Afebrile Neuroleptic Malignant Syndrome associated with Fluphenazine decanoate: A case report

"nNeuroleptic Malignant Syndrome (NMS) is unusual but could be a lethal reaction associated with neuroleptic drugs. It occurs in almost 0.07-2.2% of patients under treatment with neuroleptics. There are some medical treatments that may also be helpful for its treatment, including dopamine agonists, muscle relaxants, and electroconvulsive therapy (ECT). We present this case to alert the clinicians to the potential for inducing afebrile NMS. Our case is a 41-year-old man with a history of schizophrenia showing signs and symptoms in accordance with NMS, 2 weeks after receiving one dose of 12.5 mg fluphenazine decanoate, abruptly following the 3rdsession of ECT. The patient presented with decreased level of consciousness, muscular rigidity, waxy flexibility, mutism ,generalized tremor, sever diaphoresis and tachycardia which progressed during the previous 24 h. Laboratory data indicated primarily leukocytosis, an increasing level of creatinine phosphokinase and hypokalemia during the next 72h. In patients receiving antipsychotics, any feature of NMS should carefully be evaluated whether it is usual or unusual particularly in patients receiving long acting neuroleptics

Epidemiological Survey on the Status of Obsessive-compulsive Disorder among School-age Childrenin Iran

Background and purpose: The age of the onset of obsessive-compulsive disorder (OCD) and its&nbsp;manifestation is now identified at childhood. In the present study, we aimed to&nbsp;epidemiologically assess OCD and its main determinants in school-age children.&nbsp; Materials and Methods: This cross-sectional study was performed on 600 consecutive schoolage children (7-12 years old) in primary schools at Kermanshah, Iran in May 2012. OCD status was assessed using the Maudsley Obsessive Compulsive Inventory. Results: In this study, the prevalence of OCD in children were 12.2% (73 person). Among&nbsp;OCDs, 32.0% were male and 68.0% were female with a significant difference (P < 0.001).&nbsp;Among different subscales of OCD, checking was more prevalent in girls than in boys (74.0%&nbsp;vs. 65.0%, P < 0.001), whereas doubting was more revealed in boys than in girls (56.0% vs.&nbsp;34.0%, P < 0.001). In this regard, no differences were found between boys and girls in the rate&nbsp;of washing subscale (43.0% vs. 40.0%, P = 0.456) and slowness domain (30.0% vs. 34.0%,&nbsp;P = 0.294). Totally, mean MOCI score was significantly a higher in girls than in boys in&nbsp;different grades of education. OCD was influenced by father&rsquo;s occupation status, parents&rsquo;&nbsp;education level, order of birth, dependence to mothers and previous history of OCD in fathers. Conclusion: The prevalence of OCD was a higher than other areas in the country and other&nbsp;populations. Because of the existence of OCD potential determinants including socioeconomic&nbsp;level and familial tendency, the high prevalence of the disease must be considered in correlation&nbsp;with these factors