Background: We report the case of sulfonylurea induced hypoglycemia manifesting as acute encephalopathy with focal neurological signs misdiagnosed as posterior circulation acute ischemic stroke (AIS) and discuss the potential effects of hypoglycemia on central nervous system, as well as its differentiation from AIS. Case presentation: A 64-year-old patient with type II diabetes treated with glimepiride was transferred to the Department of Neurology after the procedure of radical prostatectomy. On admission, the patient was unconscious with four limb paresis and bilateral Babinski sign. Non-contrast head CT and CT angiography vessels did not reveal any abnormalities. Due to exceeded therapeutic window the patient was disqualified from intravenous thrombolysis. At the admission hypoglycemia was observed and promptly corrected with the 5% dextrose infusion. For the next 72 hours repeated intravenous glucose infusions were needed to maintain its levels above 70 mg/dl. Based on the absence of ischemic changes on MRI and repeated decreases in glucose level for the next 3 days, glimepiride induced hypoglycemic encephalopathy was diagnosed. Within 24 hours of admission the patient regained consciousness and eventually presented four-limb paresis as a result of prolonged neuroglycopenia. Conclusions: Prolonged insufficient brain nutrition can result in permanent or long-lasting brain damage, manifesting as impaired consciousness and focal neurological signs. Perioperative sulfonylureas intake may result in prolonged hypoglycemia.

Background and objectives: Psoriasis can lead to feelings of stigmatization, hinder social functioning, and impair quality of life. Psoriasis can also affect sexual activity, but there is still little research on this topic. The present study investigated whether and to what extent psoriasis, its severity, location and extent of skin lesions affect sexual dysfunction. Materials and Methods: A total of 45 women and 64 men aged 18 to 73 years hospitalized for psoriasis exacerbations were included in the study. Psoriasis severity, as assessed by the Psoriasis Area and Severity Index (PASI), ranged from 0.2 to 65 points (mean: 17.0 ± 14.9 points). After collecting demographic and clinical data, each subject was asked to complete the Dermatology Life Quality Index, the 11-item Sexual Life Questionnaire and the International Index of Erectile Function (only men). Results: Our study found that more than 90% of the patients surveyed felt at least a slight unattractiveness due to psoriasis. In approximately 80% of the subjects, the skin lesions at least occasionally affected their sex life, and more than 50% at least sometimes avoided sexual contact. The location of psoriasis, particularly in the genital area (p = 0.01), on the face (p = 0.03) and hands (p = 0.05), also had a significant impact on the level of sexual problems. Psoriasis has a significant impact on the quality of life (QoL), and a deterioration in QoL was strongly correlated with sexual dysfunction (r = 0.6, p < 0.001), PASI scores (r = 0.36, p < 0.001), self-assessment of psoriasis severity and location of psoriatic lesions. Conclusions: Psoriasis leads to various limitations, especially in the sphere of sexual life. Patients with psoriasis feel stigmatized, have lowered self-esteem and consequently experience significant sexual problems. Awareness of the co-occurring psychological aspect of psoriasis and the routine use of validated scales in dermatology practice should contribute to the rapid identification of patients with sexual dysfunction.

Hypoglycemia is a dangerous adverse effect of some blood glucose-lowering agents like insulin and sulfonylureas. Sympathetic nervous symptoms and impaired consciousness are common in hypoglycemia, while paresis is rare and creates diagnostic difficulties. So far, only about 10 cases of paresis caused by sulfonylureas were described (including only one with persistent neurological deficits). We describe the case of the man with sulfonylurea induced hypoglycemia manifesting as acute encephalopathy with focal neurological signs misdiagnosed as posterior circulation acute ischemic stroke (AIS). Case presentation:A 64-year-old patient treated with glimepiride (2 BID) for type II diabetes mellitus, after radical prostatectomy for prostate cancer, was admitted to Stroke Unit in Rzeszow Regional Hospital No.2, Poland. Upon admission, the patient was unconscious, with upward gaze deviation, tetraparesis, extensor response to pain, bilateral positive Babinski's sign. Non-contrast head CT and CT-angiography did not reveal any abnormalities. Low serum glucose level (46 mg/dl) was noted and corrected with intravenous glucose infusion (80 mg/dl). Based on acute onset of focal neurological signs the initial diagnosis of AIS was made. Due to exceeding of treatment window, no reperfusion therapy was performed. In further serum glucose measurements hypoglycemia was noted. For the next 72 hours repeated intravenous glucose infusions were needed to maintain blood glucose levels above 70 mg/dl. Head MRI performed on the 3rd and 7th day did not reveal ischemic changes. Hypoglycemic encephalopathy due to glimepiride poisoning was diagnosed. Conclusion:Preoperatively taken sulfonylureas resulted in prolonged hypoglycemia misdiagnosed as AIS. Prolonged insufficient brain nutrition can result in permanent brain damage and cause impaired consciousness and focal neurological signs.

Covid-19 can manifest with serious neurological complications and hypercoagulability. Latest data from China showed neurological complications in 36% of 214 COVID-19 patients- mainly ischemic stroke. Coagulopathy associated with Covid-19 was reported to increase the risk of stroke also in young adults without comorbidities. A 29-year-old patient with hypertension admitted to the hospital with dysarthric speech and balance disorders and dizziness with vomiting was referred for thrombectomy of an occluded basilar artery after ineffective RTPA therapy. After the thrombectomy, a gradual reduction in the neurological deficit was observed-the permeability of the basilar artery was restored. However, during the intervention, the posterior right cerebral artery was damaged and a short-term extravasation of the contrast blood to the subarachnoid space occurred. MRI showed minor multifocal ischemic changes in the area of the cerebellum, pons and cerebral peduncle. In the pre-hospital interview a week earlier, transient changes in smell and taste were noted. On the day of admission, the patient had a negative antigen and PCR tests for SARS-CoV-2- virus. Laboratory tests showed high D-Dimers (5696 H ng /ml) and reduced fibrinogen. After mechanical thrombectomy, the patient reported double vision when looking straight and left. He was correctly oriented with slight ataxia and a deficit of strength in the left limbs, meningeal symptoms were negative. It is important to understand the association between Covid 19 and the possibility of an ischemic stroke and coagulation changes in order to choose appropriate stroke treatment methods.

The COVID-19 pandemic has had a significant impact on global mental health, affecting individuals of all age groups and various demographic backgrounds including athletes. Anxiety disorders have become more prevalent during the pandemic, attributed to factors such as quarantine, social isolation, fear of the virus, job insecurity, and the psychological impact of a pandemic. This narrative review aims to summarize the existing literature addressing mental health issues related to the COVID-19 pandemic, as well as the associated risk factors and potential interventions. Additionally, the review explores the impact of COVID-19 on specific populations, including athletes, frontline healthcare workers, children and adolescents, and individuals with pre-existing mental health conditions. In addition, the review explores the long-term consequences of the pandemic on mental health, including the potential for a surge in post-traumatic stress disorder (PTSD) and other trauma-related disorders. Overall, this review underscores the urgent need for comprehensive mental health support and resources in response to the COVID-19 pandemic.

Protective vaccinations are crucial for preventing infectious diseases and their complications, offering a high safety profile and minimal adverse effects. However, vaccine hesitancy has emerged as a public health concern, leading to outbreaks of communicable diseases. This study aims to investigate the attitudes towards vaccinations among doctors and nurses, as well as their knowledge level and vaccination frequency. The research employed a cross-sectional design and collected data using an anonymous questionnaire. The study was conducted in southern Poland, involving Primary Healthcare Centers and hospitals. A total of 878 paper surveys were collected among 542 doctors and 336 nurses.

Introduction: Inflammatory bowel diseases (IBD) are a global public health problem, and their incidence is continuously increasing. IBD is characterized by a relapsing nature and is associated with symptoms such as abdominal pain, diarrhoea, malabsorption, and nutritional deficiencies. Patients affected by this disease are typically young individuals, and physical activity plays a significant role in this age group. Understanding the role of exercise and sports activities in individuals with IBD can help consider potential therapeutic interventions for these patients. Objective: The aim of this study is to summarize the knowledge regarding the role of physical activity in patients with IBD. Materials and methods: A literature review was conducted using the PubMed and Google Scholar databases, using the following keywords: IBD, physical activity, stress and fatigue in individuals with IBD, anxiety in patients with IBD. State of knowledge: The role of physical activity in promoting health and preventing various diseases is well-established. However, there is limited research on the association between exercise and IBD. Conclusions: Physical activity, by reducing fatigue and stress, has a positive impact on the functioning of patients with IBD. There are reports suggesting a reduction in gastroenterological symptoms in patients after engaging in exercise. With appropriate control of the underlying disease using pharmacological and other recommended methods, participating in sports activities does not pose a barrier for patients. Physicians should encourage patients to engage in exercise with tailored intensity due to its beneficial effects on various aspects of life for individuals with IBD. Further research is necessary to explore this topic more extensively.