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Öğe Efficacy of 904 nm gallium arsenide low level laser therapy in the management of chronic myofascial pain in the neck: A double-blind and randomize-controlled trial(Wiley, 2004) Gür, Ali; Saraç, Ayşegül Jale; Çevik, Remzi; Altındağ, Özlem; Saraç, SerdarBackground and Objectives: A prospective, doubleblind, randomized, and controlled trial was conducted in patients with chronic myofascial pain syndrome (MPS) in the neck to evaluate the effects of infrared low level 904 nm Gallium-Arsenide (Ga-As) laser therapy (LLLT) on clinical and quality of life (QoL). Study Design/Patients and Methods: The study group consisted of 60 MPS patients. Patients were randomly assigned to two treatment groups: Group I (actual laser; 30 patients) and Group II (placebo laser; 30 patients). LLLT continued daily for 2 weeks except weekends. Follow-up measures were evaluated at baseline, 2, 3, and 12 weeks. All patients were evaluated with respect to pain at rest, pain at movement, number of trigger points (TP), the Neck Pain and Disability Visual Analog Scale (NPAD), Beck depression Inventory (BDI), and the Nottingham Health Profile (NHP). Results: In active laser group, statistically significant improvements were detected in all outcome measures compared with baseline (P < 0.01) while in the placebo laser group, significant improvements were detected in only pain score at rest at the 1 week later of the end of treatment. The score for self-assessed improvement of pain was significantly different between the active and placebo laser groups (63 vs. 19%) (P < 0.01). Conclusion: This study revealed that short-period application of LLLT is effective in pain relief and in the improvement of functional ability and QoL in patients with MPS.Öğe Efficacy of low power laser therapy and exercise on pain and functions in chronic low back pain(Wiley, 2003) Gür, Ali; Karakoç, Mehmet; Çevik, Remzi; Nas, Kemal; Saraç, Ayşegül Jale; Karakoç, Meral; 0000-0001-9680-6268; 0000-0002-9511-7070; 0000-0002-4124-1586; 0000-0002-5845-0851Background and Objectives: The aim of this study was to determine whether low power laser therapy (Gallium-Arsenide) is useful or not for the therapy of chronic low back pain (LBP). Study Design/Materials and Methods: This study included 75 patients (laser+exercise-25, laser alone-25, and exercise alone-25) with LBP. Visual analogue scale (VAS), Schober test, flexion and lateral flexion measures, Roland Disability Questionnaire (RDQ) and Modified Oswestry Disability Questionnaire (MODQ) were used in the clinical and functional evaluations pre and post therapeutically. A physician, who was not aware of the therapy undertaken, evaluated the patients. Results: Significant improvements were noted in all groups with respect to all outcome parameters, except lateral flexion (P < 0.05). Conclusions: Low power laser therapy seemed to be an effective method in reducing pain and functional disability in the therapy of chronic LBP.Öğe Genç yaştaki fibromiyaljili hastalarda solunum fonksiyon testleri(2001) Şenyiğit, Abdurrahman; Saraç, Ayşegül Jale; Karakoç, Mehmet; Gür, Ali; Çevik, Remzi; Nas, Kemal; Erdoğan, FerdaFibromiyalji; nonartiküler orijinli, etyolojisi bilinmeyen, jeneralize kas iskelet sistemi ağrısı, karekteristik bölgelerde hassas noktalar, yorgunluk, tutukluk, uyku bozuklukları ve anksiyete ile karakterize, ağrılı bir sendromdur. Bu çalışmanın amacı, genç fibromiyaljili hastalarda solunum fonksiyon testlerini değerlendirmektir. Çalışmaya Amerikan Romatoloji Birliği (ARA) kriterlerine göre Fibromiyalji Sendromu (FMS) tanısı konan 38 hasta ile benzer yaş ve cinsiyette 23 kişilik kontrol grubu alındı. Vakaların hiçbiri sigara içmemekteydi. Hastalarda zorlu vital kapasite (FVC), birinci saniye zorlu ekspirasyon hacmi (FEV1), FEV1/FVC, ekspiryum ortası akım hızı (FEF25-75), ekspiryum en yüksek akım hızı(PEF), ekspire edilen vital kapasitenin ilk %25, %50 ve %75'inde atılan hava volümü (FEF25,FEF50 ve FEF75) değişkenleri ölçüldü. Tüm spirometrik ölçümler kontrol grubuna göre hasta grubunda düşük bulunmasına rağmen, sadece FEV1, FVC, FEF25 ve PEF değerlerindeki düşüklük anlamlıydı (p<0.05). Bu bulgular restriktif tip solunum fonksiyon bozukluğunu göstermekteydi. Çalışmamız; fibromiyaljili hastalarda şiddetli ağrı, yorgunluk, fiziksel inaktiviteye ve solunum kaslarının etkilenmesine bağlı olarak restriktif tipte solunum fonksiyon bozukluğu gelişebileceğini göstermiştir.Öğe Intramedullary tuberculoma of the cones medullaris(Nature Publishing Group, 2001) Kemaloǧlu, Serdar; Gür, A; Nas, Kemal; Çevik, Remzi; Büyükbayram, Hüseyin; Saraç, Ayşegül JaleObjective: To illustrate the dilemmas in the diagnosis and management of intramedullary tuberculomas of the spinal cord. Methods: Case report of a 32 year-old man with tuberculous meningitis. The presence of unexplained urinary retention and progressive weakness in the legs led to the discovery of an additional tuberculoma of the conus medullaris. Setting: Dicle University Diyarbakir, Turkey. Results: The patient was on a 1-year course of isoniazid, pyrazinamide and rifampicin, and responded well to conservative treatment. Our patient's unique features were represented by the worsening of neurological symptoms while being treated with adequate anti-tuberculous medication. Conclusion: We present a case of intramedullary tuberculoma of the conus medullaris to illustrate the dilemmas in the diagnosis and management of this curable disease, and review of the literature to date.Öğe Quality of life in young fibromyalgia patients and effect of depression(2006) Gür, Ali; Çevik, Remzi; Nas, Kemal; Saraç, Ayşegül Jale; Özen, Şakir; 0000-0001-9680-6268Aim: The purpose of this study was to compare the depression and quality of life (QOL) scores of fibromyalgia (FM) patients and control subjects. We also aimed to detect relationships between different QOL scales, depression and clinical symptoms. Method: Ninety-eight fibromyalgia patients and 48 healthy volunteers were included in the study. Depression was evaluated by a psychiatrist according to the Hamilton Depression Rating Scale and Diagnostic and Statistical Manual for Mental Disorders Edition.4 (DSM-IV) criteria. QOL of the FM patients was assessed according to the Nottingham Health Profile (NHP), Health Assessment Questionnaire (HAQ), and Fibromyalgia Impact Questionnaire (FIQ). Results: We found significantly higher scores of depression, NHP, FIQ and HAQ in FM patients compared with controls (P < 0.000). Pain, tender point count (TPC), pain intensity, skinfold tenderness, FIQ, HAQ, and NHP scores were higher in patients with depression than in those without depression. Depression scores correlated with FIQ (r = 0.39, P < 0.01), HAQ (r = 0.35, P < 0.01), NHP (r = 0.55, P < 0.01) scores, TPC (r = 0.34, P < 0.01) and duration of disease (r = 0.21, P < 0.05). Fibromyalgia Impact Questionnaire scores correlated with HAQ scores (r = 0.45, P < 0.01), NHP scores (r = 0.49, P < 0.01) and TPC (r = 0.21, P < 0.05). HAQ scores correlated with NHP scores (r = 0.40, P < 0.01) and TPC (r = 0.29, P < 0.05). Nottingham Health Profile scores correlated with TPC (r = 0.43, P < 0.01) and duration of disease (r = 0.22, P < 0.05). Conclusion: We found higher scores of TPC, pain intensity, skinfold tenderness, NHP, FIQ, and HAQ in depressive FM patients as compared with non-depressive FM patients. Our study indicates that there is an important relationship between pain, depression and QOL scales in young FM patients. Therefore; these patients should be managed using a multidisciplinary approach including psychiatric support.Öğe The relationship between educational level and bone mineral density in postmenopausal women(2004) Gür, Ali; Saraç, Ayşegül Jale; Nas, Kemal; Çevik, RemziBackground: This study describes the influence of educational level on bone mineral density (BMD) and investigating the relationship between educational level and bone mineral density in postmenopausal women. Methods: A total of 569 postmenopausal women, from 45 to 86 years of age (mean age of 60.43 ± 7.19 years) were included in this study. A standardized interview was used at the follow-up visit to obtain information on demographic, life-style, reproductive and menstrual histories such as age at menarche, age at menopause, number of pregnancies, number of abortions, duration of menopause, duration of fertility, and duration of lactation. Patients were separated into four groups according to the level of education, namely no education (Group 1 with 209 patients), elementary (Group 2 with 222 patients), high school (Group 3 with 79 patients), and university (Group 4 with 59 patients). Results: The mean ages of groups were 59.75 ± 7.29, 61.42 ± 7.50, 60.23 ± 7.49, and 58.72 ± 7.46, respectively. Spine BMD was significant lower in Group 1 than that of other groups (p < 0.05). Trochanter and ward's triangle BMD were the highest in Group 4 and there was a significant difference between Group 1 and 4 (p < 0.05). The prevalence of osteoporosis showed an inverse relationship with level of education, ranging from 18.6% for the most educated to 34.4% for the no educated women (p < 0.05). Additionally, there was a significant correlation between educational level and spine BMD (r = 0.20, p < 0.01), trochanter BMD (r = 0.13, p < 0.01), and ward's BMD (r = 0.14, p < 0.01). Conclusions: The results of the study suggest that there is a significant correlation between educational level and BMD. Losses in BMD for women of lower educational level tend to be relatively high, and losses in spine and femur BMD showed a decrease with increasing educational level.Öğe The results of rehabilitaion on motor and functional improvement of the spineal tuberculosis(2004) Nas, Kemal; Kemaloǧlu, Mustafa Serdar; Çevik, Remzi; Ceviz, Adnan; Necmioǧlu, Serdar; Bükte, Yaşar; Coşut, Abdülkadir; Şenyeǧit, Abdurraham; Gür, Ali; Saraç, Ayşegül Jale; Özkan, Ümit; Kırbaş, Gökhan; 0000-0001-9680-6268Objectives. - To evaluate the result of rehabilitation on motor and functional improvement in spinal tuberculosis. Methods. - Prospective case study. Data were collected from 47 patients with spinal tuberculosis medically and/or surgically treated, and rehabilitated over a period of 6 months, after spinal decompression and fusion. The main outcome measures were motor development of the patients was evaluated at the beginning, in the 1st week, in the 3rd month, and in the 6th month. Functional development of the patients was evaluated at the beginning and in the 6th month. Functional assessment was made according to Modified Barthel Index (MBI), and motor examination was make according to American Spinal Injury Association (ASIA). Results. - The study population consisted of 47 patients (22 males and 25 females) mean age 37.9 ± 18.3 years (range 5-76 years). The most common site of spinal tuberculosis was the thoracic region. Localized back pain, paraparesis, sensory dysfunction and fever were typical clinical manifestations. Surgical management was performed as anterior or posterior drainage of abscess and/or stabilization of the spine. The rehabilitation program was performed in all patients during the preoperative, early postoperative and late postoperative 6th month periods. Muscle-strengthening exercises on necessary localization such as pectoral, abdominal, lower extremities, truncal and sacrospinal extansors were started for the rehabilitation. The motor score for the lower limbs and the MBI scores for activities of daily living (ADL) and mobility improved significantly ( P < 0.001). The self-care and mobility categories of the MBI on admission were 14.8% severely dependent and 10.6% independent. However, at the end of the rehabilitation program, 4.2% were severely dependent and 70.2% independent. Conclusion. - Early diagnosis and appropriate medical and/or surgical treatment together with a rehabilitation program will improve the life quality of patients with spinal tuberculosis.Öğe Romatoid artritli hastalarda kardiyak sempatovagal aktivitenin kalp hızı değişkenliği ile değerlendirilmesi(Dicle Üniversitesi Tıp Fakültesi, 2010) Çevik, Figen Ceylan; Yazıcı, Selma; Kara, Ali Fuad; Atılgan, Zuhal; Çil, Habib; Tekbaş, Ebru; Çevik, Remzi; Tahtasız, Mehmet; Saraç, Ayşegül JaleAmaç: Romatoid artritte (RA) inflamatuar strese bağlı sempatik sinir sistemi aktivitesinde artış ve buna bağlı kalp hızı değişkenliğinde bozulma olduğu bildirilmiştir. Bu çalışmada RA’lı hastalarda kalp hızı değişkenliği (KHD) gibi noninvaziv elektrofizyolojik parametreler aracılığıyla kardiyak sempatovagal aktivite değerlendirildi. Gereç ve yöntem: Bu çalışmaya 49 RA’lı hasta ve benzer yaşta 28 sağlıklı birey kontrol grubu olarak alındı. Tüm bireylerin klinik ve laboratuar parametreleri değerlendirildi ve hepsine 24 saatlik Holter elektrokardiografik monitorizasyon yapıldı. Bulgular: Hasta grubunda minimal, maksimal ve ortalama kalp hızları kontrol grubuna kıyasla oldukça anlamlı düzeyde yüksek ve ortalama RR intervali de anlamlı düzeyde düşük bulundu. Ek olarak, zaman bağımlı KHD parametreleri arasında SDNN, SDANN ve triangular indeks anlamlı düzeyde düşük saptandı. (sırasıyla p<0.05, p<0.01, p<0.01). Korelasyon analizinde herhangi bir KHD parametresi ile yaş, cinsiyet, hastalık süresi ve aktivitesi, inflamasyon belirteçleri, supraventriküler ya da ventriküler ekstrasistol sayısı (VES) arasında anlamlı bir ilişki saptanmadı. Yalnızca pNN50, SDANN ve RMSDD ile VES arasında anlamlı ve negatif bir ilişki saptandı. Fakat multivaryans analizde bu parametreler arasında bağımsız bir ilişki gösterilemedi. Sonuç: RA’lı hastalarda KHD gibi nonivaziv parametrelerin geleneksel risk faktörlerine ek olarak kardiyovasküler riskin değerlendirilmesi ve ani kardiyak ölüm riskinin öngörülmesinde ılımlı bir rolü olabilir. Fakat daha kesin yargıya varılabilmesi için farklı hasta gruplarını içeren, daha geniş ve uzun dönemli çalışmalar gerekmektedir.Öğe Romatoid artritli hastalarda kardiyak tutulumun noninvaziv elektrofizyolojik parametrelerle değerlendirilmesi(Dicle Üniversitesi Tıp Fakültesi, 2010) Çevik, Figen Ceylan; Yazıcı, Selma; Tahtasız, Mehmet; Kara, Ali Fuad; Çil, Habib; Atılgan, Zuhal; Tekbas, Ebru; Saraç, Ayşegül JaleAmaç: Romatoid artrit (RA)’te hem hastalığa ve hem de kullanılan ilaçlara bağlı olarak kalp tutulumu olabilmekte ve çoğunlukla sessiz seyretmektedir. Bu çalışmada RA’li hastalarda non-invaziv elektrofi zyolojik parametreler aracılığıyla kardiyak etkilenimin varlığı araştırıldı. Gereç ve yöntemler: Bu çalışmaya benzer yaşta 49 RA’li hasta ve 28 sağlıklı birey kontrol grubu olarak alındı. Tüm bireyler klinik ve laboratuar parametreleri açısından değerlendirildi ve 24 saatlik Holter elektrokardiografi k monitorizasyonları yapıldı. Bulgular: Maksimum QT aralığı kontrollere göre RA’lı hastalarda daha düşük iken (p<0.05), minimum, maksimum ve ortalama kalp hızı (sırasıyla; p<0.05, p<0.01, p<0.01) ise daha yüksekti. P dalga parametreleri (P maksimum, P minimum and P dispersiyonu) her iki grupta benzerdi. Korelasyon analizlerinde sadece düzeltilmiş QT dispersiyonu ile eritrosit sedimantasyon hızı arasında anlamlı ters bir ilişki mevcuttu (p<0.05). Bununla beraber, P dalga süresi ve QT parametreleri ile herhangi bir klinik veya laboratuar parametresi arasında anlamlı bir ilişki bulunmadı (p>0.05). Sonuç: Romatoid artritli hastalarda QT dispersiyonu gibi nonivaziv parametrelerin geleneksel risk faktörlerine ek olarak kardiyovasküler riskin değerlendirilmesi ve ani kardiyak ölüm riskinin öngörülmesinde ılımlı bir rolü olabilir. Fakat daha kesin bir yargı için farklı ve daha fazla sayıda içeren, prospektif ve uzun süreli çalışmalara gereksinim vardır
