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Öğe Characteristics of neuropathic pain in patients with diabetes mellitus(2021) Güntel, Murat; Hüzmeli, Esra Doğru; Melek, İsmet; Urfalı, Senem; Urfalı, Boran; Aslan, Evrim; Korkmaz, Nilufer ÇetişliAbstractAim: Epidemiological data on the frequency, quantity, and consequences of symptomatic diabetic neuropathy remain poor. We conducted this study to examine the characteristic of neuropathic pain in patients with diabetes mellitus (DM).Materials and Methods: Average daily pain intensity was measured using a 100 mm visual analog scale (VAS). Localization of the pain, position that aggravated pain, frequency of the pain, duration of the pain, pain’s influence on daily living activities were examined.Results: The average patient age was 62.56 years and the number of males was 21 (42%). 29 Patients had only DM and 13 patients had hypertension (HT) plus DM, 4 patients had DM+HT+heart disease. The mean of pain according to VAS was 6.86±2.79. Thirtytwo patients defined that the pain affected their daily living activities negatively; 30 patients’ pain localization was lower extremity,12patients’ was upper and lower extremity; mostly pain was aggravated by standing and 40 patients’ pain frequency was as every day; 24 patients’ pain duration was less than 1 year and 18 patients’ was between 1-5 years.Conclusion: Studies on diabetic neuropathy are important drivers to improve the treatment of these patients. Neuropathic pain is considered to be more serious than other types of pain. So patients diagnosed with DM should be examined for neuropathic pain and the treatment plan should include pain decreasing medication and/or neurosurgical interventions.Öğe Comparison of diadynamic current, interferential current and transcutaneous electrical nerve stimulation therapies in patients with chronic low back pain(Ondokuz Mayis Universitesi, 2022) Uysal, Alper; Güntel, MuratThis study aims to compare the effects of diadynamic current (DDC), interferential current (IFC), and transcutaneous electrical nerve stimulation (TENS) therapies on pain and disability levels in patients with chronic low back pain (CLBP). Patients with chronic low back pain between the ages of 18-65 were included in the study. The patients were divided into three groups. The first group received DDC, the second group IFC, and the third group TENS. The patients were evaluated in terms of pain and disability levels before the treatment, the 0th day after the treatment, and the 1st month after the treatment. Thus, these three treatment modalities were compared in terms of their effectiveness. A total of 83 patients were included in the study. There was no statistically significant difference between the groups in terms of age, gender, BMI, disease duration, pain, and disability levels of the patients before treatment. A statistically significant difference was found between the 0th day before and after the treatment and the 1st month before and after the treatment in terms of pain and disability levels in all three groups. The VAS scores of the individuals in the IFC group were significantly lower on the 0th day and 1st month after the treatment than in the DDC and TENS groups. Although there was no statistically significant difference, when looked at clinically, the RMDQ scores of the individuals in the IFC group tended to decrease more than those in the DDC and TENS groups. All three treatment modalities are effective in patients with CLBP. However, IFC seems to be superior. © 2022 Ondokuz Mayis Universitesi. All rights reserved.Öğe Comparison of the treatment effects of extracorporeal shock wave therapy and trigger point injection in myofascial pain syndrome(Ondokuz Mayis Universitesi, 2022) Uysal, Alper; Güntel, MuratMyofascial pain syndrome (MPS) is a common chronic musculoskeletal disease and the lifetime prevalence is about 85%. Comparison of the effects of ESWT (extracorporeal shock wave therapy) and trigger point injection (TPI) treatments on sleep quality in myofascial pain syndrome has rarely been studied. The aim of this study was to compare the effects of TPI + Dry Needling (DN) and ESWT treatments on pain, neck disability level, and sleep quality in patients with myofascial pain syndrome. 63 patients diagnosed with myofascial pain syndrome were included in the study. The patients were divided into two groups. ESWT was given to 32 patients and TPI to 31 patients. These two treatment regimens were compared in terms of pain (VAS), sleep quality (PSQI), and neck disability (NDI). In terms of mean VAS, NDI, and PSQI values, there was no statistically significant difference between the groups in the mean of pre-treatment, post-treatment day 0 and post-treatment 1 month. A similar and significant improvement was observed in both groups in terms of the evaluated parameters and based on our results, we can recommend both treatment options to MPS patients. © 2022 Ondokuz Mayis Universitesi. All rights reserved.Öğe Detecting the presence of inflammation in fibromyalgiasyndrome with neutrophil/lymphocyte ratio, platelet/ lymphocyte ratio, and mean platelet volume(2021) Güntel, Murat; Uysal, AlperAim: Our purpose was to determine the presence of inflammation in Fibromyalgia Syndrome (FMS), whether the parameters ofneutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) and mean platelet volume (MPV) can be used as inflammationmarkers. Materials and Methods: FMS patients who applied to Hatay State Hospital Physical Medicine and Rehabilitation Clinic in the lasttwo years were analyzed retrospectively from the patient records. 92 participants were enrolled in the study, 43 of them wereFMS patients, and 49 were healthy control group. Hemogram, glucose levels, hepatic panel and renal function tests, thyroid andparathyroid function testing, vitamin B12 and 25-hydroxyvitamin D, serum iron panel, folate, lipid panel, erythrocyte sedimentationrate (ESR), C-reactive protein, RF, Bucella agglutination test results were evaluated. Thus, patients with diseases that could affectNLR, PLR, and MPV were not enrolled in the study. Results: No significant difference between the groups in terms of gender distribution was found (p = 0.999). No significant differencebetween the groups in terms of age was found (p=0.327). When the groups were compared in terms of MPV, the values were found tobe lower in the FMS group. Statistically significant difference was not found in both groups in terms of NLR, PLR, White blood count(WBC) and Platelet (PLT) levels (p=0.106; p=0.710; p=0.271; p=0.141, respectively). Conclusion: A significant difference was not found in both groups in terms of NLR and PLR, which were thought to be inflammationmarkers. The statistically significant higher values of mean ESR values in the FMS group indicate that inflammation may be presentin the pathogenesis of FMS, but NLR and PLR cannot be used as indicators of inflammation, so correlating these rates with theseverity of symptoms would be meaningless.Öğe The effect of initial complaints and third year MRI lesion load on EDSS of multiple sclerosis patients(2021) Güntel, Murat; Duman, Taşkın; Demetgül, ÖzcanAim: We aimed to investigate the effect of initial complaints and third-year MRI lesion burden on Expanded Disability Status Scale (EDSS) of Multiple Sclerosis Patients.Materials and Methods: Patients who were admitted to the Mustafa Kemal University Faculty of Medicine Neurology clinic and diagnosed with Multiple Sclerosis according to Mc Donald diagnostic criteria were included in the study. The initial symptoms of patients, MRI lesion burden at the end of the third year, and the EDSS score were recorded retrospectively from the patient files. 74.5 % of the participants were female and 25.5 % were male. The most common initial symptoms were: Sensory symptoms, vision symptoms, pyramidal tract symptoms, and polysymptomatic. The mean age of the patients was 33.4. Mean EDSS was found to be 1.8±1.3. The total number of lesions in the brain was 14.8 ± 4.83 on average.Results: If patients compared according to the initial symptoms at the end of the third year, the highest EDSS score was at the polysymptomatic onset group, the second-highest score was at the motor onset group. The patients with the initial symptoms of motor or polysymptomatic group had a higher mean EDSS score than the patients with the initial symptoms of vision, sensorial symptoms, or cranial neuropathy. When we examine the relationship between MRI lesion load at the end of the third year and the EDSS score, there is a strong positive correlation between them. Patients who have more lesions in the brain on MRI studies have higher average EDSS scores than patients who have fewer lesions in the brain.Conclusion: We found that the initial symptoms are directly related to the third-year EDSS score and the prognosis of the disease. We found that there was a significant relationship between the number of lesions in the brain on MRI studies at the end of the third year and the mean EDSS score.Öğe Evaluating effects of different musical types on depression, sleep quality, mental state and anxiety in stroke patients(İnönü Üniversitesi, 2018) Hüzmeli Doğru, Esra; Melek, İsmet; Çömük Balcı, Nilay; Güntel, Murat; Dağ, ErsinAim: Music’s rehabilitative effects are clear in the literature, but the effect of the music type on the post-stroke patients is not clear. The aim of the present study was to investigate the effects of listening different types of music on depression, sleep quality, mental state and anxiety in post-stroke patients. Material and Methods: The study was conducted prospectively. Thirty post-stroke pateints admitted to Department of Neurology, Faculty of Medicine at Mustafa Kemal University, were considered for the study. The patients’ depression level, sleep quality, anxiety and cognitive status were evaluated. Subjects were listening music during the rehabilitation program. Subjects were separated as the Eastern Music group (n=10), western music group (n=10) and control group (n=10). Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Standardized Mini Mental Test (SMMS), and Pittsburgh Sleep Quality Index (PSQI) tests were performed for all subjects twice pre and post- treatment. Results: There was a significant difference in SMMT and BDI within the eastern and Western Music groups (p<0.05). PSQI score decreased an average of 1.4 points within only the Western Music group and it was statistically significant. There was no significance in any of the parameters of the control group. There was no statistical difference between the three groups. Conclusion: Although positive results within groups were found, there was no significant difference among the groups; therefore, music listening independent of the music type has no effect on sleep quality, mood, mental state and anxiety.Öğe Multipl skleroz hastalarının hastaneye geliş semptomu ve manyetik rezonans lezyon yükü ile 3. yıl edss skoru arasındaki ilişki(Hatay Mustafa Kemal Üniversitesi, 2015) Güntel, Murat; Duman, Ahmet TaşkınAmaç: Multiple Skleroz'da klinik seyrin öngörülebilmesine olanak sağlayan özelliklerin rolü çeşitli çalışmalarda incelenmiştir. Bu çalışmada 3 yıl ve üzerinde MS hastalığı olan kişilerde üçüncü yılsonundaki EDSS skorlarına, hastalığın başlangıç semptomu ve üçüncü yılsonundaki MRI lezyon yüklerinin katkısı araştırılmıştır. Bu araştırmaya hastalık süresi 3 yıl ve daha fazla olan 153 MS hastası alınmıştır. Yöntem: MS'da başlangıç tutulumu açısından 2 ya da daha fazla sistemin varlığının, kötü prognoz göstergesi olduğuna dair bulgular mevcuttur. Başlangıçta 2 veya 2'den fazla sistem tutulumuna sahip hastalar yüksek EDSS puanlarına diğer monosemptomatik başlangıçlı hastalara göre daha erken ulaşmaktadır (1-3). Bu çalışmada başlangıç semptomlarının EDSS değeri ile olan ilişkisi incelenmiş olup en yüksek skor polisemptomatik olanlarda ikinci sırada ise motor semptomları olanlarda görülmüştür. Başlangıç semptomları ile ortalama EDSS skorları arasında istatistiksel açıdan anlamlı fark saptanmıştır. Polisemptomatik ve motor semptomları olanların ortalama EDSS skorları optik ve duyusal semptomu olanlara göre daha yüksek olup, aralarındaki fark istatistiksel olarak anlamlı olarak saptanmıştır. Bulgular: MS'in tanı ve takibinde Manyetik Rezonans Görüntüleme'nin (MRG) çok önemli rolü vardır. Ancak bunlara rağmen, MS'de klinik ile MRG bulguları arasındaki korelasyon zayıftır. Bazen fazla sayıda lezyona rağmen, minimal semptom görülürken, bazen de birkaç lezyon daha fazla özürlülüğe neden olabilmektedir (4-6). Sonuçlar:Bu çalışmada MS hastalarının beyinlerindeki toplam lezyon sayısına bakılmış olup, lezyon sayısı ile EDSS skorları arasında pozitif yönde güçlü bir ilişki olduğu ve bu ilişkinin istatistiksel açıdan anlamlı olduğu saptanmıştır.Öğe Two cases of primary stabbing headache(2016) Güntel, Murat; Hürdoğan, Özge; Uluduz, Derya; Duman, TaşkınPrimer saplanıcı baş ağrısı; saniyeler süren nadir ve şiddetli bir başağrısıdır. Ağrı özellikle trigeminal sinirin birinci dalı boyunca hissedilir ve günde bir veya birkaç günde bir gelen bir veya birkaç kez tekrarlayan saplanma atakları şeklinde ortaya çıkar. Primer saplanıcı başağrısı yıllardır bilinmekle birlikte tanı için klinisyenin sorgulaması gereklidir. Primer saplanıcı başağrısının tanısını koymada diğer olası nedenlerin dışlanması önemlidir. İndometazin klasik olarak ilk tedavi seçeneğidir ancak olguların %35'e yakını tedaviye direnç gösterir. Son yıllarda cyclooxygenase-2 inhibitörleri, gabapentin, nifedipine, parasetamol, ve melatonin tedavisinin etkinliğini destekleyen çalışmalar bildirilmektedir.Öğe Two multiple sclerosis cases developed herpes zoster during use of fingolimod(Ondokuz Mayis Universitesi, 2018) Terzi, Murat; Duman, Taşkın; Şen, Sedat; Güntel, Murat; Şen, Nalan ÖrtücüMultiple sclerosis (MS) is an inflammatory, demyelinating disease of the central nervous system. Immunosuppressive and immunomodulating drugs are used during disease monitoring. Fingolimod is one of the immunomodulatory treatments used in MS patients. It is a therapeutic agent acting on lymphocytes. Latent varicella-zoster virus infections may occur in MS patients receiving fingolimod therapy. In this article, the information of two cases with varicella-zoster virus reactivation during fingolimod use were presented. © 2018 OMU
