Assessment of relationship between C-reactive protein to albumin ratio and 90-day mortality in patients with acute ischaemic stroke

Aim and clinical rationale for the study. It is now known that inflammation is involved in the pathophysiology of acute ischaemic stroke (AIS). It has been proven that CRP and albumin alone are useful in predicting a prognosis for stroke patients. A combination of these two parameters, namely the ratio of CRP to albumin (CAR), is believed to be a more accurate indicator of inflammatory status than CRP or albumin alone, and may be more valuable than either of them separately in predicting the prognosis of ıschaemic stroke patients. However, the role of CAR as a predictor of mortality in patients with AIS remains unclear.Materials and methods. We retrospectively enrolled 260 patients who were referred to our clinic within the first 24 hours of symptom presentation and who were diagnosed with AIS between January 2015 and December 2018. The patient group was classified into two groups according to 90-day mortality. These groups were compared in terms of C-reactive protein, albumin, and CAR.Results. The C-reactive protein and CAR values were higher, and the albumin level was lower, in non-surviving patients. The CAR value was also found to be a significant independent variable of 90-day mortality in patients with AIS (p < 0.001). The optimum cut-off value of CAR in predicting the 90-day mortality for patients with AIS was 0.50, with 64.1% sensitivity and 56.2%specificity.Conclusions and clinical implications. Our study demonstrated that a high CAR value is an independent predictor of 90-day mortality in patients with AI

Bilateral intracerebral hemorrhage of basal ganglion: a case report

Serebral kanamanın en sık gözlendigi bölgeler putamen, temporal lob, parietal lob veya frontal lobların santral maddesi, thalamus, serebllar hemisfer ve beyin sapında ponstur. Bazal ganglionlar hipertansiyona baglı intraserebral hemorajinin (ISH) en yaygın gözlendigi bölgedir. Etyolojisinde hipertansiyon, vasküler anomaliler, vaskülopatiler, hematolojik bozukluklar, tümörler, antikoagülanlar, ilaçlar rol oynar. Bilateral intraserebral hemoraji (BIH) gelisiminde hipertansiyondan baska metanol intoksikasyonu, etilen glikol intoksikasyonu, neonatal asfiksi, migren ve hiperglisemik hiperosmolar koma ile iliskili vakalar da bildirilmistir. Hipertansiyona baglı olarak bilateral bazal ganglion kanaması az rastlanılan bir tablodur. Bu olgu sunumunda, sol hemiparezisi olan, risk faktörü olarak hipertansiyon ve diabeti bulunan ve hipertansiyona baglı bilateral intraserebral hemoraji gelisen bir hastadan bahsedecegiz.Cerebral hemorrhages are mainly seen in the area of the central matter of putamen, temporal lobe, parietal lobe or frontal lobe, thalamus, cerebellar hemisphere and pons in the brainstem. Hypertension related intracranial hemorrhages are most commonly seen in basal ganglia. The etiology of the hemorrhages are hypertension, vascular anomalies, vasculopaties, hematological disease, tumors, anticoagulant drugs. Besides hypertension, methanol or ethylene glycol intoxication, neonatal asphyxia, migraine and hyperglycemic hyperosmolar coma are also related with this condition. In this case report we discuss a patient with hypertension and diabetes mellitus who developed bilateral intracerebral hemorrhages of the basal ganglia

Patient and physician delay in the diagnosis and treatment of non-small cell lung cancer in Turkey

Aim: The early diagnosis and treatment of lung cancer are important for the prognosis of patients withlung cancer. This study was undertaken to investigate patient and doctor delays in the diagnosis andtreatment of NSCLC and the factors affecting these delays.Materials and methods: A total of 1016 patients, including 926 (91.1%) males and 90 (8.9%) females with amean age of 61.5 10.1 years, were enrolled prospectively in this study between May 2010 and May2011 from 17 sites in various Turkish provinces.Results: The patient delay was found to be 49.9 96.9 days, doctor delay was found to be 87.7 99.6 days,and total delay was found to be 131.3 135.2 days. The referral delay was found to be 61.6 127.2 days,diagnostic delay was found to be 20.4 44.5 days, and treatment delay was found to be 24.4 54.9 days.When the major factors responsible for these delays were examined, patient delay was found to be morefrequent in workers, while referral delay was found to be more frequent in patients living in villages(p < 0.05). We determined that referral delay, doctor delay, and total delay increased as the number of doctorswho were consulted by patients increased (p < 0.05). Additionally, we determined that diagnostic andtreatment delays were more frequent at the early tumour stages in NSCLC patients (p < 0.05)

Retospective analysis of risk factors, etiological factors and treatment options in patients with cerebral venous thrombosis

PURPOSE: Cerebral venous thrombosis (CVT) is not a common disease. It is known to have a varied clinical spectrum. There is too much cause of the etiology of disease. In this manuscript we discussed our patients initial symptoms, cause of CVT and our patients' prognosis. MATERIALS and METHODS: This study was a retrospective database analysis of 29 patients who had CVT followed from 2004 to 2010. All of the patients had cranial magnetic resonans imaging (MR) and Mr /Computarized Tomography (CT) venography. RESULTS: There were 27 female, 2 male in this study. Mean age of the patients was 34.97 ±12.79 years old. Only eight patients had abnormal neurological examination (4 patients papilloedema, 2 patients confusion, 1 patient cerebellar dysfunction, 1 patient homonymous hemianopsia). Initial symptoms of patients were headache(n=19), epileptic seizures (n=6), blurred vision (n=1), diplopia (n=2) and one of the patient had vertigo. Ten patients had only one sinus thrombosis however 19 patients had more than one sinus thrombosis. Thrombotic risk factors were found in 21 patients. Most important risc factor were pregnancy, postpartum condition, oral contraceptive usage and acquired hypercoagulable disease. CONCLUSION: CVT is rare but important condition. Sometimes non specific headache is a herald of this condition. Especially pregnancy and postpartum period are susceptibility of this condition

Intravenous Lidocain in SUNCT Treatment

SUNCT/SUNA are rare, severe, neuralgiform headaches with high frequency. They are often considered as a primary headache type. It is called episodic or chronic according to the peridiocity. At the time of attack, it can affect the daily life of the patient such that it can keep the patient from oral feeding. Therefore, it is specifically important to relieve the pain of the patient during the headache episode. Here, we present a patient treated with IV lidocaine during an acute episode that gained sustained remission

A case with basilar artery thrombosis resulted in Locked-in syndrome in spite of endovascular treatment

Locked-in Sendrome is a clinical picture consist of quadriplegia, lower cranial nerve paralysis, and mutism with preservation of only vertical gaze and upper eyelid movement. Consciousness remains intact and the patient is able to communicate intentionally using eye blinking. The most common cause underlying the locked-in syndrome is thrombosis of the basilar artery. In this study, we reported a 49-years-old male with past medical history for cerebrovascular disease presented with acute basilar artery thrombosis, manifesting as reduced level of consciousness, weakness in all extremity dominated on the right side, speech impairment, horizontal gaze disorder and for reaching us of the last munite of endovascular intervention threshold, so it can perform only mechanical and intra-arterial thrombosis treatment method as an endovascular treatment modalities of acute stroke

The significance of neutrophil/lympocyte ratio and platelet/lymphocyte ratio in predicting diabetic polyneuropathy and neuropathic pain severity as inflammatory factors

Background and purpose – Neuropathic pain may appear as one of the first symp- toms that take the patient to the physician in type 2 diabetes, which can be asymptomatic for years. Although it is accepted that diabe- tes is a trigger for vascular inflammation, it has been suggested that inflammation itself may trigger diabetes. In our study, we aimed to investigate the relationship between dia- betic polyneuropathy and neuropathic pain and inflammatory markers. Methods – The study included 44 healthy controls, 46 diabetic patients with normal electroneuromyography (ENMG) and 44 dia- betic patients with polyneuropathy detected in ENMG. Sedimentation, C-reactive protein (CRP), Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLO) and mean platelet volume (MPV) values were record- ed in the sera of the patients. The Douleur Neuropathic 4 (DNP4) Questions was used to evaluate the presence of neuropathic pain in the patients, and the Visual Analogue Scale (VAS) was used to evaluate the severity of pain. Results – NLR, CRP, sedimentation levels were statistically significantly higher in the DMP+ and DMP– patient groups compared to the control group. PLO and MPV levels were significantly higher in the DMP+ patient group compared to both the DMP– patient group and the control group. The means of VAS and DN4 scores were statistically significantly higher in the DMP+ patient group than in the DMP– patient group. In the DMP– patient group, the NLR levels of those with neuropathic pain according to the DN4 scale were statistically significantly higher than those without neu- ropathic pain. Conclusion – Diabetic neuropathy is one of the common complications of diabetes, affecting about half of patients. Our study shows that NLR, PLO, MPV values can be used as parameters to help us make an easy and fast diagnosis in diabetic polyneurop- athy. However, their reliability in the diag- nosis of diabetic polyneuropathy should be evaluated with studies to be conducted with larger patient and control groups

A case of multiple cerebral fat embolism syndrome associated with femoral fracture after motorcycle accident

Fat embolism syndrome is a clinical condition which is caused by oil particles introduce into the systemic circulation and result in respiratory distress, altered consciousness and petechial rashes. The most common occurrence develops following the long bone fractures within 24-72 hours. The clinical picture may vary from mild respiratory distress to grave respiratory failure and coma.We aimed to present case of diagnosis and treatment process with fat embolism syndrome following femur fractures due to motorcycle acciden