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In recent years, synthetic cannabis use has been increasing in appeal among adolescents, and its use is now at a 30 year peak among high school seniors. The constituents of synthetic cannabis are difficult to monitor, given the drug's easy accessibility. Currently, 40 U.S. states have banned the distribution and use of some known synthetic cannabinoids, and have included these drugs in the Schedule I category. The depressive respiratory effect in humans caused by synthetic cannabis inhalation has not been thoroughly investigated in the medical literature. We are the first to report, to our knowledge, two cases of self-reported synthetic cannabis use leading to respiratory depression and necessary intubation.

Background: Sleep disorders in autism spectrum disorders (ASD/SD) are distinct, broad, and highly variable clinical entities that ubiquitously affect core symptomatology, development of comorbid disorders, and overall quality of life for affected children and families. High genetic predisposition and the presence of co-occurring disorders present significant challenges in assessment and appropriate interventions. Objective: The study aimed to review the best available evidence and address the clinical gaps in the knowledge about sleep disorders in children and adolescents with autism spectrum disorders. Methods: The review provides a comprehensive literature search of 1622 articles and summarizes 110 selected for empirical evidence to methodically consider critical aspects of sleep disorders in ASD for informing clinicians of useful information. Results: Clinicians have insufficient guidance and support to effectively manage sleep disruptions in ASD youth in practice. Prevalence of sleep disruption in ASD, close to 80%, is characterized by unique subtypes, including but not limited to obstructive sleep apnea, circadian rhythm disorders, and sleep-related movement disorders. Greater awareness of sleep disruption, its neurodevelopmental basis, scope, and impact allows for improved treatment and prevention efforts of these conditions, and is critical for clinical practice and future research. The bidirectional nature of disruptive sleep and ASD is considered a major area requiring further clarification. Conclusion: Clinician-friendly screening tools are needed for everyday office practice to identify ASD/SD conditions and interventions, and mitigate harmful effects. Psychoeducational and cognitive-behavioral approaches for improving and supporting healthy sleep hygiene, considered the first line of treatment, are detailed. The weak database for the use of psychopharmacologic agents is summarized, and the strength of prescribing prolonged-release melatonin for optimal results is described. The promise of other medications is discussed.

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According to the Center for Disease Control (CDC), 3.2% of children aged 3-17 years have been diagnosed with depression. Many genetic conditions predispose children and adolescents to various mental health problems. Turner syndrome is a common sporadic genetic condition in females with medical issues, developmental delays, and psychiatric comorbidities. There is limited literature about adolescents with a late diagnosis of Turner syndrome and struggles with affective psychopathology. The early recognition and understanding of its unique genetics, neurobiology, and specific clinical manifestations are critical for addressing the needs of these patients.

Definition and diagnostic criteria for histiocytic sarcoma (HS) have changed over last two decades due to available new immunohistochemical markers, as well as better understanding of the biology of disease. We report here a case of 4 years old boy diagnosed as acute lymphoblastic leukemia (ALL), who later developed HS of pleura, when he was on maintenance phase of ALL protocol. HS constitutes less than 1 % of the haematolymphoid neoplasm, even more rare is association of HS with ALL. Thus reporting here a rare association of HS with ALL, will help in knowing the actual incidence of HS as well as association with ALL.

Children and Adolescent Mental Health Services (CAMHS) have been at the forefront of widespread attention given mounting needs, workforce shortage, and the task to implement cost-effective measures.The current categorical systems present a unique set of diagnostic challenges. Some criteria require multisource informants, attention to detail in the responses, ascertaining the language, and cognitive barriers that are subjected to errors and not time efficient. The traditional assessment of psychiatric phenomenology is dependent on subjective accounts of symptoms and implicit heuristics. When clinicians rely on their clinical judgment alone, they may be prone to biases leading to misdiagnosis and missed diagnoses. Therefore, the call for standardizing these evaluation processes has merits. The current use of objective rating scales as screening questionnaires has been discretionary and varies across clinical spectrums despite their high validity and internal consistency (Table 1). Amidst these challenges, many support implementing precision measurement-based strategies to improve diagnostic uncertainty and thereby provide cost-effective equitable access to healthcare. There is no consensus or guidance about "which and how" to implement measurement-based care (MBC). 1 The screening for neurodevelopmental disorders like ASD continues to remain challenging and controversial. The sensitivity and positive predictive value (PPV) of the commonly used screening tool the Modified Checklist for Autism in Toddlers (M-CHAT) were in the range of 33.1% to 38.8%, and 14.6% to 17.8%, respectively. While the burden of missed or late diagnosis of ASD continues to mount, the scientific basis for controversial population-based universal screening grows. However, with the advances in artificial intelligence Cognoa ASD Diagnosis Aid developed software to assist in evaluating at-risk individuals with ASD. Besides, costs, time, and training, there were also concerns about the validity when DSM or ICD are revised in future editions. The widely used SNAP-IV Rating Scale in the United States is a revision of the Swanson, Nolan, and Pelham (SNAP) Questionnaire from 1983. The items from the DSM-IV (1994) criteria for Attention-Deficit/Hyperactivity Disorder (ADHD) are included in the current version but lack a DSM-V criterion update.Evidence-based assessments (EBA) (also referred to as standardized diagnostic assessment [SDA] tools) are not the same as just incorporating screening but are more advanced measures delivered with validated instruments to generate. 2 They work by developing models which synthesize probabilities of having a diagnosis. However, there are many caveats to these approaches: firstly, the instruments are often varying in specificity and sensitivity, are timeconsuming, and are not always free. Secondly, multi-informant broad scales may yield better scores for many disorders, but they require an office visit for contextual clinicians' interpretation. Thirdly, short and lengthier questionnaires have strengths and weaknesse...