| 1. | Cover Page I |
| ORIGINAL ARTICLE | |
| 2. | Is ChatGPT an Accurate and Reliable Source of Information for Patients with Vaccine and Statin Hesitancy? Cundullah TORUN, Abdurrahman SARMIS, Aytekin OGUZ doi: 10.4274/MMJ.galenos.2024.03154 Pages 1 - 7 Objective: Chat Generative Pre-trained Transformer (ChatGPT) is an artificial intelligence (AI) language model that is trained to respond to questions across a wide range of topics. Our aim is to elucidate whether it would be beneficial for patients who are hesitant about vaccines and statins to use ChatGPT. Methods: This cross-sectional and observational study was conducted from March 2 to March 30, 2023, using OpenAI ChatGPT-3.5. ChatGPT provided responses to 7 questions related to vaccine and statin hesitancy. The same questions were also directed at physicians. Both the answers from ChatGPT and the physicians were assessed for accuracy, clarity, and conciseness by experts in cardiology, internal medicine, and microbiology, who possessed a minimum of 30 years of professional experience. Responses were rated on a scale of 0-4, and the ChatGPT’s average score was compared with that of physicians using the Mann-Whitney U test. Results: The mean scores of ChatGPT (3.78±0.36) and physicians (3.65±0.57) were similar (Mann-Whitney U test p=0.33). The mean scores of ChatGPT were 3.85±0.34 for vaccination and 3.68±0.35 for statin use. The mean scores of physicians were 3.73±0.51 for vaccination and 3.58±0.61 for statin use. There was no statistically significant difference between the mean scores of ChatGPT and physicians for both vaccine and statin use (p=0.403 for vaccination, p=0.678 for statin). ChatGPT did not consider sources of conspiratorial information on vaccines and statins. Conclusions: This study suggests that ChatGPT can be a valuable source of information for guiding patients with vaccine and statin hesitancy. |
| 3. | Effective and Safe Treatment of Risky Localized Liver Tumors Using Microwave Ablation in Patients with Comorbid Lung Diseases Unfit for Deep Anesthesia Murat ASIK doi: 10.4274/MMJ.galenos.2024.54358 Pages 8 - 15 Objective: To assess the safety and efficacy of percutaneous microwave ablation (MWA) in treating high-risk localized liver tumors in patients unable to undergo deep anesthesia because of comorbid lung diseases. Methods: Between January 2019 and January 2022, percutaneous MWA procedures were performed for 50 liver tumors. These lesions were situated in close proximity to anatomically essential structures, with a maximum distance to surrounding structures being 10 mm. Because of comorbid lung diseases, patients could not undergo deep anesthesia. Regular follow-ups were performed using blood tests and dynamic contrast-enhanced computed tomography or magnetic resonance imaging. Results: The patient cohort consisted of 30 (68%) men and 14 (32%) women, with a mean age of 64.36±11.65 years (range: 40-80 years). The lesions were challenging to access and were located in proximity to critical structures such as the diaphragm (32, 64%), gallbladder (8, 16%), major vessels (5, 10%), and heart (5, 10%). During the follow-up period, 10 patients (23%) had local tumor recurrence and 14 (32%) had new primary foci in a different location and metastasis [liver (10) and non-liver organs (4)]. No major complications developed, and 21 of 44 patients experienced minor complications, which were treated with local medications during follow-up. Conclusions: Percutaneous MWA results in very low mortality and morbidity, coupled with high complete ablation rates for liver cancer. Most liver tumors can be treated safely and effectively with percutaneous MWA, even in cases of high-risk localization, without the need for deep anesthesia. |
| 4. | Effect of Different Doses of Sugammadex on Recovery and Hemodynamic Parameters in Reversing Neuromuscular Blockade in Patients Undergoing Electroconvulsive Therapy Kadir ARSLAN, Gozde UCUKSARAC, Hale CETIN ARSLAN, Erkan AYDIN, Ayca Sultan SAHIN doi: 10.4274/MMJ.galenos.2024.60052 Pages 16 - 23 Objective: This retrospective observational study aimed to investigate the effect of different doses of sugammadex used in reversing neuromuscular blockade in electroconvulsive therapy (ECT) procedures on patient recovery and hemodynamic measurements. Methods: Anesthesia induction was performed using propofol (1 mg/kg) and rocuronium (0.4 mg/kg). Patients were classified into group 2 (2 mg/kg) and group 3 (3 mg/kg) according to the dose of sugammadex used to reverse neuromuscular blockade. The patient’s spontaneous breathing time, eye-opening time, time to comply with voluntary commands, time to reach Modified Aldrete score (MAS) 9, complications, and hemodynamic data were analyzed. Results: In total, 314 ECT sessions were performed on 46 patients. The average age of the patients was 38.3±12.6 years, and 56.6% (n=26) were male. While the average number of ECTs applied to the patients was 6.8±2.8, the average seizure duration was 28.2±12.7 seconds. The most common diagnosis (32.7%) in patients who underwent ECT was bipolar disorder. The average time to recovery of spontaneous breathing, eye-opening time, time to comply with voluntary commands, and time to reach MAS 9 were found to be significantly lower in group 3 (p<0.001, p<0.001, p<0.001, and p=0.002, respectively). Tooth damage was observed in 0.3% (n=1) and tongue abrasion in 0.6% (n=2) of the cases. Hemodynamic measurements were similar between groups (p>0.05). Conclusions: Sugammadex used at a dose of 3 mg/kg in ECT procedures significantly reduces recovery times compared with 2 mg/kg. However, both doses can be safely and cost-effectively used to reverse the neuromuscular blockade provided by 0.4 mg/kg rocuronium. |
| 5. | Assessment of Nutritional Status in Patients with Head and Neck Cancer Before Radiotherapy: A Single-center, Cross-sectional Study Susetyowati SUSETYOWATI, Fuadiyah Nila KURNIASARI, Amalia Sarah SHOLIKHATI, Mardiah HARDIANTI, Ericko EKAPUTRA doi: 10.4274/MMJ.galenos.2024.02448 Pages 24 - 32 Objective: It is important to assess nutritional status to determine the presence of malnutrition because poor nutritional status will reduce the efficacy and increase the side effects of radiotherapy. The aim of this research was to assess nutritional status by comparing several parameters, namely anthropometry, biochemistry, physical condition, and inflammatory parameters, with Patient Generated-Subjective Global Assessment (PG-SGA) as the gold standard. Methods: A cross-sectional study with 78 subjects was conducted at the General Hospital Dr. Sardjito Yogyakarta, Indonesia, in 2022. The Malnutrition Screening Tool, Simple Nutrition Screening Tool, PG-SGA, and objective parameter data were used in the nutritional assessment. The objective parameters were determined by analyzing anthropometric data [body weight, mid-upper arm circumference (MUAC), and body fat], biochemical data (albumin and a complete blood profile), physical data (hand grip strength), and food intake data using the 1×24-hour recall method. The data were analyzed using One-Way ANOVA and the Kruskal-Wallis test. Results: Malnutrition was found in 33.3% of pre-radiotherapy head and neck cancer (HNC) patients. Patients with good nutritional status did not experience weight loss, decreased appetite, gastrointestinal symptoms, decreased functional capacity, or fat and/or muscle deficit (p<0.05). The findings showed a significant relationship between PG-SGA and nutritional status based on body weight, weight loss, MUACs, handgrip strength, visceral fat, resting metabolic rate (RMR), and hemoglobin (p<0.05). A better nutritional status was associated with higher parameter values. Conclusions: The method for nutritional status assessment in HNC patients undergoing radiotherapy can be performed by measuring body weight, weight loss, upper arm circumference, visceral fat, hemoglobin, and RMR in addition to PG-SGA as the gold standard. |
| 6. | The Course of Endoscopic Treatment Success in Biliary Complications After Living Donor Liver Transplantation Engin ATAMAN, Murat HARPUTLUOGLU, Yilmaz BILGIC, Yasir Furkan CAGIN, Mehmet Ali ERDOGAN, Ramazan KUTLU, Koray KUTLUTURK, Ibrahim ORMAN, Osman SAGLAM, Ali Riza CALISKAN doi: 10.4274/MMJ.galenos.2024.89289 Pages 33 - 38 Objective: Our aim was to present the results of endoscopic retrograde cholangiopancreatography (ERCP) after living donor liver transplantation (LDLT) between February 2015 and June 2021. Methods: Clinical data included LDLT indications, time to perform ERCP after LDLT, number of ERCP procedures, indications for ERCP, and all treatment outcomes, including ERCP, percutaneous, and surgical interventions. We compared the obtained data with our previous study published by our team in 2018, which included 446 patients who underwent ERCP for biliary complications after LDLT between 2005 and 2015. Results: We performed ERCP in 283 of 1506 patients with LDLT who underwent duct-to-duct anastomosis during transplantation and then developed biliary complications. Our endoscopic success rates were 60.9% and 71.0% in the previous and present studies, respectively. Conclusions: Our findings suggest that the success rate of endoscopic treatment of biliary complications in patients with LDLT increases in correlation with the increasing experience of clinicians treating these patients. |
| 7. | Effects of Different Taping Techniques in Individuals with Myofascial Pain Syndrome with a Trigger Point in the Trapezius Muscle: A Sham-controlled Randomized Study Kubra KARDES, Pinar VAN DER VEER, Yunus Emre TUTUNEKEN, Hale Nur AYKAC, Esra ARSLAN, Aysenur AKSOY, Yasemin BURAN CIRAK doi: 10.4274/MMJ.galenos.2024.59207 Pages 39 - 48 Objective: This study aimed to compare the effects of three different kinesio taping (KT) techniques in individuals with myofascial pain syndrome (MPS) who have a trigger point in the trapezius muscle. Methods: The individuals included in our study were randomly divided into four groups: Group 1: Functional correlation technique, group 2: Fascia correlation technique, group 3: Star taping technique (STT), and group 4: Sham group. The visual analog scale was used to assess pain, cervical joint range of motion (ROM) with a universal goniometer, grip strength with a hand dynamometer, number of active trigger points by palpation, pressure-pain threshold with an algometer, quality of life with the Nottingham Health Profile and functional level with the Neck Disability index were evaluated before and after treatment. Results: There was no difference between the groups in terms of demographic data and pre-treatment outcome measures (p>0.05). There was a significant difference in the pain score between the groups after treatment (p<0.05). A statistically significant difference was found in the cervical flexion ROM of all groups after treatment (p<0.05). In pairwise comparisons, these differences were found due to group 3 (p<0.05). Conclusions: The three KT techniques are effective in reducing pain, increasing ROM, reducing the number of active trigger points, and increasing grip strength. Among these techniques, STT was found to be more effective in reducing pain and increasing cervical flexion ROM. KT is a method that can be used in the clinic for patients with MPS. |
| 8. | In Silico PASS Predictions and Exploration of Antioxidant and Anti-inflammatory Activity of Citrus Karna Raf. Fruit Prasad JAMKHANDE, Mahavir GHANTE, Rajeshwar KSHIRSAGA doi: 10.4274/MMJ.galenos.2024.49775 Pages 49 - 58 Objective: Inflammation and oxidative stress are major factors in the development of many disorders. Natural antioxidants present in plants can interrupt, decrease, or reduce the oxidation of components sensitive to oxidative processes by scavenging free radicals and lowering oxidative stress. Most anti-inflammatory agents used in the management of inflammatory disorders diminish oxidative damage. The biological potential of Citrus karna Raf. remains undisclosed, despite its richness in several bioactive compounds. Methods: The methanolic extract was evaluated for quantitative phytochemical analysis and antioxidative efficacy using 1,1-diphenyl-2-picrylhydrazyl radical and hydrogen peroxide scavenging activity. A carrageenan-induced paw edema model was employed to evaluate the anti-inflammatory potential as antioxidants exert anti-inflammatory effects. In silico prediction of activity spectra for substance predictions were performed to understand the possible mechanism of action of phytochemicals. Results: Citrus karna methanolic extract (CKME) showed dose-dependent radical scavenging effects. The powerful scavenging activity of CKME could be due to the diverse polyphenolic compounds such as ascorbic acid, beta-carotene, and naringin. In addition, the percentage inhibition of paw edema and swelling was observed in CKME-treated rats and mice, which is the same as that of standard drug-treated groups. The Pa value of ascorbic acid, beta-bisabolene, linalool, and naringin is more than 0.7 which shows that these phytoconstituents might contribute to the anti-inflammatory action of extract samples such as CKME. Conclusions: Our findings shows that CKME possess strong antioxidant and anti-inflammatory effects. The richness of plants in polyphenolics such as flavonoids might be a contributing factor for these potential effects. |
| CASE REPORTS | |
| 9. | A Rare Complication of Transcatheter Aortic Valve Replacement: Delayed Down Migration of a Portico Valve Busra GUVENDI SENGOR, Cemalettin YILMAZ, Regayip ZEHIR doi: 10.4274/MMJ.galenos.2024.31967 Pages 59 - 61 There are some complications after transcatheter aortic valve replacement (TAVR), which is an alternative to surgery for the treatment of severe aortic stenosis. Valve migration, an unusual but life-threatening complication of TAVR, usually occurs during or several hours after the procedure and is associated with poor outcome. Therefore, operators must be experienced in rescue treatments. Placement of a second prosthesis as a salvage strategy appears to be a safe method to avoid the need for conversion to surgery. |
| 10. | Fallopian Tube Hemangioma Discovered on Follow-up for Uterine Leiomyoma Dmitrii SUMTSOV, Georgii SUMTSOV, Natalia HYRIAVENKO, Mykola LYNDIN, Kateryna SIKORA, Volodymyr KOLYSHKIN, Yulia REDKO, Igor GLADCHUK doi: 10.4274/MMJ.galenos.2024.50687 Pages 62 - 65 Hemangioma in female reproductive organs, particularly in the fallopian tube (FT), is a sporadic disease. In this report, we describe a case of hidden capillary hemangioma in FT in a 39-year-old woman who suffered from uterine leiomyoma. During the preoperative stage, pelvic sonography, computed tomography, and diagnostic laparoscopy revealed a subserous leiomyomatous nodule located along the posterior wall of the uterus. Despite this, intraoperatively, a benign vascular neoplasm was diagnosed. Histologically, it is characterized by multiple thin-walled vascular spaces lined with a single layer of endothelial cells, in which single mitoses were observed. The diagnosis was then confirmed immunohistochemically by CD31 and CD34 expression in the endothelial cells lining the inner surface of the spaces and the low mitotic activity of the tumor cells. It is virtually impossible to diagnose this asymptomatic neoplasm before and during surgery, which can result in an inadequate number of surgeries. Incorrect interpretation of a benign tumor at a young age can lead to unnecessary radical surgery with a resulting loss of fertility, and an unrevealed malignant process can threaten life. |
| LETTERS TO THE EDITOR | |
| 11. | Clarifications Regarding “Investigation of Morphological and Biomechanical Properties of the Scapula for Shoulder Joint” Rajesh KUMAR, Dibakar BORTHAKUR, Chetan SAHNI doi: 10.4274/MMJ.galenos.2023.31384 Pages 66 - 67 Abstract | |
| 12. | Corrections Regarding “Investigation of Morphological and Biomechanical Properties of the Scapula for Shoulder Joint” Nilgün TUNCEL CINI, Nazan GUNER SAK, Serdar BABACAN, Ilknur ARI doi: 10.4274/MMJ.galenos.2023.64614 Pages 68 - 69 Abstract | |
| 13. | Correspondence on “Factors in Vaccine Refusal by Patients Applying for COVID-19 PCR Test” Hinpetch DAUNGSUPAWONG, Viroj WIWANITKIT doi: 10.4274/MMJ.galenos.2024.71508 Pages 70 - 71 Abstract | |
| 14. | About on “Factors in Vaccine Refusal by Patients Applying for COVID-19 PCR Test” Behcet AL, Ferhat ARSLAN doi: 10.4274/MMJ.galenos.2024.26053 Pages 72 - 73 Abstract | |