Galician Medical Journal https://ifnmujournal.com/gmj <p>“Galician Medical Journal” is an open access, double-blinded peer-reviewed scholarly journal that publishes articles in the fields of medicine.<br>The aim of the journal is to provide scientific communication, share experience and presentation of scientific results and clinical observations among members of the global medical community.<br>The journal publishes original research articles, clinical case reports, letters to the editor, literature review in pathology, internal medicine, dentistry, and new trends in medical education.</p> <p><strong>ISSN 2414-1518 (English ed. Online) ISSN 2306-4285 (Ukrainian ed. Print)</strong></p> Ivano-Frankivsk National Medical University en-US Galician Medical Journal 2414-1518 <div id="copyrightNotice"><span style="font-family: Georgia, serif; font-size: 17px;">Authors who publish with this journal agree to the following terms:</span> <ul style="list-style-type: circle;"> <li class="show"><span style="font-family: Georgia, serif; font-size: 16px;">Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a <a href="http://creativecommons.org/licenses/by-nc/4.0" 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="http://opcit.eprints.org/oacitation-biblio.html" target="_new">The Effect of Open Access</a>).</span></span></li> </ul> </div> The Effect of the Progressively Lowered Stress Threshold Model Training Program on Depression and Care Burden in Dementia Patient Caregivers https://ifnmujournal.com/gmj/article/view/E202223 <p><strong>The objective</strong> of this study was to determine the effect of the Progressively Lowered Stress Threshold training program on depression and care burden in dementia patient caregivers.</p> <p><strong>Materials and Methods.</strong> We applied an experimental model based on a pretest-posttest control group. The sample consisted of 140 dementia caregivers (the experimental group and the control group with 70 participants per group). The sample size was determined, and the participants were allocated to groups using power analysis. Data of the study were collected between April 15, 2016 and July 15, 2016. For the pre-test, both groups were provided with the Sociodemographic Characteristics Form, the Beck Depression Inventory (BDI), and the Caregiver Burden of Dementia Patient Caregiver Scale (CBDPCS) to be filled in. Then, the experimenter visited the homes of the experimental group patients twice at 2-week intervals to provide nursing care based on the Progressively Lowered Stress Threshold Model. Finally, after 8 weeks, the post-test was conducted by letting both groups complete the Sociodemographic Characteristics Form, the BDI, and the CBDPCS once again. Percentage, chi-square, in independent and dependent sample t-tests were used to evaluate the related data.</p> <p><strong>Results.</strong> The mean BDI score was 15.61 ± 10.97 in the pre-test and 11.08 ± 8.82 in the post-test (t=6.738, p=0.001). The mean pre-test and post-test total CBDPCS scores of caregivers were 67.02 ± 16.23 and 59.27 ± 15.25, respectively (t=5.974, p=0.001). The difference between the intergroup comparison of the mean experiment and control group post-test scores was statistically significant (p=0.001) on the CBDPCS and the total BDI score.</p> <p><strong>Conclusions.</strong> Our results suggest that education provided to caregivers can efficiently decrease their care burden and depression levels.</p> Sinan Aslan Rukuye Aylaz Copyright (c) 2022 Sinan Aslan, Rukuye Aylaz https://creativecommons.org/licenses/by-nc/4.0 2022-06-01 2022-06-01 29 2 E202223 E202223 10.21802/gmj.2022.2.3 Risk Factors Associated with Treatment Default Among Tuberculosis Patients in Adamawa State, Nigeria https://ifnmujournal.com/gmj/article/view/E202221 <p><strong>Background.</strong> Tuberculosis is an infectious disease caused by bacteria called <em>Mycobacterium tuberculosis</em>. The treatment of drug-resistant tuberculosis is complex, costly, and usually has poor outcomes. Treatment default is well known as a very significant factor associated with drug-resistant tuberculosis.</p> <p><strong>The aim</strong> of this study was to investigate the hazard ratios associated with treatment default among tuberculosis patients in Adamawa State, Nigeria.</p> <p><strong>Materials and Methods. </strong>The Cox proportional hazards regression was used to determine the hazard ratios associated with tuberculosis patient treatment default in Adamawa State, Nigeria. The Kaplan-Meier method was used to analyze time-to-event data. The study assessed the survival status and treatment outcomes of tuberculosis patients over a six-month period (January 2019 to June 2019). Data analysis was done using R - Programming Software and the statistical significance was considered at p &lt; 0.05.</p> <p><strong>Results. </strong>Out of the 197 (124 males and 73 females) tuberculosis patients, 148 (75.1%) individuals were diagnosed with pulmonary tuberculosis and 49 (24.9%) individuals were diagnosed with extrapulmonary tuberculosis. The treatment outcomes were as follows: 33 (16.8%) patients were cured; 36 (18.3%) individuals completed their treatment; 3 (1.5%) patients died during treatment; 105 (53.3%) subjects defaulted; 8 (4.1%) patients were lost to follow-up; the remaining 12 (6.1%) individuals were still on treatment at the end of the study. According to the Cox proportional hazards analysis, HIV-positive status (p &lt; 0.05, 95% CI [0.361 - 0.879]), primary education level (p &lt; 0.01, 95% CI [1.248 - 3.354]), poor quality of life (p &lt; 0.01, 95% CI [1.239 - 3.511]) and age over 60 years old (p &lt; 0.05, 95% CI [0.569 - 2.206]) were significant hazard ratios to experience the event (treatment default) in the study area.</p> <p><strong>Conclusions. </strong>This study revealed that HIV-positive tuberculosis patients, older patients, patients with primary education, and those with poor quality of life are significant risk factors to experience treatment default in the study area. Therefore, it is recommended that stakeholders managing the treatment and care of tuberculosis patients should be dedicated and intentional in the provision of psychosocial therapy to patients with poor quality of life.</p> Charles Okoro Olateju Alao Bamigbala Ayodeji Oluwatobi Ojetunde Abdulmudallib Ibrahim Copyright (c) 2022 Charles Okoro, Olateju Alao Bamigbala, Ayodeji Oluwatobi Ojetunde, Abdulmudallib Ibrahim https://creativecommons.org/licenses/by-nc/4.0 2022-06-01 2022-06-01 29 2 E202221 E202221 10.21802/gmj.2022.2.1 The Relationship between the Fear of Childbirth and Anxiety during the Covid-19 Pandemic https://ifnmujournal.com/gmj/article/view/E202222 <p><strong>Introduction.</strong> The novel coronavirus disease (COVID-19), which emerged in Wuhan, China, in late 2019, has affected the whole world. Pregnant women who are expected to give birth during this period are one of the most important groups affected by these processes.</p> <p><strong>The aim of this</strong> study was to identify the relationship between the fear of childbirth and anxiety among pregnant women during the COVID-19 pandemic.</p> <p><strong>Materials and Methods.</strong> The cross-sectional study was conducted on 181 pregnant women in a city in the eastern region of Turkey between July and November 2020.</p> <p><strong>Results.</strong> Mid-level fear of childbirth was experienced by 44.8% of pregnant women. A positive correlation was found between the average anxiety score of pregnant women and childbirth fear.</p> <p><strong>Conclusions. </strong> The findings of the study will guide healthcare professionals in finding applicable solutions to the problems experienced by pregnant women during the COVID-19 pandemic period.</p> Sevinç Köse Tuncer Figen Alp Yılmaz Papatya Karakurt Nadire Yıldız Çiltaş Copyright (c) 2022 Sevinç Köse Tuncer, Figen Alp Yılmaz, Papatya Karakurt, Nadire Yıldız Çiltaş https://creativecommons.org/licenses/by-nc/4.0 2022-06-01 2022-06-01 29 2 E202222 E202222 10.21802/gmj.2022.2.2 The Mongoose Phenomenon: A New Logical Heuristic https://ifnmujournal.com/gmj/article/view/E202226 <p>Often when discussing what is considered a rarer occurring event, individuals reference the Baader-Meinhof phenomenon as insurance against fallacious thinking. Also known as the frequency bias, this logical heuristic states that rare occurring events are rare and the knowledge of the existence of rare occurrences makes the interlocutor more likely to search out the event or see it occur more frequently. These false increases in observation frequency can logically be blamed, at least in part, on the interlocutor being made aware of the event existence. This Baader-Meinhof logical heuristic is often mis-utilized in the sciences to minimize the chances of rarer phenomena from being considered within a logical framework for the work up of a problem. This article presents a new logical heuristic, the “Mongoose Phenomenon” as a counter argument and presents it in the context of the fields of medicine, the hard sciences, engineering, and philosophy. It is the intention of the authors that this logical heuristic be utilized to improve the thought process of scientists, clinicians, and others to ensure the best thought process for the work up and creation of a solution for problems.</p> Thomas C. Varkey John A. Varkey Milan Sivakumar Zachary I. Merhavy Copyright (c) 2022 Thomas C. Varkey, John A. Varkey, Milan Sivakumar, Zachary I. Merhavy https://creativecommons.org/licenses/by-nc/4.0 2022-06-01 2022-06-01 29 2 E202226 E202226 10.21802/gmj.2022.2.6 Anticancer Agent Effect and Polychemotherapy Regimens for Malignant Tumor Treatment - A Review https://ifnmujournal.com/gmj/article/view/E202227 <p>Cancer is a leading cause of millions of deaths worldwide and, despite the improvements in molecular biology, issues concerning how to advance cancer treatment are still relevant. Cancer research must be focused on finding new and efficient chemotherapeutic regimens that can relieve severe side effects caused by conventional treatments. Modern technologies are currently under estimation in clinical trials or have already been introduced into clinical practice. Nowadays cancer therapy is characterized by ineffectiveness and serious side effects, as well as by hope of remission and cure in many cases. Antitumor drugs and radiation have been used as the treatment of choice in some cancer cases, except for the choice of surgery in case of solid tumors. Recently, immunotherapy has emerged as a significant therapeutic alternative, and in many cases, it is the first choice. These therapies can be applied either alone or in combination with other agents. Additionally, gene treatment and nanotechnology are promising methods for cancer treatment as well. The current review presents the progress of cancer treatments, starting with surgery, chemotherapy, radiation and immunotherapy, gene treatment and nanomedicine, giving emphasis to the most common anticancer agents and polychemotherapeutic regimens.</p> Nikolaos Andreas Chrysanthakopoulos Eleftheria Vryzaki Copyright (c) 2022 Nikolaos Andreas Chrysanthakopoulos, Eleftheria Vryzaki https://creativecommons.org/licenses/by-nc/4.0 2022-06-01 2022-06-01 29 2 E202227 E202227 10.21802/gmj.2022.2.7 Validity and Reliability of the Turkish Version of the COVID-19-Impact on Quality of Life Scale https://ifnmujournal.com/gmj/article/view/E202224 <p><strong>The objective </strong>of this study was to adapt the COVID-19-Impact on Quality of Life (COV19-QoL) scale for Turkish individuals and to determine its validity and reliability.</p> <p><strong> Materials and Methods. </strong>This methodological study was conducted between December 25, 2020 and January 10, 2021. The research was conducted online and included 485 participants who completed a socio-demographic questionnaire, the COV19-QoL scale and the Duke Health Profile (DUKE) on Google Forms. Back translation was used for the Turkish version of the COV19-QoL scale. Language and content validity of the scale were found to be acceptable.</p> <p><strong> Results. </strong>Ten experts were consulted regarding content validity of the scale. The results, item content validity of 0.95 and scale content validity of 0.95, indicated excellent content validity. Explanatory factor analysis found one principal structure with a total variance of 59.449%. The Cronbach’s alpha internal consistency coefficient was 0.86 for the scale. A statistically significant moderate negative correlation was found between the participants’ COV19-QoL scale score and their general health score on the DUKE (r = − 0.384; p &lt; 0.01).</p> <p><strong> Conclusions. </strong>This study found that the Turkish version of the COV19-QoL scale is a valid and reliable instrument for assessing the effects of the COVID-19 pandemic on the Turkish population’s quality of life.</p> Çiğdem Ökten Havva Gezgin Yazıcı Copyright (c) 2022 Çiğdem Ökten, Havva Gezgin Yazıcı https://creativecommons.org/licenses/by-nc/4.0 2022-06-01 2022-06-01 29 2 E202224 E202224 10.21802/gmj.2022.2.4 Artificial Intelligence Approach in Prostate Cancer Diagnosis: Bibliometric Analysis https://ifnmujournal.com/gmj/article/view/E202225 <p><strong>Background.</strong> Prostate cancer is one of the most common male malignancies worldwide that ranks second in cancer-related mortality. Artificial intelligence can reduce subjectivity and improve the efficiency of prostate cancer diagnosis using fewer resources as compared to standard diagnostic scheme.</p> <p><strong>This review aims</strong> to highlight the main concepts of prostate cancer diagnosis and artificial intelligence application and to determine achievements, current trends, and potential research directions in this field, using bibliometric analysis.</p> <p><strong>Materials and Methods.</strong>The studies on the application of artificial intelligence in the morphological diagnosis of prostate cancer for the past 35 years were searched for in the Scopus database using “artificial intelligence” and “prostate cancer” keywords. The selected studies were systematized using Scopus bibliometric tools and the VOSviewer software.</p> <p><strong>Results. </strong>The number of publications in this research field has drastically increased since 2016, with most research carried out in the United States, Canada, and the United Kingdom. They can be divided into three thematic clusters and three qualitative stages in the development of this research field in timeline aspect.</p> <p><strong>Conclusions.</strong> Artificial intelligence algorithms are now being actively developed, playing a huge role in the diagnosis of prostate cancer. Further development and improvement of artificial intelligence algorithms have the potential to automate and standardize the diagnosis of prostate cancer.</p> Anastasiia Denysenko Taras Savchenko Anatolii Dovbysh Anatolii Romaniuk Roman Moskalenko Copyright (c) 2022 Anastasiia Denysenko, Taras Savchenko, Anatolii Dovbysh, Anatolii Romaniuk, Roman Moskalenko https://creativecommons.org/licenses/by-nc/4.0 2022-06-01 2022-06-01 29 2 E202225 E202225 10.21802/gmj.2022.2.5 Imaging Evaluation of Mesenteric Ischemia: Is There a Golden Period for This Entity? https://ifnmujournal.com/gmj/article/view/E202212 <p><strong>Background.</strong>The study was aimed at assessing the role of ultrasonography and multidetector computed tomography angiography in evaluating patients with suspected mesenteric ischemia, as well as assessing the effect of the time from presentation to management on mortality and morbidity.</p> <p><strong>Materials and Methods.</strong> Patients with clinically suspected mesenteric ischemia underwent Doppler ultrasound and contrast-enhanced computed tomography. On ultrasonography, we assessed any filling defect in the superior mesenteric artery/vein, narrowing or occlusion of the proximal superior mesenteric artery, ascites, bowel wall thickening, and pneumatosis/portal venous gas. Computed tomography angiography was performed looking for any filling defect in the superior mesenteric artery/vein, superior mesenteric artery/vein calibre, bowel wall thickening, calibre and enhancement and pneumatosis/portal vein gas. Most of our patients underwent emergency surgery and the findings correlated with imaging. All the patients were divided into Group A (n=30) and Group B (n=17) based on the time from presentation to management: within 48 hours of presentation and 48 hours after presentation, respectively.</p> <p><strong>Results</strong>. On computed tomography scan, mesenteric vascular involvement was seen in 27 (55%) patients, mesenteric/intestinal twist was observed in 12 (25%) patients, and non-occlusive mesenteric ischemia was found in 6% of patients. The computed tomography findings were found to have a sensitivity of 86%, a specificity of 94% and an accuracy of 90% in cases of mesenteric ischemia. Among 35 patients operated on, those presenting within 48 hours, had a significantly less mortality (63%) in comparison to those presenting after 48 hours (90%).</p> <p><strong>Conclusions. </strong>Clinical, laboratory and ultrasound features are non-specific in diagnosing mesenteric ischemia. Computed tomography angiography is a sine qua non in mesenteric ischemia diagnosis. Patients with venous ischemia respond well to conservative management. Early intervention within the first 48 hours is associated with better prognosis.</p> Ishfaq Zargar Irfan Robanni Omair Shah Tariq Gojwari Riaz Rasool Naseer Choh Faiz Shera Munir Wani Copyright (c) 2022 Ishfaq Zargar, Irfan Robanni, Omair Shah, Tariq Gojwari, Riaz Rasool, Naseer Choh, Faiz Shera, Munir Wani https://creativecommons.org/licenses/by-nc/4.0 2022-03-01 2022-03-01 29 2 E202212 E202212 10.21802/gmj.2022.1.2 Emphysematous Pyelonephritis and Emphysematous Osteomyelitis: A case report https://ifnmujournal.com/gmj/article/view/E202217 <p><strong>Background.</strong> Emphysematous osteomyelitis and emphysematous pyelonephritis are both rare entities responsible for a high death rate. The first is defined by the presence of intravertebral or intraosseous gas, while the second is infectious damage to the renal parenchyma and perilesional tissues caused by gas-producing microorganisms and is, therefore, characterized by the formation of gas. Imaging plays a crucial role in making a rapid diagnosis and, thus, the initiation of the necessary treatment.</p> <p><strong>Case Report.</strong> A 66-year-old woman with a medical history of type 2 diabetes mellitus and hypertension presented with the altered general condition and flank pain for 5 days, associated with fever and chills. The patient’s vital signs were remarkable with a disturbed biological workup, which led to emergency abdominal and pelvic computed tomography scanning that revealed emphysematous osteomyelitis of the spine and emphysematous pyelonephritis.</p> <p><strong>Conclusions.</strong> The coexistence of emphysematous pyelonephritis and emphysematous osteomyelitis is a rare life-threatening entity, occurring in patients with comorbidities such as diabetes mellitus. Computed tomography is currently the gold standard in making the positive diagnosis, staging, for a quick and better management and, thus, a favorable prognosis.</p> Sanae Sninate Tlaite Oubaddi Soukaina Allioui Leila Jroundi Fatima Zahrae Laamrani Copyright (c) 2022 Sanae Sninate, Tlaite Oubaddi, Soukaina Allioui, Leila Jroundi, Fatima Zahrae Laamrani https://creativecommons.org/licenses/by-nc/4.0 2022-03-01 2022-03-01 29 2 E202217 E202217 10.21802/gmj.2022.1.7 Nursing Care Satisfaction among Patients Infected with Covid-19: A Turkish Perspective https://ifnmujournal.com/gmj/article/view/E202213 <p><strong>The aim</strong> of this study was to determine the satisfaction with nursing care among patients diagnosed with Covid-19 and related factors.</p> <p><strong>Materials and Methods.</strong> The study was conducted between June and July 2020. The population of the study consisted of 102 patients treated in the Covid-19 clinics of the University Teaching and Research Hospital. The data were collected using the Newcastle Satisfaction with Nursing Care Scale with a total of 19 items, and the Patient Description Form designed to record the sociodemographic characteristics and medical histories. The data were evaluated using the program package IBM SPSS 20.0. To test the significance of the difference between two independent groups, the Student’s t-test was used, and the one-way ANOVA was used to test the significance of the difference between more than two groups.</p> <p><strong>Results. </strong>The results showed that most patients were satisfied with nursing care. A higher level of satisfaction was seen in patients treated in the Covid-19 intensive care units, those with chronic conditions, and those who received information about their health state from nurses. Patients’ family type, sharing fears and worries with nurses, getting information from nurses and the quality of nursing care were the variables significantly associated with patient satisfaction with nursing care.</p> <p><strong>Conclusions.</strong> Satisfaction with nursing care among Covid-19 patients was moderate. When nurses use effective communication skills to meet patients’ care needs, provide patients with adequate information, allow them to express their feelings, and keep them safe, this will further enhance patient satisfaction.</p> Handenur Gündoğdu Fatma Tanrıkulu Funda Erol Ferhat Koç Dilek Yılmaz Yurdanur Dikmen Copyright (c) 2022 Handenur Gündoğdu, Fatma Tanrıkulu, Funda Erol, Ferhat Koç, Dilek Yılmaz, Yurdanur Dikmen https://creativecommons.org/licenses/by-nc/4.0 2022-03-01 2022-03-01 29 2 E202213 E202213 10.21802/gmj.2022.1.3 Diagnostic Accuracy of MR Mammography in Comparison with Digital Mammography and Sonomammography https://ifnmujournal.com/gmj/article/view/E202214 <p><strong>Background. </strong>Even though the sensitivity of contrast-enhanced breast magnetic resonance mammography (CE-MRM) is consistently high in the range of 94-100%, conventionally, digital mammography and sonomammography continue as standard imaging modalities for the detection and evaluation of breast disease.</p> <p><strong>The objective</strong> of the study was to detect additional lesions that go undetected by routine digital mammography and sonomammography using CE-MRM.</p> <p><strong> Materials and Methods.</strong> In a prospective study, 68 patients who came for screening diagnostic mammogram and had breast lesions of Breast Imaging-Reporting and Data System category 3-6 were evaluated. All patients underwent bilateral digital mammography and targeted high-frequency sonomammography of the primary lesion. Those patients who were thought to possibly have breast cancer and to be candidates for surgical management were offered bilateral CE-MRM.</p> <p><strong>Results</strong>. In this prospective study, we included 68 patients (mean age - 50.6 years, range - 30-73 years). A total of 74 lesions were evaluated. In detecting these lesions, digital mammography had a sensitivity of 40.0%, specificity of 100% and diagnostic accuracy of 63.5%. CE-MRM sensitivity was found to be 71.7%, specificity - 96.6% and diagnostic accuracy - 83.7%. Among the 27 additional lesions detected by CE-MRM, histopathological evaluation confirmed only 19, indicating the sensitivity of 100%, specificity of 85.4%, positive predictive value of 67.8%, negative predictive value of 100%, diagnostic accuracy of 89.2%.</p> <p><strong> Conclusions.</strong> The diagnostic accuracy of CE-MRM was found to be 83.7%, with a specificity of 96.6%. CE-MRM detected 19 additional lesions that were undetected by either digital mammography or ultrasonography. CE-MRM is sensitive in detecting additional malignant lesions which are not detected by other imaging modalities.</p> Sreenidhi Sedguli Raghu Srinivasa Gowda Rupa Ranganathan Senthil Kumar B Copyright (c) 2022 Sreenidhi Sedguli, Raghu Srinivasa Gowda, Rupa Ranganathan, Senthil Kumar B https://creativecommons.org/licenses/by-nc/4.0 2022-03-01 2022-03-01 29 2 E202214 E202214 10.21802/gmj.2022.1.4 Cytokine Response of CD4+ T-Lymphocytes with Red Rose (Rosa Rosaceae – Pierre de Ronsard) Extracts by in Vitro Evaluation https://ifnmujournal.com/gmj/article/view/E202215 <p><strong>Background.</strong> Red rose extract is known to have anti-inflammatory and immune-modulation effects. In this study, the red rose extract was tested on CD4+T lymphocytes <em>in vitro</em>, and cytokine response was evaluated.</p> <p><strong>Materials and Methods. </strong>The red rose (<em>Rosa Rosaceae</em> - Pierre de Ronsard) extract used in this study was prepared and stored at -20° C until use. CD4+T-cells were seeded in 96-well plates at 313,500 cells/well in 100μ l cell culture medium in duplicate. One-half of the wells were used for biomarker screening in the culture medium, and the other half was used for cytotoxicity assay. Twenty-four hours after plating, the cells were treated in duplicate with 100μ l of the red rose extract diluted at 0.5%, 0.1%, 0.05%, 0.01% and 0.005% (v/v) in the cell culture medium or with culture medium only as control for 72 hours. Some other wells were allocated for untreated cells, and cells treated with the rose extract at 0.005% for 48-h incubation time.</p> <p><strong>Results</strong>. Several cytokines (GRO; IFN-γ; IL-1α, 6, 10; MCP-1; RANTES; TGF-β1; TIMP 1, 2; Ang1, Ang2; G-CSF; MMP-9; and VEGF R2) were elevated. Except for MMP-9, which had fold changes &gt; 2, other cytokines were minimally elevated at various concentrations and timing of rose extract treatment. None of the mentioned cytokines were less than 0.8-fold after treatment with the rose extract. Cytotoxicity assay revealed insignificant changes in the viability of T-cells.</p> <p><strong>Conclusions</strong>. There was a mild elevation in few inflammatory markers by CD4+ T-lymphocytes after <em>in vitro </em>treatment with the red rose extract (<em>Rosa Rosacea</em> - Pierre De Ronsard). Further <em>in vitro </em>and <em>in vivo </em>studies are required to evaluate the benefits of the red rose extract in immune regulation.</p> Mark Christopher Arokiaraj Eric Menesson Copyright (c) 2022 Mark Christopher Arokiaraj, Eric Menesson https://creativecommons.org/licenses/by-nc/4.0 2022-03-01 2022-03-01 29 2 E202215 E202215 10.21802/gmj.2022.1.5 Learning or Memorization: Self-Directed Medical School Curriculum and the Dangers of Overemphasizing Student Selected Ancillary Resources https://ifnmujournal.com/gmj/article/view/E202211 <p>This article is a response to an opinion article, authored by Wu JH et al. and published in JAMA 2021, vol 326 (20) which suggested the that pre-clinical (first two) years of medical school curriculum should revolve around “high-yield” resources as the dominant teaching tool. The article posited that this highly controversial view was the best way to engage with students and was published in a well-read and utilized medical journal. Due to the growing divide between learning resources provided by medical schools and outside resources actually utilized by students, the conclusions drawn in the mentioned opinion article were understandable but interpreted in the wrong vein. Herein, the authors review landmark changes in medical education over the last century and the underpinning rationale to preface their examination of the suggested changes from the mentioned opinion article. The authors conclude with recommendations from a student perspective and a continuation of the last 100 years of advancements.</p> Thomas C. Varkey Zachary I. Merhavy Rhonda M. J. Varkey Jack B. Ding John A. Varkey Copyright (c) 2022 Thomas C. Varkey, Zachary I. Merhavy, Rhonda M. J. Varkey, Jack B. Ding, John A. Varkey https://creativecommons.org/licenses/by-nc/4.0 2022-03-01 2022-03-01 29 2 E202211 E202211 10.21802/gmj.2022.1.1 Pyramidal Lobe Variations of the Thyroid Gland and Its Clinical Implications: A Short Review and Case Report https://ifnmujournal.com/gmj/article/view/E202216 <p>The thyroid gland is characterized by significant anatomical variability, which may lead to difficulties in diagnostic and treatment outcomes. The pyramidal lobe is the most common variation present in up to 30% of the population. Literature has witnessed research on different variations of the pyramidal lobe, preference for the lobe from which it arises, gender preference, etc. Understanding such variations is essential for successful treatment outcomes for thyroid diseases. This short review was aimed to highlight embryological aspects of the thyroid gland, variation of its pyramidal lobe and present a rare case of demarcated left lobe, pyramidal lobe, and an associated cyst.</p> Nagavalli Basavanna Pushpa Rohan Karkra Kunjappagounder Pushpalatha Deepa Bhat Copyright (c) 2022 Nagavalli Basavanna Pushpa, Rohan Karkra, Kunjappagounder Pushpalatha, Deepa Bhat https://creativecommons.org/licenses/by-nc/4.0 2022-03-01 2022-03-01 29 2 E202216 E202216 10.21802/gmj.2022.1.6 The Effect of Educational Intervention on Care Dependency and Symptom Management After Hematopoietic Stem Cell Transplantation: A Theory-Based Randomized Controlled Study https://ifnmujournal.com/gmj/article/view/E202143 <p><strong>The objective </strong>of the research was to determine the effect of educational intervention based on Bandura’s Social Cognitive Learning Theory on care dependency and symptom management after hematopoietic stem cell transplantation.</p> <p><strong>Methods.</strong> This randomized controlled trial was conducted between January 2019 and February 2020 at the Hematopoietic Stem Cell Transplantation Center. All the patients were randomly divided into two groups: 53 individuals in the intervention group and 53 individuals in the control group. The sociodemographic data collection form, the Edmonton Symptom Assessment Scale and the Care Dependency Scale were used for data collection. Data were collected from the patients one day after hematopoietic stem cell transplantation and 12 weeks later.</p> <p><strong>Results. </strong>There were no statistically significant differences between the groups regarding the mean scores of the Edmonton Symptom Assessment Scale and the Care Dependency Scale at baseline. Twelve weeks after intervention, there were statistically significant differences between the groups regarding the mean scores of the Edmonton Symptom Assessment Scale and the Care Dependency Scale.</p> <p><strong>Conclusions.</strong> Educational intervention along with telephone counseling based on Bandura’s theory was found to be an effective way to reduce symptom severity and care dependency in patients who underwent hematopoietic stem cell transplantation and is recommended for all patients after hematopoietic stem cell transplantation.</p> Tuğba Menekli Bülent Yaprak Copyright (c) 2021 Tugba Menekli, Bülent Yaprak https://creativecommons.org/licenses/by-nc/4.0 2021-12-01 2021-12-01 29 2 E202143 E202143 10.21802/gmj.2021.4.3 Reproducibility of Retinal Nerve Fiber Layer and Macular Thickness Measurements Using Spectral Domain Optical Coherence Tomography https://ifnmujournal.com/gmj/article/view/E202147 <p><strong>The objective </strong>of the research was to assess the reproducibility of retinal nerve fiber layer (RNFL) and macular thickness using spectral domain optical coherence tomography and to establish whether the same investigator can get the same or similar results when performing the scan thrice in an hour, without reference to the previous scan and the repeat function.</p> <p><strong>Materials and Methods.</strong> In this prospective observational study, 200 subjects who fulfilled the inclusion and exclusion criteria were scanned 3 times according to predefined guidelines at 0, 30 and 60 minutes on the same day, by the same investigator, using spectral domain optical coherence tomography for measurements of RNFL and macular thickness; observations were statistically analyzed and correlated.</p> <p><strong> Results. </strong>In RNFL thickness, the temporal sector showed the worst reproducibility as compared to other sectors. RNFL was the greatest in the superior quadrant and the thinnest in the temporal quadrant. For macular thickness, the temporal sector (mid zone) showed the worst reproducibility, while in the outer zone, the inferior sector showed the worst reproducibility; macular thickness was the thinnest at the central zone (innermost 1-mm ring), the thickest within the inner 3-mm ring and diminished peripherally.</p> <p><strong> Conclusions. </strong>RNFL and macular thickness measurements using spectral domain optical coherence tomography by the same observer at 0, 30 and 60 minutes were very reproducible, except for the sectors specifically mentioned. The greater the thickness of the RNFL in any sector the better was the reproducibility in that sector. For macular thickness, the temporal sector (mid zone) showed the worst reproducibility.</p> Amit Sood Rahul Omprakash Paliwal Rishu Yogesh Mishra Copyright (c) 2021 Amit Sood, Rahul Omprakash Paliwal, Rishu Yogesh Mishra https://creativecommons.org/licenses/by-nc/4.0 2021-12-01 2021-12-01 29 2 E202147 E202147 10.21802/gmj.2021.4.7 Monoarthritis of the Elbow Revealing Osteoid Osteoma: A Case Report and Literature Review https://ifnmujournal.com/gmj/article/view/E202145 <p>Osteoid osteoma is a rare benign osteoblastic tumor that mainly occurs in the extra-articular segments of lower limb long bones. The elbow is an exceptional location for osteoid osteoma.</p> <p>The diagnosis is usually delayed since the elbow is a rare site for this tumor and unspecific clinical signs, such monoarthritis, may mimic other more common conditions.</p> <p>We report the case of a 16-year-old girl who presented with chronic monoarthritis of the elbow which was treated falsely as tuberculous arthritis and monoarticular rheumatoid involvement.</p> <p>The laboratory tests were negative. Computed tomography scan and magnetic resonance imaging showed the focal nidus at the coronoid process of the ulna with mild synovitis. The diagnosis of osteoid osteoma was not made until the disease had been progressing for eighteen months and the elbow had already become stiff.</p> <p>Arthroscopic excision of the lesion was performed, and histopathology of the nidus was consistent with osteoid osteoma. Since then, the patient has been pain-free with an improved elbow range of motion.</p> Najlae El Ouardi Siham Sadni Laila Taoubane Aziza Mounach Ahmed Bezza Copyright (c) 2021 Najlae El Ouardi, Siham Sadni, Laila Taoubane, Aziza Mounach, Ahmed Bezza https://creativecommons.org/licenses/by-nc/4.0 2021-12-01 2021-12-01 29 2 E202145 E202145 10.21802/gmj.2021.4.5 Psychometric Evaluation of the Diabetes Distress Scale in Patients with Type 2 Diabetes in Turkey https://ifnmujournal.com/gmj/article/view/E202144 <p><strong>The objective</strong> of the research was to evaluate the validity and reliability of the Diabetes Distress Scale in patients with type 2 diabetes in Turkey.</p> <p><strong>Materials and Methods.</strong> Our study was conducted between September 2016 and January 2017 and included 170 patients with type 2 diabetes. The Personal Information Form and Diabetes Distress Scale were used as a data collection tool. Statistical analysis was performed using SPSS 23.0 and SAS package program.</p> <p><strong>Results.</strong> According to the results of the research, Cronbach’s alpha reliability for the total scale was 0.91. The model fit indices for the revised confirmatory factor analysis model failed to meet the criteria for acceptability: the GFI was 0.8185, the CFI was 0.9316, the Bentler - Bonett (1980) NFI was 0.9005, and the RMSEA was 0.1067. In our study, exploratory factor analysis provided support for the three-factor model: [I] emotional and regimen-related distress, [II] health professional-related distress, [III] diabetes-related interpersonal distress.</p> <p><strong>Conclusions.</strong> When the translation and cultural adaptation process have been considered, the Diabetes Distress Scale is a valid and reliable tool for the Turkish community. It is recommended to be used in the studies and clinical trials.</p> Nurten Terkes Hicran Bektas Copyright (c) 2021 Nurten Terkes, Hicran Bektas https://creativecommons.org/licenses/by-nc/4.0 2021-12-01 2021-12-01 29 2 E202144 E202144 10.21802/gmj.2021.4.4 Comparison of Preclinical Coursework Perception Among Dental Students from India and the Republic of North Macedonia https://ifnmujournal.com/gmj/article/view/E202146 <p><strong>Background. </strong>The difference in the preclinical curriculum and teaching methodology between European and Southeast Asian countries has a great influence on the process of choosing which education model is predominant and, therefore, students’ opinion on the effectiveness of a preclinical coursework is diverse.</p> <p>The <strong>objective</strong> of the research was to assess the perception of the preclinical coursework in prosthodontics, conservative dentistry, and endodontics among Indian and North Macedonian students.</p> <p><strong>Materials and Methods.</strong> This cross-sectional comparative study was carried out among 3<sup>rd</sup>-year students, final-year students and interns of dental schools of two respective countries. The data were collected in July 2021 using Google Form, a link to which was sent via available social media platforms. The data obtained were analyzed using SPSSv.21.0 (IBM) software.</p> <p><strong>Results.</strong> The data on dental students’ perception of the preclinical coursework were obtained, analyzed, compared, and discussed. A total of 50% of Indian students stated preclinical exercises to be good to get knowledge about treating patients, whereas 47% of North Macedonian students felt the average level of knowledge needed for treating patient.</p> <p><strong>Conclusions.</strong> In this study, the majority of the students were in favor of attending the preclinical course and understood its importance for building up their confidence, better understanding of the subject and better patient handling in future dental practice. However, there were different students’ opinions on the course content, its duration, exercises, faculty interaction, helpfulness of theory lectures that evidence essentiality to view dental studies from a student-centered perspective.</p> Manu Batra Vesna Ambarkova Deeksha Gijwani Hansika Popli Natasa Stavreva Sonja Apostolska Niharika Narang Tamanna Mutneja Mira Jankulovska Kiro Ivanovski Copyright (c) 2021 Manu Batra, Vesna Ambarkova, Deeksha Gijwani, Hansika Popli, Natasa Stavreva, Sonja Apostolska, Niharika Narang, Tamanna Mutneja, Mira Jankulovska, Kiro Ivanovski https://creativecommons.org/licenses/by-nc/4.0 2021-12-01 2021-12-01 29 2 E202146 E202146 10.21802/gmj.2021.4.6 Non-Alcoholic Fatty Liver Disease and Hypothyroidism: Review of Clinical and Experimental Studies https://ifnmujournal.com/gmj/article/view/E202142 <p>Hypothyroidism is a widespread condition affecting people of different socio-economic background and geographical location. A lot of studies highlight the effect of hypothyroidism on the metabolic processes in various organs, including the liver. On the other hand, liver damage often results in the development of non-alcoholic fatty liver disease; however, the data on the impact of hypothyroidism on liver morphology, which can serve as a direct indicator and marker of liver condition and function, are limited and controversial. In this report, we reviewed the relationship between non-alcoholic fatty liver disease and hypothyroidism with an accent on morphological alteration of the liver discovered in clinical and experimental studies.</p> Tetiana Ranhulova Copyright (c) 2021 Tetiana Ranhulova https://creativecommons.org/licenses/by-nc/4.0 2021-12-01 2021-12-01 29 2 E202142 E202142 10.21802/gmj.2021.4.2 Analysis of Covid-19 Hospital Admissions in Ivano-Frankivsk, Ukraine https://ifnmujournal.com/gmj/article/view/E202141 <p>The Covid-19 pandemic has a substantial impact on socioeconomic, political, demographic, and other aspects of life. Effective healthcare is, however, a primary determinant of successful fighting against Covid-19. The analysis of local healthcare indicators serves as a source for estimating pandemic magnitude and the adaptation of healthcare at a national level. In this study, the rates of Covid-19 hospital admissions to the Ivano-Frankivsk City Hospital, Ukraine, from April 2020 to May 2021 were analysed. All cases were grouped by age, sex, and the type of admission; data were analyzed monthly and seasonally. The peaks of hospital admissions were observed in November 2020 and March 2021; however, the highest mortality rates were seen from August to November 2020. The analysis of age- and sex-disaggregated Covid-19 mortality data showed the predominance of elderly males (61.9%, 66.6 ± 3.9 years) over females (38.1%, 71.8 ± 2.3 years). The ratio of hospital admissions was unstable: the percentage of emergency, GP-referred and self-referred admissions was similar from April to May 2020; however, GP-referred admissions prevailed, and the number of self-referral patients decreased twice between March and May 2021. In conclusions, the trends in hospital admissions were similar to those reported in other studies. However, the differences in time frames and socio-demographic characteristics were observed that highlights the importance of considering regional, social and geographic aspects of the population when improving the capacity of healthcare system and establishing effective preventive measures against the pandemic at the local level.</p> Oryna Detsyk Natalia Fedorkiv Olha Burak Roksolana Kaluzhna Copyright (c) 2021 Oryna Detsyk, Natalia Fedorkiv, Olha Burak, Roksolana Kaluzhna https://creativecommons.org/licenses/by-nc/4.0 2021-12-01 2021-12-01 29 2 E202141 E202141 10.21802/gmj.2021.4.1 Oral and Dental Manifestations of Fanconi Anemia https://ifnmujournal.com/gmj/article/view/E202132 <p>Fanconi anemia is a rare disease, which is characterized by decreased production of all blood cell types. Fanconi anemia is the most common inherited form of aplastic anemia. Congenital abnormalities of the eyes, ears, and heart, malformed or absent kidney, urogenital system involvement are common. There is a delay in physical development. Intelligence in patients with Fanconi anemia is usually normal. The most serious problems associated with Fanconi anemia include the gradual development of bone marrow disorders. Many patients with Fanconi anemia develop leukemia or myelodysplastic syndrome, as well as other oncological diseases. Oral manifestations in patients with Fanconi anemia can be classified as gingivitis, periodontitis, dental caries, dental anomalies, soft tissue lesions, oral cancer, and lesions of the tongue. Patients with Fanconi anemia have increased predisposition to squamous cell carcinoma of the head and neck and oral cancer. The interdisciplinary team of medical and dental specialists must be included in the medical and dental treatment of patients with Fanconi anemia. For proper dental care of patients with Fanconi anemia, the close cooperation of dental specialists, including orthodontists, pedodontists, prosthetists, oral surgeons, as well as specialists in periodontology and oral diseases, is of particular importance.</p> Vesna Ambarkova Copyright (c) 2021 Vesna Ambarkova https://creativecommons.org/licenses/by-nc/4.0 2021-09-01 2021-09-01 29 2 E202132 E202132 10.21802/gmj.2021.3.2 Assessment of Nursing Students’ Attitudes Towards Recording and Protecting Patients’ Personal Health Data: A Descriptive Study https://ifnmujournal.com/gmj/article/view/E202133 <p><strong>Introduction.</strong> Since health information is considered as sensitive personal data and requires more careful protection, healthcare professionals need to be careful about this issue.</p> <p><strong>The objective</strong> of this research was to determine nursing students’ attitudes towards recording and protecting patients’ personal health data.</p> <p><strong> Materials and </strong><strong>Methods. </strong>The population of this descriptive research consisted of 450 students who studied at the Department of Nursing, Faculty of Health Sciences, Erzincan Binali Yildirim University. Sample selection was not used, and the research was completed with 374 students who were continuing education and who were accepted to participate in the research. Descriptive Information template and Attitude Scale for Recording and Protecting Personal Health Data for nursing students were used as data-collection instruments. The numbers, percentage, mean, standard deviation, non-parametric tests (the Mann-Whitney U test and the Kruskal-Wallis test) were used in data analysis.</p> <p><strong>Results</strong>. Among our research participants, 68.4% of the students were females; 28.1% of the students were freshmen; 69% of the students were graduates of Anatolian high schools. Approximately 72.5% and 52.9% of the participants stated that they were aware of the concept of “personal data” and “personal health data” , respectively. The mean score of nursing students on the Attitude Scale for Recording and Protecting Personal Health Data was 3.97±0.71. The means scores obtained from subscales were as follows: 3.91±0.72 for Personal Health Data Information, 4.15±0.80 for Legal Information, 4.05±0.94 for Legal Data Sharing, 3.90±0.80 for Personal Health Data Sharing, and 3.77±0.33 for Recording of Personal Health Data, respectively. A statistically significant difference was found between the total scale and subscale scores of the students regarding their academic level.</p> <p><strong> Conclusions</strong>. Students were found to have a positive attitude towards recording and protecting personal data. Increasing the responsibilities and raising awareness of the students for the protection of personal health data during their study is suggested to be important.</p> Sebahat Atalıkoğlu Başkan Papatya Karakurt Necla Kasımoğlu Copyright (c) 2021 Sebahat Atalıkoğlu Başkan, Papatya Karakurt, Necla Kasımoğlu https://creativecommons.org/licenses/by-nc/4.0 2021-09-01 2021-09-01 29 2 E202133 E202133 10.21802/gmj.2021.3.3 The Discovery of Coronavirus – An Interesting Journey https://ifnmujournal.com/gmj/article/view/E202131 <p>The coronavirus, which is causing the ongoing Covid-19 pandemic and has crippled the entire world, was discovered by June Dalziel Almeida - a school dropout from Scotland who had no formal medical education. She had to master the knowhow of immune electron microscopy to climb up the academic ladder and she finally discovered the coronavirus only to see her research paper getting rejected by reputed journals. A single mother is now associated with the coronavirus, as well as with a significant contribution to the classification of viruses, viral imaging and bringing Rubella virus, Hepatitis B virus and Human immunodeficiency virus into the limelight.</p> Kaushik Bhattacharya Neela Bhattacharya Aditya Shikar Bhattacharya Copyright (c) 2021 Kaushik Bhattacharya, Neela Bhattacharya, Aditya Shikar Bhattacharya https://creativecommons.org/licenses/by-nc/4.0 2021-09-01 2021-09-01 29 2 E202131 E202131 10.21802/gmj.2021.3.1 Dual-Energy Multidetector Computed Tomography: A Highly Accurate Non-Invasive Tool for in Vivo Determination of Chemical Composition of Renal Calculi https://ifnmujournal.com/gmj/article/view/E202134 <p><strong>Introduction.</strong> Computed tomography is more accurate than excretory urography in evaluation of renal stones due to its high sensitivity and temporal resolution; it permits sub-millimetric evaluation of the size and site of calculi but cannot evaluate their chemical composition. Dual-energy computed tomography allows evaluating the chemical composition of urinary calculi using simultaneous image acquisition at two different energy levels.</p> <p><strong>The objective</strong> of the research was to determine renal stone composition using dual-energy multidetector computed tomography, and its correlation with post-extraction chemical analysis of stones.</p> <p><strong>Materials and Methods.</strong> This prospective study was conducted in the Department of Radiodiagnosis and Imaging from September 2017 to March 2019. A total of 50 patients with urolithiasis at the age of 18-70 years were included in the study. Dual-energy computed tomography ratios of various stones were noted, and preoperative composition of calculi was given based on their colour and dual-energy computed tomography ratio. These results were compared with the post-extraction chemical analysis of stones (using Fourier infrared transform spectroscopy as the standard comparative method.)</p> <p><strong>Results</strong>. The most common type of calculi in our study population was calcium oxalate stones (78%) followed by uric acid stones (12%), cystine stones (6%) and hydroxyapatite stones (4%). The dual-energy ratio of calcium oxalate, uric acid, cystine and hydroxyapatite stones ranged from 1.38-1.59, 0.94-1.08, and 1.20-1.28 and 1.52-1.57, respectively, with the mean dual-energy ratio of 1.43, 1.01, 1.25 and 1.55, respectively. Dual-energy computed tomography was found to be 100% sensitive and specific for differentiating uric acid stones from non‑uric acid stones. The sensitivity and specificity in differentiating calcium oxalate calculus from non‑calcium oxalate calculus was 97.5% and 90.9%, respectively, with 96% accuracy and kappa value of 0.883 suggesting strong agreement.</p> <p><strong>Conclusions</strong>. Dual-energy computed tomography is highly sensitive and accurate in distinguishing between various types of renal calculi. It has vital role in management as uric acid calculi are amenable to drug treatment, while most of non-uric acid calculi require surgical intervention.</p> Shafqat Shabir Bhawani Majid Jehangir Mohammad Masood Sajjad Ahmad Dar Sajad Nazir Syed Copyright (c) 2021 Shafqat Shabir Bhawani, Majid Jehangir, Mohammad Masood, Sajjad Ahmad Dar, Sajad Nazir Syed https://creativecommons.org/licenses/by-nc/4.0 2021-09-01 2021-09-01 29 2 E202134 E202134 10.21802/gmj.2021.3.4 Level of Knowledge and Awareness of Diabetic Emergencies Among Turkish Bus Drivers: Example of the Mediterranean Region https://ifnmujournal.com/gmj/article/view/E202135 <p><strong>The objective</strong> of this research was to determine the level of knowledge and awareness of diabetic emergencies among Turkish bus drivers.</p> <p><strong>Methods. </strong>The universe of this descriptive and cross-sectional study was all the individuals working as bus drivers in the Mediterranean Region between January-June 2019, and the study sample was 1292 drivers who met the inclusion criteria of the research. Data were collected by the Personal Information Form and the Diabetic Emergency Information and Awareness Survey Form. Descriptive statistics, the Mann-Whitney U test and the Kruskal-Wallis test were used in data evaluation.</p> <p><strong>Results.</strong> The average age of bus drivers participating in the study was 38.29 ± 9.44 years, while their average work experience was 12.50 ± 8.92 years. Among them, 14.9% of bus drivers had a diabetic family member; 23.7% of bus drivers had a first aid certificate; 11.5% of bus drivers received diabetes-related training. The average score of drivers for the level of knowledge and awareness regarding diabetic emergencies was found to be 15.39 ± 4.72. There was a statistically significant difference between the drivers’ average scores for the level of knowledge and awareness and their age, education status, work experience, the presence of chronic disease, the presence of a diabetic family member, the presence of a first aid certificate, diabetes-related training, the place of receiving this training variables (p &lt; 0.05).</p> <p><strong>Conclusions.</strong> Bus drivers were found to have above average levels of knowledge and awareness of diabetic emergencies. Bus drivers are recommended to be trained on diabetic emergencies and raising awareness of diabetes mellitus to ensure a proper intervention in case of emergencies in individuals with diabetes mellitus during travels.</p> Sibel Şentürk Nurten Terkeş Copyright (c) 2021 Sibel Şentürk, Nurten Terkeş https://creativecommons.org/licenses/by-nc/4.0 2021-09-01 2021-09-01 29 2 E202135 E202135 10.21802/gmj.2021.3.5 Online Learning Modules in Anatomical Sciences: Effective Sources for Continued Learning for Medical Undergraduates During the Unprecedent COVID-19 Pandemic https://ifnmujournal.com/gmj/article/view/E202136 <p><strong>Introduction. </strong>During the COVID-19 pandemic-induced lockdown, the selection of simple and authentic online material among plethora of web content is difficult for both students and teachers. This forces students and teachers to explore various avenues of learning.</p> <p><strong>The objective </strong>of this research was to evaluate free open-access anatomy e-learning resources in accordance with required standard learning outcomes for medical students.</p> <p><strong>Methods.</strong> During February 2021, an extensive search for online modules for learning anatomy across six Massive Open Online Courses, including edX, Coursera, Udemy, Khan Academy, Canvas and FutureLearn, along with Google and YouTube was conducted. Courses or modules on e-learning platforms, YouTube channels, standalone videos, anatomy atlases, 3D models were considered as learning resources and evaluated. Online materials were classified as structured learning resources if they had a defined syllabus, time duration and instructional design. Resources lacking these characteristics were considered as unstructured ones.</p> <p><strong>Results</strong>. Twenty structured learning courses were identified on the Udemy (6 courses), Coursera (3 courses), edX (2 courses), FutureLearn and Khan academy platforms. Learning resources available through Swayam Prabha were aligned with the defined syllabus and video lectures. The content hosted within Clinical Anatomy, Medvizz and Kenhub was eye-catching. Thirty-two YouTube channels offering standalone learning material were identified. Seven resource materials, other than YouTube channels, offered anatomy learning material in the form of charts and tables. Four websites noted to have 3D interactive learning content regarding gross anatomy.</p> <p><strong>Conclusions</strong>. During the pandemic-induced lockdown, the list presented in the study may act as guide in selection of the simplest and best materials for those teaching and learning anatomy in medical undergraduate courses. However, in most cases, there is no alignment with standard learning outcomes as defined by medical education regulatory authorities.</p> Srinivasan Viveka Nagavalli Basavanna Pushpa Kumar Satish Ravi Copyright (c) 2021 Srinivasan Viveka, Nagavalli Basavanna Pushpa, Kumar Satish Ravi https://creativecommons.org/licenses/by-nc/4.0 2021-09-01 2021-09-01 29 2 E202136 E202136 10.21802/gmj.2021.3.6 Features of Changes in the Structural and Functional State of the Myocardium in Patients with Acute Myocardial Infarction Depending on Body Mass Index Considering FABP4 and CTRP3 Levels https://ifnmujournal.com/gmj/article/view/E202137 <p><strong>Introduction.</strong> Adipokines such as fatty acid-binding protein 4 (FABP4) and C1q tumor necrosis factor-related protein 3 (CTRP3) can affect the structural and functional state of the myocardium in patients with acute myocardial infarction and obesity.</p> <p><strong>The objective </strong>of the research was to determine the relationship between FABP4, CTRP3 and echocardiographic parameters of the left ventricular myocardium in patients with acute myocardial infarction depending on body mass index.</p> <p><strong>Materials and Methods.</strong> The observational cross-sectional study examined 189 patients with acute myocardial infarction depending on body mass index, who were divided into the following groups: Group 1 included 60 patients with acute myocardial infarction and normal body mass index; Group 2 comprised 68 patients with acute myocardial infarction and excess body weight; Group 3 included 61 patients with acute myocardial infarction and obesity.</p> <p><strong>Results</strong>. In Group 1, the statistical significance correlations were found: between FABP4 and end-diastolic dimension (EDD; r = -0.458), end-systolic dimension (ESD; r = -0.460), end-diastolic volume (EDV; r = -0.452), left ventricular myocardial mass (LVMM; r = -0.411), LVMM/body surface area index (LVMMI2; r = -0.419); between CTRP3 and EDV (r = 0.425), EDD (r = 0.469), left ventricular relative posterior wall thickness (LVRPWT; r = -0.469). In Group 2, there were found the statistical significance relationships between: FABP4 and EDD (r = 0.461), ESD (r = 0.467), EDV (r = 0.449), end-systolic volume (ESV; r = 0.485), LVMM (r = 0.487), LVMMI1 (r = 0.406); between CTRP3 and EDD (r = -0.440), EDV (r = -0.413), LVMM (r = -0.430), LVMM/height<sup>2.7</sup> index (LVMMI1; r = -0.483). In Group 3, the statistical significance correlations were found between: FABP4 and EDV (r = 0.481), ESD (r = 0.411), ESV (r = 0.490), LVMMI1 (r = 0.403); between CTRP3 and EDV (r = -0.326), ESD (r = -0.367), ESV (r = -0.453), LVMMI1 (r = -0.415).</p> <p><strong>Conclusions.</strong> In patients with acute myocardial infarction and overweight/obesity, echocardiographic parameters had a significant low positive correlation with FABP4 and a low negative correlation with CTRP3. On the contrary, in patients with acute myocardial infarction and normal body mass index, echocardiographic parameters had a significant low negative correlation with FABP4 and a low positive correlation with CTRP3.</p> Mariia Koteliukh Copyright (c) 2021 Mariia Koteliukh https://creativecommons.org/licenses/by-nc/4.0 2021-09-01 2021-09-01 29 2 E202137 E202137 10.21802/gmj.2021.3.7 What Could Aid in Slowing Down Cognitive Function? https://ifnmujournal.com/gmj/article/view/E202124 <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 https://creativecommons.org/licenses/by-nc/4.0 2021-06-01 2021-06-01 29 2 E202124 E202124 10.21802/gmj.2021.2.4 Mucinous Cystadenoma of the Ovary Associated with Hyperplasia of Stromal Leydig Cells in Pregnant Woman https://ifnmujournal.com/gmj/article/view/E202125 <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 https://creativecommons.org/licenses/by-nc/4.0 2021-06-01 2021-06-01 29 2 E202125 E202125 10.21802/gmj.2021.2.5