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    Effect of Coexisting Foot Deformity on Disability in Women with Knee Osteoarthritis
    (Amer Podiatric Med Assoc, 2009) Guler, Hayal; Karazincir, Sinem; Dicle Turhanoglu, Ayse; Sahin, Gunsah; Bald, Ali; Ozer, Cahit
    Background: Knee osteoarthritis, a common musculoskeletal disorder, can cause considerable pain and disability. This study investigates the effect of certain foot deformities on the functional status of women with knee osteoarthritis. Methods: The common foot deformities pes planus and hallux valgus were evaluated in 115 women with knee osteoarthritis and Kellgren-Lawrence grade 2 and 3 osteoarthritis. Anteroposterior and lateral foot-ankle standard radiographs were obtained bilaterally. A lateral talometatarsal angle greater than 4 degrees was defined as pes planus. A hallux valgus angle greater than 21 degrees was defined as hallux valgus. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to objectively assess functional impairment. Knee pain intensity was measured with a visual analog scale. Results: Fifty-nine patients had bilateral pes planus, hallux valgus, or both. The mean visual analog scale value was higher for the deformity group, but the difference was not statistically significant. There was a significant difference in WOMAC scores between the group with foot deformities versus the group without (P = .000). Visual analog scale scores were positively correlated with WOMAC scores (r = 0.499, P = .000). Also, there was a significant correlation between WOMAC scores and lateral talometatarsal angle (r = 0.266, P = .004) and hallux valgus angle (r = 0.362, P = .000) values. Conclusions: There is a significant correlation between indicators of pain and disability (visual analog scale and WOMAC scores). Also, the presence of foot deformities increased disability levels in women with knee osteoarthritis. (J Am Podiatr Med Assoc 99(1): 23-27, 2009)
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    Fibromyalgia, obesity and obesity related measurements
    (2006) Güler, Hayal; Sahin, Gunsah; As, Ismet
    Objective: To evaluate the relationship between obesity and fibromyalgia (FM). Methods: 241 female patients with FM were seen consecutively in outpatient clinic and they were analyzed. Spearman correlation was used. The relationship between FM and obesity was compared with respect to the BMI (body mass index) value. A p value of 0.05 was accepted as significant. Results: Body mass index was significantly correlated with age in FM patients. BMI was also correlated with waist/hip ratio. A significant positive correlation was found between health assessment questionnaire (HAQ) and VAS score in all patients. HAQ was also correlated positively with tender points (P < 0.05). We divided patients into two groups according to BMI values (obese and non-obese). Subjects with BMI value >25 were considered as obese. Obese patients were older than non-obese patients. The values of waist/hip ratio and skin fold thickness and number of tender points were higher in obese patients. Also, the mean duration of disease was longer in obese patients. There was no statistically significant difference in VAS score and HAQ between obese and non-obese patients. However, in obese patients, BMI was significantly correlated with HAQ and VAS score (P < 0.05) in contrast to the non-obese patients. Conclusion: Decreased physical functioning in FM patients should be taken into account and patients were encouraged to lose weight and to increase exercise. © 2006 VSP.
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    P wave dispersion in patients with rheumatoid arthritis: its relation with clinical and echocardiographic parameters
    (Springer, 2007) Guler, Hayal; Seyfeli, Ergun; Sahin, Gunsah; Duru, Mehmet; Akgul, Ferit; Saglam, Hayrettin; Yalcin, Fatih
    P wave dispersion (PWD) is a sign for the prediction of atrial fibrillation (AF). The aim of this study was to assess P wave dispersion and its relation with clinical and echocardiographic parameters in patients with rheumatoid arthritis (RA). Thirty RA patients (mean age 49 +/- 10 years) and 27 healthy controls (mean age 47 +/- 8 years) were included in the study. We performed electrocardiography and Doppler echocardiography on patients and controls. Maximum and minimum P wave duration were obtained from electrocardiographic measurements. PWD defined as the difference between maximum and minimum P wave duration was also calculated. Maximum P wave duration and PWD was higher in RA patients than controls (P = 0.031 and P = 0.001, respectively). However, there was no significant difference in minimum P wave duration between the two groups (P = 0.152). There was significant correlation between PWD and disease duration (r = 0.375, P = 0.009) and isovolumetric relaxation time (r = 0.390, P = 0.006). P wave duration and PWD was found to be higher in RA patients than healthy control subjects. PWD is closely associated with disease duration and left ventricular (LV) diastolic dysfunction.