Tofoski, Gligor
Preferred name
Tofoski, Gligor
Official Name
Tofoski, Gligor
Main Affiliation
Email
gligor.tofoski@medf.ukim.edu.mk
26 results
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Item type:Publication, 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); ; 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. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Impact of epysiotomy on anal continence in women after vaginal delivery(Macedonian Association of Anatomists and Morphologists, 2019); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, MATERNAL OBESITY, АGE AND MATERNAL THYROID STATUS - AN INTRIGUING CONNECTION TO THE NEONATAL OUTCOME(Македонско лекарско друштво /Macedonian Medical Association, 2020); ; Introduction. Thyroid dysfunction is the second most common endocrine disorder affecting women of reproductive age. Higher body mass index (BMI>30 kg/m2) is linked with many endocrine abnormalities, including thyroid dysfunction. Gestational age at birth (GAB) and birth weight (BW) are important predictors of neonatal mortality and morbidity. The objective of this prospective study was to determine the adverse neonatal outcomes of women [small for gestational age (SGA), intrauterine growth restriction (IUGR) and others] complicated with impaired thyroid function and obesity, when compared with those with normal function. Methods. Dried blood spot and urine samples were analyzed for thyroid and iodine status in 358 pregnant women in any gestational week, without known thyroid disorders. They gave birth at the University Clinic of Gynecology and Obstetrics-Skopje. The blood samples were analyzed with time-resolved fluoroimmunoassay in Zurich, and UIC was analyzed by mass spectrometry in Helsinki. Results. We found a significant positive correlation between total thyroxine (TT4) and GAB (p=0.045) and UIE and mother age (p=0.007), but a significant negative correlation between GAB and UIE (p=0.051), GAB and mother’s age (p=0.01), GAB and BMI (p=0.02). There was an inverse correlation between BW and maternal age (βst=-0.0641, P=0.010) and between BW and maternal TT4 (βst=-3.3640, P=0.0016). We found a positive correlation between BW and maternal BMI (βst = 21.847, P = 0.006). Conclusion. Overweight, obese and older women are at increased risk of thyroid dysfunction during pregnancy considered as high-risk pregnancies for adverse neonatal outcomes. We can use maternal TT4, BMI and age for predicting the BW. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Reproductive Outcome after Hysteroscopic Metroplasty in Patients with Infertility and Recurrent Pregnancy Loss(ID Design 2012/Scientific Foundation SPIROSKI, 2014-03-15); Introduction: Reproductive outcome can be negatively affected in patients with congenital uterine anomalies (CUA), increasing the number of unsuccessful pregnancies and obstetric complications. Compared with the population with normally formed uterus, patients with CUA have higher abortion rate, higher fetal loss rate and decreased live birth rate. Hysteroscopic metroplasty (HM) is a standard, safe and minimally invasive method for the treatment of correctible types of congenital uterine anomalies.Aim: The aim of the study was to analyze the reproductive outcome in group of patients with infertility and recurrent pregnancy loss and present CUA, before and after hysteroscopic metroplasty.Material and Methods: We analyzed 67 patients to whom 78 interventions hysteroscopic metroplasty were performed at the University Clinic of Obstetrics and Gynecology in Skopje during a two year period, between 01.01.2010 and 31.12.2011. Their reproductive outcome was monitored during a two-year period and the same group served as a control group, taking into account their previous reproductive history. Statistical analysis was performed using Chi-square test and p < 0.05 was considered to be statistically significant.Results: Most common CUA were types 5b and 6 represented by 88 %. In a follow up period of two years, 33 of the patients become pregnant. There was a statistically significant decrease of abortion rate from 92% to 21.2%, as well as an increase in the term delivery rate from 0% to 69.7%.Conclusion: Treatment with hysteroscopic metroplasty is significantly improving the reproductive outcome in patients with CUA and previous fetal loss. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, HYDROSALPINX AND DISTRIBUTION OF PREGNANCIES AMONG LAPAROSCOPICALLY TREATED PАTIENTS(Македонско лекарско друштво = Macedonian Medical Association, 2020); ; Introduction. Hydrosalpinx is a common medical condition encountered among female population with infertility issues. One or both fallopian tubes can be filled with a substantial amount of fluid, making them dilated and dysfunctional, usually as a result of an injury or infection. Damages of different degrees can be seen on the mucosal lining, which compromise the processes of normal fertilization and zygote passage. Methods. We retrospectively analyzed clinical records from a period of five years (2013-2017), selecting pa- tients diagnosed as having unilateral or bilateral hydrosalpinx. Clinical files were divided by years and according to the treatment protocol used. Our scope of interest was focused on patients who were treated surgically, with different types of laparoscopic interventions. A total of 74 patients met our criteria for selection. Results. Two groups were related to conservative la- paroscopic approaches and one to complete radical surgical treatment, unilateral or bilateral salpingectomy. Patients in the first group, 9(16.36%), were treated with a laparoscopically-guided creation of salpingostomy. The second group comprised patients treated only with bi- lateral chromopertubation and consisted of 17 (30.91%) patients. The third, and the most numerous group com- prised 29(52.7%) patients treated with salpingectomy. Bilateral salpingectomy was performed in 9(31.03%) and unilateral in 20(68.97%) patients, showing that majority of patients were treated with unilateral salpingectomy, after intraoperative evaluation of tubal patency of the contralateral uterine tube. A total number of 30 patients (54.5%) had successful pregnancies, which ended up with a desired outcome, healthy live birth. Procedures for artificial reproduction and successful pregnancies achieved with IVF were recorded in 11(36.67%) patients and in the remaining 19(63.33%) patients pregnancies were achieved via spontaneous conception. Conclusion. Hydrosalpinx management is mainly influenced by the local tubal changes evaluated laparoscopically and can be surgically treated, either conservative or radical. Conservative approaches lead to fair chances of spontaneous conception and successful pregnancies. An integrated management of hydrosalpinx with bilateral salpingectomy and postsurgical usage of artificial reproduction techniques also leads to a substantial cumulative pregnancy rate. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ISOLATED MATERNAL HYPOTHYROXINEMIA AND ITS PERINATAL OUTCOME IN NORTH MACEDONIA(Sestre Milosrdnice University Hospital Center (KBC Sestre milosrdnice), 2021-06); ; Isolated maternal hypothyroxinemia (IMH) is defined as the presence of low maternal total thyroxine (TT4) level in conjunction with normal maternal thyroid-stimulating hormone (TSH) level. The aim was to investigate whether IMH is associated with adverse pregnancy outcome in North Macedonia. Dried blood spot samples were obtained from 359 pregnant women meeting the inclusion criteria and analyzed for TT4 and TSH. Postpartum data were entered from their medical histories. Out of 359 women, 131 (37.42%) belonged to IMH group. There were statistically significant differences in birth weight (p=0.043), intrauterine growth restriction (IUGR) (p=0.028), Apgar score at 1 min <7 (p=0.018) and cesarean section for dystocia/disproportion (p=0.024) between the IMH and normal thyroid function (NTF) groups. In regression analysis, TSH was a significant variable predicting Apgar score (βst=0.05597, p=0.047), body mass index predicting birth weight (βst=0.02338, p=0.045) and TT4 predicting small for gestational age/IUGR (βst=-0.089834, p=0.029) in IMH group. TT4 was a strong predictor of birth weight (βst=-0.004778, p=0.003) and premature delivery (βst=0.028112, p=0.004) in NTF group. The impact of IMH in pregnancy remains controversial. IMH was associated with an increased maternal BMI and higher birth weight of neonates. Overweight could be a potential risk factor for thyroid dysfunction in pregnant women, and specifically IMH. The worst fetal outcome was seen in IMH mothers examined in second trimester. We found TSH, TT4 and BMI to be strong predictors of perinatal outcomes. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Influence of obstetrically-associated risk factors in assessing anal incontinence in patients post vaginal delivery(Macedonian Association of Anatomists and Morphologists, 2018); ; ; ; Stojoska Lazarova, AleksandraIntroduction: Anal incontinence (AI) is an inconvenient and limiting medical condition that can cause social and hygienic problems, isolation, low self-esteem and low quality of life. The etiology is multifactorial. Women are eight times more affected than men and the reason is considered to be childbirth. In order to prevent this social, physical and psychological problem, it is necessary to define the risk factors leading to development of such symptoms in female patients after undergoing vaginal delivery. Factors that influence occurrence of anal incontinence in patients after vaginal delivery, have been categorized into obstetric, maternal and fetal factors. Objective: The purpose of this study is to determine the impact of individual obstetric risk factors on occurrences of anal incontinence in patients after vaginal delivery, and express it as anal score value. Materials and methods: We designed the study cross-sectional, and developed the research it at the University Clinic of Obstetrics and Gynecology, "Ss. Cyril and Methodius" University in Skopje, Macedonia, in a 3-month period, from August to November 2017. In this study, we engaged patients in their reproductive age, who had undergone at least one vaginal delivery. The degree of incontinence was determined using St. Mark's Anal Incontinence Score (SMIS). Results: In the examined segments, multi-parity (at least 2 vaginal births) increased by OR = 4.69 (95% CI 2.04-10.82) the patient's risk of having St. Mark’s score of ≥8 and this is statistically significant difference. Induced labor also reduced the likelihood of OR = 0.39 (95% CI 0.15-1.04) for St. Mark’s score of ≥8, but the difference was not a statistically significant one. Use of mediolateral episiotomy had protective significance against the risk of St. Mark score of ≥8. Conclusion: Results of this study show consistency with data published so far on the influence of obstetric risk factors on occurrences of anal incontinence in patients after vaginal delivery. Changes in anal incontinence are expressed in increased St. Mark’s score. Our study showed that the following factors had statistically significant impact on the score value: multi-parity, fetal macrosomia and perineal injury (grades 3 and 4). - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Topical Imiquimod 5% as a Treatment Option in Solitary Facial Keratoacanthoma(ID Design 2012/Scientific Foundation SPIROSKI, 2018-03-15); ; Keratoacanthoma (KA) is a rapidly growing epithelial tumour with histopathologic and clinical features similar to squamous cell carcinoma (SCC) and a certain tendency toward spontaneous regression. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Thyroid Function of Pregnant Women and Perinatal Outcomes in North Macedonia(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2021-10) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Reproductive outcome, duration of pregnancy and mode of delivery after hysteroscopic metroplasty in patients with infertility(Association of Medical Doctors, 2016); ; ; Introduction: Reproductive outcome can be negatively affected in patients with congenital uterine anomalies (CUA), increasing the number of un- successful pregnancies and obstetric complications. Standard, safe and minimally invasive method for the treatment of correctible types of congenital uterine anomalies is hysteroscopic metroplasty (HM). The aim of the study was to analyze the reproduc- tive outcome, duration of pregnancy and mode of deli- very in group of patients with infertility after hystero- scopic metroplasty. Material and methods: We analyzed 48 patients with previous history of fetal loss (abortion) to whom hysteroscopy was done in the period of 01. 11. 2009 to 01. 05. 2013 year at the University Clinic of Obstetrics and Gynecology in Skopje. In patients who were diag- nosed having CUA hysteroscopic metroplasty was do- ne. Patients and their reproductive outcome were follo- wed for a period of at least 2 years after the interven- tion. Reproductive outcome was followed considering pregnancy rate, fetal loss (abortion) up to 22 gestatio- nal week, rates of preterm and term deliveries, live births and mode of delivery. Statistical analysis was performed using computer software and value for the confidence interval (± 95% CI) was considered to be statistically significant with level of p < 0.05. Results: After hysteroscopic metroplasty, there was a significant decrease of the abortion rate to 13.9%, and significant increase in pregnancy rates of 86.1%. Overall pregnancy rate was 75%, and term delivery was noted in 93,6% of the patients, with spontaneus deliveri- es in 58,6%. There were no complications during the hysteroscopic metroplasty, nor during the deliveries. Conclusion: Hysteroscopic metroplasty has a sig- nificant effect on the reproductive outcome, resulting in a large number of live births and no significant com- plication during consecutive pregnancy and delivery.
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