Open Access Case Report

Clinical and Electrophysiological Aspects of Charcot – Marie Tooth Disease- A Case Report of Two Patients

Geetanjali Sharma

International Neuropsychiatric Disease Journal, Page 71-78
DOI: 10.9734/indj/2020/v14i430139

Aims/ Objectives: To study the importance of electrophysiological tests in diagnosing hereditary motor sensory neuropathy in absence of genetic studies.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Physiology, Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.

Methodology: The patients were referred from the Department of Medicine to the Department of Physiology for nerve conduction, F-wave, EMG, VEP & BERA studies.

Results: On electrophysiological examination, there was symmetrical decreased motor conduction velocity of median nerve (less than 38 m/sec), ulnar, tibial and peroneal nerves except in the first patient where the left peroneal nerve conduction velocity was not recordable with decreased amplitude and increased distal motor latencies. Sensory conduction velocities for bilateral median nerves were also decreased with increased latency and decreased amplitude in both the patients. Sensory conduction velocity and amplitudes of bilateral sural nerves were decreased in the first patient with increased latencies. However, sensory conduction velocity wasn’t recordable for bilateral sural nerves in the other patient. EMG shows decrease in recruitment of motor unit potentials, amplitude in bilateral tibial, peroneous, abductor digiti minimi & 1st dorsal interosseus muscle in the first patient. In proximal upper & lower limb muscles, EMG showed features of denervation. In the second patient, EMG was not advised. VEP in one patient had increased latency of P100 wave & other had normal VEP. Brainstem auditory evoked potential was normal in both patients.

Conclusion: The paper highlights the importance of electrophysiological studies in diagnosis of motor sensory neuropathy in absence of genetic studies. Marked slowing of conduction velocity is the hallmark of CMDT1 [demylinating type].

Open Access Case Study

Significance of Early Recognition of Somatic Symptoms of Depression in General Practice: A Case Report

Jintong Liu, Haider Muhammad Imran

International Neuropsychiatric Disease Journal, Page 55-58
DOI: 10.9734/indj/2020/v14i430137

In primary health care centers somatic symptoms of depression usually dominates over psychological presentation. In Pakistan, before seeking help of a proper qualified medical doctors, people living in rural areas generally get advice from faith healers and local hakims (Unani medicine man in East). We have presented the case of a 37-year-old housewife with medically unexplained symptoms. The case highlights the contribution of GPs in managing the psychiatric disorders under limited resources. Moreover the impact of locally devised methods of treatment on the outcome of mental disorders.

Method of Collecting the Case Information: This information has been based on general practice at outpatient setting of a 25-bed hospital situated at rural Punjab, Pakistan.

Open Access Original Research Article

COVID-19: Mental and Social Health-Related Complaints among Children and Adolescents in Nigeria: Parents’/Caregivers’ Perception – An Online Survey

Datonye Christopher Briggs, Kattey Amos Kattey

International Neuropsychiatric Disease Journal, Page 1-13
DOI: 10.9734/indj/2020/v14i430134

Aim: This survey aimed to highlight the mental and social health-related complaints of children and adolescents during the lockdown in Nigeria.

Study Design: Descriptive cross-sectional.

Place and Duration of Study: Respondents from all six geopolitical zones in Nigeria, from May 9 to June 8, 2020.Nigeria.

Methodology: A snowball sampling technique was used to recruit 260 respondents, consisting of parents/caregivers of children 18 years and below from states affected by the lockdown. An online self-administered questionnaire was used to collect data. Logistic regression analysis was done on mental health-related complaints (dependent variables), with participation in the radio/TV sessions, presence of computer at home, access to the internet, and income-level of parents as independent variables. Adjusted odds ratios with 95% confidence intervals were calculated.

Results: The median age of respondents was 38 years (with an interquartile range of 9); 155 (59.7%) were females, 239 (91.9%) married, 167 (64.2%) had tertiary education, 83 (31.9%) were low-income earners, 202 (77.7%) had computer devices at home, 243 (93.5%) had internet access at home. Logistic regression revealed that children who participated in the radio/TV sessions were more likely to complain of being bored; and children without internet access at home were more likely to complain of being unhappy, express anxiety/fear and show signs of stress. However, 113 (43.4%) agreed their children learnt a new skill, and 159 (61.1%) agreed there was increased family bonding during the COVID-19 lockdown.

Conclusion: The pandemic threatens the mental and social wellbeing of Nigerian children. Policymakers must put in place measures that address factors which increase the likelihood of mental and social health-related complaints among children by improving access to the internet, subsidizing costs and developing child-focused mental health services with new strategies to reach those already affected.

Open Access Original Research Article

Knowledge and Attitudes of Caregivers’ of People with Schizophrenia towards the Illness: A Cross-Sectional Study from a Regional Psychiatric Hospital in Nigeria

E. A. Uteh Blessing, O. Olotu Sunday, O. Omoaregba Joyce, O. James Bawo

International Neuropsychiatric Disease Journal, Page 59-70
DOI: 10.9734/indj/2020/v14i430138

Aim: To ascertain the attitudes of caregivers of patients with schizophrenia comprising their knowledge of the illness and social distance towards people with the illness.

Study Design: A cross sectional study design.

Place and Duration of Study: Federal Neuropsychiatric Hospital, Edo State, Nigeria, between April and July 2015.

Methodology: A systematic random sample of caregiver/patient dyads (n=281) were recruited. Caregivers were administered a socio-demographic questionnaire and, a brief interview on their knowledge of the aetiological factors, treatment for schizophrenia and level of social distance towards people with schizophrenia. Patients were administered a socio-demographic questionnaire and the PANSS.

Results: Three hundred and forty-one caregivers were approached but 281 gave consent and participated in the study (response rate was 82%, level of significance value was set at p<0.05 and 95% confidence interval was used). Among the 281 caregivers surveyed, 22.7% mostly ascribed psychosocial cause for schizophrenia, their level of knowledge of schizophrenia was generally average (49.5%). More than two-thirds of the caregivers reported high social distancing. Better attitudes to schizophrenia among caregivers was significantly associated with caregivers who were unemployed (p<0.03) and caregivers whose patients’ had at least 12 years of formal education (p<0.01).

Conclusion: Average knowledge of disease aetiology among caregivers was associated with high social distancing. Qualitative studies are required to explore the interactions of these identified factors.

Open Access Original Research Article

Validation of the Hungarian Version of Addenbrooke's Cognitive Examination for Detecting Major and Mild Neurocognitive Disorders

Beáta, Kaszás, Judit, Fekete

International Neuropsychiatric Disease Journal, Page 79-88
DOI: 10.9734/indj/2020/v14i430140

Aim: The screening of cognitive decline is a mandatory step in the early diagnosis and appropriate treatment of dementia to begin. In order to achieve this, an easy-to-take, validated neurocognitive test with good specificity and sensitivity are essential in the assessment. The aim of this study was to evaluate the Hungarian version of Addenbrooke’s Cognitive Examination (version I., ACE)- by comparing it with the conventional Mini-Mental State Examination (MMSE)- as a new form of assessment in order to screen for early dementia among the elderly.

Study Design: Descriptive cross-sectional.

Place and Duration of Study: This study is a part of a larger research, conducted among voluntary elderly from the city of Pécs (Hungary) between January 2016 and December 2018.

Methodology: The study refers to 66 patients with mild neurocognitive disorder (NCD), 51 patients with major NCD, and 133 healthy participants. The Diagnostic and Statistical Manual of Mental Disorders (version 5.) criteria were used for the diagnosis of dementia. Statistical analysis was performed using the receiver operator characteristics method.

Results: The optimal cut-off score for the ACE-I for detecting mild NCD was 82, with a sensitivity of 89% and a specificity of 96%. The optimal cut-off for the ACE for identifying major NCD was 76 with sensitivity of 98% and a specificity of 98%.

Conclusion: We concluded that the Hungarian version of the ACE is an accurate test for the detection of NCD, and could be adopted in various clinical practices.

Open Access Original Research Article

Socio-demographic Risk Factors in Depression among the Clergy in Nigeria

Enyidah Nonyenim Solomon, Osika Ubigh Micheal, Akoko Sokiprim

International Neuropsychiatric Disease Journal, Page 89-95
DOI: 10.9734/indj/2020/v14i430141

Background: Depression poses a huge challenge on personal, professional, and social life of individuals. Studies on the prevalence of depression have largely been on the general population, using socio-demographic variables to explain it’s outcome. The clergy constitutes a special group of trained professionals on the vocation of care-giving, problem solving and spiritual healing. Information is scanty on the prevalence of depression among them and the contribution of socio-demographic risk factors on their mental health.

Objectives: This study seeks to determine the prevalence of depression among the clergy and impact of socio-demographic variables on their mental health.

Methods: 84 pastors of the Seventh-Day Adventist Church in southern Nigeria, were evaluated for depression using the 9-item patients health questionnaire (PHQ-9), which assesses vulnerability to depression, and a 27 item demographic and risk factor questionnaire which assessed the demographic variables. Using the statistical package for social sciences (SPSS-25.0), cross tabulation of variables of interest were obtained using x2 and t-test. Level of correlation of variables with depression was done by a bivariate correlation analysis.

Results: Out of the 84 pastors who consented to the study, 16 (19%) had depression, mean age of participants was 43.6yr, 72 (85.7%) were currently married, all the participants were educated, the mean year of service was 10 years and 45% had at least 3 children. There was no significant correlation between the socio-demographic variables and depression.

Conclusion: The study revealed a 19% prevalence rate for depression among the clergy and that the socio-demographic variables of age, marital status, level of education, number of children and year of service impacted positively on the mental health of the clergy.

Open Access Original Research Article

Non-invasive Neurologic Assessment in Recovery and Treatment Phase Acrylamide Exposure in Ageing Wistar Rats

O. N. Ilochi, A. N. Chuemere

International Neuropsychiatric Disease Journal, Page 96-101
DOI: 10.9734/indj/2020/v14i430142

Acrylamide is a chemical that naturally forms in starchy food products during every day high temperature cooking. The ingredients, storage and processing conditions greatly influence acrylamide formation in food.  Home-cooking choices can have a substantial impact on the level of acrylamide humans are exposed to through the diet. This study scientifically determined the neurologic impact of acrylamide treatment and recovery in male wistar rats of different ages. A total of 20 male wistar rats were randomly sampled into 4 groups aged 45, 60, 75 and 90 days. The treatment dose was 50 mg/kg of acrylamide for 7 days. The study duration was 15 days with 2 phases; day 1 to 7 for exposure phase and day 8 to 14 as recovery phase after acrylamide exposure. Neurologic tests performed include open field test (OFT), buried reward test (BRT) and hand grip test (HGT). The study data was statistically significant at a confidence interval less or equal to 95%. Acrylamide adversely affected the tested physiologic responses in all ages during the phase of exposure. The distance covered and escape attempts were significantly reduced        in all ages during acrylamide exposure phase with significant recovery in 45 and 60 days old animals. Group 45 and 60 days old animals had a wider field area during recovery phase but no observed improvement in exploratory behavior in ages 75 and 90 days. Olfactory and neuromuscular function was significantly improved in all age groups during recovery, however, the response of ages 45, 60 and 75 were similar during recovery. In this study, Acrylamide caused manifestations typical of a neurotoxic agent. The neurologic effect of acrylamide may be reversed if exposure period with the studied dose is within 7 days. Recovery in cognitive, exploratory, emotional, olfactory and neuromuscular function may be dependent on age during exposure.

Open Access Review Article

COVID-19 Pandemic: Scoping Review through the Lens of 9-Month-based Knowledge and Brief Snapshots of 10 Cases and Five Family Units, Riyadh, Saudi Arabia

Naseem Akhtar Qureshi, Abdulhameed Abdullah Al- Habeeb

International Neuropsychiatric Disease Journal, Page 14-47
DOI: 10.9734/indj/2020/v14i430135

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has questioning origin in Wuhan, an industrial city of China. The novel coronavirus 2 (NCV2) was first identified in December 2019, and World Health Organization (WHO) declared the outbreak a global public health emergency on 30 January 2020, officially named it as COVID-19 on February 11 2020, and a pandemic on 11 March 2020. COVID-19 causes physical and mental health problems of variable severity and outcomes among people around the world.

Objective: This study has two aims;1) to conduct a scoping review of COVID-19’s epidemiological trend, clinical manifestations, therapeutics, diagnosis, and progress on vaccine development; and 2) to describe a case series of ten consultees’ and conveniently selected five family units’ mental and physical health effects of COVID-19 over the past 9 months, December to August 31, 2020.

Methods: We used keywords and Boolean Operators for conducting electronic searches of published literature in three largest databases on COVID-19 and regularly received notifications from COVID-19 resource centers, scientific journals, international and national research and economic institutions, and various websites, which helped to retain 82 articles after iterative screening for this review. In addition, 10 cases and the heads of 5 family units were interviewed virtually for assessing the mental and physical health of all family members affected by COVID-19.

Results: COVID-19 pandemic presents with variable clinical manifestations and outcomes attributable to the persons’ immune system, age and gender, physical and mental comorbidities, and adversely affects the biopsychosocial, cultural and economic fabrics of the world population. Basic preventive precautions and nonspecific drug interventions against COVID-19 are relatively effective with inconstant morbidity and mortality, and vaccine development researches (phase I-III) are in progress around the world. All persons in case series, not corona positive except one, presented with mental and physical health problems of wider nature that required integrated treatment interventions while majority of family unit members were less affected mentally or physically by COVID-19 and improved with preventive precautions.

Conclusion: COVID-19 is highly virulent disease linked with variable mental health problems, greater morbidity and mortality, severe strains on healthcare organizations and economic downturn around the world. Despite difficult access to services, overall our case series and family members showed good outcome. Information concerning COVID-19 is continuously evolving and, hence, further scoping reviews, randomized clinical trials and surveys concerning its several perspectives are needed in Saudi Arabia and elsewhere in the Gulf countries.

Open Access Review Article

A Review of Radiographic Findings in Sars-Cov-2 Patients

Denise Freitas Santana, Kárita Amanda Ribeiro de Melo, Agrinazio Geraldo Nascimento Neto, Wellington Carlos da Silva, Fábio Alves dos Santos, Amanda Aguiar Barros, Maisa Adriele Nalves da Silva, Lívia Gomes de Oliveira, Leidimar da Silva Carvalho, Taynara Dantas Batista, Larissa Lima dos Santos, Bianca de Andrade Nery, Murilo de Sousa Reis, Yan de Lima Borges

International Neuropsychiatric Disease Journal, Page 48-54
DOI: 10.9734/indj/2020/v14i430136

Introduction: At the end of 2019, more specifically in December, the outbreak of the new coronavirus - Sars-Cov-2, which caused pneumonia, emerged in Wuhan, and soon spread throughout China, where researchers began to suspect a possible pandemic. , being a disease that causes a deficiency of structures of the respiratory system, leading to alterations in breathing functions, with respiratory muscle deficiencies and exercise tolerance. During the pandemic peak still in Wuhan, the main radiographic findings in hospitalized patients revealed bilateral opacity on computed tomography (CT) examination, lobular and subsegmental consolidation areas, ground-glass opacities, consolidation with rounded morphology, and peripheral pulmonary distribution.

Aims: Analyze through the available literature review the main radiological alterations caused by Sars-Cov-2.

Methodology: This is an integrative literature review using PubMed, Scielo, Google Scholar, Microsoft Academic databases. Inclusion criteria were complete and original articles in English and Portuguese. Duplicates and other literature reviews were excluded.

Results: Radiographic findings are different in the early and advanced phases of the disease, but characteristic signs such as the matte glass pattern were found in both phases.

Conclusion: The radiographic findings of patients diagnosed with COVID-19 are not the main criteria for clinical diagnosis, but knowledge of characteristic symptoms is fundamental. Therefore, the multidisciplinary team must discuss the radiological findings most common to the virus, this will directly aid early diagnosis, in addition to reducing the high mortality rates globally.