Background: Intramuscular injections are routine interventions worldwide, yet when executed incorrectly they can cause sciatic nerve injury (SNI) that leaves patients with lifelong motor-sensory disability. Although international guidelines recommend the ventrogluteal site, the dorsogluteal region remains dominant in Turkey, potentially elevating risk. This study analysed Turkish Supreme Court decisions on injection-induced SNI from public-health, ethical and legal perspectives. Methods: We conducted a retrospective cross-sectional content analysis of all publicly available Supreme Court criminal and civil decisions issued between January 2006 and April 2025 that contained SNI-related keywords. After deduplication and relevance screening, 92 unique cases were eligible. Two investigators independently coded each judgment; disagreements were resolved by consensus. Variables recorded were legal category, injection site, clinical indication, drug class, injector profession, defendant identity, symptom latency, electrophysiological pattern, first-instance verdict and Supreme Court outcome. Frequencies and percentages were calculated with SPSS v.29. Results: Negligent bodily injury was the leading charge (50/92, 54%); 32% of files also sought monetary compensation. Gluteal injections accounted for 79% of cases, most administered for postoperative analgesia (33%) or antibiotic therapy (27%). Nurses performed 60% of injections, physicians 9%. Individual health professionals (physicians ± nurses) were defendants in 65% of lawsuits, while hospitals (alone or jointly) appeared in 23%. Symptoms emerged immediately or within 1 h in 76% of plaintiffs, and electromyography typically revealed severe axonal damage—predominantly of the peroneal division. The Supreme Court overturned 100% of firstinstance convictions and 32% of acquittals, most often citing inadequate expert evaluation (35%), contradictory reports (20%), uncertainty over negligence versus complication (18%) or missing informedconsent documentation (10%). Conclusions: Injection-related sciatic nerve injuries in Turkey remain potentially preventable. The entrenched use of the dorsogluteal site, limited anatomical awareness, inadequate informed consent practices, and inconsistencies in medico-legal evaluations continue to contribute to both patient harm and an increased burden of litigation. Transitioning to the ventrogluteal technique, mandating annual refresher training, standardising consent forms, and accrediting neurophysiology expert panels could help reduce both injury incidence and courtroom burden—advancing the WHO’s “zero harm” patient safety goal.

Objective: A considerable number of individuals are diagnosed with idiopathic trigeminal neuralgia. In order to achieve a more complete understanding of the pathophysiology, it is essential to adopt a range of novel approaches and utilize new animal models. This study investigated changes in the messenger RNA (mRNA) expression of ion-channels in a newly developed animal model of trigeminal neuropathic pain induced by cervical spinal dorsal horn compression. Methods: Eighteen rabbits were randomly assigned into three groups (spinal cord compression, sham, and control groups), and a previously developed animal model was applied. Quantitative polymerase chain reaction was applied to examine the genetic expression of Na, K, and Ca channels in the cervical dorsal horn, trigeminal ganglion, and infraorbital nerve. Results: The mRNA expression levels of SCN8A and SCN9A exhibited a marked increase in the infraorbital nerve of the spinal cord compression group when compared to the sham group. Furthermore, the mRNA expression levels of CACNA1C, KCNK1, and SCN9A demonstrated a significant increase in all investigated regions when compared to the control group. Conclusions: The present findings indicate the potential critical involvement of Nav1.6 and Nav1.7 in the pathogenesis of trigeminal neuropathic pain. However, the potential involvement of the CaV2.1, CaV1.2, and K2P1.1 channels cannot be ruled out at this juncture.

Background: Despite the identification of various environmental factors that increase the risk of multiple sclerosis (MS), the effects of many factors on the etiology of MS remain to be elucidated. In this study, we aimed to investigate the effects of radon, a factor previously studied in relation to various other neurodegenerative diseases, on the epidemiology of MS. Methods: A door-to-door field study was conducted in residential areas with relatively high and low radon gas concentrations to determine the prevalence of MS. The study area comprises the Bolvadin and İhsaniye regions, which have different geological characteristics, such as seismic activity, active faults, and distributions of volcanic rocks. CR-39 detectors, with an accepted limit of 300 Bq/m³, were utilized to measure radon gas concentrations. During the screening field, the patients diagnosed with multiple sclerosis were confirmed with their hospital records. Mc Donald’s revised diagnostic criteria were used for multiple sclerosis diagnosis. Results: The regions were grouped into higher radon areas and lower radon areas. The İhsaniye city center, Kayıhan, Kemerkaya, Döğer, and Bolvadin city center were classified as higher radon regions, whereas Dişli, Yaylabağı, Gazlıgöl, and Özburun were identified as lower radon regions. A total of 40,841 individuals were surveyed in the field. The crude MS prevalence was 41.8/100,000 in settlements with high radon gas concentrations and 20.5/100,000 in settlements with low radon gas concentrations. Conclusions: In this study, we revealed that the prevalence of MS was greater in settlements with high radon gas concentrations than in settlements with low radon gas concentrations. These results demonstrated that radon gas is an important environmental risk factor in the etiopathogenesis of MS.

This study aims to evaluate the effectiveness of combined antiplatelet and oral anticoagulant (OAC) therapy versus OAC therapy alone on one-year post-stroke outcomes in patients with non-valvular atrial fibrillation (NVAF) and systemic atherosclerosis. A retrospective study was conducted using the recorded data of patients diagnosed with ischemic cerebrovascular disease between January 1, 2022, and January 1, 2023, at the Neurology Clinic, Afyonkarahisar Health Sciences University. Patients with non-valvular atrial fibrillation (NVAF) and systemic atherosclerosis were included in the study. Collected data included demographic information, medical history. Patients were divided into two groups based on the treatment regimen used at discharge: those receiving OAC alone and those receiving a combination of OAC and antiplatelet therapy. Clinical outcomes were evaluated within one year following the stroke. A total of 671 stroke patients were screened, and 565 (84.2%) had ischemic stroke. Among these, 113 (20%) had NVAF, and 53 had both NVAF and systemic atherosclerosis. Data from these 53 patients were analyzed. The mean age was 71.81±11.90 years, with a female gender ratio of 52.8%. Logistic regression analysis showed no statistically significant differences between the two treatment groups in terms of all-cause mortality, bleeding, recurrent stroke, and hemorrhagic stroke (p>0.05 for all comparisons). The combination of antiplatelet and OAC therapy did not demonstrate superiority over OAC therapy alone in reducing the risks of recurrent ischemic stroke, hemorrhagic stroke, myocardial infarction, and mortality in patients with NVAF and systemic atherosclerosis. These findings suggest that OAC therapy alone may provide sufficient protection in this patient population. Prospective studies with larger samples are needed to confirm these results.

This study analyzes Supreme Court decisions involving parties diagnosed with Multiple Sclerosis (MS) between 2008 and 2024, focusing on disability justice

Background: Dementia is frequently invoked in medico-legal contexts where questions of legal capacity, guardianship, testamentary validity, transactional validity, and criminal responsibility arise. Although subtype differentiation and cognitive assessment are central to clinical dementia evaluation, it remains unclear to what extent such clinically meaningful detail is visible in appellate judicial reasoning. This study examined the visibility of dementia subtype specification and cognitive evidence in decisions of the Turkish Court of Cassation (2005–2025), and examined the ethical implications of these textual patterns for transparency, accountability, and procedural fairness in judicial decision-making. Methods: We conducted a retrospective, cross-sectional, document-based analysis of publicly accessible Court of Cassation decisions. Using keyword-based searches (“demans,” “bunama,” and “Alzheimer”), 1,180 decisions were identified; after screening for legal relevance, 1,031 decisions were included. Each decision was coded across 15 variables, including dementia subtype specification, cognitive evidence visibility, legal context, and medical report source. Descriptive statistics were calculated for all variables. Temporal trends in dementia subtype visibility were analysed using logistic regression, supplemented by year-by-year distributional assessment and multivariable sensitivity modelling. A parallel logistic regression was also conducted for the broader binary outcome of any visible cognitive evidence (specific or non-specific; n = 104 events). Results: Dementia subtype information was explicitly specified in 46.4% of decisions (478/1,031; 95% CI, 43.3–49.5%), whereas 53.6% used only general or unspecified terminology. Alzheimer’s disease was the most frequently reported subtype, appearing in 451 decisions (43.7% of the full sample; 94.4% of subtype-specified decisions). Subtype visibility increased significantly over time (OR = 1.062 per year; 95% CI, 1.034–1.091; p < 0.001). In contrast, visible cognitive evidence remained limited: 89.9% of decisions contained no reference to cognitive assessment, 9.8% included only non-specific references, and only 0.3% explicitly named the Mini-Mental State Examination (MMSE; 95% CI, 0.1–0.8%). No decision referred to the Montreal Cognitive Assessment (MoCA). Any visible cognitive evidence was present in 10.1% of decisions (104/1,031; 95% CI, 8.3–12.1%) and was highest in guardianship/restriction cases (19.7%). Temporal modelling of any visible cognitive evidence was associated with a statistically significant decrease over the study period (OR = 0.918 per year; 95% CI, 0.880–0.958; p < 0.001). Conclusions: Dementia subtype specification became moderately more visible in appellate judicial reasoning over time, whereas the textual visibility of cognitive evidence remained limited. These findings concern the traceability of clinically relevant information within decision summaries rather than the adequacy of the underlying evidentiary process itself. Strengthening the structured reporting of diagnostic basis, relevant cognitive findings, and functionally relevant capacity-related findings in medico-legal documentation may support improved transparency and accountability in the translation of clinical evidence into legal reasoning.