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Objectives: This study aims to investigate the deterioration in kinesthetic kinesthesia (KKS) and visual kinesthesia (VKS) of the hand as a component of proprioception in patients with idiopathic carpal tunnel syndrome (CTS). Patients and methods: This study included a total of 90 hands of 60 patients (9 males, 51 females; mean age: 47.6±9.4 years; range, 28 to 60 years) who were diagnosed with CTS and 25 hands of 25 healthy individuals (8 males, 17 females; mean age: 42.6±14.4 years; range, 20 to 60 years) as the controls between January 2019 and January 2021. The KKS and VKS scores were compared between the groups. Clinical parameters such as pain levels, hand grip strength (HGS) values, and two-point discrimination (2PD) test scores were compared between the patients with and without KKS or VKS deficits. The association between the severity of electromyographic findings and KKS or VKS deficits was examined. Results: The mean VKS score of the CTS group was 22.9±1.6 and the KKS score was 20.8±3.4, which was significantly lower than that of the control group (p=0.002 and p

Betül Kurtses Gürsoy,1 Cansu Köseo&gbreve;lu Toksoy2 1Afyonkarahisar Health Science University, Faculty of Medicine, Department of Psychiatry, Afyonkarahisar, Turkey; 2Afyonkarahisar Health Science University, Faculty of Medicine, Department of Neurology, Afyonkarahisar, TurkeyCorrespondence: Betül Kurtses Gürsoy, Afyonkarahisar Health Science University, Faculty of Medicine, Department of Psychiatry, Afyonkarahisar, 03030, Turkey, Tel +90 544 595 1985, Email betulkurtses@yahoo.comPurpose: It was aimed to determine the level of psychological resilience and to investigate the psychological and clinical parameters that affect the resilience level in migraine patients.Patients and Methods: A total of 100 migraine patients and 100 healthy controls who agreed to participate in the study filled in the sociodemographic data form and also Beck Anxiety Scale, Beck Depression Scale, Psychological Resilience Scale for Adults, Perceived Stress Scale, Stress Coping Styles Scale, and Psychological Well-Being Scale. Also, the results of Migraine Disability Assessment Scale (MIDAS) were recorded in order to determine the clinical parameters of migraine patients.Results: When the migraine patients were examined in terms of the number of painful days in the last 3 months, duration of illness, and correlations between clinical scales, there were statistically significant correlations between the psychological resilience scale and well-being (r=0.691 p< 0.001), positive coping styles (r=0.676 p< 0.001), Beck depression scale (r=− 0.670 p< 0.001).Conclusion: Self-confident approach, social support-seeking approach, and level of psychological well-being predict psychological resilience in migraine patients. Interventions aiming to increase the level of psychological resilience, which is negatively correlated with depression, are expected to increase the quality of life of patients with migraine.Keywords: migraine, psychological resilience, coping skills, depression

Background: It has been reported that a new type of headache may develop as a result of face mask use during the COVID-19 pandemic. The aim of this study is to investigate the clinical features of face mask-related headache during the COVID-19 pandemic. Methods: This is a cross-sectional study carried out on healthcare workers at the Afyonkarahisar Health Sciences University. The number of workers at our university was established. Sample size was calculated using the G*Power program. A questionnaire consisting of questions relating to pre-existing headache, an aggravation in headache, and de-novo headache was filled out by 3 neurologists with all participants. Results: Data was collected from a total of 375 participants, after the exclusion of 5 individuals who refused to participate. Out of all participants, 26 (6.9%) used a filtering mask, 274 (73.1%) used a surgical mask, 75 (20.0%) participants used a combination of both masks. The number of participants with preexisting headache was 114 (30.4%) had pre-existing headache. Of those with pre-existing headache, 77 (67.5%) healthcare workers had reported an aggravation in their headache after mask use. De-novo headache was observed in 116 (30.9%) of participants. De-novo headache characteristics included throbbing in 17 (14.7%) participants and pressing in 99 (85.3%) participants. In addition, symptoms such as tachypnea, sleep disturbance, and fatigue were found to be significantly higher. Conclusions: This study indicates that healthcare workers develop headaches due to use of masks during the COVID-19 outbreak.

OBJECTIVE: Burnout syndrome is an important problem among healthcare workers. During the Covid-19 pandemic, healthcare professionals have struggled with an unprecedented effort. The aim of this study is to investigate occupational burnout levels among healthcare professionals working at Afyonkarahisar Health Sciences University during the Covid-19 pandemic.MATERIAL AND METHODS: This study was carried out at the Afyonkarahisar Health Sciences University between February 1st and March 1st, 2021. G* power package software was used in the sample calculation. A questionnaire form consisting of 20 parameters on demographic data and work life was used. Maslach Burnout Inventory was used as the burnout scale.RESULTS: A total of 312 healthcare professionals participated in this study. 139 of the participants were men (44.6%) and 173 were women (55.4%). The mean age of the participants was 30.7± 7.28. 138 of the participants were doctors (44.2%) and 174 were nurses (55.8%). 110 of the participants were working in a covid ward or covid intensive care unit (ICU) (35.3%) and 202 were working in other departments (64.7%). The mean subscale scores were 19.21±7.28 for emotional exhaustion, 7.31±7.19 for depersonalization, and 20.05±3.88 for personal accomplishment. These results show that healthcare workers experience high levels of burnout according to the emotional exhaustion and personal accomplishment subscales and moderate burnout according to the depersonalization subscale.CONCLUSIONS: The results of this study are very valuable for establishing future prevention protocols and educating healthcare professionals in the face of a pandemic. Based on our findings, we suggest closely monitoring risk groups that work directly with Covid-19 patients and providing psychological support when necessary. Also, making the necessary arrangements in working conditions is crucial to increase job satisfaction and reduce burnout in healthcare workers., AMAÇ: Tükenmişlik sendromu sağlık çalışanlarında önemli bir sorundur. Covid-19 pandemisinde sağlık çalışanları emsalsiz bir çaba ile mücadele etmişlerdir. Bu çalışmanın amacı, Covid-19 pandemisinde Afyonkarahisar Sağlık Bilimleri Üniversitesinde çalışan sağlık çalışanlarında mesleki tükenmişlik düzeylerini araştırmaktır.GEREÇ VE YÖNTEM: Bu çalışma 01 Şubat - 01 Mart 2021 tarihleri arasında Afyonkarahisar Sağlık Bilimleri Üniversitesi'nde gerçekleştirilmiştir. Örnek hesaplamada G* power paket programı kullanılmıştır. Katılımcıların demografik verileri ve iş hayatına ilişkin 20 parametreden oluşan anket formu kullanılmıştır. Tükenmişlik ölçeği olarak Maslach Tükenmişlik Envanteri kullanılmıştır.BULGULAR: Bu çalışmaya toplam 312 sağlık çalışanı katılmıştır. Katılımcıların 139'u erkek (%44.6), 173'ü kadın (%55.4) idi. Katılımcıların yaş ortalaması 30.7± 7.28 idi. Katılımcıların 138'i doktor (%44.2), 174'ü hemşire (%55.8) idi. Katılımcıların 110'u Covid servis veya Covid yoğun bakım ünitesinde (%35.3), 202'si (%64.7) diğer bölümlerde çalışıyordu. Ortalama duygusal tükenme puanı 19.21 ± 7.28, duyarsızlaşma puanı 7.31 ± 7.19 ve kişisel başarı puanı 20.05 ± 3.88 idi. Bu sonuçlar, sağlık çalışanlarının duygusal tükenme ve kişisel başarı alt boyutlarına göre yüksek düzeyde tükenmişlik, duyarsızlaşma alt boyutuna göre ise orta düzeyde tükenmişlik yaşadıklarını göstermektedir.SONUÇ: Bu çalışmanın sonuçları, gelecekte önleme protokollerinin oluşturulması ve sağlık profesyonellerinin pandemi karşısında eğitilmesi için çok değerlidir. Çalışmamızın sonuçlarına göre doğrudan Covid-19 hastaları ile çalışan risk gruplarının yakından takip edilmesi ve gerektiğinde psikolojik destek verilmesi önemlidir. Ayrıca sağlık çalışanlarında iş doyumunun artırılması ve tükenmişliğin azaltılması için çalışma koşullarında düzenlemelerin yapılması oldukça önemlidir.

Objective: We sought to evaluate neurologic symptoms and findings in patients with COVID- 19 infection hospitalized in a ward and intensive care unit (ICU). Methods: This study was designed as a prospective study. Hospitalized COVID-19 rRt-PCR positive patients in the ward and ICU were included in the study. A 54-item questionnaire was used to evaluate the patients. Patients were examined within 3 hours of hospitalization. Results: A total of 379 patients were included in the study. The mean age of the patients was 56.1 ± 17.8. 89 of the patients were in intensive care. At least one general symptom was recorded in 95.5% of patients. The most common neurologic symptoms were myalgia (48.5%), headache (39.6%), anosmia (34.8%), and dysgeusia (34%). Neurological symptoms in ICU patients were higher than in the ward. 53.6% of patients had comorbidities. Discussion: This study indicated that the prevalence of neurological symptoms was very high in patients with COVID-19. The percentage of neurological symptoms and findings was higher in patients hospitalized in ICU.

Background/Aim: COVID-19 is a serious disease, primarily affecting the respiratory system. The disease spreads from person to person and has become a global health problem of great concern worldwide. The aim of this study was to compare the clinical and laboratory characteristics and the mortality rates of suspected and confirmed COVID-19 cases admitted to the intensive care unit with severe pneumonia. Methods: A retrospective case-control study examination was made of 397 patients diagnosed with suspected or confirmed COVID-19 who were followed up in the intensive care unit (ICU) of Afyonkarahisar Health Sciences University Medical Faculty Hospital between 20 March 2020 and 31 December 2020. The cases were compared in respect of demographic, clinical and laboratory characteristics, prognosis, and mortality rates. Results: 397 patients comprised of 37 (9.3%) with suspected COVID-19 and 360 (90.7%) confirmed COVID-19. No difference was determined between the suspected and confirmed cases in respect of age, gender, and comorbidities (P

BACKGROUND: After the first COVID-19 case, reported neurological complications are increasing day by day. METHOD: In this paper, we present a benign-course Guillain-Barre syndrome (GBS) emerging 2 weeks after COVID-19 infection in a 35-years-old male. RESULTS: Cough and fever were started 18 days ago and his PCR test was resulted positive for COVID-19 infection. After treatment and quarantine were completed, he developed sudden leg weakness following autonomic features. Cerebrospinal fluid was suggestive for GBS despite the electrodiagnostic test was not helpful because it was done in the first days. He recovered without needing any immunotherapy. CONCLUSION: Our case suggested that COVID-19 can cause atypical benign GBS forms in addition to well-known variants. Comprehensive studies are needed to describe the unknowns and determine the exact prevalence of GBS after COVID-19 infection, including mild cases that did not require hospital admission.

Background. This study aims to determine the stroke prevalence in Akçakoca which is a rural area in Turkey. Methods. The study was designed as a cross-sectional, door-to-door survey. The stroke questionnaire was completed by a trained team in the presence of the participants according to their answers. Based on the screenings, patients who had been diagnosed with stroke previously were reexamined by a neurologist and determined the prevalence values, risk factors, and stroke types. Results. A total of 3750 people over 44 years old were reached in the screenings. It was determined that 83 people had previously suffered a stroke. The prevalence rate of stroke in those above 44 years was found to be 2.2 (98% confidence level and ± 2% margin of error). 70 (84.3%) patients had suffered an ischemic stroke while 12 (14.5%) had suffered a hemorrhagic stroke. Male/female ratio was 1.1. Conclusion. The results of this study give the prevalence rate of stroke among the Turkish population living in a rural area. Due to a lack of other similar studies, it is impossible to make any data comparison. However, the results of this study help shed light on the stroke prevalence rate.

Nerve injections have been used for the acute and preventive treatment of migraine in recent decades. Most of these injections focused on greater occipital nerve (GON) blockade. However, few studies were placebo controlled, and only a few of them investigated GON and supraorbital nerve (SON) blockade together. This study aimed to evaluate the efficacy of GON and SON blockade with local anesthetics for the preventive treatment of migraine without aura.Eighty-seven patients diagnosed with migraine without aura were included in the study. Patients were divided randomly. One group was injected with 1% lidocaine, the other group was injected with 0.9% saline. GON and SON injections were done bilaterally. The injections were repeated weekly for 3 weeks. Patients were followed up for 2 months to assess clinical response.Seventy-one patients completed the study. After 2 months, the number of headache days decreased significantly from 12.8 ± 10.9 to 5.3 ± 7.4, and VAS decreased from 8.3 ± 1.0 to 5.5 ± 1.9 in the blockade group. The number of headache days decreased from 12.4 ± 10.3 to 7.5 ± 7.2 and VAS decreased from 8.2 ± 1.1 to 7.4 ± 1.3 in the placebo group. Response was seen in 65.1% of the patients in the blockade group (65.4% for episodic migraine, 64.7% for chronic migraine) and 28.6% of the patients in the placebo group. The difference was significant.The results suggest that GON and SON blockade with lidocaine was more effective than the placebo in the prophylactic treatment of both episodic and chronic migraine.

Objectives We aimed to determine whether multiple sclerosis (MS) and methylprednisolone and disease-modifying drugs have an effect on menopausal age. Methods A total of 86 patients and 98 healthy subjects were included in this study. The natural menopausal age of the patients and healthy subjects were compared. The cumulative dosages of methylprednisolone, beta interferons (IFNβs), and glatiramer acetate were calculated. The effects of the Expanded Disability Status Scale (EDSS), duration of the disease, and cumulative dosage of medications on menopausal age were evaluated. Results The patients’ mean menopausal age was 45.3 ± 4.8 years and healthy subjects’ menopausal age was 46.8 ± 4.3 years, with no significant difference between the two groups. The cumulative dosage of methylprednisolone showed an effect on menopausal age. There was a significant inverse correlation between menopausal age and dosage of IFNβ-1b, while the disease duration and EDSS score showed no correlation with menopausal age. Conclusions We conclude that menopausal age is not affected by MS. However, long-term methylprednisolone and IFNβ-1b treatments may change menopausal age in a dose-dependent manner.

Background and Purpose Multiple sclerosis (MS) is an autoimmune disease characterized by inflammatory demyelination. Recent studies have shown that long-term exposure to air pollutants (including PM10 particulates) is potentially an environmental risk factor for MS. We aimed to determine the prevalence rates of MS in two cities with different levels of air pollution. Methods This door-to-door population-based study was conducted between April 2014 and June 2015. Two cities were screened for the prevalence rates of MS: 1) Karabük, which borders an iron-and-steel factory, and 2) Akçakoca, which is a coastal city located in the same region. A validated survey form was used for screening MS. The 2010 McDonald Criteria were used for diagnosing MS. The patients were examined twice, first by a neurology assistant in the field and then by a senior neurologist in public health centers in the cities. Results The prevalence of MS was 95.9/100,000 in Karabük and 46.1/100,000 in Akçakoca. In total, 33 patients were diagnosed with clinically definite MS. The female/male ratio was 1.5, and 21 patients were diagnosed with relapsing-remitting MS, 9 with secondary progressive MS, and 3 with primary progressive MS. Conclusions We found that the prevalence of MS was more than two fold higher in Karabük than in Akçakoca, which supports a link between air pollution and the pathogenesis of MS. However, larger etiological and epidemiological studies are needed to confirm this hypothesis. © 2018 Korean Neurological Association.