Galician Medical Journal <p>“Galician Medical Journal” is an open access, double-blinded peer-reviewed scholarly journal, publishes articles in medicine.</p> <p>The aim of journal is to provide scientific communication, share experience and presentation of scientific results and clinical observations between members of the global medical community.</p> <p>Journal publishes original research articles, clinical case reports, letters to the editor, literature review in pathology, internal medicine and related fields, dentistry, new trends in medical education.</p> <p><strong><span lang="EN-GB">ISSN&nbsp;</span></strong><strong><span lang="EN-US">2414-1518 (English ed. Online) </span></strong><strong><span lang="EN-US">ISSN 2306-4285 (Ukrainian ed. Print)</span></strong></p> <div class="page" title="Page 3">&nbsp;</div> 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> The Effect of Educational Intervention on Care Dependency and Symptom Management After Hematopoietic Stem Cell Transplantation: A Theory-Based Randomized Controlled Study <p><strong>The objective </strong>of the research was to determine the effect of educational intervention based on Bandura’s Social Cognitive Learning Theory on care dependency and symptom management after hematopoietic stem cell transplantation.</p> <p><strong>Methods.</strong> This randomized controlled trial was conducted between January 2019 and February 2020 at the Hematopoietic Stem Cell Transplantation Center. All the patients were randomly divided into two groups: 53 individuals in the intervention group and 53 individuals in the control group. The sociodemographic data collection form, the Edmonton Symptom Assessment Scale and the Care Dependency Scale were used for data collection. Data were collected from the patients one day after hematopoietic stem cell transplantation and 12 weeks later.</p> <p><strong>Results. </strong>There were no statistically significant differences between the groups regarding the mean scores of the Edmonton Symptom Assessment Scale and the Care Dependency Scale at baseline. Twelve weeks after intervention, there were statistically significant differences between the groups regarding the mean scores of the Edmonton Symptom Assessment Scale and the Care Dependency Scale.</p> <p><strong>Conclusions.</strong> Educational intervention along with telephone counseling based on Bandura’s theory was found to be an effective way to reduce symptom severity and care dependency in patients who underwent hematopoietic stem cell transplantation and is recommended for all patients after hematopoietic stem cell transplantation.</p> Tuğba Menekli Bülent Yaprak Copyright (c) 2021 Tugba Menekli, Bülent Yaprak 2021-12-01 2021-12-01 28 4 E202143 E202143 10.21802/gmj.2021.4.3 Reproducibility of Retinal Nerve Fiber Layer and Macular Thickness Measurements Using Spectral Domain Optical Coherence Tomography <p><strong>The objective </strong>of the research was to assess the reproducibility of retinal nerve fiber layer (RNFL) and macular thickness using spectral domain optical coherence tomography and to establish whether the same investigator can get the same or similar results when performing the scan thrice in an hour, without reference to the previous scan and the repeat function.</p> <p><strong>Materials and Methods.</strong> In this prospective observational study, 200 subjects who fulfilled the inclusion and exclusion criteria were scanned 3 times according to predefined guidelines at 0, 30 and 60 minutes on the same day, by the same investigator, using spectral domain optical coherence tomography for measurements of RNFL and macular thickness; observations were statistically analyzed and correlated.</p> <p><strong> Results. </strong>In RNFL thickness, the temporal sector showed the worst reproducibility as compared to other sectors. RNFL was the greatest in the superior quadrant and the thinnest in the temporal quadrant. For macular thickness, the temporal sector (mid zone) showed the worst reproducibility, while in the outer zone, the inferior sector showed the worst reproducibility; macular thickness was the thinnest at the central zone (innermost 1-mm ring), the thickest within the inner 3-mm ring and diminished peripherally.</p> <p><strong> Conclusions. </strong>RNFL and macular thickness measurements using spectral domain optical coherence tomography by the same observer at 0, 30 and 60 minutes were very reproducible, except for the sectors specifically mentioned. The greater the thickness of the RNFL in any sector the better was the reproducibility in that sector. For macular thickness, the temporal sector (mid zone) showed the worst reproducibility.</p> Amit Sood Rahul Omprakash Paliwal Rishu Yogesh Mishra Copyright (c) 2021 Amit Sood, Rahul Omprakash Paliwal, Rishu Yogesh Mishra 2021-12-01 2021-12-01 28 4 E202147 E202147 10.21802/gmj.2021.4.7 Monoarthritis of the Elbow Revealing Osteoid Osteoma: A Case Report and Literature Review <p>Osteoid osteoma is a rare benign osteoblastic tumor that mainly occurs in the extra-articular segments of lower limb long bones. The elbow is an exceptional location for osteoid osteoma.</p> <p>The diagnosis is usually delayed since the elbow is a rare site for this tumor and unspecific clinical signs, such monoarthritis, may mimic other more common conditions.</p> <p>We report the case of a 16-year-old girl who presented with chronic monoarthritis of the elbow which was treated falsely as tuberculous arthritis and monoarticular rheumatoid involvement.</p> <p>The laboratory tests were negative. Computed tomography scan and magnetic resonance imaging showed the focal nidus at the coronoid process of the ulna with mild synovitis. The diagnosis of osteoid osteoma was not made until the disease had been progressing for eighteen months and the elbow had already become stiff.</p> <p>Arthroscopic excision of the lesion was performed, and histopathology of the nidus was consistent with osteoid osteoma. Since then, the patient has been pain-free with an improved elbow range of motion.</p> Najlae El Ouardi Siham Sadni Laila Taoubane Aziza Mounach Ahmed Bezza Copyright (c) 2021 Najlae El Ouardi, Siham Sadni, Laila Taoubane, Aziza Mounach, Ahmed Bezza 2021-12-01 2021-12-01 28 4 E202145 E202145 10.21802/gmj.2021.4.5 Psychometric Evaluation of the Diabetes Distress Scale in Patients with Type 2 Diabetes in Turkey <p><strong>The objective</strong> of the research was to evaluate the validity and reliability of the Diabetes Distress Scale in patients with type 2 diabetes in Turkey.</p> <p><strong>Materials and Methods.</strong> Our study was conducted between September 2016 and January 2017 and included 170 patients with type 2 diabetes. The Personal Information Form and Diabetes Distress Scale were used as a data collection tool. Statistical analysis was performed using SPSS 23.0 and SAS package program.</p> <p><strong>Results.</strong> According to the results of the research, Cronbach’s alpha reliability for the total scale was 0.91. The model fit indices for the revised confirmatory factor analysis model failed to meet the criteria for acceptability: the GFI was 0.8185, the CFI was 0.9316, the Bentler - Bonett (1980) NFI was 0.9005, and the RMSEA was 0.1067. In our study, exploratory factor analysis provided support for the three-factor model: [I] emotional and regimen-related distress, [II] health professional-related distress, [III] diabetes-related interpersonal distress.</p> <p><strong>Conclusions.</strong> When the translation and cultural adaptation process have been considered, the Diabetes Distress Scale is a valid and reliable tool for the Turkish community. It is recommended to be used in the studies and clinical trials.</p> Nurten Terkes Hicran Bektas Copyright (c) 2021 Nurten Terkes, Hicran Bektas 2021-12-01 2021-12-01 28 4 E202144 E202144 10.21802/gmj.2021.4.4 Comparison of Preclinical Coursework Perception Among Dental Students from India and the Republic of North Macedonia <p><strong>Background. </strong>The difference in the preclinical curriculum and teaching methodology between European and Southeast Asian countries has a great influence on the process of choosing which education model is predominant and, therefore, students’ opinion on the effectiveness of a preclinical coursework is diverse.</p> <p>The <strong>objective</strong> of the research was to assess the perception of the preclinical coursework in prosthodontics, conservative dentistry, and endodontics among Indian and North Macedonian students.</p> <p><strong>Materials and Methods.</strong> This cross-sectional comparative study was carried out among 3<sup>rd</sup>-year students, final-year students and interns of dental schools of two respective countries. The data were collected in July 2021 using Google Form, a link to which was sent via available social media platforms. The data obtained were analyzed using SPSSv.21.0 (IBM) software.</p> <p><strong>Results.</strong> The data on dental students’ perception of the preclinical coursework were obtained, analyzed, compared, and discussed. A total of 50% of Indian students stated preclinical exercises to be good to get knowledge about treating patients, whereas 47% of North Macedonian students felt the average level of knowledge needed for treating patient.</p> <p><strong>Conclusions.</strong> In this study, the majority of the students were in favor of attending the preclinical course and understood its importance for building up their confidence, better understanding of the subject and better patient handling in future dental practice. However, there were different students’ opinions on the course content, its duration, exercises, faculty interaction, helpfulness of theory lectures that evidence essentiality to view dental studies from a student-centered perspective.</p> Manu Batra Vesna Ambarkova Deeksha Gijwani Hansika Popli Natasa Stavreva Sonja Apostolska Niharika Narang Tamanna Mutneja Mira Jankulovska Kiro Ivanovski Copyright (c) 2021 Manu Batra, Vesna Ambarkova, Deeksha Gijwani, Hansika Popli, Natasa Stavreva, Sonja Apostolska, Niharika Narang, Tamanna Mutneja, Mira Jankulovska, Kiro Ivanovski 2021-12-01 2021-12-01 28 4 E202146 E202146 10.21802/gmj.2021.4.6 Non-Alcoholic Fatty Liver Disease and Hypothyroidism: Review of Clinical and Experimental Studies <p>Hypothyroidism is a widespread condition affecting people of different socio-economic background and geographical location. A lot of studies highlight the effect of hypothyroidism on the metabolic processes in various organs, including the liver. On the other hand, liver damage often results in the development of non-alcoholic fatty liver disease; however, the data on the impact of hypothyroidism on liver morphology, which can serve as a direct indicator and marker of liver condition and function, are limited and controversial. In this report, we reviewed the relationship between non-alcoholic fatty liver disease and hypothyroidism with an accent on morphological alteration of the liver discovered in clinical and experimental studies.</p> Tetiana Ranhulova Copyright (c) 2021 Tetiana Ranhulova 2021-12-01 2021-12-01 28 4 E202142 E202142 10.21802/gmj.2021.4.2 Analysis of Covid-19 Hospital Admissions in Ivano-Frankivsk, Ukraine <p>The Covid-19 pandemic has a substantial impact on socioeconomic, political, demographic, and other aspects of life. Effective healthcare is, however, a primary determinant of successful fighting against Covid-19. The analysis of local healthcare indicators serves as a source for estimating pandemic magnitude and the adaptation of healthcare at a national level. In this study, the rates of Covid-19 hospital admissions to the Ivano-Frankivsk City Hospital, Ukraine, from April 2020 to May 2021 were analysed. All cases were grouped by age, sex, and the type of admission; data were analyzed monthly and seasonally. The peaks of hospital admissions were observed in November 2020 and March 2021; however, the highest mortality rates were seen from August to November 2020. The analysis of age- and sex-disaggregated Covid-19 mortality data showed the predominance of elderly males (61.9%, 66.6 ± 3.9 years) over females (38.1%, 71.8 ± 2.3 years). The ratio of hospital admissions was unstable: the percentage of emergency, GP-referred and self-referred admissions was similar from April to May 2020; however, GP-referred admissions prevailed, and the number of self-referral patients decreased twice between March and May 2021. In conclusions, the trends in hospital admissions were similar to those reported in other studies. However, the differences in time frames and socio-demographic characteristics were observed that highlights the importance of considering regional, social and geographic aspects of the population when improving the capacity of healthcare system and establishing effective preventive measures against the pandemic at the local level.</p> Oryna Detsyk Natalia Fedorkiv Olha Burak Roksolana Kaluzhna Copyright (c) 2021 Oryna Detsyk, Natalia Fedorkiv, Olha Burak, Roksolana Kaluzhna 2021-12-01 2021-12-01 28 4 E202141 E202141 10.21802/gmj.2021.4.1 Oral and Dental Manifestations of Fanconi Anemia <p>Fanconi anemia is a rare disease, which is characterized by decreased production of all blood cell types. Fanconi anemia is the most common inherited form of aplastic anemia. Congenital abnormalities of the eyes, ears, and heart, malformed or absent kidney, urogenital system involvement are common. There is a delay in physical development. Intelligence in patients with Fanconi anemia is usually normal. The most serious problems associated with Fanconi anemia include the gradual development of bone marrow disorders. Many patients with Fanconi anemia develop leukemia or myelodysplastic syndrome, as well as other oncological diseases. Oral manifestations in patients with Fanconi anemia can be classified as gingivitis, periodontitis, dental caries, dental anomalies, soft tissue lesions, oral cancer, and lesions of the tongue. Patients with Fanconi anemia have increased predisposition to squamous cell carcinoma of the head and neck and oral cancer. The interdisciplinary team of medical and dental specialists must be included in the medical and dental treatment of patients with Fanconi anemia. For proper dental care of patients with Fanconi anemia, the close cooperation of dental specialists, including orthodontists, pedodontists, prosthetists, oral surgeons, as well as specialists in periodontology and oral diseases, is of particular importance.</p> Vesna Ambarkova Copyright (c) 2021 Vesna Ambarkova 2021-09-01 2021-09-01 28 4 E202132 E202132 10.21802/gmj.2021.3.2 Assessment of Nursing Students’ Attitudes Towards Recording and Protecting Patients’ Personal Health Data: A Descriptive Study <p><strong>Introduction.</strong> Since health information is considered as sensitive personal data and requires more careful protection, healthcare professionals need to be careful about this issue.</p> <p><strong>The objective</strong> of this research was to determine nursing students’ attitudes towards recording and protecting patients’ personal health data.</p> <p><strong> Materials and </strong><strong>Methods. </strong>The population of this descriptive research consisted of 450 students who studied at the Department of Nursing, Faculty of Health Sciences, Erzincan Binali Yildirim University. Sample selection was not used, and the research was completed with 374 students who were continuing education and who were accepted to participate in the research. Descriptive Information template and Attitude Scale for Recording and Protecting Personal Health Data for nursing students were used as data-collection instruments. The numbers, percentage, mean, standard deviation, non-parametric tests (the Mann-Whitney U test and the Kruskal-Wallis test) were used in data analysis.</p> <p><strong>Results</strong>. Among our research participants, 68.4% of the students were females; 28.1% of the students were freshmen; 69% of the students were graduates of Anatolian high schools. Approximately 72.5% and 52.9% of the participants stated that they were aware of the concept of “personal data” and “personal health data” , respectively. The mean score of nursing students on the Attitude Scale for Recording and Protecting Personal Health Data was 3.97±0.71. The means scores obtained from subscales were as follows: 3.91±0.72 for Personal Health Data Information, 4.15±0.80 for Legal Information, 4.05±0.94 for Legal Data Sharing, 3.90±0.80 for Personal Health Data Sharing, and 3.77±0.33 for Recording of Personal Health Data, respectively. A statistically significant difference was found between the total scale and subscale scores of the students regarding their academic level.</p> <p><strong> Conclusions</strong>. Students were found to have a positive attitude towards recording and protecting personal data. Increasing the responsibilities and raising awareness of the students for the protection of personal health data during their study is suggested to be important.</p> Sebahat Atalıkoğlu Başkan Papatya Karakurt Necla Kasımoğlu Copyright (c) 2021 Sebahat Atalıkoğlu Başkan, Papatya Karakurt, Necla Kasımoğlu 2021-09-01 2021-09-01 28 4 E202133 E202133 10.21802/gmj.2021.3.3 The Discovery of Coronavirus – An Interesting Journey <p>The coronavirus, which is causing the ongoing Covid-19 pandemic and has crippled the entire world, was discovered by June Dalziel Almeida - a school dropout from Scotland who had no formal medical education. She had to master the knowhow of immune electron microscopy to climb up the academic ladder and she finally discovered the coronavirus only to see her research paper getting rejected by reputed journals. A single mother is now associated with the coronavirus, as well as with a significant contribution to the classification of viruses, viral imaging and bringing Rubella virus, Hepatitis B virus and Human immunodeficiency virus into the limelight.</p> Kaushik Bhattacharya Neela Bhattacharya Aditya Shikar Bhattacharya Copyright (c) 2021 Kaushik Bhattacharya, Neela Bhattacharya, Aditya Shikar Bhattacharya 2021-09-01 2021-09-01 28 4 E202131 E202131 10.21802/gmj.2021.3.1 Dual-Energy Multidetector Computed Tomography: A Highly Accurate Non-Invasive Tool for in Vivo Determination of Chemical Composition of Renal Calculi <p><strong>Introduction.</strong> Computed tomography is more accurate than excretory urography in evaluation of renal stones due to its high sensitivity and temporal resolution; it permits sub-millimetric evaluation of the size and site of calculi but cannot evaluate their chemical composition. Dual-energy computed tomography allows evaluating the chemical composition of urinary calculi using simultaneous image acquisition at two different energy levels.</p> <p><strong>The objective</strong> of the research was to determine renal stone composition using dual-energy multidetector computed tomography, and its correlation with post-extraction chemical analysis of stones.</p> <p><strong>Materials and Methods.</strong> This prospective study was conducted in the Department of Radiodiagnosis and Imaging from September 2017 to March 2019. A total of 50 patients with urolithiasis at the age of 18-70 years were included in the study. Dual-energy computed tomography ratios of various stones were noted, and preoperative composition of calculi was given based on their colour and dual-energy computed tomography ratio. These results were compared with the post-extraction chemical analysis of stones (using Fourier infrared transform spectroscopy as the standard comparative method.)</p> <p><strong>Results</strong>. The most common type of calculi in our study population was calcium oxalate stones (78%) followed by uric acid stones (12%), cystine stones (6%) and hydroxyapatite stones (4%). The dual-energy ratio of calcium oxalate, uric acid, cystine and hydroxyapatite stones ranged from 1.38-1.59, 0.94-1.08, and 1.20-1.28 and 1.52-1.57, respectively, with the mean dual-energy ratio of 1.43, 1.01, 1.25 and 1.55, respectively. Dual-energy computed tomography was found to be 100% sensitive and specific for differentiating uric acid stones from non‑uric acid stones. The sensitivity and specificity in differentiating calcium oxalate calculus from non‑calcium oxalate calculus was 97.5% and 90.9%, respectively, with 96% accuracy and kappa value of 0.883 suggesting strong agreement.</p> <p><strong>Conclusions</strong>. Dual-energy computed tomography is highly sensitive and accurate in distinguishing between various types of renal calculi. It has vital role in management as uric acid calculi are amenable to drug treatment, while most of non-uric acid calculi require surgical intervention.</p> Shafqat Shabir Bhawani Majid Jehangir Mohammad Masood Sajjad Ahmad Dar Sajad Nazir Syed Copyright (c) 2021 Shafqat Shabir Bhawani, Majid Jehangir, Mohammad Masood, Sajjad Ahmad Dar, Sajad Nazir Syed 2021-09-01 2021-09-01 28 4 E202134 E202134 10.21802/gmj.2021.3.4 Level of Knowledge and Awareness of Diabetic Emergencies Among Turkish Bus Drivers: Example of the Mediterranean Region <p><strong>The objective</strong> of this research was to determine the level of knowledge and awareness of diabetic emergencies among Turkish bus drivers.</p> <p><strong>Methods. </strong>The universe of this descriptive and cross-sectional study was all the individuals working as bus drivers in the Mediterranean Region between January-June 2019, and the study sample was 1292 drivers who met the inclusion criteria of the research. Data were collected by the Personal Information Form and the Diabetic Emergency Information and Awareness Survey Form. Descriptive statistics, the Mann-Whitney U test and the Kruskal-Wallis test were used in data evaluation.</p> <p><strong>Results.</strong> The average age of bus drivers participating in the study was 38.29 ± 9.44 years, while their average work experience was 12.50 ± 8.92 years. Among them, 14.9% of bus drivers had a diabetic family member; 23.7% of bus drivers had a first aid certificate; 11.5% of bus drivers received diabetes-related training. The average score of drivers for the level of knowledge and awareness regarding diabetic emergencies was found to be 15.39 ± 4.72. There was a statistically significant difference between the drivers’ average scores for the level of knowledge and awareness and their age, education status, work experience, the presence of chronic disease, the presence of a diabetic family member, the presence of a first aid certificate, diabetes-related training, the place of receiving this training variables (p &lt; 0.05).</p> <p><strong>Conclusions.</strong> Bus drivers were found to have above average levels of knowledge and awareness of diabetic emergencies. Bus drivers are recommended to be trained on diabetic emergencies and raising awareness of diabetes mellitus to ensure a proper intervention in case of emergencies in individuals with diabetes mellitus during travels.</p> Sibel Şentürk Nurten Terkeş Copyright (c) 2021 Sibel Şentürk, Nurten Terkeş 2021-09-01 2021-09-01 28 4 E202135 E202135 10.21802/gmj.2021.3.5 Online Learning Modules in Anatomical Sciences: Effective Sources for Continued Learning for Medical Undergraduates During the Unprecedent COVID-19 Pandemic <p><strong>Introduction. </strong>During the COVID-19 pandemic-induced lockdown, the selection of simple and authentic online material among plethora of web content is difficult for both students and teachers. This forces students and teachers to explore various avenues of learning.</p> <p><strong>The objective </strong>of this research was to evaluate free open-access anatomy e-learning resources in accordance with required standard learning outcomes for medical students.</p> <p><strong>Methods.</strong> During February 2021, an extensive search for online modules for learning anatomy across six Massive Open Online Courses, including edX, Coursera, Udemy, Khan Academy, Canvas and FutureLearn, along with Google and YouTube was conducted. Courses or modules on e-learning platforms, YouTube channels, standalone videos, anatomy atlases, 3D models were considered as learning resources and evaluated. Online materials were classified as structured learning resources if they had a defined syllabus, time duration and instructional design. Resources lacking these characteristics were considered as unstructured ones.</p> <p><strong>Results</strong>. Twenty structured learning courses were identified on the Udemy (6 courses), Coursera (3 courses), edX (2 courses), FutureLearn and Khan academy platforms. Learning resources available through Swayam Prabha were aligned with the defined syllabus and video lectures. The content hosted within Clinical Anatomy, Medvizz and Kenhub was eye-catching. Thirty-two YouTube channels offering standalone learning material were identified. Seven resource materials, other than YouTube channels, offered anatomy learning material in the form of charts and tables. Four websites noted to have 3D interactive learning content regarding gross anatomy.</p> <p><strong>Conclusions</strong>. During the pandemic-induced lockdown, the list presented in the study may act as guide in selection of the simplest and best materials for those teaching and learning anatomy in medical undergraduate courses. However, in most cases, there is no alignment with standard learning outcomes as defined by medical education regulatory authorities.</p> Srinivasan Viveka Nagavalli Basavanna Pushpa Kumar Satish Ravi Copyright (c) 2021 Srinivasan Viveka, Nagavalli Basavanna Pushpa, Kumar Satish Ravi 2021-09-01 2021-09-01 28 4 E202136 E202136 10.21802/gmj.2021.3.6 Features of Changes in the Structural and Functional State of the Myocardium in Patients with Acute Myocardial Infarction Depending on Body Mass Index Considering FABP4 and CTRP3 Levels <p><strong>Introduction.</strong> Adipokines such as fatty acid-binding protein 4 (FABP4) and C1q tumor necrosis factor-related protein 3 (CTRP3) can affect the structural and functional state of the myocardium in patients with acute myocardial infarction and obesity.</p> <p><strong>The objective </strong>of the research was to determine the relationship between FABP4, CTRP3 and echocardiographic parameters of the left ventricular myocardium in patients with acute myocardial infarction depending on body mass index.</p> <p><strong>Materials and Methods.</strong> The observational cross-sectional study examined 189 patients with acute myocardial infarction depending on body mass index, who were divided into the following groups: Group 1 included 60 patients with acute myocardial infarction and normal body mass index; Group 2 comprised 68 patients with acute myocardial infarction and excess body weight; Group 3 included 61 patients with acute myocardial infarction and obesity.</p> <p><strong>Results</strong>. In Group 1, the statistical significance correlations were found: between FABP4 and end-diastolic dimension (EDD; r = -0.458), end-systolic dimension (ESD; r = -0.460), end-diastolic volume (EDV; r = -0.452), left ventricular myocardial mass (LVMM; r = -0.411), LVMM/body surface area index (LVMMI2; r = -0.419); between CTRP3 and EDV (r = 0.425), EDD (r = 0.469), left ventricular relative posterior wall thickness (LVRPWT; r = -0.469). In Group 2, there were found the statistical significance relationships between: FABP4 and EDD (r = 0.461), ESD (r = 0.467), EDV (r = 0.449), end-systolic volume (ESV; r = 0.485), LVMM (r = 0.487), LVMMI1 (r = 0.406); between CTRP3 and EDD (r = -0.440), EDV (r = -0.413), LVMM (r = -0.430), LVMM/height<sup>2.7</sup> index (LVMMI1; r = -0.483). In Group 3, the statistical significance correlations were found between: FABP4 and EDV (r = 0.481), ESD (r = 0.411), ESV (r = 0.490), LVMMI1 (r = 0.403); between CTRP3 and EDV (r = -0.326), ESD (r = -0.367), ESV (r = -0.453), LVMMI1 (r = -0.415).</p> <p><strong>Conclusions.</strong> In patients with acute myocardial infarction and overweight/obesity, echocardiographic parameters had a significant low positive correlation with FABP4 and a low negative correlation with CTRP3. On the contrary, in patients with acute myocardial infarction and normal body mass index, echocardiographic parameters had a significant low negative correlation with FABP4 and a low positive correlation with CTRP3.</p> Mariia Koteliukh Copyright (c) 2021 Mariia Koteliukh 2021-09-01 2021-09-01 28 4 E202137 E202137 10.21802/gmj.2021.3.7 What Could Aid in Slowing Down Cognitive Function? <p><strong>The objective</strong> of this research was to assess the relationship between cognitive function, physical activity level, nutritional and depression status in the elderly.</p> <p><strong>Materials and Methods.</strong> A total of 200 individuals (≥ 65 years) were included in the study. General characteristics of the individuals, biochemical findings, nutritional habits, 24-hour physical activity level and food consumption records were assessed. Cognitive function and depression status were screened by the Standardized Mini-Mental State Examination (S-MMSE) and Geriatric Depression Scale-Short Form (GDS-SF), respectively.</p> <p><strong>Results</strong>. Thirty-eight (19%) of the 200 individuals were diagnosed with dementia. On the evaluation of all the individuals, moderate and statistically significant negative correlation (r=-0.558, p &lt; 0.01) was found between the S-MMSE and GDS-SF values. In addition, a moderate and statistically significant positive correlation was found between the S-MMSE and physical activity level values (r=0.553, p &lt; 0.01). Vitamin B<sub>1</sub>, vitamin B<sub>2</sub>, vitamin B<sub>3</sub>, vitamin B<sub>6</sub>, and zinc intakes were lower in women than in men (p &lt; 0.05). Moreover, it was observed that the vitamin B<sub>3</sub> and calcium intakes were below the recommended daily intake in both the genders.</p> <p><strong>Conclusions</strong>. Proper nutritional treatment and increasing the levels of physical activity may aid in slowing down the progression of dementia.</p> Azad Ilhan Murat Varli Pelin Bilgic Copyright (c) 2021 Azad Ilhan, Murat Varli, Pelin Bilgic 2021-06-01 2021-06-01 28 4 E202124 E202124 10.21802/gmj.2021.2.4 Mucinous Cystadenoma of the Ovary Associated with Hyperplasia of Stromal Leydig Cells in Pregnant Woman <p><strong>Background</strong>: The hormonally induced non-neoplastic lesions of ovarian stroma during pregnancy must be recognized by pathologist in order to avoid mistaking them for true tumors.</p> <p><strong>Case report</strong>: A 28-year-old woman was delivered of a healthy infant by cesarean section. As an incidental finding, a multicystic tumor in the left ovary was found and resected. Histopathology was consistent with benign mucinous cystadenoma. In addition, within the stroma beneath the lining mucinous epithelium, a dense population of cohesive polygonal cells with abundant eosinophilic cytoplasm, typically resembling the Leydig cells, was seen. They were uniform without atypia, accompaning by minimal proliferative activity. They strongly expressed vimentin, inhibin, CD99 and calretinin. The final diagnosis of mucinous cystadenoma associated with hyperplasia of stromal Leydig cells was made.</p> <p><strong>Conclusions</strong>: Leydig cell hyperplasia belongs to the specific changes of ovarian stroma associated with pregnancy. The present case stresses that in such situation the pathologists should be aware of it and not confuse it with a tumor.</p> Vladimír Bartoš Copyright (c) 2021 Vladimír Bartoš 2021-06-01 2021-06-01 28 4 E202125 E202125 10.21802/gmj.2021.2.5 Examination of Affiliate Stigma, Hopelessness and Life Satisfaction in Parents of Children with Intellectual Disabilty <p><strong>Introduction</strong>. While expecting a healthy child, having a child with a disability can be quite traumatic for all family members, especially parents.</p> <p><strong>The objective</strong> of the research was to evaluate affiliate stigma, hopelessness, and life satisfaction in parents of children with intellectual disability.</p> <p><strong>Materials and Methods</strong><strong>. </strong>The descriptive research included 203 parents of children with intellectual disabilities, who met the research inclusion criteria and agreed to participate in the study. The data were collected using the Personal Information Form, the Affiliate Stigma Scale, the Beck Hopelessness Scale, and the Satisfaction with Life Scale.</p> <p><strong>Results.</strong> The mean age of parents included in the study was 40.74 ± 7.22 years, with 67.5% of caregiving mothers. The levels of affiliate stigma and hopelessness among parents were low, and they were satisfied with their lives. In case of increasing parental affiliate stigma, their hopelessness was found to increase, while life satisfaction was found to decrease.</p> <p><strong>Conclusions. </strong>In order to increase public acceptance of people with disabilities by society, it is recommended to provide trainings and raise awareness against individuals with disabilities and their families.</p> Necla Kasımoglu Duygu Arıkan Copyright (c) 2021 Necla Kasımoglu, Duygu Arıkan 2021-06-01 2021-06-01 28 4 E202123 E202123 10.21802/gmj.2021.2.3 Ogilvie Syndrome Following Caesarean Section: A Case Report <p><strong>Background. </strong>Ogilvie syndrome is a rare postpartum complication. It is characterized by an acute colonic pseudo-obstruction which occurs in the absence of a mechanical cause. Early detection of the diagnosis is essential to avoid cecal perforation.</p> <p><strong> Case report. </strong>We report a case of Ogilvie syndrome following caesarean section in a 39-year-old woman (gravida 2, para 2) with a history of secondary infertility 10 years ago due to tubal stenosis and subserous fibroma, which led to the indication for cesarean section in second pregnancy at 39 weeks of gestation. Three days after cesarean section, the patient presented with significant abdominal distension and tenderness, vomiting, weakness, and nausea; an abdominal X-ray showed cecal distension. Abdominal computed tomography scan with intravenous contrast revealed distension of the ascending and transverse colon with air-fluid levels but without transitional mechanical obstruction. The patient was successfully treated.</p> <p><strong>Conclusions</strong>. Ogilvie syndrome is a rare but serious complication that should be considered in fit young patients who present with pain, severe abdominal distension and failure to pass flatus after caesarean section.</p> Sanae Sninate Habib Bellamlih Soukaina Allioui Leila Jroundi Fatima Zahrae Laamrani Copyright (c) 2021 Sanae Sninate, Habib Bellamlih, Soukaina Allioui, Leila Jroundi, Fatima Zahrae Laamrani 2021-06-01 2021-06-01 28 4 E202126 E202126 10.21802/gmj.2021.2.6 Evaluation of Quality of Life and Self-Care Among Individuals with Heart Failure <p><strong>The objective </strong>of the research was to evaluate quality of life and self-care agency among individuals with heart failure.</p> <p><strong>Materials and Methods.</strong> The study sample consisted of 61 patients who were diagnosed with heart failure that occurred at least six months before we started our research, had no communication problems, were over 18 years old and were selected by random sampling method. The data were collected by the researcher using a face-to-face interview technique, a descriptive information form, the Short Form-36 Quality of Life Scale, and the Self-Care Agency Scale. In the analysis of the data, numbers, percentiles, means, the Kruskal-Wallis test, the Mann-Whitney U test, and the Pearson correlation coefficient were used.</p> <p><strong>Results</strong>. The patients’ average self-care agency score was 71.75 ± 33.66. The patients received the highest score on the subscale of bodily pain (46.76 ± 31.02) and the lowest score on the subscale of role limitations due to physical health problems (19.26 ± 32.40). The patients’ age and disease duration were found to affect their self-care. Some quality-of-life subscales were affected by the educational, occupational and socioeconomic status, age, disease duration.</p> <p><strong>Conclusions</strong>. Patients’ quality of life was found to be low, and the level of self-care agency was found to be moderate. Patients’ quality of life can be improved by increasing the frequency of self-care trainings given to patients.</p> Demet Güneş Sebahat Atalıkoğlu Başkan Necla Kasımoğlu Copyright (c) 2021 Demet Güneş, Sebahat Atalıkoğlu Başkan, Necla Kasımoğlu 2021-06-01 2021-06-01 28 4 E202121 E202121 10.21802/gmj.2021.2.1 Evaluation of the Implementation of Personal Protective Behaviors and the Interventions Made in Fighting Against COVID-19 Through the View of a University Staff <p><strong>The objective </strong>of this study was to evaluate the application status of Personal Protective Behaviors (PPB) in the fight against COVID-19 among the employees of an institution and the interventions that may be effective for maintaining PPB.</p> <p><strong>Materials and Methods.</strong> In this descriptive study, the interviews were made with each participant to answer the structured questions. In the interviews, we questioned whether PPB were applied correctly and which interventions could be effective in maintaining PPB.</p> <p><strong>Results.</strong> PPB were correctly applied by more than half of 101 people who participated in the study. When considering the distribution of responses to which interventions to maintain PPB were effective, the first three places were arranged as follows: education, coercion-punishment and treatment/death of a relative due to COVID-19. The face mask use and compliance with social distancing were found to be the most important and applied PPB.</p> <p><strong>Conclusions.</strong> The participants stated that health education models should be used at the beginning of different intervention types and supported with fines and restrictions, if necessary. In addition, the positive detection of COVID-19 in the close environment and the experience of the treatment process were found to be effective in taking precautions.</p> İnci Arıkan Barış Kılıç Demir Copyright (c) 2021 İnci Arıkan, Barış Kılıç Demir 2021-06-01 2021-06-01 28 4 E202122 E202122 10.21802/gmj.2021.2.2 Compliance with Postoperative Recommendations by Patients with Different Psychological Types after Early Implant Loading Treatment <p><strong>The objective </strong>of the research was to explore the relationship between different psychological types of patients with an edentulous mandible and their attitudes toward postoperative recommendations and prescriptions after early implant loading treatment.</p> <p><strong>Materials and Methods.</strong> The study was conducted at the Dentistry Center (University Clinic, Ivano-Frankivsk National Medical University), November 2019 - March 2020. Study group consisted of 28 individuals with an edentulous mandible. Patients were divided into subgroups (philosophical, exacting-mind, indifferent, and hysterical) based on their mental characteristics. Surveys about complaints, compliance with postoperative recommendations and prescriptions were performed on the 2<sup>nd</sup>, 4<sup>th</sup>, 8-10<sup>th</sup> and 12-14<sup>th</sup> days after surgical treatment.</p> <p><strong>Results</strong>. Clinical evaluation data, patients’ complaints, and compliance with the postoperative treatment protocol after early implant loading treatment were analyzed. The degree of compliance to prescribed recommendations in patients with different psychological types were evaluated and discussed.</p> <p><strong>Conclusions</strong>. According to the results within the limitations of this study, it can be concluded that compliance with postoperative recommendations and prescriptions is highly dependent on the patient’ psychological type.</p> Bogdan Pelekhan Mykola Rozhko Lyubomyr Pelekhan Olena Rozhko Copyright (c) 2021 Bogdan Pelekhan, Mykola Rozhko, Lyubomyr Pelekhan, Olena Rozhko 2021-06-01 2021-06-01 28 4 E202129 E202129 10.21802/gmj.2021.2.9 Multidetector Computed Tomography Evaluation of Uncommon Acute Post-Caesarean Section Complications <p><strong>Introduction</strong>. The most common major abdominal surgery in women is caesarean section. Despite being a safe procedure, a variety of complications, both acute and chronic, can occur. About 14.5% of caesarean sections result in complications. Infection followed by postpartum haemorrhage is the most frequent complication. Imaging modalities such as ultrasonography and multidetector computed tomography are often used in the evaluation of suspected uncommon post-caesarean complications. Computed tomography has been found to be a good initial modality for assessing acute postoperative complications after caesarean delivery.</p> <p><strong>The objective</strong> of the research was to evaluate the imaging findings and the characteristic visual manifestations of atypical acute complications of caesarean section, other than common complications such as postpartum haemorrhage, wound infection, etc.</p> <p><strong>Materials and Methods. </strong>This prospective study was carried out at the Department of Radiodiagnosis and Imaging, Government Medical College, Srinagar from June 2019 to February 2020 in collaboration with the Department of General Surgery and Gynaecology and Obstetrics of the Sher-i-Kashmir Institute of Medical Sciences. All patients with suspected complication in the immediate post-caesarean period were evaluated with contrast-enhanced multidetector computed tomography.</p> <p><strong>Results</strong>. Out of 427 patients who underwent caesarean section, 25 patients were suspected of having uncommon acute complications. Out of 25 patients evaluated for suspected immediate post-caesarean complication, only 5 patients had bladder flap hematoma, 8 patients were diagnosed with uterine dehiscence, 6 patients had uterine rupture, 3 patients suffered from ureteral injury, 1 patient had gossypiboma, 2 patients developed pelvic sepsis.</p> <p><strong>Conclusions</strong>. Multidetector computed tomography plays an important role in detection and confirmation of multiple acute complications after caesarean delivery and can also help in guiding the management of complications as well.</p> Musaib Ahmad Dar Suhail Rafiq Sheema Posh Imran Wagay Copyright (c) 2021 Musaib Ahmad Dar, Suhail Rafiq, Sheema Posh, Imran Wagay, Suhail Rafiq 2021-06-01 2021-06-01 28 4 E202127 E202127 10.21802/gmj.2021.2.7 The Relationship Between Perceived Parental Attitude and Life Satisfaction Among University Students <p><strong>Introduction. </strong>The effect of parental attitudes and behaviors in raising their children on the individual’s life has been the subject of numerous studies for many years. There is a strong correlation between parental attitudes and the child’s ability to be satisfied with life.</p> <p><strong> The objective </strong>of the research was to determine the relationships between perceived parental attitudes (overprotection, rejection, emotional warmth) and life satisfaction among university students. We investigated whether parental attitudes play a role in predicting life satisfaction among university students, and what role they play.</p> <p><strong> Materials and Methods. </strong>The study was conducted from June 2020 to September 2020. Data were collected using Google Forms. Each person consented to anonymously participate in the study and was informed about the objectives of the study being a descriptive one. The population of the study consisted of nursing students enrolled in the Faculty of Health Sciences. For this purpose, 220 students at the age of 20 to 30 years participated in the study. The assessment battery consisted of Student Demographic Form, the Short-Egna Minnen Beträffande Uppfostran (Own Memories of Upbringing), and the Life Satisfaction Scale.</p> <p><strong> Results.</strong> There was a significant negative correlation between maternal rejection and life satisfaction among the students. Male students were more likely to perceive their fathers as being disapproving than female students did. These findings were discussed in line with the studies in the related literature.</p> <p><strong> Conclusions.</strong> High life satisfaction is a variable that protects young people from risk factors. Therefore, a focus should be placed on increasing life satisfaction among students. Parental attitude is an effective factor for life satisfaction among students. For this reason, it can be said that it would be beneficial to inform families about appropriate parental attitudes to increase their children’s life satisfaction.</p> Nurten Arslan Işik Copyright (c) 2021 Nurten Arslan Işik 2021-06-01 2021-06-01 28 4 E202128 E202128 10.21802/gmj.2021.2.8 Investigating the Factors Affecting Depression By Using Structural Equation Modeling <p><strong>The objective</strong> of the research was to study the factors affecting depression in general population.</p> <p><strong>Materials and Methods.</strong> A total of 1,291 individuals at the age of 15-68 years participated in this cross-sectional study. The Demographic Information Form, the Beck Depression Inventory for Primary Care and the Generalized Anxiety Disorder Scale were used as data collection tools. The data obtained were evaluated in the SPSS 23 package program. Missing data were validated for extreme values, and, then, tested for normality and homogeneity. Testing for the research model was implemented by structural equation modeling using the AMOS program.</p> <p><strong>Results</strong>. The following goodness-of-fit values were determined for the revised model predicting the factors influencing depression: χ<sup>2</sup> = 535.62, χ<sup>2</sup>/df = 4.74, the normed fit index = 0.95, the Tucker-Lewis index = 0.95, the comparative fit index = 0.96, the goodness-of-fit index = 0.95, the adjusted goodness-of-fit index = 0.94, the root-mean-square error of approximation = 0.05, the root mean square residual = 0.12, which were within acceptable limits. According to our model, the generalized anxiety disorder-7 (t = 15.923; p &lt; 0.001), gender (t = -5.866; p &lt; 0.001), age (t = -8.193; p &lt; 0.001) and marital status (t = -6.107; p &lt; 0.001) had a significant effect on depression. However, there was no significant relationship between depression score and educational status, place of residence, family type, and smoking.</p> <p><strong>Conclusions</strong>. In this model of our study, generalized anxiety disorder was found to have the greatest effect on depression, followed by age, marital status, and gender, respectively.</p> Meryem Firat Yalçın Kanbay Burcu Demir Gökmen Mehmet Utkan Ayşe Okanli Copyright (c) 2021 Meryem Firat, Yalçın Kanbay, Burcu Demir Gökmen, Mehmet Utkan, Ayşe Okanli 2021-03-01 2021-03-01 28 4 E202111 E202111 10.21802/gmj.2021.1.1 Blood Plasma Serotonin and von Willebrand Factor as Biomarkers of Unstable Angina Progression Toward Myocardial Infarction <p><strong>Aim: </strong> To investigate the serotonin and von Willebrand factor (vWF) concentrations among unstable angina (UA) patients without and with progression toward myocardial infarction (outcome) and to assess the utility of both as prognostic markers of UA complications.</p> <p><strong>Materials and methods: </strong> In observational cohort study, we recruited 103 patients with ischemic heart disease (the median age 65.0 (59.0-69.0) years, 45 females (43.7%)). After full set of investigations including high sensitive Troponin I test and 28-day follow-up period, we defined three groups: Group 1 - stable angina patients (n=22) as control, Group 2 - UA patients without outcome (n=71), Group 3 - UA patients with outcome (n=10). We analyzed the blood plasma serotonin content by the ion-exchange chromatography with measurement of serotonin on fluorescence spectrophotometer. VWF concentration was determined by ELISA. We compared the concentrations of observed parameters among the groups with the Kruskal-Wallis test (with post-hoc Mann-Whitney test with Bonferroni-Holm correction). We assessed binary logistic models, receiver operating characteristic curves, calculated sensitivity (Se), specificity (Sp), and positive likelihood ratio (LR+) for each indicator.</p> <p><strong>Results: </strong> We registered elevation in serotonin concentration and decline in vWF concentration in Group 3 in comparison with Group 2 (22.670 (20.687-24.927) μg/ml vs 11.980 (8.120-15.000) μg/ml, p&lt; 0.001, and 0.117 (0.109-0.120) rel.units/ml vs 0.134 (0.127-0.143) rel.units/ml, p &lt; 0.001) and Group 1 (12.340 (10.052-13.619) μg/ml, p &lt; 0.001, and 0.137 (0.127-0.156) rel.units/ml, p &lt; 0.001), respectively. No significant differences in serotonin and vWF concentrations between Group 1 and Group 2 were detected (p=0.81 and p=0.36, respectively). The probability of outcome increased significantly (by 60.7% and 59.7%, LR+ 19.0 [6.0, 60.0] and 18.0 [3.9, 80.0]) if serotonin concentration was above 21.575 μg/ml (Se=80.0%, Sp=95.8%, AUC=0.975) and vWF concentration was below 0.114 rel.units/ml (Se=50.0%, Sp=97.2%, AUC=0.973), respectively.</p> <p><strong>Conclusions: </strong> Serotonin and vWF as biomarkers are demonstrated promising results for rule-in the patients with risk of short-term UA progression toward myocardial infarction.</p> Yuliya Tyravska Oleksandr Savchenko Viktor Lizogub Nataliia Raksha Olexiy Savchuk Copyright (c) 2021 Yuliya Tyravska, Oleksandr Savchenko, Nataliia Raksha, Viktor Lizogub, Prof., Olexiy Savchuk, Prof. 2021-03-01 2021-03-01 28 4 E202112 E202112 10.21802/gmj.2021.1.2 Theoretical Justification of the Dermatoglyphics Use As Basic Identification Method <p>The article analyzes the main literature sources providing a holistic view of the state and issues of studying the issue related to the possibility of using the dermatoglyphic research method for identification purpose; it is about external recognition, behavioral, psychological identification. The main directions of application of the dermatoglyphic method, providing the study of this issue, are highlighted. Problematic issues related to the areas of application of the dermatoglyphic method have been studied and further prospects for its study have been outlined.</p> Oleksandr Dunayev Igor Gunas Oksana Popadynets Ruslan Kozoviy Elvira Kindrativ Copyright (c) 2021 Oleksandr Dunayev, Igor Gunas, Oksana Popadynets, Ruslan Kozoviy, Elvira Kindrativ 2021-03-01 2021-03-01 28 4 E202116 E202116 10.21802/gmj.2021.1.6 Bifocal Tuberculosis with Adalimumab Revealed by Laryngeal Involvement: Case Report <p><strong>Introduction</strong>. Anti-TNF treatment has transformed the treatment of chronic inflammatory rheumatism. Although the therapy can be highly effective, anti-TNF drugs are associated with an increased risk of tuberculosis, especially extra-pulmonary tuberculosis.</p> <p>Laryngeal tuberculosis is rare and its symptoms are not specific. Laryngeal tuberculosis is often secondary to another localization, particularly pulmonary. In the use of anti-TNF therapy, its development is unusual.</p> <p><strong>Case report.</strong> We report a case of bifocal tuberculosis: laryngeal and pulmonary tuberculosis revealed by laryngeal involvement in a patient aged 41 years with axial spondylarthritis treated with Adalimumab.</p> <p><strong>Conclusion.</strong> This presentation highlights the importance to consider the rare possibility of laryngeal tuberculosis in the presence of atypical otorhinolaryngologic signs under anti-TNF therapy and underlines the importance of looking for other tuberculosis involvement.</p> Najlae El Ouardi Laila Taoubane Adil Zegmout Marouane Balouki Siham Sadni Lahsen Achemlal Copyright (c) 2021 Najlae El Ouardi, Laila Taoubane, Adil Zegmout, Marouane Balouki, Siham Sadni, Lahsen Achemlal 2021-03-01 2021-03-01 28 4 E202117 E202117 10.21802/gmj.2021.1.7 Assessment of Relationship Between Serum Vitamin D Levels and Metabolic Syndrome Components in Hemodialysis Patients <p><strong>Aim: </strong>This study is aimed to evaluate the relationship between serum vitamin D levels and metabolic syndrome in hemodialysis patients.</p> <p><strong>Materials and Methods: </strong>This study was conducted with participation of 80 patients undergoing hemodialysis for more than 6 months three times a week, aged &gt; 18 years. Their height, dry weight, waist circumference were measured. Biochemical parameters such as serum 25-hydroxyvitamin D, lipid profile, and fasting blood glucose were analyzed. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. Severe vitamin D deficiency, 25 (OH) vitamin D &lt; 5 ng/ml; mild vitamin D deficiency, 25 (OH) vitamin D 5-15 ng/ml; vitamin D insufficiency, 25 (OH) vitamin D 16-30 ng/ml, and vitamin D sufficiency, 25 (OH) vitamin D &gt; 30 ng/ml were categorized. Statistical analysis of the data was performed with the use of SPSS version 21.0.</p> <p><strong>Results: </strong>48.4% of hemodialysis patients were identified to have metabolic syndrome. According to the serum levels of vitamin D; 35.0% of patients had severe vitamin D deficiency, 37.4% of patients had mild vitamin D deficiency, 18.8% of patients had vitamin D insufficiency and 8.8% of patients had vitamin D sufficiency (&gt; 30 ng/ml). Vitamin D insufficiency was significantly associated with metabolic syndrome and central obesity.</p> <p><strong>Conclusions: </strong>Deficiency/insufficiency is observed in serum 25-hydroxyvitamin D levels in hemodialysis patients. Vitamin D insufficiency is associated with metabolic syndrome.</p> Sevil Karahan Yılmaz Cuma Mertoğlu Aylin Ayaz Copyright (c) 2021 Sevil Karahan Yılmaz, Cuma Mertoğlu, Aylin Ayaz 2021-03-01 2021-03-01 28 4 E202113 E202113 10.21802/gmj.2021.1.3 Styloid Process: What Length Is Abnormal? <p>The length of the styloid process varies greatly in different populations and depends on ethnicity and geographical background. The elongated styloid process may be associated with Eagle’s syndrome. Therefore, the mean normal length of the styloid process in different population groups needs to be calculated and the upper cutoff limit for elongated styloid process should be found.</p> <p><strong> The objective </strong>of the research was to evaluate the styloid process length in the Kashmiri population using multidetector computed tomography.</p> <p><strong> Materials and Methods</strong>. We retrospectively evaluated 304 patients who underwent computed tomography of the head and paranasal sinuses, and the mean styloid process length was calculated on both sides. The mean of three measurements of styloid process length was taken. The study population was grouped as follows: Group I included patients at the age of 21-30 years; Group II comprised patients at the age of 31-40 years; Group III included 68 patients at the age of 41-50 years; Group IV comprised patients &gt; 50 years old.</p> <p><strong>Results. </strong>The mean length of the styloid process in the studied population varied from 20 to 51 mm (mean 31.3 ± 4.5 mm). There was no significant difference in the length on both sides (p=0.835). The mean length of the styloid process was 30.1 ± 4.2 mm in females and 32.3 ± 4.8 mm in males (p&lt; 0.034). The lengths of the styloid process in different age groups were as follows: in Group I - 30.9 ± 4.4 mm; in Group II - 31.2 ± 4.8 mm; in Group III - 31.6 ± 4.3 mm; in Group IV - 31.5 ± 4.5 mm.</p> <p><strong> Conclusions</strong>. The mean length of the styloid process in our population was higher as compared to many other ethnic groups. The styloid process in males was longer. The elongated styloid process on computed tomography scan should not be labeled as Eagle’s syndrome unless clinical symptoms are present.</p> Omair Shah Faiz Shera Naseer Choh Tariq Gojwari Fahad Shafi Jan Suhail Musadiq Rafiq Copyright (c) 2021 Omair Shah, faiz shera, naseer choh, tariq gojwari, fahad shafi, jan suhail, musadiq rafiq 2021-03-01 2021-03-01 28 4 E202114 E202114 10.21802/gmj.2021.1.4 Effects of Different Applications on Postoperative Seroma Formation and Wound Healing Following Mastectomy and Axillary Dissection in Rats <p>The most frequent postoperative complication after breast surgery is seroma formation. Seroma occurs due to lymphatic and vascular fluid leakage into the dead space created by surgical dissection.</p> <p><strong>The objective</strong> of the research was to evaluate the effects of local fibrin glue, tetracycline, talc applications, and flap fixation technique on reducing seroma formation after mastectomy and axillary dissection. In addition, we aimed to determine the level of efficacy for these applications, as well as to identify the most appropriate method to be used in operations with high risk of seroma formation.</p> <p><strong> Materials and Methods. </strong>This experimental study was conducted using a total of 60 female Wistar albino rats. They were allocated into six groups and each comprised ten rats. Unilateral mastectomy and axillary dissection were performed on all the rats. Local applications of fibrin glue, tetracycline, talc, and alcoholic iodine were performed in four separate groups. Flap fixation technique was applied in one group and those rats that did not receive any intervention constituted the control group. On the 10<sup>th</sup> postoperative day, seroma was aspirated under anesthesia, and the amount of seroma fluid was recorded. Seroma fluid was analyzed for interleukin 1-β, vascular endothelial growth factor, and C-reactive protein levels. Tissue samples were obtained from the skin overlaying the dissection area, the axilla, and the thoracic wall. Wound healing was evaluated with histopathological examination.</p> <p><strong> Results</strong>. Seroma volume was lower and the wound healing scores were the highest in the flap fixation group and the tetracycline group as compared to the control group. However, the alcoholic iodine group and the talc group had a greater amount of seroma (p &lt; 0.05). There was no difference between the fibrin glue group and the control group.</p> <p><strong> Conclusions.</strong> In our mastectomy model, local application of alcoholic iodine and talc substances caused more wound site problems and postoperative seroma formation. While fibrin glue did not cause wound site problems, it did increase seroma formation. These three substances were determined to be inefficacious in postoperative seroma formation. Local tetracycline application and flap fixation technique were found to reduce postoperative seroma and benefit wound healing.</p> Oktay Karaköse Hüseyin Pülat Kazım Çağlar Özçelik İsmail Zihni Kemal Kürşat Bozkurt Serdar Şenol Fatma Nihan Cankara Hasan Erol Eroğlu Copyright (c) 2021 Oktay Karaköse, Hüseyin Pülat, Kazım Çağlar Özçelik, İsmail Zihni, Kemal Kürşat Bozkurt, Serdar Şenol, Fatma Nihan Cankara, Hasan Erol Eroğlu 2021-03-01 2021-03-01 28 4 E202115 E202115 10.21802/gmj.2021.1.5