Faculty of Medicine
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Item type:Publication, Herpes zoster in 5-year-old girl with no previous history of chickenpox: Case report(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2024-07); ; Hristijan, BozhinoskiHerpes zoster (shingles) is caused by VZV (varicella zoster virus) infection. VZV is an enveloped, double-stranded DNA virus belonging to the Herpesviridae family; its genome encodes approximately 70 proteins. In humans, primary infection with VZV occurs when the virus comes into contact with the mucosa of the respiratory tract or conjunctiva. From these sites, it is distributed throughout the body. After primary infection, the virus migrates along sensory nerve fibers to the satellite cells of dorsal root ganglia where it becomes dormant. Reactivation of VZV that has remained dormant within dorsal root ganglia, often for decades after the patient’s initial exposure to the virus in the form of varicella (chickenpox), results in herpes zoster. This case report describes a herpes zoster infection in an immunocompetent 5-yearold girl, whose hetero-anamnesis from the parents provides information that the girl has not had chickenpox, and that she was not vaccinated against chickenpox, the mother denies that she had chickenpox as a child, and during pregnancy. Case report: A 5-year-old girl with the appearance of a macule, papule, vesicular rash in the area of the chest and back, in the area of the 4th, 5th, and 6th dermatome, in the form of clusters. Before the appearance of a rash accompanied by burning pain. Serological analyses in addition to Herpes Zoster infection with elevated values of ELISA VZV IgM positive + 2.8, ELFA VZV IgG-+1.38 positive. This case of a 5-year-old girl with herpes zoster, without previous evidence of varicella infection or immunodeficiency, presents a unique and interesting clinical scenario. It highlights the complexity of VZV infections and the need for comprehensive clinical and immunological evaluations in pediatric patients with herpes zoster. Future research in the mechanisms of viral latency and reactivation in such atypical cases will be critical to enhance our knowledge and management of VZV infections in children. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, AIRWAY MANAGEMENT IN 7-WEEKS-OLD INFANT WITH PIERRE ROBIN SYNDROME AND CONGENITAL PYLORIC STENOSIS(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2024-05); ; Angjusev, DarkoPierre Robin Syndrome (PRS) is characterized by a sequence of events including mandibular hypotrophy (micrognathia), abnormal posterior placement of tongue (glossoptosis), and airway obstruction. Pyloric Stenosis on the other hand is the most common infant surgical condition which presents with episodes of projectile vomiting leading to dehydration and weight loss. Airway management in these patients is a true challenge for every anesthesiologist. The patient was 7 weeks old infant, weighted 3,1 kg, admitted in Intensive Care Department for surgical repair of pyloric stenosis, previously diagnosed with Pierre Robin Syndrome at birth. Preoperative preparation, intravenous rehydration and electrolyte substitution was obtained. Video laryngoscope was used for management of difficult airway. We had many attempts in visualization of the vocal cords, eventually we performed awake intubation with stylet uncuffed endotracheal tube size 3. Pyloromyotomy was performed. Maintenance of anesthesia was with Sevoflurane and bolus doses of Fentanyl as adjunct. Perioperative vital signs were within normal ranges. Awake extubation was performed. The facial malformation that appears in patients with Pierre Robin Syndrome makes visualization of the glottis extremely difficult to impossible. In cases where tracheal intubation is needed, awake fiberoptic intubation is recommended, but it can have many limitations. These two conjoined conditions present the quandary of safely managing an expected difficult airway in an uncooperative patient. With this case we can conclude that for children with Pierre Robin syndrome, video laryngoscopy should be considered as a first attempt intubation device both in the operating room and for emergent situations. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ACHALASIA OF THE CARDIA - A PEDIATRIC CASE REPORT(Macedonian Association of Anatomists and Morphologists, 2021); ; ; Chakalarovska, IrenaIntroduction: Achalasia is an esophageal motor disorder characterized by aperistalsis of the esophageal body and lack of relaxation of the lower sphincter in response to swallows. It affects both sexes and all age groups. The exact etiology of this degeneration is unclear though many theories have been proposed. Possible etiology of achalasia can be familial, infection or autoimmune. Patients often present with progressive dysphagia to solids and liquids, heartburn, chest pain, regurgitation, and varying degrees of weight loss or nutritional deficiencies. Case report: In January 2020, a 10 years old boy was admitted to our hospital due to vomiting, chest pain during swallowing, and prolonged cough. A lot of investigations were performed. Fyberbronchoscopy showed that the trachea, the right main bronchus and the left main bronchus were with anteroposterior narrowed lumen. Computed tomography of thorax and abdomen showed dilated esophagus with largest diameter of 45 mm subcarinal with retained content.There is a compression of the right hillus. The finding indicates achalasia of the cardia. One month after the hospital stay, the child was admitted at the Clinic for pediatric surgery. Laparoscopic Heller Myotomy (LHM) with antireflux Dor fundoplication was performed. The following period the boy has no gastric or respiratory symptoms. Conclusion: We can conclude that it is worth to suspect achalasia in a pediatric patient with prolonged cough and recurrent respiratory infections refractory to conventional treatments such as bronchodilators, especially if the patient also has a history of vomiting and dysphagia. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, EPIDEMIOLOGY, TREATMENT, AND COMPLICATIONS OF CROUP SYNDROME IN CHILDREN(Macedonian Association of Anatomists and Morphologists, 2020); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Demographic, Clinical and Biochemical Characteristics of Pediatric Obesity: Interim Analysis of a Larger Prospective Study(Medical University of Plovdiv, 2020-12);