Evaluation of two different respiratory physiotherapy methods after thoracoscopy with regard to arterial blood gas, respiratory function test, number of days until discharge, cost analysis, comfort and pain control.

INTRODUCTION: Although the methods used in thoracic surgery have been developing rapidly over the last five decades, postoperative pulmonary complications are seen in this field more than in other surgical branches. We aimed at comparing the acute effects of incentive spirometry (IS) and breathing retraining exercises by a respiratory physiotherapist or experienced physiotherapist. METHODS: Patients were randomized into two groups as spirometry and physiotherapist. Combined respiratory exercises were implemented through IS inspirometry group and by a physiotherapist in physiotherapist group. Blood gas, respiratory function tests, survey results of the Burford pain thermometer, discharge days, and cost analyses of both groups were examined just before the beginning of physiotherapy and on the 3rd day of therapy. RESULTS: There were no statistical difference in first and last values of pH and PCO2and also there were no difference between groups (P > 0.05). Forced expiratory volume one second (FEV1) values are statistically increased compared to basal levels in both groups and mean difference in FEV1values was statistically increased in physiotherapist group compared to spirometry group (P < 0.001). Forced vital capacity (FVC), PO2and SaO2 values are statistically increased compared to basal levels in both groups but mean difference in FVC values was not statistically different between groups (P > 0.05). Cost analysis was not statistically different, mean hospitalization day and mean pain score were statistically decreased in physiotherapist group. CONCLUSIONS: Based on the outcome of this study, respiratory physiotherapy methods carried out by a respiratory physiotherapist are more effective in acute cardiothoracic conditions after thoracotomy compared to IS by patients.

Prevalence of IgE mediated cow's milk and egg allergy in children under 2 years of age in Sanliurfa, Turkey: the city that isn't almost allergic to cow's milk.

AIM: Food allergy is a common problem in children and adults. The aim of this study was to determine the frequency of cow's milk and egg allergy based on skin prick test and oral food challenge results METHODS: We recruited 614 children aged 1 month-2 years in from different areas of Sanliurfa. An interview was conducted with each parents and family demographic, and prenatal-antenatal-postnatal information was recorded, then skin prick test was applied to the children for egg white, egg yolk and cow's milk. Cases that are required, sIgE levels for cow's milk, egg white and egg yolk were measured and food challenge tests were applied. RESULTS: Cow's milk and egg allergy was determined in 1 case (0.16%) and 8 cases (1.30%) respectively from the results of the tests applied. Six cases (0.97%) were accepted as sensitive to egg white and egg yolk. Within the factors which were questioned, (only the egg allergy evaluation was made without the cow's milk allergy case) of those with parental consanguinity was determined at a statistically significantly high level (OR=5.8, 95% CI: 1.2-27.2, P=0.01). CONCLUSION: The prevalence of cow's milk allergy in Sanliurfa is the lowest reported prevalence rate to date in children under 2 years of age. When infants develop a food allergy, this takes the form of egg allergy. Within the several factors evaluated to explain this situation, a significant relationship was determined only with parental consanguinity. However, as reported above, to date there is no genetic or epidemiological study to explain this situation.

Management of Chenopodium polyspermum toxicity with plasma exchange and hemodialysis.

A 45-year-old male patient was admitted to our emergency department complaining of fatigue, headache, mild confusion, nausea, and vomiting. He had had Type 2 diabetes mellitus for 10 years that was managed with insulin injections. Two days before the onset of symptoms, he had consumed the natural herb Chenopodium polyspermum to regulate his blood glucose levels. Upon examination, he was found to be experiencing tenderness in the upper left abdominal area, icteric sclera, and pallor conjunctivas. Laboratory tests revealed that he was anemic and had increased levels of indirect bilirubin, lactic dehydrogenase, and creatinine in blood. Direct and indirect Coombs tests were negative, and fragmented erythrocytes were observed in peripheral blood smears. The best supportive care was provided, and therapeutic plasma exchange (TPE) treatments were administered. TPE was performed five times and hemolytic findings improved. The patient then developed chronic renal failure and was transferred to the dialysis program and discharged. In this article, we present a case with hemolytic and renal toxicity induced by the ingestion of Chenopodium polyspermum that was managed with TPE and hemodialysis.

Intestinal parasites, nutritional status and physchomotor development delay in migratory farm worker's children.

OBJECTIVE: The aim of this study was to investigate the prevalence of intestinal parasites, nutritional status and physchomotor developmental delay and anaemia in children of migratory seasonal farm worker families. MATERIAL AND METHODS: In this cross-sectional study, 168 children aged between 6 and 59 months selected through probability sampling method were contacted in the Sanliurfa district of south-eastern Anatolia of Turkey. The data were collected using a structured questionnaire, anthropometry and Ankara Developmental Screening Inventory to measure physchomotor development. In order to evaluate the anaemia, finger-prick blood samples were used and laboratory analyses of faecal samples were conducted. RESULTS: 55.4% of children were infected by intestinal parasites. The most common infections involved the protozoan parasite Giardia intestinalis (37.2%). Of the children 17.8% had general psychomotor development delay. Regarding the nutritional status of the 168 children who participated, 38.1% were stunted, 20.8% were underweight, and 5.4% were wasted. Of these children, 16.6% were anaemic. CONCLUSION: The findings demonstrated that the children of migratory seasonal farm workers were defined as a high-risk group in terms of nutritional status, intestinal parasites and physchomotor development delay. Therefore, the effective delivery of mobile environmental and individual primary healthcare services to the farm workers' children must be ensured both while residing in the agricultural zone and in their permanent addresses.