Psychiatry morbidity in patients attending neurological outpatient department.

Background: Neurological disorders are often associated with psychological, emotional, and other psychiatric disturbances and may impede recovery of patient, making early identification and treatment of potential importance. Aims & Objective: The objective of the study was to see the psychiatric morbidities in in patients attending neurological outpatient department. Material and Methods: The study was conducted in the Neurological Outpatient department in the Department of Medicine in Shri Maharaja Singh Hospital (SMHS) Hospital of Government medical college Srinagar. This was a cross sectional study. Five hundred cases of neurological patients were taken up for the study. Psychiatric diagnosis was done by using MINI plus scale which was structured interview. Morbidity in were analysed by the Pearson chi-squared test and t test. Results: Males constituted 46.6% i.e. 233 and females constituted 53.4% i.e. 267 of sample and mean age of the patients was 35.85 ± 9.475. The maximum number of patients, 40% (n=200) belong to 16-30 years age group ,Total patients 300 patients (60%) out of 500 had psychiatric diagnosis. The presence of psychiatric disorder was maximum in age group of 16-30 years. Conclusion: The results indicate that neurological patients have high levels of psychiatric morbidity. Screening patients with neurological disorders for psychiatric problems and timely psychiatric intervention can go a long way in improving the quality of life of these patients.

First reported case of reactive airway dysfunction syndrome in a laborer due to porcelain tile dust

Reactive airway dysfunction syndrome [RADS] is a type of non-immunologically mediated asthma-like disease. It usually occurs after a massive exposure to an irritating substance in the atmosphere in the form of smoke, fumes, gases, and vapor. Unlike bronchial asthma, there is no latency to the symptoms seen in RADS. A number of agents are known to cause RADS, but tile dust, as an etiological agent, has not been previously reported. We report a 45-year-old male laborer, who presented with an acute onset of cough, chest tightness, breathlessness, and audible wheeze after his first time exposure to porcelain tile dust within 5 hours of exposure. Lab tests, including, chest X-ray, electrocardiogram, air blood gas analysis, and serum IgE, were unremarkable. Spirometry showed a mild obstruction [forced expiratory volume in 1 second [FEV1]=72% of predicted], while the bronchodilator reversibility test was significant[14% increase in FEV1 above the baseline].Bronchial biopsy revealed a chronic inflammatory reaction with lymphocytic and plasma cell infiltration and more importantly a striking absence of eosinophils. To t he best of our knowledge, this is the first reported case of RADS as a result of exposure to tile dust [porcelain ceramics]

Sheehan's syndrome presenting as psychosis: a rare clinical presentation

Sheehan's syndrome [SS] refers to the occurrence of varying degree of hypopituitarism after parturition [1]. It is a rare cause of hypopituitarism in developed countries owing to advances in obstetric care and its frequency is decreasing worldwide. However, it is still frequent in underdeveloped and developing countries. Sheehan's syndrome is often diagnosed late as it evolves slowly [2, 3]. Reports of psychoses in patients with Sheehan's syndrome are rare. Herein, a case report of psychosis in a 31 year old woman who developed Sheehan's syndrome preceded by postpartum haemorrhage is presented. Treatment with thyroxine and glucocorticoids resulted in complete remission after attaining euthyroid and eucortisolemic state

Comparison of hematological parameters in untreated and treated subclinical hypothyroidism and primary hypothyroidism patients

Thyroid hormones play an important physiological role in human metabolism. Erythrocyte abnormalities are frequently associated with thyroid disorder. However, they are rarely investigated and related to the subclinical and primary hypothyroidism in Kashmiri Patients. In this study an attempt was made to study hematological parameters in untreated and treated subclinical hypothyroidism and primary hypothyroidism patients. This retrospective study included 600 subjects, among which were untreated subclinical hypothyroid [n=110], treated subclinical hypothyroid [n=110], untreated primary hypothyroid [n=100], treated primary hypothyroid [n=100] and euthyroid [n=180]. This study was carried out at Department of Biochemistry, Government Medical College Srinagar. The hematological parameters and thyroid profile of the subjects were assessed by the Sysmex [Italy] and ECLIA [Germany] 2010 automatic analyzer. Mean, standard deviation [SD], analysis of variance [Two-way ANOVA], and multiple comparisons were used to report our results, with p<0.05 or p<0.01 considered as statistically significant. In this study group we compared the hematological parameters in these groups, untreated subclinical hypothyroid, treated subclinical hypothyroid, untreated primary hypothyroid, treated primary hypothyroid and euthyroid. We found that hematological parameters like Hb, RBC, MCV, HCT, RDW,RBC% were significantly increased in untreated subclinical hypothyroidism and untreated primary hypothyroidsm, with the p value being less than 0.05 whereas, in treated SCH and Pr. Hypothyroid, results were insignificant. The results reported in these groups as mean +/- SD, were statistically tested by ANOVA and multiple comparison tests. In untreated subclinical hypothyroid the values were: Hb [10.83 +/- 1.33 g/dl], RBC [4.21 +/- 0.66 10[6]/micro l], MCV 2.2%], [84.56 +/- 6.84 fL], HCT [38.5 +/- 2.2%], RDW [17.91 +/- 2.37 fL], RBC% [84.36 +/- 13.2%] and in untreated primary hypothyroid, Hb [10.73 +/- 0.86 g/dl], RBC [4.63 +/- 0.51 10[6]/micro l], MCV [83.34 +/- 6.92 fL], HCT [38.6 +/- 2.6%], RDW [14.93 +/- 5.47 fL], RBC% [92.63 +/- 10.30%] suggesting that these patients were at risk of anemia and other erythrocyte abnormalities. MCV is an inexpensive approach to study the types of anemia and explore related information like production, destruction, loss and morphological changes of RBC'S. The thyroid dysfunction is frequently associated with anemia in subclinical hypothyroidism and primary hypothyroidism. Subclinical hypothyroidism [SCH] is associated with serious complications. Substantial numbers of patients with the risk of SCH could be getting converted into primary hypothyroidism. Such conditions should be identified and corrected. On the other hand, their presence could move to a thyroid dysfunction, allowing its early management

Glucose intolerance in relation to socioeconomic status and gender in population of Srinagar city

To assess the pattern of type -2 diabetes in different socioeconomic groups in the urban and peri-urban areas of Srinagar city. A detailed questionnaire on the Socioeconomic and Clinical background of the 1040 subjects was collected. After an overnight for blood fasting blood samples were drawn for determination of plasma glucose. Diagnosis of diabetes was based on the American Diabetes Association [ADA 2004]. The overall Prevalence of the diabetes in the study population was 6.05% which included 4.03% of known diabetic and 2.02% undiagnosed subjects. There was significant difference between the prevalence of type 2 diabetes in men and women [3.6%vs 8.3% respectively, P=0.0013]. Subjects belonging to higher socioeconomic status had greater prevalence of diabetes compared to lower 17.4% vs 3.2% [P<0.001][middle class [class II and Class III] versus lower class[Class IV]respectively]. Socioeconomic factors influence the occurrence of diabetes in this study population, with prevalence being more come in the middle class

case report on bronchoalveolar carcinoma presenting as non-resolving consolidation

Bronchoalveolar carcinoma presenting as non-resolving consolidation is an uncommon presentation. The typical presentation of bronchoalveolar carcinoma is asymptomatic [solitary nodule] and remains without symptoms even as disease disseminates. We report a case of bronchoalveolar carcinoma presenting as non-resolving consolidation in a young male with productive cough, exertional breathlessness and physical examination revealing the features of right lower consolidation on x-ray chest, with subsequent CT of the chest and bronchoscopic examination revealed bronchoalveolar carcinoma. Patient had good score and was managed conservatively