January 2018

Original Article

Analysis of nasal skin biopsies: 354-case series

Asuman Kilitci¹, Yücel Çiçek², Ersoy Acer³, Emine Müge Acar⁴

¹Department of Pathology, Ahi Evran University Medical Faculty,  Kırşehir, ² Clinics of Otorhinolaryngology,Ulus State Hospital,  Ankara, ³ Department of Dermatology,  Osmangazi University Medical Faculty, Eskişehir, ⁴Clinics of Dermatology, Ahi Evran University Education and Research Hospital, Kırşehir, Turkey

DOI: 10.4328/AEMED.123 

Abstract

Aim: Epidemiological studies are important for the prevention and resolution of health problems. We carried out this study to evaluate the incisional and excisional biopsies applied to the nasal skin in the Kırşehir region. Material and Method: Between December 2014 and October 2017, 354 patients and 354 lesions were evaluated with a mass on the nasal skin retrospectively. The mean age of the patients, gender distribution, localization of lesions and histopathological type were investigated. These masses were classified as non-neoplastic, benign, premalignant, and malignant. Results: The number of females were 226, and the number of males were 128. Age distribution ranged from 9 to 90. There were 20 cases under 18 years old. Premalignant and malignant lesions were not observed in adolescent/pediatric age group. Eighty-two cases over 60 years of age were identified, and 60% of them had a malignant tumor. Nasal skin lesions were more common in the 31-40 age range (24.9%). The most common lesion group was benign tumors (65.2, n=231), followed by malignant tumors (20.1%, n=71), non-neoplastic lesions (9.6%, n=34) and premalignant lesions (5.1%, n=18). Nevus (175), basal cell carcinoma (67) and chronic nonspecific inflammations (21) were the most common diagnoses. Among the malignant tumors, basal cell carcinoma was diagnosed (67) (M/F:1.09, mean age:65.8) more than squamous cell carcinoma (4). In the patient group with benign tumors, there were vascular tumors (13: capillary hemangioma; 10, hemangioma; 3), verruca vulgaris (12), skin appendage tumors (11: trichoepithelioma; 4, trichofolliculoma; 2, steatocystoma; 1 hydradenoma papilliferum; 1, chondroid syringoma; 3), seborrheic keratosis (8), fibroepithelial polyp (7), fibroma (4) and dermatofibroma (1) respectively after nevus. In 18 premalignant lesions, 11 cases were diagnosed as actinic keratosis, and 7 cases were diagnosed as keratoacanthoma. Discussion: The literature on demographic and histopathological evaluation of nasal lesions is limited. The increase in epidemiological studies can offer a comparative advantage over other studies and can be a guide for health management. Patients with a mass on the nose are required to undergo differential diagnosis with a biopsy.

Keywords

Nose; Skin; Histopathology

Corresponding Author: Asuman Kilitci, Dept of Pathology, Ahi Evran University Medical Faculty, 40200 Kırşehir, Turkey. T.: +90 3862134515 E-Mail: dr.asuk@gmail.com

How to Cite: Asuman Kilitci, Yucel Cicek, Ersoy Acer, Emine Muge Acar . Analysis of nasal skin biopsies: 354-case series. J Ann Eu Med 2018;6(1): 5-9

Evaluation of health situation and problems of the families having disabled child: quantitative study

Betül Battaloğlu İnanç1 , Yaşar Topal2 , Hatice Topal2

1 Department of Family Medicine, 2 Department of Pediatrics, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey

DOI: 10.4328/AEMED.116

Abstract

Aim: Having multiple disabled child is stressful for parents because they continue to carry out demanding care procedures in everywhere. In this context, we planned to investigate the health conditions and problems of the families with quantitative method. Matherial and Method: The universe of the study consists of the families of 10 disabled children registered in Counseling and Research Center affiliated with Muğla Provincial Directorate of National Education in Turkey. No sampling was executed in this study, and 10 parents accepting to participate into the study voluntarily were involved. An exploratory, qualitative study was conducted, including individual interviews with parents focus groups. Results: ‘‘Concerns for the child’s well-being” was central for the parents and focussed on the areas of their “Development”. They devoted themselves entirely to their children. Even his illnesses were focused for their children. They are protecting their children, but sometimes they are feeling burnout themselves. They did not think their health, also they did not think even could do something for their health. Discussion: Parents work hard to safeguard the well-being of their disable child first. And of course, they need professionals care sometimes. Becuse, still they do not know, how will live their own lifes.

Keywords

Disability; Parents; Health; Chronic Diseases

Corresponding Author: Betül Battaloğlu İnanç, Family Medicine Department, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey. T.: +90 2522141326-28/5195 F.: +90 2522111345 E-Mail: betulbattaloglu@mu.edu.tr

How to Cite: Betul Battaloglu Inanc, Yasar Topal, Hatice Topal . Evaluation of health situation and problems of the families having disabled child: quantitative study. J Ann Eu Med 2018;6(1): 1-4

Letter to Editor

Tobacco use and development of diabetes: examination of the underlying mechanisms

Hammad Akram

Graduate Hamdard College of Medicine and Dentistry, Pakistan

DOI: 10.4328/AEMED.121

To the editor:

The role of tobacco use in the development of diabetes can easily be missed possibly in the presence of other widely known risk factors. A regional study done in 2012 explores this relationship using data collected through a population-based survey [1]. The study is an example of how effectively the data collected through a cross-sectional survey can be used to address various population-level health issues. This article examines a positive relationship between tobacco use and development of diabetes [1]. This is an interesting relationship which has also been examined in another regional cross-sectional study; however, no significant results were found at different levels of smoking use [2]. The authors in both studies use data from the well-recognized World Health Organization based STEPwise survey; hence, represents characteristics of target population well. Population-based surveys if implemented with proper planning and appropriate sampling techniques and tools could provide quality information about the health risks and certain related outcomes effectively. A cohort study from the United States also examines the impact of active and passive smoking in the development of glucose intolerance [3].To understand the background process behind this important relationship, between tobacco use and development of diabetes, it is critical to examine several health-related cofactors. These factors can be social, cultural, behavioral, and genetic related. While examining diabetes, some important population characteristics that can influence diabetes (in addition to tobacco use) could include education, diet, physical activity, body weight, family history of diabetes, parental consanguinity, and sedentary lifestyle [2]. Furthermore, the families share common habits or follow cultural norms in terms of diet, physical activity, tobacco use, occasionally work and other practices that could predispose them to certain diseases including diabetes. For example, among some cultures and ethnic groups the obesity is considered favorable and represent prosperity, in some smoking represent social status or class etc. At physiological and biochemical levels, the literature review in the area reveals that even though smoking can cause a decrease in the body weight, is associated with central obesity and oxidative stress both of which could lead to insulin resistance through several complex metabolic mechanisms [4-6]. The direct effect of smoking on diabetes could be associated with inflammatory and oxidative stress along with damaging impact on the beta cells of pancreas [5]. Since, smoking can lead to the central obesity [4], increased abdominal and/or body fat leads to the higher levels of inflammatory substances such as cytokines, TNF-α, IL-6, etc. and all of these substances are associated with insulin resistance [6]. Simply, the excess abdominal fat behaves like an endocrine tissue and release all these detrimental chemicals that eventually could lead to diabetes [5, 6]. It is also important to mention here that the smoking with existing diabetes can further complicate the course of the disease by its adverse effect on microvasculature [5]. At the population level, the type of methodology authors used in above-mentioned papers, allow them to obtain quantitative data and fails to collect subjective aspects of the target population. This kind of research excludes the underlying complex phenomenon behind the numbers and interview responses thus provides objective aspects of the problem. Using mixed methods or pragmatic approach to examine the overt as well as cognitive aspects of social and behavioral factors and their influence on diabetes could provide a better understanding of the complex relationships described here. By doing so, the tobacco use and its role in diabetes can be examined appropriately in the light of other related factors and underlying phenomenons.

References

1. Saeed AA. Association of tobacco products use and diabetes mellitus-results of a national survey among adults in Saudi Arabia. Balkan medical journal. 2012; 29(3): 247. 2. Al-Thani M, Al-Thani AA, Al-Chetachi W, Khalifa SE, Vinodson B, Al-Malki B, et al. Situation of Diabetes and Related Factors Among Qatari Adults: Findings From a Community-Based Survey. JMIR Diabetes. 2017; 2(1): e7. 3. Houston TK, Person SD, Pletcher MJ, Liu K, Iribarren C, Kiefe CI. Active and passive smoking and development of glucose intolerance among young adults in a prospective cohort: CARDIA study. BMJ. 2006; 332(7549): 1064-9. 4. Canoy D, Wareham N, Luben R, Welch A, Bingham S, Day N, et al. Cigarette Smoking and Fat Distribution in 21, 828 British Men and Women: A Population-based Study. Obesity. 2005; 13(8): 1466-75. 5. Chang SA. Smoking and type 2 diabetes mellitus. Diabetes & Metabolism journal. 2012; 36(6): 399-403. 6. Akram H. An overview of non-surgical approaches and their role in Type 2 Diabetes remission. International Journal of Biosciences and Technology. 2017; 10(4): 26

Corresponding Author: Hammad Akram, Graduate, Hamdard College of Medicine and Dentistry, Pakistan. T.: 01197440399008 E-Mail: hammadakram77@yahoo.com