Faculty of Medicine
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Item type:Publication, The occurrence of acute subdural haematoma and diffuse axonal injury as two typical acceleration injuries(Elsevier, 2012); ; ; ; Popevska, ZClosed head injuries have already been classified into contact injuries and acceleration–deceleration injuries. Two typical acceleration–deceleration injuries and at the same time, the two worst head injuries are acute subdural haematoma (ASDH) and diffuse axonal injury (DAI), and that is where they got their medico-legal importance. Using experiments, it has been shown that acceleration with an impact time of more than 20–25 min (which occurs in traffic accidents in real life) causes DAI, whereas an impact time of 5–10 min is more likely to produce acute subdural haematoma. The aim of this research is to show that not all, but some types of traffic accidents are more typical for the occurrence of DAI, as well as that the ASDH is not a common feature for all types of fall. The analysis conveyed covered 80 cases of closed head injuries (traffic accidents, falls and assaults) where a complete forensic medical autopsy has been undertaken, followed by a complete forensic–neuropathological examination. For the purpose of diagnosing DAI, immunohistochemistry using antibody against β-amyloid precursor protein has been involved. Results show that ASDH is more likely to occur in cases of simple fall, assaults and cyclists and DAI is more typical for vehicular traffic accidents and cases of falling from a considerable height. The paper also comprises discussion about some open questions regarding the diagnosis of DAI in the medico-legal practice. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Dilemmas concerning the diffuse axonal injury as a clinicopathological entity in forensic medical practice(Elsevier, 2012); ; ; ; Popevska, ZDilemmas and discussions concerning the diffuse axonal injury (DAI) and still existing in forensic medical practice are as it follows: 1. Whether the occurrence of DAI can indicate the type of traumatic event that has caused the head trauma, 2. Whether the presence of axonal damage in cases of hypoxia, ischaemia and other pathological conditions casts a shadow on the post-mortem pathological diagnosis of DAI and totally negates it, or there are certain clues in the findings that can point to the aetiology of the axonal damage. This paper discusses our findings based on neuropathological examination of 60 forensic cases of closed head injury. The neuropathological examination included: a macroscopic examination of the coronal sections and a microscopic examination involving an immunohistochemical method with antibody against β-amyloid precursor protein. Our findings indicate that DAI, as a clinicopathological entity, is undoubtedly an acceleration–deceleration injury, predominant in road traffic accidents as it is classically outlined, and cases of falling from a considerable height. Our findings point to a certain difference between the features of traumatic and ischaemic axonal damage. In this paper we also investigate the correlation between pathological grades of DAI and the impairment of the brain function before death. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Comparative analysis of effect of metoprolol and remifentanyl on mean arterial pressure in general anaesthesia(Medical faculty, Ss Cyril and Methodius University in Skopje, 2017) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Comparison of adductor canal block with femoral nerve block in anterior cruciate ligament reconstruction(Association of Physiologists of Macedonia, 2018) - Some of the metrics are blocked by yourconsent settings
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Item type:Publication, Validation of the ELISA Method for Quantitative Detection of TNF-α in Patients with Intracerebral Hemorrhage(Scientific Foundation SPIROSKI, 2017-09); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Review of patients with diabetes in Macedonia(Scientific association of endocrinologist and diabetologist of Macedonia, 2014); ; I. Ahmeti - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Case report of patient with mixed medullary-papilary carcinoma of thyroid gland(Scientific association of endocrinologist and diabetologist of Macedonia, 2018-05); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, One-year retrospective study of hospitalized patients on parenteral bisphosphonate therapy at Univ.Kl. for Endocrinology, Diabetes and Metabolic Disorders, Skopje, Republic of Northern Macedonia.(2019-04); - Some of the metrics are blocked by yourconsent settings
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.