De novo Tardive Tourette-like syndrome after prolonged combination depot and oral neuroleptic therapy.

Introduction Tardive Tourette-like syndrome is recognised by the observation of several motor and vocal tics often in individuals receiving psychotropic medications and can happen within 1-3 months of treatment. Clinical case We report a case which is unique in its onset of Tardive Tourette-like syndrome comprising of vocal, motor tics and coprolalia after more than three decades of treatment with combination depot and oral neuroleptics. Discussion Use of the Naranjo Adverse Drug Reaction Probability Scale indicates a probable relationship between the onset of Tardive Tourettism and the antipsychotic therapy in this patient. This was in contrast to earlier reports which noted earlier onset and partial reversal with termination or change of medications. Clinicians need to pay heed to the emergence of late-onset Tourettism in order to better manage its manifestation and prevent its worsening in the context of holistic care for patients with neuropsychiatric conditions including schizophrenia.

Synthesis and antimicrobial activity of N¹-benzyl or N¹-benzyloxy-1,6-dihydro-1,3,5-triazine-2,4-diamines.

The emergence and spread of multidrug-resistant strains of Staphylococcus aureus and Mycobacterium tuberculosis are generating a threat to public health worldwide. In the current study, a series of N(1)-benzyl and N(1)-benzyloxy-1,6-dihydro-1,3,5-triazine-2,4-diamine derivatives were synthesized and investigated for their antimicrobial activity against S. aureus, and Mycobacterium smegmatis which is taxonomically related to M. tuberculosis. Most of the compounds exhibited good activity against M. smegmatis as determined by comparison of diameters of the zone of inhibition of test compounds and standard antibiotics. Compound 7o showed potent antimycobacterial activity against M. smegmatis without mammalian DHFR inhibition liability. The results from this study indicate that 1-benzyl derivatives of 1,6-dihydro-1,3,5-triazine-2,4-diamines may be used as lead compounds for the discovery of antimycobacterial agents.

Persistent, severe hypoglycemia-induced organic brain syndrome with neurological sequelae: a case report.

Hypoglycemia is a biochemical abnormality and often the rate-limiting step in the treatment of both type 1 and type 2 diabetes mellitus. Left uncorrected and prolonged, hypoglycemia can result in neuronal dysfunction and death, with deficits ranging from measurable cognitive impairments to aberrant behavior, seizures and coma. In this case report, hypoglycemia resulted in severe and persistent neurological (slurred speech and gait abnormalities), cognitive (inattention, disorientation and memory deficits) and behavioral manifestations (verbal hostility and irritability). It highlights the potentially severe neuropsychiatric sequelae following hypoglycemia and is timely for clinicians to be reminded that hypoglycemia prevention needs to be more of a focus of diabetes care in general.