Background and objectives: The optic nerve is a component of the central nervous system, and the optic nerve sheath is connected to the subarachnoid space. For this reason, intracranial pressure (ICP) increases are directly transmitted to the optic nerve sheath. Knowing the normal optic nerve sheath diameter (ONSD) range in a healthy population is necessary to interpret this measurement as a sign of intracranial pressure in clinical practice and research. In this study, we aimed to determine the standard ONSD value in healthy adultsaged65 years of age or older who had not previously been diagnosed with a disease that could increase the ICP. Materials and Methods: The right and left ONSD values and ONSD differences were compared, according to the gender of the patients. The patients were divided into 3 groups, according to their age. The age groups were assigned as follows: Group 1: 65–74 years of age; Group 2: 75–84 years of age; and Group 3: 85 years of age or older. The ONSDs and the ONSD difference between the left and right eyes of Group 1, Group 2 and Group 3 were compared. Results: The study included 195 volunteers. The mean ONSD of both eyes was 4.16±0.69 mm, and the difference between the ONSD of the left and right eyes was 0.16±0.18 mm. There was no difference between genders in terms of right ONSD, left ONSD, mean ONSD and ONSD difference between the left and right eyes. There was no correlation between age and ONSD and ONSD difference. When the age groups and ONSD were compared, no difference was found between the groups. Conclusions: In conclusion, the ONSDs of both eyes do not vary with age in healthy adults aged65 years or older. ONSD does not vary between genders. The calculation of ONSD difference can be used to determine ICP increase.

DeepSeek is a recently launched large language model (LLM), whereas GPT-4o is an advanced ChatGPT version whose electrocardiography (ECG) interpretation capabilities have been previously studied. However, DeepSeek's performance in this domain remains unexplored. This study aims to evaluate DeepSeek's accuracy in ECG interpretation and compare it with GPT-4o, emergency medicine specialists, and cardiologists. A secondary aim is to assess any performance changes in GPT-4o over one year. Between February 9 and March 1, 2025, 40 ECG images (20 daily routine, 20 more challenging) from the book 150 ECG Cases were evaluated by both GPT-4o and DeepSeek, each model tested 13 times. The accuracy of their responses was compared with previously collected answers from 12 cardiologists and 12 emergency medicine specialists. GPT-4o's 2025 performance was compared to its 2024 results on identical ECGs. GPT-4o outperformed DeepSeek with higher median correct answers on daily routine (14 vs. 12), more challenging (13 vs. 10), and total ECGs (27 vs. 22) with statistically significant differences (p=0.048, p<0.001, p<0.001). A moderate agreement was observed between the responses provided by GPT-4o (p<0.001, Fleiss Kappa=0.473), while a substantial agreement was observed in the responses provided by DeepSeek (p<0.001, Fleiss Kappa=0.712). No significant year-over-year improvement was observed in GPT-4o's performance. This first evaluation of DeepSeek in ECG interpretation reveals its performance is lower than that of GPT-4o and human experts. While GPT-4o demonstrates greater accuracy, both models fall short of expert-level performance, underscoring the need for caution and further validation before clinical integration.

Objectives: The aim of our study was to evaluate the association between the presence and severity of CAD and NAFLD. Methods: The study group consisted of 153 patients who underwent coronary angiographies. Patients were categorized into CAD and non-CAD groups. CAD severity was determined by the number of CAD-involved arteries and the vessel score multiplied by Gensini score, the latter judging CAD severity. Fatty liver was diagnosed by abdominal ultrasonography (USG), with the patients being categorized by the degree of hepatosteatosis, as Grade 0, Grade 1, and Grade 2-3. Results: Among the whole study population, 47.1% of patients (n=72) were female and 52.9% of patients (n=81) were male. Forty-three patients had normal coronary arteries; 27 patients had non-critical CAD and side branch disease; and 83 patients had clinically significant CAD (stenosis>50%). The rate of CAD and Gensini score were significantly different between Grade 0, 1 and 2-3 hepatosteatosis groups (p<0.05). Patients with CAD had a significantly higher AST level than those without (p< 0.05). Conclusion: Ultrasonographically detected hepatosteatosis independently predicts the presence and severity of CAD. Keywords: Nonalcoholic fatty liver disease; gensini score; obesity.

Background and Objectives: The primary objective of this study was to obtain quantitative data, taking into account the amount of radiation exposure, about the clinical and diagnostic benefit obtained from panCT in pediatric trauma cases. Thus, we aim to create greater awareness in all physicians and primarily emergency medicine physicians regarding correct selection in terms of the patient group where this effective radiological method is to be applied, and to protect children from the adverse effects of radiation. Materials and Methods: The computed tomography (CT) images were retrieved from the hospital radiological archive system (PACS). The effective dose (Ed) was calculated using the standardized method including the tissue weighted parameters. The radiological pathologies determined as a result of CT imaging of the cases were categorized according to clinical significance in accordance with the Modified CT Colonography Reporting and Data System (C-RADS). Results: The data for a total of 268 patients were analyzed, comprising 89 (33.2%) females and 179 (66.8%) males with a mean age of 8.81 ± 5.21 years. The mean Ed was determined to be 18.14 ± 10.44 mSv. The Ed was determined to be statistically significantly higher in the 1–5 years age group than in the 15–18 years age group (p = 0.024). A statistically significant difference was determined between the age groups in terms of the pathologies determined (p = 0.028). Conclusions: In order to prevent performing unnecessary CT imaging, trauma teams in Emergency Departments (ED) should work in harmony and individual decision-making should be based on the severity of the trauma mechanism, the severity of the predicted injury, and the clinical status of the injured child.

Aim: The aim of this study was to compare the effectiveness of manual versus mechanical chest compression by using continuous end-tidal carbon dioxide (ETCO2) monitoring in-hospital cardiac arrest patients. Methods: The study included 90 patients meeting the inclusion criteria. Forty-seven (52.2%) patients were male and 43 (47.8%) were female. A prospective observational study of patients who experienced cardiac arrest while being monitored at the emergency department (ED) was conducted at the ED of a tertiary university hospital between April 2018 and September 2019. Demographics, electrocardiography (ECG) rhythm, cardiopulmonary resuscitation (CPR) technique (manual or automatic), laboratory data, the time to return of spontaneous circulation (ROSC), length of stay in the ED, hospitalization, and mortality were compared according to CPR type. Forty-four (48%) patients underwent manual CPR, and 46 (52%) patients underwent automatic CPR. Results: The 15th-minute and 20th-minute oxygen saturation (SaO2) levels, and the 10th-, 15th-, and 20th-minute ETCO2 levels showed a significant difference between the automatic CPR and manual CPR with all three variables being higher in the automatic CPR group (p=0.013, p=0.002, p=0.037, p=0.002, p<0.001, respectively). The causes of cardiopulmonary arrest, consultations, POCUS results, post-CPR lifetime, treatment types and neurological conditions were similar in both of the groups. Exitus was more frequent in the manual CPR device group (p=0,013). Conclusion: Mechanical Chest Compression provides more high-quality CPR than manual Chest Compression in-hospital cardiac arrest, and mid-resuscitation ETCO2 values equal to or greater than 20 mmHg appear to be a good predictor of ROSC. How to cite this article Yılmaz Y, Yılmaz F, Yılmaz A, Sönmez BM, Tekkanat S, Kavalcı C, Komut S, Beydilli İ, Zortuk Ö. Comparison of manual versus mechanical chest compression with ETCO2 value in-hospital cardiac arrest: A prospective observational study. J Med Dent Invest. 2025;6:e250172.