Arsovska, Anita
Preferred name
Arsovska, Anita
Official Name
Arsovska, Anita
Main Affiliation
Email
anita.arsovska@medf.ukim.edu.mk
14 results
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Item type:Publication, Case report-patient with cerebellar stroke and percutaneous enterogastric tube(2017); ; ; Babunovska MarijaAbstract Introduction: Cerebellar strokes occur in 1,5-2,3% of all ischemic stroke cases. Aim: We present 74-year-old male patient, admitted at the University Clinic of neurology due to acute ischemic cerebellar stroke with speech and swallowing difficulties, disturbed balance, weakness of the left side extremities, impaired consciousness. Case report: On admission the patient was presented with clinical picture of left hemicerbellar syndrome with compression of the medulla. Computer tomography of the brain (CT)on admission was with normal finding. Control CT of the brain after 48 hours showed irregular ischemic lesion in the left cerebellar hemisphere. Nuclear magnetic resonance imaging (MRI) of the brain confirmed the CT findings. Color duplex sonography of the vertebral arteries (VA)showed reduced Doppler signal in the left VA,finding conclusive with distal occlusion and compensatory increased blood flow velocity in the right VA. CT angiography of vertebral arteries showed hypoplastic extracranial segment of the left VA, while its intracranial segment could not be visualized. Posterior inferior cerebellar artery (PICA) was not visualized intracranially as well, finding conclusive with its occlusion. The right VA on CT angiography was seen with compensatory increased lumen. Patient was treated with usual therapy for ischemic stroke during a period of 3 weeks. Due to dysphagia, nasogastric feeding tube was placed. During the stay in hospital, the patient's physical and neurologicl status gadually improved, But, dysphagia still persisted and according to current guidelines for stroke treatment, together with the specialists from the Clinic of Gastroenterohepatology, we decided to place a percutaneous enterogastric tube (PEG). The intervention went very well and the patient was discharged for home treatment. He came for regular control check-ups every month for a period of 1 year. His physical and neurological symptoms gradually improved, and his swallowing function recovered. After 6 months, the PEG probe was taken out, and the patient continued to eat and swallow normally. Discussion: Dysphagia is a serious complication after stroke. It carries risk for aspiration and occurrence of pneumonia. Placement of nasogastric feeding tube is recommended in patients who have swallowing difficulties in the acute phase of stroke. Placement of PEG tube is recommended 2 weeks after stroke occurrence. Studies so far have shown that feeding through the PEG tube is more efficient than feeding through the nasogastric tube in terms of improved nutritive status and has lower complication risk. Conclusion: Successful treatment of stroke depends on many factors. Particular attention should be brought to the food and beverage intake, and assessment of early signs and risk factors of dysphagia in order to take appropriate therapeutic measures. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Transcranial color duplex sonography in post-stroke cognitive impairment(2015); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Color Duplex Sonography Findings of the Carotid Arteries and Associated Risk Factors in Patients with Transient Ischemic Attack(Macedonian Medical Association = Македонско лекарско друштво, 2016-01-01); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Clinical Characteristics, risk factors and outcome in patients with in tracerebral haemorrhage(Leage against epilepsy of Macedonia, 2015); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, BASELINE STROKE SEVERITY BEFORE AND AFTER INTRAVENOUS THROMBOLYSIS(League against epilepsy of Macedonia, 2017); ; Mitrevska Velkov JasminaAbstract Introduction Acute ischemic stroke is caused by thrombotic or embolic occlusion of a cerebral artery and is more common than hemorrhagic stroke. Recanalization strategies such as intravenous recombinant tissue-type plasminogen activator (rt-PA), attempt to establish revascularization so that cells in the ischemic penumbra can be rescued before irreversible injury occurs. The National Institutes of Health Stroke Scale (NIHSS) is a systematic assessment tool that provides a quantitative measure of stroke-related neurologic deficit. Aim To evaluate and compare the baseline stroke severity-NIHSS score in acute stroke patients before and after application of intravenous thrombolysis. Material and methods We made a retrospective analysis of 1058 acute stroke patients, hospitalized during a period of April 2014-February 2016, at the Department for Urgent Neurology, University Clinic of Neurology, Skopje. Of them, 27 patients met the inclusion criteria for rtPA application according the guidelines. Results I.v. thrombolysis was administered in 27 patients (2,5%). 9 (33,3%) patients had mild stroke (NIHSS 5-10), 11 (40,7%) patients had moderate stroke (NIHSS 10-15) and 7 (25,9%) patients had severe stroke (NIHSS > 15). After the administration of rtPA, we registered improvement on the NIHSS score in 20 patients (74%). Most of them (18-90%) were improved by 3 points on the NIHSS score (range 1-10 points). Best response to therapy had patients with mild and moderate stroke according to NIHSS scores. In unchanged condition after rtPA application were 2 patients (7,4%) with NIHSS score of 10 and 12, respectively. Worsening of the neurological deficit was registered in 1 patient (3,7%), who had initial NIHSS score of 9 and 1 hour after application of rtPA his NIHSS score increased to 12. 4 patients (14,8%) had lethal outcome. Discussion and conclusion Our study shows the initial experience with i.v. thrombolysis in eligible patients with acute ischemic stroke. More than 70% of the thrombolysed patients improved their functional deficit after the treatment. Intravenous thrombolytic therapy with rtPA is the only approved therapy so far approved for treatment of acute ischemic stroke. Meta-analysis of the trials so far have confirmed the benefit of i.v. thrombolytic therapy in selected patients with acute ischemic stroke. All agree that the earlier the therapy is given, the results are better and the health systems should increase their percentage of stroke patients treated within 60 minutes of presentation to hospital until application of thrombolytic therapy. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Atrial fibrillation and risk for ischemic stroke(League against epilepsy of Macedonia, 2017); ; Cheperganova Changovska, TatjanaAbstract Objective: To investigate the frequency of atrial fibrillation in patients who develope acute ischemic stroke, associated risk factors and their outcome. Material and methods: A retrospective study was conducted at the University Clinic of Neurology Clinic, Department for Urgent Neurology.We analyzed medical records of acute ischemic stroke patients hospitalized between April 2014 and April 2016. Statistical analysis was performed with the programme Statistica for Windows 12. Results: Of the 1102 patients in the study,219 (19.8%) had atrial fibrillation. Of them, 109 (49,8%) were males and 110 (50,2%) were females. The mean age of those patients was 65±14 years compared to 60±16 years for the rest. Patients with AF had higher modified Rankin Scale(mRS) score on admission and at discharge from the hospital and had lethal outcome in higher percentage, compared to the rest (p<0.05). Conclusion: AF significantly increases the risk of stroke and affects its prognosis and outcome. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, VESTIBULAR MIGRAINE-CASE REPORT(2016); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ДЕГЕНЕРАТИВНО ЗАБОЛУВАЊЕ НА ЦЕРВИКАЛНИОТ СЕГМЕНТ ОД ‘РБЕТОТ КАЈ ПАЦИЕНТИ СО ЦЕРВИКОБРАХИЈАЛЕН СИНДРОМ(SHMSHM - AAMD, 2020); ; ; Janevski, GeorgiВовед: Една од главните причини за рефракторна вратна болка е дегенеративното заболување на цервикалниот сегмент од `рбетот. Наша цел е да го прикажеме типот на дегенеративното заболување на цервикалниот сегмент од `рбетот кај овие пациенти. Материјали и методи: Студијата е аналитичка-трансверзална студија во која беа користени МР прегледите на цервикалниот `рбет и податоците од прашалниот дизајниран за оваа студија. Фокусната група се состои од 98 испитаници на возраст од 35-70 год. со рефракторна вратна болка. Резултати: Нашата студија покажа дека кај 77 испитаници постои надув на еден или повеќе интервертебрални дискови додека кај 50 испитаници резултатите од МР на цервикалниот сегмент од ‘рбетот покажаа дека постои протрузија на еден или повеќе интервертебрални дискови. Ваквиот наод незначајно е асоциран и со трауматска повреда на вратот (Chi-square=0,54 df=1 p=0,46). Заклучок: Надув на интервертебрален диск на цервикалниот сегмент од ‘рбетот како патолошка промена е чест кај симптоматските пациенти и се регистрира кај 78,57% од испитаниците. Од друга страна појавата на дискус хернија не е толку честа и се јавува кај нешто повеќе од половина од испитаниците (51,02%). - 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, STRATEGIC OUTSOURCING IN PHARMACEUTICAL INDUSTRY(2022-02-18); ; ; The pharmaceutical industry is facing a tremendous challenge from the current global economic crisis. Enormous earnings from new “blockbuster” drugs are perishing and old drug targets are leading to limited profits. Despite substantial investment in research and development of new drugs, the return thereof is disappointing. New targets including biologic, biomarker, as well as studies of the genome, as well of drugs for treatment of chronic diseases, have much longer duration of the development phase. Therefore, companies are focused on shortening duration, lowering costs, enhancing efficiency and minimizing usage of resources. All these challenges are forcing the pharmaceutical industry to change its drug development model from a model relying on internal capacities to an open model that embodies aid from a Contract Research Organization (CRO) experienced in understanding regulatory standards, equipped with adequate infrastructure, qualified and competent staff in pharmacy, and experienced in dealing with regional issues. Outsourcing has great importance for pharmaceutical companies. Manufacturers of original pharmaceuticals may opt for outsourcing of different phases of drug development, while generic companies confide the clinical trial – the last phase of drug development – to selected CROs which meet high standards of expertise in performing the studies, using highly reliable analytical methods, located in attractive geographic locations and have competitive pricing. This paper is inspired by the challenges with which the pharmaceutical industry has to cope in the new globalized world. At the beginning the authors provide short introduction to the significance of outsourcing in the case of the pharmaceutical industry; than differentiate Big Pharma from generic pharmaceutical companies; define benefits and risks from outsourcing in the pharmaceutical industry; stress the significance of project management as a key prerequisite of planned and executed outsourced activities; and finally present concluding remarks.