Adaptation of cognitive behaviour therapy in childhood obsessive-compulsive disorder: a case study

Cognitive behaviour therapy (CBT) has been proved to be one of the most well-researched and effective therapy. It has been found effective in many clinical conditions in children and adolescents as well. Application of therapeutic processes gets complicated by the facts that childhood and adolescent problems do not come in neat packages and tend to overlap and/or coexist. For instance, there is much overlap among clinical problems like anxiety, depression, behavioural problems, and between reading and writing difficulties, and attention and hyperactivity. Many behavioural and emotional disturbances in children are also associated with specific medical conditions. The relationship between physical and/or medical conditions and emotional and behavioural disorders in children and adolescent has been documented in various studies. This demands attention to the therapeutic intervention to the childhood problems with greater monitoring and modulation. Use of CBT in childhood and adolescent problems for efficiency and convenience may be grouped into externalising and internalising disorders, and the management techniques may be formulated and tailored to meet the two opposing dimensions. In this case study, index client was an eight years old girl who presented with compulsive behaviour along with anxiety and fear, and the application of CBT techniques, its adaptability and efficacy in this case of obsessive-compulsive disorder (OCD), with specific phobia would be discussed.

A clinico-epidemiological study of the first outbreak of Nipah virus in India – report from ground zero

Introduction: The first Nipah Virus (NiV) outbreak occurred in India in the year 2001 at Siliguri. The second outbreak happened at Nadia in 2007. Nipah Virus exhibits neurological and pneumonic tropism with the predominant clinical presentation being encephalitis in humans. Material and Methods: The present study was a record based prospective study on 67 cases admitted with pyrexia of unknown origin in North Bengal Medical College during the period from 18.02.2001 to 30.02.2001 and a parallel study on epidemiological record carried out by PSM department also taken into account. All necessary investigations including autopsy examination, pathological, and microbiological study were done. Results: There was a clustering of cases around Bhaktinagar. There was a strong H/O Medinova Nursing Home Contact among the patients. 18 out of 20 cases were staff of that Nursing Home. Serum samples tested show NiV specific IgM and IgG in 9 out of 17 samples with one sample which was positive for IgG only suggesting past infection. The cases were admitted with predominant neurological symptoms (53.73% cases) but about 80% recovered with no residual neuro deficit. The natural reservoir of NiV is present in Bangladesh and in Northern India. Conclusion: When NiV infection is suspected, infection control practices must be strengthened to avoid an outbreak in a hospital setting. Here the present study is presenting the experience in the first outbreak of the Nipah virus in India at Siliguri for awareness of clinical personnel to control further outbreak at the very beginning.

Familial Brachydactyly in an Indian Family: A case report.

Brachydactyly or short digit is a rare deformity involving fingers and toes. We present a rare family with 6 known members affected with similar pattern of brachydactyly, affecting only bilateral index fingers. The knowledge of this entity is important and a thorough clinical and radiological evaluation is mandatory for any patient with digital deformities.

Potassium channel openers exhibit cross-tolerance with morphine in two experimental models of pain / Los abridores de canales de potasio exhiben tolerancia cruzada con la morfina en dos modelos experimentales de dolor

OBJECTIVE: The study was performed to assess the effect of potassium channel openers on morphine tolerance and vice-versa. METHODS: Swiss albino mice of either gender weighing between 25-30 g were used for the study. The study assesses the effect of potassium channel openers (cromakalim, diazoxide and minoxidil) on morphine tolerance and vice-versa, using formalin and tail-flick tests. RESULTS: The antinociceptive effect of cromakalim and minoxidil was significantly reduced when administered to morphine-tolerant mice, in both the behavioural tests. However, reduced analgesic effect of diazoxide was observed on morphine-tolerance in the formalin test but not in the tail-flick test. Tolerance was observed when morphine was administered to animals chronically treated with any of the potassium channel openers. The same effect was observed when morphine was injected into a group treated with a combination of morphine and any of the potassium channel openers. CONCLUSIONS: This study, therefore, suggests that both morphine and potassium channel openers are cross-tolerant. However, such interaction occurs at the level of potassium channels rather than at the level of receptors.

OBJETIVO: El estudio fue realizado para evaluar el efecto de los abridores de canales de potasio en la tolerancia a la morfina, y viceversa. MÉTODOS: Para el estudio, se usaron ratones albinos suizos de ambos sexos que pesaban entre 25-30 g. El estudio evalúa el efecto de los abridores de canales de potasio (cromacalina, diazóxido y minoxidil) en la tolerancia a la morfina, y viceversa, usando la prueba de la sacudida de la cola y la prueba de la formalina. RESULTADOS: El efecto antinociceptivo de la cromacalina y el minoxidil fue significativamente reducido cuando se le administró a los ratones tolerantes a la morfina, en ambas pruebas conductuales. Sin embargo, se observó un efecto analgésico reducido de diazóxido sobre la tolerancia a la morfina en la prueba de la formalina, pero no en la prueba de la sacudida de la cola. Se observó tolerancia al administrar morfina a animales crónicamente tratados con cualquiera de los abridores de canales de potasio. El mismo efecto fue observado cuando se inyectó la morfina al grupo tratado con una combinación de morfina y cualquiera de los abridores de canales de potasio. CONCLUSIONES: Por consiguiente, este estudio sugiere que tanto la morfina como los abridores de canales de potasio son tolerantes cruzados. Sin embargo, tal interacción ocurre a nivel de los canales de potasio más bien que a nivel de los receptores.

Role of bilirubin as antioxidant in neonatal jaundice and effect of ethanolic extract of sweet lime peel on experimentally induced jaundice in rat.

Bilirubin above a threshold level is toxic to human system and is excreted in urinary and through gastrointestinal tract. The role of bilirubin as antioxidant is debatable. This paper aims at elucidating the role of bilirubin as an antioxidant in neonatal jaundice patients. It is observed that bilirubin up to 6 mg/dl in blood acts as an antioxidant and above 12.5 mg/dl is strongly prooxidant. Phototherapy is the accepted therapeutic management of neonatal jaundice and has been shown to enhance the oxidative stress. Approaches have been taken to formulate a herbal medication which will reduce bilirubin level in the neonates without inducing additional damages. The ethanolic extract of sweet lime peel, administered orally at a dose of 72 microg is found to reduce the oxidative stress in erythrocytes of phenylhydrazine-induced jaundiced rats treated with phototherapy.

Thoracoscopic excision of mediastinal bronchogenic cyst: a case report and review of literature.

Thoracoscopic resection of mediastinal cysts results in less postoperative pain, shorter hospital stay and better cosmetic outcome when compared to the standard thoracotomy. We report successful thoracoscopic resection of a mediastinal cyst in a 17-year-old male who presented with right-sided chest pain.

Impact of modified leprosy elimination campaign in a MDT pilot project district of India.

A study was carried out based upon the data available from National Leprosy Eradication Program of Purulia district in West Bengal. The result showed that the disease was in a declining trend up to the year 1998 and was inclining during the year 1998-1999 due to more case detection through MLEC-I, then followed by declining trend during the year 2000 as it was observed by MLEC-II. Single skin lesion rate was higher, MB rate was same and reduced deformity rate indicates early detection of cases due to better awareness of the community about the disease.

Bioactive forms of gonadotropin releasing hormone in the brain of an Indian major carp, Catla catla (Ham.).

Two forms of biologically active gonadotropin releasing hormones were isolated from the hypothalami of Catla catla. Gonadotropin releasing hormone activity was studied in vitro using enzymatically dispersed carp pituitary cell incubation system. Gonadotropin released into the medium was measured by carp gonadotropin-radio immuno assay. Acetic acid extracted hypothalamic material was subjected to acetone fractionation. Among the three protein pellets obtained at different time periods (AC I, AC II and AC III), AC II exhibited the gonadotropin releasing hormone activity. Gel filtration of AC II through Sephadex G-25 column showed three protein peaks (SG I, SG II SG III) and only SG II demonstrated strong gonadotropin releasing hormone activity. Elution of SG II through FPLC Mono Q column (an anion exchanger) in NaCl gradient programme showed one unadsorbed (MQ I) and three adsorbed (MQ II, MQ III and MQ IV) protein peaks. MQ III, which was eluted with 51% NaCl, exhibited gonadotropin releasing hormone activity. Surprisingly, unadsorbed fractions, MQ I, also showed gonadotropin releasing hormone activity. MQ 1 was therefore subjected to FPLC Mono S (a cation exchanger) column chromatography where a highly active gonadotropin releasing hormone enriched peak, i.e., MS III, could be eluted with 45% NaCl. These findings show that Catla catla hypothalamus has two forms of gonadotropin releasing hormones one anionic (carp gonadotropin releasing hormone I) and another cationic (carp gonadotropin releasing hormone II). These two forms of gonadotropin releasing hormones were also active in heterologous carp species, rohu (Labeo rohita), mrigal (Cirrhinus mrigala) and an exotic common carp (Cyprinus carpio). Combined activity of two forms of gonadotropin releasing hormones was significantly greater as compared to any of the single form.