A study to assess the magnitude of various minor physical anomalies in bipolar disorders and to compare them between bipolar disorder patients and their first degree relatives

Background: Bipolar disorder appears to be related to anatomic abnormalities in medial temporal lobe, in particular amygdale, prefrontal cortex and cerebellum. Two recent MRI findings have supported a neuro developmental etiology of bipolar disorders.Methods: It was a cross-sectional comparative hospital based study. The subjects were recruited for the study by the purposive sampling technique. The study was conducted at the Institute of Mental Health and Hospital Mathura Road Agra. The study sample consisted of 20 bipolar disorder patients diagnosed as per ICD-10 DCR (WHO, 1992) criteria, 20 first degree relatives, one for each patient. Total sample size is 40.Results: It was observed that in bipolar patients’ maximum anomalies were seen in Mouth (0.35±0.48) head (0.30±0.57) followed by anomalies of eyes (0.25±0.55) hand (0.20±0.41) and ear (0.05±0.22). It was observed that in Bipolar FDRs maximum anomalies were seen in mouth (0.20±0.04) ear (0.15±0.45) head (0.1±0.3) and then anomalies of eye and hand in equal propensity (0.05±0.22) and least anomalies in feet (0.00±0.00).Conclusions: The rate of MPAs in bipolar patients was more than their FDRs but not statically significant. Both sibling groups had fewer MPAs than the patients. When viewed within a vulnerability-stress model, the results are consistent with the theory that MPAs may reflect early, largely extra-genetic, stressful events.

Salivary Cortisol Levels in Severely Depressed Patients and Healthy Individuals

Introduction: This study compared the levels of salivary cortisol in patients suffering from severe depression and in healthy individuals. Methods: Sample size included 30 diagnosed cases of major depression based on outdoor clinical assessment (from April 2015 to December 2105) and was established by ICD-10 and DSM-IV criteria and 30 physically and mentally healthy subjects. In this study diagnosed cases of hyperaldosteronism, Cushing’s syndrome/ disease were omitted. A predesigned proforma was created on the basis of Becks Inventory. Saliva samples were collected and processed, and the measurement of cortisol levels was done by ELISA. Results: In a normal subject, the mean cortisol level was 1.46 ± 0.9 μg/dl (Mean ± SD) whereas in depressive patients it was raised (2.2 ± 1.6 μg/dl, p=0.031). Results also showed that high level of cortisol in saliva was found in individuals with a positive family history of depression (2.3 ± 1.8 μg/dl) as compared to healthy subjects (1.5 ± 1.0 μg/dl). Mean BMI was also found to be different between the 2 groups (p=0.012). Conclusion: We concluded that salivary cortisol may act as an early diagnostic tool and non-invasive biomarker for prompt diagnosis of potential cases of depression for effective management. Hence, early initiation of treatment can be helpful in improving the late clinical consequences in severely depressed patients and decreasing the morbidity.

Depression and Routine Biochemical Markers: A Cross Sectional Study

Background: Today, globally up to 6–12% of the adult population suffered mental disorder and recurrent depression. The prevalence of depression in India was reported as 4.5% by WHO. Currently the diagnosis of major depression is carried out through symptom-based assessment process, which has limitation of the development of personalised treatment plans. Objective: To determine the association between various biochemical markers of the inflammation, lipid profile, BMI, thyroid profile and depression among the patients attending department of psychiatry in a tertiary care centre. Methods: A cross-sectional study conducted among 50 patients attending the psychiatry department at S.N. Medical college, Agra and diagnosed as Depression disorder, during April 2012 to December 2012. Hamilton rating scale (HAM-D) was used to assess the severity of depression. The patients were also assessed for their vitals, lipid profile, thyroid profile, ESR, CRP and BMI. Results: 19 (38%) study subjects were in the age group of 18yrs to 30 yrs with mean age as 34.2 ±14.57 years. 36(72%) were of normal weight or under-weight and14 (28%) were pre-obese. Among 14 pre-obese and obese study subjects, 2(15.4%) had mild, 4(18.2%) had moderate and 8(53.3%) had severe type of depression(p=0.03). ESR is more in severe depression as compared to mild and moderate depression. (p=<0.001%). C-reactive protein is statistically more in severe depression (T =2.25; P= < 0.001). Conclusions: There is a positive and significant relationship between the severity of depression and ESR, CRP and BMI among the patients attending department of psychiatry.

Significant increases in monocyte counts and serum creatine kinase in acute myocardial infarction versus general infections.

Background: Biomarkers specificity is an important factor for their reliable utilization. Known markers for acute myocardial infarction (AMI), including creatine kinase (CK), C-reactive protein (CRP), and blood cell counts are thought to be altered in other pathologic conditions, such as infections. Aim: To compare the level of these biomarkers in AMI patients and infected controls with respect to normal subjects. Materials and Methods: We recruited 15 AMI patients, 15 patients with bacterial infections (infected control group) and 35 normal subjects. Peripheral blood samples were obtained for blood cell counts and biochemical analyses. Results: Only monocytes were significantly increased in AMI patients (0.793 × 10 9 /L) than normal controls (0.497 × 10 9 /L). Infected controls showed a significant increase in total white blood cell (11.50 × 10 9 /L versus 6.149 × 10 9 /L) and neutrophil (9.360 versus 3.223 × 10 9 /L) counts and a significant decrease in red blood cell (3.750 versus 5.105 × 10 12 /L) counts as compared with normal controls. Serum CK was significantly increased in AMI patients (313.20 ± 94.84 U/L) and decreased in infected controls (48.40 ± 10.35 U/L) as compared with normal controls (100.82 ± 8.86 U/L). The levels of CRP were significantly higher in infected controls (136.93 ± 34.83 mg/L) and nonsignificantly higher in AMI patients (38.53 ± 12.76 mg/L) than normal controls (3.48 ± 0.59 mg/L). Monocytes were significantly correlated with both CK and CRP; however, there was no correlation between CK and CRP. Conclusion: Differential trends of monocytes and CK in AMI and infective controls point toward their possible application in prognosis of AMI patients.

Ureteric nephrogenic adenoma: A report of two cases.

Nephrogenic adenoma is a rare, benign, metaplastic lesion predominantly seen in urinary bladder, which occurs even more rarely in the ureters. We report two such cases, arising in the ureter. Both patients were young adult males. Histology of both cases was similar, showing tubules lined by columnar cells with hobnailing of nuclei. Immunohistochemically, both cases resembled their counterparts in urinary bladder. These lesions are important to recognize, since they can easily be confused with several malignancies.

Gastrointestinal stromal tumor with skeletal muscle, adrenal and cardiac metastases: An unusual occurrence.

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the bowel. It most commonly arises in the stomach, followed by the small intestine, colorectum and the esophagus. It usually spreads to the liver or the peritoneum, with bone and lung metastases being infrequent. Here, we present a case report of GIST behaving in a bizarre way. The patient presented with skeletal muscle metastasis and was initially misdiagnosed as leiomyosarcoma. On follow-up, he developed adrenal metastasis, and later, cardiac metastasis. None of the above unusual sites has previously been reported in literature to our knowledge.

Bioluminometric assay of ATP in mouse brain: Determinant factors for enhanced test sensitivity.

Firefly luciferase bioluminescence (FLB) is a highly sensitive and specific method for the analysis of adenosine-5-triphosphate (ATP) in biological samples. Earlier attempts to modify the FLB test for enhanced sensitivity have been typically based on in vitro cell systems. This study reports an optimized FLB procedure for the analysis of ATP in small tissue samples. The results showed that the sensitivity of the FLB test can be enhanced several fold by using ultraturax homogenizer, perchloric acid extraction, neutralization of acid extract and its optimal dilution, before performing the assay reaction.