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.

High-Sensitive c-Reactive Protein Levels in Euthymic Bipolar Patients: Case-Control Study.

Bipolar disorder is a chronic, disabling disease that is characterized by the recurrence of thymic episodes. The role of the immune-inflammatory system in the etiopathogenesis of this affection arouses the interest of research. The aim of this work was to determine the plasma levels of the high sensitivity C reactive protein (hs-CRP) in patients with bipolar disorder in remission phase by comparing them to a control group.A case-control cross-sectional study was conducted from 56 subjects with bipolar disorder in clinical remission, and 56 volunteers and healthy control subjects.Mean plasma hs-CRP was significantly higher in patients with bipolar disorder than control subjects. In bipolar patients, a hs-CRP elevation was significantly associated with the disease severity item mean score.Through this study, bipolar disorder appears to be associated with a state of chronic inflammation. This should lead to randomized controlled trials evaluating the value of anti-inflammatory drugs in the management of bipolar disorder.

Depression in Tunisian type 2 diabetic patients: prevalence and association to glycemic control and to treatment compliance.

AIM: to study the prevalence of depression in type 2 diabetes and to seek for a relationship between glycemic control and treatment adherence. METHODS: This cross-sectional study was carried out at the outpatient department of the Tunis nutrition institute. A total of 100 diabetic patients followed for Type 2 diabetes were randomly recruited. We used a structured questionnaire to collect patients' socio-demographic, clinical and therapeutic data. The treatment adherence was assessed by using MAS, Glycemic control according to blood glucose and glycated hemoglobin (HbA1c) levels and depression and anxiety by administering a dialectal Arabic validated version of Hospital Anxiety and Depression Scale (HAD). Finaly we also used the modules on mood disorders of the mini international neuropsychiatric interview (MINI). RESULTS: The prevalence of depression in T2DP was 38% according to the HAD scale with severe forms in 18%. The anxiety prevalence was 31%. However, 18% of T2DP had anxious-depressive co morbidity. According to the MINI, 31% of T2DP had a mood disorder. Dysthymia was noted in 14% of cases, an isolated depressive episode in 6%. Depressed T2DP have a poor glycemic control than those no depressed. Macro-angiopathy, irregular followed-up, poor treatment adherence and unbalanced diet were associated with depression. CONCLUSION: The detection of depression related to somatic pathology in particular diabetes, seems essential. As a result, depression treatment may improve the overall prognosis of the associated somatic diseases.

Rubella and pregnancy: diagnosis, management and outcomes.

Rubella is a mild viral disease that typically occurs in childhood. Rubella infection during pregnancy causes congenital rubella syndrome, including the classic triad of cataracts, cardiac abnormalities and sensorineural deafness. Highly effective vaccines have been developed since 1969, and vaccination campaigns have been established in many countries. Although there has been progress, the prevention and diagnosis of rubella remain problematic. This article reviews the implications and management of rubella during pregnancy.

Uxoricide by a schizophrenic patient with delusional misidentification syndromes: A case report.

Delusional misidentification syndromes in psychiatric disorders might result in dangerous behavior leading sometimes to homicide. An early diagnosis and thorough follow up is important to avoid such consequences.

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.

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.

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.

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.

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.

Solvent-dependent excited-state hydrogen transfer and intersystem crossing in 2-(2'-hydroxyphenyl)-benzothiazole.

The excited-state intramolecular hydrogen transfer (ESIHT) of 2-(2'-hydroxyphenyl) benzothiazole (HBT) has been investigated in a series of nonpolar, polar aprotic, and polar protic solvents. A variety of state-of-the-art experimental methods were employed, including femto- and nanosecond transient absorption and fluorescence upconversion spectroscopy with broadband capabilities. We show that the dynamics and mechanism of ESIHT of the singlet excited HBT are strongly solvent-dependent. In nonpolar solvents, the data demonstrate that HBT molecules adopt a closed form stabilized by O-H···N chelated hydrogen bonds with no twisting angle, and the photoinduced H transfer occurs within 120 fs, leading to the formation of a keto tautomer. In polar solvents, owing to dipole-dipole cross talk and hydrogen bonding interactions, the H transfer process is followed by ultrafast nonradiative deactivation channels, including ultrafast internal conversion (IC) and intersystem crossing (ISC). This is likely to be driven by the twisting motion around the C-C bond between the hydroxyphenyl and thiazole moieties, facilitating the IC back to the enol ground state or to the keto triplet state. In addition, our femtosecond time-resolved fluorescence experiments indicate, for the first time, that the lifetime of the enol form in ACN is approximately 280 fs. This observation indicates that the solvent plays a crucial role in breaking the H bond and deactivating the excited state of the HBT. Interestingly, the broadband transient absorption and fluorescence up-conversion data clearly demonstrate that the intermolecular proton transfer from the excited HBT to the DMSO solvent is about 190 fs, forming the HBT anion excited state.