Efficacy of low power laser therapy and exercise on pain and functions in chronic low back pain.

Background and Objectives: The aim of this study was to determine whether low power laser therapy (GalliumArsenide) is useful or not for the therapy of chronic low back pain (LBP). Study Design/Materials and Methods: This study included 75 patients (laser þ exercise-25, laser alone-25, and exercise alone-25) with LBP. Visual analogue scale (VAS), Schober test, flexion and lateral flexion measures, Roland Disability Questionnaire (RDQ) and Modified Oswestry Disability Questionnaire (MODQ) were used in the clinical and functional evaluations pre and post therapeutically. A physician, who was not aware of the therapy undertaken, evaluated the patients. Results: Significant improvements were noted in all groups with respect to all outcome parameters, except lateral flexion (P < 0.05). Conclusions: Low power laser therapy seemed to be an effective method in reducing pain and functional disability in the therapy of chronic LBP

Development of Teacher Autonomy Scale for Turkish Teachers

The purpose of this study was to develop a valid and reliable instrument in order to measure the level of autonomy of Turkish classroom teachers. For this purpose, an 18-item 5-point Likert type scale was developed and tested. Data were collected from 292 classroom teachers (teaching at grades 1 to 4) working in state elementary schools located in five main districts of Ankara, and analyzed through Exploratory Factor Analysis (EFA) in order to investigate the factor structure of the instrument. EFA resulted in three factors named as (1) autonomy in instructional planning and implementation, (2) autonomy in professional development, and (3) autonomy in determining the framework of the curriculum. Also, Cronbach's Alpha coefficients were calculated for all subscales and the whole scale. The Cronbach's Alpha coefficients for the 1st, 2nd, and 3rd factors of the instrument were calculated as .91, .80, and .86 respectively, and the Cronbach's Alpha coefficient for the whole scale was calculated as .89. While the reliability of the 1st factor was considered as 'excellent', the reliability coefficients of the 2nd and 3rd factors, and the whole scale were considered as 'very good'. This study was the first step of an instrument development. Second step will be taken for the verification of the validity and reliability of the scale

Postspinal baş ağrısı sonrası gelişen ve atipik prezentasyon gösteren posterior reversibl ensefalopati sendromu

Headache is common in the postpartum period. Post-dural puncture head- ache (PDPH) is the most common major complication after spinal anaes- thesia. the clinical features and history of spinal anaesthesia are sufficient for diagnosis. However, the differential diagnosis is extensive and the evaluation of persistent symptoms requires a multidisciplinary approach for diagno- sis and treatment. Here, we report an 31 year-old woman with a history of normal pregnancy, presenting with persistent headache that started on postpartum day 2, and was refractory to conservative therapy of PDPH; the patient developed hypertension, seizures, visual disturbances, and altered mental status on postpartum day 7. the clinical outcome and neuroimaging findings of the patient were compatible with an atypical presentation of pos- terior reversible encephalopathy syndrome (PRES) associated with late post- partum preeclampsia. She showed dramatic improvement with antihyper- tensive therapy. PRES is a frequently reversible acute neurologic entity with different aetiologies including preeclampsia/eclampsia. However, a delay in diagnosis and treatment can result in permanent brain damage and death. Therefore, it is important to recognise atypical clinical and radiological pre- sentations of PRES for early diagnosis and treatment.Doğum sonrası dönemde baş ağrısı sık görülür. Postspinal baş ağrısı (PSBA) spinal anestezi sonrası en çok görülen büyük komplikasyondur. Tanı için klinik tablo ve spinal anestezi öyküsü yeterlidir. Fakat ayırıcı tanı listesi çok geniştir ve devam eden semptomlar varlığında tanı ve tedavi için çok yönlü yaklaşım gerekmektedir. Burada, sorunsuz bir gebeliği takiben postpartum 2. günde başlayan ve PSBA tedavisine yanıt vermeyen inatçı baş ağrısı ve 1. haftada hipertansiyon, görme bozukluğu, konvülziyon ve şuur durumunda bozukluk gelişen 31 yaşında kadın hastayı sunuyoruz. Olgunun klinik gidişi ve nöroradyolojik bulgular ile geç başlangıçlı preek- lampsiye bağlı, atipik prezentasyon gösteren posterior reversibl ensefalopa- ti sendromu (PRES) tanısı konmuştur. Hasta antihipertansif tedavi ile dra- matik iyileşme göstermiştir. PRES preeklampsi/eklampsiyi de içeren farklı etiyolojik etkenlere bağlı ortaya çıkan, çoğu zaman geri dönüşü olan akut bir nörolojik tablodur. Ancak tanı ve tedavide gecikme, kalıcı beyin hasa- rı ve ölüme neden olabilir. Bu nedenle PRES erken evre tanı ve tedavisi açısından atipik klinik ve radyolojik prezentasyonun bilinmesi önemlidir

The prevalence of microalbuminuria and relevant cardiovascular risk factors in Turkish hypertensive patients.

Objectives: A growing body of data illustrates the importance of microalbuminuria (MAU) as a strong predictor of cardiovascular risk in the hypertensive population. The present study was designed to define the prevalence of MAU and associated cardiovascular risk factors among Turkish hypertensive outpatients. Study design: Representing the Turkish arm of the multinational i-SEARCH study involving 1,750 sites in 26 countries around the world, a total of 1,926 hypertensive patients from different centers were included in this observational and cross-sectional survey study. Patients with reasons for a false-positive MAU test were excluded. The prevalence of MAU was assessed using a dipstick test, and patients were inquired about comorbidities, comedication, and known cardiovascular risk factors. Results: The overall prevalence of MAU was 64.7% and there was no difference between genders. Most of the patients (82.5%) had uncontrolled hypertension, 35.6% had dyslipidemia, and 35.5% had diabetes, predominantly type 2. Almost one-third of the patients (26.4%) had at least one cardiovascular-related comorbidity, with 20.3% having documented coronary artery disease (CAD). Almost all patients (96.8%) had one or more risk factors for cardiovascular disease in addition to hypertension, including family history of myocardial infarction or CAD, diabetes, dyslipidemia, lack of physical exercise, and smoking. A trend towards higher MAU values in the presence of CAD was determined. Conclusion: Microalbuminuria tests should be routinely used as a screening and monitoring tool for the assessment of subsequent cardiovascular morbidity and mortality among hypertensive patients. © 2011 Turkish Society of Cardiology