Clinical perspectives on the management of common psychiatric disorders in India

Psychiatric disorders are common health problems in patients of all age groups, under-diagnosis and under-treatment of these disorders can result in disability and serious complications. With an objective of creating a comprehensive evidence-based consensus on common mental health disorders and their management in the Indian setting, 10 expert groups meetings involving 98 psychiatrists across India were conducted in the month of May 2020. Clinical insights related to burden, signs and symptoms, diagnosis and management were summarized based on the discussions during these meetings. Experts agreed that depressive disorders and anxiety disorders represent two important psychiatric disorders in India. Selective serotonin reuptake inhibitors (SSRIs) are commonlyused for the treatment of depression. Benzodiazepines are effective for the treatment of comorbid anxiety in patients with depression, but their long-term use causes adverse events such as dependence and withdrawal reaction. Obsessive compulsive disorder (OCD), bipolar disorder, substance use especially alcohol withdrawal syndrome, and sleep disorders are other common psychiatric disorders found among Indian patients. Lithium and valproate represent the commonly used and effective pharmacological treatments for bipolar disorder. SSRIs are preferred drugs in the treatment of OCD,whereas benzodiazepines such as chlordiazepoxide and diazepam represent important pharmacological treatment optionsfor alcohol withdrawal. Early identification and timely and effective treatment of psychiatric disorders is important for prevention of complications. Treatment should be individualized based on efficacy, tolerability profile of the medicine, risk of drug interactions, and cost. This consensus may be useful to psychiatrists and general practitioners treating common psychiatric conditions in Indian patients.

Treatment of skeletal class II malocclusion using the “Forsus” appliance: A case report.

Fixed functional appliances are valuable tools introduced to assist in the correction of skeletal class II malocclusions at the deceleration stage of growth for achieving stable results. The most commonly used such appliances are the Herbst appliance and the Jasper jumper. The recent advance in the field of fixed functional appliance is the Forsus appliance. We are reporting a 16 year old patient with a skeletal class II malocclusion treated using the Forsus appliance. The appliance was worn for 4 months after the initial alignment with fixed mechanotherapy (MBT O22). The mandible was brought forward to a class I skeletal and dental relationship by the end of this treatment.

Evaluation and selection of elite plant growth-promoting rhizobacteria for suppression of sheath blight of rice caused by rhizoctonia solani in a detached leaf bio-assay.

Sheath blight (ShB) of rice, caused by Rhizoctonia solani, is one of the most important rice diseases worldwide. The objective of this study was to screen selected plant growth-promoting rhizobacteria (PGPR) strains for suppression of ShB under controlled conditions. Sclerotia of R. solani were produced on PDA and immature sclerotia (< 5-day-old) were harvested. Leaves of 60-day-old rice plants grown under greenhouse conditions were used to screen PGPR strains by detached leaf assay. Leaf sections of 8 cm in length were cut and placed in Petri dishes, inoculated with immature sclerotia, and incubated in a growth chamber. Approximately 70 PGPR strains were screened. The disease was quantified by the Relative Lesion Height (RLH) method. Among 70 strains, 31 significantly suppressed the RLH of ShB lesions compared to the control. Among these, Bacillus subtilis strain MBI 600 resulted in greatest suppression of ShB disease severity under the conditions tested.

In-vitro antagonistic potential of pseudomonas fluorescens isolates and their metabolites against rice sheath blight pathogen, rhizoctonia solani.

Sheath blight of rice caused by Rhizoctonia solani is an economically important disease affecting rice production. Eight Pseudomonas fluorescens strains were isolated from rhizosphere of rice seedlings collected from Andhra Pradesh and Tamilnadu. These strains were characterized with PCR based RAPD technique and tested for their in-vitro antagonistic activity against R. solani. Crude metabolites from one particular isolate of P. fluorescens (P. f 003) were extracted with organic solvents such as ethyl acetate and petroleum ether and these were tested against R. solani. Commonly used fungicides in rice sheath blight disease management such as hexaconazole, carbendazim, copper oxy chloride and mancozeb at 150 ppm were screened against mycelial growth of R. solani using poisoned food technique. All the strains tested were exhibited antagonistic activity against R. solani. One isolate, P.f 003 gave 78% inhibition compared to control. All the fungicides and crude extracts of P.f.003 inhibited the mycelial growth of R. solani. Highest inhibition was recorded with hexaconazole and ethyl acetate crude metabolite extract. The results offer a scope for integrating P. fluorescens with chemical fungicides for control of sheath blight of rice.

Isolation of siderophore- producing strains of rhizobacterial fluorescent pseudomonads and their biocontrol against rice fungal pathogens.

Rice blast caused by Magnaporthe grisea and sheath blight caused by Rhizoctonia solani are the major diseases affecting the rice production. Application of beneficial bacteria as seed or seedling root dip to protect these diseases may be an alternative strategies to chemical control. In this study, fluorescent Pseudomonads isolated from rice seedlings were used to screen for their antagonistic ability and siderophore mediated antibiosis under in-vitro conditions against these pathogens. Among 10 isolates, strain P.f 003 gave significantly higher inhibition of mycelial growth of M. grisea and R. solani. Strains of P.f 001, P.f 003, P.f 005 and P.f 007 produced siderophores when grown on Fe deficient and Fe fortified King’s B medium. These strains again tested for their in-vitro antagonistic activity against M. grisea and R. solani on King’s B media with or without FeCl3. Our results showed that all these strains significantly reduced the growth of M. grisea and R. solani with FeCl3 in the media compared to without FeCl3. Strain P.f 003 activity was superior compared to other strains evaluated.

Diurnal regulation of plastid genes in Populus deltoides.

Light regulates leaf and chloroplast development, together with overall chloroplast gene expression at various levels. Plants respond to diurnal and seasonal changes in light by changing expression of photosynthesis genes and metabolism. In Populus deltoides, a deciduous tree species, leaf development begins in the month of March and leaf maturation is attained by summer, which is subsequently followed by autumnal senescence and fall. In the present study, diurnal changes in the steady state transcript levels of plastid genes were examined in the fully developed leaves during summer season. Our results show that steady state level of the psaA/B, psbA, psbEFLJ and petA transcripts showed differential accumulation during diurnal cycle in summer. However, there was no significant change in the pigment composition during the day/night cycle. Our studies suggest that the diurnal regulation of steady state mRNA accumulation may play a crucial role during daily adjustments in plants life with rapidly changing light irradiance and temperature.

Topical diclofenac sodium for treatment of postoperative inflammation in cataract surgery.

PURPOSE: To study the effect of a topical non-steroidal anti-inflammatory drug as an alternative to topical steroids for postoperative control of inflammation in cataract surgery. METHODS: The effect of diclofenac sodium 0.1% following cataract surgery was studied and compared to routine corticosteroid, dexamethasone phosphate 1% in a prospective, double-blind randomized study. Both groups were similar in baseline parameters. Postoperative inflammatory response, intraocular pressure and best-corrected visual acuity following standard extracapsular cataract extraction were assessed in both groups in the initial 21 days and the severity of these parameters was graded. The severity of postoperative inflammatory response to the two drugs was graded at 1, 3, 7, 14 and 21 days. Intraocular pressure and visual acuity at baseline and endpoint were compared and statistically analyzed. RESULTS: The two groups did not differ statistically in treatment effect for any of the variables including aqueous cells, flare, ciliary congestion, Descemet's folds, visual acuity and intraocular pressure (p < 0.001). However there seemed to be a trend towards quicker improvement with corticosteroid when cells in the anterior chamber were considered. There were no side effects from topical diclofenac, and it was well tolerated. CONCLUSION: Diclofenac sodium is as effective as topical corticosteroid and can be used as an alternative in routine postoperative treatment following uncomplicated cataract surgery.