The use of macronutrient and micronutrient foods is associated with the duration of sleep. This study aimed to determine the effect of zinc supplements on the sleep quality of older adults. The current parallel randomized clinical trial study was performed using a convenience sampling method. One hundred and fifty older adults who met the inclusion criteria were assigned to intervention and control group. The participants in the intervention group received a daily dose of 30 mg zinc supplementation pill for 70 days and the control group did not receive any supplement. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Serum zinc level in both groups was measured through the auto-analysis method. The questionnaire was completed and the serum level of zinc was measured twice, before the intervention and 70 days after the intervention. Both groups were homogeneous in terms of demographic variables, sleep quality, and serum zinc level before the intervention. Of all, 73.3% of older adults in the intervention group and 74.7% of older adults in the control group had poor sleep quality. Sleep quality in the intervention group, as compared with the control group, significantly improved after the intervention. Furthermore, serum zinc levels in older adults in the intervention group, as compared with the control group, significantly increased after the intervention. Based on the results of this study, it is recommended to utilize zinc supplementation as a new therapeutic approach for improving sleep quality in older adults.

Parkinson's disease (PD) is a chronic, neurodegenerative disorder that in certain stages can present a series of acute symptoms and signs, the development of which lasts several hours or days. Emergencies in PD can be a direct consequence of the pathophysiology of the disease or a secondary consequence of the administration of antiparkinsonian drugs. Urgent conditions in PD can also occur due to falls, infectious diseases, after deep brain stimulation or surgical treatment of other accompanying diseases.This article describes the following emergency conditions: parkinsonism-hyperpyrexia syndrome, dyskinesia hyperpyrexia syndrome, occurrence of acute psychosis and delirium during PD. Morbidity and mortality in these disorders are a consequence of the inability to make a timely diagnosis and provide appropriate therapeutic treatment. Timely diagnosis and treatment are very important for reducing the mortality and morbidity rates.

Wernicke encephalopathy is a rare acute/subacute neurological disorder, commonly caused by prolonged thiamine deficiency in patients who chronically consume alcohol. According to the Caine classification criteria, the clinical diagnosis of this encephalopathy involves at least two of the following four signs: nutritional deficiency, oculomotor dysfunction, ataxia, and changes in the mental status. This case report highlights rare clinical signs in the late stage of the disease, as well as the consequences of possible local hypoperfusion of the brainstem in the form of an ischemic vascular event. A 39-year-old female patient (previously treated at a regional general hospital) was admitted to the Department of Emergency Neurology at the University Clinical Center of Vojvodina with a history of a series of epileptic seizures, altered consciousness, oculomotor signs, opisthotonus, and cognitive dysfunction, following years of alcohol consumption and nutritional deficiency. The diagnosis was confirmed by typical neuroimaging findings and specific laboratory tests. Hypertonia with subsequent opisthotonus was one of the clinical manifestations in our patient, while the occurrence of an ischemic stroke was an unexpected event. Empirical administration of high-dose thiamine, along with additional supportive intensive therapy, did not yield satisfactory outcomes. Wernicke encephalopathy represents a clinical diagnosis based on physical and neurological examination, with neuroimaging. Early recognition of both common and unusual symptoms, particularly in the late stage of the disease, could potentially reduce morbidity and mortality. It is essential to administer thiamine before glucose infusion to all patients with an undetermined cause of altered consciousness.