OBJECTIVE To investigate potential risk factors for Parkinson`s disease (PD) in elderly individuals rural living in Turkey. METHODS In total, 72 consecutive elderly Parkinson disease patients referred to the Neurology Clinic, Igdir State Hospital, Igdir, Turkey were included in the study. A structured questionnaire comprising questions on history of pastoral living, pit water consumption, and exposure to ionizing radiation and pesticides was administered to the patients. The patients were divided into 2 groups on the basis of water consumption well water consumption group and city network consumption group. RESULTS Of 72 patients with PD, 49 (68.1%) exposed to well water while 23 (31.9%) did not exposed to well water. The average duration of well water consumption was 20 (standard deviation 6) years (p less than 0.01) in group 1. Nitrate, sulfate and heavy metal levels were significantly higher in well water than in city network water (p less than 0.05). CONCLUSION Consumption of well water containing heavy metals and nitrates in early life may contribute to the etiology of Parkinson disease in elderly individuals in Igdir province of Turkey.OBJECTIVE To assess knowledge about secondary stroke and adherence to stroke discharge medication and prevention strategies among stroke survivors, and to identify possible causes of poor adherence. METHODS A cross-sectional study that involved 82 stroke survivors who were treated at Prince Mohammed Bin Abdulaziz Hospital (PMAH) in Riyadh, Saudi Arabia, from July 2015 to August 2018. Patient adherence level (PAL) was assessed using a tool developed by Sidorkiewicz et al (2016). RESULTS Of the 82 participants, 63.4% believed that the risk of secondary stroke is higher and 70.7% believed it would results in worse outcome, compared to primary stroke. Out of a list of 7 preventive strategies, treating risk factors (80.5%), keeping a healthy diet (65.9%) and regular exercise (63.4%) were the most frequently identified. Forgetful-ness (51.2%), polypharmacy (18.3%) and patient-perceived improvement (17.1%) were the most frequently reported causes for nonadherence. At the patients` level, PAL was adequate among 46.8%, and was higher among females (60.0% versus 35.7%, p=0.033) and married (52.2% versus 0.0%, p=0.006) ones, and lower among smokers (22.2% versus 54.2%, p=0.029), compared to their counterparts. No correlation of adherence level with knowledge was observed. Regression showed approximation to statistical significance for smoking (OR=4.28 [0.99, 18.41], p=0.051) as a predictor for inadequate adherence. CONCLUSION Stroke survivors have suboptimal adherence to discharge prescriptions and preventive strategies, despite a relatively sound knowledge, which exposes them to high risk of secondary stroke. It is part of the healthcare providers` role to identify eventual barriers to adherence and to implement efficacious strategies to alleviate such barriers and improve patients` adherence.OBJECTIVE To estimate reference data for the commonly performed sensory nerve conduction studies (NCS) using a cohort of healthy subjects from Saudi Arabia. METHODS This is a cross-sectional study conducted between May 2015, and June 2019. Sensory nerve action potential (SNAP) amplitude, conduction velocity (CV), and peak latency (PL) were recorded. Associations between these parameters and the covariates (age, sex, height, weight, and body mass index) were tested with Pearson correlations. Reference data were then derived using the lowest percentile that could be reliably determined for SNAP amplitude and CV. Reference data were derived using the highest percentile for PL. RESULTS Upper and lower limb sensory NCS were performed in 127 and 137 participants, respectively. Age was the only covariate that required adjustment for estimation of SNAP amplitude. Therefore, a prediction model was generated for each nerve. Percentile estimation for PL and CV did not require adjustment for any of the covariates. Hence, it was derived for all the subjects pooled together. CONCLUSION The sensory NCS reference data were comparable to the data from other countries. However, minimal differences were observed. Further studies are required with a focus on the older age group.OBJECTIVE To improve the understanding of the association between electrocardiographic (ECG) abnormalities and clinical outcomes of patients with all types of intracranial hemorrhage (ICH). METHODS A retrospective cohort study was conducted in a tertiary healthcare hospital on patients with ICH without cardiac disease or renal disease requiring dialysis. Demographic and clinical data were collected from hospital records. ECG record were obtained within 24 hours of presentation and prior to treatment. Records were interpreted for this study by a cardiologist blinded to other data. RESULTS Assessment of 291 patients (228 adults and 63 children) showed that subdural hemorrhage was the most common type of ICH (31.6%) followed by intraparenchymal hemorrhage (23.0%). ECG records were available for 98 patients. ECG abnormalities were most commonly nonspecific ST-segment changes (32.6%). In adults, history of neurological disease was associated with atrioventricular block (p=.004) and QTc prolongation (p=.041). Pediatric patients exhibited associations between ST-segment changes (p=.045) and sinus tachycardia (p=.027) and type of ICH. However, ECG changes were not statistically associated with clinical outcomes in adults or children. CONCLUSION Significant ECG changes frequently occurred in patients with all types of ICH but did not consistently predict the outcome in this study. Close observation of patients is still recommended to detect ECG changes that could affect the treatment.OBJECTIVE To investigate the importance of the side of clinical findings in predicting the prognosis in multiple sclerosis (MS) patients. METHODS In our study we enrolled 361 MS patients. https://www.selleckchem.com/products/pu-h71.html This study as retrospective was performed. On neurological examinations, clinical findings were recorded as right, left and bilateral. We used the Expanded Disability Status Scale (EDSS), Multiple Sclerosis Severity Score (MSSS), Progression Index (PI) for neurological status. RESULTS At the first attack, there were differences in the EDSS, PI and MSSS of right-sided findings between remission and attack periods (p=0.057, p=0.008, p=0.017 respectively). In the right-sided clinical findings, the value of PI and MSSS were higher than the others between in remission and attack periods (p=0.002, p=0.045 respectively). At last attack, we found statically differences in EDSS, MSSS values between remission and attack periods in only right-sided clinical findings (p=0.042, p=0.027 respectively). In the first presentation the PI value in bilateral clinical signs was lower (p=0.