Open Access Case Study

A Case Study of Oxcarbazepine-induced Stevens-johnson Syndrome

Imad Shubbar, Ashraf ALakkad, Majid Aziz, Mouayad Al Shtawi

International Neuropsychiatric Disease Journal, Page 1-6
DOI: 10.9734/indj/2022/v17i130186

Background:  Stevens–Johnson syndrome is a rare potentially fatal disorder characterized by mucosal membrane erosions, bullous skin lesions and epidermal detachment.

Objective: This case report discusses a case of a patient who developed seizures and macular rashes as a result of Stevens–Johnson syndrome induced by oxcarbazepine.

Case presentation: An eight-year-old girl was admitted to hospital with complaints of seizure episodes that occurred during sleep, characterized by drooling, jerky stiff upper limbs, throat sounds, and blue lips. Patient was born with severe intrauterine growth retardation and microcephaly and was diagnosed with congenital cytomegalovirus (CMV). EEG results confirmed that focal epilepsy was the underlying cause of seizures. The patient was given oxcarbazepine as an anticonvulsant medication after confirming epilepsy diagnosis.  However, after two weeks of treatment, patient developed rashes and skin lesions all over her body except hands. These skin lesions and rashes were red and tan in color, swollen, itchy, scaly, dry, popular, macular and patchy. The skin detachment was less than 10% of BSA (body surface area). The Naranjo algorithm was used to check the probability of a drug reaction and through the WHO-UMC criteria for causality, it was decided that oxcarbazepine induced the syndrome. Hence, patient was diagnosed as a case of Stevens-Johnson syndrome.

Conclusion:Stevens–Johnson syndrome is a rare condition that can cause rashes and epidermal detachment. It can be caused by adverse effects of medications; however, exact pathogenesis is unknown. Therefore, studies on large number of patients are required to understand the pathogenesis of oxcarbazepine-induced SJS.

Open Access Original Research Article

Neurobehavioral and Ameliorative Effect of Complan Milk and Bambara Nut on Rats Fed With Bitter Cassava – A Nutritional Approach

Lekpa Kingdom David, Victor Hogan Idung, Precious Ojo Uahomo

International Neuropsychiatric Disease Journal, Page 7-17
DOI: 10.9734/indj/2022/v17i130190

Cassava products have been introduced to the market in different regions of the world as part of diet, despite containing more than one toxic substance. Roots and leaves of cassava of all varieties contain cyanogenic glucoside, mainly as linamarin, but also as lotaustralin, in different concentrations in their cellular vacuoles. Twenty (20) albino Wistar rats were used for this research and were randomly selected into 4 groups of five 5 rats each. The result obtained from the study showed that there was a significant reduction in weight of the Konzo induced Wistar rats group from week 1 to week 4. A weight gain of 21.7g to 34.7g was observed in the cassava-induced Konzo and complan milk fed group Wistar rats and cassava-induced Konzo and Bambara nut (Okpa) fed group Wistar rats when compared with the cassava-induced Konzo group Wistar rats. There was a decrease in Na+,K+, Urea, Creatinine and HCO3 in cassava-induced Konzo and Bambara nut (Okpa) fed group Wistar rats when compared with cassava-induced Konzo Wistar rat group and control group. In evaluating the motor coordination/impairment using rotarod test, cassava-induced Konzo Wistar rat group, cassava-induced Konzo and complan milk fed group Wistar rats group and cassava-induced Konzo and Bambara nut (Okpa) fed Wistar rats group spent a significantly less mean time 20.65±0.33, 24.93±0.67 and 25.71±0.72 respectively when compared to the control group mean time of 39.45±0.42. Also, a significant improvement in motor coordination was observed in cassava-induced Konzo and complan milk fed group Wistar rats group and cassava-induced Konzo and Bambara nut (Okpa) fed Wistar rats group when compared with cassava-induced Konzo Wistar rat group. From the histological evaluation of the brain of the Wistar rats showed neurons that are vacuolated as a result of bitter cassava and alpha motor neurons. It is hence concluded that the toxic effect of bitter cassava can be ameliorated using proteins or balanced diets such as milk and bambara nuts (Okpa).

Open Access Original Research Article

Depression as a Risk Factor for Dementia among aged People with Type 2 Diabetes

Hossam Egila, Monzer Mustafa, Ahmed Esmael, Shady Alrashedy, Ibrahem Hamdey Rashed Elkalla, Sahar El Emam Gad, Fady Azmy Kyrillos, Mohammed Abbas

International Neuropsychiatric Disease Journal, Page 18-26
DOI: 10.9734/indj/2022/v17i130191

Objective: The aim of this study is to detect the relation between depression and dementia in patients with type 2 diabetes mellitus (DM).

Methods: Clinically diagnosed Type 2 diabetes underwent screening for depression using Beck's Depression Inventory scale and subsequent risk of dementia defined using medical reports, prescription data and death certificates. The mediating act of inflammation systemically was measured by assessing three inflammatory markers (C reactive protein, ESR and Fibrinogen).

Results: The study was conducted on 102 diabetic type 2 patients, included 48 males and 54 females. Patients divided into 12 (11.7%) patients with depression and 90 (88.3%) patients without depression (mean age 61±8.6 and 60.9±9.2 respectively). Mean BMI (body mass index) in depressive patients was 33.5 ± 9.3 and was 31.9 ± 8.9 in non-depressive cases (P value 0.01). There were no significant differences in patients with and without depression regarding the presence of hypertension, hyperlipidemia and smoking as risk factors of dementia. Patients with depression had significant impaired cognition and the total MoCA (Montereal Cognitive Assessment) scores were significantly lower than those of patients without depression (23.21 ± 3.48 vs 26.34 ± 3.78, P <0.05). Complication of diabetes in patients with depression as neuropathy was significant (P value 0.005). Other complications as diabetic retinopathy and nephropathy were non-significant. Inflammatory markers levels in patients with depressive symptoms were significantly higher (P value < 0.01).

Conclusion: In patients with type 2 diabetes, there is an important association between dementia and depression. Systemic inflammation had a significant role in the relation between depression and dementia.

Open Access Original Research Article

Psychiatric Comorbidities among University Students with Relapsing-Remitting Multiple Sclerosis

Wessam Mustafa, Samer Salama, Mohamed Jawad, Ibrahem Elkalla, Shady El Rashedy, Mohammed Abbas

International Neuropsychiatric Disease Journal, Page 27-35
DOI: 10.9734/indj/2022/v17i130192

Background: Multiple sclerosis (MS) has been reported to be associated with psychological manifestations like depression, anxiety, and depression. Its presence in university students may impact their academic performance. As the relapsing-remitting type (RRMS) is the commonest MS type, we conducted this study to evaluate the prevalence and severity of the previous psychological manifestations in University students diagnosed with RRMS. The impact of MS on their academic performance was also assessed.

Patients and Methods: This case-control study included 65 students diagnosed with RRMS in addition to the same number of healthy controls. Psychological manifestations were evaluated via the Arabic form of DASS (depression, anxiety, and stress score), while academic performance was assessed via the GPA (grade point average).

Results: Patient criteria, including age and gender, were statistically comparable between the two groups. The three components of DASS expressed significantly higher values in cases compared to controls, indicating increased prevalence and severity of psychological issues in association with RRMS. MS was associated with a significant decline in the student’s academic performance as had median values of 1 and 3 in cases and controls, respectively.

Conclusion: MS is associated with a significant increase in both prevalence and severity of depression, anxiety, and depression compared to the normal healthy population. MS also has a significant negative impact on the academic performance of these students.

Open Access Original Research Article

Sexual Dimorphism in Dementia and Alzheimer Diseases- A Neuropsychiatric Hospital Based Study

P. C. Ibeachu, P. O. Uahomo, L. K. David

International Neuropsychiatric Disease Journal, Page 36-45
DOI: 10.9734/indj/2022/v17i130193

Introduction: Dementia which is a highly neglected syndrome in Nigeria is an umbrella of term that houses a group of diseases and illnesses that affect your thinking, memory, reasoning, personality, mood and behavior.Alzheimer’s disease which is the leading cause of dementia disproportionately affects women than men. The objective of the study is to investigate gender and age differences in dementia and AD.

Method: This study retrospectively analyzed eighty-two (82) consecutive patients’ folder who had been diagnosed with dementia and AD in Rivers State Neuropsychiatric Hospital Rumuigbo, Port-Harcourt from the year 2014 to 2020.

Result: The result obtained showed that the mean age for dementia and AD for males and females were 68.44±8.96 and 70.74±12.98 respectively.

Discussion: It was observed that the females are likely to develop dementia and AD the males, with the prevalence rate of 59 (72.0%) for females while 23 (28.0%) were males respectively. The analysis of comorbidities showed that hypertension and depression were major risk factors in males while depression was a major risk factor in females. There was high risk of association between smoking and dementia in males while Alcohol was a high-risk factor for dementia in females.

Conclusion: Early detection plays a major role in the management of dementia and AD, this study therefore advocates for campaign to educate people about the danger of this sickness and set plan for proper management which will go along way reducing the stigmatization that comes with dementia.