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Öğe Bilateral Avascular Necrosis of the Femoral Head After COVID-19 Infection: A Case Report(2022) Uysal, Alper; Uysal, Merve ErdemAim: Avascular necrosis of the femoral head is a condition characterized by limited range of motion, pain, and gait disturbance resulting from insufficient blood flow. We aim to evaluate the relationship between COVID-19 and avascular necrosis. Case: Herein, we present a 63-year-old male patient who developed avascular necrosis of the bilateral femoral head after COVID-19. Conclusion: COVID-19 infection alone and corticosteroids given to treat it can increase the incidence of avascular necrosis of the femoral head. MRI of the hip is highly specific in detecting early stagea vascular necrosis of the femoral head and can reduce patient’s disability and need for surgery.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 Diyabetik Periferik Nöropati ve Vitamin D İlişkisi(2021) Bingöl, İzzet; Uysal, AlperAmaç: Elektrofizyolojik olarak desteklenen ve desteklenmeyen diyabetik periferik nöropati (DPN) hastalarının, kendi içerisinde ve kontrol grubu ile D vitamini düzeyleri açısından karşılaştırması amaçlanmıştır.Yöntem: Hatay Devlet Hastanesi Fiziksel Tıp ve Rehabilitasyon Polikliniğine başvurmuş ve DPN tanısı almış hastalar elektrofizyolojik olarak patolojik bulgu saptanıp, saptanmamalarına göre iki gruba ayrıldı. Benzer yaş ve cinsiyette, kas ağrısı şikâyeti ile poliklinik başvurusu olan hastalar da kontrol grubunu oluşturdu ve gruplar D vitamini düzeyleri açısından karşılaştırıldı. DPN alt grupları da kendi içerisinde HbA1c seviyeleri ve diyabet süreleri açısından kıyaslandı.Bulgular: DPN grupları ve kontrol grubu arasında yaş ve cinsiyet açısından istatistiksel olarak anlamlı farklılık saptanmadı. Vitamin D düzeyleri, elektrofizyolojik olarak desteklenen DPN grubuna kıyasla, kontrol grubunda anlamlı derecede daha yüksek bulunmuştur. DPN alt grupları kendi içerisinde karşılaştırıldığında elektrofizyolojik olarak desteklenen DPN grubunda, diyabet süresi ve HbA1c düzeyleri istatistiksel olarak anlamlı olacak şekilde daha yüksek bulunmuştur.Sonuç: Düşük D vitamini seviyeleri diyabetik hastalarda nöropati gelişimini hızlandırabilir ve hastaların klinik durumlarını kötüleştirebilir.Öğe Diz osteoartriti olan hastalarda extracorporeal shock wave therapy (Eswt) tedavisinin kas gücü, ağrı ve fonksiyonel durum üzerine olan etkileri(Hatay Mustafa Kemal Üniversitesi, 2018) Uysal, Alper; Yıldızgören, Mustafa TurgutAmaç: Bu araştırmanın amacı, Kellgren-Lawrence sınıflamasına göre Evre 2-3 diz osteoartriti olan hastalarda radial-extracorporeal shock wave therapy (r-ESWT) tedavisinin ağrı, eklem hareket açıklığı, izokinetik kas gücü, fonksiyonel durum ve yürüme hızı üzerine etkisini araştırmaktır. Yöntem: Çalışmaya 01.06.2017 – 01.04.2018 tarihleri arasında FTR polikliniğine başvuran diz osteoartrit tanılı 55 hastanın 104 dizi dahil edildi. Hastalar, Grup I (Hot pack + TENS + ESWT) ve Grup II (Hot pack + TENS + Sham ESWT) olmak üzere randomize şekilde 2 gruba ayrıldı. Grup I' deki hastalara r-ESWT (1 seans/hafta, toplam 3 seans) uygulandı. Tüm hastalara diz çevresi kasları güçlendirme egzersizi ev programı şeklinde önerildi. Hastaların istirahat ve hareket esnasındaki ağrı şiddeti, eklem hareket açıklıkları (EHA), yürüme hızı, fonksiyonel durumu, kas güçleri tedavi öncesi, tedavi sonrası 0., 1. ve 3. ayda değerlendirildi. Bulgular: Gruplar arasında tedavi sonrası 0. ay, 1. ay ve 3. aydaki VAS-istirahat, VAS-hareket, 20 metre yürüme testi, EHA, 60˚/sn ve 180˚/sn açısal hızdaki ekstansör pik tork (PT) değerleri, WOMAC'ın tutukluk haricindeki diğer parametreleri, Lequesne skorlarında anlamlı farklılık vardı (p<0.05). Grup 1'deki hastaların test sonuçları daha iyiydi. Sonuçlar: Konvansiyonel fizik tedaviyle kombine edilen r-ESWT tedavisinin ağrı, fonksiyonel durum, kas gücü üzerine daha etkili olduğu bulunmuştur.Öğe Effects of radial extracorporeal shock wave therapy on clinical variables and isokinetic performance in patients with knee osteoarthritis: a prospective, randomized, single-blind and controlled trial(Springer, 2020) Uysal, Alper; Yildizgoren, Mustafa Turgut; Guler, Hayal; Turhanoglu, Ayse DicleObjective This study aims to compare the efficacy of r-ESWT treatment with sham-ESWT on pain, walking speed, physical function, and isokinetic muscle strength in knee osteoarthritis. Methods The study included 104 patients (mean age 61.0 +/- 6.2 years; range 50 to 70 years) who were admitted to our outpatient clinic with newly diagnosed with knee osteoarthritis. Patients were randomly assigned to two groups. Both groups received transcutaneous electrical nerve stimulation for 30 minutes, hot pack for 40 minutes, and home-based exercise program of around the knee strengthening for 30 minutes in a day for three weeks (5 days in a week). Also, one group was treated with r-ESWT, while the other group was treated with sham-ESWT. For r-ESWT, patients received 2000 pulses of shockwave at 2.0 to 3.0 bar weekly for three weeks. All patients were evaluated with visual analog scale (VAS), active knee range of motion (ROM), 20-metre walk test, Western Ontario and McMaster Osteoarthritis Index (WOMAC), Lequesne's disability index, and isokinetic muscle performance before treatment, at the end of treatment, at one month and three months after treatment. Results When groups were compared, group 1 scores were significantly better than the group 2 in all outcome parameters except WOMAC-stiffness at the end of treatment, at one month and three month follow-up (all p < 0.05). The VAS-resting, VAS-movement, knee ROM, 20-m walk test, WOMAC, and Lequesne's disability scores and peak torque values of knee extension improved in both groups with the highest improvement in the r-ESWT group. A comparison of difference of the two group scores showed statistically significant superior improvement in group 1 in all parameters at both one month and three months. Conclusion Our findings revealed that r-ESWT combined with conventional electrotherapy is an effective treatment for improving pain and physical function in knee osteoarthritis to control symptoms up to three months.Öğe Evaluation of Depression, Anxiety and Sleep Quality Scores in Patients with Cervical Disc Herniation: A Study Conducted in Turkey(2023) Uysal, Alper; Bingöl, İzzetAim: Neck pain is one of the most prevalent medical complaints. Chronic pain conditions can lead to depression, anxiety and sleep problems in individuals. Thus, both the pain itself and the psychiatric problems it causes impair the quality of life of the patient. Depression and anxiety can also cause changes in the perception of pain. In this study, we aimed to investigate the effects of cervical disc herniation (CDH), which causes chronic neck pain, on the level of neck disability, sleep quality, anxiety and depression. Material and Methods: Patients’ pain intensity, neck disability indexes, depression and anxiety status, and sleep quality were evaluated using a visual analog scale (VAS), the neck disability index (NDI), Beck Depression Inventory (BDI), beck anxiety inventory (BAI) and the Pittsburgh Sleep Quality Index (PSQI), respectively. Results: We found a statistically significant relationship between CDH and anxiety, depression and sleep quality. In addition, we found higher levels of pain, anxiety and depression in the group with poor sleep quality. Conclusion: For optimal treatment approaches of patients with chronic neck pain, accompanying sleep disorder, depression and anxiety should also be evaluated.Öğe The relationship between cartilage thickness and muscle thickness or leg length discrepancy in poliomyelitis sequelae(Jmni, 2023) Uysal, Alper; Guntel, Murat; Dede, Hava OezlemObjectives: To evaluate the relationship between cartilage loss and differences in muscle thickness and/or leg length in poliomyelitis sequelae (PMS). Our study is the first to evaluate the relationship between cartilage loss and both muscle atrophy and leg length discrepancy in the same population. Methods: 37 patients with PMS and 38 healthy controls were included. Talar and distal femoral cartilage thicknesses and gastrocnemius medialis and quadriceps femoris muscle thicknesses were measured via ultrasound. Leg length differences and manual muscle strength were also evaluated. Results: The mean muscle thicknesses and cartilage thicknesses were thinner in the more affected legs than in the less affected legs in the patient group. All of the ultrasonographic measurements were thinner in the less affected legs of the patient group than in the right legs of the control group, except for the knee cartilage thicknesses. While there was a correlation between the cartilage thickness difference and the muscle thickness difference between the less and more affected legs in the patient group, there was no correlation between the cartilage thickness difference and leg length differences. Conclusions: Patients with PMS are predisposed to osteoarthritis. Talar and knee cartilage thicknesses may be more associated with the muscle thickness than the leg length discrepancy in PMS.Öğe Relationship of restless legs syndrome with blood parameters(Cukurova Univ, Fac Medicine, 2022) Guntel, Murat; Uysal, Alper; Melek, Ismet MuratPurpose: We aimed to investigate the factors affecting the etiopathogenesis by comparing the restless legs syndrome patients with the healthy control group in terms of some laboratory parameters. Materials and Methods: Patients who were diagnosed with restless legs syndrome were included in the study. A control group that was similar in terms of age and gender was formed. Both groups were compared in terms of iron, ferritin, iron-binding capacity, folate, vitamin B12, vitamin D, calcium, magnesium, ALT, AST, hemogram, creatinine, fasting blood sugar, and thyroid hormone levels. Results: 37 patients with restless legs syndrome and 41 controls were included in the study. In the restless legs syndrome group hemoglobin, ferritin, iron, fasting blood sugar, vitamin D, and fT4 values were 12.7 (10.3-16.0) g/dL, 37.3 (3.7-89.4) mg/L, 62 (21-195) mu g/dL, 96 (65-250) mg/L, 11.26 (4.20-41.57) ug/L and 1.24 (0.73-2.14) mu g/dL respectively, they were 14.8 (12.3-16.1) g/dL, 56 (9-189) mg/L, 90 (30-245) mu g/dL, 91 (70-107) mg/L, 17.31 (5.73-32.90) mu g/L and 1.08 (0.63-2.04) mu g/dL respectively in the control group.There were statistically significant differences between the groups in terms of hemoglobin, ferritin, iron, fasting blood sugar, vitamin D, and fT4 levels. Conclusion: Hemoglobin and iron parameters, vitamin D levels, fasting blood sugar and T4 levels should be evaluated in patients with restless legs syndrome and should be replaced if necessary. Correction of deficiencies may be beneficial for patients' clinics.Öğe Relationship of vitamin D level, fasting blood sugar, andbody mass index, to carpal tunnel syndrome severity(2021) Uysal, Alper; Guntel, MuratAim: This study aims to investigate the relationship between Idiopathic Carpal Tunnel Syndrome (CTS) and Vitamin D Level, BodyMass Index (BMI), and Fasting Blood Sugar.Materials and Methods: 54 CTS patients diagnosed electrophysiologically were included in the study. These patients' ages, genders,height and body weights, and body mass index values were recorded. Laboratory tests including vitamin D levels and fasting blood sugars were performed for each participant. The CTS stage was determined electrophysiologically and the Boston questionnaire and the visual analogue scale (VAS) were filled to assess total pain scores, symptom severities (CNS), and functional states (FSS).Results: There was a statistically significant difference between the distribution of CTS stages in female patients and male patients (p = 0.008). There was no statistically significant difference between mild, moderate, and severe CTS stages in terms of age, body mass index, and fasting blood glucose (p = 0.459; p = 0.232; p = 0.413, respectively). There is a statistically significant difference between CTS stages in terms of vitamin D levels (p<0.001). Vitamin D averages were observed to decline from mild to severe stages of CTS. According to the Boston Carpal Tunnel Syndrome functional status scale, it was determined that there is marginal statistical significance between the stages of CTS. It was observed that the mean functional status scale scores increased from the mild stage to the severe stage (p = 0.055). There was no statistically significant difference between mild, moderate, and severe CTS stages in terms of VAS pain and paresthesia scores and the Boston Carpal Tunnel Syndrome symptom severity scale (p = 0.340; p = 0.359; p = 0.250, respectively).Conclusion: We found a significant relationship between the vitamin D level and the CTS stage. According to Boston Carpal TunnelSyndrome Questionnaire, we found that there is a marginal statistical significance between the stages of CTS.Öğe Ultrasonographic Evaluation of the Distal Femoral Cartilage Thickness in Parkinson's Patients(Jmni, 2023) Uysal, Alper; Guntel, Murat; Demetgul, Ozcan; Cicek, UlacObjectives: Both Parkinson's disease (PD) and osteoarthritis (OA) are characterized by chronic inflammation and tissue degeneration. The aim of this study is to investigate the relationship between PD and distal femoral cartilage thickness (DFCT). Our study is the first in the literature to measure DFCT in PD. Methods: 68 patients with PD and 30 healthy individuals participated. The patient group was divided into three subgroups, according to the Hoehn Yahr stages (HYS): mild, moderate and severe. Patient subgroups and the control group were compared with each other in terms of neutrophillymphocyte ratio (NLR), C-reactive protein (CRP), and DFCT. Results: The NLR and CRP levels of the PD patients were higher than the values of the healthy people. The DFCT values of the mild PD subgroup were significantly higher than those of the control group, except for one value. The DFCT values of the moderate PD subgroup and the healthy group were similar. The DFCT values of the severe PD subgroup were lower than the values of the healthy group. Conclusions: Our study showed the presence of ultrasonographic evidence consistent with early signs of cartilage destruction in early-stage PD disease. As the PD stage progressed, the cartilage thickness decreased accordingly.Öğe Ultrasonographic Evaluation of the Distal Femoral Cartilage Thickness in Parkinson’s Patients(International Society of Musculoskeletal and Neuronal Interactions, 2023) Uysal, Alper; Guntel, Murat; Demetgül, Özcan; Çiçek, UlaşObjectives: Both Parkinson’s disease (PD) and osteoarthritis (OA) are characterized by chronic inflammation and tissue degeneration. The aim of this study is to investigate the relationship between PD and distal femoral cartilage thickness (DFCT). Our study is the first in the literature to measure DFCT in PD. Methods: 68 patients with PD and 30 healthy individuals participated. The patient group was divided into three subgroups, according to the Hoehn Yahr stages (HYS): mild, moderate and severe. Patient subgroups and the control group were compared with each other in terms of neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP), and DFCT. Results: The NLR and CRP levels of the PD patients were higher than the values of the healthy people. The DFCT values of the mild PD subgroup were significantly higher than those of the control group, except for one value. The DFCT values of the moderate PD subgroup and the healthy group were similar. The DFCT values of the severe PD subgroup were lower than the values of the healthy group. Conclusions: Our study showed the presence of ultrasonographic evidence consistent with early signs of cartilage destruction in early-stage PD disease. As the PD stage progressed, the cartilage thickness decreased accordingly. © 2023, International Society of Musculoskeletal and Neuronal Interactions. All rights reserved.
