Serum Irisin Levels and Its Relationship with Spasticity Severity in Chronic Stroke Patients.

Objective Irisin is a myokine released from muscles by exercise and it has been shown to be a prognostic indicator in acute stroke patients. However, irisin's relationship with the chronic phase of stroke and spasticity has not been studied yet. We aimed to determine the serum level of irisin to examine its relationship with the functional status and severity of spasticity in patients with chronic stroke, and to compare these with healthy controls. Materials and Methods A total of 70 (35 chronic stroke and 35 control patients) patients were included in the study. The blood serum irisin levels of the patients and the controls were evaluated using enzyme-linked immunosorbent assay method, their functional status was evaluated with the modified Rankin scale (mRS), and spasticity severity using the modified Ashworth scale (MAS). Results The mean serum irisin levels of the stroke and the control groups were 6.20 ± 2.2 and 5.45 ± 2.3, respectively, and there was no statistically significant difference ( p > 0.05). No significant correlation was found between the serum level of irisin and the severity of spasticity and functional status, assessed by the mRS in stroke patients. Conclusion These results showed that irisin levels in chronic stroke patients were similar to controls, and there was no relationship between the severity of spasticity and functional status and irisin level.

Can the long term using of pregabalin in fibromyalgia affect the choroid and retinal nerve fiber layer?

BACKGROUND: In this study, the effects of long-term pregabalin use on the choroid and retinal nerve fiber layer were investigated in the fibromyalgia disease. METHODS: The patient group consisted of 41 fibromyalgia patients using pregabalin. The control group consisted of 41 newly diagnosed fibromyalgia patients who had not received any treatment yet. Choroidal and retinal nerve fiber layer thickness measurements were performed with Cirrus HD-OCT (Carl Zeiss Meditec Inc., Dublin, CA, USA) 30 minutes after pupil dilation with 1% tropicamide. RESULTS: There was no difference in subfoveal choroidal thickness, nasal choroidal thickness and temporal choroidal thickness between the patient and control groups (p > 0.05). Increasing the duration of drug use within the patient group was found to thin the retinal nerve fiber layer (p < 0.05). CONCLUSION: We found that pregabalin had no effect on the choroid, while it had a thinning effect for retinal nerve fiber layer. It is recommended not to be preferred pregabalin in fibromyalgia patients with retinal nerve fiber layer damage such as diabetic retinopathy and glaucoma. Patients treated with pregabalin should have regular control in the ophthalmology clinic.

Evaluation of Duruöz Hand Index in diagnosis and staging of Carpal tunnel syndrome.

Carpal tunnel syndrome (CTS) is a common entrapment neuropathy of the upper limb. In this cross-sectional study our aim is to investigate the value of Duruöz Hand Index (DHI) in diagnosis and staging of CTS patients and comparing it with Boston Carpal Tunnel Questionnaire (BQ) and provocative tests. Among 423 patients who were referred to the EMG laboratory at the physical medicine and rehabilitation unit with the symptoms of CTS, 294 patients were included in the study. Patients' demographic data, weight, height, body mass index (BMI) measurements, physical examinations, Tinel and Phalen provocative test results, visual analog scale for pain, DHI and BQ scores were recorded. Electrophysiological examinations were also performed. The mean age was 45.1 ± 11.6 years and 254 (86.4%) patients were women. Based on the results of EMG, 120 (40.8%) patients were found negative for CTS, 57 (19.4%) patients had mild CTS, 89 (30.3%) patients had moderate CTS and 28 (9.5%) patients had severe CTS. Among the parameters evaluated, DHI scores were found to be significantly higher in the severe CTS group. DHI (r: 0.306, p < 0.001) and Boston functional status scale (FSS) (r: 0.257p = 0.001) were found to be correlated with CTS severity. Tinel positivity (OR: 2.36, p: 0.01), Phalen positivity (OR: 2.22, p: 0.02), Boston symptom severity scale (SSS) scores (OR: 1.76, p: 0.024), increasing age (OR: 1.06, p < 0.001) and increased BMI (OR: 1.07, p: 0.03) were found to be associated with increased likelihood of CTS diagnosis. In conclusion, DHI was found to be correlated with CTS severity similar to Boston FSS.

Dry eye in chronic stroke patients with hemiplegia: A cross-sectional study.

Objective: Dry eye is reported to be associated with several neurological diseases. The aim of this study is to evaluate the patients with hemiplegia after stroke for dry eye and compare their results with a control group.Materials and methods: Forty-five patients with hemiplegia and 45 individuals as the control group were included in the study. Tear function tests (Schirmer and tear breakup time) and a dry eye questionnaire for dry eye symptoms (ocular surface disease index) were performed and the results of the two groups were compared.Results: Schirmer test results were significantly lower in the post-stroke hemiplegia group compared to the control group (11.3 ± 8.2 mm and 20.6 ± 11.6 mm, respectively, p < .001). Tear breakup time results were significantly lower in the post-stroke hemiplegia group compared to the control group (7.9 ± 3.1 s and 12.1 ± 4.3 s, respectively, p < .001). Ocular surface disease index scores were not significantly different between hemiplegia and control groups (21.6 ± 20.0 and 19.8 ± 13.9, respectively, p = .635). Schirmer scores lower than 10 mm (60% and 30%, p < .001) and tear breakup time results lower than 10 s (65.6% and 28.9%, p < .001) were also higher in the hemiplegia group compared to control group.Conclusion: We found lower Schirmer test and tear breakup time results and similar OSDI scores in hemiplegia patients compared to controls. Hemiplegia patients may have dry eye without typical symptoms. This should be taken into consideration in the follow-up and rehabilitation of post-stroke hemiplegia patients.