Comorbid Neurocognitive Impairment in Patients with Epilepsy

Background: Epilepsy is a common chronic non-communicable neurological disorder in which the brain function is impaired. Cognitive function is more frequently impaired in people with epilepsy than in the general population. The neurocognitive outcome of epilepsy in children and adults is vital for social prognosis and quality of life assessment. Cognitive changes in epilepsy have multifactorial etiology, including the epilepsy itself, age at onset, duration of epilepsy, treatment of epilepsy, reaction to epilepsy and any associated brain dysfunction and /or damage. This study was conducted to check association of neurocognitive impairment with the socio-demographic factors and disease associated factors in patients with epilepsy. Methodology: This study was a single centre cross-sectional study in which 96 patients were included. Severity of neurocognitive impairment was measured by Addenbrookes’ Cognitive Examination- R (ACE- R) score. Results: Out of 96 patients, neurocognitive impairment was seen in 23 (23.95%) patients. Conclusions: This study shows that neurocognitive impairment was found to be more when the age at onset of epilepsy was less, when the duration of the illness was more and when frequency of seizure was higher. Conclusion: Neurocognitive impairment is noted in patients with epilepsy and must be treated in the long- term management of epilepsy

Olfactory Reference Syndrome: a case report

Olfactory reference syndrome (ORS) is a psychiatric condition characterized by the false belief that an individual emits an offensive or foul odour from their body. It causes lot of embarrassment and social impairment to these patients. Treatment options include antidepressants and antipsychotics. Here we present a case of Olfactory Reference Syndrome who responded to combination of antipsychotics and antidepressant.

Delusional Parasitosis: An Analysis of 177 Cases from a Tertiary General Hospital.

Introduction: Delusional parasitosis (DP) is a form ofmonohypochondriacalpsychosis characterized by a feelingthat there are parasites crawling beneath the skin and is seen inrarely in psychiatric or primary carepractice. The disorder haspoor prognosis with a varied course and multiple relapses. Thepresent paper reports an analysis of 177 cases of delusionalparasitosis seen in a tertiary general hospital over the last 11years.Material and methods: The present study is an analysis of177 cases of DP that presented to the psychiatry departmentof a tertiary general hospital over the past 11 years and thedata has been analyzed using a semi-structured proforma anddescriptive statistics.Results: The mean age of the sample was 34.6 ± 21.3 yearsand the mean age of onset of the disorder was 28.3 ± 17.1years. The mean duration of illness of the sample was 3.9 ±10.3 years. 103 (58.19%) had a magnetic resonance imagingof the brain done which was within normal limits. 56(31.63%) patients had repeated neuroimaging investigationslike EEG, MRI and CT Scans done which were also all withinnormal limits. Most patients were treated with Risperidoneand Aripiprazole while few were treated with Pimozide,Haloperidol and Amisulpride. 43 (24.29%) patients received acourse of electroconvulsive therapy (ECT) as well in additionto medications.Conclusion: DP though rare is seen in clinical practice andfurther longitudinal studies are needed to establish withgreater certainty facts about the course and prognosis of thedisorder

Benign Familial Essential Head Tremor: A Case Report

Introduction: Essential tremor is a movement disordercharacterized by tremors of the hands and head and seen in5-10% of patients above the age of 60 years.Case report: We report a case of benign essential familialhead tremor that was diagnosed when the patient was referredfor psychiatric fitness and that responded very well toPropranolol.Conclusion: It is a condition where the causative factors andthe pathophysiology are ill understood and there are no fixedneuroimaging paradigms for the disorder.

Psychogenic Belching: A Case Report

Persistent psychogenic belching is a condition where supragastric belching occurs repeatedly in relation to apsychological stressor. Treatment involves trials of multiple medications with identification and/orelimination of the stressor. We present herewith the case of a female patient with persistent psychogenicbelching that responded well to a combination of medications.

Neurocognitive impairment secondary to herpes simplex encephalitis improved with inject cerebrolysin

Herpes simplex encephalitis (HSE) is an acute illness that causes both general and focal signs of cerebraldysfunction We present herewith the case of a 33 years old female who presented with neurocognitiveimpairment that was secondary to the herpes simplex encephalitis. The patient’s case is discussed as thepatient bettered with the administration of injection cerebrolysin along with psychopharmacotherapy andcognitive exercises.

Knowledge, Attitude, Practices Of Disulfiram Amongst Relatives Of Patient With Alcohol Use Disorder

KAP (Knowledge, Attitude and Practice) studies are highly focused evaluations to measure changes in response to a specific intervention, usually outreach, demonstration or education. This study was conducted to assess KAP of Disulfiram amongst relatives of patients suffering from alcohol use disorder. Relatives of 100 patients diagnosed as alcohol use disorder were interviewed using a self–designed semi structured proforma. Alcohol use was documented to ascertain the pattern and dependence. On asking if “Heard about disulfiram” 38 respondents stated yes whereas 62 said no.36% said that they have used disulfiram.32% reported good experience.35% showed improved quality of life and achieved abstinence from alcohol.The present study demonstrated poor knowledge among relatives, but good attitudes toward use of disulfiram. The results suggest the need to implement an intervention strategy that reflects specific local circumstances and plan activities that are suited to the population involved.

A Study on Quality of Life and Self Esteem in children and adolescents with Strabismus

Background/Context: Strabismus is a condition that results in loss of self esteem and affects quality of lifedue to the changes it may cause in facial appearance and other factors. There is a dearth of Indian literatureon children and adolescents with strabismus. The current study analyzed self esteem and quality of life inchildren and adolescents with strabismus.Methods: Children and adolescents between 6-17 years attending the ophthalmology out-patient departmentof a tertiary general hospital and their normal siblings were identified and assessed after parental consentusing a semi-structured proforma and the KINDL questionnaire. The results were statistically analyzed andpresented.Results: 35 children and adolescents with strabismus were compared to 38 siblings who were the controls.It was seen that children and adolescents with strabismus scored lower on family and social contacts qualityof life scores on all subscales of the KINDL questionnaire. However, self-esteem did not differ across bothgroups.Conclusion: Further larger studies in diverse populations are needed to corroborate the effects of strabismuson self esteem and quality of life.

Smoking and Peer Preference in College Students: an exploratory study

Background: Smoking in adolescents is related to multiple factors like genetics, family variables and peerpreference and influence. The aim of the following study was to study the prevalence of smoking and age ofinitiation college students while comparing peer preferences in smoker and non-smoker college students.Methods: 100 college students were divided on the basis of current smoking status into two groups. Thesetwo groups were administered the Evers-Pasquale peer preference test and the Global Youth Tobacco Survey(GYTS). Sociodemographic variables were assessed using a semi-structured proforma. The data was thenstatistically analysed.Results: The prevalence of current smoking was 54%. Almost 44% of college students had initiated smokingat or after 16 years of age, whereas only 4% of the entire sample had initiated smoking before 10 years ofage. Close to one fifth (18.52%) of current smokers smoked daily and smoked cigarettes first in morningsuggesting dependence. Students who currently smoked were most likely to engage in any activity in thecompany of best friends, followed by cool friends (p = 0.0001).Conclusion: Smoking and peer pressure are linked and there is a need for tobacco intervention programmesto be directed at adolescent specific factors. Further research is needed to understand other factors promotingsmoking like personality factors, social influence, genetic factors etc.

Episodic Psychotic Behavior: a case report

Episodic psychotic behaviour is a rare condition where the patient presents with psychotic behaviour inepisodes where the symptoms remit totally in between. We describe herewith a case of a lady thatpresented with episodic psychotic behaviour and that responded to treatment in our department.

A Clinical Analysis of patients seen in a Geriatric Mental Health Camp organized in Mumbai

Background: Geriatric mental health is a neglected domain of mental health and many cases remainundetected in the community. Community programs have often helped to detect many cases of the elderlywith psychiatric problems and help them access care. The current paper aims to present an analysis ofpatients seen in a geriatric health camp from a psychiatric perspective.Methods: 103 elderly attended the geriatric camp and were assessed clinically for psychiatric problems. Theywere also administered the Adenbrooke’s Cognitive Examination Revised (ACE-R) Hindi version, Barthel’sIndex for Activities of Daily Living and 3.Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST). Theresults were analyzed statistically and presented.Results: The mean age of the subjects in the study was 66.05 ± 7.9 years. 83 subjects (79%) out of the 105were female. The mean BIADL score of the sample was 19.52 ± 1.9 and on the basis of scores on the ACER they were classified as having cognitive impairment (n=67) and not having cognitive impairment (n=27).The cognitively impaired group differed from the non-cognitive impairment on all subscales of the ACE-R.55 (52.4%) reported the presence of elder abuse but had taken no action against it. The BIADL scores showeda significant correlation on all aspects of ACE-R scores.Conclusions: Geriatric health camps can serve as a useful arena for the detection of geriatric mental healthproblems. Further studies in larger populations are needed to corroborate the findings seen in the geriatrichealth camp reported in this study

Psychogenic Hiccups – a case report

Hiccups are a common occurrence which may be many a time organic in nature. We present herewith thecase of a 20 year old girl that presented with hiccups of a psychogenic in nature. The patient’s case isdiscussed as the patient responded to a combination of medical and psychological interventions.

Electroconvulsive therapy in a patient with glaucoma.

There is little information on the use of electroconvulsive therapy (ECT) in the presence of glaucoma. An elderly man with known severe depression underwent surgery for cataract and glaucoma in the left eye. His depression worsened in the postoperative period and he required two sessions of ECT within 2 months of the surgery. There were no ophthalmic complications or adverse events associated with ECT and he responded well to treatment. Natl Med J India 2016;29:85–6