Galician Medical Journal <p>“Galician Medical Journal” is an open access, double-blinded peer-reviewed scholarly journal that publishes articles in the fields of medicine.<br>The aim of the journal is to provide scientific communication, share experience and presentation of scientific results and clinical observations among members of the global medical community.<br>The journal publishes original research articles, clinical case reports, letters to the editor, literature review in pathology, internal medicine, dentistry, and new trends in medical education.</p> <p><strong>ISSN 2414-1518 (English ed. Online) ISSN 2306-4285 (Ukrainian ed. Print)</strong></p> Ivano-Frankivsk National Medical University en-US Galician Medical Journal 2414-1518 <div id="copyrightNotice"><span style="font-family: Georgia, serif; font-size: 17px;">Authors who publish with this journal agree to the following terms:</span> <ul style="list-style-type: circle;"> <li class="show"><span style="font-family: Georgia, serif; font-size: 16px;">Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a <a href="" target="_blank" rel="noopener">Creative Commons Attribution License&nbsp;(CC BY-NC)</a> that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</span></li> <li class="show"><span style="font-size: 16px;"><span style="font-family: Georgia,serif;">Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</span></span></li> <li class="show"><span style="font-size: 16px;"><span style="font-family: Georgia,serif;">Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See&nbsp;<a href="" target="_new">The Effect of Open Access</a>).</span></span></li> </ul> </div> COVID-19 Through the Eyes of a Physiatrist: Back Pain Can Be a Symptom and May Predict Pneumonia in COVID-19 <p>The study aimed to determine whether back pain is a clinical manifestation in patients with COVID-19 and whether several demographic and disease characteristics could be an effective indicator of back pain.</p> <p><strong>Materials and Methods.</strong> A total of 99 patients with COVID-19 were recruited from the Department of Infectious Diseases of the Kirikkale High Specialized Hospital in Turkey and divided into two groups depending on the presence (n=50) or absence of back pain (n=49). The primary outcomes included were demographic and disease characteristics, the Nord-Trøndelag Health Study Physical Activity Level for Work (HUNT), and the 6-minute walking test.</p> <p><strong>Results</strong>. The most common symptom was fatigue (n=63, 63.6%), followed by back pain (n=50, 50.5%). In the back pain group, the number of patients with sedentary lifestyle, oxygen requirement, pneumonia, and typical pneumonia pattern were significantly higher (p=0.009, p=0.026, p=0.001, p=0.001, respectively), while aerobic capacity was lower (p=0.001). In a logistic regression analysis, back pain was found to be associated with pneumonia presence.</p> <p><strong>Conclusions</strong>. Back pain may be associated with the presence of COVID-19 pneumonia and should be evaluated as its early warning symptom.</p> Cuma Uz Copyright (c) 2022 Cuma Uz 2022-12-01 2022-12-01 29 4 E202241 E202241 10.21802/gmj.2022.4.1 Neurogenic Myositis Ossificans of the Hip in a Patient with Axonal Polyneuropathy <p><strong>Background.</strong> Neurogenic myositis ossificans is a rare entity defined by the development of soft tissue ossifications in patients with paraplegia or tetraplegia following neurological pathologies, often after cranial or spinal cord trauma. The diagnosis is based on imaging, in particular CT scan, which often reveals the presence of intramuscular ossifications of periarticular location. Treatment is based on analgesics, physiotherapy, and surgery as a last resort.</p> <p><strong>Case Report</strong>. We present a case of neurogenic myositis ossificans in a 26-year-old patient followed for axonal polyneuropathy secondary to vitamin deficiency.</p> <p><strong>Conclusions. </strong>Neurogenic myositis ossificans is a rare entity but is easily diagnosed, given the context of severe neurological disorders and the characteristic appearance on CT scan. In doubtful and atypical cases, a biopsy with histological study is recommended.</p> Oubaddi Tlaite Imrani Kaoutar Rostoum Soufiane Moatassim Billah Nabil Nassar Ittimad Copyright (c) 2022 Tlaite Oubaddi, Imrani Kaoutar, Rostoum Soufiane, Moatassim Billah, Nassar Ittimad 2022-12-01 2022-12-01 29 4 E202248 E202248 10.21802/gmj.2022.4.8 An Unusual Presentation of “Two-Thirds Tumor” in the Mandible – A Diagnostic Quandary with a Review of the Literature <p>An adenomatoid odontogenic tumor (AOT) is an uncommon benign tumor of the oral cavity commonly found in the maxillary anterior region and is associated with impacted canines in young females. It rarely occurs in the mandibular region with no impacted or missing teeth. A 21-year-old female reported to the clinic with swelling on the right side of the face for the past six months with no history of pain. Radiographic features such as unilocular radiolucency with thinning of the cortical borders and considerable buccal cortical expansion, as well as some evidence of radiopaque specks were noted. Histopathological examination revealed cells with hyperchromatic nuclei, rosette-like structures with focal areas of calcified mass, and concentric rings resembling Liesegang rings, suggestive of AOT. The tumor was treated surgically by enucleation and cauterization. Although follicular type is a common variant, the tumor presented in this case was of extrafollicular type noted in the mandibular canine and premolar regions of a young female patient with no related impacted tooth.</p> Jayapriya T Namratha Patil Vaishali Keluskar Sridhar M Lokesh Kumar S Arun Panwar Copyright (c) 2022 Jayapriya T, Namratha Patil, Vaishali Keluskar, Sridhar M, Lokesh Kumar S, Arun Panwar 2022-12-01 2022-12-01 29 4 E202247 E202247 10.21802/gmj.2022.4.7 Prognostic Value of Serum Interleukin-6 Level in Hypertensive Patients with COVID-19-Associated Pneumonia <p><strong>Background.</strong> An interleukin-6 (IL-6) is a proinflammatory cytokine which plays an important role in COVID-19-associated hyperinflammation.</p> <p><strong>Aim.</strong> This study aimed to assess the predictive ability of serum IL-6 levels for the development of severe/critical clinical conditions, a hypoxemic state requiring supplemental oxygen, and lethal outcomes in patients with COVID-19-associated pneumonia and arterial hypertension (AH).</p> <p><strong>Materials and Methods.</strong> One hundred and thirty-five unvaccinated patients hospitalized for COVID-19-associated pneumonia were enrolled in the study. AH was diagnosed in 78.5% of cases. Pneumonia was confirmed radiologically. SARS-COV-2 as an etiological factor was confirmed by either PCR or ELISA. In addition to conventional laboratory tests, IL-6, ferritin, and soluble interleukin-2 levels were measured.</p> <p><strong>Results.</strong> Among AH patients, the median levels of IL-6 were higher in non-survivors (95.1 [37.8 - 158.8] pg/mL) as compared to survivors (39.5 [13.6 - 81.1] pg/mL) (p=0.04). Among AH patients, the median serum level of IL-6 was 98.3 [37.8 - 158.8] pg/mL in critically ill patients, 41.7 [11.8 - 83.4] pg/mL in severely ill patients, 37.8 [13.6 - 74.4] pg/mL in moderately ill patients (p=0.051). The median serum level of IL-6 was lower at the time of discharge (6.5 [2.0 - 21.5] pg/mL) as compared to that on admission (43.2 [16.1 - 92.0] pg/mL) (p&lt; 0.001). IL-6 level failed to predict severe/critical condition (AUC=0.59, p=0.13) and the need for supplemental oxygen (AUC=0.61, p=0.06); however, it might be used for the prediction of the lethal outcome (AUC=0.69, p=0.03). The cut-off value of IL-6 level for lethal outcome prediction of 91.0 pg/mL showed a sensitivity of 58.3% and a specificity of 78.7%. Patients with IL-6 levels &gt; 91.0 pg/mL on admission had higher odds of lethal outcomes (OR = 4.87 [1.40 - 16.92], p=0.01).</p> <p><strong>Conclusions.</strong> Serum IL-6 level on admission did not show significant predictive ability for severe/critical conditions and hypoxemic states requiring supplemental oxygen in AH patients. However, serum IL-6 levels on admission were higher in non-survivors and might be used for the prediction of lethal outcomes with a cut-off value of 91.0 pg/mL in AH patients.</p> Oleksii Skakun Sergiy Fedorov Nestor Seredyuk Olha Verbovska Copyright (c) 2022 Oleksii Skakun, Sergiy Fedorov, Nestor Seredyuk, Olha Verbovska 2022-12-01 2022-12-01 29 4 E202242 E202242 10.21802/gmj.2022.4.2 Curcumin Attenuates Lipopolysaccharide-Induced Neuroinflammation and Memory Deficiency by Inhibiting Microglia Activation in Mice Hippocampus <p><strong>Background.</strong> Curcumin has a variety of properties, including antioxidant and anti-inflammatory ones, and has demonstrated some protective prospects on neurological conditions.</p> <p><strong>Aim</strong>: This study explored the neuroprotective ability of curcumin in lipopolysaccharide-induced neuroinflammation in an animal model.</p> <p><strong>Methods</strong>. A total of thirty-two adult male mice were randomly assigned to four groups (A, B, C, and D, n=8): Group A (Control) received distilled water; Group B was administered lipopolysaccharide (LPS) only to induce neuroinflammation for seven days; Group C was treated with both LPS and curcumin simultaneously for fourteen days; Group D received only curcumin for fourteen days. After appropriate exposure to the mice, their cognitive abilities were assessed using the Y-maze and novel object recognition tests. At the termination of the administration period, the mice were sacrificed, and the hippocampi were dissected for histology and immunostaining using GFAP and Iba1. Statistical analysis for the data generated was done with GraphPad prism. Tests of significance were with one-way ANOVA and Tukey tests for post-hoc.</p> <p><strong>Results.</strong> Curcumin significantly (p &lt; 0.05) increased object recognition, mean alternation, and markedly restored neuronal distortion caused by LPS toxicity in the CA3 region and the dentate gyrus of the hippocampus of Group C animals as compared to Group B. In addition, curcumin significantly down-regulated Iba1 expression and GFAP cell activities of both the CA3 region and the dentate gyrus.</p> <p><strong>Conclusions</strong>. Curcumin showed a promising role in attenuating LPS-induced neuroinflammation in the brain by inhibiting microglial activation and improving memory of neurotoxic mice.</p> Kingsley Iteire Raphael Uwejigho Glory Okonofua Copyright (c) 2022 Raphael Uwejigho, Kingsley Iteire, Glory Okonofua 2022-12-01 2022-12-01 29 4 E202245 E202245 10.21802/gmj.2022.4.5 The Effect of the Mucinous Component Presence on the Clinical Outcomes of Colorectal Cancer <p><strong>Background.</strong> The effect of colorectal cancer (CRC) histological subtypes on the prognosis is still a controversial issue. We aimed to compare clinical findings, histopathologic data, and survival outcomes in CRC patients with classical and mucinous subtypes.</p> <p><strong>Methods. </strong>Patients who were operated on for CRC between 2010 and 2017 were included in the study. Patients were classified into two groups according to the presence of a mucinous component: mucinous adenocarcinoma (MAC) - mucinous component &gt; 50% and classical adenocarcinoma (CAC). Clinical and histopathologic findings, recurrence, metastasis, and survival rates were compared.</p> <p><strong>Results. </strong>Data of the 484 CRC patients were documented. Sixty-nine patients (14.3%) were in the MAC group and 415 (85.7%) patients were in the CAC group. The mean age of patients with MAC and CAC was 63.4 ± 13.5 and 68.5 ± 12.7 years, respectively (p = 0.002). Proximal colon localization was found in 30 (43.5%) MAC patients and 123 (29.6%) CAC patients (p = 0.029). The number of patients with metastatic lymph nodes was higher in the MAC group (58% vs. 41.2%, p = 0.03). Nevertheless, there was no significant difference between the CAC and MAC groups in terms of disease-free survival (63.1% vs. 69.6%, p = 0.37) and disease-related mortality (23.6% vs. 23.2%, p = 0.94) over the follow-up period. Multivariate analysis showed that the presence of perineural invasion, patient’s age, and disease stage were associated with mortality in CRC patients.</p> <p><strong>Conclusions. </strong>MACs occurred at a younger age than CACs and were more likely localized in the proximal colon as compared to CACs. Despite increased lymph node metastasis in MAC patients, no statistical significance was detected in overall survival or disease-free survival. Multivariate analysis revealed that age, perineural invasion, and disease stage were relevant to mortality in CRC patients.</p> Ibrahim Ali Ozemir Muhammed Ali Aydemir Aman Gapbarov Ozgur Ekinci Orhan Alimoglu Copyright (c) 2022 Ibrahim Ali Ozemir, Muhammed Ali Aydemir, Aman Gapbarov, Ozgur Ekinci, Orhan Alimoglu 2022-12-01 2022-12-01 29 4 E202246 E202246 10.21802/gmj.2022.4.6 Microbiological Assessment of Glycyrrhizic Acid Effectiveness in Bacterial Vaginosis – A Comparative Study <p><strong>Background.</strong> Bacterial vaginosis (BV) is one of the most common female diseases, which is currently characterized by an increasing rate of clinical sign reccurence, the appearance of asymptomatic carriers, and atypical forms.</p> <p><strong>This study was aimed</strong> to evaluate the effectiveness of glycyrrhizic acid administration in the prevention of BV recurrence.</p> <p><strong>Materials and Methods.</strong> The study involved 88 women after BV treatment (metronidazole <em>per os</em> for seven days). Participants were randomly divided into two groups: the main group included 46 patients who were administered 0.1% glycyrrhizic acid intravaginally for three months after the main treatment; the control group comprised 42 women who received no anti-recurrence BV course. The effectiveness was assessed three and six months after the beginning of treatment and included gynecological examination and laboratory assessments (pH, amine test, microbiological investigation).</p> <p><strong>Results.</strong> After recommended BV treatment without anti-recurrence course, the recurrence of laboratory criteria for BV increased three months after the treatment, including the increase in vaginal pH to &gt; 4.5 in all subjects, positive amine test in 35.7% of patients, the presence of <em>Gardnerella vaginalis</em> at a concentration of 10<sup>4</sup>-10<sup>5</sup> CFU/ml in 31.0% of women, reduction in the frequency of Lactobacillus detection with worsening of the condition and the onset of clinical manifestations of the disease six months later. In the main group, after glycyrrhizic acid administration, laboratory criteria of BV recovery three months after the treatment, and clinical and laboratory markers of BV recovery six months after the treatment were lower as compared to the control group.</p> <p><strong>Conclusions.</strong> The anti-recurrence course of BV (vaginal administration of 0.1% glycyrrhizic acid) demonstrated a decrease in the frequency of complaints, clinical and laboratory markers, stabilization of the species composition of Lactobacillus, and a decrease in facultative anaerobe concentration in the vaginal microbiome as compared to group without anti-recurrence treatment.</p> Svitlana Ostafiichuk Ivan Polishchuk Oksana Perkhulyn Olena Kusa Nataliya Henyk Oksana Makarchuk Lesya Kurovets Roman Kutsyk Copyright (c) 2022 Svitlana Ostafiichuk, Ivan Polishchuk, Oksana Perkhulyn, Olena Kusa, Nataliya Henyk, Oksana Makarchuk, Lesya Kurovets, Roman Kutsyk 2022-12-01 2022-12-01 29 4 E202243 E202243 10.21802/gmj.2022.4.3 Combined Effects of Cadmium- and Cyanide-Contaminated Diet on Oxidative Stress Biomarkers in Different Tissues of Rats <p><strong>Background.</strong> Several toxicants present simultaneously in the environment have combined toxicological effects. In addition, various xenobiotics have distinct effects on oxidative stress biomarkers in animal cells and tissues.</p> <p><strong>The aim</strong> of this study was to analyze the effect of cadmium (Cd) and cyanide (CN) through the food chain on some antioxidant indices in the tissues (lungs, testes, heart, and brain) of male Wistar rats.</p> <p><strong>Materials and Methods</strong>. The study included sixty African catfish allocated to four groups, each comprising fifteen fish, treated with potassium cyanide (KCN) and cadmium chloride (CdCl<sub>2</sub>), held at a temperature of 25°C in a 100-litre fish tank aquarium with water contaminated with 0.4 mg of both cyanide and cadmium/100 ml of water. All the fish were later killed, dried, and used to prepare diet for experimental animals. Twenty male rats divided into four groups, each comprising five rats, were used for this study as well, and fed for 28 days as follows: Group A - control diet; Group B - cyanide-contaminated diet; Group C - cadmium-contaminated diet; Group D - diet contaminated with cyanide + cadmium. Subsequently, they were sacrificed. Biochemical analysis of the tissues excised from the rats was done.</p> <p><strong>Results</strong>. There was a significant (p &lt; 0.05) increase in lipid peroxidation level and a significant decrease in superoxide dismutase, catalase and reduced glutathione activities in the lungs, testes, heart, and brain of rats fed a catfish diet containing both cyanide and cadmium as compared to controls. In addition, contaminated diet altered acetylcholinesterase activity in the brain, glutathione peroxidase activity, glutathione-S-transferase activity, and glutathione reductase activity in the tissues of experimental rats.</p> <p><strong>Conclusions</strong>. Cadmium and cyanide, via the food chain, induce oxidative stress in the lungs, testes, heart, and brain of rats.</p> Ovigueroye Ekayoda Helen Ejiro Kadiri Oghenenyore Andy Ohwokevwo Copyright (c) 2022-10-18 2022-10-18 29 4 E202244 E202244 10.21802/gmj.2022.4.4 Utilizing Proximity for Increasing Student Knowledge Retention: A Near-Peer Tutoring Program Needs Study <p><strong>The purpose</strong> of this study was to demonstrate the desire and need for peer-to-peer tutoring programs at Division 1 Dell Medical School at the University of Texas.</p> <p><strong>Materials and Methods</strong>. Two sets of surveys were created and sent to students at the Dell Medical School, University of Texas, USA. One survey asking about the need or desire to engage with a peer tutor was sent to first-year students, and another one asking about the desire to provide these services to underclassmen as a potential leadership course option was sent to third-year students.</p> <p><strong>Results</strong>. For the first-year student survey, 52.9% of respondents disagreed or strongly disagreed of being aware of near-peer tutoring and 70.5% of respondents either agreed or strongly agreed that it would be an option utilized by students. For the third-year student survey, 75% of students either disagreed or felt neutral in being aware of near-peer tutoring as an option to serve underclassmen, whereas 65% of upperclassmen either agreed or strongly agreed that if near-peer tutoring had been offered, they would have chosen this leadership course option in the effort to teach their underclassmen peers.</p> <p><strong>Conclusions</strong>. Numerous studies have demonstrated peer-to-peer tutorial options to be of high utility to students in the medical education space. This particular paper obtained results demonstrating students’ desire to engage in peer tutoring voluntarily for their own course success goals and upperclassmen’s desire to participate as near-peer tutors for the benefit of underclassmen.</p> Johnathon S. Lueck Thomas C. Varkey Daniel Ramirez Copyright (c) 2022 Johnathon S. Lueck, Thomas C. Varkey, Daniel Ramirez 2022-09-01 2022-09-01 29 4 E202232 E202232 10.21802/gmj.2022.3.2 Immunohistochemical Expression of IMP3 in Cutaneous Basal Cell Carcinoma <p><strong>Background.</strong> Insulin-like growth factor-II mRNA-binding protein 3 (IMP3) is an oncofetal protein upregulated in tumor cells during carcinogenesis. It has been linked to adverse clinical outcome in many malignancies.</p> <p><strong>This study was aimed</strong> to evaluate an immunohistochemical expression status of IMP3 in cutaneous basal cell carcinoma (BCC) and to correlate it with the Ki-67 index values.</p> <p><strong>Methods.</strong> Biopsy specimens from 32 cases of BCC were enrolled into this analysis. All samples were immunohistochemically stained for IMP3 (Clone 69.1) and Ki-67 antigen (Clone MIB-1).</p> <p><strong>Results.</strong> IMP3 showed a weak expression in 11 (34.4%) cases, a moderate expression in 11 (34.4%) cases, a strong expression in 5 (15.6%) cases, and negative staining in 5 (15.6%) cases. Among seven BCCs exhibiting aggressive-growth features, all but one showed weak reactivity. In contrast, all five BCCs manifesting strong IMP3 positivity consisted of the indolent-growth histologic subtypes. BCCs with infiltrative histomorphology did not appear to have a tendency towards more striking production of IMP3. There was no significant relationship between the IMP3 expression status and the proliferation status (Ki-67 ≤ 50% vs. Ki-67 &gt; 50%) of the tumor tissue (p &gt; 0.05).</p> <p><strong>Conclusions.</strong> The vast majority of cutaneous BCCs express IMP3, suggesting this oncoprotein is implicated in BCC carcinogenesis. However, more pronounced expression does not seem to be associated with aggressive-growth phenotype of BCC or higher proliferative activity of neoplastic cells.</p> Vladimir Bartos Copyright (c) 2022 Vladimir Bartos 2022-09-01 2022-09-01 29 4 E202231 E202231 10.21802/gmj.2022.3.1 Hyperostosis Frontalis Interna and Temporalis Interna: A Rare Case Report <p>Hyperostosis is a slow-growing benign bone tumour often seen in the bones of the cranial vault, more commonly found in elderly females. It is an incidental finding noted during radiological examination. The clinical manifestation of such tumour depends on its location inside the cranial cavity: the proximity to the paranasal sinuses, brain tissue, nerves, or blood vessels, etc. Its clinical findings may range from mild obstruction of the paranasal sinuses or blood vessels to severe compression of the surrounding cranial nerves. Here a rare case of hyperostosis of the frontal and temporal bones found during a routine cadaveric dissection in the Department of Anatomy is presented. Causes of the formation of such unusually enlarged bone masses inside the cranial cavity and their clinical presentation are discussed.</p> Mathada Vamadevaiah Ravishankar Vidya Chikkarahalli Srikantaiah Nagavalli Basavanna Pushpa Sapna Patel Copyright (c) 2022 Mathada Vamadevaiah Ravishankar, Vidya Chikkarahalli Srikantaiah, Nagavalli Basavanna Pushpa, Sapna Patel 2022-09-01 2022-09-01 29 4 E202238 E202238 10.21802/gmj.2022.3.8 Awareness of and Attitudes Towards Domestic Violence in Turkish Society <p><strong>The objective</strong> of this study was to identify domestic violence awareness and attitudes towards violence among adult individuals in Turkish society.</p> <p><strong>Materials and Methods. </strong>This descriptive and cross-sectional study was conducted online between September 15, 2021 and November 15, 2021 and included 353 individuals. The data were collected using the snowball sampling method, the Google Forms, the Socio-Demographic Descriptive Information Form, the Domestic Violence Awareness Scale, and the Attitudes Towards Domestic Violence (ADV) Scale. For data analysis, the number, percentage, mean, standard deviation, Student’s t-test, one-way analysis of variance (ANOVA), post hoc (Tukey, LSD) analyses, Cohen’s d and Eta squared (η <sup>2</sup>) coefficients, and correlation analysis were used.</p> <p><strong>Results. </strong>Most research participants were females (79.0%), with the average age of 30.53 ± 13.11 years. Of all the participants, 56.9% stated that they witnessed domestic violence, 22.7% stated that they experienced violence against women, 8.2% stated that they used violence. While the mean Domestic Violence Awareness Scale score was calculated as 41.09 ± 3.98, the mean score of the ADV Scale was calculated as 20.18 ± 7.82. The scores of domestic violence awareness differed significantly depending on education level (p=0.042; η <sup>2</sup>=0.018). The scores of women’s attitude towards domestic violence (19.10) were lower than those in men (24.26) (p=0.05; d=0.684; η<sup>2</sup>=0.072). Participants’ attitudes towards domestic violence varied significantly by family type (p=0.006; η<sup>2</sup>=0.029), education level (p=0.007; η<sup>2</sup>=0.028), and occupation (p=0.007; η<sup>2</sup>=0.040). There was a significant positive relationship between awareness of and attitudes towards domestic violence (r=0.226).</p> <p><strong>Conclusions. </strong>Study participants had a high sense of awareness towards domestic violence and a negative attitude towards violence. Their awareness of domestic violence was affected by education level, while their attitudes towards domestic violence was affected by gender, type of family, education level, and occupation.</p> <div style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">&nbsp;</div> Havva Gezgin Yazici Makbule Batmaz Cigdem Okten Copyright (c) 2022 Makbule Batmaz, Havva Gezgin Yazici, Cigdem Okten 2022-09-01 2022-09-01 29 4 E202234 E202234 10.21802/gmj.2022.3.4 Perceived Stress and Quality of Life in Healthcare Workers of Non-COVID-19-Designated Hospitals During the COVID-19 Pandemic in Ukraine <p><strong>Introduction.</strong> Healthcare workers are more vulnerable to negative influences of the Covid-19 pandemic than cross-border travelers as they experience greater occupational stress, exacerbated by the possibility of self-contamination or contamination of their relatives through direct contact with patients, reduced social communication, deterioration in self-care and quality of life due to lack of energy and time.</p> <p><strong>The aim</strong> of the study was to assess the level of stress and quality of life in healthcare workers of non-COVID-19-designated hospitals in Ukraine during the COVID-19 pandemic.</p> <p><strong>Materials and Methods.</strong> There was carried out a case-control study that included 150 respondents divided into three groups: experimental groups (EG) 1 and 2 comprised 50 physicians and 50 nurses of non-COVID-19-designated hospitals, respectively; the control group (CG) included 50 healthy individuals not working in the healthcare field. The data were collected using paper questionnaires involving sociodemographic questions, the Perceived Stress Scale, and the 36-Item Short Form Health Survey.</p> <p><strong>Results</strong>. EG 1 and EG 2 had significantly increased stress levels as compared to the CG. Physical functioning criterion in EG 2 was significantly lower than those in EG 1 and the CG. Vitality and social functioning indicators were significantly lower in EG 1 and EG 2 as compared to the CG. Quality of mental health was worse in EG 1 than in the CG.</p> <p><strong>Conclusions</strong>. During the COVID-19 pandemic, healthcare workers of non-COVID-19-designated hospitals experienced a significant reorganization of their work environment, which required them to adjust rapidly to new conditions and psychological difficulties. The medical staff was found to have an increased level of perceived stress and decreased quality of life, which could affect the quality of medical care. Our findings suggest that the COVID-19 pandemic necessitates the development and implementation of stress coping measures to improve mental and physical health of healthcare workers, which can be used to achieve proper work and rest routines, create a microclimate within the team, and restore the work-life balance.</p> Oksana Mats Zoriana Karpik Dmytro Boiko Vadym Rud Liliia Zhyvotovska Copyright (c) 2022 Oksana Mats, Zoriana Karpik, Dmytro Boiko, Vadym Rud, Liliia Zhyvotovska 2022-09-01 2022-09-01 29 4 E202233 E202233 10.21802/gmj.2022.3.3 Antibacterial Polyacrylamide and Dextran-Graft-Polyacrylamide Hydrogels for the Treatment of Open Wounds <p><strong>Background.</strong> Open wound treatment requires a use of bandage material to prevent the development of pathogenic microflora and to provide the necessary conditions for tissue regeneration.</p> <p><strong>The aim </strong>of the study was to compare the effectiveness of polyacrylamide (PAA) and dextran-graft-polyacrylamide (D-PAA) hydrogels loaded with silver nanoparticles (AgNPs), antibiotics, and photosensitizers for the treatment of bacterial infection of open wounds.</p> <p><strong>Materials and Methods.</strong> PAA and D-PAA hydrogels with AgNPs, methylene blue (0.001%) without (MB) and with red light irradiation (660 nm) (MB+L), chlorhexidine (0.05%) and cefuroxime (0.1%) were used. There were tested <em>in vitro</em> and <em>in vivo </em> (a rat model) antibacterial activities against wild-type <em>Staphylococcus aureus</em>, <em>Escherichia coli</em>, antibiotic-resistant <em>Escherichia coli</em> and <em>Klebsiella pneumoniae </em>strains obtained from the wound. Clinical investigations were performed in patients with chronic venous ulcers of the lower extremities with no response to traditional treatments.</p> <p><strong>Results.</strong> <em>S. aureus</em>, <em> E. coli</em>, and <em>K. pneumoniae</em> strains were sensitive to PAA and D-PAA hydrogels with AgNPs, chlorhexidine, and cefuroxime. Antibiotic-resistant <em>E. coli</em> was not inhibited by the hydrogels with cefuroxime. This strain was less sensitive to chlorhexidine and MB+L. There were no differences between unloaded PAA and D-PAA hydrogels; the antibacterial properties of the dressing were determined by an antibacterial component loaded into the hydrogel. The use of unloaded D-PAA hydrogels <em>in vivo</em> helped reduce the size of the wound by 28.6% and 42.8% three and five days after wound modeling, respectively. Similar results were obtained for D-PAA hydrogels loaded with cefuroxime, chlorhexidine, and MB+L. D-PAA hydrogel with AgNPs reduced wound size by 50% and 62.5% three and five days after wound induction, respectively, demonstrated greater antibacterial activity and was selected for clinical investigations. In a patient, 14 days after bandage application, the fibrin membrane disappeared, the ulcers were covered with pink granulations, marginal epithelialization appeared.</p> <p><strong>Conclusions. </strong>PAA and D-PAA hydrogels can be loaded with the antibacterial compounds of various types. The type of polymer does not affect the antibacterial properties of the final hydrogels. The hydrogels with chlorhexidine and MB+L can be potentially used to treat bacterial contamination of wounds and ulcers. Nevertheless, their disadvantage is the inability to absorb or precipitate tissue breakdown products that interfere with normal regeneration and inflammation. D-PAA/AgNPs are the best option for treating ulcers due to the ability to control the properties of the hydrogels and nanoparticles, as well as multiple mechanisms of antibacterial action.</p> Pavlo Virych Oksana Nadtoka Nataliya Kutsevol Bohdan Krysa Vasyl Krysa Copyright (c) 2022 Pavlo Virych, Oksana Nadtoka, Nataliya Kutsevol, Bohdan Krysa, Vasyl Krysa 2022-09-01 2022-09-01 29 4 E202235 E202235 10.21802/gmj.2022.3.5 The Effect of Preoperative Anxiety on Postoperative Symptoms in Patients Without a History of Anxiety Scheduled for Coronary Artery Bypass Grafting <p><strong>The aim</strong> of this study was to measure the level of preoperative anxiety in patients scheduled for coronary artery bypass grafting (CABG) to assess the relationship between anxiety and postoperative symptoms.</p> <p><strong>Materials and Methods. </strong>This descriptive study was conducted at a single university hospital from February to November 2021. Seventy-four CABG patients who completed the Anxiety Specific to Surgery Questionnaire, the Visual Analogue Scale, the Modified Borg Scale, the Rhodes Index of Nausea, Vomiting and Retching were included in the study. The data were analyzed by the mean, standard deviation, frequency distribution, Mann-Whitney U Test, and Spearman’s correlation analysis.</p> <p><strong>Results.</strong> The average age of participants was 65.55 ± 8.35; 66.2% of them were males. The ASSQ total scores of female participants were significantly higher as compared to male participants (p &lt; 0.05). There was a statistically significant positive relationship between the levels of anxiety in patients before CABG and the levels of postoperative pain and dyspnea severity (p &lt; 0.05).</p> <p><strong>Conclusions.</strong> Patients were found to experience predominantly moderate to severe anxiety before CABG, and increased dyspnea complaints and pain in the postoperative period. A coordinated, multidisciplinary approach to preoperative training of healthcare professionals may offer a promising way to provide more efficient and productive services.</p> Nurten Arslan Isik Izzet Emir Copyright (c) 2022 Nurten Arslan Isik, Izzet Emir 2022-09-01 2022-09-01 29 4 E202237 E202237 10.21802/gmj.2022.3.7 A Different Approach to Breast Self-Examination Training: Family Training <p><strong>Background. </strong>Breast self-examination (BSE) is an effective, cost-free, early diagnosis method that enables women to take responsibility for their own health in the early diagnosis of breast cancer, which is the most common cause of death in women.</p> <p><strong>The objective</strong> of the study was to determine the effect of BSE training given by female nursing students to their mothers and sisters on their BSE behavior and self-esteem.</p> <p><strong>Materials and Methods. </strong>This study is of one-group pretest-posttest quasi-experimental design. It was carried out at the Faculty of Health Sciences of Erzincan University in Turkey between December 2019 and May 2020. The universe of the study consisted of 140 third- and fourth-year female students over the age of 18 enrolled in the Department of Nursing, Faculty of Health Sciences, Erzincan University, Turkey. The total number of mothers and sisters in the study sample was 126. The data were collected in two stages, before and one month after family training. IBM SPSS Statistics 22 software package was used for statistical data analysis. The percentage, mean, standard deviation, and Student’s t-test were used for statistical processing. The p-value of 0.05 was considered statistically significant for all tests.</p> <p><strong>Results. </strong>The knowledge level of study participants about breast cancer and BSE was analyzed, and the source of their knowledge was assessed. Applying family training approach showed a significant increase in BSE knowledge level of participants one month after training. It was accompanied by increasing BSE skills and self-esteem levels (according to the mean values of the Rosenberg Self-Esteem Scale).</p> <p><strong>Conclusions.</strong> Training for family members is an effective method to increase women' s knowledge and skills in BSE. In addition, BSE training enabled female students and their families to participate in BSE practice.</p> Gulsun Ayran Gulsum Gundogdu Ece Yaman Sema Kutluata Copyright (c) 2022 Gulsun Ayran, Gulsum Gundogdu, Ece Yaman, Sema Kutluata 2022-09-01 2022-09-01 29 4 E202236 E202236 10.21802/gmj.2022.3.6 The Effect of the Progressively Lowered Stress Threshold Model Training Program on Depression and Care Burden in Dementia Patient Caregivers <p><strong>The objective</strong> of this study was to determine the effect of the Progressively Lowered Stress Threshold training program on depression and care burden in dementia patient caregivers.</p> <p><strong>Materials and Methods.</strong> We applied an experimental model based on a pretest-posttest control group. The sample consisted of 140 dementia caregivers (the experimental group and the control group with 70 participants per group). The sample size was determined, and the participants were allocated to groups using power analysis. Data of the study were collected between April 15, 2016 and July 15, 2016. For the pre-test, both groups were provided with the Sociodemographic Characteristics Form, the Beck Depression Inventory (BDI), and the Caregiver Burden of Dementia Patient Caregiver Scale (CBDPCS) to be filled in. Then, the experimenter visited the homes of the experimental group patients twice at 2-week intervals to provide nursing care based on the Progressively Lowered Stress Threshold Model. Finally, after 8 weeks, the post-test was conducted by letting both groups complete the Sociodemographic Characteristics Form, the BDI, and the CBDPCS once again. Percentage, chi-square, in independent and dependent sample t-tests were used to evaluate the related data.</p> <p><strong>Results.</strong> The mean BDI score was 15.61 ± 10.97 in the pre-test and 11.08 ± 8.82 in the post-test (t=6.738, p=0.001). The mean pre-test and post-test total CBDPCS scores of caregivers were 67.02 ± 16.23 and 59.27 ± 15.25, respectively (t=5.974, p=0.001). The difference between the intergroup comparison of the mean experiment and control group post-test scores was statistically significant (p=0.001) on the CBDPCS and the total BDI score.</p> <p><strong>Conclusions.</strong> Our results suggest that education provided to caregivers can efficiently decrease their care burden and depression levels.</p> Sinan Aslan Rukuye Aylaz Copyright (c) 2022 Sinan Aslan, Rukuye Aylaz 2022-06-01 2022-06-01 29 4 E202223 E202223 10.21802/gmj.2022.2.3 Risk Factors Associated with Treatment Default Among Tuberculosis Patients in Adamawa State, Nigeria <p><strong>Background.</strong> Tuberculosis is an infectious disease caused by bacteria called <em>Mycobacterium tuberculosis</em>. The treatment of drug-resistant tuberculosis is complex, costly, and usually has poor outcomes. Treatment default is well known as a very significant factor associated with drug-resistant tuberculosis.</p> <p><strong>The aim</strong> of this study was to investigate the hazard ratios associated with treatment default among tuberculosis patients in Adamawa State, Nigeria.</p> <p><strong>Materials and Methods. </strong>The Cox proportional hazards regression was used to determine the hazard ratios associated with tuberculosis patient treatment default in Adamawa State, Nigeria. The Kaplan-Meier method was used to analyze time-to-event data. The study assessed the survival status and treatment outcomes of tuberculosis patients over a six-month period (January 2019 to June 2019). Data analysis was done using R - Programming Software and the statistical significance was considered at p &lt; 0.05.</p> <p><strong>Results. </strong>Out of the 197 (124 males and 73 females) tuberculosis patients, 148 (75.1%) individuals were diagnosed with pulmonary tuberculosis and 49 (24.9%) individuals were diagnosed with extrapulmonary tuberculosis. The treatment outcomes were as follows: 33 (16.8%) patients were cured; 36 (18.3%) individuals completed their treatment; 3 (1.5%) patients died during treatment; 105 (53.3%) subjects defaulted; 8 (4.1%) patients were lost to follow-up; the remaining 12 (6.1%) individuals were still on treatment at the end of the study. According to the Cox proportional hazards analysis, HIV-positive status (p &lt; 0.05, 95% CI [0.361 - 0.879]), primary education level (p &lt; 0.01, 95% CI [1.248 - 3.354]), poor quality of life (p &lt; 0.01, 95% CI [1.239 - 3.511]) and age over 60 years old (p &lt; 0.05, 95% CI [0.569 - 2.206]) were significant hazard ratios to experience the event (treatment default) in the study area.</p> <p><strong>Conclusions. </strong>This study revealed that HIV-positive tuberculosis patients, older patients, patients with primary education, and those with poor quality of life are significant risk factors to experience treatment default in the study area. Therefore, it is recommended that stakeholders managing the treatment and care of tuberculosis patients should be dedicated and intentional in the provision of psychosocial therapy to patients with poor quality of life.</p> Charles Okoro Olateju Alao Bamigbala Ayodeji Oluwatobi Ojetunde Abdulmudallib Ibrahim Copyright (c) 2022 Charles Okoro, Olateju Alao Bamigbala, Ayodeji Oluwatobi Ojetunde, Abdulmudallib Ibrahim 2022-06-01 2022-06-01 29 4 E202221 E202221 10.21802/gmj.2022.2.1 The Relationship between the Fear of Childbirth and Anxiety during the Covid-19 Pandemic <p><strong>Introduction.</strong> The novel coronavirus disease (COVID-19), which emerged in Wuhan, China, in late 2019, has affected the whole world. Pregnant women who are expected to give birth during this period are one of the most important groups affected by these processes.</p> <p><strong>The aim of this</strong> study was to identify the relationship between the fear of childbirth and anxiety among pregnant women during the COVID-19 pandemic.</p> <p><strong>Materials and Methods.</strong> The cross-sectional study was conducted on 181 pregnant women in a city in the eastern region of Turkey between July and November 2020.</p> <p><strong>Results.</strong> Mid-level fear of childbirth was experienced by 44.8% of pregnant women. A positive correlation was found between the average anxiety score of pregnant women and childbirth fear.</p> <p><strong>Conclusions. </strong> The findings of the study will guide healthcare professionals in finding applicable solutions to the problems experienced by pregnant women during the COVID-19 pandemic period.</p> Sevinç Köse Tuncer Figen Alp Yılmaz Papatya Karakurt Nadire Yıldız Çiltaş Copyright (c) 2022 Sevinç Köse Tuncer, Figen Alp Yılmaz, Papatya Karakurt, Nadire Yıldız Çiltaş 2022-06-01 2022-06-01 29 4 E202222 E202222 10.21802/gmj.2022.2.2 The Mongoose Phenomenon: A New Logical Heuristic <p>Often when discussing what is considered a rarer occurring event, individuals reference the Baader-Meinhof phenomenon as insurance against fallacious thinking. Also known as the frequency bias, this logical heuristic states that rare occurring events are rare and the knowledge of the existence of rare occurrences makes the interlocutor more likely to search out the event or see it occur more frequently. These false increases in observation frequency can logically be blamed, at least in part, on the interlocutor being made aware of the event existence. This Baader-Meinhof logical heuristic is often mis-utilized in the sciences to minimize the chances of rarer phenomena from being considered within a logical framework for the work up of a problem. This article presents a new logical heuristic, the “Mongoose Phenomenon” as a counter argument and presents it in the context of the fields of medicine, the hard sciences, engineering, and philosophy. It is the intention of the authors that this logical heuristic be utilized to improve the thought process of scientists, clinicians, and others to ensure the best thought process for the work up and creation of a solution for problems.</p> Thomas C. Varkey John A. Varkey Milan Sivakumar Zachary I. Merhavy Copyright (c) 2022 Thomas C. Varkey, John A. Varkey, Milan Sivakumar, Zachary I. Merhavy 2022-06-01 2022-06-01 29 4 E202226 E202226 10.21802/gmj.2022.2.6 Anticancer Agent Effect and Polychemotherapy Regimens for Malignant Tumor Treatment - A Review <p>Cancer is a leading cause of millions of deaths worldwide and, despite the improvements in molecular biology, issues concerning how to advance cancer treatment are still relevant. Cancer research must be focused on finding new and efficient chemotherapeutic regimens that can relieve severe side effects caused by conventional treatments. Modern technologies are currently under estimation in clinical trials or have already been introduced into clinical practice. Nowadays cancer therapy is characterized by ineffectiveness and serious side effects, as well as by hope of remission and cure in many cases. Antitumor drugs and radiation have been used as the treatment of choice in some cancer cases, except for the choice of surgery in case of solid tumors. Recently, immunotherapy has emerged as a significant therapeutic alternative, and in many cases, it is the first choice. These therapies can be applied either alone or in combination with other agents. Additionally, gene treatment and nanotechnology are promising methods for cancer treatment as well. The current review presents the progress of cancer treatments, starting with surgery, chemotherapy, radiation and immunotherapy, gene treatment and nanomedicine, giving emphasis to the most common anticancer agents and polychemotherapeutic regimens.</p> Nikolaos Andreas Chrysanthakopoulos Eleftheria Vryzaki Copyright (c) 2022 Nikolaos Andreas Chrysanthakopoulos, Eleftheria Vryzaki 2022-06-01 2022-06-01 29 4 E202227 E202227 10.21802/gmj.2022.2.7 Validity and Reliability of the Turkish Version of the COVID-19-Impact on Quality of Life Scale <p><strong>The objective </strong>of this study was to adapt the COVID-19-Impact on Quality of Life (COV19-QoL) scale for Turkish individuals and to determine its validity and reliability.</p> <p><strong> Materials and Methods. </strong>This methodological study was conducted between December 25, 2020 and January 10, 2021. The research was conducted online and included 485 participants who completed a socio-demographic questionnaire, the COV19-QoL scale and the Duke Health Profile (DUKE) on Google Forms. Back translation was used for the Turkish version of the COV19-QoL scale. Language and content validity of the scale were found to be acceptable.</p> <p><strong> Results. </strong>Ten experts were consulted regarding content validity of the scale. The results, item content validity of 0.95 and scale content validity of 0.95, indicated excellent content validity. Explanatory factor analysis found one principal structure with a total variance of 59.449%. The Cronbach’s alpha internal consistency coefficient was 0.86 for the scale. A statistically significant moderate negative correlation was found between the participants’ COV19-QoL scale score and their general health score on the DUKE (r = − 0.384; p &lt; 0.01).</p> <p><strong> Conclusions. </strong>This study found that the Turkish version of the COV19-QoL scale is a valid and reliable instrument for assessing the effects of the COVID-19 pandemic on the Turkish population’s quality of life.</p> Çiğdem Ökten Havva Gezgin Yazıcı Copyright (c) 2022 Çiğdem Ökten, Havva Gezgin Yazıcı 2022-06-01 2022-06-01 29 4 E202224 E202224 10.21802/gmj.2022.2.4 Artificial Intelligence Approach in Prostate Cancer Diagnosis: Bibliometric Analysis <p><strong>Background.</strong> Prostate cancer is one of the most common male malignancies worldwide that ranks second in cancer-related mortality. Artificial intelligence can reduce subjectivity and improve the efficiency of prostate cancer diagnosis using fewer resources as compared to standard diagnostic scheme.</p> <p><strong>This review aims</strong> to highlight the main concepts of prostate cancer diagnosis and artificial intelligence application and to determine achievements, current trends, and potential research directions in this field, using bibliometric analysis.</p> <p><strong>Materials and Methods.</strong>The studies on the application of artificial intelligence in the morphological diagnosis of prostate cancer for the past 35 years were searched for in the Scopus database using “artificial intelligence” and “prostate cancer” keywords. The selected studies were systematized using Scopus bibliometric tools and the VOSviewer software.</p> <p><strong>Results. </strong>The number of publications in this research field has drastically increased since 2016, with most research carried out in the United States, Canada, and the United Kingdom. They can be divided into three thematic clusters and three qualitative stages in the development of this research field in timeline aspect.</p> <p><strong>Conclusions.</strong> Artificial intelligence algorithms are now being actively developed, playing a huge role in the diagnosis of prostate cancer. Further development and improvement of artificial intelligence algorithms have the potential to automate and standardize the diagnosis of prostate cancer.</p> Anastasiia Denysenko Taras Savchenko Anatolii Dovbysh Anatolii Romaniuk Roman Moskalenko Copyright (c) 2022 Anastasiia Denysenko, Taras Savchenko, Anatolii Dovbysh, Anatolii Romaniuk, Roman Moskalenko 2022-06-01 2022-06-01 29 4 E202225 E202225 10.21802/gmj.2022.2.5 Imaging Evaluation of Mesenteric Ischemia: Is There a Golden Period for This Entity? <p><strong>Background.</strong>The study was aimed at assessing the role of ultrasonography and multidetector computed tomography angiography in evaluating patients with suspected mesenteric ischemia, as well as assessing the effect of the time from presentation to management on mortality and morbidity.</p> <p><strong>Materials and Methods.</strong> Patients with clinically suspected mesenteric ischemia underwent Doppler ultrasound and contrast-enhanced computed tomography. On ultrasonography, we assessed any filling defect in the superior mesenteric artery/vein, narrowing or occlusion of the proximal superior mesenteric artery, ascites, bowel wall thickening, and pneumatosis/portal venous gas. Computed tomography angiography was performed looking for any filling defect in the superior mesenteric artery/vein, superior mesenteric artery/vein calibre, bowel wall thickening, calibre and enhancement and pneumatosis/portal vein gas. Most of our patients underwent emergency surgery and the findings correlated with imaging. All the patients were divided into Group A (n=30) and Group B (n=17) based on the time from presentation to management: within 48 hours of presentation and 48 hours after presentation, respectively.</p> <p><strong>Results</strong>. On computed tomography scan, mesenteric vascular involvement was seen in 27 (55%) patients, mesenteric/intestinal twist was observed in 12 (25%) patients, and non-occlusive mesenteric ischemia was found in 6% of patients. The computed tomography findings were found to have a sensitivity of 86%, a specificity of 94% and an accuracy of 90% in cases of mesenteric ischemia. Among 35 patients operated on, those presenting within 48 hours, had a significantly less mortality (63%) in comparison to those presenting after 48 hours (90%).</p> <p><strong>Conclusions. </strong>Clinical, laboratory and ultrasound features are non-specific in diagnosing mesenteric ischemia. Computed tomography angiography is a sine qua non in mesenteric ischemia diagnosis. Patients with venous ischemia respond well to conservative management. Early intervention within the first 48 hours is associated with better prognosis.</p> Ishfaq Zargar Irfan Robanni Omair Shah Tariq Gojwari Riaz Rasool Naseer Choh Faiz Shera Munir Wani Copyright (c) 2022 Ishfaq Zargar, Irfan Robanni, Omair Shah, Tariq Gojwari, Riaz Rasool, Naseer Choh, Faiz Shera, Munir Wani 2022-03-01 2022-03-01 29 4 E202212 E202212 10.21802/gmj.2022.1.2 Emphysematous Pyelonephritis and Emphysematous Osteomyelitis: A case report <p><strong>Background.</strong> Emphysematous osteomyelitis and emphysematous pyelonephritis are both rare entities responsible for a high death rate. The first is defined by the presence of intravertebral or intraosseous gas, while the second is infectious damage to the renal parenchyma and perilesional tissues caused by gas-producing microorganisms and is, therefore, characterized by the formation of gas. Imaging plays a crucial role in making a rapid diagnosis and, thus, the initiation of the necessary treatment.</p> <p><strong>Case Report.</strong> A 66-year-old woman with a medical history of type 2 diabetes mellitus and hypertension presented with the altered general condition and flank pain for 5 days, associated with fever and chills. The patient’s vital signs were remarkable with a disturbed biological workup, which led to emergency abdominal and pelvic computed tomography scanning that revealed emphysematous osteomyelitis of the spine and emphysematous pyelonephritis.</p> <p><strong>Conclusions.</strong> The coexistence of emphysematous pyelonephritis and emphysematous osteomyelitis is a rare life-threatening entity, occurring in patients with comorbidities such as diabetes mellitus. Computed tomography is currently the gold standard in making the positive diagnosis, staging, for a quick and better management and, thus, a favorable prognosis.</p> Sanae Sninate Tlaite Oubaddi Soukaina Allioui Leila Jroundi Fatima Zahrae Laamrani Copyright (c) 2022 Sanae Sninate, Tlaite Oubaddi, Soukaina Allioui, Leila Jroundi, Fatima Zahrae Laamrani 2022-03-01 2022-03-01 29 4 E202217 E202217 10.21802/gmj.2022.1.7 Nursing Care Satisfaction among Patients Infected with Covid-19: A Turkish Perspective <p><strong>The aim</strong> of this study was to determine the satisfaction with nursing care among patients diagnosed with Covid-19 and related factors.</p> <p><strong>Materials and Methods.</strong> The study was conducted between June and July 2020. The population of the study consisted of 102 patients treated in the Covid-19 clinics of the University Teaching and Research Hospital. The data were collected using the Newcastle Satisfaction with Nursing Care Scale with a total of 19 items, and the Patient Description Form designed to record the sociodemographic characteristics and medical histories. The data were evaluated using the program package IBM SPSS 20.0. To test the significance of the difference between two independent groups, the Student’s t-test was used, and the one-way ANOVA was used to test the significance of the difference between more than two groups.</p> <p><strong>Results. </strong>The results showed that most patients were satisfied with nursing care. A higher level of satisfaction was seen in patients treated in the Covid-19 intensive care units, those with chronic conditions, and those who received information about their health state from nurses. Patients’ family type, sharing fears and worries with nurses, getting information from nurses and the quality of nursing care were the variables significantly associated with patient satisfaction with nursing care.</p> <p><strong>Conclusions.</strong> Satisfaction with nursing care among Covid-19 patients was moderate. When nurses use effective communication skills to meet patients’ care needs, provide patients with adequate information, allow them to express their feelings, and keep them safe, this will further enhance patient satisfaction.</p> Handenur Gündoğdu Fatma Tanrıkulu Funda Erol Ferhat Koç Dilek Yılmaz Yurdanur Dikmen Copyright (c) 2022 Handenur Gündoğdu, Fatma Tanrıkulu, Funda Erol, Ferhat Koç, Dilek Yılmaz, Yurdanur Dikmen 2022-03-01 2022-03-01 29 4 E202213 E202213 10.21802/gmj.2022.1.3 Diagnostic Accuracy of MR Mammography in Comparison with Digital Mammography and Sonomammography <p><strong>Background. </strong>Even though the sensitivity of contrast-enhanced breast magnetic resonance mammography (CE-MRM) is consistently high in the range of 94-100%, conventionally, digital mammography and sonomammography continue as standard imaging modalities for the detection and evaluation of breast disease.</p> <p><strong>The objective</strong> of the study was to detect additional lesions that go undetected by routine digital mammography and sonomammography using CE-MRM.</p> <p><strong> Materials and Methods.</strong> In a prospective study, 68 patients who came for screening diagnostic mammogram and had breast lesions of Breast Imaging-Reporting and Data System category 3-6 were evaluated. All patients underwent bilateral digital mammography and targeted high-frequency sonomammography of the primary lesion. Those patients who were thought to possibly have breast cancer and to be candidates for surgical management were offered bilateral CE-MRM.</p> <p><strong>Results</strong>. In this prospective study, we included 68 patients (mean age - 50.6 years, range - 30-73 years). A total of 74 lesions were evaluated. In detecting these lesions, digital mammography had a sensitivity of 40.0%, specificity of 100% and diagnostic accuracy of 63.5%. CE-MRM sensitivity was found to be 71.7%, specificity - 96.6% and diagnostic accuracy - 83.7%. Among the 27 additional lesions detected by CE-MRM, histopathological evaluation confirmed only 19, indicating the sensitivity of 100%, specificity of 85.4%, positive predictive value of 67.8%, negative predictive value of 100%, diagnostic accuracy of 89.2%.</p> <p><strong> Conclusions.</strong> The diagnostic accuracy of CE-MRM was found to be 83.7%, with a specificity of 96.6%. CE-MRM detected 19 additional lesions that were undetected by either digital mammography or ultrasonography. CE-MRM is sensitive in detecting additional malignant lesions which are not detected by other imaging modalities.</p> Sreenidhi Sedguli Raghu Srinivasa Gowda Rupa Ranganathan Senthil Kumar B Copyright (c) 2022 Sreenidhi Sedguli, Raghu Srinivasa Gowda, Rupa Ranganathan, Senthil Kumar B 2022-03-01 2022-03-01 29 4 E202214 E202214 10.21802/gmj.2022.1.4 Cytokine Response of CD4+ T-Lymphocytes with Red Rose (Rosa Rosaceae – Pierre de Ronsard) Extracts by in Vitro Evaluation <p><strong>Background.</strong> Red rose extract is known to have anti-inflammatory and immune-modulation effects. In this study, the red rose extract was tested on CD4+T lymphocytes <em>in vitro</em>, and cytokine response was evaluated.</p> <p><strong>Materials and Methods. </strong>The red rose (<em>Rosa Rosaceae</em> - Pierre de Ronsard) extract used in this study was prepared and stored at -20° C until use. CD4+T-cells were seeded in 96-well plates at 313,500 cells/well in 100μ l cell culture medium in duplicate. One-half of the wells were used for biomarker screening in the culture medium, and the other half was used for cytotoxicity assay. Twenty-four hours after plating, the cells were treated in duplicate with 100μ l of the red rose extract diluted at 0.5%, 0.1%, 0.05%, 0.01% and 0.005% (v/v) in the cell culture medium or with culture medium only as control for 72 hours. Some other wells were allocated for untreated cells, and cells treated with the rose extract at 0.005% for 48-h incubation time.</p> <p><strong>Results</strong>. Several cytokines (GRO; IFN-γ; IL-1α, 6, 10; MCP-1; RANTES; TGF-β1; TIMP 1, 2; Ang1, Ang2; G-CSF; MMP-9; and VEGF R2) were elevated. Except for MMP-9, which had fold changes &gt; 2, other cytokines were minimally elevated at various concentrations and timing of rose extract treatment. None of the mentioned cytokines were less than 0.8-fold after treatment with the rose extract. Cytotoxicity assay revealed insignificant changes in the viability of T-cells.</p> <p><strong>Conclusions</strong>. There was a mild elevation in few inflammatory markers by CD4+ T-lymphocytes after <em>in vitro </em>treatment with the red rose extract (<em>Rosa Rosacea</em> - Pierre De Ronsard). Further <em>in vitro </em>and <em>in vivo </em>studies are required to evaluate the benefits of the red rose extract in immune regulation.</p> Mark Christopher Arokiaraj Eric Menesson Copyright (c) 2022 Mark Christopher Arokiaraj, Eric Menesson 2022-03-01 2022-03-01 29 4 E202215 E202215 10.21802/gmj.2022.1.5 Learning or Memorization: Self-Directed Medical School Curriculum and the Dangers of Overemphasizing Student Selected Ancillary Resources <p>This article is a response to an opinion article, authored by Wu JH et al. and published in JAMA 2021, vol 326 (20) which suggested the that pre-clinical (first two) years of medical school curriculum should revolve around “high-yield” resources as the dominant teaching tool. The article posited that this highly controversial view was the best way to engage with students and was published in a well-read and utilized medical journal. Due to the growing divide between learning resources provided by medical schools and outside resources actually utilized by students, the conclusions drawn in the mentioned opinion article were understandable but interpreted in the wrong vein. Herein, the authors review landmark changes in medical education over the last century and the underpinning rationale to preface their examination of the suggested changes from the mentioned opinion article. The authors conclude with recommendations from a student perspective and a continuation of the last 100 years of advancements.</p> Thomas C. Varkey Zachary I. Merhavy Rhonda M. J. Varkey Jack B. Ding John A. Varkey Copyright (c) 2022 Thomas C. Varkey, Zachary I. Merhavy, Rhonda M. J. Varkey, Jack B. Ding, John A. Varkey 2022-03-01 2022-03-01 29 4 E202211 E202211 10.21802/gmj.2022.1.1 Pyramidal Lobe Variations of the Thyroid Gland and Its Clinical Implications: A Short Review and Case Report <p>The thyroid gland is characterized by significant anatomical variability, which may lead to difficulties in diagnostic and treatment outcomes. The pyramidal lobe is the most common variation present in up to 30% of the population. Literature has witnessed research on different variations of the pyramidal lobe, preference for the lobe from which it arises, gender preference, etc. Understanding such variations is essential for successful treatment outcomes for thyroid diseases. This short review was aimed to highlight embryological aspects of the thyroid gland, variation of its pyramidal lobe and present a rare case of demarcated left lobe, pyramidal lobe, and an associated cyst.</p> Nagavalli Basavanna Pushpa Rohan Karkra Kunjappagounder Pushpalatha Deepa Bhat Copyright (c) 2022 Nagavalli Basavanna Pushpa, Rohan Karkra, Kunjappagounder Pushpalatha, Deepa Bhat 2022-03-01 2022-03-01 29 4 E202216 E202216 10.21802/gmj.2022.1.6