Tracheal injury due to blunt chest trauma: a rare surgical emergency

Tracheal injury is a rare complication of blunt chest trauma. The patients usually present with signs of respiratory distress. Primary repair is the treatment of choice in case of large defects, while small tears can be managed conservatively. Immediate operation is recommended to improve deteriorating pulmonary function. The decrease in mortality and long-term morbidity depends on early diagnosis. We report a case of tracheal injury due to non-penetrating thoracic trauma which was successfully managed with surgery

Quality of life in chronic schizophrenic patients

To assess the quality of life in a group of schizophrenic patients who have completed rehabilitation programme in a residential Facility. Design: This prospective study was completed at Fountain House, Lahore. Subjects: Thirty patients and thirty controls were included in this study. Main outcome measures: Brief Psychiatric Rating Scale [BPRS], Morningside Rehabilitation Status Scale [MRSS] and Quality of life Index [QLI]. The results showed that patient groups, despite their successful rehabilitation, had significant lower scoring in terms of quality of life as compared to the controls. Female patients did comparatively well on the measure of quality of life. Conclusions: The results confirm the importance of measurement and evaluation of quality of life in psychiatric patients in routine clinical assessments, as well as, in follow up and after care plans

Serotonin syndrome

The Serotonin syndrome results from an over stimulation of serotonergic neurotransmission. It can be induced by drugs like specific serotonin re-uptake inhibitors. Co-administration of these drugs with a number of psychotropic compounds have also been linked to this syndrome. A case is being reported showing clinical symptoms and signs of this condition following use of Fluoxetine

Emery- dreifuss muscular dystrophy: a study of four cases in a family

Emery-Dreifuss muscular dystrophy is characterised by a slowly progressive muscle weakness in a humero-peroneal distribution, early contractures, and cardiomyopathy. This study describes the characteristics and genetics of this syndrome in family of four male siblings all of whom were affected by the disorder. An 11 year old boy presented with muscle weakness and wasting in a humero-peroneal distribution, absent tendon reflexes, elbow contractures and elevation of creative kinase [CK] without cardiac involvement. Three asymptomatic male siblings were also found to have evidence of the syndrome. The father and two other paternal relatives of these siblings had persistently raised creative kinase levels without evidence of muscle weakness or cardiomyopathy. There was no evidence of the disorder on the maternal side. Clinically the pedigree was consistent with either X-linked recessive inheritance or could also represent autosomal dominant inheritance. Molecular genetic studies were carried out to confirm the pattern of inheritance. The marker st14 is closely linked to Emery-Dreifuss muscular dystrophy. All four boys and their mother had the same pattern, therefore confirming that all siblings had inherited the same maternal allele, strongly supporting sex linked recessive inheritance. This was virtually confirmed by further analysis which showed that all 4 boys had the same maternal allele for an informative microsatellite marker in intron 13 of the factor 8 coagulant gene

Suicidal symptoms in depressed Pakistani patients

Depressive patients are at a high risk for suicide. The data on the frequency of suicidal symptoms in depressed patients, however, varies widely. This paper describes the extent of these symptoms in a group of Pakistani patients. Contrary to the findings of other Muslim countries, forty five percent of our patients showed suicidal psychopathology. Female patients showed more suicidal ideation and significant assasination was found between severity and duration of depressive illness with these symptoms. These findings are also discussed in terms of their importance in early recognition of these symptoms

Depression in schizophrenic patients

Depressive symptoms were assessed in a group chronic schizophrenic patients. Out of 75, thirty three [44%] patients were found to have a depressive illness when compared with non-depressed schizophrenics. Patients with depressed mood had significantly higher scores on brief psychiatric rating scale [BPRS] and negative symptoms scale. However, there were no significant differences between the two group in terms of cognitive deficits and extrapyramidal symptoms. The findings of the study are discussed in relation to the significance of depression in schizophrenic patients

Racial discrimination and psychiatric morbidity among overseas students in Britain

Evidence suggesting elevated levels of psychological disturbances among immigrants have been well documented in the literature. Most of the studies in this area have shown a relationship between psychological well-being and immigrants experience of racial discrimination and prejudice in host countries. The present paper describes findings concerning such a relationship from a study which was designed to measure the psychiatric morbidity among overseas students at Edinburgh University, Scotland, Britain The results did not indicate any significant association between experience of prejudice and psychiatric sympatomatology. Suggestions for future research in this area are also discussed

Argotherapy-new concept of rehabilitation for chronic schizophrenics in Pakistan

The provision of comprehensive programme for mental health in the community setting has achieved an important place in the field of psychiatric rehabilitation. The concept of agrotherapy which is based on the philosophy of keeping patients occupied in a rural and agricultural setting with more structured activities has been found to be a promising innovation for the rehabilitation of chronic schizophrenics in this regard. This paper describes the results of a three years follow-up study conducted at Fountain House Farm, Farooqabad to evaluate the effectiveness of agrotherapy. The findings are discussed in terms of practical implications of this innovative approach in the rehabilitation of chronic schizophrenic patients

Risk factors for depression

The role of social factors in the causation of depression based on the aetiological model proposed by Brown and Harris was examined in a sample of 50 depressed female patients. Loss of mother before age 11 years and lack of confiding relationship was found to act as a vulnerability factor whereas employment status and having three or more children aged 14 or under were not found to have an increased vulnerability in these patients. These results which provide general support for Brown and Harris's causal model are discussed with their possible implications in our socio-cultural settings

Emotional and behavioural problems among school children in Pakistan

The prevalence of emotional and behavioural problems in school children using Rutters children behavioural questionnaire was 9.3% with antisocial disorders being the commonest one. These disorders are not only present in this culture but also differ in terms of psychopathology with different levels of schooling. The findings are discussed in terms of their relevance to mental health of children with comparison of results from other countries

Anxiety and depressive disorders among general practice patients

This paper describes the prevalence of anxiety and depressive symptoms among attenders of a general practice in Lahore. The possible association of these symptoms with different socio-demographic variables is examined. The results are discussed in terms of their importance as these common symptoms are often missed in busy practice and if untreated may affect the management of these patients

Behavioural problems in epileptic children

Behavioural problems commonly occur in association with epilepsy and it has been generally observed that behaviour disturbances are the most frequent cause of psychiatric referral for epileptic children. This paper described the nature and extent of such disorders in a sample of 50 epileptic children. The data about behaviour disturbances were collected by using Rutter's questionnaire. The results are discussed with special reference to the practical implications of these findings in the assessment and management as well as in relation to some of the common factors associated with the aetiology of these disorders