Methamphetamine psychosis, the efficacy of atypical antipsychotics

Worldwide growing methamphetamine abuse is one of the most serious health problems with several different consequences for victims, especially in developing countries. Chronic methamphetamine abuse is associated with several psychiatric problems in all countries which are faced to epidemic methamphetamine abuse. Methamphetamine-induced psychosis is a major medical challenge for clinical practitioner from both diagnostic and therapeutic viewpoints. Stimulant psychosis commonly occurs in people who abuse stimulants, but it also occurs in some patients taking therapeutic doses of stimulant drugs under medical supervision. The main characteristic of meth psychosis is the presence of prominent hallucinations and delusions. Other drugs, such as cocaine and marijuana, can trigger the onset of psychosis in someone who is already at increased risk because they have [vulnerability]. The current literature review attends to explain several aspects of MIP epidemiologically and clinically. Investigators proposed pharmacologically treatment based on recently published data

effect of nasal surgery on apnea-hypopnea index

One of the factors, which is involved in obstructive sleep apnea, is anatomic or inflammatory pathologies of nasal airway obstruction. Thus, it is logical to observe improvement of polysomnographic parameters of sleep-disordered breathing after nasal surgery. The authors performed a review of the literature, up to 2013, to determine the impact of nasal surgery on obstructive sleep apnea. Most current idea in this field is based on case series studies while randomized controlled trials evaluating the effect of surgery for nasal obstruction on sleep apnea are few and far between. According to these studies, surgery for nasal obstruction does not improve objective parameters of sleep apnea. Although nasal obstruction is one of the factors involved in obstructive apnea, one has to keep in mind that surgery will not result in major reduction of obstructive sleep apnea severity to relieve nasal obstruction. Detailed upper airway analysis has to be considered when surgery is an option for obstructive sleep apnea. Thus, nasal surgeries are beneficial when they are part of a multilevel approach in obstructive sleep apnea treatment

The comparison of personality types in patients with vascular headache and tension-type headache

Objective: This is a study to evaluate the personality types based on Myers-Briggs Type Indicator (MBTI) in patients with chronic vascular or tension-type headache. Methods: This was a cross-sectional study conducted on 210 patients with tension-type and vascular headache in the Mashhad city, northeast of Iran. Patients were selected through convenience nonprobability method from December 2010 to January 2012. They were asked to fill demographic questionnaire and MBTI. Data were analyzed with SPSS using Mann-Whitney U, Chi-square and Fisher exact test. Results: The mean age of participants was 33.7 ± 8.2. Patients with vascular headache were mostly female, had higher levels of education, experienced more attacks per month and had shorter duration of headache until seeking treatment compared to the patients with tension-type headache. There was a significant difference in the distribution of personality types and frequency of each personality dimension between two groups. Patients with vascular headaches were significantly more introverted, sensing, thinking and judgmental, as compared to extraversion, intuitional, feeling, and perceiving among the tension-type headaches. Conclusion: Since there was a significant difference in the personality type of the different headache patients, further neuropsychological studies may throw light on the etiology of these chronic headaches.

[ efficacy of developmental attachment-based play therapy on developmental trauma disorder symptoms in children from 3 to 9 years old]

The present study conducted to examine the effect of attachment based play therapy on developmental traumatic disorder [DTD] in children. This semi-experimental study with control group, conducted in 2008, in Mashhad. Fourteen kids [3-9 years], who were diagnosed as having DTD based on Vander Kolk criteria, were selected from child psychiatry clinic in Ibn-e-Sina and dr. Sheikh hospitals. Their parents permitted to involve in this study. Patients were divided to 2 groups of intervention and control groups. Mothers of children completed Yule's scale and for evaluation of children's stress parenting stress index-short form [PSI-SF] for evaluation of parents' stress. Ten sessions of play therapy were conducted for intervention groups. Then mothers in 2 groups completed the tests again. In the variables of age, sex and grade of children also in the age and education of mothers, patients in 2 groups did not have any significant differences [P>0.05]. There were not any significant differences in scores of Yule's scale, PSI-SF and parental distress at base- line between 2 groups [P=0.10, P=0.34 and P=0.58 respectively]. After play therapy these test in the intervention group was significantly different from the control group [P<0.001, P=0.01 and P=0.01 respectively]. The differences in scores of difficult child subscale between 2 groups, before and after intervention were not significant [P=0.86, P=0.14 respectively]. The differences in scores of malfunction in child-parent relation before and after treatment were significant in intervention group [P=0.01] but there were not meaningful differences in control group [P=0.52]. Attachment based developmental play therapy reduces the stress of children and their mothers

Cognitive deficits and memory disturbances in patients with chronic post-traumatic stress disorder

Some studies have demonstrated high cognitive deficits in patients with post-traumatic stress disorder [PTSD]. Considering the limited available information about this issue, we decided to assess the cognitive deficits and memory disturbances in these patients. The present study is a case control research conducted on 50 patients with post-traumatic stress disorder who were admitted to Ibn-e-Sina psychiatric hospital in Mashhad, in north-eastern part of Iran in 2008. The control group included 50 people of first degree relatives of these patients who met the inclusion criteria of the study. Case and control groups were selected by simple sampling method; and for all of them, a questionnaire of demographic information, Wechsler memory scale, and mini mental status examination [MMSE] were completed. The gathered data were analyzed using SPSS 14th edition by chi square, t-test, and analyze of variance. The mean score of Wechsler memory scale in patients with PTSD [80.78 +/- 18.39] was significantly higher than control group [67.92 +/- 7.38] [p=0.001]. The mean score of MMSE was significantly lower in patients with PTSD compared to control group [p=0.001]. The determined disability level assessed by Iranian veterans' organization and also comorbidity of other psychiatric disorders with PTSD did not have a significant relationship with cognitive deficits, but the duration of PTSD and age of patients were significantly related to the level of cognitive deficits. Cognitive deficits and memory disturbances are higher in patients with PTSD than general population.

[Assessment the rules of demographic variables and body mass index in sleep quality among medical students]

This study aimed to assess the rules of demographic variables and body mass index in sleep quality among medical students of Mashhad University of Medical Sciences. In this descriptive study, in 2007-2008 the random sample of 310 medical students, including 222 male and 88 female, completed a researcher made demographic questionnaire and the Pittsburg Sleep Quality Index [PSQI] questionnaire. A total score of more than 5 were considered as the poor sleep quality. The data were analyzed using SPSS version 16 and chi-square, exact Fischer and U Mann-Whitney tests. Based on data, 39.8% of the students had poor sleep quality. Gender [P=0.003] and body mass index [>/= 25 and <25] [P<0.19] had significant relationship and marital status [P=0.547] and age [P=0.500] had no significant relationship with sleep quality. Also, there was no significant relationship between sleep quality of students who live in university dormitories and those of nondormitory residents [P=0.109]. According to significant differences of BMI in men compare to women [P<0.00001], results showed that no significant differences of sleep quality in men and women with BMI >/= 25 [P=1.00]. On the other hand, in BMI<25, male students had poor sleep quality compare to female students [P=0.019]. Compared with the similar studies, the high prevalence of poor sleep quality among Mashhad medical students need special attention and further researches to are needed to identify factors associated with sleep quality of medical students

Juvenile Churg-Strauss syndrome as an etiology of myocarditis and ischemic stroke in adolescents; a case report

Churg-Strauss syndrome [CSS], a systemic vasculitis accompanied by asthma and eosinophilia, almost invariably affects the lung and is frequently associated with cutaneous involvement It rarely has cardiac involvement. We report an unusual case of CSS with myocardial. A 16-year old female suffered of allergic asthma for 4 years. She was under treatment with oral prednisolone and seretide inhalation. After CSS diagnosis, she developed paroxysmal atrial tachycardia. Serum levels of Troponin I and Troponin T were increased indicating massive myocardial damage probably due to myocarditis. After 5 months she developed acute hemiparesis without any evidence of ischemic or hemorrhagic event. She was treated with IVIg, intravenous pulses of methylprednisone and cyclophosphamide for each complication. Myocarditis and stroke may also complicate CSS which should be taken in consideration for better management

[On the relationship between perceived childhood/adolescent attachments and identity status in 15-17 years adolescents]

The aim of this research was to determine the relationship between perceived childhood attachment and adolescent attachment with identity status. This was a descriptive-analytic, cross sectional study. The sample was consisted of 106 females and 104 males' high school students [15-17 years] in Torbat-e-Jam city, north east of Iran, which was selected through randomized and multistage sampling in 2008-2009. Attachment to parents measured by Attachment to Each Parents Scale and attachment in adolescents measured by Revised Adult Attachment Scale and identity status measured by Extended Objective Measure of Ego Identity Status-2 Version Scale [EOM-EIS-2]. Data were analyzed through chi square and liner regression analysis. Findings show that secure, non secure-ambivalence and non secure-avoidance attachment styles had the most effect on the achieved identity, respectively. Non secure-avoidance, non secure-ambivalence and secure attachment styles had the most effect on the foreclosure identity, respectively too. Moreover non secure-ambivalence and avoidance attachment styles [positive relationship] and secure attachment style [negative relationship] had the most effect on the moratorium identity respectively and Non secure-avoidance and secure attachment styles [negative relationship] and ambivalence attachment style [positive relationship] had the most effect on the diffused identity respectively. Findings indicated that there are meaningful relationships between perceived childhood attachment style and identity status and between different attachment styles and identity status in high school students

Effect of topiramate augmentation in chronic schizophrenia a placebo-controlled trial

The limitations of antipsychotics for treatment of schizophrenia have led to investigation of the usefulness of pharmacological augmentation strategies. Clinical studies have provided evidence for glutamate abnormalities in schizophrenia. Topiramate is an anticon-vulsant drug with alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid receptor antagonist properties; therefore, the objective of the present study was to explore the therapeutic efficacy of topiramate as an adjunctive medication in schizophrenia. A17 week, double-blind, placebo-controlled clinical trial was performed on 80 patients [25 - 65 years] from 2005 - 2007. All were hospitalized in Mashhad psychiatric hospitals with chronic DSM-IV-TR-diagnosed schizophrenia. All participants received up to 300 mg/day of clozapine. In addition, participants randomly received either topiramate [200 - 300 mg/day] or placebo gradually added to their ongoing treatment. Efficacy of medication was measured by administering. Positive and Negative Syndrome Scale at baseline and weeks 4, 8, 12, and 17. During the study, 5 patients from the placebo group and 12 participants from topiramate group were excluded. Clozapine and topiramate group showed significant decreases in all three subscales of PANSS values from baseline, with the maximum efficacy in week 12. However, after tapering topiramate, the general psychopathology sign was the only subscale that showed a significant difference. The clozapine and placebo group showed a significant decrease in all three subscales of PANSS values compared to baseline. The significant efficacy for all subscales was obtained at the end point. No significant differences in PANSS scores from baseline to end point were noted between case and control groups. Augmentation of clozapine and topiramate did not significantly decline patterns in any of the three subscales of PANSS compared to the clozapine and placebo group. Irct ID: IRCT138904014236N1

[Case-control study of anxiety and depression on parents of children with anxiety disorders]

Anxiety disorder is one of the prevalent disorders among children which could be the cause of many dysfunctions. As many researches have shown the family structure for anxiety disorders, this study is aimed at investigating the frequency of anxiety and depressive disorders in the parents of children with anxiety and comparing it with the control group. In this case-control study, the parents of 30 children which had been diagnosed as an anxiety case by child psychiatrist in Dr. Sheikh Hospital and 30 children without any psychiatric disorder with the age range of 3 to 12 were tested employing Beck Depression Inventory and Spielberger state trait anxiety inventory to evaluate the severity and frequency of depressive and anxiety disorders. The frequency of depression in patients' mothers was significantly higher than the control group [P=0.002] whereas the results among fathers showed no meaningful difference. The frequency of trait anxiety was significantly higher [P=0.004] in patients' mothers in comparison to the control group; however, this revealed no meaningful difference among fathers of the two groups. Although, the frequency of state anxiety in both fathers and mothers of the control group was a little higher than the patient's parents, this showed no significant difference. The results of this study showed that the frequency of depressive and anxiety disorder in patient's mothers was higher than the control group. Also, the findings indicated that the mentioned disorders in patients' fathers did not show any significant difference