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    A case of multiple trigger digits of one hand
    (2017) Uzun, Erdal; Ekinci, Yakup; Ulusoy, Ersin Kasim; Yetis, Mehmet
    The trigger finger is a tenosynovitis that causes pain, stabbing and loss of function and occurs as a result of inflammation and hypertrophy in flexor tendon and tendon sheath at the level of A1 pulley. The annual incidence of the population is 28 / 100,000 and the risk of life-time is 2-3%. It can affect all fingers mostly involving the ring, middle fingers and the thumb. Trigger finger is more common in middle-aged women rather than men mostly with predisposing factors. The treatment consists of conservative and surgical treatment. A 74-year-old woman with no other illnesses except diabetes mellitus was presented with a single-handed, multiple-patterned, surgically treated trigger finger.
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    Complementary treatment options in carpal tunnel syndrome surgery; Prospective randomized controlled study
    (2018) Ekinci, Yakup; Ulusoy, Ersin Kasim; Cirakli, Alper
    Aim: In this study, we aimed to determine the efficacy of splinting and exercise modalities in addition to surgical treatment in advanced carpal tunnel syndrome (CTS) cases. Material and Method: Patients were divided into 3 different groups according to the order of application, and after surgical intervention their treatment was continued according to the group they were in. There were 51 hands in 50 female patients in group 1 (control group); 52 hands in 51 female patients in group 2 (exercise group); 52 hands in 50 patients in group 3 (wrist splint group). Patients were given a follow-up number by computer software under which the following data were recorded: age, body mass index (BMI), date of surgery, operated side, preoperative disorders, pre and postoperative EMG findings, surgical technique, pre and postoperative visual analogue scales (VAS), pre and post-operative Boston Carpal Tunnel Questionnaire (BCTQ) and post-operative complications. Kolmogorov-Smirnov test and Spearman’s rho correlation coefficient (r) were used for statistical analysis. Results: There was no statistical difference between the groups in terms of VAS and FSS change. However, there was a statistically significant difference in terms of BSSS change. In the exercise group (Group 2) it was found that the healing was better and faster than the other groups. Conclusion: We believe that early and effective postoperative exercise, which is to be applied in addition to surgical treatment in advanced CTS cases, leads to healing of the patient and, in parallel, early return to work.
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    Declined vitamin D may be a trigger for hemifacial spasm
    (2018) Ulusoy, Ersin Kasim
    Aim: In this study, we aimed to measure the serum vitamin D levels in Hemifacial Spasmic (HFS) patients and show the role of HFS in the pathogenesis and place in etiology. Material and Methods: In this study, prospective 80 HFS patients and 80 healthy volunteers who were followed up at neurology clinic were prospectively included. The serum vitamin D levels of the patient and the control group with similar age, gender, and body mass index (BMI) was measured on the same day. The severity of the disease was measured using Jeong’s Quality of Life Scale and correlated with vitamin D concentration. The results were compared using the independent t test and the Mann-Whitney U test. Results: Serum vitamin D levels in patients with HFS were 16.4 [9 - 30.4] ng / ml in the patient group and 21.8 [9 - 42.6] ng / ml in the control group, and this difference was statistically significant (p <0.05). There was no significant correlation between serum vitamin D deficiency and the severity of the disease and the quality of life in the patient group. Conclusions: These results show us the role of vitamin D in the pathogenesis of HFS, the cause of which is unknown, and the importance of its location in etiology. We hypothesize that deficiency of vitamin D in HFS may lead to mechanisms that may cause to spasm starting to demyelination.
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    Evaluation of retinal nerve fibre layer and ganglion cell complex thickness with optical coherence tomography in migraine patients
    (2019) Ulusoy, Dondu Melek; Ulusoy, Ersin Kasim; Duru, Zeynep
    Aim: In this study, we aimed to assess thicknesses of retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) in patients with episodic migraine and to compare data between from patients with migraine and healthy individuals. Material and Methods: The study included 44 eyes (right) of 44 patients with migraine who presented to neurology outpatient clinic and 54 eyes (right) of healthy individuals. In patients with migraine (with identified subtypes), demographic and clinical characteristics, Visual Analog Scale (VAS) and Migraine Disability Assessment Scale (MIDAS) results were recorded. After detailed ophthalmological examination, RNFL and GCC thicknesses were measured with optical coherence tomography (OCT) (Carl Zeiss Meditec AG, Jena, Germany, software version: 6.5.0.773). The values obtained were compared between groups. The correlation between VAS and MIDAS scores and RNFL and GCC thicknesses were assessed. Results: Mean age was 36.05±8.84 years in migraine group and 32.89±10.89 years in control group. Mean time of follow-up was 5.50±3.42 years in patients with migraine. No significant differences were detected in mean RFNL and GCC thicknesses from all quadrants (p>0.05 for all). It was found that VAS and MIDAS scores were negatively correlated to mean RNFL thicknesses in temporal and inferior quadrants (p0.05). Conclusion: In our study, it was found that migraine did not affect in ocular structures of posterior segment such as RNFL and GCC thickness.Keywords: Migraine; retinal nerve fiber layer; ganglion cell complex; optical coherence tomography.
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    Is clinical evaluation sufficient enough to diagnose the cubital tunnel syndrome
    (2017) Cirakli, Alper; Ekinci, Yakup; Ulusoy, Ersin Kasim; Uzun, Erdal
    Aim: The aim of the study was to determine the diagnostic value of clinical history and neurological examination for cubital tunnel syndrome. Materials and Methods: 132 limbs of 128 patients treated with electromyography with a preliminary clinical diagnosis of cubital tunnel syndrome between the years of January 2009 and January 2016 were evaluated. Patients were evaluated according to gender, affected side and electromyography results to assess the presence of neuropathy. The obtained data were statistically analyzed by Kormogonov-Smirnov and Shapiro-Wilk test. Results: 70 patients (54%) were male and 58 (46%) were female and the average age was 40.25±12.66. The affected side was right extremity in 70 (53%) of cases and left extremity in 62 (47%) who underwent electromyography with a preliminary diagnosis of neuropathy. Symptoms were bilateral in 4 cases. As a result of electromyography 43 (32.6%) (27 male, 16 female) patients had neuropathy. Affected side in 23 of these patients (53.5%) was left limb and 20 (46.5%) was right limb and 30 of involved patients were in the range of 30-60 years. Conclusion: According to the results of our study, we found that history and neurological examination have a low efficiency in the diagnosis of cubital tunnel syndrome. This may be associated with relatively subjective evaluation of neurological examination and history and also many pathologies in the differential diagnosis of cubital tunnel syndrome. We believe that electromyelography application is required in addition to a detailed physical examination for cubital tunnel syndrome in order to avoid delayed diagnosis and incomplete/incorrect treatment.