E-ISSN 2651-3455 (Online) | ISSN 2630-5593 (Print)
The Anatolian Journal of Family Medicine - anatol j fm: 6 (1)
Volume: 6  Issue: 1 - 2023
1.Front Matter 2023-1

Pages I - VII

2.From the Editor
Mustafa Reşat Dabak

3.Laboratory Measurements and Thorax Computed Tomography Findings for Inpatient Pregnant with COVID-19
Merve Aldıkaçtıoğlu Talmaç, Pınar Yalçın Bahat, Ali Kocataş, Ayşegül Bestel, Ozan Karadeniz, Ibrahim Polat
doi: 10.5505/anatoljfm.2023.39206  Pages 2 - 6
INTRODUCTION: The purpose of this study was to evaluate the laboratory measurements and thorax computed tomography (CT) findings of pregnant women with COVID-19.
METHODS: This was a single-center, observational study performed in a Training and Research Hospital from March 1 to May 31, 2020. Laboratory data, clinical conditions, and thorax CT images of pregnant women with COVID-19 were analyzed retrospectively. The patients who agreed to the image and were not suspected of pneumonia were classified according to their degree of lung involvement.
RESULTS: A total of 155 pregnant women have included in the study, and the thorax CT of 86 (55.5%) pregnant women who participated in the study was evaluated. While no symptoms were observed in 44 (28.4%) of the pregnant women, the most common symptoms were dyspnea and cough in 27 (17.4%). Of the pregnant wom-en evaluated for thorax CT, 24 (27.9%) had negative, 19 (21.1%) had mild involvement, 30 (34.9%) had moderate involvement, and 13 (15.1%) had heavy involvement. C-reactive protein (CRP) levels of pregnant women with negative tomography were 4.5 (0.7–83.4) mg/L, 13.4 (0.7–107.3) mg/L with mild involvement, 37.7 (3.8–292.6) mg/L with moderate involvement and, 48.6 (5.7–234.1) mg/L with heavy involvement (p<0.001).
DISCUSSION AND CONCLUSION: All factors affecting the prognosis for pregnant women with COVID-19 have not been fully elucidated. It was determined that a significant frequency of pregnant women was asymptomatic. In addition, an increase was observed in the CRP level according to the severity of pneumonia, while no similar difference was found in the D-dimer level.

4.The Effect on Perceived Pain of Ice Massage Applied to Large Intestine-4 Pressure Point during Episiotomy Repair: A Randomized Controlled Trial
Bihter Akın, Yeşim Yeşil, Birsen Karaca Saydam, Hafize Öztürk Can
doi: 10.5505/anatoljfm.2023.60024  Pages 7 - 12
INTRODUCTION: This study aimed to determine the effect on perceived pain of ice massage applied to the Large Intestine-4 (LI4) pressure point during episiotomy repair.
METHODS: Research data were collected between April 15, 2018, and December 15, 2018. Women who met the criteria for inclusion in the study and had an episiotomy performed by a midwife were assigned to the intervention or control group according to the randomization scheme. Women assigned to the intervention group were given plastic gloves filled with ice pieces just before the episiotomy repair began, and they were asked to press the glove into the LI4 region in their hands until the episiotomy repair was finished. The routine practice was carried out with the women in the control group. The questionnaire containing sociodemographic and birth-related information and a Visual Analogue Scale (VAS) were applied to all women.
RESULTS: A total of 347 women, 178 (51.0%) in the intervention group and 169 (49.0%) in the control group, were included in the study. There was no difference between the intervention group and the control group in the scores obtained from the VAS before the ice application (6.0 (6.0-7.0) vs. 6.0 (6.0-7.0), p=0.530). On the other hand, a significant difference was found between the mean VAS scores of women in the intervention and control groups after ice application (4.0 (4.0-6.0) vs. 5.0 (5.0-6.0), p=0.001).
DISCUSSION AND CONCLUSION: It was determined that ice massage applied to the LI4 pressure point in the hands during episiotomy repair significantly reduced the perceived pain level.

5.Evaluation and Screening of COVID-19, Contact and Risk Conditions in Healthcare Workers in a University Hospital
Kamile Marakoğlu, Hüsamettin Vatansev, Ilhan Çiftci, Zeynep Ebru Şener, Muhammet Özmen, Aslıhan Titrek, Esma Mutlu, Cevat Erkan
doi: 10.5505/anatoljfm.2023.70188  Pages 13 - 24
INTRODUCTION: The aim of this study was to evaluate the management and risk conditions of healthcare workers (HCWs) having COVID-19 infection before and after the normalization process (NP).
METHODS: The working group of this study consisted of 1881 HCWs who applied to the Occupational Health and Safety Unit. A form for determining the HCWs’ sociodemographic characteristics and the Healthcare Work-er COVID-19 Contact Case Follow-up Form were used using the Ministry of Health COVID-19 Guide.
RESULTS: This study included 1881 HCWs. The polymerase chain reaction (PCR) test was assessed in 1373 (73.0%) of the HCWs, and 172 (12.5%) of the PCR tests were positive HCWs who underwent PCR testing. Before the NP, 13 (2.5%) of the HCWs had PCR positive, and after the NP, 159 (18.4%) of 862 HCWs were PCR positive. While 80 (46.5%) of PCR-positive HCWs were using personal protective equipment (PPE), 478 (39.8%) of PCR-negative HCWs were using PPE (p<0.001). While 5 (38.4%) PCR-positive and 262 (52.6) PCR-negative HCWs were using PPE before NP, 75 (47.1%) PCR-positive and 216 (30.7) PCR-negative HCWs were using PPE after NP (p<0.001 and p<0.001, respectively).
DISCUSSION AND CONCLUSION: The study showed that the frequency of COVID-19 PCR positivity in the HCWs is similar to that given by World Health Organization.

6.Family Physician’s Opinions and Recommendations on the Family Medicine Practices
Kazım Baş
doi: 10.5505/anatoljfm.2023.56933  Pages 25 - 30
INTRODUCTION: This study aims to evaluate the opinions and recommendations of family physicians working in family health centers regarding the practices of family medicine.
METHODS: This descriptive research was conducted with 307 family physicians working in family health centers of Elazığ and Muş provinces located in the east of Turkey between September and November 2021. The sample of this study was comprised of 193 (62.9%) family physicians who were available during the study period. The questionnaire created by the researcher was used to collect with the face-to-face interview technique and/or Google Forms data.
RESULTS: A total of 193 family physicians were included in the study. The mean age of the family physicians was 41.4±8.5 years, and their mean population was 3138.1±534.1 people. Of the family physicians, 184 (95.3%) stated professional devaluation, 179 (92.7%) excessive workload, the problems arising from the legislation, 173 (89.6%) performance, 158 (81.9%) the excess of the population to be served, 155 (80.3%) financial problems, coordination problems with senior management, 132 (68.4%) inadequate with the physical structure of the building and equipment, and 125 (64.8%) stated the insufficient number of non-physician personnel were among the factors negatively affecting work in family health centers. In addition, 180 (93.2%) family physicians stated that changes are needed in existing family medicine practices.
DISCUSSION AND CONCLUSION: According to the study results, there are negative situations that affect the effective and efficient implementation of family medicine practices. The current policy needs to be revised to carry out family medi-cine practices effectively and efficiently.

7.Role of Illness Perception and Medication Beliefs in Medication Adherence among Hypertensive Patients in South-South Nigeria
Lillian Ngozi Ozumba, Paul Dienye, Geraldine Ndukwu
doi: 10.5505/anatoljfm.2021.02486  Pages 31 - 36
INTRODUCTION: The study aimed to determine the influence of illness perception and medication beliefs on hypertension medication adherence.
METHODS: The study was a hospital-based, and cross-sectional study that lasted for 3 months, from March to May 2016. Those included in the study were hypertensive patients aged 18–65 years who had been on hyper-tensive medications for at least 6 months. Data were obtained using a semi-structured interviewer-administered questionnaire consisting of sociodemographic characteristics, the brief illness perception questionnaire (BIPQ), beliefs about medication (BMQ), and Morisky Medication Adherence Scale.
RESULTS: Out of 400 respondents, 115 (28.8%) had good adherence to antihypertensive medications, and 91 (22.8%) had controlled blood pressure. The median score of timeline of the BIPQ dimension was 6.0 (0.0–10.0) in the adherent group and 4.0 (0.0–10.0) in the non-adherent group (p=0.001). However, consequence, personal control, treatment control, identity, concern, coherence, and emotional representation were lower in the adherent group than non-adherent group (p=0.001, p=0.001, p=0.001, p=0.001, p=0.001, p=0.001, and p=0.001, respectively). The median score of the necessity of the BMQ dimension was 18.0 (11.0–22.0) in the adherent group and 13.0 (5.0–22.0) in the non-adherent group (p=0.001). On the other hand, concern, harm, and overuse were lower in the adherent group than in the non-adherent group (p=0.001, p=0.001, and p=0.001, respectively).
DISCUSSION AND CONCLUSION: This study showed that having good illness perception and medication beliefs was linked to adherence to treatment in hypertension patients.

8.Clinical Spectrum of Non-venereal Genital Dermatoses in Adult Males
Liza Mohapatra, Surajit Nayak, Satyadarshi Pattnaik, Siddhartha Dash
doi: 10.5505/anatoljfm.2023.57441  Pages 37 - 41
INTRODUCTION: This study aims to evaluate the frequency of non-venereal genital dermatoses in male patients.
METHODS: This was a descriptive, observational study was included adult male patients having non-venereal genital dermatoses attending the skin and venereal disease outpatient department of a tertiary care referral hospital between January 2014 and August 2015. All patients with any venereal dermatoses were excluded from the study.
RESULTS: The study included 200 male subjects with non-venereal genital dermatoses. The mean age of the study population was 39.8±14.1 years. Of the cases, 68 (34.0%) were dermatological, 52 (26.0%) were infectious causes, 32 (16.0%) were physiological variants, 29 (14.5%) were genital dermatoses revealed drug-induced, 11 (5.5%) were malignant, and 8 (4.0%) were idiopathic. Among the non-venereal genital dermatoses, the most common disorders were balanoposthitis with 42 (21.0%), erosive balanitis with 29 (14.5%), fixed drug eruptions with 29 (14.5%), pearly penile papules with 22 (11.0%), vitiligo with 15 (7.5%), and lichen planus with 15 (7.5%). Itching was the most common symptom in 73 (36.5%) of the cases. Glans and prepuce were the most frequent site of the involved area in 60 (30.0%) cases. Extragenital involvement was observed in 68 (34.0%) of the cases. The most common morphological presentation was papules in 50 (25.0%) cases, followed by plaques in 38 (19.0%) and erosions and fissuring in 35 (17.5%).
DISCUSSION AND CONCLUSION: Family physicians frequently encounter dermatological diseases. Therefore, the management of dermatological diseases by family physicians is important.

9.A Case with the Left Common Carotid Artery Involvement as Large Vessel Vasculitis after COVID-19
Deniz Esin Tekcan Şanlı
doi: 10.5505/anatoljfm.2022.59827  Pages 42 - 44
It is known that there are many other organ involvements in the coronavirus disease of 2019 (COVID-19) apart from respiratory tract involvement, and the disease may occur in different clinical spectrums in different patients. One of the most important structures affected by the virus is the vascular structure. It creates a tendency to thrombosis, especially by causing damage to the vascular endothelium and activating the coagulation system and may lead to important complications. It is known that the virus, which especially affects venous and small-sized arterial vessels, also affects medium-sized vessels. However, large-sized arterial vascular involvement is very rare. In this case report, it was aimed to present the left common carotid artery vasculitis, together with radiological appearance and clinical features, in a patient who presented with the complaint of left anterior neck pain in 4 weeks after COVID-19 infection.

10.Evaluation of the Patient with a Diabetic Foot in the Chronic Wound Service: A Case Report
Mahcube Çubukçu, Latife Merve Yıldız, Nur Şimşek Yurt, Seçil Müderrisoğlu
doi: 10.5505/anatoljfm.2023.03525  Pages 45 - 47
Diabetic foot (DF) are wounds that appear on the feet in diabetic patients and do not heal for a long time. It is important to investigate the presence of an obstruction in the leg veins in patients with DF. DF is a common and serious complication of diabetes. It is an important cause of morbidity and mortality in diabetic patients. The principles of essential surgical and non-surgical wound care are indispensable factors in the healing of these wounds. The patient, who underwent surgical debridement, was continued with negative-pressure wound therapy and silver foam dressing for wound healing.

11.A Rare Case of Pretibial Dystrophic Epidermolysis Bullosa: A Scientific Letter
Nirma Joy, Surajit Nayak
doi: 10.5505/anatoljfm.2023.12599  Pages 48 - 49
Abstract |Full Text PDF

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