Faculty of Medicine
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Item type:Publication, DEFINING THE PHYSICAL ACTIVITY ENVIRONMENT IN PRIMARY SCHOOLS ACROSS NORTH MACEDONIA: COSI STUDY(Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2025-06); Encouraging children to engage in physical activity (PA) is crucial for their overall development. The school environment can play a significant role in shaping children‘s PA habits, which in turn can positively impact their overall health and wellbeing. The aim of this study was to describe characteristics of the PA environment in primary schools across North Macedonia using data from the World Health Organization’s European Childhood Obesity Surveillance Initiative (COSI)—6th round. Materials and Methods: A primary school representative (n=111) responded to questions regarding the PA environment, which included questions about having outdoor and indoor playgrounds and gymnasiums, using of outdoor playgrounds outside of the school hours and during unfavorable weather conditions and organizing PA in and outside of the school hours. Descriptive statistics were conducted to depict the PA environment in primary schools across North Macedonia. Results: Most primary schools had an outdoor playground (94.6%), provided ≥2 hours per week of physical education lessons (89.2%), and had an indoor gymnasium (83.8%). However, smaller primary schools (≤29 pupils) were significantly less likely to have an indoor gymnasium. Approximately half of the primary schools (48.5%) offered organized sport/physical activities ≥1 time per week outside of school hours. Outside of school hours, most primary schools permitted the use of outdoor play areas (77.1%). Conclusion: In conclusion, while the overall PA environments were positive, all Macedonian primary schools did not possess adequate recreational facilities and space for students to be engaged in regular PA. Thus, there is a pressing need for collaborative efforts among schools, local and national authorities to address this issue effectively, aiming to combat childhood obesity and promote increased PA among young students - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Bony Cochlear Nerve Canal as a Predictor for Cochlear Nerve Status in Prelingually Deaf Children(Македонска академија на науките и уметностите, Одделение за медицински науки = Macedonian Academy of Sciences and Arts, Section of Medical Sciences/ Sciendo, 2023-03); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Pediatric Echinococcosis: diagnosis, urgent surgical intervention, and treatment – case report(Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2024-11); ; ; Racaj, AnilaEchinococcus tapeworms cause human echinococcosis, which causes hydatid cysts, most commonly in the liver and lungs but also in other organs. Delays in symptom onset can lead to diagnostic issues, especially in children. Pediatric cases are rare and often lead to unintentional diagnoses. Living in a rural area increases risk. Imaging and serological testing are essential for diagnosis. This case is rare since it involves pediatric echinococcosis. Children rarely get echinococcosis, and symptoms are often vague; thus, diagnosis is mainly by accident. Case report: A 10-year-old female child developed symptoms and signs such as tachycardia, fever, and facial urticaria. On the first clinical examination, classic signs of an acute abdomen were present, indicating a possible abdominal emergency. Laboratory results showed significantly high levels of inflammatory markers, including CRP and WBC, indicating an active inflammatory process, most likely caused by infection or tissue injury. Imaging examinations, particularly a contrast CT scan of the abdomen, revealed two burst liver cysts in the peritoneal cavity, confirming the diagnosis of echinococcal cysts in the liver. We undertook an urgent surgical intervention to address the burst cysts and avert potential complications like peritonitis or sepsis. Post-operative treatment included constant monitoring of the patient's condition, antibiotic and antihelminthic medication to control infection, pain management, and supportive measures to help with recovery. Echinococcosis in children manifests as nonspecific symptoms, which often leads to a rare suspicion and coincidental diagnosis. Echinococcosis is often considered a possible cause of stomach discomfort. The standard treatment for echinococcosis usually involves a combination of antiparasitic medication and surgical removal of the cyst. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Alisklamp versus Conventional Dorsal Slit Circumcision: A Multicentric Randomized Controlled Trial(MDPI (Multidisciplinary Digital Publishing Institute), 2024-08); Sergey KlyuevBackground: There are numerous methods of circumcision performed worldwide, typically classified into two main groups: conventional surgical techniques and various device-assisted techniques. Each method has its own advantages, limitations, and potential complications. The aim of this study was to compare outcomes of the Alisklamp technique versus the dorsal slit technique in male circumcision procedures. Method: This multicenter RCT compared the dorsal slit and Alisklamp techniques for circumcision, assessing patient demographics and intraoperative and postoperative outcomes. All patients, under local anesthesia via dorsal penile nerve block, were discharged on the same day and followed up at 24-48 h, 1 week, and 1 month. Results: A total of 180 patients enrolled, and 166 patients were included. The study compared postoperative outcomes between the Alisklamp (AK) and dorsal slit (DS) circumcision techniques in 166 patients. Key findings included significantly higher penile edema in the DS group (19%) compared to the AK group (2.4%) (p < 0.001), with severe edema occurring only in the DS group. Wound gaping was more common in the AK group (8.3%) compared to the DS group (1.2%) (p = 0.030). Skin tunnels were observed only in the DS group (9.5%) (p = 0.004). There were no significant differences in nausea, vomiting, bleeding, necrosis, infection, wound dehiscence, chordee, rotational anomalies, or secondary phimosis between the groups. Mean operation time was lower in the AK group than the DS group (7.8 min vs. 15.5 min; p < 0.001). Conclusions: The Alisklamp technique is recommended as the preferred method for circumcision because it minimizes complications, shortens the procedure time, and is easy to apply. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, TREATMENT OF UNSTABLE FOREARM FRACTURES WITH ELASTIC INTRAMEDULLARY OSTEOSYNTHESIS IN CHILDREN(Association of Albanian Medical Doctors in Macedonia, 2018); ; Lumani Nj.Introduction: Over the past years there has been a marked increase in the use of intramedullary fixation in the management of displaced forearm fractures in children. This reflects high incidents of redisplacement, malunion and functional limitations. Aim: This retrospective study was performed to analyze the functional results of the elastic intramedullary titanium nail fixation used in the treatment of unstable, diaphyseal forearm fractures in children. Material and methods: From March 2013 to March 2012, 235 patients with forearm fractures were treated at our institution. Percutaneous intramedullary f ixation with titanium nail was performed in 132 patients, 96 with unstable reposition and 36 with redislocation 48 hours after the injury. The mean age of the patients was 9.6 (5-13) years. In 34 patients (31%) limited open approach to one or both was necessary for reduction. Result: In 12 patients we encountered minor complications. The average union time was 7.5 (5-13) weeks. We rated the functional results using the Price grading scheme. Thirty-two patients obtained excellent results, four very good, four good and two scored poorly. Conclusion: Despite the minor complications, percutaneous intramedullary fixation with titanium nails is an appropriate and safe treatment method for unstable fractures of the forearm in children which cannot be treated by closed manipulation. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Anthropometric indices: waist circumference and waist-to-hip ratio cut-off percentiles to identify abdominal obesity in children from North Macedonia(Firenze University Press, 2024-09-04); ; ; ; Abdominal obesity (AO) has been associated with children’s risk of metabolic and cardiovascular disease. For this reason, this study aimed to provide gender-specific cut-off percentiles of anthropometric indices WC and WHR to identify AO in children aged 9 from North Macedonia. In this study, a total of 320 children aged 9 (160 boys and 160 girls) were investigated. We selected four parameters to measure (weight and height) and two circumferences (waist and hip) using a standard protocol. The following indices are taken into consideration Body-Mass Index (BMI), Waist Circumference (WC), and Waist-to-Hip Ratio (WHR). The percentile distribution of the tested parameters was done by gender. General obesity based on the BMI cut-off occurs at 5.63% in boys and 6.88 % in girls. Abdominal obesity across cut-off points WHR and WC-for age>=90th percentile occur at 11.88% and 6.26% in boys and 12.5 and 11.25% in girls respectively. Both the WHR and WC identify more children with abdominal obesity, but we note that more girls were classified as obese than boys. However, the anthropometric indices of WC and WHR, complement nutritional evaluation and are of great importance for the early detection of AO in our 9-year-old children. These findings support the need to use WC and WHR as strong predictors for AO in routine clinical practice. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Characterizing food, diary and beverage availability in primary schools premises in North Macedonia COSI-Study(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2024-07); Introduction: Childhood obesity remains a global public health challenge. As part of the World Health Organization's (WHO) Childhood Obesity Surveillance Initiative (COSI), North Macedonia participates in each data collection round to monitor primary school nutritional environments across the country. School nutrition environment characteristic exploration is necessary for managing and tracking childhood obesity and associated risk factors over time. Aim: Using WHO COSI-6thround data, the aim of this study was to depict availability of select foods, dairy and beverages in a nationally representative sample of primary schools across North Macedonia. Material and methods: Data were drawn from the WHOCOSI-6thround conducted in North Macedonia in 2022. A designated official (n=111) at the respective primary school reported availability of the following: (1) food (fruits, vegetables, ice cream, sweet snacks, and savory snacks), (2) dairy (milk, yogurt, and/or ayran), (3) beverages without added sugar (water, tea, and fruit juices), and (4) beverages with added sugar (non-carbonated fruit juices, carbonated drinks, hot drinks [e.g., cocoa], and flavored milk).Additionally, the designated school official reported whether their primary school had a canteen and/or shop/cafeteria where foods or beverages could be purchased. Results: Across primary schools in North Macedonia, availability of healthy options(i.e., fruits and vegetables)was lower as compared to energy-dense selections (i.e., sweet and savory snacks). Overall, 18.3% of schools offered dairy products (including milk, yogurt, and ayran).Water was the most commonly available (69.0%) beverage. No significant differences emerged in availability of food, dairy, beverages without added sugar or beverages with added sugar across primary school enrollment (small versus large). Less than one-fifth of primary schools had a canteen (17.4%) and/or shop/cafeteria (14.4%) where foods or beverages could be purchased. Conclusion: In conclusion, access to food, dairy, and beverages for primary school children in North Macedonia was limited. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, COVID-19 IN CHILDREN WITH DOWN SYNDROME-CASE SERIES(Macedonian Association of Anatomists and Morphologists, 2023-11-05) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Multiplex PCR in Diagnosing Respiratory Tract Infections in Hospitalized Children(Macedonian Academy of Sciences and Arts, 2024-04-04); ; ; Smilevska Spasovska, OlgaObjectives: To elaborate the utility of multiplex quantitative polymerase chain reaction (multiplex qPCR) for the accurate diagnosis of severe respiratory tract infections (RTIs) in hospitalized children. Methods: In two separate periods during 2022, 76 respiratory specimens (combined throat/nasopharyngeal swabs) were submitted for multiplex qPCR regarding 26 respiratory pathogens. The specimens were obtained from children with severe RTIs hospitalized in the Institute for Respiratory Diseases in Children, Skopje. Results: Multiplex qPCR detected at least one respiratory pathogen in all examined specimens (76/76), with 83% (63/76) rate of co-infections. Considering that positive results are only the ones with Ct value below 28, the rates of detected pathogens and co-infections decrease to 75% and 22%, respectively. The most commonly detected pathogens during the spring period were Parainfluenza type 3 (PIV3) followed by Adenovirus (AdV) and Respiratory syncytial virus type B (RSVB) with frequency rate of 23%, 19% and 19%, respectively. During the autumn period, the most common were RSVB and Streptococcus pneumoniae with frequency rate of 31% and 17%, respectively. Conclusion: Multiplex qPCR is a powerful tool for diagnosing RTIs. Semi-quantification of the viral load by reporting Ct values added higher level of evidence for accurate diagnosis. Seasonal detection of the examined viruses was notable with higher prevalence of PIV3 in spring and RSVB in autumn period. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The Influence of a School Environment on Obesity in Children(MDPI Proceedings, 2024-02); Obesity is a complex, multifactorial and widespread condition that affects all age groups of children. The rising prevalence of childhood obesity has become an important public health challenge because it affects the physical and mental health of children and is becoming an economic burden on the health systems. North Macedonia, as part of WHO’s Childhood Obesity Surveillance Initiative (COSI), is collecting data to show the importance of the surveillance of obesity in school-aged children and to provide evidence for informed policy making. Objectives: The aim of this cross-sectional study is to further investigate the influence of a school environment on obesity in 7-year-old schoolchildren and therefore improve children’s nutrition by targeting the food environment in and around schools. Materials and methods: Anthropometric measurements of body height and body weight were performed, and data from a school environment were collected, following the COSI protocol and data-collecting procedures. Results: The results from the previous rounds show that the overweight (including obesity) prevalence in 7–9-year-old schoolchildren is 31%. While physical education lessons in schools consist of 120 minutes of physical activity per week, only one-third of the schools studied organize sport activities outside school hours, and 39% of schools do not have indoor gyms. Only 31.2% of the schools are free of sugary beverage and calorie-dense food advertisements, but there are nutritional education classes in the curriculum in almost every school. One-third of the schools provide fresh fruit and one-third have vending machines on their premises, enabling children to acquire unhealthy snacks and beverages other than water and fruit juice. Conclusion: By comparing the previous and latest anthropometric data, there is a rising trend of childhood obesity in the country. School environments should be improved towards providing healthier nutrition and physical activity practices for pupils.