Changes in retinal nerve fiber layer thickness may be the cause of post-COVID-19 headaches.

OBJECTIVE: The prevalence of post-COVID headaches is not low. The eye can be affected by this infection, but it is not clear yet what the relationship is between persistent headaches and the thickness of the retinal nerve fiber layer (RNFL) after COVID-19 infection this study aims to investigate the relationship between these subjects. METHODS: In this retrospective study, in patients who have had a persistent headache, SD-OCT analysis of RNFL was obtained, and RNLF thickness values before and after COVID-19 infection were analyzed. RESULTS: A total of 26 eyes from 13 patients (nine (69.2%) females, four (30.8%) males) with persistent headaches after COVID-19 infection were studied. The average age was 47,35 years for females and 63 years for males. The mean RNFL thickness of both eyes between before and after COVID-19 infection decreased, which was statistically significant. CONCLUSION: In this study, a correlation between headache and changes in RNLF after COVID-19 infection was found. It may have wider ramifications to look into the COVID-19-associated headache phenotype of people with a history of migraines, contributing to a more comprehensive understanding of migraine pathogenesis. This relationship can provide further insight into this infection.

The relationship between medication adherence and complementary medicine use in epilepsy patients.

OBJECTIVE: The aim of this research is to examine the usage of Complementary and Integrated Medicine (CIM) in individuals with epilepsy and the impact of CIM usage on medication adherence. MATERIALS AND METHODS: This descriptive and cross-sectional study was conducted in a university hospital in northern Turkey between July and October 2023, involving 101 individuals with epilepsy (PWE). Descriptive information forms and the Morisky Medication Adherence Scale-4 (MMS-4) were used as data collection tools. Descriptive statistics, t-tests, ANOVA, and post-hoc LSD analyses were employed for data evaluation. RESULTS: The participants consisted of 65.3 % males, 25.7 % were not working due to epilepsy, and 61.4 % with generalized epilepsy. The average MMS-4 score was found to be 3.08 ± 0.96. MMS-4 scores showed significant differences based on epilepsy type (F = 3.998, p = 0.021; η2 = 0.07). 76.2 % (n = 21) of the participants who used at least one CIM technique preferred "having a religious person read a prayer." CONCLUSION: Medication adherence in PWE was at a moderate level. Individuals with focal and secondary generalized epilepsy showed better medication adherence compared to those with generalized types. Of those participant who used at least one CIM technique to improve their general health or control seizures, the most common was "having a religious person read a prayer."

The Effect of Direct Oral Anticoagulants on Gastric Mucosa and Helicobacter Pylori Prevalence in Dyspeptic Patients: A Retrospective Cross-Sectional Study.

Background and aim Although direct oral anticoagulants (DOACs) are widely used and their side effects related to bleeding at various body sites have been well studied in the literature, less is known about their local impact on gastric mucosa. Some studies suggest that the higher risk of gastrointestinal (GI) bleeding associated with DOACs may be due to their direct local anticoagulant effects on the gastric mucosa. In this study, we aim to evaluate whether this potential local effect has a favorable outcome on the gastric mucosa and the prevalence of Helicobacter pylori (HP).  Materials and methods A total of 125 patients with dyspepsia were included in the study. Sixty patients who had been using a DOAC for at least one month were classified as the "DOAC group," while 65 patients who had not used DOACs were designated as the "control group." Demographic, laboratory, and pathological findings for these patients were retrospectively analyzed from their medical files. Results Patients in the DOAC group were significantly less likely to have antral gastritis (AnG) (p = 0.028), while the frequencies of HP and atrophic gastritis (AtG) were similar between the two groups. Although not statistically significant, the DOAC group showed fewer instances of intestinal metaplasia (IM) and a higher number of upper GI ulcers. Patients who had been using DOACs for more than 12 months had increased incidences of IM, upper GI ulcers, AnG, and HP compared to those who had been using DOACs for 12 months or less. The Rivaroxaban subgroup showed significantly lower HP positivity compared to patients using other DOACs (p = 0.042). Among all subgroups, the Rivaroxaban group had the lowest frequency of AnG (p = 0.024). Conclusion While DOACs seem to prevent AnG, HP, and IM at their early use stages, unfavorable gastric mucosa manifestations might increase with prolonged use. Higher upper GI ulcer prevalence is another controversial result of this issue. Rivaroxaban shines amongst other DOACs with its lesser HP and AnG association. These exciting findings should be supported by randomized controlled trials with large patient populations.

Does enteral nutrition through a percutaneous endoscopic gastrostomy, attenuate Helicobacter pylori colonization?: is it worth mentioning?

OBJECTIVE: In patients who experience difficulties in oral feeding, alimentary intake can be supported by creating direct access into the stomach through a percutaneous endoscopic gastrostomy. The present study purposed to compare naïve and exchanged percutaneous endoscopic gastrostomy tubes in terms of Helicobacter pylori infection and other clinical characteristics. METHODS: A total of 96 cases who underwent naïve or exchanged percutaneous endoscopic gastrostomy procedures with various indications were incorporated into the study. The patients' demographic data, such as age and gender, etiology of percutaneous endoscopic gastrostomy, anti-HBs status, Helicobacter pylori status, the presence of atrophy and intestinal metaplasia, biochemical parameters, and lipid profiles, had been analyzed. In addition, the anti-HCV and anti-HIV statuses had also been evaluated. RESULTS: The most common indication for percutaneous endoscopic gastrostomy placement was dementia in 26 (27.08%) cases (p=0.033). The presence of Helicobacter pylori positivity was significantly lower in the exchange group compared to the naïve group (p=0.022). Total protein, albumin, and lymphocyte levels were significantly higher in the exchange group compared to the naïve group (both p=0.001), and the mean calcium, hemoglobin, and hematocrit levels were statistically significantly higher in the exchange group (p<0.001). CONCLUSION: Preliminary outcomes of the present study revealed that enteral nutrition attenuates the incidence of Helicobacter pylori infection. Considering the acute-phase reactant, the significantly lower ferritin values in the exchange group suggest that there is no active inflammatory process in the patients and that immunity is sufficient.

Does enteral nutrition through a percutaneous endoscopic gastrostomy, attenuate Helicobacter pylori colonization?: is it worth mentioning?

SUMMARY OBJECTIVE: In patients who experience difficulties in oral feeding, alimentary intake can be supported by creating direct access into the stomach through a percutaneous endoscopic gastrostomy. The present study purposed to compare naïve and exchanged percutaneous endoscopic gastrostomy tubes in terms of Helicobacter pylori infection and other clinical characteristics. METHODS: A total of 96 cases who underwent naïve or exchanged percutaneous endoscopic gastrostomy procedures with various indications were incorporated into the study. The patients' demographic data, such as age and gender, etiology of percutaneous endoscopic gastrostomy, anti-HBs status, Helicobacter pylori status, the presence of atrophy and intestinal metaplasia, biochemical parameters, and lipid profiles, had been analyzed. In addition, the anti-HCV and anti-HIV statuses had also been evaluated. RESULTS: The most common indication for percutaneous endoscopic gastrostomy placement was dementia in 26 (27.08%) cases (p=0.033). The presence of Helicobacter pylori positivity was significantly lower in the exchange group compared to the naïve group (p=0.022). Total protein, albumin, and lymphocyte levels were significantly higher in the exchange group compared to the naïve group (both p=0.001), and the mean calcium, hemoglobin, and hematocrit levels were statistically significantly higher in the exchange group (p<0.001). CONCLUSION: Preliminary outcomes of the present study revealed that enteral nutrition attenuates the incidence of Helicobacter pylori infection. Considering the acute-phase reactant, the significantly lower ferritin values in the exchange group suggest that there is no active inflammatory process in the patients and that immunity is sufficient.

Determination of health fatalism and the factors affecting health fatalism in patients with epilepsy in the North of Turkey.

OBJECTIVE: In individuals with epilepsy, health fatalism can affect their perceptions of health and their responses to solutions offered, both positively and negatively. This study aimed to investigate health fatalism in people with epilepsy in Turkey and the factors that influence their health fatalism. METHOD: This descriptive and cross-sectional study was conducted between December 2019 and April 2020 with 100 epilepsy patients who were referred to a neurology outpatient clinic in the North of Turkey. The data for the study were collected using a descriptive information form and the Health Fatalism Scale (HES). RESULTS: The total mean score on the Health Fatalism Scale for the study participants was found to be 56,16 ±â€¯15,71. Significant association was found between health fatalism and educational status (p < 0,05), polytherapy (p < 0,05), and frequency of seizures (p < 0,001). CONCLUSION: In this study, individuals with epilepsy expressed high levels of fatalism in their health beliefs. It was found that illiterate individuals with epilepsy held more fatalistic beliefs. In addition, it was found that participants who used polytherapy and those who had frequent seizures also had higher levels of fatalistic health beliefs.

Fear of negative evaluation and the concealment of their disease by epilepsy patients.

OBJECTIVE: The fear of being negatively evaluated and subjected to social stigma causes people with epilepsy to conceal their disease. This study aims to explore the fear of negative evaluation and disease concealment in epilepsy patients in northern Turkey. METHOD: This descriptive, cross-sectional study was conducted between November 2019 and March 2020 with 109 epilepsy patients who applied to a neurology outpatient clinic in northern Turkey. The study data were collected using a descriptive questionnaire, the Brief Fear of Negative Evaluation Scale (BFNE) and the Concealment of Epilepsy Scale (CES). RESULTS: The mean score of participants on the CES was 46.93 ±â€¯9.55, while the mean score on the BFNE was 31.19 ±â€¯4.86. Participants' tendency to conceal their disease increased with the age of the participant (p < 0.001). At the same time, it was found that individuals who had more than one seizure a week had a greater tendency to conceal their disease compared with the other participants (p < 0.01). No significant relationship was found between the descriptive characteristics of people with epilepsy and their fear of negative evaluation (p > 0.05). However, a negative significant relationship was found between participants' fear of negative evaluation and their tendency to conceal their disease (r = -0.32, p < 0.01). CONCLUSION: In this study, it was found that people with epilepsy had high levels of fear of negative evaluation by society and a strong tendency to conceal their disease. As the patients' age and seizure frequency increased, their tendency to conceal their disease also increased. Surprisingly, as concealment of their disease increased, participants' fear of negative evaluation decreased.

Acute Seizures in Cerebral Venous Sinus Thrombosis: Risk Factors and Prognosis.

BACKGROUND: Cerebral venous sinus thrombosis (CVST) often presents with acute seizures, and recurrent seizures may also be seen in the long term in some patients. The purpose of this retrospective study was to investigate the frequency and type of acute seizures and to define the risk factors. METHODS: Sixty-two patients diagnosed with CVST between September 2007 and October 2018 were retrospectively evaluated for the occurrence of acute seizures. Seizures which developed as a presenting symptom or occurred within 2 weeks of diagnosis were defined as acute seizures. Demographic, clinical, and radiologic characteristics were compared between patients with or without acute seizures. RESULTS: Twenty (32.3%) of the 62 CVST patients had acute seizures. Univariate analysis revealed a significant association between acute seizures and aphasia (P=0.03), motor deficit (P<0.001), sensory deficit (P=0.018), severe (≥3) modified Rankin Scale scores on admission (P=0.017), sagittal sinus thrombosis (P=0.037), cortical vein thrombosis (P<0.001), supratentorial lesions (P<0.001), and hemorrhagic lesions (P<0.001). Multivariate regression analysis identified supratentorial lesions (P=0.015, odds ratio: 9.131, 95% confidence interval: 1.525-54.687) and cortical vein thrombosis (P=0.034, odds ratio: 5.802, 95% confidence interval: 1.146-29.371) as independent factors for acute seizures. Although 25% of patients with acute seizures had recurrent seizures during hospitalization, only 2.6% of the 38 patients with long-term follow-up had recurrent seizures. CONCLUSIONS: Approximately one third of patients with CVST had acute seizures. Cortical vein thrombosis, supratentorial, and especially hemorrhagic lesions were the most significant risk factors associated with acute seizures. Although seizure recurrence may occur early in the course, long-term recurrence is rare in CVST.

The frequency of juvenile spondyloarthropathies in childhood familial Mediterranean fever.

OBJECTIVES: The aim of this study is to evaluate the frequency of juvenile spondyloarthropathies (JSpA) in childhood familial Mediterranean fever (FMF) patients from a single tertiary centre. Additionally, we aimed to investigate the main clinical characteristics of FMF patients with coexistence of JSpA clinical features. METHODS: We evaluated 323 paediatric FMF patients who were followed at our clinic. All of the patients were evaluated by three different investigators (EO, DS, ET) for the presence of JSpA clinical signs, according to the recently proposed JSpA criteria. Patients preliminary diagnosed as FMF+JSpA were further evaluated by the experienced paediatric rheumatologist (OK) who made the final decision on the diagnosis of the patients. RESULTS: The female/male ratio was 1.13 (n =172/151). Preliminarily, 33 (10.2%) out of 323 paediatric FMF patients had been classified as FMF+JSpA. An experienced paediatric rheumatologist re-evaluated the classified patients and all of them were diagnosed as definitive FMF+JSpA. The M694V mutation was the most common mutation, seen in (n=18/32) (56.3%) FMF+JSpA and in (n=152/251) (61.1%) FMF patients without JSpA/JIA. CONCLUSIONS: Apart from acute monoarthritis of the lower extremities, the chronic arthritis should be kept on mind among FMF patients with articular involvement. The JSpA should be considered in FMF patients with oligoarthritis, inflammatory back pain and enthesopathy complaints with onset over 6 years. Newly proposed JSpA criteria can be used to spondyloarthropathies in childhood FMF.