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    Cold effect in median nerve conductions in clinical carpal tunnel syndrome with normal nerve conduction studies
    (Elsevier Sci Ltd, 2019) Say, Bahar; Ergün, Ufuk; Turgal, Ebru; Yardımcı, İlknur
    Clinical diagnosis of carpal tunnel syndrome (CTS) is confirmed by nerve conduction studies (NCS). In some cases, NCS may be normal. We aimed to demonstrate changes of distal motor latency (DML) and nerve conduction velocity (NCV) pathology of demyelination in entrapment neuropathy with cold application in case of clinical CTS with normal NCS. This prospective, cross-sectional, randomise, case-control involved 15 patients (25 hands) with clinically definite unilateral or bilateral CTS and normal nerve conduction studies (NCS), and 11 controls (22 hands). Ice pack was applied to median nerve trasse at wirst with monitoring skin temperature. NCS of median nerve were examinated again. Increases of DML, decrease of velocity of median nerve were observed in two groups after post-cooling. The change in NCV was greater than the change in DML. Cold effect was evident in DML and NCV in the patient group. This could be sign of the demyelination pathology. We think that cold application is influential to determine electrophysiologic abnormalities in clinic CTS with normal NCS. (C) 2018 Elsevier Ltd. All rights reserved.
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    Detecting pain severity with full cup test in painful diabetic peripheral neuropathy
    (2020) Say, Bahar; Ergün, Ufuk; Yıldız, Ayşe; Alpua, Murat; Arıkan, Şenay Durmaz; Turgal, Ebru
    Objectives: The aim of this study was to test the utility and validity of the full cup test (FCT) to assess the severity of pain in subjects with painful diabetic peripheral neuropathy (PDPN). Methods: Subjects with diabetic PDPN were enrolled for this prospective, cross-sectional study. Other causes of PDPN and subjects with cognitive impairment were excluded. The diagnosis of neuropathic pain was made using the results of a physical examination and the Douleur Neuropathique 4 questionnaire. Pain severity was assessed with a FCT and a visual analog scale (VAS) administered before and after treatment. The correlation of FCT with VAS was evaluated to examine validity. Results: A total of 43 (33 female, 10 male) subjects were included. The mean age was 61.9±8.25 years and the mean disease duration was 13.02±7.6 years. Type I diabetes mellitus (DM) was present in 2 (4.7%) subjects and Type II DM in 41 (95.3%) subjects. The mean glycated hemoglobin level was 8.9±1.9 mmol/mol. When the mean VAS and FCT scores were analyzed, the results were 6.7±2.05 and 66.35±23.2, respectively, pretreatment and 4.6±2.2 and 41.36±23.5 posttreatment, which were both statistically significant (p<0.001, p<0.001). The mean control period was 23.4 days (min–max: 15-30 days). The VAS and FCT scores in pretreatment and posttreatment demonstrated a high positive correlation (rs =0.86, p<0.001; rs =0.843, p<0.001). Conclusion: The FCT can be useful to detect pain severity in PDPN.
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    Optical coherence tomography neurodegenerative findings in patients with bipolar disorder
    (WILEY, 2020) Gokcinar, Nesrin Buyuktortop; Buturak, Sadiye Visal; Ozkal, Fatma; Ozcicek, Gamze; Yumusak, Mehmet Erhan; Turgal, Ebru
    Introduction Neuroimaging studies of patients with bipolar disorder (BD) have recently revealed neurodegenerative changes in the central nervous system. Optical coherence tomography (OCT) imaging of the retina, as an extension of brain, may be a biomarker in understanding the neurobiology of the disease. To assess OCT as a tool to detect neurodegeneration in BD we compared the retinal changes between patients with BD and healthy individuals. Methods We performed complete ophthalmological examinations and took OCT images for 70 eyes of 70 patients with BD, and for age and sex-matched individual controls. We compared retinal nerve fiber layers (RNFLs) and total retinal (TR) thickness in the peripapillary areas; and ganglion cell complexes (GCCs) and TR thickness in the maculas between the groups. Results The mean age of the patients was 40.41 +/- 13.22 years and that of the controls 40.20 +/- 13.03 years. The men/women ratios were 37/33 in both groups. BD was significantly associated with a decrease in the average peripapillary RNFL, with the average peripapillary TR, and with the average GCC thickness (P = .033, P = .008, and P = .009, respectively). The peripapillary RNFL and TR thinnings were prominent in the superior (P = .039, P = .033, respectively) and inferior quadrants (P = .031, P = .018, respectively). The BD effects on GCC thinning was prominent in the superior half (P = .001) and in the nasal sectors (except in the inner superonasal sector; all P < .05). BD was associated with a decrease in macular TR thickness only at the inner superior sector (P = .014). Disease duration was inversely correlated with the peripapillary RNFL, TR, and macular GCC thicknesses (P < .05). Discussion Our findings support the neurodegeneration hypothesis in the etiopathogenesis of BD. OCT, a non-invasive neuro-imaging method, may be useful for BD diagnosis and follow-ups.
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    The Relationship of Perceived Social Support with Level of Insight and Treatment Adherence in Individuals Diagnosed with Schizophrenia and Bipolar Disorder
    (2024) Kocakaya, Hanife; Arslan, Kübra; Buturak, Şadiye Visal; Turgal, Ebru
    Purpose: This study aims to examine the relationship between perceived social support, insight, and treatment adherence in patients with schizophrenia and bipolar disorder. Materials and Methods: This study was conducted with 110 individuals, including 55 bipolar and 55 schizophrenia patients, who had been hospitalized in our clinic in the last 1 year and were in remission. Participants were administered a sociodemographic and clinical data form, Young Mania Rating Scale (YMDÖ), Clinical Global Impression Scale (CGI), Three Components of Insight Rating Scale (IÜBDÖ), Morisky Treatment Compliance Scale (MTUÖ) and Multidimensional Perceived Social Support Scale (MSPSS). Results: The mean age was 40.47±12.96 for bipolar patients and 40.45±11.71 for schizophrenics. Perceived family, friend, significant others support, and total support was found to be higher (p=0.000, p=0.000, p=0.004, p=0.000, respectively) of bipolar patients, and the highest support was perceived from family, followed by friends and significant people. Although the groups did not differ in terms of treatment adherence (p=0.083), the insight score was significantly higher in bipolar patients (p=0.001). Groups were evaluated with hierarchical regression analysis in terms of factors affecting perceived social support. Gender, years of education, insight, and treatment adherence were found to be predictive of social support (p=0.04, p=0.01, p<0.001, p=0.01, respectively). Conclusion: Informing caregivers (family, etc.) of bipolar and schizophrenic patients about the effect of social support on clinical outcome may reduce the burden of caregivers by contributing positively to insight and treatment compliance.