Faculty of Medicine

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Start date: 2025Subject: search.filters.subject.treatment

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Now showing 1 - 4 of 4
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    TREATMENT OF VENTRAL HERNIA WITH COMPOSITE MESH: A CASE REPORT
    (Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2026-05-18)
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    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.
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    Visceral Leishmaniasis in the Republic of North Macedonia: A Retrospective Cohort Study
    (Galenos Yayinevi, 2025-11-11)
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    Khezzani, Bachir
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    Cana, Fadil
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    Visceral leishmaniasis (VL) is a systemic protozoan vector-borne disease and represents the most severe clinical form of leishmaniasis, with fatal outcomes if left untreated. This study aimed to evaluate the key epidemiological, clinical, and laboratory findings, treatment options, and outcomes in patients with VL. Materials and Methods A retrospective analysis was conducted on the epidemiological and clinical characteristics of 84 patients diagnosed and treated for VL at the University Hospital for Infectious Diseases in Skopje, Republic of North Macedonia (RNM), between 2001 and 2023. Results The median age of patients was 47 years (range 1-74), with 77.4% being male. Contact with dogs was reported in 41.7% of cases. Seven percent of patients were immunosuppressed, and all were Human Immunodeficiency Virus-negative. The median time from symptom onset to diagnosis was 30 days (range 4-330 days). The predominant clinical manifestations were splenomegaly (97.6%), fever (96.4%), hepatomegaly (90.5%), and weight loss (54.8%). On admission, anemia, leukopenia, thrombocytopenia, and hypergammaglobulinemia were detected in 75%, 73.8%, 70.2%, and 63.1% of patients, respectively. A favorable outcome was achieved in 91.7% of cases; therapeutic failure occurred in 1.2%, and 7.1% of patients died. Conclusion VL should be considered a crucial differential diagnosis in patients from the RNM presenting with prolonged unexplained fever, splenomegaly, cytopenia, and hypergammaglobulinemia.
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    CONGENITAL DIAPHRAGMATIC HERNIA - DIAGNOSIS, TREATMENT AND FAMILY PLANNING
    (Македонско лекарско друштво = Macedonian medical association, 2025-08)
    Mirjana Kjaeva Pejkovska
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    Introduction. Congenital diaphragmatic hernia is a rare structural and genetic disorder. Early diagnosis, proper treatment and expectance of the outcome in terms of future family planning are needed. Aim. To increase the awareness of early diagnosis and to present the current protocols for diagnosis, treatment and family planning if congenital diaphragmatic hernia occurs, particularly in early childhood. Methods. For the purpose of this retrospective study, 20 mothers who gave birth to children with congenital diaphragmatic hernia were enrolled. They had been given questionnaires regarding the timing of their fetus’s diagnosis, the treatment that followed, and the frequency of this condition in their family. Before the treatment, parents of the patients signed a consent form. Their data were collected and analyzed in the period of two years. Results. Early diagnosis can be life saving because the baby needs to be intubated as soon as the mother gives birth. Some mothers had to plan their deliveries ahead in institutions with highly developed intensive care, with Discussion. Early diagnosis is of crucial importance for timely preparation and treatment of both mothers and babies. ECMO treatment, to provide the best treatment protocol for better quality of life for both mother and child. In the literature the need for sterilized conditions during the treatment is described because of the possible complication such as sepsis caused by healthcare-associated infections. Conclusion. Congenital diaphragmatic hernia is a condition for which awareness must be raised for proper diagnosis, treatment and family planning.
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    INCIDENTAL HEMATOPERITONEUM IN LAPAROSCOPIC APPENDECTOMY IN PREGNANT PATIENT
    (Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2025-04)
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    Shurlani, Arben
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    Ismaili, Bashkim
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    Acute appendicitis is the most common non obstetric emergency in pregnant women and often associated with a late diagnosis and complications such as perforation and fetal loss. We present a case of a 25-year-old primigravida, with epigastric pain radiating to the lower right quadrant that appeared 12 hours before admission, nausea, vomiting, white tongue and foetor ex ore. The laboratory values: WBC 18.000, RBC 4.12, HCT 36.2, CRP 22. Ultrasound examination: fetal biometry corresponded to 7 gestational weeks, positive cardiac activity, a small amount of peritoneal fluid was present in the right paracolic, ileocecal region and in Douglas's space, thickening of the wall of appendix vermiformis, surrounding inflammation of fatty tissue. The patient was observed in the next 6 hours, pain persisted in the lower right quadrant with propagation to the left quadrant. An indication for laparoscopic intervention for acute appendicitis has been made. The patient was placed in the supine position with the first camera and extraction port supraumbilically (10 mm) and the second port (5 mm) suprapubically. On laparoscopic exploration, 200 ml of bloody content was found in the pelvis and the vermiform appendix with reactive changes in the middle part towards the apex. An infundibular paraovarian cyst with a diameter of 20 mm was present on the right fallopian tube. The right ovary was ruptured with bleeding on one side. A third port (5 mm) was placed left pararectally. Aspirated pelvic blood was sent in the laboratory for beta HCG determination and partial resection of the right ovary and appendectomy were performed. After lavage, a Redon drain was placed in the pelvis through the suprapubic port. Postoperative course was normal and the drain was removed on the second postoperative day. Gynecological ultrasound was performed on the third postoperative day, the findings were normal and patient was discharged home.