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Item Retinal Scan with Optical Coherence Tomography in Adult Attention Deficit Hyperactivity Disorder(2021) Tunel, Munevver; Sahinoglu Keskek, NedimeObjective: In this study, the retinal nerve fiber layer (RNFL) thicknesses were compared between adult attention deficit hyperactivity disorder (ADHD) cases and healthy controls. Method: The study included adults diagnosed with ADHD based on the DSM-5 criteria and age and gender matched healthy controls. Spectral area optical coherence tomography (OCT) was performed on the 52 eyes of 26 participants with ADHD and the 52 eyes of the 26 healthy control individuals. Results: Comparing the data on the 52 eyes of 26 ADHD participants and the 52 eyes of 26 healthy control participants indicated that the central macular thickness (CMT) and the RNFL thicknesses, the ganglion cell complex (GCC), the mean inner macular ring (MIRAVG) and the mean outer macular ring (MOR-AVG) thicknesses were significantly lower in the ADHD group. Conclusion: This is the first study in the literature on the RNFL thickness in adult ADHD patients. Our findings demonstrated that RNFL thickness is lower in ADHD cases as the unmyelinated axons are reduced in ADHD. Hence, the quantitative and reproducible nature of Spectral Domain-OCT thickness measurements can be used as biomarkers to monitor disease progression in ADHD cases.Item The relationship between serum ferritine levels and subtypes and the severity of symptoms on non-anemic adult ADHD(2020) Tunel, Munevver; 0000-0001-7140-1803; AAD-8660-2021Objective: To compare serum ferritin levels in non anemic adult patients who were diagnosed as attention deficit hyperactivity disorder (ADHD) with a matched healthy control group, and to evaluate the relationship between serum ferritin levels and the severity of ADHD symptoms and ADHD subtypes. Methods: A prospective study was performed on 91 adult non-anemic and cognitively normal ADHD patients (according to the DSM-5 criteria) and 51 healthy controls. They were divided into three subgroups according to the clinical interview and the results of the scale; Group 1, 31 patients with compound type; Group 2, 30 patients with attention deficit subtype; Group 3, 30 patients with impulsivity-hyperactivity subtype. Wender-Utah Rating Scale and Adult Attention Deficit Hyperactivity Assessment Scale were used. Serum ferritin levels were determined. Results: The ferritin levels of the patient groups were found to be significantly lower than the control group. Mean ferritin level was 23 ng/ml in ADHD compound type, 37 ng/ml in attention deficit subtype, 46 ng/ml in hyperactivity and impulsivity subtype, and 65 ng/ml in the control group. Ferritin level was not different between Group 1, Group 2, and Group 3 while the ferritin level of the patients in Group 4 (control group) was significantly higher than the other groups. Conclusion: Our findings revealed the low ferritin levels in ADHD patients. Low ferritin levels without anemia may play a role in the pathophysiology of the disorder. Testing for the ferritin levels may be considered during the general evaluation of this disorder.Item Dialysis modality and sexual dysfunction in male patients(2020) Tekkarismaz, Nihan; Tunel, Munevver; Ozer, Cevahir; 0000-0001-7631-7395; 0000-0002-7850-6912; 0000-0001-7140-1803; 0000-0001-6037-7991; 32627887; AAD-9088-2021; AAM-2222-2020; AAD-8660-2021Sexual dysfunction is an under-recognised problem in due to very limited number of studies in the literature. This study aims to evaluate the sexual dysfunction related effects of dialysis modality among male patients with chronic renal failure. All patients were asked to complete 2 questionnaires: Hospital Anxiety Depression Scale [HADS] and International Index of Erectile Function [IIEF-5]. A total of 51 patients who completed the questionnaires were included in the study. 31 of them were under haemodialysis (HD) treatment, and 20 were under peritoneal dialysis (PD) treatment. After adjustment for age and HADS score, there was no statistically significant difference between HD and PD groups in terms of the mean IIEF scores (55 vs. 40,p = .058), and the frequency of sexual dysfunction (12.9% vs. 30%,p = .163). Age (r = -0.553), blood pressure (r = -0.299/ -0.374), use of iron (r = -0.333), lipid levels (r = -0.281/ -0.276) and HADS-D score (r = -0.276) inversely associated with IIEF score (p < .05). To conclude, sexual dysfunction is more common in patients who receive PD therapy than those who receive HD therapy. Older age, higher blood pressure, iron treatment, higher lipid levels and the presence of depression were associated with higher prevalance of sexual dysfunction.Item A Case of Simultaneous Mania and Idiopathic Normal Pressure Hydrocephalus: Etiology or Comorbidity?(2019) Tunel, Munevver; Cakmak, Soner; Tamam, Lut; Demir, Turgay; 32594492Normal pressure hydrocephalus (NPH), typically associated with the triad of gait disturbance, dementia and urinary incontinence, rarely presents with symptoms of mania, depression or psychosis and psychiatric disorders may complicate the diagnosis. Few cases of NPH and psychiatric disease comorbidity have been reported so far. In most of these cases, NPH was associated with depression and psychotic symptoms. Mania symptoms were also reported in a few cases those of which were associated with a history of bipolar disorder (BPD) or subthreshold BPD symptoms. In this paper, we present a case of late-onset mania symptoms simultaneously presenting with NPH in a healthy individual without a history of psychiatric disorder.