Pregnancy-related lumbopelvic pain in early postpartum period and risk factorr

Background: Pregnancy-related lumbopelvic pain is known as lower back and pelvic girdle pain of unclear etiology, which affects almost half of pregnant women, often starts at 18 weeks and decreases at 6 months postpartum. The purpose of this study is to identify the risk factors in patients with pregnancy-related lumbopelvic pain in early postpartum period and determine the factors associated with pain in patients suffering from lumbopelvic pain at 1 month postpartum.Methods: 339 women of 18-40 years of age who were in the 1st month of postpartum period were included in the study. Socio-demographic data, gynecological history and method of delivery were recorded for all subjects. All subjects were evaluated for pregnancy-related lumbopelvic pain. The Oswestry disability index was used for functional evaluation and the Beck depression inventory was used for assessment of depression.Results: 114 (33.6%) patients had a history of pregnancy-related lumbopelvic pain. 59 (18.9%) patients had ongoing pain at 1 month postpartum. When patients were divided into two groups, consisting of women with and without lumbopelvic pain at 1 month postpartum, no statistical difference was observed between two groups in terms of age, parity, employment status, smoking status, depression score, method of delivery, type of anesthesia, and emergency or elective cesarean section. When the risk factors affecting postpartum lumbopelvic pain were evaluated by using the Stepwise Logistic regression analysis, weight gain during pregnancy, body mass index and presence of lumbopelvic pain during previous pregnancy were found to be independent risk factors (p<0.05).Conclusion: Pregnancy-related lumbopelvic pain is a significant cause of disability that affects many pregnant women. Control of weight gain during pregnancy could be important in avoiding the development of lumbopelvic pain. In patients experiencing lumbopelvic pain in previous pregnancies, necessary measures should be taken against development of lumbopelvic pain during a new pregnancy.

A Case Report on Upper Extremity Pain of Cardiac Origin

Upper extremity pain can originate from the musculoskeletal system, or be a reflection of problems originating from various organs. Therefore, it is highly important to perform a detailed clinical evaluation on patients during differential diagnosis. In this case report, we present a 61 year-old male patient who was admitted with pain in both upper extremities and the upper back that presumed to be of cardiac origin following our clinical evaluations. The patient was referred to the cardiology department, where he was diagnosed with coronary heart disease. The patient’s complaints of pain were fully resolved through the application of an intracoronary stent

Efficiency of back pain-school program in the treatment of patients with chronic mechanical back pain

ÖZET Amaç: Bu araştırma mekanik özellikte kronik bel ağrısı olan hastaların tedavisinde bel ağrısı okulu programının etkinliğini araştırmayı amaçlamaktadır. Hastalar ve Yöntem: Kronik mekanik bel ağrısı tanısı konulan 59 hasta (35 kadın, 24 erkek) iki gruba ayrıldı. Her iki gruba üç hafta (15 seans) sıcak paket, konvansiyonel transkutanöz elektriksel sinir stimülasyonu (TENS), terapotik ultrason uygulamalarıyla birlikte Williams ve mobilizasyon egzersizlerinden oluşan geleneksel fizik tedavi programı uygulandı. 1. gruba dahil edilen hastalara bu tedavi yöntemine ek olarak bel ağrısı okulu eğitimi verildi. Hastaların ağrısı (Görsel Analog Skala), depresyon (Beck Depresyon Ölçeği) ve fonksiyonel yetersizlik (Oswestry Sorgulama Formu) düzeyleri tedavi öncesi, sonrası ve tedavi bitiminden 4 hafta sonra değerlendirildi. Bulgular: Bel ağrısı okulu eğitimi verilen grubun ağrı skorları tedavi sonrası ve takip değerlendirmelerinde anlamlı düzeyde azaldı (p=0,000). Depresyon skorları her iki grupta da istatistiksel olarak anlamlı değişiklik göstermedi. Fonksiyonel yetersizlik düzeyi bel okulu eğitimi verilen grupta gelişme gösterdi (p=0,000). Takip değerlendirmesinde ağrı ve fonksiyonellik bakımından bel ağrısı okulu grubu daha üstün sonuçlara sahipti. Sonuç: Kronik mekanik bel ağrılı hastaların tedavisinde geleneksel fizik tedavi uygulamalarına ek olarak bel ağrısı okulu eğitimi verilmesi özellikle uzun dönemde ağrı ve fonksiyonelliğin iyileşmesinde olumlu etkiler sağlamaktadır.Objective: The aim of the study was to investigate the efficiency of back pain-school programs in the treatment of patients with chronic mechanical back pain. Patients and Methods: Fifty nine (35 females, 24 males) patients diagnosed with chronic mechanical back pain were divided into two groups. Both groups received traditional physical therapy consisting of hot pack, conventional transcutaneous electrical nerve stimulation (TENS), therapeutic ultrasound, Williams and mobilization exercises for three weeks (15 sessions). Patients in the 1st group received back pain-school program in addition. Patients were evaluated for pain (Visual Analogue Scale), depression (Beck Depression Scale) and functional disability (Oswestry Disability Index) before, after and 4 weeks after the treatment. Results: Pain scores were significantly reduced after treatment and in the follow up assessments (p=0.000) in the back pain school group. The depression scores did not differ significantly in both groups. Functional disability improved in the back pain school group (p=0.000). The back pain-school group had superior results in pain and function scores in the follow up assessment. Conclusion: Attending the back pain-school program in addition to traditional physical therapy in the management of patients with chronic back pain has positive effects on improving pain and function, especially in the long term

Common mistakes in the dual-energy x-ray absorptiometry (dxa) in turkey. A retrospective descriptive multicenter study

Background: Osteoporosis is a widespread metabolic bone disease representing a global public health problem currently affecting more than two hundred million people worldwide. The World Health Organization states that dual-energy X-ray absorptiometry (DXA) is the best densitometric technique for assessing bone mineral density (BMD). DXA provides an accurate diagnosis of osteoporosis, a good estimation of fracture risk, and is a useful tool for monitoring patients undergoing treatment. Common mistakes in BMD testing can be divided into four principal categories: 1) indication errors, 2) lack of quality control and calibration, 3) analysis and interpretation errors, and 4) inappropriate acquisition techniques. The aim of this retrospective multicenter descriptive study is to identify the common errors in the application of the DXA technique in Turkey. Methods: All DXA scans performed during the observation period were included in the study if the measurements of both, the lumbar spine and proximal femur were recorded. Forearm measurement, total body measurements, and measurements performed on children were excluded. Each examination was surveyed by 30 consultants from 20 different centers each informed and trained in the principles of and the standards for DXA scanning before the study. Results: A total of 3,212 DXA scan results from 20 different centers in 15 different Turkish cities were collected. The percentage of the discovered erroneous measurements varied from 10.5% to 65.5% in the lumbar spine and from 21.3% to 74.2% in the proximal femur. The overall error rate was found to be 31.8% (n = 1021) for the lumbar spine and 49.0% (n = 1576) for the proximal femur. Conclusion: In Turkey, DXA measurements of BMD have been in use for over 20 years, and examination processes continue to improve. There is no educational standard for operator training, and a lack of knowledge can lead to significant errors in the acquisition, analysis, and interpretation

Common Mistakes in the Dual-Energy X-ray Absorptiometry (DXA) in Turkey. A Retrospective Descriptive Multicenter Study

Background: Osteoporosis is a widespread metabolic bone disease representing a global public health problem currently affecting more than two hundred million people worldwide. The World Health Organization states that dual-energy X-ray absorptiometry (DXA) is the best densitometric technique for assessing bone mineral density (BMD). DXA provides an accurate diagnosis of osteoporosis, a good estimation of fracture risk, and is a useful tool for monitoring patients undergoing treatment. Common mistakes in BMD testing can be divided into four principal categories: 1) indication errors, 2) lack of quality control and calibration, 3) analysis and interpretation errors, and 4) inappropriate acquisition techniques. The aim of this retrospective multicenter descriptive study is to identify the common errors in the application of the DXA technique in Turkey. Methods: All DXA scans performed during the observation period were included in the study if the measurements of both, the lumbar spine and proximal femur were recorded. Forearm measurement, total body measurements, and measurements performed on children were excluded. Each examination was surveyed by 30 consultants from 20 different centers each informed and trained in the principles of and the standards for DXA scanning before the study. Results: A total of 3,212 DXA scan results from 20 different centers in 15 different Turkish cities were collected. The percentage of the discovered erroneous measurements varied from 10.5% to 65.5% in the lumbar spine and from 21.3% to 74.2% in the proximal femur. The overall error rate was found to be 31.8% (n = 1021) for the lumbar spine and 49.0% (n = 1576) for the proximal femur. Conclusion: In Turkey, DXA measurements of BMD have been in use for over 20 years, and examination processes continue to improve. There is no educational standard for operator training, and a lack of knowledge can lead to significant errors in the acquisition, analysis, and interpretation