Objectives: This study aims to evaluate the cost expenses and rehabilitation share of hand and/or wrist injuries and to contribute to the development of health and economic policies. Patients and methods: A total of 59 patients (55 males, 4 females; mean age: 39.1±11.3 years; range, 20 to 64 years) who presented with hand and/or wrist injuries between January 2015 and December 2017 were retrospectively reviewed. Demographic data, hand injury information, and the Modified Hand Injury Severity Scores (MHISS) were retrieved from the patient file system. The cost analysis with direct and indirect costs was performed. Results: According to the MHISS, 27.1% of patients had a minor injury, 23.7% had a moderate injury, 18.6% had a severe injury, and 30.5% had a major injury. The mean direct cost of the patients was $726.00±641.87 and the total cost of the indirect cost was $2,776.93±1,619.00. The mean day-off time was 125±68.62 days. Indirect costs accounted for 79% of the total cost. The mean cost of rehabilitation was $150.18±86.88. Rehabilitation costs accounted for 4% of the total cost. There was a positive correlation between the MHISS and direct, indirect and total cost, but not between the MHISS and rehabilitation cost. Conclusion: The proportion of the share allocated to rehabilitation expenditures, which is the subunit of direct cost, is low and not related to the injury severity. The data obtained from the study contributed to the creation of evidence-based health and economic policies. We believe that these data also contribute to the planning of rehabilitation services according to the severity of injury which would improve the quality of life and return to work.

Özet: Bu çalışmanın amacı, fibromiyalji sendromu olan hastalarda 25(OH)D düzeyini değerlendirmek ve hassas nokta sayısı ile 25(OH)D düzeyi arasındaki ilişkiyi araştırmaktı. Bu retrospektif çalışmaya, 2016-2017 yılları arasında fibromiyalji tanısı almış 61 hasta dahil edildi. Hastaların demografik verileri, 25(OH)D düzeyleri, hassas nokta sayıları değerlendirildi. Hastalar 25(OH)D düzeyleri göre; D vitamini eksikliği (<20 ng/ml), D vitamini yetersizliği (20-30 ng/ml) ve normal D vitamini düzeyi olarak (>30 ng/ml) sınıflandırıldı. Fibromiyalji tanısı olan 61 hastanın 25(OH)D düzeyleri ortalaması 18,08±11,72 idi. D vitamin düzeyleri incelendiğinde, 40 fibromiyalji hastasında D vitamini eksikliği, 14 fibromiyalji hastasında D vitamini yetersizliği olduğu saptandı. Fibromiyalji tanısı olan hastaların sadece 7'sinde (%11,48) D vitamin düzeyleri normal seviyede bulunmuştur. Hastaların 25(OH)D düzeyleri ve hassas nokta sayıları arasında anlamlı bir korelasyon gözlemlenmedi. Fibromiyaljili hastaların büyük çoğunluğunda vitamin D düzeylerinin düşük olduğu, bununla birlikte fibromiyaljili hastalarda saptanan hassas nokta sayısının 25(OH)D değerleriyle ilişkili olmadığı sonucuna varılmıştır.Abstract: The aim of this study was to evaluate 25(OH)D levels in patients with fibromyalgia syndrome and to investigate the relationship between tender point count and 25(OH)D levels.Sixty one patients with a diagnosis of fibromyalgia were included in this retrospective study between 2016-2017. Demographic data of patients, 25(OH)D levels, number of tender points were evaluated. Patients were classified as vitamin D deficiency (<20 ng/ml), vitamin D insufficient (20-30 ng/ml) and normal vitamin D level (> 30 ng /ml) according to 25(OH)D levels. The mean 25(OH)D levels of 61 patients with firomyalgia was 18.08±11.72. When vitamin D levels were examined, vitamin D deficiency was found in 40 patients with fibromyalgia and vitamin D deficiency in 14 patients with fibromyalgia. Only 7 (11,48%) of the patients with fibromyalgia had normal vitamin D levels. There was no significant correlation between 25(OH)D levels and tender point counts of patients. It was concluded that the vitamin D levels were low in the majority of patients with fibromyalgia, however the number of tender point detected in patients with fibromyalgia was not related to 25(OH)D values.

This study evaluates effects of therapeutic ultrasound (continue, pulsed, placebo) treatment on the clinical and biochemical parameters in knee osteoarthritis. 30 patients (30-70 aged) diagnosed with knee osteoarthritis were randomly separated into three groups. The 1st group includes 10 patients given continue ultrasound treatment (1 MHz, 2W/cm2), the 2nd group consists of 10 patients given pulsed ultrasound treatment (1MHz, 2 W/cm2, 1:4) and 3th group includes 10 patients given placebo ultrasound treatment (switch off). The patients were assessed before and one month after the treatment with WOMAC, COMP, Hs CRP, MMP-1, MMP-3 levels in serum and CTX-II levels in urine. When the demographic characteristics were compared, no statistically significant difference was found between the three groups in terms of age, body mass index and radiological staging (p > 0.05). In terms of clinical parameters, there was an improvement in all three groups in the first month after treatment except WOMAC stiffness in pulsed and placebo groups, although no statistically significant difference was observed between the groups (p > 0.05). In the evaluation of biochemical parameters, there was no significant difference between the groups in terms of pre-treatment and post-treatment 1 month, whereas there was a statistically significant difference between the group 1 and group 3 in favor of group 3 (p = 0.019). The efficacy of therapeutic US (continuous / pulsed) which was applied short term and alone, on clinical and biochemical markers in knee osteoartrithis, has not been demonstrated.