Are treatment guides and rational drug use policies adequately exploited in combating respiratory system diseases?

SummaryThe aim of the present study was to increase awareness regarding the rational use of medicines. The data were obtained via the Material Resources Management System Module of the Ministry of Health. For the appropriateness of treatments, the Global Initiative for Asthma, the Global Initiative for Chronic Obstructive Lung Disease, and the guidelines for the rational use of medicines were used. We also investigated whether any de-escalation method or physical exercise was performed. Statistical analyses were performed using descriptive statistics to determine the mean, standard deviation, and frequency. The results showed that healthcare providers ignored potential drug reactions or adverse interactions, and reflecting the lack of adherence to the current treatment guides, 35.8% irrational use of medicines was recorded. Thus, de-escalation methods should be used to decrease costs or narrow the antibiotic spectrum, antibiotic selection should consider the resistance patterns, culturing methods should be analyzed, and monotherapy should be preferred over combination treatments

COMPARISON OF THE SUPERIORITY OF ISOMETRIC AND ISOTONIC STRENGTHENING EXERCISES FOR QUADR?CEPS WITH RESPECT TO PAIN, QUALITY OF LIFE, AND FUNCTIONAL CAPACITY OF PATIENTS WITH CHONDROMALACIA PATELLAE

Purpose: This study aims to investigate the superiority of different exercise modalities, including isotonic and isometric strengthening for quadriceps, over each other and their effect on pain, quality of life and functional capacity in patients diagnosed with chondromalacia patellae (CMP). Material and Methods: This study was designed as a prospective study in 30 patients (15 patients in isometric, 15 patients in isotonic group) and 15 healthy volunteers aged 20-50 years who were diagnosed with CMP based on physical examination and magnetic resonance imaging and had pain complaints. Pain level was evaluated with Visual Analogue Scala (VAS), functional capacity with Lysholm scale, and quality of life with Short Form-36(SF-36). Q-angle, and thigh circumference were evaluated before and after exercise in all patients. Results: In patients with CMP, there were significant differences in Q-angle, pain, functional capacity, and some subcomponents of the SF-36 quality of life after performing isometric or isotonic exercises compared with the control group (p0,05). In the evaluation of the isotonic and isometric exercise groups, there were no significant difference in the assessment of Q-angle, thigh circumference, pain, functional capacity, and quality of life of patients with CMP (p>0,05). Conclusion: Isometric and isotonic quadriceps strengthening exercises are not superior to each other in terms of pain, functional capacity, and quality of life in CMP treatment

Horners Syndrome-Torticollis Relation; a Case Report [Horner Sendromu Tortikollis Iliskisi; bir Olgu Sunumu]

Horner Syndrome is a rare condition characterized with ptosis, miosis, unilateral anhidrosis and rarely enophtalmos resulting from the sympathetic innervation loss by interruption of oculosymathetic pathway. Congenital muscular torticollis is a musculoskeletal system malformation resulting from fibrosis, therefore shortening of sternocleidomastoid muscle. In this report, Horners syndrome secondary to congenital muscular torticollis and diagnosis in rehabilitation period are discussed. Three-month-old baby girl was referred to our unit by pediatrics clinic with congenital muscular torticollis diagnosis. Her history comprised of cesarean delivery following a 34-week pregnancy as twin, and no intensive care need; her parents realized asymmetry in neck when she was a-month-and-a-half old and they admitted to pediatrics. Craniofacial asymmetry, cervical left lateral flexion, restricted left rotation and olive sign were detected in physical examination. During rehabilitation, anhidrosis in the right side of face, soft left miosis and ptosis were also observed, and patient was diagnosed with Horners syndrome. Other possible reasons were ruled out with differential diagnosis and etiology was linked to torticollis. Consequently, while evaluating patients with torticollis, it must be considered that Horners syndrome, rarely accompanies, and since clinical findings may be soft, diagnosis may easily be missed out. [Med-Science 2016; 5(3.000): 829-37

Vitamin D Related Musculoskeletal System Findings

Objective: The effect of vitamin D on bone metabolism has been well known for a long time. Recently, various hormonal and immunity related effects has have been obtained. Additionally, the deficiency of vitamin D is thought to be related with various pain syndromes. In this study, we aimed to investigate the main musculoskeletal symptoms of patients with vitamin D deficiency admitting to physical medicine and rehabilitation clinics. Materials and Methods: The data were retrospectively investigated in patients with myalgia, arthralgia, regional pain, widespread body pain (WBP) and in whom vitamin D levels were measured. Patients over 50 years old and with known osteoporosis/osteomalacia diagnosis, endocrinological pathology, and inflammatory rheumatological disease were excluded. Results: The data of 571 patients were investigated and totally 214 of them were included in the study. There were 178 females (83.2%), 36 males (16.8%). The mean age of the patients was 39.19 +/- 9.58 years. Of the patients, 100 (46.7%) were in severe deficiency, 68 (31.8%) were in deficiency, 46 (21.5%) were in insufficient group. The symptoms were regional pain in 65 (30.3%), WBP in 63 (29.4%), arthralgia in 49 (23%), and myalgia in 37 (17.3%) patients. Conclusion: Vitamin D deficiency may be encountered as musculoskeletal problems. In the presence of persistent joint-muscle pain, regional pain and fibromiyalgia, vitamin D deficiency should be kept in mind