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    Cutoff Value of Metabolic Score for Visceral Fat in Patients with Nonalcoholic Fatty Liver Disease
    (Kare Publishing, 2022) Demir, Ş.
    Objectives: This study aimed to determine the cutoff values of a novel adiposity index and the metabolic score for visceral fat (METS-VF) for nonalcoholic fatty liver disease (NAFLD) and its related factors. Methods: A total of 1603 individuals participated in our checkup program and were retrospectively evaluated between June 2020 and January 2022. Patients who were less than 18 years of age and those with malignancies, hepatitis, HIV, insulin-dependent diabetes mellitus (DM), corticosteroid, parenteral nutrition, or alcohol use were excluded from the study. As a result, 1034 (64.5%) subjects were included in the study. Anthropometric and biochemical values in patient files were used to calculate indexes. Ultrasonography was used for the diagnosis of hepatic steatosis. Results: Among the 1034 participants, 611 (59.1%) were females. The mean age was 48.7±12.9 years. Metabolic syndrome, DM, and hypertension were identified in 331 (50.5%), 96 (14.7%), and 179 (27.3%) patients with NAFLD, respectively, and in 47 (12.4%), 11 (12.4%), 34 (9.0%) patients without NAFLD (p<0.001, p<0.001, p<0.001, respectively). METS-VF cutoff value was 6.43 regardless of gender (sensitivity:85.1%, specificity:66.9%, AUC=0.836, p<0.001). When the genders were examined separately, the cutoff value was 6.41 for females (sensitivity: 78.2%, specificity: 82.8%, AUC=0.872, p<0.001) and the cutoff value was 6.91 for males (sensitivity: 79.6%, specificity: 67.9%, AUC=0.813, p<0.001). Conclusion: The cutoff values of METS-VF in patients with NAFLD were found to be 6.41 in females and 6.91 in males. Copyright © 2023 Magnolia Press.
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    The Management of Irritable Bowel Syndrome in Primary Health Care and the Effect of Residency Training: A Cross-Sectional Study
    (Kare Publishing, 2022) Dabak, M.R.; Bayramiçli, O.U.; Tüzün, S.; Ölmez, B.; Demir, Ş.; Sezgin, G.; Bor, S.
    Objectives: 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. 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. ©Copyright 2022 by Anatolian Journal of Family Medicine.