Studies were conducted on properties of seeds and oil extracted from fully ripened
Phoenix canariensis date seeds. The percentage composition of the
P. canariensis seeds found is: ash 1.18%, oil ...10.36%, protein content 5.67%, total carbohydrate 72.59% and moisture 10.20%. The major nutrients (mg/100
g of oil) determined were: potassium (255.43), magnesium (62.78), calcium (48.56) and phosphorus (41.33). The physicochemical properties of the oil observed include: the saponification number 191.28; the iodine number 76.66, the p-anisidine value 3.67; the peroxide value 3.62
meq/kg; the unsaponifiable matter content 1.79%, the free fatty acids content 0.59%; the carotenoid content 5.51
mg/100
g; the chlorophyll content 0.10
mg/100
g and the refractive index 1.45. The main fatty acids of oil were oleic (50.10%), linoleic (19.23%), lauric (10.24%). palmitic (9.83%) and stearic (7.51%). The main triacylglycerols found in
P. canariensis seed oil were: LaMM
+
LaLaP (18.9%), LaMP
+
MMM (15.31%) and LaOO
+
PLL
+
MPL (12.86%). The DSC melting curves revealed that: melting point
=
3.71
°C and melting enthalpy
=
62.08
J/g. The sterol marker, β-sitosterol, accounted for 76.06% of the total sterols content in the seed oil followed by campesterol (8.89%) and Δ
5avenesterol (8.79%). α-Tocotrienol was the major tocol (66%) with the rest being γ-tocotrienol and γ-tocopherol.
IntroductionSexual dysfunctions (SD) are common in patients with schizophrenia. The link between schizophrenia and sexuality is complex. Studies have shown that SD can be linked to the side effects ...of antipsychotic medications, but also to symptoms of illness.ObjectivesTo identify the clinical and therapeutic factors associated with SD in outpatients with schizophrenia.MethodsA cross-sectional and analytical study was conducted between Mars and September 2019. It included 53 outpatients with schizophrenia in clinical remission for at least two months.We used the Positive and Negative Symptom Scale (PANSS) to assess clinical symptoms and the Arizona Sexual Experiences Scale (ASEX) to assess sexual functioning.ResultsThe average age was 42.28 ±10.49 years old. The sex ratio was 3.81. The mean age of onset was 27.09±5,46 years. The mean duration of illness was 18.11±9.29 years. First-generation antipsychotics were prescribed in 77.4% of cases, while second-generation antipsychotics were prescribed in 39.6% of cases.The average ASEX score was 19.77±5.99, and 67.9% of participants had at least one SD. the analytical study revealed significantly higher average scores for the PANSS-negative subscale (p=0.006) and the PANSS total score (p=0.04) in patients with SD. SD correlated with first-generation antipsychotic treatments (p=0.02).ConclusionsOur results show that SD are frequent in patients with schizophrenia and that they are related to the severity of the symptoms, in particular the negative symptoms of illness, and the prescription of first-generation antipsychotics.Disclosure of InterestNone Declared
IntroductionBipolar disorder is one of the leading causes of disability among young adults. Given the heterogeneity of the disorder and the complexity of its etiopathogenesis, combination therapy is ...often considered as part of the treatment regimen.ObjectivesTo assess the place of non-pharmacological interventions as a co-adjuvant to pharmacological treatment, to discuss the role of polytherapy in the management of bipolar disorder and to underline the drug to drug interactions to keep in mind.MethodsWe present a critical review of recent international recommendations for the management of bipolar disorder. Two main evidence-based guidelines were included: The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders and The 2018 Canadian Network for Mood and Anxiety Treatment.ResultsAccording to guidelines, the outcomes in bipolar disorder are improved when medication is combined with evidence-based psychological treatment and lifestyle changes. As to polytherapy, it is often recommended to maximise the treatment efficacy. Studies have shown that combination treatments tend to work faster and more effectively than monotherapy especially in episodes with higher index severity. For the management of agitation, an adjuctive treatment by Haloperidol with midazolam or promethazine can be prescribed. In acute mania, combination therapy with quetiapine, aripiprazole, risperidone or asenapine and lithium or divalproex is recommended as first-line treatment options. Combinations of mood-stabilizing drugs may be more often necessary when rapid cycling is present. In a manic episode with mixed features the use of divalproex with an atypical antipyshcotic is recommended. In bipolar I depression, lurasidone and lamotrigine are often used as adjunctive therapies. When anxious distress is present, the combination of olanzapine and fluoxetine has shown to be effective. In a depression with atypical features, tranylcypromine (IMAO) can be added to lithium, divalproex or a second generation antipsychotic for a better result. Adjunctive treatment of olanzapine with fluoxetine may be necessary in a depression with mixed features. However, in bipolar II depression and for maintenance treatment no adjunctive therapies are recommended. Finally, it is important to consider the adverse effects resulting from polytherapy. Using lithium as an adjunctive medication may increase the risk of tremor and acute dystonic reactions and can be a contributing factor for neuroleptic malignant syndrome, whereas divalproex can be an inducer or an inhibitor of some atypical antipsychotics.ConclusionsRational polytherapy allows better and faster control over symptoms of bipolar disorder and should be considered after a detailed discussion of risks and benefits.Disclosure of InterestNone Declared
Introduction
Psychotic disorders have been consistently associated with aggressive behaviors. Psychiatrists are frequently asked to perform assessment regarding potentially aggressive patients. Thus, ...many psychometric instruments can be useful for identifying the risk of violence and thereby offering appropriate treatment for these individuals.
Objectives
The aims of this study were to assess the risk of agressive behavior in inpatients with schizophrenia or schizoaffective disorder and to determine its correlates.
Methods
Using face-to-face interviews, inpatients diagnosed with schizophrenia or schizoaffective disorder, in psychiatric department of the University Hospital in Sfax (Tunisia) were included in this cross-sectional, descriptive and analytical study, carried out between novembre 2020 and octobre 2022.
The modified overt aggression scale (MOAS) and historical clinical risk management-20 (HCR-20) questionnaire were used for data acquisition. The HCR-20 score of 20 was used as threshold to divide the sample to violent patients (scoring>20) and non-violent patients (scoring ≤ 20).
Results
The sample consisted of 60 male inpatients. The mean age was 38.23± 10.37 years.
In our sample, 68.3% were single, 35% didn’t reach the secondary educational level, 16.7% used psychoactive substance(s), 35% had prior criminal record, 30% had a history of suicidal attempt and 81.7% had previous hospitalization.
The mean score of MOAS was 13.08±8.19. The mean total HCR-20 score was 19.25±5.26. The Historical, Clinical and Risk Management subscales showed mean scores of 8.33±2.96, 5.62±1.89, and 5.28±2.42, respectively.
The violent patients represented 45% of the sample.
The mean scores of the items H3, H10, C1, C2, C4 and R5 of HCR-20 were respectively : 1.33±0.79, 1.20±0.77, 1.22±0.88, 0.38±0.71, 1.30±0.64 and 1.28±0.73.
There was no statistical difference between the two groups in socio-demographic factors.
A history of suicidal attempts was significantly more common in the group of violent patients (p=0.029).
Regarding the HCR subscales, H3 score (relationship instability) and H10 score (Prior supervision failure) were significantly higher among violent patients (p=0.018 and 0.003 respectively). The C1 score (lack of insight), the C2 score (negative attitudes) and the C4 score (impulsivity) were also significantly higher among violent patients (p=0.016, 0.009 and 0.005 rescpectively).
The item R5 (stress) of the risk management subscale was significantly higher in the group of violent patients (p=0.003).
The total MOAS score detected severe agression in the nonviolent group (p=0.031).
Conclusions
Our study suggests the efficacy of HCR-20 in identifying and distinguishing between violent and nonviolent patients with schizophrenia or schizoaffective disorder. The use of such reliable instrument in clinical psychiatric settings should be encouraged.
Disclosure of Interest
None Declared
Introduction
Homicide is the most serious, radical and irreversible criminal act. It arouses a multitude of questions and fears. Committed by women, the homicide seems more unusual and weird.
...Objectives
Our objective is to describe the circumstances of the homicide committed by Tunisian women
Methods
This study was retrospective and descriptive. It focused on the files of criminal psychiatric expertise and involved female accused subjects.We have collected all the criminal expert reports carried out over a period of 24 years (from January 1, 1998 to December 31, 2021)
Results
This study included 21 women who committed homicide.The majority of victims of homicide or attempted homicide (85.6%) belonged to the family circle of the accused.Five women (23.8% ) committed this act against their children and four women (19.1%) committed this act against their husbands.The means most used in homicide and its attempt were immolation (23.8%), strangulation (23.8%) and blows (23.8%).
Among those charged with homicide or its attempt, seven (33.3%) presented a personality disorder, 14.3% a depressive disorder, 14.3% a moderate intellectual disability, 4.8% a schizophrenia and 4. 8% mild intellectual disability.
Conclusions
This female criminality, in particular homicide, would find their explanations in different factors and the existence of a mental disorder at the origin of deviant behavior in women seems to be a significant factor in the determinism of such behavior. Much effort remains to be made to apply preventive measures.
Disclosure of Interest
None Declared
Introduction
While bipolar disorder–obsessive compulsive disorder overlap is quite common, sexuality remains a largely unexplored area of this clinical entity.
Objectives
Illustrate through a ...clinical vignette the case of a patient with diagnosed homosexual obsessive –compulsive disorder (OCD) comorbid with bipolar disorder (BD).
Methods
The clinical case report was prepared through the review of the patient´s clinical record.
Results
We report a rare case of a 22 year-old man who was diagnosed with Homosexual Obsessive–compulsive Disorder comorbid with Bipolar Disorder, admitted to our department for a suicide attempt. He came from a religious and conservative background and suffered from intrusive, unwanted mental images of homosexual behaviour since the age of 17. He presented periods of remission from his obsessive thoughts, while showing signs of elevated mood, talkativeness, restlessness, agitation and hyperactivity that would last for a few days, with recrudescence of obsessive and depressive symptoms again afterwards. The present case showed a significant reduction in depressive symptoms and in the impact of his obsessive intrusive thoughts after prescription of Risperidone and Sodium Valproate along with Exposure and Response Prevention Therapy conducted over a period of 6 weeks.
Conclusions
The homosexual OCD comorbid with bipolar disorder can cause important distress and impairment and severely impact a person’s life in multifaceted ways. Correct diagnosis, adequate medication and psychotherapy provide the effective treatment.
Disclosure of Interest
None Declared
IntroductionSchizophrenia is a chronic psychotic disorder characterized by a high prevalence of sexual dysfunctions (SD). SD can affect the quality of life (QOL) of patients, cause low self-esteem ...and self-stigma.ObjectivesTo evaluate the sexual functioning, the QOL, and the internalized stigma among outpatients with schizophrenia.To determine the links between SD, the QOL, and the internalized stigma.MethodsA cross-sectional, analytical study was conducted between Mars and September 2019. It included 53 outpatients with schizophrenia in clinical remission for at least two months.We used the Arizona Sexual Experiences Scale (ASEX) to assess sexual functioning, the Internalized Stigma of Mental Illness scale (ISMI) to assess the subjective experience of stigma, and the 36-item Short-Form Health Survey (SF-36) to evaluate the QOL.ResultsThe average age of patients was 42.28 years old, and their sex ratio was 3.81. The average ASEX score was 19.77±5.99, and 67.9% of participants had at least one SD.The mean ISMI score was 2.47±0,34. 60,4% of patients had a high level of internalized stigma. The QOL was impaired in 66% of the cases.We found correlations between SD and a high level of internalized stigma (p=0.011) and its subscales «alienation » (p=0.013), «stereotype endorsement» (p=0.034) and « discrimination experience» (p =0.001).SD correlated with impaired QOL (p<0.001), emotional limitation (0.050), and social functioning (0.031).ConclusionsOur study highlights the importance of the impact of SD on the prognosis of schizophrenia through internalized stigma and altered QOL.Disclosure of InterestNone Declared
IntroductionTunisia, a pioneer in the Arab world in terms of promoting the status of women, has adopted a strategy to combat violence against women and now has a legal arsenal to protect women’s ...rights.ObjectivesTo study the contribution of the Tunisian jurisdiction in terms of protection of women victims of violence.MethodsA review of the different legal texts, using the key words: “Women”, “Violence”, “Jurisdiction” and “Protection”.Results*The National Survey on Violence against Women in Tunisia is a long process that involved the efforts of several stakeholders.*In 2011, Tunisia was the first country in the region to have ratified and lifted all specific reservations to CEDAW (Committee on the Elimination of Discrimination Against Women). Violence against women is considered a threat to peace and security.*Secondly, the adoption of Article 46 of the new Constitution of 2014 obligated the State to combat violence against women and make it its priority.*The adoption of Organic Law 58/17 of 11 August 2017 finally gave the status of victim to the abused Woman. This law came into force in 2018.*A number of mechanisms have been put in place, including the establishment of the National Observatory to Combat Violence against Women.*Most magistrates still resist the application of Law 58/17, which contributes to the resurgence of violence against women, especially during periods of slackening of the justice system, such as the COVID lockdown period.ConclusionsDespite the revolutionary legal arsenal acquired for the protection of women in Tunisia, there is still a gap between legislation and practice, and the rate of violence against women continues to increase. Nationwide awareness-raising campaigns aiming to spread awareness among women of their rights are necessary.Disclosure of InterestNone Declared
The outer limiting membrane (OLM) is considered to play a role in maintaining the structure of the retina through mechanical strength. However, the observation of junction proteins located at the OLM ...and its barrier permeability properties may suggest that the OLM may be part of the retinal barrier.
Normal and diabetic rat, monkey, and human retinas were used to analyze junction proteins at the OLM. Proteome analyses were performed using immunohistochemistry on sections and flat-mounted retinas and western blotting on protein extracts obtained from laser microdissection of the photoreceptor layers. Semi-thin and ultrastructure analyses were also reported.
In the rat retina, in the subapical region zonula occludens-1 (ZO-1), junction adhesion molecule (JAM), an atypical protein kinase C, is present and the OLM shows dense labeling of occludin, JAM, and ZO-1. The presence of occludin has been confirmed using western blot analysis of the microdissected OLM region. In diabetic rats, occludin expression is decreased and glial cells junctions are dissociated. In the monkey retina, occludin, JAM, and ZO-1 are also found in the OLM. Junction proteins have a specific distribution around cone photoreceptors and Müller glia. Ultrastructural analyses suggest that structures like tight junctions may exist between retinal glial Müller cells and photoreceptors.
In the OLM, heterotypic junctions contain proteins from both adherent and tight junctions. Their structure suggests that tight junctions may exist in the OLM. Occludin is present in the OLM of the rat and monkey retina and it is decreased in diabetes. The OLM should be considered as part of the retinal barrier that can be disrupted in pathological conditions contributing to fluid accumulation in the macula.
IntroductionMany neurological, sensory and behavioural deficits, are linked with significant limitations in the overall functioning not only of the child but also his/her closest family, and poses a ...great challenge for the primary parental caregivers.ObjectivesTo assess the caregiver burden in parents of children with neurological impairement (NI), and itsrelated factors.MethodsA total of33 caregivers of children with NI participated in this cross-sectional, descriptive and analytical study, carried out in Child Neurology Department of the University Hospital in Sfax (Tunisia), between February and April 2021.The Zarit-Caregiver-Burden-Scale (Zarit-CBS) was administered.ResultsThe average age of the caregivers (27 mothers and 6 fathers) was 38,33 ± 6,53 years. Among the parents, 17.14% had another disabled child and 30.3% had a mediocre health status. Mother caregivers constitutes the majority of caregiving (82.85%).The average of the number of children in the family was 1.97±1.18 and the average age of the children (21 boys and 12 girls) was 7,58±4,29 years. Near to the half of them (51,51%) had intellectual disability.Over 54.54% of the children had a functional independence, while 21.21% required help in walking and 24.24% were unable to walk. The intervention was based on motor rehabilitation (57,57%), adequate equipment (24,24%), ergotherapy (45,45%) and speech therapy (60,6%).After the intervention, 63,63% of children had an improvement and 30,3% had a stationary state.The mean score of Zarit-CBS was 52,45±14,26. The caregiver burden was noted in 96,96%.The total Zarit-CBS score was associated with the number of children in the family (p=0.047).There was no significant relationship between Zarit-CBS and the severity of impairement (p=0.418).ConclusionsGiven the variety of factors affecting caregiver burden, specific interventions may promote parental caregivers’well-being, and consequently lead to improved quality of care provided to children with NI.Disclosure of InterestNone Declared
PDF