Makale Arama

Cerebral Venous Thrombosis occurs less frequently in comparison to the arterial diseases of the brain. The diagnosis can only be made through imaging techniques and its mortality and morbidity is relatively high. Cerebral Venous Thrombosis can occur due to primary or secondary hipercoagulopathies. İt is known to have a varied clinical spectrum. We evaluated the patients with CVT etiological, topographical, presentational, clinical features and prognosis of the patients whom have been followed by our inpatient clinic years between 2009 and 2013 retrospectively. We examined the demographical features, signs and symptoms, ethiological factors, neuroradiological findings and treatments of 33 patients with CVT. Thirty three patients with CVT (24 female, 9 male) were identified. The average age was 33.4 (range:24-58). The most common symptoms were headache (81.8%) and nausea (48.4%). Focal neurological deficits were observed in 36.3% of patients and impaired consciousness was observed in 6.06% of cases. In cerebral venography examinations single sinus involvement was recorded in 16 patients and multiple sinus involvement was reported in 17 cases. Genetic and acquired coagulopathies, vasculitis and hormonal changes were the most common detected etiologic causes. All patients were treated with anticoagulants. Mortality was observed two patient. The patients with CVT have quite different etiological causes and the risk of mortality and severe disability could be reduced by early diagnosis and treatment.

In 1989, 200 patientes, admitted to ENT outpatient clinic with the cornpiani of headache were included in ihis researchment. Examinations and history in tetail taken from the patients and with the help of related clirtics the etiologic spread of headache was found out. in 85 cases headache was due to the pathology of the nose and the paranasal sinus. in 115 of cases, the cause of headache was attribuied to the other pathologies.

\r\nAim: Diabetes is a serious health problem which has increased rapidly in recent years and causes numerous complications. Vitamin D levels may be a contributing factor to the glycemic control. The aim of the study was to evaluate the relationship between vitamin D levels and glycemic control in diabetic patients.

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\r\nMethods: 330 patients with Diabetes Mellitus type 2, who were admitted to our outpatient clinic between September 2015 and June 2016, were included in the study. Patients were stratified into three groups according to the vitamin D levels; ≤20 ng / mL, between 20-30 ng / mL and ≥30 ng / mL. These groups were compared in terms of patients' socio-demographic characteristics, blood parameters, diabetes-related characteristics, and diabetes treatment. Patients were categorized into two groups according to the HbA1c levels;  ≤7% and  ≥7%. The same parameters and vitamin D values were compared between two groups. All data were recorded into the SPSS version 21. Participants' demographic datas, percentage and frequency values, were tabulated. A p value  of <0.05 was the limit for statistical significance. 

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\r\nResults: A total of 330 patients (51.2% females, mean age 53,79±10,2 years) with diabetes were interviewed. When evaluated in terms of body mass index, 13.9% (n = 46) were classified as normal, 34.5% (n = 114) were overweight and 51.5% (n = 170) were obese. When patients were divided into groups according to vitamin D levels, 286 (86.7%) patients with a vitamin D level below 20 ng / mL and 44 patients (13.3%) with a level above 20 ng / mL were detected. When patients were compared according to vitamin D levels, there was a negative correlation (-r = 0.357, p <0.001, -r = 0.344, p <0.001, respectively) between vitamin D levels and patients' fasting blood glucose level (FBG) and postprandial glucose level (PBG). There was a negative correlation (-r = 0.433, p <0.001) between vitamin D levels and HbA1c levels. Negative correlation (-r = 0.131, p <0.05) was found between vitamin D and triglyceride levels.

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\r\nConclusion: Vitamin D levels were significantly lower in patients with HbA1c> 7% (n = 191) when compared to those with HbA1c <7 (n = 95) (p <0.001). Vitamin D levels may be important in glycemic control of diabetic patients.

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Lymphocytic adenohypophysitis is a rare disease associated with late pregnancy and early postpartum. Autoimmune mechanism is blamed as cause. İt is frequent in females, and may be misdiagnosed as pituitary adenoma. 29 years-old -female with 2 children presented with headache follovving cryptic tonsillitis. Recently she had problems vvith her Vision. Clinical and radiological work up including magnetic rezonance imaging revealed a mass in the sellar and suprasellar region. She undervvent surgical decompression follovving functional hormona! studies. Histopathologic evaluation of the specimen was reported as lymphocytic hypophysitis. Differential diagnosis of lymphocytic hypophysitis from that of adenoma is important in planning surgery. Relation to the pregnancy, a severe hypopituitarism, edematous anterior and posterior pituitary lobe are in favour of lymphocytic hypophysitis. But certain diagnosis is made via histopathologic diagnosis. İt is thought to be autoimmune in origin especially in pregnant or recently delivered vvomen. But in nonpregnant persons it may start or be aggravated after an infection as it is in our patient.

Duchenne muscular dystrophy is a progressive, hereditary neuromuscular disease with the cause of death usually occurring because of respiratory failure. The development of respiratory failure during wakefulness usually preceded by hypoventilation during sleep. The aim of this study were to assess the presence and severity of nocturnal desaturations and to determine the parameter of daytime lung function associated with nocturnal desaturations in patients with DMD. Material and method: The monitoring of overnight oxygen saturation is widely used for sleep apnoea-hypopnea screening. As our method we choosed aprospective comparison of wakeful respiratory function tests (spirometry, maximum voluntary ventilation, maximal mouth pressures, arterial blood gases) with outcomes of overnight oxymetry. Fourteen clinically stable patients with DMD, mean age (±SD) 13,83 ± 1,86 were studied. Results: The lowest oxygen saturation < 85% was present in 9 (64%) patients and oxygen desaturation index > 5 was found in 10 subjects (71%). Desaturation index was significantly related to maximum inspiratory pressure (r= -0,633, p<0,05), FVC (r= -0,730, p<0,01) and FEV1 (r= 0,664, p<0,05). However logistic regression analysis showed that overnight desaturations could not be reliably predicted from the daytime pulmonary function test results. Conclusion: Sleep-related desaturations are freguently present in clinically stable patients with DMD. Overnight desaturations can not be predicted from daytime respiratory function tests. Even in the absence of sleep-related symptomatology (headache, somnolence, etc.), sleep related respiratory disturbances should be suspected and searchhed in DMD patients.

Caloric induced nystagmus slow phase maximuın velocities were ıneasured in 44 palients who suffered from migraine. Obtained values were higher ihan normal ones. Especially responsiveness to the stimulation of 44°C was noticibly high. Whaiever the mechanism, tlti,s results indieated that vestibular sensibilitv was increased.

Certain psychiatric symptoms such as dissociative disorder, anxiety, and depression are more prevalent in migraine patients than in the rest of the society. Identification of these symptoms is important for the treatment success. We define the purpose of our study as the comparison of the levels of dissociative symptoms, anxiety, and depression between patients with chronic migraine and normal individuals, and the analysis of these levels for their relationship with the demographic properties such as severity of pain and frequency of attacks. The study included 77 female patients with chronic migraine who applied to the neurology polyclinic with the complaint of headache and were diagnosed by the criteria defined by International Headache Society, and 44 healthy volunteers with similar age and educational level with those patients. Both groups were applied Short Dissociative Experiences Scale (DES-Taxon), Somatoform Dissociation Questionnaire (SDQ), Beck Anxiety Scale (BAS), and Beck Depression Scale (BDS) by a psychologist. Demographic and clinical properties and Visual Analog Scale (VAS) results of patients with identified types of migraine were recorded. The scale results of patients with migraine and of the control group, and between the patients of migraine aura and without aura were compared. The results were compared by T-test and Pearson Correlation for the independent group. Dissociative symptoms was more common in the group with migraine (p=0,001). While this increase was correlated with depression and severity of pain, it was not correlated with anxiety. There was not any significant difference between migraine patients of migraine with aura and without aura, statistically. The results of this study reveals that the frequency of dissociative symptoms is higher in patients with migraine than in normal population. This difference was found to be in correlation with depression and VAS score. According to these data, it is important for the success of treatment and prevention of disability to question the symptoms of dissociative symptoms in patients with chronic migraine

In this study: the effect of and tolerability to long actinz Verapamil SR 240 mg treatment on ',ordu, mild, moderate and malignant hypenension were in-vestigated.7'he drug was giyen orally once a day. If there was a necessity, a Jose o f 360 mg was used. At the end of Iliis study Verapamil SR 240 mg was found effective in most of thepaıients. Afier theVe-rapamil SR 240 mg treatınent, the patients diastolic blood pressure was ender 90 mın lig. Cardiac and ex-tracardiac tolercllıility to Verapamil SR 240 mg iher-apı. was excelknt. AV-block wasn't seen. In some of the patients, there were Side ellects such as headache, fiıtigue. flushing, nausea, vomiting and dizziness.

Vitamin D is a liposoluble prohormon and a secosteroid which is produced in the skin after exposure to sun-shine. It is turned to calsitriol which has an important role in the calcium and phosphate metabolism by different metabolic pathways. Deficiency of vitamin D is related to some factors such as less sunlight exposure, inadequately intake of vitamin D and absorbtion problems. Studies recently done have shown vitamin D deficiency exists in many people. The effects of vitamin D deficiency on numerous diseases and functional disorders such as chronic musculoskeletal pain, Type 1 and Type 2 Diabetes Mellitus (DM), obesity, multiple sclerosis, rheumatoid arthritis, cardiovascular diseases, osteoporosis, microalbuminuria, renal failure involving colon, prostat and breast cancers either are reported in literature.Vitamin D is one of the main structural elements playing an essential role in several metabolic pathways both directly and indirectly providing numerous functions carring vital importance for organism. In spite of causing a lot of functional disorders and diseases, vitamin D replacement therapy in case of deficiency is safe, economic and simple unless neglected. In this review, we aimed to demonstrate the metabolism, functions and effects of vitamin D, increased risks of chronic diseases likely to be encountered in vitamin D deficiency and the importance of vitamin D replacement therapy.

Neurophysiological studies have shown decreased excitability of the brain stem inhibitory interneurons in patients with headache. The C3 component of the trigemino-cervical reflex is nociceptive in character and may reflect the brain stem interneuron activity. This reflex is evoked by stimulation of the supraorbital nerve and recorded from the neck muscles. VVe recorded this reflex in 16 patients with migraine without aura and in 20 healthy subjects. There was not significant difference in latencies and amplitudes betvveen the two groups. VVe concluded that there is not decrease in brain stem inhibitory interneuronal activity İn migraine and this mechanism may not be responsible from pain control.

It is known that development of lacunar infarcts were seen due to involvement of lentikulositrial and talamoperforan arteries in hypertension and diabetes mellitus. In this study, we aimed to compare ADC (apparent diffusion coefficient) values of basal ganglia and talamus free of lacunar infarct in patients with diabetes mellitus and hypertension and individuals who have not any systemic diseases. Cranial MR imagings of 52 patients with hypertension, 8 patients with diabetes mellitus and 116 patients with a symptom like headache or vertigo but without any systemic disease were analyzed for ADC values at the levels of caudat nucleus, thalamus and lentiform nucleus. Results were evaluated for statistically. Statistically important difference was found between individuals without systemic disease and patients with diabetes mellitus for ADC values of left lentiform nucleus (p< 0.05). Statistically important difference was determined between hypertensive patients and healthy individuals for ADC values of both thalamus and lentiform nucleus (p<0.05). Even there is no distinct lacunar infarct, differences in ADC values of basal ganglia and thalamus in patients with diabetes mellitus and hypertension may represent microscopic chronic ischemia or developing lacunar infarct.

Aim: According to the neurovascular theory, stimulation of the trigeminovascular system is the cause of neurogenic inflammation and pain in migraine. The blink reflex that is elicited by supraorbital stimulation of trigeminal ophthalmic division is a useful method to study the functioning of trigeminal system. The purpose of this study was to examine the blink reflex in migraine patients. Material and method: In this study, blink reflex latencies were evaluated in 25 migraine patients (average age 34,76±8,23 yrs) and compared to those of 25 healthy controls (average age 35,5±8 yrs). Statistical analysis was performed using unpaired Student t test. Results: Results obtained from migraine patients were as follows; ipsilateral latency component R1:11,22±1,64 msec, ipsilateral latency component R2:31,33±4,12 msec, contralateral latency component R2:33,12±5,18. Results obtained from healthy controls were as follows; ipsilateral latency component R1: 10,21±1,42 msec, ipsilateral latency component R2 31,09±2,4 msec, contralateral latency component R2: 32,31±3,34 nmsec. Ipsilateral R1 latencies were found to be significantly prolonged than those of the healthy controls. Conclusion: The results might suggest a dysfunction in trigeminal networks in brainstem bof migraineurs and support the trigeminovascular theory of migraine.

 Moyamoya disease is an entity, which is caused by obstruction or stenosis in the area between the internal carotid artery, and anterior and middle cerebral arteries, identified angiographically, and does not have an exactly known etiology. The most frequent symptoms of onset are hemorrhage in adults and ischemia in children. In this paper, we present a case of Moyamoya disease which was diagnosed with a 21 year old male patient who was admitted to our emergency department with headache, nausea vomiting and left hemiparasi complaints and whose radiological findings showed right basal ganglia hemorrhage.

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Aim: It was aimed to compare with healthy volunteers the changes in heat shock protein (HSP) 90 alpha and vitamin levels during exacerbation and remission periods in our patients with familial Mediterranean fever (FMF), to research whether these molecules will benefit in control of FMF exacerbation and prevention of amyloid accumulation, and also to investigate the relationship of these molecules with FMF gene mutations.

Patients and Methods: HSP 90 alpha, vitamin A, vitamin B 12, vitamin D, vitamin E and folic acid levels were studied in 30 patients with AAA diagnosed in our hospital's pediatric nephrology department during the exacerbation and remission periods and 30 healthy volunteers. The results were compared statistically.

Results: In our series, 19 (63.3%) of the patients were male, 11 (36.7%) were female, with a mean age of 11 years. The most common presenting complaint was abdominal pain (n=19; 63.3%) after fever and only high fever was found to be present in five (16.7%) patients. The most common genetic mutation was M694V (n=14; 46.7%), whereas no mutation was detected in five (16.7%) patients. Although HSP 90 alpha was the highest in the exacerbation group and the lowest in the remission group, there was no significant difference between the groups. Vitamin B12 was significantly different between the groups and the highest value was in the control group. Vitamin D was significantly different between the exacerbation and the remission groups and the highest value was in the exacerbation group. In addition, vitamin D levels were significantly higher in boys. There was no significant difference between vitamin A, vitamin E and folic acid levels. FMF gene mutations did not affect HSP 90 alpha and vitamin levels.

Conclusion: Our findings showed that serum HSP 90 alpha, vitamin D, vitamin E and folic acid levels were normal in AAA, but vitamin B12 and vitamin A levels were low during exacerbation and remission. However, we think that prospective studies including larger series should be performed about the subject.

To investigate the level of 25(OH)D and association between 25(OH)D level and hormonal-biochemical parameters in Polycystic ovary syndrome (PCOS). Thirty three patients diagnosed with PCOS and 42 age- body mass index (BMI) matched control group admitted to Bolge Training and Research Hospital from May to October were included in the study. Serum total testosterone (TT), free testosterone (fT), 25(OH)D, dihydroepiandrostenodione sulphate, LH, FSH, thyroid stimulating hormone (TSH), cortisol, 17αOH-progesterone, fasting glucose, insulin levels were evaluated after 12 hour fasting. HOMA-IR (fasting glucose level x fasting insülin / 405) was calculated. Serum 17αOH progesterone and 25(OH)D levels were significantly lower in PCOS group (p<0.01). Serum LH, LH/ FSH TT, FT, insulin, ACTH, and DHEAS levels were significantly higher in PCOS group (p<0.01). There was statistically significant negative correlation of 25(OH)D levels with PCOS, LH/FSH, TT, fT, DHEAS ve FGS. There was no statistically significant correlation between 25(OH)D levels and age, body mass index and insulin resistance. The results of this study indicated that vitamin D deficiency is highly prevalent among women with PCOS independent of body mass index. We also demonstrated that vitamin D deficiency was correlated with hyperandrogenism in PCOS women. Low serum 25(OH)D levels might exacerbate PCOS symptoms. Large intervention trials are needed to evaluate the effect of vitamin D supplementation on hormonal and clinical parameters in PCOS women.

Migraine is a frequent headache disorder in the population. The aim of this cross-sectional study was to document demografic and clinical features of subjects with migraine headache who admitted to the outpatient department of a university hospital in Konya. The study included 206 patients diagnosed as migraine according to the 2004 International Headache Society criteria and 218 healty controls of identical sex, age, marital status and education level who did not suffer from frequent headaches other than tension type with a frequency of not more than once a month. Using a questionnaire, we evaluated patient demographics, characteristics of migraine headache, family history and associated symptoms in 206 migraine pattients. 173 woman and 33 men were evaluated. The male:female ratios of migraine patients were 1:5. The mean age at consultation was 37.02±10.40 years. Of the 206 patients, 64.4% met criteria for migraine without aura, while 35.4% met criteria for migraine with aura. Most of the women were of lower educational level. Approximately half of the patients had severe and more than 3 attacks per month. Attack treatment was used frequently. Result of the study confirm that migraine is a more common disorder in women with lower educational level. In additon; this article emphasizes the need for informing patients of the hazards of drug overuse.

Chronic myeloid neoplasms are pluripotent hematopoetic diseases characterized by maturating and differantiating defects of bone marrow cells and reflecting to peripheral blood. We retrospectively analysed the clinical features of Philedelphia (-) 114 Chronic myeloid neoplasm diagnosed patients of Ege Universty Hematology Department Outpatient Clinic. 58 (49.1%) of patients are female, 56 (50.1%) of patients are male. The median age is 52. 39 of patients has policytemia vera, 23 of patients has primary myelofibrosis, and 52 of patients have essential trombocytosis diagnosis. The appealing sypmtoms are; for 29 of patients have weakness, for 29 of patients have ischemic symptomps, 11 have headache, 8 have pruritis and 3 patients have vertigo. 24 patients were diagnosed incidentally. The mean leucocyte value is 11.163x 〖10 〗^6±5600µL, platelet: 901.336±439.105/µ and hemoglobin:13.8±2.91 g/dl. 25.4% of patients had a story of thrombosis while the 74.6% not. 18 patients are under treatment with anegralide, 26 hydroxyurea, 8 acetylsalisilic acid other patients have combination treatments or under follow up without treatment. This study is one of the largest series in our country.

HaNDL syndrome is a rare syndrome mimicking migraine and stroke with lymphocytosis in the CSF, migraine-like moderate or severe headaches and transient neurological deficit. In this article, we present a 26-year-old male patient with headache, transient neurological deficit and CSF lymphocytosis who was diagnosed as HaNDL Syndrome.

Cyclic vomiting syndrome (CVS) is characterized by recurrent episodes of nausea and vomiting. Age at onset of symptoms ranges between 4–6 years and there is a female predominance. CVS attacks are generally associated with psychosocial or physical triggers. In last years a shared pathophysiology between migraine and CVS has suggested. Children with CVS and their mothers have elevated rates of anxiety disorders. In this report, we presented a 5-year-old girl who referred to our out-patient clinic because of recurrent vomiting episodes. Because of her anxiety symptoms and vomiting attacks, escitalopram, a selective serotonin reuptake inhibitor, was initiated and she had significant improvement during treatment.

 

Aim: The aim of this study was to primarily investigate the effects of selected anesthesia method on anxiety, patient satisfaction and pain level in elective caesarean section, and secondarily obtain information about quality of service.

Materials and Methods: The study was carried out as a prospective questionnaire in the Department of Anaesthesiology and Reanimation the Meram Medical Faculty Hospital of Necmettin Erbakan University between June 2017 and August 2017, on 160 volunteers aged between 18 and 45 years for whom elective cesarean section under General Anesthesia (GA) or Spinal Anesthesia (SA) was planned. Demographic data of the patients such as age, place of residence, education level, number of children, and cesarean experiences were recorded. In the preoperative and postoperative period, anxiety levels were measured by State-Trait Anxiety Inventory (STAI-D), pain levels were measured by Visual Analog Scale (VAS) scores and satisfaction levels were evaluated at postoperative 6th and 24th hours by (Quality of Recovery: QoR 40 T) questionnaire.

Results: There was no statistically significant difference between the patients' preoperative and postoperative anxiety scores and demographic data (p> 0.05). Patients with previous cesarean experience had lower preoperative anxiety levels (p <0.05). The STAI-D scores and the numbers of patients with anxiety in the GA and SA groups were similar (p> 0.05).Postoperative anxiety levels were significantly lower in both groups than in the preoperative period (p <0.05). VAS values of the SA group at the 6th and 24th hours were significantly higher than the group treated with GA.(p<0.05). The 24th hour VAS values of the SA group were higher than the VAS values at the 6th hour (p <0.05). In the GA group, VAS values at 24th hour were lower than the VAS values at 6th hour (p <0.05). The satisfaction levels of general anesthesia and spinal anesthesia were similar in the postoperative period (p> 0.05). Complaint of headache was high in SA group while complaint of sore throat was high in GA group(p<0.05). While there was no correlation between anxiety level, VAS values and satisfaction level (p> 0.05), there was a negative correlation between VAS values and pain parameters, which are the subgroup of satisfaction questionnaire, in both groups (p <0.05).

Conclusion: It is concluded that the preferred anesthesia method in elective cesarean section has no effect on anxiety and satisfaction, and the patient satisfaction level and service quality will be improved by providing effective analgesia by reviewing our postoperative pain algorithm.

 

This study was carried out to find out the clinical affect, tolerance, side affect and metabolic affects of nitrendipine on 43 hypertensive patients. The pa-tients were divided tn to 3 groups as light, rnild and severe. In study group 11 patients had atherosciehot-ic heart disease, 3 had congestive heart failure and 13 had diabetes mellitus. Nitrendipine was giyen ta all patients 20 mg one dese daily in the morning. The patients were examined upon his application, in the firsth, the third and the sixth weeks. At the end of the six week treatment, the affect and the side affect of nitrendipine were evaluated. The success rate of nitrendipine in light hypertension was 86.66%, in mild hypertension was 81.81%, 64.70% in severe hypertension and considering the total 43 patients, the success was 76.74% in our study. While meaningful decrease in blood pressure in all hypertensive groups was observed at the end of six week treat►ent, meaningful increase in pulse rate was noticed in all except diabetic and the old pa-tients. The side affects such as particularly palpita-tion, headache and flushing, dizziness, feel of vomit-ing and exhoustion were noticed 44.18% of all groups. In conclusion, nitrendipine was proved to be ef-fectiw and reliable drug in all hypertensive patients.

İn this study a revievv of 9 arteriovenous malformation eases surgically treated between October 1991 and Oc- tober 1999 is presented. Of these cerebral AVM cases, 5 were presented with intracranial hemorrhages, 2 had Progressive neurologic deficit, 2 had headaches initially. Surgical mortality was 1/9 in the series. The clinical di- agnostic and therapeutic aspects of cerebral AVM' s ar e emphasized and the literatüre on this subject has been reviewed.

Aim: In this case report, it is aimed to discuss the ‘HaNDL Syndrome’ with the relevant literature. Case Report: A 20 year-old woman was admitted to the emergency department with left-sided, severe, throbbing headache accompanied with nausea, vomitting, sonophophia and phonophophia. Approximately 30 minutes after the pain emerged, she had suffered numbness and mild paresis on the right side of the body including the right side of her face accompanied with difficulty in speech which improved in approximately 20-25 minutes. She reported that 2 weeks prior these symptoms, she had suffered severe nausea and diarrhea that had lasted for 3 days. A diagnosis of viral gastroenteritis had been made and supportive therapy had been advised by a doctor. In the clinic, spinal tap was performed which revealed lymphocytic pleocytosis and mild elevation of protein level (49 mg/dL). Brain computerized tomography and the contast MR were normal. After the exclusion of other conditions which may cause CSF pleocytosis and severe headache; a diagnosis of HaNDL Syndrome was made. Conclusion: Recognition of this bening syndrome, is important as performing a diagnostic angiography may cause severe complications.

Aim: The aim of this study was to investigate the relationship between non-alcoholic fatty liver and
demographic characteristics, laboratory parameters and predictory non-high density lipoprotein to high
density lipoprotein ratio.
Material and Methods: Between February and September 2020, 329 patients with fatty liver prediagnosis
were evaluated prospectively. Laboratory (whole blood counts, transaminases, lipid profiles, 25-oh vitamin
d3 levels) and ultrasonography findings, body height, body weight and body mass index of patients were
compared between fatty liver and control groups.
Results: Fatty liver was diagnosed in 164 patients out of 329 participants. There were significant
relationships between existence of fatty liver and age, body weight, body mass index, triglyceride
levels, non-high density lipoprotein, non-high density lipoprotein to high density lipoprotein ratios. Also
relationships between severity of fatty liver and body weight, alanine aminotransferase and body mass
index were found to be significant. There were no relationship between existence of fatty liver and
monocyte to high density lipoprotein ratio and vitamin D levels. Linear regression analysis for Non-HDL/
HDL ratio in diagnosis of nonalcoholic fatty liver, revealed a correlation coefficient as r=0.179. Positive
and negative predictive values for Non-HDL/HDL ratio in diagnosis of nonalcoholic fatty liver were, 56.3%
and 60.9%, respectively .
Conclusion: There is a significant relationship between fatty liver and non-high density lipoprotein to
high density lipoprotein ratio. This ratio may be a simple and readily available predictor in patients with
fatty liver.

The case, is applied to infectious Dseases Clinic with some complainıs as a headache, fever, nausea, vorniiing after traffic accident and mandibular operation, was evaliated r,s a Pseudomonas meningitidis. We published because it is rare and important.

Objective: To determine the frequency of subclinical vitamin D deficiency in patients with non specific musculoskeletal symptoms in a tertiary care hospital.

Study Design: Cross-sectional study

Place and Duration of Study: Department of Medicine, Bolan Medical Complex Hospital, Quetta from1^st July 2018 to 30^th June 2019.

Methodology: A total of 97 patients between 20 and 45 years of age were recruited after written consent. The subjects presenting with history of generalized body aches greater than six weeks were included in this study. The detail history was taken and clinical examination was done. Blood sample of each patient were collected to detect the vitamin D3 levels by radioimmunoassay kit.

Results: Mean age of the patients was 34.25±10.64 years. Mean duration of symptoms was 7.71±0.82 weeks. Male to female ratio was found to be 4:6. The frequency of vitamin D deficiency in patients with non-specific musculoskeletal symptoms was found to be 72(74.20%).

Conclusion: The frequency of subclinical vitamin D deficiency was significantly high in patients with non specific musculoskeletal symptoms

Aim: This study aimed to evaluate vitamin D levels, which were determined over a year in the pediatric
clinic of a training and research hospital in Central Anatolia, according to age groups, gender, and
seasonal characteristics.
Patients and Methods: This retrospective study was conducted using the data of children aged 0–18
years who applied to the children’s clinic of a hospital between January 2019 and December 2019 and
whose vitamin D levels were determined. Children were divided into five different age groups, 28 days–12
months, 13 months–2 years, 2–5 years, 6–11 years, and 12–18 years, in accordance with Standard 6
recommendations. Vitamin D levels were evaluated in terms of age group, gender, and admission season.
Results: A total of 9496 children, 5360 (56.4%) females and 4136 (43.6%) males, were included in the
study. A 25(OH)D level below 20 ng/mL (representing a deficiency) was found in 6472 (68.2%) of the
participants, while 2085 (21.9%) participants had a 25(OH)D level between 21–29 ng/mL (representing an
insufficiency) and 939 (9.9%) participants had a 25(OH)D level over 30 ng/mL (representing sufficiency).
It was determined that vitamin D levels are lower in girls than in boys, vitamin D levels are inversely
proportional to age, and vitamin D levels reach their lowest values in winter and highest values in summer.
The effects of age group, gender, and season of admission on vitamin D levels were statistically significant
(P < 0.001).
Conclusion: The mean vitamin D levels for all age groups were either insufficient or deficient. Vitamin D
levels in children aged 0–18 is related to age, gender, and season. Necessary measures should be taken,
especially for at-risk groups, to prevent vitamin D deficiency or insuf ficiency.

HemiField Pattern Visual Evoked Potentials in Migraine Patients Some results of visual evOked potentials (VEP) obtained froın migraineus patients have importantly contributed to the discussion of pathogenetic process in migraine. Especially the results indicate to hemi-spharical asymetry in both latency and amplitute of VEP are notabk. Bioccipital cortical revonses to visual herni-field pattern were recorded in 22 migraine patients and in 22 healty control subjects who both groups are 20- 25 years old. Aınplitude and latency values were sta-tistically analysed (Student's test) VEP's latencies and amplitudes recorded from Ol and 02 (Ipsilateral records) in nonclassical migraine group were langer and higher than those of classical migraine group (p<0.05). This result is highly parel-lel to the ones in the relevant literature. It is sug-gested that the left hemisphere is more sensitive than the right due to the fact that it has more neurotran-smitter content. In addition to this results Fast back-ground activity was recorded in 90% of migraine pa-tients. This observations as in the literature possibly suggested to be an electrodiagnostical helpfull method in migraine patients in first and second decades.