Faculty of Medicine
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Item type:Publication, Drug Induced Acute Pancreatitis(SHMSHM - AAMD, 2016); ; ; Mikjunovikj, LjubicaAcute pancreatitis is a severe disease with considerable morbidity and mortality. Drug-induced acute pancreatitis is rare, with an estimated incidence of 0.1-2%. More than 100 drugs have been implicated in causing the disease: acetaminophen has been associated with acute pancreatitis in cases where there has been an overdose of drugs; however, the frequency is rare. Based on analysis of the level of evidence, 4 classes of drugs could be identified. We report the case of a 28-year-old man who presented abdominal pain and elevated pancreatic enzymes suggesting acute pancreatitis, severe metabolic acidosis and systemic inflammatory response syndrome after overdosing on a drug containing acetaminophen. He was taking acetaminophen more than 5 g every day two weeks.Workup including an ultrasound,CT scan, microbiological and serological analysis failed to reveal any obvious etiology for the pancreatitis. The possibility of drug-induced pancreatitis was considered and acetaminophen was thought to be the probable etiologic agent and discontinued. A review of the relevant literature is also presented. Drug-induced acute pancreatitis is challenging for clinicians and a detailed mechanism is unknown. It is very important to rule out drug-induced pancreatitis when treating pancreatitis with an unknown etiology. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Anesthetic Challenges for Major Hepatectomy(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2022-03); ; Rushiti, KjemalHepatic resection is the treatment of choice for many liver diseases. However, it is a large and complex operation with a high risk of side effects in the patients, and it is a challenge for both surgeons and anesthesiologists. This paper presents a case of successfully performed right hepatectomy in a 45-years-old woman with the finding of a giant liver hemangioma, larger than 10cm, placed near the inferior vena cava and the challenges faced by the anesthesiologists when guiding such a patient during the entire perioperative period. The main concern was the risk of massive blood loss, which might significantly increase the rate of morbidity and mortality. During liver resection, central venous pressure (CVP) was optimally maintained below 5cmH2O to reduce blood loss. The cell salvage technique was used to minimize heterologous blood transfusion. Epidural anesthesia can be safely applied in patients undergoing major hepatic resection, provided that they have corrected perioperative hemostasis. The surgical approach after Belghiti “liver hanging maneuver” performed by the surgeons in our case may involve transient compression of the inferior vena cava that cause profound hypotension. Therefore, a successful outcome requires close collaboration between the anesthesiology and surgical team by sharing decisions throughout the operation and following and implementing the latest evidence-based recommendations. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Rhabdomyolysis in Critically Ill Surgical Patients(Academy of Medical Sciences of Bosnia and Herzegovina, 2016-07-27); ; Rhabdomyolysis is a syndrome of injury of skeletal muscles associated with myoglobinuria, muscle weakness, electrolyte imbalance and often, acute kidney injury as severe complication. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Effect of Adding Dexamethasone as a Ropivacaine Adjuvant in Ultrasound-Guided Transversus Abdominis Plane Block for Inguinal Hernia Repair(Macedonian Academy of Sciences and Arts / Walter de Gruyter GmbH, 2015); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Clearance of vancomycin calculated according to different formulas and their influence against different pharmacokinetic parameters(Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2015); ; ; Zdravkovska, Milka - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Insulin Resistance, Glycemia and Cortisol Levels in Surgical Patients who Had Preoperative Caloric Load with Amino Acids(Macedonian Academy of Sciences and Arts/ Walter de Gruyter GmbH, 2015); ; ; ; Surgical stress response, results in elevated levels of anti-insulin hormones and reduced insulin secretion. This hormonal state may be detrimental for surgical patients due to the presence of insulin resistance and hyperglycemia. Additionally, pre-operative fasting favors this conditions. The aim of this study is to analyze the impact of pre-operative caloric load, with 440kJ from amino acid infusions on the levels of glucose, cortisol and insulin resistance in surgical patients. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Evaluation of Anesthesia Profile in Pediatric Patients after Inguinal Hernia Repair with Caudal Block or Local Wound Infiltration(ID Design 2012/DOOEL Skopje, 2016-03-15); ; ; Leshi, AlbertThe aim of this study is to evaluate anesthesia and recovery profile in pediatric patients after inguinal hernia repair with caudal block or local wound infiltration.