Analysis of physiological [PAO[2], pulse and blood pressure] changes during modified ECT under general anaesthesia

To study the changes in physiological parameters ie PAO[2], pulse and blood pressure changes during ECT under GA. Quasi-experimental study. Department of Psychiatry and Department of Anaesthesiology, Combined Military Hospital Abbottabad from Sep 2009 to Feb 2010. A total of 50 patients with depression were given four separate ECT sessions each. All patients were anaesthetized using propofol 180-200 mg I/V and suxamethonium 50 mg ie 0.75-1 mg per kg I/V without atropine. They were stratified according to physiological changes including PAO[2], pulse and blood pressure at 1, 2 and 5 min after ECT. Oxygen saturation was measured using a pulse oximeter, which measures saturations in the range of 65-100%. Age range was 19-65 years; mean 46 years [SD +/- 13]. Mean diastolic BP before ECT was 84.72 that decreased post ECT ie 78.02 and 77.46 and 74.44 at interval of 1, 2 and 5 minute respectively. Post-ECT pulse and PAO[2] behaved similarly. Post ECT systolic BP decreased at land 5 minutes. Pulse rate decreased after ECT. ECT under propofol is one of the most effective and safe modality of treatment for psychiatric patients under the supervision of qualified psychiatrists and anaesthesiologists and it gives more stable hemodynamic changes

Pattern of somatic symptoms in anxiety and depression

To determine the pattern of somatic symptoms in anxiety and depressive disorders. Cross Sectional Comparative study. Department of Psychiatry Military Hospital Rawalpindi. From May to November 2002. Patients were divided in Group I of anxiety and group II of depression. Fifty patients considered in each group by convenience sampling. The organic basis of their symptoms was ruled out. The patterns of their somatic symptoms and other information like educational and economic status were recorded on Semi Structured Proforma. The patient's diagnosis was made on schedule based ICD-10 research criteria. The severity of anxiety and depression was assessed by using HARS and HDRS respectively. The pattern of somatic symptoms in both groups was then analyzed by the urdu version of Bradford Somatic Inventory. Patterns of somatic complaints were then analyzed by chi square test. Out of 100 patients we placed 50 each in group I [anxiety] and group II [Depression]. Males were higher in depression whereas females were higher in anxiety disorder group. P-value for headache was 0.017 while in rest of the somatic symptoms it was insignificant ranging from 0.4 to 1. We found that the patterns of somatic symptoms are present in both the groups of anxiety and depression like symptoms related to musculoskeletal and gastrointestinal system were commonly observed in cases of depression whereas symptoms related to autonomic nervous system and cardiovascular system is more significantly somatized in patients of anxiety. A larger sample is required for further studies to get better results

Cerebral blood flow patterns using single photon emission computed tomography in patients with dissociative disorders and healthy controls

To compare the cerebral blood flow [CBF] changes in patients diagnosed to have Dissociative Disorder with healthy controls. Cross Sectional Comparative study. The study was done in the Department of Psychiatry Military Hospital Rawalpindi in collaboration with Nuclear Medical Centre [NMC] Armed Forces Institute of Pathology [AFIP], a tertiary care centre of Pakistan Armed Forces from Dec 2004 to May 2005. This cross sectional comparative study was done at Dept of Psychiatry Military Hospital Rawalpindi in collaboration with nuclear Medical Centre [NMC], at Armed Forces Institute of Pathology [AFIP] which is a tertiary referral center. A sample of 30 patients diagnosed as having Dissociative Disorder was compared with 10 controls for brain perfusion changes using TC-99m HMPAO [Hexamethyl-propylene-amine-oxime] Tc-99m. In group 1 perfusion changes were observed in 27 [90%] cases whereas unremarkable and insignificant changes were noted in 3 [10%] cases but no perfusion were noted in controls [P< 0.001] In patients who were suffering from different types of dissociative disorder marked cerebral hypoperfusion was observed in frontal, frontomotor, orbitofrontal and temporal regions whereas hyperperfusion was noted in frontal and orbitofrontal areas in few cases. Cerebral blood flow changes in the fronto parietal brain are associated with symptomotology in dissociative disorders