International Journal of Current Medical and Biological Sciences

Positive And Negative Aspects Of Artificial İntelligence İn Psychiatry

Okan İMRE — 2024-04-01

Dear Editor, the reason why I wrote this letter is to draw attention to the positive and negative aspects of increasingly developing artificial intelligence applications and machine learning in psychiatry and to start a discussion.

The Long-term Exposure to 50 Hz Extremely Low Frequency Pulsed Electromagnetic Field Does not Alter the Electrocardiographic Parameters of Rats

Yasin Gökçe — 2024-04-16

Abstract

Background: The heart is a contractile organ with the ability to generate its own signals. Because of the excitable nature of heart cells, they may be impacted by external impulses or stimuli. The purpose of this research is to use electrocardiogram (ECG) measurements to ascertain the effects of exposure to an extremely low frequency pulsed magnetic field (ELF-PEMF) at 1 milli Tesla (mT) and 5 mT intensity on the heart's electrical stimulation system. Materials and Methods: Eighteen Wistar Albino rats, weighing 200-250g and aged 8 weeks, were randomly allocated into three groups, with six rats in each group: sham, 1 milli Tesla (1 mT), and 5 mT exposure groups. Rats were subjected to ELF-PEMF for 4-hours each day, 5-days per week for 8-weeks. The rats in the sham group were held in same condition, but the exposure system was turned off. Results: According to the findings, ELF-PEMF exposure at 1 mT and 5 mT intensities had no influence on ECG parameters commonly used in the evaluation of cardiac rhythmic activity, such as heart rate, P wave amplitude, PR interval, QRS interval, R amplitude, and QT interval. Conclusion: The 8-week exposure to ELF-PEMF at the 1 mT and 5 mT intensities didn’t show any effect on ECG parameters in rats, at least according to the design applied in this study. The effects of these magnetic fields are also directly related to exposure durations and intensity. Therefore, more research is required to ascertain how varied application intensities and durations affect cardiac function.

Keywords: Heart function; Electrocardiogram (ECG); Extremely Low Frequency Pulsed Electromagnetic Fields (ELF-PEMF)

Evaluation of Self-Perception and Obesity Prejudice Among Generation Z

Betül KAPLAN — 2024-05-20

Background: Obesity has arisen as an increasingly noteworthy public health issue worldwide, exerting its impact on nearly all countries. The objective of this study was to assess the self-perception and obesity prejudice among young individuals enrolled in health sciences programs and belonging to Generation Z. Materials and Methods: Irrespective of the magnitude of the sample, a collective of 787 individuals, including 450 undergraduate students and 357 associate degree students, were involved in the study. The researchers utilized two methods in this study. Firstly, they developed a tool called the "Personal Information Form" to assess students' attitudes towards those who are obese and to collect data on their dietary habits. Secondly, they employed the GAMS-27 Obesity Prejudice Scale for Health Sciences Students in the second half of the study. Results: The study revealed that a majority of the students (68.7%) self-identified as having a normal/average weight, whereas an even smaller majority (51.5%) reported having seen themselves as overweight at certain times in their lives. The study revealed that a significant proportion of students, including 31.0% and 64.8% respectively, exhibited bias towards those who are obese. Conclusion: The results of our study indicate that the younger individuals belonging to Generation Z exhibit views characterized by bias against individuals with obesity. Taking proactive measures to mitigate prejudice in the educational experiences of health sciences students prior to embarking on their professional endeavors has significant importance.

Is Cystic Duct Anastomosis a Suitable Option in the Presence of Double Bile Ducts in Living Donor Liver Transplantation?

Hüseyin Yönder — 2024-05-25

Background: The biliary duct anastomosis performed during living donor liver transplantation (LDLT) surgery is a critical surgical procedure that significantly influences postoperative patient mortality and morbidity. The aim of the present study was to evaluate the feasibility of utilizing the recipient's cystic duct along with the common bile duct in situations where biliary duct anastomosis becomes necessary.

Materials and Methods: In 16 of 49 liver transplants performed at Harran University Faculty of Medicine Organ Transplant Clinic between 2018 and 2021, the donor graft had double bile duct orifice. For the anastomosis of these bile ducts, the cystic duct was used along with the common bile duct in 9 patients, whereas in 7 patients, reconstruction was completed using various techniques without utilizing the cystic duct. Patients who underwent anastomosis to the cystic duct and those who underwent alternative techniques were evaluated in terms of difficulty and complications.

Results: Of the 16 patients included in the study, 7 (44%) were female and 9 (56%) were male. The mean age was 51.18 (±12.77) years. Anastomosis was performed to the cystic duct in nine patients. Regarding postoperative complications, among patients who underwent anastomosis to the cystic duct, only one developed bile leakage, which was treated with endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous drainage. Complications developed in 3 of 7 patients in the other group. The two cases of bile duct strictures were treated with ERCP, while the bile leakage in one patient was conservatively monitored, and the leakage resolved spontaneously.

Conclusion: The utilization of the cystic duct in bile duct anastomosis in LDLT may offer advantages, especially in grafts with multiple and distant bile ducts. When preparing donors for LDLT, when multiple bile ducts are detected in the donor liver preoperatively or intraoperatively, it should be kept in mind that in cases with a narrow donor pool, the cystic duct can also be used in the anastomosis.

Anxiety and depression levels of patients undergoing external dacryocystorhinostomy (DSR) for tear duct obstruction

Berkay Kızıltaş — 2024-05-28

Background: The purpose of this study was to evaluate the impact of treatment on psychological well-being by looking at changes in anxiety and depression levels in patients receiving treatment for tear duct obstruction.

Materials and Methods: Forty patients who had been diagnosed with tear duct obstruction and receiving dacryocystorhinostomy (DSR) were included in our prospective cohort study. The Beck Anxiety and Depression Inventory, two standardized psychometric measures, were used to measure the individuals' levels of anxiety and depression both before and after DSR treatment.

Results: The study comprised 40 patients in total, 16 (40%) of whom were male and 24 (60%) of whom were female. The number of patients in the "minimal anxiety" class climbed to 37 (92.5%) after DSR, compared to 22 (55%) patients in the class prior to DSR, based on the patients' anxiety levels. There was a significant change (p<0.001) in the median Beck anxiety scores before and after DSR. The median was 0 after it was 6.5 previously. There was a significant change (p<0.001) between the median Beck depression ratings before and after DSR. The median after was 13, compared to the prior median of 14. The results indicate that the scores for anxiety and depression decreased in a way that was statistically significant.

Conclusion: In summary, this study represented a significant advancement in our understanding of the anxiety and sadness experienced by patients having DSR for tear duct obstruction. The study's noteworthy reduction in the levels of depression and anxiety implies that DSR might be beneficial for psychological as well as physical health.

Identification of Clinical Features and Prognosis of Children Hospitalized with First Afebrile Seizure: A Single-Center Study

Fatma TAT — 2024-05-30

Background:

It is aimed to evaluate the risk of recurrence of the first afebrile seizure according to the use of antiepileptics.

Materials and Methods:

One year follow up of children with first afebrile convulsion were investigated retrospectively. Age, gender, history, neurological findings, electroencephalogram, neuroradiological imaging were evaluated for seizure recurrence considering antiepileptic treatment use.

Results:

Antiepileptic was started in 45.2% (33 out of 73) of patients. Seizure recurrence was 39.4% (13 out of 33) under treatment. No recurrence was observed in 92.5% (37 out of 40) of untreated patients (p=0.001).

Conclusion:

After the first afebrile seizure, antiepileptic treatment could lower but could not remove recurrence risk totally. Seizure did not recur in most of children followed-up without treatment, therefore decision to start antiepileptic after the first unprovoked seizure should be carefully evaluated.

Analysis of Patients Hospitalised in the Comprehensive Palliative Care Service-1-Year Experience

Muhammed Emin Göktepe — 2024-08-12

Aim: It was aimed to evaluate the patients who were admitted to SamsunTraining Research Hospital (STRH), PCS since it was started to be admitted by family-medicine clinic.

Methods: Cross-sectional, retrospective study consisted of all PC-patients admitted to STRH-PCS between 01/12/2019-01/12/2020. Gender, age, occupation, blood type, diagnosis, where we were consulted from, how many days of received, how many hospitalizations were made, number of deaths, reason for hospitalization, requests for imaging, specific interventional procedures etc. was collected with the help of automation-system and analyzed in SPSS.

Results: The mean age of the participants in the study was 76.3±12.9 years, and the female ratio was 51.3%. The majority of the people's blood groups were found to be A Rh+ with 36.9%. The average hospitalization period of the individuals was 12.0±10.4 days, and it was determined that the most hospitalizations were made in winter with 46.7%. While 62.8% of the individuals were discharged from the hospital, it was determined that 21.7% of them died. It was determined that nearly half of the patients were hospitalized due to nutritional deficiencies. The primary diagnosis distributions of the individuals Lung-cancer (15.8%), CVO (14.8%) and Alzheimer (14.1%),

Conclusion: More consultation was requested from the emergency department and intensive care departments, and patients who were asked to have direct radiography as an imaging need died more.

Prognostic Value of the Status Epilepticus Severity Score in Clinical Outcomes

Tulin Gesoglu Demir — 2024-07-24

Background: Status epilepticus (SE) is a neurological emergency associated with high morbidity and mortality. The Status Epilepticus Severity Score (STESS) has been proposed as a prognostic tool to predict outcomes in SE patients. This study aims to evaluate the effectiveness of STESS in predicting clinical outcomes and mortality rates among SE patients.

Materials and Methods: We conducted a retrospective analysis of patient data collected between January 2020 and February 2024 at XXX Hospital. The study included 29 patients diagnosed with SE, who were categorized based on etiological factors and treatment modalities. STESS was calculated for each patient, and its correlation with clinical outcomes and mortality rates was analyzed using statistical methods.

Results: The mean age of the study group was 37.55±18.81 years, mortality was 13.7% (n=4), and acute symptomatic etiology played a 31% role in the etiology. The most common etiology was CNS infections and the most common comorbidity was DM. 13.8% of the patients died during follow-up. There was no significant difference between the survivors and the deceased patients in terms of mean age, duration of hospitalization and duration of status (p>0.005). The mean STESS score of the patients was 1.48±1.05. Age was significantly higher in patients with STESS scores 3-6 (p=0.004). Mortality was significantly higher in patients with higher STESS scores (p=0.005). The sensitivity of STESS in predicting mortality was 95.7%, specificity was 50% and PPV 75%, NPV 12%.

Conclusions: The study demonstrates the prognostic value of STESS in predicting clinical outcomes in SE patients. Utilizing STESS in clinical practice can help identify high-risk patients and guide therapeutic strategies to improve patient outcomes. Further research is warranted to validate these findings in larger, multi-center studies.

The Effect of Albumin Level and Neutrophil Lymphocyte Ratio on Mortality and Recovery in Fournier's Gangrene

Hakan Türk — 2024-08-28

Background: Fournier's gangrene is a polymicrobial bacterial infection with high mortality and morbidity rates, and early diagnosis and treatment are crucial. The essentials of treatment are broad spectrum antibiotics and surgical debridement. In our study, we aimed to predict mortality more accurately in Fournier's gangrene.

Materials and Methods: Medical records of 60 patients operated for Fournier's gangrene in our clinic between 2016 and 2021 were retrospectively reviewed.

Results: 15% of the patients were of urogenital origin, 61.7% were colorectal, and 23.3% were idiopathic. The albumin value was lower in deceased individuals (27.35±4.66) compared to those who recovered (34.53±7.75) (p=0.001). A lower number of debridements and shorter hospital stay were observed in surviving patients (p<0.05). Being above the age of 59.50 was found to be a risk factor for mortality. An albumin value below 31.25 was found to be a risk factor for mortality. It was observed that the Neutrophil Lymphocyte ratio did not have a significant effect on mortality (p=0.733).

Conclusions: Serum albumin level was found to be a predictive value for mortality and recovery in patients with Fournier's gangrene. The Neutrophil Lymphocyte ratio did not have a significant effect on mortality and recovery in Fournier's gangrene.

Effect of Inflammation on Amino Acid Profile in Heart Failure Patients

Assoc. Prof. Zulkıf Tanrıverdi — 2024-08-21

Background: Heart failure (HF) is a clinical syndrome which caused by a structural and/or functional cardiac abnormality, resulting in a decreased cardiac output. The pathophysiology of HF is quite complex, and inflammation play a critical role in the development and progression of HF. Heart can use many substrates including fatty acids, glucose, ketone bodies and amino acids (AAs) to meet its high energy demand. However, the metabolism of the substrates that heart use for energy demand change dramatically in HF. Studies demonstrated that the heart's dependence on AAs increased during HF and plasma AAs profile could have significant impact on the risk-stratifying in patients with HF. However, the underlying mechanism of impaired AAs metabolism in HF has not been clearly elucidated yet. The aim of our study is to evaluate the AAs profile in HF patients and to demonstrate the effect of inflammation on the AA profile.

Methods: Seventy-two patients with compensated HF and 64 age- and sex-matched healthy individuals were included in our study as the control group. A new marker, CRP/albumin ratio (CAR), was used to assess inflammation. High performance liquid chromatography technique was used to evaluate the AA profile.

Results: When compared to the control group, valine (P = 0.040), leucine (P <0.001) and methionine values (P = 0.001) were significantly lower, whereas phenylalanine (P <0.001), tyrosine (P = 0.027), asparagine ( P <0.001), arginine (P <0.001), glycine (P = 0.006) and ornithine (P = 0.035) values were higher in patients with HF. Also, CAR level (P < 0.001) was significantly higher in HF patients than in the control group. The best cut-off value of CAR for predicting HF was determined as 0.91 according to the ROC curve analysis. Our patient group with HF was divided into 2 groups according to this cut-off value. HF patients with CAR ≥0.91 were defined as the high inflammation group, and HF patients with CAR <0.91 were defined as the low inflammation group. When compared to low inflammation group, HF patients with high inflammation had significantly lower valine (P < 0.001) and leucine (P < 0.001), whereas higher phenylalanine (P < 0.001), tyrosine (P < 0.001), asparagine (P < 0.001) 0.001) and ornithine (P = 0.006). In correlation analysis, CAR level was negatively correlated with valin, leucine and methionine, whereas positively correlated with phenylalanine, tyrosine and asparagine. Leucine (odds ratio [OR]: 0.955, 95% Confidence interval [CI]: 0.929-0.981, P = 0.001) phenylalanine (OR: 1.142, 95% CI: 1.070-1.218, P <0.001) and asparagine (OR: 1.053, 95% CI: 1.025-1.082, P <0.001) were detected as the independent predictors of HF in multivariate logistic regression analysis showed that.

Conclusions: Significant changes occur in the AA profile in HF. In our study; we found that the impairment in AA metabolism was more pronounced in patients with higher inflammation compared to patients with lower inflammation. Therefore, it can be suggested that the main mechanism underlying the impaired AA profile in HF is increased inflammation.