Effects of ECT-dothiepin combination on learning in rats.

Electroconvulsive therapy (ECT) and antidepressant drugs are each known to impair learning and memory. No information is available on their effects on cognition when used concurrently in the treatment of depression, as is frequent in India. In the present study, therefore, the effects of electro-convulsive shocks (ECS) and dothiepin, separately and in combination, were studied in an animal model employing a complex maze operant learning paradigm. ECS were given on alternate days (3/week) for 2 weeks. Dothiepin (10 mg/kg, ip) was administered once daily for 2 weeks. Learning was assessed on days 2-10 post-treatment ECS produced greater initial impairment in learning while dothiepin produced a more sustained impairment. While impairment was maximum in the combined treatment group, the statistical significances that emerged to proscribed the combination were but weak.

Delay in specialist consultation in cancer patients.

A psychiatric evaluation of 75 cases of different types of cancer revealed significant psychological morbidity in 81% of cases. The time lag, if any, between primary diagnosis and presentation to oncologists was noted and the reasons for the delay were ascertained. 62% of patients (N = 47) delayed three months or more and this group also showed significantly greater (p < 0.05) psychological morbidity compared to those who delayed less than three months (N = 28). 89% of patients used denial as a mental defence mechanism and there was no significant difference in the degree of denial displayed by both groups. Psychological reasons such as denial of the illness, fear of cancer, fear of its treatment, and domestic difficulty were commonly cited as causes of delay. It is hoped that addressing these issues will reduce delay and help early detection in cancer programmes.

Proptosis: management of 22 patients.

The clinical features and management of 22 cases with proptosis is highlighted. Proptosis was unilateral in fifteen and bilateral in seven cases. The common etiologic factors were neoplasms, infections and bleeding diatheses. Of the ten cases with neoplasms as many as 7 expired, whereas of nine cases due to infections only one expired and one developed phthisis bulbi. All three patients with proptosis due to bleeds recovered completely without sequelae. Orbital CT scan was done in fourteen and ultrasound in eight cases, while in five cases both investigations were done. As neoplasms are a frequent cause of proptosis in children and there is a high mortality in this group, a thorough systemic examination and hematological profile is essential to arrive at a speedy diagnosis. CT and USG are useful imaging modalities of the orbit, the latter being particularly useful for follow up of the lesion.

Profile of congenital cholesteatomas of the petrous apex.

Congenital cholesteatomas of the petrous apex are now frequently being approached by otologists. Involvement of the cerebello pontine angle by this lesion produces a myriad of signs and symptoms. Otological as well as neurosurgical literature is reviewed to achieve an overall understanding of the nature and behaviour of this uncommon but interesting lesion.