OBJECTIVE:Our aim in this study is to investigate the total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) values of diclofenac sodium, which is a non-steroidal anti-inflammatory analgesic, after sciatic nerve injury, to examine the histopathological changes in the sciatic nerve, and to examine the results and enable important changes in treatment. It is one of the rare studies conducted histopathologically on post-injection sciatic nerve damage of diclofenac sodium, and the parameters of our biochemical approach have not been evaluated before in the literature. METHODS:study was divided into 5 main groups as control, sham, trauma, isotonic fluid, and diclofenac sodium. Sham, trauma, isotonic fluid, and diclofenac sodium groups were divided into four subgroups as early stage (day 1, day 3) and late stage (day 7 and day 14). Subjects in each group were evaluated daily by neurological examination according to the Tarlov scale. In all groups except the control group, the sciatic nerve was exposed through appropriate surgical procedures. TAS, TOS, and OSI were run on blood samples biochemically. Nerve tissue samples were evaluated histopathologically and immunohistochemically. RESULTS:There was a significant difference in pairwise comparison of the groups in terms of CASPASE-3 values. A statistically significant difference was found between the groups in terms of myelin thickness and axon diameter. A statistically significant difference was found between the groups in terms of nerve diameter values. CONCLUSION:Our study demonstrates that intramuscular injections of diclofenac sodium have potential harmful effects. We recommend that alternative methods of using diclofenac sodium intramuscularly be preferred whenever possible due to the potential complications associated with this drug, that healthcare professionals receive necessary training on intramuscular administration, that the procedures be performed more carefully, and that patients be informed about these complications.
Today, minimally invasive oxygen(O2)-ozone(O3) intramuscular lumbar paravertebral injections are used to relieve pain in conditions such as low back pain. Repeated paraspinal, peridural, or spinal O3 injections, when performed under non-aseptic conditions or not performed with proper technique, may carry a risk of parameningeal inoculation of bacteria resulting in meningitis and pneumocephalus. Although this treatment is well tolerated in most cases, the patient may sometimes develop rare but very serious complications. Our study presents a case of pneumocephaly and meningitis due to the injection of an intramuscular O2-O3 mixture directed into the subarachnoid space after dural puncture for the treatment of low back pain. Air-density lesions were detected in the temporal and frontal horns of the left lateral ventricle on the patient's computed tomography scan of the brain. The cerebrospinal fluid appeared slightly cloudy, with a leukocyte count of 4000/mm3, protein level of 483 mg/dL, glucose at 40 mg/dL, and chlorine at 113 mmol/L. Ensuring that ozone injection therapy is performed by qualified professionals and that strict aseptic precautions are taken before the procedure will prevent serious iatrogenic complications such as pneumocephalus and meningitis.
OBJECTIVE:This study aimed to evaluate the nutritional knowledge levels of mothers of children aged 4-6 years attending pediatric outpatient clinics, analyze knowledge levels according to maternal age, education, and income, and investigate their relationship with children's anthropometric measurements. METHODS:This cross-sectional study included 282 mothers of preschool-aged children who attended a pediatric outpatient clinic. Nutritional knowledge was assessed using the Nutritional Knowledge Level Scale for Adults, comprising Basic Nutritional Knowledge (BNK) and food preference (FP) subscales. Mothers also rated Nutrition-Health Awareness (NHA) and Dietary Adequacy Self-Assessment (DAS) on a 0-10 visual scale. Children's height-for-age (HAZ) and weight-for-age (WAZ) z-scores were calculated. Multiple linear regression and correlation analyses were performed. RESULTS:The median maternal age was 34 (interquartile range [IQR]: 29.25-40) years. Median BNK and FP scores were 58 (IQR: 51-69) and 35 (IQR: 30-40), respectively. Educational attainment was the strongest independent predictor of BNK (p=0.006) and DAS (p=0.033). Household income independently predicted FP (p=0.022) and NHA (p=0.026) after adjusting for age and education. Younger maternal age was associated with higher BNK scores. No statistically significant associations were found between maternal nutritional knowledge variables and children's HAZ or WAZ scores (all p>0.05). CONCLUSION:Most mothers demonstrated adequate BNK; however, this did not consistently translate into FP competence or healthy dietary self-perception. Maternal nutritional knowledge was not directly associated with children's growth outcomes in this cohort, suggesting the pathway from knowledge to child growth is indirect and multifactorial. Nutrition interventions should move beyond knowledge transfer to address practical dietary skills and socioeconomic determinants of eating behavior.
OBJECTIVE:The objective of the study is to evaluate the association between serum 25-hydroxyvitamin D (25[OH]D) levels and fatigue severity. METHODS:This single-center, cross-sectional study included 228 participants aged 18-65 years who completed the fatigue severity scale (FSS) questionnaire. Individuals who had received vitamin supplementation within the previous 3 months, had known chronic disease, used regular medication, or had a history of antidepressant/anxiolytic use for depression/anxiety were excluded. Serum 25(OH)D, hemoglobin, ferritin, iron, magnesium, vitamin B12, and folate values were retrieved from the hospital information system. The Mann-Whitney U-test was used for comparisons between genders, and the Spearman correlation test was used for relationships between FSS and biochemical parameters. P<0.05 was considered statistically significant. RESULTS:A total of 228 participants (57 males and 171 females) were included in the study. Most variables were not normally distributed; therefore, non-parametric analyses were performed. Spearman correlation analysis demonstrated a weak but significant negative correlation between FSS scores and both hemoglobin (p=0.003) and ferritin levels (p=0.001). No significant correlations were found between FSS and vitamin D, vitamin B12, folate, magnesium, or serum iron levels (p>0.05).In group comparisons based on fatigue severity, ferritin levels were significantly lower in the high-fatigue group compared to the low-fatigue group (p<0.001). Hemoglobin levels were also lower in the high-fatigue group (p=0.043). In contrast, vitamin B12 levels were significantly higher in the high-fatigue group (p=0.032). No significant differences were observed between groups in terms of vitamin D, folate, magnesium, or serum iron levels (p>0.05). CONCLUSION:Serum 25(OH)D levels were not associated with fatigue severity. The observed relationship between fatigue severity and hematological markers (hemoglobin and ferritin) suggests that these parameters should be considered in the clinical evaluation of fatigue.
OBJECTIVE:To examine changes in motor and non-motor clinical outcomes following participation in a home-based telerehabilitation program incorporating motor-cognitive dual-task exercises in individuals with Parkinson's disease (PD). METHODS:This retrospective cohort study analyzed prospectively recorded clinical data obtained from a government-supported telerehabilitation service implemented at a tertiary physical medicine and rehabilitation center in Istanbul, Türkiye. The study included 60 participants with mild-to-moderate PD (Hoehn and Yahr stages 1-3) who completed a 6-week intervention consisting of 30 supervised sessions (60 min/session, 5 days/week). The program combined motor exercises, cognitive tasks, and integrated dual-task activities delivered through synchronous video-based supervision. Clinical assessments included balance (Berg Balance Scale, Mini-BESTest), balance confidence (Activities-specific Balance Confidence Scale), mobility (Timed Up and Go test), manual dexterity (Nine-Hole Peg Test), quality of life (PD Questionnaire-39), depressive symptoms (Beck Depression Inventory), and self-reported urinary/fecal incontinence. RESULTS:Post-intervention analyses demonstrated statistically significant improvements in all evaluated outcomes (all p<0.001). Participants showed better balance, mobility, and hand dexterity, accompanied by increased balance confidence and improved gait-related performance. Quality-of-life scores improved, while depressive symptom severity decreased following the intervention. The proportion of participants reporting urinary incontinence declined from 40% to 23%, whereas fecal incontinence decreased from 12% to 2%. Effect size analyses demonstrated moderate-to-large improvements across the primary and key secondary outcomes, with the largest effects observed for depressive symptoms, quality of life, and balance-related performance. No intervention-related adverse events were identified during the study period. CONCLUSION:Participation in a remotely supervised, dual-task-based telerehabilitation program was associated with favorable changes across multiple clinical domains in individuals with PD. The findings suggest that home-based telerehabilitation may represent a feasible and clinically relevant rehabilitation approach within routine practice. Given the retrospective nature of the study and the lack of a control group, the observed findings should be considered preliminary. Prospective randomized controlled trials are needed to confirm these findings and evaluate their long-term clinical significance.
