Faculty of Medicine

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ANEMIA IN PREGNANCY AND RISK FACTORS
(Македонско лекарско друштво = Macedonian medical association, 2025-09)
Aleksandar Nakov
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Bekim Dika
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Introduction: During pregnancy, there is a “dilution” of hemoglobin concentration due to the increase in plasma volume. Iron and folic acid are necessary for the development of the fetus and are transported to it, so the mother can develop anemia due to their deficiency. Anemia affects 36% of pregnant women worldwide. Of those affected, about 40% are due to iron deficiency. Iron is an essential micronutrient involved in vital processes such as erythropoiesis, immune responses, and during pregnancy in the development of the placenta and fetus. The aim of our research was to determine the prevalence of anemia in pregnancy as well as the influence of certain risk factors: age, body mass index - BMI, parity and history of taking iron supplements. Material and methods: A blood count was performed in 100 patients in the third trimester of pregnancy in order to determine the hemoglobin concentration. The patients' body weight and height (to determine BMI) were measured and data were collected about age, number of previous births, and whether they were taking iron supplements. Results: Anemia (hemoglobin level below 110g/L) was present in 42.1% of pregnant women. Anemia was significantly common in women with ≥3 births and in those not taking iron supplements. Statistically insignificant anemia was more common in women under 25 years of age and in those with a BMI below 20. Conclusion: The results of the study showed the importance of regular controls of hemoglobin levels as well as the significance of iron supplementation during pregnancy, when the needs for this element are significantly higher.
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CASE OF A PATIENT WITH POSTPARTUM ECLAMPSIA
(Македонско лекарско друштво = Macedonian medical association, 2025)
Aleksandar Nakov
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Petko Isjanovski
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Nurdzan AJeti
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Shqipe Sarachini - Hajdari
Gestational hypertension is hypertension without proteinuria or other signs/symptoms of preeclampsia that develops after 20 weeks of gestation in a patient with a previously normal blood pressure. Development of proteinuria upgrades the diagnosis to preeclampsia. Even without proteinuria, patients who develop severe hypertension or other features of severe disease are managed in the same way as those with preeclampsia with severe features.
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THE IMPACT OF SUBCLINICAL HYPOTHYROIDISM ON THE LIPID PROFILE IN PERIMENOPAUSAL AND POSTMENOPAUSAL WOMEN
(Македонска асоцијација на гинеколози и опстетричари = MACEDONIAN ASSSOCIATION OF GYNECOLOGISTS AND OBSTETRICIANS, 2025)
Aleksandar Nakov
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Aleksandra Eftimova - Kitanova
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Marijana Filipovska - Rafajlovska
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Iskra Martinovska
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Perinatal outcome in patients with gestational diabetes mellitus
(2022)
Dimitar Georgiev
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Aleksandar Nakov
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A case report of serous carcinoma of the uterine corpus
(2022-09)
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Emil Bajalski
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Bashkim Ismaili
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Dimitar Georgiev
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In the Republic of North Macedonia, in 2020, there were 369 new cases of cancer of the uterine body, which were 10.9% of all new cases of malignancies and was the third most common in women, after breast cancer and colorectal cancer. Endometrial polyps are common pathological findings and their prevalence is between 16% to 34%. The prevalence of malignant and premalignant lesions found in the endometrial polyps ranges from 0.8% to 4.8%. Uterine serous carcinoma is an aggressive variant of EC that accounts for only 5-10% of all EC, but is related with 80% of endometrial cancer–related deaths. It is not related with increased estrogen levels and atypical endometrial hyperplasia. They arise in a background of atrophic endometrium or endometrial polyps in postmenopausal women. We present a case of 72 years old patient with serous carcinoma of the uterine corpus that arises on endometrial polyp. She was 20 years postmenopausal and bleeding was present. The transvaginal ultrasound examination showed that heterogeneous and irregular endometrial thickening was present. We performed fractionated explorative curettage. The histopathological report showed the presence of the parts of an endometrial polyp with surface that is coated with atrophic endometrium, and in parts it was coated with malignantly altered endometrium. The morphology of serous endometrial carcinoma with complex papillary and glandular architecture was present. Pathological mitoses have been verified. Lymphovascular invasion or infiltration of the cervical stroma were not found. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Histopathological analysis of the operative material showed the absence of lymphovascular infiltration but present infiltration of the cervical stroma (pTNM= pT2 pNx pMx R0 L0 V0 Stage II). The patient was referred for further treatment to an oncologist.
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A case report of fetal spinal meningomyelocella
(2022-09)
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Bashkim Ismaili
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Dimitar Georgiev
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Neural tube defects are congenital malformations of the CNS resulting from defective closure of the neural tube during early embryogenesis between 3rd and 4th week of intrauterine life. It involves defect in the skull, vertebral column, the spinal cord and other portion of CNS. It occurs about 1 to 5 per 1000 live births. Myelomeningocele is most common and severe form of spina bifida cystica, characterised by protrusion of spinal cord through the open vertebrae into the amniotic fluid. We present a case of a 25-year-old pregnant woman who came into our hospital in the 17th week of pregnancy with characteristic ultrasound signs for the presence of fetal spina bifida. Lumbosacral meningomyelocella was present. The anterior part of the head started to develop ‘‘the lemon sign’’ and cerebellum showed ‘‘the banana sign’’. Dilated lateral ventricle was also present. There was anamnesis for folic acid supplementation starting at 6 weeks of gestation. We performed induction of labour with oxytocine and termination of this pregnancy. The autopsy report showed the presence of spina bifida in the lumbosacral region, with a defect of the skin and the vertebral arches, measuring 1.7 × 1 cm, with protrusion of meninges and the spinal cord.
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A RARE CASE OF SEROUS CARCINOMA OF THE UTERINE CORPUS THAT ARISES IN POLYP
(Macedonian Association of Anatomists, 2022)
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Emil Bajalski
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Dimitar Georgiev
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Bashkim Ismaili
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Endometrial polyps (EPs) are common pathological findings and their prevalence range is between 16% to 34% depending on characteristics of the examined population and detecting methods. Clinically, these lesions cause thickening of the endometrium and abnormal uterine bleeding. Asymptomatic EPs can be detected by routine ultrasound examination or infertility investigations. Most EPs are benign. Their malignant potential is highest in postmenopausal women with uterine bleeding (2.3%). Serous carcinoma is the prototype of type-II endometrial cancer (nonendometrioid) and accounts for <10% of all endometrial carcinomas. It is a very aggressive tumor, unrelated to estrogen stimulation, arising occasionally in endometrial polyps or from precancerous lesions developing in atrophic endometrium that mainly occur in older women. We present a case of 72-years-old patient with uterine bleeding, with thick and heterogenous endometrium detected on ultrasound. Fractionated explorative curretage was performed and serous carcinoma that arises in polyp was diagnosed. After operative treatment, histopathological analysis of the operative material showed stage II of the disease.

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