Patients with first episode psychosis and chronic schizophrenia may not differ in mean platelet volume affecting its value as an indicator of cardiovascular disease

Objective: The aim of the present study was to examine differences in terms of mean platelet volume (MPV) in patients with first episode psychosis, chronic schizophrenia, and psychiatrically healthy controls and to determine the potential value of MPV for cardiovascular disorders in patients with psychotic disorders. Methods: A total number of 32 patients with first episode psychosis, 44 patients with chronic schizophrenia, and 43 randomly selected weight- and body mass index-matched psychiatrically healthy controls who presented to the Psychiatry Outpatient Clinic were included. The Positive and Negative Syndrome Scale (PANSS) was administered to the patients group. The body mass index (BMI) was calculated and MPV was measured for each subject. Results: The mean MPV level was 9.38±1.00 fL in patients with first episode psychosis, 9.60±1.02 fL in patients with chronic schizophrenia, and 9.2±0.94 fL in psychiatrically healthy controls group. MPV levels were not significantly different between the three groups. There were no statistically significant differences between the three groups in terms of platelet count or BMI. There were no statistically significant correlations between the MPV levels and total PANSS scores in the patients groups. Conclusions: To the best of our knowledge, the present study was the first to evaluate the MPV levels in patients with first episode psychosis. We consider that it is not appropriate for MPV to be used as an indicator for CVDs in patients with psychosis. Better-designed and more advanced studies are necessary to determine the exact function of platelets and the importance of MPV in patients with first episode psychosis and chronic schizophrenia

Otoskopik fenomenin eşlik ettiği kannabis kullanımına bağlı psikotik bozukluk olgusu

Kannabis (esrar), en fazla kullanılan bağımlılık yapan yasa dışı maddelerden birisidir. Kannabis kullanımı ile birlikte görülen psikiyatrik belirtiler huzursuzluk, uykusuzluk, depresif ya da yükselmiş duygudurum, anksiyete, halüsinasyonlar ve konsantrasyon güçlüğüdür. Kannabis kullanımının psikoz ve bipolar bozukluk ortaya çıkma riskini arttırdığı ve var olan psikoz ve bipolar bozukluğun klinik görünümünü kötüleştirdiği bilinmektedir. Otoskopik psikozun karakteristik semptomu, kişinin kendi vücudunun bir parçasının ya da tümünün görsel varsanısıdır. Kişinin davranışları taklit ediliyor ve sanki aynada görünüyormuş gibi algılanır. Herhangi bir mental bozukluğun özel bir semptomu değildir. Sebebi tam olarak bilinmemektedir. Bu olgu sunumunda, kannabis kullanımına bağlı otoskopik psikoz tanısıyla takip edilen hastanın klinik belirtileri literatür eşliğinde tartışılmıştı

The frequency of Demodex spp in depression patients

Objective: Demodex spp., usually located on the human skin, including the face and eyelashes, is a mandatory ectoparasite. The aim of this study was to evaluate the prevalence and factors affecting Demodex spp. in patients with depression. Materials and Methods: In this study, 63 depressed patients and 63 healthy controls were evaluated. To collect samples for analysis, a drop of glue containing cyanoacrylate was put on a lamella and the lamella was pressed on the certain areas of the face (forehead, cheeks, nose, and chin) for about a minute. Then it was carefully removed and the density of Demodex spp. in a cm 2 was counted under a microscope. For the diagnosis, the presence of fve or more Demodex spp. in a cm 2 was considered to be positive. Results: In 23.8% of depressed patients (n=15) and in 9.5% of the control group (n=6), Demodex spp. was detected in the facial area. The presence of Demodex spp. in the facial area of depressed patients was signifcantly higher compared to the control group. When CGI severity scores of patients and the relationship between the severity of depression and the presence of Demodex spp. were compared, no signifcant difference was detected. Conclusion: Depression may be a risk factor for the infection of Demodex parasites because of impaired immune system as well as reduction of self-care and hygiene of the person. For the itchy lesions on the face of depressed patients, Demodex spp. infestation should also be taken into consideration

PEDAL ÖDEM: LİTYUMUN NADİR BİR YAN ETKİSİ

Lithium, is an alkali ion that is used for acute treatment and prophylaxis of mood disordes over 50 years. The most seen side effects of lithium are tremor, diarrhea, polyuria, polidipsia, hypotiroidi, weight gain, nephrogenik diabetes insipidus and nausea. Due to narrow therapeutic index, intra and interpersonal variable pharmacokinetics; close monitoring of blood lithium concentrations is recommended. Also it is suggested that lithiumneuroleptic combination can increase neurotoxicity and side effects via dopamine receptor blockade. In this case report we aimed to discuss the clinic and mechanisms of probable lithium induced pedal edema in a bipolar affective disorder patien

The relationship between depression, anxiety, childhood trauma, quality of life and sociodemographic feature in patients with psoriasis

Amaç: En sık görülen dermatolojik hastalıklardan biri olan psöriazis sadece dermatolojik değil çeşitli psikososyal sorunları da beraberinde getirmektedir. Psöriazis hastalarında psikolojik değişkenler birçok çalışmada incelenmiştir. Çalışmamızda ise hastaların depresyon, anksiyete, çocukluk çağı travması ve yaşam kalitesi düzeylerini incelemeyi amaçladık.Yöntem: Çalışmaya Mustafa Kemal Üniversitesi Tayfur Ata Sökmen Tıp Fakültesi Araştırma Hastanesi Dermatoloji Ana Bilim Dalı Polikliniklerine başvuran ve psöriazis tanısı almış olan 70 hasta alındı. Sağlıklı gönüllü 72 kişi kontrol grubunu oluşturdu. Bu kişilere Psöriazis Alan Şiddet İndeksi (PAŞİ), Psöriazis İşlev Kaybı İndeksi (PİKİ), Kısa Form 36 Yaşam Kalitesi Ölçeği (KF-36), Hastane Anksiyete ve Depresyon Ölçeği (HAD), Çocukluk Çağı Travma Ölçeği (ÇÇTÖ), Sheehan Yeti yitimi Ölçeği (SYYÖ) uygulandı.Bulgular: Çalışmamızda psöriazisli hasta grubunda sağlıklı kontrol grubundan istatistiksel olarak anlamlı daha fazla depresyon olduğu, psöriazisli hasta grubunda sağlıklı kontrol grubundan istatistiksel olarak anlamlı daha fazla anksiyete olduğu saptandı. Hastaların işlevselliğinde bozulma meydana geldiği ve hastaların kontrol grubundan istatistiksel olarak anlamlı daha fazla işlevsellikte bozulma olduğu saptandı. Psöriazisli hasta grubunda sağlıklı kontrol grubundan istatistiksel olarak anlamlı daha fazla çocukluk çağı travması olduğu saptandı. Hasta grubu olguların KF-36 alt puanlarına bakıldığında enerji canlılık aktivite alt boyutu, canlılık alt boyutu ve sosyal işlevsellik alt boyutu puanları kontrol grubu olgulara göre istatistiksel olarak anlamlı düzeyde düşük saptanmıştır.Sonuç: Bizim çalışma bulgularımıza göre psöriazisli hastaların anksiyete, depresyon, yaşam kalitesi ve çocukluk çağı ruhsal travması gibi psikiyatrik belirtilerle birlikteliği anlamlı bulunmuş olup farklı çalışmalarda bu bulgular değişiklik gösterse de psöriazisli hastaların psikiyatrik yardıma ihtiyacı olduğunu göstermektedir.Objective: One of the most common dermotological disease psoriasis is not just a dermotological problem, it brings various psychosocial problems with it. Psychological variables in psoriasis patients examined in many studies. In our study we aimed to examine depression, anxiety, life quality and childhood trauma levels of patients. Method: 70 patients who had been diagnosed with psoriasis and applicanted to Mustafa Kemal University Tayfur Ata Sokmen Faculty of Medicine Research Hospital Dermatology Department received to the study. 72 healthy volunteers constituted the control group. Psoriasis Area Severity Index (PASI), Psoriasis Function Loss Index (PFLI), Short Form-36 Quality of Life Questionnaire (SF- 36), Hospital Anxiety and Depression Scale (HAD), the Childhood Trauma Questionnaire (CTQ), the Sheehan Disability Scale (SDS ) were performed to these people. Results: In our study, more statistically significantly depression in psoriasis group than in the healthy control group, more statistically significantly anxiety in psoriasis group than in the healthy control group were detected. Deterioration occurred in the functioning of the patients and more statistically significantly funcionality deterioration were found than in control group. More statistically significantly childhood trauma scale score in psoriasis group than in the healthy control group, When we look at the activity vitality energy subscale score, vitality subscale score, social functioning subscale scores in SF-36 subscale scores of the patient group were detected statistically significant lower than the control group. Conclusions: According to our study findings psoriasis patients' anxiety, depression, quality of life and childhood psychological trauma has significant association with psychiatric symptoms although in different studies these findings also changes but indicates that patients needed psychiatric help

First manic episode induced by over the counter slimming drug that contains sibutramine

Sibutramin obesite tedavisinde kullanılan serotonin, noradrenalin ve daha zayıf bir şekilde de dopamin geri alımını engelleyen ve birçok psikiyatrik yan etkileri olan bir beta feniletilamindir. Kardiyolojik yan etkileri nedeniyle yasaklanmış olmasına rağmen halen internet üzerinden “Zayıflama hapı” adı altında satışı devam etmektedir. Antidepresanların manik veya hipomanik kaymaya neden olabilecekleri bilinmektedir. Sibutramin, antidepresan özelliğinden dolayı manik veya hipomanik kaymaya neden olabilir. Biz, internetten satın aldığı sibutramin içeren bir zayıflama ilacını kullandıktan hemen sonra ilk kez manik bir hecme geçiren altı ay sonrasında ise servisimize yine manik hecme nedeniyle yatırılan bir adölesanı sunuyoruz.Sibutramine, a serotonin, noradrenalin and to a lesser extent dopamine reuptake inhibitor, is a beta phenyletylamine used in obesity treatment and has many psychiatric side effects. Although, prohibited due to cardiologic side effects, it is still being sold as “Slimming pills” via internet. It is known that antidepressants can cause manic or hypomanic shifts. Since sibutramine has an antidepressant activity it may cause manic or hypomanic shifts. We present an adolescent who had his first manic episode after using sliming pills, which contain sibutramine, and was admitted to our service for his second manic episode 6 months after his first episode

The effect of the work environment on job satisfaction among nurses

Amaç: Bu çalışmanın amacı, hemşirelerin iş doyumunu etkileyen faktörleri karşılaştırmalı olarak incelemek, doyumu azaltan etkenleri belirlemek ve doyumu artırabilecek önerilerde bulunmaktır. Gereç ve Yöntem: Tanımlayıcı tipte olan araştırma, Mustafa Kemal Üniversitesi Tıp Fakültesi Araştırma Hastanesi’nde çalışan ve araştırmaya katılmayı kabul eden 174 hemşire ile yapılmıştır. Veriler, tanıtıcı bilgi formu, çalışma ortamı ölçeği (ÇOÖ) ve Minnesota iş doyumu ölçeği (MİDÖ) ile toplandı. Bulgular: Hemşirelerin MİDÖ puan ortalaması 64.24±11.00 ve ÇOÖ toplam puan ortalaması 88.52 ±11.66 olarak bulundu. Kadınların, ÇOÖ toplam puanı (t=0.979 p=0.020), çalışan korkuları (t=0.196 p=0.042) ve kalite yönetimi (t=0.451 p=0.042) alt ölçek puan ortalamalarının, erkeklere göre yüksek ve istatistiksel olarak anlamlı saptandı. Sonuç: Bu çalışmaya katılan hemşirelerin, iş doyumlarının, orta düzeyde olduğu ve çalışma ortamlarını olumlu değerlendirdikleri; kadın cinsiyet olma, çalıştığı birimden memnun olma, sosyoekonomik düzeyin yüksek olması ve diğer sağlık personeli ile sorun yaşamamış olma iş doyumunu etkileyen olumlu faktörler olarak belirlendi.Objective: The aim of this study to investigate comparison influencing the factors job satisfaction in nurses’, determine reduce the satisfaction factors and recommendations to increase satisfaction. Material and Methods: This descriptive study was conducted in the Mustafa Kemal University Faculty of Medicine and Research Hospital in working who agreed to participate with 174 nurses. Data were collected by personal information questionnaire, Minnesota Job Satisfaction Scale (MJSS) and Work Environment Scale (WES). Results: Nurses’ MJSS mean score is determined as 64.24±11.00 and WES total mean score is 88.52±11.66. WES total score (t=0.979; p=0.020), worker fears (t=0.196; p=0.042) and quality management (t=0.451; p=0.042) sub-scale scores of females were higher than males and significant. Conclusion: In this study participating nurses’, job satisfaction is medium level and they evaluate positive their work environment; being female gender, being satisfied with the working department, higher socioeconomic status and having experienced any problems with other health professionals were determined as positive factors influencing job satisfaction

Corpus Callosum Agenesis Presented with Attention Deficit Hyperactivity Disorder: Two Case Reports

Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB) erişkin hayatta da devam edebilen, tedavi edilebilir nöropsikiyatrik bir bozukluktur. Dikkat eksikliği, aşırı hareketlilik ve dürtüsellikle karakterize üç alt tipi bulunmaktadır. DEHB, etiyolojisi halen yeterince aydınlatılamamış bir alandır. DEHB de erken gelişim evrelerinde, çeşitli genetik ve çevresel etkenlerin etkileşimiyle, nörogelişimde bir aksama olduğu öne sürülmektedir. Korpus kallozum, korteksten köken alan uyaranları karşı taraf hemisfere bağlayarak beynin motor, duyusal ve kognitif performansını sağlamaktadır. Bu bölgede meydana gelen bir hasar kognitif beceriler, konuşma, ögrenme ve dürtü kontrol gibi beyin fonksiyonlarında bozulmaya neden olabilir. Bu yazıda; ilk ruhsal belirtileri dikkat eksikliği ve hiperaktivite olan iki çocuk olgudaki, korpus kallozum agenezisi ve DEHB birlikteliğinin olası patofizyolojik mekanizmaları tartışılmaktadır.ADHD is a treatable neuropsychiatric disorder which can continue till adulthood. There have been three subtypes including attention deficiency, hyperactivity and impulsivity. Its etiology remains unclear yet. It is hypothesized that there is an impairment of neurodevelopment in early developmental periods through the interactions between genetic and environmental processes. Corpus callosum provides an integration of cognitive, sensorial and motor functions of brain as a response to the impulses originating from the cortex. The damage of this region may result in deterioration of some cerebral functions such as cognitive functions, speaking, learning ability and impulse control. In this paper, we report two pediatric cases who had comorbid attention deficiency and corpus callosum agenesis without mental retardation

The Frequency of Demodex Spp in Depression Patients

Objective: Demodex spp., usually located on the human skin, including the face and eyelashes, is a mandatory ectoparasite. The aim of this study was to evaluate the prevalence and factors affecting Demodex spp. in patients with depression. Materials and Methods: In this study, 63 depressed patients and 63 healthy controls were evaluated. To collect samples for analysis, a drop of glue containing cyanoacrylate was put on a lamella and the lamella was pressed on the certain areas of the face (forehead, cheeks, nose, and chin) for about a minute. Then it was carefully removed and the density of Demodex spp. in a cm 2 was counted under a microscope. For the diagnosis, the presence of fve or more Demodex spp. in a cm 2 was considered to be positive. Results: In 23.8% of depressed patients (n=15) and in 9.5% of the control group (n=6), Demodex spp. was detected in the facial area. The presence of Demodex spp. in the facial area of depressed patients was signifcantly higher compared to the control group. When CGI severity scores of patients and the relationship between the severity of depression and the presence of Demodex spp. were compared, no signifcant difference was detected. Conclusion: Depression may be a risk factor for the infection of Demodex parasites because of impaired immune system as well as reduction of self-care and hygiene of the person. For the itchy lesions on the face of depressed patients, Demodex spp. infestation should also be taken into consideration

Amotivational syndrome : less known and diagnosed as a clinical

Amotivasyonel sendrom (AS) süreğen esrar kullananlarda tanımlanmış geniş anlamıyla ilgisizlik, vurdumduymazlık ve asosyal davranışı içermektedir. Bu etkilerin bir kısmı genel olarak diğer santral sinir sistemi baskılayıcılarında da görülmektedir, bundan dolayı bu sendromu esrar kullanımına özgülemenin ne kadar doğru olduğu hala tartışılmaktadır. AS genellikle ergenlik çağında ve erkek- lerde görülmektedir. Farklı çalışmalarda AS görülme sıklığı olarak düzenli esrar kullananlarda %16 ve %21 gibi oranlar bildirilmiştir. Patofizyolojisinde rol oynayan nedenler hala tartışmalı olmakla birlikte etiyolojide en sık suçlanan etmen esrardır. Nörobiyolojisinde noradrenerjik ve dopaminerjik sistemleri içeren limbik yolakta meydana gelen değişiklikler suçlanmaktadır. Tanısı öznel yakınmalara dayanır, tanı klinik belirtiler ve Apati Değerlendirme Ölçeği (ADÖ) kullanılarak konmaktadır. AS tedavisi konusunda günümüzde çok az deneysel veriler mevcuttur ve klinik deneyim de oldukça azdır. Aralık 2013’te seçilen ‘amotivational syndrome, cannabis and amotivational syndrome, cannabis and motivation’ anahtar sözcükleriyle yapılan PUBMED taraması sonucunda 1960’dan beri yayınlanan, esrar ve AS ilişkisini inceleyen çalışmalar gözden geçirilmiştir. Bu yöntem sonunda 76 tanesi direkt AS ile ilişki olmak üzere 536 makaleye ulaşılmıştır. İngilizce olmayan makaleler değerlendirme dışı bırakılmıştır.Amotivational syndrome (AS) is a disorder that includes apathy, callousness and antisocial behavior in chronic cannabis users. Some of these effects may generally be seen in other central nervous system depressants as well. Therefore, to make these effects specific for this syndrome is still debated. AS is usually seen among men during puberty. In different studies, the incidence of AS in regular cannabis users has been reported as between 16 to 21%. Although the causes accused in pathophysiology is still controversial, cannabis is the most commonly accused factor in the etiology. In neurobiology of the disease, noradrenergic and dopaminergic systems containing changes in limbic road have been blamed. The diagnosis is based on subjective complaints, and scored by clinical signs and Apathy Evaluation Scale (AES). There are very few experimental data available in treatment of AS, and clinical experience is very limited. By PubMed searching the keywords of ‘amotivational syndrome, cannabis and amotivational syndrome, cannabis and motivation’ from 1960 to December 2013, the published studies examining the relationship between marijuana and AS have been reviewed. We have reached 536 articles, of which 76 include direct relationship with AS, by the end of this search. Non-English articles were excluded from the study