Mansour Alharbi

Background: Somatic cough syndrome, formerly termed psychogenic cough or habit cough, is an under-recognized cause of chronic cough in pediatric populations, characterized by repetitive, dry, and honking cough that is absent during sleep. Behavioral interventions are first-line treatment with high success rates of 80%–90%. However, when access to behavioral therapy is unavailable, alternative pharmacological interventions, particularly benzodiazepines, have received minimal investigation in this population. Case presentation: I report a 13-year-old previously healthy male patient with abrupt-onset, near-continuous dry cough occurring every 2 seconds during waking hours. The cough had a distinctive honking quality and disappeared completely during sleep. The patient presented with severe impairment in function, including inability to eat for 3 days, multiple emergency presentations requiring intravenous hydration, and complete school absence. Medical evaluation, including physical examination, laboratory investigations, spirometry, and chest X-ray, was unremarkable. Empirical trials of inhaled bronchodilators and nasal corticosteroids yielded no improvement. Psychiatric assessment excluded psychotic features, depression, obsessive-compulsive disorder, and tic disorder but noted family stressors, including high expressed emotion and overprotective parenting behavior. Based on the sign of sleep-related cough cessation and exclusion of organic pathology, somatic cough syndrome was diagnosed. Given the severity of impairment and family circumstances precluding immediate behavioral therapy, bromazepam 3 mg orally was initiated. Within 24–36 hours, the cough resolved completely. At 3-month follow-up, the patient remained symptom-free without medication. He had returned to school and demonstrated normal eating patterns. Conclusion: This case demonstrates rapid and sustained resolution at 3-month follow-up of severe psychogenic cough following short-term bromazepam treatment in an adolescent. While behavioral therapy is still an evidence-based first-line treatment, this report suggests using benzodiazepines as a pharmacological intervention alternative when behavioral therapy is unavailable. The rapid response and sustained remission at 3-month follow-up are consistent with the hypothesis that benzodiazepines may interrupt the self-perpetuating cycle of anxiety and cough in somatic cough syndrome. Further research is needed for this case in pediatric populations to establish efficacy, safety, and optimal treatment duration.

Background/Objectives: The clinical impact of antipsychotics on the human body remains inadequately investigated, hence we aimed to compere the effects olanzapine (OLZ) and Clozapine (CLZ) on different body systems. Methods: 48 patients and 24 healthy individuals were involved, and followed over six months. PANSS, metabolic, cardiovascular, inflammatory, and neuronal transmitter parameters were determined. Results: No significant difference was found between the effects of the two drugs on blood mineral and cardiovascular parameters, except for CK-MB, which showed a greater increase in the OLZ group than in the CLZ group. Both drugs increased the lipid profile and HbA1C levels, with the effect of CLZ being more prominent. Both drugs increased the patients’ body weights, with no significant difference between their effects. Regarding renal and hepatic functions, OLZ had a more notable effect on creatinine and albumin levels than CLZ, while AST and ALT showed markedly greater increases in the CLZ-treated group than in the OLZ-treated group. Regarding the effects on neurotransmitters and inflammatory mediators, both drugs increased serotonin and ghrelin levels, in addition to decreasing leptin concentrations, and decreased the inflammatory mediators IL-1β, IL-6, and –TNF-α, with the effect of OLZ being more prominent. Regarding therapeutic efficacy, CLZ was more effective at reducing general and negative symptoms than OLZ. Conclusions: The present study revealed that CLZ had a greater impact on metabolic parameters and better therapeutic efficacy in attenuating both general and negative symptoms, whereas OLZ had more detectable anti-inflammatory effects, aid determining the appropriate treatment for schizophrenic patients.

Context: The presence of anxiety in individuals with coronary heart disease (CHD) is widespread, and it is related to a higher risk of negative outcomes. There has been a dearth of research on the management of anxiety in people with coronary artery disease. Aims: The present study aimed to determine the associated risk of anxiety among coronary artery disease (CAD). Settings and Design: This was a cross-sectional study conducted on a group of patients with IHD between the ages of 20 and 60 years. Methods and Material: A total of 200 individuals participated. Medical records were one of the data sources. The data of patients who meet the selection criteria gathered from the cardiology departments of the PSCC in KFSH. Statistical analysis used: Statistical package for Social Science (SPSS) version 23 was used for statistical analysis. Results: This research comprised 200 patients, the majority of whom were male (81%) and female (19%). According to the findings, 70% of people had minimal depression, 13.5 percent had mild depression, 8.5 percent had moderate depression, 4.5 percent had severe depression, and 3.5 percent had moderately severe depression. Medications were utilized in the majority of cases (98%). Conclusions: Anxiety disorders that manifest themselves in the setting of heart disease must be recognized and treated with caution in the early stages of the disease. When giving medical therapy, it is important to examine the effects of the drugs on the heart, as well as the possibility of drug-drug interactions.