Risk factors for Stroke

 

Anyone can have a stroke at any age. Because some risk factors increase the likelihood of stroke, the best way to protect yourself and your loved ones from stroke is to know these risk factors and understand how to manage them.

You may not be able to control some of the risk factors for stroke, such as age or family history, but you can reduce your risk of stroke by controlling other risk factors. Stroke can occur in both men and women. Some factors that we cannot control, such as age, gender, race or ethnicity, can increase the risk of stroke: Age is the most important risk factor for stroke. The risk of stroke increases as you get older. Over the age of 55, the risk of stroke doubles every 10 years. However, the risk of stroke is quite high under the age of 65. Gender, stroke is more common in men than women in most age groups. However, the probability of death from stroke is higher in women than in men. Pregnancy and use of birth control pills can increase the risk of stroke in women. Race or ethnicity, the risk of stroke is nearly twice as high for blacks as for whites, and blacks have a higher stroke death rate than whites.

Many diseases can increase the risk of stroke. For risk control, be sure to consult your doctor and have regular check-ups at centers where you can have check-ups suitable for your family history, age, gender and risk factors.

previous stroke or transient ischemic attack; If you have a known previous stroke or transient ischemic attack, you have a higher risk of having another stroke.

Hypertension; High blood pressure is a major risk factor for stroke, and lowering blood pressure with medications or lifestyle changes can reduce the risk of stroke.

High Cholesterol; Cholesterol is made by the liver, or a waxy, fat-like substance found in certain foods, which our liver makes enough for the body's needs, but we usually get more cholesterol than we need from the foods we eat. If we take in more cholesterol than our body can use, the extra cholesterol can build up in the arteries, including in the brain. This accumulation can lead to narrowing of the vessels, stroke and other problems.

Heart disease; Many heart diseases can increase the risk of stroke. Coronary artery disease forms plaques in the arteries, reducing the flow of oxygen-rich blood to the brain and increasing the risk of stroke. Heart valve defects, irregular heartbeats such as atrial fibrillation, and other heart conditions such as enlarged heart chambers can cause embolism and stroke.

Diabetes; Since diabetes also increases the risk of stroke, managing diabetes correctly reduces the risk.

Sickle Cell Disease; It is a blood disease associated with ischemic stroke, in which red blood cells are in an abnormal sickle shape. These sickle-shaped cells can attach to a blood vessel, blocking blood flow to the brain, leading to paralysis.

Lifestyle and Habits; Your lifestyle choices can affect your risk of stroke. To reduce the risk, your doctor may suggest lifestyle changes. Your healthy lifestyle can reduce the risk of stroke.

Unhealthy Diet; Diets high in saturated fat, trans fat and cholesterol increase the risk of heart disease and stroke. Too much salt (sodium) in the diet can increase blood pressure levels and increase the risk of stroke.

Physical Inactivity; Inadequate physical activity along with other risk factors such as obesity, high blood pressure, high cholesterol and diabetes increases the risk of stroke. You can reduce your risk of stroke with regular physical activity.

Obesity; In obesity, there is excess fat in the body, “bad” cholesterol and triglyceride levels are high and “good” cholesterol levels are low. In addition to heart disease, it leads to high blood pressure and diabetes, increasing the risk of stroke.

Excessive use of alcohol; can increase blood pressure levels and the risk of stroke. It also hardens the arteries, increases triglycerides and blood fats.

Tobacco use; It increases the risk of stroke and can damage the heart and blood vessels. Also, nicotine raises blood pressure, reducing the amount of oxygen the blood can carry. Exposure to secondhand smoke from other people (passive smoking) can increase the risk of stroke, even in non-smokers.

Modifiable risk factors for stroke;

• Hypertension (High Blood Pressure)
• Diabetes
• Hyperlipidemia (high fat, especially bad cholesterol called LDL-cholesterol)
• Atrial fibrillation (a kind of rhythm disorder in the heart)
• Heart diseases
• Smoking
• Alcohol use
• Obesity
• physical inactivity
• Nutrition habits
• Neck vascular occlusions that have not yet given symptoms (asymptomatic carotid stenosis)        

Non Modifiable risk factors for stroke;

• Age
• Gender
• Race
• family history
• History of previous stroke and transient ischemic attack

What is a Seasonal Allergy? Seasonal Allergy Symptoms

Allergic diseases that occur in spring; It is known as seasonal allergic rhinitis, seasonal allergic asthma and seasonal allergic conjunctivitis. These diseases occur during the pollination time of meadow grasses, weeds, cereal crops and trees (in March - August), and sometimes they may appear as allergic rhinitis and allergic asthma attacks in autumn months due to the effect of mold fungi.

What are the triggers and symptoms of seasonal allergies?

The triggers of seasonal allergies are house dust mites, cat and dog antigens, indoor molds and cockroach antigens indoors. Outdoors, it is meadow, grass, tree pollen and outdoor molds.

Symptoms of seasonal allergies are nasal discharge, itching, sneezing, congestion, itchy eyes, watering, itching on the palate, shortness of breath, chest tightness, dry cough. The incidence of seasonal allergies after the age of 10 is 10-15%, and these ailments can occur suddenly at any time in life.

What are the symptoms of seasonal allergies mixed with?

Since the symptoms of seasonal allergic diseases are similar, they can be confused with non-allergic rhinitis, vasomotor, infectious, hormonal and drug-induced rhinitis. Allergic rhinitis can also be accompanied by diseases such as rhinosinusitis, conjunctivitis, nasal polyps, otitis, sleep disorders and asthma. Seasonal allergic diseases occur with the interaction of genetic susceptibility, environmental factors and triggers. Seasonal allergic rhinitis is frequently seen in the family members of patients with allergic asthma with similar diseases.

How are seasonal allergies related to asthma?

Allergic rhinitis and asthma often coexist in the same individual. 80% of individuals with asthma have allergic rhinitis, and 40% of patients with allergic rhinitis have asthma. There are 3 different methods in the diagnosis of seasonal allergies.

- Evaluation of the complaint and the story

- Physical examination (Complete examination of the nose, eyes and respiratory system)

- Skin tests (Prick tests)

Prick skin tests are the most commonly used tests for diagnosis. These tests are inexpensive, simple, sensitive and give immediate results. In cases where allergy tests cannot be performed when necessary, the diagnosis is made by measuring specific "IgE" in the blood.

What are the treatment options for seasonal allergies?

Periodic treatment is applied in allergic rhinitis. The treatment can be applied in 3 steps.

- Prevention therapy: Avoiding allergens that cause allergic diseases and taking preventive measures. This is difficult with pollen allergy.

- Drug therapy: (pharmacotherapy): Antihistamines, intranasal corticosteroids, leukotriene antagonists, oral decongestants, intranasal anticholinergics are used.

- Vaccine Treatment (immunotherapy): There is no definitive treatment that eliminates seasonal allergic diseases. The only treatment that changes the natural course of allergic diseases is immunotherapy, that is, vaccine treatment.

What are the precautions that patients can take in their daily life?

If patients have increased complaints about pollen and seasonal allergies in the spring months, spending their time indoors more in April-May, changing their clothes after returning home and taking a shower, and not doing sports activities in the morning when pollen is high in the atmosphere are among the precautions they can take. In addition, untreated allergic diseases reduce the quality of life of the individual, as well as increase the severity of the disease and increase the probability of developing allergic asthma.

Secondary infertility

 

Since you've given birth before, it may not occur to you that you are suffering from infertility unless you become pregnant again. Those who have experienced secondary infertility learn that this can happen only when they consult a doctor.

There is a misconception that infertility is congenital and will not happen to women giving birth, but infertility is usually an afterthought. As you know, infertility is a very broad topic. However, today I will talk about a more subtle topic, secondary infertility.

What is Secondary Infertility?

Secondary infertility is the inability to get pregnant even if you have had a child before, even though you try to get pregnant again.

Just like primary infertility, secondary infertility can occur due to a problem at any point in the natural process necessary to get pregnant. Any problems with ovulation, fertilization, entry of the fertilized egg into the uterus, or the development of the fertilized egg may result in inability to become pregnant or the pregnancy terminated in miscarriage.

What Are the Causes of Secondary Infertility?

Primary and secondary infertility often share the same causes. I will explain them one by one for you.

Ovulation Disorders

In fact, 40 percent of women with infertility problems do not ovulate consistently. Therefore, the chance of getting pregnant decreases. Ovulation disorders can be caused by a variety of conditions and factors, such as:

• 
  
• Polycystic Ovary Syndrome (PCOS)
• Primary Ovarian Insufficiency (POI)
• Decreased egg production due to aging
• Thyroid or other endocrine disorders that affect hormone production
• Certain lifestyle factors, such as weight, diet, and alcohol or drug use        

One of the most common causes of infertility in women is PCOS, which causes the ovaries or adrenal glands to produce too many hormones that prevent the ovaries from releasing eggs. It can also cause cysts to develop in the ovaries, which can further inhibit ovulation.

But do not despair at this point. I have good news for you. 70 percent of women with PCOS do not have any problems getting pregnant after the necessary treatments.

Problems with the Uterus and Fallopian Tubes

Structural issues can affect your ability to get pregnant. For example, if there is a blockage in the fallopian tubes, the sperm and egg may not be able to come together. The uterus may also have a structural or tissue defect that prevents implantation. Some special conditions that affect the fallopian tubes or uterus include:

• Endometriosis
• uterine fibroids or polyps
• uterine wound
• Uterine-shaped abnormality, such as a unicornuate uterus            

  Secondary infertility due to endometriosis can occur after cesarean section or uterine surgery, when uterine cells are misplaced and symptoms begin or increase.

Scar in the Womb

If you had a cesarean delivery with a previous pregnancy, it's possible to have a scar on the uterus called an isthmocele. An isthmocele can lead to inflammation in the uterus that affects implantation. This causes problems in conceiving.

Infections

Infections, including sexually transmitted infections, can cause pelvic inflammatory disease. This can cause injury and blockage of the fallopian tubes. A human papillomavirus (HPV) infection (and its treatments) can also affect cervical mucus and reduce fertility.

I have to give important information about this. The sooner the infections are treated, the less impact it will have on fertility. This is an important example for you to see again the importance of regular gynecological examination.

Age

Age plays an important role in fertility. Biologically, fertility peaks around age 20 in women and begins to decline at age 30. Of course, this does not mean that a successful pregnancy cannot occur at a later maternal age. Just getting pregnant may take longer or be more challenging.

Other Causes

Causes such as stress, smoking and weight gain are also factors affecting fertility. Just like primary infertility, secondary infertility can also occur due to such conditions.

When Is Secondary Infertility Suspected?

If you can't get pregnant despite trying for the last year or if your pregnancies end in miscarriage, we start to suspect secondary infertility. For women over the age of 35, this period decreases to 6 months.

How Is Secondary Infertility Diagnosed?

When we suspect secondary infertility, we want to do an examination and some tests for diagnosis. These:

• 
  
• blood tests to look at your hormone levels
• Ovulation tests
• pelvic exam
• X-rays to view your fallopian tubes
• Transvaginal ultrasound
• Other tests to view your uterus and cervix                           

         If your tests show no problems, we may recommend testing for male infertility.

How Is Secondary Infertility Treated?

Once we know the cause, we develop a treatment plan to increase the likelihood of conception. I have listed the most common ones for you below.

Medicines

Medications are often used to normalize hormones, or fertility-enhancing drugs are recommended to help stimulate ovulation.

Operation

In some cases, you may need to have surgery. There are several effective surgical procedures that can treat problems such as uterine fibroids, uterine scarring or advanced endometriosis. Most of these procedures are performed minimally invasively.

Hysteroscopy is used to diagnose and treat uterine abnormalities such as polyps and endometriosis.

Laparoscopy is a method to help diagnose infertility when other measures have failed and can be used in conjunction with hysteroscopy as an effective treatment.

Vaccination and IVF treatment are among the most preferred methods in the treatment of infertility.

Naegleria fowleri (Brain-eating amoeba)

 

In Naegleria fowleri disease, the single-celled amoeba infects the brain, and cases are often fatal. Single-celled Naegleria fowleri, which is mostly found in fresh waters such as lakes and rivers, is transmitted only through the nose and is not passed from person to person.

Amoebae entering the olfactory canal pass through the nasal mucosa and settle in the cerebrospinal fluid and brain via the olfactory nerve. They cause meningitis, which is a sudden fatal disease called Primary Amoebic Meningoencephalitis (PAM).

What Are the Symptoms of Brain-Eating Amoeba?

As the name suggests, the disease caused by this type of amoeba is mainly the inflammation of the brain tissue called meningoencephalitis and the membrane surrounding the brain. It usually starts with severe headache, fever, nausea and vomiting within 10 days of ingestion. In the following days, neck stiffness typically develops, seizures, and consciousness are impaired. The delusions we call hallucinations begin. Loss of interest in one's surroundings. Loss of balance develops. It deteriorates rapidly, with coma and death within about 5 days.

Is there a cure?

There is no known cure for this disease. It is 97% fatal. There are two survivors after a new drug called Miltefosine was tried. However, it is very difficult to cope with the excessive brain edema that occurs in this disease.

Elden Ring - Shadow of the Erdtree DLC Announced

 

Elden Ring, which has surpassed 20 million sales worldwide in the past weeks, has turned into a great success story for developer studio FromSoftware. Legendary game director Hidetaka Miyazaki and Game of Thrones writer George R.R. The soulslike RPG, brought to life in partnership with Martin, impressed both critics and players.

FromSoftware introduced the first expansion pack for its first-year game. Elden Ring DLC ​​named Shadow of Erdtree was officially announced in the social media post. The tweet in question read, "Tarnished, let's stand up and walk together. Shadow of Erdtree, an upcoming expansion for Elden Ring, is currently in development. We hope you look forward to new adventures in Lands Between." statements were included.

When will Elden Ring DLC ​​be released?

No details have been announced about the new story yet, but it is possible to make some inferences from the promotional image. A man with long blond hair sits on a torrent-like mount. The character, which we're not sure about, but presumes to be Fia or Miquella, looks to a distant place in a countryside with spectral figures resembling tombstones.

Some players on social media think that the place in the image may be Haligtree. If that's really it, we're back in one of the wildest parts of The Lands Between. This could also be pointing to the Deathbed Companion, which takes place after Age of the Duskborn ends. Everything we say goes beyond speculation, as there are hardly any details about the DLC that is still in development.

Shadow of Erdtree in development

To predict a release date, we don't expect Elden Ring Shadow of Erdtree to arrive until at least November-December 2023. However, given the depth of the expansion, it wouldn't be surprising if the Elden Ring DLC ​​is out in the first months of 2024. We will likely see an expansion that follows in the footsteps of the story in the main game.

Lassa Fever

What is Lassa Fever?

Lassa fever is an acute viral disease of rodent origin. It is transmitted to humans through contact with food and objects contaminated with rodent urine or feces. The virus is called Lassa after the first case was encountered in Lassa, Nigeria. According to sources, the first case occurred in 1969. Although Lassa fever is known to be endemic in West African countries such as Ghana, Guinea, Mali, Benin, Liberia, Sierra Leone, Togo and Nigeria, it is also thought to exist in other West African countries.

Diagnosis of the disease is important for early treatment. According to the World Health Organization (WHO) data, 80% of people exposed to Lassa virus do not have any symptoms. In addition, the virus seriously affects various organs such as the liver, spleen and kidney in 1 out of every 5 infections.

Where and when was Lassa fever first seen?

Lassa virus was discovered in 1969 after the death of two nurses working in Lassa, Nigeria.

How Is Lassa Fever Transmitted?

Lassa fever is a disease transmitted from animals to humans. It is a rodent known as Mastomys natalensis that carries the Lassa virus. Their frequent reproduction and easy settlement in living areas affect the rate of spread of the virus. Lassa virus is transmitted to humans through respiration and food. In addition, consuming these animals also causes the transmission of the disease.
Person-to-person transmission of the disease is also possible. Especially in cases where the necessary hygiene is not provided in health care equipment, the risk of transmission is high.

How Long Is the Incubation Period of Lassa Fever?

The incubation period of the disease varies between 6-21 days.

What Are the Symptoms of Lassa Fever?

Lassa virus usually presents with mild symptoms such as fever and headache. However, some people also experience significant symptoms such as bleeding and difficulty breathing. If we list the symptoms of the disease as follows:

• slight fever
• Weakness
• Headache

Lassa fever produces more severe symptoms in about 20% of cases.

• Bleeding in places such as the gums, eyes, or nose
• difficulty breathing
• severe vomiting
• facial swelling
• Pain in the chest, back and abdomen

How Is Lassa Fever Diagnosed?

In the early stage of Lassa fever, the disease is diagnosed with a swab taken from the person. Blood test also has an important place in the diagnosis of the disease.

How Is Lassa Fever Treated? Is There a Vaccine for Lassa Fever?

An antiviral drug is given for treatment. There is no vaccine yet for the treatment of Lassa fever.

Who is at Risk for Lassa Fever?

Visitors to countries in West Africa have a higher incidence of the disease than people living in countries outside the continent. If you are going to these countries, you can reduce the risk of transmission by following the safety precautions below. 

•  Storing food in rodent-proof containers
•  Paying attention to the cleanliness of the accommodation 
•  Avoiding contact with rodents

Nonalcoholic fatty liver disease (NAFLD)

 

It is a disease caused by the accumulation of more than normal fat in the liver, in this disease the cause of excessive fat accumulation in the liver is not alcohol.


One of the variants of non-alcoholic fatty liver disease is NASH. NASH siroza ilerleyebilen bir hastalık olduğundan çok daha önemlidir.

What is NASH?

More than normal fat accumulation in the liver can be seen alone or together with inflammation (inflammation). If fatty liver is accompanied by inflammation, this disease is called NASH. NASH is actually the severe type of fatty liver disease. The name NASH is given by using the initials of the words Non-Alcoholic SteatoHepatitis. 'Steato' means fat, and 'hepatitis' means inflammation of the liver. In NASH disease, fat in your liver and hepatitis are associated with liver cell damage, which can lead to the formation of scar tissue in the liver, which we call fibrosis, over time. In NASH disease, cirrhosis occurs when this scar increases in parallel with the damage over the years. NASH is therefore a disease that can lead to cirrhosis and liver cancer.

What are the symptoms of fatty liver disease?

Fatty liver disease or NASH usually causes no symptoms. Rarely, it may cause weakness, feeling unwell, restlessness, fullness or mild pain in the upper right part of the abdomen. The cause of the pain here is the enlargement of the liver with excessive accumulation of fat in the liver, stretching the liver capsule. Symptoms usually appear years after cirrhosis develops, so NASH is considered an insidious disease. In advanced stages of cirrhosis, symptoms such as swelling, enlargement of the spleen, yellowing of the eyes, redness of the palms, shedding of chest hair in men and breast enlargement can be seen due to fluid accumulation in the abdomen.

Is fatty liver disease a serious disease?

Since fatty liver disease is a disease that can lead to cirrhosis, it is a disease that should definitely be taken seriously. Fortunately, we know that at least 80% of those with fatty liver do not develop any serious health problems. However, in 10-20% of cases, non-alcoholic steatohepatitis (NASH), a severe form of the disease, which occurs with inflammation of liver cells, may develop. NASH is more likely to occur in patients with fatty liver detected on ultrasound and elevated liver tests. NASH can lead to potentially fatal diseases such as irreversible liver damage, cirrhosis and even liver cancer. In the past, we could not find the cause of cirrhosis in a significant number of patients who were diagnosed with cirrhosis. Today, it has been understood that the most important cause of cirrhosis in these patients is fatty liver disease. If NASH has caused cirrhosis and cirrhosis has progressed to liver failure, a liver transplant may be needed to survive.