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, dentistry, and 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> 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 2 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 2 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 2 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 2 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 2 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 2 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 2 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 2 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 2 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 2 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 2 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 2 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 2 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 2 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 2 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 2 E202115 E202115 10.21802/gmj.2021.1.5 Multi-Vessel Coronary Artery Disease: Choice of Myocardial Revascularization Strategy <p>Multi-vessel coronary artery disease is quite a common state, which is often diagnosed by coronary angiography in patients with both stable coronary artery disease and acute coronary syndromes. Major difficulties in percutaneous coronary intervention include stent thrombosis and the need for antiplatelet therapy (aspirin and a P2Y<sub>12</sub> inhibitor). Stent thrombosis leads to the recurrence of myocardial infarction and may occur within the first few hours after percutaneous coronary intervention. The use of dual antiplatelet therapy, especially that combined with low-molecular-weight heparin in the first days after myocardial infarction, poses a risk of bleeding, which often occurs in real clinical practice. Among P2Y<sub>12&nbsp; </sub>inhibitors, ticagrelor causes bleeding somewhat more frequently than clopidogrel. A case of multi-vessel coronary artery disease is described in this paper. Coronary angiography revealed right-dominant circulation; occlusion of the proximal and medial segments of the right coronary artery, thrombolysis in myocardial infarction flow grade 0; stenosis of the left main coronary artery (50-60%), thrombolysis in myocardial infarction flow grade 2; diffuse stenosis of the medial and distal segments of the left anterior descending artery, thrombolysis in myocardial infarction flow grade 1; stenosis of the proximal segment of the left circumflex artery (&gt; 75%), thrombolysis in myocardial infarction flow grade 1. The patient underwent percutaneous coronary intervention; the stents were implanted in the infarct-dependent right coronary artery. The clinical course was complicated by early stent thrombosis with subsequent thrombus extraction; a day later melena developed. Bleeding was stopped, the intensity of antithrombotic therapy was reduced: the combination of aspirin and ticagrelor was replaced by the combination of aspirin and clopidogrel. Six weeks after stenting of the infarct-dependent coronary artery, complete myocardial revascularization (hybrid intervention) was performed: coronary artery bypass grafting [the left internal mammary artery → the left anterior descending artery], coronary autogenous bypass grafting [the aorta → the right coronary artery and the aorta → the left circumflex artery]. The role of fractional flow reserve or instantaneous wave-free ratio-controlled complete myocardial revascularization techniques is discussed. The following algorithm for myocardial revascularization was used: percutaneous coronary intervention for the right coronary artery + coronary artery bypass grafting-3: the left internal mammary artery → the left anterior descending artery, the aorta → the left circumflex artery, the aorta → the right coronary artery.</p> Nestor Seredyuk Andrii Matlakh Yaroslava Vandzhura Mykyta Bielinskyi Oleksii Skakun Ruslana Denina Copyright (c) 2020 Nestor Seredyuk, Andrii Matlakh, Yaroslava Vandzhura, Mykyta Bielinskyi, Oleksii Skakun, Ruslana Denina 2020-12-26 2020-12-26 28 2 E202041 E202041 10.21802/gmj.2020.4.1 Fistulized Crohn’ Disease Mimicking Sigmoid Cancer: A Case Report <p>Crohn’s disease is an inflammatory bowel disease of unknown etiology, progressing with frequent exacerbation periods that can involve any part of the gastrointestinal tract. Although, it can manifest itself with complaints from the entire gastrointestinal tract; abdominal pain, diarrhea, nausea, weight loss and fever are the most important clinical symptoms. In this presentation, a 41-year-old male patient with known Crohn’s disease was presented to our hospital with the help of operation images.</p> Bartu Badak Ercument Pasaoglu Huseyin Tarik Caga Enver Ihtiyar Adnan Sahin Serdar Erkasap Ersin Ates Necdet Fatih Yasar Copyright (c) 2020 Bartu Badak, Ercument Pasaoglu, Huseyin Tarik Caga, Enver Ihtiyar, Adnan Sahin, Serdar Erkasap, Ersin Ates, Necdet Fatih Yasar 2020-12-26 2020-12-26 28 2 E202042 E202042 10.21802/gmj.2020.4.2 Experience of Laparoscopic Cholecystectomies in a Tertiary Care Hospital: a Retrospective Study <p><strong>Introduction: </strong> Laparoscopic cholecystectomy is the most commonly performed surgical procedure of digestive tract. It has replaced open cholecystectomy as gold standard treatment for cholelithiasis and inflammation of gallbladder.&nbsp; It is estimated that approximately 90% of cholecystectomies in the&nbsp; United States are performed using a laparoscopic approach.&nbsp; The aim of this study was to evaluate the outcome of Laparoscopic cholecystectomy in context to its complications, morbidity and mortality in a tertiary care hospital.&nbsp;</p> <p><strong>Methods: </strong> This retrospective study was conducted on 1200 patients, who underwent laparoscopic cholecystectomies, during the period from January 2019 to December 2019, at Government Medical College Jammu J &amp; K, India and necessary data was collected and reviewed.</p> <p><strong>Results: </strong> In our study, a total of 1200 patients were studied including 216 males (18%) and 984 females (82%). The mean age of the patients was 43.35±8.61. The mean operative time in our study was 55.5±10.60 minutes with range of 45 – 90 minutes. Conversion rate was 2.6%. 2 patients were re-explored. Bile duct injury was found in 6 patients (0.5%).&nbsp;</p> <p><strong>Conclusions: </strong> Gallstone disease is a global health problem. Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first choice of treatment for gallstones. Gall stone diseases is most frequently encountered in female population. The risk factors for conversion to open cholecystectomy include male gender, previous abdominal surgery, acute cholecystitis, dense adhesions and fibrosis in Calot’ s triangle, anatomical variations, advanced age, comorbidity, obesity, suspicion of common bile duct stones, jaundice, and decreased surgeon experience. The incidence of surgical site infection has significantly decreased in laparoscopic cholecystectomy compared to open cholecystectomy. In our study we could not find any case of surgical site infection.</p> Aamir Hussain Hela Haseeb Mohammad Khandwaw Rahul Kumar Mir Adnan Samad Copyright (c) 2020 Aamir Hussain Hela, Haseeb Mohammad Khandwaw, Rahul Kumar, Mir Adnan Samad 2020-12-26 2020-12-26 28 2 E202043 E202043 10.21802/gmj.2020.4.3 Mycotic Infection (Fungal Ball) of the Paranasal Sinuses: A Clinicopathological Observation <p>Mycotic infections of the nasal cavity and paranasal sinuses represent a wide spectrum of disorders that vary in clinical presentation, histopathologic appearances, and biological significance. The second most common form is a fungal ball.</p> <p><strong>The objective </strong>of the research was to describe the cases of paranasal sinus fungal ball found in the files of patients with chronic rhinosinusitis.</p> <p><strong>Materials and Methods.</strong> There were demonstrated clinical and histopathological data of two patients.</p> <p><strong>Results.</strong> A 42-year-old woman and a 40-year-old man with chronic hypertrophic sinusitis had a large amount of friable cheesy mass in the maxillary sinus. The female patient previously underwent upper dental arch sanation. Histology revealed dense laminated masses of matted fungal hyphae that were separate from the mucosa. Sinonasal mucosa showed mild chronic inflammation (male) and severe non-specific chronic active inflammation (female). No evidence of fungal invasion in the mucosa was found.</p> <p><strong>Conclusions.</strong> Fungal ball represents a non-invasive form of mycotic rhinosinusitis with favourable prognosis. Biopsy examination plays an important role in the diagnostic process. Although the diagnosis can also be achieved by polymerase chain reaction assays, biopsy is the only way to explore the status of an inflammatory damage to adjacent tissue and, thus, to rule out potential invasive mycotic sinus disease with much worse clinical outcome.</p> Vladimír Bartoš Veronika Bartošová Copyright (c) 2020 Vladimír Bartoš, Veronika Bartošová 2020-12-26 2020-12-26 28 2 E202046 E202046 10.21802/gmj.2020.4.6 The Effect of the Infectious Disease Nursing Course on Turkish Students’ Knowledge and Attitudes Towards AIDS: A Quasi-Experimental Study <p>There is no available treatment or vaccine for HIV/AIDS, and health education has, therefore, become a top priority in the prevention of disease. It is of great importance to have sufficient information about HIV/AIDS and how to control infection. This study was conducted to determine the effect of the Infectious Disease Nursing course on nursing students’ knowledge and attitudes towards AIDS.</p> <p><strong> Materials and Methods. </strong>This quasi-experimental study was carried out between February 12 - May 28, 2019 and included 50 nursing students who were taking the Infectious Disease Nursing course for the first time and attended the pre-test and post-test. The data were collected using a Personal Information Form and the AIDS Knowledge and Attitude Scale. Descriptive statistics, the paired sample t-test and Pearson correlation analysis were used in the evaluation of the data.</p> <p><strong> Results. </strong>Among the students who participated in the study, 94.0% of students were at the age of 18-21 years; 80.0% of students were females; 54.0% of students stated that they had adequate knowledge of AIDS; 78.0% of students stated that they did not want to provide care to individuals with HIV/AIDS. There was found a significant strong positive correlation between the mean pre- and post-education scores for the AIDS Knowledge and Attitude Scale (p&lt;0.05, r=0.34; p&lt;0.01, r=0.72). There was a significant, weak negative correlation between the mean post-education AIDS total Attitude mean score and the status of having contact with a patient with HIV/AIDS and wanting to provide care for a patient with HIV/AIDS (p&lt;0.05, r=-0.31), and a significant weak positive correlation between the status of wanting to provide care for a patient with HIV/AIDS and seeing people with HIV/AIDS as a threat (p&lt;0.01; r=-0.50).</p> <p><strong> Conclusions. </strong>All the students benefited from the information on AIDS and became informed due to attending the Infectious Diseases Nursing course and their attitudes towards AIDS improved.</p> Sibel Şentürk Alev Yıldırım Keskin Copyright (c) 2020 Sibel Şentürk, Alev Yıldırım Keskin 2020-12-26 2020-12-26 28 2 E202045 E202045 10.21802/gmj.2020.4.5 Surgical Correction of Hirschsprung's Disease in Children Using the Soave-Boley Technique with Manual Colorectal Anastomosis <p><strong>Introduction.</strong> Current trends in surgical treatment of Hirschsprung's disease are aimed at minimally invasive interventions. However, the experience of using Soave-Boley procedure in surgical treatment of Hirschsprung's disease in children of different ages is valuable in the arsenal of differentiated approach to the treatment of this pathology.</p> <p><strong>The objective of the research</strong> was to evaluate the results of surgical correction of Hirschsprung's disease in children using the Soave-Boley technique with manual colorectal anastomosis.</p> <p><strong>Materials and Methods.</strong> The analysis of surgical treatment of 1,187 children with different forms of Hirschsprung’s disease aged from birth to 18 years over the period 1980-2020 was conducted in the National Children's Specialized Hospital“ Okhmatdyt”. Surgical correction of Hirschsprung's disease using the Soave-Boley technique was performed in 597 children. Before surgery, 156 patients underwent the first stage of treatment that consisted in the creation of a protective colostomy; in 441 cases, this intervention was performed without an intestinal stoma; the benefits of the Soave-Boley technique were evaluated.</p> <p><strong>Results</strong>. All the patients survived. In 15 (2.51%) out of 597 children, in the early postoperative period, there were observed: retrocolic hematoma (n = 2), retrocolic abscess (n = 7), anastomotic leak (n = 2), adhesive intestinal obstruction (n = 3), intussusception (n = 1). Fourteen (2.36%) patients developed surgical complications in the long-term period: residual aganglionosis (n = 9), anastomotic stenosis (n = 4) and coloptosis. Repeated Soave-Boley operation with manual colorectal anastomosis was successfully performed in 26 (4.362%) patients after primary correction of Hirschsprung's disease using different methods. Periodic episodes of fecal smearing in the remote period in 45 (7.53%) children were eliminated by conservative treatment. The success of this technique is confirmed by a much lower number of early (2.51%) and late (2.36%) postoperative surgical complications, as compared to those after using other methods of open surgical correction - 17.52% and 16.35%, respectively.</p> <p><strong> Conclusions.</strong> Surgical correction of Hirschsprung's disease in children using the Soave-Boley technique with manual colorectal anastomosis allows better control over applying each suture, anatomical joining the edges of the bowel, and reducing trauma to the rectal mucosa, which ensures the high reliability of colorectal anastomosis; it is the most effective way of radical correcting Hirschsprung' s disease in children in an open way in one-stage or two-stage interventions, and this technique is the operation of choice for secondary surgical correction of Hirschsprung's disease.</p> Oleh Kurtash Copyright (c) 2020 Oleh Kurtash 2020-12-26 2020-12-26 28 2 E2020410 E2020410 10.21802/gmj.2020.4.10 Congenital Aneurysm/Diverticulum of the Left Ventricle in the Newborn <p>Left ventricular aneurysms and diverticula are severe congenital heart defects. The low prevalence and mostly asymptomatic course of these anomalies do not always allow us to suspect these defects in time and to differentiate them among themselves. That is why early detection of pathology with the help of fetal echocardiography is a key factor in determination of the tactics of patients’ management. The paper reviews the literature and describes a complex case of prenatally diagnosed left ventricular aneurysm.</p> Oleksandra Tsaruk Valerian Ryzhyk Khrystyna Ilnytska Copyright (c) 2020 Oleksandra Tsaruk, Valerian Ryzhyk, Khrystyna Ilnytska 2020-12-26 2020-12-26 28 2 E2020415 E2020415 10.21802/gmj.2020.4.15 Disposition and Challenges of Alternative to Physical Classroom Teaching and Learning in a Pandemic; an Appraisal of Biochemistry Students COVID-19 Learning with WhatsApp <p><strong>The objective</strong> of the study was to assess the disposition and challenges of students towards teaching and learning of biochemistry through WhatsApp.</p> <p><strong>Materials and Methods.</strong> The study was a cross-sectional survey which had 200 level (Second Year) and 400 level (Fourth Year) students of biochemistry as respondents. Data collection was done using a self-developed questionnaire administered through the WhatsApp group created for learning and collected through a designated e-mail address. Data analysis was carried out using the mean and standard deviation setting a mean score of 2.5 as a benchmark for accepting or rejecting statements made in the questionnaire.</p> <p><strong>Results.</strong> The study revealed that students had a level of openness to using online teaching resources for biochemistry; they do not believe that the use of WhatsApp for teaching and learning of biochemistry as a means of alternative to face to face classroom interaction will be effective in imparting the right knowledge in biochemistry. Several challenges identified are linked to not just money but is hinged around the curriculum structure of the biochemistry programme.</p> <p><strong>Conclusion.</strong> It is concluded that WhatsApp represents a potential means of instruction but may be hampered by challenges hinged on the curriculum structure of biochemistry.</p> Peter Agbadobi Uloku Ossai Chukwudi Ogwu Patrick Chukwuyenum Ichipi-Ifukor Fidelis Ifeakachuku Achuba Copyright (c) 2020-12-26 2020-12-26 28 2 E2020411 E2020411 10.21802/gmj.2020.4.11 Laser-Induced Spectral-Selective Autofluorescent Microscopy as a Prospective Method of Research in Biomedicine <p>In modern medical diagnostics, optical methods of studying living tissues have become widespread and are collectively called "optical biopsy". One such method is autofluorescence microscopy, which provides additional information about the structural and functional features of the sample. In this paper, an analysis of existing data was performed on the properties of autofluorescence of cells and tissues to evaluate the available instrumental systems and methods for monitoring autofluorescence and the potential for its application in the biomedical field.</p> <p>Over the past few years, advanced optical-electronic methods have become available to detect various pathological conditions of tissues and environments of the human body by evaluating signals emitted by endogenous fluorophores. Because these molecules are often involved in basic biological processes, they are important parameters for checking the condition of cells and tissues. In our opinion, analytical methods based on autofluorescence monitoring have great potential in both research and diagnosis, and interest in the use of these new analytical tools is constantly growing. Methods based on autofluorescence can give more information about the object under study with relatively lower costs and less diagnostic error.</p> Nataliia Kozan Ivan Savka Viktor Kryvetskyi Igor Oliynyk Copyright (c) 2020 Nataliia Kozan, Ivan Savka, Viktor Kryvetskyi, Igor Oliynyk 2020-12-26 2020-12-26 28 2 E202048 E202048 10.21802/gmj.2020.4.8 Morphological Characteristics of Changes in the Duodenal Wall Within 14-56 Days of the Development of Streptozotocin-Induced Experimental Diabetes Mellitus <p><strong>The objective </strong>of the research was to determine the morphological features of the duodenal wall of animals within 14-56 days of developing streptozotocin-induced diabetes mellitus using light optical microscopy.</p> <p><strong>Materials and Methods.</strong> The research was carried out on 40 white nonlinear adult male rats. Diabetes mellitus was simulated by a single intraperitoneal injection of streptozotocin (Sigma, USA) at a dose of 60 mg/kg body weight. The material was taken from the duodenum on the 14<sup>th</sup>, 28<sup>th</sup> and the 56<sup>th</sup> days after the onset of experimental diabetes mellitus. For histological study, the preparations were made using the conventional method, which included the staining of sections with hematoxylin and eosin.</p> <p><strong>Results.</strong> Streptozotocin-induced diabetes mellitus was experimentally found to lead to dystrophic changes in the epithelial components of the duodenal mucosa from the 14<sup>th</sup> day of developing. There were observed a shortening of the villi of the mucous membrane and a lack of distinctness of striated border contours on the apical surface of epitheliocytes. Between the connective-tissue fibers of the lamina propria of the mucosa and thin-walled vessels, the cellular elements, including mainly macrophages, lymphocytes, were found. There was a shortening of the villi, edema and histiolymphocytic infiltration of the villous stroma 28 days after developing experimental diabetes mellitus. The epithelium covering was discontinuous; numerous areas of desquamation were found at the apex of the villi. Fifty-six days after developing experimental diabetes mellitus, the destruction and desquamation of the epithelium of the villi and crypts were observed. The surface of the duodenal mucosa smoothed down due to the shortening and flattening of the villi (indicating their atrophy), while the crypts elongated and their depth increased.</p> <p><strong>Conclusions.</strong> Histological study of the duodenal wall of diabetic animals showed pronounced desquamation at the apex of the villi, destructive and dystrophic changes in the surface epithelium, edema and increased cellular infiltration of the lamina propria of the mucosa. Thus, in diabetes mellitus, structural changes in the duodenal wall of rats are characterized by the dystrophic processes, which can be considered as the morphological reflection of enteropathy.</p> Ihor Bilinskyi Copyright (c) 2020 Ihor Bilinskyi 2020-12-26 2020-12-26 28 2 E2020413 E2020413 10.21802/gmj.2020.4.13 Determination of Caregiver Burden and Social Support Levels among Caregivers Providing Care for Patients Hospitalized in Palliative Care Clinics <p>Providing care to someone with a chronic disease requires being physically, emotionally, and mentally energetic. In particular, the presence of a patient with a disease that requires palliative care changes daily activities and routines, increases responsibilities of those who take the responsibility for patient’s care and changes the roles in the family.</p> <p><strong>The objective</strong> of this study was to determine the care burden and social support levels among the caregivers providing care for patients hospitalized in palliative care clinics.</p> <p><strong>Materials and Methods:</strong> The population of this descriptive and correlational study consisted of caregivers taking care of patients treated at the Palliative Care Clinic of Training and Research Hospital between May and October 2018; the sample consisted of 73 caregivers who volunteered to join the study and were open to communication. Data were collected by questioning patients and their caregivers about their sociodemographic characteristics, using the Caregiver Burden Scale and the Multidimensional Scale of Perceived Social Support. Data analysis included percentages, the Kruskal-Wallis test, the Mann-Whitney U test, and the Spearman’s Correlation Coefficient.</p> <p><strong>Results:</strong> The average caregivers’ age was 45.44±13.76 years; 75.3% of caregivers were females, 30.1% of caregivers were literate or had primary school degrees. Caregiver’s gender and educational levels were found not to affect caregiving and social support levels; however, the economic status affected caregiving and social support levels. There was a reverse correlation between the caregiver burden and their social support levels.</p> <p><strong>Conclusions:</strong> With increased caregiver burden, their social support level decreased. Nurses caring for patients in palliative care clinics will benefit from educating and supporting caregivers about clinic and home care; it will result in a positive level of social support for both caregivers and patients receiving care.</p> Papatya Karakurt Sevinç Köse Tuncer Nadire Yildiz Çiltaş Mehmet Doğan Copyright (c) 2020 Papatya Karakurt, Sevinç Köse Tuncer, Nadire Yildiz Çiltaş, Mehmet Doğan 2020-12-26 2020-12-26 28 2 E2020414 E2020414 10.21802/gmj.2020.4.14 Effects of Siam Weed (Chromolaena odorata) Leaf Extract on Crude Oil-induced Toxicity <p style="text-align: justify;"><strong>The objective</strong> of this study was to investigate the effects of the different extracts&nbsp; (aqueous, ethanol and blended mixture) of <em>Chromolaena odorata</em> leaves on Wistar rats feed with crude petroleum (CP) tainted feed (4 ml/100 g diet).</p> <p style="text-align: justify;"><strong>Materials and methods</strong>: Twenty-five male Wistar rats weighing 140 -180 g were used for this study. The rats were kept one in a cage. Group A which was the control was allowed diet free of crude oil and were not treated with any of the extracts. Group B were exposed to a diet contaminated with crude oil that contained 4ml of crude oil per 100 gram of animal feed without treatment. Groups C-E were fed with diets contaminated with 4ml of crude oil per 100g of feed and treated with 500mg/Kg<sup>-1</sup> bodyweight of aqueous, ethanol and blended mixture of ethanol and aqueous extracts, respectively. The respective extracts and blended mixture were given daily to the rats via oral gavage in line with body weights. The study was for duration of twenty eight days after which the rats were sacrificed under sedation with chloroform. This was followed with collection of blood samples and organs of interest. All samples were stored at 4<sup>0</sup>C and used within forty eight hour for various biochemical analyses.</p> <p style="text-align: justify;"><strong>Results</strong>: There were significant decrease in haematological indices, liver proteins, oxidative enzymes, &nbsp;and antioxidant enzymes when compare with&nbsp; Group 1. Also, liver function maker enzymes, white blood cells (WBC), and malondialdehyde (MDA) &nbsp;&nbsp;were significantly increased &nbsp;by petroleum intoxication. Significant increase were observed in Hb, PCV, RBC, SO, MO, XO, SOD, CAT, albumin, total protein in the serum, liver and kidney; as against decreases in WBC, AST, ALT, ALP and MDA&nbsp; in rats fed crude petroleum (CP) tainted feed that was treated with<em> C. &nbsp;odorata </em>extract.&nbsp;</p> <p style="text-align: justify;"><strong>Conclusion</strong>: This study showed that administration of <em>C. odorata</em> leaves extracts to rats prevented health risk associated with crude petroleum toxicity.</p> Fidelis Ifeakachuku Achuba Charles Offor Copyright (c) 2020 Fidelis Ifeakachuku Achuba, Charles Offor 2020-09-28 2020-09-28 28 2 E202031 E202031 10.21802/gmj.2020.3.1 Impact of Periodontal Pocket Depth on the Efficiency of Surgical Treatment of Generalized Periodontitis <p>The paper is aimed at increasing the efficiency of surgical treatment by using a combination of platelet-rich fibrin, a synthetic hydroxyapatite Kergap, minimizing the body’s response to operative wound, and improving diagnostic and therapeutic approaches in surgical treatment of stage II-III generalized periodontitis.</p> <p><strong>The objective </strong>of the research was to study the efficiency of using the combination of platelet-rich fibrin, synthetic hydroxyapatite Kergap, magnesium preparation in comprehensive treatment of stage II-III generalized periodontitis at various stages and in different depths of the periodontal pockets.</p> <p><strong>Materials and Methods. </strong>The efficiency of surgical treatment was evaluated using clinical (periodontal pocket depth, attachment level, gingival bleeding, tooth mobility) and laboratory methods (X-ray, computed tomography) 3, 6, and 12 months after surgical treatment.</p> <p><strong>Results. </strong>The clinical picture was characterized by positive changes in all clinical indicators 3, 6 and 12 months after treatment. The best results by clinical and laboratory findings were obtained in case of an average pocket depth of 5-7 mm.</p> <p><strong>Conclusions. </strong>There was demonstrated a high clinical efficiency of using the combination of platelet-rich fibrin, synthetic hydroxyapatite Kergap and magnesium preparation in comprehensive treatment of stage II-III generalized periodontitis.</p> Mariana Ilkiv Mykola Rozhko Vitalii Hereliuk Copyright (c) 2020 Mariana Ilkiv, Mykola Rozhko, Vitalii Hereliuk 2020-09-28 2020-09-28 28 2 E202032 E202032 10.21802/gmj.2020.3.2 Study of the Association Between Antihyperglycemic Therapy and Cancer in Patients with Type 2 Diabetes Mellitus <p><strong>The objective </strong>of the research was to investigate the features and association of antihyperglycemic therapy and cancer in patients with type 2 diabetes mellitus.</p> <p><strong>Materials and Methods. </strong>The study included the analysis of medical records of patients with type 2 diabetes mellitus who were diagnosed with cancer during 2012-2016. The obtained results were processed by statistical methods using the software packages Microsoft Excel and Statistika-12. The significance of differences between the frequency of using different treatment schemes was assessed by the Pearson’s test (χ²). To determine the risk of predicted events, the odds ratio, the 95% confidence interval, the positive and negative prognostic values were calculated.</p> <p><strong>Results.</strong> There were diagnosed 533 cases of cancer in patients with type 2 diabetes mellitus. The most common scheme of antihyperglycemic therapy prior to the detection of malignant diseases was a combination of metformin and sulfonylurea derivatives (35.65%), as well as monotherapy with sulfonylurea derivatives (17.26%) and metformin (11.28%). Prior to diagnosing cancer in 396 (74.30%) patients, antihyperglycemic therapy<br>along with sulfonylurea derivatives and insulin was used. Among obese patients 68.82% used sulfonylureas and insulin as part of antidiabetic therapy before diagnosis of cancer. The connection between insulin therapy and the risk of cancer development in patients with type 2 diabetes mellitus was proved (the odds ratio=2.35; the 95% confidence interval (1.91 - 2.91); p&lt;0.001).</p> <p><strong>Conclusions.</strong> Prior to the detection of cancer in patients with type 2 diabetes mellitus, the combination therapy with metformin and sulfonylurea derivatives was most often used. The association between insulin therapy and the development of cancer in patients with type 2 diabetes mellitus was revealed. Cancer screening is advisable for patients with type 2 diabetes mellitus and obesity, who receive as a therapy sulfonylurea derivates and/or insulin.</p> Tamara Vatseba Liubov Sokolova Volodymyr Pushkarev Nataliia Koshel Copyright (c) 2020 Tamara Vatseba, Liubov Sokolova, Volodymyr Pushkarev, Nataliia Koshel 2020-09-28 2020-09-28 28 2 E202033 E202033 10.21802/gmj.2020.3.3