Remission of obsessive-compulsive symptoms following temporoparietal haemorrhage: a case report

Many etiological factors have been implicated in the pathophysiology of obsessive-compulsive disorder (OCD). The non-invasive neuroimaging studies regarding the pathophysiology of OCD indicate the abnormalities in distinct brain regions. Cortico-striato-thalamo-cortical (CSTC) tracts are proposed to be involved in OCD symptomatology. Reports of OCD cases after a brain injury including cerebrovascular accident (CVA) also support the involvement of CSTC pathways in OCD. Moreover, a few cases of OCD whose OC symptoms displayed an improvement after CVA in the brain regions related CSTC tracts. These reports will guide the surgical interventions in OCD. Here, we present a case of OCD whose symptoms resolved within a few days after a haemorrhage in the left temporo-parieto-occipital lobes. In this case, we supposed that the compression of the subcortical striatal tissues which is known to be involved in the OCD pathophysiology might be associated with the resolution of OCD symptoms

Hot Water Epilepsy: A Review with Five Cases

Hot water epilepsy is a kind of reflex epilepsy in which seizures are initiated by exposure of the head and/or body to hot water. Presently described are 5 cases from an epilepsy outpatient clinic that were diagnosed between 2012 and 2018. None of the patients had a history of cranial trauma, febrile convulsion, or a family history of epilepsy/hot water epilepsy. Two of patients were men and the remaining 3 were women. Both of the male patients described an aura of pleasure during the seizure; only 1 had a history of self-induction. Interictal electroencephalographies were normal in 4 cases and demonstrated mild hemispheric asymmetry in the fifth patient. All of the patients had a normal cranial magnetic resonance imaging result. One patient experienced non-reflex seizures during sleep. A noteworthy fact was that non-reflex seizures always occurred while she was dreaming of bathing. She had a suicide attempt in 2017. In 3 patients, seizure control was achieved via antiepileptic medications, while changing the bathing habits was sufficient in 2 cases. These cases of hot water epilepsy represent 2 types of seizures (focal seizures with impaired awareness and unknown onset impaired awareness seizures). One of the patients experienced recurrent seizures because of a drug import problem

Acute pancreatitis in Turkey: Results of a nationwide multicenter study

Background: Acute pancreatitis (AP) is the most common gastrointestinal disease requiring hospitalization, with significant mortality and morbidity. We aimed to evaluate the clinical characteristics of AP and physicians’ compliance with international guidelines during its management. Methods: All patients with AP who were hospitalized at 17 tertiary centers in Turkey between April and October 2022 were evaluated in a prospective cohort study. Patients with insufficient data, COVID-19 and those aged below 18 years were excluded. The definitions were based on the 2012 revised Atlanta criteria. Results: The study included 2144 patients (median age:58, 52 % female). The most common etiologies were biliary (n = 1438, 67.1 %), idiopathic (n = 259, 12 %), hypertriglyceridemia (n = 128, 6 %) and alcohol (n = 90, 4.2 %). Disease severity was mild in 1567 (73.1 %), moderate in 521 (24.3 %), and severe in 58 (2.6 %) patients. Morphology was necrotizing in 4.7 % of the patients. The overall mortality rate was 1.6 %. PASS and BISAP had the highest accuracy in predicting severe pancreatitis on admission (AUC:0.85 and 0.81, respectively). CT was performed in 61 % of the patients, with the majority (90 %) being within 72 h after admission. Prophylactic NSAIDs were not administered in 44 % of the patients with post-ERCP pancreatitis (n = 86). Antibiotics were administered to 53.7 % of the patients, and 38 % of those received them prophylactically. Conclusions: This prospective study provides an extensive report on clinical characteristics, management and outcomes of AP in real-world practice. Mortality remains high in severe cases and physicians’ adherence to guidelines during management of the disease needs improvement in some aspects