Iodopovidone is an effective, inexpensive, safe, and easily available alternative in chemical pleurodesis in MPE. The success rates of pleurodesis were found to be similar regardless of the type of the tube inserted.

AIMS: We aimed to investigate the effectiveness of a telerehabilitation exercise program performed without requiring any special equipment on the physical condition of COVID-19 subjects. SETTINGS AND DESIGN: This was a randomized controlled study. METHODS: This study included subjects with a history of hospitalization with a diagnosis of COVID-19 and discharged within 4 weeks. The subjects were divided into two groups randomly, namely telerehabilitation group (TeleGr, n = 17) or control group (CGr, n = 17). The TeleGr received breathing and range of motion exercises, active cycle of breathing technique, and an aerobic training 3 days a week for 6 weeks, while CGr received an exercise brochure with the same content. Subjects were evaluated using the modified Medical Research Council (mMRC) dyspnea score for dyspnea, 30 s sit-to-stand test (30STS) and short physical performance battery (SPPB) to determine their physical status, Saint George Respiratory Questionnaire (SGRQ) to assess quality of their life, and Beck Depression Inventory. All evaluations were carried out at home using videoconferencing. RESULTS: A significant improvement was observed in TelerGr in terms of mMRC (P= 0.035), 30STS (P= 0.005), 5 sit-to-stand time which is one of the subtests of SPPB ( P = 0.039) and SGRQ scores. Significant improvement was observed only in the pain score in the CGr ( P = 0.039). There was a statistically significant difference between the groups in SGRQ activity ( P = 0.035) and total ( P = 0.042) scores. In addition, more symptomatic improvement was found in TeleGr. CONCLUSION: Telerehabilitation exercise program with less technical equipment is a good alternative treatment method for COVID-19 subjects, which improves the quality of life and symptomatic status of subjects. Clinical Trial Registration Number: nct04402983

The aim of this study was to determine the clinical features, and outcome of the patients with miliary tuberculosis (TB).We retrospectively evaluated 263 patients (142 male, 121 female, mean age: 44 years, range: 16–89 years) with miliary TB. Criteria for the diagnosis of miliary TB were at least one of the followings in the presence of clinical presentation suggestive of miliary TB such as prolonged fever, night sweats, anorexia, weight loss: radiologic criterion and pathological criterion and/or microbiological criterion; pathological criterion and/or microbiological criterion.The miliary pattern was seen in 88% of the patients. Predisposing factors were found in 41% of the patients. Most frequent clinical features and laboratory findings were fever (100%), fatigue (91%), anorexia (85%), weight loss (66%), hepatomegaly (20%), splenomegaly (19%), choroid tubercules (8%), anemia (86%), pancytopenia (12%), and accelerated erythrocyte sedimentation rate (89%). Tuberculin skin test was positive in 29% of cases. Fifty percent of the patients met the criteria for fever of unknown origin. Acid-fast bacilli were demonstrated in 41% of patients (81/195), and cultures for Mycobacterium tuberculosis were positive in 51% (148/292) of tested specimens (predominantly sputum, CSF, and bronchial lavage). Blood cultures were positive in 20% (19/97). Granulomas in tissue samples of liver, lung, and bone marrow were present in 100% (21/21), 95% (18/19), and 82% (23/28), respectively. A total of 223 patients (85%) were given a quadruple anti-TB treatment. Forty-four (17%) patients died within 1 year after diagnosis established. Age, serum albumin, presence of military pattern, presence of mental changes, and hemoglobin concentration were found as independent predictors of mortality. Fever resolved within first 21 days in the majority (90%) of the cases.Miliary infiltrates on chest X-ray should raise the possibility of miliary TB especially in countries where TB is endemic. Although biopsy of the lungs and liver may have higher yield rate of organ involvement histopathologicaly, less invasive procedures including a bone marrow biopsy and blood cultures should be preferred owing to low complication rates.

No abstract

Background/aim New treatment regimens for COVID-19, which has threatened the world recently, continue to be investigated. Although some of the treatments are promising, it is thought to be early to state that there is definitive treatment. Experiences and treatment protocol studies from treatment centers are still important. The aim of this study is to evaluate factors affecting the treatment process of the first cases followed in our clinic. Materials and methods The consecutive hospitalized patients with COVID-19 pneumonia were analyzed in this retrospective and cross-sectional study. Data were recorded from the electronic and written files of patients. Results Eighty-three patients were evaluated. The median age was 50 ± 15 years. Forty-eight (57.8%) patients had one or more comorbidities. The most common comorbidity was hypertension. The most common symptom was cough in 58 patients (70%). The overall mortality was 15%, and 85% of the patients were discharged. The time between the onset of symptoms and hospitalization was statistically significantly longer in deceased patients (P = 0.039). Age, D-Dimer, troponin, CK, CK-MB, ferritin, procalcitonin, and neutrophil to lymphocyte ratio were statistically significantly higher in deceased patients than survivor patients. In subgroup analysis, in the patients receiving azithromycin plus hydroxychloroquine and other antibiotics plus hydroxychloroquine, the duration of hospitalization was shorter in the azithromycin group (P = 0.027). Conclusion Early treatment and early admission to the hospital can be crucial for the better treatment process. Combination therapy with azithromycin may be preferred in the first treatment choice because it can shorten the length of hospital stay.

No abstract

OBJECTIVES:Increased awareness and understanding of chronic obstructive pulmonary disease (COPD) is important for its management, but there are limited data regarding the basic knowledge among patients with COPD. This study aimed to evaluate the basic information and knowledge of patients who were specifically provided with a medical exemption certificate for COPD. MATERIAL AND METHODS:This cross-sectional, observational, single-center study was conducted at an outpatient clinic of our hospital and included 201 consecutive ambulatory patients who visited the outpatient clinic between January 01, 2015 and June 30, 2015. Data regarding sex, age, educational level, symptoms, smoking history, years since diagnosis, years since obtaining the exemption certificate, and COPD GOLD (Global Initiative for Chronic Obstructive Lung Disease-GOLD) stage were obtained. A questionnaire comprising 15 questions was used. RESULTS:The question regarding the organ primarily affected by COPD was correctly answered as "lung" by 145 (72%) of patients. In addition, 152 (76%) patients declared that they knew the localization of the affected organ; only 44 (22%) patients correctly located the organ on an image. Only seven (3.5% of the total) patients could correctly write "chronic obstructive pulmonary disease." CONCLUSION:The lack of awareness among patients with COPD emphasizes the lack in the field of patient education. Simple questionnaires can be used to determine and also to improve the awareness and basic knowledge among patients with chronic diseases. KEYWORDS:Chronic Obstructive Pulmonary Disease, awareness of disease, patient education INTRODUCTIONChronic respiratory diseases are a major cause of morbidity and mortality. According to the World Health Organization (WHO) fact sheet that was updated in January 2017, chronic obstructive pulmonary disease (COPD) claimed 3.2 million lives in 2015 and is projected to rank third in 2030, with 8.6% in burden of disease caused worldwidewhich is a modelling technique that combines multiple data sources to count and compare the total fatal and nonfatal health loss from diseases and injuries in a population [1]. In 2013, a survey regarding chronic diseases and risk factors conducted in Turkey reported that COPD prevalence based on self-reporting of a doctor's diagnosis or spirometry was 5.0% (4.9% in males and 5.1% in females). In addition, 46.1% of patients with COPD regularly used medication [2]. Many attempts are being made to mitigate the negative effects of COPD on the general health worldwide. Increasing the awareness level regarding the disease is one of the key components of these attempts. WHO established the Global Alliance Against Respiratory Disorders (GARD) project with the aim to reduce the global burden of chronic respiratory diseases. [3]. As a participant of GARD project, Turkey conducted studies to evaluate the knowledge and awareness regarding asthma and COPD in the general population [4]. Increased awareness and understanding of COPD is an important part of disease manage...

No abstract