Osmani, Arlinda

Preferred name

Osmani, Arlinda

Official Name

Osmani, Arlinda

Main Affiliation

arlinda.osmani@medf.ukim.edu.mk

Now showing 1 - 7 of 7

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Epidemiological and clinical features of patients with Clostridoides difficile infection
(Elsevier BV, 2024-12)
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Eftimovski, Georgi
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Vidinic, Ivan
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Georgievska, Dajana
AIM Investigation and identification of epidemiological characteristics, risk factors and treatment regimens effectivity in reducing morbidity and mortality. BACKGROUND C.difficile remains the leading cause of health care associated diarrhea, usually as a result of irrational use of antimicrobial therapy. METHODS Retrospective descriptive study (October 2020-january2024) included all patients with clinical symptoms of Clostridoides difficile infection (CDI) admitted at our clinic. Diagnosis is based on isolation with coproculture for C.difficile, toxin confirmation with immunochromatography, small number confirmed with PCR film array. RESULTS 594 inpatients with clinical symptoms of CDI were evaluated and diagnosis was confirmed in 44. Average mean age was 58,5 (29-90)years, approximately with no differencies on sex representation. Comorbidities and previous hospitalisations were noted in two third of them, and 63% had used antimicrobial drugs, while 34% had history of corticosteroid usage and 4,5% imunosupressive therapy. Often used antibiotics cephalosporins, clindamycine, quinolones and macrolides. 68,2% had history of protein pump inhibitors usage. Culture positive were 38%, toxinA/B is confirmed with immunochromatography in 77% of patients, PCR film array confirmed C.difficile toxin A/B in the remaining patients. Treatment is carried out with oral vancomycine in 56% of patients, 15% with metronidazole and the remaining with combination of two drugs. Regarding outcomes 90% of patients were cured while 10% had fatal outcomes and CDI is not considered the main cause of death. CONCLUSION Elderly patients with antibiotic history treatment, previous healthcare exposures and comorbidities were the most affected by CDI infection. Metronidazole and vancomycine has shown good therapeutic results.
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Visceral leishmaniasis as a leading cause of fever of unknown origin in immunocompetent adults: a prospective, observational, single-center study
(Pensoft Publishers, 2025-12-18)
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Shopova, Zhaklina
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Trajkova, Irena
To evaluate the presentation patterns of visceral leishmaniasis (VL) as a cause of fever of unknown origin (FUO) and compare them with other FUO etiologies. Materials and methods This prospective observational study was conducted at the Clinic for Infectious Diseases and Febrile Conditions in Skopje, Republic of North Macedonia, from 2019 to 2025. We included ninety-four immunocompetent patients, aged 14 or over who met the FUO criteria by Durack and Street and had a definitive etiology subsequently established. Based on the final diagnosis, patients were categorized into those with VL and those with alternative FUO etiologies. Demographic, clinical, and laboratory data from standardized investigations were compared between the groups using appropriate statistical tests. Results Sixty-six percent of participants were male, and their median age was 49 years (IQR 36–65). Infectious diseases were responsible for 52.1% of all FUO cases, followed by noninfectious inflammatory disorders (20.2%), miscellaneous causes (17%), and malignancies (10.6%). VL was the leading single diagnosis, identified in 17% of the total cohort. Compared with non-VLFUO cases, VL patients more often presented with weight loss, diaphoresis, and splenomegaly (all <0.001), hepatomegaly ( =0.002), and higher febrile peaks (p=0.026). Hematologic abnormalities were more pronounced in VL, with lower hemoglobin, hematocrit, leukocyte, and platelet counts (all p≤0.006), as well as lower albumin (p=0.029) and higher globulin levels (p=0.001). Conclusion Visceral leishmaniasis can be an important yet underrecognized cause of FUO in endemic regions. Greater clinical awareness and early diagnostic testing are essential to prevent delays and inappropriate treatment.
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FEVER OF UNKNOWN ORIGIN: CLINICAL CHARACTERISTICS AND ETIOLOGICAL SPECTRUM
(Здружение на инфектолози на Република Македонија = Macedonian Society of Infectious Diseases, 2024-10-06)
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Shopova, Zhaklina
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Vidinic, Ivan
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Objective: This study aimed to provide an overview of the etiological distribution, clinical features, and laboratory findings among patients with classic fever of unknown origin (FUO) admitted to the University Clinic for Infectious Diseases and Febrile Conditions in Skopje. Materials and Methods: All participants underwent a comprehensive medical history review, physical examination, and predetermined laboratory investigations. The final diagnosis was established using specific diagnostic procedures guided by potential diagnostic clues (PDCs). After diagnosis, patients were categorized into infectious and non-infectious FUO groups. Results: The analysis included 47 participants, with a mean age of 57 years, the majority of whom were male. Fever lasted an average of 30 days, with a median temperature of 39 °C. Infections accounted for 53.2% of cases, followed by inflammatory non-infectious diseases (25.5%), malignancies, and other miscellaneous conditions (10.6%). The most frequent symptoms were myalgia, arthralgia, fever, sweating, and malaise. On physical examination, hepatosplenomegaly, heart murmurs, joint swelling, and skin rashes were the predominant findings. Significant laboratory abnormalities included elevated ferritin and procalcitonin levels across groups. Conclusion: Specific variations in clinical presentation and laboratory findings may help facilitate a more rapid differential diagnosis of classic FUO.
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Phenotypic characteristics and clinical outcome in hospitalized patients with COVID-19 and diabetes
(AMALTEA Medical Publishing House, 2022-12-31)
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Sopova, Zaklina
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<jats:p>Objectives. The aim is to describe the phenotypic, biological and clinical characteristics of hospitalized patients with COVID-19 and diabetes, and the association with the clinical outcome of the patients. Material and methods. This single-center, retrospective study was conducted on 200 patients. The primary endpoint was death observed within day 7, 14 and beyond day 14 of hospitalization, and secondary objective was to compare the survival group with non-survival group. The variables that demonstrated significant association with primary endpoint were subject to multivariate binary logistic regression analysis. Outcomes. The estimated prevalence was 17.87% of the total COVID-19 hospitalizations during this period (n=1119). The majority of the patients were with diabetes mellitus type 2 with a median age of 67 years and BMI of 27.8 kg/m2. On admission, 156 patients (78%) presented with severe/critical illness. A total of 93 patients (46.5%) met the primary endpoint, with most deaths occurring within day 7 of hospital stay. Non-survival group showed significantly higher levels of leucocytes count, more pronounced lymphopenia, higher CRP, LDH and D-dimer levels. Multivariate analysis identified four independent risk factors associated with death: age OR 1.05 (CI 95% 1.01-1.09), severity of disease at admission OR 0.22 (CI 95, 0.07-0.65), COVID-19 vaccination status OR 3.07 (CI 95%, 1.36-6.91) and LDH levels OR 1.00 (CI 95%,1.002-1.008). Conclusions. Diabetic patients admitted to hospital for COVID-19 infection tend to have high mortality rate. Severity of disease at admission, advanced age, not completed vaccination and increased LDH levels are independent risk factors for lethal outcome, irrespective of diabetes status.</jats:p>
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ARTERIAL THROMBOSIS IN A COVID-19 PATIENT
(Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2022)
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Shopova, Zhaklina
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Vidinic, Ivan
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Arterial thrombosis is one of the complications descry bed in severe COVID-19. Our presented case had throm bosis of abdominal aorta and left renal artery despite prophylactic treatment with low molecular heparin - enoxaparine. Thrombotic lesions were defined with CT angiography. Treatment consisted of therapeutic doses of low molecular heparin and Bergman solution. After 42 day of hospital treatment, the patient was dischar ged and vascular surgeon consultations were performed. By presenting this case, we want to draw attention to the need for early diagnosis of this complication and to highlight the need for treatment with therapeutic doses of low molecular heparin in patients with severe Covid pneumonia or oxygen dependent patients and in risk for thrombosis.
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Clinical outcome in hospitalized patients with COVID-19 and Diabetes
(Macedonian Infectious Diseases Society, 2022-11-11)
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Shopova, Zhaklina
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Vidinic, Ivan
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RECURRENT CLOSTRIDIOIDES DIFFICILE COLITIS – CASE REPORT
(Peytchinski Publishing Ltd., 2024-10-06)
Georgievska, Dajana
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Vidinic, Ivan
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Shopova, Zhaklina
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Rangelov, Goran
Recurrent Clostridium difficile infection (rCDI) is usually defined as the reappearance of enteral symptoms 2-8 weeks after resolution of the initial episode with an appropriate therapy. Recurrence occurs in approximately 25% of patients within the first 30 days of the treatment. A 62-year-old female was initially hospitalized at our hospital within the intensive care unit (ICU) due to acute encephalitis and bilateral bronchopneumonia. Her comorbidities were diabetes mellitus and hypertension. She was treated with a combination of parenteral beta-lactam antibiotics for 35 days, acyclovir, probiotics, gastric suppression, and other supportive therapies. On the 18th hospital day, she developed diarrhea with liquid mucous green stools, prompting stool cultures and a C.difficile toxins test, which were negative and her condition stabilized spontaneously. A week later, she experienced a recurrence of enteral symptoms when stool cultures showed C.difficile positivity, but negative toxin tests. A colonoscopy was performed, revealing pseudomembranous pancolitis. Treatment continued with intravenous metronidazole and oral vancomycin for two weeks, alongside probiotics. This led to gradual improvement and normalization of stool consistency. Control cultures were C.difficile negative, and she was discharged after 49 days. Three weeks later, she complained of persistent watery stools and malaise, thus she was readmitted. New stool cultures confirmed C.difficile positivity with negative toxin tests. A repeat colonoscopy showed significant regression of pseudomembranous colitis and biopsy results indicated chronic nonspecific colitis. She was treated with probiotics, intravenous metronidazole for a week, and oral vancomycin. On first follow-up visit after three weeks, she returned asymptomatic with normal stools, and was advised to continue oral vancomycin, rifaximin, and probiotics. A second follow-up visit two weeks later confirmed normal stool characteristics. Prolonged use of antibiotics, extended hospital stays, advanced age, severe preexisting illness are significant risk factors for recurrent CDI. Prolonged oral vancomycin therapy has shown high efficacy in treatment of this serious condition.

Osmani, Arlinda

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