Background: Diabetic neuropathy is one of the most common causes of neuropathic pain. LANSS, sLANSS, DN4 and painDETECT are scales which are commonly used worldwide. There are not many studies comparing these screening tools in specific neuropathic pain subgroups. The aim of this study is to compare the utilities of LANSS, sLANSS, DN4 and PainDETECT for the diagnosis of diabetic neuropathic pain. Methods: One hundred-one individuals without diabetic neuropathic pain were included in control group, 102 patients with diabetic neuropathic pain to DNP group. LANSS, sLANSS, DN4 and painDETECT scores of the groups were compared. Results: The difference between the groups was significant for all questionnaires and for all questions/titles they included. DN4 had the highest sensitivity and painDETECT had the highest specificity. Conclusions: All questionnaires seemed to be useful for detecting diabetic neuropathic pain. DN4 had a high specificity and sensitivity. PainDETECT, also had a high sensitivity and specificity when cut off value was accepted more than 12.

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.

AMAÇ: Multipl skleroz (MS), merkezi sinir sisteminin (CNS) sık görülen bir otoimmün demiyelinizan hastalığıdır. Bu çalışmada retrospektif olarak MS tanılı hastaların toplanması Türk toplumunda ailesel ve sporadik MS hastalarının özelliklerini karşılaştırmak ve ailesel özellik gösteren MS hastalarının sıklığı ve bu hastaların klinik ve demografik özelliklerini belirlemek amaçlandı. GEREÇ VE YÖNTEM: Bu kesitsel kayıt tabanlı çalışma, 01 Ocak 2022-01 Haziran 2022 tarihleri arasında Afyonkarahisar Sağlık Bilimleri Üniversitesi Nöroloji Anabilim Dalı’nda 2017 McDonald kriterlerine göre MS tanısı ile takipli hasta verileri ile yapıldı. Hastaların demografik verileri, klinik bulguları, başlangıç yaşları, ortalama hastalık süresi, başlangıç semptomları ve MS subtipleri değerlendirildi. BULGULAR: Türk populasyonunda ailesel MS (FMS) sıklığı %7.3 olarak saptandı. FMS varlığı erken hastalık yaşı ile ilişkili bulunmadı. En sık başlangıç semptomu duyusal semptomlar en sık MS subtipi relapsing remitting MS olarak değerlendirildi ve genişletilmiş durum özürlülük skalası skoru hesaplandı ve FMS varlığı ile yüksek hastalık aktivitesi arasında ilişki saptanmadı. SONUÇ: Türk populasyonunda FMS oranı daha çok Avrupa-Latin ülkelerine benzer bulunmuştur. Klinik ve demografik özellikler ise Avrupa ve Orta doğu ile benzer bulunmuştur.

Objectives: The present study aimed to examine the effects of diabetes complications on the ischemic stroke risk among patients with type 2 diabetes mellitus (T2DM). Patients and methods: The medical records of all patients (n=5,468) who were admitted to a tertiary care hospital between January 1, 2021, and June 1, 2022, were retrospectively reviewed. Of 911 patients diagnosed with T2DM for at least two years, 37 patients with a history of hemorrhagic cerebrovascular disease were excluded. Consequently, the study was conducted with 874 patients (460 males, 414 females; mean age: 65.5±12.1 years; range, 39 to 92 years) with T2DM. Demographic data, presence of chronic disease other than diabetes, duration of diabetes, retinopathy, nephropathy, peripheral arterial disease, and diabetes medications were recorded. The patients were divided into two groups: those with and without a history of ischemic stroke. The two groups were compared in terms of demographic characteristics and diabetes complications. Results: The prevalence of ischemic stroke was 18.6% (n=163). Patients with ischemic stroke were older than those without ischemic stroke, had longer diabetes durations, and had higher rates of hypertension, hyperlipidemia, and insulin use (p=0.001, p<0.001, p<0.001, p<0.001, and p<0.001, respectively). Diabetic retinopathy (41.7%), diabetic nephropathy (27.6%), and peripheral arterial disease (16.6%) were more commonly observed among patients with ischemic stroke compared to the others. Examining the parameters differing between the groups, diabetes duration, hypertension, insulin use, and peripheral arterial disease were found to be independent risk factors for ischemic stroke (p<0.001, p<0.001, p=0.001, and p=0.001, respectively). Conclusion: Examining the relationship between diabetes complications and ischemic stroke risk from a broader perspective, the present study provided important implications for clinical management. Large-scale studies are needed in the future.

OBJECTIVE: Migraine is a chronic neurological disorder characterized by recurrent headache attacks that substantially impair quality of life. This study aims to investigate changes in hematological parameters such as neutrophil-to-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) in migraine patients, and to evaluate the involvement of inflammatory processes and oxidative stress in migraine pathophysiology.MATERIAL AND METHODS: The study included 35 migraine patients evaluated during an attack and a control group of 76 healthy individuals matched for age and gender. The diagnosis of migraine was made according to the International Classification of Headache Disorders (ICHD-3) criteria by the International Headache Society. Demographic data and hematological parameters obtained from participants were analyzed using SPSS 26.0 software.RESULTS: A total of 111 participants were included in the study; 35 were migraine patients experiencing an attack, and 76 were healthy controls. The average age of the migraine group was 34, while the control group had an average age of 33.5. In the migraine group, 30 (85.7%) participants were female, whereas 60 (78.9%) participants in the control group were female. Neutrophil count and NLR were found to be significantly higher in the migraine group compared to the control group (p=0.018). Additionally, RDW and lymphocyte count were significantly higher in the control group (p=0.042, p=0.028).CONCLUSIONS: Our study suggests that hematological parameters may vary in migraine patients and these changes may be associated with the inflammatory mechanisms of the disease. Although a significant relationship between RDW and migraine attacks was not found, NLR may be a meaningful parameter for migraine attacks. Additional research is necessary to evaluate the clinical impact of these findings.

Aim: Type 2 diabetes mellitus (T2DM) can significantly affect stroke outcomes. There is a lack of studies examining the association between diabetic polyneuropathy (DPN), diabetic autonomic neuropathy (DAN), and stroke. This study aimed to investigate the relationship between ischemic stroke by comparing patients with and without DPN. Materials and Methods: Patients diagnosed with DPN who presented to the neurology clinic of Afyonkarahisar Health Sciences University Hospital between January 2022 and January 2023 were included Afyonkarahisar Health Sciences University Hospital, Afyonkarahisar, Turkey, between January 2022 and January 2023 were included. Demographic information, electromyography results, and findings of DAN were recorded. The presence of DAN symptoms was assessed with the Survey of Autonomic Symptoms. The association of ischemic cerebrovascular (CV) disease was investigated in both groups of patients with and without DPN. Additionally, the relationship between DAN findings and ischemic CV disease was explored in patients with polyneuropathy. Results: A total of 400 patients, comprising 200 with T2DM and DPN and 200 with T2DM without DPN, were included in the study. Ischemic stroke was observed in 23 (11.5%) patients in the group with DPN and 15 (7.5%) patients in the group without polyneuropathy. Although the rate of ischemic stroke was higher in the group with polyneuropathy, no statistically significant difference was found between the groups (P = 0.232). The presence of DAN was higher in the group with both DPN and ischemic stroke, and this difference was statistically significant (P < 0.001). Conclusion: The study illustrated that DAN is a significant risk factor for T2DM and CV ischemic stroke. Although a higher rate of ischemic stroke was observed in DPN, the presence of polyneuropathy did not show an additional enhancing effect on the risk of stroke. The rate of CV ischemic stroke in patients with DPN was found to be 11.5%.