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Öğe AWARENESS AND APPROACHES OF FAMILY PHYSICIANS ABOUT CHRONIC PAIN(Dokuz Eylul Univ Inst Health Sciences, 2021) Sultanoglu, Tuba Erdem; Gamsizkan, Zerrin; Ataoglu, Safinaz; Sultanoglu, HasanPurpose: We aimed to investigate family physicians' awareness and approaches to chronic pain in its management. Methods: This study was planned as a descriptive, crosssectional study to investigate family physicians' awareness and approaches to chronic pain between September and November 2020.A questionnaire were used as data collection tools.The physicians sociodemographic characteristics, the number of registered patients, the percentage of patients with chronic pain, the status of participation in training activities on pain management, the most common cause of chronic pain, initial approach to chronic pain management were recorded. They were also questioned about the medical treatment option that they preferred for the treatment of patients with chronic pain, the most commonly demanded medication group by their patients and their practice of prescribing those medications, their views on traditional and complementary medicine, and the most effective treatment option for chronic pain. Results: 81 family physicians participated in the study. The mean age was 34.2 +/- 7.3.58% of the participants are women;42% of them were male.Half of the family physicians participating reported that low back pain was the most common cause of chronic pain. In our country, the responses given to the question about the most common causes of chronic pain were psychiatric problems and low back pain. Initial approach to a patient presenting with chronic pain, the most the physicians responsed 'I treat the patient'.66.7% of the physicians agreed with multidisciplinary approach. Conclusion: Developing algorithms for chronic pain management, structuring specialist training and planning continuous training after graduation will contribute significantly to increasing awareness of chronic pain.Öğe Chronobiological evaluation and an intervention study on timing of food intake in the treatment of obesity(Wiley, 2021) Gamsizkan, Zerrin; Onmez, Attila; Sahip Karakas, TubaBackground The chronotype of patients who cannot reach their ideal weight despite diet and exercise may play a role in this resistance. In this study, the relationship between BMI and chronobiological preferences was examined and a weight loss programme was applied to refractory obese patients with evening type (ET). Method The study included 50 obese (BMI >= 30 kg/m(2)), 50 overweight (BMI = 25-29 kg/m(2)) and 50 normal weight (BMI < 25 kg/m(2)). The patients were asked to fill out a questionnaire including questions about sociodemographic characteristics, breakfast and night eating habits, as well as the morningness-eveningness quastionnaire (MEQ). In the second stage of the study, awareness interviews were held with ET obese patients in terms of eating time and habits. Results A statistically significant difference was observed between the BMI averages and the MEQ scores of ET, intermediate type (IT) and morning type (MT) groups (P = .0001). There was a statistically significant difference between the ET, IT and MT groups in terms of the distribution of late-night eating habits (P = .0001). The habit of skipping breakfast and taking more calories at dinner was found to be high in the ET patients (respectively; P = .021, P < .001). According to the results of the 3-month follow-up and intervention, the ET patients lost an average of 9.07 +/- 4.30 kg and a significant decrease was observed in the BMI scores (P < .001). Conclusions The study results support the idea that an individualised weight loss programme according to the patient's chronotype preferences may increase the success rate of obesity treatment. A weight loss programme that includes the timing of food intake and regulation of eating habits in evening-type obese patients can be used in the treatment of obesity.Öğe Comparison of Hematological and Biochemical Parameters and Cardiovascular Risk Scores in Patients Applying to the Obesity Outpatient Clinic(Duzce Univ, Fac Medicine, 2022) Kaya, Nursel; Gamsizkan, Zerrin; Sungur, Mehmet AliObjective: The aim of this study was to compare hematological and biochemical parameters and cardiovascular risk scoring in patients admitted to the obesity outpatient clinic.Methods: In this descriptive cross-sectional study, data of the patients who admitted to the Obesity Outpatient Clinic of Duzce University Research and Application Hospital between 2017 and 2018 were evaluated retrospectively. Age, gender, smoking status, presence of Diabetes Mellitus (DM), and body mass index (BMI) were recorded and the cardiovascular risk of the patients was calculated by using the scoring system of the European Society of Cardiology (ESC) and Turkish Society of Cardiology (TSC).Results: A total of 631 participants were included in the study. The mean age was 38.9 +/- 12.1 (min=21, max=65) and 75.1% of the patients were female and 24.9% were male. It was observed that 19.2% of the patients were smokers, 4.6% had DM and 36.9% had insulin resistance. When the patients were evaluated according to the BMI scores, it was found that 3.3% of them were underweight, 7.3% were normal weight, 22.5% were overweight and 66.9% were obese. According to TSC risk scoring system, 51.4% of the patients were in low risk, 20.5% were in medium risk and 28.1% were in high risk category. According to the ESC risk scoring system, 83.5% of the patients were in low risk, 10.9% were in medium risk and 5.5% were in high risk category. According to both risk scoring systems, there were significant differences between the risk groups in terms of age, gender, BMI, and presence of DM (p<0.001). When evaluated according to the TSC risk score, it was seen that the patients in the high-risk category had a lower platelet/lymphocyte ratio and a higher total cholesterol/HDL ratio. According to both risk scoring systems, no correlation was found between cardiovascular risk and RDW, MPV, leukocyte count, and NLR(Neutrophil-Lymphocyte ratio). Conclusions: Conducting a cardiovascular risk assessment for patients who admit to primary health care services for obesity counseling is important. A cardiovascular risk assessment conducted at admission may help some precautions to be taken earlier. There is a need for more studies to determine easily accessible parameters that can predict cardiovascular risk.Öğe The effect of COVID-19 lockdown on glycemic control in patients with type 2 diabetes mellitus in Turkey(Elsevier Sci Ltd, 2020) Onmez, Attila; Gamsizkan, Zerrin; Ozdemir, Seyma; Kesikbas, Enis; Gokosmanoglu, Feyzi; Torun, Serkan; Cinemre, HakanBackground and aims: A national lockdown to prevent the spread of coronavirus disease (COVID-19) in Turkey was introduced in March 2020. We think that lockdowns may lead to weight gain and worsening of glycemic parameters in patients with type 2 diabetes mellitus (DM). The purpose of this study was to investigate how type 2 DM patients were affected by the lockdown. Method: Type 2 DM patients unable to attend regular follow-ups due to lockdown over a 75-day period between March and June 2020 and who again attended polyclinic follow-up when the lockdown was lifted were included in the study. These patients' glycemic control and weight status were compared with the pre-lockdown period. In addition, patients' general habits, and adherence to diet and exercise were evaluated, while their general health was assessed using the Short-Form 36-item survey. Result: The research involved 101 type 2 DM patients, 57 men (56.5%) and 44 women (44.5%), with a mean age of 55 +/- 13. Patients' mean pre-lockdown weight was 84.7 +/- 16.4 kg, rising to 85.5 +/- 16.8 kg post-lockdown, although the increase was not statistically significant (p = 0.781). In terms of glycemic parameters, Hba1c rose from 7.67 +/- 1.76 to 8.11 +/- 2.48, and fasting glucose from 157.9 (83-645) mg/dl to 163.2 (84-550) mg/dl, none of which were statistically significant (p = 0.253, p = 0.079, respectively). Conclusion: In addition to weight gain among type 2 DM patients during the Covid 19 lockdown, statistically insignificant increases were also observed in such glycemic parameters. This was a small sample and further studies with larger sample are needed. (C) 2020 Diabetes India. Published by Elsevier Ltd. All rights reserved.Öğe Evaluation of the health literacy levels of patients applying to Family Medicine outpatient clinics(Termedia Publishing House Ltd, 2021) Gamsizkan, Zerrin; Sungur, Mehmet AliBackground. Today, the concept of health literacy is used to determine the health needs of the population in parallel with ever-increasing health knowledge. Objectives. The aim of the study is to evaluate the health literacy level of patients who apply to the Family Medicine preventive health services of Duzce University Hospital and to investigate the relevant factors that may be related to health literacy. Material and methods. This study was a cross-sectional study carried out between October 2018 and April 2019. The patients were evaluated utilizing the Health Literacy Survey-European Union (HLS-EU) scale. The study took place in Duzce Medical Faculty Hospital, Turkey. Results. A total of 816 patients, 48.5% (n = 396) of them male and 51.4% (n = 420) female, were included in the study. The general health literacy levels of the patients were as follows: 30.6% (n = 250) insufficient, 33.4% (n = 272) limited, 28.9% (n = 236) sufficient, 7.1% (n = 58) excellent. According to all subdimensions and matrix averages of the scale used in the study, the mean score that patients received in understanding and applying health information in the disease prevention dimension (8.45 +/- 2.30, 8.10 +/- 2.38, respectively) was found to be lower than health care (11.20 +/- 2.72, 11.63 +/- 3.01, respectively). Conclusions. The study results revealed a lower level of health literacy in terms of disease prevention rather than healthcare utilization. Initiatives to increase people's knowledge of disease prevention should be planned.Öğe Exposure of Violence and its Effects on Health Care Workers(Duzce Univ, 2021) Karakas, Tuba Sahip; Gamsizkan, Zerrin; Cangur, SengulObjective: The aim of this study is to examine the frequency of violence that the healthcare workers of Duzce University Research and Practice Hospital encountered, situations that cause violence, post-violence attitude and the effects of violence on the personnel, and to evaluate the relationship between violence and the burnout levels of the healthcare workers. Methods: This descriptive cross-sectional study was conducted on the physicians and nurses working in different departments at Duzce University Research and Application Hospital, between October 2020 and February 2021. A questionnaire form consisted of 24 questions including demographic information and questions about working conditions and violence and Maslach Burnout Scale consisting of 22 questions were applied to the participants. Results: The frequency of the participants being exposed to violence throughout their professional life was found 74.4%. The most common type of violence was psychological violence (92.7%). Exposure to physical violence was more common among male healthcare workers (22.7%) (p <0.001). It was found that the rate of exposure to violence increased as the time spent in the profession, the average number of duty shifts, and the number of patients examined daily increased (p <0.05). Swearing and insult were the most common types of violence exposed (71.1%). In the comparison of the exposure to violence and sub-dimensions of burnout scale, it was found that Emotional exhaustion and Depersonalization subscale scores of those who were exposed to violence were significantly higher than those who were not (p = 0.005). Conclusions: Violence in the health sector is a serious problem that decreases the motivation of healthcare workers and causes mental, emotional and physical problems. In order to deal with this problem, instead of ignoring the problem, we need to reveal the violence and its destructive effects through more comprehensive studies.Öğe The Frequency of Atopic Dermatitis and Other Skin Manifestations in Infants with Cow's Milk Protein Allergy in Karabuk, Turkey(Mashhad Univ Med Sciences, 2021) Dogan, Erkan; Sevinc, Eylem; Gamsizkan, Zerrin; Korkut, Burcu; Sevinc, NergizBackground Atopic dermatitis (AD) is the most common skin disease in childhood, and Cow's milk protein allergy (CMPA) is the most common cause of food allergies in infancy and may be characterized by atopic dermatitis with skin involvement as the first finding. The aim of this study is to determine the serum eosinophil cationic protein (sECP) levels, eosinophil counts and the frequency of AD and other skin manifestation among infants with CMPA. Materials and Methods: This cross-sectional study was conducted in Karabuk province, Turkey. Eighty-three infants who were diagnosed with CMPA and followed at the Karabuk Training Hospital Pediatric outpatient clinic. The first group consisted of 52 infants presenting with skin manifestations. The second group consisted of 31 infants who were not presenting skin manifestations. The sECP level of infants in both groups was measured using an Immulite 2000 XPi analyzer Immunoassay System (Germany). Results: Of 83 infants with CMPA, 62.6% (n=52) were detected skin involvement as the first finding. The proportions of atopic dermatitis and urticaria in CMPA infants with skin involvement were 90.4% and 9.6% respectively. The median sECP level and eosinophil counts (56.5 ng/mL vs 470/mm(3), p-value=0.001), in skin manifestations with CMPA group were significantly higher than that in the CMPA group without skin manifestations (33.1 ng/mL vs. 270/mm(3), p-value=0.006). Conclusion This study revealed that AD is the most common skin manifestation of CMPA and also found higher sECP levels in infants with skin involvement. The frequency of both diseases, which are easily treated with elimination diet, is increasing day by day.Öğe How do older age, gender and risk groups affect protective behaviours and mental health in the COVID-19 pandemic?(Wiley, 2021) Gamsizkan, Zerrin; Sungur, Mehmet Ali; Erdemir, GokhanBackground COVID-19 infection is severe in the presence of older age, male gender and risk factors. The aim of this study was to examine the relationship between the level of anxiety created by immensely spreading COVID-19-related information and age, gender and the presence of risk factors. Material and Methods The data used in this study were obtained by collecting a 25-question questionnaire created through Google forms with various communication tools. Results The data of 929 people who answered the questionnaire were used. The level of anxiety increased with age significantly, upon hearing that a person from their age group was harmed by the virus (P < .001). The feelings of being depressed and hopeless significantly increased as the age increased (P < .001). There was no significant difference between the genders in terms of feeling depressed and feeling of lack of joy in life (P = .066, P = .308, respectively). Participants with chronic diseases stated that they felt more depressed and hopeless and a lack of joy in life more frequently (P < .001). Conclusion Our results indicated that individuals with older age and having risk factors were more vulnerable to the stress caused by the pandemic. It is necessary for healthcare providers to identify high-risk groups by considering these situations, in order to make early psychological interventions.Öğe Pandemic Process with the Dimensions of Academic, Managerial and Healthcare(Duzce Univ, 2020) Gamsizkan, ZerrinThe covid-19 pandemic, which has influenced the whole world and people, has created different transformations in many institutions, especially in healthcare. It is emphasized that Covid 19 and any viral outbreaks that do not have a vaccine and an effective drug should be accepted as a part of our lives in the near future. The biggest advantage of human beings who have been in a war against pandemic since December 2019 is that they can transfer information that can be used to combat the virus at the same speed. In this pandemic process, scientists continued to transmit evidence-based scientific data to each other. The transfer of knowledge and experience will contribute to the solution of the global health problems we will encounter without causing any chaos environment.Öğe The predictive role of laboratory parameters in cardiovascular risk assessment in obese(Lippincott Williams & Wilkins, 2023) Kaya, Abdulkadir; Gamsizkan, Zerrin; Kaya, Nursel; Davran, FatihThe significance of cardiovascular diseases in mortality is indisputable. It is well-established that cardiovascular diseases are more prevalent among individuals with obesity. This study aimed to determine the predictive value of easily accessible hematological and biochemical parameters in assessing cardiovascular risk among obese patients. The study was designed as an observational retrospective. Department of Family Medicine, study was carried out between 25/06/2022 to 30/10/2022. The data of 439 obese patients were analyzed retrospectively. Using the online Heart Score system, the patients were classified into low, medium, high, and very high cardiovascular risk categories. The hemogram and certain biochemistry values of the patients at the time of admission were examined. Receiver operating characteristic (ROC) analyses were conducted to discriminate cardiovascular risk classes based on laboratory values. Markers with high diagnostic value, including a high area under the curve (AUC) value, sensitivity, and specificity, were presented. Significant differences were observed between the groups in terms of age, systolic blood pressure, diastolic blood pressure, total cholesterol, low-density lipoprotein, glucose, HbA1c, hemoglobin, platelet count, neutrophil (NEU) count, and platelet-lymphocyte ratio parameters (P < .05). The white blood cell count and NEU count of patients in the high-risk groups were found to have significantly higher AUC values compared to the moderate-risk group (AUC values of .737 and .779, respectively). The white blood cell and NEU parameters were found to have a positive predictive value in estimating the degree of cardiovascular risk. These parameters can potentially serve as biomarkers in identifying individuals at high risks for cardiovascular diseases.
