Effect of single or multiple injection of platelet-rich plasma in comparison with hyaluronic acid on knee osteoarthritis

Aim: To compare the effect of administration of 2 different doses of platelet rich plasma (PRP) and a single dose of hyaluronic acid (HA) preparation on pain and daily life activities of knee osteoarthritis (KOA) patients. Method: In this nonrandomized comparative study, three groups of patients who received either a single dose of intraarticular (IA) PRP (PRP1 group), three doses of IA PRP (PRP3 group), or single dose IA HA (HA group) were included. Assessments were before treatment, and in the 3rd week and 6th week after treatment (after the final injection). The pain-visual analog scale (VAS), Euro-Qol (EQ)-5D-3L, EQVAS, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used. Results: In the 3rd week, there were statistically significant differences between the PRP1-HA groups in all parameters except EQ5; between PRP3-HA groups in all parameters except EQ5 and WOMAC stiffness; and between PRP3-PRP1 groups in all parameters except EQVAS, WOMAC pain and WOMAC stiffness. In the 6th week, there were statistically significant differences between the PRP1-HA groups in all parameters except WOMAC stiffness; between PRP3-HA groups in all parameters; and between PRP3-PRP1 groups in all parameters except WOMAC pain. Conclusion: Intraarticular PRP injections (single or three doses) were found to be more beneficial in the short term in terms of pain and functional improvement than HA injection and administration of three consecutive doses of PRP may be more effective compared to single-dose PRP administration in KOA patients

Relationship of glycemic control and diabetes duration with fibromyalgia in patients with type 2 diabetes mellitus

Aim: Fibromyalgia (FM) is a syndrome characterized by chronic widespread musculoskeletal pain, presence of specific tender points and other somatic symptoms. The objective of the present study was to identify the association of glycemic control and diabetes duration with FM based on 2016 American College of Rheumatology (ACR) criteria in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 275 consecutive patients with T2DM admitted to a university hospital setting were included in this cross-sectional study. FM was diagnosed based on ACR 2016 criteria in all patients. Age, gender, diabetes duration, and body mass index (BMI) were recorded and metabolic parameters were determined in all participants. Results: HbA1c and fasting blood glucose were not significantly different between patients with FM and without FM. Diabetes duration was independently associated with FM in patients with T2 DM. Conclusions: Development of FM in patients with T2DM was not associated with glycemic control but associated with diabetes duration. Clinicians should be aware of the possibility of concomitant FM in long term diabetes patients complaining of pain, fatigue and cognitive symptoms because of its devastating effect on quality of life

Evaluation of the applications of traditional and complementary medicine in the perspective of family medicine in a tertiary referral center

To evaluate the clinical and demographic characteristics of the patients who apply to Traditional and Complementary Medicine (TCM) center. The medical charts of patients, who were admitted to AIBU Izzet Baysal Physical Therapy and Rehabilitation Training and Research Hospital, TCM centre, from September 2018 to August 2019, were retrospectively reviewed. Only patients over the age of 18 were included in the study. 879 (84.4%) of the patients were female, 163 of them were (15.6%) male. 44 (4.2%) patients in the 18 - 24 age group, 137 (13.1%) patients in the 25 - 34 age group, 223 (21.4%) people in the 35 - 44 age group, 287 (27.5%) patients in the 45 - 54 age group, 205 (19.7%) patients were in the 55-64 age group, and 146 (14.0%) patients were in the age group 65 and over. Mean age of the patients was 48.64 ± 13.86 (19-87). 365 (35.0%) of TCM applications were made in spring, 266 (25.5%) in winter, 223 (21.5%) in summer and 188 (18.0%) in autumn. In this study, the most preferred TCM applications are acupuncture (48.1%), ozone therapy (34.3%) and mug treatment (13%), respectively. Determining by whom, in which age group and in which period of the year are more preferred TCM applications, which have been increasingly used in recent years, may prevent problems that may develop during the service delivery process. [Med-Science 2020; 9(1.000): 216-20

THE EFFECTS OF BALNEOTHERAPY IN ELDERLY PATIENTS WITH CHRONIC LOW BACK PAIN TREATED WITH PHYSICAL THERAPY: A PILOT STUDY

WOS: 000492145900004Objective: The aim of this study was to compare whether balneotherapy has a positive effect on the treatment of elderly individuals receiving physical therapy for chronic low back pain (CLBP). Methods: 244 participants were randomly placed into two groups. The first group was treated with physical therapy (PT), the second group was treated with PT and balneotherapy (BT). Assessments were made using the PainVAS, Quebec Back Pain Disability Scale (Quebec), Health Assessment Questionnaire (HAQ) before treatment (T0) and after treatment (T1). Results: In both groups, there was a statistically significantly decrease in terms of pain-VAS, Quebec and HAQ scores (p<0.001). When pain-VAS scores were compared between the two groups, pain-VAS T0 was significantly higher and pain-VAS T1 was significantly lower in the BT+PT group than the PT group (p=0.001). When the HAQ and Quebec values were compared between the groups, the T0 value was similar in the BT+PT and PT groups (HAQ p=0.068, Quebec p=0.495) while the BT+PT group HAQ and QuebecT1 scoreswere significantly lower than the PT group (p<0.001). The BT+PT group change values were significantly higher than the PT group (p<0.001). Conclusion: These results recommend that combining therapies may be more effective in treating CLBP and balneotherapy may increase the effectiveness of the treatment

Assessment of the health workers knowledge and belief about rheumatic and musculoskeletal diseases and spa treatments: A descriptive study

To investigate identifying the knowledge levels, behavior attitude and belief levels about rheumatic and musculoskeletal diseases (RMDs) and spa treatments (ST) among health workers in communication with patients and determining target groups for health training. Cross-sectional, descriptive study. Bolu Izzet Baysal Physical Medicine and Rehabilitation Education and Research Hospital and Izzet Baysal Education and Research Hospital 01.04.2019-15.04.2019. 600 participants completed 6 descriptive questions with yes-no answers about demographic characteristics and completed a survey determining knowledge levels about RMDs and ST as correct or incorrect. Though there was statistically significant difference in favor of women about RMDs knowledge level, there was no statistically significant difference between 2 groups for ST knowledge levels. When RMDs and ST knowledge levels are compared, doctors and physiotherapists had statistically similar knowledge levels, with statistically significant level of difference compared to the other groups. Among groups reporting similar opinions about the efficacy of ST, there was no statistically significant difference identified between RMDs knowledge levels, with a statistically significant level of difference identified for ST knowledge levels. Apart from doctors and physiotherapists, 307 other health workers did not have RMDs themselves or in their family, while only 167 had RMDs themselves and 126 stated both they and their family had RMDs. There was a statistically significant difference identified for RMDs knowledge levels. We found that even among the health workers who communicate with patients in hospitals, the level of knowledge with RMDs and ST is very variable. Taking this into account, we believe that all personnel should be provided with supportive scientific information and training in order to ensure that the health workers who are intertwined with the health problems of the individuals reach the correct information. [Med-Science 2019; 8(4.000): 901-7

Is circulating survivin altered in acromegaly?

Acromegaly is a chronic disorder which is characterized by growth hormone (GH) excess. In most of cases, GH hypersecretion is derived from somatotroph cell tumors. Survivin is a member of apoptosis protein family, which was recently showed to be expressed in tissue samples of different benign and malignant human tumors. This study is intended to determine circulating levels of survivin in newly diagnosed acromegaly patients with somatotroph adenomas. 19 newly diagnosed acromegaly patients with somatotroph adenomas were inclu-ded in the study. Concurrently, 19 healthy individuals were included as control group. Serum survivin levels, GH, insulin like growth factor-1 (IGF-1) and, some other biochemical parame-ters as fasting glucose, creatinine, alanine aminotransferase, cholesterol, triglyceride, high den-sity lipoprotein cholesterol, low density lipoprotein cholesterol were measured in each subject. Correlation analysis was performed between survivin and GH, IGF-1. Serum survivin levels tended to be higher in acromegaly group, but this was not reach statistical significance (p&gt;0.05). Serum survivin levels were comparable among acromegaly patients and controls. Neither GH nor IGF-1 correlated with serum survivin. Larger scale studies are needed concerning the circulating levels of survivin in patients with acromegaly. [Med-Science 2018; 7(2.000): 265-8