Comparison of the efficacy of a neutral wrist splint and wrist splint with lumbrical unit for the treatment of patients with carpal tunnel syndrome

Purpose: The purpose of this study was to compare the effect of a neutral wrist splint or a wrist splint with an additional metacarpophalangeal (MCP) unit on pain, function, grip and pinch strength in patients with mild-to-moderate carpal tunnel syndrome (CTS). Methods: Twenty four patients received conservative treatment using either the neutral wrist splint or wrist splint with the MCP unit for a period of 6 weeks. Primary outcome measures were pain, function, grip and pinch strength. Data was collected immediately before and after using the two types of splints at baseline (0 weeks) and 6 weeks. Statistical analysis was performed using the paired t-test and independent T-test. Results: Compared to baseline, both the neutral wrist splint and the wrist splint with an MCP unit significantly decreased pain, increased function and pinch and grip strength. Comparisons of the two types of splints for grip (P =0.675) and pinch strength (P =0.650) revealed that there were no significant differences between the two after 6 weeks of wear. However, there were significant differences in pain levels (P =0.022) and the DASH score (P =0.027) between the two types of splints from baseline to 6 weeks. Conclusion: The wrist splint with an MCP unit was more effective than the neutral wrist splint in pain reduction and improvement of function

Prevalence of Concomitant Sacroiliac joint Dysfunction in Patients With Image Proven Herniated Lumbar Discs

Background:Sacroiliac joint (SIJ) dysfunction is a widely known but poorly defined cause of low back pain. To our knowledge, few published studies have been conducted to evaluate systematically the prevalence and significance of concomitant sacroiliac joint dysfunction in patients with herniated lumbar discs. As concomitant SIJ dysfunction in low back pain patients is likely to respond to particular noninvasive interventions such as manipulation,improved understanding of the relationship between these two diagnoses would improve clinical decision making and research.Methods:This study was designated to estimate the prevalence of concomitant sacroiliac joint dysfunction in sub acute low back pain patients with image proven discopathy and evaluate the theory that sacroiliac joint dysfunction can be a source of pain and functional disability in discopathy. A total of 202 patients with sub acute radicular back pain and MRI proven herniated lumbar discs underwent standardized   physiatrist history and physical examination, specified for detection of concomitant sacroiliac joint dysfunction.Results: Sacroiliac joint dysfunction is a concomitant finding in 72.3% of evaluated patients.There was significantly higher SIJ dysfunction prevalence in female patients (p <0.0001). Conclusion: SIJ dysfunction is a significant pathogenic factor with high possibility of occurrence in low back pain. Thus, in the presence of radicular and sacroiliac joint symptoms, SIJ dysfunction, regardless of intervertebral disc pathology, must be considered in clinical decisiomaking

Antimicrobial effects of silver nanoparticles coated leather on diabetic foot ulcer

Background: Lower limb infection is among significant causes of mortality, morbidity, and prolonged treatment in diabetic patients. Lately, silver nanoparticles, found in various medical applications such as silver coated medical devices, have been introduced as an effective antimicrobial agent. Considering the fact that the antibacterial activity of silver nanoparticles has been established, the aim of study was to determines the efficacy of these particles in reducing the number of microorganisms which grow on diabetic foot ulcer and subsequently prevent diabetic foot infections. Methods: In this case-control study aerobic and anaerobic microorganism were taken from diabetic foot infections of patients visiting the outpatient diabetes clinic by micro debridement. Microorganisms were recognized through standard microbiological methods using kits such as tio glycolat, blood Agar, MacConkeys and chocolate Agar. The natural leather and nanoparticle-coated leather were then inserted in culture media. After 24 hours, samples were count by Muller. Results: Two hundred twenty two strains of 24 different types of bacteria were isolated from 95 diabetic foot ulcers, from among which 94 [42.3%] and 128 [57.7%] strains were respectively gram negative and gram positive. The number of bacteria that grew on the nanoparticle-coated leather was significantly lower. Conclusion: Considering the reduced number of aerobic, anaerobic, gram positive and negative bacteria that grew in diabetic foot ulcers when using nanoparticle-coated leather culture, it could be concluded that the use of such silver coats leather in diabetic foot shoes may prevent diabetic foot infections considerably