Faculty of Medicine

Permanent URI for this communityhttps://repository.ukim.mk/handle/20.500.12188/14

Browse

Settings

Author: search.filters.author.Buklioska, AdrianaLanguage: search.filters.language.English

Search Results

Now showing 1 - 4 of 4
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    FIRST AND SECOND TRIMESTER MEDICAL ABORTION - PILOT STUDY IN REPUBLIC OF NORTH MACEDONIA
    (Македонско лекарско друштво = Macedonian medical association, 2021)
    ;
    ;
    ;
    ;
    Introduction. Medical abortion is a procedure in which medication is used to end a pregnancy up to 22 weeks of gestation. The aim of this study was to assess the efficiency, safety and acceptance of medical abortion in the first and second trimester using a regimen of medications, mifepristone followed by misoprostol. Methods. In a prospective study, conducted at the University Clinic for Gynecology and Obstetrics in Skopje in the period from March to November 2021, women that came for medical abortion in the first and second trimester were enrolled. They were divided into two groups: Group I (5 to 12 weeks of gestation) and Group II (12 to 22 weeks of gestation). Participants in Group I were given 200 mg mifepristonе for peroral application and after 24 hours instructed for sublingual application of 800 µg misoprostol at home. Participants in Group II were hospitalized and treated with the same regimen. Additional dosage of misoprostol was given to complete abortion. Results. A total of 208 women with medical abortion up to 22 weeks of gestation (173 in the first group and 35 in the second group) were enrolled in the study. In the first group a complete uterine evacuation was achieved in 168 women (97.1%) and in 25 women (71.4%) in the second group. Acceptability of the method was high among both groups (95.14 % in Group I and 82.14 % in Group II). All doctors/clinicians who participated in this pilot study were satisfied with the method. Conclusions. Medical abortion is effective, safe and acceptable option for women in the first and second trimester. Acceptability of the method was high among both groups. All doctors/clinicians who participated in this pilot study were satisfied with the method and would offer it as an option to their patients in the future.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    PREVALENCE OF BRONCHIECTASIS IN COPD PATIENTS
    (2023-01)
    ;
    Mickovski, Ivana
    ;
    Neshovska, Radmila
    ;
    Buklioska, Adriana
    ;
    Trajkova, Vesna
    Introduction - There is increasing recognition that radiological bronchiectasis is present in many patients with COPD. Computed tomography scan images have been used to identify different radiological COPD phenotypes based on the presence and severity of emphysema, bronchial wall thickening, and bronchiectasis. Bronchiectasis is defined as an abnormal dilation of the bronchi, usually as a result of chronic airway inflammation and/or infection. The prevalence of bronchiectasis in patients with COPD is high, especially in advanced stages, estimated prevalence varies from 4% to 50%. Methods - COPD patients underwent chest CT as part of their clinical assessment. Patients were included if COPD was diagnosed based on spirometry and clinical assessment and excluded if there was clinical bronchiectasis. Scoring was by a simplified system based on Smith (Thorax, 1996) and returned a score of 0 (no bronchiectasis), 1 (0–50% of bronchi involved), or 2 (50–100% of bronchi involved) for each lobe, with a total score of 12 including the lingula; emphysema, interstitial lung disease (ILD), or other pathology was noted. A total of 220 COPD patients (77.2% ex- or current smokers, 79.5% male) were consecutively enrolled. Results - Bronchiectasis was present in 54.5% of patients (score ≥2/12) and there was significant inter-observer correlation in the scoring (r=0.63, p<0.0001). Scores were highest in the lower lobes and lowest in the middle lobes (1.66 vs 0.86, p<0.000). Patients with widespread bronchiectasis (score ≥6/12) had a trend towards reduced bronchodilator reversibility (4% vs 9%, p=0.08) than those with limited bronchiectasis. Emphysema was present in 77.2% and ILD in 11.36%. The overall prevalence of emphysema was not different between patients with and without previous pulmonary tuberculosis (PTB) n=30 (13.63%), but in those with previous PTB, a higher number of subjects with middle (p=0.002) and lower (p=0.017) lobe emphysema, higher severity score (p=0.029), higher prevalence of panlobular emphysema (p=0.015), and more extensive centrilobular emphysema (p=0.036) were observed. Conclusions - In this study, we found a higher prevalence of bronchiectasis than previously reported which may reflect the heterogeneity of COPD patients in a general respiratory clinic. Radiological features of bronchial wall thickening and mild bronchiectasis were commonly seen and when widespread this may result in reduced bronchodilator reversibility; however, the presence of radiological bronchiectasis was not related to disease severity. COPD patients with previous PTB had unique features of bronchiectasis and emphysema on HRCT, which were associated with significant dyspnea and higher frequency of severe exacerbations.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    Association Between Bacterial Vaginosis and Squamous Intraepithelial Lesions of the Uterine Cervix
    (Македонско лекарско друштво = Macedonian medical association, 2016-01-01)
    ;
    ;
    ;
    ;
    Introduction. Bacterial vaginosis is polymicrobial, primarily anaerobic infection, previously called non-specific vaginitis or vaginitis accompanied by Gardne-rella vaginallis. It is a result of an imbalance between different types of bacteria in the vagina. The aim of the study was to determine the association between bacterial vaginosis and squamous intraepithelial lesions of the uterine cervix. Methods. This cross-sectional study was conducted in a series of 338 sexually active women with cytologicallly diagnosed squamous intraepithelial lesion of the uterine cervix at the University Clinic of Gynecology and Obstetrics in Skopje in the period from October 2014 to October 2015. The age of the patients ranged from 20 to 59 years (35±10.49). All women underwent cervical biopsy with endocervical curettage for histopathological analysis and cervical biopsy for detection and HPV typing. Criteria for diagnosis of bacterial vaginosis was the presence of ≥20% clue cells of ePapanicolaou smear. Results. Bacterial vaginosis was detected in 19.5% (66/338) of the examined women. The most affected was the young population under the age of 30 years. The results showed an association between bacterial vaginosis and squamous intraepithelial lesions of the uterine cervix (p=0.032). There was no association between bacterial vaginosis and the grade of lesion of the uterine cervix (p=0.118), nor with HPV infection (p=0.570). But, however an association was found between HPV infection and squamous intraepithelial lesions of the uterine cervix (p=0.001). Conclusion.The most common risk factor for squamous intraepithelial lesions of the uterine cervix are persistent high-risk HPV infections. Bacterial vaginosis is the most common co-infection.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    Chronic Obstructive Pulmonary Disease (COPD) as a risk factor for Metabolic Syndrome (MetS)
    (Slovenian Respiratory Society, 2020-12)
    ;
    Trajkovska, Ivana
    ;
    Buklioska, Adriana
    Background: MetS represents a cluster of risk factors (abdominal obesity, atherogenic dyslipidemia, hypertension and insulin resistance) that predispose affected patients to systemic inflammation, cardiovascular disease and physical inactivity. COPD is a major health problem worldwide, the fourth leading cause of death with prevalence in increase. There is a limited data about the prevalence of MetS in COPD. The aim of the study is to determine the frequency of coexisting MetS in COPD. Methods: Case control study of 120 patients with COPD (82 men and 38 women, aged 40-75 years, mean age 64.2±10.4), diagnosed according to Global Initiative for Chronic Obstructive Lung Disease, 30 healthy non-COPD subjects, randomly selected as controls. Anthropometric measurements, fasting blood sugar (FBS), lipid profile, high-sensitivity C-reactive protein (hsCRP), spirometry, CAT (COPD assessment test) and mMRC (Modified Medical Research Council Dyspnea scale) questionnaires, were assessed. COPD subjects were stratified based on combined assessment test (ABCD criteria) and spirometry (stages I - IV). Results: The presence of MetS was diagnosed in 50(41.67%) of COPD patients vs. 5(16.67%) of controls (p=0.01). The frequencies of the MetS in patients with COPD, GOLD stages I, II, III, and IV, were 50(41,67%), 66(55%), 60(50%), 42(35%) respectively. Frequency of MetS according to combined assessment test (A, B, C, D) was 42(35%), 54(45%), 25(30%), 36(30%) respectively. The presence of MetS was associated with significantly worse cough, sleep and mood (p<0.01) and higher total CAT score (p=0.031). Average BMI was 29.18. There was a correlation between the presence of MetS and hs-CRP (p=0.02) and no correlation with the pulmonary function. FBS was higher in COPD than controls (8.5±1.2mmol/L vs 5.4±1.1mmol/L) with statistical significance (p<0.0001), but HDL was lower in COPD than controls (42.1±5.4mg/dl vs 53±3.6mg/dl) with statistical significance (p<0.0001). Waist circumference and blood pressure were higher in COPD than controls 93.8s±2.4m vs. 92.3±3.1sm, p=0.004, and mean systolic BP 135±10mmHg vs. 113.5±8.1mmHg, p < 0.0001. Conclusion: The high prevalence of MetS in patients with COPD show the urgent need to develop comprehensive strategies for prevention, screening and start of treatment in early stage. Correction of the MetS may have a significant role in prevention of complications related with the COPD.