Sima, Aneta
Preferred name
Sima, Aneta
Official Name
Sima, Aneta
Translated Name
Сима Анета
20 results
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Item type:Publication, Knowledge gaps and knowledge acquisition of HPV infection and HPV vaccines among medical students in North Macedonia(Elsevier BV, 2023-04); ; ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Evaluation of HOMA IR in perimenopause patients with abnormal uterine bleeding(MSD Publications India Pvt Ltd., 2024-02-25); ; ; <jats:p>Introduction: Perimenopause as a clinical entity is characterized by a series of symptoms that occur due to estrogen deficiency in multiple organs and systems. Obesity is a risk factor that favors all these changes, especially hyperplasia. Glucose homeostasis is often impaired in these patients, insulin levels are increased, and HOMA IR is increased. Goals: to detect hyperplasia in obese perimenopausal patients with abnormal uterine bleeding to determine insulin levels, HOMA IR, to determine the association between hyperplasia and HOMA IR. Material and Methods: This was a prospective cohort study, performed at the OB/GYN Clinic, over 1 year. 100 patients with abnormal uterine bleeding during the perimenopause were involved, aged 45–50, divided into two groups based on BMI. 1-patients with a BMI above 30, 2-patients with a BMI under 30, and the control group consisted of 40 asymptomatic patients. Results: The average value of glycemia in the first group was higher and was 5.7 mmol/l, the cut-off value was 5,5. The average value of the HOMA-IR insulin resistance index in the first group was highest - 2.8 (the cut-off value was 1.8). Endometrial hyperplasia was registered in the first group at 40.9%. Discussion: The first group registered a significant association between HOMA IR and hyperplasia, the risk of endometrial hyperplasia occurring was eight times higher. The first group registered a significant association between glycemia and endometrial hyperplasia. High levels of glycemia increase the risk of endometrial hyperplasia occurring three times. Conclusion: In menopausal transition patients with abnormal uterine bleeding there is an increased incidence of endometrial hyperplasia, hyperglycemia, and increased HOMA IR. There is a strong association between these changes and the risk of cardiovascular disease increases. Menopause is a period in a woman’s life that requires a multidisciplinary approach to diagnostics and treatment. Keywords: HOMA IR, perimenopause, abnormal bleeding, hyperplasia.</jats:p> - Some of the metrics are blocked by yourconsent settings
Item type:Publication, PREGNANCY WITH POLYCYTHEMIA VERA - AN OBSTETRIC CHALLENGE(DEPARTMENT OF ANAESTHESIA AND REANIMATION, FACULTY OF MEDICINE, “SS. CYRIL AND METHODIUS” UNIVERSITY, SKOPJE, MACEDONIA, 2022); ; ; ; Polycythemia vera (PV) is a rare chronic myeloproliferative disorder of the haematopoietic stem cell type characterized by increased erythrocyte production. The disease is associated to a high risk of clinical complications - arterial and venous thrombosis, especially in pregnancy, bleeding, possible evolution to myelofibrosis and acute myeloid leukemia. We present the case of a 28-years-old patient, whose diagnosis was made 2 years before pregnancy (positive for mutation JAK2 V617F, bcr-abl negative, MPL, CALR negative). She was regularly monitored at the Hematology Clinic, had therapeutic venipunctures performed and anticoagulant therapy was prescribed. Pregnancy was regularly followed, with proper fetal growth and development, regular screening for fetal abnormalities, under anticoagulant therapy and under the supervision of a hematologist. At 34 weeks gestation, due to bleeding and pain, she was hospitalized in the Peripartal Intensive Care Department suspected of placental abruption. A caesarean section was performed immediately, a premature fetus was delivered in relatively good condition, and during the operation abruption of 1/3 of the placenta was found. The operative and postoperative periods were stable, the patient received replacement therapy and was discharged from the hospital on the 5th postoperative day in good general condition. The newborn was stabilized and discharged in good general condition after 3 weeks of stay at the Neonatal Intensive Care Department. Conclusion: Pregnancy in patients with this disease carries serious risks to the life and health of both mother and fetus, which requires special attention during pregnancy in order to reduce antenatal and postnatal morbidity. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Prenataly Diagnosed Bilateral Congenital Cystic Adenoid Malformation, Class 2, a Case Report(2022-05); ; Cystic adenomatoid malformations (CCAM) are rare developmental abnormalities of the fetal lung with incidence between 1:11,000 and 1:35,000 live births. They are benign dysplastic lung tumors characterized by overgrowth of terminal bronchioles with a reduction in the number of alveoli. The aim of this paper is to present a case of a prenatal diagnosis of a fetus with congenital cystic adenomatoid lung malformation, discuss the need for pregnancy termination and the prognosis of this condition. We present a case of 30 year old pregnant women (G2, para 1), reffered to University gynecology and obstetrics clinic in 21 gestational week for 2nd trimester anomaly scan. Fetal lung was markedly abnormal with hyperehogenic and cystic lesions mostly in the right lung lobe with displacement of the heart and largest cyst with diameter of 10mm. Amniocentesis was performed: quantitative analysis for trisomy 13,18 and 21was negative for chromosomopathy. MRI was performed and the diagnosis was confirmed. After detaled counceling termination of pregnancy according to the legal procedure was performed. Pathohistological examination of the fetus confirmed the prenatal diagnosis. Conclusion: CCAM is a rare congenital anomaly with reported perinatal mortality as high as 49%. Genetic counseling is necessary and termination of pregnancy is an option in cases of poor prognosis. Postnataly surgical management is the preferred option over conservative management. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Multidisciplinary approach to management of hypofibrinogenemia in pregnancy: a case report(Društvo doktora medicine Republike Srpske, Banja Luka i Univerzitet u Banjoj Luci - Medicinski fakultet, Banja Luka, 2020-06-30); ; Saso StojcevskiInherited fibrinogen disorders introduce risk for recurrent abortions, sub-chorionic haematoma, placental abruption and postpartum haemorrhage. This is a case report of a successful pregnancy outcome in a 37-year old woman with hypofibrinogenaemia. She was referred to a coagulation test in the first trimester because of history of preeclampsia and HELLP syndrome in previous pregnancy. Hypofibrinogenaemia was diagnosed with fibrinogen level of 0.7 g/L. During the pregnancy she was regularly monitored for fibrinogen levels and multiple cryoprecipitate concentrates were given. She delivered at 39th gestation week, with elective caesarean section under general anaesthesia. There was one episode of postpartum haemorrhage treated with 2 units of red blood cells, repeated infusions of cryoprecipitate to obtain the level of fibrinogen of 2 g/L. She was discharged on the 6th postpartum day in a good condition. In these disorders levels of fibrinogen should be higher than 1 g/L during pregnancy or 2 g/L in case of caesarean section for successful prenatal and peripartal management. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Атосибан наспроти конвенционален третман за заканувачко предвремено породување(Лекарска комора на Република Северна Македонија, 2023); ; ; ; Ива ПаневаПредвременото породување е најважната причина за неонатален морбидитет и морталитет на светско ниво. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Analysis of etiological factors for emergence of endometrial hyperplasia in perimenopause(Институт за јавно здравје на Р Северна Македонија = Institute of Public Health of R North Macedonia, 2019-06-15); ; ; ; The aim of this study was to evaluate the possible reasons for the emergence of endometrial hyperplasia in perimenopause. Material and methods: A total of 71 patients with irregular bleeding were analyzed, at the age of 40-50 years, who should have undergone diagnostic curettage. Depending on the histopathological findings, we divided them into 2 groups: group 1-findings for endometrial hyperplasia, group 2 - atrophic or endometrium with deficient secretory changes. Body mass index (BMI) was determined (obesity defined with BMI >30 kg/m2); we measured blood pressure (cut-off value was 135/90 mmHg), waist circumference (cut-off value was 88 cm) as well as data of anamnesis (age, physical activity, type of diet, smoking cigarettes). All these data were analyzed as etiological factors in the emergence of endometrial hyperplasia. Results: The mean age of patients was 47 years, and the results obtained were very similar in both examined groups. BMI and waist circumference were increased, more than 60% of patients had hypertension, but not all had a statistical significance. Most of them were with completed secondary education, and city living statistically significantly increases the risk of endometrial hyperplasia (p <0.05). As for the lifestyle (physical activity, caloric diet, smoking), the results have shown that a small number of patients are active, almost half of them consume caloric food and smoke, but without a statistical significance. Conclusion: Increased body weight and elevated blood pressure have a major impact on the onset and progression of pathological changes in the endometrium. As clinicians, we should always think of hyperplasia in obesity and patients with hypertension who are irregularly bleeding. At the same time, we should educate them to change the lifestyle in order to prevent gynecological and internistic morbidity. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Correlation between cytopathology and histopathology in women with squamous cell abnormalities of the uterine cervix(Macedonian Association of Pathology, 2016-09); ; ; ; Objective: The objective of our study was to investigate the correlation between cytology and cervical biopsy findings in women with squamous cell abnormalities on cervical cytology. Material and Methods: A comparative retrospective study was conducted in the period from September 2015 to March 2016 in a series of 184 sexually active women, aged from 20 to 60 years, with squamous cell abnormalities in the liquid-based cytology test. In all women, cervical biopsy with endocervical curettage was performed colposcopically for histopathological analysis. Results: Cytologically, there were 118 (64.13%) atypical squamous cells of undetermined significance (ASC-US), 22 (11.96%) low-grade squamous intraepithelial lesions (LSIL), 38 (20.65%) high-grade squamous intraepithelial lesions (HSIL) and 6 (3.26%) invasive squamous cell carcinoma cases. According to the histopathological findings in the cervical biopsy and/or endocervical curettage material in 108 (58.70%) women only nonneoplastic lesions were diagnosed. Twenty-four (13.04%) women had histologically confirmed LSIL, 42 (22.83%) had HSIL and in 10 (5.43%) cases invasive SCC was confirmed. For all squamous cell abnormalities, the sensitivity of the liquid-based cytology test in LSIL and higher grade lesions was 58.70% (108/184) and false positivity was 41.30% (76/184). Excluding ASC-US lesions, the sensitivity of the liquid-based cytology test was 78.80% (52/66) and the false positivity was 21.21% (14/66). The positive predictive value was 100% (6/6) for invasive SCC, 68.42% (26/38) for HSIL and 31.82% (7/22) for LSIL. Conclusions: The high sensitivity of the liquid-based cytology test for HSILs shows that it is an effective screening test for cervical cancer and its precursor lesions. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Congenital Pulmonary Airway Malformation Type II and Challenge in the decision-making process in developing countries-a case report(Creative Commons Attribution License, MSD Publications, 2024-10-22); ; ; ; Aliji, NurieCongenital Pulmonary Airway Malformation (CPAM) is a congenital lung disease that can be present from prenatal to childhood. The overall incidence of CPAM is reported to be 1 in 10,000 to 1 in 35,000 births, making it the most common type of congenital lung lesion. This malformation results from the interruption of lung development during various stages of embryogenesis. This case report aims to illustrate the disease through ultrasound imaging, emphasize its characteristics, and discuss parental counseling and decision-making regarding the continuation of pregnancy. It is important to highlight the limitations of prenatal diagnostic precision in developing countries and the need for additional diagnostic tools to improve parental decision-making options - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Interleukin 6 in pregnancy with gdm(2019-09-14); ; ; ; Abstract Background: Gestational diabetes melitus is a glucose intolerance diagnosed for the first time in pregnancy which may lead to maternal, fetal and neonatal unfavourable outcome. In GDM inflammatory markers like interleukin 6 are elevated and may provide informations on pathophysiology and prediction of perinatal risk. Aim: to evaluate the average concentration of interleukin 6 in GDM and normoglycemic women and the influence of body mass index on concentration of IL-6 in these women. Material and Methods: A case control study was made at the University Clinic for obstetrics and gynecology, Skopje in a period of one year. 100 pregnant women were selected from the pregnant women that performed 75g OGTT in the second trimester for sreening for GDM. Body mass index was calculated according to the terms of Institute of medicine and pregnant women were divided in 4 groups: GDM, BMI>25 (n=25); GDM, BMI<25(n=25); normoglycemic, BMI>25(n=25); normoglycemic BMI<25(n=25). Serum levels of IL-6 were analysed with ELISA method. Results: The medium values of IL-6 were higher in GDM compared to controls (2.77 ± 1.1 pg/ml vs 2.16 ± 0.5 pg/ml, p=0.0016). Pregnant women with GDM and BMI>25 vs GDM and BMI < 25 had statistically different values of IL-6 (2.58 ± 1.1 vs 2.19 ± 0.5 pg/ml, p=0.0019). Overweight women with GDM had significantly higher interleukin 6 than overweight women without GDM (3.06 ± 1.4 pg/ml vs 2.28 ± 0.7 pg/ml, p=0.021). Average value of IL-6 in GDM women with normal weight was 2.48 ± 0.8 pg/ml and significantly higher than normoglycemic women with normal weight, 2.04 ± 0.1 pg/ml, p=0.016. IL- 6 had insignificantly higher values in the overweight women from the control group compared to normal weight women from the control group (2.28 ± 0.7 pg/ml vs 2.04 ± 0.1 pg/ml; p=0.11). Conclusion: IL-6 is significantly higher in GDM compared to normoglycemic women. It can be used in addition with other biomarkers in eventual prediction of this condition.