Comparing Myofascial Pain Syndrome Treatment with Dry Needling Versus Extracorporeal Shock Wave Therapy for Plantar Fasciitis on Pain and Function of the Heel.

The aim of this study was to compare the effects of dry needling (DN) and extracorporeal shock wave therapy (ESWT) in the treatment of plantar fasciitis (PF). The study included 55 patients with PF. The patients were randomly divided into 2 groups. The DN group applied 3 sessions of DN to the myofascial trigger points in the lower limb muscles. The ESWT group applied 3 sessions of ESWT to the plantar fascia. For clinical evaluation, we used a visual analog scale (VAS) (first step, rest, activity) and Foot Function Index (FFI) (pain, disability, activity). Assessments were done baseline, post-treatment first week, and fourth week. Maximum pain-free standing time (Max PfST) and maximum pain-free walking distance (Max PfWD) were recorded at baseline and post-treatment fourth week. In this study, we found significant improvement in VAS, FFI, Max PfST, and Max PfWD in both groups (p < .01). VAS-activity baseline-forth week change was significantly superior in the DN group compared to the ESWT group (p = .023). FFI-disability baseline-fourth week change was significantly superior in the DN group compared to the ESWT group (p = .048). There was no significant difference in other treatment-related changes between the groups (p > .05). However, VAS-rest baseline-fourth week change and FFI-pain baseline-fourth week change trended towards statistical significance between groups ((p = .056), (p = .052) respectively). This study showed that DN may be a good alternative treatment for patients with PF, with effects similar to or even superior to ESWT.

Use of the Oswestry Disability Index in ankylosing spondylitis.

OBJECTIVE: The Oswestry Disability Index is considered the gold standard in the evaluation of disability in patients with chronic mechanical back pain. The aim of this study was to assess the applicability of Oswestry Disability Index in patients with ankylosing spondylitis and its relationship with disease assessment parameters for ankylosing spondylitis. METHODS: A total of 100 patients diagnosed with ankylosing spondylitis were included in the study group. The control group consisted of 50 individuals with nonspecific low back pain. The Oswestry Disability Index and Bath Ankylosing Spondylitis Disease Activity Index were applied to both groups. In addition, the Visual Analog Scale, the Ankylosing Spondylitis Disease Activity Score C-Reactive Protein, the Ankylosing Spondylitis Disease Activity Score-the Erythrocyte Sedimentation Rate, the Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, and the Ankylosing Spondylitis Quality of Life scales were applied in the study group. the Erythrocyte Sedimentation Rate, C-Reactive Protein levels, and HLA-B27 analysis were noted as laboratory markers in ankylosing spondylitis patients. RESULTS: The scores of Oswestry Disability Index had a significant correlation with scores of Bath Ankylosing Spondylitis Disease Activity Index in ankylosing spondylitis patients (r=0.543) and in the control group (r=0.401). There was a significant correlation between the scores of Oswestry Disability Index and the Bath Ankylosing Spondylitis Functional Index (r=0.544), Bath Ankylosing Spondylitis Metrology Index (r=0.317), the Ankylosing Spondylitis Quality of Life (r=0.723), the Ankylosing Spondylitis Disease Activity Score-the Erythrocyte Sedimentation Rate (r=0.501), the Ankylosing Spondylitis Disease Activity Score C-Reactive Protein (r=0.530), Visual Analog Scale-Rest (r=0.476), and Visual Analog Scale-Activity (r=0.441) values in patients with ankylosing spondylitis. CONCLUSION: Evaluation of Oswestry Disability Index in conjunction with Bath Ankylosing Spondylitis Disease Activity Index may warn the physician to interpret high Bath Ankylosing Spondylitis Disease Activity Index scores in the context of mechanical pain. Therefore, the use of Oswestry Disability Index in patients with ankylosing spondylitis will be beneficial.

Does locally applied epidermal growth factor stop anastomotic leak in the colon?

AIM: Anastomosis leakage is one of the most common complications after colorectal surgery. Studies have shown that the incidence of anastomotic leakage is between 0.5-30%. The aim of our study was to investigate the efficacy of local application of of epidermal growth factor (EGF) on colon anastomosis healing. MATERIAL AND METHODS: 28 Wistar rats were randomly divided into 4 groups. Sham group, control group, saline injection group, EGF injection group. Anastomosis line was determined as 3 cm distal to ilealcecal junction. The rats were reoperated on the 7th postoperative day. The colon segment was cut out 3 cm proximal and distal to the anastomotic line.The bursting pressure of each removed colon segment was measured and the segments were fixed with 10% formaldehyde for pathology examination. Anastomosis line was stained with hematoxylin eosin and histopathological evaluation was performed. Evaluation parameters were inflammatory cells, fibroblast, angiogenesis (neovascularization) and collagen amounts. RESULTS: Bursting pressure was higher in the EGF group than in the control group and saline injection group. There was statistically significant difference between EGF and positive control group. (p<0,05) Histopathological examination revealed that the inflammatory cell density was higher in the positive control group than in the other groups. Fibroblast cell density, neovascularization and collagen content were higher in EGF group than the others. However, no statistically significant difference was found between the control group,saline injection group and EGF injection group. CONCLUSION: As result of our study,we think that local application of EGF may have a positive effect on healing of colon anastomosis. KEY WORDS: Colonic Anastomosis, Egf, Experimental, Healing.

Carpal tunnel syndrome evaluation with ultrasound in rheumatoid arthritis patients.

AIM: In this study, our primary aim was to compare ultrasound (US) findings of the median nerve between rheumatoid arthritis (RA) with carpal tunnel syndrome (CTS) (RA(+)CTS), RA without CTS (RA(-)CTS) and healthy controls (HC) and to determine the optimal US parameters to detect the presence of CTS in RA patients. METHODS: 65 RA patients and 25 HC patients were included in this study. The diagnosis of CTS was made according to the clinical history and physical examination of the participants. Median nerve cross-sectional area(CSA) was measured at the carpal tunnel inlet(CTI), outlet(CTO), and forearm level by the US. In addition, anteroposterior(AP) and mediolateral(ML) diameters of the median nerve were measured. After the measurements, wrist-to-forearm ratio, wrist-to-forearm difference, and flattening ratio were calculated. The presence of tenosynovitis was investigated. RESULTS: CTS was detected in 26(40.0%) of 65 RA patients who participated in the study. CTS was detected in 43(35.2%) of 122 wrists of 65 RA patients. CTI CSA, CTO CSA, forearm CSA, anteroposterior/mediolateral diameter, wrist-to-forearm ratio, wrist-to-forearm difference, and flattening ratio were significantly higher in RA(+)CTS than in RA(-)CTS and HC(p<0.01). In addition, CDAI and CTI CSA(r=0.322, p<0.01), CTO CSA(r=0.301, p<0.01), CTI-to-forearm ratio(r=0.345, p<0.001), CTI-to-forearm difference(r=0.362, p<0.01) and CTO-Forearm difference(r=0.304, p<0.01) moderate correlation was found between. The frequency of tenosynovitis was higher in wrists with CTS than in wrists without CTS (p<0.05). CONCLUSION: While the presence of CTS in RA patients is sonographically evaluated, it may be useful to evaluate parameters such as CTI-to-forearm difference, ratio, and CTI ML diameter rather than just sticking to CTI CSA during diagnosis. Correlations of these parameters with disease activity can also be noted.

Use of the Oswestry Disability Index in ankylosing spondylitis

SUMMARY OBJECTIVE: The Oswestry Disability Index is considered the gold standard in the evaluation of disability in patients with chronic mechanical back pain. The aim of this study was to assess the applicability of Oswestry Disability Index in patients with ankylosing spondylitis and its relationship with disease assessment parameters for ankylosing spondylitis. METHODS: A total of 100 patients diagnosed with ankylosing spondylitis were included in the study group. The control group consisted of 50 individuals with nonspecific low back pain. The Oswestry Disability Index and Bath Ankylosing Spondylitis Disease Activity Index were applied to both groups. In addition, the Visual Analog Scale, the Ankylosing Spondylitis Disease Activity Score C-Reactive Protein, the Ankylosing Spondylitis Disease Activity Score-the Erythrocyte Sedimentation Rate, the Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, and the Ankylosing Spondylitis Quality of Life scales were applied in the study group. the Erythrocyte Sedimentation Rate, C-Reactive Protein levels, and HLA-B27 analysis were noted as laboratory markers in ankylosing spondylitis patients. RESULTS: The scores of Oswestry Disability Index had a significant correlation with scores of Bath Ankylosing Spondylitis Disease Activity Index in ankylosing spondylitis patients (r=0.543) and in the control group (r=0.401). There was a significant correlation between the scores of Oswestry Disability Index and the Bath Ankylosing Spondylitis Functional Index (r=0.544), Bath Ankylosing Spondylitis Metrology Index (r=0.317), the Ankylosing Spondylitis Quality of Life (r=0.723), the Ankylosing Spondylitis Disease Activity Score-the Erythrocyte Sedimentation Rate (r=0.501), the Ankylosing Spondylitis Disease Activity Score C-Reactive Protein (r=0.530), Visual Analog Scale-Rest (r=0.476), and Visual Analog Scale-Activity (r=0.441) values in patients with ankylosing spondylitis. CONCLUSION: Evaluation of Oswestry Disability Index in conjunction with Bath Ankylosing Spondylitis Disease Activity Index may warn the physician to interpret high Bath Ankylosing Spondylitis Disease Activity Index scores in the context of mechanical pain. Therefore, the use of Oswestry Disability Index in patients with ankylosing spondylitis will be beneficial.