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1.
Egyptian Journal of Hospital Medicine [The]. 2018; 70 (5): 745-753
em Inglês | IMEMR | ID: emr-192588

RESUMO

Background: Bipolar disorder is a chronic relapsing and mostly severe psychiatric disorder accompanied with a significant psychiatric comorbidity, considerable role impairment, and significant risk of suicide attempts according to recent researches. Mood stabilizers and antipsychotic medications have proved to be effective in managing symptoms for many patients. Nevertheless, medication noncompliance for some patients is a raising concerns. Additional risk for increased symptom severity and relapse when subjected to high levels of psychosocial stress, such as living in a negative family environment has also been reported. Psychosocial treatments, such as cognitive-behavioral therapy [CBT] and family-focused therapy [FFT] were hence introduced in hope of an integrated strategy for the management of bipolar disorder


Objective of the Study: This article is intended to review the optimal approach for the management of bipolar disorder. Advances in biopsychosocial treatments are also briefly reviewed, including new health service models for providing care


Methods: Electronic search in the scientific database from 1960 to 2017- The studies in this comprehensive review were selected for inclusion based on clinical relevance, importance, and robustness of data related to diagnosis and treatment of bipolar disorder. The search terms that were initially used on MEDLINE/PubMed and Google Search terms included "bipolar disorder," "mania," "bipolar depression," "mood stabilizer," "atypical antipsychotics," and "antidepressants." High-quality, recent reviews of major relevant topics were included to supplement the primary studies


Results: Bipolar disorder is a major public health concern. Management includes a lifetime course of medication and attention to psychosocial issues for patients and their families. Standardized treatment guidelines for the management of acute mania have been developed. New potential treatments are being investigated


Conclusion: Bipolar disorder have a very dynamic and chronic nature and thus, careful selection of a treatment should be tailored to the phases of the disorder, together with the safety profile identified in clinical trials. Nevertheless, Psychosocial interventions, such as CBT and FFT should be employed in combination with pharmacological therapy for bipolar patients in order to increase medication compliance, decrease depressive symptoms and recognize early warning signs of an affective episode should ideally help to optimize the course and outcome of this devastating condition

2.
Egyptian Journal of Hospital Medicine [The]. 2017; 69 (6): 2627-2631
em Inglês | IMEMR | ID: emr-190673

RESUMO

Over the past few decades, vitamin D was proposed to be highly influential on female fertility and reproductive health. Its role was extensively studied and evaluated specifically in females with polycystic ovarian syndrome


Objectives: the aim of this research was to study the correlation between vitamin D and fertility in general, and in polycystic ovarian syndrome-associated infertility in particular


Methods: we searched Cochrane Library and PubMed for articles addressing the impact and role of vitamin D in fertility issues in females with polycystic ovary disease. Specifically-related topics were carefully reviewed and analyzed to summarize their conclusive results


Results and Discussion: Vitamin D was lower in females with PCOS and vitamin D administration had increased its level, improved metabolic disturbance and shortened inter-menstrual intervals in those patients. Patients with high vitamin D levels had a better success rate of invitro fertilization. However, it did not affect the time to pregnancy in PCOS women


Conclusion: Vitamin D is beneficial for improving metabolic as well as reproductive functions in women with PCOS. It is also essential for successful in-vitro fertilization, and it is probably protective against endometriosis. However, results from different studies are contradictory, and still there is no solid evidence that there is a cause-effect relationship between vitamin D and fertility

3.
Egyptian Journal of Hospital Medicine [The]. 2017; 69 (6): 2640-2646
em Inglês | IMEMR | ID: emr-190675

RESUMO

Introduction: Diagnosis of schizophrenia is largely a clinical assessment of a group of signs and symptoms. There are various factors that can be a cause or a risk factor for creating this disorder; some preventable and some non-preventable. The treatment options are diverse and are continuously being studied in order to enhance results and minimize adverse effect of various forms of therapy


Methodology: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1987, through March 2017. The following search terms were used: schizophrenia, etiology of schizophrenia, pathophysiology, clinical features, and treatment of schizophrenia


Aim: Our aim in this study was to understand the etiology, pathophysiology, and study various lines and advancement in management of schizophrenia


Conclusion: In the recent years, many treatment options are emerging where newer drugs and their combination with or without non-pharmacological therapy have shown promising results. More studies must be done to implement advanced regimens for treatment of schizophrenia

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