Assessment of rational use of drugs and self-medication in Turkey: A pilot study from Elazig and its suburbs.

The concepts of "essential drugs" and "national drug policy" described by the World Health Assembly in 1975 were the first steps taken towards the rational use of drugs (RUD). According to WHO, more than half of all medicines worldwide are prescribed, dispensed or sold inappropriately and half of the patients fail to take them appropriately. The aim of this study has been to evaluate the habits of patients related to RUD with a specific aim to investigate the factors associated with self-medication. This descriptive survey study was carried out in Elazig, located at the Southeastern region of Turkey. A Rational Usage of Drug Questionnaire", querying the socio-demographic characteristics, health status, knowledge and manners of people with respect to rational drug use and insensible consumption of over the counter (OTC) drugs was applied to a total of 3521 patients during 19.09.2014 to 26.09.2014.The number of females and males were almost equal and the majority were in the range of 25-45 years of age. It was found that 58.9% of patients were practising some form of self-medication, 29.4% of the patients were reported using antibiotics without prescriptionand55.5% of them discontinued antibiotherapy. Self-medication was found to be more common among males, more educated patients and less frequent among patients under 18 years and over 65 years of age and patients with a chronic disease. Patient awareness about RUD is inadequate in Turkey as in many countries. Considering the high rates of haphazard use of drugs, drug usage without prescription, i.e. OTC drugs, should be discouraged. It is possible to take significant steps towards increasing awareness in terms of RUD with the cooperation of physicians, health organizations, educational institutions, non-governmental organizations and media. Might then be possible to achieve the expected benefits of the drugs.

Assessment of cardiac functions using tissue Doppler imaging in children with familial Mediterranean fever.

OBJECTIVE: Familial Mediterranean fever may carry a potential for cardiovascular disorders because of sustained inflammation during its course; however, there has been a limited number of studies investigating the cardiac functions in children. The aim of this study was to assess both ventricular diastolic functions using conventional echocardiography and tissue Doppler imaging in children with familial Mediterranean fever. PATIENTS AND METHODS: The study population included 25 patients with familial Mediterranean fever - mean age was 11.8 plus or minus 5.30 years - and 23 healthy patients as controls - mean age was 9.88 plus or minus 3.69 years. Both ventricular functions were measured using echocardiography comprising standard M-mode and conventional Doppler and tissue Doppler imaging during an attack-free period. RESULTS: The conventional echocardiographic parameters with myocardial performance index were in normal ranges and similar in patients with familial Mediterranean fever and controls, with a p-value more than 0.05. However, right ventricular diastolic dysfunction was observed in patients with familial Mediterranean fever documented by tissue Doppler imaging, with a p-value less than 0.05 for E't and A't wave ratio. CONCLUSION: Using tissue Doppler imaging, we have demonstrated that although left ventricular functions were comparable in the patients and healthy children, right ventricular diastolic function indices were impaired in patients with familial Mediterranean fever during childhood. Impaired right ventricular diastolic function may be an early manifestation of cardiac involvement in children with familial Mediterranean fever.