ABSTRACT
Background: The exact magnitude and phase of sexual function affected remains to be elucidated for most psychotropic drugs. So far little research has been done into sexual dysfunctions that develop during the use of antipsychotics. Most clinically used psychotropics cause sexual side-effects, but the nature, severity and frequency of these effects have not been systematically studied in Indian patients. Aim: To evaluate the frequency of sexual dysfunction and its impact on treatment adherence in patients with mental illness treated with various psychotropics under routine clinical conditions. Methods: We assessed the participants’ sexual functioning using Psychotropic-Related Sexual Dysfunction (PRSexDQ) is a brief and relatively nonintrusive questionnaire that has shown adequate psychometric properties in patients with mental disorder. Results: It was found that the rate of sexual dysfunction in the study group varied across the scale. However, sexual dysfunction was highest in the Antipsychotic group compared to others. Among the various domains of sexual dysfunction, decreased libido was the most common sexual dysfunction in all groups. On the PRSexDQ, all patients had sexual dysfunction on more than 1 domain (n = 20) out of 45 subjects which is higher in anti-psychotic group compared to the antidepressant group. Conclusions: In order to keep patients symptomatically stable and to help alleviate these side effects, clinicians should alter the treatment strategy, possibly by switching medications, to encourage adherence to the medication as well as optimize patients’ outcomes. Our results show that sexual dysfunction is very common in patients receiving long-term treatment with antipsychotics, and it is associated with a great impact in a substantial proportion of patients. Key message: Because psychotropic-associated sexual dysfunction is considerably underestimated by physicians, greater recognition and education are imperative when prescribing psychotropic treatment.
ABSTRACT
Background: Female sterilization a popular contraceptive procedure that results in loss of reproductive function whereas hysterectomy, the surgical removal of uterus results in loss of both reproductive and menstrual function. These are important events in women that are found to be contributing for psychological problems as these are related with feminine identity. Though the usual age at operation is different for both the groups, the concerns are same like feminine identity and sexual life. Aim: To compare and study the psychological problems in terms of depression and anxiety and sexual problems in women who have undergone female sterilization and hysterectomy and also to find out whether these procedures affect quality of life; and, also to study whether better information education communication (IEC) activities, round the clock medical services and careful selection of cases have impact on outcome of these procedures. Methods: A cross sectional epidemiological Study conducted in urban slums by administering semi structured questionnaire and instruments like Hospital Anxiety and Depression scale(HADS), World Health Organization Quality of Life-BREF scale (WHOQOL-BREF) Results: Though the hysterectomy group showed slightly higher mean scores in terms of anxiety and depression but they are not statistically significant. Quality of life was good in all domains in both groups where as sexual problems are slightly more in hysterectomy group. Conclusion: Thus the knowledge about procedure, round the clock medical facility, careful selection, pre procedural distress has impact on outcome Key message: We can minimise psychosexual problems by careful selection and regular follow up counselling
ABSTRACT
Germ cell tumours of the central nervous system infiltrating the ipsilateral extracranial tissues are not a common presentation. A case of intracranial germ cell tumour with extracranial extension in a four month old infant is reported. The patient had undergone excision of the extracranial lesion followed by combination chemotherapy. Twelve months after the completion of the treatment the patient is doing fine and is on regular follow up.
Subject(s)
Infant , Central Nervous SystemABSTRACT
One hundred and seventy five malnourished children aged between 1(1/2) and 12 years attending pediatric department of Regional Institute of Medical Sciences Hospital, Imphal from January 2001 to June 2002 were screened for human immunodeficiency virus (HIV) infection along with their biological mothers after pretest counselling and informed consent. The prevalence rate of HIV seropositivity among malnourished children was 21.7%. Children aged between 1(1/2) and 3 years had the highest seroprevalence (47.4%) and male to female ratio was 1.5: 1. Underweight children showed the highest seroprevalence (47.4%) and children with kwashiorkor showed least seroprevalence (10.5%). Mode of HIV transmission was vertical in 94.7%. The causative agent was HIV-I in all the cases. AIDS defining children features were seen more frequently among HIV seropositive malnourished children as compared to the seronegative children. Prolonged fever (p 0.001), oropharyngeal candidiasis (p<0.001), generalised lymphadenopathy (p<0.001) and disseminated maculopapular dermatitis (p<0.001) were significantly related to HIV infection. Among seronegative children 18.2% fulfilled the clinical criteria for AIDS and among seropositive children 94.7% had AIDS. The total mortality encountered among seropositive children was 34.2%. It is suggested to confirm findings based on larger community based data before recommending mandatory HIV testing in all malnourished children. Specific guidelines on the nutritional management of children with HIV/AIDS is needed in Manipur where HIV is spreading rapidly.