Scientific Publishing Company, 2026-03-20)
Alidema, Fitim
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Kostovska, Irena
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Alidema, Arieta Hasani
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Mustafa, Lirim
Arterial hypertension remains a major public health challenge that requires longterm pharmacological management; however, antihypertensive therapy may also be associated with metabolic and biochemical alterations. This multicenter retrospective study evaluated the association between antihypertensive drug use and biochemical parameters among primary care patients in Kosovo and compared outcomes across three healthcare centers (Prishtina, Ferizaj, and Gjilan). A total of 900 patients with essential hypertension receiving continuous treatment for at least 12 months were included. Data were extracted from medical records and laboratory registers between January 2024 and January 2025 and comprised demographic variables, treatment regimens (monotherapy or combination therapy), and biochemical parameters, including lipid profile, fasting glucose, renal markers, and electrolytes. Statistical analyses included ANOVA or Kruskal–Wallis tests, chi-square tests, correlation analysis, and multivariate logistic regression. Combination therapy was associated with significantly higher levels of LDL cholesterol, triglycerides, and creatinine compared to monotherapy (p < 0.05), while lipid alterations were more prominent among patients treated with beta-blockers and diuretics (p < 0.01). The use of two or more antihypertensive drug classes independently predicted an increased risk of dyslipidemia (OR 1.8, 95% CI: 1.2–2.5; p = 0.004). No significant differences were observed in glucose levels between the study centers (p = 0.21). Long-term antihypertensive therapy, particularly polytherapy, is associated with clinically relevant biochemical changes affecting lipid metabolism and renal function, highlighting the necessity for routine laboratory monitoring and individualized treatment optimization in primary care practice.
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CONSERVATIVE TREATMENT OF A CHRONIC WOUND WITH HYDROFIBER DRESSINGS: A CASE REPORT
(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2026-06-19)
Mihajloski, Vladimir
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Volchevski, Goce
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Ognjenovikj, Ljubomir
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Non-ampullary mucinous adenocarcinoma of the small intestine unmasked by persistent anemia: A Case Report
(Liga-Inform, Ltd., 2026-02-23)
;
Jankoski D
;
Kutanoski D
;
;
Kostovska Irena
Non-ampullary mucinous adenocarcinoma of the small intestine unmasked by persistent anemia: A Case Report
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Perforated solitary mid-rectal diverticulum diagnosed with colonoscopy: a case report and literature review
(Oxford University Press (OUP), 2025-12-24)
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Avramoski, Vladimir
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Gjinoska, Klaudia
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Kostovska, Irena
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Stoicovski, Emil
Rectal diverticulum is an exceedingly rare clinical entity, typically occurring as a solitary lesion or, less frequently, as up to three diverticula. Its development is often associated with underlying conditions such as obstructive defecation syndrome, rectal malignancy, pelvic floor weakness, chronic rectal impaction, obesity, or infection-related muscular atrophy. Although uncommon, rectal diverticulitis represents a surgical emergency requiring timely recognition and management. In this case, a female patient presented with rectal bleeding and secondary anemia. During the clinical course, the patient developed pelvic sepsis secondary to rectal diverticulitis. Appropriate surgical intervention, combined with antimicrobial therapy and supportive management, led to a favorable outcome. Rectal diverticulitis is a rare but potentially life-threatening condition. Awareness of this entity and early diagnosis are essential to prevent severe complications such as perforation and pelvic sepsis. This case highlights the importance of considering rectal diverticulum in the differential diagnosis of lower gastrointestinal bleeding and pelvic infections.
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Linking inflammation and cardiovascular disease: the emerging role of lipoprotein-associated phosphoplipase A2
(Ltd Chetverta Кhvylia, 2025-12)
Kostovska, Irena
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Over the past decades, inflammation has been recognized as a key contributor to the development of atherosclerosis, prompting extensive research. Numerous inflammatory markers have demonstrated predictive value for both initial and recurrent coronary events in individuals with or without established coronary vascular disease (CVD). Among these, lipo protein associated phospholipase A2 (Lp PLA2) has garnered significant attention. Lp PLA2 may be involved in the athero sclerotic process and contribute to plaque destabilization through its inflammatory activity within atherosclerotic lesions. Lipoprotein associated phospholipase A2 (Lp PLA2), a recently identified cardiovascular specific inflammatory mediator, is closely associated with the onset and progression of cardiovascular events. This review explores the potential of Lp PLA2 as both a risk marker and a therapeutic target in CVD. Elevated levels of Lp PLA2 mass and activity have been linked to an increased risk of CVD in both the general population and patients with pre existing disease. However, it remains uncer tain whether incorporating Lp PLA2 measurements into risk prediction models significantly enhances risk stratification beyond traditional cardiovascular risk factors. Additionally, the failure of darapladib, a potent and selective Lp PLA2 inhibitor, to reduce CVD events in major randomized, placebo controlled trials suggests the importance of ongoing research to fully understand its functions and develop effective strategies for CVD prevention and treatment.
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Laparoscopic revision of open appendectomy complicated by high-output colo-cutaneousfistula:acasereport
(Oxford University Press and JSCR Publishing Ltd., 2025-12)
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Jankoski, Daniel
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Kostovska, Irena
Colo-cutaneous fistulae are rare complications following appendectomy, especially when high-output, and can cause significant morbidity. We report a 66-year-old male who presented nine days post-open appendectomy with fecal discharge from the incision. Imaging showed cecal adherence to the anterior abdominal wall, consistent with a colo-cutaneous fistula. Conservative management failed, with persistent high-output drainage of 600–1000 mL/day. The patient underwent laparoscopic revision, including adhesiolysis, mobilization of the terminal ileum and ascending colon, and resection with extracorporeal ileocolic anastomosis. Postoperative wound healing was managed with secondary intention and negative pressure therapy. The patient recovered well and was discharged in stable condition. This case demonstrates the effectiveness of laparoscopic intervention in high-output colo-cutaneous fistulae and highlights the need for timely surgical management when conservative measures fail.
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DIAGNOSTIC VALUE OF FINE-NEEDLE ASPIRATION BIOPSY IN PATIENTS WITH THYROID CANCER AND HASHIMOTO THYROIDITIS
(Department of Anaesthesia and Reanimation Faculty of Medicine, “Ss. Cyril and Methodius” University, Skopje, R.N.Macedonia, 2025-12)
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Kostovska, Irena
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Introduction: Thyroid nodules are a common finding in clinical practice, with prevalence ranging from 2-6% on physical examination, 19–35% on ultrasound, and 8–65% in autopsy studies. Their incidence increases with age and is more frequent in women, individuals with iodine deficiency, and those previously exposed to ionizing radiation. Hashimoto’s thyroiditis may alter cytological interpretation and affect diagnostic accuracy.
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Liver Echinococcosis - A Single-Center Retrospective Study
(GALENOS PUBLISHING HOUSE, 2025-12)
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Kostovska, Irena
Liver echinococcosis, endemic to Mediterranean and livestock-farming regions, is characterized by hydatid cyst formation, primarily affecting the liver. Surgical management remains the primary treatment for large or complex cysts. The study aimed to evaluate surgical outcomes, complications, and recurrence rates associated with the Papadimitriou procedure, hepatic resections, and splenectomy in patients with liver echinococcosis at a single center.

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