A rare complication of tuberculosis: Acute paraplegia

Background: Tuberculous radiculomyelitis(TBRM) is one of the complications of neurological tuberculosis and includes cases of arachnoiditis, intradural spinal tuberculoma or granuloma, and spinal cord complications of tuberculous meningitis (TBM). Here, we report a case of TBRM which presented with acute paraplegia.Case Details: Neurological examination on admission revealed flaccid paralysis, bilateral extensor plantar responses, and exaggerated deep tendon reflexes. Cerebrospinal fluid analysis showed xanthochromic fluid that contained 600 cells/mm3, 98% lymphocytes, protein 318 mg/dl and glucose 51 mg/dl (blood glucose 118 mg/dl). On thorax CT, calcified lymph nodes that were sequelae of primary tuberculosis infection was detected. Antituberculosis and intravenous corticosteroids treatment was started. Seven weeks from the onset, on-control spinal MRI myelomalacia was determined, and there was no leptomeningeal enhancement. After six weeks of rehabilitation, lower limb total motor score was increased from 0/50 to 15/50.Conclusion: Tuberculous radiculomyelitis is a complication of TBM. It is rarely seen.Keywords: Tuberculosis, Paraplegia, Tuberculous radiculomyeliti

LIMPRINT study - the Turkish experience

Background: Lymphedema and chronic oedema is a major healthcare problem in both developed and non-developed countries The LIMPRINT study is an international health service based study to determine the prevalence and functional impact in adult populations of member countries of the International Lymphoedema Framework (ILF). Methods: 1051 patients from 8 centers in Turkey were recruited using the LIMPRINT study protocol. Data were collected using the core and module tools which assess the demographic and clinical properties as well as disability and QoL. Results: Most of the Turkish patients were recruited from specialist lymphedema services and were found to be female, housewives and having secondary lymphedema due to cancer treatment. The duration of lymphedema was commonly less than 5 years and most of them had ISL Grade 2 lymphedema. Cellulitis, infection and wounds were uncommon. The majority of patients did not get any treatment or advice before. Most of the patients had impaired QoL and decreased functionality, but psychological support was neglected. Although most had social health security access to Lymphedema centres nevertheless access seemed difficult due to distance and cost. Conclusion: The study has shown the current status and characteristics of lymphedema patients, treatment conditions, the unmet need for the diagnosis and treatment as well as burden of the disease in both patients and families in Turkey. National health policies are needed for the prevention, diagnosis and treatment in Turkey that utilise this informative data

Efficacy of peloidotherapy in patients with subacromial impingement syndrome

Çalışmamızın temel amacı subakromiyal sıkışma sendromunda evde uygulanan ve hastanede uygulanan peloidoterapinin etkinliği araştırmaktır. Tek taraflı omzunda subakromiyal sıkışma sendromu tanısı almış olan 73 kadın hasta çalışmaya alındı. Hastalar tedavi grubu (n=42) ve kontrol grubu (n=31) olmak üzere iki farklı gruba ayrıldı. Tedavi grubundaki hastalara peloid tedavisi deriye direk temas olacak şekilde peloidoterapi ünitesinde uygulandı. Kontrol grubundaki hastalar ise peloidi evde kendi imkanlarıyla uyguladı. Her iki grup rutin medikal tedavilerine ve ev egzersiz programlarına devam ettiler. Değerlendirilmelerde hastaların omuz fonksiyonlarını değerlendirmek için DASH-T (Kol,omuz ve el yaralanması anketi) skorları, ağrı için VAS(Visuel Ağrı Skalası) ve genel durumları için sağlık değerlendirme anketi HAQ(Sağlık Değerlendirme Anketi) kullanıldı. Çalışma grubunda DASH ve HAQ skorları bakımından tedavi sonrasında tedavi öncesine göre anlamlı farklılık görülmemiştir (p>0.05). Yaptığımız çalışmada çalışma grubundaki peloidoterapi uygulamalarında kontrol grubundaki peloidoterapi uygulamalarına göre ağrı parametrelerinde daha olumlu sonuçlar elde edilmiştir. İleride yapılacak vaka sayısının arttırıldığı çalışmalara ihtiyaç vardır.The main purpose of our study is to investigate the efficacy of peloidotherapy applied at home in subacromial impingement syndrome and applied at the hospital. 73 female patients who were diagnosed with subacromial impingement syndrome were enrolled on one-sided shoulder. The patients were divided into two different groups, the treatment group (n = 42) and the control group (n = 31). Peloid therapy was performed in the Peloid therapy unit to direct contact with the skin in patients with treatment group. The patients in the control group applied the Peloid therapy at home with their own facilities. Both groups continued their routine medical treatment and home exercise programs. In the evaluation, DASH-T (Disabilities of the Arm, Shoulder and Hand) scores were used to assess the patient's shoulder functions..VAS (Visual Analogue Scale) was used for pain and health Assessment Questionnaire HAQ (Health Assessment Questionnaire) was used for general conditions.In the study group, in terms of DASH and HAQ scores, there was no significant difference after treatment (P > 0.05).In the study of Peloidotherapy in the study group, more positive results were obtained in pain parameters according to peloidotherapy applications in the control group. Studies are needed to increase the number of cases in the future