Güldal İzbırak

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

ObjectiveThis 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).MethodsA cross-sectional study was carried out between October and December 2010 among medical students. Data were collected from a total of seven medical schools.FindingsThe 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.ConclusionsMajority 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.

Rotavirus and adenovirus frequency among patients with acute gastroenteritis and their relationship to clinical parameters: a retrospective study in Turkey

BackgroundDiarrhea is the third leading cause of death related to infectious diseases all over the world. The diseases related to viral gastroenteritis are gradually increasing, particularly in the developed countries. The purpose of our study was to determine the frequency and to investigate the clinical manifestations of acute rotavirus and adenovirus gatroenteritis and to assess the diagnostic value of the related clinical findings.MethodsIn 2007-2008 patients with diarrhea and/or vomiting attended to Yeditepe University Hospital and related clinics, Istanbul, were studied. The rotavirus and/or adenovirus antigen in stool of these patients were investigated. Data regarding clinical findings were collected from the electronic records, retrospectively. Age, gender, symptoms, fever, antibiotic use, vomiting, number of vomiting and diarrhaeae, dehydration, abdominal pain, the other pathological physical examination findings were analyzed by the physicians in the study group. To investigate the rotavirus and adenovirus antigen CerTest Rota-Adeno Blister Test (CerTest, Biotec, Spain), a qualitative immunochromotographic assay was used. Statistical analysis wasperformed with SPSS v. 11,5 statistical software. X2 test was used for bivariate and logistic regression analysis was used for multivariate analysis.ResultsRotavirus positivity was 18,7% (n = 126). Concomitantly, in 596 cases adenovirus antigen test were also performed. Adenovirus positivity was 8,9% (n = 53) and rota-adenovirus co-infection was 4,4% (n = 26). Most of rotavirus positive cases were seen in December, January, February and March (p < 0.001). In clinical parameters, there was a significant difference between rotavirus positive cases and negative cases regarding to vomiting, dehydration and vomiting and diarrhea coexistence (respectively p = 0.010, p < 0.00, p = 0.007).ConclusionRotavirus can be seen in all age groups, but more frequently in childhood. Although there is no clinical gold standard to distinguish the rotavirus cases from the other gastroenteritis agents, the findings of dehydration and vomiting-diarrhea coexistence, considering months of referral may lead clinician to perform rapid antigen tests and affect approach to the treatment. Prospective studies with representative samples are needed to determine the rotavirus and adenovirus incidence and to develop safe and reliable protective policies in our country.

The sensitivity and the specifity of rapid antigen test in streptococcal upper respiratory tract infections.

BACKGROUND It is aimed to detect the sensitivity and specificity of rapid antigen detection of group A beta hemolytic streptococci from throat specimen compared with throat culture. The other goal of the study is to help in giving clinical decisions in upper respiratory tract infections according to the age group, by detection of sensitivity and positive predictive values of the rapid tests and throat cultures. MATERIALS AND METHODS Rapid antigen detection and throat culture results for group A beta hemolytic streptococci from outpatients attending to our university hospital between the first of November 2005 and 31st of December 2008 were evaluated retrospectively. Throat samples were obtained by swabs from the throat and transported in the Stuart medium and Quickvue Strep A [Quidel, San Diego, USA] cassette test was applied and for culture, specimen was inoculated on 5% blood sheep agar and identified according to bacitracin and trimethoprim-sulphametaxazole susceptibility from beta hemolytic colonies. RESULTS During the dates between the first of November 2005 and 31st of December 2008, from 453 patients both rapid antigen detection and throat culture were evaluated. Rapid antigen detection sensitivity and specificity were found to be 64.6% and 96.79%, respectively. The positive predictive value was 80.95% whereas negative predictive value was 92.82%. Kappa index was 0.91. When the results were evaluated according to the age groups, the sensitivity and the positive predictive value of rapid antigen detection in children were 70%, 90.3% and in adults 59.4%, 70.4%. DISCUSSION When bacterial infection is concerned to prevent unnecessary antibiotic use, rapid streptococcal antigen test (RSAT) is a reliable method to begin immediate treatment. To get the maximum sensitivity of RSAT, the specimen collection technique used and education of the health care workers is important. While giving clinical decision, it must be taken into consideration that the sensitivity and the positive predictive value of the RSAT is quite lower in adult age group than in pediatric age group.