Person: OKÇU, MEHMET
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OKÇU
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MEHMET
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Publication Open Access Rare complication of ganglion impar blockade with the transsacrococcygeal approach: A case of rectal perforation(2022-06-01) OKÇU, MEHMET; ŞENCAN, SAVAŞ; GÜNDÜZ, OSMAN HAKAN; OKÇU M., ŞENCAN S., GÜNDÜZ O. H.Although it has been reported that caution should be exercised in terms of rectal perforation, as the ganglion impar is located just behind the rectum in the presacral space, the authors could not find any case or images of rectal perforation occurring during ganglion impar blockade in the literature. In this report, the case of a 38-year-old female with rectal perforation that developed during ganglion impar blockade, performed by the transsacrococcygeal approach under fluoroscopy guidance, is presented. Wrong needle selection and the structurally short presacral space of the patient may have influenced the development of rectal perforation in the patient. This study presents the first case and images of rectal perforation in the literature that developed during the application of ganglion impar blockade using the transsacrococcygeal technique. In ganglion impar block applications, technically appropriate needles should be used, and care should be taken in terms of rectal perforation.Publication Open Access Epicardial adipose tissue thickness and growth differentiation factor 15 in axial spondyloarthritis(2022-09-01) OKÇU, MEHMET; OKÇU M., KOÇAK F. A. , ŞAŞ S., Guclu K.Objectives: To investigate growth differentiation factor-15 (GDF-15) levels and the thickness of epicardial adipose tissue (EAT) in patients with axial spondyloarthritis (axSpA) and to evaluate their relationship with functional status, disease activity, disease duration, and the type of medical treatment received by the patients.Methods: This cross-sectional study was carried out at Kirsehir Ahievran University School of Medicine between February and June 2020. Twenty-nine healthy controls and 44 patients with axSpA were included in the study. Gender, age, erythrocyte sedimentation rate, GDF-15, body mass index, complete blood count, ejection fraction, the EAT thickness, and C-reactive protein of all participants were recorded. Ankylosing Spondylitis Quality of Life Index, Bath Ankylosing Spondylitis Functional Index, the disease duration, Bath Ankylosing Spondylitis Metrology Index, and Bath Ankylosing Spondylitis Disease Activity Index scores of patients with axSpA were noted.Results: Epicardial adipose tissue thickness values (0.35 +/- 0.09 cm) in the AxSpA group were higher compared to the control group (0.26 +/- 0.06 cm) (p<0.01). Growth differentiation factor-15 levels of the control group and axSpA group were similar. The treatment received by the patients did not have a significant relationship with EAT thickness and GDF-15. Bath Ankylosing Spondylitis Functional Index scores, disease duration, and age were significantly positively correlated with GDF-15 levels.Conclusion: In this study, EAT thickness values were found to be significantly higher in the axSpA group. In addition, GDF-15 was positively correlated with age, Bath Ankylosing Spondylitis Functional Index score, and disease duration.Publication Open Access Incidence and disease course of covid-19 infection among unvaccinated patients who received local corticosteroid injections(2023-04-01) OKÇU, MEHMET; GÜNDÜZ, OSMAN HAKAN; ŞENCAN, SAVAŞ; OKÇU M., Azizov S., GÜNDÜZ O. H., ŞENCAN S.Objective There are concerns that local corticosteroid injections may increase the risk of COVID-19 infection because of the immunosuppressive effect of corticosteroids. This study aimed to examine the relationship between local corticosteroid injections and the risk of COVID-19 infection. Design The date and type of procedure as well as the dose and type of corticosteroids used in patients who underwent local corticosteroid injections within 1 yr after the first COVID-19 case in the country were examined retrospectively and recorded. Patients who did not receive corticosteroids were included in the control group. Coronavirus disease 2019 infection histories of all patients were recorded. Results There was no significant difference between the patients who received local corticosteroids and the control group in terms of the incidence of COVID-19 infections, and the number of patients who needed hospitalization or intensive care treatment. In addition, it was found that the administration of two injections, the type of procedure performed, and the dose and type of steroids were not associated with the incidence or severity of COVID-19 infections. Conclusions It has been shown that local corticosteroid injections are not associated with the incidence of COVID-19 infections and the number of patients who need hospitalization or intensive care treatment due to COVID-19.Publication Open Access Does osteoporosis cause pain even without a fracture? An observational study(2023-03-01) OKÇU, MEHMET; OKÇU M., Erden Y., TUNCAY F., KOÇAK F. A., Kaya S. S., Dogru Y. G.Introduction/backgroundOsteoporotic fractures are usually painful. However, data on whether osteoporosis without fracture causes pain are insufficient. This study aims to determine whether osteoporosis without fracture is the cause of pain.MethodologyPatients aged over 18 years who visited the Physical Medicine and Rehabilitation outpatient clinic of a tertiary university hospital for dual-energy X-ray absorptiometry scan and were suitable for dual-energy X-ray absorptiometry scan without a history of fracture were included in the study. Patients with a history of fractures or those with fracture/fracture sequelae on X-rays were excluded. The cervical, lumbar, and thoracic spine and general body pains of the patients were questioned and dual-energy X-ray absorptiometry results were recorded.ResultsThe study was conducted with 139 patients. Lumbar bone mineral density and T score values of the patients were found to be negatively correlated with the numerical rating scale levels of the cervical, thoracic, lumbar spine, and general body pain. Hip total bone mineral density and T score values were also negatively correlated with numerical rating scale scores of the lumbar and thoracic spine and general body pain. When the patients were divided into two groups as those with and without osteoporosis, it was found that the cervical, lumbar, thoracic spine, and general body pain numerical rating scale levels of the patients with osteoporosis were significantly higher than the group without osteoporosis.ConclusionThe results of this study showed that osteoporosis might be associated with pain even though there is no fracture.Publication Metadata only Is low-dose dextrose prolotherapy as effective as high-dose dextrose prolotherapy in the treatment of lateral epicondylitis? A double-blind, ultrasound guided, randomized controlled study(2022-01-01) OKÇU, MEHMET; Ciftci Y. G. D. , Tuncay F., Kocak F. A. , OKÇU M.© 2022 American Congress of Rehabilitation MedicineObjectives: To investigate the effects of prolotherapy (PrT) on pain, functionality, clinical improvement and to compare the 5% low and 15% high dose dextrose PrT in chronic lateral epicondylitis. Design: A double-blind, parallel groups, randomized controlled study. Settings: Outpatient Clinic. Participants: Sixty patients (N=60), aged 44.30±10.31 years old, with chronic lateral epicondylitis were allocated randomly into 3 groups. Interventions: To Group 1 5% dextrose PrT, to Group 2 15% dextrose PrT, to Group 3 0.9% saline injections were done at 3 times (weeks 0, 3, 6), to the entheses of forearm extensors and annular ligament. Main Outcome Measures: The primary outcomes were handgrip strength, visual analog scale-rest (VAS-R), visual analog scale-activity (VAS-A), pressure-pain threshold, and Quick Disability of the Arm, Shoulder and Hand (Q-DASH). The secondary outcomes were clinical improvement (Disease Global Assessment Questionnaire), side effects, and complications. Primary outcomes were collected at baseline week 0, week 3, and 12. Secondary outcomes were collected at weeks 3 and 12. Results: In Group 2, VAS-A and VAS-R (at week 3), handgrip strength and pressure-pain threshold (at week 12) were significantly different than other groups (P.05). Conclusion: In chronic lateral epicondylitis, 5% and 15% dextrose PrT is more effective in pain, handgrip strength, functionality, and clinical improvement than %0.9 saline. There was no difference in functionality, clinical improvement, side effects, and complications between the PrT groups. 15% dextrose PrT was more effective in handgrip strength and pressure-pain threshold at week 12 and pain at week 3. We recommend 15% dextrose PrT based on this study.Publication Open Access Follow-up of at least 3 years after ganglion impar block for control of chronic coccygodynia(2023-03-01) GÜNDÜZ, OSMAN HAKAN; OKÇU, MEHMET; Gunduz O. H., Okcu M., ŞENCAN S.IntroductionAlthough it is well known that ganglion impar block (GIB) reduces pain in the short term in patients with chronic coccygodynia, there are insufficient data on long-term treatment outcomes. The aim of this study was to examine the long-term outcomes of patients who underwent GIB for chronic coccygodynia and possible factors that might affect these outcomes.MethodsThe pre-treatment, 1st-hour, and 3rd-week numeric rating scale (NRS) scores of patients who underwent GIB 36-119 (min-max) months ago (between November 2011 and October 2018) due to coccygodynia were obtained from the medical records. Final NRS scores and presence of factors that may affect success such as accompanying low back pain (LBP) were questioned via telephone interviews. Treatment success was defined as a 50% or more reduction in final NRS scores compared with pre-treatment NRS scores.ResultsTelephone interviews were made with 70 patients. Treatment success was achieved in 55.7% of the patients. The patients were divided into two groups as those who achieved treatment success (group A) and those who could not (group B) and were compared. The NRS scores at the 3rd week and the number of patients with LBP in the group B were significantly higher than the group A. No serious complications developed in any patients.ConclusionIn patients with chronic coccygodynia, GIB is an effective and safe treatment option for pain reduction in the long term. Accompanying LBP and high pain scores in the 3rd week after injection should be considered as parameters that negatively affect long-term treatment success.Publication Open Access Do the presence, size, and shape of plantar calcaneal spurs have any significance in terms of pain and treatment outcomes in patients with plantar fasciitis(2023-01-01) OKÇU, MEHMET; OKÇU M., TUNCAY F., KOÇAK F. A., Erden Y., Ayhan M. Y., Kaya S. S.Background/aim: The purpose of this study was to determine the effect of the presence, size, or type of calcaneal spurs on pain or the outcomes of extracorporeal shock wave therapy (ESWT) therapy in patients with plantar fasciitis.Materials and methods: Seventy-four patients with unilateral plantar fasciitis who had no pain in the contralateral foot, either currently or in the past, were included in the study. The length, base width, type, and presence of plantar calcaneal spurs in both heels of the patients were determined using radiography. A total of five sessions of ESWT (3 bar, 2000 shocks/session, 12 Hz frequency) with an interval of 3 days were performed on the painful sides of the patients. Symptom duration and numerical rating scale (NRS) scores were recorded pretreatment and 1 week and 12 weeks after treatment.Results: Spurs were detected in 85.1% of painful feet and 71.6% of painless feet, this difference was statistically significant (p = 0.046). There was no significant correlation between the type of the spurs and whether the foot was painful. Patients with spur sizes of >5 mm or with horizontal and hooked spurs had a higher NRS decrease than patients with spur sizes of <= 5 mm or with a vertical spur. Symptom duration, spur length, and base width were found to be correlated with pretreatment NRS scores.Conclusion: The presence and size of calcaneal spurs are associated with pain. However, it should be kept in mind that a high rate of spurs can also be found in painless feet, so spur is not the only factor that causes pain. Patients with a spur size of <= 5 mm or a vertical spur have less pain relief with ESWT.