Objective: Even though the internet is a valuable resource for medical information, it has the potential to increase anxiety, fear or obsessive-compulsive behaviours, particularly among individuals more prone to health related anxiety. Researchers have found that health anxiety, hypochondria, and online health searches are associated with increased anxious symptomatology. The aim of this study is to investigate the psychometric properties of the Turkish version of the Cyberchondria Severity Scale, a measure of online health anxiety. Method: Three hundred thirty-seven university students with an age range of 16-55 were included in the study. The Cyberchondria Severity Scale (CSS), Internet Addiction Test (IAT), Anxiety Sensitivity Inventory-3 (ASI-3), and Health Anxiety Inventory (HAI) were administered to participants. Results: Confirmatory factor analysis revealed that five-factor solution best fit to the data. The overall and subscales of the CSS had excellent internal consistency (Cronbach α = 0.91, for the overall measure, and Cronbach α values ranged from 0.78 to 0.87), with an exception of 'mistruct of medical professional' subscale (Cronbach α = 0.64). The total and subscales of the CSS had generally good convergent validity. Conclusion: The CSS is a newly developed screening tool to assess online health anxiety, and present study demonstrated that the Turkish version of the scale had promising psychometric properties.

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ÖzGündüz aşırı uykululuğu en sık görülen uyku ile ilişkili belirti olup, toplum içindeki tahmini yaygınlı-ğı %18'e kadar çıkabilmektedir. Gündüz aşırı uykululuğu olan kişiler yaşamı tehdit eden yol veya iş kazaları, sosyal uyumsuzluk, akademik veya mesleki performansta düşme yaşayabilir ve daha düşük sağlık standartlarına sahip olabilirler. Bu yüzden gündüz aşırı uykululuk incelenmesi, tanısı ve tedavisi öncelikle yapılması gereken önemli bir durumdur. Çoğu tıbbi durumda olduğu gibi, gündüz aşırı uykululuğunun değerlendirilmesi titiz bir öyküyle başlar ve bunun için çeşitli öznel ve nesnel araçlar da geliştirilmiştir. Gündüz aşırı uykululuğunun en sık sebepleri uyku hijyenine uymama, kronik uyku yoksunluğu, ilaçlar, fiziksel ve psikiyatrik durumlar ve obstruktif uyku apnesi ve narkolepsi gibi uyku bozukluklarıdır. Tedavi seçenekleri iyi uyku hijyeni sağlayarak uyku miktarı ve kalitesini artırmayı amaçlamalıdır.Anahtar sözcükler: Gündüz aşırı uykululuk, narkolepsi, sirkadiyen ritm uyku bozuklukları. AbstractExcessive daytime sleepiness is one of the most common sleep-related patient symptoms, with prevalence in the community estimated to be as high as 18%. Patients with excessive daytime sleepiness may exhibit life threatening road and work accidents, social maladjustment, decreased academic and occupational performance and have poorer health than comparable adults. Thus, excessive daytime sleepiness is a serious condition that requires investigation, diagnosis and treatment primarily. As with most medical condition, evaluation of excessive daytime sleepiness begins a precise history and various objective and subjective tools have been also developed to assess excessive daytime sleepiness. The most common causes of excessive daytime sleepiness are insufficient sleep hygiene, chronic sleep deprivation, medical and psychiatric conditions and sleep disorders, such as obstructive sleep apnea, medications, and narcolepsy. Treatment option should address underlying contributors and promote sleep quantity by ensuring good sleep hygiene.

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Introduction:Valproate (VPA) is widely used for acute and maintenance therapy of bipolar disease and it is the most prescribed drug for epilepsy treatment worldwide. VPA-induced hyperammonemia is a serious and unusual advers effect of VPA treatment.Objectives:We aimed to describe the 20 year-old-woman bipolar case of VPA induced hyperammonemic encephalopaty with therapeutic VPA levels and normal liver functions.Methods:The case will be discussed.Results:The patient complained of confusion, disorientation, somnolance, agitation and slurred speech at the end of the first week of VPA treatment. VPA blood level was 116.5 μg/mL (N:50-125) and ammonia level was 237 μmol/L (N:10-50). Other laboratory tests including serum transaminases (both ALT and AST) and coagulation profile (PT, PTT and INR) were normal. After discontinuation of VPA treatment and hydration, these symptoms have disappeared dramatically. After 24 hours, blood ammonia level was 80 μmol/L and patient returned the baseline mental status.Conclusions:Hyperammonemia occurs due to inhibition of mitochondrial enzymes in the urea cycle by valproic acid. Hyperammonemia and encephalopathy can develop even at therapeutic concentrations without elevated liver function enzymes. Clinicians should be aware that VPA- induced hyperammonemia and encephalopathy is still one of the most feared side effects of VPA which may require emergent management.