Wilson’s Disease with Extrapyramidal Symptom as the First Finding: A Case Report

Wilson’s disease is rarely seen an autosomal recessive disorder which leads to degenerations in liver and brain due to disorder in copper metabolism. It was determined for a patient with limited arm movement after physical examination, and medical treatment was administrated. Clinical, laboratories and radiology findings of the patients were compared in detail with the current literary

Mask-Related Headache Among Health Workers During COVID-19 Pandemics: Study from Somalia

Aim: After the outbreak of Coronavirus Disease 2019 (COVID-19), new headaches have been reported to develop or worsen among healthcare workers who regularly wear personal protective equipments. In this study, we investigated the possible relationship between de-novo (new-onset) headache features associated with the mask used and pre-existing and exacerbated headaches. It is the first study on this subject on behalf of Somalia. Methods: This is a cross-sectional study conducted at the Mogadishu COVID-19 pandemic hospital, Somalia, with volunteer healthcare workers. Data were collected through a questionnaire. Participants were asked 15 questions in the survey and Pearson-chi-square test was used as statistics. Results: This study was conducted with 200 healthcare workers working in the hospital, 114 (57%) were male, 86 (43%) were female, and the mean age was 28. Participants 90 (45%) used surgical masks, 32 (16%) filtered masks (N95), 78 (39%) both; majority of 109 (54.5%) wore masks for more than 6 hours a day. Pre-existing headache was reported by78(39%) of the subjects. 55(70%) of those with pre-existing headache reported aggravation of their headache. Statistically significant relationship was found between duration of mask use and aggravation of pre-existing headache. De-novo headache characteristics were throbbing 21(20%), pressing 31(29%), unilateral 19(18%), and 35(33%) bilateral. A statistically significant relationship was also found between the duration of use of face mask and the development of de-novo headache, regardless of mask type. Conclusion: As per our study, prolonged use of face masks during COVID-19 pandemics was associated with de-novo headaches and exacerbation of pre-existing headache. This situation, which has caused complaints as healthcare professionals and some patients continue to wear masks, will continue to be investigated

A comparative ID migraine screener study in ophthalmology, ENT and neurology out-patient clinics

Migraine is more likely to be misdiagnosed in patients with comorbid diseases. Not only primary care physicians, but also specialists might misdiagnose it due to the lack of diagnostic criteria awareness. The ID migraine test is a reliable screening instrument that may facilitate and accelerate migraine recognition. This study aimed to compare the prevalence and characteristics of migraine in a large sample of patients admitted to clinics of ophthalmology (OC), ear, nose and throat diseases (ENTC) and neurology (NC), as well as to validate the use of the ID migraine test in OC and ENTC settings. This was a multicentre (11 cites) study of out-patients admitting either to NC, ENTC or OC of the study sites during five consecutive working days within 1 week. From each of the clinics, 100 patients were planned to be recruited. All recruited patients were interviewed and those having a headache complaint received an ID migraine test and were examined for headache diagnosis by a neurologist, blinded to the ID migraine test result. A total of 2625 subjects were recruited. Only 1.3% of OC patients and 5.4% of ENTC patients have been admitted with a primary complaint of headache, whereas the percentage of NC patients suffering from headache was 37.6%. Whereas 138 patients (19.3%) in OC, 154 (17.3%) in ENTC and 347 (34%) in NC were found to be ID migraine test positive, 149 patients (20.8%) in OC, 142 (16%) in ENTC and 338 (33.1%) in NC were diagnosed with migraine. The sensitivity, specificity, and positive and negative predictive ratios of the ID migraine test were found to be similar in all clinics. An important fraction of the patients admitted to NC, as well as to OC and ENTC, for headache and/or other complaints were found out to have migraine by means of a simple screening test. This study validated the ID migraine test as a sensitive and specific tool in OC and ENTC, encouraging its use as a screening instrument.Pfizer-Türkiy

Etiology, Localization and Prognosis in Cerebellar Infarctions

Cerebrovasculer disease are the most frequent disease of the brain. Cerebellar infarct remains % 1.5-4.2 of these diseases. Etiological factors, lesion localization, symptoms and findings and relationship with prognosis of our patients with cerebellar infarct were investigated in our study. For this purpose, 32 patients were evaluated who were admitted to the Dicle University Medical School Department of Neurology in 1995-2001 hospitalized with the diagnosis of clinically and radiological confirmed cerebellar infarction.All of patients in the study group, 21 (%65.6) were male and 11 (%34.3) female. Age of overall patients ranged between 40 and 75 years with a mean of 57.8±10.2 years. Atherothrombotic infarct was the most frequent reason at the etiologic clinical classification. The most frequently found localization was the posterior inferior cerebellar artery infarct (%50). The leading two risk factors were hypertension (%78.1) and cigarette smoking (%50). The most common sign and symptoms were vertigo (%93.7), vomiting (%75), headache (%68.7) and cerebellar dysfunction findings (%50). The mean duration of hospitalization was 16.3±7.6 days. Overall mortality rate was found to be % 6.2. Finally, the most remarkable risk factors at cerebellar infarct patients are hypertension and atherosclerosis at etiology. We are considering that, controlling of these factors will reduce the appearance frequency of cerebellar infarcts

Evaluation of potential auras in generalized epilepsy from EEG signals using deep convolutional neural networks and time-frequency representation

PubMed: 318258862-s2.0-85089618356The general uncertainty of epilepsy and its unpredictable seizures often affect badly the quality of life of people exposed to this disease. There are patients who can be considered fortunate in terms of prediction of any seizures. These are patients with epileptic auras. In this study, it was aimed to evaluate pre-seizure warning symptoms of the electroencephalography (EEG) signals by a convolutional neural network (CNN) inspired by the epileptic auras defined in the medical field. In this context, one-dimensional EEG signals were transformed into a spectrogram display form in the frequency-time domain by applying a short-time Fourier transform (STFT). Systemic changes in pre-epileptic seizure have been described by applying the CNN approach to the EEG signals represented in the image form, and the subjective EEG-Aura process has been tried to be determined for each patient. Considering all patients included in the evaluation, it was determined that the 1-min interval covering the time from the second minute to the third minute before the seizure had the highest mean and the lowest variance to determine the systematic changes before the seizure. Thus, the highest performing process is described as EEG-Aura. The average success for the EEG-Aura process was 90.38 ± 6.28%, 89.78 ± 8.34% and 90.47 ± 5.95% for accuracy, specificity and sensitivity, respectively. Through the proposed model, epilepsy patients who do not respond to medical treatment methods are expected to maintain their lives in a more comfortable and integrated way. © 2019 Walter de Gruyter GmbH, Berlin/Boston 2019

Health Status of Disabled Children and Youth Receiving Public Home Care Services Between 2010 and 2015 in Diyarbakir, Turkey

Objective: The aim of this study was to provide information on utilization of home health care services provided by government and determine health status of children and young people who received this medical care. Methods: Data for 576 patients who were followed and recorded by the health staff of the Ministry of Health between 2010 and 2015 were used in this study. Of these patients 234 (40.63 %) were female and 342 (59.37%) were male. The patients were divided into three age groups: 0-6 years of age: 93(16.15%), 7–14 years of age:219 (38.02%), and 15–22 years of age: 264 (45.83%). Results: There was no significant difference in gender between the age groups (χ2=1.077, p>0.05). In 2015, there was an increase in the prevalence of home care services across all age groups (χ2=38.734, p<0.01). Diyarbakir Children Hospital was more efficient than other hospitals (χ2=42.230, p<0.01) in providing this medical care. The most common diseases seen among these young patients were central nervous system diseases, neurodevelopmental diseases, and acquired brain injuries. In addition, epilepsy, SSPE, and cerebral palsy were also widely prevalent among this group of children and youth. The prevalence of cerebral palsy was larger in the 0–6 and 15–22 age groups (χ2=6.491, p<0.05). A prevalence of central nervous system diseases was seen most in the 0–6 age group (χ2=11.937, p<0.01). Apart from these, there were no other significance diseases observed by gender or age groups. Conclusion: After favorable adjustments to public home care services, an increase was seen in the utilization of services in recent years. As disabled patients need health care in their homes, this service has to be a primary goal for governments in order to provide them with a higher quality of life

Classification of Epilepsy Types from Electroencephalogram Time Series Using Continuous Wavelet Transform Scalogram-Based Convolutional Neural Network

During the supervisory activities of the brain, the electrical activities of nerve cell clusters produce oscillations. These complex biopotential oscillations are called electroencephalogram (EEG) signals. Certain diseases, such as epilepsy, can be detected by measuring these signals. Epilepsy is a disease that manifests itself as seizures. These seizures manifest themselves in different characteristics. These different characteristics divide epilepsy seizure types into two main groups: generalized and partial epilepsy. This study aimed to classify different types of epilepsy from EEG signals. For this purpose, a scalogram-based, deep learning approach has been developed. The utilized classification process had the following main steps: the scalogram images were obtained by using the continuous wavelet transform (CWT) method. So, a one-dimension EEG time series was converted to a two-dimensional time-frequency data set in order to extract more features. Then, the increased dimension data set (CWT scalogram images) was applied to the convolutional neural network (CNN) as input patterns for classifying the images. The EEG signals were taken from Dicle University, Neurology Clinic of Medical School. This data consisted of four classes: healthy brain waves, generalized preseizure, generalized seizure, and partial epilepsy brain waves. With the proposed method, the average accuracy performance of three of the EEG records' classes (healthy, generalized preseizure, and generalized seizure), and that of all four classes of EEG records were 90.16 % (± 0.20) and 84.66 % (± 0.48). According to these results, regarding the specific accuracy ratings of the recordings, the healthy EEG records scored 91.29 %, generalized epileptic seizure records were at 96.50 %, partial seizure EEG records scored 89.63 %, and the preseizure EEG records had a 90.44 % rating. The results of the proposed method were compared to the results of both similar studies and conventional methods. As a result, the performance of the proposed method was found to be acceptable

Effect of Caffeic Acid Phenethyl Ester on Cerebellar Tissue Damage Secondary to Methanol Intoxication: Experimental Study

OBJECTIVE: Previous studies have shown the role of oxidative stress in methanol neurotoxicity. CAPE is noted to have an antioxidant property by many experimental studies. In this study, we aim to investigate whether CAPE has a protective effect against oxidative stress observed in the cerebellar tissue in methanol intoxication METHODS: In this study, a total of 40 rats were split into 5 groups: Control group (n=8), MTX-alone group (n=8), MTX+Methanol group (n=8), MTX+Methanol+Ethanol group (ie., ethanol group) (n=8), and MTX+Metanol+CAPE group (ie.,CAPE group) (n=8). All the rats except the control group were delivered methotrexate (MTX) therapy (0.3 mg/kg/day, via i.p. route) for 7 days in order to induce methanol toxicity. The control group received no drug therapy. Seven days later, 3 g/kg (i.p.) methanol was delivered in the ethanol and CAPE groups. Four hours after the delivery of methanol, ethanol group received 0.5 g/kg ethanol (i.p.) and CAPE group received 10 µmol/kg CAPE (i.p.), while the other groups were delivered only saline (i.p.). The rats were decapitated at 8 hours and the cerebellar tissues were removed. PON-1, TAS, and MDA levels were measured in the tissues. RESULTS: MTX-alone group demonstrated decreased TAS and PON-1 levels (p=0.001 and p=0.004, respectively) and increased MDA level (p=0.001), as compared to the Control group. When MTX+Methanol group was compared with the MTX-alone group, MTX+Methanol group was found to have decreased TAS and PON-1 activities (p=0.037 and p=0.046, respectively) and increased MDA level (p=0.022). The Ethanol group was found to show a significant decrease in MDA level (p=0.001), as compared with the MTX+Methanol group. The CAPE group exhibited increased TAS and PON-1 levels (p=0.001 and p=0.001, respectively) and decreased MDA level, as compared with the MTX+Methanol group. CONCLUSION: Cerebellum demonstrates oxidative stress secondary to methanol intoxication. CAPE therapy is more effective against cerebellar oxidative stress than ethanol therap