Faculty of Medicine
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Item type:Publication, Perinatal complications and their association with maternal hypothyroidism(Bulgarian Association of Young Surgeons (ScopeMed), 2022-05); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, BLEPHAROPLASTY - OUR EXPERIENCE(Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2021); ; ; ; One of the most popular aesthetic surgery procedures is blepharoplasty. Preoperative planning and tissue resection can reduce complications and improve outcomes. Although some patients want blepharoplasty to address age-related changes in the skin of their eyelids, the procedure is more of a sculpture and contouring of the overall aesthetic unit. In this paper we present the history, basic anatomy, indications and surgical technique of upper and lower blepharoplasty. The importance of the preoperative patient evaluation for blepharoplasty has also been stated. We present our experience in blepharoplasty surgery done at the University Clinic for Plastic and Reconstructive Surgery in a three-year period, along with the complication rate and outcome. We have briefly described the techniques of standard upper and lower eyelid blepharoplasty. Practically, the rejuvenation of this complex anatomical area requires a combination of therapies including fat excision, repositioning or transfer, simultaneous brow or midface lift, and adjunctive treatment for skin resurfacing and periorbital hollows. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Role of education in prevention and delay of complications in type 2 diabetic patients(bioscientifica, 2012); ; ; ; Lumani, SedatAim: To assess the impact of education of people with T2DM and complications. Patients and methods. Observational study, 100 T2DM patients of age 35–75 years, both sex, duration of DM >1 year.Results. From 100 T2DM 47% were male sex and 53% female. Mean age 60.45±8y, duration of DM 10.45y±3 y. Average A1c 8%±0.6, BMI 27%, systolic BP 140±6 mmHg, TG 2.2±0.3 mmol/L, LDL 4.0±0.6 mmol/L. Education (diet, physical activities, drug compliance) for DM was 67% for male and 54% for female. Education for diabetic foot care (inspection, foot hygiene, appropriate shoes) 51% for male and 49% for female. Conclusion: Metabolic risk factors are poorer in no educated than in educated T2DM, People who had not satisfactory education for foot care have higher risk for foot ulceration. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Clinical Characteristics, risk factors and outcome in patients with in tracerebral haemorrhage(Leage against epilepsy of Macedonia, 2015); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Impact of socioeconomic status on the occurrence of complications after cochlear implantation - A case study(Institute of Sensory Organs, 1 Mokra Street, Kajetany, 05-830 Nadarzyn, Poland, 2018-06-27); INTRODUCTION Cochlear implantation is a powerful tool for helping children with severe to profound sensorineural hearing loss gain the ability to hear, achieve age-appropriate reading skills, and develop communication skills equal to those of their hearing counterparts. Although it’s a reliable and safe procedure cochlear implantation surgery, like any other surgical procedures, has some minor and major complications. Major complications are those that are require surgery whereas minor complications are those that can be medically treated. The overall rate of complications among cochlear implant patients ranges from 6% do 20%. According to the time of appearance can be classified as immediate (< 1 week) or delayed (≥1 week) events. One of the quite worrying and potentially devastating are the postoperative wound infections after cochlear implantation. Because of the risk of the implant infection in this cases, which can lead to device removal with loss of the implant function, every effort must be made to prevent this infections, or if they occur to be timely and appropriately treated which will enable salvage of the implant and its function. AIM Тo emphasize the importance of socioeconomic status as risk factors for the occurrence of postoperative wound infection after cochlear impantation. MATERIALS AND METHODS We report the case of 4-year-old child with delayed postoperative surgical wound infection. The one appeared 14 days after the cochlear implantation (postoperatively). Anamnestic data obtained from the mother indicates that after discharging from the hospital the child was repeatedly itchy the wound. On examination a half of the surgical wound was reddish with mild discharge and starting dehiscence at one point. The swab obtained from the wound was positive for Vancomycin resistant-Enterococcus faecium. RESULTS An outpatient medical care with antiseptic dressing, topical and oral antibiotics was started immediately. Because of no response, even worsening of the local status, 7 days after a revision surgery was required. With the employment of timely and appropriate intraoperative wound debridement and re-suture the healthy edges without using a flap, the implant was salvaged. DISCUSSION/CONCLUSIONS As reported in the literature, in children from families with lower socioeconomic background incidence of complications is higher comparing to the children that come from families with higher income level. The reason for this can be poor hygienic conditions and habits, as well as negligent care of the parents. Тhis case is just another(one more) confirmation that the socioeconomic status can represents a possible risk factor for the occurrence of postoperative complications in children after CI surgery. Specially in an environment where because of financial barriers, access to the cochlear implantation is limited, special attention should be paid to the socioeconomic status of the candidates for CI. This indicates that a special approach in pre-operative preparation and postoperative care in the candidates for cochlear implantation with lower socio-economic back-ground is needed. Involvement of a motivated social workers in the care of the cochlear implant children is necessary for additional support and education if this group of parents and children, in order to prevent and reduce the negative impact of the socioeconomic background of the CI surgery outcomes. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, THE PREDICTIVE VALUE OF SERUM LACTATE ON THE OUTCOME AFTER MAJOR ABDOMINAL SURGERY(Department of Anaesthesia and Reanimation, Faculty of Medicine, “Ss. Cyril and Methodius” University in Skopje, R.N.Macedonia, 2019-05); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Posterior Reversible Encephalopathy Syndrome (PRES) in Children Undergoing Allogeneic Stem Cell Transplantation(Macedonian Academy of Sciences and Arts / Sciendo, 2019-05-01); ; ; ; Posterior reversible encephalopathy syndrome (PRES) is one of the most serious complication after allogeneic stem cell transplantation in paediatric setting. It is most commonly reported as adverse event of immunosuppressive strategies during transplantation. We present a case of a 7 years old girl with myelodysplastic syndrome (MDS) treated with allogeneic stem cell transplantation (ASCT) at our department. Diagnosis of PRES was confirmed by imaging techniques during the first month after transplant and it was very likely connected with cyclosporine neurotoxicity. The aim of this article is to present our first experience in diagnosing and treating PRES in paediatric stem cell transplantation. Our experience showed that PRES is one of the reasons for higher transplant related mortality in children. Early prediction of factors contributing to PRES and closely monitoring of patient's vital signs, especially blood pressure, neurological status and vision are the main contributors for challenging the patient with another immunosuppressive agent that has less neurological toxicity. Still studies have to be initiated to confirm the influence of PRES on transplant outcome. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Connection between cytokines and complications derived from preeclampsia pregnancies(ScopeMed Publishing, 2020-05)Preeclampsia is a condition of multiorgan involvement that can cause severe complications for the mother’s health and endanger the intrauterine development of the fetus. Purpose: The purpose is to detect the risk of developing preeclampsia in the second trimester, by examining cytokines and closely monitoring the pregnancy for complications from preeclampsia, whether they are affected by the same cytokines. Material and methods A total of 100 patients were monitored in the second trimester between 14 and 20 weeks of gestation. Values of immune biomarkers of their serum were analyzed after obtaining anamnestic data and performing ultrasound examination. With the help of the ELISA methodology, cytokines were verified: TNF-a, IL-1a, IL-2, and IL-6 versus IL-4 and IL-10. Results Of the 100 patients examined, 21 patients developed clinical symptoms and were diagnosed with preeclampsia in the third trimester. The interaction of proinflammatory interleukins is in favour of a mutual increase, and a decrease in the values of antiinflammatory interleukins is a significant predictive parameter in the second trimester for the development of preeclampsia. The increase in IL-6 is the largest statistically significant variable in the prediction of preeclampsia. The correlation between IL-6 and pregnancy complications is also with statistical significance (p=0.012). Conclusion The impaired immune response can result in consequences such as multiple organic disorders that occur in the clinical preeclampsia syndrome and problems with fetal development. The benefit of analyzing cytokines is highly significant for early diagnose and prevention of further complications. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Histological positivity of resection margins as risk factor for occurrence of early postoperative complications in patients undergoing ileocolic resection due to complications from Crohn's disease(2017); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, POSTOPERATIVE COMPLICATIONS IN PATIENTS UNDERGOING THYROID SURGERY(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Macedonia, 2018); ; ; ; Background and objectives: Postoperative complications from thyroid surgery are numerous and may be shown on different levels. Some of these complications may be detrimental for patients, so minimization of the risks should be always considered. We evaluated the postoperative complications in patients after surgery of the thyroid gland at the Clinic for Thoracic Surgery, Skopje. Material and method: In retrospective manner, all patients undergoing thyroid surgery during the one-year period (1. January- 31. December 2017) were evaluated. Patients were divided into two groups, whereas group ST included patients who underwent goiter removal and subtotal thyroidectomy while group TT included patients in who total thyroidectomy was done. In both groups we analyzed the demographic data and the occurrence of postoperative (in the first 48 hours) complications (stridor, hoarseness, hemorrhage, nerve dysfunction, tracheomalacia, hypocalcemia and the need for reintubation and tracheostomy). Results: Total data from 197 patients was evaluated. 120 patients had subtotal thyroidectomy while total thyroidectomy had 77 patients. Postoperative complications occurred in significantly larger number of patients in the TT group (64.9 vs. 40%). Hoarseness (8.4% vs. 18.5%), stridor (18.3% vs. 9.2%) tracheomalacia (5% vs. 1.2%) and hematoma (2.5% vs. 3.8%) occurred in respect to the groups. Hypocalcaemia occurred in significantly larger number of patients in TT group. Permanent nerve injury was found in one patient in the same group and tracheotomy was done only in one patient. Conclusion: Overall results from our study show that the complications after thyroid surgery occur in all patients who undergo thyroid surgery. However, more severe complications and outnumbered are complications in patients who undergo total thyroidectomy.