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    Preoperative magnesium sulphate usage as a medical challenge in postoperative pain management.
    (Department of Anesthesia and reanimation, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Macedonia, 2018-12)
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    Mojsova Miovska M
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    Toleska M
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    The Effect of Rectus Sheath Block as a Supplement of General Anesthesia on Postoperative Analgesia in Adult Patient Undergoing Umbilical Hernia Repair
    (Walter de Gruyter GmbH, 2017-12-01)
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    Zdravkovska, Milka
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    Ultrasound guided rectus sheath block can block the ventral rami of the 7th to 12th thoracolumbar nerves by injection of local anesthetic into the space between the rectus muscle and posterior rectus sheath. The aim of this randomized double-blind study was to evaluate the analgesic effect of the bilateral ultrasound guided rectus sheath block as supplement of general anesthesia on patents undergoing elective umbilical hernia repair.
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    Tretman na plevralen empiem
    (Македонско лекарско друштво = Macedonian medical association, 2023-09-21)
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    Cholanceski R
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    Jakupi N
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    POSTOPERATIVE SERUM CREATININ LEVEL IN TWO DIFERENT HYDRATION REGIMES IN LIVING DONOR KYDNEY TRANSPLANATATION
    (Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Macedonia, 2017-04)
    Mojsova Mijovska, Maja
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    Introduction: Early graft function is very important and can be achieved with adequate intraopeartive perfusion characteristics of the graft and urine output. The goal of this study was to examine the influence of targeting central venous pressure (CVP) on early graft function. Material and methods: After approval of Ethical committee of the Medical Faculty-Skopje, we obtained inform consent of 60 patients, ASA 2-3 undergoing renal transplantation of livingrelated person in the Clinic of Urology – Skopje. A prospective clinical study was performed in the period of 2 years. Patients were divided into 2 groups of thirty patients : group A receiving normal saline intraoperatively targeting for CVP to 15 mmHg until vascular clamps were off and group B receiving normal saline 10ml/kg/h. We recorded lactate at the end of the surgery, onset of diuresis and total urine output from unclamping the renal vessels to the end of the surgery in both groups and postoperative serum creatinine in 3times (3, 12, 36 hours). Results: The onset of diuresis in seconds was insignificantly longer in group B p>0,05 (p=o,31). The average value of postoperative levels of the lactate showed that in group B the levels of the lactate were significantly higher for Z=-5,79 and p<0,001 (p=0,000). We didn’t find any statistical differences in postoperative serum creatinine in both groups. Conclusion: Our study didn’t show any benefit from targeting CVP to 15 mmHg. We couldn’t find any significant difference on onset of diuresis and urine output after the unclamping the vessels. However, in the constant infusion group (group B) the level of the lactate was higher CVP. In postoperative biochemical parameters we had no statistical difference between the average values of serum cratinine.
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    Steven-Johnson syndrome and anesthesia
    (Department of Anesthesia and reanimation, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Macedonia, 2019)
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    Temenugova I
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    The effects of two thermal insulation methods on the postoperative lactate levels, shivering and patient’s thermal comfort.
    (Department of Anesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Macedonia, 2019-05)
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    Tolevska M
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    Myasthenia Gravis and Associated Diseases
    (Scientific foundation SPIROSKI, 2018-03-05)
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    Novotni, Gabriela
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    Sazdova-Burneska, Slobodanka
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    Kuzmanovski, I
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    Boshkovski, Bojan
    BACKGROUND: Myasthenia gravis (MG) is an autoimmune disease caused by the action of specific antibodies to the postsynaptic membrane of the neuromuscular junction, leading to impaired neuromuscular transmission. Patients with MG have an increased incidence of other autoimmune diseases. AIM: to determine the presence of other associated diseases in patients with MG.METHOD: A group of 127 patients with MG followed in 10 years period, in which the presence of other associated diseases has been analysed.RESULTS: The sex ratio is in favour of the female sex, the average age of the initial manifestation of the disease is less than 50 years, 65.4% of the patients with MG have another disease. 15.0% patients have associated another autoimmune disease. Thyroid disease is the most common associated with MG, rarely rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and other autoimmune diseases. Other diseases include hypertension, heart disease, diabetes, respiratory diseases, dyslipidemia. 10.2% of the patients are diagnosed with extrathymic tumours of various origins. CONCLUSION: Associated diseases are common in patients with MG, drawing attention to the possible common basis for their coexistence, as well as their impact on the intensity and treatment of the disease.</jats:p>
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    Evaluation of Total Thyroidectomy for Treatment of Benign Diseases of Thyroid Gland
    (Scientific foundation SPIROSKI, 2020-04-25)
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    Tolevska, Natasha
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    Qafjani, Ardit
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    BACKGROUND: The controversy of using total thyroidectomy (TT) in treatment of benign thyroid diseases still remains controversial over the rates of complication, mostly recurrence nerve palsy and hypocalcemia, compared to non-total thyroidectomies. The latest reports in this field of research showed that that the number of complications of TT is decreasing as the skills of surgeons increase. AIM: In this study, we reviewed 209 cases of total thyroidectomies for benign thyroid diseases where such surgery was indicated. The results were evaluated whether they support the previous reports that TT is save method of treatment of diffuse multinodular goiters, Graves’ disease thyroid adenomas with diffuse goiters and thyroiditis. METHODS: Two hundred and nine patients, 36 males and 173 females, medium age 47 (17–77) operated with TT between 2016 and 2018 were included in the evaluation study. We evaluated the: Diagnosis, indications for operation, pre-operative medication administration, laryngeal recurrent nerve palsy, hypocalcemia, hypoparathyroidism, and patohistology findings. The follow-up for hypocalcemia and laryngeal nerve palsy was performed 1 year postoperatively. RESULTS: The age of the patients was between 17 and 77 years, medium-range 47 years old. Of 209 patients, 173 (83%) were female and 36 (17%) male with a gender ratio of 1:4.8 males to females. Diagnoses before surgery were established as follows: Multinodular euthyroid goiter (MNEG) n = 106 (48.80%), multinodular toxic goiter n = 12 (5.74%), Graves’s disease n = 6 (2.87%), adenoma with multinodular goiter n = 73 (34.92%), and n = 16 (7.65%) patients with thyroiditis. Recurrence laryngeal nerve palsy (RLNP) occurred in 6 patients (2.87%), temporary within 3 months after the operation in 4 patients (1.92%) and permanent palsy within 6 months and more after an operation in 2 patients (0.95%). Voice hoarseness immediately and within 1 month after the operation was registered in 32 patients (15.3%). RLNP and hoarseness were registered mostly in patients with pre-operative problems, mostly with extra big MNEG. One of the permanent injuries of RLN was bilateral and all others were one sided. All patients were operated with normal pre-operative vocal cord movement findings. Post-operative hypocalcemia was registered in 35 patients (16.74%). Temporary nonsignificant hypocalcemia in 10 (4.78%), temporary significant hypocalcemia in 17 (8.13%), temporary severe hypocalcemia in 6 patients (2.87%), and permanent hypocalcemia in 2 patients (0.95%). CONCLUSION: Many studies have shown that the rate of complications is almost even for TT and NTT done for benign and malignant diseases of thyroid gland. Our data have shown that the risk of post-operative complications with TT is proportional to the number of complicated pre-operative findings of benign thyroid glands.
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