Pub Date : 2023-08-23DOI: 10.36347/sasjm.2023.v09i08.013
B. S. Emir, S. Yıldız, Şeyma Sehlikoğlu, Erkan Çakmak, N. Gözel
Although not completely understood, fibromyalgia is characterized by intense physical complaints with psychiatric factors involved in its etiopathogenesis. The present study aimed to investigate alexithymia, type D personality, and childhood traumas that might accompany fibromyalgia in those patients. The study enrolled 44 healthy controls and 44 patients with fibromyalgia. Sociodemographic and Clinical Data Form, Type D Personality Scale (DS-14), Toronto Alexithymia Scale (TAS), and Childhood Trauma Questionnaire (CTQ-28) were used for the purposes of collecting data from all the participants. The group including patients diagnosed with fibromyalgia had significantly higher type D personality traits compared to the control group (p=.015). Furthermore, there was a significant intergroup difference by the TAS scale (p<0.05). CTQ-28 total and emotional, physical neglect, and emotional abuse subscales were higher in the patient group compared to the control group (p<0.05). Upon intragroup comparison of DS-14 subscale and CTQ-28 subscale scores in the patient group, patients with negative affection were significantly more emotionally neglected (p=.009). There was a moderate positive correlation between the CTQ-28 total scores and the TTS total score of patients with fibromyalgia (r=.54, p=.01). Individuals with fibromyalgia have a history of childhood trauma, difficulty in expressing their emotions, and distressed personality structures. Psychological assessment and psychosocial support therapies would prove to be beneficial in the treatment of fibromyalgia, a psychosomatic disease.
{"title":"An Investigation of Alexithymia, Type D Personality Traits, and Childhood Traumas in Patients with Fibromyalgia","authors":"B. S. Emir, S. Yıldız, Şeyma Sehlikoğlu, Erkan Çakmak, N. Gözel","doi":"10.36347/sasjm.2023.v09i08.013","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i08.013","url":null,"abstract":"Although not completely understood, fibromyalgia is characterized by intense physical complaints with psychiatric factors involved in its etiopathogenesis. The present study aimed to investigate alexithymia, type D personality, and childhood traumas that might accompany fibromyalgia in those patients. The study enrolled 44 healthy controls and 44 patients with fibromyalgia. Sociodemographic and Clinical Data Form, Type D Personality Scale (DS-14), Toronto Alexithymia Scale (TAS), and Childhood Trauma Questionnaire (CTQ-28) were used for the purposes of collecting data from all the participants. The group including patients diagnosed with fibromyalgia had significantly higher type D personality traits compared to the control group (p=.015). Furthermore, there was a significant intergroup difference by the TAS scale (p<0.05). CTQ-28 total and emotional, physical neglect, and emotional abuse subscales were higher in the patient group compared to the control group (p<0.05). Upon intragroup comparison of DS-14 subscale and CTQ-28 subscale scores in the patient group, patients with negative affection were significantly more emotionally neglected (p=.009). There was a moderate positive correlation between the CTQ-28 total scores and the TTS total score of patients with fibromyalgia (r=.54, p=.01). Individuals with fibromyalgia have a history of childhood trauma, difficulty in expressing their emotions, and distressed personality structures. Psychological assessment and psychosocial support therapies would prove to be beneficial in the treatment of fibromyalgia, a psychosomatic disease.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"256 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123103012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-19DOI: 10.36347/sasjm.2023.v09i08.012
P. Sy, Traoré Djénébou, B. Berthé, Togo Mamadou, Diarra Aoua, Sékou Landouré, Keïta Kaly, Traoré Abdramane, Tolo Nagou, Camara Boua Daoud, S. Mahamadou, D. Karim, Koné Nouhoum, S. Seydou, Goïta Issa Souleymane, S. A, Sandji Ouma, Traoré Abdel Kader, So Kaya
Introduction: Over the age of 40, kidney function decreases with age, with a decrease in glomerular filtration (DFG) flow in the range of 0.5 to 1 ml/mn per year. Purpose: To study the épidémio-clinical and paraclinical profile of the kidney function of the elderly. Methods and Material: Cross-sectional study with prospective collection and retrospective data on the files of subjects aged 65 or over from 01 January 2017 to 30 May 2018. Results: Forty-four (44) files met the inclusion criteria out of 196, representing a hospital frequency of 21%. The sex ratio was 2.4. Medical history was represented by HTA (56.1%), diabetes 14.6%. The reasons for admission were: abdominal pain (22%), disorders of consciousness (22%) and edema syndrome (10%). Creatininemia was high (75.6%). The association hypocalcemia and hyperphosphatemia in 12.5%. Anemia was normocytic normocyticnormochrome (53%). On ultrasound a good differentiation of renal cortico-medullary (80.5%), kidneys of normal size (87.8%) and urinary tract dilation (4.9%). Kidney failure was acute (80.5%) chronic (19.5%). Dehydration accounted for 41% of the causes, followed by hypertensive kidney disease (9.75%). Conclusion: Kidney function changes with age. Cardiovascular risk factors should be prevented early and corrected as best they can be to prevent them from acting later.
{"title":"Assessment of Renal Function in the Elderly","authors":"P. Sy, Traoré Djénébou, B. Berthé, Togo Mamadou, Diarra Aoua, Sékou Landouré, Keïta Kaly, Traoré Abdramane, Tolo Nagou, Camara Boua Daoud, S. Mahamadou, D. Karim, Koné Nouhoum, S. Seydou, Goïta Issa Souleymane, S. A, Sandji Ouma, Traoré Abdel Kader, So Kaya","doi":"10.36347/sasjm.2023.v09i08.012","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i08.012","url":null,"abstract":"Introduction: Over the age of 40, kidney function decreases with age, with a decrease in glomerular filtration (DFG) flow in the range of 0.5 to 1 ml/mn per year. Purpose: To study the épidémio-clinical and paraclinical profile of the kidney function of the elderly. Methods and Material: Cross-sectional study with prospective collection and retrospective data on the files of subjects aged 65 or over from 01 January 2017 to 30 May 2018. Results: Forty-four (44) files met the inclusion criteria out of 196, representing a hospital frequency of 21%. The sex ratio was 2.4. Medical history was represented by HTA (56.1%), diabetes 14.6%. The reasons for admission were: abdominal pain (22%), disorders of consciousness (22%) and edema syndrome (10%). Creatininemia was high (75.6%). The association hypocalcemia and hyperphosphatemia in 12.5%. Anemia was normocytic normocyticnormochrome (53%). On ultrasound a good differentiation of renal cortico-medullary (80.5%), kidneys of normal size (87.8%) and urinary tract dilation (4.9%). Kidney failure was acute (80.5%) chronic (19.5%). Dehydration accounted for 41% of the causes, followed by hypertensive kidney disease (9.75%). Conclusion: Kidney function changes with age. Cardiovascular risk factors should be prevented early and corrected as best they can be to prevent them from acting later.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129338203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-18DOI: 10.36347/sasjm.2023.v09i08.011
H. Hammod
Objectives: The aim of this article were to review usefulness of early clinical detection of UTI without lab tests as diagnostic tool for UTI in primary care and to describe when to start antibiotic treatment for management of UTI according to international guidelines. The emphasis of this review is uncomplicated UTI. Methods: A search was conducted on PubMed and official webpages of major urological, infectious diseases and general practice organisations to identify peer reviewed original articles and reviews, using the search terms ‘UTI’. I considered only papers written in English, with emphasis on more recent articles published up to July 2023. Results: There is a variation in recommendations between guidelines can be a source of confusion and controversy for clinicians in primary care. However, early detection and treatment, education of patients and removal of risk factors may reduce the number of symptomatic episodes, antibiotics usage and antimicrobial resistance in primary care. Conclusion: The diagnosis of acute uncomplicated cystitis in healthy women can be made with reasonable certainty by evaluation of symptoms and signs without a doctor’s visit or urine tests. Individualised assessment of risk factors and previous clinical history is needed to choose the most suitable antimicrobial treatment. Immediate antimicrobial therapy with Trimethoprim-sulfamethoxazole (160/800 mg twice daily for 3 days), Nitrofurantoin (100 mg twice daily for 5-7 days), or Fosfomycin (3g in a single dose) is indicated for acute cystitis in adult women. However, local guidelines advice that immediate antibiotic treatment was not considered necessary for women with uncomplicated lower UTI. Antimicrobial resistance have complicated treatment of UTI worldwide.
{"title":"UTI in Primary Care: Are we Prescribing Too Much?","authors":"H. Hammod","doi":"10.36347/sasjm.2023.v09i08.011","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i08.011","url":null,"abstract":"Objectives: The aim of this article were to review usefulness of early clinical detection of UTI without lab tests as diagnostic tool for UTI in primary care and to describe when to start antibiotic treatment for management of UTI according to international guidelines. The emphasis of this review is uncomplicated UTI. Methods: A search was conducted on PubMed and official webpages of major urological, infectious diseases and general practice organisations to identify peer reviewed original articles and reviews, using the search terms ‘UTI’. I considered only papers written in English, with emphasis on more recent articles published up to July 2023. Results: There is a variation in recommendations between guidelines can be a source of confusion and controversy for clinicians in primary care. However, early detection and treatment, education of patients and removal of risk factors may reduce the number of symptomatic episodes, antibiotics usage and antimicrobial resistance in primary care. Conclusion: The diagnosis of acute uncomplicated cystitis in healthy women can be made with reasonable certainty by evaluation of symptoms and signs without a doctor’s visit or urine tests. Individualised assessment of risk factors and previous clinical history is needed to choose the most suitable antimicrobial treatment. Immediate antimicrobial therapy with Trimethoprim-sulfamethoxazole (160/800 mg twice daily for 3 days), Nitrofurantoin (100 mg twice daily for 5-7 days), or Fosfomycin (3g in a single dose) is indicated for acute cystitis in adult women. However, local guidelines advice that immediate antibiotic treatment was not considered necessary for women with uncomplicated lower UTI. Antimicrobial resistance have complicated treatment of UTI worldwide.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116134606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-17DOI: 10.36347/sasjm.2023.v09i08.010
S. Mayura, Prachi Gaddam, S. Cherian, U. Chaturvedi, R. Naidu
Objectives: This study was undertaken to categorize various cytomorphological patterns of tuberculous lymphadenitis and with utility of Xpert MTB/RIF as an adjunct to cytology. Materials and methods: Cases based on various cytomorphological features were categorized into 3 patterns as 1. Granulomatous lymphadenitis (GL), 2. Necrotizing granulomatous lymphadenitis (NGL) 3. Necrotizing lymphadenitis (NL). The utility of microbiological test on cytosmears and histopathological examination were assessed in these categories wherever available. Results: Overall cytology had 86% sensitivity, 94% specificity, 92% positive and negative predictive value for diagnosis of tuberculosis. All these categories were correlated with microbiological test and gene Xpert wherever available. NGL had higher positive predictive value indicating that this group when subjected to microbiological methods provide definite diagnosis of tuberculosis. GL had higher specificity; hence negative microbiological test should be subjected to histopathological examination to rule out other causes of granulomatous lymphadenitis. GeneXpert when combined with cytologically suspicious smears, has high sensitivity of 85% and the agreement with culture is moderate as indicated by the kappa value of 0.4%. Conclusion: A synchronous analysis of cytomorphological features and GeneXpert and other microbiological test increases the diagnostic yield of Tuberculosis. Excisional biopsy for diagnosis of tuberculosis should be recommended only for patients in whom Fine Needle Aspiration Cytology PCR is negative or there is discrepancy with the clinical impression.
{"title":"Tuberculous Lymphadenitis: Analysis of Cytomorphological Features with Utility of Genexpert MTB/RIF and Other Microbiological Test as an Adjunct to Cytology","authors":"S. Mayura, Prachi Gaddam, S. Cherian, U. Chaturvedi, R. Naidu","doi":"10.36347/sasjm.2023.v09i08.010","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i08.010","url":null,"abstract":"Objectives: This study was undertaken to categorize various cytomorphological patterns of tuberculous lymphadenitis and with utility of Xpert MTB/RIF as an adjunct to cytology. Materials and methods: Cases based on various cytomorphological features were categorized into 3 patterns as 1. Granulomatous lymphadenitis (GL), 2. Necrotizing granulomatous lymphadenitis (NGL) 3. Necrotizing lymphadenitis (NL). The utility of microbiological test on cytosmears and histopathological examination were assessed in these categories wherever available. Results: Overall cytology had 86% sensitivity, 94% specificity, 92% positive and negative predictive value for diagnosis of tuberculosis. All these categories were correlated with microbiological test and gene Xpert wherever available. NGL had higher positive predictive value indicating that this group when subjected to microbiological methods provide definite diagnosis of tuberculosis. GL had higher specificity; hence negative microbiological test should be subjected to histopathological examination to rule out other causes of granulomatous lymphadenitis. GeneXpert when combined with cytologically suspicious smears, has high sensitivity of 85% and the agreement with culture is moderate as indicated by the kappa value of 0.4%. Conclusion: A synchronous analysis of cytomorphological features and GeneXpert and other microbiological test increases the diagnostic yield of Tuberculosis. Excisional biopsy for diagnosis of tuberculosis should be recommended only for patients in whom Fine Needle Aspiration Cytology PCR is negative or there is discrepancy with the clinical impression.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"98 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133783439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-15DOI: 10.36347/sasjm.2023.v09i08.009
S. Benhammou, H. Zarof, M. Raissouni, H. Kisra
Depression in children and adolescents is a major mental health concern, being the leading cause of illness and disability in children over ten years old. It increases the risk of suicide, affects education, social interactions, and contributes to obesity, tobacco, and substance use. The aim of this study was to highlight the sociodemographic and clinical profile of depression in young individuals, identify risk factors, and discuss appropriate therapeutic options. We conducted a retrospective descriptive and analytical study, using a questionnaire completed jointly by children with characterized depressive disorder and their parents. The study included 79 participants. Statistical analysis was performed using Jamovi version 2.3.21.0 and Microsoft Excel 2021. We found a predominance of females, with an average age of 13.5 years. Antecedents of self-harm and family history of psychiatric disorders were risk factors for suicidal ideation. Common symptoms included sleep disturbances (89.9%), irritability (83.5%), and mood sadness (70.9%). Depression had a significant impact, with 88.6% experiencing social withdrawal and 81% showing decreased school engagement, reflecting the multidimensional effects of depression. Pharmacotherapy was used in 82.3% of cases. However, therapeutic adherence was only good in 60.4% of cases. In summary, this study provides crucial insights into the characteristics, risk factors, and treatments of depression in young individuals within a specific hospital setting. It reinforces knowledge while emphasizing the importance of early and personalized intervention to counteract negative consequences during this critical age.
{"title":"Evaluation of Characterized Depressive Disorder in Children and Adolescents: A Study of 79 Cases","authors":"S. Benhammou, H. Zarof, M. Raissouni, H. Kisra","doi":"10.36347/sasjm.2023.v09i08.009","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i08.009","url":null,"abstract":"Depression in children and adolescents is a major mental health concern, being the leading cause of illness and disability in children over ten years old. It increases the risk of suicide, affects education, social interactions, and contributes to obesity, tobacco, and substance use. The aim of this study was to highlight the sociodemographic and clinical profile of depression in young individuals, identify risk factors, and discuss appropriate therapeutic options. We conducted a retrospective descriptive and analytical study, using a questionnaire completed jointly by children with characterized depressive disorder and their parents. The study included 79 participants. Statistical analysis was performed using Jamovi version 2.3.21.0 and Microsoft Excel 2021. We found a predominance of females, with an average age of 13.5 years. Antecedents of self-harm and family history of psychiatric disorders were risk factors for suicidal ideation. Common symptoms included sleep disturbances (89.9%), irritability (83.5%), and mood sadness (70.9%). Depression had a significant impact, with 88.6% experiencing social withdrawal and 81% showing decreased school engagement, reflecting the multidimensional effects of depression. Pharmacotherapy was used in 82.3% of cases. However, therapeutic adherence was only good in 60.4% of cases. In summary, this study provides crucial insights into the characteristics, risk factors, and treatments of depression in young individuals within a specific hospital setting. It reinforces knowledge while emphasizing the importance of early and personalized intervention to counteract negative consequences during this critical age.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"73 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120864455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-11DOI: 10.36347/sasjm.2023.v09i08.008
M. Raissouni, H. Zarrof, H. Kisra
Sexual violence refers to any contact or interaction (visual, verbal, or psychological) where an adult uses a child or adolescent for sexual stimulation, either for their own satisfaction or that of a third party. It represents a fairly common, urgent, and challenging situation to diagnose, while avoiding any underestimation or overestimation. Hence, the relevance of our study, which aims to describe and analyze the psychological and social aspects of sexual abuse in minors under the age of 18 who were seen at the pediatric psychiatry department of Arrazi Hospital in Salé. The identified risk factors were as follows: an average age of 10 years, male gender, and a conflicted family dynamic. The only factor associated with the occurrence of post-traumatic stress disorder (PTSD) after sexual assault was having a stay-at-home mother. Furthermore, it was observed that the higher the age of the first sexual assault, the greater the risk of developing depressive disorders. Victims from families marked by domestic violence had a 25.5 times higher risk of developing this disorder after a sexual assault. Compared to victims with parents in a couple, those who were divorced had a higher number of comorbid PTSD diagnoses, while widowhood was associated with a decrease in the number of comorbid diagnoses. Lastly, it was found that justice intervention in response to sexual assault was associated with a higher number of comorbid psychiatric disorders with PTSD. To ensure the care of children who are victims of abuse and family violence, it is essential to involve professionals from various disciplines. A comprehensive and multidisciplinary evaluation must be conducted, taking into account medical, psychological, psychiatric, and social aspects. Thus, this information provides valuable foundations for developing strategies for the prevention and early detection of child abuse.
{"title":"Sexual Violence against Minors: A Study of 35 Cases","authors":"M. Raissouni, H. Zarrof, H. Kisra","doi":"10.36347/sasjm.2023.v09i08.008","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i08.008","url":null,"abstract":"Sexual violence refers to any contact or interaction (visual, verbal, or psychological) where an adult uses a child or adolescent for sexual stimulation, either for their own satisfaction or that of a third party. It represents a fairly common, urgent, and challenging situation to diagnose, while avoiding any underestimation or overestimation. Hence, the relevance of our study, which aims to describe and analyze the psychological and social aspects of sexual abuse in minors under the age of 18 who were seen at the pediatric psychiatry department of Arrazi Hospital in Salé. The identified risk factors were as follows: an average age of 10 years, male gender, and a conflicted family dynamic. The only factor associated with the occurrence of post-traumatic stress disorder (PTSD) after sexual assault was having a stay-at-home mother. Furthermore, it was observed that the higher the age of the first sexual assault, the greater the risk of developing depressive disorders. Victims from families marked by domestic violence had a 25.5 times higher risk of developing this disorder after a sexual assault. Compared to victims with parents in a couple, those who were divorced had a higher number of comorbid PTSD diagnoses, while widowhood was associated with a decrease in the number of comorbid diagnoses. Lastly, it was found that justice intervention in response to sexual assault was associated with a higher number of comorbid psychiatric disorders with PTSD. To ensure the care of children who are victims of abuse and family violence, it is essential to involve professionals from various disciplines. A comprehensive and multidisciplinary evaluation must be conducted, taking into account medical, psychological, psychiatric, and social aspects. Thus, this information provides valuable foundations for developing strategies for the prevention and early detection of child abuse.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129001882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-11DOI: 10.36347/sasjm.2023.v09i08.007
M. Raissouni, S. Benhammou, H. Kisra
In recent years, the prescription of antidepressants for children has come under serious scrutiny, as some studies have shown an increased risk of suicide among those treated in this way. The main aim of this study is to investigate the causal relationship between antidepressant use and suicidal behaviour in children and adolescents. We reviewed the literature on the Google Scholar, pubmed, science direct database. The data in the literature were contradictory; while it has now been demonstrated that SSRIs very moderately increase the risk of suicide ideation and attempts, with venlafaxine, paroxetine and sertraline in particular showing a higher risk than other SSRIs such as fluoxetine and citalopram, several studies show that their use is associated with a significant reduction in suicide rates in children and adolescents. There is currently no certainty of a causal relationship between antidepressants and suicidality in children and adolescents, so the mechanisms are still poorly understood.
{"title":"Association Between Antidepressant Use and the Risk of Suicide in Children and Adolescents","authors":"M. Raissouni, S. Benhammou, H. Kisra","doi":"10.36347/sasjm.2023.v09i08.007","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i08.007","url":null,"abstract":"In recent years, the prescription of antidepressants for children has come under serious scrutiny, as some studies have shown an increased risk of suicide among those treated in this way. The main aim of this study is to investigate the causal relationship between antidepressant use and suicidal behaviour in children and adolescents. We reviewed the literature on the Google Scholar, pubmed, science direct database. The data in the literature were contradictory; while it has now been demonstrated that SSRIs very moderately increase the risk of suicide ideation and attempts, with venlafaxine, paroxetine and sertraline in particular showing a higher risk than other SSRIs such as fluoxetine and citalopram, several studies show that their use is associated with a significant reduction in suicide rates in children and adolescents. There is currently no certainty of a causal relationship between antidepressants and suicidality in children and adolescents, so the mechanisms are still poorly understood.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116349866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-10DOI: 10.36347/sasjm.2023.v09i08.006
Rumana Afroz Majumder, Amanul Islam, Md. Abdul Mannan, A. Chowdhury
Background: HNSCC is the fifth most common cancer in the world and one of the most prevalent cancers in Bangladesh. Despite significant improvement in radiotherapy, the high incidence of loco-regional recurrences is a major challenge for radiation oncologists. This study was done to compare the response and toxicity of Docetaxel, Cisplatin, Leucovorin and 5- Fluorouracil (TPLF) vs Leucovorin, 5- Fluorouracil, and Cisplatin (LFP) as neoadjuvant chemotherapy followed by concurrent chemo-radiation with Cisplatin in the treatment of locally advanced head and neck cancer of squamous cell carcinoma. Materials and Methods: This study was carried out among 60 patients of locally advanced of head and neck cancer at Khwaja Yunus Ali Medical College & Hospital, Sirajganj from January 2015 to December 2015. In Arm-A, 30 patients received three cycles of neoadjuvant chemotherapy with Docetaxel 75 mg/m2 on D1, Cisplatin 75 mg/m2 on D1, Leukovorine 30 mg on D1-D3, 5-Flourouracil 750 mg/m2 on D1-D5 and in Arm B 30 patients received neoadjuvant chemotherapy with Cisplatin 75 mg/m 2 on D1, Leucovorine 30 mg on D1-D3, 5-Flourouracil 750mg/m 2 on D1-D5 3 cycles with three weeks interval followed by concurrent chemoradiotherapy with 66 Gy in 33 fractions and weekly Cisplatin 40 mg/m 2 started on the first day of radiation. Results: Most of the patients were male and middle-aged group. In Arm-A, 21 patients (70%) showed complete response whereas in Arm-B regimen complete response was noticed in 16 patients (53.3%) which was statistically significant; however, partial responses were significantly more found in Arm-B. Regarding toxicity, with Arm-A patients experienced slightly more toxicities in comparison to Arm-B which was statistically non-significant. Conclusion: So, it could be concluded from this study that the therapeutic gain was better obtained in Arm-A compared to Arm-B in patients with locally advanced head and neck cancer.
{"title":"Docetaxel, Cisplatin, Leucovorin and 5- Fluorouracil versus Leucovorin, 5-Fluorouracil, and Cisplatin as Neoadjuvant Chemotherapy Followed by Chemoradiation in Head and Neck Cancer","authors":"Rumana Afroz Majumder, Amanul Islam, Md. Abdul Mannan, A. Chowdhury","doi":"10.36347/sasjm.2023.v09i08.006","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i08.006","url":null,"abstract":"Background: HNSCC is the fifth most common cancer in the world and one of the most prevalent cancers in Bangladesh. Despite significant improvement in radiotherapy, the high incidence of loco-regional recurrences is a major challenge for radiation oncologists. This study was done to compare the response and toxicity of Docetaxel, Cisplatin, Leucovorin and 5- Fluorouracil (TPLF) vs Leucovorin, 5- Fluorouracil, and Cisplatin (LFP) as neoadjuvant chemotherapy followed by concurrent chemo-radiation with Cisplatin in the treatment of locally advanced head and neck cancer of squamous cell carcinoma. Materials and Methods: This study was carried out among 60 patients of locally advanced of head and neck cancer at Khwaja Yunus Ali Medical College & Hospital, Sirajganj from January 2015 to December 2015. In Arm-A, 30 patients received three cycles of neoadjuvant chemotherapy with Docetaxel 75 mg/m2 on D1, Cisplatin 75 mg/m2 on D1, Leukovorine 30 mg on D1-D3, 5-Flourouracil 750 mg/m2 on D1-D5 and in Arm B 30 patients received neoadjuvant chemotherapy with Cisplatin 75 mg/m 2 on D1, Leucovorine 30 mg on D1-D3, 5-Flourouracil 750mg/m 2 on D1-D5 3 cycles with three weeks interval followed by concurrent chemoradiotherapy with 66 Gy in 33 fractions and weekly Cisplatin 40 mg/m 2 started on the first day of radiation. Results: Most of the patients were male and middle-aged group. In Arm-A, 21 patients (70%) showed complete response whereas in Arm-B regimen complete response was noticed in 16 patients (53.3%) which was statistically significant; however, partial responses were significantly more found in Arm-B. Regarding toxicity, with Arm-A patients experienced slightly more toxicities in comparison to Arm-B which was statistically non-significant. Conclusion: So, it could be concluded from this study that the therapeutic gain was better obtained in Arm-A compared to Arm-B in patients with locally advanced head and neck cancer.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130805375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-08DOI: 10.36347/sasjm.2023.v09i08.003
Elkhansaa Ali Elsheikh Mohamed Elsamani, Duaa Salah Ali Mohamed, Malaz Elnagi Musa Elshiekh
Background: HCM Syndrome is a left ventricle hypertrophic in the absence of another cardiac or other systemic condition. An epidemiologic study reported that the prevalence of HCM is 0.02in the general population. Case Presentation: We report a case report of a 65- year- old man who was referred to the clinic after presenting with a typical symptom. Past medical history and family history were insignificant. Echocardiography showed asymmetrical basal septal hypertrophy with a preserved ejection fraction of 65%. The patient was asymptomatic with no functional limitation but later developed atrial fibrillation with mild diastolic heart failure, which was treated by pharmacological medication and cardio version. Conclusion: In conclusion, the earlier the diagnosis, better the prognosis. HCM has a lot of complications including atrial fibrillation. Therefore, awareness of how often AF and other arrhythmias are associated with HCM patients will lead to lower mortality as a follow-up ECG and echocardiography can be performed to prevent subsequent complications.
{"title":"Case Report: Late Presentation of Hypertrophic Cardiomyopathy in a 65- Year- Old Sudanese Man at Royal Care International Hospital","authors":"Elkhansaa Ali Elsheikh Mohamed Elsamani, Duaa Salah Ali Mohamed, Malaz Elnagi Musa Elshiekh","doi":"10.36347/sasjm.2023.v09i08.003","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i08.003","url":null,"abstract":"Background: HCM Syndrome is a left ventricle hypertrophic in the absence of another cardiac or other systemic condition. An epidemiologic study reported that the prevalence of HCM is 0.02in the general population. Case Presentation: We report a case report of a 65- year- old man who was referred to the clinic after presenting with a typical symptom. Past medical history and family history were insignificant. Echocardiography showed asymmetrical basal septal hypertrophy with a preserved ejection fraction of 65%. The patient was asymptomatic with no functional limitation but later developed atrial fibrillation with mild diastolic heart failure, which was treated by pharmacological medication and cardio version. Conclusion: In conclusion, the earlier the diagnosis, better the prognosis. HCM has a lot of complications including atrial fibrillation. Therefore, awareness of how often AF and other arrhythmias are associated with HCM patients will lead to lower mortality as a follow-up ECG and echocardiography can be performed to prevent subsequent complications.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124663743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-08DOI: 10.36347/sasjm.2023.v09i08.005
Tahri Joutei Hassani Kenza, Z. Douhi, Rasha Moumna, H. Baybay, S. Elloudi, Meryem Soughi, F. Mernissi
Vulvar malignancies are rarely encountered in dermatology. The vulvar intraepithelial neoplasia (VIN) are the most common ones and the incidence of VIN is increasing in younger women. Early diagnosis and tailoring the management on individual basis may help to reduce the long-term morbidity. We report a case of differentiated VIN of the vulva presenting a pseudo papillomatous aspect mimicking a granulomatous disease.
{"title":"A Pseudo Papillomatous Vulva: A Diagnostic Challenge","authors":"Tahri Joutei Hassani Kenza, Z. Douhi, Rasha Moumna, H. Baybay, S. Elloudi, Meryem Soughi, F. Mernissi","doi":"10.36347/sasjm.2023.v09i08.005","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i08.005","url":null,"abstract":"Vulvar malignancies are rarely encountered in dermatology. The vulvar intraepithelial neoplasia (VIN) are the most common ones and the incidence of VIN is increasing in younger women. Early diagnosis and tailoring the management on individual basis may help to reduce the long-term morbidity. We report a case of differentiated VIN of the vulva presenting a pseudo papillomatous aspect mimicking a granulomatous disease.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"23 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116841189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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