This is the first report of acute WNV infections caused by lineage 1 strains from Turkey, in concordance with previous reports from some European and North African countries.
Miller Fisher Syndrome is characterised by the classical triad of ophthalmoplegia, ataxia, and areflexia. Ophthalmoparesis without ataxia, without areflexia, or with neither have been attributed as atypical forms of MFS. We report two patients with MFS who had tonic pupils and raised anti-GQ1b antibody titres. Bilateral dilated pupils (either tonic or fixed) can be a manifestation of MFS and anti-GQ1b immunoglobulin G (IgG) antibodies are useful to confirm the diagnosis in unexplained cases. The site of involvement is thought to be the ciliary ganglion or short ciliary nerves.
Objectives:
Data are limited regarding the relationship of neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), and platelet/ lymphocyte ratio (PLR) with neurological symptoms (NS) in COVID-19 patients. This study is the first to assess the utility of the NLR, MLR, and PLR for predicting COVID-19 severity in infected patients with NS.
Materials and Methods:
Consecutive 192 PCR-positive COVID-19 patients with NS were included in this cross-sectional and prospective study. The patients were classified into the non-severe and severe groups. We analyzed routinely complete blood count in these groups in terms of COVID-19 disease severity.
Results:
Advanced age, a higher body mass index, and comorbidities were significantly more common in the severe group (P < 0.001). Among the NS, anosmia (P = 0.001) and memory loss (P = 0.041) were significantly more common in the non-severe group. In the severe group, the lymphocytes and monocyte counts and the hemoglobin level were significantly lower, while the neutrophil count, NLR, and PLR were significantly higher (all P < 0.001). In the multivariate model, advanced age and a higher neutrophil count were independently associated with severe disease (both P < 0.001) but the NLR and PLR were not (both P > 0.05).
Conclusion:
We found positive associations of COVID-19 severity with the NLR and PLR in infected patients with NS. Further research is required to shed more light on the role of neurological involvement in disease prognosis and outcomes.
Background: Chronic subdural hematoma (CSDH) may cause neurological deficits as well as adverse effects on the patient’s general health status. Although CSDH cases are diagnosed in the advanced age group with a very high rate, clinical findings may not be related only to CSDH. The aim should be related to clinical recovery rather than radiological recovery for these cases. We aimed to evaluate Karnofsky’s score as a measurement criterion of postoperative clinical outcomes in patients with CSDH. Methods: Cases operated for the diagnosis of CSDH were defined retrospectively. The cases that had been operated with this diagnosis were identified by examining the institution database records. Karnofsky scores equivalent to clinical status were performed by examining patient files. Karnofsky scoring before the symptomatic period was determined and compared with the Karnofsky score belonging to the late postoperative period. The clinical and radiological findings of the preoperative and postoperative periods were compared. Independent samples t test was used to reveal the difference between the two groups. Results: Data of 184 cases were evaluated. Seventy-three cases were operated on the left, 51 cases on the right, and 60 cases bilaterally with the diagnosis of CSDH. Burrhole exploration was performed in 119 cases, and a craniotomy was performed in 65 cases. Although a significant decrease in hematoma thickness was detected radiologically in cases operated with the craniotomy method, a more significant improvement was observed in Karnofsky’s score in cases operated with the burrhole method. In younger patients, improvement in Karnofsky’s score was significantly higher. Conclusion: The main aim should be to improve clinical status rather than radiological improvement in the treatment of CSDH cases. In the surgical treatment of these cases, it is possible to encounter a high rate of complications depending on age. It is possible to evaluate the postoperative status rationally with Karnofsky scoring. According to the preoperative Karnofsky scoring, deciding on the surgical technique may help reduce complications.
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