Faculty of Medicine

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Anatomy education and clinical practice: students’ views
(Grupa Via Medica, 2025-10-16)
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Background and objectives: This study was aimed at evaluating students’ per spectives on the relevance of anatomy education to clinical practice throughout their studies at the Faculty of Medicine in Skopje. Materials and methods: The study was designed as a cross-sectional, questionnaire-based investigation and took place at the Faculty of Medicine in Skopje at the University of “Ss Cyril and Methodius”, R. North Macedonia. The questionnaire form included demographics, five-point Likert items, and open-ended questions. Questionnaire data was collected from volunteer student participants, currently and not currently involved in anatomy education, consisting of 134 first-year and 87 fourth- and fifth-year students during March and April 2024. Results: Junior students agreed that their anatomy education helped them achieve some important goals for clinical practice, such as adopting and applying medical terminology and the ability to visualise a three-dimensional human body map. Senior students were less convinced that the structures and concepts acquired during anatomy education were relevant to clinical practice, or that they helped them acquire clinical knowledge and skills effectively, or to understand the principles of evidence-based medicine. Junior students and their senior colleagues disagreed as to whether anatomy education succeeded in developing their self-confidence, teamwork, and communication skills. Conclusions: Both groups of students had similar preferences and suggestions for redesigning anatomy courses to focus on essential elements that are functionally and clinically relevant. This can be achieved through traditional and modern teaching methods, small group work, and the establishment of learning outcomes within clinically relevant contexts.
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Prevalence and Characteristics of Allergic Asthma in a Sample of Dairy Farmers
(Scientific Foundation Spiroski, 2024-01)
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Atanasovska, Aneta
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Bislimovska, Dragana
AIM: The objective of the study is to evaluate the prevalence characteristics of allergic asthma in a sample of dairy farmers. METHODS: We performed a cross-sectional study including 83 dairy farmers (mean age: 52.6 ± 8.7 years; mean exposure duration: 23.7 ± 7.6 years) compared to 80 office controls (mean age: 52.7 ± 8.2 years) matched for age, smoking habits, and socioeconomic status. Methods of evaluating examined subjects included a questionnaire on respiratory symptoms in the past 12 months, baseline spirometry and histamine challenge, and skin prick tests to standard inhalant and occupational allergens. RESULTS: The frequency of asthma was non-significantly higher in dairy farmers than in controls (7.2% vs. 5%). The frequency of allergic asthma was non-significantly higher in dairy farmers than in controls (6% vs. 3.8%). The frequency of allergic asthma was significantly higher compared to non-allergic asthma in both groups, while the frequency of subjects with allergic asthma who are sensitized to occupational allergens (wheat, corn, rye, cow hairs, molds) was similar in dairy farmers and controls. The risk of sensitization to occupational allergens was non-significantly higher among dairy farmers with allergic asthma (OR = 1,39 [0,18–12,28] CI 95%), compared to office controls. The risk for asthma development was non-significantly higher in subjects sensitized to occupational allergens compared to those who are not sensitized to them both in dairy farmers (OR = 2.00 [0.11–40.60] CI 95%) and office controls (OR = 3.00 [0.00–197.11] CI 95%). The risk for asthma development was about 4 times higher in subjects with atopy compared to those without atopy among dairy farmers (OR = 4.00 [0.22–104.88] CI 95%), while in office controls was almost identical (OR = 1.00 [0.00–39.77] CI 95%). Having in mind sensitization to certain inhalant allergens, asthma was significantly associated with sensitization to Dermatophagoides pteronyssinus both in dairy farmers (p < 0.01) and office controls (p < 0.05). CONCLUSION: The results suggest that occupational exposure among dairy farmers was associated with a higher prevalence respiratory symptoms, lung function impairment, and allergic asthma development. Study findings also can contribute in the detection of critical points for action, predict asthma development, and indicate the need for reduction of adverse occupational exposures by appropriate preventive measures, use of respiratory protective equipment, and implementation of engineering controls.
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ESSENCE-Q: Slavic language versions for developmental screening in young children
(Dovepress, 2018)
Stevanovic D
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Knez R
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Anderluh M
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Kodrič J
Purpose: The Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations – Questionnaire (ESSENCE-Q) was developed as a brief screener to identify children with developmental concerns who might have neurodevelopmental disorders (NDDs). This study aimed to translate the ESSENCE-Q into south Slavic languages, namely, Bosnian, Bulgarian, Croatian, Macedonian, Montenegrin, Serbian, and Slovenian, and to evaluate its psychometric properties for screening purposes in clinical settings. Patients and methods: In the study, the ESSENCE-Q was completed for 251 “typically devel oping” children and 200 children with 1 or more diagnosed NDDs, all aged 1–6 years. Internal consistency and construct validity were tested first, followed by generating receiver operating characteristic curves and the area under the curve. Optimal cutoff values were then explored. Results: The Cronbach’s α coefficients were 0.91, 0.88, and 0.86 for ESSENCE-Q parent completed form, and the telephone and direct interview forms administered by trained nurse or specialist, respectively. The 3 versions produced area under the curve values (95% confidence interval): 0.96 (0.93–0.99), 0.91 (0.86–0.95), and 0.91 (0.86–0.97), respectively. An optimal cutoff for ESSENCE-Q parent-completed form was found to be $3 points, while for the tele phone and direct interviews, it was $5 points. Conclusion: We found adequate measurement properties of the south Slavic languages versions of the ESSENCE-Q as a screener for NDDs in clinical settings. This study provided additional data supporting sound psychometric properties of the ESSENCE-Q.
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COPD IN A SAMPLE OF GENERAL ADULT POPULATION FROM THE SKOPJE REGION
(University Ss. Cyril and Methodius in Skopje, 2022)
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Atanasovska, Aneta
Introduction. Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity, disability and mortality in the last decades worldwide. Aim of the study. To determine the COPD prevalence in a sample of general adult population from the Skopje region and its distribution by sex, age, smoking status, working status, family history of chronic bronchitis/asthma, and mode of household heating and cooking. Methods. A cross-sectional study (prevalence study) including 2,348 participants (1,239 males and 1,109 females, aged 18 to 86 years) from the Skopje region was performed at the Institute for Occupational Health of RN Macedonia, Skopje, in the period 2018-2021. The study protocol included completion of a questionnaire and spirometric measurements (pre and post-bronchodilator spirometry). COPD was defined by spirometric finding of persistent airflow limitation in symptomatic study subjects. Results. COPD prevalence in the whole study sample was 4.6%, being non-significantly higher in men (5.1%) than in women (4.1%). Fourfold higher prevalence of COPD was registered in the study subjects aged over 45 years as compared to the younger ones (6.7% vs. 1.6%; P = 0.000). COPD prevalence was significantly higher in active smokers as compared to non-smoking study subjects (9.4% vs. 1.9%; P = 0.000). In regard to working status, COPD prevalence among active workers was 3.9%, in the group of retired persons 8.7%, while in the group of students there was not a single subject with COPD. In addition, COPD prevalence in the workers occupationally exposed to noxious particles or gases was significantly higher than in unexposed workers (4.7% vs. 2.4%; P = 0.021). There was no statistically significant difference in the COPD prevalence between study subjects with positive and negative family history of asthma/chronic bronchitis (4.8% vs. 4.5%), as well as between study subjects who used biomass fuels for heating and cooking (6.2%) and those who did not use traditional fuels for household needs (4.0%). Conclusion. Our findings have indicated the age, active smoking and occupational exposures to noxious particles or gases as the factors significantly related to COPD prevalence in the examined sample of general adult population from the Skopje region.
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Exposure to environmental tobacco smoke in the workplace in Macedonia: where are we now?
(Walter de Gruyter GmbH, 2008-06)
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Risteska-Kuc, Snezana
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To assess the prevalence and the level of exposure to environmental tobacco smoke (ETS) in the workplace after the enactment of the law restricting indoor smoking in Macedonia, we performed a cross-sectional, self-administered questionnaire study including 372 never-smoking workers recruited from six workplaces. We found a high prevalence of workers exposed to ETS in the workplace (27.4 %) with no significant difference between particular occupation groups. We found no significant difference in the prevalence of passive smokers in the workplace between this study and our study conducted before the law was enacted (31.5 % vs. 27.4 %, P=0.324). The prevalence of workers exposed to ETS for less than three hours a day was significantly lower than of passive smokers with longer exposure (28.4 % vs. 71.6 %, P=0.038). The prevalence of workers exposed to ETS from less than 10 cigarettes smoked by coworkers per day was lower than the prevalence of workers with higher exposure, but statistical significance was not reached (37.9 % vs. 62.1 %, P=0.087). Our findings indicate a high prevalence and a high level of exposure to ETS in the workplace, which calls for stricter adherence to smoking-free legislation or even the total ban of smoking in the workplace.
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Chronic obstructive pulmonary disease in never-smoking male workers exposed to grain dust
(2015)
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Engin Tutkun
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Introduction. Existing literature indicates that workplace exposure to grain dust is associated with adverse respiratory effects in exposed workers. Aim of the study. To assess prevalence and characteristics of chronic obstructive pulmonary disease (COPD) in workers exposed to grain dust. Material and methods. We performed a cross-sectional study including 37 never-smoking male grain workers and an equal number of male office workers matched to grain workers by age and smoking status studied as a control. Evaluation of examined subjects consisted of completion of a questionnaire, baseline spirometry, and bronchodilator reversibility testing. Results. We found higher prevalence of respiratory symptoms in grain workers with significant difference for cough and phlegm. Majority of respiratory symptoms in grain workers were work-related. The mean values of all measured spirometric parameters were significantly lower in grain workers. The prevalence of COPD, diagnosed by spirometric confirming of persistent airflow limitation, was significantly higher in grain workers as compared to office workers (10.8% vs. 2.7%, P = 0,021).COPD in grain workers was close related to age over 45 years and duration of employment at the actual workplace over 20 years. Conclusions. Our findings suggest relationship between workplace exposure to grain dust and persistent airflow limitation in exposed workers.
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National survey on identifying vulnerable workers and availability of occupational health services in the Republic of Macedonia
(Società italiana di medicina del lavoro, 2010)
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Risteska-Kuc, Snezana
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In order to identify vulnerable groups and high risk sectors which are at greater need of basic occupational health services, we performed a questionnaire-based study including, as key informants, different stakeholders and key players in the process of improving health and safety at work.
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Carbocysteine in the Management of Stable COPD: Are Its Antioxidant and Anti-Inflammatory Properties Clinically Relevant?
(ID Design Press, 2017-12-27)
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Petrova, Tatjana
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The recent epidemiological and experimental evidence suggest possible antioxidant effect of carbocysteine in patients with chronic obstructive pulmonary disease (COPD).AIM: To assess efficacy and tolerability of carbocysteine in the management of stable COPD.METHODS: We performed an observational, non-randomized, open study (a real life study) including 87 patients with stable COPD (group B and D by combined COPD assessment) divided in two groups, examined group (EG) and control group (CG). All participants were treated with the regular treatment of the stable disease, but in the participants of the EG carbocysteine 1,500 mg daily was added to their regular treatment during the period of two months. The study protocol included completion of the COPD Assessment Test (CAT) and spirometric measurements at initial visit and at the end of the mentioned period.RESULTS: We found significantly lower mean value of the overall CAT score in the EG at the end of the study as compared to its mean value registered at initial visit (26.9 vs. 24.3; P = 0.007). In regard to certain CAT items, we found significantly lower values of the mean scores related to cough phlegm and sleep disturbances as compared to their mean scores at initial visit. In addition, the mean values of the overall CAT scores at initial visit and at the end of the study in controls were similar. In EG we found significantly higher mean value of the MEF 25-75 at the end of the study as compared to its mean value registered at initial visit (59.3% vs. 67.2%; P = 0.003). There was no significant difference in the mean values of other spirometric parameters at the end of the study as compared to their mean values at initial visit. In controls we registered similar values of all measured spirometric parameters at the end of the study as compared to their values registered at initial visit. Mild gastrointestinal manifestations were registered in 13.3% of the participants of the EG during the examined period.CONCLUSION: Our findings indicate positive effects of carbocysteine regarding the symptoms and lung function, as well as its good tolerability in the patients with stable COPD.</jats:p>
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Chronic obstructive pulmonary disease in never-smoking dairy farmers
(2015)
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Work-related chronic obstructive pulmonary disease (COPD) represents a considerable part of the disease burden globally.

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