Comparing the Effect of Cognitive Therapy and Spiritual Therapy on Depression between Iranian Students Residing in Iran and India.

Introduction: Cognitive therapy is a well accepted treatment option for patients suffering from depressive disorders. Spiritual well-being is a central component of psychological health. Objectives: The main objective of the study is to compare the effect of cognitive and spiritual therapy on depression between Iranian Students residing in Iran and India. Methods: 64 female students ranging in the age of 18 to 45 years were selected from counselling centres from India and Iran. 32 students having higher depressive scores were administered cognitive therapy and spiritual therapy using a purposive random sampling technique. Pre and post treatment assessments of depression scores was done using Beck’s Depressing Inventory. Results: Our findings indicated that spiritual therapy is more effective than cognitive therapy in Iranian female students residing in India and Iran. Conclusion: Culture plays a significant role in treatment options that the patient chooses and accepts.

Comparative Efficacy of Cognitive Retraining Techniques and Remedial Training in Children with Learning Disability.

Background : Computer-assisted cognitive retraining approaches that work on the principle of cerebral plasticity are by now established rehabilitation methods for various neuropsychiatric conditions including Learning Disability. Also, remedial education is considered to be an integral part of management of learning disability. Objectives: To compare the efficacy of cognitive retraining techniques and remedial education for enhancing academic performance of children with learning disability. Sample & Methods: Pre-Post experimental design study was carried out with forty children(between seven to ten years of age), with diagnosis of mixed disorder of scholastic skills (ICD-10). Subjects in Group1 (n=20) were given 36 hours of manualized CR package over 18weeks, consisting of activities for sustained attention, visuospatial skills, visual memory; and verbal learning and memory. Subjects in group 2 (n=20) were given 36-remedial education sessions. Pre and post intervention assessment; was done using NIMHANS Index for Specific Learning Disability, Grade Level Assessment Device(GLAD).SPSS version 12.0 was used for descriptive and analytical statistical analysis. Results: Highly significant improvement was noted in mathematics (p > 0.01) for Group 1. Also, there was significant improvement in Hindi language of Group 2 (p > 0.05). Conclusion: Both-manualized cognitive retraining and remedial education over thirty six hours can help to partially improve scholastic performance in children with learning disability. The findings have implications for combining both the approaches for future educational curricula aiming at improved academic performance stemming from an enhanced skill base rather than from just educational based interventions.

Sensory, cognitive and motor assessment of children with poor academic performance: An auditory evoked potential study.

The present study aims to evaluate the auditory sensory process in the brainstem, thalamocortical and cortical areas by using auditory evoked potentials [auditory brainstem response (ABR), mid latency response (MLR) and slow vertex response (SVR)], cognitive functions by P300 and motor response by reaction time in children with poor academic performance. Thirty children between 6–12 years of age were selected as subjects on the basis of poor academic school records. While thirty children with good academic performance served as controls. The recordings were done using a computerized evoked potential recorder by 10–20 electrode placement system. There was no difference in the anthropometric parameters and IQ of the two groups. There was a significant increase in latency of waves II, III, IV and V, and Inter-peak latency I-V of ABR in poor performer females. All the component waves of MLR and SVR showed increased latency in the subjects but could not reach the level of significance. There was a significant increase in latencies of P300 at Cz and Pz electrode positions with no change in amplitude in poor performer females. The reaction time was also increased in the poor performer females as compared to the controls. The latencies of all the waves of ABR, P300 and reaction time are also increased in male poor performers as compared to male controls but could not reach the level of significance. The conduction of impulses is slower in pontine and midbrain auditory pathway along with inefficient cortical processing of task relevant stimuli and motor response in female children having poor academic performance.

Rehabilitation need assessment of severely Mentally ill and effect of Intervention.

To study the rehabilitation needs of severely mentally ill person and to ascertain the efficacy of intervention strategies to meet out these needs, a group of 50 severely mentally ill persons, 25 each in experimental and control group as per proposed inclusion and exclusion criteria were selected from indoor and out patient clinic of IHBAS as sample of the study. Intervention package used in the study included psycho-education, activity scheduling and social skill training. To see the effect of intervention parameters used were symptom reduction, disability remediation, subjective wellbeing and dysfunction in social, family, personal, vocational and cognitive areas. Rehabilitation need assessment schedule, Mini Mental Status Examination, Positive and Negative symptom scale, Disability Assessment Schedule, Subjective well being Inventory and Dysfunctional Analysis Questionnaire were administered to collect desired data twice in the pre and post intervention phases. Pre assessment followed intervention sessions conducted for the experimental group for eight weeks duration. During this period control group subjects were waitlisted for this intervention. Results indicated that intervention is effective in symptom reduction, disability remediation, improving subjective well being and functioning in personal, social, family and cognitive areas.

Neuro-Cognitive Functioning in Children with Learning Difficulties.

Learning difficulties can occur due to complex interplay of factors that may reside in the child’s own constitution, temperament and cognitive abilities and/or in the background and quality of child’s schooling and/ or in family related factors that affect interactions and emotional well being of the child. Aims & Objectives: To study the neuro-cognitive functioning of children with learning difficulties . Method: Forty children studying in English medium schools in Delhi from Grade 2nd to 5th who were reported to be having learning difficulties. The children were divided into two groups (n=20, each.) One of the groups had children having learning disability. The other group had children with learning difficulties but without any diagnosable psychiatric/ emotional/ behavioural problems. All children were assessed for their intelligence, scholastic performance (on three basic subjects- Hindi, English and Mathematics)); Sustained attention; Verbal Working Memory, Visual Learning and Memory; Verbal Learning and Memory , Verbal Comprehension, Visuo-Constructive Ability and Visuo-Conceptual Skills. Conclusions:Both the groups had impairment in assessed neuro-cognitive skills. Children with learning disability had significantly poorer performance on tasks of sustained attention, visual memory and learning , delayed recall and visuo constructive skills. There were no differences among children on other assessed functions.

Efficacy of Cognitive Retraining Techniques in Children with Learning Disability.

Background :Cognitive Retraining(CR) is known to help in reattainment of cognitive abilities following brain injury.Due to high cerebral plasticity in children,CR can perhaps also be used to ameliorate known cognitive deficits in children with learning disability. Objectives: To study the efficacy of cognitive retraining techniques for enhancing cognitive skills and scholastic performance in children with learning disability. Sample & Methods: Pre and Post experimental design study was carried out with thirty children(between eight to ten years of age), with diagnosis of mixed disorder of scholastic skills(ICD-10). Each subject was given 36 hours of manualized CR package over 18weeks, consisting of activities for sustained attention,visuospatial skills,visual memory;and verbal learning and memory.Pre and post intervention assessment; was done using NIMHANS Index for Specific Learning Disability,Grade Level Assessment Device(GLAD) and Rey’s Auditory Verbal Learning Test(AVLT).SPSS version12.0 was used for descriptive and analytical statistical analysis. Results:Highly significant improvement was noted in total verbal learning, delayed verbal recall,visuo-spatial skills and mathematics(p>0.01).Also, there was significant improvement in sustained attention(time taken and errors),visual memory and immediate verbal recall(p>0.05). Conclusion:Manualized cognitive retraining over thirty six hours can help to partially remediate cognitive deficits in children with learning disability and improve their scholastic performance. The findings have implications for future educational curricula aiming at improved academic performance stemming from an enhanced skill base rather than from just educational based interventions.

A study of bone marrow failure syndrome in children.

Background: Bone marrow failure syndrome (BMFS), or aplastic anemia, includes peripheral blood single cytopenias, as well as pancytopenia due to inability of the marrow to effectively produce blood cells. Aim: To study the clinico-hematological profile and etiological factors of bone marrow failure syndrome in children. Setting and Design: This prospective study was carried out in the Department of Pediatrics of a university teaching hospital over 36 months. Materials and Methods: Children with pancytopenia (Hb 9 /L, platelet count < 100 x 10 9 /L) and bone marrow cellularity < 25% were included in the study. History of exposure to drugs, socioeconomic status, ethnicity and occupation of father were noted. Bone marrow aspiration; trephine biopsy; Ham test; viral studies for hepatitis A, B and C; and cytogenetic investigations were carried out. Statistical Analysis: Relative risk was estimated by odds ratio (OR) with 95% confidence interval (CI) in matched cases and controls. Results: Of the 53 children studied, 6 (11.3%) were diagnosed as Fanconi anemia. Two cases had features of myelodysplastic syndrome. Forty-five children were labeled as acquired aplastic anemia, of whom one had evidence of hepatitis B infection and two patients (5.8%) had paroxysmal nocturnal hemoglobinuria. Aplastic anemia was more common in children from family with lower socioeconomic status; in Muslims; and where the father's occupation was weaving, dyeing and painting. However, the number was small to make statistically significant conclusions. No correlation could be established with exposure to drugs. Conclusion: Fanconi anemia was responsible for approximately one-tenth of the cases of bone marrow failure syndrome. Majority of the patients had acquired aplastic anemia. Hepatitis B infection was an uncommon cause of acquired aplastic anemia.

Estimation of CD4+ and CD8+ T-lymphocytes in human immunodeficiency virus infection and acquired immunodeficiency syndrome patients in Manipur.

PURPOSE: To estimate and stratify CD4 + and CD8 + T-lymphocyte levels in human immunodeficiency virus (HIV) infected (asymptomatic) and acquired immunodeficiency syndrome (AIDS) patients (symptomatic) and correlate the clinical features of the patients with CD4+ and CD8+ lymphocyte level. METHODS: Between April 2002 and September 2003, a total of 415 HIV seropositive adult patients (297 males and 118 females) attending Regional Institute of Medical Sciences (RIMS) hospitals were tested for CD4+ and CD8+ T-lymphocytes by fluorescent activated cell sorter (FACS) counter (Becton Dickinson). Symptomatic patients were diagnosed as per NACO clinical case definition. RESULTS: Ranges of 0-50, 51-100, 101-200, 201-300, 301-400, 401-500 and above 500 CD4+ T-lymphocyte per microlitre were seen in 68, 52, 101, 73, 47, 31 and 43 patients respectively whereas CD8+ T-lymphocyte ranges of 0-300, 301-600, 601-900, 901-1500, 1501-2000, 2001-3500 per microlitre were seen in 29, 84, 92, 145, 40 and 25 patients respectively. One hundred and fifty patients were asymptomatic and 265 were symptomatic. CD4/CD8 ratio in asymptomatics and symptomatics were 0.13-1.69 and 0.01-0.93 respectively. Tuberculosis and candidiasis occurred in CD4+ T-lymphocyte categories between 0-400 cells per mL in symptomatics. However, cryptosporidiosis, toxoplasmosis, herpes zoster, cryptococcal meningitis, Pneumocystis carinii pneumonia, penicilliosis and cytomegalovirus retinitis were seen in patients having CD4+ T-lymphocyte less than 200 per mL. CONCLUSIONS: CD4+ T-lymphocyte was decreased in both asymptomatic and symptomatic HIV patients, The decrease was greater in symptomatics while CD8+ T-lymphocyte was increased in both except advanced stage symptomatics. CD4:CD8 ratio was reversed in both groups. Opportunistic infections correlated with different CD4+ T-lymphocyte categories.

Artemether vs quinine therapy in Plasmodium falciparum malaria in Manipur--a preliminary report.

Qinghaosu and its derivatives are rapidly effective antimalarial drugs derived from a Chinese plant (sweet worm wood). Preliminary studies suggest that these drugs may be more effective than quinine in the treatment of Plasmodium falciparum malaria. A randomised double blind trial was conducted in 52 cases of Plasmodium falciparum malaria cases. In all 26 cases were given artemether and another 26 were given quinine. There were 2 (7.5%) deaths in artemether group and 4 (15%) deaths in quinine group. The parasites were cleared more quickly from the blood in artemether group when compared to quinine group (mean-72 hrs vs 96 hrs). Resolution of fever was comparable in both artemether and quinine group (mean-84 hrs vs 78 hrs) and also the average time of recovery from coma was more earlier in artemether group (mean-60 hrs vs 72 hrs). The only side effect noticed with artemether therapy was gastrointestinal (GI) intolerance while quinine therapy was associated with myocarditis, hypotension, hypoglycemia and GI intolerance.

Perceptual development in relation to nutritional status.

The present study was conducted on 180 children in the age group 5-10 years. These children were divided accordingly their ages into 3 sub-groups i.e. 5-6, 7-8 and 9-10 years respectively. In each group 60 children were studied. For the assessment of perceptual skills each child was tested with the help of Picture Ambiguity Test. Responses to the ambiguous cards were scored with respect to time taken to react in each card and ability of the child to perceive figure and ground relationship i.e. centration and decentration. The observations showed that with increase in age, centration effect reduces and majority of the children start decentring their perception by middle childhood. Further, children in higher age group took lesser time to respond on different ambiguous cards. When the responses of well-nourished and undernourished children were compared for perceptual flexibility in terms of part-whole perception i.e. centration and decentration; no difference was observed between the two groups. There was a significant difference in the performance of well-nourished and undernourished children when time to respond on ambiguous card was compared. Well-nourished children took lesser time to respond on different ambiguous cards. These observations in general suggest that poor nutrition may result in impaired perceptual abilities in children.

Impact of the integrated child development services (ICDS) on maternal nutrition and birth weight in rural Varanasi.

OBJECTIVE: To evaluate the impact of ICDS on maternal nutrition and birth weight. SETTING: 28 ICDS and 21 non-ICDS villages in two adjoining blocks of Varanasi. METHODS: 5289 pregnancies were registered during 1987-1993 in these two blocks. In the ICDS block 916 and 1453 nutrition supplemented and unsupplemented, respectively and 1748 of the non-ICDS live births with weight recorded within 48 h formed the study subjects. RESULTS: The ICDS supplemented mothers gained 100g more in pregnancy and birth weight was higher by 58 g (p < 0.05) as compared to unsupplemented ICDS mothers. Birth weight in unsupplemented ICDS areas was 25g higher as compared to non ICDS area. ICDS supplemented women had a significantly smaller proportion of low birth weight babies (14.4%) compared to ICDS unsupplemented (20.4%) and non-ICDS women (26.3%). The corresponding prevalence of preterm births was 2.0, 2.4 and 4.3%, respectively (P < 0.001). Multiple regression analysis showed that increased wight gain in pregnancy, length of gestation, caloric intake and term hemoglobin were significantly associated with birth weight. However, the length of gestation was not influenced by factors improving the birth weight. CONCLUSION: Undernourished pregnant women are benefitted by late pregnancy nutrition supplement