Neuroleptic malignant syndrome induced by ziprasidone on the second day of treatment

Neuroleptic malignant syndrome (NMS) is the rarest and most serious of the neuroleptic-induced movement disorders. We describe a case of neuroleptic malignant syndrome (NMS) associated with the use of ziprasidone. Although conventional neuroleptics are more frequently associated with NMS, atypical antipsychotic drugs like ziprasidone may also be a cause. The patient is a 24-year-old male with a history of schizophrenia who developed signs and symptoms of NMS after 2 days of treatment with an 80-mg/day dose of orally administrated ziprasidone. This case is the earliest (second day of treatment) NMS due to ziprasidone reported in the literature

Cadaver analysis of thoracic outlet anomalies

Background: This study aims to determinate the rate of thoracic outlet anomalies by means of analysis of cadavers.Methods: Supraclavicular incisions were applied by two anatomists and two thoracic surgeons in the thoracocervicoaxillary region of both extremities (n=40) in twenty cadavers (7 females, 13 males; mean age 46). The formation and type of fibrous bands, cervical ribs, C7 long transverse processes and anomalies of the clavicles, scalenus anterior and scalenus medius muscles, brachial plexus, subclavian arteries and veins were evaluated. The type and formation of fibrous bands were classified using Roos' classification.Results: Anomalies were found in 34 (85%) of extremities. The type 3-band was most frequently (15%) observed and all of them were on the right extremity. The type 4-band was rarely seen (2.5%). Two bands (type 9 and type 11) in the same extremity were notified in one cadaver. (2.5%). The occurrence rate of cervical rib and C7 long transverse process was 10%. Some fibers of m. scalenus medius emerged from a cervical rib in one extremity (2.5%). The arteria subclavia anterior passed through the scalene muscle in three extremities (7.5%). In 10% of extremities the C5 truncus passing through the anterior scalene muscle and upper truncus of brachial plexus passing anterior scalene muscle via perforation was found in 7.5% of patients.Conclusion: In our population, brachial plexus and subclavian artery variations are frequently observed. Therefore these types of anomalies should be taken into consideration to prevent morbidity and complications when muscle division or blockage applications are performed

Effect of Ramadan fasting on heart rate variability as a measure of cardiac stress in a Lebanese cohort

Contains fulltext : 225320.pdf (Publisher’s version ) (Closed access)BACKGROUND: Intermittent fasting is an annual religious practice of Muslims worldwide, which affects the physiology of the body due to lifestyle alterations. This study aimed to evaluate the effect of Ramadan fasting on the HRV, an indirect measure of cardiac sympathetic stress. METHODS: This study included 80 healthy Lebanese females (aged 18-25 years old) monitored for 24 h when following normal routine; 38 and 42 females were enrolled before and during Ramadan, respectively. RESULTS: Our results reveal no effect of fasting on HRV; there was insignificant change in HRV between the first and last weeks of Ramadan (P > 0.05). Morning fasting was significantly the least stressful period (lowest HR, P < 0.001), with lower HR compared with non-fasting day (P < 0.001). Therefore, Ramadan fasting does not alter the autonomic nervous activity of the heart, neither HRV levels. CONCLUSIONS: This may imply that intermittent fasting is a risk-free practice, which does not interfere with the cardiac autonomic nervous system function