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Aim: Hallux valgus is a common foot deformity that causes significant pain and functional impairment. This study aimed to compare the effectiveness of prolotherapy and dry needling in treating mild to moderate hallux valgus pain. Material and Methods: Patients with hallux valgus deformity experiencing refractory pain after orthotic and analgesic treatment, and treated with prolotherapy (52 patients, 68 feet) or dry needling (49 patients, 57 feet) methods were included in the study. Each group received three treatment sessions at 3-week intervals. Clinical assessments were performed using the visual analog scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) scores at baseline, in the third month, and twelfth month. Results: Both groups showed significant improvement in VAS and AOFAS scores after treatment (p<0.001). In the prolotherapy group, the VAS score decreased from 6 (range, 4-8) in the pre-treatment period to 2 (range, 1-5) both in the third and twelfth months (p<0.001). In the dry needling group, the VAS score decreased from 6 (range, 4-7) in the pre-treatment period to 4 (range, 2-7) both in the third and twelfth months (p<0.001). While the AOFAS scores improved to 75 (range, 63-85) in the third month and 76 (range, 60-80) in the twelfth month in the prolotherapy group (p<0.001), improved to 56 (range, 44-75) in the third month and 50 (range, 36-75) in the twelfth month in the dry needling group (p<0.001). Conclusion: Both prolotherapy and dry needling effectively treat hallux valgus pain and improve foot function, with prolotherapy showing superior effectiveness. [ABSTRACT FROM AUTHOR]

Aim: Valproic acid (VPA) is primarily used in the treatment of epilepsy but also has uses in the treatment of manic episodes in bipolar disorder and substance use disorders. Manic episodes and psychosis may also affect hepatic clearance and drug distribution volume. The aim of this study was to assess the effect of mania and psychosis compared to substance use on VPA pharmacokinetics, specifically changes in total and unbound clearance. Material and Methods: Fifty patients with a manic episode of bipolar disorder, and 51 patients with substance use disorder, 38 of whom were considered as substance-induced psychosis, were included in this retrospective study. All patients received a constant dose of 1000 mg VPA daily for at least five days, and serum VPA concentrations were measured. Results: The mean serum levels of VPA were 59.2±17.4 μg/ml in the substance use disorder group, 60.9±13.5 μg/ml in the substance-induced psychosis group, and 61.8±13.7 μg/ml in the manic episode of bipolar disorder group. No significant difference was found between the groups (p=0.840). When considering substance use disorder and substance-induced psychosis as one group, the mean VPA level of 60.5±14.4 μg/ml in this group showed no significant difference compared to 61.8±13.7 μg/ml in the manic episode of bipolar disorder (p=0.630). Conclusion: After reaching steady-state plasma levels, no significant difference in serum VPA levels was observed between the three groups. This suggests that manic episodes do not lead to a significant increase in VPA metabolism compared to substance use disorder or substanceinduced psychosis. [ABSTRACT FROM AUTHOR]