Objective: This study evaluated the effectiveness of a virtual reality (VR) based stress reduction program tailored for healthcare and information technology (IT) professionals during the coronavirus disease-2019 pandemic. Methods: The 2-week program, based on forest healing principles, was designed to alleviate occupational stress and improve sleep quality. Participants (n=54; 46 healthcare, 8 IT professionals) underwent pre- and post-intervention assessments using validated psychological scales and physiological measurements. Results: Results showed significant reductions in stress (Perceived Stress Scale [PSS], p=0.001) and anxiety (Hospital Anxiety and Depression Scale [HADS] anxiety, p=0.002) across all participants. Healthcare professionals demonstrated significant decreases in depression (Patient Health Questionnaire-9, p=0.015), anxiety (HADS anxiety, p<0.001), and stress (PSS, p=0.001). Unexpectedly, weekday sleep quality (Pittsburgh Sleep Quality Index) worsened in the healthcare group (p=0.013). The IT group showed no significant changes, possibly due to the small sample size. Physiological measurements revealed significant differences between groups post-intervention, including melatonin levels (p=0.001) and electrocardiogram values (p=0.031), suggesting occupation-specific responses to VR interventions. Conclusion Despite limitations such as unequal sample sizes, this study provides valuable insights into the potential of VR-based stress management programs. The findings underscore the need for occupation-specific approaches and further research with larger, balanced samples to validate these results and explore long-term effects.

Disruptive mood dysregulation disorder (DMDD) is a DSM-5 diagnosis for children and adolescents characterized by persistent irritability and severe temper outbursts. Due to overlapping symptoms with other disorders, DMDD is frequently misdiagnosed. This study presents two clinical cases. The first case involves a 14-year-old male patient with chronic irritability, temper outbursts, and impulsive aggression, resulting in significant academic and social impairment. The second case involves a 14-year-old female patient who initially presented with pathological gambling and emotional instability. These cases illustrate the diagnostic complexity of DMDD and its potential progression to mood disorders, such as bipolar disorder. Careful clinical observation and comprehensive assessment of irritability and mood dysregulation are essential for an accurate diagnosis. This study underscores the importance of continuous follow-up in DMDD patients to monitor disease progression and optimize treatment strategies. Understanding the developmental trajectory, comorbidities, and treatment responses in DMDD can help improve clinical outcomes and prevent long-term psychiatric complications.

Disruptive mood dysregulation disorder (DMDD) is a DSM-5 diagnosis for children and adolescents characterized by persistent irritability and severe temper outbursts. Due to overlapping symptoms with other disorders, DMDD is frequently misdiagnosed. This study presents two clinical cases. The first case involves a 14-year-old male patient with chronic irritability, temper outbursts, and impulsive aggression, resulting in significant academic and social impairment. The second case involves a 14-year-old female patient who initially presented with pathological gambling and emotional instability. These cases illustrate the diagnostic complexity of DMDD and its potential progression to mood disorders, such as bipolar disorder. Careful clinical observation and comprehensive assessment of irritability and mood dysregulation are essential for an accurate diagnosis. This study underscores the importance of continuous follow-up in DMDD patients to monitor disease progression and optimize treatment strategies. Understanding the developmental trajectory, comorbidities, and treatment responses in DMDD can help improve clinical outcomes and prevent long-term psychiatric complications.

Spontaneous coronary artery dissection (SCAD) is a condition in which an intramural hematoma within the coronary artery leads to acute coronary syndrome without atherosclerosis, trauma, or iatrogenic causes. It predominantly affects middle-aged women and is associated with several predisposing conditions, including fibromuscular dysplasia, systemic inflammatory disorders, connective tissue diseases, and coronary artery spasms. We report the case of a 64-year-old male with a history of hypertension who died of SCAD. His death occurred suddenly and without preceding trauma while the decedent was working overtime at a construction site. On gross examination, a thrombus-like material was identified in a branch of the left anterior descending artery and was initially presumed to be a postmortem clot. However, microscopic examination revealed an intramural hemorrhage, medial dissection, and formation of a false lumen within the coronary artery. This case report highlights the importance of a thorough histopathological examination of the coronary arteries during autopsy, even in the absence of atherosclerosis.

Disruptive mood dysregulation disorder (DMDD) is a DSM-5 diagnosis for children and adolescents characterized by persistent irritability and severe temper outbursts. Due to overlapping symptoms with other disorders, DMDD is frequently misdiagnosed. This study presents two clinical cases. The first case involves a 14-year-old male patient with chronic irritability, temper outbursts, and impulsive aggression, resulting in significant academic and social impairment. The second case involves a 14-year-old female patient who initially presented with pathological gambling and emotional instability. These cases illustrate the diagnostic complexity of DMDD and its potential progression to mood disorders, such as bipolar disorder. Careful clinical observation and comprehensive assessment of irritability and mood dysregulation are essential for an accurate diagnosis. This study underscores the importance of continuous follow-up in DMDD patients to monitor disease progression and optimize treatment strategies. Understanding the developmental trajectory, comorbidities, and treatment responses in DMDD can help improve clinical outcomes and prevent long-term psychiatric complications.

Objective: This study evaluated the effectiveness of a virtual reality (VR) based stress reduction program tailored for healthcare and information technology (IT) professionals during the coronavirus disease-2019 pandemic. Methods: The 2-week program, based on forest healing principles, was designed to alleviate occupational stress and improve sleep quality. Participants (n=54; 46 healthcare, 8 IT professionals) underwent pre- and post-intervention assessments using validated psychological scales and physiological measurements. Results: Results showed significant reductions in stress (Perceived Stress Scale [PSS], p=0.001) and anxiety (Hospital Anxiety and Depression Scale [HADS] anxiety, p=0.002) across all participants. Healthcare professionals demonstrated significant decreases in depression (Patient Health Questionnaire-9, p=0.015), anxiety (HADS anxiety, p<0.001), and stress (PSS, p=0.001). Unexpectedly, weekday sleep quality (Pittsburgh Sleep Quality Index) worsened in the healthcare group (p=0.013). The IT group showed no significant changes, possibly due to the small sample size. Physiological measurements revealed significant differences between groups post-intervention, including melatonin levels (p=0.001) and electrocardiogram values (p=0.031), suggesting occupation-specific responses to VR interventions. Conclusion Despite limitations such as unequal sample sizes, this study provides valuable insights into the potential of VR-based stress management programs. The findings underscore the need for occupation-specific approaches and further research with larger, balanced samples to validate these results and explore long-term effects.

Objective: This study evaluated the effectiveness of a virtual reality (VR) based stress reduction program tailored for healthcare and information technology (IT) professionals during the coronavirus disease-2019 pandemic. Methods: The 2-week program, based on forest healing principles, was designed to alleviate occupational stress and improve sleep quality. Participants (n=54; 46 healthcare, 8 IT professionals) underwent pre- and post-intervention assessments using validated psychological scales and physiological measurements. Results: Results showed significant reductions in stress (Perceived Stress Scale [PSS], p=0.001) and anxiety (Hospital Anxiety and Depression Scale [HADS] anxiety, p=0.002) across all participants. Healthcare professionals demonstrated significant decreases in depression (Patient Health Questionnaire-9, p=0.015), anxiety (HADS anxiety, p<0.001), and stress (PSS, p=0.001). Unexpectedly, weekday sleep quality (Pittsburgh Sleep Quality Index) worsened in the healthcare group (p=0.013). The IT group showed no significant changes, possibly due to the small sample size. Physiological measurements revealed significant differences between groups post-intervention, including melatonin levels (p=0.001) and electrocardiogram values (p=0.031), suggesting occupation-specific responses to VR interventions. Conclusion Despite limitations such as unequal sample sizes, this study provides valuable insights into the potential of VR-based stress management programs. The findings underscore the need for occupation-specific approaches and further research with larger, balanced samples to validate these results and explore long-term effects.

Spontaneous coronary artery dissection (SCAD) is a condition in which an intramural hematoma within the coronary artery leads to acute coronary syndrome without atherosclerosis, trauma, or iatrogenic causes. It predominantly affects middle-aged women and is associated with several predisposing conditions, including fibromuscular dysplasia, systemic inflammatory disorders, connective tissue diseases, and coronary artery spasms. We report the case of a 64-year-old male with a history of hypertension who died of SCAD. His death occurred suddenly and without preceding trauma while the decedent was working overtime at a construction site. On gross examination, a thrombus-like material was identified in a branch of the left anterior descending artery and was initially presumed to be a postmortem clot. However, microscopic examination revealed an intramural hemorrhage, medial dissection, and formation of a false lumen within the coronary artery. This case report highlights the importance of a thorough histopathological examination of the coronary arteries during autopsy, even in the absence of atherosclerosis.

Spontaneous coronary artery dissection (SCAD) is a condition in which an intramural hematoma within the coronary artery leads to acute coronary syndrome without atherosclerosis, trauma, or iatrogenic causes. It predominantly affects middle-aged women and is associated with several predisposing conditions, including fibromuscular dysplasia, systemic inflammatory disorders, connective tissue diseases, and coronary artery spasms. We report the case of a 64-year-old male with a history of hypertension who died of SCAD. His death occurred suddenly and without preceding trauma while the decedent was working overtime at a construction site. On gross examination, a thrombus-like material was identified in a branch of the left anterior descending artery and was initially presumed to be a postmortem clot. However, microscopic examination revealed an intramural hemorrhage, medial dissection, and formation of a false lumen within the coronary artery. This case report highlights the importance of a thorough histopathological examination of the coronary arteries during autopsy, even in the absence of atherosclerosis.

Disruptive mood dysregulation disorder (DMDD) is a DSM-5 diagnosis for children and adolescents characterized by persistent irritability and severe temper outbursts. Due to overlapping symptoms with other disorders, DMDD is frequently misdiagnosed. This study presents two clinical cases. The first case involves a 14-year-old male patient with chronic irritability, temper outbursts, and impulsive aggression, resulting in significant academic and social impairment. The second case involves a 14-year-old female patient who initially presented with pathological gambling and emotional instability. These cases illustrate the diagnostic complexity of DMDD and its potential progression to mood disorders, such as bipolar disorder. Careful clinical observation and comprehensive assessment of irritability and mood dysregulation are essential for an accurate diagnosis. This study underscores the importance of continuous follow-up in DMDD patients to monitor disease progression and optimize treatment strategies. Understanding the developmental trajectory, comorbidities, and treatment responses in DMDD can help improve clinical outcomes and prevent long-term psychiatric complications.