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Article: Thiamine Deficiency Neuropathy in a Patient with Malnutrition due to Melancholic Depression.

Melki, Rihene / Ben Soussia, Rim / Mrabet, Houcem Elomma / Bouali, Walid / Zarrouk, Lazhar

2024 Volume 2024, Page(s) 1797983

Abstract: Introduction: Melancholic depression is a daily clinical reality in psychiatry. It is a therapeutic emergency that can jeopardize life if not promptly and adequately treated. Apart from its high suicidal risk, complications related to the under- ... ...

Abstract	Introduction: Melancholic depression is a daily clinical reality in psychiatry. It is a therapeutic emergency that can jeopardize life if not promptly and adequately treated. Apart from its high suicidal risk, complications related to the under-nourishment state are to be feared. Conclusion: In our case, the rapid weight loss facilitated a cascade of complications related to nutritional deficiencies. Based on our clinical observations and the literature, thiamine deficiency should be considered in the presence of malnutrition and vulnerability, both on an organic and psychiatric level.
Language	English
Publishing date	2024-03-08
Publishing country	United States
Document type	Case Reports
ZDB-ID	2629914-8
ISSN	2090-6838 ; 2090-682X
ISSN (online)	2090-6838
ISSN	2090-682X
DOI	10.1155/2024/1797983
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Hunger strike in prison: medical, ethical and legal aspects.

Bouali, Walid / Gniwa, Rim Omezzine / Ben Soussia, Rim / Zarrouk, Lazhar

La Tunisie medicale

2022 Volume 99, Issue 11, Page(s) 1045–1054

Abstract: Background: A hunger strike is a common form of protest in prison and is a potential cause of many types of problems, both for facility administrators and health care staff. Issues of conflict of rights and obligations involved, and how to treat people ... ...

Abstract	Background: A hunger strike is a common form of protest in prison and is a potential cause of many types of problems, both for facility administrators and health care staff. Issues of conflict of rights and obligations involved, and how to treat people who are subject, have created major controversies. Objectives: To identify and review published studies that discuss the medical, ethical and legal considerations of managing a hunger strike in a prison setting from a physician's perspective. Methods: A database search using "Medline" "Ovid" and "Science Direct was conducted to identify relevant publications. We included case series, guidelines and, review articles. Results: The physician must clearly inform the striker of the risks and provide clinical assessment and regular monitoring of the concerned. The role of the psychiatrist is to detect an initial mental pathology underlying or secondary to fasting and assess the capacity of the striker's judgment. Thus, the clinician is faced with two paradoxical obligations: to assist and respect the striker's will. In addition, medical intervention is possible if the prognosis is life-threatening even without the patient's consent. Conclusion: The current practice of non-consensual attitude among hunger-striking seeking in detention needs a closer inquiry. Medical practitioners should be aware of their ethical and legal responsibilities, and that they should act independently of government or institutional interests.
MeSH term(s)	Dissent and Disputes/legislation & jurisprudence ; Ethics, Medical ; Fasting/adverse effects ; Humans ; Prisoners/legislation & jurisprudence ; Prisons/ethics ; Prisons/legislation & jurisprudence
Language	English
Publishing date	2022-03-15
Publishing country	Tunisia
Document type	Journal Article
ZDB-ID	128627-4
ISSN	2724-7031 ; 0041-4131
ISSN (online)	2724-7031
ISSN	0041-4131
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Article ; Online: [Antipsychotic prescription amongst the elderly].

Bouali, Walid / Omezzine Gniwa, Rim / Hadj Mohamed, Ahmed / Ben Soussia, Rim / Zarrouk, Lazhar

La Tunisie medicale

2023 Volume 100, Issue 11, Page(s) 782–787

Abstract: Introduction: The treatment of certain psychotic, behavioural and delusional symptoms in the elderly frequently involves the prescription of antipsychotics. Prescribing such drugs to elderly patients has recently been called into question, leaving ... ...

Abstract	Introduction: The treatment of certain psychotic, behavioural and delusional symptoms in the elderly frequently involves the prescription of antipsychotics. Prescribing such drugs to elderly patients has recently been called into question, leaving physicians with little or nothing to treat a range of symptoms that are often complex and difficult to treat. Aims: The study aimed to evaluate the prescription of antipsychotics amongst elderly and to compare it with data in the literature. Methods: This retrospective cohort study included patients aged 65 and older admitted to the psychiatric ward of Mahdia University Hospital over the period from 2014 to 2018 who received antipsychotic treatment during their hospitalization. Results: The sample consisted of 44 elderly patients, with 31.8% patients using atypical agents, 34.1% using typical agents, 27.3% received both of them and 6.8% received a long-acting injectable antipsychotic. A majority of the elderly study sample were men (75 %). The mean (SD) age of the study sample was 69.8 years. 61.3% had at least somatic comorbidity. The most common diagnosis was schizophrenia with 31.8%, followed by dementia (27.3%). 34.1% reported adverse effects due to antipsychotic treatment. Conclusion: The study findings suggest that there is a need to be cautious when prescribing antipsychotic in the elderly population. Patient education and regular follow-up of patients can be instrumental in minimizing the adverse outcomes associated with the use of antipsychotics in the the aging population.
Language	French
Publishing date	2023-08-08
Publishing country	Tunisia
Document type	English Abstract ; Journal Article
ZDB-ID	128627-4
ISSN	2724-7031 ; 0041-4131
ISSN (online)	2724-7031
ISSN	0041-4131
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Article ; Online: Corrigendum to "Fatal pulmonary embolism in patients on antipsychotics: Case series, systematic review and meta-analysis" [Asian J. Psychiatry 73 (2022) 1-11/103105].

Manoubi, Syrine Azza / Boussaid, Marwa / Brahim, Oumeima / Ouanes, Sami / Mahjoub, Yosra / Zarrouk, Lazhar / Amin Mesrati, Mohamed / Aissaoui, Abir

Asian journal of psychiatry

2023 Volume 83, Page(s) 103575

Language	English
Publishing date	2023-04-01
Publishing country	Netherlands
Document type	Published Erratum
ZDB-ID	2456678-0
ISSN	1876-2026 ; 1876-2018
ISSN (online)	1876-2026
ISSN	1876-2018
DOI	10.1016/j.ajp.2023.103575
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Article ; Online: Catatonia in patients with dementia: a case report.

Younes, Samira / Khouadja, Sabria / Younes, Samia / Zarrouk, Lazhar

The Pan African medical journal

2019 Volume 33, Page(s) 117

Abstract: Catatonia occurring as part of a clinical picture of dementia has been reported with almost all types of dementia. It remains under-diagnosed in older adults and those with dementia. We review a case of a young patient admitted in our psychiatric ... ...

Abstract	Catatonia occurring as part of a clinical picture of dementia has been reported with almost all types of dementia. It remains under-diagnosed in older adults and those with dementia. We review a case of a young patient admitted in our psychiatric department for catatonia and after efficient treatment with Lorazepam, assessment revealed a dementia. Catatonia is a severe neuropsychiatric syndrome with an excellent prognosis if recognized and treated without delay.
MeSH term(s)	Anti-Anxiety Agents/administration & dosage ; Catatonia/drug therapy ; Catatonia/etiology ; Dementia/complications ; Dementia/diagnosis ; Humans ; Lorazepam/administration & dosage ; Male ; Middle Aged ; Prognosis ; Treatment Outcome
Chemical Substances	Anti-Anxiety Agents ; Lorazepam (O26FZP769L)
Language	English
Publishing date	2019-06-14
Publishing country	Uganda
Document type	Case Reports
ZDB-ID	2514347-5
ISSN	1937-8688 ; 1937-8688
ISSN (online)	1937-8688
ISSN	1937-8688
DOI	10.11604/pamj.2019.33.117.18629
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Article ; Online: Fatal pulmonary embolism in patients on antipsychotics: case series, systematic review and meta-analysis.

Manoubi, Syrine Azza / Boussaid, Marwa / Brahim, Oumeima / Ouanes, Sami / Mahjoub, Yosra / Zarrouk, Lazhar / Mesrati, Mohamed Amin / Aissaoui, Abir

Asian journal of psychiatry

2022 Volume 73, Page(s) 103105

Abstract: Since the 1950 s, several studies have reported that patients using first generation and/or second-generation antipsychotics had increased risk of venous thromboembolism events. These events include deep vein thrombosis and/or pulmonary embolism (PE). ... ...

Abstract	Since the 1950 s, several studies have reported that patients using first generation and/or second-generation antipsychotics had increased risk of venous thromboembolism events. These events include deep vein thrombosis and/or pulmonary embolism (PE). However, data about fatal PE in patients on antipsychotics (APs) remain scarce. Thus, the current study aimed to investigate sociodemographic, clinical and pharmacological characteristics related to psychiatric patients on APs and who died from a fatal PE. We reported a case-series, then conducted a literature review of relevant studies and performed a meta-analysis of studies with usable data. The main outcome of the study suggested a significantly high risk of fatal PE in patients using APs compared to nonusers (Odds Ratio=6.68, with 95% confidence interval 1.43-31.11). Clozapine was the most incriminated drug. Low potency first generation APs were the second most exhibited medication. Studies about the topic remain scarce with a high heterogeneity and a high probability of bias. Further studies are needed to ascertain this risk and to establish target preventive measures in this particularly vulnerable population.
MeSH term(s)	Antipsychotic Agents/adverse effects ; Clozapine ; Humans ; Odds Ratio ; Pulmonary Embolism/chemically induced ; Pulmonary Embolism/epidemiology ; Risk Factors ; Venous Thromboembolism/chemically induced ; Venous Thromboembolism/epidemiology
Chemical Substances	Antipsychotic Agents ; Clozapine (J60AR2IKIC)
Language	English
Publishing date	2022-04-12
Publishing country	Netherlands
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID	2456678-0
ISSN	1876-2026 ; 1876-2018
ISSN (online)	1876-2026
ISSN	1876-2018
DOI	10.1016/j.ajp.2022.103105
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Article ; Online: Aspects épidémiocliniques et suites judiciaires des abus sexuels chez les mineurs à Monastir, Tunisie.

Soussia, Rim Ben / Omezzine, Rim Gniwa / Bouali, Walid / Zemzem, Mouna / Bouslah, Sarra / Zarrouk, Lazhar / Gaha, Lotfi

The Pan African medical journal

2021 Volume 38, Page(s) 105

Abstract: Introduction: Child sexual abuse is a disturbing reality and a major public health problem. Indeed, it is a subject that has long been treated as taboo, with dramatic consequences on physical and mental health as well as on social wellbeing of the ... ...

Title translation	Epidemioclinical and legal aspects of sexual abuse among minors in Monastir, Tunisia.
Abstract	Introduction: Child sexual abuse is a disturbing reality and a major public health problem. Indeed, it is a subject that has long been treated as taboo, with dramatic consequences on physical and mental health as well as on social wellbeing of the victims. The purpose of this study was to highlight the epidemiological and clinical features as well as the legal aspects of child sexual abuse. Methods: we conducted a retrospective descriptive study at the psychiatric outpatient service of the University Hospital of Monastir over a period of 12 years and 6 months. All children younger than 18 years diagnosed with suspected or confirmed sexual assault were included. Results: a total of 93 children, victims of sexual abuse were enrolled. The average age of patients was 10 years, with a standard deviation of 3.9 years. Sex-ratio M/F was 0.9. The most common sexual contact was touching (47,3% of cases). The majority of abusers were male (93,5%). In more than half of the cases (53,8%) they were relatives of the child and in 28% of cases intra-familial abuse was reported. Initial psychiatric assessment showed mental disorders in 70% of cases. Conclusion: sexual abuse is a very broad field of violence which varies widely in nature and intensity. Although, in some types of sexual abuse occasionally there is a lack of physical traces, the emotional and psychological impact is ubiquitous and characterized by numerous clinical manifestations.
MeSH term(s)	Adolescent ; Ambulatory Care ; Child ; Child Abuse, Sexual/legislation & jurisprudence ; Child Abuse, Sexual/statistics & numerical data ; Criminals/psychology ; Female ; Humans ; Male ; Mental Disorders/diagnosis ; Mental Disorders/epidemiology ; Mental Health Services ; Retrospective Studies ; Tunisia/epidemiology
Language	French
Publishing date	2021-02-01
Publishing country	Uganda
Document type	Journal Article
ZDB-ID	2514347-5
ISSN	1937-8688 ; 1937-8688
ISSN (online)	1937-8688
ISSN	1937-8688
DOI	10.11604/pamj.2021.38.105.21766
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Article ; Online: Psychiatric disorders in the acoustic neuroma: about a case.

Younes, Samira / Khouadja, Sabria / Younes, Samia / Soussia, Rim Ben / Bouali, Walid / Mohamed, Ahmed Haj / Zarrouk, Lazhar

The Pan African medical journal

2019 Volume 33, Page(s) 80

Abstract: Neurofibromatosis type 2 (NF2) is a rare autosomal dominant disorder characterized by formation of central nervous system tumors. They are associated to significant morbidity due to multiple problems such as hearing loss that can lead to many psychiatric ...

Abstract	Neurofibromatosis type 2 (NF2) is a rare autosomal dominant disorder characterized by formation of central nervous system tumors. They are associated to significant morbidity due to multiple problems such as hearing loss that can lead to many psychiatric disorders.
MeSH term(s)	Hearing Loss/etiology ; Humans ; Male ; Mental Disorders/diagnosis ; Mental Disorders/etiology ; Neurofibromatosis 2/complications ; Neurofibromatosis 2/diagnosis ; Neuroma, Acoustic/diagnosis ; Neuroma, Acoustic/etiology ; Young Adult
Language	English
Publishing date	2019-06-04
Publishing country	Uganda
Document type	Case Reports
ZDB-ID	2514347-5
ISSN	1937-8688 ; 1937-8688
ISSN (online)	1937-8688
ISSN	1937-8688
DOI	10.11604/pamj.2019.33.80.18398
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Article: Psychiatric emergencies : Factors associated with suicide attempts.

Gniwa, Omezzine Rim / Ben Soussia, Rim / Bouali, Walid / Sriha Belguith, Asma / Younes, Samira / Zarrouk, Lazhar

La Tunisie medicale

2019 Volume 97, Issue 7, Page(s) 910–917

Abstract: Background: Among psychiatric emergencies, suicide attempt is a frequent reason for consultation. The magnitude of this phenomenon is not only related to its increasing frequency or life-threatening, but also to the psychosocial consequences of suicidal ...

Abstract	Background: Among psychiatric emergencies, suicide attempt is a frequent reason for consultation. The magnitude of this phenomenon is not only related to its increasing frequency or life-threatening, but also to the psychosocial consequences of suicidal gesture both on the patient and his entourage. Objectives: To determine the prevalence of suicide attempts in psychiatric emergency department patients and to identify associated factors. Methods: This is a cross-sectional study carried out in the emergency department of Mahdia University Hospital during a three months period, including consultants for whom a psychiatric opinion was solicited. Regarding statistical analyzes, we studied associations between suicide attempt and sociodemographic, contextual, anamnestic and clinical variables. Results: Forty-four suicidal patients were included, with a prevalence of 0.5% of all emergencies. The patients mean age was 26.6 years with a female predominance (sex ratio = 0.29). Self-induced intoxication was the most widely used method (93.2%). Reactional suicidal attempts accounted for 75%. Many factors were significantly associated with suicide attempts: young age, female gender, secondar y level of education, students, presence of trigger factor, family and personal history of suicide attempt and the provenance of the examination request from a physician. Conclusion: This study highlights a particular profile of patients at high risk of suicide, a codified action is to begin, including all health care providers to prevent its occurrence. This primary prevention is only possible through the identification of risk factors associated with it.
MeSH term(s)	Adult ; Age Factors ; Cross-Sectional Studies ; Educational Status ; Emergency Service, Hospital/statistics & numerical data ; Female ; Hospitals, University ; Humans ; Male ; Prevalence ; Risk Factors ; Sex Factors ; Suicidal Ideation ; Suicide, Attempted/psychology ; Suicide, Attempted/statistics & numerical data ; Tunisia
Language	English
Publishing date	2019-12-22
Publishing country	Tunisia
Document type	Journal Article
ZDB-ID	128627-4
ISSN	0041-4131
ISSN	0041-4131
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Article ; Online: Clinical and genetic influencing factors on clozapine pharmacokinetics in Tunisian schizophrenic patients.

Ammar, Helmi / Chadli, Zohra / Mhalla, Ahmed / Khouadja, Sabria / Hannachi, Ibtissem / Alshaikheid, Mohammed / Slama, Ahlem / Ben Fredj, Nadia / Ben Fadhel, Najeh / Ben Romdhane, Haifa / Chaabane, Amel / Boughattas, Naceur A / Gaha, Lotfi / Zarrouk, Lazhar / Aouam, Karim

The pharmacogenomics journal

2021 Volume 21, Issue 5, Page(s) 551–558

Abstract: Clozapine (Clz) is an atypical antipsychotic, which its pharmacokinetics can be influenced by several factors. The CYP1A2 and CYP2C19, major enzymes implicated in Clz metabolism, present an interethnic variation on their activity caused by single ... ...

Abstract	Clozapine (Clz) is an atypical antipsychotic, which its pharmacokinetics can be influenced by several factors. The CYP1A2 and CYP2C19, major enzymes implicated in Clz metabolism, present an interethnic variation on their activity caused by single nucleotide polymorphisms (SNPs). The present study investigated the influence of genetic and nongenetic factors on Clz pharmacokinetics in a southern Mediterranean population. We included adult Tunisian schizophrenic patients having received Clz and undergone a therapeutic drug monitoring (TDM) of Clz by morning C0 monitoring. The genomic DNA was extracted using a salting-out procedure. CYP1A21F (rs762551;-163C>A), CYP1A21C (rs2069514;-3860 G>A) and CYP 2C192 (rs4244285; 681G>A) was analyzed using PCR-RFLP. Fifty-one patients were enrolled in the study. The mutant allele (CYP1A21F) was the most frequently detected (58.8%). For CYP1A2*1F, Clz dose-normalized (C0/D ratio) was as high as 1.28 ± 0.37 in CC versus 0.67 ± 0.32 ng mL
MeSH term(s)	Adult ; Alleles ; Antipsychotic Agents/blood ; Antipsychotic Agents/pharmacokinetics ; Antipsychotic Agents/therapeutic use ; Clozapine/blood ; Clozapine/pharmacokinetics ; Clozapine/therapeutic use ; Cytochrome P-450 CYP1A2/genetics ; Cytochrome P-450 CYP2C19/genetics ; Female ; Genotyping Techniques ; Humans ; Male ; Middle Aged ; Polymorphism, Single Nucleotide/genetics ; Schizophrenia/drug therapy ; Schizophrenia/genetics ; Tunisia ; Young Adult
Chemical Substances	Antipsychotic Agents ; CYP1A2 protein, human (EC 1.14.14.1) ; CYP2C19 protein, human (EC 1.14.14.1) ; Cytochrome P-450 CYP1A2 (EC 1.14.14.1) ; Cytochrome P-450 CYP2C19 (EC 1.14.14.1) ; Clozapine (J60AR2IKIC)
Language	English
Publishing date	2021-03-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2106831-8
ISSN	1473-1150 ; 1470-269X
ISSN (online)	1473-1150
ISSN	1470-269X
DOI	10.1038/s41397-021-00231-x
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