The aim of this study is preparation and characterization of diclofenac sodium microparticles and their application to the orthopedic support materials. The microparticles were obtained using spray drying method involving ethyl cellulose as shell material. The morphology, particle size, drug loading capacity and in vitro release characteristics of the drug microparticles were optimized for impregnation diclofenac sodium microparticles onto the orthopedic support materials. Scanning electron microscopy (SEM) was used to characterize the drug microparticles and the treated fabrics with microparticles. SEM images illustrated that the microparticles were spherical in shape and also fixed onto the orthopedic support materials. Furthermore, the resistance of materials containing microparticles to washing were also investigated. Finally, in vitro drug release studies of microparticles and textile impregnated with microparticles were done. This study suggested that textile systems containing diclofenac sodium microparticles could have a potential for long-term therapy for rheumatic disorders.
Aim: The aim of this study was to evaluate the effectiveness of microwave therapy and global postural reeducation (GPR) exercises on disease activity, pain, quality of life and functional status in patients with ankylosing spondylitis (AS).
Materials and Methods: 77 patients diagnosed with AS were included in the study. First group (n: 25) was treated with global postural reeducation exercises 5 days a week, for 3 weeks. Patients in the second group (n: 26), in addition to GPR, were treated with microwave therapy before each exercise session to warm lumbar paraspinal muscles. Third group (n: 26) consisted of controls. Subjects were evaluated at baseline, on the third week, third and six months.
Results: In the first group, improvement in all parameters was found to be significant (p
To determine the efficacy of neck stabilization exercises in the management of neck pain.Sixty patients with neck pain were randomized to 3 groups, as follows: group 1--physical therapy agents including transcutaneous electrical nerve stimulation, continuous ultrasound and infra-red irradiation; group 2--physical therapy agents + isometric and stretching exercises; and group 3--physical therapy agents + neck stabilization exercises. The exercises were performed as a home training programme following a 3-week supervised group exercise. The patients were evaluated with a visual analogue scale, by intake of paracetamol, Neck Disability Index, Beck Depression Scale and range of motion in the 3 planes at baseline and at months 1, 3, 6, 9 and 12.Compared with baseline, all groups showed a significant decrease in visual analogue scale scores during the first 6 months. However, this improvement was maintained only in group 3 at 9 and 12 months, with a significant difference among the groups (p<0.05). During the study, the improvement in disability was marked in group 3 with respect to Neck Disability Index, Beck Depression Scale and range of motion in the frontal plane (p<0.05).This study demonstrates the superiority of the neck stabilization exercises, with some advantages in the pain and disability outcomes, compared with isometric and stretching exercises in combination with physical therapy agents for the management of neck pain.
Ankylosing spondylitis (AS)is a chronic inflammatory disease of the axial skeleton manifested by back pain and progressive stiffness of the spine.
Objectives
The purpose of this clinical trial was to evalute the effects of physical modality as microwave therapy and global postural reeducation program (1) in patients with anklyosing spondylitis (AS) on pain, functional and mobility outcomes.
Methods
Seventy-seven patients diagnosed with AS according to the modified criteria of New york and/or ASAS were allocated to three groups using a random numbers table. All patients received medical therapy which was not changed during the study.The first group was treated with global postural reeducation (GPR) method in which the shortened muscle chains are strecthed and strenghtened. The second group was treated with microwave therapy to heat lumbar paraspinal muscles in additon to GPR. The third group is control group which received only medical therapy The study lasted 3 months.During this period,patients received group sessions for three weeks. Each session was managed by an experienced physiotherapist and lasted for an hour.All patients were evaluted at the entry to the study,on the third week and third month visits by an assessor blinded to the intervention.The assesment parameters were: BASMI, BASDAI, BASFI, SF-36,VAS (for pain intensity) and beck depression questionaire.
Results
Between the groups there was no difference in demographic data. In the intragroup comparison (pre-post scores),the improvement in all outcome measures was statistically significant in GPR group (p<0.05) (except emotional role subscala of SF-36). In GPR plus microwave group showed stastitical improvement in all outcome measures at the third week (except VAS and emotional role subgroup of SF-36). Development in this group carried on to third month (except VAS). Intergroup comparison between the first and second groups which were based on GPR showed a greater improvement than the control group in BASMI, BASFI, BASDAI as well as beck depression and SF-36 scores. Intermalleolar distance and phsycial function subgroup of SF-36 showed a greater improvement in GPR group compared to GPR plus microwave group on third month visit (p<0.05). In the control group, the improvement in BASDAI, beck depression score, modified schober test and intermalleolar distance was stastistically significant at the third month follow-up (p<0.05).Although this outcomes also reached a significant level in control group,they did not show clinical improvement.
Conclusions
Our study shows that GPR method has a beneficial effect on spinal mobility, disease activity, quality of life and depression in patients with AS. It seems that using pysical modality such as microwave before exercise may not have additional benefit however this notion requires further research.
References
Fernández-de-Las-Peñas C, Alonso-Blanco C, Morales-Cabezas M, Miangolarra-Page JC. Two exercise interventions for the management of patients with ankylosing spondylitis: a randomized controlled trial. Am J Phys Med Rehabil. 2005 Jun;84(6):407-19.
Ochronosis is a rare metabolic disease caused by the deficiency of the homogentisic acid oxidase enzyme. It gives clinical findings related to the accumulation of homogentisic acid in soft tissues and excretion in urine. Patients with chronic arthropathy usually have some joint pain and inflammatory back pain. Although axial involvement radiologically resembles ankylosing spondylitis (AS), it is differentiated by the absence of typical syndesmophytes, facet involvement, sacroiliac erosion and fusion.Although there is no effective treatment for ochronosis disease; our patient was given a protein-poor diet, vitamin C supplementation (100 mg/kg/day) and analgesic treatment for symptoms recommended in the literature; and a reduction in joint complaints was observed. In this case, the aim is to diagnose the rare ochronotic arthropathy followed with the diagnosis of AS and to show that both axial and peripheral joint involvement can be together in this disease.
Article Antiepileptic Drug-induced Osteopenia in Ambulatory Epileptic Children Receiving a Standard Vitamin D3 Supplement was published on June 1, 2005 in the journal Journal of Pediatric Endocrinology and Metabolism (volume 18, issue 6).
This case report demonstrates the importance of the CISS sequence, a fast imaging technique in MRI, in case of suspected nerve root avulsion. We present a case of traumatic pseudomeningoceles at T1-T2 root levels with right T2 ventral root avulsion without associated skeletal fracture diagnosed by MRI using the three dimensional CISS technique. A 28-year-old man presented to the Emergency Department following a motorcycle accident. Clinical examination revealed paresis in intrinsic muscles of the right hand. Traumatic pseudomeningoceles at T1-T2 root levels bilaterally with right T2 ventral root avulsion without associated skeletal fracture were diagnosed by three dimensional cervicothoracic MRI with CISS technique.
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