Endoplasmic Reticulum Stress: Implications for Neuropsychiatric Disorders / 전남의대학술지

The Endoplasmic reticulum (ER), an indispensable sub-cellular component of the eukaryotic cell carries out essential functions, is critical to the survival of the organism. The chaperone proteins and the folding enzymes which are multi-domain ER effectors carry out 3-dimensional conformation of nascent polypeptides and check misfolded protein aggregation, easing the exit of functional proteins from the ER. Diverse conditions, for instance redox imbalance, alterations in ionic calcium levels, and inflammatory signaling can perturb the functioning of the ER, leading to a build-up of unfolded or misfolded proteins in the lumen. This results in ER stress, and aiming to reinstate protein homeostasis, a well conserved reaction called the unfolded protein response (UPR) is elicited. Equally, in protracted cellular stress or inadequate compensatory reaction, UPR pathway leads to cell loss. Dysfunctional ER mechanisms are responsible for neuronal degeneration in numerous human diseases, for instance Alzheimer's, Parkinson's and Huntington's diseases. In addition, mounting proof indicates that ER stress is incriminated in psychiatric diseases like major depressive disorder, bipolar disorder, and schizophrenia. Accumulating evidence suggests that pharmacological agents regulating the working of ER may have a role in diminishing advancing neuronal dysfunction in neuropsychiatric disorders. Here, new findings are examined which link the foremost mechanisms connecting ER stress and cell homeostasis. Furthermore, a supposed new pathogenic model of major neuropsychiatry disorders is provided, with ER stress proposed as the pivotal step in disease development.

Satisfaction of outpatients and inpatients with psychiatric services at Allama Iqbal Memorial Hospital, Sialkot

Objective: The objective of the current study was to assess satisfaction of outpatients and inpatients with psychiatric services and to compare the satisfaction level of both groups of patients to understand areas to be improved in delivery of psychiatric care

Study Design: Observational / descriptive / cross sectional study

Place and duration of study: This study was conducted at the Department of Psychiatry and Behavioural Sciences, Government Allama Iqbal Memorial Teaching Hospital affiliated to Khawaja Muhammad Safdar Medical College Sialkot, Pakistan from August 2015 to July 2016

Material and methods: Sample size was 600 patients; including 300 outpatients and 300 inpatients. Patients aged 18 years or above, from both genders, who gave written informed consent, were consecutively included in the study. Excluded from the study were the patients with mental retardation, delirium, impairment of cognition, severe medical illness and severe psychotic symptoms. Demographic information of the patients was taken on a pre- designed proforma. Urdu version of the Client Satisfaction Questionnaire 8 [CSQ-8] was administered to assess patient satisfaction. The results were analyzed using SPSS version 21

Results: Among the outpatients there were 67.7% patients mostly satisfied, 22% mildly satisfied and 10.3% dissatisfied. While in the inpatients there were 68% mostly satisfied, 22.3% mildly satisfied and 9.7% dissatisfied with the psychiatric services. Only age was significantly associated with satisfaction

Conclusion: Most of the outpatients and inpatients were satisfied with the psychiatric services. The outpatients and inpatients were almost equally satisfied. Older patients were more satisfied than the younger patients. Other demographic variables like gender, marital status, education and economic status did not influence the satisfaction