Efficacy of low-level laser versus high-intensity laser therapy in the management of adhesive capsulitis: A randomized clinical trial

Background: Low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) are effective in alleviating pain and improving functionality in patients with adhesive capsulitis (AC); however, no study has compared the efficacy of these two laser treatments. Objective: To compare the effectiveness of LLLT and HILT in improving the shoulder joint range of motion and functional status and in reducing pain level in patients with AC. Trial Design: Prospective, randomized, parallel group, patient- and assessor-blinded. Methods: A total of 45 patients (aged: 18–65 years) with complaint of shoulder pain were evaluated for inclusion criteria, which included being aged 18–65 years and a diagnosis of AC based on physical examinations. Using computer-generated random numbers, eligible patients were randomized into two groups: HILT + stretching exercise and LLLT + stretching exercise groups. Both HILT and LLLT were performed three times/week for 3 weeks. Functional status and pain of the patients were evaluated with Shoulder Pain and Disability Index (SPADI) and Visual Analog Scale (VAS), while shoulder joint range of motion was measured with goniometry. All assessments were done before and 3 weeks after treatment. Results: A total of 40 patients (20 in each group) completed the study. At baseline, there was no statistically significant difference in the demographic and clinical characteristics between both groups. Both the LLLT and HILT groups showed significant improvement in the VAS and SPADI scores 3 weeks after treatment; however, the improvement was significantly higher in the HILT group than the LLLT group. There was no significant improvement in goniometric scores in both groups compared with baseline. No injury or other musculoskeletal complications were recorded during or after the treatments. Conclusion: HILT + stretching exercise treatment was more effective than LLLT + stretching exercise for improving functional parameters and pain in patients with AC. Trial Registration: ClinicalTrials.gov Identifier: NCT05469672. Funding: Non

Spontaneous Osteonecrosis of the Tibial Plateau: A Case Report

Tibia platosunun spontan osteonekrozu: Olgu sunumuOsteonekroz nedeni tam olarak bilinmeyen eklemin yapısını bozan ve ilerleyici fonksiyon kaybına neden olan bir hastalıktır. Osteonekroz kalça ekleminde sık görülmesine karşın, diz ekleminde oldukça seyrek rastlanan patolojik bir durumdur. En sık görülen diz osteonekroz tipi idiyopatik (spontan) tiptir. Altmış yaş üstünde daha sık görülür. Bu olgu sunumunda otuz dokuz yaşında kadın hastada aniden gelişen diz ağrısı sonrasında saptanan spontan osteonekroz olgusu sunulmuştur.Spontaneous osteonecrosis of the tibial plateau: a case report Osteonecrosis is a disease of unknown origin which degenerates the structure of the joint and causes progressive loss of function. While osteonecrosis mostly affects hip joint, it is a pathologic condition which is rarely seen in knee joint.The most frequent type of knee osteonecrosis is idiopathic osteonecrosis (spontaneous). Spontaneous osteonecrosis is more common in patients older than 60 years. In this case report, a 39-year-old female patient diagnosed as having spontaneous osteonecrosis of the knee after a sudden pain was presented

Assessment of the Relationship Between Vitamin D Level and Non-specific Musculoskeletal System Pain: A Multicenter Retrospective Study (Stroke Study Group)

WOS: 000419743500005Objective: In this study, it was aimed to evaluate the relationship between vitamin D level and pain severity, localization and duration in patients with non-specific musculoskeletal pain. Materials and Methods: Patients who applied to physical medicine and rehabilitation outpatient clinics due to non-specific muscle pain in 19 centers in Turkey were retrospectively screened. Three thousand four hundred fourpatients were included in the study, whose pain level was determined by visual analog scale (VAS) and the painful region, duration of pain and vitamin D level were reached. D group was found to be D deficient (group 1) when 25 (OH) D level was 20 ng/mL or less and group D 2 (vitamin D deficiency) was higher than 30 ng/mL (group 3). The groups were compared in terms of pain duration, localization and severity. In addition, the correlations of pain localization, severity and duration with vitamin D levels were examined. Results: D vitamin deficiency was detected in 2202 (70.9%) of 3 thousand four hundred and four registered patients, and it was found that vitamin D deficiency in 516 (16.6%) and normal vitamin D in 386 (12.4%). The groups were similar in terms of age, body mass index, income level, duration of complaint, education level, family type and working status (p>0.05). There was no statistically significant difference between groups in terms of VAS, pain localization and duration scores (p>0.05). Conclusion: Our study shows that vitamin D deficiency in patients with nonspecific musculoskeletal pain is not associated with the severity and duration of pain

Evaluation of salivary alpha-amylase activity after stroke

This study aimed to investigate the levels of sAA (Salivary Alpha-Amylase) in stroke patients. The H0 hypothesis of the study was established as the increase in sAA activity after stroke is not statistically significant when compared with the normal healthy population of the similar age group. Patients and Methods: This research is a case-control study. Forty-two patients who had a stroke during the period of February-November 2018 in the Department of Physical Medicine and Rehabilitation in Turkey and 40 healthy volunteers were included in the study. Saliva samples were collected within the first seven days after stroke. Saliva samples were taken by passive dilution (drool) technique with the standard method at certain hours. The concentration in U/mL of sAA in the samples is then calculated by comparing optical densities (OD) of the samples to the standard curve. Results: In the stroke group, a total of 42 patients and a total of 40 patients as volunteers were evaluated. The mean age was 69.4 ± 6.1 in the stroke group and 69.6 ± 6.4 in the healthy volunteers. The mean functional independence criterion in the stroke group was 64.7 ± 18.4. The sAA levels were found to be 142.18 ± 42.15 U / mL in the stroke group and 103.69 ± 36.52 U / mL in the healthy volunteers. There were statistically significant difference levels of the sAA between the two groups (p: 0.012). Conclusion: The levels of sAA in stroke patients were not clearly investigated in the literature, and the results indicate that patients with stroke have higher sAA activity compared to healthy subjects. The relationships between autonomic dysfunction and high sAA activity in stroke patients are new topics to be investigated. [Med-Science 2019; 8(4.000): 852-6

Evaluation of Sexual Dysfunction in Females With Ankylosing Spondylitis

Objectives: This study aims to evaluate sexual function in females with ankylosing spondylitis (AS), compare them with healthy controls, and demonstrate the effects of AS on female sexual functions.Patients and methods: Fifty-four AS patients (mean age 39.33±8.57 years; range 20 to 55 years) and 56 similar aged healthy controls were included in the study. Depression levels and sexual functions of all participants were evaluated by the Beck Depression Inventory and Female Sexual Function Index (FSFI), respectively. Other assessment methods included the visual analog scale for pain, fatigue, and importance of sexual life; Bath Ankylosing Spondylitis Disease Activity Index for disease activity, Bath Ankylosing Spondylitis Functional Index for functionality, Bath Ankylosing Spondylitis Metrology Index for spinal mobility, and Short Form-36 (SF-36) for quality of life.Results: Total FSFI and all FSFI subscale scores and number of weekly sexual intercourse were significantly lower while Beck Depression Inventory score was significantly higher in females with AS when compared to controls. In AS patients with depression, total FSFI score and FSFI subscales scores of desire and arousal were significantly lower than those without depression. In females with AS, there were negative correlations between total FSFI score and duration of complaint, Beck Depression Inventory score, Bath Ankylosing Spondylitis Metrology Index score, visual analog scale score, age, and duration of marriage while positive correlations existed between total FSFI score and visual analog scale importance of sexual life score and number of weekly sexual intercourse, SF-36 fatigue, SF-36 social function, SF-36 pain, and SF-36 mental component scores.Conclusion: Sexual dysfunction was more common in female AS patients without marked impairment in body image and hip involvement when compared to normal population. Sexual problems which are generally neglected should be handled regardless of disease activity when evaluating patients with AS and establishing a treatment plan

Nurse’s Knowledge of Neuropathic Pain

The aim of our study was to determine the levels of information and awareness of the nurses who work on neuropathic pain in the departments of physical medicine and rehabilitation, neurology and neurosurgery. A total of 60 nurses (20 per each department) who work in the physical medicine and rehabilitation, neurology and neurosurgery departments of Beyhekim State Hospital of Konya in Turkey took part in the study. The level of information and awareness of the nurses on neuropathic pain were assessed via a questionnaire prepared by specialists in the light of recent literature. The questionnaire was composed of 30 questions including the definition, symptoms, treatment and management of neuropathic pain. None of 60 nurses participating in the study were given any previous in-service training on neuropathic pain. According to the assessments, 80% of nurses (48) were found not to have sufficient knowledge about definition of neuropathic pain; 83.3% (50) about diseases causing neuropathic pain; 83.3% (50) about symptoms of neuropathic pain; and 90% (54) about management of neuropathic pain. The findings obtained from the nurses of these three departments showed no statistically significant relation. Our findings indicated that the knowledge of participants’ about neuropathic pain who work in these three departments seriously lack of information. Informing nurses about neuropathic pain during in-service training will be an important step towards improving the quality of services provided

Assessment of Nutritional Status and Bowel Habits in Osteoporosis: A Cross-Sectional, Multicenter Study of Turkish Elderly Female Population

World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO-IOF-ESCEO) -- APR 04-07, 2019 -- Paris, FRANCE[No Abstract Available]Int Osteoporosis Fdn, ESCEO, Mylan, UCB, IBSA, Medimaps, Lilly, Hologic, Strax Corp, Kyowa Kirin, Galgo Med, EffRx, Amgen, Abiogen Pharma, Medi, Fidia Pharma Grp, TRB Chemedica Sa, AgNovos Healthcare GmbH, Expanscience Labs, Wisepress Com, GE, Pierre Fabre, Roche, Echolight, Thuasne, Theramex, Bindex, Gedeon Richter, Sinklar Conf Management B

Polypharmacy in osteoporosis patients

Amaç: Bu çalışmada osteoporoz hastalarında çoklu ilaç kullanım oranını, kemik metabolizması ve denge üzerine etkili ilaçların kullanım oranını belirlemek amaçlanmıştır. Gereç ve Yöntem: Ocak-Mayıs 2014 tarihleri arasında Fiziksel Tıp ve Rehabilitasyon polikliniklerine başvuran hastalar arasından primer veya sekonder osteoporoz tanısı konulan, kadın hastalar yazılı onamları alınarak çalışmaya dahil edildi. Çalışmaya katılmayı kabul eden ilk 1000 hastanın verileri değerlendirildi. Hastaların yaşı, özgeçmiş bilgileri ve o an itibariyle kullanmakta olduğu tüm ilaçların ve mevcut kontrolünde başlanan ilaçların kayıtları tutuldu. Kemik metabolizması üzerine etkili olan ilaçların kullanımı belirlendi. Yan etki proflinde baş dönmesi, uykuya meyil, dikkat dağınıklığı, görme keskinliğinde azalma, ortostatik hipotansiyon ve ototoksisitenin olduğu, denge üzerine potansiyel etkileri olabilecek ilaçların kullanımı belirlendi. Bulgular: Bu çalışmada katılımcıların %64'ünün 5 ve üzeri ilaç kullanmakta olduğu ve en sık kullanılan ilaç gruplarının Analjezikler (%65,4), anti-hipertansifer (%52,6) ve sindirim sistemi (%37,3) ilaçları olduğu belirlendi. Ayrıca katılımcıların %65,5'inin kemik metabolizması üzerine ve %93,7'sinin denge üzerine olumsuz etki potansiyeli olan bir ilaç kullanımı olduğu belirlendi. Sonuç: Osteoporoz tedavisi esnasında hasta çoklu ilaç kullanımı açısından değerlendirilmeli, kullandığı ilaçlar kaydedilmeli, varsa ilaç etkileşimleri belirlenmelidir. Özellikle belirli ilaç gruplarının kemik metabolizması üzerine olumsuz etkileri olduğundan bu grup ilaçlar mümkün olduğunca kısa süreli kullanılıp, kesilmelidir. Ayrıca görme, somatosensöryal sistem ve vestibüler sistem üzerine etkili olan ilaçların kullanımı esnasında hastaya yan etkiler açısından ayrıntılı bilgi verilmeli ve günlük yaşam aktiviteleri düzenlenmelidir. (Türk Osteoporoz Dergisi 2015;21: 5-9)Objective: In this study, it was aimed to determine the rates of multiple drug use in the patients with osteoporosis as well as the use of drugs affecting bone metabolism and balance. Materials and Methods: We included outpatients from Physical Medicine and Rehabilitation Policlinics diagnosed with primary or secondary osteoporosis between January 2014 and May 2014. Written consent of the participants was obtained. Data of the frst 1000 patients who agreed to participate in the study were evaluated. Data regarding age, history, drugs currently being used and newly initiated were recorded. The drugs that affect bone metabolism were determined. The drugs that heva side effects including dizziness, somnolence, distractibility, decrease in the visual acuity, orthostatic hypotension and ototoxicity and were recorded because these can cause a balance disorder. Results: In this study, 64% of the participants were on fve or more drugs. The most commonly used drugs were analgesics (65.4%), anti- hypertensives (52.6%), and drugs for digestive system (37.3%). We found that 65.5% of the participants were using drugs that may have side effects on bone metabolism and 93.7% were using drugs that may have side effects on balance. Conclusion: Multi-drug use and drug interactions should be considered during the treatment of osteoporosis and the drugs used should be recorded. Drugs that affect bone metabolism should only be used over the short term. Also, patients should be informed about side effects that might affect visuality, somatosensorial system and vestibular system and their daily activities should be regulated. (Turkish Journal of Osteoporosis 2015;21: 5-9