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Volume : 3 Issue : 3 Year : 2020

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The Anatolian Journal of Family Medicine - anatol j fm: 3 (3)
Volume: 3  Issue: 3 - 2020
1.From the Editor
Yeşim Uncu
Page I

2.List of Reviewers
List Of Reviewers
Page 2
Abstract | Full Text PDF

3.Using the Ventrogluteal Site for Intramuscular Injection
Aynur Kaynar Şimşek, Şule Ecevit Alpar
doi: 10.5505/anatoljfm.2020.84755  Pages 195 - 199
Intramuscular (IM) injection is one of the most common invasive procedures performed by nurses. Many complications due to unsafe IM injections have been reported in the literature. Most of these complications develop due to injections into the dorsogluteal (DG) site. Recent studies conducted to increase safe injection applications have determined that the DG site is the most risky region for IM injections because it is close to sciatic nerves, may have subcutaneous adipose tissue thick enough to prevent access to target muscles, and allows to detect injection site only with imaginary lines. However, the ventrogluteal (VG) site has been reported as the most reliable region for and suggested as the first choice of IM injections because it is far from sciatic nerves, receives the blood from small branches of arteries, allows detecting injection site by palpating bone structures, and has subcutaneous adipose tissue thin enough to reach target muscles. Despite the changes in the literature regarding site selection for IM injections, studies have reported that nurses prefer the DG site as the first choice for administering IM injections. In addition, studies of the reasons why nurses prefer the DG site for IM injections have emphasized that they do not have adequate knowledge of VG injections. This study was conducted to explain the reasons why the IM site should be preferred for administering IM injections to increase the level of knowledge on the administration of IM injections into the IM site and to raise the use of the IM site for administering IM injections.

4.Viewpoint on COVID-19 Pandemic
Ernest Herbert, Dominique Fournier
doi: 10.5505/anatoljfm.2020.06025  Pages 200 - 204
Infections with COVID-19 are now global, reaching 213 countries, and as of May 29, 2020, more than 5M+ confirmed cases, with over 355.000+ deaths, although the number is still rising by the day. This short review aims to briefly highlight what is known about the epidemiology, aetiology, testing techniques and clinical features of COVID-19. The inter-human transmission of coronaviruses mainly occurs through saliva droplets, aerosols and direct/indirect contact through surfaces. Successful containment preceding any future effective vaccine includes social distancing, contact tracing, tracking of infected people, mass screening and providing healthcare professionals and social care workers with adequate personal protective equipment.

5.The Investigation of the Effects of the Very and Mild Preterm Birth on the Musculoskeletal System
Hayriye Kul Karaali, Sema Savcı, Ayşe Özden, Celal Gençoglu, Nuray Duman
doi: 10.5505/anatoljfm.2020.96641  Pages 205 - 210
INTRODUCTION: The aim of study was to examine the musculoskeletal system of the very preterm (VP) and mild preterm (MP) born children and to compare them with their term born peers.
METHODS: Children born with VP and MP between January 1998 and April 2003, whose contact information was available from patient records, were included in our study. The control group consisted of volunteers who were admitted to the Department of Child Health and Diseases during the study. Skeletal muscle mass, fat free mass, posture and physical fitness of all participants were assessed.
RESULTS: Eighteen (28.2%) VP, 23 (35.9%) MP and 23 (35.9%) term born children were included in this study. Total posture score was 6.0 [3.5] in the VP group, 5.0 [5.0] in the MP group and 4.0 [2.0] in the term group and the difference between VP and term group was significant (p=0.004). Munich Physical Fitness Test score was 44.0±6.3 in the VP group, 45.6±4.8 in the MP group and 51.9±3.8 in the term group and the difference between VP and term groups and between MP and term groups was significant (p=0.001 and p=0.001, respectively).
DISCUSSION AND CONCLUSION: The musculoskeletal system of the VP and MP born school age children is affected negatively in comparison to their term peers. This situation suggests that very and MP born children later on may have potential health problems originated from musculoskeletal system.

6.A Gender-Based Comparative Aneurysm Study Regarding Age at Presentation, Location, and Possible Causative Factors
Janeane Watt, Conrad Watt, Albert Van Schoor
doi: 10.5505/anatoljfm.2020.52297  Pages 211 - 215
INTRODUCTION: The worldwide prevalence of cerebral aneurysms is estimated at 3.2%, with a female predominance of 2: 1. A significant gender-specific difference also exists regarding the aneurysm location. This study aimed to find out if the South African population falls within these parameters.
METHODS: This study is a cross-sectional study. The data (gender and age of patients), infarct locations and causative factors present for the 485 patients was obtained from the departments’ logbooks and noted from 1 January 2015 until 31 July 2019. Only patients that showed evidence of aneurysms for the first time were included in this study to avoid duplication of the data.
RESULTS: The mean age regardless of gender for this South African based population study was 53.1±13.0 years. Males were mainly affected in the age group 51-60 years of age. Females were more broadly affected: 51-60 years (29.8%), 41-50 years (26.8%) and 61-70 years (20.2%). The male to female ratio was 1: 2.17. Two hundred and fifty (52.6%) patients had hypertension. Smoking affected 174 (35.9%) participants and hypercholesterolemia affected 90 (18.6%) patients. The most predominant aneurysm location was the anterior communicating artery.

DISCUSSION AND CONCLUSION: The South African aneurysm statistics correlate with available international data when we assess the male to female ratio. Hypertension was the leading possible cause of aneurysms, which also correlates with the literature. A family history of aneurysms should be included in the questionnaire in the future as it is one of the biggest possible risk factors to develop aneurysms.

7.Serum Calcium, Vitamin D Levels in Pediatric Flatfoot Patients That were Brought to Clinic with or without in-Toeing Complaint
Kadri Yıldız, Hayrunnisa Bekis Bozkurt, Vahit Yıldız
doi: 10.5505/anatoljfm.2020.03522  Pages 216 - 220
INTRODUCTION: This study aims to evaluate the serum levels of calcium and Vitamin D in pediatric patients with flatfoot, who were brought to clinic with or without in-toeing compliants.
METHODS: Flatfoot patients who were followed up between November 2017 and December 2019 were divided into four groups. Group A included patients who had flatfoot with in-toeing. Group B included patients who had flatfoot without in-toeing. Group C included patients who had in-toeing without flatfoot. Group D was the control group and it included patients who had neither flatfoot nor in-toeing. Group D had no other acquired or congenital diseases via to the pediatric age. Serum levels of calcium and Vitamin D were detected by biochemical assays on study and control groups.
RESULTS: In this study, four study groups included 204 children who were divided in to four groups as Group A, B, C and D. All groups included 51 (%25.0) patients. According to test results, in the serum calcium levels, there was a significant difference between Group A and Group D in favor of the control group (p=0.040). There was no significant difference between serum vitamin D levels and foot deformities (p=0.457). The relationship between calcium values and foot deformities was significant (p=0.004). The relationship between vitamin D values and foot deformities was not significant (p=0.457).
DISCUSSION AND CONCLUSION: The coexistence of flatfoot and in-toeing may be related to lower serum calcium levels. Flatfoot with or without in-toeing has no relationship with serum Vitamin D levels.

8.Sociodemographic Factors Associated with Utilization of Oral Rehydration Therapy Among Under Five Children with Diarrhoea in a Rural Nigerian Community
Ajibola Idowu, Yetunde Olasinde, Ayodele Olatayo Aremu, Oluwaseyi Kolawole Israel, Oluwabukola Ayodele Ala
doi: 10.5505/anatoljfm.2020.96636  Pages 221 - 228
INTRODUCTION: This study assessed the prevalence of childhood diarrhea disease and identified associated factors of oral rehydration therapy (ORT) use in treating childhood diarrhoea in a rural Nigerian community.
METHODS: A cross-sectional study design involving caregivers of under-five children with at least one episode of diarrhea in the past six months in Ejigbo, Osun-State, Nigeria was conducted using a multistage sampling method. Pretested interviewer-administered, semi-structured questionnaire was used for data collection.
RESULTS: A total of 410 caregivers were included in the study. Two hundred and fifty-two (61.5%) of under-five children in the study area had at least one episode of diarrhea within six months preceding the survey. Only 50 (13.8%) of all the participants who were aware of ORT had good knowledge, but 312 (76.1%) of them had a positive attitude to its use. ORT was utilized in treating only 145 (57.5%) of childhood-diarrhea cases. Determinants of ORT uptake in the study population included gender (OR=0.470, 95% CI=1.160-3.110), educational status (OR=0.620, 95% CI=2.300-4.120), knowledge on availability of ORT (OR=3.010, 95% CI=1.820-3.990) and overall ORT knowledge (OR=0.640, 95% CI=0.110-0.640).
DISCUSSION AND CONCLUSION: The burden of childhood diarrhea disease is high in the study population. Authors advocate for improvement in the general socio-economic wellbeing of rural dwellers for this burden to be lessened. There is also an urgent need for a renewed awareness campaign on proper use of ORT in treating childhood diarrhea diseases in rural Nigeria.

9.Effects of Pancreatin therapy on Gastrointestinal Symptoms in Patients with Type 2 Diabetes Mellitus
Reşat Dabak, Engin Ersin Şimşek, Sabah Tüzün, Can Öner, Ismet Tamer, Ekrem Orbay, Oya Bayramiçli
doi: 10.5505/anatoljfm.2020.25349  Pages 229 - 233
INTRODUCTION: Gastrointestinal symptoms (GIS) are more common in individuals with type 2 diabetes mellitus (DM) in comparison to normal population. This study aimed to evaluate the effects of the pancreatin therapy on the GIS in patients with type 2 DM.
METHODS: This study included patients with type 2 DM admitted to the Gastroenterology Department between February to July 2017. Age, HbA1c, level of C-peptide, triglyceride, antidiabetic treatments, fecal elastase levels were evaluated in the files of all patients. The GIS of the patients, who were considered to suffer from the exocrine pancreatic insufficiency, including abdominal pain, bloating, constipation and diarrhea were evaluated before and after the 25000 IU pancreatin therapy.
RESULTS: The study included 35 patients with type 2 DM, the mean age was 59.1±7.6 years, and 24 (68.6%) of the patients were female. The exocrine pancreatic insufficiency was detected in 1 (2.9%) of the patients. Prior to the pancreatin therapy, 33 (94.3%) of the patients were determined to have abdominal pain, 34 (97.1%) had bloating, 33 (94.3%) had constipation and 32 (91.4%) had diarrhea. After the therapy, 29 (82.9%) of the patients were found to have abdominal pain, 31 (88.6%) had bloating, 31 (88.6%) had constipation and 29 (82.9%) had diarrhea. GIS including abdominal pain, bloating, constipation and diarrhea were decreased after pancreatin treatment (p=0.015, p<0.001, p=0.001 and p=0.024, respectively).
DISCUSSION AND CONCLUSION: GIS in patients with type 2 DM can be treated with pancreatic enzyme replacement therapy.

10.Attention Deficit Hyperactivity Disorder as a Risk Factor for Fractures
Ayla Uzun Çiçek, Seda Aykube Sarı, Ilknur Ucuz
doi: 10.5505/anatoljfm.2020.72473  Pages 234 - 241
INTRODUCTION: It has been reported that attention-deficit/hyperactivity disorder (ADHD) is related to an increased risk of fracture. However, relevant data have been provided from either population with fractures or population-based cohort studies. In this study, we aimed to determine the fracture risk in children with ADHD.
METHODS: The children with ADHD between the ages of 6 and 16 who were admitted between April 2019 and July 2020 and healthy children matching in age and gender were included in this study. A semi-constructed diagnosis interview, Conners' Parent Rating Scale-Revised Short Form, and Strengths and Difficulties Questionnaire were administered to both groups.
RESULTS: Two hundred and twelve children with ADHD and 215 healthy children were included in this study. One-time fracture was found in 76 (35.8%) children in the ADHD group and 39 (18.1%) children in the healthy group (p<0.001). While there were recurrent fractures in 27 (12.7%) patients in the ADHD group, this rate was 13 (6.0%) for healthy controls (p=0.018). Also, 45 (59.2%) of the children with fractures and 57 (41.9%) of the children without fractures had comorbid diseases (p=0.016).
DISCUSSION AND CONCLUSION: ADHD poses a significant risk for fractures and is related to an increased risk of fracture. It would be advisable to screen children with bone fractures concerning ADHD and referring them to a child and adolescent psychiatrist if there is a suspicion of ADHD.

11.Are Patients Diagnosed with Chronic Hepatitis B Aware of Their Disease?
Pınar Ergen, Fatma Yılmaz Karadağ, Özlem Aydın, Arzu Doğru, Ayşe Canan Üçışık, Saadet Yazıcı, Zuhal Aydan Sağlam, Mustafa Haluk Vahaboğlu
doi: 10.5505/anatoljfm.2020.83803  Pages 242 - 248
INTRODUCTION: This study aims to determine the level of knowledge of patients being followed up with a diagnosis of chronic hepatitis B Infection about the disease, route of transmission, prevention and treatment.
METHODS: A cross-sectional survey was conducted between June-December 2016. The survey consisted of questions about demographic information, general information about the disease, routes of transmission, prevention, treatment and patient follow-up.
RESULTS: The questionnaire was administered to 500 patients. The mean age of the patients was 42.2±12.9 years, 319 (63.8%) were male. In this study, 141 (28.2%) of the patients said that hepatitis B was not an infectious disease. The level of knowledge about the name of the disease, infectiousness and its complications was significantly high in patients with a high education level and in patients who were diagnosed with hepatitis B for more than five years. While 214 (98.7%) patients with high education level knew the name of the disease and 191 (88.0%) patients knew virus’ infectiousness and its complications. Three hundred twenty-one (97.6%) patients with hepatitis B for more than five years knew the name of the disease and 278 (84.5%) patients knew the virus' infectiousness and its complications.
DISCUSSION AND CONCLUSION: Hepatitis B infection stil remains a critical health problem for both the patient and his environment. Increasing awareness of patients about their diseases will decrease the spread of infection and control the complications that may arise in the future due to hepatitis B.

12.Effects of Cervical Dilatation during Cesarean Section on Postpartum Process
Asiye Uzun
doi: 10.5505/anatoljfm.2020.36035  Pages 249 - 253
INTRODUCTION: To evaluate the effects of cervical dilatation on postoperative maternal morbidity during a cesarean.
METHODS: Pregnant women who applied to Nisa Hospital between 01 June 2019 and 31 August 2019 were included in this study. The cases were compared according to whether cervical dilatation was performed or not. For all cases, evaluation included fever during the postpartum process, preoperative hemoglobin and leukocytes, postoperative 6th-hour hemoglobin and leukocytes, wound infection in postpartum 1st week, postpartum bleeding and postpartum 6th-month scar thickness.
RESULTS: In this study, 95 women were included. There were 48 (50.5%) women in the cervical dilatation group and 47 (49.5%) women in the non-cervical dilatation group. The pre- and postoperative hemogram values of the individuals in both groups were compared. In the cervical dilatation group, hemoglobin was 11.9 (7.7-14.6) g/dL in the preoperative period and 11.4 (7.6-14.5) g/dL in the postoperative period (p<0.001). However, hemoglobin was 11.3 (6.4-13.0) g/dL in the preoperative period and 11.3 (8.3-15.2) g/dL in the postoperative period of the non-cervical dilatation group (p=0.459). Concerning wound infection, fever, bleeding and scar thickness in both groups after birth, only the dilated group was found to be significantly thick in terms of scar thickness in the sixth month (p<0.001).
DISCUSSION AND CONCLUSION: In our study the mean of difference of hemoglobin and hematocrit values were found to be significantly higher in the cervical dilatation group. Besides this, significant results were found in the dilatation group in terms of long-term scar thickness.

13.Determination of Sexual and Reproductive Health Stigmatization Levels of Young Women
Metin Yıldız, Mehmet Salih Yıldırım, Güray Okyar
doi: 10.5505/anatoljfm.2020.36349  Pages 254 - 259
INTRODUCTION: This research was carried out to investigate the sexual and reproductive health stigmatization levels of young women.
METHODS: This cross-sectional study was conducted between 18-24 years old women registered in the Family Health Centers located in Igdir city center between March and April 2020.
RESULTS: In this study, the median value of the Sexual and Reproductive Health Stamping Scale was 8.0 [6.0] in young women. The median value of "Accepted stigma", "Internalized stigma", "Stigma based attitudes", which are sub-dimensions of the the Sexual and Reproductive Health Stamping Scale in young women, were found as 3.0 [3.0], 2.0 [4.0], 3.0 [3.0], respectively. A positive statistically significant relationship was found between the Sexual and Reproductive Health Stigma Scale subscales Attitudes Based on Stigma and age in young women (r=0.171, p=0.004).
DISCUSSION AND CONCLUSION: The results suggest that the level of stigmatization may vary according to the level of education and income, and it is recommended to provide training on stigmatizing sexual and reproductive health for this group.

14.Corona Virus Disease 2019 Pandemic: Strengthening the Prevention and Control Activities in the American Region
Saurabh Shrivastava, Prateek Shrivastava
doi: 10.5505/anatoljfm.2020.87587  Pages 260 - 261
Abstract | Full Text PDF

15.Ensuring the Preparedness and Development of an Emergency Response Plan in the Fight Against the COVID-19 Outbreak in Libya
Saurabh Shrivastava, Prateek Shrivastava
doi: 10.5505/anatoljfm.2020.96268  Pages 262 - 263
Abstract | Full Text PDF

16.Enterobius Vermicularis Infestation of the Uterine Cavity: A Rare Cause of Dysfunctional Uterine Bleeding
Hasan Ali Inal, Zeynep Öztürk Inal, Tuğba Günler
doi: 10.5505/anatoljfm.2020.58561  Pages 264 - 266
Extraintestinal infestations of Enterobius are extremely rare, and the worm larvae may migrate primarily to invade the female genital tract. A 47 year-old woman having irregular menstruation for six months was admitted and had endometrial biopsy. The patient, whose pathology report had enterobiasis in the endometrium, was cured by treatment with 500 mg mebendazole. Endometrial sampling should be considered by the clinician before unnecessary and aggressive surgery in patients presenting with a similar complaint.

17.A Rare Case of Bilateral Peritonsillar Abscess in a Child: An Impending Deadly Condition
Rajarajeswari Arunathan, Shi Nee Tan
doi: 10.5505/anatoljfm.2020.98700  Pages 267 - 269
Peritonsillar abscess (PTA) is one of the deep neck infections. Unilateral PTA is more common than bilateral PTA and is more common in adults than children. Therefore, it is a rare condition with a low rate of incidence. To the best of our knowledge, the literature on this topic (bilateral PTA in children) is limited with this manuscript. In this study, we present a 5-year-old girl who presented with sore throat, odynophagia, and loss of appetite for two weeks, and fever for one week. On clinical examination,a bilateral enlarged tonsil with grade III-IV right tonsil, and grade III left tonsil was observed, respectively. The right tonsil is more erythematous, bulging, and exudative compared to the left tonsil, with the uvula centrally placed. The patient underwent bilateral incision and drainage under general anesthesia followed by intravenous antibiotics for one week. This case report highlighted the need for a high level of clinical suspicion to reach a prompt diagnosis. The management of the airway, which would be difficult, is an important aspect of the treatment. Thus, an immediate rapid drainage is required as much as an emergency surgical intervention to avoid unwanted morbidity and mortality.

18.Panic Buying: Is It a Normal Social Construct?
Pawan Sharma, Sujita Kar, Vikas Menon, Charanya Ravi, Srijeeta Mukherjee, Angi Alradie-Mohamed, Marthoenis Marthoenis, Russell Kabir, S.M. Yasir Arafat
doi: 10.5505/anatoljfm.2020.52523  Pages 270 - 271
Abstract | Full Text PDF

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