فهرست مطالب zekeriya okan karaduman

Extracorporeal shock wave therapy is a noninvasive, safe, and well- tolerated treatment method which is increasingly used in the treatment of lateral epicondylitis. However, the gold standard treatment protocol is still controversial. This study aimed to investigate and compare the efficacy of two different pneumatic pressure levels of radial extracorporeal shockwave therapy (rESWT) in active patients with lateral epicondylitis, unresponsive to conservative treatment. This retrospective comparative study was carried out in the Department of Orthopedics and Traumatology, Duzce University School of Medicine in 2018. A total of 330 patients with lateral epicondylitis unresponsive to conservative treatment were underwent rESWT during years 2010 - 2017. The patients were divided into two groups of 181 patients (group 1) with a total of 1500 impulses of 10 Hz frequency at 1 bar of air pressure during five treatment sessions at 1 week intervals, and 149 patients (group 2) with a total of 2000 impulses of 10 Hz frequency at 2 bars of air pressure during five treatment sessions at 1 week intervals. Functional and clinical outcomes were assessed just before the treatment, at six weeks and six months after treatment using the visual analogue scale (VAS) and the Quick-Disabilities of the Arm, Shoulder, and Hand (Q-DASH) score. The mean VAS score had significantly decreased in group 1 from 8.34 ± 1.22 to 2.59 ± 1.49 (P = 0.0001) and had also in group 2 from 8.56 ± 1.22 to 2.56 ± 1.76 (P = 0.0001). The mean Q-DASH score decreased significantly in both groups; from 58.92 ± 18.48 to 9.27 ± 5.85 (P = 0.0001), and from 65.36 ± 19.32 to 9.25 ± 6.28 (P = 0.0001) in group 1 and group 2, respectively. No significant difference was observed between the pretreatment VAS and the 6-month scores of groups 1 and 2 (P = 0.103). The mean difference in the Q-DASH pretreatment and 6-week scores and between the pretreatment and 6-month scores in group 2 were higher than those in group 1 (P = 0.011, P = 0.003). Although both rESWT treatment regimens caused a decrease in pain and loss of function, the superior treatment protocol for rESWT appears to be five treatment sessions at 1-week intervals, with 2000 impulses per session and 2 bars. rESWT is a good option for treating lateral epicondylitis, as it is safe and effective and leads to no complications.

Various topical treatments are available for skin defects. Chronic and complicated wounds can affect a patient’s quality of life and cause significant economic burden and even mortality. Nigella sativa (NS) oil and silver-containing solutions are separately used to treat various skin disorders. The current study aimed at examining the healing potential of NS oil, Nano-silver (AgNPs) solution, and their combination to manage skin wounds in a rat model. The current clinical experimental study was conducted in the Experimental Animal Unit of Abant Izzet Baysal University, Bolu, Turkey, in 2017. Full-thickness skin defects with a 1 cm2 surface area were created on the backs of 20 adult Wistar albino rats. The wounds were covered with 1 cm2 of absorbable oxidized regenerated cellulose (SURGICEL). The rats were numbered and assigned to four groups by simple random sampling. The agents to be compared (saline, NS oil, and AgNPs solution) were administered to the wounds twice daily for 15 days. The wounds were observed for the percentage reduction in original wound size every three days. Scars were harvested on day 15 for histological morphometric analysis. There were no significant differences in the mean vertical scar thickness among the saline (group 1) [1.06 ± 0.18], NS oil (group 2) [0.76 ± 0.14], AgNPs (group 3) [0.98 ± 0.44], and NS oil + AgNPs (group 4) [0.87 ± 0.38] groups (P = 0.556). However, the mean collagen density was significantly lower in groups 1 and 3 [56.50 ± 11.18 and 59.60 ± 3.16] compared with groups 2 and 4 [73.57 ± 6.30 and 80.99 ± 7.19] (P < 0.001). Wounds treated with the combination of NS oil and Nano-silver healed significantly faster, with less scar formation, than the ones treated with NS oil or Nano-silver alone.