Objective: Diabetes Mellitus is one of the most common metabolic diseases. The most frequent complication of DM is diabetic polyneuropathy. Diabetic polyneuropathy is related to high mortality, morbidity, hospitalization rate and serious level of economic burden. We aimed in this study to determine the risk factors that affect DPN pathology. Methods: Patients with abnormalities in the nerve conduction study constituted the polyneuropathy group, and patients without abnormalities formed the control group. When the laboratory values of the patients were analyzed, blood tests of 168 of 202 patients were reached. 117 of these patients had PNP and 51 did not have PNP. Results: In patients with PNP, glycolyzed hba1c ratio and fasting blood sugar were significantly higher than patients without PNP (p<.001). While HDL rate was lower in patients with PNP than those without PNP (p<0.01), TG/HDL ratio was higher (p<0.05). In patients with PNP, glycolyzed urea (p<0.001) and creatinine (p<0.01) were significantly higher than those without PNP. The serum level of 25(OH) vitamin D was significantly lower in patients with PNP than in patients without PNP (p<0.05). Ferritin was significantly higher in patients with PNP than patients without (p<0 .01). Conclusions: Knowing and preventing risk factors for diabetic polyneuropathy, we can take a new direction to our treatment approaches and take early measures. Fasting blood sugar and hba1c control, regulation of lipid profile, monitoring of vitamin d and ferritin levels are particularly necessary for protection of polyneuropathy.

Aim: Triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio is defined as the serum atherogenicity index. High TG/HDL-C ratio is related with vascular diseases, insulin resistance and metabolic syndrome. The TG/HDL-C ratio in cerebrovascular diseases, especially in silent cerebral lesions hasn't been well studied. The aim of this study was to evaluate the frequency of silent cerebral ischemia (SCI) and leukoaraiosis (LA), and its relationship with TG/HDL-C ratio in patients admitted with the first ischemic stroke attack. Material and Methods: We retrospectively evaluated 200 patients who admitted to Bulent Ecevit University Faculty of Medicine, Department of Neurology with the diagnosis of acute first ischemic stroke. Silent cerebral lesions were defined as LA and SCI with magnetic resonance imaging. TG/HDL-C ratio was calculated by dividing TG levels by HDL-C levels. Results: Silent cerebral lesions were detected 124 (83.2%) of 149 patients. LA severity was evaluated according to Fazekas score, 22 (14.8%) of patients were grade 0, 49 (32.9%) of them were grade 1, and 78 (52.3%) of them were advanced periventricular white matter hyperintensity (adv-PWMH) group. TG/HDL-C ratio in SCI group was higher than the group without SCI, but it wasn't statistically significant (p=0.091). A significant increase was observed in the TG/HDL-C ratio, as LA severity increased. TG/HDL-C ratio was significantly higher in adv-PWMH group (p=0.050). Conclusion:High serum atherogenicity index is associated with atherosclerosis and vascular endothelial dysfunction. With this simple, inexpensive and effective test method, high-risk group of LA and SCI could be identified.

Limited scleroderma, also termed CREST syndrome (calcinosis cutis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly and telangiectasia), is a form of scleroderma which is an autoimmune connective tissue disease. Neurological involvement is less common than other system involvements in scleroderma. Epileptic seizure is a rare neurological complication. Gyral enhancement is not an expected finding during disease. Gyral enhancement is contrast enhancement of superficial brain parenchyma and it usually occurs as a result of vascular, inflammatory, infectious and neoplastic processes. A-sixty-seven-year old female patient, who was diagnosed as CREST syndrome for three years was admitted to our hospital. She had an epileptic seizure three days ago and behavioral changes after the seizure. There was not epilepsy diagnosis in her medical history. In neurological examination; she was apathic and deep tendon reflexes were hyperactive, Hoffman's and Babinski reflexes were positive on the right side of her body. In laboratory studies; anti-nuclear antibody was positive at 1/1000 and anti-centromere antibody was positive. On contrast-enhanced cranial magnetic resonance imaging (MRI); gyral enhancement was observed in the left parieto-occipital region. Cerebrospinal fluid tests were within normal limits. Electroencephalography demonstrated diffuse cerebral dysfunction. We administrated antiepileptic drug to the patient during hospitalization. On the follow up, apathy and restriction of the cooperation were improved. Epileptic seizure did not recur. After ten days, in the control cranial MRI, gyral enhancement was reduced significantly. Neurological involvement in CREST syndrome is rare and epileptic seizures have been appeared in a limited number in the literature. Inflammatory and vascular processes can cause gyral enhancement, but also it must be kept in mind that gyral enhancement can be observed transiently after epileptic seizure.Keywords: CREST syndrome, epileptic seizure, gyral enhancement Sınırlı skleroderma; otoimmün bağ dokusu hastalığı olan sklerodermanın bir formudur ve CREST sendromu (kalsinozis kutis, Raynaud fenomeni, özefageal dismotilite, sklerodaktili ve telenjiektazi) olarak da adlandırılır. Sklerodermada nörolojik tutulum diğer sistem tutulumlarına göre daha az görülür. Epileptik nöbet ise nadir görülen nörolojik komplikasyonlardandır. Hastalıkta giral kontrastlanma beklenen bir bulgu değildir. Giral kontrastlanma, beyin parankiminin yüzeyel kontrast tutulumudur ve genellikle vasküler, enflamatuvar, enfeksiyöz ve neoplastik süreçler sonucu ortaya çıkar. Üç yıldır CREST sendromu tanısı olan 67 yaşında kadın hasta hastanemize başvurdu. Üç gün önce epileptik nöbet geçirmişti ve nöbet sonrasında davranış değişiklikleri mevcuttu. Özgeçmişinde epileptik nöbet hikayesi yoktu. Nörolojik muayenesinde; apatikti ve kooperasyonu kısıtlı idi. Derin tendon refleksleri yaygın olarak artmıştı, sağda Hoffman ve Babinski refleksleri pozitifti. Laboratuvar incelemelerinde anti-nükleer antikor pozitifti (1/1000) ve...