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Volume : 4 Issue : 2 Year : 2021

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The Anatolian Journal of Family Medicine - anatol j fm: 4 (2)
Volume: 4  Issue: 2 - 2021
1.From the Editor
Reşat Dabak
Page I

REVIEW
2.Clinical View of COVID-19 Impact on Children and Adolescents
Ernest Herbert, Dominique Fournier
doi: 10.5505/anatoljfm.2021.80664  Pages 112 - 119
The first case of coronavirus disease (COVID-19) infection was on 17 November 2019 according to Chinese government sources. COVID-19 symptoms among children seem to be milder compared with adults. Moreover, whether certain groups of children, for instance, those with comorbidities, may be at higher risk of more severe illness is unknown. Emerging data on the spread of COVID-19 in children have not been presented in detail. Due to its long incubation period (2–14 days) and because children can be asymptomatic or present mild, nonspecific symptoms, everyone should be considered potential COVID-19 carriers unless proven otherwise. This article is aimed at highlighting vertical transmission, clinical presentation, pediatric inflammatory multisystem syndrome and common COVID-19 features among children/adolescents and its impact on them. Pediatric patients with COVID-19 may not have fever or cough. However, social distancing and everyday preventive measures are necessary as those with less serious illness and others without symptoms are likely to play a major role in disease transmission.

ORIGINAL RESEARCH
3.The Effects of Mothers’ Anxiety and Depression on the Sleep Habits of 0–3-month-old Infants
Meliha Sevim, Ufuk Beyazova, Enes Ahmet Güven, Aysu Duyan Çamurdan
doi: 10.5505/anatoljfm.2020.96720  Pages 120 - 127
INTRODUCTION: This study aimed to explain sleep habits of infants and investigate the factors that may affect their sleep in the first 3 months after birth.
METHODS: Infants who were born between October 29, 2014, and November 30, 2014, at the Department of Gynecology and Obstetrics were recruited for this study. A face-to-face interview was conducted to mothers of the infants within the 3 days after birth. The mothers were asked to fill out the “Baby sleep evaluation questionnaire” and the Edinburgh Postnatal Depression and Beck Anxiety Scale were filled. All questionnaire were applied monthly.
RESULTS: The study included 70 infants. The mean sleep duration of 1-month-old infants was found to be 14.0±2.4 hours, while the mean daily sleep duration of 3-month-old infants was 13.7±2.0 hours. While 10 (83.3%) of the mothers who experienced anxiety in the second month stated that their babies had poor sleep quality, 23 (39.7%) of the mothers who did not have anxiety evaluated the sleep quality of their babies as poor (p=0.010). When comparing the first, second and third months of the babies separately, factors such as using a pacifier, nasal obstruction, nurse availability, or sex had no effect on sleep duration and waking frequency (p>0.05).
DISCUSSION AND CONCLUSION: Poor sleep quality reported by mothers decreases toward the third month. It was evaluated that the babies of mothers with anxiety in the second month had worse sleep quality than babies of mothers without anxiety.

4.Parents' Family-Centered Care Perception and Investigating Factors Affecting Such Perception
Emel Avçin, Şeyda Can, Fatma Yeşil
doi: 10.5505/anatoljfm.2020.98159  Pages 128 - 133
INTRODUCTION: This study aimed to examine the perception of family-centered care (FCC) and the factors affecting this perception from the perspective of the parents.
METHODS: The study design used is descriptive and cross-sectional. The study was carried out in two public hospitals in Bursa and Yalova city centres in Turkey. The universe of the study consists of 240 families whose 0–18-year-old child is hospitalized and stays with the child for at least 3 days between the specified dates.
RESULTS: A total of 240 parents participated in the study and 177 (73.8%) were women. The median value of significance was 26.0 (20.0-34.0) in hospitalized girls and was 28.0 (22.0-33.0) in hospitalized boys (p=0.019). The median value of significance dimension for children with chronic disease was 28.0 (22.0-31.0) and 28.0 (20.0-34.0) for those without chronic disease; in the consistency dimension, the median value of children with chronic disease was 22.0 (17.0-27.0) and 24.0 (14.0-31.0) of children without chronic disease (p=0.049 and p<0.001, respectively). Matching percentage of all items in the scale changes between 68.3-80.5%.
DISCUSSION AND CONCLUSION: It was determined that nurses make parents feel that the care given to their children is good, but they need to be more supportive as provided to make the parents feel an important place in the care of the child. When FCC is applied in hospitals, the satisfaction level of the child, family, and nurse will increase.

5.Perceived Stress Levels and Influencing Factors of Stress in Family Caregivers: A Cross-Sectional Study
Selçuk Akturan, Canan Tuz, Nadire Yıldız Çiltaş, Gokhan Kumlu
doi: 10.5505/anatoljfm.2021.69885  Pages 134 - 140
INTRODUCTION: This study aims to measure the perceived stress level of family caregivers of patients in palliative care units, and to reveal the socio-cultural and health-related characteristics that might affect their perceived stress.
METHODS: The population of this cross-sectional study consisted of family members who had taken care of their patients who were hospitalized in palliative care units between March 1, 2018, and June 1, 2018. A sociodemographic questionnaire and Perceived Stress Scale-14 (PSS-14) was applied face-to-face to all participants. Moreover, the Patient Health Questionnaire (PHQ-2) was applied to all participants.
RESULTS: Seventy-five family caregivers attended to the study. Twenty-two (34.7%) of family caregivers were patients’ children. Fifty-seven (75.0%) of family caregivers struggled with problems during care processes. Fifteen (19.5%) participants gave positive responses to both questions of the PHQ-2. The number of family caregivers who had chronic diseases was 49 (64.5%). The mean score of PSS-14 was 46.9±5.7.
DISCUSSION AND CONCLUSION: Difficulties in the management of care processes may have increased perceived stress levels and may adversely affect the caregivers' health and social life. Providing early psychological support to family caregivers by health professionals may help to reduce perceived stress.

6.Awareness of Parents about Human Papillomavirus Vaccine
Cansu Levent, Ali Özdemir, Berrin Telatar
doi: 10.5505/anatoljfm.2021.18189  Pages 141 - 145
INTRODUCTION: Cervical cancer is one of the leading preventable cancers and human papillomavirus (HPV) plays an important role in its etiology. Vaccination is recommended to prevent cervical cancer during adolescence. This study aimed to determine the awareness levels of parents about HPV vaccines recommended in adolescence and their attitudes towards vaccination.
METHODS: Parents with children aged 9-18 years who applied to pediatric outpatient clinic between June 2019 and August 2019 were included in this cross-sectional study. The questionnaire examined about sociodemographic characteristics and information source regarding the HPV vaccine and attitude toward paid vaccine.
RESULTS: A total of 299 parents were enrolled in the study. When parents’ awareness of the vaccine was questioned, only 47 (15.7%) stated that they had heard of the vaccine before. After being provided with the information on the vaccine, 207 (69.2%) of the participants stated that they did not want their children to be vaccinated against HPV, 118 (57.0%) of them showed a negative approach due to the cost.
DISCUSSION AND CONCLUSION: In our study, it is observed that the awareness level of the parents was low. The most common reason for not wanting their children to be vaccinated was the cost of the vaccine.

7.Changes to the Domestic and Family Life of Health Personnel during the COVID-19 Pandemic
Celali Kurt, Arzu Altunçekiç Yıldırım
doi: 10.5505/anatoljfm.2021.44366  Pages 146 - 152
INTRODUCTION: Health personnel have experienced several challenges in the fight against the Coronavirus disease 2019 (COVID-19). They have experienced problems apart from work life and been forced to make sacrifices. This study was aimed to evaluate the changes in home and family life of health personnel during the COVID-19 pandemic.
METHODS: Health personnel were reached in the using an electronic environment through social networks and communication applications, and they completed a survey containing 16 multiple choice questions from 9 May 2020 to 15 May 2020.
RESULTS: Two thousand and fifty people participated in this study. Five hundred and ninety-one (28.8%) participants were doctors, 903 (44.0%) were nurses, and 556 (27.1%) were other groups of health personnel. Of the 2013 responses, 126 (6.3%) stayed elsewhere continuously, and 198 (9.8%) sometimes stayed at home. Of 1993 responses, 767 (38.5%) did not apply any isolation at home, while 827 (41.5%) continuously implemented isolation measures. Eight hundred and forty (43.4%) of 1937 responses continuously avoided hugging or kissing their partner and/or children. Of 2017 responses, 78 (3.9%) stated that they or at least one of their family members developed the COVID-19 disease.
DISCUSSION AND CONCLUSION: There should be more aware of the difficulties experienced by health personnel outside of work life. The procedures outside of work life for personnel with duties during the pandemic should be discussed. Health management systems should provide more support for health employees on these topics and guide the determined procedures.

8.Relationship between Lifestyle Behaviors and Upper Respiratory Tract Infections
Burcu Aykanat Yurtsever, Turan Set, Ceyhun Yurtsever
doi: 10.5505/anatoljfm.2021.86547  Pages 153 - 158
INTRODUCTION: This study aims to investigate the relationship between the frequency and recovery time of upper respiratory tract infections (URTIs) and lifestyle behaviors.
METHODS: This cross-sectional study was conducted in a tertiary family medicine outpatient clinic between November 2015 and June 2017. Voluntary individuals who applied to the clinic for any complaint between the ages of 18 and 45 years were included in this study. Of 384 participants, the sociodemographic characteristics, lifestyle behaviors, and information on URTIs they had for the last 1 year were collected and analyzed.
RESULTS: The median total number of URTIs was 2.0 [interquartile range: 3.0], and the median recovery time of URTIs was 5.0 [4.0] days. The frequency of URTIs in current smokers was 3.0 [2.5], while it was 2.0 [3.0] in nonsmokers and 2.0 [2.0] in former smokers (p=0.028). Daily smoking exposure time of non-smokers, daily amount of fluid consumption and number of meals consumed fast-food per month were positively correlated with the frequency of URTIs (p=0.017, p=0.037 and p=0.044, respectively). The median number of URTIs was 2.0 [3.0] in those who ventilated their house every day, and 3.5 [3.3] in those who did not (p=0.037). The median recovery time of URTIs in females was 5.0 [3.0] days, while it was 5.0 [4.0] days in males (p=0.017). There were negative correlations between the median recovery time of URTIs and age and weekly exercise duration (p=0.039 and p=0.039, respectively).
DISCUSSION AND CONCLUSION: This study shows that some lifestyle behaviors affect the frequency of URTIs and their recovery times.

9.Evaluation of Nomophobia and Smartphone Addiction Levels among University Students in terms of Alcohol and Drug Abuse Risk
İzzet Fidancı, Hilal Aksoy, Duygu Ayhan Başer, Duygu Yengil Taci, Mustafa Cankurtaran
doi: 10.5505/anatoljfm.2020.30502  Pages 159 - 164
INTRODUCTION: This study examines the relationship between nomophobia and smartphone addiction, which have not become increasingly prevalent, and other addictions, especially drug abuse.
METHODS: This study included Hacettepe University students aged 18 years and above between June 2020 and August 2020. The questionnaire used in this study consisted of questions about socio-demographical characteristics in the first part and the Nomophobia Questionnaire (NMP-Q), Smartphone Addiction Scale (SAS), Alcohol Risk Screening Scale (ARSS) and Drug Use Risk Screening Scale (DRSS) in the second part.
RESULTS: The study included 386 university students and 195 (50.5%) were men. The median of NMP-Q, SAS, ARSS, and DRSS were 78.0 (20.0 140.0), 35.0 (10.0-60.0), 6.0 (0.0-12.0), 0.0 (0.0-2.0), respectively. No significant difference in the nomophobia score was found between the alcohol and drug addiction risk scale scores (p=0.545 and p=0.186, respectively). Also, no significant difference in the smartphone addiction score was found between the alcohol and drug addiction risk scale scores (p=0.520 and p=0.945, respectively). There was a weak negative relationship between nomophobia scores and age (p=0.046).
DISCUSSION AND CONCLUSION: Given the increased tendency to follow technological developments among university students, their incapability to stay away from smartphones and similar devices due to smartphone addiction is an indicator of the student’s addiction. This may predispose them to other accompanying addictions such as alcoholism and drug abuse. However, many different factors may cause this. All health institutions should take necessary protective measures to minimize and eliminate such addictions.

10.Sitagliptin Add-on to Metformin Plus Sulphonylurea Combination Therapy: The Efficacy of Triple Therapy on Metabolic and Glycemic Control in Type 2 Diabetes
Savaş Volkan Kısıoğlu, Ozgur Can, Sakin Tekin, Mehmet Sargin
doi: 10.5505/anatoljfm.2021.87049  Pages 165 - 169
INTRODUCTION: This study aimed to evaluate the efficacy of sitagliptin add-on metformin and sulphonylurea combination therapy in type 2 diabetic patients with insufficient glycemic control.
METHODS: This study included who were treated with sitagliptin and continued with sitagliptin for 12 months while receiving metformin-sulphonylurea combination. The fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels of the patients were measured at the initial, 3rd month, 6th month and 12th month.
RESULTS: A total of 40 patients were included in this study. The mean age patients was 59.2±9.6 years and initial HbA1c level was 7.6% (7.0-10.5). The HbA1c level of the patients was 6.8% (5.9-8.7) at 3 months, 6.7% (5.3–7.5) at 6 months, and 6.9% (5.4–9.1) at 12 months (p<0.001 for 0-3. months, p<0.001 for 0-6. months, p=0.003 for 0-12. months).
DISCUSSION AND CONCLUSION: Adding sitagliptin to the treatment is an effective and well-tolerated option in patients with type 2 diabetes who are not able to achieve adequate glycemic control despite metformin–sulphonylurea combination treatment.

11.Change in Air Pollution and Human Mobility Trends during COVID-19 Lockdown Measures in Turkey
Caner Baysan, Seher Palanbek Yavaş, Meltem Çöl
doi: 10.5505/anatoljfm.2021.25338  Pages 170 - 177
INTRODUCTION: This study aimed to examine the change in the air quality parameters of 31 cities that were affected by the strict measures taken in Turkey during the months of March, April, and May and their relationship with the activity parameters.
METHODS: Thirty-one cities included in this study were assessed in terms of their average particulate matter (PM10), sulfur dioxide (SO2), carbon monoxide (CO), nitrogen dioxide (NO2), and ozone (O3) values in the months of March, April, and May between 2017 and 2020 and their activity data in the same months of 2020, which had six different subdimensions.
RESULTS: When the compared the 3-month average air parameters of the cities and the 3-month average parameters of the previous 3 years, the PM10 and NO2 levels decreased from 47.6 μg/m3 to 38.1 μg/m3 and from 54.8 μg/m3 to 25.7 μg/m3, respectively (p=0.001 and p=0.001). When the change in the air quality parameter and the activity change correlation were evaluated, a statistically significant correlation regarding “retail and recreation,“workplaces,” and “residential,” which were the three subdimensions of the SO2 change activity was determined (p=0.034, p=0.002, and p=0.003, respectively). In the linear regression models established, it was determined that “workplaces” had a statistically significant relationship regarding SO2 change (r=0.339, p=0.038).
DISCUSSION AND CONCLUSION: The decrease in air pollution that is an indirect positive effect of the pandemic on the environment is temporary, but governments should learn from this lockdown on how to reduce pollution on a longterm basis.

12.Effect of the COVID-19 Pandemic on Antenatal Care Behavior of Pregnant Women in Burdur, Turkey
Ayşen Til, Sevinç Sütlü
doi: 10.5505/anatoljfm.2021.42744  Pages 178 - 181
INTRODUCTION: Antenatal care (ANC) is the follow-up of pregnant women at regular intervals by healthcare personnel to protect and improve their own and their babies' health. This study aimed to reveal the effect of the COVID 19 pandemic on pregnant women's behavior receiving ANC in Burdur.
METHODS: The sample of this cross-sectional study consisted of 538 pregnant women who were registered in the Family Medicine Information System in Burdur and required prenatal care on 15 May-15 June 2020. The accessibility rate in the study was 515 (95.7%) for 538 pregnant women called by phone.
RESULTS: In terms of prenatal care, 14 (2.7%) and 69 (13.4%) of the pregnant women received ANC services from primary and secondary healthcare institutions, respectively, whereas 410 (79.6%) received ANC services from both institutions. In this study, 82 (81.2%) of the pregnant women who did not receive ANC could not attend the family doctor or gynecologist/obstetrician appointment for ANC due to fear of COVID-19 transmission.
DISCUSSION AND CONCLUSION: The study found a decrease in the utilization of ANC services in Burdur, mainly associated with the COVID-19 pandemic. Initially, many arrangements were made to ensure that safety is prioritized in the implementation of ANC services. However, ANC services should be modified in line with the recommendations of the World Health Organization.

CASE REPORT
13.A Rare Case of Idiopathic Lymphedema
Seval Sarıkaya, Hilal Bektaş Uysal, Ayfer Gemalmaz, Hulki Meltem Sönmez
doi: 10.5505/anatoljfm.2020.29290  Pages 182 - 186
Lymphedema is the swelling of a part of the body due to the accumulation of lymphoid fluid in the subcutaneous soft tissue as a result of abnormalities in lymphatic drainage. Primary lymphedema is thought to have a mixed genetic component that arises from the erroneous development of the lymphatic system, which is also responsible for the malfunction of the lymphatic system. This condition can be sporadic or genetic. In this case present a 25-year-old male patient. The patient reported a bite on his finger because of a poisonous fish at age 18 years. Afterwards, he reported marked lymphedema, which gradually and progressively spread from the left ankle to the left thigh. Then, the patient was diagnosed as primary lymphedema praecox and classified as stage 2. In this case report, it is aimed to elucidate the genetic disease associated with primary lymphedema and to expatiate on the management of this chronic disease.

14.Multisystem Inflammatory Syndrome with Features of Incomplete Kawasaki Disease in an Adolescent Boy with COVID-19
Pallithottangal Kunju Moideen Hidayathullah, Shamsudeen Moideen, Santha Velappan Rakhesh, Pichen Shihabudheen, Nalakath Arakkal Uvais
doi: 10.5505/anatoljfm.2021.53315  Pages 187 - 189
Although the coronavirus disease (COVID-19) in the pediatric population appears to be less severe among children <18 years old, emerging evidence from Europe, North America, Asia, and Latin America indicates that COVID-19 infection may precipitate the hyperinflammatory state among children following infection. This paper reports a case of multisystem inflammatory syndrome with features of incomplete Kawasaki disease in an adolescent boy who also tested positive for COVID-19 antibody. This case highlights the potential COVID-19 complications in adolescents.

15.Three Faces of COVID-19 in Children and the Susceptibility of the Children of Healthcare Professionals
Özgür Ceylan, Leman Tekin Orgun, İlknur Erol
doi: 10.5505/anatoljfm.2021.42275  Pages 190 - 196
The coronavirus disease 2019 (COVID-19) is spreading around the world affecting many people and leading to serious morbidity and mortality. Detailed clinical data about COVID-19 in the adult population have been reported from different countries; however, data about COVID-19 in the pediatric population are limited with only a few reports. Three children with COVID-19 were presented to discuss different clinical and radiologic findings of COVID-19 in children in this case reports. Three consecutive children (ages 6 months, 18 months, and 3 years) were diagnosed through real-time polymerase chain reaction as being positive for severe acute respiratory syndrome coronavirus 2. Two of the patients were children of healthcare workers. Two of the cases could be classified as pneumonia; however, one of these had a severe clinical course with secondary bacterial infection, while the other was diagnosed as acute bronchiolitis. None of our patients required intensive care, mechanical ventilation, or had any severe complications. They were all discharged in good health and had no additional symptoms or signs during the follow-up period. Two of the children were the first two children from Turkey to be diagnosed COVID-19 positive, and unfortunately, two of the patients were children of healthcare workers.

LETTER TO THE EDITOR
16.Time to Take Vitamin D Seriously in the Current Coronavirus Disease 2019 Pandemic
Darko Siuka, Bojana Pinter
doi: 10.5505/anatoljfm.2020.86158  Pages 197 - 198
Abstract | Full Text PDF

17.Irrational Drug Usage in Turkey: The Need for More Active Educational Intervention among Health Care Professionals and Patients
Zakir Khan, Yusuf Karatas
doi: 10.5505/anatoljfm.2021.63644  Pages 199 - 200
Abstract | Full Text PDF

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