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Öğe A case of Adie’s tonic pupil(Selçuk BAŞAK, 2021) Ocak, Özgül; Zan, Burak; Ocak, BarışAdie's tonic pupil, the round unilateral tonic pupil, is a neuro-ophthalmologic disorder with dilation and no light response. Although usually idiopathic, it may be associated with infection, inflammation, and postganglionic paraneoplastic nerve damage. It is called Holmes-Adie syndrome when deep tendon reflex loss accompanies Adie’s tonic pupil. The diagnosis is made by observing a miotic response after dilated pilocarpine instillation. Spontaneous recovery depends on etiological factorsÖğe Central pontine myelinolysis due to chronic alcohol use: Case report(Neurological Society R.O.C (Taiwan), 2020) Ocak, Özgül; Çelik, Hamit; Korkmazer, Bora; Ocak, Barış; Karaman, Handan Işın ÖzışıkCentral pontine myelinolysis (CPM) is a neurological disorder characterized by demyelination on the bottom of pons. CPM is known to be the most common clinical presentation of osmotic demyelination syndrome. Osmotic stress formed by rapid correction of hyponatremia in glia cells is thought to be important in pathogenesis. Oligodendroglias are more sensitive to dehydration and volume changes as they are tightly aligned in the pontine. Chronic alcohol use is a rare cause of osmotic demyelination. In chronic alcoholics, central pontine myelinolysis may be asymptomatic or mild symptoms may develop. We presented the case to emphasize that chronic alcoholism is a rare cause of central pontine myelinosis. © 2020, Neurological Society R.O.C (Taiwan). All rights reserved.Öğe COVID-19 Hastalarında Huzursuz Bacak Sendromunun Değerlendirilmesi(2022) Ocak, Özgül; Şahin, Erkan MelihGiriş ve Amaç: COVID-19 pandemisi sürecinde birçok nörolojik hastalık yanında birlikte huzursuz bacak sendromu olan vaka bildirimleri de olmuştur. COVID-19 hastalığı uyku ve hareket bozukluğu hastalıklarına sebep olmaktadır. Çalışmamızın amacı COVID-19 polikliniğine başvuran hastalarda huzursuz bacak sendromu (HBS) sıklığını değerlendirip, COVID-19 hastalarında artma olup olmadığını belirlemektir.\rGereç ve Yöntemler: Kesitsel tanımlayıcı araştırma için COVID Polikliniğine başvuran yetişkin hastalar davet edilmiştir. Hastalara HBS tanısına yönelik soru formu doldurtulmuştur. HBS tanısı için Uluslararası HBS Çalışma Grubu tarafından hazırlanan revize tanı kriterleri kullanılmıştır.\rBulgular: 440 katılımcıdan 232’si erkek, 208’i kadındı. Başvuruları herhangi bir şikayete dayalı olan 301 hastadan 33’ünde (%11,0) HBS bulunduğu değerlendirildi. HBS oranları RT-PCR test sonucu açısından anlamlı farklı değildi. \rSonuç: COVID-19 hastalığında HBS vaka bildirimleri yapılmış olmasına rağmen geniş prospektif çalışma bulunmamaktadır. Bu çalışmada COVID-19 polikinik başvurularında HBS olan hastalar saptamamıza rağmen HBS sıklığının RT-PCR testi ile COVID-19 olduğu gösterilen hastalarda farklı olmadığını bulduk. Bu sonuç viral üst solunum yolu enfeksiyonları ile birlikte ortaya çıkabilen HBS şikayetlerinin COVID-19’a özgü özellik göstermediğini şeklinde yorumlanmıştır.Öğe COVID-19 Symptoms at First Admission to Hospital(Düzce Üniversitesi Tıp Fakültesi, 2021) Şahin, Erkan Melih; Ocak, Özgül; Demiral, Cansu; Dönmez, BüşraObjective: The aim of this study is to profile the complaints in the disease application using a symptom survey in patients presenting with the suspicion of COVID-19 disease and to determine the disease-specific and descriptive characteristics of the initial symptoms in those who were diagnosed with the disease. Methods: In this cross-sectional study, symptoms at first admission were questioned in adult patients who applied to the Covid Outpatient Clinic between 21 December 2020 - 22 January 2021. A total of 43 complaints were analyzed in PCR test positive and negative patients. Results: 273 (62.0%) first application and 167 (38.0%) control applications were included in the study. The PCR test was positive in 16.5% of the first admissions. The most common complaints in the first admissions with positive PCR test were fatigue (73.0%), headache (64.9%), pain (32.2%), cough (56.8%), sore throat (51.4%), loss of appetite (45.9%) while 15.9% of them were asymptomatic. Odd's rates of significant complaints for PCR positivity were calculated as 2.607 for fever, 2.724 for anorexia, 2.051 for cough, 2.594 for loss of smell, and 2.243 for loss of strength. Conclusions: COVID-19 is a disease that affects many organs and systems. Comparing the admission symptoms with the PCR test results will contribute to the recognition of the disease at the initial stage. Fever, anorexia, cough, loss of smell and loss of strength were found to be the distinguishing complaints of PCR positivity in our study.Öğe Diagnosis Confirmation Rates of Desired Electroneuromyography Results with Pre-Diagnosis of Upper Extremity Entrapment Neuropathy(Fazile Nur Ekinci Akdemir, 2020) Ocak, Özgül; Çelik, HamitObjective Electroneuromyography (ENMG) is an examination used by clinicians to confirm the diagnosis of patients with suspicion of entrapment neuropathy. The correlation between the ENMG results and requests increases when the clinical examination and anamnesis are well evaluated. This study aims to determine the compatibility of the electroneurophysiological examinations made due to the prediagnosis of entrapment neuropathy at the ENMG Laboratory in the Neurology Clinic and determine whether there is a difference between the clinics that made the requests. Materials and Methods The study complied the examinations made in Canakkale Onsekiz Mart university neurology clinic ENMG laboratory between 01/07/2019 and 21/07/2020, and these examinations were retrospectively scanned. Results: In total, 1464 results were scanned and those who underwent ENMG examination on the entrapment neuropathy protocol (SUT code 703220) were included in the study. Patients for whom requests were made lower extremity entrapment neuropathy and those who were younger than 18 were not included. Information regarding 445 (313 women, 132 men) patients with upper extremity entrapment neuropathy were obtained. The mean age of the patients was 49.5±14.2 (18-89). The study found that among electroneurophysiological examinations made due to the prediagnosis of entrapment neuropathy, 155 (34.8%) were diagnosed with carpal tunnel syndrome, 18 (4.0%) were diagnosed with ulnar nerve entrapment neuropathy, 3 (0.7%) were diagnosed with radial nerve entrapment neuropathy, and 253 (56.9%) had normal results. While there were no significant differences between the rates of normal results in terms of clinics that made the requests. Conclusion: While normal results were obtained on the majority of the electroneurophysiological requests due to the pre-diagnosis of upper extremity entrapment neuropathy, there were no significant differences between the clinics.Öğe Evaluation of clinical features and the factors related to nutrition in home care patients with pressure ulcer(2021) Çetiner, Mustafa; Ari, Selma Akkaya; Eşkut, Neslihan; Ocak, Özgül; Kabaya, Sibel Canbaz; Karaman, Handan Isin OzisikIntroduction: In this study, we aimed to determine the demographic and clinical characteristics of patients with pressure ulcers who received home health care in Kutahya city and to investigate the relationship between the factors related to nutrition and pressure ulcer grades. Methods: This study is designed as a retrospective and cross-sectional. The files of 500 patients who were registered at home health services unit of Kutahya Health Sciences University Training and Research Hospital between December 2016 and May 2017 were reviewed retrospectively. Of these, sixty-three patients with pressure ulcers were included in the study. Results: In this study, 26 (41.3%) were male and 37 (58.7%) were female. The mean age of the patients with pressure ulcers was 74.41 ± 12.30 (years). 36 patients (57.1%) had cerebrovascular disease, 5 patients (7.9%) had dementia, 9 patients (14.3%) had malignancy, 8 patients (12.7%) had osteoarthritis, 4 patients 6.3%) had peripheral vascular disease, and 1 patient (1.6%) had previous traffic accident. The majority (62.1%) were neurological disease-sequenced and nursing-care group. When all the patients were examined, the region with the most pressure was the sacrum (35.3%). Hemoglobin level was found to be related to pressure ulcer grade (One-way ANOVA, p = 0.019). There was no significant relationship between other nutrition-related parameters and pressure ulcer stage. Conclusion: Patients with cerebrovascular disease constitute a significant proportion of patients receiving home care services. Low hemoglobin increases the severity of the pressure ulcer. Therefore, determining risk factors that contribute to pressure ulcer formation and efforts to prevent them should be the primary target of the home health care unit.Öğe Evaluation of Headache Characteristics in Patients Presenting with Suspected COVID-19(Ankara Yıldirım Beyazit Üniversitesi, 2021) Ocak, Özgül; Şahin, Erkan MelihINTRODUCTION: This study aimed to determine the frequency of headaches in COVID-19 related hospital admissions and whether they are specific to the disease. METHODS: All patients over the age of 18 who applied to the COVID Outpatient Clinic were included in the cross-sectional descriptive study. Patients were asked to answer an 18-item questionnaire about the presence and characteristics of headache complaints. The ID Migraine scale and International Headache Society diagnostic criteria were used for classification, and the visual Pain Scale was used for pain intensity. RESULTS: Of the 440 participants, 208 (47.27%) were women. Of the 273 first applicant patients, 44 (16.12%) had positive RT-PCR results. Of the 301 patients whose applications were based on any complaint, 179 (59.47%) had headaches. According to VAS, the pain intensity was 5.86 ± 2.72. Rates of headache presence or pain intensity did not differ in terms of RT-PCR test results. There was no significant difference in headache diagnostic groups according to RT-PCR test results. DISCUSSION AND CONCLUSION: The headache is one of the most common complaints in COVID-19 patients. In our study, there was no difference in the frequency and characteristics of headaches according to RT-PCR test among patients who applied to the COVID-19 outpatient clinic with suspicion of the illness.Öğe Evaluation of Serum 25-Hydroxyvitamin Vitamin D, Vitamin B12, and Folate Levels in Patients with Benign Paroxysmal Positional Vertigo(Emergency Physicians Associations of Turkey, 2021) Çelik, Hamit; Yardım, Ahmet; Ertaş, Atilla; Varışlı, Behçet; Ocak, ÖzgülAim: This study aimed to compare 25-hydroxyvitamin D (25-OH Vit D), vitamin B12, and folic acid levels in patients presenting with vertigo diagnosed with benign paroxysmal positional vertigo (BPPV) and healthy volunteer control group without vertigo, and to examine whether they are disease-associated. Materials and Methods: A total of 190 patients who applied between October to December 2019 diagnosed with BPPV and 149 volunteers without any complaints (control group), who came only for checkup, were included in the study. Serum 25-OH Vit D, vitamin B12, and folic acid levels of all participants were examined. Results: Of all participants, 209 (61.6%) were male and 130 (38.4%) were female. Out of 94 participants, 25-OH Vit D level was found to be at low levels. Of participants with low 25-OH Vit D levels, 65 (69.1%) were in the BPPV group and 29 (30.9%) were in the control group. Of all participants, 68 had low folic acid levels, wherein 33 (48.5%) were in the control group and 35 (51.5%) were in the BPPV group. The level of vitamin B12 of 2 participants among all participants was below normal values and these 2 participants were in the BPPV group. Conclusion: In our study, any significant relationship was not found between BPPV and serum vitamin B12 and serum folic acid levels. A significant relationship was determined between BPPV and decreased serum 25-OH Vit D level (p<0.01). We identified that low serum 25-OH Vit D levels may be an independent risk factor in the progress of BPPV.Öğe Evaluation of the Quality and Reliability of Youtube Videos on Neurological Symptoms of COVID-19(2022) Ocak, Özgül; Şener, AlperPurpose: The objective of this study was to identify key features of the videos related to neurological symptoms of COVID-19 published on YouTube and evaluate the quality and reliability of them. Methods: YouTube searches was performed using keywords “COVID -19 Neurological Symptoms” and the first 50 YouTube videos with the highest number of views were evaluated by one neurologist and one infectious disease specialist with DISCERN and JAWA scoring systems. Results: Videos uploaded by health channels (50%), news channels (26%), physicians (22%), or patients (2%). The mean Video Power Index value was 95.51. The mean DISCERN score was 46.59±10.90 (average) and the mean JAMA score was 2.87±0.65. Health Channel mean JAMA and DISCERN scores were higher than News Channel scores. DISCERN or JAMA scores did not correlate with view counts, view rate, comment counts, like counts, or dislike counts. Conclusion: Proper use of Youtube as a source for reaching information, can play a role in managing the COVID-19 outbreak. Lack of control on video sources reduces validity of information. With the increase of the publication of videos by neurologists, the spread of false information can be minimized.Öğe Fragile-X-associated Tremor/Ataxia Syndrome (FXTAS) in a Female with FMR1 Premutation: Case Report(2022) Ocak, Özgül; Sılan, FatmaPeople carrying a fragile-X-mental retardation 1 (FMR1) expansion between 55 and 200 cytosine-guanine-guanine (CGG) repeats are at increased risk of the fragile-X-associated tremor/ataxia syndrome (FXTAS). FXTAS clinical findings are late-onset psychological disorders, cerebellar gait ataxia, cognitive decline, and cerebellar intentional tremor. About 8% of female and 75% of male FMR1 premutation carriers develop FXTAS. Due to the protective effect of the second X chromosome, FXTAS have rarely been observed in women extremely rare. We describe a sixty-eight-year-old female carrier of the FMR1 premutation who presented with symptoms of tremor and gait ataxia and whose son has mental retardation with fragile-X syndrome. Mild global brain atrophy and white- matter lesions were observed in the magnetic resonance imaging images. Genetic analysis confirmed the premutation with a number of 90 CGG repeats. FXTAS is a neurodegenerative disease with a premutation of the FMR1 gene. Female patients with gait ataxia and tremor should be referred for a genetic test with family members.Öğe Guillain-Barré Syndrome with Bilateral Peripheral Facial Nerve Paralysis After COVID-19 Infection(Turkish Neurosurgical Society, 2021) Ocak, ÖzgülIsolated bilateral peripheral facial paralysis in Guillain-Barré syndrome (GBS) is also quite rare. This case meets the diagnostic criteria of GBS with isolated bilateral peripheral facial paralysis following the coronavirus disease-2019 (COVID-19) infection. A 48-year-old male patient with bilateral peripheral facial nerve paralysis on neurological examination and without other abnormalities was admitted to the emergency department, 18 days after a COVID-19 infection. An increase in cell-free protein (albuminocytological dissociation) in the patient’s cerebrospinal fluid and demyelinating polyneuropathy in electrophysiological examinations suggested GBS in the patient. Facial paralysis findings were completely resolved after 5 days of intravenous immune globulin therapy. Physicians must closely monitor patients’ neurological signs because of the possible association between GBS and COVID-19. © 2021 by Turkish Neurological Society Turkish Journal of Neurology published by Galenos Publishing House.Öğe Intravenous thrombolytic treatment of a patient who had a stroke after COVID-19 Thrombolytic treatment and stroke after COVID-19(Bayrakol Medical Publishing, 2021) Çam, Mustafa; Ocak, ÖzgülThe infection, reported by the WHO as COVID-19, may occur with asymptomatic or mild symptoms, resulting in shock and even death. Stroke occupies an important place among the neurological complications of this disease. In the acute period, intravenous (IV) alteplase therapy is useful in patients suitable for the treatment.This case report includes a 70-year-old patient with mild COVID findings, who had an early complication of stroke and who received a nearly complete benefit from thrombolytic therapy.Stroke can occur in COVID patients at an early stage of the disease. IV thrombolytic therapy should be administered in appropriate patients during the period of acute stroke. As far as we know, the earliest application in our country was carried out in our hospital and was quite successful. After the treatment, the symptoms of COVID-19 also regressed and he was discharged on the 5th day of his hospitalization.Öğe Investigation of the frequency and relationship of fragmented QRS in patients with ischemic stroke Fragmented QRS in patients with ischemic stroke(Bayrakol Medical Publishing, 2021) Çam, Mustafa; Malçok, Ümit Ali; Akşit, Ercan; Ocak, ÖzgülAim: Acute ischemic stroke is an important cause of morbidity and mortality. Fragmented QRS (fQRS) is a depolarization disorder, which may be easily detected in 12-lead superficial electrocardiography (ECG), which displays a conduction delay caused by myocardial fibrotic tissue. Although the association of fQRS with ischemic heart disease is well known, there is no clear information about its relationship with ischemic stroke. In the present study, we aimed to investigate the relationship between fQRS and ischemic stroke.Material and Methods: Seventy consecutive patients with a diagnosis of ischemic stroke and 48 healthy individuals were included in this cross-sectional study. Baseline demographic and echocardiographic characteristics were recorded, and surface 12-lead standard ECGs were used.Results: The mean age of the patients was 65.19±13.91 years, and 46.6% were male. The number of patients with fQRS in the ischemic stroke group was greater than in the control group (p = 0.009). In multiple logistic regression analysis, left ventricular end-systolic diameter (LVESD) (p = 0.013, Odds ratio (OR) = 4.284, 95% Confidence interval (C.I.) = 1.366–13.432), and left atrium diameter (p = 0.020, OR = 3.985, 95% C.I. = 1.240–12.803) were found to be independent predictors of ischemic stroke.Discussion: The current study was the first to focus on evaluating the relationship between fQRS and ischemic stroke. In light of these results, we can say that patients with fQRS, who had lower LVEF, greater LVESD, and larger left atrium represent a high-risk group for ischemic stroke. fQRS may be utilized in a follow-up of these patients and in any consideration of early anticoagulation treatmentÖğe Long/post COVID’de anosminin nörolojik semptomlar içindeki sıklığı ve yaşam kalitesine etkisi(Çanakkale Onsekiz Mart Üniversitesi, 2023) Ocak, ÖzgülAmaç: Anosmi, yaşam kalitesinde bozulmalara sebep olan ve Corona virüs hastalığı 2019 (COVID-19)’lu hastalarda görülen nörolojik semptomlar arasında en sık gözlenenlerden biridir. Bu çalışmada COVID-19 olan hastalarda uzun dönemde anosminin sıklığının ve yaşam kalitesi üzerindeki etkilerinin incelenmesi amaçlamıştır. Yöntem: Çalışmaya tanıları polimeraz zincir reaksiyonu (PCR) testi ile teyit edilmiş 18 yaş ve üzeri 266 (103’ü erkek, 163’ü kadın) hasta dahil edilmiştir. Yaşam kalitesini ölçmek için Notthingham Sağlık Profili (NSP) kullanılmıştır. Bulgular: Katılımcıların 46’sının (%17.3) hiçbir şikayetleri olmamıştır. Koku kaybı şikayeti 220 katılımcıdan (%82.7) 76’sında (%34.5) hiç olmamış, 111’inde (%50.5) sadece akut hastalıkta, 33’ünde (%15.0) ise uzamış COVID-19 döneminde de devam edecek şekilde görülmüştür. Koku kaybı yaşadığını bildirenlerin NSP ağrı, fiziksel aktivite ve enerji alt ölçek ortalama skorları koku kaybı yaşamamış olanlardan daha yüksektir. Akut hastalık döneminde koku kaybı yaşayıp takiplerinde iyileşenlerin NSP ağrı, duygusal reaksiyon alt ölçek ortalama skorları uzamış COVID-19 döneminde devam edenlerden daha düşüktür. Sonuç: COVID-19 hastalarında uzamış anosmi yüksek oranda saptanmıştır. Anosmi, yaşamı tehdit etmediği için nörolojik bulgular içinde daha az önemsenmiş olmasına rağmen uzamış COVID-19 döneminde de devam etmekte ve hastaların yaşam kalitesini olumsuz etkilemektedirÖğe Migren Baş Ağrısının Nötrofil-Lenfosit Oranı, Platelet Lenfosit Oranı ve Eritrosit Dağılım Genişliği ile İlişkisi(2021) Ocak, Özgül; Şahin, Erkan MelihAmaç: Bu çalışmada, nötrofil lenfosit oranı (NLO), platelet lenfosit oranı (PLO) ve eritrosit dağılım genişliği (RDW) değerlerinin migren baş ağrısının diğer baş ağrılarından ayırıcı tanısında kullanılabilirliğini incelemek amaçlanmıştır.Yöntem: Çalışmaya nöroloji polikliniğine 01/01/2018 ve 31/12/2020 tarihleri arasında başvuran migren ve diğer baş ağrısı tanısı almış hastaların kayıtları alınmıştır. Bu kayıtlardan eritrosit dağılım genişliği (RDW) değerine ek olarak nötrofil-lenfosit oranı (NLO), platelet lenfosit oranı (PLO) hesaplanmıştır. Migren tanılı hastalar ile diğer baş ağrısı tanıla hastalar arasında karşılaştırma yapılarak NLO, PLO ve RDW açısından fark olup olmadığı incelenmiştir.Bulgular: Çalışmaya toplam 2535 kayıt dahil edilmiştir. Migren tanı grubunda 117 (%4,6) diğer baş ağrıları tanı grubunda 2411 (%95,4) kayıt mevcuttu. Migren tanı grubunda kadın oranı (%82,9) diğer baş ağrıları tanı grubundaki kadın oranından (%65,6) anlamlı yüksekti. Çalışma ve kontrol gruplarının ortalama NLO değerleri (2,02±1,05 ve 2,27±2,36), ortalama PLO değerleri (127,70±68,78 ve 128,05±92,57) ve ortalama RDW değerleri (14,18±1,48 ve 14,19±1,73) arasında anlamlı bir fark izlenmedi (p>0,05).Sonuç: Bu çalışmada migren hastaları ile diğer baş ağrısı tanılı hastaların NLO, PLO ve RDW değerleri arasında anlamlı farklılık bulunmamıştır. Bu değerlerin migren ile diğer baş ağrısı tanıları arasında ayırıcı tanı için kullanım değerleri olmadığı sonucuna varılmıştır.Öğe Presence of Peripheral Neuropathy Does Not Affect Urine 6-Sulfatoxymelatonin Levels in Type 2 Diabetics(NLM (Medline), 2021) Kurt, Kemal; Karakılıç, Ersen; Ocak, Özgül; Çakına, SuatBACKGROUND: Oxidative stress plays a crucial role in the pathogenesis of diabetic peripheral neuropathy. Melatonin is one of the most powerful antioxidant substances and its role in the pathogenesis of diabetes has been the focus of much research. However, no data exist on melatonin levels in diabetic peripheral neuropathy. We investigated how levels of urinary 6-sulfatoxymelatonin, the main metabolite of melatonin, differed in diabetic peripheral neuropathy. METHODS: A total of 127 participants were enrolled into 3 groups: diabetic neuropathy (n=43), diabetes but no neuropathy (n=44), and controls (n=40). Neuropathy was diagnosed using the Michigan Neuropathy Screening Instrument. Melatonin level was evaluated by measuring 24-hour urine 6-sulfatoxymelatonin levels. RESULTS: We found significant differences in urinary 6-sulfatoxymelatonin levels between the 3 groups (p=0.023). The distribution of 6-sulfatoxymelatonin among all diabetic participants was significantly lower than in the control group (p=0.006). However, there was no difference in diabetics with and without neuropathy (p=0.792). 6-sulfatoxymelatonin levels were negatively and weakly correlated with plasma glucose(r = -0.211, p=0.017) and positively and weakly correlated with microalbuminuria (r= 0.209, p=0.023). Regression analysis was found a significant relationship between age (B = 0.826, 95% CI=0.227 to 1.426), insulin use (B = 14.584, 95% CI= 3.857 to 25.311), glomerular filtration rate (B = 0.248, 95% CI= 0.018 to 0.478) and 6-sulfatoxymelatonin levels. 6-sulfatoxymelatonin levels in insulin users were significantly higher than they were in nonuser diabetics (p=0.001). CONCLUSION: Urinary 6-sulfatoxymelatonin levels were lower in diabetics but the presence of neuropathy did not affect 6-sulfatoxymelatonin levels. Insulin may improve melatonin levels in diabetics.Öğe RELATION BETWEEN SPONTANEOUS INTRACEREBRAL HEMORRHAGE AND fQRS COMPLEX(Merthan TUNAY, 2021) Malçok, Ümit Ali; Çam, Mustafa; Akşit, Ercan; Ocak, ÖzgülIntroduction: There has not been a change in spontaneous intracerebral hemorrhage (SICH) incidence over the last three decades. Mean age of cases keep rising. Despite the rising success rate of treatments, there has not been a significant improvement in prediction of hemorrhages beforehand. In this study, we aimed to find whether there was a relation between fragmented QRS (fQRS) complex and SICH in follow-up of risky patients.Materials and Methods: This study was planned as a case-control study. The data of 30 SISH and 30 healthy control individuals who meet the criteria were used in the study. Those who scored between 1-5 points according to the hemorrhage severity scale were discarded and the cases who scored zero points were included in the study. Interpretation of electrocardiogram (ECG) records and echocardiogram (ECHO) procedures were performed blindly by a cardiologist. The existence of fQRS complex in ECG records and standard parameters in ECHO procedure were evaluated.Results: Mean age of hemorrhage cases was 69 and 19 of them (%63) were male. There were not any significant differences in age, diabetes prevalance and smoking habits between groups, however, hypertension (HT) was seen more frequently in hemorrhage cases (p<0.05). fQRS complexes were seen more frequently in SICH group compared to the control group (p<0.01). In addition to the decrease in left ventricular ejection fraction (LVEF) (p<0.05), there was also an increase in left atrium (LA) (p<0.05). However, it was observed that SISH cases with fQRS complex in ECG recordings were 5 times more than the control group (OR 5.2, p<0.01).Conclusion: In this study, the relation between the existence of fQRS and SICH risk was evaluated. The fQRS complex in his ECG; It was concluded that in patients with a decrease in LVEF, an increase in LA and accompanying HT, SISH is seen moreÖğe SPONTAN İNTRASEREBRAL HEMORAJİ İLE fQRS KOMPLEKSİ ARASINDAKİ İLİŞKİ(2021) Malçok, Ümit Ali; Çam, Mustafa; Aksit, Ercan; Ocak, ÖzgülAmaç: Spontan intraserebral hemoraji (SİSH) insidansında, son üç dekat boyunca değişim olmadığı ve olguların yaş ortalamalarının arttığı görülmektedir. Günümüzde, hastaların tedavilerindeki başarı oranı artmakta ancak kanamaların tahmin edilmesinde umut verici bir ilerleme sağlanamamıştır. Bu çalışmada, fragmente QRS (fQRS) kompleks varlığı ile SİSH arasında bir ilişki olup olmadığını göstermeyi amaçladık. Materyal ve Metot: Bu çalışma vaka-kontrol çalışması olarak planlanmıştır. Çalışma kriterlere uygun 30 SİSH’li ve 30 sağlıklı kontrol bireye ait veriler kullanıldı. Hemoraji derecelendirme ölçeğine göre 1-5 puan alanlar çalışma dışı bırakıldı ve sıfır puan alan olgular çalışmaya alındı. Tüm olgulara ait elektrokardiyogram (EKG) kayıtlarının yorumlanması ve ekokardiyografi (EKO) işlemleri, kardiyoloji uzmanı tarafından kör olarak gerçekleştirildi ve EKG kayıtlarında fQRS kompleksi varlığı arandı. Bulgular: Hemoraji geçiren hastaların yaş ortalaması 69 ve 19’u (%63) erkekti. Grupların yaşları, diyabet prevalansı ve sigara alışkanlıkları arasında belirgin bir fark yoktu, ancak hipertansiyonun (HT) kanama geçiren olgularda daha fazla bulunduğu görüldü (p<0,05). Ayrıca SİSH hastalarında, kontrol grubuna kıyasla fQRS kompleksi daha sık görüldü (p<0,01). SİSH olgularına ait EKO parametrelerinde ise sol ventrikül ejeksiyon farksiyonunda (SVEF) azalmanın (p<0,05) yanı sıra sol atriyumda (SA) artış olduğu görüldü (p<0,05). Bununla birlikte, EKG kayıtlarında fQRS kompleksi bulunan SİSH olgularının, kontrol grubuna göre 5 kat daha fazla olduğu görüldü (OR 5,2, p<0,01). Sonuç: Bu çalışmada fQRS varlığı ile SİSH arasındaki ilişki değerlendirildi. EKG’sinde fQRS kompleksi bulunan; SVEF’de azalma, SA’da artma olan ve eşlik eden HT’si olan hastalarda, SİSH’nin daha fazla görüldüğü sonucuna ulaşıldı.Öğe The Effects of Distance Education Applied Due to COVID-19 on Clinical Neurology Education(Turkish Neurosurgical Society, 2021) Ocak, Özgül; Şahin, Erkan MelihObjective: The aim of this study was to compare distance and face-to-face learning models applied in neurology clinic education during the coronavirus disease-2019 (COVID-19) pandemic. Materials and Methods: Medical faculty students who received clinical neurology education in the 2019-2020 academic years were included in the study. The online questionnaire used in the study consisted of three parts. The first part contained questions on students’ sociodemographic data and education; in the second part, questions were asked on the students’ competence level in meeting the cognitive and practical learning objectives of clinical neurology education; and in the third part, the medical school students’ attitudes toward online learning scale was included. Results: The average passing grades of the 45 students (84.3) who took the clinical neurology education face to face were lower than those of the 40 participants (91.1) who received distance education. In 30 of the 40 cognitive goals and 39 of the 40 practical goals, the group averages of the students who received face-toface training were higher than those of the distance education group. There was no correlation between passing grades and total scores on cognitive and practical goals. There was a significant correlation between the cognitive and practical total scores of the students and attitude scale toward distance/online learning scale score in the distance education group. Conclusion: Distance education was started for clinical neurology education in the COVID-19 pandemic. The proficiency levels declared by students regarding their learning goals after distance education were lower. The results achieved with distance education, especially in practical goals, were worse. Conversely, student grades were higher in the distance education group. These results show that there are serious difficulties in measurement and evaluation methods in distance education. It is necessary to review the experiences gained from the pandemic to eliminate deficiencies and improve clinical neurology education.Öğe The impact of neuropsychiatric burden on Restless Legs Syndrome (RLS) disease severity(Elsevier, 2025) Kılınçarslan, Mehmet Göktuğ; Ocak, Özgül; Şahin, Erkan MelihObjective: In patients with Restless Legs Syndrome (RLS), neuropsychiatric comorbidities like anxiety, depression, and somatization are common, yet the precise connection between somatization and RLS severity remains unclear. This study aims to elucidate the influence of neuropsychiatric comorbidities on RLS severity, focusing particularly on the role of somatization. Methods: This cross-sectional analytical study was conducted at a tertiary hospital. All 113 RLS patients who followed in neurology clinic for at least a year were invited, and 87 participated. Data collection included sociodemographic details, the International Restless Legs Syndrome Study Group rating scale (IRLS), the Beck Depression Inventory, Beck Anxiety Scale, and Somatization Scale. Elastic-net regularized path analysis was used as the statistical method. Results: Among the 87 participants (70.1 % female, mean age 52.5 +/- 13.2 years), the mean duration of RLS diagnosis was 4.95 +/- 4.53 years. Univariate statistics revealed positive correlations among RLS severity, anxiety, depression, and somatization. Path analysis showed that somatization was associated with RLS severity (p = 0.014). Anxiety had no direct effect on RLS severity but influenced it indirectly through its positive association with somatization (p < 0.001). Depression was found to have no effect on RLS severity, either directly or through somatization. Conclusions: The relationship between anxiety and RLS severity is mediated by somatization. Furthermore, the association between RLS severity and somatization appears to be more significant than previously recognized, highlighting the importance of considering somatization in addressing the neuropsychiatric burden of RLS patients.
