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, VITAMIN D AND BODY MASS INDEX IN GESTATIONAL DIABETES MELLITUS(Department of Anaesthesia and Reanimation, Faculty of Medicine, “Ss. Cyril and Methodius” University in Skopje, R.N.Macedonia, 2021); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Recurrent Severe Polyhydramnios in Bartter Syndrome: A Case Report(Journal of Biomedical Science Networks+ LLC, 2023); ; Gurzanova, TatjanaRepetitive severe polyhydramnios is a potentially serious obstetric condition which requires detail evaluation. We present a case of a 35-year-old pregnant woman referred due to extreme repetitive polyhydramnios in 19 gestational week. She had history of two missed abortions and premature labor in 23 gestational weeks with extreme polyhydramnios and death. Pat histology report didn’t show any anomaly of the organs and systems of that neonate. The actual pregnancy was conceived with IVF procedure and went uneventful until 19 GW. Combined first trimester screening and the noninvasive prenatal test went with low risk for aneuploidies. Gestational diabetes was excluded. Second trimester morphology scan and TORCH infections were within normal. She was hospitalized in 26 GW as a result of premature contractions, received tocolytic therapy on several occasions. Amnioreduction was performed twice, amniotic fluid for quantitative karyotype was done and came negative for aneuploidies (13,18,21 and sex chromosomes). Consultation with genetics and pediatric nephrologist was made due to suspicion of Bartter syndrome. Amniotic fluid as well as blood from both partners was sent to referent genetic laboratory and the molecular findings were in line with the diagnosis of SLC12A1 associated Bartter syndrome type 1 in the fetus. Corticosteroid therapy for fetal lung maturation was given and delivery was made by caesarean section in 31 gestational weeks. The neonate with weight 1180g, length 30cm, Apgar score 6/6/7, was admitted to neonatal intensive care unit. On the 7th day there was a gradual worsening in the general condition with cardiopulmonary failure and no response to reanimation resulted in neonatal death. Conclusion: Bartter syndrome is an autosomal recessive disease characterized by severe fetal polyuria and extreme polyhydramnios. It can be cause of preterm labor and should be suspected in cases of repetitive polyhydramnios. - 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, Human papillomavirus infections in women with and without squamous cell abnormalities of the uterine cervix(Centre for Evaluation in Education and Science, 2019); ;