ABSTRACT
DRESS syndrome (Drug reaction with eosinophilia and systemic symptoms) is defined as a drug-induced complex of symptoms consisting of fever, rash, lymphadenopathy, eosinophilia and a wide range of mild to severe systemic presentations. Here we report a case of a 24-year-old female who developed a severe generalized Anasarca, skin erythema, facial puffiness, reddish discoloration over the body, fever, eosinophilia, leukocytosis and hepatitis 30 days after ingestion of olanzapine. Considering the occurrence of fever, eosinophilia, enlarged lymph nodes, typical skin rash and internal organ involvement, a ‘’ Probable diagnosis “of DRESS syndrome was made using the RegiSCAR Criteria. DRESS induced by psychotropic medications have been scarcely reported. Extensive reporting and educating clinicians as well as patients regarding DRESS will lead to decreased morbidity as well as mortality. Further research is warranted in elucidating its pathogenesis with the aim of designing personalized treatment plans
ABSTRACT
Background: The aim of this study is to study the change in motivation in patients with alcohol dependence syndrome (ADS).Design: 50 consecutive patients admitted for the treatment of ADS in a tertiary care hospital were evaluated. It was a cross sectional observational study.Methods: The study was done in a tertiary care hospital in the in-patient department of psychiatry. Structured performa for sociodemographic details. Psychiatric morbidity was assessed by structured clinical interview according to ICD10. SAD-Q (severity of alcohol dependence questionnaire) to assess severity of alcohol dependence. The assessment of motivation was done using the University of Rhode Island change assessment scale at baseline and after 10 days of admission. Data was evaluated keeping the aims and objectives in mind with appropriate statistical method using Statistical package social software (SPSS) version 21 and descriptive statistics was used. Chi square and Fisher exact test were used to assess the significance.Results: A total 64% were in pre-contemplation, 30% in contemplation and 6% were in action stage of motivation at baseline assessment. A significant change was seen in the levels of motivation towards contemplation and action stage after a brief hospital stay of 10 days. Motivation to change had a significant association with education and severity of alcohol dependence.Conclusions: Pharmacological and non-pharmacological treatment during a short hospital stay results in improvement in readiness for change in patients of alcohol dependence syndrome.
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Background: Prevalence of chronic schizophrenia is somewhat less than 1% of the population but this is one of the most important psychiatric illness due to its early onset, chronicity and associated disability.Methods: A prospective and observational study was carried out on 76 patients for 12 months. Patients of either sex, aged between 18 to 50 years who were diagnosed as schizophrenia according to DSM IV-TR were screened and recruited for the study. Prescriptions were analyzed for socio demographic details and psychotropic drugs prescribed.Results: Out of 76 patients 46 (60.53%) were males, maximum occurred 19 (41.30%) between 18 and 25 years of age. Females were 30 (39.47%), maximum occurred 12 (40%) between 34 - 39 years of age. 52 (68.42%) were from urban area and 24 (31.57%) were from rural area. 26 (34.21%) were illiterate, 24 (31.58%) primary educated, 16 (21.05%) secondary educated and 10 (13.16%) higher secondary and above. 20 (26.32%) were unemployed, students 9 (11.84%), housewives 19 (25%), agricultural workers 10 (13.16%), nonagricultural outdoor workers 4 (5.26%) and nonagricultural indoor workers were 14 (18.42%). Only atypical antipsychotics were prescribed .Olanzapine was prescribed in 30 (39.47%), risperidone 16 (21.05%), amisulpride 13 (17.11%), aripiprazole 11 (14.47%) and quetiapine 06 (7.89%) respectively.Conclusions: The sociodemographic factors associated with schizophrenia are urban locality, illiteracy, low socioeconomic status and unemployment. The treatment pattern observed correlates with the changing trends in the treatment of schizophrenia worldwide.
ABSTRACT
Background: Schizophrenia is one of the most commonly encountered psychiatric disorders. It is characterized by impairment in perception or expression of reality, leading to occupational and social dysfunction. Now a day’s mainstay of treatment of schizophrenia is by using atypical antipsychotics. Amisulpride and olanzapine are atypical antipsychotics which are commonly used in treatment of schizophrenia. The current study is undertaken to assess the efficacy of amisulpride which is a relatively newer antipsychotics against existing antipsychotic olanzapine.Methods: This was designed as a single-blind, prospective, parallel-group, observational study. Eighty adult patients of either sex were randomized to receive standard doses of the two drugs orally for 12 weeks, with follow up at 4 and 8 weeks. Effectiveness was assessed by change in the score of Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression (CGI) score during the treatment period. Data were entered in Microsoft excel and statistical analysis were done using graph pad and p value <0.05 considered to be statistically significant.Results: Out of 80 adults patients 76 patients were evaluated by dividing into two groups, 38 patients were included in each group. Final BPRS score was less for olanzapine as compared to amisulpride (p<0.001). Improvement in CGI score is more in olanzapine group than amisulpride group which became statistically significant from 8th weeks onwards.Conclusions: Both amisulpride and olanzapine are very effective in controlling the symptoms of schizophrenia which is evident by significant decrease in BPRS, CGI-S and CGI-I score, but efficacy of amisulpride is still inferior to olanzapine.