A new rolling forecasting framework using Microsoft Power BI for data visualization: A case study in a pharmaceutical industry.

CONTEXT AND OBJECTIVES: Demand forecasting is a vital step for production planning and consequently, for supply chain efficiency, especially for the pharmaceutical (pharma) supply chain due to its unique characteristics. Numerous models and techniques that are proposed in the literature but little in concrete and generic framework to forecasting process, mainly for pharmaceutical supply chain. Unlike studies in the literature, this study not only perfectly predict the sales of a pharma manufacturer, but also visualize the results via a developed dashboard using modern information technology and business intelligence. MATERIAL AND METHODS: In this research, a rolling forecasting framework comprising of different steps and specialized tools is proposed that can assist supply chain managers to perform an accurate sales forecasting and consequently a better performance and specifically patient satisfaction. The proposed generic framework combines the use of Visual studio C++ software to extract optimal forecasting and the Power BI software to monitor the accuracy of the obtained sales forecasts. Three exponential smoothing methods are integrated in the proposed framework, which is open to adding more new forecasting methods. RESULTS: The proposed framework is tested for many data sets from a pharmaceutical manufacturer company, and the results obtained show superior performance, especially a clear decline in both forecast errors, which can reach 75% and a drop of stock level to 50%. Therefore, the company is currently using it and a future integration with their ERP is being carried out. CONCLUSION: The proposed rolling forecasting framework contributes to insightful decision-making through the visualization of accurate future sales and turnover, and consequently, an efficient stock management and effective production planning.

CSMD1 rs10503253 increases schizophrenia risk in a Tunisian population-group.

OBJECTIVES: Schizophrenia is a complex and chronic neuropsychiatric disorder. Recent genome-wide association studies have identified several at risk genetic variants, including two single nucleotide polymorphisms, namely the rs10503253 and the rs1270942 respectively located in the CSMD1 and the CFB loci. The present case-control study was designed to assess potential associations between the two variants and the risk of developing schizophrenia and disease severity. Further we demonstrate the relationship between these variants and clinical characteristics in a population-group from Tunisia. PATIENTS AND METHODS: In total, 216 patients diagnosed with schizophrenia along with176 healthy controls were included in this case-control study. The molecular analysis of the two polymorphisms was performed using tetra the Primer Amplification Refractory Mutation System-Polymerase Chain method. The statistical analysis was done using Compare V2.1 software, and correlations between genetic results and clinical characteristics were examined by Kruskal-Wallis testing. RESULTS: The frequency of the rs10503253A allele was found significantly higher among patients with schizophrenia as compared to healthy controls and associated with high negative PANSS scores. While no association was found concerning the implication of the rs1270942 variant in schizophrenia risk, a positive correlation with high positive PANSS scores was further observed. CONCLUSION: The present finding confirms the previously reported association between the Cub and Sushi multiple Domain 1 rs10503253A allele and the risk to develop schizophrenia and identified the rs1270942 variant as a potential disease risk modifier. Such observations may be important for the definition of the susceptible immunogenetic background in North African individuals at risk to develop mental disorders.

Serial killing in schizophrenia.

Serial criminality, although rare, has always aroused the interest of researchers in criminology, psychiatry, psychology, and sociology. We report the case of a patient, suffering from a chronic psychotic disorder, having committed several murders over a period of 9 years, underpinned by a delirium of misidentification of Frigoli syndrome.

Hospitalizations in psychiatry during the month of Ramadan: A study at the Tunisian mental health hospital.

BACKGROUND: Muslims fast each year during the Holy Month of Ramadan. This rite has major socio-cultural consequences. The circadian rhythms, energy expenditure, body temperature and biological clock are also influenced by Ramadan fasting. The impact of fasting on patients with mental disorders has been little studied. The aim of this study was to assess the number of hospitalizations in psychiatry during Ramadan compared to the other months of the lunar year. METHOD: A cross-sectional and retrospective study was conducted at Razi hospital, the psychiatric hospital in Tunis. The following data over the five lunar years (1434-1438) was checked for: The monthly and the annual number of hospitalizations in the different departments of Razi mental health hospital in Tunis as well as the monthly and annual rates of different legal modalities of admissions. RESULTS: An important decrease in the number of hospitalizations during Ramadan was observed each year followed by a constant increase during the following month.Ramadan was the only lunar month to have had a consistently below-average number of admissions. There has been a significant increase in the mean number of hospitalizations per month over the years. A general trend towards an increase in the proportion of enforced hospitalizations has been noted. CONCLUSION: Ramadan stands out not only on a religious but also on a social level. Our results add support to the usefulness of research on mental health and Ramadan in the psychiatric community.

The first Tunisian case of postorgasmic illness syndrome: A case report.

Postorgasmic illness syndrome (POIS) is a rare and singular syndrome. About fifty cases have been reported in the medical literature. Through a clinical observation, we illustrate the first case diagnosed in Tunisia and the difficulties in the etiological diagnosis and the therapeutic management of this syndrome. Given the shortage of cases reported in the literature, the syndrome of POIS remains poorly identified and subsequently misdiagnosed. The clinical diagnosis is relatively simple, yet etiological and therapeutic questions remain to overcome.

Simultaneous occurrence of a Takotsubo syndrome and paranoia delirium, related to Covid-19 pandemic: A case report.

Some psychosomatic diseases, like Tako-tsubo cardiomyopathy, may occur because of exposure to a stressful event like COVID-19. The simultaneous development of psychosis and Tako-tsubo cardiomyopathy suggests a field of vulnerability. Specific measures need to be taken to help vulnerable people to manage these stressful events.

First psychotic episode, related to COVID-19 pandemic, in a patient with tuberous sclerosis complex.

Clinical symptoms of tuberous sclerosis may occur because of exposure to a stressful event like COVID-19. During pandemics, specific considerations should be deserved to the mental state of people suffering from genetic diseases to prevent mental illness caused by a coronavirus.

Delusional misidentification syndrome and criminal acting out: A case report of maternal filicide.

Delusional misidentification syndromes are associated with danger and may lead to homicide. Early assessment of the danger is a key part of the psychiatric examination. Compliance to treatment in psychosis is important to avoid the devastating consequences, for the perpetrator, the victim, and the community.

Cognitive Impairment Among Tunisian Bipolar Patients: a Case-Control Study.

Studies exploring the cognitive performance of bipolar patients have mainly been conducted in Western countries. To our knowledge, no surveys have been reported to date in Tunisia. The present work aimed to evaluate the cognitive functions, in the three domains of memory, attention and executive functions, among a sample of Tunisian individuals with bipolar disorder, during the remission period, compared to healthy control subjects. We found that Cognitive functions in euthymic patients with bipolar disorder were significantly more impaired than in controls, apart from the working memory that did not show a significant difference between the two groups. Our findings confirm cognitive deficits associated with bipolar disorder, even at a distance from the symptomatic phases of the disease. Thus, these anomalies may be considered as a trait marker of the disease. A better understanding of cognitive decline certainly allows for better management of psychiatric pathologies, thus improving patients' social skills and quality of life.

La résistance à la sectorisation : exemple du gouvernorat de Nabeul en Tunisie.

Sectorisation was introduced in Tunisia in 1999. The objective of this study was to examine the difficulties and resistance to the sectorisation of psychiatric care in the state of Nabeul. A transversal study was conducted over a period of 5 months from 1 November 2014 to 31 March 2015 on 96 patients resident in the state of Nabeul and treated at Razi hospital. Patients were aged between 18 and 69 years old ( sex ratio equal to one), 55.2% were single and 46% had a low socioeconomic level (n=44). Chronic psychotic disorder was diagnosed in 64.3% , depression in 12.3%, bipolar disorder in 18.8% and mental retardation in 3% of cases. Most of them refused to continue psychiatric treatment in the second or the first line of care. Resistance to sectorisation was associated with a low socioeconomic level (P = 0.039), availability of a companion (P = 0.04), celibacy (P = 0.04), gender (P = 0.05) and negatively correlated to psychotic disorder diagnosis. It was concluded that the environment plays an important role in the choice of the place of care. Subjects treated for mental illness were found to have greater trust in the structures that treated the acute episode of their illness, and paradoxically felt less stigmatized in Razi hospital.

La résistance à la sectorisation : exemple du gouvernorat

Sectorisation was introduced in Tunisia in 1999. The objective of this study was to examine the difficulties and resistance to the sectorisation of psychiatric care in the state of Nabeul. A transversal study was conducted over a period of 5 months from 1 November 2014 to 31 March 2015 on 96 patients resident in the state of Nabeul and treated at Razi hospital. Patients were aged between 18 and 69 years old [ sex ratio equal to one], 55.2% were single and 46% had a low socio-economic level [n=44]. Chronic psychotic disorder was diagnosed in 64.3%, depression in 12.3%, bipolar disorder in 18.8% and mental retardation in 3% of cases. Most of them refused to continue psychiatric treatment in the second or the first line of care. Resistance to sectorisation was associated with a low socioeconomic level [P = 0.039], availability of a companion [P = 0.04], celibacy [P = 0.04], gender [P = 0.05] and negatively correlated to psychotic disorder diagnosis. It was concluded that the environment plays an important role in the choice of the place of care. Subjects treated for mental illness were found to have greater trust in the structures that treated the acute episode of their illness, and paradoxically felt less stigmatized in Razi hospital

La sectorisation a été instaurée en Tunisie en 1999. Afin d'étudier les difficultés et les résistances qui s'opposent à la poursuite du programme de sectorisation des soins psychiatriques dans le gouvernorat de Nabeul, une étude transversale a été menée sur une période de cinq mois allant du 1er novembre 2014 au 31 mars 2015 auprès d'une population de 96 patients, demeurant dans le gouvernorat de Nabeul et traités à la postcure de la troisième ligne [service de psychiatrie F de l'hôpital Razi]. Agés entre 18 et 69 ans avec un sex ratio égal à un, la plupart des patients étaient célibataires [55,2% ; n = 53] ; le niveau socio-économique était faible dans 46% des cas [n = 44]. Ces patients étaient suivis pour un trouble psychotique chronique dans 64,3% des cas [n = 62], un trouble dépressif dans 12,3% [n = 12], un trouble bipolaire de l'humeur dans 18,8% [n = 18] et un retard mental dans 3% [n = 3] des cas. La majorité des malades [65,6% ; n = 63] refusaient de poursuivre les soins en deuxième ou première ligne. La réticence à la sectorisation était positivement corrélée au niveau socio-économique bas [p = 0,039], à la disponibilité d'un accompagnant [p = 0,04], au célibat [p = 0,04] et au sexe féminin [p = 0,005], et négativement corrélée à la nature du trouble psychiatrique de type psychotique [p = 0,048]. L'environnement joue un rôle important dans le choix du lieu des soins. Le malade souffrant d'un trouble mental fait plus confiance aux structures qui ont soigné l'épisode aigu et se sent, paradoxalement, moins stigmatisé à l'hôpital Razi