Todorovska shapova, Biljana

Preferred name
Todorovska shapova, Biljana
Official Name
Todorovska shapova, Biljana
Main Affiliation
Email
biljana.shapova@medf.ukim.edu.mk

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    Does mild form of subclinical hypothyroidism needs treatment?
    (Bioscientifica, 2022-08-17)
    Velkoska Nakova, Valentina
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    Stevchevska Gjorgjievska, Aleksandra
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    Background Overt hypothyroidisms warrants L-T4 treatment, but treatment in subclinical hypothyroidism (ScH), especially in mild form of ScH (TSH between 4,2-10mU/l and normal free thyroxine) is unknown. Objectives To compare the presence of risk factors for atherosclerosis in patients with mild form of ScH to euthyroid subjects. Methods Prospectively 67 consecutive patients with newly diagnosed ScH, and 30 healthy subjects were recruited from the outpatient department of University clinic of endocrinology in Skopje, R. of N. Macedonia. Measurement of thyroid hormones, thyroid antibodies, blood pressure, lipids, and carotid intima media thickness (CIMT) were performed in all patients. Results Mean TSH value in ScH group was 8.71G1,9 mU/l. TSH value above 7mU/l was associated and positively correlated with symptoms of hypothyroidism. Prevalence of hypertension in ScH group was higher than the control group (35.4% vs. 13.3%, PZ0,03), with a 3.5 times higher risk for hypertension (ORZ 3,5 95%CI 1,1 – 11,4). In patients with mild form of SCH statistical significant difference in percentages of patients with arterial hypertension, hypertriglyceridemia, and values of total cholesterol/HDL-C and LDL/HDL above upper reference value were found (33.9 vs. 13.3%, 33.9 vs. 10%, 26.5 vs. 6.9%, 30.6% vs. 10.3%, respectively P ! 0.05). Mean CIMT was statistically significantly higher in ScH patients than the control group (0.61 G 0.1 vs. 0,56 G 0,1 mm, PZ0.03), but not different between the mild form of ScH and control group (PZ 0.08). Positive thyroid antibodies in the ScH group have no statistically significant influence on the CIMT. Conclusions In a small study, mild form of ScH was associated with higher risk for atherosclerosis, so these patients may benefit with L-T4 treatment.
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    EVALUATION OF POSTOPERATIVE PAIN IN PRESERVATION AND ELECTVE DISSECTION OF THE ILIOINGUINAL NERVE IN INGUINAL HERNIOPLASTY
    (Macedonian Association of Anatomists, 2023-05)
    Jovanovska Spasova, Zanita
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    Obocki Lukovska, Elizabeta
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    The use of mesh techniques in the treatment of inguinal hernias significantly reduce recurrences. However the incidence of inguinodinia still present significant complication. The study was designed as a randomized, prospective, unilaterally blind clinical study. Forty male patients were included, to whom hernioplasty by Lichtenstein method with implantation of polypropylene mesh was performed. Patients were divided into 2 groups of twenty patients each. In first one the technique of the ilioinguinal preservation was used, and in the second one dissection of the ilioinguinal nerve was performed. At appropriate time points two types of scales were used to assessed the intensity of the pain: Numeric scale of pain (NSP) and Stanford pain scale (SPS).Data from 40 patients have been analyzed, of which 20 with preservation and 20 with dissection of the ilioinguinal nerve. Inguinodynia was present in two patients, one in each group, i.e. 5%, which indicates that there was no significant difference in the occurrence of inguinodynia in the group with preservation and dissection of the ilioingvinal nerve. No single direction can yet be given as to whether it is better to preserve or dissect the inguinal nerves, and there is also division over whether, if a neurectomy should be performed, it should be limited to the IIN or a triple neurectomy should be performed.
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    ХИРУРШКИ ТРЕТМАН НА ТУМОРИ НА НАДВОРЕШНАТА ПОВРШИНА НА НОСОТ – НАШЕ ИСКУСТВО
    (SHMSHM / AAMD, 2012-01)
    Маре Стевковска
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    Грета Марцикиќ
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    Добрила Андоновска
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    Емилија Атанасова
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    The external surface of the nose is crossed by ridges and valleys that separate it into slightly convex or concave surfaces. The nose is an aesthetic unit of the face and the surgeon should be aware of both the topographic and the internal anatomy of the nose before proceeding with any reconstructive procedure. Goal: To review nasal reconstruction over 4 years ( 2006-2009) at the University Surgical Clinic "Sv. Naum Ohridski" Skopje, Macedonia, at the Department of Plastic and Aesthetic Surgery . Material and Methods: 70 cases underwent surgery for tumors of external surface of the nose between 2006 and 2009: Female 33 (47%), Male 37( 53%), average age 40- 81 years old; with the nasal reconstruction options (under local or general anesthesia): simple suture close 5 cases (7%) , secondary intention healing 2 cases (3%), skin grafting 12 cases ( 17%), local flaps 47 cases ( 67% ) and regional flaps 4 cases (6%) Results: Tumors of the external surface of the nose are basal in 62 cases (89%) and squamous cell skin cancers in 8 cases (11%), with localization: radix nasi 15 (21%), dorsum nasi 44(63%), apex nasi 8 (12%), alae nasi 2 (3%), columella nasi 1(1%), Nasal reconstructive procedures can be safe and effective with proper training, patient selection, surgical planning, and operative technique. Few complications are associated: operative site bleeding, hematoma formation 2 cases (3%), wound infection at 5 cases (7%), tissue necrosis at 2 cases (3%), and non adequate tumor removal (recurrent basal cell carcinoma) at 4 cases (6%), and 1 (1%) patient without aesthetic satisfactory result. The sutures are removed within 10-14 days. Conclusion: Defects vary in site, size, shape, depth. A large variety of sophisticated techniques continue to emerge with the goal of producing increasingly natural results for patients. Key words: Nose, tumor, reconstruction, flap