Caregivers had an impaired emotional state and the level of their anxiety was associated with the severity of functional disability of the patients. Therefore, the support provided to the caregiver might be influential on the functional recovery of the patients.

Objective: To compare the efficacy of phonophoresis (PH) versus ultrasound (US) in patients with primary knee osteoarthritis (OA). Materials and Methods: Forty patients were divided into two groups as PH and US. Acoustic gel containing no pharmacological agent was applied in the US group, whereas a gel containing 1.16% diclofenac diethylamonium was applied in the PH group for 10 sessions. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale and Visual Analogue Scale (VAS) were used for the assessment of pain. The WOMAC physical function subscale, Lequesne functional index and Stanford Health Assessment Questionnaire (HAQ) were used for the assessment of physical activities. Patients were assessed for a 3 month follow-up period. Results: In the PH group, painless walking duration improved at all follow-up times except for week 2 (p<0.05). Painless walking distance and VAS scores also improved at all follow-up times (p<0.05). In the US group, VAS scores during walking and flexion of the knee, WOMAC pain and physical function scores and total WOMAC scores improved significantly at all follow-up times (p<0.05). Conclusion: Both therapeutic modalities were found effective. We suggest neither therapy is superior to the other but PH can improve painless walking duration more successfully than US.

Objective: Motor dysfunction is an important clinical finding in patients with liver cirrhosis (LC), but there is no study assessing fine motor coordination in patients with chronic hepatitis B (CHB). We aimed to investigate hand functions and fingertip dexterity in patients with CHB. Materials and Methods: A total of 17 female and 15 male patients diagnosed with CHB without histopathological findings of cirrhosis were enrolled to the study; 21 female and 9 male healthy volunteers were included as a control group. Hand grip strength was assessed by Jamar hand dynamometer. Three kinds of pinch strength of fingers were assessed by Jamar pinchmeter. Functional status was evaluated by using the Stanford Health Assessment Questionnaire (HAQ). Duruoz Hand Index (DHI) was used to assess the hand functions. Fingertip dexterity was evaluated by Purdue pegboard test. Results: Bilateral hand grip strength and pinch strength were not statistically different from controls (p>0.05). There was also no significant difference between the categories of the Purdue pegboard test between the groups. HAQ scores of patients were higher than controls (p<0.05). Conclusion: Hand functions are not influenced in patients with CHB. Disruptions in the functional status of patients with CHB may be due to fatigue and depression, which are usually seen in chronic liver diseases.

TurkeyCarvacrol prevents methotrexateinduced renal oxidative injury and renal damage in rats AbstractPurpose: e purpose of this study was to investigate the e ect of carvacrol (CAR) on methotrexate (MTX)-induced renal damage in rats.Methods: Twenty-four male rats were equally divided into three groups: group I, control treatment; group II, MTX-treated; and group III, MTX+CAR-treated. A single dose of CAR (73 mg/kg) was administered intraperitoneally to group III on the rst day of the experiment and a single dose of MTX (20 mg/kg) was administered intraperitoneally to groups II and III on the second day of the experiment. Blood samples and kidney tissue were obtained from each animal on day 8 for the measurement of malondialdehyde (MDA), total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI). Light microscopy was used for histopathological examination of kidney specimens.Results: MDA, TOS and OSI levels were signi cantly greater in the group receiving MTX alone relative to the control animals, while the TAS level was signi cantly reduced in the MTX group compared with the control group. e administration of CAR was associated with signi cantly decreased MDA, TOS, and OSI levels and increased TAS levels relative to the rats treated with MTX alone. Animals treated with CAR exhibited decreased tubular degeneration and architectural impairment relative to animals treated with MTX alone; however, the di erence in histological scores did not meet the threshold of statistical signi cance. e folic acid antagonist methotrexate (MTX) is used clinically to inhibit the synthesis of purines and pyrimidines [1]. MTX is commonly used at high doses to limit the growth of malignancies, but may also be used at low doses in in ammatory diseases, including psoriasis and rheumatoid arthritis, to inhibit the proliferation of in ammatory leukocytes [2][3][4]. MTX remains an essential component of modern clinical therapy for acute lymphoblastic leukemia and is the primary treatment for malignant gestational trophoblastic disease [5]. In addition to anti-proliferative activity, MTX has antiin ammatory and immunomodulatory properties; however, cytotoxic e ects and other side e ects limit the e cacy of MTX as an anti-in ammatory. Signi cant side e ects of MTX have been described in several organ systems. In particular, MTX has a detrimental e ect on kidney function [6]; however, the mechanism of MTX-induced toxicity remains unclear. More than 90% of MTX is ltered by the kidneys [7] and MTX treatment is known to cause renal failure at high doses [8]. Renal impairment can result in altered metabolism of MTX, delayed drug excretion and, subsequently, systemic toxicity. e toxic e ects of MTX are typically treated through hydration and alkalinization of the patient; however, these methods are insu cient to prevent all instances of MTX toxicity. Reactive oxygen species (ROS) have been implicated in the pathogenesis of MTX-induced renal damage [9,10]. MTX produces free oxygen radicals, resulting in enhanced li...

Calprotectin may play a significant role in the pathogenetic mechanisms of BD. Further insight into this area of research might provide opportunities to develop novel treatment strategies.