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    Responses of Five Different Artificial Intelligence Chatbots to the Top Searched Queries About Erectile Dysfunction: A Comparative Analysis
    (Springer, 2024) Sahin, Mehmet Fatih; Ates, Huseyin; Keles, Anil; Ozcan, Ridvan; Dogan, Cagri; Akgul, Murat; Yazici, Cenk Murat
    The aim of the study is to evaluate and compare the quality and readability of responses generated by five different artificial intelligence (AI) chatbots-ChatGPT, Bard, Bing, Ernie, and Copilot-to the top searched queries of erectile dysfunction (ED). Google Trends was used to identify ED-related relevant phrases. Each AI chatbot received a specific sequence of 25 frequently searched terms as input. Responses were evaluated using DISCERN, Ensuring Quality Information for Patients (EQIP), and Flesch-Kincaid Grade Level (FKGL) and Reading Ease (FKRE) metrics. The top three most frequently searched phrases were erectile dysfunction cause, how to erectile dysfunction, and erectile dysfunction treatment. Zimbabwe, Zambia, and Ghana exhibited the highest level of interest in ED. None of the AI chatbots achieved the necessary degree of readability. However, Bard exhibited significantly higher FKRE and FKGL ratings (p = 0.001), and Copilot achieved better EQIP and DISCERN ratings than the other chatbots (p = 0.001). Bard exhibited the simplest linguistic framework and posed the least challenge in terms of readability and comprehension, and Copilot's text quality on ED was superior to the other chatbots. As new chatbots are introduced, their understandability and text quality increase, providing better guidance to patients.
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    The Predictive Factors for the Longer Survival of the Reusable Flexible Ureterorenoscopy
    (Springer, 2023) Dogan, Cagri; Demir, Aslan; Sahin, Mehmet Fatih; Keles, Anil; Ates, Huseyin; Akgul, Murat; Yazici, Cenk Murat
    PurposeThe flexible ureterorenoscopy (FURS) is expensive and fragile equipment which easily break down during the surgery. f-URS have yet some problems with their durability that affect survival. One of the most important ways to increase the survival of a device is to improve its use in the right indications. We aimed to investigate whether the durability of the f-URS will be affected due to the volume and location of the stone and some anatomical features of the including infundibulopelvic angle (IPA), and location anomalies.Materials and methodsThe collected data from 705 patients' data including their age, sex, stone location, and stone volume, S-ReSC score, Hounsfield unit (HU) as stone density, IPA, BMI, and the usage time of f-URS using 10f-URS were included to study. Exp(B) values and confidence intervals (95% CIs) of parameters were calculated with COX regression and Roc curve analysis was also used to determine the cut-off value.ResultsRenal malformation, DJstent use, previous ESL application, and UAS use did not affect contrary to expectations stone volume, HU, IPA, and S-ReSC score were among the factors statistically significant affecting the durability of the device. It was observed, Exp(B) values of the affecting factors to be 0.984, 0.268, 0.894, and 0.607, respectively. We found the most appropriate cutoff value for IPA as 41.25 degrees.ConclusionThe mean stone volume broken by each of the subsequent f-URS may increase, while the mean operative time may decrease as time progresses. This result shows us the importance of mastery of the device, such as the deflection maneuver, and the correct use distance of the laser, which improves with the increase in user experience, and makes us interpret that the operation time is shortened with this self-confidence. Factors including stone volume, HU, IPA, S-ReSC score affect the durability of the f-URS device and the as well as manufacturing features.
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    What is the appropriate empirical antibiotic treatment for patients diagnosed with Fournier's gangrene? A single tertiary center experience
    (Bayrakol Medical Publisher, 2024) Sahin, Mehmet Fatih; Dogan, Cagri; Ates, Huseyin; Koroglu, Muhammed Sencer; Orbegi, Onur; Akgul, Murat; Yazici, Cenk Murat
    Aim: Fournier's gangrene (FG) is a highly destructive condition characterized by necrotizing fasciitis in the perineal, genital, or perianal area. The primary treatment involves fluid resuscitation, surgical debridement, and broad-spectrum antibiotics. However, there is insufficient evidence regarding antibiotic use in FG. This research aims to assess the microbiological characteristics of FG. Material and Methods: This study covered 40 FG patients from 2010 to 2023. In surgery, all necrotic areas were removed until viable tissue was seen. Primary deformity wound care was performed using vacuum-assisted closure (VAC). Patients with significant issues were evaluated, and plastic surgery was performed to repair the afflicted areas. The research examined FG patients' demographics, clinical features, bacterial cultures, and antibiotic susceptibility to establish the best empirical antibiotic therapy. Results: All patients were male and averaged 66.4 +/- 17.5 years old. The average hospital stay was 13.5 +/- 1.7 days. The median debridement number was 2 (1-4). Despite proper FG therapy, 7 (17.5%) patients died due to multiorgan failure. The wound cultures of 35 individuals (87.5%) showed bacterial growth. In 15 cases (37.5%), Escherichia coli was the most prevalent bacterium, followed by Enterococcus sp., Acinetobacter baumannii, and Streptococcus. Amikacin had the most significant bacterial sensitivity (62.5%), followed by ceftriaxone (60%) and carbapenems (imipenem 57.5%, meropenem 55%). Metronidazole has the greatest bacterial sensitivity (52.5%) among anaerobic bacteria. Discussion: The empirical antibiotherapy of amikacin + metronidazole and ceftriaxone/carbapenem antibiotics shows a notable susceptibility rate. Based on the findings of the culture antibiogram, it is recommended that the antibiotic treatment regimen be modified.