Diabetes mellitus and peripheral organs involvement: Current treatment options

Diabetes mellitus is a chronic and multi-systemic disease with various treatment options and has long-term effect on lifestyle of individuals and society. Not only disesase itself but also damage to peripherical organs as a result of disease in long term is an important cause of morbidity and mortality. In this review study it has been aimed to assess complications caused by peripherical organ involvment and treatment options rather than those caused by diabetes mellitus itself. J Clin Exp Invest 2014; 5 (2): 329-33

Periferik fasiyal paralizi ile komplike olmuş COVID-19

Coronavirus disease-2019 (COVID-19) is a highly contagious disease that first began in Wuhan province of China and rapidly spread all over the world in a short time, affecting millions of people. At the beginning, COVID-19 has been reported as a severe respiratory tract disease. During this period, typical signs and symptoms were those expected from a respiratory virus such as fever, cough and dyspnea, as a result of the rapid spread of the virus, affecting more people and increasing number of studies in the literature, it has been noticed that the symptoms can manifest in many ways. In addition to malaise, fatigue, diffuse muscle-joint pain, neurological symptoms such as dizziness, loss of taste and smell were also reported. Commonly reported neurological symptoms such as loss of taste and smell in COVID-19, suggest that cranial nerves may also be affected. In this context, COVID-19 can cause various neurological symptoms including peripheral facial paralysis. In this report, we aimed to present a young male patient with peripheral facial paralysis who was diagnosed with COVID-19, and to make a contribution to neurological symptoms caused by COVID-19.Koronavirüs hastalığı-2019 [coronavirus disease 2019 (COVID19)], ilk olarak Çin’in Wuhan kentinden başlayan ve kısa sürede tüm dünyaya yayılarak milyonlarca kişiyi etkileyen oldukça bulaşıcı bir hastalıktır. Başlangıçta COVID-19, şiddetli solunum yolu hastalığı olarak rapor ediliyordu. Bu dönemde tipik belirti ve bulgular ateş, öksürük ve nefes darlığı gibi bir solunum virüsünden beklenebilecek bulgular iken; virüsün hızlı bir şekilde yayılarak daha fazla kişiyi etkilemesi ve zamanla yapılan çalışmaların sayısının artması sonucunda bulguların birçok şekilde ortaya çıkabileceği fark edildi. Hâlsizlik, kırgınlık, yaygın kas-eklem ağrıları yanında baş dönmesi, tat ve koku alma problemleri gibi nörolojik semptomlar da bildirilmiştir. COVID-19’da tat ve koku almada kayıp gibi nörolojik semptomların yaygın olarak bildirilmesi, kranyal sinirlerin de etkileniyor olabileceğini düşündürmektedir. Bu bağlamda COVID-19, periferik yüz felci dâhil olmak üzere çeşitli nörolojik semptomlara neden olabilir. Bu olguda, COVID-19 tanısı konmuş periferik fasiyal paralizili genç bir erkek hastayı sunarak, COVID-19’un sebep olduğu nörolojik belirtilere katkıda bulunmayı amaçladık

Comparison of High-Intensity Laser Therapy and Ultrasound Treatment in the Patients with Lumbar Discopathy

The aim of the present study was to evaluate the efficiency of high intensity laser and ultrasound therapy in patients who were diagnosed with lumbar disc herniation and who were capable of performing physical exercises. 65 patients diagnosed with lumbar disc were included in the study. The patients were randomly divided into three groups: Group 1 received 10 sessions of high intensity laser to the lumbar region, Group 2 received 10 sessions of ultrasound, and Group 3 received medical therapy for 10 days and isometric lumbar exercises. The efficacy of the treatment modalities was compared with the assessment of the patients before the therapy at the end of the therapy, and in third month after the therapy. Comparing the changes between groups, statically significant difference was observed in MH (mental health) parameter before treatment between Groups 1 and 2 and in MH parameter and VAS score in third month of the therapy between Groups 2 and 3. However, the evaluation of the patients after ten days of treatment did not show significant differences between the groups compared to baseline values. We found that HILT, ultrasound, and exercise were efficient therapies for lumbar discopathy but HILT and ultrasound had longer effect on some parameters

Clonus: definition, mechanism, treatment

Clonus is involuntary and rhythmic muscle contractions caused by a permanent lesion in descending motor neurons. Clonus may be found at the ankle, patella, triceps surae, wrist, jaw, biceps brachii. In general, clonus may occur in any muscle with a frequency of 5-8 Hz and the average period of oscillations of the ankle clonus is approximately 160–200 ms. Plantar flexion (PF) comprises 45% of the period, dorsifleksion (DF) comprises 55% of the period. The first beat is always longer, with the time shortening in continuing beats and becoming stable in the 4th or 5th period. The exact mechanism of clonus remains unclear. Two different hypotheses have been asserted regarding the development of clonus. The most widely accepted explanation is that hyperactive stretch reflexes in clonus are caused by self-excitation. Another alternative explanation for clonus is central generator activity that arises as a consequence of appropriate peripheral events and produces rhythmic stimulation of the lower motor neurons. The durations of clonus burst were found longer than the durations of Soleus medium-latency reflex (MLR). There is a similarity in their nature, although the speed and cause of the stretch of triceps surae differ in the MLR and the clonus, and there is a sufficient period of time for group II afferents and for other spinal mechanisms to be involved in the clonus, together with Ia afferents. Clonus can be treated by using baclofen, applying cold, botox or phenol injections

The outcome of conservative treatment of adult distal radius fractures compared with the other wrist: radiological and functional evaluation

Amaç: Erişkin hastalarda kapalı redüksiyon ve uzun kol alçı ile tedavi edilen distal radius uç kırıklarının radyolojik ve fonksiyonel sonuçları karşı taraf el bileği ile karşılaştırılarak değerlendirildi.Yöntemler: Ocak 2010-Aralık 2010 tarihleri arasında 77 hastaya distal radius uç kırığı için konservatif tedavi uygulandı. Kırıklar prospektif olarak incelendi ve AO ile Frykman sınıflama sistemi kullanıldı. Radyolojik ve anatomik sonuçlar Stewart skorlama kriteri ile değerlendirildi. Fonksiyonel sonuçlar kol, omuz ve el sakatlık sorgulaması (Q-DASH) ve Stewart II skorlama kriterleri değerlendirildi. Hastaların ortalama takip süresi 12 aydı.Bulgular: 40 hastanın sağ el bileğinde, 37 hastanın sol el bileğinde kırık mevcuttu. Frykman sınıflamasına göre 46 olgu tip I-II kırık, AO sınıflamasına göre 59 olguda 23,A2,1 ve 23,A2,2 kırık tespit edildi. Stewart radyolojik ve anatomik skorlama kriterine göre 77 hastanın toplam 57'sinde mükemmel, 17'sinde iyi, 3'ünde orta sonuç elde edildi. Stewart II'ye göre fonksiyonel skorlama kriterler sonuçları değerlendirildiğinde, 57 hastada mükemmel, 8 hastada iyi, 12 hastada orta sonuç alındı. Q-DASH skoru ortalama puanı 6,37 olarak bulundu. Komplikasyon oranlarımız %12,98 idi. İki hastada median sinirde hafif derecede tuzaklanma, dört hastada ulna stiloidinde kaynamama, bir hastada distal radioulnar eklemde hassasiyet, üç hastada distal radioulnar eklemde hassasiyet ve median sinirde hafif derecede tuzaklanma idi.Sonuç: Distal radius kırıkları tedavisinde kapalı redüksiyon ve alçılı tespit halen etkin ve son derece ucuz bir tedavi yöntemi olarak görülmektedirObjective: This study was designed to evaluate anatomical and functional results of closed reduction-long arm cast treatment for distal radius fractures and compared other healthy wrist in the adults. Methods: 77 patients with distal radius fracture were treated conservatively between January 2010 and December 2010. The fractures were classified according to AO and Frykman classification system and investigated prospectively. The radiological and anatomical results were assessed by the Stewart score criteria. The functional results were assessed by Quick-Disability of Arm, Shoulder and Hand questionnaire (Q-DASH) and the Stewart II score criteria. The mean follow-up of patients was 12 months.Results: The forty patients had right wrist fractured, 37 patients had left wrist fractured. According to Frykman classification 46 patients were type I-II fractured, according to AO classification 59 patients were type 23,A2,1 and 23,A2,2 fractured. According to Stewart the radiological and anatomical, the result were excellent in 57, good in 17, fair in 3. According to Stewart II functional criteria, the results were assessed excellent in 57, good in 8, fair in 12 The mean Q-DASH score was 6,37. The overall complication rate was 12.98%. Mild Carpal tunnel syndrome was observed in the two patients, ulna styloid nonunion in the four patients, pain of distal radioulnar joint in the one patient, mild carpal tunnel syndrome and tenderness of distal radioulnar joint in the three patients.Conclusion: Closed reduction and cast immobilization is still an effective and inexpensive treatment method in distal radial fractures. J Clin Exp Invest 2014; 5 (3): 403-40