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    CURRENT SITUATION IN CHEMOPROPHYLAXIS AND THERAPEUTIC TREATMENT OF COVID-19
    (Faculty of Medicine, University Ss. Cyril and Methodius in Skopje, 2022)
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    Mateska, Sofija
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    Grujoski, Milan
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    The influence of illness duration before diagnosis on clinical characteristics and outcome in human brucellosis
    (SAGE Publications, 2019-07)
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    Siskova, Dijana
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    Vidinic, Ivan
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    Our study assesses the influence of illness duration before establishing the diagnosis of brucellosis and initiating therapy on patients' main clinical characteristics and outcome in an endemic area. The medical files of 297 patients with brucellosis were retrospectively analysed. They were divided into four groups according to illness duration before initiating therapy: <10 days; 11-30 days; 31-90 days; and >90 days. There were significant differences in the occurrences of fever (P = 0.019), focal forms (P = 0.026), spondylitis (P = 0.034) and therapeutic failures (P = 0.006) between the groups. Duration of >30 days before treatment initiation is responsible for more serious clinical presentation and outcome, whereas illness duration of >90 days further worsens the clinical progression in human brucellosis.
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    Sellers of unpasteurized animal milk in unregulated markets: a key factor for human brucellosis control in El-Oued province, Algeria
    (African Field Epidemiology Network (AFENET), 2025)
    Khezzani, Bachir
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    Nikolić, Jadranka
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    Chakarova, Borislava
    To the editors of the Pan African Medical Journal
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    Prevalence of Rotaviruses in the Etiology of Acute Diarrhea in Young Children, Clinical forms, Extraintestinal Manifestations and Complications
    (Macedonian Academy of Sciences and Arts/Sciendo, 2020-12-08)
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    Rotavirus is highly contagious factor with dominant feces-oral transmission. Because it is stable in external environment, transmission clusters are possible by close contact, ingestion of contaminated water or food or contact with contaminated surfaces. It survives within hours and days on hands and contaminated surfaces. This makes it the most common enteric and nosocomial pathogen in the world, especially in early childhood. In addition to the rapid dehydration with pronounced electrolyte disturbances, numerous extraintestinal possibilities have been recorded in the clinical picture, which emphasizes the need for prevention of this disease.In the period from 1.02.2018 to 31.01.2020 at the Clinic for Infectious diseases were treated 1060 patients with diarrheal disease, of which 502 children (47.36%). Rotavirus etiology was confirmed in 23.30% of the children. According to the protocols, laboratory and biochemical investigations were done to all 117 children, with tracking parameters and their dynamics of admission and discharge from the hospital. Most of the children, 84 (82.0 6%) are from urban areas, with a more confirmed epidemiological survey of 59 (42.00%). The average age of the children was 8 months, with a small percentage of children on maternal food (breastfed 25, i.e. 21.37%), with high febrile admission in 99% of children with an average temperature of 38.5oC and an average febrile duration of 4 days, with an average of 7 (+ 2.49) of stools and 5 (+ 2.12) of vomiting. There was a significant difference in hematocrit, leukocyte, electrolyte, glycaemia, and CRP values on admission and discharge. There was predominant isonatremic dehydration, and the compensatory mechanisms followed by the values of the electrolytes ABS, Ph, BE showed a tendency to maintain within the physiological limits. The clinical picture of extraintestinal manifestations included bronchitis, mesenteric lymphadenitis, upper respiratory infections and rash.Rotavirus infection is a serious health and economic problem in our country, so it needs continuous prevention and monitoring in order to reduce the incidence, and thus the need for hospitalization and cure of rotavirus disease.
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    Visceral Leishmaniasis in the Republic of North Macedonia: A Retrospective Cohort Study
    (Galenos Yayinevi, 2025-11-11)
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    Khezzani, Bachir
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    Cana, Fadil
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    Visceral leishmaniasis (VL) is a systemic protozoan vector-borne disease and represents the most severe clinical form of leishmaniasis, with fatal outcomes if left untreated. This study aimed to evaluate the key epidemiological, clinical, and laboratory findings, treatment options, and outcomes in patients with VL. Materials and Methods A retrospective analysis was conducted on the epidemiological and clinical characteristics of 84 patients diagnosed and treated for VL at the University Hospital for Infectious Diseases in Skopje, Republic of North Macedonia (RNM), between 2001 and 2023. Results The median age of patients was 47 years (range 1-74), with 77.4% being male. Contact with dogs was reported in 41.7% of cases. Seven percent of patients were immunosuppressed, and all were Human Immunodeficiency Virus-negative. The median time from symptom onset to diagnosis was 30 days (range 4-330 days). The predominant clinical manifestations were splenomegaly (97.6%), fever (96.4%), hepatomegaly (90.5%), and weight loss (54.8%). On admission, anemia, leukopenia, thrombocytopenia, and hypergammaglobulinemia were detected in 75%, 73.8%, 70.2%, and 63.1% of patients, respectively. A favorable outcome was achieved in 91.7% of cases; therapeutic failure occurred in 1.2%, and 7.1% of patients died. Conclusion VL should be considered a crucial differential diagnosis in patients from the RNM presenting with prolonged unexplained fever, splenomegaly, cytopenia, and hypergammaglobulinemia.
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    Clinical Significance of Quantitative HBs Antigen in the Prediction of Liver Fibrosis in Patients with Chronic Hepatitis B
    (Macedonian Academy of Sciences and Arts, 2018-07)
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    Gaseva, Magdalena
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    The assessment of liver fibrosis in patients with chronic hepatitis B (CHB) is of great importance in evaluating the phases of chronic hepatitis B viral infection, prompt administration of antiviral therapy, prevention of disease progression and late complications of CHB infection. Aim: to investigate the clinical significance of quantitative HBs antigen as a predictor for liver fibrosis in patients with HBe antigen negative chronic hepatitis B and inactive carriers. Material and Methods: the study included 44 treatment naïve patients with chronic hepatitis B, divided into two groups, HBeAg negative chronic HBV infection or inactive carriers (IC) and HBeAg negative chronic hepatitis B patients. All patients underwent laboratory, serologic testing, ultrasound and transient elastography (TE). In both patient groups, quantitative HBs antigen (HBsQ), alanine aminotransferase (ALT), hepatitis B virus deoxyribonucleic acid (HBV DNA) and liver fibrosis were analyzed. Results: The value of HBsQ is significantly higher in patients with HBeAg negative CHB 2477.02±4535.44 IU/ml than in the IC group 8791±11891 IU/ml; Z=3.32, p<0.001 (p=0.0009). In IC patients, 1 (4.76%) had fibrosis and 20 (95.24%)) did not have fibrosis. Out of 23 patients with HBeAg negative chronic hepatitis B, 8 (34.78%) had fibrosis and 15 (65.22%) did not have fibrosis. Patients with HBeAg negative hepatitis B had significantly higher liver fibrosis than IC; Fisher Exact Test p<0.05 (p=0.02). The increase of HBsQ for one single unit (IU/ml) does not have predictive value for fibrosis (Ext (B) =1.00), 95% C.I. for EXP (B): 1.00-1.00 / p>0.05. Conclusion: Quantitative hepatitis B surface antigen has intermediate weak statistically insignificant prediction for liver fibrosis R=0.25 (p<0.10).
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    Hybrid peer-reviewed journals and publishing model: Bias or impartiality in editorial policy
    (Pensoft Publishers, 2025-03-24)
    Khezzani, Bachir
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    Nikolic, Jadranka
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    Tsachev, Ilia
    In recent years, there has been a significant increase in scientific productivity—an increased number of published original articles, reviews, short communications, case reports, and letters to the editor. In this regard, there is a large number of peer-reviewed journals in all fields of scientific knowledge, including in the field of biomedical sciences. Many studies indicate the existence of so-called journal editorial board bias and acknowledge the difficulty of eliminating it. We present our brief opinion on an important topic such as how publishing policy in some peer-reviewed journals leads to feelings of bias and inequality among authors and how to address this.
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    METABOLIC SYNDROME IN ANTIRETROVIRAL THERAPY TREATMENT EXPERIENCED BY PEOPLE LIVING WITH HIV
    (Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2024)
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    Saveski, Velimir
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    Introduction: Metabolic syndrome (MS) constitutes a group of risk factors that significantly affect the quality of life and life expectancy of people living with HIV. Aim: To estimate the prevalence of MS among people living with HIV who receive antiretroviral therapy (ART) in the Republic of North Macedonia (RNM). Material and methods: A study was conducted on 53 adult patients with confirmed HIV infection at the University Clinic for Infectious Diseases and Febrile Conditions, who are receiving ART. In all patients, the presence of MS was determined according to the criteria of the National Cholesterol Education Program Adult Treatment Panel ATP III (NCEP ATP III), defined by at least three of five risk factors including: low values of HDL - high density lipoprotein cholesterol, elevated waist circumference, hypertriglyceridemia, increased values of fasting glucose and hypertension. The statistical analysis was made by utilizing the statistical program SPSS 23.0. Results: The average age of patients was 35.7 ± 8.3, with a male predominance of 90.57%. All patients had undetectable values of HIV RNA viral load in serum and 79.25% had achieved immune reconstitution with a CD4 count above 350 cells/ml. The prevalence of MS among people living with HIV in RNM was 7.55%, or out of 53 respondents 4 had MS. Conclusion: People with HIV infection in RNM who regularly receive ART have a low prevalence of metabolic syndrome.
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    Epidemiological and clinical characteristics of imported falciparum malaria in the Republic of North Macedonia : A 13-year experience
    (Springer Science and Business Media LLC, 2023-04-03)
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    Khezzani, Bachir
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    Semenakova-Cvetkovska, Vesna
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    Vidinic, Ivan
    Plasmodium falciparum is the leading cause of imported malaria and the most common cause of death in returning travellers. Aim To identify the main epidemiological and clinical characteristics of patients with imported falciparum malaria in the Republic of North Macedonia. Material and methods Retrospectively analyzed were the epidemiological and clinical features of 34 patients with imported falciparum malaria who were diagnosed and treated at the university clinic for infectious diseases and febrile conditions in Skopje from 2010 to 2022. Malaria diagnosis was based on the microscopic detection of parasites in thick and thin blood smears. Results All patients were male, with a median age of 36 years and a range of 22–60 years. Of the patients 33 (97.1%) acquired the disease in Sub-Saharan Africa. All patients except one stayed in endemic regions for work/business purposes. Chemoprophylaxis was completely applied in 4 (11.8%) patients. The median time of onset between the symptoms and diagnosis was 4 days, with a range of 1–12 days. Prevailing clinical manifestations were fever, chills, and splenomegaly in 100%, 94%, and 68% of patients, respectively. Severe malaria was noticed in 8 (23.5%) patients. In 5 (14.7%) patients the initial parasitemia was higher than 5%. On admission, thrombocytopenia, hyperbilirubinemia, and elevated alanine aminotransferase were registered in 94%, 58%, and 62% of patients, respectively. Out of the 33 patients with adequate follow-up, the outcome was favorable in 31 (93.9%). Conclusion In every febrile traveller returned from Africa, imported falciparum malaria should be an essential part of differential diagnostic considerations.