Faculty of Medicine

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RELATIONSHIP BETWEEN THE MEATABOLIC SYNDROME AND THE INDIVIDUAL METABOLIC RISCK FACTORS AND SYMPTOMATIC AND ASYMPTOMATIC CAROTID ARTERY DISEASE: IS THE WHOLE LARGER THAN ITS PARTS
(Macedonian Association of Anatomists and Morphologists, 2021)
Deleva Stoshevska, Tatjana
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Nikoloska, Sofija
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Stoshevski, Bojan
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Nikoloski, Marko
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Metabolic syndrome (MetS) is a group of at least three of the following metabolic risk factors : central obesity, elevated glycaemia, high serum triglycerides, low serum high-density lipoprotein (HDL), and high blood pressure. Atherosclerosis is the most common cause of extracranial CAD. It may be asymptomatic and symptomatic with clinical presentation of cerebrovascular insult (CVI) and transient ischemic attack (TIA). Aim: to determine the relationship between MetS as a whole compared to individual metabolic risk factors and CAD. This analytical unicentric cross-sectional study included 160 subjects divided into two groups: 80 subjects with MetS according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria in the examined group (EG) and 80 subjects who have 1 or 2 individual metabolic risk factors and do not meet the diagnostic criteria for MetS in the control group (CG). CAD was diagnosed with the Esaote My Lab70 HVG device, with a linear probe (7.5 MHz), according to the Ultrasound consensus criteria for CAD of the Association of Radiologists (2002, San Francisco). CAD was significantly more frequently diagnosed in 77 (96.25%) EG subjects, compared to 34 (42.5%) CG subjects (p <0.0001). In EG symptomatic CAD had 52 subjects (67.5%) compared to only 2 (5.9%) subjects in CG. With asymptomatic CAD were 25 (32.47%) EG and 32 (94.12%) CG subjects, which was statistically confirmed as significant (p <0.0001). MetS is significantly associated with CAD, which is of cardinal importance for primary and secondary prevention of CVI and TIA.
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ASSOCIATION OF THE NUMBER OF COMPONENTS OF THE MEATBOLIC SYNDROME AND CAROTID ARTERY DISEASE
(Macedonian Association of Anatomists and Morphologists, 2021)
Deleva Stoshevska, Tatjana
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Nikoloska, Sofija
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Nikoloski, Marko
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Stoshevski, Bojan
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Metabolic syndrome (MetS) is a group of at least three of the following metabolic disorders: central obesity, elevated glycaemia, high serum triglycerides, low serum high-density lipoprotein (HDL), and high blood pressure. Carotid artery disease (CAD) involves changes in the arterial wall that cause thickening of the intima-media (IMT), narrowing, or complete obstruction of the carotid artery lumen. Objective:To determine the impact of the number of MetS components on CAD. This analytical unicenteric cross-sectional study included 80 subjects with MetS according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. CAD was diagnosed with the Esaote My Lab70 HVG device, with a linear probe (7.5 MHz), according to the Ultrasound consensus criteria for CAD of the Association of Radiologists (2002, San Francisco). 34 subjects (42.5%) had 4 components of MetS, 24 subjects (30%) had 3 components, 22 subjects (27.5%) had 5 components. Gender and age have no statistically significant effect on the influence of metabolic risk factor as components of MetS (p = 0.38, p = 0.72, respectively). CAD was diagnosed in 77 subjects (96.25%), in 21 subject (87.5%) with 3 components of MetS and in all subjects with 4 and 5 components of MetS.This statistically confirmed that subjects with a smaller number of MetS components significantly have less CAD (p = 0.026). The increase in the number of components and the synergistic effect of individual MetS components is significantly associated with CAD.
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MIGRAINE AND PATENT FORAMEN OVALE - CASE REPORT
(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2023)
Deleva Stoshevska, Tatjana
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Nikoloska, Sofija
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Nikoloski, Marko
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Stoshevski, Bojan
AbstractMigraine is a headache disorder, typically characterized by unilateral headache (with or without aura) of pulsating quality, which is associated with nausea, phonophobia and photophobia. The patent foramen ovale (PFO) is a remnant of the fetal circulation. Multiple studies suggest that migraine is more prevalent in subjects with PFO and vice versa, suggesting that PFO and migraine may be risk factors for each other.Case report.We present a 33-year-old female patient with unilateralhemicranialheadache,mostly on the right side, pain in the right eye, nausea, vomiting, photo and phonophobia, with previous visual difficulties with the ipsilateral eye. The complaints usually lasted2-3 days and wereassociatedmostly with the menstrual cycle. Therewerealso occasional bouts of dizziness. Ophthalmological and otorhinolaryngological nature of these complaints wasexcluded with additional investigations. In addition, nuclear magnetic resonance (NMR)of the brain, color Doppler duplex sonography(CDDS)of carotid and vertebral arteries were performed, all with normal findings. On transcranial color Doppler sonography with Bubble test, a positive finding was obtained for a Grade 4 right-left shunt and the patient was referred for cardiology assessment and evaluation. The patient was diagnosed with migraine with aura (visual) and PFO.Conclusion.Results from epidemiological studies examining the relationship between PFO and migraine are mixed at best. It is unclear if there is a causal relationship or simply a co-existence of these two conditions. Moreresearch of PFO in migraine is clearly needed before we can consider changing our views on the aforementioned conclusions.Keywords:migraine, patent foramen ovale.
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CORRELATION BETWEEN TONSIL HYPERTROPHY AND ALLERGIC RHINITIS IN CHILDREN
(Macedonian Association of Anatomists, 2020-12-25)
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Dukovska, Vesna
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Nikoloska, Sofija
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To show whether there is a correlation between the tonsils hypertrophy and adenoid hypertrophy (AH) with allergic rhinitis in children in R. Macedonia. A total of 120 children (5.3 ± 1.2 years old)with tonsil hypertrophy, adenoid hypertrophy, persistent upper respiratory infections and consecutive nasal obstruction were examined, after their parents gave a verbal consent for their participation. Inclusion criteria were: frequent upper respiratory infections, angina, nasal congestion due to nasal obstruction caused by adenoid hypertrophy, frequent serous otitis due to adenoid hypertrophy and sleep apnea due to tonsil hypertrophy.The prevalence of allergic rhinitis (AR) was as follows: AR had 70% of children with concha nasal hypertrophy, 39.2% of children with tonsillar hypertrophy, and 78.3% of children with adenoid hypertrophy. Although in the group of children with adenoid hypertrophy, a more severe degree of nasal concha hypertrophy was registered in children with AR compared to children without AR, itwasstatistically not significant.Regarding children with adenoid hypertrophy (AH), the results showed that children with AR presented significantly different results for Parikh's scale (p = 0.0076). Obstruction of torus tubarius was more common in children with AR (86.8% vs. 61.2%), while these children had a finding of soft palate obstruction (9.4% vs.26.8%), and vomer obstruction (3.8% vs.11.9%) less often than children without AR.Our study found that almost half of the children with tonsillitis/adenoid hypertrophy hadAR. Grade 3 and 4 TH was present in third of the children.

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