Hot water epilepsy: a report of two cases

Hot water epilepsy is a rare reflex epilepsy which is characterized by complex partial seizures during a hot bath. It has a good prognosis and generally seen in male children, however it can be also seen in adults. Although the exact mechanism is still unknown, repeated hot water stimuli were shown to have a kindling phenomen effect. Our aim is to outline the clinical features of two patients with hot water epilepsy, seen at our clinic. Two male patients 23 and 35 years old, had complex partial seizures during bathing since their childhood. Neurological examinations, psychomotor development and cranial magnetic resonance images were found to be normal. In EEG examinations epileptic activity originated from temporal regions were observed in both patients. Our patients were under control with lamotrigine (300 mg/day; 200 mg/day) medication. In this report, we aimed to present this rare and commonly misdiagnosed reflex epilepsy

Analysis of Recurrence after Frontolateral Laryngectomy

Objective: This study aimed to evaluate the recurrence and survival of patients treated with frontolateral laryngectomy for T1 and T2 glottic laryngeal carcinoma.Methods: Patients who underwent frontolateral laryngectomy for glottic laryngeal carcinoma at a tertiary hospital between March 2009 and June 2014 were included. Patient demographics, tumor stage, treatment and histopathological examination data, and adjuvant therapy details were evaluated.Results: Thirty patients with T1aN0, T1bN0, and T2N0 vocal fold carcinoma were examined. The mean follow-up duration was 40 months. Of the 30 patients, nine (30%) were stage T1 and 21 (70%) were in stage T2. Twenty-nine patients were males and one was female, and the mean age was 59 (range, 42-81) years. During follow-up, local recurrence was observed in four patients following frontolateral laryngectomy. Six patients continued smoking after frontolateral laryngectomy, of which three developed tumor recurrence. The local control rate was poor in patients with anterior commissure involvement (66.6%) compared with those with no involvement (95.2%). Two of four patients with local recurrence were treated with salvage total laryngectomy and adjuvant postoperative radiotherapy; the remaining two were treated with only radiotherapy. One patient who was treated with only radiotherapy developed lung metastasis during follow-up and died because of distant metastasis.Conclusion: Frontolateral laryngectomy is an efficient choice of treatment for selected cases of T1 and T2 glottic laryngeal carcinoma

Anatomical variations of anterior circulation in the brains of patients with and without intracranial aneurysm

INTRODUCTION: Anatomic variations of cerebral arteries may influence the development of aneurysms. In this study our aim was to determine vascular anatomical variations of the anterior circulation of the brain in patients with and without cerebral aneurysms and also the relationship between vascular variations. METHODS: The cerebral digital subtraction angiography data of 438 patients were investigated retrospectively. Anatomical vascular variations of MCA and ACA-AcomA complex were investigated separately in patients with and without aneurysm. RESULTS: Most of our patients with cerebral aneurysms had SAH (n: 68, 80%). Although normal ACA AcomA complex and MCA vascular anatomy was less frequently seen in SAH, there was no statistical significance. ACA AcomA vascular anatomy was not significantly different between patients with and without cerebral aneurysm, however patients with cerebral aneurysm had statistically higher MCA vascular anatomical variations (p: 0.03). DISCUSSION AND CONCLUSION: ACA-AcomA vascular anatomy was not significantly different between patients with and without cerebral aneurysm. However MCA vascular anatomical variations were more commonly seen in patients with cerebral aneurysm. Variations of MCA may increase the risk of aneurysm formation and therefore have an important role in the planning of aneurysm treatment

Admission Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratio as a predictor of mortality in patients with Subarachnoid Hemorrhage

INTRODUCTION: Inflammation is associated with the pathogenesis of subarachnoid hemorrhage (SAH) which is a serious disease with high mortality. NLR and PLR as novel inflammatory markers may serve as predictors of clinical severity and mortality in patients with SAH. METHODS: Medical records of adult SAH patients who were admitted to our Neurology and Neurosurgery Departments were investigated. Clinical, neuroradiological, laboratory, and follow-up data were collected from electronic database. Admission complete blood count values including hemoglobin, leukocyte, neutrophil, platelet and mean platelet volume, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were also studied. Fisher score and mortality rates were also evaluated. RESULTS: : A total of 152 patients with a mean age of 52.94±17.04 (20-104) years, (94 (%61.8) females and 58 (38.2%) males) with SAH were included in the study. The patients were divided into two groups: aneurysmal (group 1, n: 99) and nonaneurysmal SAH (group 2, n: 53). In comparison of complete blood count parameters we found lower lymphocyte and higher neutrophil, NLR and PLR values in aneurysmal SAH patients who had also higher Fisher scores and mortality rate. There were also correlations between Fisher score and leukocyte, neutrophil, lymphocyte, NLR and PLR values. We also found that advanced age and higher NLR, PLR values are significantly related to mortality rates independent of presence of aneurysm. DISCUSSION AND CONCLUSION: Aneurysmal SAH patients had lower lymphocyte and higher neutrophil, NLR, PLR values with higher mortality rates and disease severity. Additionally advanced age and higher NLR, PLR values were significantly related to mortality rates independent of presence of aneurysm. We believe that NLR and PLR can be used as simple parameters to evaluate severity of SAH and short term mortality in clinical practice

Türkiye’nin Güneydoğusu’nda mezbahalarda kesilen sığırlarda onchocerca armillata’nın neden olduğu parazitik aortitis

Bu çalışmada, Türkiyenin Güneydoğusu’nda 2011-2012 yılları arasında mezbahalarda kesilen 400 sığır aortasında gözlenen parazitik aortitis olguları incelendi. Aortaların alınış yeri arcus aorta ve çevresi idi. İncelemeler sonunda 400 hayvandan 32 tanesinde (%8) makroskobik, 43 tanesinde ise (%10.75) hem makroskobik, hem de mikroskobik olarak aortik onkoserkozis tespit edildi. Bu çalışmanın amacı Türkiye’nin Güneydoğusu’nda Onchocerca armillata adlı parazitin neden olduğu parazitik aortitis olgularının prevalansı ve patolojisinin ayrıntılı bir biçimde incelenmesidir.In this study, total of 400 aorta suspected with parasitic aortitis was investigated between the years 2011-2012 in slaughtered cattle in the Southeastern of Turkey. Particularly arcus aorta and its surroundings were investigated. Macroscopically 32 of 400 (8%), both macroscopically and microscopically 43 (10.75%) cattle were diagnosed as aortic onchocercosis. The aim of this study is to investigate prevalance and pathology of parasitic aortitis in detail caused by Onchocerca armillata in the Southeastern region of Turkey

Kaba yemlerin rumende protein parçalanabilirliklerinin in situ naylon torba tekniği ile belirlenmesi

The aim of the present study was to obtain the effective rumen degradable (ERDP) and undegradable protein (RUP) values of some roughages grown Western Anatolia (alfalfa hay, grass hay, maize silage and wheat straw) by using in situ Nylon Bag Method to determine metabolizable protein (MP) content. The crude protein (CP) degradability parameters b (potential degradable CP), c (fractional rate of degradation of feed CP per hour) and T (Lag time) were obtained based on the degradation rates of roughage CP in the rumen for 0 (water soluble CP), 4, 8,16,24,48 and 72 hours. Furthermore, p (effective degradability) values were found by using these parameters according to rumen outflow rates. Lastly, ERDP and RUP (CP-ERDP) amounts were calculated based on CP contents. According to the obtained findings, ERDP amounts were decreased in the following order alfalfa hay, grass hay, maize silage and wheat straw, RUP amounts were ranked as alfalfa hay, maize silage, grass hay and wheat straw from the highest to the lowest according to the rumen outflow rates. It can be stated that, to meet ruminants protein requirements with MP system, the ERDP is needed to prepare rational ration formulation and to prevent N pollution leads to an excess of N in the rumen. Also, intestinal digestibility of RUP needs to be considered.Bu çalışmanın amacı Batı Anadolu koşullarında yetiştirilen bazı kaba yemlerin (yonca kuruotu, çayır kuruotu, mısır silo yemi, buğday samanı) Metabolik Protein (MP) içeriklerinin hesaplanmasında kullanılan rumende etkin parçalanan protein (ERDP) ve parçalanmayan protein (RUP) fraksiyonlarını in situ naylon torba tekniği ile belirlemektir. Bu amaçla, rumende 0 (A, ham proteinin suda çözülebilir kısmı), 4, 8, 16, 24, 48 ve 72 saatlik inkübasyon periyotlarına göre ham protein (HP) parçalanabilirliklerinden, HP parçalanabilirlik parametreleri olan b (HP’nin suda çözünmeyen fakat rumen mikroorganizmaları tarafından parçalanabilir kısmı), c (b’nin saatte parçalanma oranı) ve T (Lag time) elde edilmiş, bunlardan rumenden geçiş hızı katsayılarına göre değişen p (etkin protein parçalanabilirliği=ERDP) oranları hesaplanmıştır. Son olarak da, kaba yemlerin HP’leri içerisindeki rumenden geçiş hızlarına göre ERDP ve RUP (HP-ERDP) miktarları bulunmuştur. Sonuç olarak, kaba yemler MP içeriklerinin hesaplanmasında kullanılan ERDP fraksiyonu bakımından yonca kuruotu, çayır kuruotu, mısır silajı, buğday samanı, RUP fraksiyonu bakımından ise yonca kuruotu, mısır silajı, çayır kuruotu ve buğday samanı şeklinde sıralanmıştır. Ruminantların protein gereksinimlerinin MP olarak karşılanabilmesi için hazırlanan rasyonlarda protein kaynaklarının rasyonel kullanılmasında ve rumende protein metabolizmasında kayıp olan azottan kaynaklanan çevre kirliliğinin önlenmesinde, kaba yemlerin ERDP miktarlarının dikkate alınması gerekmektedir. Ayrıca, bu yemlerin RUP içeriklerinin kalitelerinin belirlenmesi gerektiği de ileri sürülebilir

Determination of roughages protein degradation in the rumen by using in situ nylon bag method

Bu çalışmanın amacı Batı Anadolu koşullarında yetiştirilen bazı kaba yemlerin (yonca kuruotu, çayır kuruotu, mısır silo yemi, buğday samanı) Metabolik Protein (MP) içeriklerinin hesaplanmasında kullanılan rumende etkin parçalanan protein (ERDP) ve parçalanmayan protein (RUP) fraksiyonlarını in situ naylon torba tekniği ile belirlemektir. Bu amaçla, rumende 0 (A, ham proteinin suda çözülebilir kısmı), 4, 8, 16, 24, 48 ve 72 saatlik inkübasyon periyotlarına göre ham protein (HP) parçalanabilirliklerinden, HP parçalanabilirlik parametreleri olan b (HP’nin suda çözünmeyen fakat rumen mikroorganizmaları tarafından parçalanabilir kısmı), c (b’nin saatte parçalanma oranı) ve T (Lag time) elde edilmiş, bunlardan rumenden geçiş hızı katsayılarına göre değişen p (etkin protein parçalanabilirliği=ERDP) oranları hesaplanmıştır. Son olarak da, kaba yemlerin HP’leri içerisindeki rumenden geçiş hızlarına göre ERDP ve RUP (HP-ERDP) miktarları bulunmuştur. Sonuç olarak, kaba yemler MP içeriklerinin hesaplanmasında kullanılan ERDP fraksiyonu bakımından yonca kuruotu, çayır kuruotu, mısır silajı, buğday samanı, RUP fraksiyonu bakımından ise yonca kuruotu, mısır silajı, çayır kuruotu ve buğday samanı şeklinde sıralanmıştır. Ruminantların protein gereksinimlerinin MP olarak karşılanabilmesi için hazırlanan rasyonlarda protein kaynaklarının rasyonel kullanılmasında ve rumende protein metabolizmasında kayıp olan azottan kaynaklanan çevre kirliliğinin önlenmesinde, kaba yemlerin ERDP miktarlarının dikkate alınması gerekmektedir. Ayrıca, bu yemlerin RUP içeriklerinin kalitelerinin belirlenmesi gerektiği de ileri sürülebilir.The aim of the present study was to obtain the effective rumen degradable (ERDP) and undegradable protein (RUP) values of some roughages grown Western Anatolia (alfalfa hay, grass hay, maize silage and wheat straw) by using in situ Nylon Bag Method to determine metabolizable protein (MP) content. The crude protein (CP) degradability parameters b (potential degradable CP), c (fractional rate of degradation of feed CP per hour) and T (Lag time) were obtained based on the degradation rates of roughage CP in the rumen for 0 (water soluble CP), 4, 8,16,24,48 and 72 hours. Furthermore, p (effective degradability) values were found by using these parameters according to rumen outflow rates. Lastly, ERDP and RUP (CP-ERDP) amounts were calculated based on CP contents. According to the obtained findings, ERDP amounts were decreased in the following order alfalfa hay, grass hay, maize silage and wheat straw, RUP amounts were ranked as alfalfa hay, maize silage, grass hay and wheat straw from the highest to the lowest according to the rumen outflow rates. It can be stated that, to meet ruminants protein requirements with MP system, the ERDP is needed to prepare rational ration formulation and to prevent N pollution leads to an excess of N in the rumen. Also, intestinal digestibility of RUP needs to be considered

Depression, social phobia and quality of life after major lower limb amputation

Introduction: In this study, we aimed to compare the social phobia, depression and quality of life in patients with major lower limb amputation to non-amputated.Methods: Patients who were underwent above or below the knee amputation in the past were evaluated retrospectively by examining the hospital records. All the participants were administered Liebowitz Social Anxiety Scale (LSAS), Hospital Anxiety and Depression Scale (HADS), and Short-Form 36 (SF-36).Results: The number of patients was 30 (21 males, nine females) in the amputated group and 30 (22 males, eight females) in the control group. The mean age was 41.8±14.09 years in the amputated group and 43.3±18.68 years in the control group. All LSAS and HADS scores were higher, and SF-36 scores were lower in the amputation group compared to the control group (p<0.05). The patients who were amputated more than five years ago had higher LSAS social fear scores, and lower HAD depression scores compared to patients less than five years (p=0.035, p=0.024, respectively). The employed patients had lower HAD depression and HAD total scores compared to unemployed patients (p=0.008, p=0,049, respectively). The patients amputated due to medical complications had higher scores in anxiety compared to the patients with traumatic amputation (p=0.005, p=0.016, respectively).Discussion and Conclusion: Social phobia, depression and poor quality of life are common problems in patients with major lower limb amputation. After five years, it should not be forgotten that social phobia will increase; depression will decrease along with its seriousness. Therefore, amputated patients should be psychiatrically counseled and treated. It is important to provide permanent employment opportunities to improve the quality of life