Faculty of Medicine

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    FIRST AND SECOND TRIMESTER MEDICAL ABORTION - PILOT STUDY IN REPUBLIC OF NORTH MACEDONIA
    (Македонско лекарско друштво = Macedonian medical association, 2021)
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    Introduction. Medical abortion is a procedure in which medication is used to end a pregnancy up to 22 weeks of gestation. The aim of this study was to assess the efficiency, safety and acceptance of medical abortion in the first and second trimester using a regimen of medications, mifepristone followed by misoprostol. Methods. In a prospective study, conducted at the University Clinic for Gynecology and Obstetrics in Skopje in the period from March to November 2021, women that came for medical abortion in the first and second trimester were enrolled. They were divided into two groups: Group I (5 to 12 weeks of gestation) and Group II (12 to 22 weeks of gestation). Participants in Group I were given 200 mg mifepristonе for peroral application and after 24 hours instructed for sublingual application of 800 µg misoprostol at home. Participants in Group II were hospitalized and treated with the same regimen. Additional dosage of misoprostol was given to complete abortion. Results. A total of 208 women with medical abortion up to 22 weeks of gestation (173 in the first group and 35 in the second group) were enrolled in the study. In the first group a complete uterine evacuation was achieved in 168 women (97.1%) and in 25 women (71.4%) in the second group. Acceptability of the method was high among both groups (95.14 % in Group I and 82.14 % in Group II). All doctors/clinicians who participated in this pilot study were satisfied with the method. Conclusions. Medical abortion is effective, safe and acceptable option for women in the first and second trimester. Acceptability of the method was high among both groups. All doctors/clinicians who participated in this pilot study were satisfied with the method and would offer it as an option to their patients in the future.
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    DISTAL TRANSRADIAL APPROACH IN HIGH-RISK PATIENT WITH STEMI AND CARDIOGENIC SHOCK – A CASE REPORT
    (Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2022)
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    Kitanoski, Darko
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    Bushljetikj, Oliver
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    Conventional transradial access has been considered as a recommended choice in PCI and myocardial revascularization.The vascular complications such as radial artery occlusion, perforation and spasm have led to the development of a new approach, which was proposed to overcome these limitations. This was a distal transradial approach (snuffbox approach). A 74-year-old woman presented to the emergency department with oppressive chest pain and dyspnea formore than 3 hours.On clinical examination, the patient appeared pale and diaphoretic, with weak and rapidpulsation and systolic blood pressure below 70mmHg. A 12 lead ECG lead was performed, whichshowed ST segment elevation of 4 mm in inferior lead.She was admitted to the catheterization laboratory with blood pressure 70/40mmhg andnorepinephrine vasopressor support. A 6Fr introducer sheath was placed in distal radial (anatomical snuffbox). The coronary angiography revealed RCA with acute total occlusion and high thrombotic burden TIMI 5 in proximal segment,normal LMCA, LAD and Circumflex. RCA was engaged with a guide catheter and advanced distally a floppy guidewire, then the occlusion site was predilated with a balloon and advanced stent from proximal segment with TIMI3 final flow. 2D transthoracic echocardiography was performed, and it showed heart failure with mildly reduced ejection fraction and hypokinesia of the inferior wall. Distal transradial access is a new approach which might offer several advantages over conventional radial access such as reduction of the risk of radial artery occlusion, short hemostasis andsaving the radial artery for possible future coronary artery graft.