Faculty of Medicine

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Author: search.filters.author.Avramovska, MajaHas files: No

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    Inflamed Mesenteric Pseudocyst Associated with Meckel’s Diverticulitis: Cause or Consequence
    (Knowledge E DMCC, 2024-12-08)
    Talev, Stefan
    ;
    Avramovska, Maja
    ;
    Avramovski, Petar
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    Nikleski, Zorica
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    Ivkovska, Tamara
    Introduction: Mesenteric pseudocyst describes an abdominal mass that appears on small bowel mesentery or mesocolon, or at any part of the abdomen and retroperitoneum. This paper aims to emphasize the non-specific clinical appearance and highlight Meckel’s diverticulitis as a potential cause of the development of pseudocyst. Case Report: A 26-year-old male with a palpable mass in the right upper abdominal quadrant and an increased body temperature of 38.3∘C was admitted for further medical investigation. Computed tomography (CT) presented a cystic mass with a diameter of 5.5 cm, and emergency laparotomy was performed. Wedge resection of pathologic findings of small bowel, its mesenterium, and the cyst mass associated with nearby Meckel’s diverticulum was performed. Discussion: Meckel’s diverticulum can be considered as a risk for developing mesenteric pseudocyst, because of its frequent exacerbation of chronic inflammation. This report adds to the limited literature on the association between Meckel’s diverticulum and mesenteric pseudocysts, providing valuable insights that can guide future clinical evaluations and surgical interventions. Early and accurate diagnosis, aided by imaging techniques such as CT and magnetic resonance imaging (MRI), is essential for effective management. This case highlights the potential link between chronic inflammation in Meckel’s diverticulum and the formation of mesenteric pseudocysts. Conclusion: This case highlights the need to consider Meckel’s diverticulitis in patients with mesenteric pseudocysts, suggesting a possible pathophysiological link between them. Surgical resection is recommended for effective management.
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    ISOLATED MATERNAL HYPOTHYROXINEMIA AND ITS PERINATAL OUTCOME IN NORTH MACEDONIA
    (Sestre Milosrdnice University Hospital Center (KBC Sestre milosrdnice), 2021-06)
    Avramovska, Maja
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    Karanfilski, Borislav
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    Isolated maternal hypothyroxinemia (IMH) is defined as the presence of low maternal total thyroxine (TT4) level in conjunction with normal maternal thyroid-stimulating hormone (TSH) level. The aim was to investigate whether IMH is associated with adverse pregnancy outcome in North Macedonia. Dried blood spot samples were obtained from 359 pregnant women meeting the inclusion criteria and analyzed for TT4 and TSH. Postpartum data were entered from their medical histories. Out of 359 women, 131 (37.42%) belonged to IMH group. There were statistically significant differences in birth weight (p=0.043), intrauterine growth restriction (IUGR) (p=0.028), Apgar score at 1 min <7 (p=0.018) and cesarean section for dystocia/disproportion (p=0.024) between the IMH and normal thyroid function (NTF) groups. In regression analysis, TSH was a significant variable predicting Apgar score (βst=0.05597, p=0.047), body mass index predicting birth weight (βst=0.02338, p=0.045) and TT4 predicting small for gestational age/IUGR (βst=-0.089834, p=0.029) in IMH group. TT4 was a strong predictor of birth weight (βst=-0.004778, p=0.003) and premature delivery (βst=0.028112, p=0.004) in NTF group. The impact of IMH in pregnancy remains controversial. IMH was associated with an increased maternal BMI and higher birth weight of neonates. Overweight could be a potential risk factor for thyroid dysfunction in pregnant women, and specifically IMH. The worst fetal outcome was seen in IMH mothers examined in second trimester. We found TSH, TT4 and BMI to be strong predictors of perinatal outcomes.
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    Thyroid Function of Pregnant Women and Perinatal Outcomes in North Macedonia
    (Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2021-10)
    Avramovska, Maja
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    Kostova, Neda Milevska
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    Karanfilski, Borislav
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    Hunziker, Sandra
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    Objective Thyroid diseases are the second most common endocrine disorders in the reproductive period of women. They can be associated with intrauterine growth restriction (IUGR), preterm delivery, low Apgar score, low birthweight (LBW) or fetal death. The aim of the present study is to explore thyroid dysfunction and its relationship with some poor perinatal outcomes (Apgar Score, low birthweight, and preterm delivery). Methods Dried blood spot samples from 358 healthy pregnant women were analyzed for thyroid stimulating hormone (TSH), total thyroxine (TT4), and thyroglobulin (Tg). Neonatal data were collected upon delivery. Four groups were formed based on thyroid function tests (TFTs). Results Of the 358 tested women, 218 (60.72%) were euthyroid. Isolated hypothyroxinemia was present in 132 women (36.76%), subclinical hyperthyroidism in 7 women (1.94%), and overt hypothyroidism in 1 (0.28%). The perinatal outcomes IUGR (p = 0.028) and Apgar score 1 minute (p = 0.015) were significantly different between thyroid function test [TFT]-distinct groups. In the multiple regression analysis, TT4 showed a statistically significant inverse predictive impact on LBW (p < 0.0001), but a positive impact of Tg on LBW (p = 0.0351). Conclusion Thyroid hormones alone do not have a direct impact on neonatal outcomes, but the percentage of their participation in the total process cannot be neglected. Based on the regression analysis, we can conclude that TT4 and Tg can be used as predictors of neonatal outcome, expressed through birthweight and Apgar score. The present study aims to contribute to determine whether a test for thyroid status should become routine screening during pregnancy.
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    The Gamma Gap Predicts All-Cause Mortality in Chronic Dialysis Patients
    (2021)
    Avramovski, Petar
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    Avramovska, Maja
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    Ilkovska, Biljana
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    Sotiroski, Kosta
    The gamma gap (γ-gap) represents the total serum protein concentration minus the albumin concentration. The main aim of this study was to test whether the gamma gap is a predictor of mortality and whether it is associated with other predictors of mortality in chronic hemodialysis patients (CHPs).