Open Access Case Study

Anencephaly and Its Associated Congenital Anomalies: A Case Report of a Delivery in a Rural Hospital, in Eastern Uganda

Ismail Opolot, Christopher Knox Waako, Julius Wandabwa, Joyce Namwase, Jennipher Mariam Konso

International Neuropsychiatric Disease Journal, Page 25-36
DOI: 10.9734/indj/2022/v18i130215

Introduction: Anencephaly also called cranioschisis is part of neural tube defects spectrum which occur when the neural tube fails to close normally during the 3rd and 4th weeks of development leading to fetal loss, still birth or neonatal death. Literature show that causation of anencephaly is multifactorial involving interaction of genetics and the environment though not well characterized. In this case report, we present the features of anencephaly and its different clinical associated malformations.

Methods: A case report study design was employed to explore the prenatal and antenatal events that resulted into an anencephaly delivery. The intra-natal and immediate postnatal fetal observations and outcome were documented. We also documented the care given to the mother throughout ANC, time of delivery and postnatally until discharge.

Results: 29-year G2P1+0 at 29W2D, presented with 2 days’ sudden progressive per vaginal bleeding and clear non-foul discharge on 2nd day of admission with no history of abdominal pain, fever or trauma. Two days later she was delivered by Caesarean section to a grossly neural malformed preterm baby boy with APGAR score 6 at 1 minute and 4 at 5 minutes. Birth weight and length were 1.5 kg and 48.6cm respectively. The baby life indicators deteriorated progressively and finally died at 36 minutes after time of delivery.

Conclusion: Although interaction between genomic and environmental factors that play a key role in the causation of anencephaly can not clearly be evaluated, there is an understanding of pre-natal and antenatal factors that predispose to this case such as lack of Folate and or interference with its bioavailability, use of teratogenic drugs taken during pregnancy and antenatal maternal conditions. We therefore recommend routine supply of folate to girls and women intending or risk to conceive 3 months before pregnancy through first trimester and health education about use of native drugs and any other conventional medicines during pregnancy.

Open Access Case Study

The Mental Health Syndrome Known as Alice in Wonderland - A Case Report

Jennings Hernandez

International Neuropsychiatric Disease Journal, Page 43-47
DOI: 10.9734/indj/2022/v18i1344

The Alice in Wonderland Syndrome (AIWS) is a rare neurological and psychiatric condition, represented as the appearance of disorienting perceptual disorder with occasional episodes of bizarre visual illusions and spatial distortions. It was first introduced by John Todd in 1955, based on the literary chronicles of the strange encounters described by Lewis Carroll in Alice in Wonderland books. A 30-year-old healthy male presented to the doctor’s office with left-sided headaches lasting 24 hours and preceded by an aura. During these auras, the patient was experiencing erratic behaviors consistent with the phenomena experienced by Alice, the main character in the world-famous story. He reported objects being larger and further away than they really were and his hands appearing smaller than they really were. Symptoms lasted up to 45 minutes. All clinical and diagnostic workups and evaluations were unremarkable, and the patient was treated for migraines with auras using Valproic Acid. During his follow-up at 3 months intervals, the patient continued with symptoms, and his medication dosage was increased. In his next follow-up three months later, he described having no more symptoms. AIWS has been found to be related to migraines with preceding auras.  It is both common in pediatrics as well as in adults. I present an AIWS case co-existent with aura migraines.

Open Access Original Research Article

Effects of Ethanolic Root Extract of Clitoria ternatea against Experimentally Induced Convulsions and Anxiety in Rodents

N. V. L. Suvarchala Reddy V, M. Ganga Raju, M. Niharika, B. Pratyusha

International Neuropsychiatric Disease Journal, Page 1-10
DOI: 10.9734/indj/2022/v18i130212

In animal models for screening for anticonvulsant activity, it has been scientifically established that medicinal herbs used in traditional medicine for the treatment of epilepsy possess promising anticonvulsant properties and can be a source of newer anticonvulsants. This study's objective was to evaluate the ethanolic root extract of Clitoria ternatea Linn for its preliminary phytochemical components, anticonvulsant, and anxiolytic effects. Anticonvulsant activity was evaluated against Maximum electroshock (MES) induced convulsion and pentylenetetrazole (PTZ)-induced convulsion model in rats. Using phenytoin (25 mg/kg) as a standard drug, the efficacy of the extract at oral dose levels of 200 and 400 mg/kg were evaluated in an experimental rat model. The marble bury test was used to assess the mice for anxiolytic activity, and lorazepam served as the standard drug at a dose of 0.05 mg/kg. Phytochemical screening revealed that C. ternatea extract contain carbohydrates, flavonoids, alkaloids, proteins, triterpenoids, phenols and steroids. The ethanolic extract significantly decreased the duration of tonic flexion and tonic extension in MES induced model (p<0.05). The ethanolic extract significantly increased the latency of convulsion and decreased the duration of convulsion in PTZ induced model (p<0.05). The ethanolic root extract were found to be significantly decrease the number of marbles buried in the treated groups as compared to control group, indicating anxiolytic activity. According to specific investigations, terpenes and steroids exhibited anticonvulsant effects in some experimental seizure models, including MES and PTZ. Alkaloids and triterpenes, which are phytoconstituents in ethanolic extract of Clitoria ternatea (EECT), might be the basis of its anxiolytic actions. Based on the findings of the study, Clitoria ternatea's ethanolic root extract has anticonvulsant and anxiolytic effects on animals.

Open Access Review Article

Risk Factors Associated with Substance Abuse among Adolescents

H. Igunma, Chisom, Ohaeri, Beatrice, O. Ojo, Iyanuoluwa, Babarimisa, Oluwatoyin

International Neuropsychiatric Disease Journal, Page 11-24
DOI: 10.9734/indj/2022/v18i130214

Substance abuse is a global public health problem with physical, social, psychological, economic, and health implications. Adolescent age is an important transitional period and comes with a high level of vulnerability, curiosity, experimentation, and making choices that may be detrimental to them in the long run. The problem of substance abuse has become very popular among adolescents, several researchers from different parts of the world have reported a high prevalence rate of substance abuse among teenagers and its resultant health and social problems. This study identified four different levels of factors that influence substance abuse among teenagers which includes family-related problems, and individual, psychological and social factors. Different preventive measures have also been identified, highlighting roles that should be played by family, the community, schools, as well as the government. These measures will have a great impact on curbing the menace of substance abuse among young people in societies, they will be able to avoid risky behaviors, function effectively, and achieve their dreams.

Open Access Review Article

Trends in Psychological Distress and Burnout Syndrome among Healthcare Workers due to COVID-19

Jennings Hernandez

International Neuropsychiatric Disease Journal, Page 37-42
DOI: 10.9734/indj/2022/v18i1343

The coronavirus COVID-19 pandemic has caused significant physical and mental tension among frontline workers globally. Poor working conditions, lack of protective personal equipment (PPE), short-staffed departments, medication shortage, depleted hospital beds, and ventilators have had a direct correlation with occupational burnout syndrome (BOS) and psychological distress among frontline healthcare workers (HCW) and their physical and mental well-being. The limitless hours on shift, the abundant number of daily cases, and the upturn of fatalities have contributed to the stressors among HCWs during this pandemic. In this paper, we will examine the occupational burnout syndrome and the psychological distress among HCWs working frontline during the pandemic. Also, the paper will explore whether there is a correlation between occupational burnout syndrome, mental and psychological distress, and COVID-19. The goal of this research is to acquire and establish if there had been an increase in anxiety and other mental health concerns as well as burnout levels for workers impacted by COVID-19. Categories explored will entail anxiety levels, mental and physical strains of working long hours, working under subpar conditions with limited PPE and patient rooms, and fear of exposure to the virus. Throughout the pandemic, many cases of tragic suicidal deaths have emerged. Consequently, attention to the well-being of healthcare professionals (HCPs) across the world has become imperative to adequately support and monitor. The Diagnostic and Statistical Manual of Mental Disorders, (DSM-5) and the Maslach Burnout Inventory – Medical Personnel (MBI-MP) are tools used by psychiatrists to diagnose and treat mental health such as burnout syndrome and psychological distress levels which also encompasses post-traumatic stress disorder (PTSD) and mass traumatic events (MTE). Studies have shown a high prevalence of PTSD symptoms, anxiety, fear, depression, and frustration in emergency professionals involved in the COVID-19 pandemic. Through various studies, we will demonstrate how the pandemic has affected frontline workers' mental and psychological well-being as well as how inadequate working conditions and long working hours lead to occupational burnout syndrome. Results will show how healthcare workers are feeling unaccomplished, second-guessing their clinical decisions, defeated, and mentally and physically drained. It is expected that subpar working conditions will continue to deteriorate the physical and mental well-being of HCWs on the frontline as the number of COVID-19 cases continue globally even after three years since its inception.