Comparison of efficiencies of michigan neuropathy screening instrument, neurothesiometer, and electromyography for diagnosis of diabetic neuropathy.

Aim. This study compares the effectiveness of Michigan Neuropathy Screening Instrument (MNSI), neurothesiometer, and electromyography (EMG) in detecting diabetic peripheral neuropathy in patients with diabetes type 2. Materials and Methods. 106 patients with diabetes type 2 treated at the outpatient clinic of Ankara Numune Education and Research Hospital Department of Endocrinology between September 2008 and May 2009 were included in this study. Patients were evaluated by glycemic regulation tests, MNSI (questionnaire and physical examination), EMG (for detecting sensorial and motor defects in right median, ulnar, posterior tibial, and bilateral sural nerves), and neurothesiometer (for detecting alterations in cold and warm sensations as well as vibratory sensations). Results. According to the MNSI score, there was diabetic peripheral neuropathy in 34 (32.1%) patients (score ≥2.5). However, when the patients were evaluated by EMG and neurothesiometer, neurological impairments were detected in 49 (46.2%) and 79 (74.5%) patients, respectively. Conclusion. According to our findings, questionnaires and physical examination often present lower diabetic peripheral neuropathy prevalence. Hence, we recommend that in the evaluation of diabetic patients neurological tests should be used for more accurate results and thus early treatment options to prevent neuropathic complications.

Serum iron, vitamin B12 and folic acid levels in Parkinson's disease.

We aimed to investigate possible associations between systemic iron metabolism deficiency and Parkinson's disease, and also to research any possible correlations between stage of the disease and vitamin B12 and folic acid levels. 33 male and 27 female patients diagnosed with idiopathic Parkinson's disease and 22 male and 20 female age- and sex-matched controls were enrolled in the study. Having the diagnosis of secondary Parkinsonism or Parkinson plus syndromes, and for the females, not being in the menopausal stage were considered as exclusion criteria. Recordings of blood samples of both groups collected after 8 h fasts were assessed in terms of serum iron, ferritin levels and iron-binding capacity, vitamin B12 and folic acid levels. The Hoehn and Yahr scale was used to determine the stage of the disease. No statistically significant difference was found with respect to mean serum iron, median serum ferritin levels and median serum iron-binding capacity between the groups. A statistically significant but inverse correlation was found between symptoms' duration and serum iron and ferritin levels. There was no statistically significant difference between the groups with respect to vitamin B12 and folic acid levels. However, a statistically significant but inverse correlation was determined between the patients' vitamin B12 levels and the Hoehn and Yahr scores. As Parkinson's disease progresses, serum iron, ferritin and vitamin B12 levels may decrease. The lower levels of these parameters may be the cause of the progression or may be the result of it.

Nutritional status and anthropometric measurements of patients with multiple sclerosis.

OBJECTIVE: To determine the nutritional status and anthropometric measurements of patients with multiple sclerosis (MS). METHODS: This research was conducted on 37 (15 men, 22 women) new diagnosed MS patients who applied to Ankara Numune Education and Research Hospital, Ankara Turkey, from June to August 2011. The nutritional status of patients was determined by a 3-day and 24-hour dietary record and a food frequency questionnaire. Body composition was analyzed by bioelectrical impedance analyzer, and body mass index was calculated. The Nutrient Data Base (BEBIS) program was used to evaluate the energy and nutrient intakes of patients and compared with Dietary Reference Intakes recommendations. Blood samples were collected and serum glucose, lipid profiles, total protein, albumin, total calcium, magnesium, vitamin B12, and vitamin D levels were analyzed. RESULTS: Approximately 5.4% of patients were underweight, 54.1% were normal weight, 24.3% were overweight and 16.2% were obese. Daily mean energy intakes were 2730+/-840.97 kcal in men and 1967+/-647.24 kcal in women. The percentage of the carbohydrates was 46.9%, proteins was 14.6%, and fats of the total energy was 38.4%. Approximately 16.7% of the patients' serum vitamin D, and 6.7% of the patients' serum vitamin B12 levels were below than the reference ranges. CONCLUSION: Multiple sclerosis patients have high body mass index values and poor nutritional status. It was verified that life style modification with adequate and balanced nutritional habits is very important in MS patients.