Faculty of Medicine

Permanent URI for this communityhttps://repository.ukim.mk/handle/20.500.12188/14

Browse

Settings

Start date: 2025Has files: No

Search Results

Now showing 1 - 10 of 105
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    TREATMENT OF VENTRAL HERNIA WITH COMPOSITE MESH: A CASE REPORT
    (Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2026-05-18)
    ;
    ;
    ;
    After each abdominal surgical intervention, there is a risk of developing a hernia in the anterior abdominal wall. Тhis type of hernia are also known as incisional hernia. Such hernias can happen regardless of the type of abdominal incision, but they are more common with midline and transverse incisions. The use of synthetic mesh has become a common practice nowadays as it has lower risks of complications during surgery and lower rates of hernia recurrence compared to non-mesh repairs. In this case, a 31-year-old female patient with a large ventral hernia was scheduled for planned surgical intervention with the placement of a composite mesh for correction of the defect. The use of the composite mesh proved to be an excellent surgical solution for hernia correction in this particular case.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    CHRONIC RESPIRATORY SYMPTOMS AND SPIROMETRIC PARAMETERS AMONG PROFESSIONAL DRIVERS - THE IMPACT OF OCCUPATIONAL EXPOSURE AND WORK TENURE
    (Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2026-06-18)
    Andonov, Goran
    ;
    Aim. To assess the prevalence of chronic respiratory symptoms, spirometric parameters and the effects of occupational exposure among professional drivers. Material and methods. A cross-sectional epidemiological study was conducted including 70 male professional drivers and 70 administrative staff matched by age, work tenure, occupational exposure and smoking status. Data on respiratory symptoms, smoking status, occupational exposure to harmful agents and work tenure were collected using a standardized questionnaire. Spirometry was performed to assess lung function. Results. Professional drivers had a significantly higher prevalence of respiratory symptoms compared to controls, including any respiratory symptom (81.4% vs. 58.6%, p=0.003), nasal symptoms (35.7% vs. 8.6%, p<0.001), cough (61.4% vs 34.3%, p=0.002), cough with phlegm (37.1% vs. 20.0%, p=0.040), dyspnea (31.4% vs. 17.1%, p=0.049) and wheezing (25.7% vs. 7.1%, p=0.006). All spirometric parameters were significantly lower in drivers, indicating involvement of both large and small airways (p<0.05). Drivers with ≥ 20 years of work tenure exhibited a significantly higher prevalence of symptoms and lower spirometric values. Multivariable logistic regression identified exposure to gases as the strongest independent predictor of respiratory symptoms (adjusted OR up to 12.4, p<0.01), followed by exposure to smoke (adjusted OR up to 6.31, p<0.05). Dust exposure showed a non-significant trend, while vapors were not associated with respiratory symptoms. Conclusion. Professional drivers are at increased risk of developing respiratory symptoms and lung function impairment compared to the control group. Occupational exposure to gases and smoke represents the main independent risk factor, while longer work tenure suggests a cumulative adverse effect.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    Thyrotoxicosis-Induced Reversible Dilated Cardiomyopathy: A Case Report
    (AVES YAYINCILIK A.Ş., 2026-01-07)
    ;
    Manev, Nikola
    ;
    Thyrotoxicosis-induced cardiomyopathy (TCM) is a rare but severe complication of thyrotoxicosis, characterized by significant left ventricular systolic dysfunction. While heart failure (HF) symptoms may be common in patients with thyrotoxicosis, true cardiomyopathy remains uncommon, affecting less than 1% of these individuals. A 27-year-old previously healthy woman who presented with symptoms of severe thyrotoxicosis, including irritability, hair loss, persistent dry cough, hypertension, and tachycardia is reported. Thyroid tests revealed elevated levels of free triiodothyronine and thyroxine, with suppressed thyroid-stimulating hormone. Thiamazole and propranolol therapy were initiated. Two months later, her condition worsened, with fatigue, leg and abdominal swelling, and persistent cough. Echocardiography showed a severely reduced ejection fraction (EF 19%) and dilated cardiac chambers. N-terminal pro–B-type natriuretic peptide levels were elevated. She was managed with diuretics, beta-blockers, angiotensin-converting enzyme inhibitors, and continued thyroid treatment. After 7 days, EF improved to over 40%, with reduced ventricular dimensions. Continued treatment led to progressive recovery. At the 18-month follow-up, echocardiography documented normalized chamber dimensions and preserved EF, confirming complete reversal of TCM. This case highlights the importance of early recognition and intervention, as prompt restoration of thyroid function and appropriate HF management are crucial for reversing cardiac dysfunction and improving outcomes.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    THE ROLE OF SHOCKWAVE INTRAVASCULAR LITHOTRIPSY IN THE TREATMENT OF HEAVILY CALCIFIED CORONARY ARTERY LESIONS: OUR FIRST EXPERIENCE
    (Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2025-12-17)
    ;
    Jovkovski, Aleksandar
    ;
    Manev, Nikola
    ;
    ;
    Introduction: Coronary artery disease (CAD) is typically a chronic, progressive, inflammatory disease of the coronary arteries caused by coronary atherosclerosis. Moderate-to-severe calcification is present in up to 30% of patients undergoing coronary angiography (CA). Calcified coronary artery lesions are one of the most complex and challenging lesion subsets in interventional cardiology. Shockwave intravascular lithotripsy (IVL) is a recently introduced calcium-modifying technique for the treatment of concentric, eccentric and nodular calcifications. Case presentation: We present a clinical case of a 73-year-old male complaining of intermittent chest pain. He was a non-smoker with a positive familiar history for CVD. He had previous myocardial infarction and stenting of the right coronary artery (RCA), previous CVI, paroxysmal atrial fibrillation, insulin-dependent type 2 diabetes, heart failure with mildly reduced ejection fraction (HFmrEF) and chronic kidney disease (CKD) stage II/IIIa. CA revealed heavily calcified CAD. A calcified lesion of the left anterior descending artery (LAD) was treated using a 3.0/12 mm Shockwave IVL balloon; and calcium cracks and fractures were confirmed by optical coherence tomography (OCT). We proceeded with an NC balloon and finally treated the lesion with a 3.5/15 mm drug-coated balloon (DCB). The calcified lesion of the RCA was treated with conventional techniques using guiding catheter extension, NC balloons and drug-eluting stent (DES). Conclusion: Heavily calcified coronary artery lesions remain one of the biggest challenges for interventional cardiologists. Shockwave IVL is designed for treatment of all types of heavily calcified lesions using acoustic waves (shock waves). IVL is safe and effective technique that will definitely strengthen the armamentarium for modern treatment of heavily calcified lesions.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    EMERGING BIOMARKERS AT THE CROSSROADS OF CARDIAC, RENAL, AND HEPATIC DYSFUNCTION: A NEW ERA IN MULTIORGAN RISK STRATIFICATION
    (Faculty of Medicine, Ss Cyril and Methodius University in Skopje, 2026-03-24)
    ;
    Petkovski, Dusan
    ;
    ;
    Vranjko, Elif
    ;
    Dobjani, Amela
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    DERMATOGLYPHIC PATTERNS AMONG STUDENTS IN NORTH MACEDONIA
    (Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2026-03-24)
    ;
    ;
    ;
    ;
    Introduction: Dermatoglyphics is a scientific discipline that studies the epidermal ridge patterns present on the palmar surfaces of the hands, the toes and the plantar surfaces of the feet. Aim. An analysis of individual dermatoglyphic characteristics in healthy medical students of Macedonian and Albanian ethnicity was conducted. Material and methods: The study included 234 healthy students; palm prints were obtained and dermatoglyphic parameters were read, classified and compared with data reported in the dermatoglyphic literature. Imprinting was done by the Cummins and Midlo ink method. The reading and classification of dermatoglyphic patterns were performed according to Henry's system. Results: Ulnar loops were the most prevalent patterns, followed by circular, arcuate and complex patterns, which were present in a small percentage in both genders; radial loop was present only on the second finger in both genders. There were differences on the right hand for the second, fourth and fifth finger, and on the left hand for the third, fourth and fifth finger between males and females. Also, significant differences were found in the third and fourth interdigital spaces and hypothenar area. The triradii distribution formula in females was: a > b > d > c > t; whereas in males it was: a > t > b > c = d. Additional triradii were rare in both genders. The atd angle was within the range of 32ᵒ -55ᵒ in females and 33ᵒ -50ᵒ in males, most often 40ᵒ in both groups. Conclusion: This population-based study have shown similarities and differences in the prevalence of some dermatoglyphic features in males and females among healthy students.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    The azygos vein as an alternative route for haemodialysis catheterisation
    (SMC Media, 2025-05-20)
    ;
    Janushevski, Filip
    ;
    ;
    Introduction: Central venous catheterisation (CVC) is essential for haemodialysis in end-stage kidney disease, but superior vena cava (SVC) stenosis or occlusion often complicates long-term access. The azygos vein, a collateral drainage pathway, has been rarely used intentionally for catheterisation. Case description: We report on a 68-year-old male on haemodialysis with SVC perforation and stenosis due to prolonged catheter use. After a failed guidewire-assisted exchange, a non-tunnelled CVC was successfully placed in the enlarged azygos vein under fluoroscopy. The patient continued haemodialysis without complications, and the two-month follow-up confirmed catheter patency. Conclusion: This case demonstrates the azygos vein as a viable alternative for haemodialysis access in SVC stenosis.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    Comparison between different methods in evaluating haemodialysis adequacy
    (Oxford University Press (OUP), 2025-10)
    Usprcov, Julijana
    ;
    ;
    ;
    Kabova, Angela
    ;
    Milenkova, Mimoza
    Background and Aims An increasing number of patients with chronic kidney disease (CKD) increased the need for hemodialysis. Inadequate hemodialysis affects morbidity and mortality of hemodialysis patients. KDOQI guidelines recommend that Kt/V should be kept above 1.2 or URR 65% for thrice weekly routine hemodialysis. The aim of this study was to compare the urea reduction ratio (URR), Kt/V estimation by Daugirdas formula with the results measured by an Online Clearance Monitor (OCM). Method Cross-sectional study was conducted on 15 patients on hemodiafiltration (HDF) with age 36–79 years, 4-hour hemodiafiltration sessions three times a week and hemodialysis experience ≥ 6 months, using highflux dialyzers. For every patient blood flow rate was ≥ 350 ml/min and dialysis flow rate was 500 ml/min. According to vascular access all had AVF. Kt/V was calculated by the OCM of the Nipro Surdial X machine (the hemodialysis machine automatically calculate the measured sodium ion clearance based on the plasma conductivity). Results A total of 80 sessions were assessed with a predominance of males 51% (8). The mean of URR was 78.4 ± 10. Mean Kt/V values obtained with the Daugirdas formula was 1.9 ± 0.19. Mean Kt/V delivered by machine (OCM) was 1.87 ± 0.2. There was no significant difference between age, sex, comorbidities with adequacy of hemodialysis. The study show that there was no significant difference between the URR and Kt/V calculated with the Daugirdas formula and the OCM in the evaluation adequacy of hemodialysis. Conclusion Online Clearance Monitor (OCM) can be used as noninvasive guide to the real-time adjustment of the dialysis dose.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    Acute Skin Toxicities After Ultrahypofractionated Versus Hypofractionated Postoperative Radiotherapy in Patients With Early Breast Cancer—A Single‐Institution Clinical Study
    (Wiley, 2026-01)
    Petkovska, Gordana
    ;
    Ratosa, Ivica
    ;
    Trajanovska, Valentina Bojovska
    ;
    ;
    Lazareva, Emilija
    Background Real‐world safety data from Southeastern Europe are limited for ultrahypofractionated (UHF) whole‐breast irradiation (WBI). We aimed to evaluate acute skin toxicity with UHF versus hypofractionated (HF) postoperative radiation therapy in early breast cancer, following implementation of this fractionation regimen. Methods This combined prospective–retrospective study included women aged ≥50 years following breast‐conserving surgery (pT1–2, pN0–1, M0). The UHF cohort (prospective) received 26 Gy in 5 fractions over one week between 2023 and 2024. The control group consisted of retrospective data obtained from institutional records of patients who received WBI using a HF schedule of 40.5–42.6 Gy in 15–16 fractions over 3 weeks between 2015 and 2020. All patients were treated with 3D‐CRT WBI without regional nodal irradiation or boost. Acute skin toxicity was graded by CTCAE v5.0 at end of treatment and at 4 and 12 weeks. Results This study included 80 patients, with 40 in each group, with a mean age of 61.1 ± 6.6 years. Baseline clinicopathological characteristics were comparable, except for a slightly larger median tumor size in the UHF group ( p = 0.037). At the end of radiation therapy, acute radiodermatitis occurred in 36 of 40 (90%) patients receiving UHF and in 38 of 40 (95%) patients receiving HF (p = 0.396). The grade distribution was comparable across the two groups ( p = 0.53), and no grade ≥3 events were recorded. At 4 weeks, no adverse skin reactions were observed in patients receiving UHF, and by twelve weeks, no active radiodermatitis persisted in either group. Conclusions UHF WBI (26 Gy/5 fractions) demonstrated comparable acute skin toxicity to standard HF regimens, supporting its safety and clinical feasibility in routine practice.