Faculty of Medicine

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Visceral Leishmaniasis in the Republic of North Macedonia: A Retrospective Cohort Study
(Galenos Yayinevi, 2025-11-11)
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Khezzani, Bachir
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Cana, Fadil
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Visceral leishmaniasis (VL) is a systemic protozoan vector-borne disease and represents the most severe clinical form of leishmaniasis, with fatal outcomes if left untreated. This study aimed to evaluate the key epidemiological, clinical, and laboratory findings, treatment options, and outcomes in patients with VL. Materials and Methods A retrospective analysis was conducted on the epidemiological and clinical characteristics of 84 patients diagnosed and treated for VL at the University Hospital for Infectious Diseases in Skopje, Republic of North Macedonia (RNM), between 2001 and 2023. Results The median age of patients was 47 years (range 1-74), with 77.4% being male. Contact with dogs was reported in 41.7% of cases. Seven percent of patients were immunosuppressed, and all were Human Immunodeficiency Virus-negative. The median time from symptom onset to diagnosis was 30 days (range 4-330 days). The predominant clinical manifestations were splenomegaly (97.6%), fever (96.4%), hepatomegaly (90.5%), and weight loss (54.8%). On admission, anemia, leukopenia, thrombocytopenia, and hypergammaglobulinemia were detected in 75%, 73.8%, 70.2%, and 63.1% of patients, respectively. A favorable outcome was achieved in 91.7% of cases; therapeutic failure occurred in 1.2%, and 7.1% of patients died. Conclusion VL should be considered a crucial differential diagnosis in patients from the RNM presenting with prolonged unexplained fever, splenomegaly, cytopenia, and hypergammaglobulinemia.
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Hybrid peer-reviewed journals and publishing model: Bias or impartiality in editorial policy
(Pensoft Publishers, 2025-03-24)
Khezzani, Bachir
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Nikolic, Jadranka
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Tsachev, Ilia
In recent years, there has been a significant increase in scientific productivity—an increased number of published original articles, reviews, short communications, case reports, and letters to the editor. In this regard, there is a large number of peer-reviewed journals in all fields of scientific knowledge, including in the field of biomedical sciences. Many studies indicate the existence of so-called journal editorial board bias and acknowledge the difficulty of eliminating it. We present our brief opinion on an important topic such as how publishing policy in some peer-reviewed journals leads to feelings of bias and inequality among authors and how to address this.
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Sellers of unpasteurized animal milk in unregulated markets: a key factor for human brucellosis control in El-Oued province, Algeria
(African Field Epidemiology Network (AFENET), 2025)
Khezzani, Bachir
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Nikolić, Jadranka
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Chakarova, Borislava
To the editors of the Pan African Medical Journal
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Clinical characteristics of human brucellosis in different age groups in the Republic of North Macedonia-A case series
(Springer Science and Business Media LLC, 2024-12-04)
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Khezzani, Bachir
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Osmani Lloga, Arlinda
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Background Brucellosis is a zoonotic infection that presents a major challenge to public health worldwide. Aim This research compares demographic characteristics, clinical features, and outcomes across different age groups in patients with human brucellosis. Material and methods Between 2003 and 2022 a total of 508 patients with brucellosis were subjected to diagnostics and treatment at the Clinic for Infectious Diseases in Skopje. The patients were classified into three age groups: children (up to 14 years old), adults (from 14–64 years) and older adults (older than 64 years). The demographics, clinical characteristics, and outcomes between patients from the different age groups were retrospectively evaluated. Results A family history of brucellosis (p < 0.001), fever (p = 0.013), and hepatosplenomegaly (p < 0.001) were significantly more prevalent in children compared to other age groups. Direct contact with animals (p < 0.001), arthralgia (p = 0.007), and weight loss (p = 0.004) were significantly less frequent in children, whereas the duration of illness before brucellosis diagnosis was significantly shorter in children (p < 0.001) compared to other age groups. Sacroiliitis was more predominant in adults than children (p = 0.043), while focal hematological involvement was more prevalent in children than in adults (p = 0.004). Spondylitis was more dominant in the old age group compared to the other two age groups (p < 0.001). Favorable outcomes were achieved in 88.5% of children, 89.9% of adults, and 87.1% of older patients with specific treatment. Conclusion Brucellosis presents highly variable clinical and epidemiological features across all age groups; however, certain characteristics may be associated with age.
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Epidemiological and clinical characteristics of imported falciparum malaria in the Republic of North Macedonia : A 13-year experience
(Springer Science and Business Media LLC, 2023-04-03)
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Khezzani, Bachir
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Semenakova-Cvetkovska, Vesna
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Vidinic, Ivan
Plasmodium falciparum is the leading cause of imported malaria and the most common cause of death in returning travellers. Aim To identify the main epidemiological and clinical characteristics of patients with imported falciparum malaria in the Republic of North Macedonia. Material and methods Retrospectively analyzed were the epidemiological and clinical features of 34 patients with imported falciparum malaria who were diagnosed and treated at the university clinic for infectious diseases and febrile conditions in Skopje from 2010 to 2022. Malaria diagnosis was based on the microscopic detection of parasites in thick and thin blood smears. Results All patients were male, with a median age of 36 years and a range of 22–60 years. Of the patients 33 (97.1%) acquired the disease in Sub-Saharan Africa. All patients except one stayed in endemic regions for work/business purposes. Chemoprophylaxis was completely applied in 4 (11.8%) patients. The median time of onset between the symptoms and diagnosis was 4 days, with a range of 1–12 days. Prevailing clinical manifestations were fever, chills, and splenomegaly in 100%, 94%, and 68% of patients, respectively. Severe malaria was noticed in 8 (23.5%) patients. In 5 (14.7%) patients the initial parasitemia was higher than 5%. On admission, thrombocytopenia, hyperbilirubinemia, and elevated alanine aminotransferase were registered in 94%, 58%, and 62% of patients, respectively. Out of the 33 patients with adequate follow-up, the outcome was favorable in 31 (93.9%). Conclusion In every febrile traveller returned from Africa, imported falciparum malaria should be an essential part of differential diagnostic considerations.
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Increased risk of brucellosis misdiagnosis in regions that lose their endemicity
(Malaysian Society of Parasitology and Tropical Medicine, 2023-03-31)
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Khezzani, Bachir
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Vidinic, Ivan
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Over the last decades, the epidemiology of human brucellosis globally has been subjected to significant changes, with the eradication of many existing endemic hot spots. This paper describes three cases with initial misdiagnosis of brucellosis that were managed during 2011-2017 in Republic of North Macedonia, country that until recently has been declared as endemic region. In spite of the fever, constitutional symptoms, focal disease (spondylitis, pneumonia and orchitis) and previous contact with domestic animals, brucellosis was not initially recognized, and patients were inadequately managed. Brucellosis should be part of differential diagnostic considerations in patients exposed to contacts with animals, with osteoarticular symptoms and signs, constitutional manifestations and different organ involvements in endemic regions where its incidence is diminishing.
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An overview of animal brucellosis in the province of El-Oued (Algerian Sahara)
(Journal of Fundamental and Applied Sciences, 2020-01)
Khezzani, Bachir
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Aouachria, Amira Nrimane
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Djaballah, Sonia
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Djedidi, Teber
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The main objective of this paper is to give an overview of animal brucellosis situation inEl-Oued province by analyzing a series of statistical data. The results show that 37.9% of theteste danimalshad a positive result. The highest seroprevalence was noted in goats with 38.2%,further more, the high incidence rate has been reported in cattle with 35.9 per 100,000 animals.Females are more exposed to brucellsis than males by 99%, the annual distribution of theincidence characterized by a strong fluctuation with an upward trend. In addition, the highestincidence rate was reported in the spring at 2.74 per 100,000 animals. Although local healthauthorities are making enormous efforts to limit brucellosis, the epidemic is still widespreadin the study area. This situation requires a series of urgent and specific preventive andtherapeutic measures.
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Caractéristiques épidémiologiques de la brucellose humaine dans la province d’El-Oued, sud-est algérien
(CAIRN, 2021)
Khezzani, Bachir
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Narimane Aouachria, Amira
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Khechekhouche, El Amine
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Djaballah, Sonia
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Djedidi, Teber
Brucellosis, the most common zoonosis globally, is considered a major public health problem.

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