Joksimovic, Marija

Preferred name

Joksimovic, Marija

Official Name

Joksimovic, Marija

Alternative Name

M Joksimovic

Joksimovic M

Joksimovikj m

joksimovik m

m joksimovikj

joksimovic m

m joksimovic

marija joksimovic

joksimovic marija

m trpeska

m joksimovik

trpeska m

marija trpeska

Main Affiliation

Now showing 1 - 10 of 21

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MORGAGNI HERNIA IN THE ADULT PATIENT: A CASE REPORT
(University of Niš, Faculty of Medicine, Niš, 2020-12-23)
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Stefan Jovic
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The aim of this review paper is to present the state of complementary and alternative medicine in the Republic of Serbia and compare it with other developing and developed countries around the world.In most countries of the world, the legalization and integration of the Complementary and Alternative Medicine (CAM) into the health system went very slowly until the 1970s, when there was an important global change in socioeconomic conditions. WHO estimates that $ 83 billion was spent on traditional medicine in the world market in 2008. Significant variations in financial allocations to CAM across the globe have been observed, however, their direct comparison has been hampered by differences in the definitions and categorization of CAM used, as well as by the use of different currencies in different time periods. The development of CAM in the Balkans, during the 1990s, was hampered by war and transition, and the resolution of CAM was delayed. For the first time, the law regulates the implementation of the CAM in Serbia in 2005 by Article 235 of the Health Care Act.In the Republic of Serbia, evidence of the extent of use of CAM methods is very modest, although worldwide research shows an accelerated upward trend in the use of CAM. This paper is our contribution to the further development and better recognition of CAM methods by both the Ministry of Health of the Republic of Serbia and the professional public.
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Distribution of HPV types among patients with positive histological findings for cervical precancerous lesions and invasive cancer of the uterine cervix
(Македонско лекарско друштво = Macedonian Medical Association, 2018)
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Dzikova, Elena
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Dimitrov, Gligor
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Introduction. The aim of this study was to provide basic data on the prevalence of different HPV types among the female population in R. Macedonia with histologically proven cervical intraepithelial neoplasia or invasive cervical cancer, in order to better plan the vaccination program and screening for cervical cancer. Mеthods. This study retrospectively statistically (using Statistica SPSS for Windows) analyzed histological findings positive for cervical intraepithelial neoplasia or invasive cervical cancer and positive HPV genoty- ping results of564 patients who came to the University Clinic for Gynecology and Obstetrics due to an abnor- mal Pap smear test during the last year (2017). Results. HPV isolation showed the presence of human papillomavirus in78% of the total of 564 subjects. The prevalence of HPV in LSIL, HSIL, invasive squamo- cellular carcinoma of the uterine cervix and adeno- carcinoma of the uterine cervix was 69.2%, 87.2%, 97.6% and 71.4%, respectively. HR HPV types were isolated in 75%of LSIL and 96% of HSIL. Predo- minantly isolated were HPV types 16, 18, 35, 31, 33, 58, 6, 11 and 40. HPV type 16 wasthe most commonisolated genotype among all patients with 48.4%, 30.1% and 19.6% in HSIL, invasive carcinoma and LSIL, respect- tively. HPV type 18 had the highest rate in patients with invasive adenocarcinoma of the cervix (30.1%). Conclusion. Human papillomavirus types 16, 18, 35, 31, 33, 58, 6, 11 and 40were the predominant high risk types in patients with invasive cervical cancer and its precursors in the Republic of Macedonia.
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INTERMEDIATE UVEITIS AS THE FIRST PRESENTATION OF MULTIPLE SCLEROSIS
(Macedonian Association of Anatomists, 2020-07-16)
Ana Trpeska
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Abstarct Intermediate uveitis is a chronic, relapsing disease of insidious onset in which according to the SUN Working Group, the vitreous is the primary site of inflammation as determined clinically. Intermediate uveitis associated with systemic disease has variable course. Multiple sclerosis is associated with intermediate uveitis. We report a case of multiple sclerosis were intermediate uveitis was the first presentation of the disease. A 33 year old man with a 5 months history of decreased vision in his right eye. Best corrected visual acuity was 0.6 on his right eye and 1.0 on his left eye. Intraocular pressure was 17 mmHg and 15 mmHg on the right and left respectively. He had no signs of ocular surface inflammation, cornea clear, AC without signs of inflammation, lens clear. Right eye 3+ vitreous cells and vitreous condensations left eye 1+vitreous cells. Right eye fundus showed hyperemia of optic nerve head, irregular reflexes in the macula, peripheral retina without signs of retinitis or vasculitis. Left eye fundus showed only optic nerve head slightly hyperaemic. OCT, Indocyanine Green Angiography and fluorescein angiography were performed. We performed the investigations for diagnosing uveitis (angiotensin converting enzyme , serology for Treponema pallidum, Borrelia burgdorferi, Mantoux, neurological investigation) and all turned out to be negative except of MRI Brain and Spine that revealed multiple T2 hyperintense lesions consistent with multiple sclerosis. Multiple sclerosis may present initially with an intermediate uveitis. Multiple sclerosis should be suspected in patients aged 20 - 50 even without any neurological symptoms, noting that intermediate uveitis may precede other symptoms of demyelination.
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DOUBLE, VERY SHORT CYSTIC ARTERY: ANATOMIC VARIATION REVEALED DURING LAPAROSCOPIC CHOLECYSTECTOMY: A CASE REPORT
(Македонско лекарско друштво = Macedonian Medical Association, 2020)
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Marija Toleska
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Introduction. The cystic artery (CA) is the key struc-ture sought to be clipped or ligated during laparoscopicor conventional cholecystectomy.In up to 25% of sub-jects, the superficial and deep branches of the CA have separate origins and Michels called them double CA. Case report. We are presenting a 38-year-old female with one-year history of chronic gallbladder inflamma-tion. During the laparoscopy dissection in the region of the Calot’striangle, we revealed an anatomic va-riation of the cystic artery-a double cystic artery. The more important thing was that both branches were ex-tremely short, or at the lower limit of the publishedlengths of this blood vessel-approximately 3mm each. Bydoing so, the surgicalcourse further took the standardcourse-laparoscopic clips were placed on both branches. Conclusion. The incidence of double CA ranges from 15 to 25%. Such arteries usually arise from RHA and frequently replace the deep branch of the CA. Anatomicvariations in and around Calot’s triangle are frequent. Therefore, careful dissection of Calot’s triangle is ne-cessary for both conventional and laparoscopic chole-cystectomy. Hemorrhage could be a problem during search of the CA if these variations are overlooked and that increases the rate of conversion to open surgery. It also hasto be kept in mind that during laparoscopic visualization anatomical relations are seen differently compared to conventional cholecystectomy
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Therapeutic Resistance In Synchronous Endometrioid Carcinomas: A Case Report With A Pathogenic Germline Mutation In PMS2
(Elsevier BV, 2025-02)
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The occurrence of synchronous malignancies, particularly endometrial and ovarian cancers, presents a notable clinical challenge, with studies indicating that approximately 2-10% of women diagnosed with ovarian cancer also present with endometrial carcinoma. Mismatch repair (MMR) genes, including PMS2, play a crucial role in the pathogenesis of these cancers, as mutations in MMR genes are associated with increased susceptibility to various malignancies. Understanding these genetic factors is essential for effective treatment approaches.
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CASE REPORT: SUPRASPHINCTERIC PERIANAL FISTULA – OPERATIVE TREATMENT WITH BIOGLUE SURGICAL ADHESIVE
(SHMSHM - AAMD, 2025)
Trpeski, Stanko
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Murati, Ndricim
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Ivanovski, Kristijan
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A perianal fistula is a small pus-like channel that can occur between the end of the large intestine and the skin near the anus. It might be: Blind – which has only one open end, Complete - which has both an internal and an external opening and Incomplete – an external opening that does not communicate with an internal organ. They usually occur as a result of a previous history of a perianal abscess and when it is not completely healed. These fistulas arise from the anal glands that are localized between the internal and external anal sphincter and drain into the anal canal. In the following text, a case with a perianal suprasphincteric fistula will be described. A 43-year-old patient comes to Clinic For digestive surgery in Skopje due to pain in the anal region and flow of purulent smelly contents. Physical examination shows a fistulous opening at seven o’clock. A rectal examination was performed with a probe and digital rectal examination - there is communication with the rectum - suprasphincteric. The patient was sent for further investigation – magnetic resonance of the small pelvis. The patient is advised for surgical treatment of the fistula.
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MENAGEMENT OF BUTTONHOLE RECTAL INJURY AFTER VAGINAL DELEVERY - A CASE REPORT
(Македонско лекарско друштво = Macedonian Medical Association, 2020)
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Abstract Introduction. A special form of higher degree perinealtear is a laceration of the anorectal epithelium with in-tact external anal sphincter muscle (“buttonhole tear”). This is very rare but, when not treated, carries the risk of a rectovaginalfistula. Case Report. We present a case of a nullipara, in which a spontaneous vaginal delivery of a fetus in the vertex presentation was complicated by a buttonhole rectal tear with a partial lesion of the sphincters. It was recognized on the 4thpostpartum day, and a recon-struction of the lesion with a diversing colostomy was made soon. Upon returning the colostoma, the patient at 6 months postpartum has good continence and is in a good condition. Discussion. There are very few cases reporting an isolated rectal lesion during parturition. Several factorsmay play a role in the etiology of these lesions, inclu-ding instrumentation, birth weight of more than 4 kilo-grams, midline episiotomy, persistent occipitoposterior presentation, nulliparity, tissue factors, and second sta-ge >1 hour. Obstetric anal sphincter and rectal injuriescan be missed if rectal examination is not carried out asa standard procedure prior to suturing. This can have a devastating effect on the physical and emotional well-being of women.Conclusion. Careful examination of the vagina and the rectum should be performed in all cases of perineal tears following a vaginal delivery. Buttonhole injuries, although rare, should be considered as severe traumas similar to the 4th degree lacerations and managed prom-ptlyby experienced surgeons.
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RELATIONSHIP OF IMMUNOHISTOCHEMICAL EXPRESSION OF MISMATCH REPAIR GENE PRODUCTS AND CLINICOPATHOLOGICAL FEATURES IN PATIENTS WITH LOW-GRADE ENDOMETRIAL CANCER
(Macedonian Association of Anatomists and Morphologists, 2024)
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Ognenoska Jankovska, Biljana
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Background: This study examines the relationship between mismatch repair (MMR) gene expression and clinicopathological features in patients with low-grade endometrial cancer (EC). Methods: A prospective cohort of 40 patients with histologically confirmed low-grade EC underwent immunohistochemical analysis to determine MMR status. Clinical data, including age, body mass index (BMI), menopausal status, parity, and comorbidities, were collected. Histopathological evaluations assessed myometrial invasion,lymphovascular invasion and disease stage. Results: MMR deficiency (MMRd) was identified in 35% of patients, predominantly associated with MLH1/PMS2 loss. No significant associations were found between MMR status and clinical characteristics such as age, BMI, or comorbidities. However, MMRd tumors exhibited a significantly higher prevalence of myometrial invasion over 50% (85.71% vs. 38.46%, p=0.0042) and lymphovascular invasion (71.43% vs. 19.23%, p=0.00114). Additionally, MMRd cases were more frequently associated with advanced disease stages, particularly in stage IIIC (28.57% vs. 7.69%, p=0.078). Conclusion: The importance of MMR status in the biological behavior of low-grade endometrial cancer is highlighted in this study. The strong correlation between MMR deficiency and aggressive histopathological features such as increased myometrial and lymphovascular invasion, highlights the need to integrate MMR testing into clinical practice, even if clinical parameters showed no significant association with MMR expression. These results suggest that MMRd may be a useful prognostic indicator that requires more research to improve patient outcomes and treatment approaches for low-grade endometrial cancer.
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The Occurrence of Postoperative Complications in Patients Undergoing Surgery due to Complications from Crohn's Disease: A Case Report
(Centre for Evaluation in Education and Science (CEON/CEES), 2018-03-01)
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Mančeva, Ljubinka
Crohn's disease (CD) is a chronic inflammatory condition of the gastrointestinal tract that can give rise to strictures, inflammatory masses, fistulas, abscesses, hemorrhage, and cancer. This disease commonly affects the small bowel, colon, rectum or anus. Less commonly, it affects the stomach, esophagus and mouth. Often, the disease affects multiple areas of the gastrointestinal tract. The cause of CD is not known and there is no curative treatment. The current medical and surgical treatment is effective in controlling the disease, but even with optimal treatment, recurrences and relapses are frequent. Various risk factors specific for the patients with conditions related to the CD can influence the outcome of the surgical treatment in the postoperative period. Those risk factors can be preoperative laboratory inflammatory markers such as WBC and CRP values, phlegmona of the anterior abdominal wall and preoperative interintestinal abscess, positive resection margins. Here we present a case of a patient who was surgically treated as an emergent case because of the complication due to Crohn's disease. At presentation, the patient had leukocytosis, elevated CRP, anemia, low levels of total proteins, and albumin.
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EP1071 Genotype distribution of HPV in patients with histologically proven findings for cervical intraepithelial neoplasia or invasive cervical cancer in Macedonia
(BMJ Publishing Group Ltd, 2019-11)
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Dimitrov, G
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Introduction/Background The aim of this study was to provide basic data on genotype distribution of HPV in patients from Macedonia with histologically proven findings for squamous intraepithelial lesions or invasive cervical cancer, in order to better plan the vaccination program and screening for cervical cancer and to plan and with hope to introduce a National cervical cancer screening programme with HPV genotyping as a primary screening test. Methodology We analyzed the histological findings positive for cervical intraepithelial neoplasia or invasive cervical cancer and genotype HPV distribution results in 564 patients treated at the University Clinic for Gynecology and Obstetrics in Skopje, Macedonia, during 2017. Results 78% of the total of 564 subjects appeared to be positive for HPV. The genotype distribution of HPV in cervical squamous intraepithelial lesions or invasive squamous cell cancer and adenocarcinoma of the uterine cervix was 69.2%, 87.2%, 97.6% and 71.4%, respectively. The distribution of HR HPV types was for 21% higher in HSIL lesions than in LSIL. The most frequent isolated HPV types were: 16, 18, 35, 31, 33, 58, 6, 11 and 40. The most common genotype was HPV 16 with the highest rate in HSIL (48.4%), a little bit lower in invasive squamous cancer (30.1%) and the lowest in LSIL (19.6%). On the other hand, the prevalence of HPV 18 was the highest in patients with invasive adenocarcinoma of the uterine cervix, 30.1%. Conclusion In Macedonia, the most predominant genotypes of HPV in squamous intraepithelial lesions and invasive cervical cancers are the human papillomavirus types 16, 18, 35, 31, 33, 58, 6, 11 and 40 which is very important to know in order to plan the vaccination program and to create an expedient National cancer screening programme that will be more effective strategy against invasive cervical cancer.

Joksimovic, Marija

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