Datura induced delirium: A report of two cases.

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Trihexyphenidyl (Artane) dependence: A controlled investigation between users and abusers.

This controlled study aims to identify the socioclinical factors predisposing psychiatric patients to abuse trihexyphenidyl (artane) and to document the extrapyramidal symptoms in artane abusers and users. Thirty patients (n=30), with mainly two major functional psychoses and who were abusing trihexyphenidyl, were compared with 90 artane user patients (n=90), who were matched for both the diagnosis and treatment. Besides a detailed clinical interview, each patient was assessed by using DSM-IIIR criteria, Brief Psychiatric Rating Scale, Simpson and Angus Scale, and Abnormal Involuntary Movement Scale. The analysis of data showed that, compared with users, trihexyphenidyl abusers were significantly characterized by being unmarried, unemployed, smokers and having past and concurrent history of multiple drug abuse, and genetic loading of mental disorders. Both groups of patients were prescribed antipsychotic drugs and trihexyphenidyl on a longer basis. Besides other socioclinical parameters, premorbid personalities, stressful life events and extrapyramidals, including tardive dyskinesias, we did not differentiate between the two groups. Artane abusers, when compared with users, were significantly characterized by less negative psychopathology. However, other psychopathological domains, in particular, the positive symptoms and depression, did not differentiate between abusers and users. In conclusion, patients having these socioclinical profiles tend to develop trihexyphenidyl abuse. The mental health professionals should not prescribe trihexyphenidyl indiscriminately or for a long time to such patients, who indeed require long-term antipsychotic maintenance medications.

Congenital malformations in primary health care in Al-Qassim region.

The objective of this predesigned research was to determine the prevalence, sociodemographic correlates, and pattern of congenital malformations (CMs) in a population less than 20 years of age. From January 1991 to December 1991, the extensive examination of family health files coupled with door-to-door survey identified 1736 patients with CMs. The results showed that the prevalence of CMs was 6.9/1000 population. The male to female ratio was 1.3:1. The patient's age, sibling order, co-morbid disorders of CMs, parental age, chronic maternal diseases, and the family history of CMs were significantly associated with groups of arbitrarily classified CMs. The most frequently encountered CMs were of central nervous system (39.2%) followed by cardiovascular (22.3%), alimentary (13.1%), musculoskeletal (6.85%), urogenital (6.16%), communicative and audiovisual (5.5%), and miscellaneous (6.9%). Further one-way ANOVA found significant differences among CM categories and age of patients and parents. Unlike Western trends, our study tentatively concludes that overall the inheritance rather than socioenvironmental factors contributes significantly in the etiology of different congenital malformations. We further suggest that the basic information of this research might be useful foundation data in future analytic studies on congenital malformations.

A seroepidemiological study of measles: Some practical implications for measles immunization program, Kingdom of Saudi Arabia.

It was hypothesized that the recent outbreaks of measles in a geographically defined area of Al-Qassim might reflect significant changes in the epidemiology of measles and cast doubt upon the real protective value of measles vaccines. Therefore, the two objectives of this research were to study some epidemiological parameters of cases of measles (n=993) and the current immunological status of immunized children (n=2810). The crossmatched data about measles patients were collected on an official proforma and 3 mL of blood were extracted from each child for determining the measles IgG and IgM antibodies. The results showed that female patients were significantly overrepresented (51.3%). The majority of patients encountered at primary health care centers (PHCCs) (81.3%) were more than five years of age (76.5%). Among nonvaccinated measles cases, 54.9% (n=402) were from rural/desert areas. The measles vaccine failure rate was 26.3%. The results of the surveyed children showed that 2% of them were not vaccinated. The measles IgM levels were detected significantly in recently vaccinated females (n=29/51, 56.9%). The measles IgG positivity unaffected by age, sex, and residence was found in 87.4% of children. A significant portion of children from rural/desert areas were not vaccinated (n=44/57, 77.2%). Though there were apparently high seroconversion rates in children under two years of age following Edmonston-Zagreb vaccine, overall it did not achieve any statistical significance when compared with seroconversion rates in all children following Schwartz vaccine. We conclude that besides at age six months, and MMR containing measles vaccine at 12 months, children at school entry (six years) should also be considered for measles vaccination.