Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item The Effect of Scapular Stabilisation Exercises on Posture and Pain in Patients with Fibromyalgia: A Randomised Controlled Trial(2023) Polat, Hakan; Bayramlar, Kezban; Turhan, Begamhan; 0000-0003-0842-2059; B-8254-2018Background/Aims Fibromyalgia is a complex syndrome characterised by chronic widespread pain, postural problems, sleep disorders, fatigue and psychiatric disorders. This study investigated the effect of scapular stabilisation exercises on cervical posture and pain in patients with fibromyalgia.Methods The study included 59 patients between the ages of 18-60 years. Individuals were divided into two groups: the study group (n=29) and control group (n=30). Both groups underwent hot pack application, transcutaneous electrical nerve stimulation and ultrasonography before the exercises. This application continued for a total of 6 weeks in both groups, 5 days a week. After this treatment, the control group was asked to perform conventional shoulder exercises and the scapular stabilisation group was asked to perform scapular stabilisation exercises. The patients were evaluated in terms of pain and cervical posture.Results Pain levels significantly decreased in both groups after the treatment (P=0.019). A decrease in tragus-to-wall distance occurred in the conventional exercise group (P=0.005). Scapular stabilisation exercises were found to be more effective than conventional exercises In terms of pain (P<0.001) and cervical posture, (P=0.024).Conclusions Both exercise programmes reduced pain levels in patients with fibromyalgia. However, scapular stabilisation exercises were more effective at both reducing pain and improving posture. Physiotherapists can use scapular stabilisation exercises to patients with fibromyalgia to reduce pain, improve posture and reduce the load on the joints.Item Assessment of Pain, Joint Range of Motion, and Balance in Patients with Knee Osteoarthritis(2023) Dag, Muhlis Yigitcan; Ergun, Ahmet; Incekas, Caner; Afsar, Sevgi IkbaliItem The Effect of Local Anesthetic Infiltration Around Nephrostomy Tract on Postoperative Pain Control After Percutaneous Nephrolithotomy(2014) Tuzel, Emre; Kiziltepe, Gunes; Akdogan, Bulent; 24990067The objective of the study was to investigate the effect of a long acting local anesthetic infiltration around nephrostomy tract on pain control after percutaneous nephrolithotomy. Forty-six patients with kidney stones of > 2 cm undergoing single access subcostal percutaneous nephrolithotomy (PCNL) were enrolled in the study. Patients were randomized to levobupivacaine (Group I) and saline (Group II) infiltration groups. Group I patients (n = 23) had 75 mg/30 cc levobupivacaine infiltration around the access site after placement of nephrostomy catheter. Group II patients had 30 cc saline infiltration. Postoperatively the patients were given narcotics on demand. Pain scores were collected using a visual analog scale (VAS) at 2, 4, 6, 8, 12 and 24 h postoperatively. The VAS scores, time to analgesic demand, ambulation, and duration of nephrostomy tube were compared between two groups. The mean age was 44 and 45 years in group I and II patients. There were no significant differences between the two groups with regard to demographics, surgery or stone characteristics. Comparison of pain scores at all postoperative time points was not statistically significant between the two groups. Time to first analgesic demand and total narcotic analgesic dose per patient were 1.2 +/- A 1.05 and 4.04 +/- A 1.57 h; and 96 and 112 mg for group I and II patients (p = 0.009 and p = 0.41, respectively). Ambulation time and duration of nephrostomy tube were also similar. Infiltration of nephrostomy tract site with levobupivacaine does not have a superior effect compared to saline on postoperative pain control in patients undergoing PCNL.To prolong analgesia, the effect of intermittent tract injections or continuous infusion of local anesthetics for the postoperative maintenance of the local anesthetic effect seems worth to investigate in future studies.Item Proximal Tibiofibular Joint Pain Versus Peroneal Nerve Dysfunction: Clinical Results of Closed-Wedge High Tibial Osteotomy Performed with Proximal Tibiofibular Joint Disruption(2017) Ozcan, Ozal; Eroglu, Mehmet; Boya, Hakan; Kaya, Yilmaz; https://orcid.org/0000-0001-6110-4004; 26971107; W-7391-2019Closed-wedge high tibial osteotomy (CW-HTO) requires shortening of the fibula or the fibular head or disruption of the proximal tibiofibular joint (PTFJ). However, no study has evaluated the proximal tibiofibular joint after the osteotomy. The aim of this study was to investigate the fate of the PTFJ after CW-HTO applied with using PTFJ disruption method. This prospective study included 22 knees of 20 patients who underwent CW-HTO. The mean age of the patients was 50 +/- 4 years, and the mean follow-up period was 27.5 +/- 14.3 months (12-46 months). The grade of gonarthrosis (Ahlback's classification), tibiofemoral alignment and tibial slope angles were measured on radiographs pre- and post-operatively. During the surgery, the PTFJ capsule was released meticulously so as not to injure the peroneal nerve. Tenderness over the PTFJ was recorded preoperatively and at the last follow-up. No patient had tenderness or pain over PTFJ preoperatively. On the follow-up examinations, tenderness with compression was detected in nine knees with dorsiflexion, in ten with plantar flexion and in nine with neutral position of the ankle, respectively. None of the patients had peroneal nerve injury (including hypesthesia and mild weakness) post-operatively. However, while 11 knees were pain free in all positions of the ankle, seven knees had tenderness over PTFJ both in dorsiflexion and in plantar flexion. CW-HTO using PTFJ disruption provides good clinical results in terms of medial knee pain and corrects the alignment sufficiently while avoiding peroneal nerve injury. However, the results of this study indicated that this technique might result in painful PTFJs. Thus, the surgeon should consider a possibly painful PTFJ, which can be a cause of chronic lateral knee pain when performing this technique.Item The relationship between pain and clinical parameters, depression, anxiety and sleep quality in patients with spinal injury(2022) Balikci, Sibel; Bardak, Ayse NurObjective: To examine the frequency of pain in individuals with spinal cord injury, and to assess the relationship of pain with functional status, sleep quality, anxiety and depression levels. Method: The prospective, cross-sectional study was conducted from March to June 2018 at Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, Turkey, and comprised adult patients of wither gender with spinal cord injury who were in the rehabilitation phase both on outpatient and inpatient basis. Data was collected using a questionnaire exploring demographic and clinical features. The presence of pain was assessed using the Leeds Assessment of Neuropathic Symptoms and Signs scale and, in case pain was found present, it was categorised as neuropathic, nociceptive and mixed type pain types. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index, while the Hospital Anxiety and Depression scale was used to evaluate anxiety and depression levels. Data was analysed using SPSS 20.Results: Of the 150 patients, 104(69.3%) were males and 46(30.7%) were females. The median age of the sample was 46 (IQR:20.52) years. Neuropathic pain was observed in 61(40.7%) patients, nociceptive in 32(21.3%) and mixed type in 12(8%). Depression was found in 71(47.3%) patients, poor sleep quality in 41(27.3%) and anxiety in 35(23.3%). Sleep, anxiety and depression scores were higher in the presence of neuropathic and nociceptive pain (p<0.05). Conclusion: Pain is a common complication in patients with spinal cord injury. In the presence of pain, sleep quality is worse, and anxiety and depression levels are high.Item The effect of kinesio taping and lifestyle changes on pain, body awareness and quality of life in primary dysmenorrhea(2020) Dogan, Hanife; Eroglu, Semra; Akbayrak, Turkan; 32379659The aim of this study was to investigate the effects of kinesio taping and lifestyle changes on pain, body awareness, and quality of life in individuals with primary dysmenorrhea (PD). Subjects in the first group underwent kinesio taping and lifestyle changes and subjects in the second group were instructed only lifestyle changes. The pain levels were evaluated using a visual analogue scale, menstrual symptoms using the Menstrual Symptom Questionnaire, health-related life quality using the Short Form-36, and changes in body awareness using the Body Awareness Questionnaire form. Pain intensity decreased, and body awareness and quality of life increased in both groups (p < 0.05). However, in the first group, pain severity decreased more, and body awareness and quality of life increased more (p < 0.05). As a result, it is thought that both kinesio taping and lifestyle changes can be used to improve quality of life and body awareness and to decrease pain level.Item Effectiveness of continuous versus pulsed short-wave diathermy in the management of knee osteoarthritis: A randomized pilot study(2019) Ozen, Selin; Doganci, Ekin B.; Ozyuvali, Ayla; Yalcin, Ayse Peyman; 31814942Background: Short-wave diathermy (SWD) is an electrotherapeutic modality used in the conservative treatment of knee osteoarthritis (KOA). Electromagnetic radiation delivered in continuous (cSWD) or pulse (pSWD) mode provides a deep heating effect on tissues. There is no consensus on outcomes of treatment with cSWD versus pSWD in KOA. The aim of this study was to compare the effects of cSWD versus pSWD on pain, functionality and walking distance in KOA. Methods: 34 female patients aged 49-65 with KOA were randomized into two groups. A total of 27 patients completed the study. One group (n=11) was treated with cSWD, the other (n=16) with pSWD for three weeks. Patients were assessed before, after and at one month post therapy. Outcome measures included visual analogue scale (VAS) for knee pain, Western Ontario and Mcmaster University Osteoarthritis Index (WOMAC) and a six-minute walking test (6MWT). Results: Based on the minimal clinically important improvement (MCII), there was a reduction in VAS and WOMAC scores in both cSWD and pSWD groups post treatment (-37.3mm, 31.2mm respectively for VAS and 26%, 23% respectively for WOMAC) and at one month post treatment. There was no difference in pre and post treatment VAS for pain, WOMAC or 6MWT scores between the two groups. There was a small post treatment effect size on between- group 6MWT scores (Cohen's d: 0.238). Conclusion: Both treatment options appear to be efficacious in reducing pain and improving functionality in KOA. There was no between-group difference. A larger study must be conducted to consolidate these findings.Item Administration of paracetamol versus dipyrone by intravenous patient-controlled analgesia for postoperative pain relief in children after tonsillectomy(2015) Sener, Mesut; Kocum, Aysu; Caliskan, Ebru; Yilmaz, Ismail; Caylakli, Fatma; Aribogan, Anis; 25443442Background and objective: We compared the efficacy of intravenous (iv) paracetamol versus dipyrone via patient-controlled analgesia (PCA) for postoperative pain relief in children. Methods: The study was composed of 120 children who had undergone elective tonsillectomy after receiving general anesthesia. Patients were divided into 3 groups according to the dosage of postoperative intravenous-patient-controlled analgesia: paracetamol, dipyrone, or placebo. Pain was evaluated using a 0- to 100-mm visual analog scale and 1- to 4-pain relief score at 30 min, 1, 2, 4, 6, 12, and 24h postoperatively. Pethidine (0.25 mg kg 1) was administered intravenously to patients requiring rescue analgesia. Pethidine requirements were recorded during the first 24h postoperatively, and treatment related adverse effects were noted. Results: Postoperative visual analog scale scores were significantly lower with paracetamol group compared with placebo group at 6h (p < 0.05), dipyrone group compared with placebo group at 30 min and 6 h (p <0.05). No significant differences regarding visual analog scale values at 1, 2, 4, 12, and 24h were found. No significant differences were found between groups with respect to pain relief score (p >0.05). Postoperative pethidine requirements were significantly lower with paracetamol and dipyrone groups compared with placebo group (62.5%, 68.4% vs 90%, p < 0.05). No significant differences were found between groups with respect to nausea, vomiting and the any other adverse effects of the drugs (p >0.05). Conclusions: Paracetamol and dipyrone have well tolerability profile and effective analgesic properties when administered iv-PCA for postoperative analgesia in children after tonsillectomy. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.Item The Optimum Dosage of Prilocaine in Periprostatic Nerve Block During Transrectal Ultrasound Guided Prostate Biopsy: A New Approach in Dose Calculation(2016) Gonulalan, Umut; Kosan, Murat; Kervancioglu, Enis; Cicek, Tufan; Ozturk, Bulent; Ozkardes, HakanObjective: We aimed to calculate the optimum dose of prilocaine per one mL prostate volume in periprostatic nerve block (PPNB) during transrectal ultrasound (TRUS) guided prostate biopsy (PBx). Materials and Methods: We retrospectively evaluated the medical records of 83 patients from whom 12 cores TRUS guided PBx were obtained between years 2011 and 2013. Prostatic sizes were evaluated separately as Size 1 (anterior-posterior on the axial plane), Size 2 (transversal), and Size 3 (cranial-caudal on the sagittal plane) for all patients. The visual analog scores (VAS) of the patients during PBx, prostatic volumes, and prilocaine doses per one mL prostate were evaluated. The correlation between VAS of patients during PBx and prostatic volume, the prostatic sizes and prilocaine dosage per one mL prostate was analyzed using Cubic regression test. Results: It was found that VAS scores of patients were significantly positive correlated with prostatic volume, Size 1, 2 and 3 (p<0.05). However, there was a negative significant correlation between VAS and prilocaine dose per one mL prostate volume (r=-0.402, p<0.01). The dose of 0.1 mL prilocaine infiltration per one mL prostatic tissue in PPNB was the maximum dose that caused a mild and under annoying pain (VAS<2) in patients according to cubic regression formula. Conclusion: Prilocaine dosage, prostatic volume and prostatic sizes (especially anterior-posterior and cranial-caudal) significantly affect VAS scores during TRUS guided PBx. The pain in TRUS guided PBx should be controlled with an optimum dose of prilocaine as 0.1 mL per one mL of prostatic tissue.Item Turkish neonatal society guideline on the neonatal pain and its management(2018) Yiğit, Ş.; Ecevit, A.; Altun Köroğlu, Ö.; 0000-0002-2232-8117; 31236029; AAJ-4616-2021Pain control is an important ethical issue to be considered and constitutes the basis of treatment in premature and term newborns. The inadequacy of pain control in these infants in neonatal intensive care units leads to neurodevelopmental and behavioral problems in the long term. For this reason, it is extremely important to raise awareness of the presence of pain in newborn infants, to reduce invasive procedures applied to infants as much as possible, and to minimize pain with non-pharmacologic or pharmacologic treatments when it is inevitable. © Copyright 2018 by Turkish Pediatric Association.