Beyond the ‘tic’ king clock: a case report on adult onset tic disorder

Tic is rapid recurrent non-rhythmic motor movement or vocalization; movement of limbs or other body parts is known as motor tic and involuntary repetitive sound like grunting sniffing throat clearing is known as a vocal tic. Tic is a neurodevelopmental disorder and has its onset in the developmental period. According to diagnostic and statistical manual of mental illnesses (DSM) 5, tic should have its onset before 18 years of age and can resolve with proper treatment. In this case, a 23-year-old female presented with recurrent abnormal throat clearing and excessive loud sounds which started for the last 1 year. Initially, she was diagnosed with psychogenic hiccup in another department and was treated with Baclofen 30 mg for 1 month but as no improvement was observed later she was referred to psychiatry outpatient department (OPD) for further treatment where she was diagnosed with adult onset vocal tic with a premonitory urge for tics scale (PUTS) score of 27 on admission and she was treated with tablet Risperidone 2 mg and after 4 weeks of treatment all symptoms subside and PUTS score came to be 6 at the time of discharge.

A study of the effects of pulsed electromagnetic field therapy with respect to serological grouping in rheumatoid arthritis.

The positive role of pulsed electromagnetic field (PEMF) therapy in rheumatoid arthritis (RA) is known. The differential role of serological status of patients in RA is also well known. This paper presents a study of the differential effects of PEMF therapy on the two serological groups of patients. The responses of the seropositive patients are found to be more subdued. Varying effects of the therapy in alleviating the different symptomatologies indicate that the rheumatoid factor (RF) is more resistant to PEMF.

Pseudohypophosphatasia.

Two rare cases of pseudohypophosphatasia in two siblings which so far, to best of our knowledge have not been reported.

Hyperuricemia and pregnancy induced hypertension--reappraisal.

Serum uric acid estimation was done in forty primigravidae with pregnancy induced hypertension and twenty normotensive primigravida in the third trimester of pregnancy, at delivery and six weeks postpartum. The mean serum uric acid levels in normotensive women in the antenatal period and at delivery were 4.65 +/- 0.33 and 4.88 +/- 0.23 mg% and in mild PIH were 5.42 +/- 0.55, 6.14 +/- 0.76 mg%, respectively. Level of serum uric acid in mild PIH was significantly higher than normotensive women (P). In severe PIH, the mean serum uric acid levels were 6.65 +/- 0.60, 8.24 +/- 1.09 mg% in antepartum and at delivery respectively which was significantly more than control group and mild PIH group women (P). However, no differences was observed, in the serum uric levels between these groups during the postpartum period. Serum uric acid level of 5.5 mg or more was observed to be an indicator of PIH. Levels of serum uric acid did show a high positive correlation with the severity of PIH in relation to hypertension and proteinuria. Hyper uricemia (more than 5.5 mg% is associated with increased perinatal morbidity and mortality.

Hyperuricaemia and perinatal outcome in pregnancy induced hypertension.

The effect of hyperuricaemia on perinatal outcome was evaluated in 40 primigravidae with pregnancy induced hypertension and 20 normotensive women in the 3rd trimester of pregnancy. Serum uric acid level was a better indicator than blood pressure as an index of foetal prognosis. Even severe hypertension without hyperuricaemia was associated with better prognosis for the foetus. Conversely when hypertension was mild and hyperuricaemia was severe, the prognosis for the foetus was poor. A rise in serum uric acid level > or = 5.5 mg% is associated with increased perinatal morbidity and mortality. Women in pregnancy induced hypertension group with serum uric acid level > or = 5.5 mg% had a higher incidence of intra-uterine growth retardation, low birthweight, and stillbirth making perinatal mortality rate of 200/1000 total births. The results of this study indicate that serum uric acid level > or = 5.5 mg% can reflect the perinatal outcome.

Lipid composition of intestinal brush border membrane in alloxan induced acute experimental diabetes.

Several alterations were observed in the rat intestinal brush border membrane (BBM) lipid composition after 7 days old alloxane-induced diabetes as compared to the control animals. There was no change in the total protein contents but a significant increase in the total lipid contents was observed. Glycolipids constituting the major lipid components showed a two-fold increase. No significant difference was observed in the total phospholipid contents. A significant decline in the free cholesterol (CH) level, free fatty acids, triglycerides and sialic acid contents was observed in membranes from diabetic rats. Esterified CH, monoglycerides+diglycerides, phosphatidyl serine+phosphatidyl inositol and phosphatidyl choline levels remained unaffected. A significant increase in sphingomyelin with a parallel decrease in phosphatidyl ethanolamine was observed in BBM preparations from diabetic rats. The observed changes in intestinal BBM might be responsible for altered functions of the diabetic intestines.

Alterations in rat intestinal sucrase and alkaline phosphatase activities in alloxan induced experimental diabetes.

Rat intestines revealed a significant loss of proteins after seven days of alloxan induced diabetes. The data suggested the presence of two forms of alkaline phosphatase (ALP) in normal rat intestines. Along with the loss of proteins from the intestines during diabetes, a form of ALP which appears to be loosely bound to the intestine is also flushed out. Total brush border membrane (BBM) proteins are relatively preserved from such leaching effect of alloxan induced diabetes. Thus, sucrase and another form of ALP which appears to be strongly bound to the BBM are flushed out at a slower rate as compared to the other intestinal proteins and loosely bound soluble ALP. BBM preparations from diabetic rat intestines showed lower ratios for BBM/intestinal homogenate sucrase or ALP activity/mg proteins as compared to the normal control rats. Such ratios, therefore, misdepict the purity as low for the BBM from diabetic rats which is merely because of the decreased contents of proteins in the intestinal homogenate during alloxan-induced acute experimental diabetes.