Diagnosis and treatment process of comorbid bipolar disorder in a patient diagnosed with autism: Case report

Depression is one of the main psychiatric comorbidity reported in individuals with autism spectrum disorder (ASD). However, some cases of bipolar disorder accompanying ASD have been reported. In the past, there was a tendency to attribute all psychiatric problems in autistic children and adults to autism itself. Nowadays, there is not only an increase in the number of studies on other medical conditions especially neurological conditions in ASD but also there is an increasing effort in defining the comorbide psychiatric disorders. Comorbid psychiatric conditions can make disease management difficult in cases of autism. The precise and reliable diagnosis of psychiatric disorders accompanying children and adolescents with autism is of great importance. More specific treatment options are possible when problematic behaviors are accepted only as a manifestation of comorbid psychiatric disorder from isolated behavior. In this case report, we aimed to present the diagnosis and management of an adolescent autism diagnosed patient and comorbid bipolar disorder

Does applied ultrasound prior to laparoscopy predict the existence of intra-abdominal adhesions?

diagnostic tool, in predicting the presence of intraabdominal adhesions, especially near the trocar entry area, to provide safe surgical access to the abdomen. Materials and methods: Fifty-nine women with a previous history of open abdominal surgery (group A) and a group of 91 women with no previous history of surgery (group B) underwent dynamic ultrasound evaluation of the abdominal fields before laparoscopic operations. The anterior abdominal wall was divided into six quadrants: right upper, right lower, left upper, left lower, suprapubic, and umbilical. Adhesions were evaluated by surgeons during the operation and by radiologists using USG prior to the operation. Visceral organ movements greater than 1 cm was defined as normal visceral slide (positive test), with less than 1 cm of movement defined as abnormal visceral slide (negative test). Sliding test measures movements of omental echogenicity or a stable echogenic focus that corresponds to intestine peritoneal echogenicity that underlies abdominal wall during exaggerated inspiration and expiration. Adhesions observed during surgery were evaluated on a four-point scale, with 0 indicating no adhesions present, 1 indicating the presence of a thin, filmy avascular adhesion, 2 indicating the presence of a dense and vascular adhesion, and 3 indicating adhesions that connect surrounding organs with the overlying peritoneal surfaces. The McNemar test was used to compare the results of USG and laparoscopy for each measure. Results: We found that preoperative USG was successful in identifying adhesions [sensitivity, 96.39% (95% CI 89.8–99.2); specificity, 97.43%] Conclusion: Preoperative ultrasound examination of the abdominal wall may enhance the safety of abdominal entry during laparoscopic operations

A rare case with suicide due to akathisia after use of single dose venlafaxine

Akathisia is a movement disorder characterized by an inner sense of unease, unrest and dysphoria.Suicidal behavior related with akathisia in patients is one of serious harmful behaviors and requires rapid intervention.There is limited number of cases about venlafaxine-associated akathisia in the literature, but it is not still yet known exactly what the actual incidence is.Side effects associated with antidepressants should be closely monitored and should be kept in mind without irreversible conditions. In this case report we will conclude about a case in which rapid development of akathisia and suicidal behavior occurs following venlafaxine treatment initiated with a non-psychiatric indication

Assessment the effect of diabetes education on self-care behaviors and glycemic control in the Turkey Nursing Diabetes Education Evaluating Project (TURNUDEP): a multi-center study

Background: Diabetes education in Turkey is provided by diabetes nurse educators in almost all healthcare organizations. However, the education is not standardized in terms of learning content, duration, and methods. This multi-center study was performed to assess the self-care behaviors and glycemic control following education provided to the patients with type 2 diabetes mellitus by diabetes nurse educators. Methods: This was a descriptive and cross-sectional study and included 1535 patients admitted to 28 public hospitals for the treatment of type 2 diabetes mellitus. The education was assessed by using a Patient Identification Form and Self-care Scale. Results: The proportion of individuals who received diabetes education within the last year was 78.5%, with 46.7% of them having received it once. Of the patients, 84.8% reported that they received diabetes education individually. It was found that the proportion of individuals who received education about oral antidiabetics (78.5%) and glucose testing at home (78.5%) was higher than the proportion of individuals who received education about exercise (58.8%) and foot care (61.6%). The status of diabetes education, education intervals, and the correlation of the education method with self-care and glycemic control was evaluated. Self-care and glycemic control levels were better among the patients who received diabetes education thrice or more and in patients who received education both individually and in a group (p < 0.05). Conclusions: Approximately three-quarters of individuals with type 2 diabetes mellitus received education by diabetes nurse educators in Turkey. Diabetes education is positively correlated with self-care and glycemic control levels among patients with type 2 diabetes mellitus. Efforts for generalization and standardized education for all diabetes patients are necessary. © 2022, The Author(s)