Faculty of Medicine

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Author: search.filters.author.Zhaku, VegimHas files: Yes

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    Persistent foramen ovale as a cause of cerebral strokes in young individuals - case reports
    (MIT University Skopje, 2025-03)
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    Nikolovski, Robert
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    Zhaku, Vegim
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    Foramen ovale is a small congenital defect in the level of the interatrial septum of the heart that occurs as a result of the failure of fusion between the septum primum and septum secundum during embryogenesis. It is present in about 25% of the population and is usually clinically insignificant. However, in some cases, it can lead to paradoxical embolism, which may result in an ischemic stroke. Objective: To investigate the association between patients with persistent foramen ovale (PFO) and the occurrence of strokes in young individuals, with a case report. Case Report: A 27-year-old patient presented for a check-up with a history of multiple episodes, especially in the morning, of weakness in the left limbs, particularly the left arm, accompanied by dizziness. These symptoms spontaneously improved, but in the last episode, the symptoms lasted up to 5 hours from the onset. The patient lives in a small area at a higher altitude. The patient was referred for a neurological examination. The neurological examination was unremarkable at the time of the visit, but due to the recurring symptoms, the patient was referred for a magnetic resonance imaging (MRI) scan of the brain, where punctiform hyperintense lesions were detected. The patient was then referred to a cardiologist, where a transthoracic echocardiogram (TTE) revealed a thin septum, leading to a recommendation for transesophageal echocardiography (TEE). TEE showed the presence of a 2mm PFO, after which the decision was made to close it using an Amplatzer PFO Occluder – 25mm in size. Conclusion: Although rare, a transient ischemic attack (TIA) in younger individuals should prompt consideration of the potential existence of PFO. Timely diagnosis and treatment of PFO are crucial for the lives of these patients.
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    HEART BLOCK AS A COMPLICATION OF ACUTE MYOCARDIAL INFARCTION, CLINICAL ASSESSMENT AND APPROACH. A CASE REPORT
    (Faculty of Medical Sciences, University of Tetova, 2023-09-24)
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    Murtezani, Besir
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    Zhaku, Vegim
    Optimal treatment for acute ST-elevation myocardial infarction (STEMI) within 12 hours after symptom onset includes primary percutaneous coronary intervention (PCI) or thrombolytic therapy. For STEMI patients who present later than 12 hours, current guidelines do not recommend PCI except the presence of hemodynamic or electrical instability or continuing ischemic symptoms. Thus, our intention is to show that early reperfusion may also play a role in the early recovery of AV block that may occur as a complication of myocardial infarction (MI), more commonly inferior MI. Patient 49 years old patient (male) presented in our department with weakness, dizziness, short-term instability and nausea. The symptoms started one day before admission. The ECG on admission showed a total AV block with a heart rate approximately 33 b/min and ST segment elevation in the inferior leads. Laboratory tests were normal except for an extreme elevated high sensitive troponin. The echo showed normal finding with the exception of the slightly reduced kinetics of the apex, base and mid segment of the lower-posterior wall of the IVS. Coronary angiography was immediately performed, showing 100% stenosis of the rPDA. A stent is placed on the corresponding coronary artery. The total block was present all the time, and following the recommendations, a temporary pacemaker was placed in the patient due to hemodynamic instability and bradycardia. Despite reperfusion, the block persisted 7 days after the intervention, during which a permanent pacemaker was implanted and the patient was discharged for home treatment. This case highlights the importance and ways of early reperfusion to improve outcomes in patients with STEMI. Early reperfusion may also play a role in the early recovery of AV block that may occur as a complication of MI, more commonly inferior MI.
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    Oral antioxidants mitigate levels of malonedialdehyde and protein carbonyl and improve semen parameters in men with oligoasthenozoospermia
    (2020-07-30)
    Zhaku, Vegim
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    Beadini, Sheqibe
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    Beadini, Nexhbedin
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    Raising awareness about treating options in North Macedonia, while sperm parameters are decreasing because of increased oxidative stress, in a terrain like this, represents a big challenge. All the patients that fulfilled the required criteria, 37 were enrolled in the study signing a document that explains nature of the study. The first semen sample was collected with at least three days of abstinence. From the sample 0.5 ml was used for standard semen analysis, 1.2 ml was used to evaluate the levels of malonedialdehyde (MDA) and protein carbonyl (PC). The last sample was collected after 6 months. Mean, Standard Deviation, the Pearson Correlation and an independent student t-test were used for statistical analyses. Concentration and motility were significantly increased after 6 months of treatment (p<0.001). The level of MDA shows significantly lower values after six months of therapy with antioxidants (p<0.001).Whereas another marker which is denoted by PC was also lower after the treatment, but was not statistically significant (p=0.0554). There is, however, lack of agreement, because improvement is not consistent and there is wide variation in the treatment regimens, on the dose and duration of treatment and whether mono or combined oral antioxidants should be administered. Always keep on mind that, antioxidants are not free from potential side effects “antioxidant paradox”.