No abstract

To evaluate the clinical effectiveness of wrist splint usage arranged by determining the optimal position on which the median nerve is compressed the least through sonographic examination for patients with carpal tunnel syndrome (CTS). This study was a prospective, clinical trial with a 6-week follow-up. Twenty-four patients diagnosed clinically and electromyographically with CTS were included in the study. A total of 37 wrists were studied on. When the patients were grouped according to the optimal position, Group I comprising 16 (43.24%) wrists was at 15 degree flexion, Group II comprising 12 (32.43%) wrists was neutral, Group III comprising 6 (16.22%) wrists was at 15° extension and Group IV comprising 3 (8.11%) wrists was at 30° extension configurations. Groups I, II and III were included in clinical follow-up. Symptom severity score (SSS), functional status score (FSS), Grip strength and Pinch strength were used for the clinical follow-up and evaluation of the patients. When pre- and post-treatment were compared, a statistically significant recovery was detected in all three groups in respect to SSS (Group I P < 0.01, Group II P < 0.05, Group III P < 0.05). A statistically significant recovery was detected for FSS only in Group I (P < 0.05) and for Grip strength in Group II (P < 0.05). When the groups were compared among themselves, no statistically significant difference was detected for any of the parameters (P > 0.05). In this study, by sonographic examination of the patients included in the study with CTS, we saw that the optimal position on which the median nerve is compressed the least varies depending on the individual and we determined that this position was 15° flexion most frequently for our patients. We also observed that in clinical follow-up of wrist splint usage arranged on custom optimal position results in significant recovery.

Results: Forty-one patients were included into the final analysis. Uterine contraction cessation times were 3.66±1.28 and 6.83±3.47 hours for GTN and MgSO4 groups, respectively. Similarly, maternal side effects were significantly lower in the GTN group than in the MgSO4 group, and no serious maternal side effects were recorded. Serum NO metabolite levels before treatment were significantly lower in the treatment groups than in the controls. Serum nitrite levels were significantly increased after tocolytic treatment both in MgSO 4 and GTN groups.Conclusion: GTN effectively delays preterm delivery and reduces neonatal morbidity and mortality with less maternal side effects and seems to be an effective and safe alternative to MgSO 4 . (J Turk Ger Gynecol Assoc 2015; 16: 174-8) Keywords: Glyceryl trinitrate, nitric oxide, magnesium sulfate, tocolysis Received: 28 January, 2015 Accepted: 24 March, 2015 Available Online Date: 14 July, 2015 Glyceryl trinitrate for the treatment of preterm labor Obstetrics and Gynecology, Zekai Tahir Burak Training and Research Hospital, Ankara, Turkey Abstract with intact amniotic membrane, reassuring fetal heart rate (FHR) tracing, and no contraindication for tocolysis. Exclusion criteria included multiple pregnancy, nonreassuring FHR tracing, hypotension (blood pleasure <80/50 mmHg), unexplained vaginal bleeding, placenta previa, preterm premature rupture of membranes, chorioamnionitis, cervical cerclage during present gestation, urinary system infection, maternal systemic disease, fetal growth restriction, and sensitivity or contraindication to nitrates or magnesium sulfate. Eligible women were then approached to participate in the trial, and after final recruitment, the study protocol was explained to the patients and informed consents were obtained. The patients were randomized into two treatment groups according to software-generated random allocation sequence. The random allocation sequence was held by only one author during the entire trial period. The tocolytic drug was changed in four patients from the MgSO 4 group and in three patients from GTN group, and these patients were excluded from the study in accordance with the study design ( Figure 1). In conclusion, 19 patients in the MgSO 4 group and 22 patients in GTN group were included in the final analysis. All the groups were matched with regard to maternal age, gestational age, and parity. Study designAt the time of initial assessment, blood samples were collected for routine tests and serum nitrate and nitrite levels, following which maternal sedation with 10 mg intramuscular (IM) diazepam (Diazem ® , Deva, Turkey) and hydration with 500 mL Ringer's lactate and with 500 mL 5% dextrose solution were performed. Betamethasone (Celestone Chronodose ® , Schering Plough, Turkey) was administered at 12 mg IM every 24 hours for a total of two doses to all the patients for promoting fetal lung development. Patients could not be treated with sedation and hydration underwent MgSO 4 or GTN treatment. MgSO 4 was performe...