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Öğe Acinetobacter infection developed after lech therapy in a patient with gonarthrosis: A case report(2013) Gönen, İbak; Özşahin, Mustafa; Turan, Hakan; Uslu, Mustafa; Celbek, Gökhan; Yıldırım, Mustafa; Ataoğlu, SafinazOsteoartirit yaşlı hastalarda ağrı ve fonksiyon kaybının baslıca nedenidir. Ağrıyı kontrol etmek ve hastalığın ilerlemesini engellemeye yönelik değişik tedavi seçenekleri mevcuttur. Ülkemizde bu tedavilerden fayda göremeyen veya bu tedavilere ulaşamayan bazı hastalar yaygın olarak romatizmal hastalıklara iyi geldiğine inanılan sülük tedavisine başvurabilmektedir. Bu yazıda 68 yaşında yaklaşık 15 yıldır osteoartrit tanısıyla medikal tedavi ve fizik tedavi gören bir olgu sunulmaktadır. Yakınmaları gerilemediği için 6 yıldır her iki dizindeki ağrılarına yönelik sülük tedavisi uygulamaya başlayan olguda; yine bir sülük tedavisi sonrası Acinetobacter spp. ye bağlı şiddetli cilt infeksiyonu gelişmiştir. Bu araştırmacıların bilgisi dahilinde hirudotherapy sonrası Acinetobacter ile gelişen ilk infeksiyon vakasıdır.Öğe Acinetobacter infection developed after leech therapy in a patient with gonarthrosis: A case report(2013) Gönen, İbak; Özşahin, Mustafa; Turan, Hakan; Uslu, Mustafa; Celbek, Gökhan; Yıldırım, Mustafa; Ataoğlu, SafinazOsteoarthritis is the main cause of pain and loss of function in elderly patients. Various treatments are available to control pain and to prevent progression of the disease. In our country, some patients who do not benefit from these therapies or cannot access certain treatments readily undergo hirudotherapy (leech therapy), which is regarded to be beneficial in rheumatic diseases. In this case report, 68-year-old woman who had been receiving medical treatments and physical therapy for osteoarthritis for 15 years was presented. She had been undergoing hirudotherapy for 6 years due to intractable pain in both knees. Following hirudotherapy, she developed a severe skin infection due to Acinetobacter sp. To the knowledge of the authors, this is the first case of infection with Acinetobacter following hirudotherapy.Öğe ACINETOBACTER INFECTION DEVELOPED AFTER LEECH THERAPY IN A PATIENT WITH GONARTHROSIS: A CASE REPORT(Gunes Kitabevi Ltd Sti, 2013) Gönen, İbak; Özşahin, Mustafa; Turan, Hakan; Uslu, Mustafa; Celbek, Gökhan; Yıldırım, Mustafa; Ataoğlu, SafinazOsteoarthritis is the main cause of pain and loss of function in elderly patients. Various treatments are available to control pain and to prevent progression of the disease. In our country, some patients who do not benefit from these therapies or cannot access certain treatments readily undergo hirudotherapy (leech therapy), which is regarded to be beneficial in rheumatic diseases. In this case report, 68-year-old woman who had been receiving medical treatments and physical therapy for osteoarthritis for 15 years was presented.. She had been undergoing hirudotherapy for 6 years due to intractable pain in both knees. Following hirudotherapy, she developed a severe skin infection due to Acinetobacter sp. To the knowledge of the authors, this is the first case of infection with Acinetobacter following hirudotherapy.Öğe Anemia as a risk factor for low bone mineral density in postmenopausal Turkish women(Elsevier Science Bv, 2012) Korkmaz, Uğur; Korkmaz, Nurdan; Yazıcı, Selma; Erkan, Melih; Baki, Ali Erdem; Yazıcı, Mehmet; Ataoğlu, SafinazBackground: We investigated the association of bone mineral density (BMD) by detected dual-energy X-ray absorptiometric (DXA) method and hemoglobin (Hb) levels in a large sample. Methods: The current study enrolled 371 postmenopausal women (82 anemic patients), who were screened for osteopenia or osteoporosis by DXA. Patients with osteopenia or osteoporosis (T score < -1.0 SD) were grouped as having low bone mass (LBM). Results: Anemic patients were older and had significantly higher duration of menopause. When compared with subjects with normal Hb, anemic patients had significant lower femur t score, femur BMD, femur Z score, spinal t score, spinal BMD and spinal Z score (p<0.001). Additionally, the ratio of subjects with LBM in the femur and spine were significantly high in anemic patients (pÖğe Anti-TNF-Alpha Therapy for Concomitant Behçet's Disease and Ankylosing Spondylitis(2012) Özşahin, Mustafa; Turan, Hakan; Ataoğlu, Safinaz; Baki, Ali Erdem; Çelebi, Esra…Öğe Anti-TNF-Alpha Therapy for Concomitant Behcet's Disease and Ankylosing Spondylitis(Turkish League Against Rheumatism, 2012) Özşahin, Mustafa; Turan, Hakan; Ataoğlu, Safinaz; Baki, Ali Erdem; Çelebi, Esra…Öğe Assessment of physical function, quality of life, and medication adherence in elderly patients with rheumatic diseases(Springernature, 2021) Erdem Sultanoğlu, Tuba; Ataoğlu, Safinaz; Avşar, Burcu; Merkur, Ömer FarukBackground The proportion of older people in the total population has increased in Turkey as well as worldwide. As life expectancy rises, the increasing prevalence of rheumatic diseases poses major problems in the elderly. Comorbid diseases and the aging-induced changes in the endogenous immune response and the pharmacokinetic properties of therapeutic agents may complicate the decision to use a particular drug and result in a different clinical picture and treatment response. We, therefore, aimed to investigate the characteristics of chronic inflammatory diseases, their impact on physical function and quality of life, the prevalence of comorbid diseases that may complicate treatment planning, and treatment adherence in patients aged 65 years or older. Results One hundred seventy-four patients were included and divided into two age groups: 18-64 years (group 1, n = 85) and 65 years or older (group 2, n = 89). The mean age of all recruited patients was 57.55 +/- 16.98 years. Of 174, 99 (56.9%) were female and 75 (43.1%) were male. The mean duration of rheumatic disease was 7 +/- 4.8 years and age at onset was 51.46 +/- 14.78 years. Gender distribution differed significantly by age group (P = 0.024). The percentage of females in group 1 was 48.2% and 65.2% in group 2. The occupational status also differed significantly by age group (P < 0.001). 48.2% of group 1 were employed and 57.3% of group 2 were housewives. Marital status varied significantly by age (P < 0.001). The percentage of married was 74.1% in group 1 and the percentage of separated/divorced/widowed in group 2 was 28.1%. There was no difference between groups 1 and 2 in terms of place of residence (P = 0.459). The prevalence of comorbid diseases and the rate of use of medications for comorbid diseases (non-rheumatic treatments) were higher in elderly patients. The rate of use of disease-modifying anti-rheumatic drugs (DMARDs) was 30.3% and biological agents 61.8% in the elderly group (>= 65 years) (group 2) (P < 0.001). There were positive correlations between, Health Assessment Questionnaire (HAQ), Bath Ankylosing Spondylitis Functional Index (BASFI) and Nottingham Health Profile (NHP) domains in both groups. There was also a significant negative correlation between Medication Adherence Rating Scale (MARS) and all dimensions. Conclusions Elderly and younger patients with rheumatic diseases have different demographic and clinical characteristics. Physical function and quality of life are more affected by rheumatic diseases and treatment adherence is poorer in the elderly. Our study found a positive correlation between physical function and quality of life in both age groups. The treatment adherence rating scale showed a negative correlation with physical function and quality of life scores, with individuals with poor treatment adherence having worse physical function and quality of life.Öğe Avulsion Fracture of the Anterior Inferior Iliac Spine in a Soccer Player(Elsevier Science Inc, 2013) Uslu, Mustafa; Un, Ahmet; Özşahin, Mustafa; Beşir, Fahri Halit; Ataoğlu, Safinaz…Öğe Bilateral Fifth-Finger Camptodactyly(Lippincott Williams & Wilkins, 2012) Özşahin, Mustafa; Uslu, Mustafa; Kutlucan, Ali; Baki, Ali Erdem; Ataoğlu, Safinaz…Öğe A Case of primary erythromelalgia treated with pregabalin(2010) Ataoğlu, Safinaz; Özşahin, M.; Baki, A.E.Erythromelalgia (EM) is defined as the clinical syndrome characterized by erythema, an increased skin temperature, and burning pain in the affected extremities. Symptoms are relieved by cooling and aggravated in warm temperatures. The pain is often very severe, and treating is generally difficult. The therapeutic guidelines are also not well-established yet; a number of very different treatments were advised. We present a case of a 19-year-old male with primary erythromelalgia treated with pregabalin. The diagnosis of primary EM was based on his medical history, clinical findings, and laboratory tests. The frequency, duration, and intensity of the pain episodes decreased after pregabalin therapy. Pregabalin seems to be a proper option in controlling the pain in erythromelalgia. Copyright © 2010 by Türk Tibbi Rehabilitasyon Kurumu Derne?i.Öğe Color Doppler Imaging of the Orbital Vessels in Ankylosing Spondylitis(Taylor & Francis Inc, 2015) Özşahin, Mustafa; Büyükkaya, Ramazan; Beşir, Fahri Halit; Önder, Halil İbrahim; Erdoğmuş, Beşir; Ataoğlu, Safinaz; Kolukısa, RümeysaPurpose: To analyze the hemodynamic features of orbital blood flow velocities using Doppler ultrasonography in ankylosing spondiylitis (AS) patients, as well as to compare these results with those of healthy controls. Methods: 33 AS patients and 32 healthy controls were consecutively included in the study groups. The same radiologist performed ocular blood flow measurements. Peak systolic velocity (PSV), end diastolic velocity (EDV), and resistive index (RI) were measured in the central retinal artery (CRA), posterior ciliary arteries (PCAs), and ophthalmic artery (OA). Resistive index was used to assess arterial resistance; it was automatically calculated as RI [(PSV-EDV)/PSV]. Results: There were no significant differences in the PSV, EDV, and RI of the OA, CRA, and PCAs between AS patients and controls. Conclusion: This result suggests no possible contributory role of vascular structures in formation of uveitis in AS. We believe that our preliminary results need to be complemented with further studies, particularly including AS patients with uveitis and rheumatic diseases with other ocular involvement.Öğe Comparison of the Effectiveness of Platelet-Rich Plasma, Corticosteroid, and Physical Therapy in Subacromial Impingement Syndrome(Turkish League Against Rheumatism, 2019) Pasin, Tuğçe; Ataoğlu, Safinaz; Pasin, Özge; Ankaralı, HandanObjectives: This study aims to investigate and compare the efficacy of platelet-rich plasma (PRP) injection, corticosteroid injection, and physical therapy in addition to exercise treatment on pain, shoulder functions, and quality of life in patients with subacromial impingement syndrome (SAIS). Patients and methods: Ninety patients (37 males, 53 females; mean age 48.99 years; range, 33 to 60 years) who were diagnosed as Stage 2 SAIS were included in the study. Patients were randomized into three groups. PRP injection was administered into the subacromial space of the affected shoulder in group 1, corticosteroid injection was administered in the subacromial joint space in group 2, and 10 sessions of physical therapy were given in group 3 five times weekly including transcutaneous electrical nerve stimulation, ultrasound, and hot packs. Moreover, an exercise program was administered in all groups. visual analog scale (VAS) was used to determine the resting and moving shoulder pain; while the Shoulder Disability Questionnaire, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire, and the University of California, Los Angeles Shoulder Rating Scale (UCLA SRS) were used to evaluate the functionality of patients. Quality of life was analyzed using a generic Short Form 36 (SF-36). Results: All scores improved in all three groups compared with the period before treatment. Comparison of the groups showed higher scores in group 1 compared to groups 2 and 3 at week eight on QuickDASH, UCLA SRS, VAS at rest and during activity, and SF-36 pain subgroup scores. Conclusion: All three treatment modalities were effective in the treatment of SAIS. However, we suggest that the inexpensive and noninvasive methods of physical therapy and exercise should be the first preferred treatment in SAIS owing to causing no adverse events.Öğe Determination Of The Age Of Onset To The Osteoporosis Screening Program And Frequency Of Osteoporosis: Duzce University Training And Research Hospital Sampling(Duzce Univ, 2017) Mehmet, Yılmaz; Başbuğ, Alper; Kaya, Aşkı Ellibeş; Çağlar, Mete; Özkara, Atilla; Sungur, Mehmet Ali; Ataoğlu, SafinazAim: In our study, we aimed to determine the age of onset to the osteoporosis screening program and frequency of osteoporosis in the who admitted Duzce University Training and Research Hospital Material and Methods: Between the dates 01.01.2015 and 31.12.2015, 400 women between the ages of 40 and 70, who applied to Duzce University Training and Research Hospital, Departments of Physical Therapy and Rehabilitation, Gynecology and Obstetrics, and Orthopedics, and had got their femoral neck and L1-L4 anterior vertebra BMD (Bone Mineral Density) measured with DXA method, were included in our research. With the FRAX trial questionnaire have conducted to determine major osteoporotic fracture risk, patient data were recorded via asking questions to patients. Statistics: In the statistical analysis, Independent Samples T-test was evaluated for group comparison of continuous variables, Pearson's chi-square test was used for the analysis of relations between categorical variables, and Pearson's correlation analysis was used to review the relations between continuous variables. Results: In our study, we determined the mean age of osteoporosis group as 60.6 while the frequency was demonstrated as 11.8%. Conclusion: For our region, we determined the age of onset for osteoporosis screening as 60 for women without a major osteoporotic fracture risk factor.Öğe Determination of the Appropriate Quality of Life Scale for Patients with Rheumatoid Arthritis and Osteoarthritis(2018) Ataoğlu, Safinaz; Ankaralı, Handan; Ankaralı, Seyit; Pasin, ÖzgeObjectives: A large number of quality?of?life scales are used to assess the effects of various diseases onthe quality of life. The most commonly used scale is the SF?36 quality of life scale. However, in recentyears various versions and shorter forms of this scale have been developed. Quality of life scales, whichcan be applied in a shorter period and which can be interpreted more easily and which producereliable and valid results, are preferred more. The purpose of this study is to determine the scales thatmeasure the quality of life better and practical would be appropriate in Osteoarthritis (OA) andRheumatoid Arthritis (RA).Materials and Methods: Cronbach's alpha coefficient was used for the internal consistency of thescales, the intra?class correlation coefficient was used for relations between item?total score, and theagreement between SF?36 scale and other short forms, and also the Spearman Rank correlation analysiswere used for evaluation of the relationships between the total scores of the scales. The criterion validityof the short forms (SF) of the quality of life scale were investigated by using WHOQOLBref andQuickDASH scales.Results: The internal consistency of the scales were found to be at a quite good level. In OA patients,the highest agreement in Physical Function, Bodily Pain and Vitality sub?dimensions of the SF?6D scalewere found. On the other hand, Physical Role, Emotional Role and General Health sub?dimensions inthe SF?12 scale have higher agreement. In RA, Bodily Pain and Vitality sub?dimensions of the SF?6D werefound to have higher agreement, and the SF?12 scale have higher agreement in the Physical Function,Physical Role, General Health and Emotional Role. Moreover, in both disease groups, the validity ofSF?12 and SF?6D scales was similar to each other in many conditions, and better than the SF?8 scale.Conclusion: According to the results, SF?12 or SF?6D scales could be used effectively to evaluate thequality of life in RA and OA patients.Öğe Dual Diagnosis: Rheumatoid Arthritis and Multiple Sclerosis(Elsevier Science Inc, 2014) Özşahin, Mustafa; Dikici, Süber; Kocaman, Gülşen; Beşir, Fahri Halit; Baltacı, Davut; Ataoğlu, SafinazJuvenile rheumatoid arthritis (JRA) is the most common rheumatologic disease in children. Moreover, multiple sclerosis (MS) is the most frequent demyelinating disease and has been associated with various chronic inflammatory diseases: However, its association with JRA. has not been frequently described. Autoimmunity in both JRA and MS has been documented in the scientific literature, although there has been no definitive finding that patients with JRA are prone to the development of MS. An increasing frequency of MS resulting from an increased use of antitumor necrosis factor agents in the treatment of rheumatoid arthritis and other chronic inflammatory diseases has been reported recently. In this study, we report on the development of MS in a patient with JRA who did not have a history of antitumor necrosis factor use.Öğe The effect of breast-feeding duration on bone mineral density in postmenopausal Turkish women: a population-based study(Termedia Publishing House Ltd, 2011) Yazıcı, Selma; Korkmaz, Uğur; Erkan, Melih; Korkmaz, Nurdan; Baki, Ali Erdem; Alçelik, Aytekin; Ataoğlu, SafinazIntroduction: In the present study, we investigated the effects of breast-feeding time on bone mineral density (BMD) later in life. Material and methods: The current study was based on a retrospective analysis of 586 postmenopausal women with a mean age of 60.8 years, who were screened for osteoporosis by dual energy X-ray absorptiometry (DXA). They were classified into 4 groups with respect to the duration of their breast-feeding as never (group 1), 1-24 months (group 2), 25-60 months (group 3), or > 60 months (group 4). Bone mineral density results for the femur neck and lumbar spine were classified into 3 groups according to WHO criteria as normal (T score > -1.0 SD), osteopenia (T score -1.0 to -2.5 SD), and osteoporosis (T score < -2.5 SD). Patients with osteopenia or osteoporosis (T score < -1.0 SD) were considered as having low bone mass (LBM). Results: We found a correlation between duration of lactation and femur BMD or spine BMD in the study population (r = 0.116, p < 0.005; r = -0.151, p = 0.001, respectively). Significant differences were found between femur BMD and spine BMD of groups in one-way ANOVA analysis (p = 0.025, p = 0.005, respectively). Additionally, when compared with the other three groups, group 4 was older and had longer duration of menopause (p < 0.01). In logistic regression analysis, age and body mass index were found as independent risk factors of LBM [odds ratio: 1.084 (95% CI 1.031-1.141); odds ratio: 0.896 (95% CI 0.859-0.935)], while duration of lactation was not found as an independent predictor of LBM. Conclusions: In this study, we have found that changes of bone metabolism during lactation had no effect on postmenopausal BMD measured by DXA. Consequently, it can be suggested that long breast-feeding duration is not a risk factor for low bone mass later in life.Öğe The effect of osteoporosis on self-report sleep quality in postmenopausal women(Wiley-Blackwell, 2011) Yazıcı, Selma; Canan, Fatih; Baki, Ali Erdem; Erkan, Melih Engin; Ataoğlu, Safinaz; Ataoğlu, AhmetWe aimed to show the effect of osteoporosis on sleep quality in 59 postmenopausal women. The participants' bone-mineral density levels were measured by dual-energy X-ray absorptiometry (DEXA). According to their DEXA results, participants were divided into two groups as osteoporotics and controls. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Fourteen osteoporotic women (43.8%) and four controls (14.8%) were "poor" sleepers (p < 0.05). Postmenopausal women with osteoporosis scored greater on the "sleep latency" and "sleep duration" components of PSQI than controls. According to the findings of our study, osteoporosis is a risk factor for poor sleep quality in postmenopausal women.Öğe The effect of parity on bone mineral density in postmenopausal turkish women [Postmenapozal kadinlarda do?um sayisinin kemi?k mi?neral yo?unlu?u üzeri?ne etki?si?](2010) Baş, Ersun; Yazıcı, Selma; Baki, Ali Erdem; Çalık, Yalkın; Yavuz, Metin; Önder, Elif; Ataoğlu, SafinazA lot features, belonging to reproductive periods of women can affect the development of osteoporosis. We have aimed to search whether one of the reproductive factors, which is parity, is a risk factor for the progression of postmenopausal osteoporosis or not. This research has been realized on 328 postmenopausal women who have applied to Physical Medicine and Rehabilitation Polyclinic. Patients, who have secondary osteoporosis and risk factors, have not been included in this research. The patients have been categorized into 4 groups, such as patients who have never given birth, given birth once and twice, three and four times, five times and over. Bone mineral density of the patients have been examined from femoral neck and lomber vertebrae region (L1-L4). As a result of statistical analysis, a negative correlation has been found both in bone mineral density of femoral neck and lomber vertebrae with parity (p=0.002, p=0.010, respectively). When the patients are examined according to their age group, a significant relation has been found between parity and bone mineral density only in 50-60 age group. A significant relation has not been found between parity and osteoporotic fracture. It has been found that increased parity is a factor, decreasing the bone mineral density. We have concluded that the early detection and treatment of osteoporosis can be realized with the search of the parity, while the risk factors for osteoporosis are being examined on women who are in postmenopausal period. Finally, it has been concluded that since many different results have been concluded from this subject, new studies must be done so as to enlighten this subject.Öğe Effects of depression and anxiety on quality of life of patients with rheumatoid arthritis, knee osteoarthritis and fibromyalgia syndrome(Univ West Indies Faculty Medical Sciences, 2007) Özçetin, Adnan; Ataoğlu, Safinaz; Koçer, Emel; Yazıcı, Selma; Yıldız, Özcan; Ataoğlu, Ahmet; İçmeli, CelalettinObjective: To measure the effects of depression and anxiety on quality of life (QoL) in patients with rheumatoid arthritis (RA), knee osteoarthritis (OA) andfibromyalgia syndrome (FMS). Methods: One hundred and fifty-four patients with RA, knee OA, and FMS who presented to the physical medicine and rehabilitation department were studied For evaluation of the patients, Beck depression scale, Beck anxiety scale, and Short Form-36 were used. Results: Twenty-two per cent ofpatients (n = 34) were diagnosed with of RA, 52.6% (n = 81) knee OA and 25.3% (n = 39) FMS. Except for the subscales, of physical and emotional role, there were statistically significant differences among diagnostic groups in the rest of the SF-36 subscales. In the physical functioning subscale, the highest score was obtained in the fibromyalgia group and the lowest in the RA group (p < 0.001). However in the bodily pain subscale, the lowest score was recorded in the fibromyalgia group (p = 0.019). In all diagnostic groups, the scores of SF-36 subscales were significantly low in patients who scored above the threshold value of Beck depression scale (p < 0.001). A strong negative correlation was detected between scores of Beck anxiety scale and the scores of all SF-36 subscales in patients with RA and knee OA. On the other hand, in patients with FMS, anxiety scores correlated negatively with only physical and somatic function scores of SF-36. Conclusion: Quality of life is significantly low in patients with RA, knee OA and FMS, whose depression and/or anxiety scores are high. Therefore, these patients should be managed using a multidisciplinary approach including psychiatric support.Öğe Effects of low power laser and low dose amitriptyline therapy on clinical symptoms and quality of life in fibromyalgia: a single-blind, placebo-controlled trial(Springer-Verlag, 2002) Gür, Ali; Karakoç, Mehmet; Nas, Kemal; Çevik, Remzi; Saraç, Jale; Ataoğlu, SafinazThe purpose of this study was to examine the effectiveness of low power laser (LPL) and low-dose amitriptyline therapy and to investigate effects of these therapy modalities on clinical symptoms and quality of life (QOL) in patients with fibromyalgia (FM). Seventy-five patients with FM were randomly allocated to active gallium-arsenide (Ga-As) laser (25 patients), placebo laser (25 patients), and amitriptyline therapy (25 patients). All groups were evaluated for the improvement in pain, number of tender points, skin fold tenderness, morning stiffness, sleep disturbance, muscular spasm, and fatigue. Depression was evaluated by a psychiatrist according to the Hamilton Depression Rate Scale and DSM IV criteria. Quality of life of the FM patients was assessed according to the Fibromyalgia Impact Questionnaire (FIQ). In the laser group, patients were treated for 3 min at each tender point daily for 2 weeks, except weekends, at each point with approximately 2 J/cm(2) using a Ga-As laser. The same unit was used for the placebo treatment, for which no laser beam was emitted. Patients in the amitriptyline group took 10 mg daily at bedtime throughout the 8 weeks. Significant improvements were indicated in all clinical parameters in the laser group (P = 0.001) and significant improvements were indicated in all clinical parameters except fatigue in the amitriptyline group (P = 0.000), whereas significant improvements were indicated in pain (P = 0.000), tender point number (P = 0.001), muscle spasm (P = 0.000). morning stiffness (P = 0.002), and FIQ score (P = 0.042) in the placebo group. A significant difference was observed in clinical parameters such as pain intensity (P = 0.000) and fatigue (P = 0.000) in favor of the laser group over the other groups, and a significant difference was observed in morning stiffness (P = 0.001), FIQ (P = 0.003), and depression score (P = 0.000) after therapy. A significant difference was observed in morning stiffness (P = 0.001), FIQ (P = 0.003). and depression (P = 0.000) in the amitriptyline group compared to the placebo group after therapy. Additionally, a significant difference was observed in depression score (P = 0.000) in the amitriptyline group in comparison to the laser group after therapy. Our study suggests that both amitriptyline and laser therapies are effective on clinical symptoms and QOL in fibromyalgia and that Ga-As laser therapy is a safe and effective treatment in cases with FM. Additionally, the present study suggests that the Ga-As laser therapy can be used as a monotherapy or as a supplementary treatment to other therapeutic procedures in FM.
