Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease. Immune system cells have an important role in RA. Our aim was to investigate the relationship between disease activity, systemic immune-inflammation index (SII), and pan-immune-inflammation value (PIV) levels in RA patients. We planned to investigate whether these 2 measurements have an advantage over each other. About 67 patients diagnosed with RA and 49 healthy controls included in this study. RA was diagnosed based on 2010 ACR classification criteria. In this cross-sectional study, peripheral blood tests, C-reactive protein (CRP), hemogram, and erythrocyte sedimentation rate levels were noted after the physical examination of all participants. PIV was calculated with the formula: (neutrophil count × platelet count × monocyte count) / lymphocyte count. SII was calculated as follows: (neutrophil count × monocytes count) / lymphocyte count. The disease activity score 28 (DAS28) were noted in patients with RA. CRP values of active RA group were significantly higher than remission RA and control groups (P < .001), control and remission RA groups were similar (P = .86). PIV and SII are significantly higher in active RA than remission RA and control (P < .001, P < .001) higher in remission RA than control (P < .001, P < .001). Receiver operating characteristic curve analysis in predicting remission compared to the control group, CRP was not significant, PIV and SII was significant and PIV has higher sensitivity and sensitivity, a PIV value of > 217.31 have sensitivity 75.0% and specificity 85.7%. CRP, PIV, and SII are statistically significant in predicting active RA compared to the remission RA and control group. Our findings show that PIV, and SII are easy, inexpensive and reliable markers predicting remission in RA patients. CRP was not significant compared to remission RA and control group, PIV and SII was significant and PIV has higher sensitivity and specificity than SII in the remission group in RA. Patients with high disease activity, PIV, SII, and CRP levels were effective in showing disease activity compared to RA remission group and healthy controls.

Aims: Ankylosing spondylitis(AS) is the most common and characteristic form of Spondyloarthritis. The pan-immune inflammation value(PIV) is a marker obtained from complete blood count parameters, which has been used as an inflammatory and immune marker. In this study, we aimed to investigate the relationship between inflammation and disease activity in patients with AS and PIV. Methods: In this prospective controlled study a total of 208 participants were included, consisting of 104 AS patients and 104 healthy controls. Complete blood count values, including neutrophils, monocytes, lymphocytes, platelets, and also C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), were measured in all participants. In AS group disease activity was assessed with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The AS group was divided into two subgroups based on BASDAI score: low disease activity(BASDAI score <4) and high disease activity(BASDAI score ≥4).The pan-immune inflammation value of patients and the control group was calculated as neutrophil count × monocyte count × platelet count/lymphocyte count. Comparative analysis was performed between the two groups, and these values were also compared based on the BASDAI. Results: The AS group exhibited statistically higher values of CRP, monocytes, and PIV compared to the control group (p<0.001 for all). Patients with BASDAI≥4 had a statistically lower disease duration (p<0.001) and lymphocyte count (p:0.012) compared to those with BASDAI<4. Patients with BASDAI ≥ 4 had statistically higher values of CRP, ESR, neutrophils, platelets, and PIV compared to those with BASDAI<4 (p<0.001, p<0.001, p<0.001, p:0.008, p<0.001 respectively). Strong positive correlation was found between PIV and BASDAI (rho=0.790; p<0.001), moderate positive correlation with PIV and CRP (rho=0.467; p<0.001) and also positive correlation was found between PIV and ESR (rho=0.326; p309,2 were 80.0% and 86.0% respectively, for the active group. Conclusion: Since the parameters comprising PIV are obtained from a complete blood count, it provides an advantage for its use as a simple and cost-effective marker in ankylosing spondylitis patients. In our study, we demonstrated that PIV is sensitive and specific in differentiating disease activity in patients with ankylosing spondylitis from healthy individuals and associated with disease activity.

This study aimed to assess and compare the effectiveness of adding low-level laser therapy (LLLT) and neuromuscular electrical nerve stimulation (NMES) to conventional physical therapy exercises, for stroke patients with hemiplegic shoulder pain (HSP). Seventy-five stroke patients with shoulder pain were included in this prospective randomized controlled study. Participants were divided into three groups. All patients underwent a multidisciplinary rehabilitation program five days a week for four weeks for a total of twenty sessions with classical physical therapy exercises. In addition, Group 1 received LLLT for three days a week for four weeks. Group 2 received NMES for twenty minutes for five days a week for four weeks. Group 3 control group received classical physical therapy exercises. Brunnstrom (BRS) upper extremity, BRS Hand, Barthel index, Shoulder Pain and Disability Index (SPADI), Fugl Meyer, Modified Ashworth Scale (MAS) and visual analog scale (VAS) were assessed, prior to the treatment and at the end of four weeks. After treatment, statistically significant improvements were found in BRS upper extremity, BRS Hand, Barthel index, SPADI, Fugl Meyer and VAS in all three groups (all p < 0.005). When the groups were compared, significant improvements in Bartel, SPADI and VAS in the LLLT and NMES groups than the control group(all p < 0.005), however the LLLT and NMES groups were statistically similar. LLLT, NMES and conventional exercise therapy have demonstrated efficacy in treating HSP and improving upper extremity functions and disability. Laser and NMES were more effective while the effects of laser and NMES were similar.

Aims: Postmenopausal osteoporosis (PMOP) is one of the most common bone diseases. We aimed to investigate the relationship between pan-immune inflammatory value and decreased bone mineral density in postmenopausal women. Methods: This prospective cross-sectional study was composed of 186 postmenopausal women. Osteoporosis was diagnosed with dual‐energy X‐ray absorptiometry (DEXA) results according to World Health Organization (WHO) recommendations and patients were separated into 3 groups; 1. control group with a T-score >-1; 2. group osteopenia with a T-score between -1.0 and -2.5; 3. group osteoporosis with a T-score ≤-2.5. After the physical examinations of all patients, venous blood samples were collected and the pan-immune inflammation value (PIV) was calculated. The parameters were evaluated statistically with the PIV value between the groups. Results: Groups are similar in terms of age, menopausal age, education, and occupation. PIV was significantly higher in postmenopausal women with osteoporosis than women with osteopenia and the control group (p

Objective: The purpose of this study is to determine the effectiveness of extracorporeal shock wave therapy (ESWT), ultrasound (US), and dexamethasone iontophoresis treatments on pain, grip strength, functionality, and quality of life in patients with lateral epicondylitis, and overdetermine the superiority of the treatments to each other. Material and Method: This single-blind, prospective study included 78 patients who were diagnosed with lateral epicondylitis. The patients were randomized into three groups. The same physiotherapy program consisted of hot packs, transcutaneous electrical nerve stimulation (TENS), and exercises were administered to all groups. All exercises were performed under the supervision of a qualified physiotherapist. In addition to a 10-day physiotherapy program, every 5 days, a total 3 sessions of ESWT were conducted to the 1st group, 10 days of US applied to the 2nd group, and 10 days of dexamethasone iontophoresis therapy to the 3rd group. Evaluations were carried out before, and 1 month after treatment. Pain severity levels were measured using the numeric rating scale (NRS), disability using the Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH), quality of life using the Nottingham Health Profile (NHP), and grip strength using a dynamometer and pinch strength using a pinch meter. Results: The groups were similar in demographic and clinical characteristics. A significant temporal change was found in three groups in terms of pain severity, disability, grip strength, and quality of life at the first month after treatment. When the efficacy of these treatments was compared after treatment in the first month, dexamethasone iontophoresis was statistically superior to US, and ESWT in terms of pain, and quality of life (p

BackgroundPrimary Sjögren’s syndrome (pSS) leads to impaired muscle function and mass as well as pain and fatigue. Sarcopenia is the pathological reduction of skeletal muscle mass and strength. We aimed to investigate the prevalence of sarcopenia and determine its relationship with disease activity levels in females with primary Sjögren syndrome. MethodsThis cross-sectional study was performed on 62 female patients diagnosed with pSS and 62 female age matched healthy controls. Disease activity was evaluated with the EULAR Sjögren’s syndrome patient reported index (ESSPRI) and EULAR Sjögren’s syndrome disease activity index (ESSDAI), fatigue severity scale (FSS), hospital anxiety and depression scale (HADS), and numerical rating scale (NRS). A simple questionnaire to rapidly diagnose sarcopenia (SARC-F) was used to screen for sarcopenia. Degree of sarcopenia was evaluated by handgrip strength, anterior thigh muscle thickness by USG, the 6-meter walk test (6MWT), and the five times sit-to-stand test (FTSST). ResultsThe prevalence of sarcopenia was found to be 36/62 (58.1%) in pSS and 6/62 (9.7%) in healthy controls (p<0.001). HADS anxiety and depression scores and SARC-F scores were significantly higher in pSS (p<0.001). There were significant differences in 6MWT, FTSST, and hand grip strength results in pSS (p<0.001). Anterior thigh muscle thickness was similar in both groups (p=0.298). A positive correlation was found between SARC-F on the one hand and ESSPRI and NRS on the other (r=0.595, p=0.009; r=0.569, p=0.014). ConclusionSarcopenia prevalence was increased in female patients with pSS and there was a relationship of SARC-F scores with pain and disease activity levels.