Jashari, Enes

Preferred name
Jashari, Enes
Official Name
Jashari, Enes
Main Affiliation
Email
enes.jashari@medf.ukim.edu.mk

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    Acute Pulmonary Thromboembolism – Use of Fibrinolysis to Treat a Hemodynamically Unstable Patient in the Era of the COVID-19 Pandemic: A Case Report
    (Medical Publishing, d.o.o., 2021-06)
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    Taravari, Hayber
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    Beqiri, Ardiana
    Pulmonary embolism (PE) is a common and potentially fatal condition. Despite advances in diagnostic procedures, late detection and non-detection of this condition is also not uncommon. In patients with PE, recurrent embolisms and death can be prevented with prompt diagnosis and adequate treatment. Due to presentation with a non-specific clinical picture and symptomatology, unfortunately almost one third of the patients remain undiagnosed and untreated. We know that there is a large difference in outcome between treated and untreated patients with PE (25-30% mortality in untreated and 2-8% in treated patients). We present a case of PE in the era of the COVID-19 pandemic in an adult patient with acute dyspnea, vomiting, presyncope, chest pain, and shock.
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    Учество во GHATI(Globalhear Atack Threatment iniatiative), Регистерот како евалуација на третманот на миокарден инфаркт
    (Македонско здружение по Кардиологија, 2021-10)
    Igor Zdravkovski
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    Elma Kandikj
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    Oliver Bushletikj
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    NGAL and Cystatin C: Two possible early markers of diabetic nephropathy in patients with type 2 diabetes mellitus
    (Македонско лекарско друштво = Macedonian Medical Association, 2020-12)
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    Introduction. Diabetic nephropathy (DN) is a progressive renal impairment characterized by impaired renal architecture and function and is one of the leading causes of permanent renal impairment. Patients with DN have a high mortality rate, which is primarily due to cardiovascular complications. In everyday practice in the Republic of North Macedonia, serum creatinine, microalbuminuria and glomerular filtration rate are used to detect DN. However, these standard tests do not always allow for detection of initial DN damage. Aim. The aim of this study was to investigate the role of NGAL (in urine) and Cystatin C (in serum) values as adjunctive testing of existing markers (microalbuminuria and creatinine) in unmasking early structural and functional renal impairment in asymptomatic patients with type 2 diabetes mellitus (DM type 2). Methods. This was a prospective, observational (6-month follow-up) study, involving 60 patients aged 35-70 years. The first two groups were patients with diagnosed DM type 2 for a minimum of 5 years, 15 patients diagnosed with DM type 2 with diabetic nephropathy and 15 patients without diabetic nephropathy. The third group consisted of healthy respondents (30). In addition to standard biochemical analyses, the three groups were also examined for body fluid concentrations of NGAL (architect urine NGAL) and Cystatin C (nephelometry), as well as standard biomarkers for renal nephropathy (serum creatinine and microalbumin). Results. The respondents from the three analyzed groups did not differ significantly in terms of gender structure (p=0.71) and age (p=0.068). The study found that (the core values) baseline creatinine, microalbuminuria, NGAL and Cystatin C serum levels were higher in patients diagnosed with DM type 2 and diabetic nephropathy (DN) compared to those with diabetes and without diabetic nephropathy in healthy trials. Also, after 6 months of follow-up, it was proven that in patients diagnosed with DM type 2 and DN all four parameters were higher with confirmed significance unlike the group of patients with DM type 2 without DN. In the group with diabetes and diabetic nephropathy, during the re-evaluation after 6 months of monitoring we registered a non-significant increase in the biomarker NGAL p=0.16), and a significant increase in the biomarker Cystatin C (p=0.016). There was a statistically significant correlation between baseline creatinine values and baseline control values of Cystatin C (p<0.0001), creatinine and NGAL values after a 6-month re-evaluation (p=0.014), all of which were positive. The correlation between the two biomarkers NGAL and Cystatin C were statistically insignificant in the first measurements (p=0.160), and were significant and direct positive on the second measurements, after 6 months (r=0.536, p=0.039). The two markers changed in direct proportion to the serum, with the increasing of one marker in the serum. Also, the other biomarker increased, and vice versa. Conclusion. NGAL and Cystatin C, biomarkers of renal impairment, are correlated with decreased renal function in patients with DM type 2, suggesting that NGAL and Cystatin C may be used as adjunctive tests to existing ones (creatinine and microalbuminuria) to unmask early renal dysfunction.
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    HEART BLOCK AS A COMPLICATION OF ACUTE MYOCARDIAL INFARCTION, CLINICAL ASSESSMENT AND APPROACH. A CASE REPORT
    (Faculty of Medical Sciences, University of Tetova, 2023-09-24)
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    Murtezani, Besir
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    Zhaku, Vegim
    Optimal treatment for acute ST-elevation myocardial infarction (STEMI) within 12 hours after symptom onset includes primary percutaneous coronary intervention (PCI) or thrombolytic therapy. For STEMI patients who present later than 12 hours, current guidelines do not recommend PCI except the presence of hemodynamic or electrical instability or continuing ischemic symptoms. Thus, our intention is to show that early reperfusion may also play a role in the early recovery of AV block that may occur as a complication of myocardial infarction (MI), more commonly inferior MI. Patient 49 years old patient (male) presented in our department with weakness, dizziness, short-term instability and nausea. The symptoms started one day before admission. The ECG on admission showed a total AV block with a heart rate approximately 33 b/min and ST segment elevation in the inferior leads. Laboratory tests were normal except for an extreme elevated high sensitive troponin. The echo showed normal finding with the exception of the slightly reduced kinetics of the apex, base and mid segment of the lower-posterior wall of the IVS. Coronary angiography was immediately performed, showing 100% stenosis of the rPDA. A stent is placed on the corresponding coronary artery. The total block was present all the time, and following the recommendations, a temporary pacemaker was placed in the patient due to hemodynamic instability and bradycardia. Despite reperfusion, the block persisted 7 days after the intervention, during which a permanent pacemaker was implanted and the patient was discharged for home treatment. This case highlights the importance and ways of early reperfusion to improve outcomes in patients with STEMI. Early reperfusion may also play a role in the early recovery of AV block that may occur as a complication of MI, more commonly inferior MI.