Knowledge and attitudes towards complementary and alternative medicine among medical students in Turkey

OBJECTIVE: This study aims to examine knowledge and attitudes towards Complementary and Alternative Medicine among medical students in Turkey, and find out whether they want to be trained in Complementary and Alternative Medicine (CAM). METHODS: A cross-sectional study was carried out between October and December 2010 among medical students. Data were collected from a total of seven medical schools. FINDINGS: The study included 943 medical students. The most well known methods among the students were herbal treatment (81.2 %), acupuncture (80.8 %), hypnosis (78.8 %), body-based practices including massage (77 %) and meditation (65.2 %), respectively. Acupuncture, aromatherapy, herbal treatment and meditation were better known among female participants compared to males (p < 0.05). Females and first year students, generally had more positive attitudes. A larger proportion of female students compared to male students reported that a doctor should be knowledgeable about CAM (p = 0.001), and this knowledge would be helpful in their future professional lives (p = 0.015). Positive attitudes towards and willingness to receive training declined as the number of years spent in the faculty of medicine increased. CONCLUSIONS: Majority of the medical students were familiar with the CAM methods widely used in Turkey, while most of them had positive attitudes towards CAM as well as willingness to receive training on the subject, and they were likely to recommend CAM methods to their patients in their future professional lives. With its gradual scientific development and increasing popularity, there appears a need for a coordinated policy in integrating CAM into the medical curriculum, by taking expectations of and feedback from medical students into consideration in setting educational standards

DIAGNOSTIC APPROACH TO BEHAVIORAL OR "NON-SUBSTANCE" ADDICTIONS

Until recently, non-substance related behavioral addictions were not categorized in diagnostic manuals of mental disorders. Addictive states are characterized by changed reinforcement contingencies, anhedonia, diminished capacity to experience pleasures due to reduced sensitivity to endogenous brain dopamine, and increased sensitivity to internal and external triggering factors. An underlying biological mechanism for urge-driven disorders may involve the pre-frontal cortex, nucleus accumbens, the ventral tegmental area, amygdala and hippocampus, which are considered to play a critical role in the characteristic behavioral impairments of addictive disorders. Recent literature implicates serotonergic, dopaminergic, noradrenergic, and opioidergic neurotransmitter systems in the pathophysiology of behavioral addictions. A reduction in the sensitivity of the brain reward system and hyperactivity towards addiction-associated stimuli was demonstrated in addiction disorders. Due to the lack of a diagnostic guide, different psychometric instruments were used to assess behavioral addictions, including pathological gambling, compulsive buying, internet addiction, video/computer game addiction, sexual addiction, and excessive tanning. Psychosocial interventions encourage the abstinence by lifestyle changes, and reinforce healthy behaviors via motivational enhancement and cognitive behavioral therapies. Pharmacologically, there are no medications currently approved for the treatment of behavioral addictions, but naltrexone, topiramate, and N-acerylcysteine have some promising effects

A hospital-based study: Risk factors in development of motor complications in 555 Parkinson's patients on levodopa therapy

Objectives: Although levodopa (LD) is the gold standard therapy for symptomatic treatment of Parkinson's disease (PD), the chronic use of LD leads to the development of motor complications in almost all patients

Relationship Between Sleep-related Violence and NREM Parasomnia: A Case Report

Parasomnia constitutes an important group among the situations that can lead to sleep-related violence scene. Parasomnia attacks are characterized by complex motor behaviors of various degrees, violent behaviors may result in life-threatening and rarely lethal conditions for patients and their relatives. Here is presented a patient with right temporoparietal bone fracture, pneumocephalus and hemotympanum in right ear due to head trauma during a parasomnia attack. The diagnosis could be made by a detailed history taking and polysomnography only after many other investigations. In this context, we aimed to emphasize that not only nocturnal epilepsies, especially frontal lobe epilepsies, but also parasomnia attacks should be kept in mind in differential diagnosis of sleep-related violence

The effects of amrinone and glucagon on verapamil-induced cardiovascular toxicity in anaesthetized rats

The goal of this study was to compare the effects of glucagon and amrinone on mean arterial pressure (MAP) and heart rate, when used alone and in combination, in an anaesthetized rat model of verapamil toxicity. Rats were anaesthetized and the carotid artery was cannulated for MAP and heart rate measurements. Jugular and femoral veins were cannulated for drug administration. After verapamil infusion (15 mg/kg/h), control animals were given normal saline solution and the other groups received amrinone (0.1 or 0.2 mg/kg/min), glucagon (0.3 mg/kg bolus followed by 0.1 or 0.2 mg/kg/min infusion), glucagon plus amrinone (0.1 mg/kg/min and 0.1 mg/kg/min respectively) or glucagon plus amrinone (0.2 mg/kg/min and 0.1 mg/kg/min respectively). Glucagon (0.2 mg/kg/min) significantly increased MAP when compared to the control group (P < 0.01). The combination of glucagon and amrinone did not produce a synergistic effect for the recovery of MAP. Furthermore, this combination masked the positive effects of glucagon (0.2 mg/kg/min) on MAP.Glucagon (0.2 mg/kg/min) increased the heart rates compared with those of the control group (P < 0.05). Additionally, amrinone (0.1 mg/kg/min) plus glucagon (0.1 mg/kg/min) increased the heart rates (P < 0.05). Finally, glucagon dose dependently recovered MAP. While amrinone depressed MAP in combination with glucagon, it did not alter the positive chronotropic effect of high dose glucagon

Auditory startle reflex and startle reflex to somatosensory inputs in generalized dystonia

Objective: Startle reflex is a generalized defense reaction after unexpected auditory, visual, or tactile stimuli. Auditory startle reflex (ASR) and startle reflex to somatosensory inputs (SSS) have never been studied in generalized dystonia. Here, we aimed to study the characteristics and changes of ASR and SSS in this group

Prevention of Oral Dichlorvos Toxicity by Different Activated Charcoal Products in Mice

Study objective: To determine whether immediate treatment with oral activated charcoal (AC) products of differing surface areas prevents clinical toxicity of a lethal oral dose of dichlorvos in mice. Design: An in vivo, prospective, randomized, placebo-controlled study using 75 male albino mice. Interventions: Fasting mice were administered 57.5 mg/kg of a 0.55% dichlorvos solution via feeding tube. One minute later, groups of 15 mice each received 1 or 2 g/kg of Actidose-Aqua® AC or 1 or 2 g/kg of Sigma® AC or sterile water by feeding tube. In this way, all mice received 15 mL/kg of an AC suspension or sterile water. The animals were observed for 24 hours for seizures or death. Results: In all treatment groups, mice were found to have significantly fewer seizures and deaths (P.2). Conclusion: In this in vivo mouse model, all AC products tested decreased the incidence of seizures and death. Further studies should be done to investigate the clinical effects of AC products with different surface areas. [Tuncok Y, Gelal A, Apaydin S, Guven H, Fowler J, Gure A: Prevention of oral dichlorvos toxicity by different activated charcoal products in mice. Ann Emerg Med March 1995;25:353-355.]. © 1995 Mosby, Inc. All rights reserved