Background and Objective: Carpal Tunnel Syndrome (CTS) is the most common compressive neuropathy of the upper limb and one of the causes of disability. The current study aimed to compare the therapeutic effects of Low-Level Laser Therapy (LLLT) and therapeutic ultrasound (US) in patients with mild to moderate carpal tunnel syndrome. Materials and Methods: This single-blind randomized trial was conducted on 30 patients with CTS (58 wrists) who were randomly assigned to two treatment groups: laser therapy group (15 patients, 29 wrist (and Ultrasound therapy group (15 patients, 29 wrists). Low-level laser therapy (9 joules, 808 nm infrared laser at five points) and Ultrasound treatment (1 MHz, 1.5 W/cm2, duty cycle 20%, 5 min/session) were applied to the carpal tunnel for 10 daily treatment sessions (5 sessions/week). Outcome measures were Visual analogue scale, pinch & grip strength and Boston questionnaire (BQ), which measured before and after treatment (the end of the study). The pair and independent t-test were used to evaluate the variables. Results: In both groups (laser therapy and Ultrasound therapy), there was a significant improvement in visual analog scale (P=0.000 and P=0.000, respectively), grip strength (P=0.01 and P=0.004, respectively), and pinch strength (P=0.001 and P=0.009, respectively). The results of the Boston Questionnaire also demonstrated an improvement (P=0.000 and P=0.000, respectively) at the end of the study, compared to baseline values. However, there was no significant difference in any of the measured variables between the two treatment groups. Conclusion: As evidenced by the obtained results, both low-level laser therapy and ultrasound are effective in the reduction of pain and improvement of hand function in patients with mild-to-moderate CTS in the short-term.
Introduction Various studies have examined the association between periodontitis and helicobacter pylori and reported conflicting results. The aimed of this systematic review and meta-analysis estimating the association between these two variables. Methods Electronic databases including PubMed (Medline), Scopus, Web of Sciences and Medline (Elsevier) were searched using the relevant keywords. All observational studies comparing the association between periodontitis and helicobacter pylori were considered. The Newcastle - Ottawa Quality Assessment Scale (NOS) checklist was used for assessing quality of included studies. All statistical analyses were completed using STATA (Version 16). Results Twenty-three studies with 8,638 patients (15 case-control with 2,366 patients and 8 cross-sectional with 6,272 patients) were included in this meta-analysis. After combining the selected studies, the odds of presence the Helicobacter pylori infection in patients with the periodontal disease was 2.47 (OR: 2.47; 95% CI: 2.01, 3.03; I2: 50.87%; P: 0.001). Also, the odds after combining case-control studies was 2.77 (OR: 2.77; % 95 CI: 2.11, 3.66; I2: 37.16%; P: 0.049) and after combining cross-sectional analytical ones, it was equal to 2.07 (OR: 2.07; 95% CI: 1.62, 2.65; I2: 43.25%; P: 0.050). Conclusion Based on the results of this meta-analysis, the association between Helicobacter pylori infection and the periodontal disease is evident.
Background: Carpal tunnel syndrome (CTS) is the most prevalent compression neuropathy in the upper extremity. Objectives: The present study aimed to compare ultrasound and laser therapies separately and together in relieving hand pain and improving performance in mild and moderate CTS patients. Methods: In this single-blind trial, 45 patients (84 wrists) suffering from CTS were randomly divided into three treatment groups: the ultrasound and laser combination group (15 patients), the ultrasound therapy group (15 patients), and the laser therapy group (15 patients). Low-level laser therapy (total intensity of 9 J on 5 points) and ultrasound therapy (intensity of 1.25 W/cm and duty cycle of 20% for 5 minutes per session) were applied on the carpal tunnel for 10 sessions. For the ultrasound and laser combination group, the laser was first conducted in the same way for the laser therapy group, and ultrasound was performed immediately after, with the same parameters as those of the ultrasound therapy group. A visual analog scale (VAS), grip strength, pinch strength, and the Boston Questionnaire results were evaluated before and after the treatment. Results: All three treatment groups (the ultrasound and laser combination group, the ultrasound therapy group, and the laser therapy group) demonstrated significantly improved VAS (P=0.000, P = 0.000, and P = 0.000, respectively), grip strength (P = 0.003, P = 0.001, and P = 0.01, respectively), pinch strength (P = 0.000, P = 0.004, and P = 0.002, respectively), and Boston questionnaire results (P = 0.000, P = 0.000, and P = 0.000, respectively). However, a comparison of treatment groups' mean changes indicated no significant difference among them (P > 0.05). Conclusions: Both ultrasound and laser modalities effectively relieve pain and improve functional hand performance in patients with mild and moderate CTS in the short term. The compound use of these two modalities may have a greater impact in treating these patients.
Background: Knee osteoarthritis is a debilitating disease that affects a large proportion of the elderly population. Treatments for this disease are mostly based on symptomatic management. The primary treatments are physiotherapy, which is associated with high costs, and nonsteroidal antiinflammatory drugs (NSAIDs), which have serious side effects, including gastrointestinal bleeding, renal failure, and cardiovascular complications. This study aimed to assess the effects of leech therapy versus physiotherapy as a noninvasive method in the treatment of knee osteoarthritis. Methods: This double-blind randomized clinical trial was performed on 98 patients with osteoarthritis of the knee. The patients were randomly divided into two groups: leech therapy or physiotherapy. The analgesic effects and recovery of the patients were assessed using the KOOS questionnaire 90 days after the beginning of the study. Student's t-test, the Wilcoxon test, and the Mann-Whitney U test were used for comparisons between the two groups. Results: The mean age of the patients was 61.03 ± 10.99 years. The KOOS ADL and KOOS sport/recreational activities decreased significantly in the leech therapy group (P < 0.05). Additionally, the mean KOOS QOL after treatment was significantly lower than it was before treatment (P < 0.001). In the physiotherapy group, the KOOS pain score increased significantly after treatment (25.86 ± 18.77 vs. 31.60 ± 11.71; P = 0.008). The KOOS ADL score also showed a significant increase (24.59 ± 18.55 vs. 35.74 ± 15.83; P < 0.001). In addition, the median KOOS sport/recreational activities and KOOS QOL increased significantly in the physiotherapy group (P < 0.05). All of the factors in the physiotherapy group had significantly better prognoses than those in the leech salivary therapy group (P < 0.05). Conclusion: This study failed to identify any therapeutic or remedial effects of leech therapy on pain and symptoms in the symptomatic treatment of knee osteoarthritis. Future studies using more leeches and examining the therapeutic effects over a shorter period of time are recommended to more fully evaluate the effectiveness of leech therapy.
Background:The success rate of extracorporeal shock wave therapy (ESWT) in treating epicondylitis, plantar fasciitis, rotator cuff tendonitis, Achilles tendonitis, and Jumper knee has been reported to be 60% to 80%. Most published studies have compared focused ESWT at different intensities with local corticosteroid injection (LCI). We only identified a few studies that specifically compared ESWT with LCI in patients with pes anserine bursitis (PAB). This study aimed to compare the effectiveness of ESWT and LCI in patients with PAB.Methods: The present study was a randomized clinical trial. Patients diagnosed with PAB who were referred to the physical medicine and rehabilitation clinic underwent a complete physical examination. They (n = 60 patients) were randomly assigned to the ESWT and LCI groups if they met the study criteria. In the ESWT group, 1 ESWT session was performed weekly for 3 consecutive weeks. In the LCI group, 1 injection was performed under an ultrasonography guide. Pes anserine thickness, pain intensity, and treatment satisfaction were measured with visual analog scale (VAS) and quality of life (Short Form-12). A paired-samples t test was used to compare the results obtained in the pre-and posttests. Analysis of variance for repeated measures was used to detect differences over time. The null hypothesis would not be confirmed if the P value was less than the 0.05 level of significance.Results: Pes anserine thickness and pain intensity decreased significantly during the study in both groups (P < 0.001). However, the mean difference of pes anserine thickness was more in the LCI group the ESWT group [(-0.6; 95% CI, -1.0 to -0.3) than (-0.1; 95% CI, -0.5, -0.2); P = 0.008]. Also, the mean difference of pain intensity was lower in the ESWT group] than the LCI group [(-2.9; 95% CI, -3.7 to -2.1) (1.0; 95% CI, 0.1to 1.8); P < 0.001]. Patients' quality of life in both groups increased significantly during the study period (P < 0.001), but the increase in quality of life in patients in the ESWT group (mean difference, 15.3 [95% CI, 10.6-19.9]) was considerably more than in the LCI group (mean difference, -5.3 (95% CI, -10.0 to -0.6).Conclusion: Overall, the results of this study showed that both local corticosteroid injections and extracorporeal shock wave therapy are safe and effective in PAB patients.
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