The relationship between internet gaming disorder and psychotic experiences: cyberbullying and insomnia severity as mediators.

BACKGROUND: The nature of the relationship between Internet Gaming Disorder (IGD) and psychosis is unclear so far. There is evidence that greater time spent in playing video games may expose players to both insomnia and a toxic online environment with widespread cyberbullying. These two possible consequences of IGD may, in turn, be associated with greater psychotic experiences (PE). Based on this theoretical framework, the present study proposed to contribute the body of the knowledge in this area, by testing the possible indirect effects of insomnia severity, cyber-victimization and cyberbullying in the cross-sectional association between IGD and PE in a sample of Tunisian university students. METHOD: We conducted a cross-sectional study over 4 months (February-May 2022). The Arabic versions of the Brief Symptom Inventory, the Internet Gaming disorder-20 Test, the Insomnia Severity Index, and the Revised Cyber Bullying Inventory-II were administered to a total of 851 students (mean age = 21.26 ± 1.68 years, 53.7% females). RESULTS: We found that 25% of students were at risk of IGD, and 1.8% had an IGD. The results of the mediation analysis showed that insomnia severity fully mediated the association between IGD and paranoid ideation. Higher IGD was significantly associated with more insomnia severity, which was, in turn, significantly associated with more paranoid ideation. Cyberbullying partly mediated the association between IGD and psychoticism. Higher IGD scores were significantly associated with more cyberbullying, which was, in turn, significantly associated with more psychoticism. Finally, greater IGD was significantly and directly associated with higher psychoticism. CONCLUSION: Our findings suggest that insomnia and cyberbullying may be regarded as potential targets for youth mental health promotion, as well as community-focused prevention and early intervention in psychosis. More particular attention should be devoted to the huge potential for engaging in cyberbullying among online gamers. Sleep deprivation should be prevented, assessed and treated in heavy gamers.

Surgical management of benign noninfected urachal cysts in adult patients: two case reports.

BACKGROUND: Abnormalities of the urachus include the patent urachus, cysts, sinus, and fistula. Each of these entities represents a failure of complete obliteration of the urachus. Contrary to other urachus anomalies, urachal cysts are usually small and silent unless they are infected. The diagnosis is often made during childhood. A benign noninfected urachal cyst discovered in adulthood is a rare condition. CASE PRESENTATION: Herein we report two cases of benign noninfected urachal cysts in adults. The first case is a 26-year-old Tunisian white man who presented with complaints of clear fluid draining from the base of the umbilicus evolving for a week, with no other associated symptoms. The other case was 27-year-old Tunisian white woman who was referred to the surgery department with a history of intermittent draining of clear fluid from the umbilicus. The two cases had laparoscopic resection of urachus cysts. DISCUSSION: Laparoscopy represents a good alternative for the management of persistent or infected urachus, especially when this is suspected, despite a lack of radiological evidence. Laparoscopy in the management of urachal cysts is safe, effective, and offers good cosmesis, with all the advantages of a minimally invasive approach. CONCLUSION: Managing persistent and symptomatic urachal anomalies requires a wide surgical excision. Such intervention is recommended to prevent symptom recurrence and complications, most notably malignant degeneration. A laparoscopic approach offers excellent outcomes, and is recommended to treat these abnormalities.

An epigastric mass? And what if it was an intra-abdominal esophageal duplication cyst: Case report.

INTRODUCTION AND IMPORTANCE: Duplication of the alimentary tract are uncommon congenital malformations that may be found anywhere from mouth to anus. Esophageal cystic duplication is a congenital cystic malformation of the alimentary tract consisting of a duplication of the segment of the esophagus to which it is adjacent. CASE PRESENTATION: We report the case of a 29-year-old female who had complained of intermittent epigastric pain and post prandial nausea for several weeks. Physical examination was without particularity except for the presence of abdominal epigastric mass. Transabdominal sonography combined with CT scan showed an epigastric cyst with no topographic relation to the pancreas measuring about 80 mm in diameter. Because of persistence of the epigastric pain and the nausea we decided to operate the patient. Histological exam than showed that the cystic mass was in fact an esophageal cystic duplication with no histological signs of malignancy. CLINICAL DISCUSSION: Here we describe a case of intra-abdominal esophageal duplication cyst in adult patient. Most of duplications cause symptoms in infancy or early childhood. Digestive duplication revealed at adulthood is a condition considered rare. CONCLUSION: Esophageal duplication cysts are uncommon developmental lesions arising from the primitive foregut, when diagnosed or encountered incidentally. The diagnosis of this anomaly in adulthood is exceptional and requires surgery.

Closed loop small bowel obstruction due to small intestine volvulus associated with early adhesion after laparoscopic appendectomy: Case report and review of the literature.

INTRODUCTION AND IMPORTANCE: Nowadays the majority of appendectomies are undertaken laparoscopically. The associated per and postoperative complications are well established and known. However, some rare postoperative complications continue to be reported such as small bowel volvulus. CASE PRESENTATION: We report the case of 44-year-old women who developed a small bowel obstruction from acute small bowel volvulus due to early postoperative flanges five days after a laparoscopic appendectomy. CLINICAL DISCUSSION: Laparoscopy is associated with less adherences and morbidity however we must be careful in post operative course. Mechanical obstruction can happen even with laparoscopy procedure. CONCLUSION: Occlusion earlier after surgery even with laparoscopy procedure must be explored. Volvulus can be incriminated.