Aim: Pregnancy, birth and post-partum period is an important process in which many physiological, psychological and social changes are experienced by mothers and fathers. Pregnancy is also one of the periods when sexuality is most affected, and sexual dysfunctions are common during this period. The aim of this study is to investigate the sexuality and sexual myths of pregnant women and their partners. Material and Method: This research was conducted in an university hospital in Turkey with a total of 128 participants, 77 pregnant women and 51 spouses who agreed to participate. Results: There was a statistically significant relationship in terms of working status, having a history of miscarriage in the family, and sexual knowledge adequacy before marriage. Men's employment rate and pre-marital sexual knowledge adequacy status were higher than women. A statistically significant difference has been achieved in the "Sexuality/Attractivess" sub-dimension in Sexual Myths During Pregnancy Scale (SMDPS) and the "Avoidance" and "Communication" sub-dimensions in Glombock - Rust sexual satisfaction Scale (GRSSS). An inverse low correlation between sexual myths during pregnancy and GRSSS in men and low-level lineer relationship between GRSSS and Relationship Satisfaction Scale(RSSS) scores in women are detected. Conclusions: Exaggerated, false beliefs that are considered true but not actually related to sexuality, sexual myths negatively affect the relationship of couples. The prevalence of sexual myths during pregnancy will decrease and the impact on the quality of sexual life during pregnancy will be minimized by obtaining consultancy services.

The aim of this study was to examine the relationship between caregiver burden, family adaptation, partnership, growth, affection, and resolve score, anxiety levels, and the perceived social support of the relatives of patients who had open heart surgery.

Background/Objectives: This study aimed to investigate plasma duloxetine concentrations, factors influencing these concentrations, and the relationship between plasma levels and clinical response in patients diagnosed with generalized anxiety disorder who were treated with duloxetine. Additionally, the study evaluated whether dose escalation resulted in proportional increases in plasma concentration and assessed the clinical utility of therapeutic drug monitoring (TDM) for duloxetine. Methods: In this study, plasma duloxetine levels were analyzed in 68 patients with generalized anxiety disorder who had been receiving duloxetine treatment for at least three months. A review of digital medical files revealed that duloxetine was initiated at 30 mg/day in all patients, and doses were increased to 60 or 90 mg/day in those with insufficient symptom improvement. Digital medical files indicated that participants had been on the final prescribed duloxetine dose for at least four weeks at the time of plasma level measurement. Baseline Hamilton Anxiety Rating Scale (HAM-A) and Generalized Anxiety Disorder-7 (GAD-7) scores were compared with scores obtained on the day of blood sampling. Plasma duloxetine concentrations were quantified using liquid chromatography–tandem mass spectrometry (LC-MS/MS). Associations between dose, plasma concentration, and clinical response were statistically analyzed. Results: Plasma duloxetine concentrations increased significantly following dose escalation. However, no significant correlation was observed between plasma concentrations and percentage change in HAM-A scores. Although patients receiving 60 or 90 mg/day had higher plasma levels than those maintained on 30 mg/day, clinical improvement did not differ significantly between dose groups. In addition to dose, increasing age and non-smoking status were associated with higher plasma duloxetine concentrations. Conclusions: Duloxetine demonstrates a predictable dose–concentration relationship; however, in this response-guided titration setting, plasma concentrations were not consistently associated with clinical improvement. Accordingly, these findings suggest that routine therapeutic drug monitoring may not consistently predict clinical response to duloxetine in generalized anxiety disorder; nevertheless, considering the study’s limitations, it could still offer clinically relevant insights in selected pharmacokinetically sensitive or treatment-resistant cases.

Lithium is used for the treatment of bipolar disorder and some other psychiatric disorders. Due to the narrow therapeutic range, intoxications are common. In this case, chronic lithium intoxication with severe neurological symptoms was discussed in light of the literature. A 72-year-old female patient. The patient had been receiving psychiatric treatment for 7 years with the diagnosis of unipolar depression. In the 6th month of lithium use, she was brought by her relatives with complaints of drowsiness, tremor, muscle twitching, and difficulty walking. On examination, consciousness was confused, there was no cooperation orientation and there was general rigidity, tremor, fasciculations, and ataxic gait. Vital signs; blood pressure 147/92 mmHg, heart rate 69 bpm, SpO2: 94%. The laboratory tests: lithium 2.98 mEq/L, potassium 5.8 mmol/l, sodium 129 mmol/l, creatinine 1.66 mg/dl, urea 166 mg/dl. The patient was transferred to the internal medicine clinic with the diagnosis of lithium intoxication. Lithium treatment was discontinued. On the 7th day, her neurological symptoms improved with supportive treatment, and biochemical parameters returned to normal. A lithium concentration of more than 3.5 mEq/L was defined as severe poisoning. Neurological findings are prominent in severe poisonings. Especially, geriatric population is at greater risk. In our case; age, use of three different groups of diuretics as antihypertensive treatment, and urinary tract infection were defined as factors that predispose to poisoning. In this case, it's emphasized that although the lithium blood level isn't very high, severe neurological symptoms can be seen clinically in the presence of risk factors.