4th International Conference on Clinical and Medical Case Reports April 17-19, 2017 Dubai, UAE

Mohamed Abd Elalem Aziz has finished his psychiatry residency from Abbassya psychiatric hospital, Cairo, Egypt. Finished Addiction Diploma in 2015 and expected to finish his master degree in May 2017 from Menoufia Faculty of Medicine. He is psychiatry supervisor at (Medical research group of Egypt) which is a highly prestigious research group in Egypt with more than 50 international published research papers. His main scope is systematic reviews and meta-analysis in gene therapy especially gene therapy related to Parkinson\'s disease.

Subject objective: Baclofen is a GABAB receptor agonist, commonly used as a muscle relaxant so it is used mainly for treatment of spasticity, pain, stiffness and used offlabel for treatment of alcohol dependence. rnCase rnrnPresentation: Here, we present a case of a 35 year old Egyptian male with no previous history of medical or psychiatric disorders was admitted to our addiction unit for alcohol dependence for 6 years. Full laboratory investigations were in the normal range. We initiated treatment with baclofen oral tablets to decrease alcohol consumption with a gradual increase of Baclofen dose till 200 mg/ day. On regular psychiatric evaluation, we noticed a change in patient behavior, including euphoric mood, grandiose ideas and suspicious with persecutory delusions against his family members, rapid talking with a high flow of ideas, and insomnia. We started the gradual decrease of baclofen dose to avoid its withdrawal symptoms with antipsychotic medication (olanzapine). Patient regained his normal behavior 1 month later and continue his alcohol dependence treatment with regular visits to outpatient clinic. rnrnrnMethods: we searched medical electronic rnrndatabases: PubMed, Ovid Midline, EBSCO and Web of science using the following query: \"Baclofen AND mania AND Psychotic symptoms\". Conclusion: the mechanism of inducing manic symptoms by baclofen is still unclear and. Psychiatrists should pay more attention while using baclofen to treatment of baclofen dependence. Future studies should explore the relationship between GABA receptors and the psychotic symptoms induced by Baclofen. rnrnrnFunding: This research received no specific grant from any funding agency in the public, commercial, or not‐for‐profit sectors.

Ekaterina Kovaleva was born in Russia into a family of medical doctors. Kovaleva graduated from I.M.Sechenov First Moscow State Medical University in 2014. Also she has been studying at Faculty of medicine, University of Milan for a few years. She was then admitted to a residency program at the I.M.Sechenov First Moscow State Medical University , where she studied Obstetrics and Gynecology. \r\nCurrently, she works as an assistant professor at the Department for Personalized Medicine at the I.M. Sechenov First Moscow State Medical University. Her field of interests includes genetics, reproductive health. \r\n

Contemporary healthcare systems can’t provide a good level of prediction and prevention of diseases. In past 10 years there has been emerged a new concept called Personalized medicine. It uses individual genomic information and others OMICS technologies to risk assessment, proper diagnosis and targeted treatment.\r\nThe Personalized Healthcare Management Program is an approach developing by the Department for Personalized medicine at I.M.Sechenov First Moscow State Medical University provides health monitoring during different stages of life utilizing OMICS technologies. The top priority of the Program is monitoring of personal health based on the individual’s genetic details, calculation of risks for disease and the use of predictive models. This Program can be implemented during different stages of life, including preconception and the prenatal period. \r\nThe speaker, a gynecologist and reproductive health specialist, will explain how the Personalized Healthcare Management Program can be used in this field of medicine. It’s important to include a reproductive health specialist in the maintenance of personal health long before conception. Health management starts immediately after the decision to create a family is made. Each couple making the decision to create a family will be offered a genetic consultation about the possible risks of abnormalities in their offspring. After genetic testing finished, risk assessment and the formation of risk groups are carried out. Then using a panel of biomarkers (proteomic, immunomic and metabolomic screening) the monitoring of personal health is performed (supervision by the multi-specialist team, and the use of mobile technologies).\r\nGenetic screening, medical screening, risk management, and monitoring are shown in a model of Down Syndrome, Beta-thalassemia and familial hypercholesterolemia.\r\nUnderstanding the importance of changing to a patient-centric personalized view will lead to tremendous changes in future clinical practice. It’s clear that the Personalized Healthcare Management Program can be a good basis for creative longevity as a result. It requires the collaboration of a multidisciplinary team of specialists including geneticists, reproductive health specialists, internists, etc.

Mohamed Abd Elalem Aziz has finished his psychiatry residency from Abbassya psychiatric hospital, Cairo, Egypt. Finished Addiction Diploma in 2015 and expected to finish his master degree in May 2017 from Menoufia Faculty of Medicine. He is psychiatry supervisor at (Medical research group of Egypt) which is a highly prestigious research group in Egypt with more than 50 international published research papers. His main scope is systematic reviews and meta-analysis in gene therapy especially gene therapy related to Parkinson\\\'s disease.

Subject objective: Beclomethasone is a commonly used inhaled, synthetic glucocorticoid in treatment of asthma and rhinitis (allergic and non-allergic). Behavioral changes are rare but documented side effects of Beclomethasone. Hereby, we report a case of an Egyptian patient, treated with Beclmehtasone for newly diagnosed asthma who developed behavioral changes.rnCase Presentation: A 19 years old asthmatic patient with no history of psychiatric disorders. The patient has started receiving Beclomethasone since 2 weeks in response to his worsening asthma and he was not receiving any other prescriptions. After 2 days of starting inhaled beclomethasone inhaler, the patient showed a sudden, progressive change in behavior, including aggression, insomnia, pressured speech, elevated mood, impulsivity and grandiose delusions. Patient was admitted to our psychiatric department and his aggression was controlled by haloperidol 5 mg (intramuscular). Mini mental status examination showed (1) Euphoria, (2) increase in rate and amount of speech, (3) Delusion of grandeur (4) impaired abstract thinking, (5) impaired judgment. We used mood stabilizer drug (lithium) and antipsychotic medication (risperidone) for the treatment of the manic episode. The patient was discharged after 3 weeks.rnConclusion: According to our knowledge, this is the first case of mania induced by inhaled beclomethasone in Egypt. The mechanism of psychiatric symptoms caused by corticosteroids stills unclear, may be caused by increasing dopamine level in the brain according to some studies. General physicians must pay more attention to behavioral changes caused by commonly used drugs like inhaled beclomthasone.rnFunding: This research received no specific grant from any funding agency in the public, commercial, or not‐for‐profit sectors.rn