Search

Rym Maamouri, Molka Ferchichi, Yasmine Houmane, Zaineb Gharbi, Monia Cheour Department of Ophthalmology, Habib Thameur Hospital, Tunis, TunisiaCorrespondence: Rym Maamouri, Department of Ophthalmology, Habib Thameur Hospital, 3, Rue Ali Ben Ayed, Montfleury, Tunis, 1089, Tunisia, Tel +21698314970, Email ryma.maamouri@fmt.utm.tnAbstract: Horner’s syndrome (HS) is caused by a damage to the oculosympathetic pathway. HS may be congenital, but it is usually acquired and may reveal a life-threatening condition. According to the anatomic location of the underlying pathologic process, HS is classified as central, pre- or postganglionic, when the lesion affects the first, second or third-order neuron, respectively. Pharmacological testing, if available, can be used to differentiate HS from « pseudo-HS » in patients with mild symptoms. Given the financial burden that imaging of the entire oculosympathetic pathway represents, a targeted imaging approach is advised. Although in the majority of cases, clinical examination may predict etiology, in other cases pharmacological testing can help in the localization process. We searched PubMed data base for papers published before December 2022 that concerned Horner’s syndrome, its neuro-ophthalmological manifestations and diagnosis. In this article, we describe the main neuro-ophthalmological manifestations of the three types of HS, the most common etiologies, and a targeted diagnostic strategy in each type.Keywords: Horner’s syndrome, neuro-ophthalmology, pharmacological testing

Introduction: Psychotic experiences (PE) and disordered eating (DE) are frequently observed among the general population, especially in childhood and adolescence. However, the relationship between the two groups of disorders is still unclear. Objectives: To explore the hypothesis that the pathways from PEs to DE are mediated by body-image disturbances in a sample of adolescents Methods: We conducted a 12-month longitudinal study on high school students from four different high schools from the Ariana governorate, from April 2022 to April 2023. Participants were evaluated at baseline then every 6 months with a target length of follow-up of 1 year. The questionnaire contained Questions about socio demographic variables The Eating Attitude Test (EAT-26) The Multidimensionnal Body Self-Relations Questionnaire Appearance Scale (MBSRQ-AS) The Community Assesment of Psychic Experiences (CAPE-42) Results: 1) Sample characteristics Sample was constituted of 510 individuals. Of those, 312 (61.2%) were females. Mean age was of 16.05 (SD=1.01) years. The majority of the students resided in urban areas, accounting for 97.8% of the total. When it comes to family income, 4.1% of the students' families had an income of less than 1000 Tunisian Dinars (TD), 25.9% had an income between 1000 and 2000 TD, 32.2% had an income ranging from 2000 to 3000 TD, and the remaining 37.8% had a family income of over 3000 TD. The EAT-26, MBSRQ-AS and CAPE-42 scores are shown in table 1. Table 1. The longitudinal evolution of study variables Baseline T 6 months T 12 months p Partial Eta Squared η2 Disordered eating (EAT-26) 11.9 ± 9.4 11.9 ± 9.7 12.6 ± 10.2.080.006 Self-classified weight (Body image) 6.0 ± 1.7 5.9 ± 1.6 6.0 ± 1.6.946.001 Body areas satisfaction 30.9 ± 6.4 31.8 ± 6.4 31.4 ± 6.8.025.010 Overweight preoccupation 9.3 ± 3.6 9.2 ± 3.7 9.2 ± 3.7.545.001 Appearance Orientation 41.0 ± 5.4 41.6 ± 5.4 41.6 ± 5.5.007.014 CAPE positive dimension (total) 39.6 ± 8.7 39.1 ± 9.1 39.7 ± 9.5.756.001 Body Mass index 21.6 ± 3.4 21.5 ± 3.2 21.7 ± 3.2.034.009 2) Findings of the mediating analysis Disordered Eating scores had no significant effect in subjects across time. However, the effect of the interaction between baseline Overweight Preoccupation with Disordered Eating across time was statistically significant (p=0.036). Overweight Preoccupation (Z=85.095, p<0.001), Body Area Satisfaction (Z=25.053, p<0.001), and CAPE positive dimension (Z=59.931, p<0.001) scores had significant main effects between subjects. (figure 1 and figure 2) Image: Image 2: Conclusions: Findings showed that body image disturbances mediated the prospective association between PEs and DE. Adolescents with increased PEs were more likely to experience body image disturbances and, in turn, DE symptoms. These findings offer promising new avenues for prevention and early intervention. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: G6PD is essential for the production of NADPH, which is a cofactor for many enzymes involved in antioxidant defense and neurotransmitter synthesis. A deficiency in this enzyme could lead to increased oxidative stress, impaired neurotransmitter and immune function. The latter have been implicated in the pathophysiology of schizophrenia. Objectives: The present case is presented to underscore the infrequent and uncharacteristic manifestation of this condition, in the context of clinical symptoms and the trajectory of evolution of schizophrenia when associated with G6PD Deficiency. Moreover, it sheds light on the challenges clinicians encounter in the management of such cases. Methods: A case report of a patient who was admitted to the Psychiatry Department ("Ibn Omrane") of Razi Hospital". Results: Mr. M.T is a 26 year-old unmarried man. He comes from a non-consanguineous marriage and has an educational level of a bachelor's degree plus three additional years of study. He has a significant family medical history. His maternal uncle is under treatment for a chronic psychotic disorder. He has a personal history of G6PD deficiency and no specific habits to note. At the age of 24, he insidiously developed anxiety with incoherent statements of persecution accompanied by behavioral manifestations leading to mistrust and social isolation. He discontinued his studies for a year and began verbalizing suicidal thoughts accompanied by self-harm behaviors. The family sought help from a psychiatrist who prescribed 5 mg of olanzapine, which was covertly administered to the patient. At the age of 28, after a suicide attempt, he was involuntarily admitted to Razi Hospital. The clinical presentation was dominated by disorganization, with a partial response to treatment. Conclusions: More research is needed to confirm the association between G6PD deficiency and schizophrenia and to determine the underlying mechanisms. Larger studies with well-defined populations and methodologies are needed. It is also important to study the interaction between G6PD deficiency and other genetic and environmental factors that contribute to schizophrenia. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]