Bilateral Wrist Drop Caused by Non-invasive Continuous Monitoring of Blood Pressure During Severe COVID-19 Pneumonia: A Case Report.

Compressive peripheral nerve injury can be observed as a long-term outcome during the treatment of severe COVID-19 pneumonia. In this case study, we report a man with bilateral wrist drop due to prolonged noninvasive blood pressure monitoring. A 52-year-old man who had undergone invasive ventilation because of severe COVID-19 pneumonia was admitted with bilateral loss of function of the wrist, digital, and thumb extensors and hypoesthesia in the dorsum of the forearm and hand. The patient had not been treated with prone positioning respiratory therapy. However, he had undergone bilateral automated sphygmomanometry that measured his blood pressure every ten minutes during his ICU stay. His electrophysiological findings were compatible with the presence of bilateral radial nerve compression at the level of the spiral groove. Awareness of potential compressive peripheral nerve injury is important for rehabilitation after the treatment of COVID-19-associated pneumonia.

Neuropsychiatric Effects of COVID-19 Pandemic on Alzheimer's Disease: A Comparative Study of Total and Partial Lockdown.

Objectives: Coronavirus disease 2019 (COVID-19)-related lockdown may have a negative effect on the neuropsychiatric status of Alzheimer's disease (AD) cases. In this study, it was aimed to find future implications by evaluating the neuropsychiatric conditions of AD cases during total and partial lockdown periods. Methods: It is a prospective, cross-sectional, and multicenter study that includes AD cases which have been followed for at least 1 year by outpatient clinics from different regions of Turkey. Sociodemographic data, comorbidities, mobility, existence of social interactions, clinical dementia rating (CDR) scale, and neuropsychiatric inventory (NPI) for total and partial lockdown were questioned by the caregivers with the help of case files of the patients. Results: A total of 302 AD cases were enrolled to the study (mean age: 78±8 years, mean duration of education: 5.8±9 years). The total comorbidity ratio was found to be 84%, with the most frequent comorbidity being hypertension. The mean NPI score was 22.9±21 in total lockdown and 17.7±15 in partial lockdown, which is statistically significantly different. When lockdown periods were compared with the total scores of NPI scores according to gender, existence of social interactions, mobility, and comorbidities were found higher in the total lockdown than the partial lockdown. When switching from total lockdown to partial lockdown, the presence of comorbidities, mobility, and CDR were found to be factors that had a significant effect on NPI scores. In regression analysis, CDR score was found as the most effective parameter on the neuropsychiatric status of AD cases for both lockdown periods. Conclusion: When lockdown-related restrictions were reduced, the neuropsychological conditions of AD cases were significantly improved. Lockdown rules should be considered with these data in mind.

The prevalence of complementary and alternative medicine use among Turkish patients with primary headache

Background/aim: The use of complementary and alternative medicine (CAM) is common in patients with primary headache. However, no study has been reported in which standardized modalities were questioned in a Turkish population. The aim of the present study was to investigate the frequency of CAM use and factors related to it in these patients. Materials and methods: Patients with a diagnosis of primary headache were included in this cross-sectional observational study. Demographic and disease specific characteristics were recorded. The use and effect of 15 CAM modalities were evaluated in accordance with the Traditional and Complementary Medicine Regulations. The patients were categorized into two groups according to their use of CAM procedures. Logistic regression analysis was further performed to assess the association between CAM use and related factors. Results: One hundred twenty patients [101 (84.2%) female, mean age 38.20 ± 12.24 years] were included. Use of CAM was reported in 33.3% of the patients. The most frequently used CAM modalities were phytotherapy (37.5%), cupping (27.5%), and chiropractic adjustment (17.5%). Compared with nonusers, CAM users showed a longer duration of disease (respectively mean 5.68 ± 4.96 years and 10.97 ± 8.57 years, p = 0.000). There were no differences with respect to age, sex, education, presence of systemic disease, headache subtypes, number of headache days in a month, or headache severity. Patients who underwent cupping reported that they benefited more than those who tried phytotherapy and multiple CAM methods (respectively 45.5%, 33.3%, 16.6%, p = 0.039). Subsequently, the logistic regression analysis showed a significant association between only disease duration and CAM use [respectively p value, OR (95% CI), and confidence intervals = 0.002 (1.143 (1.050­1.243)]. Conclusion: Our results suggest that Turkish patients with primary headache, especially those with long disease duration, use CAM modalities. Larger population-based studies are required to clarify the safety and efficacy of these methods.

Cognitive Profile of Patients with Thalamic Hemorrhage according to Lesion Localization.

BACKGROUND: The thalamus is known as the central sensory and motor relay station of the brain generally. However, cognitive decline due to thalamic lesions has been previously reported in different studies. Also, it has been observed that different cognitive subdomains are affected according to the localization of the lesion in the thalamus. OBJECTIVES AND METHODS: Detailed neurophysiological tests were performed on 28 patients with thalamic hemorrhage and the control group. Patients were grouped according to lesion localization. The results were compared with both the control group and the hemorrhage groups themselves. RESULTS: The performance of patients in all neuropsychological tests was significantly worse than that of the control group. Of the 28 patients, 15 had anterolateral, 5 had posterolateral, 5 had dorsal, and 3 had an anteromedial thalamic hemorrhage. The anteromedial group had the worst scores of almost all tests. Also, 2 situations came to notice in these tests. First, the posterolateral group achieved a remarkably low mean in the recall subgroup of the MMSE tests and verbal memory process tests. Second, the anterolateral group was found to have a low mean in both the language subgroup of the MMSE tests and the phonemic subgroup of the verbal fluency tests. CONCLUSION: It was concluded in this study that thalamic hemorrhages affect cognition entirely regardless of the lesion localization. It was also observed that the lateral part of the thalamus was associated with language, the posterior part with memory, and the anteromedial part with the rest of the cognitive subdomains.

An accurate and sensitive effervescence-assisted liquid phase microextraction method for the determination of cobalt after a Schiff base complexation by slotted quartz tube-flame atomic absorption spectrophotometry in urine samples.

In this study, an accurate analytical method development for cobalt determination in urine samples was described. The method is based on the mass transfer of the target analytes to the organic phase from the aqueous phase by the dispersing extractant throughout the solution with the aid of CO2 bubbles prior to sample measurement by using a slotted quartz tube flame atomic absorption spectrophotometer. An extractor (1-decanol) dropped effervescent tablet (anhydrous sodium carbonate and sodium dihydrogen phosphate dihydrate mixture) was used in order to separate/preconcentrate cobalt after complexation of cobalt ions in aqueous solution with the Schiff base ligand. The parameters affecting the extraction output such as complexing conditions (pH, ligand concentration, and volume) and extraction conditions (extraction solvent type and volume, extraction temperature, and heating duration, NaOH volume and mixing period) were optimized to lower the detection limit. The limit of detection and quantification values under optimized experimental and instrumental conditions were determined as 3.7 µg L-1 and 12 µg L-1, respectively with high linearity with respect to the dynamic range between 15 and 300 µg L-1. The enhancement factor obtained with the developed method was calculated as 83 fold. The pretreatment process was applied to urine samples in order to test the convenience of the developed method in urine samples for the determination of cobalt at low levels. The high percentage recovery results of 96-97% for four different concentrations of spiked urine samples indicated the proposed method's sufficient sensitivity for analyte determination in such a complex matrix.

Oculomotor Nerve Palsy Presented with Isolated Unilateral Ptosis and Minimal Upgaze Palsy.

This case with unilateral complete blepharoptosis and slight limitation of upgaze as ocular findings due to midbrain infarction represents an unusual form of intra-axial oculomotor nerve involvement. A 65-year-old man was admitted with acute unilateral ptosis of the left eyelid and gait ataxia. He had chronic hypertension in the medical history. The neurologic examination revealed that he had a complete ptosis of the left eyelid, slight limitation of elevation in the left eye, bilateral dysmetria, and gait ataxia. Magnetic resonance imaging showed acute infarction in the central part of midbrain tegmentum. Previous models for arrangement of oculomotor fascicle in the midbrain suggest that a lesion involving the most caudal fibres for levator palpebrae and superior rectus without affecting other extraocular muscles and pupillomotor fibres is the most likely aetiology.

Bioactive and rheological properties of rose hip marmalade.

In this study, bioactive (total phenolic, antioxidant and antiradical activity) and rheological properties (steady and dynamic) of rose hip marmalade were investigated. Bioactive properties were determined in rose hip marmalade and extract. Extract had higher total phenolic content (38.5 mg GAE/g dry extract), antioxidant activity (124 mg AAE/g dry extract) and antiradical activity (49.98 %) than marmalade. Steady and dynamic rheological properties of the marmalade were determined at different temperature levels (5, 25 and 45 °C). Rose hip marmalade exhibited shear thinning behavior and Ostwald de Waele model best described flow behavior of the sample (R (2)  ≥ 0.9880) at different temperature levels. Consistency index and apparent viscosity values (η 50 ) at shear rate 50 s(-1) decreased with increase in temperature level. Viscoelastic properties were determined by oscillatory shear measurements and G' (storage modulus) values were found to be higher than G'' (loss modulus) values, indicating that the rose hip marmalade had a weak gel-like structure with solid-like behavior. G', G'', G (*) (complex modulus) and η* (complex viscosity) values decreased with increase in temperature level. Modified Cox-Merz rule was satisfactorily applied to correlate apparent and complex viscosity values of the rose hip marmalade at all temperatures studied.

Cytotoxic and bioactive properties of different color tulip flowers and degradation kinetic of tulip flower anthocyanins.

This study was conducted to determine the potential use of anthocyanin-based extracts (ABEs) of wasted tulip flowers as food/drug colorants. For this aim, wasted tulip flowers were samples and analyzed for their bioactive properties and cytotoxicity. Total phenolic contents of the extracts of the claret red (126.55 mg of gallic acid equivalent (GAE)/g dry extract) and orange-red (113.76 mg GAE/g dry extract) flowers were the higher than those of the other tulip flowers. Total anthocyanin levels of the violet, orange-red, claret red and pink tulip flower extracts were determined as 265.04, 236.49, 839.08 and 404.45 mg pelargonidin 3-glucoside/kg dry extract, respectively and these levels were higher than those of the other flowers. The extracts were more effective for the inhibition of Listeria monocytogenes, Staphylococcus aureus and Yersinia enterocolitica compared to other tested bacteria. Additionally, the cytotoxic effects of five different tulip flower extracts on human breast adenocarcinoma (MCF-7) cell line were investigated. The results showed that the orange red, pink and violet extracts had no cytotoxic activity against MCF-7 cell lines while yellow and claret red extracts appeared to be toxic for the cells. Overall, the extracts of tulip flowers with different colors possess remarkable bioactive and cytotoxic properties.

Volatile compounds and bioactivity of Eremurus spectabilis (Ciris), a Turkish wild edible vegetable.

Eremurus spectabilis grows in the spring as a wild vegetable and for many years has been used both as a food or food additive and for therapeutic purposes. This study investigated the total phenolic content and the antimicrobial, antioxidant, and antiradical activities of methanol, ethanol, and aqueous extracts of E. spectabilis (obtained from the Antalya region of Turkey). In addition, volatile compounds of E. spectabilis were characterized by using gas chromatography/mass spectrometry. Major components of E. spectabilis volatile compounds were carvone (44.64%), carvacrol (14.45%), pentane, 2-methyl- (7.34%), (E)-caryophyllene (5.57%), valencene (5.11%), cis-calamenene (2.01%), cadalene (1.10%), and acetic acid (1.12%). The highest total phenolic content was seen with methanol extract (mean±standard deviation, 31.92 ± 0.48 mg gallic acid equivalents/g dry extract). The ethanol extract showed the highest antiradical activity, with a 50% inhibitory concentration of 35.14 µg/L in the 1,1-diphenyl-2- picrylhydrazyl assay. The strongest antioxidant activity was detected in methanol extract (81.72 ± 0.62 mg ascorbic acid equivalents/g). Twelve bacteria species were used to analyze the antimicrobial activity of extracts. The 1% concentrations of all extracts showed no inhibitive effect on any bacterium. The most resistant bacterium was Yersinia enterocolitica, and the most sensitive bacterium was Pseudomonas aeruginosa. A positive correlation was seen between concentrations and inhibition zones, and some differences occurred between antimicrobial activity of other concentrations.