Life and Medical Sciences
Latest articles in this journal
Published: 5 April 2023
Life and Medical Sciences; https://doi.org/10.54584/lms.2023.31
The term polypharmacy is generally known as the simultaneous use of five or more medicines. An increase in polypharmacy is also observed with chronic diseases, which increases with age. The main complications of polypharmacy are medicine side effects, inappropriate medicine use, drug-drug interaction, and drug-disease interactions. Family physicians are the most effective physician group in coordinating medicine therapy, as they provide continuous, longitudinal, and comprehensive medical care to the individual. In this study, it was aimed to determine the need of an auxiliary web application regarding family medicine residents' awareness of polypharmacy side effects in geriatric population and to identify the barriers to rational drug use in their daily clinical practice. The research is a cross-sectional observational study, and all residents actively working in the Ankara City Hospital Family Medicine Clinic were planned to be included and were invited to the study. The study was conducted through survey application method under observation. It was determined that geriatric patients mostly referred to their "clinical experience" in rational drug use according to the participants. The obstacles faced by the participants in rational drug use were mostly in that of "not having enough knowledge" and "patient-centered medicine regulation to be difficult and time consuming". 75.3% of respondents (n=70) marked strongly agree and 18.3% marked agree (n=17) for the statement "I would like to have an easily accessible an artificial intelligence aided web application that I can use in my daily practice regarding polypharmacy side effects, such as drug-drug interactions, drug-chronic disease incompatibility, potentially inappropriate medicine (PIM) in the elderly" and the mean value of this proposition was determined as 4.65±0.7. This study showed that the resources used to detect polypharmacy and its complications were not used adequately and appropriately. Moreover, the study results present the need and demand for time-saving and facilitating auxiliary web applications to minimize PIM, drug-drug interaction, drug-chronic disease interaction in the elderly and to evaluate it in the light of current data to provide person-centered and comprehensive care in the clinician's practice.
Published: 1 April 2023
Life and Medical Sciences; https://doi.org/10.54584/lms.2023.30
Eighteen months of family medicine residency training is completed as in-hospital rotation. In this process, the increase in the possibility of encountering risky situations in terms of hospital acquired infections (HAI) reveals the importance of awareness and immunization status for family medicine residents in preventing HAI. The aim of this study is to evaluate the risk status of family medicine residents about HAI, to investigate their immunization status, and to raise awareness on this issue. This study was conducted on 285 participants, including family medicine assistants who received residency training at Gülhane Training and Research Hospital between 01.08.2021 and 30.03.2022. In the 17-question survey made to the residents who accepted the study, demographic characteristics of the residents and some other information about the HAI were questioned. Afterwards, whether they encountered risky situations, periodic control examinations of the physicians, and their immunization status were questioned. Questions were asked in the form of a 5-point Likert-type table about the use of personal protective methods and their knowledge level about HAI. The answers given to the Likert type questions were scored as 1 worst and 5 as the best, and the total knowledge level score (minimum-maximum:15-75) was obtained. 180 (63.2%) of the participants were female, 196 (68.8%) were in the 24-29 age range. Of the participants, 99.3% (n=283) COVID-19, 96.5% (n=275) hepatitis B, 93.7% (n=267) tetanus, 39.6% (n=113) pneumococcus, 39.3% (n=112) influenza vaccine. The knowledge level score of female residents was higher (p=0.001). There was a significant difference between the age distribution of the participants and their knowledge level (p=0.033). According to this difference, the average knowledge level scores of the participants in the 24-29 age range were higher (p=0.047). It was determined that female residents HAI as a higher risk for family medicine residents (p=0.026). Participants who considered HAI as a risk for family medicine residents had a higher knowledge level (p=0.043). In our study, it was seen that HAI were evaluated as a risk by family medicine residents. On the other hand, the awareness and knowledge level of resident physicians on this issue was not considered sufficient. It was determined that some of the vaccines of the physicians were more careful with the effect of the COVID-19 pandemic. However, it was observed that they did not pay due attention to the periodic health examinations. In order to increase the awareness of family medicine residents about HAI, lessons on infections that may be risky can be planned in the training curriculum. By ensuring regular periodic controls, physicians can be followed up in terms of occupational health risks. In case of encountering risky situations, the use of personal protective methods is encouraged and regular inspection is recommended.
Published: 26 January 2023
Life and Medical Sciences; https://doi.org/10.54584/lms.2023.29
While enterococci are found as flora elements in many parts of the body, they have recently emerged as different infectious agents such as urinary tract infections, bacteremia, and meningitis. Increasing antibiotic resistance also poses additional challenges in treatment. In this study, it was aimed to determine the species identification and antibiotic resistance rates of enterococci isolated from the urinary tract. Enterococcus strains isolated from urine culture samples sent to the routine microbiology laboratory from various clinics of our hospital between 01.01.2020 and 31.12.2021 with the preliminary diagnosis of urinary tract infection were included in this study. Samples were cultivated on sheep blood agar and eosin methylene blue agar, and species determination and antibiogram evaluation were carried out in accordance with the recommendations of EUCAST (European Committee on Antimicrobial Susceptibility Testing-2020-2021) using conventional methods and automated identification device (VITEK 2 Compact-BioMerieux-France). All enterococci isolates (n=349) were susceptible to vancomycin, teicoplanin, tigecycline and linezolid. Of Enterococcus faecalis isolates (n=238), 32.8% were resistant to ciprofloxacin, 23.7% to high-level gentamicin, 33.2% to imipenem, 2.5% to nitrofurantoin, and 26.9% to streptomycin. Of the Enterococcus faecium isolates (n=111), 84.7% were resistant to ciprofloxacin, 58.6% to high-level gentamicin, 91% to imipenem, 31.5% to nitrofurantoin, and 83.8% to streptomycin. In conclusion, it is important to determine the resistance patterns of enterococcus strains, which are most frequently isolated as the causative agent of urinary tract infection, and also cause other clinical presentations such as wound infection or bacteremia, and to establish appropriate treatment protocols and to determine new antibiotic resistances.
Published: 25 January 2023
Life and Medical Sciences; https://doi.org/10.54584/lms.2023.28
Foreign body ingestion (FBI) is one of the common causes of emergency admissions in infancy and childhood. Although the large majority of children who present with the FBI have no psychiatric diagnosis, present studies demonstrate that attention deficit hyperactivity disorder (ADHD) and related psychiatric problems might be a risk factor for FBI. This study aimed to compare the demographic variables and attention deficit hyperactivity disorder levels and sluggish cognitive tempo symptoms (ADHD-SCT) in children who ingested foreign bodies with healthy children. Also, we aimed to address the relationship between ADHD-SCT symptoms and the age of FBI. The FBI group comprised 44 children (age 2-8, median age: 5, 68.2% boys) admitted to the emergency, pediatric surgery, and pediatric gastroenterology department after FBI, and the healthy control group comprised 30 children (age 3-8, median age: 6, 56.7% boys). We administered the sociodemographic information form, SNAP-IV ADHD rating scale, and Barkley’s child SCT ratings scale to both groups of parents. Our results demonstrated that maternal education level was significantly lower in the FBI group, although other demographic characteristics of the samples were similar (p=0.023). In addition, ADHD-hyperactivity/impulsivity scores were significantly higher in the FBI group (p=0.01). Still, there were no significant differences in ADHD-inattention, SCT-daydreaming, and SCT-sluggishness scores (for all, p>0.05). We found positive-moderate relationships between SCT-daydreaming and sluggishness symptoms and FBI age (r=0.314, r=0.348, respectively). This means that higher SCT scores are related to an older FBI age. In conclusion, for the first time, we evaluated the ADHD and SCT symptoms in young children against FBI and found that ADHD-hyperactivity, but not ADHD-inattention symptoms, were significantly higher in the FBI group, and SCT symptoms increase the risk of FBI at an older age. In addition, we found that a lower maternal education level could be an additional risk factor for FBI. Despite the high hyperactivity in the FBI group, the low rate of child psychiatry evaluation should be considered when evaluating a child.
Published: 18 January 2023
Life and Medical Sciences; https://doi.org/10.54584/lms.2023.27
The aim of this study was to analyze the posts of patients with solid organ transplant Facebook groups and to reveal the most common problems experienced by them. The study was conducted with a comprehensive search of solid organ transplant patients' Facebook groups. Posts of the participants were scanned with the keywords “organ transplant patients”, “life after organ transplant”, “organ transplant information”, “kidney transplant”, and “liver transplant”. Qualitative data were evaluated by inductive content analysis. All words of the post were analyzed in the MAXQDA (version 11) software program. There were 18,722 users in 10 groups related to solid organ transplantation and 478 posts were shared. Five main themes were determined: Seeking information/giving information, seeking support/providing support, seeking a partner for cross-transplantation of those waiting for organ transplants, financial issues and experiences related to COVID-19. It has been determined that 59.8% of individuals most frequently refer to Facebook groups for information seeking/giving information. The posts are seen as an opportunity to share experiences, to seek support/provide support, and help from others with similar experiences. Social media can be used by health professionals to inform individuals and reduce their anxiety by examining and participating in disease-specific groups.
Published: 13 January 2023
Life and Medical Sciences; https://doi.org/10.54584/lms.2023.26
In this study, we aimed to determine whether the presence and duration of diabetes mellitus (DM) is associated with changes in intervertebral disc degeneration, epiphyseal plaque degeneration, and subcutaneous fat tissue thickness. Diabetic patients and non-diabetic participants (control group) who applied to the internal medicine outpatient clinic between 2020-2022 and had lumbar spine magnetic resonance imaging due to low back and/or leg pain were included the study. Disc degeneration, epiphyseal plaque degeneration, and subcutaneous fat tissue thickness parameters of DM patients and control group were reviewed retrospectively, and the results were statistically evaluated. There were 80 DM patients in the patient group, 25 (31.3%) of these patients were male and 55 (68.8%) were female. There was a total of 121 participants in the control group, of which 39 (32.2%) were male and 82 (67.8%) were female. The mean age of the patient group was 57.85±10.76 years, while the mean age of the control group was 54.23±13.09 years. There was no significant difference between the duration of DM and disc degeneration, epiphyseal plaque degeneration, and subcutaneous adipose tissue thickness. However, there was a significant difference between the control group and the DM patient group in terms of disc degeneration and epiphyseal plaque degeneration (p=0.003 and p=0.017, respectively). This study reveals that patients with diabetes have an increased susceptibility to disc degeneration and epiphyseal plaque degeneration, regardless of disease duration. Control and treatment of diabetic disease will make an important contribution to the prevention of secondary complications.
Published: 4 January 2023
Life and Medical Sciences; https://doi.org/10.54584/lms.2023.24
Physicians are trying to cope with patients’ potentially inappropriate demands in addition to their intensive work environments. The objectives of this study were to determine physicians’ points of view regarding patient demands, such as requests for inappropriate medical tests, prescription medications, or disability, and to what extent these demands affect physicians. This survey study was completed by conducting face-to-face interviews with the physicians, to determine the knowledge, attitudes, and behaviors of the 196 physicians working in our institution toward patient demands. Physicians reported that disability-related requests were the most prevalent patient demand (71.4%; n=140). A total of 2.6% (n=5) of the physicians performed laboratory tests that they considered unsuitable, 4.1% (n=8) described inappropriate prescription medication requests, and 2.6% (n=5) reported receiving disability requests from patients that they considered to be inappropriate. It was found that knowing patients formerly or being their health workers significantly altered physician behavior and increased rates of meeting inappropriate demand (strong correlation; r=0.809, p<0.001). The average score of the physicians showing their knowledge of the non-compliance of the patient requests was 60.99±10.46 (min-max 30-87.5 points), while the average score of the physicians' attitudes towards the demands they considered inappropriate was 44.73±10.23 (min-max 15-72.5 points). Knowledge and attitude scores were statistically higher in those working time under 10 years, as knowledge scores were statistically higher in those working in the internal medicine branches. In terms of behavior scores, there was no significant difference between working times and branches. In our study, the personality type of the physician was not significant in terms of meeting the patient demand. The job satisfaction of the physicians had no effect on the physician's informed, attitude, and behavior. In terms of stress coping style, the lack of difference in the sub-size of the scale of the subjugation approach was considered to be remarkable. As a consequence, acting for the benefit of the patient in clinical decision making is necessary. It is important to remember that any unnecessary examinations, prescribed medications, or disability requests lead to additional costs, loss of labor, and added workload in addition to posing a health risk for the patient.
Published: 2 January 2023
Life and Medical Sciences; https://doi.org/10.54584/lms.2023.23
Music reduces emotional stress, relieves anxiety, and is utilized while treating various diseases. The present study explored the impacts of various music genres at different decibels on the oxidation state in the brain tissue and serum. We carried out the study on 42 male Wistar Albino rats. The rats were randomized (six rats in each cage) as a control group and groups exposed to noise, rock music, and slow music at different decibels for 21 days and 4 hours a day. At the end of the experiment, we studied oxidant [malondialdehyde (MDA), nitric oxide, protein carbonyl (PC)] and antioxidant [superoxide dismutase (SOD), glutathione peroxidase (GSH-Px)] parameters in the cerebral cortex, cerebellum, and serum. In the cortex, while MDA levels were low in the 100 dB(A) slow music group, the 50 dB(A) noise and rock music groups had elevated SOD, GSH-Px, and MDA levels when compared to the control group and higher MDA and GSH-Px levels when compared to the 50 dB(A) slow music group. In the cerebellum, although SOD levels did not significantly change, we found MDA and GSH-Px to increase in the 50 dB(A) and 100 dB(A) rock music groups and the 50 dB(A) noise group. Finally, we determined MDA and PC levels to be low and SOD levels to be high in the 50 dB(A) slow music group. Overall, that high dB rock music created oxidative stress in cerebellar tissue, that low dB rock music and noise created oxidative stress in the cortex and cerebellum, and that high and low dB slow music may have positive impacts on oxidative stress.
Published: 20 October 2022
Life and Medical Sciences; https://doi.org/10.54584/lms.2022.23
In this descriptive study, it is aimed to determine the competencies of physicians according to NCC-2014, to create databases for current educational output, to consider graduate competencies while preparing medical faculty training curriculum and to make suggestions for education. For this purpose, a total of 501 physicians agreed to answer the questionnaire and working in designated military hospitals and military primary care examination centers and residents at Ankara University Faculty of Medicine Hospital were included in the study. The data were collected by the researcher by face-to-face interviews with the participants between 10 March 2016 and 30 June 2016. The scores of the physicians regarding the basic medical practices were collected under six main topics and compared with the minimum levels described in NCC-2014. As a result of the study, 161 (32.1%) participants were adequate in “history taking” applications, 78 (15.6%) participants were adequate in “recording, reporting and notification”, 72 (14.4%) participants were competent in “preventive medicine and community medicine practice”, 62 (12.4%) participants were competent in “interventional and noninterventional practice”, 26 (5.2%) participants were competent in “laboratory tests and other related procedures”, and 25 (5.0%) participants were competent in “general and problem focused physical examinations”. It has been determined that physicians do not receive adequate training in the medical faculty, especially in the field of forensic medicine and obstetrics and gynecology. Curriculum programs should be prepared that will include measures for the development of all application areas, especially the practices determined under the heading of “general and problem focused physical examinations” and “laboratory tests and other related procedures”, where the participants have the lowest proficiency.
Published: 18 October 2022
Life and Medical Sciences; https://doi.org/10.54584/lms.2022.22
The aim of the study is to evaluate the effect of trichloroethylene (TCE) on the metal-ceramic bond of additively manufactured and casting Co-Cr alloys. For this purpose, 84 disc-shaped (r=12 mm, h=1 mm) specimens were prepared for two experimental groups (n=42) with different fabrication techniques; casting and additively manufactured with Co-Cr. Before ceramic application, the disc specimens divided into two subgroups (n=21): Casting and cleaned with TCE (CT), casting and not cleaned with TCE (C), additively manufactured and cleaned with TCE (AT), additively manufactured and not cleaned with TCE (A). Ceramic (h=4 mm, r=6 mm) was applied to the disc specimens (n=20) and their shear bond strength (SBS) was measured. The surface morphology of disc (n=1; for each subgroup) specimens before and after TCE application was analyzed with a scanning electron microscope (SEM). Results were statistically analyzed with 1-way ANOVA and the Bonferroni multiple comparisons tests (α=0.05). Significant differences were found in SBS of the CT, C, AT, and A groups. CT group (21.74±1.66 MPa) showed a significantly higher SBS value than the C (18.65±2.11 MPa), AT (19.07±1.75 MPa) and A (18.52±1.94 MPa) groups (p<0.001). In conclusion the application of the TCE increased the metal-ceramic bond of casting Co-Cr alloy. Although the results were not statistically significant the TCE also increased the bond of additively manufactured Co-Cr alloy.