Catatonia: A Rare Manifestation of Autism

• Aamir Jalal Al–Mosawi*

Citation: Al–Mosawi AJ. Catatonia: A Rare Manifestation of Autism. Medp Psychiatry Behav Sci. 2022; 1(1): mppbs–202209008.

Abstract

  Background: Autism disorders which are also known pervasive developmental disorders as are very complex and heterogeneous group of chronic disorders that marked by early impairment in socialization, communication, and behavior. Catatonia has rarely been reported in association with autism disorder. 

  Patients and methods: The father of a ten year old boy with autism was particularly concerned about an abnormal behavior the boy was showing during the previous weeks. The boy was taking an abnormal position for variable time, sometimes more that 20 minutes, and associated with some repetitive movements, and was not responding to external stimuli. 

  Results: A ten year old boy who was first observed on the fifth of November, 2021 because his father complained his son had poor communication with his parents, and was poorly responding to his name. The boy’s language was not good, and he had some repetitive movements. The abnormal communication prevented the child from learning like normal children. At the age of ten his adaptive skills was considered acceptable. The diagnosis of typical autism without significant mental retardation was made. The occurrence of a mild form of catatonia was documented. 

  Conclusion: In this paper, the rare occurrence of a mild form of catatonia in association with typical autism disorder is reported, and a therapeutic approach is suggested. 

  Keywords: Catatonia; Autism; Cerebrolysin.

 

Cerebral Palsy and Autism Associated With Periventricular White Matter Hyperintensity on Brain Magnetic Resonance Imaging: A New Disorder and Its Treatment

• Aamir Jalal Al–Mosawi*

Citation: Al–Mosawi AJ. Cerebral Palsy and Autism Associated With Periventricular White Matter Hyperintensity on Brain Magnetic Resonance Imaging: A New Disorder and Its Treatment. Medp Psychiatry Behav Sci. 2022; 1(1): mppbs–202209007.

Abstract

  Background: We have previously reported the very rare sporadic occurrence of periventricular white matter hyperintensity on brain magnetic resonance imaging with atypical neuropsychiatric manifestation including late onset (after the first year) non– progressive spastic cerebral palsy, and autistic features. There is no published experience with treatment with such rare conditions. 

  Patients and methods: A Palestinian boy from the Western Bank who had a diagnosis of cerebral palsy (mild spastic diplegia) and gross sensory motor delay with development of autistic features was previously reported to have a very rare condition consisting of spastic cerebral palsy and autism associated with periventricular white matter hyperintensity on brain magnetic resonance imaging. 

  Results: Before treatment, at the about the age of five year and half year, he was unable to stand from sitting position on the floor alone, but he could walk very slowly for few steps, but was falling on his head several times. He was not saying any word and had impaired communication with others as he was not responding to his name most of the time. The boy was treated with courses of multi–factorial therapies based on our extensive published experiences with the treatment of cerebral palsy and autism. 

 After four months of treatment, the boy showed significant improvement in motor abilities and he was able to stand from the sitting position on the floor alone, and he was walking confidently for long time and also going upstairs holding the bars. Autistic features improved and he was much more responsive to his name than before treatment, and his eye contact was better. His communication skills improved and was increasingly asking to go out and waving goodbye. 

  Conclusion: In this paper the emergence of a new clinical disorder is emphasized. It is characterized by the association of cerebral palsy and autism with periventricular white matter hyperintensity on brain magnetic resonance imaging. Treatment of the disorder with courses of evidence–based multi–factorial was associated with significant improvement. 

  Keywords: Periventricular White Matter Hyperintensity; Cerebral Palsy; Autism; Multi–Factorial Therapies. 

Atypical Genetic Autism: Cure of the Major Autistic Features and the Need for Cognitive Improvement and Rehabilitation

Aamir Jalal Al–Mosawi*

Citation: Al–Mosawi AJ. Atypical Genetic Autism: Cure of the Major Autistic Features and the Need for Cognitive Improvement and Rehabilitation. Medp Psychiatry Behav Sci. 2022; 1(1): mppbs–202209006.

Abstract

  Background: We have previously reported our extensive experiences with autism disorders and their treatments, and we showed the possibility of curing the major autistic features with a new therapeutic approach, which included individualized courses of intramuscular cerebrolysin as the main therapy for the main autistic features. Our previously published experiences included demonstrating the cure of autism in two brothers with autosomal recessive disorder. We emphasized that cure of autism in older children has never been expected to totally normalize them, as the patients have already lost several years of learning, social adaptation, and maturation of personality and behavior. In addition, patients with atypical autism associated with some degree of mental retardation need further interventions to improve their cognitive abilities. 

  Patients and methods: Our previously published experiences included demonstrating the cure of autism in two brothers with autosomal recessive disorder. We emphasized that cure of autism in older children has never been expected to totally normalize them, as the patients have already lost several years of learning, social adaptation, and maturation of personality and behavior. In addition, patients with atypical autism associated with some degree of mental retardation need further interventions to improve their cognitive abilities. These paper reports further treatments received the older of two brothers with autosomal recessive autism who were reported to achieve cure of the major autistic features. 

  Results: After eighth months of treatment, the boy experienced significant improvements in cognitive functions, as he was understanding and responding to simple commands well. 

  Conclusion: Cure of autism has been achieved in two boys with autosomal recessive disorder. However, cure of autism in older children has never been expected to totally normalizes them, as the patients have already lost several years of learning, social adaptation, and maturation of personality and behavior. 

  Keywords: Atypical Autism; Autosomal Recessive; Cure; Cognition.

Public Health and The Rule of Law

Mihaela Agheniței, Lawyer Jafar Samdani*

Citation: Agheniței M, Samdani LJ. Public Health and The Rule of Law. Medp Public Health Epidemiol. 2022; 1(1): mpphe–202207005.

Abstract

   The rule of law is a sustainable system of laws, institutions, rules and community engagement that gives accountability to both government and private actors, fair laws that protect fundamental rights, open government and accessible justice. In a strong rule of law society, these four principles intersect to ensure that citizens have efficient, transparent and accountable institutions that can defend freedom, ensure public safety, including public health, and facilitate prosperity. Evidence suggests a positive correlation between the rule of law and public health – countries with a better rule of law enjoy lower maternal and infant mortality rates, longer life expectancy and a lower incidence of chronic diseases. The rule of law fosters trust in institutions and supports a social contract between citizens, both of which are essential for resolving a public health crisis such as the COVID–19 pandemic in which a collective approach is the only way to keep and control the disease. 

The Association of Gélineau’s Syndrome (Narcolepsy without Cataplexy) With Childhood Poliomyelitis: An Educational Mini–Review

Aamir Jalal Al–Mosawi*

Citation: Al–Mosawi AJ. The Association of Gélineau’s Syndrome (Narcolepsy without Cataplexy) With Childhood Poliomyelitis: An Educational Mini–Review. Medp Psychiatry Behav Sci. 2022; 1(1): mppbs–202209005.

Abstract

  Background: Gélineau’s syndrome (Primary narcolepsy without cataplexy) is a condition of unknown etiology characterized by excessive sleepiness during day time. It is classified as narcolepsy type–2 by the third edition of the International Classification of Sleep Disorders (ICSD–3), but it is classified as hypersomnolence disorder by the fifth edition of the Diagnostic and Statistical Manual [1,2]. Although Gélineau’s syndrome was first described in 1880, the disorder has not been reported in Iraq, and the association with childhood poliomyelitis has not been mentioned before in the medical literature. 

  Patients and methods: A man who was born in 1965, and suffered from childhood poliomyelitis has been experiencing irresistible sleep during work time, almost every day for more than two years. 

  Results: A 57–year old man who didn’t receive poliomyelitis vaccine during childhood and suffered from childhood poliomyelitis the left him with permanent deformity of the right foot has been experiencing irresistible daytime sleep despite having adequate sleep at night. He has been sleeping during work time, almost every day for more than two years. He was sleeping for 10 to 15 munities, and was sometimes sleeping while some one was talking with him. However, he was easily awakened by noises. He was usually falling a sleep two or three times during work time daily. He has not been experiencing cataplexy nor has displaying symptoms of depression, and has not been experiencing obvious cognitive nor neurological deterioration, 

   Conclusion: The first case of Gélineau’s syndrome (Primary narcolepsy without narcolepsy) in Iraq is described, and the novel association with childhood poliomyelitis is reported. 

  Keywords: Primary Narcolepsy; Gélineau’s Syndrome; Childhood Poliomyelitis; Iraq; Educational Article.

Principles of Training and Development for Physicians

Aamir Jalal Al–Mosawi*

Citation: Al–Mosawi AJ. Principles of Training and Development for Physicians. Medp Psychiatry Behav Sci. 2022; 1(1): mppbs–202209004.

Abstract 

      The increasing complexity of medical care environment and medical education and practices has made the understanding the principles and concepts of training, development, and the related concepts and disciplines necessary for doctors practicing at almost any level. Physicians particularly consultants are frequently placed in teaching and training positions. Many doctors are teaching medical students in medical schools and training residents in teaching and university hospitals. In addition, many doctors have an obligation to the development of their students, trainee, and their organizations. Therefore, the principles and concepts of development have become increasingly relevant to doctors running hospitals, medical schools and other health institutions and centers. For most doctors, understanding of the concepts and disciplines related to development and training such as training methods, learning methods, coaching and mentoring is also useful. In addition, many doctors are responsible for the training and development of employees who are not doctors such as nurses, allied health professionals, and other management employees. Physicians who are having instructor’s and trainer’s duties must have satisfactory knowledge in educational learning theory to perform their role effectively. Understanding the learning process is a key element of educational learning theory and provides a framework for teachers and trainers to plan, create and deliver effective lessons, and assess each student’s learning. The aim of this paper is to provide a useful compendium of the conceptual structure of training and its methodologies. This paper serves well as a source of information to help doctors in training their less senior colleagues in different medical and clinical settings. In addition to enabling the essential understanding of the conceptual background of the process of training in general and training of trainers, this book can also help in optimizing the effectiveness of the training designed to build a potential cadre of trainers.

  Keywords: Training and Development: Physicians.

                                   

The Durable Lining: A New Tool for Malaria Vector Control Compared to Other Classical Methods (Long Lasting Insecticide Treated Nets “LLIN” During a Village Scale Long Term Trial in Angola. I. Entomological Evaluation.

• Pierre Carnevale1,* Jean-Claude Toto2, Vincent Foumane2, Filomeno Fortes3, Guillaume Carnevale4, Frédérick Gay5

Citation: Carnevale P, Gay F, Toto J–C, Foumane V, Fortes F, Carnevale G. The Durable lining: a new tool for Malaria Vector Control Compared to other Classical Methods (Long Lasting Insecticide Treated nets “LLIN”; Indoor Residual Spraying) during a Village scale long term trial in Angola. I. Entomological Evaluation. Medp Public Health Epidemiol. 2022; 2(1): mpphe–202207001.

Abstract

  Background: Deltamethrin (“δ”) treated durable lining (“DL”) or “insecticide treated plastic sheeting” (“δITPS”) were used for a long term village–scale malaria vector control (VC) program in 8 villages around Balombo town (Benguela Province, Angola) either alone (in 2 villages) or associated with Long Lasting deltamethrin Insecticide treated Net (“δLLIN”) Permanet© 2.0 (in 2 villages) or following Indoor Residual Spraying with lambdacyhalothrin “λ” (“λIRS”) (in 2 villages) while LLIN P2.0 alone were considered as “golden standard” and implemented in 2 villages. 2 models of ITPS were used, “Wall lining” and “Zero Fly” with different deltamethrin concentration. A comprehensive evaluation, entomological and parasitological, was initially planned for 5 years. Entomological evaluation was based upon the regular use of the classical CDC Miniature Light Trap inside human houses. 

   Results: During these 5 years (2 years before and 3 years after full vector control implementation) 202 CDC “night catching sessions” were done, representing 1880 “trap– night”, 1152 Anopheles were captured, belonging to 10 species, the main vectors (“MV”) were Anopheles funestus and An. gambiae. After implementation of VC the densities of “main– vector/traps” dropped by # 70%, similarly with the 4 VC methods (#63% with LLIN alone; #69% with the association LLIN +ITPS model “Zero Fly”; # 82% with ITPS model “Wall Lining” alone and #75 % after 2 rounds of λIRS followed by ITPS installation). 28 of the 1133 anopheles analyzed procured an Elisa positive test i.e. a general positivity index of 2.47%; with 8.00% (n= 50) for An. gambiae; 3.61% (n= 498) for An. funestus and 2.06% for An. marshalli (n= 243). Infectivity of main vectors An. gambiae + An. funestus dropped, but not significantly, from 4.53%, (n= 375) to 2.59% (n=193) after vector control implementation.

    Conclusions: The fact that Durable Lining, even alone, were as efficient as Indoor Residual Spraying to reduce biting rate and inoculation rate of main vectors while having a longer lasting activity, and that the association Long Lasting Treated Nets + Durable Lining was not much better than a single method are important information for the National Malaria Control Program and other Malaria Control programs.

  Keywords: Anopheles, vector control, malaria, Angola, entomological evaluation, deltamethrin treated durable lining, Long Lasting insecticide (deltamethrin) treated Nets (LLIN), lambdacyhalothrin Indoor Residual Spraying.

Structural Equation Modeling of Pregnancy in the COVID–19 Era

Felipe de Jesuus Vilchis Mora1,* Cruz Garcia Lirios1, Maria Luisa Quintero Soto1, 

• Sonia Sujell Velez Baez1, Sofia Lopez Tapía1

Citation: Mora FJV, Lirios CG, Soto MLQ, Baez SSV, Tapía SL. Structural Equation Modeling of Pregnancy in the COVID–19 Era. Medp Public Health Epidemiol. 2022; 1(1): mpphe–202207004.

Abstract

   Introduction: The interruption of pregnancy reflects the lifestyles of a high rate of population under 29 years of age, as is the case in the State of Mexico, however, the policies of decriminalization of abortion that focus their interest on making reasoned, planned and systematic decisions of the woman, avoid the influence of friends, relatives and partner(s) at the time of carrying out the request for termination of pregnancy. 

   Material & methods: The objective of the present study was to establish the exploratory factorial structure of instruments that measured psychological–cultural variables around intentions and experiences related to the interruption of pregnancy. A non–experimental, exploratory and cross–sectional study was carried out with a non–probabilistic selection of 210 students. The adjustments of the theoretical relationships with respect to the weighted relationships were estimated using two structural models, one cultural and the other cognitive. 

   Results: The values factor explained 41% of the variance (alpha = 0.732). The belief factor explained 33% of the variance (alpha = 0.705). The perceptual factor explained 28% of the variance (alpha = 0.721). The motive factor explained 23% of the variance (alpha = 0.742). The attitudinal factor explained 17% of the variance (alpha = 0.701). The normative factor explained 14% of the variance (alpha = 0.758). The intentional factor explained 9% of the variance (alpha 0.784) and the experiential factor explained 7% of the variance (alpha = 0.791). However, the fit and residual parameters ⌠χ2 = 356.46 (67df) p = 0.067; GFI = 0.990; CFI = 0.975; RMSEA = 0.000⌡ of the structural model of dependency relationships between indicators and cultural factors evidenced the spurious incidence of perceptions about experiences of termination of pregnancy. 

   Keywords: Values; Beliefs; Perceptions; Motives; Attitudes; Norms; Intentions.