A Case of Nasopharyngeal Myiasis Caused by Sarcophaga sp.

Myiasis is a parasitic infestation of tissues and body cavities of vertebrates by Diptera larvae. Nasal myiasis is mostly caused by the Sarcophagidae and Calliphoridae families. Many predisposing factors play a role in the appearance of nasal myiasis. In the treatment of the disease, the use of antiseptics together with mechanical cleaning is recommended. In this report, a case of nasopharyngeal myiasis in a 75-year-old patient hospitalized in the intensive care unit is presented. Nine larvae were detected in the patient's nose. Larvae were removed from the area and were cleaned with iodine solution for three days. As a result of macroscopic and microscopic examination, the larvae were identified as the third stage of Sarcophaga sp. in order to prevent myiasis infestations, personnel working in places where the patient is unconscious, such as intensive care units, should daily check the patient's body cavities such as nose, mouth and ear cavities, and perform their care and cleaning

Clinical and Demographic Features of Pseudotumor Cerebri Syndrome Diagnosed in a University Hospital

Objective: Pseudotumor cerebri syndrome (PTCS) is characterized by symptoms and signs of increased intracranial pressure without ventriculomegaly, intracranial tumor or mass. This study aimed to explore and analyze 34 patients with PTCS according to age, sex, symptoms of the disorder, cranial magnetic resonance images findings, etiology, and treatment. Materials and Methods: A total of 34 patients who were diagnosed as having PTCS and followed up between January 2011 and August 2016 by Dicle University Medical School Neurology Department were included in this study. PTCS was diagnosed in accordance with the modified Dandy criteria. Results: Thirty-four patients were identified as having PTCS. Twenty-one (91.2%) had headache, 19 (55.9%) had blurred vision, 6 (17.6%) had diplopia, 2 (5.9%) had vertigo, 1 (2.9%) had tinnitus, and 1 (2.9%) had numbness of the face. Twenty-seven patients were diagnosed as having idiopathic intracranial hypertension, 21 (61.8%) had no etiologic factors. Six (17.6%) patients were obese, one of whom had recently gained weight and another had polycystic ovary syndrome. Seven patients were thought to have secondary PTCS with the following etiologic factors: 2 (5.9%) patients had Hashimoto’s thyroiditis, 1 (2.9%) had a history of all-trans retinoic acid intake due to a malignancy, 1 (2.9%) had choroid plexus granuloma, 2 (5.9%) had sinus venous thrombosis, and 1 (2.9%) had Familial Meditteranian Fever. Conclusion: Although PTCS was described many years ago, its physiopathology and exact treatment procedures are not clearly understood. The most important target of its treatment is to prevent loss of vision and improve symptoms. With a better understanding of its pathophysiology, effective treatment protocols will be develope

Carotid artery stenting: Single center experience and clinical consequences

Objective: In this study, we aimed to present the characteristics and short-term clinical outcomes of the patients admitted to our clinic with a diagnosis of carotid artery disease and revascularized by carotid artery stenting (CAS). Methods: The study was retrospective and a single-centered study. Between May 2012 and May 2014 the patients with an indication for carotid artery intervention and accepted CAS procedure were included in the study. Clinical characteristics and procedural data of the patients were obtained by scanning patient files. After discharge, hospital records were scanned and patients were called to learn whether or not patients were alive and that they have suffered a recent stroke. Results: We included 26 patients that meet the inclusion criteria in the study. 69% of patients were female with a mean age of 66 ± 9 years. 73% of patients were symptomatic, 73% had hypertension, 27% had diabetes mellitus, 39% had hyperlipidemia, 69% had coronary artery disease and 31% were active smoker. In all patients, self-expandable stents and distal embolic protection devices were used. 18 left, six right, and two bilateral (in separate sessions) carotid arteries were stented with a total of 26 patients and 28 successful CAS. Due to residual stenosis a second stent was implanted only in one patient. One patient experienced a partial muscle weakening in upper extremity due to an air embolism, which recovered spontaneously in 24 hours. Patients were followed for 11.5 ± 8 (minimum 2-maximum 27, median 10) months. During follow-up, no patients had recurrent stroke and transischemic attack. One patient died after eight months of CAS. Conclusion: CAS is being successfully applied with a very low risk of complications in experienced centers. Short-term clinical results of CAS are quite satisfactory

Clinical and demographic characteristics of Guillain-Barre syndrome

Objective: We aimed to assess the epidemiological, clinical, laboratory, electrophysiological findings in patients with Guillain-Barre´ syndrome Methods: We performed a retrospective analysis of 33 patients with GBS admitted to Dicle University Medical Faculty Hospital neurology clinic from January 2011 to March 2014. Were reviewed. Epidemiological, clinical, therapeutical and evolutionary data were collected. Results: Thirty-six patients with the diagnosis of GBS included 22 males and 14 females. The average age at diagnosis was 41.3±21.38years with a wide age range (11–82) and a peak between 36 and 55 years. Based on clinical and electrophysiological features, 61.1% of the patients had acute inflammatory demyelinating polyneuropathy (AIDP), 22.2% acute motor and sensory axonal neuropathy 11.1% had acute motor axonal neuropathy, and 5.6% had Miller Fisher Syndrome. In 28 of 36 patients (77.0%), potential trigger factors could be identified. Respiratory tract infection was the most common infection (36.1%), followed by gastrointestinal infection (27.8%), after surgery (11.1%), vaccination (2.8%) Conclusion: Our study showed that surgery may be triggered GBS and suggesting a geographical and environmental factor involved in GBS etiopathogenesis

Double Filtration Plasmapheresis in the Treatment of a Case with Acute Disseminated Encephalomyelitis

Acute disseminated encephalomyelitis (ADEM), is a monophasic autoimmune demyelinating disease of the central nervous system. Although high-dose steroid management has been considered the mainstay of treatment for ADEM, some patients are unresponsive to steroid therapy. We report the case of a 44-year-old woman with ADEM who did not respond to steroid therapy, but who showed a noticeable improvement with double filtration plasmapheresis (DFPP). To the best of our knowledge, this is the first case report of ADEM in literature treated with DFP

Primary Sjögren’s Syndrome with Sensory Ganglionopathy and Painful Legs and Moving Toes Syndrome

Sjogren’s syndrome is characterized by the sicca syndrome, with dryness of the mouth (xerostomia) and the eyes (xerophthalmia). Sjogren's syndrome is the only connective tissue disease that has been associated with sensory neuronopathy. The syndrome of painful legs and moving toes consisting of pain in the lower limbs with spontaneous movements of the toes or feet. The association between Sjogren’s syndrome and painful legs and moving toes syndrome is a rare condition

Investigation of Total Oxidants/Antioxidants in Patients with Intracerebral Haemorrhage

OBJECTIVE: There are numerous study about oxidant and antioxidant status in patients with ischemic stroke however there are few study about this subject in patients with intracerebral hemorrhage (ICH). Malondialdehyde (MDA) is an oxidant parameter which was investigated in patients with ICH, although total oxidant status (TOS) has not been investigated so far. We aimed to investigate in blood samples respectively oxidant and antioxidant parameters MDA and TOS, total antioxidant status (TAS) in patients with ICH. METHODS: Total of 30 patients with ICH, admitted and treated Neurology Clinic in Dicle University Medical Faculty Hospital and 30 control, had no stroke or any systemic disorder have been included. Peripheral vein blood samples taken from patients and controls were included in the first 24 hours after stroke. Serum TAS, TOS values measured to the original, fully automatic and colorimetric method of Erel. Serum level of MDA was measured according to the method of Ohkawa et al. RESULTS: According to the control group, the serum levels of TAS, TOS and MDA were significantly higher in patient with ICH (p 0.05). CONCLUSION: These findings support that oxidative stress may play a significant role in the pathogenesis of the ICH. However, the increase of these parameters not associated with hematoma volume and GCS in patients with IC

The Increase of The Mean Platelet Volume in Patients With Intracerebral Haemorrhage

OBJECTIVE: The mean platelet volume (MPV) is a biomarker of platelet function and activity. The influence of platelet function disorders on the aetiology of intracerebral haemorrhages (ICH) and mortality is not clear yet. The purpose of this study is to investigate the change in the MPV values in patients with ICH and to observe its influence on mortality in a retrospective manner. METHODS: Sixty-six patients with intracerebral haemorrhage (32 males, 34 females; mean age: 61.9± 16.9) were enrolled in the study. Patients with ICH were divided into two groups as those who died within the first 10 days and those who survived. The MPV values and the haematoma volumes were compared between the groups. Also, the MPV values and platelet counts of the patients with ICH were compared with the values of healthy volunteers from similar age and sex groups (27 males, 17 females; mean age: 59.9 ±3.2). RESULTS: The MPV values of the patients with ICH measured within 24 hours following the intracerebral haemorrhage (8.33 ± 1.27 fl/mL) were statistically significantly higher than the MPV values of the control group (7.76 ± 1.14 fl/mL) (p=0.018). The platelet counts of the patients with ICH also measured within the first 24 hours (235.8±94.9 x103/mL) were statistically significantly lower than the platelet counts of the control group (279.1 ± 94.9 x103/mL) (p=0.022). No statistically significant difference in terms of the MPV values and platelet counts was observed between the patients with ICH who died within the first 10 days and those who survived (p>0.05). However, the difference observed in the haematoma volume between the patients with ICH who died within the first 10 days (31.1 ±33.7 ml) and those who survived (8.7± 13.4 ml) was statistically significant (p<0.001). No correlation was found between the haematoma volume and the MPV value in the patients with ICH. CONCLUSION: The increase observed in the mean platelet volume in patients with ICH may point to a disorder in the platelet function. No relationship was found between the increase in the MPV and the mortality rates

Serum paraoxonase-1 activities and malondialdehyde levels in patients with epilepsy

Objectives: We aimed to evaluate antioxidant paraoxonase-1 (PON-1) activity together with malondialdehyde(MDA) (an oxidative stress parameter) levels in patientswith epilepsy.Materials and methods: Forty-five epilepsy patientswere included in the study and compared with healthycontrols (n = 45). The levels of serum MDA and PON-1activities were measured by the Ohkawa method and theEckerson method, respectively.Results: Serum MDA level was significantly higher (P =0.015), whereas PON-1 activity was sigificantly lower (P =0.011) in the patient group than the controls.Conclusions: Increased reactive oxygen species levelsin epilepsy may result in a oxidative stress, which in turncould result in decreased antioxidant PON-1 activity andincreased MDA levels.Key words: Epilepsy, oxidative stress, malondialdehyde,paraoxonase-