BackgroundWithin the context of the support program for smoking cessation, initiated by the Turkish Ministry of Health in 2011, those who present at ‘smoking cessation’ centres and are found to be suitable for pharmacological treatment are given varenicline and bupropion free of charge. As the smoking cessation programme is centralized, the selection of the medication is made randomly to provide a fixed distribution rate. The aim of this study was to evaluate the efficacy of both varenicline and bupropion in smoking cessation and to evaluate the effect of the smoking cessation programme.MethodsA total of 405 individuals who met the study criteria were included in the study. Smoking habits and degree of dependence were determined in all the participants with the Fagerstrom test for nicotine dependence (FTND) and bupropion or varenicline therapy was initiated in those who were eligible. Patients were followed up at 15 days then at 1, 2, 3, 6 and 12 months after smoking cessation. A level of CO < 5 ppm and ‘point prevalence abstinence’ were used as the criteria of success for smoking cessation and this evaluation showed the non-smoking status in the previous 7 days.ResultsThe mean age of the participants was 35.19 ± 7.73 years and 82.8% (n = 334) were male. Of the participants, 60.2% (n = 244) were given varenicline and 39.8% (n = 161) bupropion. The mean FTND and package/year was not significantly different between the groups. The rates of success in the 1st and 2nd weeks, and 1st, 3rd and 6th months were significantly higher in the varenicline group than in the bupropion group (p < 0.05). At the end of one year, the rate of smoking cessation was determined as 13.9% (n = 34) in the varenicline group and 6.2% (n = 10) in the bupropion gruop. The difference was statistically significant (p = 0.015). At the end of 1 year when the previous 7 days smoking status was evaluated with the ‘point prevalence abstinence’ measurement as the success criteria, success rates were 20.5% with varenicline and 18.6% with bupropion and the difference was not significant (p = 0.646). The individuals who used the medications for 45 days or longer were more successful in smoking cessation (p < 0.001). The most common reasons given for discontinuing the medication were the side-effects (31.5%). No significant difference was determined between the groups in respect of the side-effects observed.ConclusionsAlthough the rates of smoking cessation in all the other control points were higher with varenicline than with bupropion, no significant difference was found between the success rates of varenicline and bupropion used in smoking cessation based on the last 7 days at the end of one year. Those who used the medications for 45 days or longer were more successful in smoking cessation.
This case report demonstrates the beneficial effects of cupping therapy (CT) in a 35-year-old man who is diagnosed with a fracture of the radial shaft due to a motorcycle accident. One year after the treatment started, pseudoarthrosis developed in the radius and an autogenous iliac bone graft was performed. However, extension dysfunction in the wrist became evident. After another 6 months of physical therapy and rehabilitation, no improvements were observed. Therefore, CT and adjunctive electrostimulation were performed, after 30 days of treatment, marked recovery of muscle function and full wrist extension were observed, as determined by electromyography and a grade 5/5 on the Medical Research Council power of wrist extension scale. The results in this case study suggest that CT in conjunction with adjunctive electrostimulation, may accelerate functional recovery from postoperative radial palsy, and provide a useful alternative treatment in this situation.
ÖZ Amaç:Gebelikte rektovajinal Grup B streptokoklar (GBS) morbidite ve mortaliteye neden olan etkenlerden biridir. Genellikle asemptomatik seyreder ancak idrar yolu enfeksiyonlarından sepsise kadar geniş enfeksiyonlara neden olabilir. Bu çalışmada da son trimester gebelerinin GBS sıklığı ve ilişkili durumlar araştırılmıştır.Materyal ve Metod: Tıp Fakültesi Hastanesi Kadın Hastalıkları ve Doğum Anabilim Dalı Polikliniği'ne başvuran ve gestasyonel haftası 30 hafta ve üzeri olan gebelerden vajinal ve anorektal sürüntü örnekleri alınarak kültür antibiyogramları bakıldı. Verilerin analizinde tanımlayıcı istatistikler, ki-kare, t-student ve Mann Whitney U testleri kullanıldı. p<0,05 istatistiksel olarak önemli kabul edildi.Bulgular: Çalışmaya alınan 214 gebenin 17'sinde (%7.9) grup B streptokok üremesi oldu. Gebelerde GBS kolonizasyon sıklığı ile yaş grupları, eğitim durumları, ikamet yerleri, sosyo-ekonomik düzey, gestasyonel öykü, hipertansiyon ve diyabet öyküsü, sigara ve RİA kullanımı karşılaştırıldığında anlamlı bir fark bulunamadı. İncelenen gebelerde menstrüel siklusları düzensiz olanlarda, gebelik öncesi herhangi bir doğum kontrol yöntemini kullananlarda ve ilk gebelik yaşı yüksek olanlarda, GBS'lerin rekto-vajinal üreme sıklığı yüksek bulundu. Alınan kültür örneklerinde grup B streptokok dışında %27.5'inde Stafilokokus epidermidis, %25.7'sinde Enterococcus faecalis, %20.9'unda Candida albicans üredi.Sonuç: İlk gebelik yaşı yüksek olan, menstrüel siklus düzensizliği yaşayan ve doğum kontrol yöntemi kullanan kadınlarda grup B Streptokok üremesinde artış gözlemlenmesi sebebiyle; bu parametreleri esas alan daha geniş kapsamlı çalışmalara ihtiyaç vardır. Yenidoğanda erken başlangıçlı enfeksiyonları önlemek için gebe tarama programları arasında yer alan grup B streptokok taramasının rutin gebe izlem programına dâhil edilmesi gerekmektedir. ABSTRACTAim: Rectovaginal Group B Streptococci (GBS) colonization is one of the reasons of the mortality and morbidity in pregnancy. It generally seems asymptomatic but cause to wide infection from urinary infection to sepsis. GBS frequency was investigated in third trimester of pregnant women in this study. Materials and methods:The study was done in the autpatient clinic of medical faculty gynecology and obstetric department. Vaginal and anorectal swab was taken from pregnant women who are 30 weeks or more gestational age. Descriptive statistics, chi-square, student-t and Mann-Whitney U test was used in the analyzing the data and p<0.05 was considered statistically significant.Results: In the study of 214 pregnant women, 17 (7.9%) of GBS was reproduction. There was no significance the incidence of GBS colonization in pregnant women with educational status, living space, socio-economic status, gestational history, hypertension, diabetes, smoking and use of intrauterin device. We found higher incidence of GBS colonization in pregnants with irregular menstrual cycles, using any method of birth control before pregnancy and higher age of first pregnancy. It produced 27.5% of Staphy...
Traditional herbal medicine is very common in the Anatolian regions and has been used for centuries. In this study, it was aimed to show the course of dermatitis in cases of phyto contact dermatitis caused by buttercups when the patients presented at different times after the application. 3 patients who lived in the same region presented at the family practice clinic because of lesions which emerged after the topical application of plants from the Ranunculaceae family for knee pain. The patients presented on the 1st, 4th and 15th day respectively after application and were all diagnosed with irritant phyto contact dermatitis. In Turkey, particularly amongst the elderly, the use of herbal treatments is greater than has been estimated. Therefore, when family practitioners observe lesions particularly on joint surfaces, the use of plant extracts must be questioned.
Objectives: Acute pharyngo-tonsillitis is one of the diseases that pediatricians and general practitioners most frequently experienced and only a small percentage of patients (20%-30% of pediatric patients, even less in adults) are actually suffering from pharyngo-tonsillitis by group A beta-hemolytic Streptococcus (GABHS). Also three quarters of pharyngitis patients have been treated with inappropriate antibiotics even these patients have viral infections. The aim of this study was to assess the effectiveness of the rapid antigen detection test (RADT) on the percentage of antibiotic prescriptions amongst patients with sore throat at a primary health care center in rural area. Methods: Retrospective Cohort Study was designed to compare antibiotic prescription in patients with sore throats in two groups, one with the use of RADT and other with the clinical desicions of physicians. The x 2 test was used between two nominal variables to assess the impact of RADT on antibiotic prescription. For comparison of more than two independent variables, the ANOVA test was used and to identify the differences between groups, the Post-Hoc test was processed. Results: Of the 580 patients, the avarage age of the study population was 25.8 years old while the median age was 21 years (min.=3, max.=65). There was a significant difference between two groups who had tested with RADT or not in terms of antibiotic prescription (p < 0.001). There was a significant difference between 3-14 years of age and 15-44 years of age (p = 0.001) as well as 3-14 years of age and 45-65 years of age (p = 0.009), however there was no significant difference between 15-44 and 45-65 years of age (p = 1.00). Conclusions: Using the RADT is truly effective in reducing the percentage of antibiotic prescriptions in our setting. We believe that, the tools like RADTs which are quickly results and easy to use are really useful in practising (particularly in rural area).
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