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KAHRAMAN KOYTAK, PINAR

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KAHRAMAN KOYTAK

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Author: ULUÇ, KAYIHAN × Subject: CLINICAL MEDICINE ×

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    Accuracy and reliability of magnetic resonance imaging in the diagnosis of idiopathic intracranial hypertension
    (2022-10-01) ULUÇ, KAYIHAN; ÇİMŞİT, NURİ ÇAGATAY; ILGIN, CAN; DERİCİOĞLU, VOLKAN; KAHRAMAN KOYTAK, PINAR; Kuzan B. N. , ILGIN C., Kuzan T. Y. , DERİCİOĞLU V., KAHRAMAN KOYTAK P., ULUÇ K., ÇİMŞİT N. Ç.
    © 2022 Elsevier B.V.Purpose: To determine the diagnostic utility of brain magnetic resonance imaging (MRI) findings in patients with idiopathic intracranial hypertension (IIH) and to investigate the significance of evaluating radiological findings together with neurological and ophthalmological data in the diagnosis of IIH. Materials and Methods: All consecutive patients diagnosed with IIH in our tertiary neuro-ophthalmology center between January 1, 2018 and March 15, 2020, were included in the study. The clinical, radiological, and ophthalmological findings of IIH patients were compared with the control group with similar demographic characteristics. Results: A total of 98 patients, 49 cases and 49 controls, were included in the study. Lateral ventricular index had the highest area under the curve (AUC) value (0.945) for prediction of disease group followed by sella height category (AUC = 0.915) and optic nerve tortuosity (AUC = 0.855) According to the multivariate model we developed, caudate index (OR = 0.572, 95% CI 0.329–0.996), lateral ventricle index (OR = 3.969, 95% CI 1.851–8.509) and bilateral optic nerve tortuosity (OR = 22,784, 95% CI 2.432–213.450) were significant predictors for disease group. Conclusion: Tortuosity in the optic nerve, lateral ventricular index and caudate index can be used as MRI parameters supporting the diagnosis of IIH in clinically suspicious cases. A holistic approach to the clinical and radiological findings of the cases in the diagnosis of IIH can prevent overdiagnosis and enable early correct diagnosis.
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    Physical and mental fatigue in myasthenia gravis and its correlation with other symptoms
    (2022-08-01) ULUÇ, KAYIHAN; KAHRAMAN KOYTAK, PINAR; Akkan Suzan A., Kahraman Koytak P., Uluc K., Tanridag T.
    Introduction:Muscle weakness and easy fatigability are the clinical hallmarks of myasthenia gravis (MG). However, fatigue perception, which can be seen quite often in myasthenic patients, and its effect on the quality of life, irrespective of motor deficit, has not been elucidated yet. The aim is to evaluate the frequency of fatigue in myasthenic patients with nearly full muscle strength and the effect of fatigue on quality of life by assessing its correlation with other symptoms.Methods:Fifty-three patients with ocular or mild generalized MG in remission or minimal manifestations completed the questionnaires measuring the severity of MG and quality of life (MG Composite Scale and MG-Activities of Daily Living Profile). Both patient group and control group (53 healthy volunteers)completed the scales assessing fatigue [Fatigue Assessment Scale (FAS) and Fatigue Impact Scale (FIS)], depression [Beck Depression Inventory (BDI)] and sleep (Epworth Sleepiness Scale). Disease severity was assessed using MG Foundation of America (MGFA) and MGFA Post-Intervention Status classifications.Results:FAS, FIS physical and BDI scores were significantly higher in patients compared to the control group (p = 0.003, p = 0.001, and p = 0.003, respectively) and fatigue was associated with depression and daytime sleepiness. Inpatient group, depressive symptoms and daytime sleepiness were higher in females (p = 0.019 and p = 0.013). The mean values of FIS total and cognitive scores were higher in patients with generalized MG (p = 0.033 and p = 0.045). Fatigue scores correlated with motor signs.Discussion:Fatigue can be seen in MG independently from muscle weakness and is an important symptom worsening the quality of life.