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OBJECTIVE: To evaluate grey-scale and elastography ultrasound imaging findings in patients with CTS compared to nerve conductive studies. METHOD: Sixty median nerves of 31 cases with confirmed CTS and 44 median nerves in 22 controls (healthy volunteers) who had no clinical evidence of CTS were evaluated. An expert radiologist performed all US evaluations. The RGB image is a three-dimensional matrix. A colour image RGB is an M × N × 3 array of colour pixels. The total pixels, total blue and red pixels, and blue and red indexes were compared between cases and controls. RESULTS: Of the 60 nerves in the cases, 17 (16.3%) were mildly affected, 30 (28.8%) were moderately affected, and 13 (12.5%) were severely affected. Mean CSA, total blue pixels and blue indexes were significantly different between controls and cases with different levels of disease severity. The best cut-off point in the blue index to differentiate patients from controls was 0.1486, with a sensitivity and specificity of 80 and 70% (AUC = 0.79, P < 0.001), respectively. The best cut-off point for the red index to differentiate patients from controls was 0.1896, with a sensitivity and specificity of 70 and 55% (AUC = 0.64, P = 0.01), respectively. CONCLUSION: Sono-elastography could be a useful diagnostic method for evaluating CTS severity in affected cases.

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AIM: To assess main indications, postoperative complications and clinicopathological correlation of ocular enucleation-evisceration. METHODS: A total of 107 subjects who underwent enucleation and/or evisceration and received hydroxyapatite implants (Scleral wrap or mesh) were assessed. For each patient clinicopathological data was collected which included demographic information, clinical history, primary clinical diagnosis, main cause of ophthalmic surgery (traumatic, non-traumatic), type of surgical procedure (enucleation, evisceration) and pathological report. Patients' postoperative clinical visits were checked for procedure-related complications during first year after surgery. RESULTS: ONE HUNDRED AND SEVEN PATIENTS (MALE: 65.4%; mean age: 26y) underwent enucleation (n=100) or evisceration (n=7) due to traumatic (n=41) and non-traumatic (n=66) causes. Disfiguring painful blind eye was the most common indication of surgery (66.4%), followed by leukocoria (19.6%) and endophthalmitis (4.7%). The main types of injury included firecracker, traffic and work accidents, and sharp object perforating injury. In 53 (80.3%) subjects in non-traumatic group the initial clinical diagnosis matched the histopathological results. Malignant tumors (retinoblastoma: 47.5%, malignant melanoma: 27.3%) were the most common pathological diagnoses followed by phthisis bulbi (25.8%). The most common procedure-related complications were major eye discharge (39.6%), and implant exposure and discharge (20.8%). CONCLUSION: Trauma and malignant tumors are the leading causes of enucleation-evisceration. Despite developing new techniques and materials, enucleation is still associated with considerable postoperative complications.

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Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. It accounts 90% of all entrapment neuropathies all over the world. Ultrasound is a non-invasive, cost effective and available para-clinical method which could be applied for CTS diagnosis. Cross-sectional area of the median nerve at the level of the inlet is considered as a diagnostic criterion in CTS cases. In this study, thirty-eight patients with electrophysiologically confirmed idiopathic CTS and 22 healthy controls were enrolled. Seventy-one affected nerves and 42 unaffected nerves were evaluated within 14 days after electrophysiological examination. The largest cross-sectional area (CSA) was measured at the level of the carpal tunnel inlet and the maximum nerve perimeter was also recorded by means of the software. Mean CSA and perimeter were 14.02 ± 4.5 mm2 and 1.7±0.28m in all patients and 8.2±2.1 mm2, 1.3±0.19 m in controls (P<0.001, P<0.001). Mean CSA and Perimeter were significantly different between patient's groups and control. The best cut off point for CSA of the tunnel inlet was 10.5 mm2 with sensitivity and specificity of 80% and 76% (AUC (Area under the Curve) = 0.9, P<0.001). The best cut off point for inlet perimeter was 1.44 m with sensitivity and specificity of 85% and 77 % (AUC=0.87, P<0.001). Our findings showed that median nerve CSA at carpal tunnel inlet could be used as the diagnostic criteria for CTS.

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OBJECTIVES: The aim of the current study was to evaluate the effect of transcranial direct current stimulation (tDCS) on cold pain perception in healthy individuals. METHODS: Anodal, cathodal (2 mA), or sham tDCSs were applied on the primary motor cortex of 22 healthy subjects in a random order. A cold pressor test was performed ten minutes after initiation of stimulation. Pain threshold and tolerance were defined as time latencies to the onset of pain perception and to the withdrawal from cold stimulus, respectively. Furthermore, pain intensity (on a scale from 0 to 10) was rated at tolerance. RESULTS: Time latencies to pain threshold and tolerance were altered by the type of stimulation (p < 0.05). Pairwise post hoc analysis revealed that anodal tDCS led to increment in pain threshold and tolerance compared with sham stimulation (13.3 ± 7.4 vs. 10.9 ± 6.0 sec for the comparison of pain threshold and 54.6 ± 26.0 vs. 45.3 ± 17.9 for the comparison of pain tolerance following anodal and sham stimulations, respectively, p < 0.05 for both comparisons). However, cathodal stimulation did not alter pain perception in comparison to anodal and sham stimulations (p > 0.05). Furthermore, pain intensity score at tolerance was not significantly affected by the type of stimulation (p > 0.05). CONCLUSION: Anodal stimulation of the primary motor area can be utilized to alleviate cold pain perception in healthy individuals.

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