Faculty of Medicine
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Item type:Publication, Influence of metabolic dysregulation in pre ulcerative phase of diabetic foot(2012); ; ; Aim. To estimate the impact of metabolic disturbances in type 2 diabetic patients (T2DM) – glucose regulation, obesity, dyslipidemia, hypertension and risk for ulceration in the preulcerative phase of the diabetic foot syndrome (DFS). Materials and methods. In this prospective study 100 T2DM patients were evaluated for 1 year. The following parameters were estimated: duration, smoking habits, BMI, BP, HbA1c, TG, HDL, LDL, fundoscopy and measurements for risk score of DFS. Groups were stratified according to measurements : 0 – low risk, 1 – medium risk, 2- high risk, and 3 – very high risk. Results. Out of 100 patients, 53% were female and 47% male. Mean duration of T2DM was 10.47 ± 4.77 years. Diabetes duration up to 10 years included 52% of subjects and 48 % had a duration of more than 10 years. Forty-three percent were smokers , of which 77.4% were male and 22.6% female. Results of measurements for risk score stratifications are in visit 1 (V1): score 0 - 29 %, score 1 – 35%, score 2-18% and score 3 – 18% and after 12 months in visit 2 (V2) score 0- 17 %, score 1 – 39%, score 2-19% and score 3 – 25%. BMI was recorded as follows: normal (18 -25 kg/m2) 14%, overweight (25-30 kg/m2) 71% and obese (>30 kg/m2) 15% of patients. Mean HbA1c in V1 according the risk score is: 0 - =7.6%, 1- 7.9%, 2 – 8.5% and 3- 8.2% (p<0,005), and in V2: score 0- 7.26%, score 1-7.46%, score 2-7.54% and score 3-7.54%. Systolic BP categorical scores were measured: score 0 – 136 mmHg, 1 – 142 mmHg, 2 – 145 mmHg, 3 – 142 mmHg. Mean levels of TG scores were: 0-1.97 mmol/L, 1- 2.37 mmol/L, 2- 2.3 mmol/L, 3- 2.6 mmol/L. Mean levels of HDL: 0 – 1.06 mmol/L, 1 – 1.02 mmol/L, 2 – 0.97 mmol/L, 3 – 1,00 mmol/L. Mean levels of LDL: 0 – 3.69 mmol/L, 1 – 4.27 mmol/L, 2 – 4.05 mmol/L 3 – 4.09 mmol/L. Diabetic retinopathy (DR) in V1 was present with 68% - 53% non proliferative and 15% proliferative. In V2, DR was present in 72% of which 51% was nonproliferative and 21% proliferative. Conclusion: Suboptimal management of T2DM – high HbA1c, high BP, High TG and high LDL, are multiple factors for early appearance of DFS and have the impact of early progression from low to high score for foot ulceration. In T2DM, patients with duration more than 10 years , HbA1c>8%, TG>2.2 mmol/L, HDL<1.04 mmol/L , LDL>4 mmol/L have a high risk (2) or very high risk (3) score for ulceration. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Stroke and dementia(League against Epilepsy of Macedonia, 2016); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Neurophysiologic evaluation of depression and dementia in post-stroke elderly patients(S. Karger AG, 2015); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Intracerebral hemorrhage and epileptic seizure : frequency, localization and seizure types(Македонско лекарско друштво = Macedonian Medical Association, 2017-07); ; ; Coskun, KeralaIntroduction. Among 2.8-18.7% of the patients that suffered from spontaneous intracerebral hemorrhage (ICH) develop seizures. Previous studies suggest that most important contributors to developing subsequent seizures are: volume and localization of hematoma, cortical involvement and age. Aims: To determine the occurrence of new epileptic seizures in patients with spontaneous intracerebral hemorrhage and to analyze it with respect to the patient’s age, gender, presence of premorbid risk factors, localization of the hematoma and the type of the seizures. Methods. This study is retrospective in design, with study population of 308 patients with spontaneous intracerebral hemorrhage admitted to our clinic in the period between 2008 and 2014. Analyzed premorbid risk factors for ICH are: hypertension, smoking, alcohol uptake. According to the computer tomography (CT) of brain findings the patients was divided in two groups: lobar and thalamic (deep). By the time of presents of seizures, they were classified as early (within 1 week of ICH) or late (more than 1 week after ICH). Also we analyzed the seizures type and we divided them in four groups: simple partial, partial complex, secondary generalized and tonic clonic generalized seizures. Results. Arterial hypertension was revealed in 78% of the patients with spontaneous supratentorial ICH. Epileptic seizures developed in 8.2% of analyzed patients, most of them in the first week of brain bleeding. Lobar ICH had 78.6% of the patients, with frontal localization was 44% of patients with lobar ICH, and most of them had simple partial and partial complex seizures. Conclusion. Cortical involvement, large volume of hematoma, may be a factor for provoked seizures, especially in the first days of brain bleeding.