Cokleska, Natalija

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Cokleska, Natalija

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Cokleska, Natalija

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ANTEGRADE ELASTIC STABABLE INTRAMEDULARI NAILING IN TREATMENT OF DISTAL RADIUS DIAPHYSEAL METAPHYSEAL JUNCTION FRACTURES IN CHILDREN
(University Ss. Cyril and Methodius in Skopje, 2023)
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Aleksovski, Zlatko
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Kamiloski, Marjan
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Racaj, Anila
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Spontaneous rectus sheath hematoma– cause of acute abdomen in patients on anticoagulant therapy: two case reports
(Scientific Foundation SPIROSKI, 2020-07-16)
Petreski, Dimitar
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Todorovic, Lazar
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Kamiloski, Marjan
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(Spontaneus) Rectus sheath hematoma ((S)RSH) is an accumulation of blood in the sheath of the rectus abdominis muscle, secondary to rupture of an epigastric vessel or muscle tear. It is defined as spontaneous in patients without history of abdominal trauma. It can be located supra- or infraumbilically. Although the exact incidence is unknown, Klingler et al. observed 23 cases (1.8%) of rectus sheath hematoma among 1257 patients evaluated by ultrasound for acute abdominal disorders. Ultrasonography can help in the diagnosis, but CT scan is most accurate in its ability to define the lesion. When diagnosed clinically, a conservative therapeutic program can usually be instituted. Only in cases of supportive management failure, progressive and large hematoma or uncontrollable hemodynamic patients, interventional management including surgery or less invasive newer techniques is indicated. Case presentation: We present two cases of SRSH in patients using oral anticoagulant agent (acenocoumarol). Their chief complaint was sudden onset of acute abdominal pain. On admission they were haemodynamically stable. After thorough clinical evaluation a suspicion for SRSH diagnosis was made and then confirmed by ultrasonography and CT. Both of them were successfully treated conservatively and discharged home in a good general condition. Conclusion: These two cases illustrate the accurate diagnosis of SRSH treated conservatively leading to optimal patient outcomes.
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PYELOPLASTY IN BIFID RENAL PELVIS WITH OBSTRUCTION OF THE LOWER MOIETY
(Macedonian Association of Anatomists, 2021-12-27)
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Zlatko Aleksovski
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Aleksandar Tanev
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Abstract Duplications in the urinary collecting system and pyeloureteral junction obstruction (PUJO) are common, but the simultaneous presence of both anomalies is rarely encountered. In duplicate incomplete systems, PUJO usually affects the lower moiety of the kidney. We present a case of a 2- year old boy with left bifid renal pelvis and hydronephrosis of the lower moiety of the kidney.
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IATROGENIC HYPERNATREMIA AFTER HYPERTONIC SALINE IRRIGATION OF SPLENIC HYDATID CYST –
(Department of Anaesthesia and Reanimation Faculty of Medicine, “Ss. Cyril and Methodius” University, Skopje, R.N.Macedonia, 2020-10)
Michunivikj Derebanova Lj
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Leshi A
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Jovchevski L
Pediatric hypernatremia is a rare electrolyte abnormality. However, it can be a complication of hypertonic saline irrigation in hydatid disease. In our case report, we present a ten-year-old boy with splenic hydatid cyst who received operation treatment and developed electrolyte disturbances. Our aim is to emphasize the potential dangers of the use of hypertonic saline and the appropriate management of hypernatremia.
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Continuous Peripheral Block as a Pain Treatment for Redressment and Physical Therapy in a 7-Year-Old Child - A Case Report
(Macedonian Academy of Sciences and Arts / Sciendo, 2022-04-22)
Ljubica Mikjunovikj-Derebanova
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Ljupco Donev
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Vesna Cvetanovska-Naunov
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Vasko Demjanski
Abstract Continuous peripheral nerve block, also known as "local anesthetic perineural infusion," refers to percutaneous placement of a catheter near a peripheral nerve or plexus followed by administration of a local anesthetic through a catheter to provide anesthesia, or analgesia for several days, in some cases even for a month. This report describes the case of a 7 year old boy with left elbow contracture with limited flexion and extension who was admitted to the Clinic of Pediatric Surgery for redressment of the elbow and physical therapy. An ultrasound-guided axillary brachial plexus block was performed, with placement of a non-tunneled perineural catheter. Redressment of the left elbow was performed twice and before each redressment boluses of local anesthetic were applied through the perineural catheter. Physical therapy was performed painlessly with continuous perineural infusion. On the 5th day of catheter placement, the perineural catheter was removed without any prior complications such as hematoma, infection, catheter dislocation or leakage of local anesthetic. Our goal is to minimize the psychological and physical trauma to the patient, no matter how immature the patient is. Continuous regional anesthesia in children is a safe technique in postoperative pain management that facilitates early mobilization due to its sufficient analgesia and better comfort. It can provide in-home treatment, with adequate education for patients and parents, and improve rehabilitation in children.
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INTERCONDYLAR (Y) FRACTURE OF THE DISTAL HUMERUS IN A 8-YEAR-OLD CHILD
(University Ss. Cyril and Methodius in Skopje, 2021)
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Kamiloski, Marjan
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Mikjunovikj, Ljubica
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TREATMENT OF NERVES INJURIES ASSOCIATED WITH PEDIATRIC SUPRACONDYLAR HUMERAL FRACTURES-OUR EXPERIENCE
(SHMSHM - AAMD, 2020)
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Kamiloski, Marjan
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Mikjunovikj Ljubica
Background: Supracondylar fractures of the humerus are the most common type of elbow fracture in children. Nerve injury is the most common complication. Our study aims to determine the risk of traumatic nerve injury associated with supracondylar fracture, to compare the risk in flexion-type compared with the extension type fractures, and to note any iatrogenic nerve injury after pin fixation. Material and methods: The target group in this study is consisting of pediatric population (90 cases) presented with a displaced supracondylar fracture of the humerus (Gartland type II and III). All patients were treated at the University Clinic of Pediatric surgery-Skopje in the period of time from 2010 to 2020. The children were 2 to 14 years old. All of them were evaluated for nerve injury before and after the operation in order to determine if the nerve injury is traumatic or iatrogenic. Type of fracture, flexion or extension type was noticed. Results: According to the data from 90 children treated for displaced supracondylar fracture of the humerus, traumatic nerve injury occurred in 9 patients (10%). 4 (44,4%) of the referred nerve injuries involved the ulnar nerve. All ulnar nerve injuries were result of a flexion type supracondylar fracture. 3 (33,3%) injuries involve the median nerve. All of them were result of an extension type of supracondylar fracture. The anterior interosseous nerve, as a branch of a median nerve was injured in all 3 cases. 2 (22.2%) were injuries of the radial nerve, all of them as a result of an extension type of supracondylar fracture. Conclusions: According to our results, among all nerve injury associated with supracondylarar fractures, ulnar nerve injury predominates. Ulnar neuropathy occurred most frequently in flexion-type injuries. All 9 neuropathies were directly related to the injury itself and were noted at the time of admission. Spontaneous neurological recovery occurred in all 9 patients at a mean of 7.7 months (3 to 15) after injury.
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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)
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Sulejmani, Haris
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Racaj, Anila
Echinococcus 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.
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Case report of a long term survival in a patient with MGMT METH/IDH-1 mutation anaplastic oligodendroglioma WHO GR. III
(2019)
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Cokleska, Natalija

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