Galician Medical Journal
https://ifnmujournal.com/gmj
<p>"Galician Medical Journal" is a double-blinded peer-reviewed scholarly journal dedicated to advancing and sharing medical knowledge, experience, and meaningful scientific communication in the field of medicine. The aim and scope of the journal covers the following key areas: internal medicine, pathology, dentistry, medical education.</p> <ul> <li class="show"><strong>Internal Medicine and Pathology:</strong> The journal welcomes original research articles, comprehensive reviews, and clinical case reports that contribute to the understanding of disease mechanisms, diagnostic techniques, and therapeutic approaches within the domains of internal medicine and pathology, including experimental studies.</li> <li class="show"><strong>Dentistry:</strong> The journal invites scholarly works focused on various aspects of dentistry, including oral health, dental innovations, clinical studies, and advancements in dental procedures.</li> <li class="show"><strong>Medical Education:</strong> In recognition of the importance of training future medical professionals, the journal seeks articles that would contribute to the development of medical education, i.e. exploring educational methodologies, developing curriculum, and other vital aspects of medical education within the field of internal medicine and dentistry.</li> </ul> <p><strong>ISSN 2414-1518 (English ed. Online) ISSN 2306-4285 (Ukrainian ed. Print)<br>ID in the Register of Media Entities - R30-01104<br></strong></p> <p>Indexing: <a href="https://mjl.clarivate.com/search-results?issn=2306-4285&hide_exact_match_fl=true&utm_source=mjl&utm_medium=share-by-link&utm_campaign=journal-profile-share-this-journal">WoS ESCI</a>, <a href="https://www.cabdirect.org/">CABI</a>, <a href="https://doaj.org/toc/2414-1518">DOAJ</a>, <a href="https://scholar.google.com.ua/scholar?q=site:ifnmujournal.com/gmj">Google Scholar</a>, <a href="https://www.worldcat.org/search?q=%22Galician+Medical+Journal%22">WorldCat</a>, <a href="https://www.base-search.net/Search/Results?type=all&lookfor=url%3Aifnmujournal.com%2Fgmj&ling=0&oaboost=1&name=&thes=&refid=dcresen&newsearch=1">BASE</a>, <a href="https://core.ac.uk/search?q=repositories.id:(706)">CORE</a></p> <p>Listed in: Ulrich’s, <a href="https://medicine.cabells.com/">Journalytics Medicine</a>, <a href="https://v2.sherpa.ac.uk/id/publication/43784">Sherpa Romeo</a></p> <p><strong>Founder and Publisher: </strong><a href="https://ifnmu.edu.ua/uk/vydavnycha-diialnist">Ivano-Frankivsk National Medical University</a></p>Ivano-Frankivsk National Medical Universityen-USGalician Medical Journal2414-1518<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="http://creativecommons.org/licenses/by-nc/4.0" target="_blank" rel="noopener">Creative Commons Attribution License (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 <a href="http://opcit.eprints.org/oacitation-biblio.html" target="_new">The Effect of Open Access</a>).</span></span></li> </ul> </div>Analysis of Artifacts and Errors on Intraoral Phosphor Plate Radiographs: A Retrospective Study
https://ifnmujournal.com/gmj/article/view/e-GMJ2024-A06
<p><strong>Introduction.</strong> The advantages of phosphor plates (PPs), including their flexibility, thinness, and wireless connectivity, have contributed to their widespread use in dentistry alongside the advancement of digital radiography techniques. Continuous use of PPs and certain errors may lead to artifacts on the images. This retrospective study aimed to determine the frequency and types of intraoral PP artifacts.</p> <p><strong>Methods.</strong> This study was conducted on 814 intraoral PP radiographs, including periapical and bitewing images. The errors and artifacts were classified into 4 main categories: technical errors, plate-related artifacts, scanner-induced artifacts, and ambient light artifacts.</p> <p><strong>Results.</strong> A total of 656 periapical and 158 bitewing radiographs were examined. The most observed artifacts on the radiographs were plate-related artifacts, followed by technical errors (n=542, n=461, respectively). Within the category of plate-related artifacts, the most common artifacts were cracks or scratches (n=418, 77.1%), while within the category of technical errors, these were cone-cut errors (n=188, 40.7%). Parallel or zigzag radiopaque lines were the most common scanner-induced artifacts (n=313, 98.7%) and fading was the most common ambient light artefact (n=93, 49.2%). On more than half of the PPs, more than one artifact group was observed.</p> <p><strong>Conclusions.</strong> Cone-cut, cracks/scratches, parallel zigzag radiopaque lines, and fading were common PP artifacts and errors in this study. The analysis revealed that over half of the PPs exhibited appearance of more than one artifact group. The high frequency of artifacts poses a risk of incorrect and incomplete diagnoses in radiographs, emphasizing the crucial importance of understanding the causes and developing effective prevention strategies for artifacts to enhance the reliability of diagnostic imaging and ensure the accuracy of patient assessments.</p>Melike Yurttas
Copyright (c) 2024 Melike Yurttas
https://creativecommons.org/licenses/by-nc/4.0
2024-03-012024-03-01311GMJ2024-A0610.21802/e-GMJ2024-A06Effect of Spaced and Massed Learning Approaches on the Performance of Faculty Members in Medical Education
https://ifnmujournal.com/gmj/article/view/e-GMJ2024-A05
<p><strong>Introduction.</strong> The effectiveness of spaced and massed strategies can be evaluated by examining how educational experts (faculty members) transfer their learning skills to real-life educational contexts, such as with their undergraduate students in Saudi Arabia. It is necessary to consider the respective benefits of these strategies for faculty members to maintain standards and capabilities, fulfilling their learning and development needs.</p> <p><strong>Aim.</strong> This study aimed to compare the effectiveness of spaced and massed practice programs for faculty members in transferring their acquired assessment skills to their students. To achieve this goal, we used a mixed methodological approach, integrating both qualitative and quantitative methods into the study design.</p> <p><strong>Methods.</strong> This study was carried out at the Faculty of Medicine, King Abdul-Aziz University (KAU), Jeddah, Saudi Arabia. Focus group discussions were employed for the qualitative approach, while the paired-sample t-test and Chi-square test of independence were used for the quantitative approach.</p> <p><strong>Results.</strong> The results of the focus group discussion indicated that participants from both groups preferred the spaced learning approach, considering the busy schedules of medical doctors and students. In terms of cost effectivity, both group participants preferred the massed learning technique. Two (25%) participants from the spaced technique group and five (62.5%) participants from the massed technique group succeeded in applying all parts of the assessment cycle without significant help from other experts. Three (37.5%) participants in the spaced groups agreed that the pathway of applying the standards was confusing and entailed extra work requirements, while five (62.5%) participants in the massed group responded that it increased the feeling of being overwhelmed. Furthermore, the statistical results did not provide a clear indication of which program faculty members should adopt to facilitate their students in a better way. The lack of statistically significant differences between the findings of both programs suggests that the results do not confirm the superiority of spaced or massed practice, as is often assumed in medical education.</p> <p><strong>Conclusions.</strong> Both spaced and massed learning strategies were found to be broadly effective in transferring assessment skills, with no significant qualitative and qualitative differences. Their effectiveness depended on the specification of modules.</p>Rani AhmadOmyayma HamedReda JamjoomYoon Soo ParkAra Tekian
Copyright (c) 2024 Rani Ahmad, Omyayma Hamed, Reda Jamjoom, Yoon Soo Park, Ara Tekian
https://creativecommons.org/licenses/by-nc/4.0
2024-02-202024-02-20311GMJ2024-A0510.21802/e-GMJ2024-A05Thiol-Disulfide Balance in Fibromyalgia: A Case-Control Study
https://ifnmujournal.com/gmj/article/view/e-GMJ2024-A04
<p><strong>Aim.</strong> We aimed to examine the thiol-disulfide (SS) balance, a recognized marker of oxidative stress, in fibromyalgia syndrome (FMS).</p> <p><strong>Methods.</strong> The study comprised 98 female participants (61 newly diagnosed patients and 37 patients under treatment) with FMS, along with 82 apparently healthy female volunteers. In both groups, assessments were conducted using the Fibromyalgia Impact Questionnaire (FIQ), Visual Analogue Scale (VAS), Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), Short Form-36 (SF-36), Tender Point Count, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Native thiol (NT) and total thiol (TT) levels were measured, SS levels and SS/NT ratio were calculated.</p> <p><strong>Results.</strong> FMS patients demonstrated significantly lower NT levels, higher SS levels, and an elevated SS/NT ratio compared to the control group (p< 0.05 for all groups). In FMS patients, a statistically significant correlation was found between SS level and the SS/NT ratio, as well as the number of tender points (r=-0.24, p=0.02; r=-0.21, p=0.04), SF-36 pain subscales (r=0.22, p=0.032; r=0.21, p=0.04), and BAI scores (r=-0.22, p=0.01; r=-0.23 p=0.03). In the subgroup analysis, all health assessment scales were observed to exhibit statistically significant differences between the under-treatment group and newly-diagnosed group when compared to the control group (p< 0.05 for all groups). The FIQ, VAS, FSS, and BAI scores were found to be significantly lower in the under-treatment group as compared to the newly-diagnosed group (p< 0.05 for all groups). In the newly-diagnosed group, NT was significantly lower and the SS/NT ratio was significantly higher than those in the control group (p< 0.05). In the under-treatment group, SS levels and SS/NT ratio were significantly higher as compared to the control group (p< 0.05). In the multivariate regression analysis, which incorporated age, health assessment scales, patient subgroups, tender points, and duration of symptoms to predict the SS/NT ratio, variabes such as being in the under-treatment group, tender points, and BAI score were identified as significant predictors (p< 0.05).</p> <p><strong>Conclusions.</strong> The thiol-SS balance was observed to shift in the oxidative direction, and oxidative stress was higher in the FMS group. The absence of a significant difference between the under-treatment group and the newly-diagnosed group in terms of thiol-SS balance parameters suggests a shift to oxidative stress in patients, independent of the treatment status.</p>Esra Sahingoz BakirciBaris NacirMurat AlisikHakan GencElmas OgusGulseren Demir KarakilicFerda BuyukOzcan Erel
Copyright (c) 2024 Esra Sahingoz Bakirci, Baris Nacir, Murat Alisik, Hakan Genc, Elmas Ogus, Gulseren Demir Karakilic, Ferda Buyuk, Ozcan Erel
https://creativecommons.org/licenses/by-nc/4.0
2024-02-072024-02-07311GMJ2024-A0410.21802/e-GMJ2024-A04Preoperatively Confirmed Idiopathic Myointimal Hyperplasia of the Mesenteric Veins: A Case Report
https://ifnmujournal.com/gmj/article/view/e-GMJ2024-A03
<p>Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is a rare cause of colonic ischemia. First documented in the literature in 1991, this condition has remained exceedingly rare, with only a limited number of case reports since its initial mention. It involves proliferation of intimal smooth muscle within the mesenteric veins, resulting in colonic ischemia due to venous constriction and non-thrombotic occlusion. Patients experience a prolonged clinical course and adverse outcomes due to its rarity and nonspecific symptoms. The definitive diagnosis is typically confirmed after surgical resection of the affected colon, as initial biopsies are not deep enough to confirm the diagnosis. Histological examination of these biopsies reveals arteriolization of capillaries, subendothelial hyaline deposits, and fibrin thrombi. We present a case of a patient with a one-year history of diarrhea and abdominal pain. Biopsy samples obtained during colonoscopy showed colitis and proliferation of muscularized capillaries, consistent with IMHMV, prior to colon resection. The patient ultimately underwent laparoscopic total abdominal colectomy to the distal one-third of the rectum with end ileostomy. IMHMV is commonly treated surgically and mismanagement of this condition involving corticosteroids and immunomodulatory agents may result in unfavorable outcomes. This case report is one of the few cases of IMHMV diagnosed preoperatively within existing literature, which highlights a rare etiology of nonspecific colitis, emphasizing the critical divergence in its management approach.</p>Kelli Kosako YostKaivan SalehpourDonald TschirhartAdam Joseph GomezNeej Jash PatelYasmin Alishahi
Copyright (c) 2024 Kelli Kosako Yost, Kaivan Salehpour, Donald Tschirhart, Adam Joseph Gomez, Neej Jash Patel, Yasmin Alishahi
https://creativecommons.org/licenses/by-nc/4.0
2024-01-242024-01-24311GMJ2024-A0310.21802/e-GMJ2024-A03Integrating Basic Sciences and Clinical Practice: A Cross-Sectional Study of UQUMED's Medical Education Approach
https://ifnmujournal.com/gmj/article/view/e-GMJ2024-A02
<p><strong>Introduction.</strong> Since the early 20<sup>th</sup> century, medical education has evolved, notably with the Flexner report emphasizing the fusion of foundational sciences and clinical reasoning. As the field grew, educators adeptly incorporated new sciences and technologies, ensuring curriculum balance and depth.</p> <p><strong>Aim.</strong> This research aimed to explore the role of basic sciences in contemporary medical education, focusing on their integration with clinical practice.</p> <p><strong>Methods.</strong> An institutional-based cross-sectional study design was implemented at Umm Al Qura University, College of Medicine, Makkah, Saudi Arabia, from March to June 2023. This study involved surveying 470 medical students, from a total campus population of 1,360 students (excluding preparatory year), using a pre-tested and structured self-administered questionnaire. All questions in the survey were formatted to elicit dichotomous responses, namely “yes” or “no”, and the collected data were analyzed using SPSS version 20.</p> <p><strong>Results.</strong> The study discovered that while a high percentage of medical students (96.6% in earlier years to 94% in senior years) recognized the importance of basic sciences in the MBBS curriculum, there was a noticeable decline in this belief as students advanced through their clinical years. Similarly, the perception of the utility of foundational knowledge of basic sciences for understanding clinical subjects decreased slightly from 93% in earlier years to 85% in senior years. About 92.7% of students across all years believed a strong understanding of basic sciences was crucial for clinical proficiency. However, the perceived benefit of suggested readings/textbooks declined from 82% in earlier years to 77% in senior years. Feedback on curriculum enhancements showed robust support for more engaging teaching methods, with over 90% favoring the incorporation of multimedia tools and group-based sessions.</p> <p><strong>Conclusions.</strong> Our findings underscore the foundational role of basic sciences in medical education for clinical competency, highlighting a gradual shift in student perceptions as they progress through their training. This shift signals the necessity for adaptive teaching strategies that effectively integrate basic sciences with clinical practice to maintain relevance and efficacy in medical curricula.</p>Saleh A.K. SalehHeba M. Adly
Copyright (c) 2024 Saleh A.K. Saleh, Heba M. Adly
https://creativecommons.org/licenses/by-nc/4.0
2024-01-152024-01-15311GMJ2024-A0210.21802/e-GMJ2024-A02Multiple Myeloma Patient with Secondary Liver and Tongue Involvement, Complicated by COVID-19-Induced ARDS: An Autopsy Case Report and Literature Review
https://ifnmujournal.com/gmj/article/view/e-GMJ2024-A01
<p><strong>Background.</strong> Liver involvement secondary to multiple myeloma is a rare and uncommon radiologic finding. Such extraosseous secondary lesions as well as tongue involvement require pathohistological confirmation to prevent misdiagnosis. Clinical and laboratory diagnostics are challenging in patients with COVID-19 and underlying multiple myeloma and its secondary lesions, leading to difficulties in treatment and outcomes.</p> <p><strong>Case Report.</strong> A 64-year-old male patient, not vaccinated against COVID-19, with a history of multiple myeloma presented with symptoms of headache, fatigue, dyspnea, cough, and fever. The patient’s medical history was intricate, involving cholecystectomy and a diagnosis of multiple myeloma, which was subsequently treated with chemotherapy and radiation therapy. Additionally, uncommon liver and tongue involvement secondary to multiple myeloma was found. Upon admission, the patient’s peripheral oxygen saturation was 90%, accompanied by increasing shortness of breath and a respiratory rate of 26 breaths per minute. A positive COVID-19 test was recorded. A lung computed tomography revealed bilateral multifocal areas of ground-glass opacity and consolidation, encompassing the entire pulmonary regions, corresponding to CO-RADS 6. The patient was admitted to the intensive care unit. Despite initiating oxygen support and symptomatic therapy, the patient’s death occurred. Autopsy confirmed the development of severe acute respiratory distress syndrome and bilateral hemorrhagic pneumonia, with multiple myeloma as a contributing factor.</p> <p><strong>Conclusions.</strong> This case report highlighted the rare occurrence of secondary liver involvement in multiple myeloma, characterized by nodules with distinct imaging features. It underscored the importance of identifying coexisting lesions, such as tongue involvement, and the diagnostic challenges they pose. Additionally, the case emphasized the need for comprehensive clinical assessment in patients with concurrent COVID-19 and underlying multiple myeloma, as it may lead to the development of acute respiratory distress syndrome.</p>Viktoriya MatskevychKhrystyna IlnytskaTetiana LenchukYulian MytsykElvira KindrativNataliia Hlushko
Copyright (c) 2024 Viktoriya Matskevych, Khrystyna Ilnytska, Tetiana Lenchuk, Yulian Mytsyk, Elvira Kindrativ, Nataliia Hlushko
https://creativecommons.org/licenses/by-nc/4.0
2024-01-082024-01-08311GMJ2024-A0110.21802/e-GMJ2024-A01Medical Students’ Knowledge, Attitude, Practice, and Perceived Barriers Towards Medical Research: A Cross-Sectional Study
https://ifnmujournal.com/gmj/article/view/e-GMJ2023-A09
<p><strong>Background.</strong> Medical research and innovation are essential for the growth of medical education and healthcare system. Medical students should be taught in a research-informed environment, which allows them to make better clinical decisions and enhances their scientific output.</p> <p><strong>Aim.</strong> The purpose of this study was to evaluate medical students’ knowledge, attitude, practice, and perceived barriers towards undergraduate medical research in the Kurdistan region of Iraq.</p> <p><strong>Methods.</strong> This cross-sectional study, which was carried out between October 2022 and April 2023, included medical students from seven medical colleges in the Kurdistan region of Iraq. The survey comprised 19 questions, categorized into five sections, and delivered to students using the Google form platform.</p> <p><strong>Results.</strong> A total of 363 medical students from seven medical colleges in the Kurdistan Region of Iraq were enrolled in this study. The sex ratio was about equal. The mean age was 20.6 (± 1.7 SD) years. Study participants demonstrated a low level of knowledge of research fundamentals, with an average correct response rate of 37.7%, as only 8.8% of participants answered all questions correctly. Three-fifths (61.5%) of participants believed research should be integrated into the curriculum, while about one-third (27%) of our study participants viewed research as an additional burden. Nearly one-third (34%) of students had participated in a research project before.</p> <p><strong>Conclusions.</strong> In our study, we found that students in clinical stages aged 21 or older and those with prior research experience showed significantly higher knowledge levels. Research participation was associated with a more favorable attitude. The vast majority of our students expressed a keen interest in participating in research projects. Students identified lack of time and deficient research skills as the most prominent barriers hindering their active participation in research.</p>Ahmed A. MosaAli Jotiar MahmoodKani F. FarooqJodi R. HajiDana JacksiDaliya K. Mohamed-SaqidTalar R. Mnasakan
Copyright (c) 2023 Ahmed A. Mosa, Ali Jotiar Mahmood, Kani F. Farooq, Jodi R. Haji, Dana Jacksi, Daliya K. Mohamed-Saqid, Talar R. Mnasakan
https://creativecommons.org/licenses/by-nc/4.0
2023-12-072023-12-07311GMJ2023-A0910.21802/e-GMJ2023-A09Three Decades of Progress and Commitment: Brief Historical Landmarks of ‘Galician Medical Journal’ Journey
https://ifnmujournal.com/gmj/article/view/e-GMJ2023-A08
<p>The 'Galician Medical Journal' celebrates its thirtieth anniversary, marking three decades of impactful contributions to the medical field. Since its establishment in 1994, the journal has evolved, overcoming challenges to become a significant platform for disseminating medical knowledge. In this editorial, we briefly reflect on the historical evolution of the journal, highlighting its transformation from local origins to an active involvement in the global medical community.</p>Oksana PopadynetsTaras KotykOksana FedorukNadiya TokarukViktoria Bedei
Copyright (c) 2023 Oksana Popadynets, Taras Kotyk, Oksana Fedoruk, Nadiya Tokaruk, Viktoria Bedei
https://creativecommons.org/licenses/by-nc/4.0
2023-12-012023-12-01311GMJ2023-A0810.21802/e-GMJ2023-A08Treatment of Teeth with Root Resorptions: A Case Report and Systematic Review
https://ifnmujournal.com/gmj/article/view/e-GMJ2023-A07
<p><strong>Aim.</strong> This article presents an evaluation of different multidisciplinary treatment approaches to managing teeth with external and internal root resorptions.</p> <p><strong>Methods.</strong> This study presents a clinical case of a 35-year-old female patient referred to Akdeniz University for dental issues. A comprehensive review of the literature was conducted, encompassing 21 articles sourced from PubMed and Web of Science over the past decade, including case reports and case series.</p> <p><strong>Results.</strong> <strong><em>Case Report.</em></strong> A clinical case of a 35-year-old female patient seeking treatment for dental aesthetic concerns was reported and discussed. Intraoral examination revealed discoloration of maxillary anterior teeth and a sinus tract in the apical region of tooth #11. The resorption area was sealed with mineral trioxide aggregate. Afterward, the coronal part of the root was filled using the warm-vertical compaction method. During the final visit, non-vital bleaching was applied to teeth #11 and #21. After all these procedures, aesthetic coronal restorations were completed. <strong><em>Systematic Review.</em></strong> In the context of this clinical case, a literature review was conducted, encompassing an assessment of a total of 25 cases of external and internal resorptions. Among these cases, a combination of surgical and endodontic treatments was applied in 12 cases, while non-surgical endodontic treatment was performed in 13 cases.</p> <p><strong>Conclusions</strong>. In the present case report, a patient who had both external and internal root resorptions was treated with mineral trioxide aggregate and flap operation, with no subsequent complications during the follow-up sessions. Among the 21 reports included in our review, 24 out of 25 treated teeth demonstrated successful outcomes, while only one tooth necessitated extraction.</p>Damla ErkalAbdullah BaşoğluDamla KırıcıNezahat Arzu KayarSimay KoçKürşat Er
Copyright (c) 2023 Damla Erkal, Abdullah Başoğlu, Damla Kirici, Nezahat Arzu Kayar, Simay Koç, Kürşat Er
https://creativecommons.org/licenses/by-nc/4.0
2023-11-192023-11-19311GMJ2023-A0710.21802/e-GMJ2023-A07Impact of Analytics Applying Artificial Intelligence and Machine Learning on Enhancing Intensive Care Unit: A Narrative Review
https://ifnmujournal.com/gmj/article/view/e-GMJ2023-A06
<p><strong>Introduction.</strong> The intensive care unit (ICU) plays a pivotal role in providing specialized care to patients with severe illnesses or injuries. As a critical aspect of healthcare, ICU admissions demand immediate attention and skilled care from healthcare professionals. However, the intricacies involved in this process necessitate analytical solutions to ensure effective management and optimal patient outcomes.</p> <p><strong>Aim.</strong> The aim of this review was to highlight the enhancement of the ICUs through the application of analytics, artificial intelligence, and machine learning.</p> <p><strong>Methods.</strong> The review approach was carried out through databases such as MEDLINE, Embase, Web of Science, Scopus, Taylor & Francis, Sage, ProQuest, Science Direct, CINAHL, and Google Scholar. These databases were chosen due to their potential to offer pertinent and comprehensive coverage of the topic while reducing the likelihood of overlooking certain publications. The studies for this review involved the period from 2016 to 2023.</p> <p><strong>Results.</strong> Artificial intelligence and machine learning have been instrumental in benchmarking and identifying effective practices to enhance ICU care. These advanced technologies have demonstrated significant improvements in various aspects.</p> <p><strong>Conclusions.</strong> Artificial intelligence, machine learning, and data analysis techniques significantly improved critical care, patient outcomes, and healthcare delivery.</p>Gopal Singh CharanAshok Singh CharanMandeep Singh KhuranaGursharn Singh Narang
Copyright (c) 2023 Gopal Singh Charan, Ashok Singh Charan, Mandeep Singh Khurana, Gursharn Singh Narang
https://creativecommons.org/licenses/by-nc/4.0
2023-11-062023-11-06311GMJ2023-A0610.21802/e-GMJ2023-A06A Case Report of Reversible Iatrogenic Compressive Myelopathy
https://ifnmujournal.com/gmj/article/view/e-GMJ2023-A05
<p>Physical rehabilitation is a proven method of non-specific lower back pain treatment in contrast to manual therapy which has no evidence of clinical effectiveness. But sometimes, in the search for relief, patients develop complications resulting from the actions of unscrupulous healthcare providers in this field. A 35-year-old patient developed unbearable pain, impaired sensitivity, decreased muscle strength, stiffness in both legs, and urinary retention after rough manual-barefoot manipulation. Computed tomography scans of the cervical, thoracic, and lumbar spine regions revealed signs of hematomyelia involving the Th9-Th10, Th10-Th11, and L1-L2 spinal cord segments. After undergoing therapy with nonsteroidal anti-inflammatory drugs and glucocorticosteroids, the patient reported a significant improvement in his condition. The description of this clinical case demonstrates a complication of the manual-barefoot manipulation presenting as compressive myelopathy.</p>Eliza BabychKsenia YarovayaYuliia SolodovnikovaAnatoliy Son
Copyright (c) 2023 Eliza Babych, Ksenia Yarovaya, Yuliia Solodovnikova, Anatoliy Son
https://creativecommons.org/licenses/by-nc/4.0
2023-10-232023-10-23311GMJ2023-A0510.21802/e-GMJ2023-A05Association of Serum Adropin Levels with Nutritional Status and Lipid Profile in Patients with Kidney Failure with Replacement Therapy
https://ifnmujournal.com/gmj/article/view/e-GMJ2023-A04
<p><strong>Objective.</strong> This study aimed to determine serum adropin levels and to examine the relationship of serum adropin levels with nutritional status and lipid profile in patients with kidney failure with replacement therapy (KFRT).</p> <p><strong>Methods.</strong> The study consisted of 88 subjects, including 30 patients treated with hemodialysis (HD), 29 patients treated with peritoneal dialysis (PD), and 29 patients who had undergone kidney transplantation (TX). The study included assessing anthropometric measurements, handgrip strength, bioelectrical impedance analysis, malnutrition-inflammation score, dietary intake, resting energy expenditure, and biochemical parameters. The patients’ food consumption was recorded for three days. The malnutrition-inflammation score (MIS) was calculated to assess the patients’ nutritional status. Blood samples were collected for serum adropin and other biochemical parameters.</p> <p><strong>Results.</strong> Adropin levels were significantly higher in the TX group when compared to the HD group. Patients with low adropin levels had higher MIS, serum ferritin, and lower low-density lipoprotein-cholesterol (LDL-C) and total cholesterol (total-C) levels. Serum adropin levels were negatively correlated with the MIS and positively correlated with total-C, LDL-C, and HDL-C levels. Multiple linear regression analyses showed that the MIS (β=-0.25 p=0.038) and LDL-C level (β=0.29, p=0.007) were associated with serum adropin.</p> <p><strong>Conclusions.</strong> Adropin may be considered as a new marker of nutritional status and possibly plays a role in the pathophysiological mechanisms and complications of patients with KFRT.</p>Gamze Yurtdaş DepboyluNilüfer Acar TekBurcu Deniz GüneşÖzge Mengi ÇelikGizem Özata UyarAyşe Derya BayazıtEmre YaşarYasemin Erten
Copyright (c) 2023 Gamze Yurtdaş Depboylu, Nilüfer Acar Tek, Burcu Deniz Güneş, Özge Mengi Çelik, Gizem Özata Uyar, Ayşe Derya Bayazıt, Emre Yaşar, Yasemin Erten
https://creativecommons.org/licenses/by-nc/4.0
2023-09-302023-09-30311GMJ2023-A0410.21802/e-GMJ2023-A04The Relationship Between Anxiety Symptoms, Anxiety Sensitivity, and Emotional Schemas in Patients Admitted to Psychiatry Outpatient Clinic
https://ifnmujournal.com/gmj/article/view/e-GMJ2023-A03
<p><strong>Introduction</strong>. Anxiety disorders are among the most common mental disorders being an important cause of disability as they impair the functionality of affected individuals.</p> <p>Our study<strong> aimed</strong> to evaluate the effects of anxiety sensitivity, which is one of the cognitive structures involved in the etiology and perpetuation of psychopathologies, and emotional schemas, which evaluate how people handle their emotions, on anxiety symptoms.</p> <p><strong>Methods.</strong> One hundred participants who were admitted to the outpatient psychiatry clinic, agreed to participate in the study, and met the inclusion criteria were included in the study. The Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-I), Leahy Emotional Schema Scale Turkish Version (LESS-T), and Anxiety Sensitivity Index (ASI-3) were administered to the participants.</p> <p><strong>Results.</strong> A correlation analysis revealed a significant relationship between the BAI score and BDI-I score, ASI-3 total score, and LESS-T Uncontrollability, Weakness, Comprehensibility, Acceptance of Emotions, Rumination, Denial of Emotions, Validation subscale scores (p < 0.05). A logistic regression analysis that examined the risk factors predicting anxiety symptoms in individuals found that increasing BDI-I and ASI-3 total scores had an increasing effect on the development of anxiety, and an increase in the LESS-T Denial of Emotions subscore had a decreasing effect.</p> <p><strong>Conclusions.</strong> Determining anxiety sensitivity and emotional schemas in patients with anxiety symptoms may be a guide in identifying and treating the risk factors for the development of anxiety disorders.</p>Ozlem Bas UluyolKumru Senyasar Meterelliyoz
Copyright (c) 2023 Ozlem Bas Uluyol, Kumru Senyasar Meterelliyoz
https://creativecommons.org/licenses/by-nc/4.0
2023-09-232023-09-23311GMJ2023-A0310.21802/e-GMJ2023-A03Relationship Between Obesity Awareness and Nutrition Attitude: A Sectional Study Among Secondary School Students
https://ifnmujournal.com/gmj/article/view/e-GMJ2023-A02
<p>This study was <strong>aimed</strong> to identify the relationship between obesity awareness and nutrition attitudes among secondary school students.</p> <p><strong>Methods.</strong> This descriptive research was conducted between April and June 2022 and involved 625 secondary school students of a province in Eastern Turkey. The data were collected using a question form consisting of a questionnaire, the Obesity Awareness Scale (OAS), and the Attitude Scale for Healthy Nutrition (ASHN). One-way ANOVA, independent sample t-test, Pearson correlation, and regression analysis were used to interpret the data.</p> <p><strong>Results.</strong> There was a balanced distribution of descriptive characteristics among the study population. In this study, age and grade level were effective on the ASHN and OAS. Additionally, there were significant differences in the OAS score only by gender; however, the ASHN value significantly depended on weight assessment status, regular eating, and body mass index variables. Although there was a considerable deviation observed within the assessed sample regarding unhealthy behaviors, average time spent per day on the computer, phone, or television was approximately one hour. Although the study population had a positive attitude towards healthy eating and a high awareness of obesity, it was seen that students consumed junk food twice per day and fast food once a week on average. A regression analysis revealed a significant negative impact of time spent per day on the phone and junk food consumption on the ASHN; however, regular eating and OAS had positive effects.</p> <p><strong>Conclusions.</strong> As students’ attitudes towards healthy nutrition increased, their levels of obesity awareness increased as well. Unhealthy lifestyle factors such as phone usage and junk food intake negatively affected healthy eating attitudes.</p>Gulsun AyranOzlem Karaca
Copyright (c) 2023 Gulsun Ayran, Ozlem Karaca
https://creativecommons.org/licenses/by-nc/4.0
2023-09-232023-09-23311GMJ2023-A0210.21802/e-GMJ2023-A02A Case of Delayed Immune Checkpoint Inhibitor Hepatitis in a Patient with Malignant Melanoma
https://ifnmujournal.com/gmj/article/view/e-GMJ2023-A01
<p>Immune checkpoint inhibitors are an increasingly utilized class of medications in oncology. Significant adverse effects have been reported, including hepatitis which mostly occurs early after initiating treatment. We present a case of a 78-year-old male with past medical history of recurrent sinusoidal mucosal malignant melanoma on pembrolizumab for three years that presented with painless jaundice of 72-hour duration. Laboratory evaluation demonstrated alkaline phosphatase at 1780 IU/L, aspartate aminotransferase at 2290 IU/L, alanine aminotransferase at 1224 IU/L, and bilirubin of 10.0 mg/dL with direct bilirubin of 7.4 mg/dL. The patient underwent interventional radiology transjugular liver biopsy demonstrating features of drug-induced liver injury secondary to pembrolizumab therapy. He was started on steroid therapy and completed six-week course with resolution in liver enzymes. This is a unique case in which pembrolizumab-induced hepatitis occurred three years after initiation of treatment. Due to the increased use of immune checkpoint inhibitors for oncologic treatment, it is important for clinicians to recognize their immune-related adverse effects and varying timing in which these toxicities may occur.</p>Dayna TelkenNael HaddadVictor Arce GutierrezDonald TschirhartYasmin Alishahi
Copyright (c) 2023 Dayna Telken, Nael Haddad, Victor Arce Gutierrez, Donald Tschirhart, Yasmin Alishahi
https://creativecommons.org/licenses/by-nc/4.0
2023-09-232023-09-23311GMJ2023-A0110.21802/e-GMJ2023-A01Visualizing Wearable Medical Device Research Trends: A Co-occurrence Network-Based Bibliometric Analysis
https://ifnmujournal.com/gmj/article/view/E202332
<p><strong>Background.</strong> One of the most crucial aspects of someone’s life is health. Therefore, individuals should be conscious about keeping themselves healthy by regular monitoring their health, which can be done with the help of modern medical technologies. Wearable medical devices using wearable sensors are the popular names of emerging technologies in the modern healthcare domain.</p> <p><strong>Aim.</strong> This work presents the results of a systematic investigation of extensive research that has occurred for the last two decades in these research streams to provide a comprehensive mapping and temporal distribution of wireless medical device research.</p> <p><strong>Methods.</strong> This study presents a relationship between the bibliographic items, their quality, and the quantity representing the most effective research topics on wearable medical devices. The analysis is performed using two useful parameters, namely a bibliometric network and a co-occurrence matrix. Data collection, data standardization, data mapping, and result analysis are the steps involved in the bibliometric analysis technique. In this study, VOSviewer software for bibliometric analysis is applied to the Scopus database.</p> <p><strong>Results.</strong> By analysing bibliometric indicators from the Scopus database and using VOSviewer, we represent their distribution in countries, institutions, top researchers, and top journals. Furthermore, we analyse the co-citation of cited authors and the co-occurrence of keywords. The outcomes of the clustering and keyword analysis indicate that the research domain primarily focuses on the Internet of Things, machine learning, wearable sensors, mobile health, electrocardiogram, etc.</p> <p><strong>Conclusions.</strong> Statistical investigation in association with the visual exploration presented in this article provides more substantial information than either of them used separately. In the future, this article can illuminate researchers and practitioners to develop a different theory to look at the factors that influence predictability in the research domain of wearable medical devices.</p>Bitan MisraNilanjana Dutta RoyNilanjan DeyRobert Simon Sherratt
Copyright (c) 2023 Bitan Misra, Nilanjana Dutta Roy, Nilanjan Dey, Robert Simon Sherratt
https://creativecommons.org/licenses/by-nc/4.0
2023-09-012023-09-01311E202332E20233210.21802/gmj.2023.3.2A Case of Long COVID-19 Myocarditis with Asymptomatic Manifestation in a Young Male
https://ifnmujournal.com/gmj/article/view/E202337
<p><strong>Background</strong>. Myocarditis is one of the most dangerous complications of both the acute phase of COVID-19 and long COVID-19, with a rather heterogeneous clinical presentation that ranges from asymptomatic to life-threatening. The diverse clinical presentation with a high risk of further complications, on the one hand, and a good prognosis in case of appropriate treatment, on the other hand, demand great attention from doctors.</p> <p><strong>Case Report.</strong> We report a case of a 27-year-old male presented to a cardiologist with complaints of dyspnea, chest pain, palpitation occurred eight months after a mild COVID-19 episode. The diagnostic search commenced with a detailed questioning and physical examination with further laboratory testing and instrumental procedures, including resting electrocardiography, resting two-dimensional speckle-tracking echocardiography, and stress echocardiography. Gadolinium-enhanced cardiac magnetic resonance was the final step in diagnosis establishment. Half-a-year follow-up period of the patient with asymptomatic manifestation of COVID-19 myocarditis demonstrated the normalization of the condition after prescribed pathogenetic treatment.</p> <p><strong>Conclusions.</strong> This case report raises awareness of the need for prolonged follow-up of patients after an episode of COVID-19 and proposes a comprehensive approach to a possible differential diagnostic search for precise diagnosis and treatment in a young male with rationale based on the relevant literature.</p>Oleksandr SavchenkoYuliya TyravskaYuliya MoshkovskaDina PliskevychNataliia AltuninaViktor Lizogub
Copyright (c) 2023 Oleksandr Savchenko, Yuliya Tyravska, Yuliya Moshkovska, Dina Pliskevych, Nataliia Altunina, Viktor Lizogub
https://creativecommons.org/licenses/by-nc/4.0
2023-09-012023-09-01311E202337E20233710.21802/gmj.2023.3.7False Beliefs About Diabetes Mellitus in the Kurdistan Region of Iraq: A Population-Based Study
https://ifnmujournal.com/gmj/article/view/E202331
<p><strong>Background.</strong> Diabetes mellitus (DM) is a chronic, non-transmissible health condition distinguished by high blood glucose levels caused by faulty insulin secretion and impaired insulin activity. People play an essential role in preventing and managing their illnesses. Thus, the misconceptions may negatively influence the prevention and management of DM.</p> <p><strong>The aim of this study</strong> was to gauge the extent of knowledge among the general population concerning DM, to determine the prevalence of misconceptions about DM in the community, and to find the factors influencing them.</p> <p><strong>Methods.</strong> A population-based study was conducted in Duhok Province, the Kurdistan Region of Iraq. A total of 2,305 adults were enrolled in the study. The study data were collected by face-to-face interview. The survey questionnaire comprised two sections: the first section included basic demographic characteristics of participants, while the second section consisted of ten questions to identify common misconceptions about DM among participants.</p> <p><strong>Results.</strong> Among the participants, there were 1,406 (61.0%) females. Participants’ age ranged from 18 to 90 years (the mean age: 54 ± 13.69 years). The most common misconceptions positively responded to were “<em>Will I become addicted to insulin if I start taking it</em>?”, followed by“ <em>Does DM occur because of increased sugar intake</em>?”. Male gender was associated with higher level of misconceptions. In addition, the misconceptions were more prevalent among diabetics as they might seek treatment from non-professionals. There was a significant association between education status and the prevalence of misconceptions. Healthcare workers were found to have a better knowledge about DM compared to the general population. Surprisingly, certain myths were prevalent even among healthcare workers.</p> <p><strong>Conclusions.</strong> Certain myths and misconceptions have been pervasive in our society. Actions must be taken to dispel these misconceptions as they lead to an avoidable burden of disease. Therefore, people’s knowledge of DM needs to be enhanced through educational programs, social media, television, newspapers and campaigns.</p>Brisik H. RashadBasheer A. AbdiIbrahim A. NaqidNawfal R. HusseinAhmed A. MosaLaween Hashim DawoudRamis Imad ElyasHalima Adill Abdulrahman
Copyright (c) 2023 Brisik H. Rashad, Basheer A. Abdi, Ibrahim A. Naqid, Nawfal R. Hussein, Ahmed A. Mosa, Laween Hashim Dawoud, Ramis Imad Elyas, Halima Adill Abdulrahman
https://creativecommons.org/licenses/by-nc/4.0
2023-09-012023-09-01311E202331E20233110.21802/gmj.2023.3.1Associations of Dietary Fructose and Sucrose Intake with HbA1c and Anthropometric Measurements in Patients with Type 2 Diabetes Mellitus
https://ifnmujournal.com/gmj/article/view/E202333
<p><strong>Aim.</strong> This study aimed to evaluate the associations of daily dietary intake of fructose and sucrose with HbA1c levels and anthropometric measurements in patients with Type 2 diabetes mellitus.</p> <p><strong>Methods.</strong> A total of 64 individuals were included in the study. Demographic characteristics, eating habits, frequency of fructose and sucrose source consumption, and dietary intakes were assessed through questioning. Anthropometric measurements, including body weight, height circumference (HtC), waist circumference (WC), hip circumference (HC), neck circumference (NC), wrist circumference (WrC), and mid-upper arm circumference (MUAC), were evaluated. The HbA1c level was categorized into two groups: good glycemic control (HbA1c≤ 7%) and poor (HbA1c> 7%) glycemic control.</p> <p><strong>Results.</strong> The mean daily fructose and sucrose intakes were 10.57 ± 8.28 g (2.38 ± 1.96%), and 29.21 ± 24.78 g (6.29 ± 5.35%), respectively. All the anthropometric measurements assessed were lower in the group with good glycemic control; however, only in case of BMI, MUAC, NC, and WrC, these differences were significant. Patients with good glycemic control were found to consume more fruit. Anthropometric measurements were not related to daily fructose intake, but positively associated with sucrose intake and HbA1c levels. Specifically, HbA1c levels were negatively associated with fiber intake and positively associated with sucrose intake. Moreover, HbA1c levels were positively affected by NC and consumption of non-alcoholic carbonated drinks, and negatively affected by WC and consumption of sugar-containing instant coffee.</p> <p><strong>Conclusions.</strong> The mean daily fructose intake among diabetics was found to be moderate and sucrose intake was consistent with the recommended range. The level of HbA1c was shown to be associated with all the anthropometric parameters assessed, and it was found that sugar-sweetened beverages could affect the level of HbA1c. However, further studies with larger sample sizes are needed to investigate these relationships more comprehensively.</p>Gulsah KanerCagla AyerTuba YalcinBuse Bakir
Copyright (c) 2023 Gulsah Kaner, Cagla Ayer, Tuba Yalcin, Buse Bakir
https://creativecommons.org/licenses/by-nc/4.0
2023-09-012023-09-01311E202333E20233310.21802/gmj.2023.3.3Usefulness of Unstimulated and Stimulated Whole Saliva, Accuracy of Minor Labial Salivary Gland Biopsy in the Diagnosis of Primary Sjögren's Disease: A Croatian Single-Center, Cross-Sectional Study
https://ifnmujournal.com/gmj/article/view/E202334
<p><strong>The aim</strong> of this cross-sectional study was to determine the accuracy of minor labial salivary gland (MLSG) biopsy in the diagnosis of primary Sjögren' s disease (pSD); to study the correlation between the focus score (FS) and anti-SSA/Ro, anti-SSB/La, anti-SSA and -SSB antibodies, unstimulated whole saliva (UWS) and stimulated whole saliva (SWS); to determine the role of UWS and SWS in the clinical evaluation of pSD patients and patients with <em>sicca</em> symptoms.</p> <p><strong>Methods.</strong> A total of 37 subjects were enrolled in the study and divided into two groups: the test group consisted of 15 patients diagnosed with pSD; the control group consisted of 22 patients who had <em>sicca</em> symptoms but did not meet the 2016 American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) diagnostic criteria. Clinical and laboratory tests, including saliva collection, MLSG biopsy, autoantibody titers, were performed in all patients.</p> <p><strong>Results</strong>. The median of the FS was 1.00 [IQR=1.00-1.50] in the test group, whereas in the control group, it was 0.00 [IQR=0.00-0.00] (p< 0.001). The sensitivity, specificity, and accuracy of MLSG biopsy were 86.7%, 100.0%, and 94.6%, respectively. The results showed a correlation between the FS and antinuclear antibodies (ANA) (p=0.002). In addition, Pearson’s correlation showed a weak negative correlation between UWS (r=-0.058, p=0.73) and SWS (r=-0.022, p=0.90) and the FS. In the test group, 73.3% of patients had abnormal UWS values, while 86.7% had abnormal SWS values; among them, values of 0.00 ml/min for UWS and SWS were found in 60.0% and 26.7% of patients, respectively.</p> <p><strong>Conclusions</strong>. Although MLSG biopsy has great diagnostic value and accuracy in diagnosing pSD, it is not always definitive. Our study found a statistically significant association between the FS and ANA, and the greater utility of SWS in diagnosing pSS.</p>Ivona BaricAntonija TadinAna Glavina
Copyright (c) 2023 Ivona Baric, Antonija Tadin, Ana Glavina
https://creativecommons.org/licenses/by-nc/4.0
2023-09-012023-09-01311E202334E20233410.21802/gmj.2023.3.4Impact of Oral Habits and Buccal Frenulum on Gingival Microcirculation in Children: Findings and Clinical Significance
https://ifnmujournal.com/gmj/article/view/E202335
<p><strong>Background.</strong> Oral mucosal abnormalities such as abnormal lip frenulum, buccal frenulum, ankyloglossia are commonly observed in a routine dental practice. The close anatomical and functional relationship between the gingiva and the alveolar bone determines the significance of abnormal mucosal structures in the development of malocclusions and periodontal diseases. Oral habits are more prevalent in childhood; however, they can persist into adolescence and adulthood, potentially leading to dentofacial impairments and malocclusions. Therefore, there is a growing interest in understanding oral mucosal blood flow in the presence of oral habits and abnormal mucosal structures, as their combined effects may have a synergistic influence on the development of maxillomandibular anomalies.</p> <p><strong>Aim.</strong> This study was aimed to investigate age-depended parameters of gingival microcirculation in children with buccal frenulum, oral habits, and maxillomandibular anomalies.</p> <p><strong>Methods.</strong> This cross-sectional study involved 45 apparently healthy children and 180 children with oral habits, buccal frenulum, and maxillomandibular anomalies, divided into 3 age groups (ages 9 to 12, 12 to 15, and 15 to 17 years). Oral mucosal blood flow was assessed using a rheograph DX (Kharkiv, Ukraine) by measuring qualitative characteristics and quantitative parameters such as the vascular tone index (VTI), venous outflow index (VOI), peripheral resistance index (PRI), extensive blood flow index (EBFI), and rheographic index (RI). Statistical analysis included Spearman’s correlation, a Kruskal-Wallis H test, and a Dunn’s post-hoc test.</p> <p><strong>Results.</strong> The study revealed a significantly higher VTI in all patient groups, increasing with age and reaching +80.54% in the oldest age group compared to the respective control group. This elevation was accompanied by a moderate correlation enhancing the PRI (+4.61% in 9-12-year-old group to +33.42% in 15-17-year-old group). Furthermore, the VOI exhibited a noteworthy and age-dependent increase; however, there was a notable reduction in the RI (-41.10% to -59.70%) and EBFI values (-35.54% and -37.70% versus -23.97% in the youngest age group).</p> <p><strong>Conclusions.</strong> This study demonstrated a relationship between oral habits, buccal frenulum, and age-dependent disturbance of gingival microcirculation in children. The findings suggest that chronic traumatization due to oral habits and abnormal mucosal structures lead to increased vasoconstriction and impaired vessel elasticity. Early intervention and management of such category of patients are crucial for preserving optimal gingival microcirculation.</p>Nataliia MakhlynetsSofia AntoniakAndrii PantusMariana PavlyshynZinovii Ozhogan
Copyright (c) 2023 Nataliia Makhlynets, Sofia Antoniak, Andrii Pantus, Mariana Pavlyshyn, Zinovii Ozhogan
https://creativecommons.org/licenses/by-nc/4.0
2023-09-012023-09-01311E202335E20233510.21802/gmj.2023.3.5Incidentally Discovered Cryptogenic Cirrhosis in a Patient with Untreated Celiac Disease
https://ifnmujournal.com/gmj/article/view/E202336
<p>Celiac disease is a common gastrointestinal disorder that primarily manifests its effects on the small bowel. However, the systemic nature of this condition, especially regarding the liver, has been gaining some recognition in the literature. Mild liver disease is common, but few cases progress to cirrhosis. We present a case of an asymptomatic 78-year-old male with a past medical history of longstanding celiac disease, atrial fibrillation, heart failure with preserved ejection fraction, type 2 diabetes mellitus (DM), and chronic kidney disease stage III who underwent a computed tomography (CT) scan for thoracic aortic aneurysm surveillance. Incidentally, on a CT scan, cirrhotic liver morphology was discovered. Right upper quadrant ultrasound confirmed heterogenous echotexture of the liver, consistent with a diagnosis of cirrhosis. Laboratory work-up demonstrated elevated alkaline phosphatase of 171, tissue transglutaminase (TTG) significantly elevated at > 100, and a negative panel of other chronic liver disease labs, including negative anti-smooth muscle antibody, antimitochondrial antibody, liver kidney microsomal antibody, HFE gene, ceruloplasmin, alpha-1-antitrypsin, and alpha-fetoprotein < 2 ng/mL. The patient was not taking any hepatotoxic medications. Although the patient did have type 2 DM, his hemoglobin A1c was well-controlled at 5.9%, and he had no hyperlipidemia and a normal body mass index, making a metabolic etiology of liver disease less likely. The patient had no significant alcohol use, either. The only patient’s major risk factor for liver disease was his untreated celiac disease, diagnosed in infancy. The patient was instructed to avoid any gluten, alcohol, and other hepatotoxic substances and was subsequently followed by a gastroenterologist. The following case report explores the pathogenesis of celiac-associated liver disease and the effect a gluten-free diet can have on the small bowel and the liver.</p>Kelli Kosako YostYasmin Alishahi
Copyright (c) 2023 Kelli Kosako Yost, Yasmin Alishahi
https://creativecommons.org/licenses/by-nc/4.0
2023-09-012023-09-01311E202336E20233610.21802/gmj.2023.3.6The Relationship Between Eating Behaviors and Functional Status in Female Patients Diagnosed with Fibromyalgia
https://ifnmujournal.com/gmj/article/view/E202323
<p><strong>Aim.</strong> To evaluate whether eating behaviors of female patients with fibromyalgia syndrome differ from those of the healthy population, what factors affect these behaviors, and whether eating behaviors are effective on patients’ life quality and functional status.</p> <p><strong>Materials and Methods.</strong> This cross-sectional and observational study included 55 female fibromyalgia patients and 55 healthy female volunteers. All participants were assessed using demographic data, body mass index (BMI), and the Three-Factor Eating Questionnaire (TFEQ) (Uncontrolled Eating, Cognitive Restraint, Emotional Eating, and Hunger Susceptibility). Fibromyalgia patients were assessed using the Visual Analogue Scale (VAS) and Fibromyalgia Impact Questionnaire (FIQ).</p> <p><strong>Results.</strong> BMI, Uncontrolled Eating, and Hunger Susceptibility scores differed significantly between fibromyalgia patients and healthy volunteers (p < 0.05). In fibromyalgia patients, the TFEQ subscores were not correlated with the FIQ (p > 0.05). There was a positive correlation between the Cognitive Restraint score and age, rest and night pain scores in fibromyalgia patients (p< 0.05). Increasing age was an independent predictor of Cognitive Restraint in fibromyalgia patients (p=0.003).</p> <p><strong>Conclusions.</strong> The proportion of overweight/obese patients, BMI, Uncontrolled Eating, and Hunger Susceptibility were significantly higher among fibromyalgia patients. Fibromyalgia patients’ eating behaviors were not associated with their quality of life and functional status. Increasing age appeared to be a predictor of Cognitive Restraint degree.</p>Alper Mengi
Copyright (c) 2023 Alper Mengi
https://creativecommons.org/licenses/by-nc/4.0
2023-05-202023-05-20311E202323E20232310.21802/gmj.2023.2.3Visualization in Anatomical Sciences for Effective Teaching and Learning
https://ifnmujournal.com/gmj/article/view/E202321
<p>Anatomy is one of the basic subjects of medical science. Medical students gain detailed knowledge of human body by dissecting cadavers. Hence, cadaveric dissection has become an essential tool in teaching and learning anatomy. In anatomy, visualization plays an important role in understanding the spatial orientation of structures. Due to technological advancement and a shortage of cadavers, there is a need to look for various complementary tools which can provide an adequate visualization of bodily structures. This issue was very well understood and reflected during the recent pandemic when cadaveric dissection was substituted by experimenting with various teaching tools. In this paper, we have tried to briefly describe the various options that can complement/supplement dissection and assist in self-directed learning.</p>Nagavalli Basavanna PushpaKumar Satish Ravi
Copyright (c) 2023 Nagavalli Basavanna Pushpa, Kumar Satish Ravi
https://creativecommons.org/licenses/by-nc/4.0
2023-05-202023-05-20311E202321E20232110.21802/gmj.2023.2.1Evaluation of the Tpeak-Tend Interval as an Arrhythmogenicity Index in Graves' Disease
https://ifnmujournal.com/gmj/article/view/E202324
<p><strong>Introduction.</strong>Graves’ disease is the most common cause of hyperthyroidism. The mortality rate increases by 20% in hyperthyroid patients; cardiac problems are the leading cause of death and arrhythmia is the most common cardiac complication.</p> <p>Our study <strong>aimed</strong> to evaluate the corrected QT interval (QTc), the Tpeak-Tend interval (Tp-e), and the Tp-e/QTc ratio to predict arrhythmia risk in patients with Graves’ disease.</p> <p><strong>Methods. </strong>The study included 64 patients with Graves’ disease and 57 euthyroid controls. The 12-lead electrocardiograms of the individuals under study were evaluated. The QTc interval, the Tp-e interval, and the Tp-e/QTc ratio of all participants were determined and statistically evaluated with thyroid stimulating hormone (TSH), free triiodothyronine (fT3) and free thyroxine (fT4) values.</p> <p><strong>Results. </strong>Tp-e (p < 0.001) and QTc (p < 0.05) were significantly prolonged in the group of patients with Graves’ disease as compared to the control group. Heart rate was higher in patients with Graves’ disease as well (p < 0.05). Correlation analysis in patients with hyperthyroidism demonstrated that Tp-e (r=0.372, p=0.002), QTc (r=0.291, p=0.020), and fT3 levels were significantly and positively correlated. Similarly, Tp-e (r=0.271, p=0.030), QTc (r=0.259, p=0.039), and fT4 levels were significantly and positively correlated.</p> <p><strong>Conclusions.</strong> We observed a significant prolongation of the Tp-e and QTc intervals with the increase in fT3 and fT4 levels. On the other hand, our study demonstrated that the sensitivity and specificity of Tp-e in the prediction of hyperthyroidism were 70.3% and 70.1%, respectively (AUC=0.724 (CI: 0.629-0.818)), the optimal cut-off value=83.5 ms). The Tp-e interval, which has recently been used as one of the arrhythmogenicity indices, may be an indicator of arrhythmia risk in patients with Graves’ disease.</p>Cem Onur KiracVehbi SirikciHuseyin Avni Findikli
Copyright (c) 2023 Cem Onur Kirac, Vehbi Sirikci, Huseyin Avni Findikli
https://creativecommons.org/licenses/by-nc/4.0
2023-05-202023-05-20311E202324E20232410.21802/gmj.2023.2.4Turkish Dental Students’ Perceptions and Awareness of Dental Implant Education: A Questionnaire Study
https://ifnmujournal.com/gmj/article/view/E202325
<p><strong>Objective.</strong> This study aimed to assess Turkish dental students’ awareness of and attitudes toward dental implant therapy, as well as the effectiveness of dental implantology lecture from their point of view.</p> <p><strong>Materials and Methods.</strong> This study used a cross-sectional online survey. A total of 425 third-, fourth- and fifth-year dental students enrolled in Gazi University School of Dentistry during the 2020-2021 academic year were invited to participate in the survey anonymously and voluntarily. Following the descriptive part (age, gender, and education status), all the participants were asked 11 questions.</p> <p><strong>Results.</strong> Total of 415 questionnaires were analyzed. The 3<sup>rd</sup>-year students stated that they were“ poorly” informed about dental implants (n=88, 64.7%), while the 4<sup>th</sup>- and 5<sup>th</sup>-year students were“ moderately” infromed (n=78, 54.2% and n=60, 44.4%, respectively) (p < 0.001). All the students were believed that they needed to get more information during their undergraduate studies (p < 0.01). More than half of all students preferred to have PhD or speciality training after graduation (p > 0.05). Approximately 80% of all students believed that dentists should receive specialized training in order to practice implant dentistry (p > 0.05).</p> <p><strong>Conclusions. </strong>The results of this study show that some Turkish dental students find DI treatment a difficult operation and that they do not know enough about it. As a result, it is anticipated that improving the current curriculum will contribute to the course success and make dental students feel better prepared for dental implantology following graduation.</p>Eda IzgiNur Mollaoglu
Copyright (c) 2023 Eda Izgi, Nur Mollaoglu
https://creativecommons.org/licenses/by-nc/4.0
2023-05-202023-05-20311E202325E20232510.21802/gmj.2023.2.5“What IVC?”: Deep Vein Thrombosis in the Context of IVC Dysgenesis
https://ifnmujournal.com/gmj/article/view/E202328
<p>Among young, otherwise healthy adults with unprovoked deep vein thrombosis (DVT), uncommon causes like variation in the normal sequential development of the inferior vena cava (IVC), must be explored. Anomalous IVC conditions are estimated to occur in up to 9% of the general population, with the rarest anomaly being IVC agenesis at 0.0005% - 1% general population prevalence. DVTs are more likely to develop in this population due to venous stasis from decreased venous return, even with the formation of extensive collateral veins. Herein, the authorial team presents a 22-year-old patient with leg pain and swelling who was found to have acute DVT, and, incidentally, the absence of the suprarenal IVC with a robust collateral system on further imaging studies. The morbidity of DVTs in this population is very high, and attention should be given to young patients who present with new-onset DVT in the setting of normal coagulation studies and lack of personal or family history of clotting disorders, as the need for specialized imaging such as venograms is necessary to secure the proper diagnosis.</p>Thomas C. VarkeyCheney E. MerhavyJack B. DingKelli Kosako YostCharles HymanDaphne HancockCaitlyn A. GarmerRaaj PyadaAnne NguyenArjun SrivastavaZachary I. Merhavy
Copyright (c) 2023 Thomas C. Varkey, Cheney E. Merhavy, Jack B. Ding, Kelli Kosako Yost, Charles Hyman, Daphne Hancock, Caitlyn A. Garmer, Raaj Pyada, Anne Nguyen, Arjun Srivastava, Zachary I. Merhavy
https://creativecommons.org/licenses/by-nc/4.0
2023-05-202023-05-20311E202328E20232810.21802/gmj.2023.2.8“MedEd” on Twitter: A Social Network Analysis
https://ifnmujournal.com/gmj/article/view/E202326
<p><strong>Background.</strong> In the current era, Twitter is an increasingly popular tool for the dissemination of information as a social media voice. Social media is a valid, but underutilized, education tool at medical education institutions. Social media technologies provide opportunities for the presentation of information in alternative and multiple formats to enhance engagement, content creation, and motivation for individual and collaborative learning.</p> <p><strong>Objective.</strong> This study examined the type of social structure and sub-clusters do exist regarding “MedEd” on the Twitter network. Additionally, it determined the top opinion leaders in these networks and which type of topics generates users’ interest regarding “MedEd”.</p> <p><strong>Methods.</strong> This study applied NodeXL to analyze the results and retrieved Twitter data on November 1, 2022 by using the keywords “MedEd”. The data were saved and interpreted in the “vertices” and “edges” on the NodeXL worksheets.</p> <p><strong>Results.</strong> We found that the top opinion leader (vertex) “Cryptovitas” had the highest in- betweenness and out-degree centrality. “Innov_medicine” had the in-degree centrality for networks. “In-Degree” and “Out-Degree” are the count of Tweets an opinion leader gets and forwards messages out, correspondingly. The study found that although “Cryptovitas” had the highest in-betweenness centrality, “taylorswift13” had the maximum number of followers (91,523,045) with in-betweenness centrality of 0.0. This indicates that the vertex having maximum influence with the largest number of in-betweenness centrality has not linked with several followers.</p> <p><strong>Conclusions.</strong> Using Twitter embodies a potential prospect to engage the medical education community. The content of top networks’ tweets was around the number of “MedEd” innovations with the potential to significantly improve medical education delivery and innovative technologies in healthcare services. There is no link between the number of followers and in-betweenness centrality to influence the strength of social media voice. Although clinical and social tweets were there, not much was discussed regarding the curriculum reforms, continued professional development, technical issues in MedEd, and assessments. This triggers the insistence for rapid and innovative adaptations to the new learning environments and remarkable revolutions in medical education, including the encouragement of evidence-based education. The Twitter discussions promoted a research network circulating a wide range of informative innovations and collaborations.</p>Shazia IqbalShahzad AhmadMohd Ali SamsudinSaood Khan LodhiSalima Naveed Manji
Copyright (c) 2023 Shazia Iqbal, Shahzad Ahmad, Mohd Ali Samsudin, Saood Khan Lodhi, Salima Naveed Manji
https://creativecommons.org/licenses/by-nc/4.0
2023-05-202023-05-20311E202326E20232610.21802/gmj.2023.2.6Saving Lives Under Fire: The Extraordinary Efforts of ICU Health Professionals in the Ukrainian War
https://ifnmujournal.com/gmj/article/view/E202322
<p>Amid the Ukrainian War, the heroes of the intensive care unit (ICU) - doctors, nurses, respiratory therapists, and many others - valiantly confront unprecedented challenges, showcasing resilience and dedication in the face of adversity. Despite limited resources and electricity backup issues, these health professionals worked tirelessly to provide life-saving care to critically ill patients, including those with gunshot wounds, shrapnel injuries, burns, and traumatic brain injuries. The article highlights the need to denounce attacks on medical personnel during conflicts, and strategies for supporting ICU health professionals in war zones are suggested, including hazard pay, comprehensive insurance coverage, safety training and equipment, support networks and mental health services, and ongoing education and professional development. The heroic efforts of ICU health professionals during times of war highlight the crucial role they play in healthcare systems worldwide.</p>Raman KaliaCharanjit KaurAmanpreet KaurGopal Singh Charan
Copyright (c) 2023 Raman Kalia, Charanjit Kaur, Amanpreet Kaur, Gopal Singh Charan
https://creativecommons.org/licenses/by-nc/4.0
2023-05-202023-05-20311E202322E20232210.21802/gmj.2023.2.2Renin-Angiotensin System: A Review of Historical Perspectives
https://ifnmujournal.com/gmj/article/view/E202327
<p>The article is a review of publications concerning historical perspectives of the renin-angiotensin system. The discovery of its components is presented in chronological order, beginning with the initial identification of renin and proceeding to the subsequent discoveries of angiotensin-converting enzyme 2, angiotensin- (1-7), Mas receptor.</p> <p>This paper presents a modern classification of the renin-angiotensin system, dividing it into classical and non-classical branches, based on the determination of the biological effects of its components. Significant attention is devoted to elucidating the biochemical cascade of the renin-angiotensin system, its physiological transformations, and its implications in human body processes. The detrimental cardiac effects of the classical renin-angiotensin system are highlighted, along with the crucial role played by its alternative axis in counteracting the development of cardiovascular diseases.</p> <p>The article presents data on the involvement of angiotensin-converting enzyme 2 and its receptors in coronavirus infections, susceptibility to infection, and disease progression.</p>Olga KovalyovaAnna ZhuravlyovaSvitlana Ivanchenko
Copyright (c) 2023 Olga Kovalyova, Anna Zhuravlyova, Svitlana Ivanchenko
https://creativecommons.org/licenses/by-nc/4.0
2023-05-202023-05-20311E202327E20232710.21802/gmj.2023.2.7