Objective: The aim of this study was to review current approaches by evaluating anemia, which is the source of many negativities in increasingly aging population and directly affecting the quality of life, and the conditions associated with it. Methods: The population of the study consisted of patients over 18 years old who applied to Family Medicine polyclinic in Ordu University Training and Research Hospital between May 2018 and May 2019. According to World Health Organization (WHO) criteria, a hemoglobin value below 13 g / dL in men and 12 g / dL in women is defined as anemia. The patients were divided into three groups according to their mean erythrocyte volume (MCV) as microcyte (MCV 100). Results: Four hundred one participants aged 65 and over were analyzed in detail. Anemia was detected in 237 (59.1%) of 401 elderly participants. Of the elderly anemic patients, 42.6% were women and 16.4% were men. Of the elderly patients, 8.8% had microcytic anemia, 87.8% had normocytic anemia, and 3.4% had macrocytic anemia. Of the elderly patients, 32.9% had chronic disease anemia, 2% had iron deficiency anemia, and 40.5% had chronic kidney disease anemia. Conclusions: The study conducted shows that anemia is a more frequent and greater problem than predicted in elderly patients admitted to an outpatient clinic. When the underlying cause is identified and treated, dramatic improvements can be achieved in the quality of life and life span of the elderly.

With the rapid advancement of technology in recent years, exposure to electromagnetic fields (EMFs) has become an integral part of daily life. Electromagnetic fields emitted by both natural and artificial sources have attracted increasing attention, particularly due to their potential biological effects on the central nervous system (CNS). Current literature suggests that EMF exposure may be associated with increased blood–brain barrier permeability, oxidative stress, altered neurotransmitter levels, impaired learning and memory processes, neurodevelopmental alterations, and potential neurodegenerative outcomes. Furthermore, conflicting findings have been reported regarding the relationship between radiofrequency EMFs and extremely low-frequency EMFs and the development of brain tumors, and the World Health Organization has classified radiofrequency EMFs as “possibly carcinogenic to humans.” It is further emphasized that critical developmental stages, such as childhood and the prenatal period, are particularly susceptible to EMF-related effects. While some findings indicate potential therapeutic applications of EMFs, the majority highlight adverse neurological outcomes. Given the widespread prevalence of EMF exposure in modern society, long-term, standardized, and multifaceted studies are required to elucidate the underlying mechanisms and clarify their effects on the CNS.

Objective: In this study, we aimed to investigate whether serum homocysteine level was higher in patients with MS, and evaluate the effect of this situation on cognitive functions. In addition, we aimed to determine whether high blood homocysteine level is associated with socio-demographic and clinical features and determine the affected cognitive functions with neuropsychological tests.Methods: We looked at changes in the levels of vitamin B12 and folic acid associated with high levels of serum homocysteine levels. Cognitive performance, and laboratory values of 60 cases with Relapsing-remitting MS (RRMS) patient, and 30 healthy volunteers were compared. The frontal lobe activities, information processing speed, flexibility, and the ability of the calculation, as well as cognitive functions of attention and visuospatial perception and construction of complex skills were also evaluated. For these purposes, Paced Auditory Serial Addition Test (PASAT), Line Orientation Test (LOT) and Stroop Test were used.Results: Test performance for all of the test steps were found to be defective in MS group more than the control group subjects. In addition, all steps of the test performance were found to be impaired in both patients and healthy subjects with high levels of homocysteine(p<0.001).Conclusion: In this study visual memory processes, visual-spatial functions, construction skills, planning, programming and executive functions were found to be significantly deteriorated and the reaction time prolonged in RRMS patients with high levels of homocysteine compared with healthy control group

Background and Objectives: Migraine is a chronic, throbbing type of headache that affects large populations worldwide. This condition is associated with neuroinflammation. Materials and Methods: In this study, polymorphism analyses were performed by KASP PCR. Serum interleukin-6 (IL-6) and 8-hydroxy-2′-deoxyguanosine (8-OHdG) levels were measured using kits based on the enzyme-linked immunosorbent assay (ELISA) principle. Results: In the APE1 Asp148Glu (rs1130409) gene polymorphism analysis, the frequency of the mutant G (Glu) allele was 93.1% and 48.0% in the control and migraine populations, respectively, while the frequency of the wild-type T (Asp) allele was 6.9% and 52.0% (p < 0.001). The frequency of the T/T (Asp/Asp) genotype was high in the migraine group (p < 0.001), while the frequency of the G/G (Glu/Glu) genotype was higher in the control group at 86.2%, compared to the migraine group (p < 0.001). The total frequency of the T/G+ G/G (Asp/Glu+Glu/Glu) composite genotype was determined to be 65.9% in the control group and 34.1% in the migraine group (p < 0.001). There was no statistical difference in allele and genotype frequency between the control and migraine groups for the XRCC1 Arg399Gln (rs25487) gene polymorphism. Serum 8-OHdG and IL-6 levels were comparable between the groups, with no statistically significant differences observed. Conclusions: Future studies with larger and more homogeneous populations are needed to further elucidate the potential interactions between inflammatory processes and DNA damage in migraine. Consideration of attack duration and environmental exposures may improve interpretation of biomarker variability. Expanding the analysis to additional DNA repair gene polymorphisms may also contribute to a better understanding of the molecular background of migraine and the evaluation of potential biomarkers.

Headache is among the most frequently encountered symptoms in clinical practice. Occipital neuralgia is characterized by sudden, sharp, electric shock-like pains in the distribution area of the occipital nerve. In this report, we present a 54-year-old female patient who developed occipital neuralgia-like symptoms shortly after the initiation of metformin treatment for type 2 diabetes mellitus. The symptoms resolved following the discontinuation of the drug. This case is discussed in light of the literature to highlight a potentially rare headache pattern triggered by metformin. This case describes an unusual form of headache possibly associated with metformin therapy. It underscores the importance of considering uncommon side effects of commonly prescribed medications, such as metformin in differential diagnoses.

In young patients presenting with acute neurological symptoms, distinguishing between psychogenic and organic causes is crucial. Patent foramen ovale (PFO) is a significant factor that can lead to cardioembolic stroke in young individuals. This case report presents a patient who was initially misdiagnosed with a psychogenic disorder but was later found to have suffered a cardioembolic stroke. A 17-year-old female presented with speech disturbances (stuttering, difficulty in articulation) and became emotional during history taking. Her past medical history revealed recurrent similar episodes. Neurological examination was normal; thus, a psychogenic etiology was suspected, and she was discharged after benzodiazepine infusion. However, she returned in the evening with right-sided numbness in her arm and leg, was again diagnosed with a psychogenic disorder, and received another benzodiazepine infusion. Later that night, she fell while attempting to use the restroom and was brought to the emergency department with speech impairment and right-sided weakness. This time, a neurological evaluation revealed left central facial paralysis, right hemiparesis, dysarthria, and cerebellar dysfunction. Brain MRI showed bilateral lacunar ischemic infarcts. A cardiology evaluation suspected PFO, which was confirmed via transesophageal echocardiography. The patient was diagnosed with acute ischemic stroke, started on fractionated heparin therapy, and underwent PFO closure five days later. Although psychogenic disorders are common in young patients, organic causes must be ruled out in cases of acute neurological deficits. PFO is a leading cause of cryptogenic strokes in young adults, often presenting with recurrent transient ischemic attacks (TIAs). Overlooking a cardioembolic etiology can lead to diagnostic and treatment delays, potentially worsening outcomes. Unexplained neurological symptoms in young patients should be thoroughly investigated before attributing them to psychogenic causes. Cardioembolic conditions such as PFO can be successfully managed with early diagnosis and appropriate intervention.