E-ISSN 2651-3455 (Online) | ISSN 2630-5593 (Print)
The Anatolian Journal of Family Medicine - anatol j fm: 5 (3)
Volume: 5  Issue: 3 - 2022
EDITORIAL COMMENT
1.Front Matter 2022-3

Pages I - VII

2.From the Editor
Mustafa Reşat Dabak
Page VIII

REVIEW
3.Mask Mouth: A Silent Threat to Oral Health
Aniruddha Khedulkar, Suraj Multani
doi: 10.5505/anatoljfm.2022.49002  Pages 136 - 141
Today, the world is facing the deadliest global pandemic, and somehow, everyone is fighting for their lives. The coronavirus being an airborne communicable disease, has created havoc among the population. The best possible way suggested to protect one is by staying indoors and using protective gear such as mouth masks, face shields, etc. As we cannot stay indoors forever, the one possible solution left to keep oneself safe while working outside is through protective gear. Among them, the most economical and easily available product is mouth masks. Mask culture has taken its place in daily life, and it is not known how long it will continue. During this pandemic, the oral health of the individual is highly neglected. However, due to negligence and poor hygiene practices, this protective tool poses another hidden threat. This opportunistic condition known as Mask Mouth is a rising global threat in the world of dentistry. Every individual harbors a biome for a variety of oral flora. Irregular and improper usage of masks provides this flora to bloom and causes various oral conditions. The long-term wearing of masks, mouth breathing, and poor mask hygiene provide adequate moisture and temperature for oral bacteria to grow, leading to different oral diseases. It can be stopped because it is preventable because the threat is real and needs to be addressed at the right time.

ORIGINAL RESEARCH
4.The Biopsychosocial Usage of Draw your Family Test in Children in Family Medicine
Ali Uçar, Derya Akbıyık
doi: 10.5505/anatoljfm.2021.32154  Pages 142 - 148
INTRODUCTION: In family medicine practices, children are generally evaluated biologically, but their psychosocial evaluation is lacking. This study aimed to evaluate the family pictures drawn by children between the ages of 4 and 12, in a biopsychosocial approach within the framework of family medicine.
METHODS: Parents and their children who applied to the family physician between the ages of 4 and 12 between February 1, 2019, and April 30, 2019, were included in the study. In the outpatient setting, a one-time Draw your family test (DYFT) was applied to the children and the drawn pictures were evaluated using the Koppitz’s Emotional Indicators Scale (EIS). Parents of the same children were asked to complete the Conners’ Parental Rating Scale (PRS).
RESULTS: A total of 212 children were included in the study. As a result of the DYFT, 85 (40.1%) children may have developmental delay, lack of self-confidence, communication disorder, impulse control disorder, shyness, introversion, and socialization problems were obtained. In the Conners’ PRS applied to parents, data indicated that 147 (69.3%) children may have hyperactivity disorder, behavioral disorder, attention deficit disorder, anxiety disorder, and psychosomatic disorder. At the end of the study, it was observed that 41 (19.3%) children scored high on both the Koppitz’s EIS and the Conners’ PRS.
DISCUSSION AND CONCLUSION: In conclusion, starting with drawing tests after a short training of family physicians will increase their communication with children and enable them to evaluate psychosocially.

5.The Management of Irritable Bowel Syndrome in Primary Health Care and the Effect of Residency Training: A Cross-Sectional Study
Mustafa Reşat Dabak, Oya Uygur Bayramiçli, Sabah Tüzün, Burak Ölmez, Şevin Demir, Gülbüz Sezgin, Serhat Bor
doi: 10.5505/anatoljfm.2022.79664  Pages 149 - 155
INTRODUCTION: This study aims to evaluate the management of irritable bowel syndrome (IBS) by family physicians (FPs) and the effect of residency training on it.
METHODS: FPs who attended the FP training program including academic courses and conferences designed for them between December 2018 and May 2019 were included in the study. Before the training session, all FPs completed a questionnaire to assess their management of IBS in the primary health-care services.
RESULTS: The mean age of the 901 FPs included in the study was 40.8±13.8 years and 707 (79.8%) FPs reported that they managed IBS patients. It was found that 134 (87.6%) of the specialist FPs, 446 (83.8%) of the general practitioner FPs, and 134 (62.6%) of the resident FPs managed the IBS patients (p<0.001). The first pharmacological agents preferred by FPs were found that 816 (90.6%) of the physicians preferred antispasmodics, 69 (7.7%) antidepressants, 31 (3.4%) laxatives, and 9 (1.0%) antidiarrheals. Furthermore, it was found that the duration of prescription of antispasmodic therapy by FPs was 4.0 [2.0] weeks. When IBS management of FPs was evaluated, resident FPs (OR=0.281, 95% CI=0.123–0.640, p=0.003) and use of Rome criteria in diagnosis (OR=0.274, 95%CI=2.027–5.924, p<0.001) were found to be significant.
DISCUSSION AND CONCLUSION: This study revealed that the FPs who did not manage IBS patients used a defensive medicine strategy due to a lack of training. In addition, this study also highlights the training needs of the FPs, particularly the resident FPs, on IBS.

6.Exposure to Occupational Accidents and Near-Miss Events of the Healthcare Workers During the COVID-19 Pandemic
Pelin Uymaz, Mikail Özdemir
doi: 10.5505/anatoljfm.2021.97659  Pages 156 - 161
INTRODUCTION: Health institutions are considered high-risk occupational areas due to the need for human resources, including numerous specialists with distinct characteristics, intensive technology, and complex occupational processes. The purpose of this study is to examine the frequency of exposure to occupational accidents and near-miss events of the nurses and physicians working in hospitals, their reporting status, and factors affecting these characteristics during the coronavirus disease-2019 (COVID-19) pandemic.
METHODS: This descriptive study evaluating the occupational accidents and near-miss events of healthcare workers in 2020 was carried out between January 1, 2020, and December 31, 2020. The questionnaire created over Google Forms was shared through social media groups (WhatsApp, Facebook, etc.) of the healthcare workers in Turkey. The data collection form consisted of four sections, which assess sociodemographic characteristics, history of employment, characteristics of occupational accidents, and near-miss events of the healthcare workers.
RESULTS: A total of 225 healthcare professionals, with a mean age of 35.2±8.5 years, 156 (69.3%) female and 163 (73.8%) doctors, participated in this study and 101 (44.9%) healthcare workers declared that they experienced a work accident and 84 (37.3%) healthcare workers reported near-miss events; however, only 14 (13.9%) healthcare workers reported this accident to their institution during the COVID-19 pandemic.
DISCUSSION AND CONCLUSION: Every occupational accident or near-miss event experienced by healthcare professionals should be reported and analyzed carefully to prevent potential risks. Training health professionals about health risks they may encounter and protective measures against occupational accidents have vital importance.

7.Biopsychosocial Experiences of Home-isolated COVID-19 Patients: A Qualitative Study
Sreevani Rentala, Govinder Thimmajja Sunanda, Kannappa Venkatesh
doi: 10.5505/anatoljfm.2022.55823  Pages 162 - 168
INTRODUCTION: This study is conducted to explore the biopsychosocial experiences, challenges, and coping strategies of home-isolated patients with coronavirus disease-19 (COVID-19) during their recovery process.
METHODS: The present study utilized a phenomenological research design. A purposive sampling technique was used to recruit 20 home-isolated mild symptomatic COVID-19 patients from an urban area in India. In-depth telephonic interviews were conducted between the 18th and 25th of August 2020. Interviews were transcribed verbatim, and thematic analysis was carried out to explore major themes.
RESULTS: Four overarching themes were identified: (1) Bio-psychosocial experiences, (2) challenges encountered, (3) coping strategies used, and (4) recommendations to address issues. Fever, dry cough, severe body pains and tiredness were the common biological symptoms felt by the participants. The common negative feelings experienced were fear, anxiety, guilt, and worry. Economic issues, being humiliated by their neighbors, and stigma were the major challenges faced by the participants. Positive thinking, becoming aware of COVID-19 facts, and practising meditation and yoga were the common coping strategies used by participants. Regular digital monitoring of home-isolated patients by medical professionals, creating web portals to clarify illness-related issues, and need to sensitizing the neighbors were some of the recommendations made by participants.
DISCUSSION AND CONCLUSION: Biopsychosocial issues are associated with COVID-19 infection. Mental healthcare professionals are in a unique position to address the psychosocial concerns arising out of the pandemic.

8.Evaluation of Medication Adherence Levels of Hypertensive Patients in an Education Family Health Center
Orçun Çalışkan, Yusuf Adnan Güçlü, Burak Altındağ
doi: 10.5505/anatoljfm.2022.38278  Pages 169 - 175
INTRODUCTION: Non-adherence to medical and non-medical treatment is the main reason for uncontrolled hypertension (HT) worldwide. It was aimed to evaluate the medication adherence levels of patients with HT in this study.
METHODS: In this cross-sectional study, patients with HT who applied to an educational family health center from August 2018 to November 2018 and received HT treatment for at least 6 months were included in the study. The form consisted of questions about sociodemographic characteristics, medical information, and lifestyle habits. Morisky, Green, and Levine’s Adherence Scale (MGL) was used to determine patients’ adherence to pharmacotherapy.
RESULTS: A total of 186 patients were included in the study. According to the MGL scale, 26 (14.0%) of the participants were found to be non-adherent to their medication. According to blood pressure measurement results, 89 (47.8%) patients had uncontrolled HT. When sociodemographic characteristics and medication compliance were evaluated, 14 (8.8%) of university and above, 30 (18.8%) were in high school, 21 (13.0%) in secondary school, 64 (40.0%) were in primary school, 14 (8.8%) of literate, and 17 (10.6%) of illiterate patients were found to be adherent to drug therapy (p=0.035). While 87 (54.4%) of the patients whose blood pressure was normotensive were adherent to drug therapy, 73 (45.6%) of the patients who had uncontrolled HT were adherent to drug therapy (p=0.132).
DISCUSSION AND CONCLUSION: It was observed that high education level was effective in increasing adherence to drug therapy. Interestingly, there was no significant difference between medication adherence and providing blood pressure control in patients.

9.Comparison of Mobile Scanning Tool and Cancer Early Diagnosis, Screening and Training Centers
Mebrure Beyza Gökçek, Hümeyra Aslaner
doi: 10.5505/anatoljfm.2022.80775  Pages 176 - 180
INTRODUCTION: Cancer Early Diagnosis, Screening and Training Centers (CEDSTCs) have been established to make cancer screenings easier and more common. In this study, it was aimed to compare the cancer screening data made in CEDSTC and the mobile screening tool in Kayseri.
METHODS: This retrospective study was performed in CEDSTCs and on a mobile screening tool in Kayseri. The mobile screening tool served in the central, rural, and semi-rural areas of Kayseri within the mentioned period of time. Mammography examinations and cervical cancer screenings performed in that period were compared with the screenings performed in seven CEDSTCs in the central districts.
RESULTS: A total of 3080 individuals were included in the study. The mean age of the participants applying to the mobile screening tool was 52.2±6.8 years, and the mean age of those applying to CEDSTCs was 54.1±6.3 years (p<0.001). While human papillomavirus-deoxyribonucleic acid (HPV-DNA) analysis was performed on 417 (27.3%) people in the mobile scanning tool, CEDSTCs were performed on 1415 (90.8%) people (p=0.005). While the number of those who were positive for HPV-DNA in the mobile screening tool was 72 (4.7%), the number of those who were positive in the CEDSTCs was 172 (11.0%).
DISCUSSION AND CONCLUSION: The use of methods such as mobile scanning devices enables people living in rural areas to have easy access to mammography devices. This method may increase the number of people being screened for at least breast cancer. Cervical cancer screening in mobile services needs to be increased.

CASE REPORT
10.Male Breast Cancer: A Case Report
Deniz Esin Tekcan Şanlı
doi: 10.5505/anatoljfm.2021.38247  Pages 181 - 183
Although it is the most common cancer in women, breast cancer is rarely seen in men. The most common clinical finding is painless stiffness in the breast, as in women. Although the treatment of male breast cancer is similar to that of female breast cancer, the cases are usually diagnosed at an advanced stage. In this case report, it was aimed to present a 78-year-old male patient with unilateral palpable stiffness in the breast with clinical, imaging, and surgical operation findings.

11.Diagnostic Challenges with Scabies: Report of Two Cases and Literature of Review
Özge Atay, Suna Asılsoy, Şebnem Aktan, Nevin Uzuner
doi: 10.5505/anatoljfm.2022.57855  Pages 184 - 186
Infantile acropustulosis is characterized by recurrent intensely itchy vesiculopustular lesions. Although its etiology has not been clarified, its relationship with scabies is still under discussion. In this review, the clinical findings of a 3-month-old male patient who presented with vesiculopustular lesions starting from the soles of the feet, and a 5.5-month-old male patient who presented with erythematous papulopustular lesions unresponsive to topical steroid therapy are presented considering the literature. In cases with scabies-like lesions, making differential diagnosis with the opinion of pediatricians and dermatologists will prevent unnecessary drug use and possible drug resistance development.

12.Kaposi’s Sarcoma with Type 2 Diabetes: A Case Report
Burcu Doğan, Betül Beyaz, Döndü Işık, Ali Tamer
doi: 10.5505/anatoljfm.2022.72687  Pages 187 - 190
This is a case report of Kaposi’s sarcoma (KS) in an HIV-negative patient with type 2 diabetes. An 84-year-old female patient presented to the hospital with lesions and yellow-brown-black colored painless papules on both feet and ankles and on the medial of the left leg that tended to connect with each other. The histopathology was confirmed as KS. The patient is screened for diseases that could suppress the immune system. The patient with HIV-negative KS has no known disease affecting the immune system other than type 2 diabetes and obesity. This raises the question of whether diabetes and obesity can be included in the group of immunosuppressive diseases.

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