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Öğe ALKAPTONURIA DIAGNOSED IN A GERIATRIC PATIENT; A CASE REPORT(Gunes Kitabevi Ltd Sti, 2020) Gunduz, Ramazan; Ustun, Betul; Uran San, Ayca; Karatas, Hatice Gulsah; Akyuz, MufitAlkaptonuria is a hereditary and metabolic disease which is characterised by ocranosis, arthritis and aciduria. It is a rare clinical condition which has an estimated incidence varies from 1/ 250,000 to 1/1000000 live births. This autosomal recessive disorder occurs as a result of homogentisic acid dioxygenase enzyme deficiency which takes part in tyrosine metabolism.This case reportaimed to present a geriatric patient who had diagnosed alkaptonuria. A 69 years old male was admitted to our department with knee-shoulder pain and range of motion (ROM) limitation. His medical history revealed that he had both mechanical and inflammatory joint pain for 22 years.The examination of his eyes were compatible with blue sclera and there was also bluish black discoloration on the ears. He had also hearing loss. Qualitative 24 hours collected urine examination showed dark black discoloration. The patient was diagnosed as alkaptonuria. A physical therapy programme were planned to the patient by our department. Clinicians should be aware of this pathology and the diagnosis should be confirmed by clinical, laboratory and radiological examinations.Öğe Dynamic thiol and disulphide homoeostasis in fibromyalgia(Termedia Publishing House Ltd, 2020) Karatas, Gulsah; Gunduz, Ramazan; Haskul, Ismail; Ustun, Betul; Neselioglu, Salim; Karatas, Fatih; Akyuz, MufitIntroduction: Thiol and disulphide levels are biomarkers that provide useful information about oxidative stress and antioxidant capacity, showing a different homoeostasis in inflammatory and proliferative diseases. We aimed to clarify the possible aetiology of this disease by using thiol and disulphide levels in patients with fibromyalgia, the basis of which has not yet been clearly elucidated. Material and methods: A total of 156 individuals: 86 patients with fibromyalgia and 70 age-matched controls were included in this prospective non-randomised case-control study. Demographic characteristics including smoking status, body mass index (BMI), the duration of complaints, and pain levels were carefully recorded. Dynamic thiol-disulphide homoeostasis in blood samples was determined by an automatic-spectrophotometric method. The Mann-Whitney U and Student's t-test were used to determine the differences between the groups. Results: Sex, BMI, and smoking status were similar between the groups (p = 0.62, p = 0.09, and p = 0.64, respectively). While native thiol levels were found to be high in patients with fibromyalgia (p = 0.018), disulphide levels and the rates of disulphide/native thiol and disulphide/total thiol were significantly low (p = 0.049, p = 0.007, and p = 0.007, respectively). Correlation analysis showed no significant relationship between thiol-disulphide levels and duration of complaints or pain level. Conclusions: Thiol-disulphide balance in fibromyalgia was found to be similar to benign proliferative diseases, suggesting that the underlying mechanism is more likely to be of proliferative pattern rather than inflammatory. Additionally, fibromyalgia is not directly associated with increase in oxidative stress. The molecular mechanisms need to be elucidated.Öğe THE EFFECTS OF THE LEVEL OF SPINAL CORD INJURY ON LIFE SATISFACTION AND DISABILITY(Literatura Medica, 2020) Karatas, Gulsah; Metli, Neslihan; Yalcin, Elif; Gunduz, Ramazan; Karatas, Fatih; Akyuz, MufitIntroduction - Spinal Cord Injury (SCI) may often lead to significant disability in affected individuals and reduce life satisfaction. Herein we aimed to investigate the effects of the level of injury on disability and life satisfaction as well as the relation between life satisfaction and disability. Methods - Patients with at least one-year history of SCI were included. Demographic-clinical data of patients were recorded. The Craig Handicap Assessment and Reporting Technique-Short Form (CHART-SF) was used for quantifying the degree of patients' disability. Life satisfaction was assessed by the Satisfaction with Life Scale (SWLS). Results - Of the 76 patients, 21 (27.6%) were tetraplegic and 55 (72.4%) were paraplegic. SWLS was found to be similar in tetraplegic vs. paraplegic patients (P=0.59), whereas CHART parameters such as physical independence, mobility, occupation, and total CHART value were significantly higher in paraplegic patients (P=0.04, P=0.04, P=0.001 and P=0.01, respectively). Social integration was found similarly high in both groups. There was a positive correlation between elapsed time after the injury and CHART physical independence, occupation and the level of economic sufficiency (P<0.01, P<0.01, P=0.01). Excluding the economic sufficiency (P=0.02), there was not any other association between the rest of CHART parameters and SWLS. Conclusions - According to our findings, although the level of injury seems to be influential on disability, it seems to have no significant effect on life satisfaction. Since the only thing that positively affects life satisfaction is economic sufficiency, more emphasis should be placed on regulations that increase the return to work in patients.Öğe Electrophysiological and clinical evaluation of the effects of transcutaneous electrical nerve stimulation on the spasticity in the hemiplegic stroke patients(Soc Physical Therapy Science, 2015) Karakoyun, Ahmet; Boyraz, Ismail; Gunduz, Ramazan; Karamercan, Ayse; Ozgirgin, Nese[Purpose] To investigate whether transcutaneous electrical nerve stimulation (TENS) mitigates the spasticity of hemiplegic stroke patients, as assessed by electrophysiological variables, and the effects, if any, on the clinical appearance of spasticity. [Subjects and Methods] Twenty-seven subjects who had acute hemiplegia and 24 healthy people as the control group, were enrolled in this study. Some of the acute cerebrovascular disease patients could walk. Subjects who did not have spasticity, who were taking antispasticity medicine, or had a previous episode of cerebrovascular disease were excluded. The walking speed of the patients was recorded before and after TENS. EMG examinations were performed on the healthy controls and in the affected side of the patients. A 30-minute single session of TENS was applied to lower extremity. At 10 minutes after TENS, the EMG examinations were repeated. [Results] A statistically significant decrease in the spasticity variables, and increased walking speed were found post-TENS. The lower M amplitude and higher H reflex amplitude, H/M maximum amplitude ratio, H slope, and H slope/M slope ratio on the spastic side were found to be statistically significant. [Conclusion] TENS application for hemiplegic patients with spastic lower extremities due to cerebrovascular disease resulted in marked improvement in clinical scales of spasticity and significant changes in the electrophysiological variables.Öğe Evaluation of Inflammation in Pathogenesis of Osteoporosis with Neutrophil Lymphocyte and Platelet-Lymphocyte Ratios(Galenos Yayincilik, 2015) Boyraz, Ismail; Caglar, Hilal; Karakoyun, Ahmet; Koc, Bunyamin; Ozkan, Hilal; Gunduz, Ramazan[No abstract available]Öğe A Rare Condition of Vertebral Squaring Accompanied by Hereditary Spherocytosis(Coll Physicians & Surgeons Pakistan, 2022) San, Ayca Uran; Tezce, Ahmet; Karatas, Hatice Gulsah; Ustun, Betul; Gunduz, Ramazan; Akyuz, MufitVertebral squaring is a radiological term which defines straightening of the ventral section of vertebral body. This condition generally occurs as a result of rheumatological inflammation such as ankylosing spondylitis. There are also several other clinical conditions rarely giving rise to this change, like Paget's disease, inflammatory arthritis, and Down's syndrome. To the best of our knowledge, this is the first case of vertebral squaring accompanied by hereditary spherocytosis (HS) in literature. HS is a relatively rare condition of hemolytic anaemia due to red cell membrane defects. A 28-year male was admitted to our department with low back pain. The patient had been diagnosed with HS. On radiological examination, vertebral squaring was detected by lateral radiograph and MRI of the lumbar spine. The detection of vertebral squaring is often confusing as the clinical picture may mimic other pathologies. The diagnosis should be confirmed by laboratory and radiological assessments.
