Faculty of Medicine
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Item type:Publication, Epidemiological and clinical features of patients with Clostridoides difficile infection(Elsevier BV, 2024-12); ; Georgievska, DajanaAIM Investigation and identification of epidemiological characteristics, risk factors and treatment regimens effectivity in reducing morbidity and mortality. BACKGROUND C.difficile remains the leading cause of health care associated diarrhea, usually as a result of irrational use of antimicrobial therapy. METHODS Retrospective descriptive study (October 2020-january2024) included all patients with clinical symptoms of Clostridoides difficile infection (CDI) admitted at our clinic. Diagnosis is based on isolation with coproculture for C.difficile, toxin confirmation with immunochromatography, small number confirmed with PCR film array. RESULTS 594 inpatients with clinical symptoms of CDI were evaluated and diagnosis was confirmed in 44. Average mean age was 58,5 (29-90)years, approximately with no differencies on sex representation. Comorbidities and previous hospitalisations were noted in two third of them, and 63% had used antimicrobial drugs, while 34% had history of corticosteroid usage and 4,5% imunosupressive therapy. Often used antibiotics cephalosporins, clindamycine, quinolones and macrolides. 68,2% had history of protein pump inhibitors usage. Culture positive were 38%, toxinA/B is confirmed with immunochromatography in 77% of patients, PCR film array confirmed C.difficile toxin A/B in the remaining patients. Treatment is carried out with oral vancomycine in 56% of patients, 15% with metronidazole and the remaining with combination of two drugs. Regarding outcomes 90% of patients were cured while 10% had fatal outcomes and CDI is not considered the main cause of death. CONCLUSION Elderly patients with antibiotic history treatment, previous healthcare exposures and comorbidities were the most affected by CDI infection. Metronidazole and vancomycine has shown good therapeutic results. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Identification of risk factors for lethal outcome in patients with severe community-acquired pneumonia(Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2020); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Evaluation of factors for poor outcome in preterm newborns with posthemorrhagic hydrocephalus associated with late-onset neonatal sepsis(Dove Press, 2018-10) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Influence of obstetrically-associated risk factors in assessing anal incontinence in patients post vaginal delivery(Macedonian Association of Anatomists and Morphologists, 2018); ; ; ; Stojoska Lazarova, AleksandraIntroduction: Anal incontinence (AI) is an inconvenient and limiting medical condition that can cause social and hygienic problems, isolation, low self-esteem and low quality of life. The etiology is multifactorial. Women are eight times more affected than men and the reason is considered to be childbirth. In order to prevent this social, physical and psychological problem, it is necessary to define the risk factors leading to development of such symptoms in female patients after undergoing vaginal delivery. Factors that influence occurrence of anal incontinence in patients after vaginal delivery, have been categorized into obstetric, maternal and fetal factors. Objective: The purpose of this study is to determine the impact of individual obstetric risk factors on occurrences of anal incontinence in patients after vaginal delivery, and express it as anal score value. Materials and methods: We designed the study cross-sectional, and developed the research it at the University Clinic of Obstetrics and Gynecology, "Ss. Cyril and Methodius" University in Skopje, Macedonia, in a 3-month period, from August to November 2017. In this study, we engaged patients in their reproductive age, who had undergone at least one vaginal delivery. The degree of incontinence was determined using St. Mark's Anal Incontinence Score (SMIS). Results: In the examined segments, multi-parity (at least 2 vaginal births) increased by OR = 4.69 (95% CI 2.04-10.82) the patient's risk of having St. Mark’s score of ≥8 and this is statistically significant difference. Induced labor also reduced the likelihood of OR = 0.39 (95% CI 0.15-1.04) for St. Mark’s score of ≥8, but the difference was not a statistically significant one. Use of mediolateral episiotomy had protective significance against the risk of St. Mark score of ≥8. Conclusion: Results of this study show consistency with data published so far on the influence of obstetric risk factors on occurrences of anal incontinence in patients after vaginal delivery. Changes in anal incontinence are expressed in increased St. Mark’s score. Our study showed that the following factors had statistically significant impact on the score value: multi-parity, fetal macrosomia and perineal injury (grades 3 and 4). - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Screening for hepatitis C among injecting drug users in Psychiatric Hospital Skopje(Medical Faculty, Ss Cyril and Methodius University Skopje, R. Macedonia, 2017); ; ;