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The incidence of neuroleptic malignant syndrome justifies the immediate discontinuation of the drug in question and the reinstitution of therapy with another drug. In the case of resistant schizophrenia treated with clozapine, there are insufficient therapeutic options. We report the case of a young patient followed up for resistant schizophrenia who developed neuroleptic malignant syndrome after 5 years of therapy with clozapine. Clozapine therapy was successfully reinitiated, and the dosage was increased to 300 mg/day over 62 days. In light of this clinical case and a review of the literature, we report the possibility of reintroducing clozapine following an incidence of malignant syndrome in patients with resistant schizophrenia with respect to certain rules; in particular, a slow increase in dose after a reasonable period of time and close monitoring.
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Normal pressure hydrocephalus typically presents with a clinical triad of progressively worsening symptoms, including gait disturbance, urinary incontinence, and cognitive deficits. Occasionally, it may also manifest with significant psychiatric symptoms, which can delay early diagnosis and treatment. We present a rare case of chronic hydrocephalus in a 54-year-old patient who initially presented with symptoms of mania, which led to a delay in diagnosis and treatment. Our case highlights the importance of considering organic causes for psychiatric symptoms, especially in older patients. Early diagnosis and treatment of conditions such as hydrocephalus can prevent delays and improve patient outcomes.
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Context: In March 2020, Morocco announced the first COVID-19 case and implemented preventive measures, including home confinement. Aims: Monitoring the psychological effects and prevalence among high- and middle-school students. Settings and Design: This study is cross-sectional, carried online. Methods and Materials: The survey was conducted by publishing an online questionnaire between May 14, 2020 and June 14, 2020, which included inquiries about socio-demographic data, the conditions of home confinement, activities carried out during confinement, and medical history and sleep patterns. To assess depressive disorder, anxiety disorders, and stress, the survey employed the "DSRS-c," "SCARED," and "PSS10" scales, respectively. Statistical Analysis Used: Data were received on Google forms coded by Excel 2010 and analyzed by IBM SPSS Statistics 22. Results: Out of the 689 participants, 73.7% were females; the mean age was 16.08 years (standard deviation 1.48). 94.8% of subjects reported changes in sleep habits, and 41.4% of adolescents had high levels of depressive symptoms, while 50.7% had high levels of anxiety symptoms. Several factors were significantly associated with anxiety and depressive symptoms, including being a girl (P = 0.000), being a high-school student (P = 0.011), economic struggles during the pandemic (P = 0.003), doubting the necessity of home confinement (P = 0.000), spending over 3 hours a day on social networks and video games (P = 0.000), dropping out of remote learning (P = 0.000), having a psychiatric history (P = 0.000), having chronic illnesses in the family (P = 0.002), and changes in sleep habits (P = 0.000). Conclusions: The study found high prevalence of depression, anxiety, and stress symptoms among students during the pandemic, emphasizing the need for mental health awareness and support.
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Hyperostosis frontalis interna is an irregular thickening of the frontal bone. Its etiology is unknown. It has been rarely linked with schizophrenia and head injury. Case Presentation. We describe an unusual case of a 44-year-old female with schizophrenia and hyperostosis frontalis interna having a history of head trauma. At the age of 3 years, she had a head injury that could be classified as mild traumatic brain injury. She presents a family history of schizophrenia. She was admitted for resistant schizophrenic disorder. The cranial computed tomography showed bilateral and asymmetrical hyperostosis of the frontal bone that was more pronounced on the right side. This corresponds to the impact of the trauma with frontal atrophy without any metabolic or endocrinal abnormalities. Conclusion. We surmise that the long-term pathological effects of traumatic brain injury, including hyperostosis frontalis interna, are likely to interact with genetic vulnerability and may lead to schizophrenic disorder.
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BACKGROUND: Biobanks are highly organized infrastructures that allow the storage of human biological specimens associated with donors' personal and clinical data. These infrastructures play a key role in the development of translational medical research. In this context, we launched, in November 2015, the first biobank in Morocco (BRO Biobank) in order to promote biomedical research and provide opportunities to include Moroccan and North African ethnic groups in international biomedical studies. Here, we present the setup and the sample characteristics of BRO Biobank. METHODS: Patients were recruited at several departments of two major health-care centers in the city of Oujda. Healthy donors were enrolled during blood donation campaigns all over Eastern Morocco. From each participant, personal, clinical, and biomedical data were collected, and several biospecimens were stored. Standard operating procedures have been established in accordance with international guidelines on human biobanks. RESULTS: Between November 2015 and July 2020, 2446 participants were recruited into the BRO Biobank, of whom 2013 were healthy donors, and 433 were patients. For healthy donors, the median age was 35 years with a range between 18 and 65 years and the consanguinity rate was 28.96%. For patients, the median age was 11 years with a range between 1 day and 83 years. Among these patients, 55% had rare diseases (hemoglobinopathies, intellectual disabilities, disorders of sex differentiation, myopathies, etc.), 13% had lung cancer, 4% suffered from hematological neoplasms, 3% were from the kidney transplantation project, and 25% had unknown diagnoses. The BRO Biobank has collected 5092 biospecimens, including blood, white blood cells, plasma, serum, urine, frozen tissue, FFPE tissue, and nucleic acids. A sample quality control has been implemented and suggested that samples of the BRO Biobank are of high quality and therefore suitable for high-throughput nucleic acid analysis. CONCLUSIONS: The BRO Biobank is the largest sample collection in Morocco, and it is ready to provide samples to national and international research projects. Therefore, the BRO Biobank is a valuable resource for advancing translational medical research.
