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

Ethics of electronic tagging of dementia patients

Dementia is one of the most common neuropsychiatric disorders seen in old age with accompanying memory loss, aggressive behaviour, sleep problems and wandering behaviour with confusion. Many patients with dementia may be all alone at home with a domestic help and no family caregiver for most of the day and may sometimes wander off from their homes. Hence, dementia care programmes insist that an identity card with the patient’s key details be worn, in case the patient wanders away and is unable to return home or inform people about the location of their home.

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.

A Study on Premenstrual Syndrome symptoms and their association with the Attitudes towards Menstruation in Nursing Staff

Background: Symptoms in the premenstrual period have a detrimental impact on the general health ofwomen. There is a lack of studies examining the relationship between menstrual attitudes and symptoms ofpremenstrual syndrome (PMS), especially in the Indian scenario. This study was conducted to look atcontributing factors, frequency of PMS in different age groups and the association of these symptomstowards the attitude towards menstruation in nursing staff.Methodology: The cross-sectional study involved 450 female nursing staff between 25- 50 years of age fromvarious tertiary care hospitals who were administered the Premenstrual Tension Syndrome Rating Scale(PMTS) and Menstrual Attitude Questionnaire (MAQ). The data was then statistically analyzed.Results: The prevalence of premenstrual symptoms was found to be 85.6% amongst the participants(according to the ACOG criteria), while the proportion of females suffering from PMS (according to DSMIVTR criteria) was 36.5%. On studying the association, a negatively significant correlation between scoreson PMTS and mean scores of MAQ across all age groups.Conclusion: The intensity of PMS was associated with negative menstrual attitude in our study. Furtherstudies on PMS, its frequent symptoms and relevant variables may guide psychoeducational interventionsand need to carried out in larger and diverse populations to corroborate our findings.

Predictors of Suicide Ideations in Adolescents

Background and Objectives: Adolescence is a crucial phase of one’s life, given the physical andpsychological changes that occur during this phase. Number of adolescent suicides are on rise and a largenumber of adolescents report higher suicidal ideations during this phase. Suicide ideation involves thoughtsand cognitions about suicidal behavior. It involves thoughts related to desire, intent or method of committingsuicide. Research on suicide ideation has established strong links between depression and hopelessness withsuicidal thoughts and tendencies. Depressed adolescents are reported to be highly vulnerable to developsuicide ideations. In addition to depression and hopelessness, familial variables like support from parentsand emotional bonding with them is detrimental to such outcomes like suicide ideation. The present studythus aims to find depression, hopelessness, emotional autonomy and hardiness as predictors of suicideideation in adolescents.Methods: A sample of 400 adolescents (242 = Females and 158 = Males) in the age group of 15 – 22 (MeanAge = 18.36 years) years was taken. Beck Depression Inventory, Beck Hopelessness Scale, Personal ViewsSurvey, Emotional Autonomy Scale and Beck Scale for Suicide Ideation were used to collect the data. Thedata so obtained for the predictor variables was first factor analysed so as to obtain independent factors.Results: Results revealed single factor with high factor loadings on all the four predictor variables. The factorscores from this factor were further used in linear regression in order to predict suicide ideation inadolescents. Regression analysis revealed that the factor was a significant predictor of suicide ideation. Theobtained results have been elucidated.Conclusion: There is a very high prevalence of depression, anxiety and stress among interns working inMaharashtra which needs to be effectively dealt with on an urgent basis. The strong association of theprevalence of psychological illnesses with many factors and stressors faced by them will help us highlightthe contributory factors and suggest strategies to deal with them effectively at a personal, institutional andnational level.

Effect of Nicotine Dependence on Cognition and Quality of Life in Patients Suffering from Schizophrenia

Introduction: The purpose of the present study was to examine the impact of nicotine dependence oncognition and quality of life in patients suffering from schizophrenia. The research was carried out to see ifthere is any significant difference between the cognition and quality of life among patients withschizophrenia having nicotine dependence in comparison to the no nicotine consumption group.Methodology: This study was carried out using the survey method. There were total 69 participants, allwere males and the age ranged from 20 to 50 years. The participants were the outpatients visiting thegovernment hospitals in Mumbai for their follow-ups to the psychiatrists. The data was collected from theparticipants after their consent was received. The screening for severity was done and only patients ratedwith moderate disturbances on the Positive and Negative Syndrome Scale (PANSS) were considered forfurther administration of tests. The two scales Montreal Cognitive Assessment Test (MoCA) andWHOQOL-Bref (Hindi) were used for measuring cognition and quality of life respectively. The obtainedscores were analyzed using two simple independent samples t-test.Results: The results showed significant difference between the scores of cognition and quality of life amongstthe two groups. The study was found to be in line with the previous researches. The results indicated thatcognition was significantly higher in the nicotine dependent group whereas the psychological domain ofquality of life was significantly higher for the no nicotine consumption group.Conclusion: The findings indicate the group of patients with schizophrenia having nicotine dependence wasfound to have significantly higher cognition but lower perceived quality of life in psychological domain,whereas the other group of patients who did not consume nicotine showed significantly higher perceivedquality of life but lower cognitive functioning. Overall the obtained statistical analysis revealed significantdifference between the cognition and quality of life amongst nicotine dependent group and no nicotineconsumption group.

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.

A study of Neurological Soft Signs and Minor Physical Anomalies in children of parents with Schizophrenia and those without Schizophrenia

Introduction: ‘Neurological soft signs (NSS)’ and ‘Minor physical anomalies (MPA)’ represent two quitedistinct markers of risk for schizophrenia that stem from genetic factors and have been studied over thepast 3 decades. The aim of the current study was to assess Neurological soft signs (NSS) and Minorphysical anomalies (MPA) in children of patients suffering from schizophrenia and compare the same tochildren having parents without any psychiatric disorders.Methodology: The study was a cross sectional study at a Private tertiary care psychiatric hospital in urbanset up. The data was collected over a period of 1 year during June 2016- June 2017. The subjects of thisstudy were children of parents suffering from schizophrenia and children of parents without anypsychiatric disorder. The control group was made up of 40 children of the same age group with parentshaving no psychiatric disorders. Following the collection of sociodemographic details using a semistructured proforma, children in both groups were assessed using the Physical and Neurological Soft signScale (PANESS) while MPAs were assessed using the Waldrop scale. The data collected was statisticallyanalyzed.Results: There was no statistically significant correlation between demographic factors like gender, age,birth order, educational status or type of delivery with neurological soft signs and minor physicalanomalies. It was found that the study group had higher score for incoordination of gait and balance;higher score for slowness in performing patterned speed of movements which included toe heel alteration,hand supination and pronation, finger succession as compared to control group along with higher scoresfor involuntary movements, excess dysrhythmia score and overflow score including mirror movements inindex group than controls. There was no statistically significant difference in lateral preference patterns ormix handedness of cases and controls. Among Minor physical anomalies, the study group also had moreanomalies in mouth like high-steeped palate and tongue anomaly, curved 5th finger of hands and big gapbetween first and second toe (sandal gap).Conclusion: NSS and MPA are important variables and biomarkers that may be assessed in patients withschizophrenia and their offspirngs.

Using social media and apps to enhance religiosity amongst Christian youth

Social Media is a term that is so often used in our daily conversations. Whether we like it or not, it hasbecome an inevitable part of our life and it is going to stay that way in the time to come. Its rapid growthand acceptability has greatly influenced human behaviour, lifestyle and thinking. Regardless of age,gender, status and geographical location, people actively get involved in different social networking sites.The speed, cost and reach captivate the users to spend more time on the social media. Whether socialmedia is good or evil will depend on the nature of its use. This article throws some light on the increaseduse of social media among Christian youth, the role it plays in uniting Christian communities and itsgrowing impact on the administering of sacraments and the conducting of church activities. Akin togeneral population, many church leaders like Pope, Cardinals, Bishops and Priests are part of the socialmedia like Facebook, Twitter, Instagram, etc. Some of them use it extensively to spread the Good Newsand to share their messages and ideas across larger population.

Manipulation of prescriptions by patients – what must a doctor do.

Over-the-counter use of medication via chemists, including the use of psychiatric medication, has always been a cause of worry in the Indian subcontinent. Over the last two years, the rules on dispensing psychiatric medication have become stringent and chemists have to dispense the exact amount of medicine written on the prescription for the time duration mentioned. The chemist also stamps the prescription with the amount of medicine dispensed so that the patient does not use the prescription at another chemist’s or counter to obtain more than the amount prescribed.