Family Medicine Outpatient Clinic Research Articles

Evaluation of osteoporosis knowledge level of women who applied to the family medicine outpatient clinics of a university hospital

Aim: This study aimed to assess the knowledge, attitude, and behavior of women aged 18–45 years toward osteoporosis.
 Material and Method: A total of 368 females (average age:32.59±7.58) who applied to the family medicine outpatient clinics between 15 May 2016 and 15 August 2016 participated in this study. Participants completed the revised osteoporosis knowledge test, which contained 12 socio-demographic questions.
 Results: The average score for participants in the exercise subgroup was found to be 9.56±3.62 out of 20; the average score for the nutrition subgroup was 12.86±4.17 out of 26, and the average total score was 15.08 ± 4.82 out of 32. In general, the average score of participants was found to be 50% percent or less of the maximum scores of each subgroup of the questionnaire. This result suggests that women have inadequate knowledge about osteoporosis. Participants’ level of knowledge of osteoporosis was related to their education levels, occupational groups, and smoking status. High educational levels of participants correlated with high average scores (p

COVID-19’da Klinik Seyri Etkileyen Parametreler

Introduction: The entire population is susceptible to COVID-19, and the course of the disease is in a wide spectrum between asymptomatic clinical and critical illness. In this study, it was aimed to see whether the laboratory level CRP, ferritin, D-dimer, lymphocyte and vitamin D values and sociodemographic characteristics are related to the clinical course of the disease in COVID-19 disease, which emerged at the end of 2019 and caused a pandemic all over the world. Materials and Methods: The study was carried out with a total of 100 participants, 50 patients who applied to Kahramanmaraş Sütçü İmam University Health Practice and Research Hospital, adult COVID-19 outpatient clinic and 50 patients who applied to the family medicine outpatient clinic between 25.01.2021 and 28.02.2021. The first part of the questionnaire was applied by face-to-face interview method during the application to the hospital and the second part was applied one month later to the participants who applied to the adult COVID-19 outpatient clinic with a positive RT-PCR test. In addition to the CRP, lymphocyte, ferritin and D-dimer values measured in the blood taken at the first visit, the serum vitamin D level was studied. Statistical evaluation of the obtained data was made using SPSS 22 program. For statistical significance, p value below 0.05 was considered significant. Results: A total of 100 people were included in this study. Fifty people with COVID-19 infection constitute the case group, and 50 people who have not had COVID-19 infection before constitute the control group. While the mean age was 51.14 ± 19.36 years in the case group, it was 37.12 ± 12.64 in the control group. The mean age of the patients in the case group was higher than the mean age of the patients in the control group (p< 0.05). Serum vitamin D result was 14.19 ± 10.63 ng/mL in the case group and 17.48 ± 12.69 ng/mL in the control group. Although the vitamin D results of the case group were lower, no statistically significant difference was found between the patient groups (p= 0.179). It was determined that there was a statistically significant relationship between the status of having chronic diseases and the case-control group. Persons with chronic diseases constitute 70.7% of the case group and 29.3% of the control group, while persons without chronic diseases constitute 35.6% of the case group and 64.4% of the control group (p= 0.001). While 14.6% of those with chronic disease had mild 34.1% and 22.0% had a critical illness; 23.7% of those without chronic disease had mild 6.8%, severe 5.1% had critical illness. In the study, the rate of severe or critical illness was found to be higher in those with chronic diseases than those without. The severe and critical patient group had higher CRP, Ferritin and D-dimer levels compared to the mildly severe patient group; It was observed that the lymphocyte level was lower (p< 0.05). The rate of severe and critical illness was found to be higher in those who partially pay attention to hand hygiene and mask rules (p< 0.05). Conclusion: Laboratory parameters such as CRP, ferritin, D-dimer and lymphocyte values were found to be significant predictors that could help in estimating the severity of the disease. Although it was lower in the case group, it was observed that there was a deficiency in vitamin D levels in both groups and insufficient doses of supplements were taken. In the study, it was observed that transmission was more common in social environments such as family and friends.

An evaluation of the use of inhalers in asthma and chronic obstructive pulmonary disease

ObjectivesInhaled therapy is the treatment of choice for obstructive lung diseases such as asthma and chronic obstructive pulmonary disease (COPD). However, the maximum benefit from such therapy depends on the correct use of inhaler devices. In this study, our primary aim was to evaluate inhaler techniques in patients with asthma and COPD in order to identify common errors. In addition, we investigated the effect of various parameters on the rate of inhaler misuse. MethodsWe enrolled a total of 300 asthma/COPD patients, who presented at the Chest Diseases and Family Medicine Outpatient Clinics of a tertiary hospital located in Ankara, Turkey. We used a face-to-face survey that included questions about sociodemographic features and inhaler therapy. Subsequently, we requested patients to demonstrate how they use their inhalers and assessed their inhalation technique according to checklists. ResultsOf the 300 patients, 70.2% used their inhaler drugs incorrectly. The rate of misuse among metered dose inhaler (MDI) users was significantly higher than those using dry powder inhalers (DPIs) (77.6% vs 64%; p = 0.002). When DPI devices were analyzed, the rates of misuse were significantly higher in Handihaler users (p = 0.012) and Diskus inhaler users (p = 0.009) when compared to Sanohaler users. Gender, type of disease (asthma/COPD), duration of inhaler use, and duration of illness had no impact on the rate of misuse. However, an advanced age (>60 years old), a level of education lower than high school, and the use of MDI were all identified as factors associated with misuse. The most common mistake was ‘failing to breath out before inhalation’ for all types of devices (for MDI: 66.7%, and for DPI: 71.1–82.8%). ConclusionsThe rate of inhaler drug misuse was high. The identification of factors associated with misuse could provide information to implement appropriate actions to reduce the rates of misuse.

Comparison of Serum Vitamin D Levels with Glucose, Lipid, and the Other Biochemical Parameters: A Cross-Sectional Study

"Since vitamin D is synthesized from cholesterol, it is claimed to be associated with insulin resistance, suggesting that there may be an association between vitamin D glucose and lipids. For this reason, we aimed to investigate a relationship between vitamin D and biochemical parameters, including glucose and lipids. This cross-sectional study included 198 patients .admitted to the family medicine outpatient clinic between June and December 2016. There was no significant correlation between vitamin D and serum glucose, total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol, calcium, magnesium, sodium, TSH, and body mass index values in both men and women. There was a correlation between vitamin D and total cholesterol and LDL cholesterol levels in the younger subjects below 41 years (p=0.002). Regression analysis with other variables showed no statistical significance between vitamin D levels on LDL-C levels (P=0.309). Despite previous studies, our study did not confirm the effects of vitamin D on serum glucose, lipid, calcium, and other biochemical parameters. However, these results suggest that the standard up-to-date literature showing the relationship between vitamin D and various metabolic and hormonal disorders may need to be confirmed by new large-scale studies. "

Adaptation into Turkish and Psychometric Properties of Athens Insomnia Scale.

The study aimed to adapt the "Athens Insomnia Scale" developed by Soldatos et al. into Turkish and to conduct validity and reliability analysis. This research was conducted on 215 patients with insomnia complaints and applied to Family Medicine, Neurology (Sleep Polyclinic), and Psychiatry outpatient clinics. Introductory Information Form, 8-item Athens Insomnia Scale, and Pittsburg Sleep Quality Index were administered to the participants. After the language adaptation of the scale, Cronbach's alpha value was used as the consistency coefficient for reliability analysis. Exploratory factor analysis was examined for structural validity, and correlation coefficients between the Athens Insomnia Scale and its subscales and the Pittsburg Sleep Quality Index were examined for concurrent validity. Cronbach's alpha coefficient was calculated as 0.87. "Kaiser-Meyer-Olkin value was calculated for factor analysis." In the Exploratory Factor Analysis, a two-factor structure with eigenvalues >1.0 and explaining 73.4% of the variance was obtained. According to the Exploratory Factor Analysis results for the Atina Insomnia Scale, the absolute value of the factor loadings of the eight items ranged between 0.650 and 0.865. The correlation coefficients between the total score and sub-dimensions of the Athens Insomnia Scale and the Pittsburg Sleep Quality Index-a scale assessing sleep quality were between 0.489-0.725 (p<0,01). For discriminant validity, Athens Insomnia Scale discriminated well between patients and healthy volunteers (Z=2.630, p=0,009). The Athens Insomnia Scale has been shown to have adequate reliability and validity in Turkish.

Drug Use Behaviors of Patients Applied to Ondokuz Mayıs University Faculty of Medicine, Department of Family Medicine Outpatient Clinic

Drug Use Behaviors of Patients Applied to Ondokuz Mayıs University Faculty of Medicine, Department of Family Medicine Outpatient Clinic

Socio-demographic and Clinical Characteristics of Patients Admitted to a Pandemic Hospital Family Medicine Outpatient Clinic during the Covid-19 Pandemic

Socio-demographic and Clinical Characteristics of Patients Admitted to a Pandemic Hospital Family Medicine Outpatient Clinic during the Covid-19 Pandemic

Evaluation of Excessive Daytime Sleepiness, Anxiety and Depression Symptomatologies in Obesity

Aim: In this study, it was aimed to evaluate the excessive daytime sleepiness, anxiety and depression symptomatology in normal-weight, overweight and obese individuals. Methods: In the study, 605 people who applied to the family medicine outpatient clinic between 2020 November 25 and 2021 March 5 were included. The questionnaire form evaluating the sociodemographic characteristics of the participants, the Hospital Anxiety and Depression Scale and the Epworth Sleepiness Scale were administered using a face-to-face interview technique. Results: Overweight status in primary school, high school/adolescence, and university/twenties were higher in obese than in overweight. Additionally, it was higher in overweight than in normal weight. The risk of being overweight was 2.19 times higher and the risk of being obese was 6.07 times higher than those with obesity in their family compared to those who did not. Excessive daytime sleepiness was 2.95 times higher in obese than in normal weight. Anxiety symptoms were 1.97 times higher in obese than in normal weight. Depression symptoms were 2.77 times more in overweight and 2.99 times more in obese compared to normal-weight individuals. Conclusion: As a result of this study, it was revealed that excessive daytime sleepiness, anxiety and depression symptomatologies are more common in obese compared to normal weight. Keywords: obesity, overweight, depression, anxiety, disorders of excessive somnolence

The Comparison of Food Addiction Rates and Characteristics Between Obese and Non-Obese Individuals: A Cross-Sectional Study

Aim: Even though obesity and food addiction have been linked, only a small number of obese individuals fulfill the diagnostic criteria for food addiction, on the other hand some normal and underweight people also meet these criteria. To investigate the difference between the prevalence of food addiction between obese and non-obese persons using Yale Food Addiction Scale.&#x0D; Material and Methods: A demographic information form and Yale Food Addiction Scale was applied to obese and non-obese individiuals admitted to family medicine and obesity outpatient clinic. Significant differences of normally distributed data were assessed using a t-test, and significant differences of not normally distributed data were analyzed using the Mann-Whitney U test. Categorical data were expressed as percentages. The associations between food addiction and age, BMI, gender, and smoking status and the associationsbetween gender, smoking, food addiction, and obesity were determined by using the established a binary logistic regression models. P

Barriers to Exercise among Non-Exercising Type 2 Diabetes Mellitus Patients Visiting a Tertiary Care Hospital

Exercise is a crucial strategy for diabetes management. However, the majority of patients with Type 2 diabetes seem reluctant to do physical activity. It increases the need of investigating the factors that are responsible for their non-exercising routine. This study aims to recognize the psychological and social barriers that prevent patients with diabetes mellitus to do exercise. A cross-sectional study was conducted with a total of 275 patients with type 2 diabetes attending family medicine outpatient clinics for the last six months. The questionnaire has been designed to collect data regarding psychological and social barriers to exercise. A comparison of social and psychological barriers with general characteristics was performed. The findings of the study reveal that all the general characteristics were significantly associated with psychological and social barriers. The patients reported that lack of interest, no willpower, a feeling of depression, unaffordability, and time barriers were the most frequent barriers among social and psychological barriers to exercise.

The Relationship between Thyroid Hormones, Metabolic Syndrome and HOMA-IR in People with Obesity or Overweight

Objective: In the literature the data about the relationship between thyroid hormone (TH) levels and Metabolic Syndrome (MetS) components are conflicting. Our aim was to evaluate the associations between THs and MetS as well as individual components of MetS and homeostatic model assessment of insulin resistance (HOMA-IR) in euthyroid people with obesity and overweight. Materials and methods: Adult patients who presented to Family Medicine Outpatient Clinics of a tertiary hospital between May 2019 and December 2019 with the intention of weight loss were enrolled in this cross-sectional, descriptive study. The data including height, weight, waist circumference, hip circumference, blood pressure (BP), fasting blood glucose (FBG), total cholesterol, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride, thyroid stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), insulin, HOMA-IR, and HbA1c were analyzed. Results: A total of 175 patients, 135 (77.1%) female, 40 (22.9%) male (mean age: 40.8 ± 13.1 years), without known thyroid dysfunction were included. A total of 86 were overweight and 89 were obese. Fifty-nine (33.7%) of the study participants were diagnosed with MetS. Subjects with MetS had significantly higher level of fT3 even within the normal range (p = 0.039). When TSH, fT4 and fT3 values were compared with other metabolic components in the group with MetS, a significant positive correlation was found only between fT4 level and HOMA-IR (Rho = 0.316, p = 0.026). Conclusions: MetS was associated with high normal fT3 suggesting differential thyroid hormone metabolism in people with MetS.

EVALUATION OF SERUM SCUBE-1 LEVELS AND AFFECTING FACTORS IN SMOKERS

Aim: Serum signal peptide-CUB-EGF domain-containing protein-1 (SCUBE-1), an indicator of platelet activation, is a biochemical marker used to evaluate the risk for cardiovascular diseases. This study aimed to evaluate the alteration of plasma levels of SCUBE-1 in smokers compared to healthy controls and determine the affecting factors.&#x0D; Materials and Methods: This prospective study was designed as an experimental, single-centered study with a control group. The study included smokers aged 18-65 years who were admitted to the Smoking Cessation Clinic of a tertiary hospital and a control group consisting of healthy volunteers admitted to the Family Medicine Outpatient Clinic and had never smoked. Sociodemographic data of all participants and smoking histories and addiction levels of smokers were questioned. Exhaled carbon monoxide (CO) levels were measured. Plasma SCUBE-1 levels were studied and compared from samples obtained from venous blood. &#x0D; Results: A total of 82 individuals, consisting of the "smoker" patient group (n=44) and the "non-smoker" control group (n=38), were included in the study. While the mean SCUBE-1 value was 1.28±0.70 ng/ml in smokers, it was 1.54±1.09 ng/ml in non-smokers. There was no statistical difference between smokers and non-smokers in terms of SCUBE-1 (p=0.500). There was no statistically significant correlation between SCUBE-1 levels and exhaled CO level, smoking characteristics and addiction levels in smokers. &#x0D; Conclusion: Our study showed that the plasma SCUBE-1 value in smokers did not increase at statistically significant levels compared to the control group. Therefore, it was concluded that it would not be useful in evaluating the risk of cardiovascular diseases and the susceptibility to thrombosis.

S1441 Improving Rate of Compliance With Hepatitis C Virus Screening

Introduction: Screening patients for hepatitis C virus infection is frequently overlooked. This is a leading cause of chronic liver disease in the US. The US Preventive Services Task Force determined screening is beneficial in patients aged 18-79. Previously, only those born between 1945-1965. The American Association for the Study of Liver Diseases recommends a one-time antibody test in adults 18 years and older. Even though treaTable, screening rate of hepatitis C virus antibody in patients aged 18-55 or 77-79 is only 70% in the primary care settings in Syracuse, Rome, and Binghamton. Inadequate detection leads to missed treatment opportunities and contributes to significant liver disease. Our quality improvement initiative aims to increase compliance rate with hepatitis C virus screening for all outpatient primary care visits for patients aged 18-55 or 77-79 by 20% from baseline of 70% to 90% in 6 months. Methods: Data was obtained from internal medicine and family medicine outpatient clinics at three locations (Syracuse, Rome, and Binghamton). Eligible patients were divided into two groups: 18-55 or 77-79 years was the group of interest and 56-76 years (born between years 1945-1965) was the reference group as testing in this group of patients had previously been practiced. Completed testing from July-September 2021 served as baseline. Gap analysis was performed identifying causes of reduced compliance. Interventions were taken at the patient level (distribution of informational flyers and provider education), provider level (education on guidelines), and system level (electronic medical record alerts). Interventions were initiated in October 2021 and testing rates were tracked until the end of February 2022. IRB approval was not pursued. Results: The rate of screening with hepatitis C virus antibody in patients aged 18-55 or 77-79 improved by 2.3% from 70% to 72.3% from October 1, 2021, to March 31, 2022, across three sites. Binghamton's rate improved by 5%. 397 tests have been ordered during this time and 240 were for the age group of interest. (Figure) Conclusion: Compliance with hepatitis C viral screening is suboptimal in outpatient settings. Focused and simple interventions at the patient, provider, and system levels can increase compliance and help reduce the burden of significant liver disease. We hypothesize continued education and monitoring of data will demonstrate improved rates due to long time between primary care visits. Additional interventions may improve rates further.Figure 1.: Hepatitis C Virus Screening Rates Between July 2021-March 2022 in the Syracuse, Rome, and Binghamton Primary Care Clinics

Assessment of Adult Attitude towards Mental Illness among Attendees of Family Medicine Outpatient Clinic at Suez Canal University Hospital, Ismailia Governorate, Egypt

Assessment of Adult Attitude towards Mental Illness among Attendees of Family Medicine Outpatient Clinic at Suez Canal University Hospital, Ismailia Governorate, Egypt

Evaluation of Mental Health Literacy Status of Patients Admitted to the Family Medicine Outpatient Clinic

Evaluation of Mental Health Literacy Status of Patients Admitted to the Family Medicine Outpatient Clinic

The Impact of Early Levothyroxine Replacement in Subclinical Hypothyroidism on Glycemic Control Parameters and Quality of Life in Adult Patients

BACKGROUND: Subclinical hypothyroidism is diagnosed by increased level of serum thyroid-stimulating hormone (TSH) with normal levels of free triiodothyronine (FT3) and free thyroxine (FT4). Controversy exists concerning the early treatment of subclinical hypothyroidism with levothyroxine when TSH level is below 10 mIU/L. AIM: This stud aims to quantify the effects of a 3-month trial of levothyroxine replacement on quality of life in SCH patients with TSH level less than 10 mIU/L as primary outcome and fasting blood sugar and HbA1C levels as secondary outcome. METHODS: This was a randomized controlled trial. It was carried out on subjects between 18 and 65 years, of both sexes attending the family medicine outpatient clinic at Cairo University Hospitals with untreated symptomatic mild subclinical hypothyroidism. Simple randomization was performed by assigning random numbers from random number table. Quality of life (Short-Form 36 Questionnaire) as well as fasting blood sugar levels and HbA1C were assessed before the replacement of levothyroxine and 3 months after starting treatment in the subclinical hypothyroidism patients (intervention group) and were compared to the control group. RESULTS: The median of role limitations due to emotional problems, social functioning, and health change was higher in the intervention group in comparison with the control group. Moreover, the median scores of all general health questionnaire items showed significant positive statistical changes in the intervention group. There was also a significant improvement in glycemic control reflected in lower HbA1C levels and FBS. CONCLUSION: The results of our study highlight the positive effect of early substitution with levothyroxine in subclinical hypothyroid patients regarding the quality of life and glycemic control in Egypt and support the argument for replacement.

Covid-19 anksiyete sıklığında sosyal medya bağımlılığının rolü nedir? Kesitsel bir çalışma.

Amaç: Pandemi sürecinde gerek iletişim gerek bilgilenme amacı ile sosyal medya maruziyeti artmıştır. Bu çalışmanın amacı koronavirüs anksiyetesi ile sosyal medya bağımlılığı arasındaki ilişkiyi saptamaktır.&#x0D; Gereç ve Yöntem: Tek merkezli, kesitsel tipte olan araştırmaya Gaziosmanpaşa Eğitim ve Araştırma Hastanesi Aile Hekimliği Polikliniği’ne 15 Eylül 2020- 15 Ekim 2020 tarihleri arasında başvuran 297 hasta alındı. Katılımcılara Koronavirüs Anksiyete Ölçeği (KAÖ) kısa formu, Hasta Sağlık Anketi-9 (PHQ-9), Bergen Sosyal Medya Bağımlılığı Ölçeği (BSMBÖ) uygulandı. Elde edilen verilerin istatistiksel analizleri için IBM SPSS Statistics 22 (IBM SPSS, Türkiye) programı kullanıldı. Anlamlılık p≤0,05 düzeyinde değerlendirildi.&#x0D; Bulgular: Ortalama yaşı 37,30±13,86 yıl ve %66 ‘ı (n:196) kadın, %34’ü (n:101) erkek olan 297 hastanın %11,8’inde (n= 35) koronavirus anksiyetesi, %23,2’sinde (n= 69) olası depresyon ve %9,1’inde (n= 27) sosyal medya bağımlılığı izlenmiştir. KAÖ puanı ortalaması 3,06±3,71, PHQ-9 puanı ortalaması 5,13±5,87, BSMBÖ puanı ortalaması 11,15±4,99 saptanmıştır. PHQ-9 puanının sırasıyla KAÖ (p= 0,043; r= 0,118) ve BSMBÖ (p= 0,004; r= 0,166) puanı arttıkça arttığı gözlenmiştir. KAÖ ile BSMBÖ puanları arasında anlamlı bir ilişki gözlenmemiştir (p= 0,525; r= -0,037). Düşük eğitim düzeyinin (ilkokul / ortaokul) KAÖ puanı üzerine 2,7 kat risk arttırıcı (OR= 2,691; C.I.= 1,300-5,571; p= 0,008) etkisi olduğu bulunmuştur.&#x0D; Sonuç: Koronavirus anksiyetesi görülenlerle görülmeyenlerin sosyal medya bağımlılık sıklığının benzer olması, medya kaynaklı artan bilgi maruziyetinde korkulduğu gibi koronavirus anksiyetesinin artmayabileceğini, eğitim düzeyinin asıl risk faktörü olduğunu göstermiştir.

An Asymptomatic Patient with Persistent Anti-HAV IgM and Anti-HAV IgG: A Case Report and Literature Review

&lt;p&gt;?一名61歲女性，因職業為供膳人員而需要每年健檢，2015年於本院健檢時意外發現A型肝炎病毒IgM抗體(anti-HAV IgM)呈現陽性反應，懷疑是急性A型肝炎感染，因而轉至胃腸肝膽科門診檢查。個案本身並無症狀，實驗室報告顯示並無異常。隔年健康檢查仍發現anti-HAV IgM呈現陽性，再次安排實驗室檢查及理學檢查，也無顯示任何異常，隨後入院接受肝臟切片病理檢驗，但報告亦無特異性表現，且個案於住院期間也無任何不適。本次入院前，個案在外院也檢查了A型肝炎病毒IgG抗體(anti-HAV IgG)，發現也呈現陽性反應，且後續追蹤直至2020年期間，個案的anti-HAV IgM及anti-HAV IgG皆持續呈現陽性反應。持續性anti-HAV IgM陽性並不常見，本文針對造成持續性anti-HAV IgM陽性的原因，進行文獻回顧，並分析此案例可能的原因及後續適當之處理程序。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;A 61-year-old female restaurant caterer had received regular annual health examinations. In 2015, hepatitis A virus immunoglobulin M antibody (anti-HAV IgM) was detected, though she showed no symptom or sign of HAV infection. She was then transferred to the gastroenterology (GI) outpatient clinic where she underwent further laboratory tests that revealed no specific findings. Medical certificates were therefore issued and regular follow-ups arranged. However, reactive anti-HAV IgM persisted with reactive result of anti-HAV IgG in 2016, and laboratory tests again showed negative findings. She was accordingly admitted for liver biopsy. Nevertheless, the pathology report also revealed no sign or symptom of infection, and she did not report any symptoms of HAV infection. As a result, she was discharged for annual monitoring. During the period from 2017 to 2020, she had visited our family medicine outpatient clinic for regular follow-ups; anti-HAV IgM and anti-HAV IgG were followed and revealed reactive findings. Persistent anti-HAV IgM is rare in the literature, and concurrent persistent anti-HAV IgG is even more unusual. In this article, we present a rare case of the above condition while the literature of persistent anti-HAV IgM is also reviewed.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

35062 Onychomycosis and irrational drug use, a growing public health problem

Introduction: Onychomycosis is the leading cause of nail disease, corresponding to 18-40% of onychopathies. Worldwide prevalence is 0.1 to 11%. Self-medication is considered a public health problem. Objective: To determine the prevalence of onychomycosis in patients with onychodystrophy and describe the therapeutic agents used in self-medication. Material and methods: A descriptive, cross-sectional study with 142 patients was carried out. Patients with history of self-medication for onychodystrophy who attended an outpatient family medicine clinic, without paraclinical diagnosis of onychomycosis, were included. Diagnosis of onychomycosis was made using KOH 40%. Results: The mean age of the population was 58.61 years, 61.7% were woman. 42.5% of the patients had diabetes mellitus. The prevalence of onychodystrophy in the first toe of the right foot was 89.3% and onychomycosis was 49.6%; in the first toe of the left foot a prevalence of 81.5% and 46.1% was found respectively. In the fifth toe of the right foot, the prevalence of onychodystrophy was 70.9% and 36.9% of onychomycosis; in the fifth toe of the left foot, the prevalence of onychodystrophy was 70.2% and onychomycosis was 34.8%. Only 50% had a diagnosis of onychomycosis. Miconazole was the most used treatment 42%, followed by bifonazole 27% and ketoconazole 17%. Conclusion: Onychomycosis was found in 50% of the patients. Despite not all onychodystrophy are onychomycosis, the entire population had received treatment, exposing themselves to adverse effects and unsupervised drug interactions. Azole antifungals were the most used. These are over-the-counter drugs that contribute to an irrational and indiscriminate use of onychomycosis medication.

Obez hastalarda serum leptin ve triptofan düzeylerinin depresyon ve anksiyete ile ilişkisi var mı?

Objectives: Depression and anxiety are common conditions in obese patients. Leptin plays a role in obesity, the role of tryptophan in obesity has been investigated frequently in current studies. The aim of this study is to evaluate whether serum leptin and triptophan levels are related to depression and anxiety in obesity patients. Methods: This is a descriptive and cross-sectional study in which the data of 88 patients aged 18 years and over, BMI 25 kg/m2 and above, who applied to the Family Medicine outpatient clinic between 01.07.2019 and 31.12.2019, were examined. Sociodemographic data form, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) were completed by all patients included in the study. Results: There was no significant relationship between BMI and leptin, BMI and tryptophan levels. A positive correlation was found between tryptophan and weight, waist circumference and systolic blood pressure (SBP). Tryptophan was also significantly higher in smokers and those with a history of psychiatric treatment. Tryptophan levels in men were found to be significantly higher than in women. Serum tryptophan concentration of the patients was positively correlated with weight, waist circumference and SBP. Tryptophan level was found significantly higher in men than in women. Tryptophan was also significantly higher in smokers and those with a history of psychiatric treatment. There was no significant relationship between BDI, BAI and leptin and tryptophan levels. Conclusion: The significant relationships between serum tryptophan level and weight, waist circumference and SBP may be useful in the management, follow-up and treatment of obese patients.