Galician Medical Journal <p>“Galician Medical Journal” is an open access,&nbsp;double-blinded peer-reviewed scholarly journal, published by Ivano-Frankivsk National Medical University.</p> <p>“Galician Medical Journal” covers the current topics of experimental and clinical medicine, publishes the results of original research, review articles, clinical case reports, commentaries, editorials, letters to the Editor, innovations in the sphere of medical education.</p> <p><strong><span lang="EN-GB">ISSN&nbsp;</span></strong><strong><span lang="EN-US">2414-1518 (English ed. Online)</span></strong></p> <p><strong><span lang="EN-US">ISSN 2306-4285 (Ukrainian ed. Print)</span></strong></p> <div class="page" title="Page 3">&nbsp;</div> Ivano-Frankivsk National Medical University en-US Galician Medical Journal 2414-1518 <div id="copyrightNotice"><span style="font-family: Georgia, serif; font-size: 17px;">Authors who publish with this journal agree to the following terms:</span> <ul style="list-style-type: circle;"> <li class="show"><span style="font-family: Georgia, serif; font-size: 16px;">Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a <a href="" target="_blank" rel="noopener">Creative Commons Attribution License&nbsp;(CC BY-NC)</a> that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</span></li> <li class="show"><span style="font-size: 16px;"><span style="font-family: Georgia,serif;">Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</span></span></li> <li class="show"><span style="font-family: Georgia, serif; font-size: 16px;">Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See&nbsp;<a href="" target="_new">The Effect of Open Access</a>).</span></li> </ul> </div> About Some Aspects of Teaching Foreign Students in the Discipline "History of Medicine" <p><strong>The objective </strong>of the research was to study the opinion of the first-year students of the Faculty of Foreign Citizens Training of the Ivano-Frankivsk National Medical University on some aspects of teaching the discipline "History of Medicine" to determine its areas for improvement.</p> <p><strong>Materials and methods.</strong> According to the author's program, a survey of 239 first-year students of Ivano-Frankivsk National Medical University was conducted. They came from 10 countries, studiyng the specialty "Medicine". The results of research were mainly categorical (qualitative) data. Therefore, calculation of each factor rates per 100 respondents, standard errors of rates, and Chi-Square Test (χ<sup>2</sup>) for comparing group differences have been used for statistical data analysis. The methods that have been mainly used are sociological, medical and statistical.</p> <p><strong>Results.</strong> The research found that the absolutely majority of students are from India (81.2%) and about 59.0% of respondents profess Hinduism (59.0%), but the shares of Muslims (21.3%) and Christians (17.6%) are also significant.There are 65.7% males vs. 34.3% of females among the respondents, which is obviously due to religious, cultural and national stereotypes of different countries (p &lt; 0.001). The results of secondary education, with which foreign students entered university, were quite high. Almost 86.7% of surveyed first-year-students noted the high level of lectures on the subject "History of Medicine", pointing to their informativeness, accessibility, interesting and illustrative manner of presenting the material.</p> <p><strong>Conclusion. </strong>It was found that among foreign first-year students studying at the IFNMU, predominated males (65.7%), aged from 19 to 21 years of (62.3%), with a high basic level of secondary education (66.9%). It was also shown that 91.7% of respondents are satisfied with the level of teaching "History of Medicine" and manner of presentation lecture material (86.7%).&nbsp;</p> Nataliia Stytsiuk ##submission.copyrightStatement## 2020-09-28 2020-09-28 27 3 E202039 E202039 10.21802/gmj.2020.3.9 Effects of Siam Weed (Chromolaena odorata) Leaf Extract on Crude Oil-induced Toxicity <p style="text-align: justify;"><strong>The objective</strong> of this study was to investigate the effects of the different extracts&nbsp; (aqueous, ethanol and blended mixture) of <em>Chromolaena odorata</em> leaves on Wistar rats feed with crude petroleum (CP) tainted feed (4 ml/100 g diet).</p> <p style="text-align: justify;"><strong>Materials and methods</strong>: Twenty-five male Wistar rats weighing 140 -180 g were used for this study. The rats were kept one in a cage. Group A which was the control was allowed diet free of crude oil and were not treated with any of the extracts. Group B were exposed to a diet contaminated with crude oil that contained 4ml of crude oil per 100 gram of animal feed without treatment. Groups C-E were fed with diets contaminated with 4ml of crude oil per 100g of feed and treated with 500mg/Kg<sup>-1</sup> bodyweight of aqueous, ethanol and blended mixture of ethanol and aqueous extracts, respectively. The respective extracts and blended mixture were given daily to the rats via oral gavage in line with body weights. The study was for duration of twenty eight days after which the rats were sacrificed under sedation with chloroform. This was followed with collection of blood samples and organs of interest. All samples were stored at 4<sup>0</sup>C and used within forty eight hour for various biochemical analyses.</p> <p style="text-align: justify;"><strong>Results</strong>: There were significant decrease in haematological indices, liver proteins, oxidative enzymes, &nbsp;and antioxidant enzymes when compare with&nbsp; Group 1. Also, liver function maker enzymes, white blood cells (WBC), and malondialdehyde (MDA) &nbsp;&nbsp;were significantly increased &nbsp;by petroleum intoxication. Significant increase were observed in Hb, PCV, RBC, SO, MO, XO, SOD, CAT, albumin, total protein in the serum, liver and kidney; as against decreases in WBC, AST, ALT, ALP and MDA&nbsp; in rats fed crude petroleum (CP) tainted feed that was treated with<em> C. &nbsp;odorata </em>extract.&nbsp;</p> <p style="text-align: justify;"><strong>Conclusion</strong>: This study showed that administration of <em>C. odorata</em> leaves extracts to rats prevented health risk associated with crude petroleum toxicity.</p> Fidelis Ifeakachuku Achuba Charles Offor ##submission.copyrightStatement## 2020-09-28 2020-09-28 27 3 E202031 E202031 10.21802/gmj.2020.3.1 Impact of Periodontal Pocket Depth on the Efficiency of Surgical Treatment of Generalized Periodontitis <p>The paper is aimed at increasing the efficiency of surgical treatment by using a combination of platelet-rich fibrin, a synthetic hydroxyapatite Kergap, minimizing the body’s response to operative wound, and improving diagnostic and therapeutic approaches in surgical treatment of stage II-III generalized periodontitis.</p> <p><strong>The objective </strong>of the research was to study the efficiency of using the combination of platelet-rich fibrin, synthetic hydroxyapatite Kergap, magnesium preparation in comprehensive treatment of stage II-III generalized periodontitis at various stages and in different depths of the periodontal pockets.</p> <p><strong>Materials and Methods. </strong>The efficiency of surgical treatment was evaluated using clinical (periodontal pocket depth, attachment level, gingival bleeding, tooth mobility) and laboratory methods (X-ray, computed tomography) 3, 6, and 12 months after surgical treatment.</p> <p><strong>Results. </strong>The clinical picture was characterized by positive changes in all clinical indicators 3, 6 and 12 months after treatment. The best results by clinical and laboratory findings were obtained in case of an average pocket depth of 5-7 mm.</p> <p><strong>Conclusions. </strong>There was demonstrated a high clinical efficiency of using the combination of platelet-rich fibrin, synthetic hydroxyapatite Kergap and magnesium preparation in comprehensive treatment of stage II-III generalized periodontitis.</p> Mariana Ilkiv Mykola Rozhko Vitalii Hereliuk ##submission.copyrightStatement## 2020-09-28 2020-09-28 27 3 E202032 E202032 10.21802/gmj.2020.3.2 Study of the Association Between Antihyperglycemic Therapy and Cancer in Patients with Type 2 Diabetes Mellitus <p><strong>The objective </strong>of the research was to investigate the features and association of antihyperglycemic therapy and cancer in patients with type 2 diabetes mellitus.</p> <p><strong>Materials and Methods. </strong>The study included the analysis of medical records of patients with type 2 diabetes mellitus who were diagnosed with cancer during 2012-2016. The obtained results were processed by statistical methods using the software packages Microsoft Excel and Statistika-12. The significance of differences between the frequency of using different treatment schemes was assessed by the Pearson’s test (χ²). To determine the risk of predicted events, the odds ratio, the 95% confidence interval, the positive and negative prognostic values were calculated.</p> <p><strong>Results.</strong> There were diagnosed 533 cases of cancer in patients with type 2 diabetes mellitus. The most common scheme of antihyperglycemic therapy prior to the detection of malignant diseases was a combination of metformin and sulfonylurea derivatives (35.65%), as well as monotherapy with sulfonylurea derivatives (17.26%) and metformin (11.28%). Prior to diagnosing cancer in 396 (74.30%) patients, antihyperglycemic therapy<br>along with sulfonylurea derivatives and insulin was used. Among obese patients 68.82% used sulfonylureas and insulin as part of antidiabetic therapy before diagnosis of cancer. The connection between insulin therapy and the risk of cancer development in patients with type 2 diabetes mellitus was proved (the odds ratio=2.35; the 95% confidence interval (1.91 - 2.91); p&lt;0.001).</p> <p><strong>Conclusions.</strong> Prior to the detection of cancer in patients with type 2 diabetes mellitus, the combination therapy with metformin and sulfonylurea derivatives was most often used. The association between insulin therapy and the development of cancer in patients with type 2 diabetes mellitus was revealed. Cancer screening is advisable for patients with type 2 diabetes mellitus and obesity, who receive as a therapy sulfonylurea derivates and/or insulin.</p> Tamara Vatseba Liubov Sokolova Volodymyr Pushkarev Nataliia Koshel ##submission.copyrightStatement## 2020-09-28 2020-09-28 27 3 E202033 E202033 10.21802/gmj.2020.3.3 Assessment of Relationship Between Nutritional Status and Handgrip Strength in Hemodialysis Patients <p>In hemodialysis patients, the prevalence of malnutrition is high; a decrease in muscle strength is observed.</p> <p>&nbsp;<strong>The objective</strong> of the research was to evaluate the nutritional status of hemodialysis patients and the relationship between the nutritional status and muscle strength.</p> <p><strong>Materials and Methods.</strong> Sixty hemodialysis patients (38 males, 22 females) were chosen from among volunteers. Food consumption, biochemical values, anthropometric measurements, body composition, physical activity status, subjective global assessment, and handgrip strength in individuals were examined.</p> <p><strong>Results.</strong> According to subjective global assessment, 73.3% of patients were well-nourished, 26.7% of patients were moderately malnourished. In male patients, a moderate positive correlation was determined between handgrip strength and lean body mass (r=0.359, p&lt;0.05), albumin level (r=0.408, p&lt;0.05), energy intake (r=0.437, p&lt;0.05), protein intake (r=0.345, p&lt;0.05). In female patients, a moderate positive correlation was determined between handgrip strength and body weight (r=0.470, p&lt;0.05), body mass index (r=0.472, p&lt;0.05), triceps skinfold thickness (r=0.530, p&lt;0.05), mid-upper arm circumference (r=0.515, p&lt;0.05), mid-upper arm muscle circumference (r=0.557, p&lt;0.05), lean body mass (r=0.470, p&lt;0.05), body fat content (%) (r=0.588, p&lt;0.05), albumin level (r=0.565, p&lt;0.05).</p> <p><strong>Conclusions.</strong> Handgrip strength alongside with more than one method of food consumption, biochemical parameters, subjective global assessment, anthropometric measurements, and body composition should be used for assessing the nutritional status in hemodialysis patients.</p> Sevil Karahan Yılmaz Neslişah Rakıcıoğlu ##submission.copyrightStatement## 2020-09-28 2020-09-28 27 3 E202034 E202034 10.21802/gmj.2020.3.4 Antimicrobial Resistance Profile Among Major Bacterial Pathogens in Southern Babil, Iraq <p><strong>Background:</strong> At present, drug-resistant pathogens are considered one of the major increasing causes of morbidity and mortality around the world. The data on microorganisms' resistance assist define the best available treatment for patients. Therefore, this study aimed to screen the antimicrobial-resistant profile of different drugs in major clinical pathogens of urine, ear and wound infections.</p> <p><strong>Methods:</strong> This study was conducted in Al-Shomali General Hospital, Southern Babil, Iraq from October 2019 to May 2020. Totally 67 clinical specimens obtained from the wound, urine, and ear discharge collected from hospitalized patients as well as 30 healthy individuals participate in this study. Then, the standard microbiological methods carried outperformed to the isolated and identified bacterial species. Antimicrobial susceptibility tests were performed using different antimicrobial discs by applying the Kirby–Bauer disc diffusion method.</p> <p><strong>Results:</strong> Totally, 67 bacterial isolates were obtained from 44 (66%) female and 23 (34%) male patients. <em>Staphylococcus aureus</em> and <em>E. coli</em> were the most common predominant organisms. All isolates were showed a high rate of resistance to evaluated cephalosporins 100% and 87% to cefotaxime and ceftriaxone respectively, while very low resistance recorded in Aminoglycosides 22% and 12% to Gentamicin and amikacin, respectively.</p> <p><strong>Conclusion:</strong> These results suggest a constant screening for the detection of antibiotic resistance, as well as developing antimicrobial stewardship programs in Babil, Iraq. Moreover, these bacterial isolates have shown multidrug resistance, mainly to commonly administered drugs that could cause therapy ineffective. Therefore, in clinical use, appropriate treatment should be chosen based on the results obtained from antimicrobial susceptibility tests.</p> Falah Hasan AL-Khikani ##submission.copyrightStatement## 2020-09-28 2020-09-28 27 3 E202036 E202036 10.21802/gmj.2020.3.6 Abdominal Ascariasis: Where to Focus on Imaging Studies <p><strong>Objective</strong>: To assess the various presentations of abdominal ascariasis and their imaging features for developing a comprehensive radiological evaluation protocol.</p> <p><strong>Methods</strong>: Demographic and clinical profile of 84 patients with abdominal ascariasis was noted. Patients were divided into 2 groups with age less than 20 comprising Group A and those with age greater than 20 Group B. All the patients had a routine lab workup and a dedicated USG scan to look for objective evidence of intestinal or hepatobiliary ascariasis. Any history of previous intervention (cholecystectomy or ERCP) was also sought.</p> <p><strong>Results</strong>: Abdominal ascariasis is more common in females observed in 62% of our patients. Peripheral eosinophilia was observed in 70 (83%) patients. We had 74 (88%) patients with intestinal ascariasis with 2 patients having appendicular ascariasis. Biliary ascariasis was observed in 20 (24%) patients and pancreatic ductal ascariasis in 6 (7%) patients. We found peritoneal ascariasis in 1 (2%) pediatric patient and 2 (3%) patients in our study had ascariasis associated with the liver abscess. OCH was observed in 4 patients while 2 patients presented with worm cholecystitis.</p> <p><strong>Conclusion</strong>: Peripheral eosinophilia can be used to select patients in endemic regions for undergoing a dedicated USG scan. USG is the investigation of choice for both intestinal and hepatobiliary ascariasis. Worm migration is more common in adults and is especially prevalent in individuals with previous history of ERCP or cholecystectomy.</p> Jan Suhail Omair Shah Obaid Shah Jan Sarfaraz Irshad Mohuiddin ##submission.copyrightStatement## 2020-09-28 2020-09-28 27 3 E202035 E202035 10.21802/gmj.2020.3.5 Role of Diffusion-Weighted and Chemical Shift Magnetic Resonance Imaging in Differentiation of Benign and Malignant Spinal Fractures <p>Atraumatic spinal compression fractures are common clinical problem. Differentiating benign osteoporotic fractures from pathological fractures due to malignant/metastatic lesions affects the management and prognoses in patients with known extraspinal malignancy. &nbsp;&nbsp; <strong>The objective</strong> of the research was to assess the role of conventional magnetic resonance imaging sequences with diffusion-weighted imaging and chemical-shift imaging in differentiating benign and malignant acute spinal compression fractures.</p> <p><strong>Materials and Methods. </strong>The study included 40 patients with acute spinal compression fractures. Patients were evaluated using magnetic resonance imaging with diffusion-weighted imaging and chemical-shift imaging to differentiate benign etiology from malignant one. The results obtained were compared with histopathological follow-up for 6 months for definite clinical diagnoses.</p> <p><strong>Results</strong>. No significant difference was noted in signal characteristics of benign and malignant fractures on T1, T2 and short-tau inversion recovery. However, posterior element involvement, soft tissue component and post-contrast enhancement were seen more frequently in malignant fractures (p&lt;0.05). On diffusion-weighted images, 77.8% of malignant fractures were hyperintense and 59.1% of benign fractures were hypointense (p&lt;0.05). The mean apparent diffusion coefficient value was 0.81 ± 0.19 for malignant and 1.24 ± 0.24 for benign fractures (p&lt;0.5). The mean signal intensity ratio for malignant fractures was 0.91 ± 0.125, whereas the signal intensity ratio for benign fractures was 0.64 ± 0.096 (p&lt;0.001).</p> <p><strong>Conclusions.</strong> Signal characteristics on T1, T2 and short-tau inversion recovery sequences do not differentiate benign from malignant fractures; however, posterior element involvement, soft tissue and post contrast enhancement help in differentiating the etiology. Diffusion-weighted imaging and apparent diffusion coefficient values, as well as using chemical shift imaging further improve the diagnostic accuracy of magnetic resonance imaging.</p> Waseem Ahmed Sheikh Feroze A Shaheen Nasir Ahmad Lone Srabjit S Chhiber Rumana Hamid Makhdoomi ##submission.copyrightStatement## 2020-09-28 2020-09-28 27 3 E202037 E202037 10.21802/gmj.2020.3.7 Study of Salivary Stress Factor Activity in Patients with Diabetes Mellitus During the Period of Adaptation to Complete Removable Laminar Dentures <p>Diabetes mellitus is referred to as non-communicable epidemic of the 21<sup>st</sup> century and the fight against diabetes is one of medical and social challenges. One of its complications is damage to periodontal tissues that is accompanied by tooth loss. Any removable denture is a foreign body being a stress factor for the oral cavity.</p> <p><strong>The objective</strong> of the research was to study dynamic changes in the activity of stress factor indicators, namely salivary cortisol, glucose and alpha-amylase levels in diabetic patients after prosthodontic treatment with complete removable laminar dentures.</p> <p><strong>Materials and Methods. </strong>For this study, patients at the age of 45 to 74 years were divided into two groups: Group I included 52 edentulous patients with type 2 diabetes mellitus who were treated with acrylic resin complete removable laminar dentures; Group II comprised 52 edentulous patients without endocrine pathology who were treated with acrylic resin complete removable laminar dentures as well. Saliva served as the study material. The enzyme-linked immunosorbent assay was used to determine salivary cortisol levels. Glucose concentration in saliva was determined by a unified enzymatic method. Alpha-amylase activity was determined by the enzymatic colorimetric method.</p> <p><strong>Results. </strong>According to the research results, before prosthodontic treatment, salivary cortisol levels of patients with diabetes mellitus were 2.4 times higher as compared to patients without somatic pathology. In phase I of adaptation to complete removable laminar dentures, in patients with diabetes mellitus, salivary cortisol concentration increased drastically by 1.4 times as compared to the indicator before prosthodontic treatment (5.61±0.83 ng/ml vs. 4.02±0.65 ng/ml, p&lt;0.01), while in the group of patients without endocrine pathology, cortisol levels increased by 1.2 times; salivary glucose level of patients with diabetes mellitus increased by 1.3 times, while in patients without endocrine pathology, it increased by 1.1 times; in patients of Group I, salivary alpha-amylase levels increased by 1.2 times, while in patients of Group II, salivary alpha-amylase concentration increased by 1.05 times.</p> <p><strong>Conclusions</strong>. In patients with diabetes mellitus, changes in saliva composition indicate a significant reduction in the adaptation mechanisms, that complicates and significantly prolongs the period of adaptation to complete removable laminar dentures.</p> Lyubov Leybyuk Mykola Rozhko Olena Rozhko ##submission.copyrightStatement## 2020-09-28 2020-09-28 27 3 E202038 E202038 10.21802/gmj.2020.3.8 Clinical Manifestations of Periodontal Tissue Diseases in Patients with Rheumatoid Arthritis Who Live in Anthropogenically Loaded Areas <p>The <strong>objective</strong> of the study is to clinically assess the condition of periodontal tissues in patients with rheumatoid arthritis, living in anthropogenically loaded and environmentally friendly areas and in people with generalized periodontitis without concomitant somatic diseases.</p> <p><strong>Materials and methods.</strong> There were examined 137 patients, including 82 patients with generalized periodontitis of the I degree (subgroups A) and the II degree (subgroups B) with rheumatoid arthritis, living in anthropogenically loaded areas (group I), environmentally friendly areas (group II) and without concomitant somatic diseases living in environmentally friendly areas (group III). Control group – included 18 healthy people.</p> <p>Periodontal tissues were evaluated according to the indices: Greene-Vermillion, PMA, periodontal index offered by Russel and the depth of periodontal pockets.&nbsp;</p> <p><strong>Results.</strong> Women (80%) dominated in each group, patients with generalized periodontitis of the II degree of severity dominated, too.</p> <p>&nbsp;The highest depth of periodontal pockets was 5.02±0.11 mm in the IB subgroup and differed significantly from this figure in the IIB subgroup 1.07-fold (p<sub>IB-IIB</sub>&lt;0.05) and from that in the IIIB subgroup 1.2-fold (p<sub>IB-II</sub><sub>I</sub><sub>B</sub>&lt;0.001). The value of the Greene-Vermilion index in patients with GP of the I degree of development in all subgroups A corresponded to “unsatisfactory”. In patients with GP of the II degree of development, the state of hygiene corresponded to “bad” in subgroups IB, IIB and was 3.04±0.11 points (p<sub>IB-IIB</sub>˂0.01, p<sub>IB-II</sub><sub>I</sub><sub>B</sub>˂0.001, p<sub>IB-</sub><sub>K</sub>˂0.001); 2,63 ± 0.07 points (p<sub>I</sub><sub>I</sub><sub>B-IB</sub>˂0.01, p<sub>I</sub><sub>I</sub><sub>B-I</sub><sub>II</sub><sub>B</sub>˂0.001, p<sub>I</sub><sub>I</sub><sub>B-</sub><sub>K</sub>˂0.001), in ІІІB – “unsatisfactory”. According to the indicators of the PMA index in patients with GP of the I degree of severity, we’ve found the average severity degree of gingivitis (within the range of 43.25±2.02 – 48.06±1.46%) and severe degree of gingivitis in patients with the GP of the II degree &gt;50 %. The highest indicator of periodontal index was found in the IB subgroup – 6.16±0.10 points (p<sub>IB-I</sub><sub>I</sub><sub>B</sub>˂0.01, p<sub>IB-I</sub><sub>II</sub><sub>B</sub>˂0.001, p<sub>IB-</sub><sub>K</sub>˂0.001), which indicated a severe form of periodontitis.</p> <p><strong>Conclusion.</strong> Most often, GP in patients with RA was diagnosed in women, most of whom were patients with GP of the II degree (most in group I – 69.04%). The highest depth of periodontal pockets was 5.02±0.11 mm in the IB subgroup. The performed clinical and index assessment of periodontal tissues in patients of three groups indicates a more severe course of GP of the I and II degree in patients with rheumatoid arthritis living in anthropogenically loaded areas (IA, IB subgroups).</p> Khristina Kovalyshyn Mykola Rozhko ##submission.copyrightStatement## 2020-09-28 2020-09-28 27 3 E2020310 E2020310 10.21802/gmj.2020.3.10 Non-Invasive Mechanical Ventilation in Children with Previous Unsuccessful Weaning from Respiratory Therapy <p><strong>The </strong><strong>objective</strong> of the research was to establish the impact of diaphragm-protective mechanical ventilation on the rate of successful weaning from invasive and non-invasive mechanical ventilation in children with acute respiratory failure.</p> <p><strong>Materials and </strong><strong>M</strong><strong>ethods.</strong> We conducted a prospective, observational cohort study. Seventy-eight patients were randomly divided into 2 groups: patients of Group I received lung-protective mechanical ventilation; patients of Group II received diaphragm-protective + lung-protective mechanical ventilation. For age-specific data analysis, patients were divided into age subgroups: the 1<sup>st</sup> subgroup included children being 1 to 12 months old; the 2<sup>nd</sup> age subgroup comprised children being 12 to 36 months old. We started respiratory support in both groups with invasive mechanical ventilation and when patients met the criteria, we weaned them. We confirmed successful weaning, when patients had no need to be mechanically ventilated within next 48 hours, otherwise, they were intubated again. Before the second trial to wean, patients in Group I were simply extubated, while patients in Group II received non-invasive mechanical ventilation. The primary endpoint was the rate of successful weaning from mechanical ventilation in the first trial. The secondary outcomes were complications, namely reintubation rate, tracheostomy rate and death.</p> <p><strong>Results</strong>. We found a significant difference in the primary outcome for the 1<sup>st</sup> age subgroup: there were 72.4% in Group I vs. 52.6% in Group II successfully weaned patients (p=0.04). No significant difference in the primary outcome was observed in the 2<sup>nd</sup> age subgroup: there were 80% in Group I vs. 82.3% in Group II successfully weaned patients (p=0.78). There were significant differences in the secondary outcomes between groups in the 1<sup>st</sup> age subgroup, namely reintubation rate was seen in 9.1% patients of Group I vs. 36.8% patients of Group II (p=0.05); death happened in 18.2% cases in Group I vs. no cases in Group II (p=0.01). There were no differences in tracheostomy rate in the 1<sup>st</sup> age subgroup and there were no differences in the &nbsp;secondary outcomes between groups in 2<sup>nd</sup> age subgroup.</p> <p><strong>Conclusions</strong>. Diaphragm-protective mechanical ventilation significantly reduced the incidence of successful weaning from invasive mechanical ventilation; however, it increased the incidence of successful weaning from non-invasive mechanical ventilation, and, significantly decreased the mortality rate in the 1<sup>st</sup> age subgroup, while in the 2<sup>nd</sup> age subgroup, it had no impact on the incidence of successful weaning from invasive mechanical ventilation and mortality rate.</p> Olha Filyk ##submission.copyrightStatement## 2020-09-28 2020-09-28 27 3 E2020311 E2020311 10.21802/gmj.2020.3.11 Aromatherapy and Quitting Smoking <p style="text-align: justify;">Today, the treatment approaches recommended for smoking cessation are pharmacological and behavioral therapy. Both approaches are reported to be effective alone; however, when used together, the success rate increases. Modern medicine methods, however, often have a negative image due to cost, complexity and limitations in human life. For this reason, complementary and alternative therapies are widely used in the community for the treatment of many diseases in every age group. When people are asked why they prefer complementary and alternative therapies, the most important reason seems to be to improve quality of life by providing symptom control. Other reasons include economic problems, the lack of health insurance, the improvement of quality of life, the influence of the media and the environment, a strong belief that it will help, disappointment of conventional treatment failure, the noninvasiveness of most complementary and alternative therapies, fear of medical treatments, dissatisfaction with the current health system, medicines. Avoiding side effects can be called as a desire to have more control over health decisions. Contrary to many pharmacological and behavioral treatments that investigate the effectiveness of smoking cessation, only a few studies have included complementary and alternative treatments. Complementary treatment methods such as aromatherapy are thought to be regularly included in smoking cessation programs and their use should be ensured/expanded.</p> Nurten Arslan Işık ##submission.copyrightStatement## 2020-06-30 2020-06-30 27 3 E202022 E202022 10.21802/gmj.2020.2.2 Abdominal Sepsis. Some Genetic-Molecular Mechanisms of Its Occurrence <p style="text-align: justify;">Sepsis is a dangerous pathology which is characterized by a high mortality and morbidity in the whole world. Among varieties of sepsis an abdominal sepsis takes the second position. A huge number of scientific investigations, dedicated to sepsis, were done and are being done now. The search for new pathophysiological links of sepsis is ongoing. Studies show that more and more scientists pay attention to the status of genes polymorphism and their influence on the molecular mechanisms of the course of abdominal sepsis, which can help to decide this complex medical problem.</p> Vasyl Kavyn ##submission.copyrightStatement## 2020-06-30 2020-06-30 27 3 E202026 E202026 10.21802/gmj.2020.2.6 Peculiar Spirit and Brand Identity of the Human Anatomy Department Oksana Popadynets Omelian Yurakh Mykola Rozhko Halyna Yurakh ##submission.copyrightStatement## 2020-06-30 2020-06-30 27 3 E202024 E202024 10.21802/gmj.2020.2.4 Primary aggressive chondroblastoma of the tibia <p align="justify">Chondroblastoma is a primary bone tumor in children, adolescents and young adults, which accounts for 1% of all bone tumors. Epiphyseal or epiphysometaphyseal localization, this lesion usually develops from secondary ossification centers close to the knee, shoulder and hip. Although chondroblastoma is a nonaggressive benign tumor, it can very rarely show a locally aggressive character or a malignant transformation or even metastases. We describe a histologically proven case of an aggressive, primary chondroblastoma of the tibia invading soft tissue in a 22-year-old girl.</p> Reda Badaoui Amine Elmaqrout Mohamed Boussaidan Jalal Mekaoui Jalal Boukhriss Bouchaib Chafry Driss Benchaba Mostapha Boussouga ##submission.copyrightStatement## 2020-06-30 2020-06-30 27 3 E202021 E202021 10.21802/gmj.2020.2.1 Giant Relapse Sigmoid Volvulus: Case Report <p style="text-align: justify;">Sigmoid volvulus is one of the acute abdomen that requires endoscopic intervention and/or surgery. High recurrence rates after detorsion require patients to be operated under elective conditions. A 32 year oldmental retarded male patient was operated for recurrent sigmoid volvulus. In this study, we aimed to present a giant recurrent sigmoid volvulus case accompanied by diaphragmatic hernia.</p> Bartu Badak Erhan Aslaner Nahid Gambarov ##submission.copyrightStatement## 2020-06-30 2020-06-30 27 3 E202023 E202023 10.21802/gmj.2020.2.3 Chiari Network in Patient with Interatrial Septal Defect and Pulmonary Hypertension <p style="text-align: justify;">Chiari network is a moving fibrous mesh-like structure that is visualized in 2% of cases in the right atrium. It is attached on one side to the valve of the inferior vena cava and on the other to different parts of the right atrium. In most cases this structure has no clinical significance and may be an accidental finding during echo- imaging. But sometimes it can be a source of thrombosis and in the future – the cause of thromboembolism, or, conversely, be an obstacle to the movement of thrombus.</p> Olha Manetska Inna Tarchenko ##submission.copyrightStatement## 2020-06-30 2020-06-30 27 3 E202027 E202027 10.21802/gmj.2020.2.7 Lump in the Throat – an Algorithm for the Actions of a Physician <p style="text-adjust: justify;">Diagnosis and treatment of patients with complaints of the “lump in the throat” remain a complex multidisciplinary problem. This is due to the polyetiology of factors causing similar symptoms and an empirical approach to the treatment. “Lump in the throat” is one of the clinical manifestations of upper respiratory tract paresthesia. According to the literature data, there is the reason for referral to an otolaryngologist in 4.1 to 5.0% of cases.</p> <p style="text-adjust: justify;"><strong>The objective</strong> of the research was to optimize and improve the diagnosis and pathogenetic approach to the “lump in the throat” treatment.</p> <p style="text-adjust: justify;"><strong>Materials and Methods</strong><strong>. </strong>To achieve the specified objective, a comprehensive examination of 38 patients who sought an otolaryngologist’s medical advice, complaining of a “lump in the throat” at the age of 18-45 years (26 women and 12 men), was performed. For the purpose of optimal diagnostics, general clinical examination, examination of ENT organs, endoscopic examination of the nasal cavity and nasopharynx, microlaryngoscopy were performed; the condition of patients’ psycho-emotional status was assessed (consultation of psychologist and psychiatrist).</p> <p style="text-adjust: justify;"><strong>Results.</strong> A comprehensive clinical study of 38 patients with complaints of the “lump in the throat” at the age of 18-45 years was performed. Psychosomatic disorders were detected in 26 patients; ENT organ diseases were present in 12 patients. All patients received treatment depending on the diagnosed somatic, otorhinolaryngological and psychosomatic pathology.</p> Diana Orishchak Nataliia Vasyliuk Ostap Orishchak ##submission.copyrightStatement## 2020-06-30 2020-06-30 27 3 E2020211 E2020211 10.21802/gmj.2020.2.11 Clinical evolution of Spitz nevi <p style="text-align: justify;">Nevus Spitz is a benign melanocytic proliferation, first described in 1948 by Sophie Spitz as a childhood melanoma. Initially, it was described as an erythematous papule or node, but further studies of the Spitz nevus proved that in 71-92% cases it is a pigmented formation. This pigmentation is often quite intense due to the rapid growth of the formation, which leads to the need for differential diagnosis with skin melanoma. After all, dermatoscopy can be used for this purpose and, when applying this research method, typically a pattern of an exploding star formed by streaks of linear pigmentation and symmetrically located pigment globules placed in the peripheral zone can be revealed. In case of non-pigmented Spitz nevus, spot vessels and reticular depigmentation are visualized. Both pigmented and non-pigmented forms of Spitz nevus in the process of evolution can regress partially or completely. Several clinical cases of different types of spitzoids, both typical and atypical, based on the non-clinical, dermatoscopic and histological diversity of the Spitz nevi, have been demonstrated in the article. Their macroscopic and dermatoscopic features as well as probable signs of dynamic changes are indicated in order to facilitate their recognition by other specialists.</p> Marian Voloshynovych Cliff Rosendahl Galyna Girnyk Ivanna Tsidylo Iryna Blaha ##submission.copyrightStatement## 2020-06-30 2020-06-30 27 3 E2020213 E2020213 10.21802/gmj.2020.2.13 Long Non-Coding RNA MALAT1 Gene Polymorphism is Associated with Disease-Free Survival in Bladder Cancer Patients <p style="text-align: justify;"><strong>The objective </strong>of the research was to study the possible association between <em>MALAT1</em> gene rs3200401 polymorphism and the survival of patients with bladder cancer and clinicopathological characteristics in bladder cancer.</p> <p style="text-align: justify;"><strong>Materials and Methods. </strong>The venous blood of 141 patients with transitional cell carcinoma of the urinary bladder was used for study. Genotyping of <em>MALAT1 </em>gene rs3200401 polymorphism was performed by real-time polymerase chain reaction using the 7500 Fast Real-Time PCR System (Applied Biosystems, Foster City, USA) and Taq-Man Assays (TaqMan® SNP Assay C_3246069_10). Statistical analysis was performed using the SPSS software package (version 17.0). The Kaplan-Meier estimator and Cox regression were used to check the possible association between <em>MALAT1</em> rs3200401-genotypes and the age of transitional cell carcinoma of the urinary bladder onset. P values ​​&lt; 0.05 were considered as statistically significant.</p> <p style="text-align: justify;"><strong>Results. </strong>The obtained results revealed that hemoglobin concentration was lower in patients with transitional cell carcinoma of the urinary bladder and rs3200401TT-genotype than in patients with rs3200401CC-genotype (p=0.024). Herewith, fasting glucose, creatinine concentration, and tumor width were significantly higher in patients with transitional cell carcinoma of the urinary bladder and rs3200401TT-genotype as compared to rs3200401CC-genotype carriers (p = 0.036, p = 0.039, p = 0.028, respectively). The results of survival analysis demonstrated that transitional cell carcinoma of the urinary bladder occurred much later in persons with rs3200401TT-genotype as compared to rs3200401C-allele carriers (log rank p = 0.016), and the risk of transitional cell carcinoma of the urinary bladder onset was lower in individuals with rs3200401TT than in major rs3200401C C-allele carriers (hazard ratio = 0.413; p = 0.047).</p> <p style="text-align: justify;"><strong>Conclusions. </strong>Rs3200401 polymorphism of <em>MALAT1</em> gene is associated with disease-free survival in Ukrainian patients with transitional cell carcinoma of the urinary bladder. Transitional cell carcinoma of the urinary bladder occurs later in persons with rs3200401TT-genotype than in individuals with rs3200401CC- and rs3200401CT-genotypes.</p> Andrii Volkogon Olena Kolnoguz Viktoriia Harbuzova Alexander Ataman ##submission.copyrightStatement## 2020-06-30 2020-06-30 27 3 E202025 E202025 10.21802/gmj.2020.2.5 State of Comorbidity in Patients with Hypertension under Conditions of Industrial Production <p style="text-align: justify;">Comorbid conditions in patients with hypertension on the background of occupational hazards create additional problems in the treatment of hypertension. An analysis of working conditions in 76 workers of the Ivano-Frankivsk armature factory who underwent regular medical check-ups regarding first-/second-degree hypertension (the main group) showed that they were exposed to occupational hazards of chemical (acrolein carbon, iron oxide, chromium, fluorine compounds, sulfuric acid) and physical (high temperature, noise, vibration, electromagnetic radiation, dust) nature for a long period of time (from 4 to 11 years). Comorbid conditions were most often observed among the patients of the main group as compared to the patients of the control group (n = 17), who were not exposed to occupational hazards - 82.06% and 73.34% of cases, respectively. In the patients of the main group, chronic bronchitis was detected in 26.56% of cases and coronary artery disease was diagnosed in 25.09% of cases as compared to 8.33% and 18.34% of cases in the control group. At the same time, 38.89% of hypertensive patients of the main group were diagnosed with chronic bronchitis and concomitant coronary artery disease, which were not observed in the patients of the control group. The patients of the main group were more likely to have dyslipidemia, left ventricular hypertrophy, aortic fibrosis, hypertensive retinopathy as compared to the patients of the control group. In the control group, patients with overweight and type 2 diabetes mellitus prevailed. Quality of life assessment using the 36-Item Short Form Health Survey among the patients of the main group revealed a significant decrease in the indicators of physical and vital activity, fulfillment of daily professional duties. In the control group, a worsening emotional state prevailed.</p> Valerii Levchenko Ihor Vakaliuk Liubov Hordiichuk Anna Ovchar Mariana Maksymiak Ivanna Svystun Lesia Levchenko ##submission.copyrightStatement## 2020-06-30 2020-06-30 27 3 E202028 E202028 10.21802/gmj.2020.2.8 Characteristics of Puberty Period in Adolescent Girls and Major Risk Factors of Menstrual Function Disorders Against the Background of Endemic Goiter <p style="text-align: justify;">Disorders of menstrual function are often the result of thyroid dysfunction and disorders of the neuroendocrine regulation, initiated by iodine deficiency, and are the most destructive in puberty period.</p> <p style="text-align: justify;"><strong>The objective of the study</strong> was to clarify the peculiarities of establishment of menstrual function and the degree of interaction between the hypothalamic-pituitary-ovarian system and thyroid gland against the background of iodine deficiency in adolescence.</p> <p style="text-align: justify;"><strong>Materials and methods of research.</strong> Analytical analysis of medical records and sociomedical audit were carried out by interviewing 490 girls of puberty age, the purpose of which was to estimate the prevalence of thyroid dysfunction and possible factors of development of menstrual disorders.</p> <p style="text-align: justify;"><strong>Results of the study and their discussion. </strong>The proportion of thyroid dysfunction in adolescent girls is quite significant; hypofunction was diagnosed 3.4 times more frequent than its increased activity. Less than half of the studied had regular menstrual cycle, while girls with thyroid dysfunction suffered much more often from menstrual dysfunction in the form of hypomenstrual syndrome (1.5-fold, p&lt;0.05), algodismenorrhea (1.6-fold, p&lt;0.05) and amenorrhea (1.4-fold, p&lt;0.05), premenstrual syndrome and anovulatory conditions associated with polycystic ovary syndrome. Such somatic diseases as neuro-vegetative dysfunction, diseases of the gastrointestinal tract, chronic tonsillitis, frequent lacunar angina and acute respiratory viral diseases are common. Clinical manifestations included symptoms of thyroid hypofunction, androgen-associated dermopathy, hirsutism syndrome, and concomitant endocrine-associated pathology of the mammary glands (mastalgia, mastopathy, and galactorrhea).</p> <p style="text-align: justify;"><strong>Conclusions. </strong>The burden of perinatal history, the presence of thyroid pathology and other manifestations of metabolic and endocrine disorders in first-degree relatives are unfavourable prognostic factors of disorders of the menstrual cycle against the background of thyroid dysfunction. The findings obtained allow us to determine the leading risk factors for problematic menstruation establishment and menstrual disorders, especially when combined with thyroid dysfunction. Hypomenstrual syndrome and algodysmenorrhea, as well as manifestations of premenstrual syndrome and anovulatory cycles, belong to major disorders of the menstrual cycle in case of thyroid gland dysfunction.</p> Svitlana Hafiichuk ##submission.copyrightStatement## 2020-06-30 2020-06-30 27 3 E202029 E202029 10.21802/gmj.2020.2.9 Analysis of Commission Forensic-medical Examinations performed in Cases Concerning the Responsibility of Surgical Professional Doctors <p style="text-align: justify;"><strong>The objective</strong> of the research was the analysis of the structure of the commission of forensic medical examinations concerning professional offenses of medical professionals of the surgical profile according to the data of the Ivano-Frankivsk Regional Bureau of Forensic Medical Expertise for the period 2015-2019.</p> <p style="text-align: justify;"><strong>Materials and methods</strong>. The material of the study were the annual reports of the Ivano-Frankivsk Regional Bureau of Forensic Medical Expertise (Commission Department) and criminal case materials. Obtained data were processed using Microsoft Exel, Statistica 6.0.&nbsp;</p> <p style="text-align: justify;"><strong>Results</strong>. It was found that forensic medical examinations in case of improper performance of professional duties by medical workers accounted for a relatively small part 71 (14.3%) of the total forensic medical expertise. After the performed analysis, it was found that the doctors made diagnostic, therapeutic, organizational-tactical, deontological and combined errors that had a direct (29%) or indirect (26%) connection with the onset of death or adverse effects on the patient’s health. In 45% of cases, there was no correlation between the doctor’s actions and the occurrence of adverse effects for the patient.</p> <p style="text-align: justify;"><strong>Conclusions</strong>. The number of cases for improper performance of professional duties by medical workers is significantly higher in surgeons and obstetricians-gynecologists than in doctors of therapeutic profile. Every year, the complexity of commission forensic medical examinations in case of improper performance of professional duties by medical workers increases. This is due to the increasing complexity of surgical interventions and instrumental examination methods, as well as the increasing legal literacy of the population.</p> Natalia Kozan Volodymyr Voloshynovych Yuliia Kotsyubynska Halyna Zelenchuk Andrii Tsikhivskyi ##submission.copyrightStatement## 2020-06-30 2020-06-30 27 3 E2020210 E2020210 10.21802/gmj.2020.2.10 Thrombophilia as a Risk Factor for Thrombosis <p>The review article presents a contemporary view on the most common causes of hereditary and acquired thrombophilias and their role in the development of venous and arterial thromboses. The examination of patients in accordance with modern requirements consists in determining the causes and risk factors for blood clot formation, as well as implementing secondary prevention of recurrent thrombosis. Analysis of genetic and acquired hemostatic disorders allows us to identify a group of patients who require long-term anticoagulant therapy and mandatory anticoagulant prophylaxis in cases involving a high risk of thromboembolic complications.</p> Stepan Henyk Anton Symchych Maryana Voloshyn ##submission.copyrightStatement## 2020-03-27 2020-03-27 27 3 E202015 E202015 10.21802/gmj.2020.1.5 Pathophysiologic Peculiarities of Different Factors’ Influence on Development and Course of IHD Complicated with Atrial Fibrillation <p>Over the last years, mortality because of cardiovascular diseases (CVD) increased significantly in Ukraine. If we speak about atrial fibrillation (AF) itself, the number of recurrent arrhythmias cases as the main cause of hospitalization of patients with AF increased at 66% over the last 20 years.</p> <p>Independent development factors of AF are heart failure, aortic and mitral valve diseases, arterial hypertension, left atrial enlargement, and also obesity and obstructive sleep apnea, etc.</p> <p>In 2013 A.A. Novykov from Kherson region and several other researchers proved the influence of chaotic changes of meteofactors in cases of overt or hidden functional cardiovascular disorders (CVD) that can significantly influence its hemodynamic stability, functional ability, particularly its rhythmic activity.</p> <p>The main problem in the treatment of one or another nosological entity of CVD today is not the adjustment of a medication for its treatment, but the finding of pathogenetic links in the development of the disease itself. Especially this occurs, when the patient gets several organs or systems disabled simultaneously.</p> <p>Several scientists and practicing physicians are interested in the development of new approaches to diagnosis and treatment of AF in patients with ischemic heart disease (IHD) considering the peculiarities of clinical course and comorbidity. After all, the finding of complications’ causes in comorbid pathology in patients with IHD will contribute to treatment optimization and prevention of other complications, especially those resulting from the anticoagulant therapy, for example when a functional liver state or metabolic processes are impaired.</p> Oksana Hotiur Iryna Drapchak Palvo Drapchak Oksana Drapchak ##submission.copyrightStatement## 2020-03-27 2020-03-27 27 3 E202018 E202018 10.21802/gmj.2020.1.8 Modern Factors for Successful Work of a Teacher in Higher Medical Institution <p>Professional pedagogical activity of a teacher can be considered as a holistic dynamic system including continuous improvement of pedagogical skills. Modern trends in medical education pose new requirements for the teacher. Among them, knowledge of the English language (the main language of international scientific communication) at a level that would allow the teacher to work out the scientific literature and share the results of the research with a wider range of scientists is of critical importance. International internships at leading universities to study the best practices and enhance the scientific level of publications are important as well. Therefore, research work becomes the main component of the educational process - a factor determining the effectiveness of the teacher’s work.</p> Oksana Melnyk ##submission.copyrightStatement## 2020-03-27 2020-03-27 27 3 E202012 E202012 10.21802/gmj.2020.1.2 A Rare Case of Large Impacted Stone in Jejunum Causing Obstruction in a Patient of Gallstone Ileus <p>Gallstone ileus is a rare complication of cholelithiasis that occurs as a result of occlusion of the intestinal lumen by a large sized gallstone accounting for 1-4% cases of small bowel obstruction. The aim of this work is to introduce a case report that emphasize the diagnostic and therapeutic management of gallstone ileus with an enterolith impacted in jejunum (an uncommon site).</p> Dawood Iqbal Wani Satish Parihar Ankit Prabhakar Nasib Chand Digra Ab Hamid Wani ##submission.copyrightStatement## 2020-03-27 2020-03-27 27 3 E202014 E202014 10.21802/gmj.2020.1.4 Primary Alveolar Hydatid Disease: A Rare Case Series with Review of Imaging Findings <p>Alveolar hydatid disease is a rare but potentially fatal parasitic infection caused by Echinococcus multilocularis. To the best of our knowledge, only few cases have been reported from India till date. We present 6 cases of pathologically proven alveolar hydatid disease with review of imaging findings.</p> <p><strong>The objective</strong>&nbsp;of this case series was to share our experiences of pitfalls in diagnosis of alveolar hydatid disease.</p> <p><strong>Materials and Methods</strong>. The study was conducted in Post Graduate Department of Radiodiagnosis and Imaging, Government Medical College, Srinagar, Jammu and Kashmir. Our study was conducted between 6<sup>th</sup>&nbsp;January&nbsp;2017 to 22<sup>nd</sup>&nbsp;May 2019. A total of 6 patients were taken up for study. The patients were evaluated clinically and investigated using the relevant imaging modalities. Diagnosis was confirmed by histopathologic examination following core biopsy of lesion.</p> <p><strong>Results</strong>. There were two males and four females with most of patients in age group of 20 to 40 years. Imaging findings in our cases suggest that typical radiological appearance of alveolar hydatid disease can be summarized as an irregular hypoattenuating mass lesion having typical calcifications (can be peripheral, as well as central) with tiny cystic components.</p> Majid Jehangir Abha Mariam Ramandeep Singh Ankit Prabhakar ##submission.copyrightStatement## 2020-03-27 2020-03-27 27 3 E202019 E202019 10.21802/gmj.2020.1.9 Relationship Between Ethical Leadership Behavior and Work Motivation in Intensive Care Nurses: A Cross-sectional Study <p><strong>Aim:&nbsp;</strong>Affecting the attitudes and the behaviors of the employees, leaders’ ethical focused behavior is one of the most important factors affecting employee work motivation.<strong>&nbsp;</strong>The study was conducted with the aim of examining the relationship between ethical leadership behavior and the work motivation of Intensive Care Nurses (ICNs).</p> <p><strong>Material and Methods:&nbsp;</strong>The study adopted a cross-sectional and descriptive design and was performed&nbsp;between August and October 2018 with 98 ICNs at a university hospital in Turkey. A Nurses’ Description Form, the Ethical Leadership Scale, and the Nurses’ Work Motivation Scale were used to collect data. Since the data were found to be normally distributed, to compare the total scores of ethical leadership scale and nurses’ work motivation scale for demographic information of the nurses independent t-test and analysis of variance (ANOVA) test were used. Pearson correlation analysis was used to determine the relationship between ethical leadership and work satisfaction.</p> <p><strong>Results:</strong>&nbsp;A statistically significant positive correlation was found between the mean total score of the Ethical Leadership Scale and the mean total score of the Nurses’ Work Motivation Scale (<em>p</em>&nbsp;&lt; 0.001). A statistically significant difference was found between the mean total score of the ELS and the number of patients for whom daily nursing care was provided (<em>p</em>&nbsp;&lt; 0.05).</p> <p><strong>Conclusions:</strong>&nbsp;It was concluded from this study that the perceptions of ICNs concerning ethical leadership behavior and their work motivation were at a medium level. In addition, it was found that the nurses’ ethical leadership behavior had a positive effect on their work motivation. Nursing leaders should therefore endeavor to maintain their ethical behavioral integrity in order to promote nurses’ work motivation.</p> Derya Uzelli Yilmaz Fatma Düzgün Dilek Yilmaz ##submission.copyrightStatement## 2020-03-27 2020-03-27 27 3 E202011 E202011 10.21802/gmj.2020.1.1 CATANOVA Analysis of Knowledge and Control Practices of Hepatitis B Virus Infection amongst Tertiary University Students <p>Frequency data, having no underlying metric, are frequently encountered in real-life situations. The analysis of such data is usually difficult as nominal data are inherently less informative than quantitative data and decisions are taken erroneously using such results.</p> <p><strong>The objective </strong>of the research was to study the significant effect of gender, faculties and interaction using categorical data in a two-way cross classification.&nbsp;</p> <p><strong>Materials and Methods.</strong> The study applied a cross sectional study with a total sample size of 434. Multistage sampling was adopted. Categorical analysis of variance (CATANOVA) technique was used for analysis. This is suitable as it uses a two-way ANOVA with quantal responses as equivalent of a three-way contingency table in which one of the classifications is treated as responses to the other two. The study considered frequency data involving response scores of students using a scale of good, fair and poor.</p> <p><strong>Results.</strong>&nbsp; Numerical results revealed poor level of student’s knowledge and control practices of hepatitis B virus infection. And it is significantly (p&gt;0.05) the same in the study Universities. Moreover, gender and faculties, as well as interaction have no significant (p&gt;0.05) effect on student’s knowledge and control practices of hepatitis B virus infection.</p> Otaru Olawole Paul Ogbonda N. Prisilia ##submission.copyrightStatement## 2020-03-27 2020-03-27 27 3 E202013 E202013 10.21802/gmj.2020.1.3