Objective: To determine diagnostic power of the symptoms and findings of patients with complaints of dizziness/balance disorder and to identify the syndromic diagnostic components for the benign paroxysmal positional vertigo (BPPV). Methods: A retrospective methodological study of 147 adult patients with dizziness/balance disorder visiting the Otorhinolaryngology Clinic between January and December 2014 was conducted. The symptoms, signs and laboratory test results of the patients in BPPV and non-BPPV groups were compared and analyzed through sensitivity, specificity, predictive values, likelihood ratios, post-test odds and probabilities, logistic regression analysis and ROC curve. The criterion indices having high post-test probability values were determined. Results: The most common three diagnoses were psychogenic vertigo (34.0%), peripheral vertigo of unknown origin (22.4%), and BPPV (16.3%). Five complaints and findings were found to have statistically significant diagnostic power: characteristic dizziness complaint, dizziness attacks lasting less than two minutes, dizziness being present for less than one week, supine roll and Dix-Hallpike test positivity. The post-test probability increased to 95.4% in patients with attacks lasting less than two minutes and dizziness lasting less than one week, when the Dix-Hallpike test was positive (triple-index positivity). According to the logistic regression model, positive result of the Dix-Hallpike test increased the probability of BPPV by 65.6 times. Accuracy of the model was 92.5%, with the area under the ROC curve of 0.891. Conclusions: Our study results have provided evidence basis for diagnostic power of the Dix Hallpike test and, to a lesser extent, of the supine roll test.

Objective: The aim of the study was to investigate the antibiotic prescription behaviors of the physicians and their perceptions of antibiotic expectations of the patients presenting to ear-nose-throat specialists, and family physicians with the primary complaint of sore throat and related factors. Methods: A prospective descriptive study was conducted at Adnan Menderes University Hospital, Outpatient Clinics of Otorhinolaryngology, together with family physicians practicing in affiliation with Family Medicine Outpatient Clinics, between February 2014 and February 2015. The study population consisted of 384 patients with the main complaint of sore throat and 26 physicians. Patient and physician questionnaires were applied to the participants. For statistical evaluation, t-test, Chi-square test and multiple logistic regression analysis were used. Results: Ten percent of the patients with sore throat had an expectation of antibiotic. The physicians perceived an expectation for antibiotics in 48.4% of the patients and 53.4% of them prescribed antibiotics to their patients. The patients’ expectations for antibiotics were not effective on physicians’ perceptions of patients’ antibiotic expectations or their antibiotic prescription behavior. The less experienced physicians (10.6 fold), family physicians (7.0 fold) and physicians who perceived expectation of their patients for antibiotics (5.8 fold) prescribed more antibiotics; patients living in urban areas were prescribed more antibiotics (3.2 fold). Conclusion: Antibiotic expectation of the patients with a sore throat is very low. Being a family physician, physician’s perception of patient’s antibiotic expectation, lack of professional experience, and living in urban area are the factors effective on physician’s antibiotic prescribing behavior.

Baş dönmesinin ve denge bozukluğunun tanısı ve tedavisi, yeni gelişen yöntemlere rağmen hâlen standardize edilememiştir. Bu alanda kullanılan tanı testlerinden biri vestibüler uyarılmış miyojenik potansiyeller [vestibular evoked myogenic potentials (VEMP)]dir. VEMP'ler, fizyolojik olmayan bir uya-

SUMMARY: Özgür E, Aksu H, Gürbüz-Özgür B, Başak HS, Eskiizmir G. Attention deficit hyperactivity disorder and other disruptive behavior disorders are risk factors for recurrent epistaxis in children: a prospective case-controlled study. Turk J Pediatr 2016; 58: 291-296.The aim of this study was to investigate the frequency of attention deficit hyperactivity disorder (ADHD) and other disruptive behavior disorders in children with recurrent epistaxis (RE). Children aged between 6-11 years were enrolled according to presence (n=34) and absence (n=103) of RE. Turgay DSM-IV-Based Child and Adolescent Disruptive Behavior Disorders Screening and Rating Scale was applied to parents. Moreover, Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version was performed. Oppositional defiant disorder (ODD) and ADHD were determined in 17.6% and 32.4% of patients, respectively. When psychiatric diagnoses between both groups were compared, statistically significant differences were found in terms of ADHD and ODD (p=0.028 and p=0.003). In children with RE, the frequency of ADHD and ODD are higher than children without RE. A referral to a child psychiatrist should be considered, if a child with RE also has symptoms of increased activity, inattention and/or body-injurious behaviors.