Open Access Macedonian Journal of Medical Sciences

135-140

Authors: Spiroski M

Aim: The aim of this study was to analyze semantically medical abstracts from the Republic of Macedonia indexed in the PubMed database with GoPubMed. Material and Methods: The analysis was performed with GoPubMed on March 18, 2013 in order to identify indexed papers affiliated with the country Macedonia in the PubMed database. A total number of 1469 abstracts were identified for analysis. Results: Macedonian medical scientists published papers in a total of 400 different journals which have been indexed in PubMed database. The largest number of published papers was in the domestic journal Prilozi. Top twenty Macedonian authors published 72.4% of the total number of abstracts indexed in PubMed. A significant increase of abstracted papers during the period of 1989-2012 was recorded (from 50 abstracts to 180 abstracts, respectively) and a significant increase of relative research interest (from 0.00006 to 0.00018, respectively). Top author networks of the Macedonian scientists have shown that the largest group was composed of scientists working in the field of nephrology and related disciplines. Conclusion: Requirements for at least one paper to be published and indexed in PubMed before a candidate approaches to the Philosophy Doctor Degree defence at the Faculty of Medicine, Ss Cyril and Methodius University of Skopje was a trigger for an increased number of publications indexed in PubMed in the last decade. A larger number of Macedonian medical journals should be indexed in PubMed in order to increase the impact of Macedonian medical scientists in the world.

146-152

Authors: Egwu O, Njoku C, Ukoha U, Eteudo A, Elem B

Objective: The thickness of the triceps surae muscle complex was assessed by ultrasound in a young adult Nigerian population. Its relationship with some anthropometric variables and sexual dimorphism was also assessed. Subjects and Methods: Sixty young adults (30 males and 30 females) between the ages of 19 and 30 years were recruited for the study. Anthropometric protocols for height, weight, foot length (FL) lower leg length (LLL) and mid calf circumference (MCC) were observed. Results: Results show that the mean thickness of the calf muscle complex (CMT) was 81.65 ± 8.92 mm for all the subjects; 83.70 ± 8.73 mm for males; 79.95 ± 8.56 mm for females. The mean mid calf circumference (MCC) was 35.26 ± 2.61 cm for all subjects; 36.41 ± 3.56 cm for males; 34.10 ± 3.33 cm for females. Pearson’s correlation coefficient showed that CMT correlated positively with height, weight, BMI and BSA in the sample subjects. However, such correlations were not observed among the male subjects. MCC also correlated with some anthropometric parameters (height, weight, BMI, BSA, FL) measured. Conclusion: The findings from this study will form the bases for further research on relationships of the calf muscle complex. It also indicates that males have thicker Calf muscles and CMT has a positive relationship with height, weight, BMI and BSA especially among the female subjects.

158-161

Authors: Kopacheva-Barsova G, Nikolovski N, Kirjas M, Avramovski A

Background: Nasal tip projection has been defined as the distance along a perpendicular line from the vertical facial plane to the most anterior projecting point of the nasal tip. The tripod concept, although an oversimplification of nasal tip dynamics, highlights the intimate relationship between projection and rotation. Aim: The aim of the study was to evaluate the rate of nasal tip irregularities after the medial crura overlay procedure, and following the Tripoid concept. Methods: We completed a retrospective review of patients who have been admitted at ENT Clinic, Skopje from the period of 2008-2012. Operative technique rhinoplasty was prepared in 36 patients. Procedures included full-transfixion incision, release of tension septum, lateral crural overlay (LCO), dome truncation, medial crural overlay (MCO), and combinations of them. We reviewed major and minor secondary revision procedures that patients underwent, postoperative complications, and any functional complaints. Results: Of the remaining 36 patients: one (2.5%) required minor revision of dorsal irregularities, 3 (3.0%) required tip revision, 33 patients (93.3%) were satisfied without qualification, 3 patients (3.5%) were not satisfied and wont for revision surgery. Three patients (2.5%) underwent radix grafts. 5 (13.3%) of the patients had had previous rhinoplasty performed by another physicians. Seven patients (18.3%) were classified as having tension nose. One patient had postoperative epistaxis, and there were no cases of postoperative functional complaints. Conclusion: Our revision rate of 4.2% for tip irregularity and our finding that no patients had postoperative functional complaints allows us to feel confident that this algorithmic paradigm can be used to accomplish tip deprojection in almost any circumstance.

168-173

Authors: Jeje E, Olajide T, Akande B

Aim: This study aims to document the indications and common findings in UGI endoscopy and evaluate the relationship between H pylori and endoscopic findings. Methods: The indications for UGI endoscopy and findings detected over a 3-year period were analyzed. Results: The commonest symptoms were epigastric pain, other upper abdominal pain, and dyspepsia while common signs were epigastric and right upper quadrant tenderness, and epigastric mass. Complete data was obtained in 172 patients of which 114 had abnormal findings. The commonest were duodenal ulcer, gastritis and duodenitis. Less common findings were gastric ulcer, gastric cancer and oesophageal cancer. There was no significant difference in the frequency of H. pylori infection between those with normal and abnormal endoscopic findings. Conclusion: The commonest indication for UGI endoscopy in Lagos, Nigeria is dyspepsia while the commonest endoscopic abnormalities are duodenal ulcer, gastritis and duodenitis.

178-181

Authors: Singh A, Coppock M, Mukaetova-Ladinska EB

The diagnosis of Munchausen by Proxy (MbP) is well recognised with children as the victims, but remains infrequently reported in later life. Older frail adults may also become victims of this syndrome. In this study we report a case of an older adult with a diagnosis of dementia and her son being the perpetrator. We discuss the diagnosis of MbP in older adults and review the available literature on MbP for this population. We also highlight the clinical features that should alert the clinicians to this diagnosis as it has considerable impact on the victim’s health and consumes disproportionately large health care resource.

186-188

Authors: Alushani M, Kasa E

Gestational trophoblastic disease is a spectrum of trophoblastic diseases that includes: Complete molar pregnancy (CMP), partial molar pregnancies (PMP), invasive mole (IM), chorioncarcinoma (CHC), and placental site trophoblastic tumors (PSTT). Hydatidiform moles are abnormal gestations characterized by the presence of hydropic changes affecting some or all of the placental villi. Hydatidiform moles arise as a result of an abnormal fertilization. In this report, the patient was a 28 year old Albanian woman who had induction of ovulation with Clomid. The majority of molar gestations arise within the uterine cavity. The occurrence of a hydatidiform mole within ectopic gestational tissue is rare. It is important to differentiate a hydatidiform mole from an ectopic pregnancy, particularly in infertile women who have a history of ovulation induction.

194-201

Authors: Amzai G, Stojanovic A

Aim: The aim of this article is to provide the health professionals with clear, novel and practical guidelines regarding management of fertility in patients with malignant hematological disorders, with special accent on lymphoma. Also, it aims at raising consciousness of all physicians administering chemotherapy, about the undesired effects of many chemotherapy regimens, on the reproductive ability, about available methods for preserving fertility and regarding many other issues in connection with fertility in patients treated for lymphoma. Materials and methods: Online internet databases and publications have been searched, and a systematic literature review has been performed, using the following keywords: fertility, chemotherapy as well as relevant keywords in connection to the subject. Results: Within the search, reports regarding smaller-sized groups, as well as in series of patients and case reports have been found, but relatively few large randomized studies or actual reports regarding the success rate and the influence of methods for fertility preservation in patients treated for Hodgkin's and Non-Hodgkin's lymphoma. We have managed in summarizing a large proportion of the research studies and transferring it into an integral multidisciplinary text, offering valid and applicable options for fertility preservation in patients treated for lymphoma. We use the term lymphoma in general, since the chemotherapy and radiotherapy approaches for Hodgkin's and for Non-Hodgkin's lymphomas are similar, rendering a major part of the fertility preservation guidelines appropriate for both entities. Recommendations: Hematologists should possess fundamental knowledge regarding the late complications of lymphoma treatment. Besides acknowledging the risk of secondary cancer development as well as of non-neoplastic cardiac and pulmonary complications, they should be prepared to raise the issue of infertility as an integral part of the treatment plan, since that is a complication of significant importance for patients treated with chemotherapy within their reproductive life period. Possible methods for preserving fertility should be presented and discussed, and patients should be referred promptly to a reproductive medicine specialist. Cryopreservation of both sperm and embryos are considered standard practice and are generally available, while other methods are still in investigational phase and performed in specialized centers under mandatory professional surveillance and expertise. Conclusion: It is recommended to utilize treatments that are with as little as possible gonadal toxicity, to consider a wide array of options for fertility preservation as soon as possible, and to practice a decision-making process most beneficial for the patient, based on the latest medical accomplishments and most novel prospects.