Evaluation of the relevance of touch imprint cytology in the diagnosis of various neoplastic lesions.

Background: Imprint is a very simple and rapid technique for tissue diagnosis. Imprint is a touch preparation in which tissue is touched on a slide and it leaves behind its imprint in the form of cells on the glass slide. In present study we have correlated the cytological diagnosis by imprint with histological diagnosis and tried to evaluate the accuracy and usefulness of this. Methods: The study was conducted in department of Pathology of Pt J.N.M. Medical College, Raipur (C.G) India. From neoplastic lesions imprint smears were prepared immediately after resection of surgical specimen. After preparation of imprint smears specimens were processed by routine histopathological processing. Final reports of both processes were compared to know accuracy of diagnosis by imprint cytology. Results: Out of total 110 cases, 25 cases were benign and 85 cases were malignant. Out of the 25 benign cases, 14 (56%) were diagnosed correctly and correlated with histological diagnosis. while 11 (44%) cases were false negative. No false positive cases were there. Out of 85 malignant lesions 78 (91.76%) were diagnosed correctly and correlated on histopathology, while 7 (8.23%) were false negative. Overall diagnostic accuracy by imprint smear after histological correlation was 83.63% increasing to 91.76% for malignant lesions. Conclusions: With an accuracy rate of 83.63% we can say that imprint cytology is a quick reliable simple and cost effective procedure.

Pharmacognostical study and establishment of quality parameters of aerial parts of Costus speciosus-a well known tropical folklore medicine

Objective: To evaluate the diagnostic pharmacognostical characters of Costus speciosus (aerial parts) along with their physico-chemical parameters and fluorosence analysis.Method:microscopy, powder microscopy, leaf constant, fluorescence analysis and preliminary phytochemical investigation.Results:The findings of macroscopy revealed that leaves elliptic to oblong or oblong-lancoelate, The pharmacognostical characters were determined in terms of macroscopy, thick, spirally arranged, with stem clasping sheaths up to 4 cm, flowers large, white, cone-like terminal spikes, with bright red bracts. Transverse section of leaflet showed the presence of cuticularised epidermis with polygonal cells on adaxial surface and bluntly angled cells on abaxial surface of lamina, mesophyll cells differentiated in to single layered palisade cells on each surface and 2-3 layered spongy parenchyma, unicellular and uniseriate multicellular covering trichomes, paracytic stomata and vascular bundles surrounded by sclerenchymatous multicellular sheath. Preliminary phytochemical screening exhibited the presence of various phytochemical groups like alkaloids, glycosides, steroids, phenolic constituents. Further, the leaf constants, powder microscopy and fluorescence characteristics indicated outstanding results from this investigationConclusions:Various pharmacognostical and physico-chemical parameters have pivotal roles in identification, authentication and establishment of quality parameters of the species.

A Study of Psychiatric Symptomatalogy in Dengue Patients.

Introducation : Dengue Fever is an acute febrile infectious caused by dengue virus which is transmitted through mosquito. A fraction of Dengue patients exhibit idengifiable psychiatric symptoms. Aims; The present studywas undertaken with an aim to identify the psychiatric symtoms associated with dengue fever. Material & Methods: The study was carried out in the department of psychiarty, University Collange of medical science (U.C.M.S ) And guru Tegh Bahadur Hospital, a designated tertiary care center for Dengue cases in Delhi. The study period ranged from May 2012 to October 2012. The Study assessed the psychiatric symptomatology in dengue fever and its progression overt the course of dengue. Results During the acute phase, nearly all (90.3%) the patients exhibited thanatophobia. Over 80% of the subjects (most females ) had panic attacks and only less than 15% of these subject needed shor course of anxiolytics. During the recovery phase ( at the end of 1st week ), all the observed psychiatric symptoms decreased both in terms of frequency as well as severity.

Evaluation of anti-arthritic potential of the methanolic extract of the aerial parts of Costus speciosus.

Objective: Costus speciosus Koen. (Keu, Crape ginger), an ornamental plant, widely distributed in India is traditionally used as astringent, aphrodisiac, purgative, anthelmintic, depurative, febrifuge and expectorant. The plant is also used in rheumatism, dropsy, urinary diseases and jaundice. The purpose of this study is to evaluate the anti-arthritic activity of the methanolic extract of the aerial parts of Costus speciosus (CS) in experimental animal models. Materials and Methods: The powdered drug was subjected to successive solvent extraction, with solvents in increasing order of polarity to obtain the methanolic extract of the aerial parts of the plant. CS was evaluated for anti-arthritic action by Freund’s adjuvant induced arthritis test in adult Albino rats (150-200 gm). Rats were injected 0.1 ml of complete Freund’s adjuvant into the planter region of the left hind paw. Statistical analysis was performed using One way analysis of variance (ANOVA) followed by Bonferonni test. P<0.05 was considered statistically significant. Results: The methanolic extract of CS in doses of 400 and 800 mg/kg showed 75.50% and 68.33% protection against increase in paw edema, respectively. CS showed dose-dependent action in all the experimental models. Conclusion: The present study indicates that CS has significant anti-arthritic properties.

A Pilot Study to Calculate the sample size for the Prevalence of Aggression in Psychiatric Outpatient Setting.

Background: There is a rise in the number of invisible mental health problems like aggression in a developing country like India. There is scarce data available on the prevalence of aggression in psychiatric patients which has been collected in a systematic manner. Objective: A pilot study to calculate the sample size for the prevalence of aggression in psychiatric outpatient setting in a General Hospital Psychiatric Unit using Modified Overt Aggression Scale in twenty patients. Results: The prevalence of aggression was 20% in the pilot study. Conclusions: This pilot study enabled us to calculate the sample size accurately. This also facilitated the investigator to handle the shortcomings and modify the research protocol accordingly.

Current Scenario of Psychiatric Diagnosis in a Tertiary Care Teaching Hospital.

Background: There is a need to evaluate the pattern of current psychiatric diagnosis in our country with the emergence of DSM-5 and ICD-11. Methods: All consecutive cases visiting a tertiary care teaching hospital in the age group of 10-80 years during November 2011 to February 2012 were recruited for the purpose of the study. Psychiatric diagnosis was made by qualified psychiatrists using semi-structured Performa as per ICD-10 Criteria. Analysis of data was done by using descriptive and inferential statistics. Results: Out of 1000 patients, 54.5 % patients are in the age group of 20-40 years with male to female ratio of 3:2 and married to unmarried ratio of 4:3. 18% patients suffered from psychosis, 6.8 % substance dependence, 3.6 % organic disorders, 12.6 % depression, 20.8 % anxiety disorders, 9.1 % bipolar disorder, 13.9 % psychosexual disorders, neurological disorders 4.6 %, and 9.2% having other psychiatric diagnosis. Conclusions: There is a need to evaluate patients visiting every psychiatric outpatient’s clinic so that changing trends in psychiatric problems, co-morbidities, prescribing patterns in view of the current diagnostic systems and treatment guidelines can be updated with special reference to Indian population.

Medication errors in psychiatric practice — A Cross-sectional Study.

Objectives: To analyse current prescription writing practices among psychiatrists and to identify and quantify various types of medication errors in psychiatric prescriptions in general and specifically in the prescriptions of antipsychotics. Method: A cross-sectional study of medication errors was carried out in the extra-mural psychiatry prescriptions brought by the patients attending the psychiatry outpatient department of a tertiary care hospital in Delhi. The study period ranged from 1st March, 2009 to 1st November, 2011. Microsoft Excel was used for data analysis. The WHO guidelines for prescription writing were used as a standard while making an assessment of the results. Results: Most of the prescriptions analysed exhibited polypharmacy, illegible handwriting, lack of necessary details pertaining to the patients (address, weight) as well as those pertaining to the prescriber (signature, contact details, registration number) and necessary instructions for the patient regarding taking drugs and advice for follow up.In the 648 extramural prescriptions analysed, the most common error was prescription of drug without dose (30 %). The least common error was the prescription of a wrong drug (2 %). In comparison to the rates found in all the 648 prescriptions, the error of prescribing drugs with same indication was identified at a relatively higher frequency (15%) among antipsychotics (only) prescriptions. Among the various antipsychotic drugs, the errors related to wrong frequency and wrong route of administration were observed at relatively higher frequencies in the prescriptions of the newly introduced drug asenapine while the first generation antipsychotic drugs like haloperidol and trifluoperazine exhibited comparatively higher rates of wrong dose errors. Conclusions: Routine psychiatric prescriptions exhibit large number of easily identifiable errors which are preventable. The need of the hour is to promote rational drug prescribing practices among psychiatrists, encouraging them to detect and report medication errors encountered by them. This approach will enrich our existing research base about this hitherto neglected domain of psychiatric practice thereby helping us in developing and implementing effective strategies to combat this menace of medication errors.

Pattern of Psychosexual Disorders among males attending Psychiatry OPD of a Tertiary Care Hospital.

Sexual dysfunction is a major healthcare issue and therefore deserves timely recognition, proper investigation and appropriate treatment. 100 consecutive male patients attending the psychiatric outpatient clinic were selected for the study. The cases with past history suggestive of primary organic pathology, Schizophrenia, depression, chronic drug intake were excluded. Mean age of the cases was 23.6 years, 26 cases (26.0%) had a history of premarital heterosexual act, 5 cases (5.0%) had homosexual contact, 72 cases (72.0%) had history of nocturnal emission and 12 cases (12.0%) gave history of extramarital heterosexual contact. The mean duration of illness was 6.2 months. 62 cases (62.0%) presented with Dhat syndrome. This was followed by erectile impotence (19 cases, 19%), premature ejaculation (12 cases;12%), and 7 cases (7%) presented with sexual misconceptions. The presence of high prevalence of additional psychiatric disorder in all types of psychosexual dysfunctions deserves for careful diagnostic evaluation, appropriate investigations and timely treatment.

A Descriptive Study of Referral Pattern in Department of Psychiatry of A Tertiary Care Hospital of North India.

Introduction: Liaison psychiatry is the one of the lynchpin between psychiatry and the other medical specialties. The incidence of mental disorders in hospitalized physically ill patients has been found to range from 5.0% to 50.0%.4 The objective of our study was to study the frequency and pattern of psychiatric referral at department of psychiatry, University College of Medical Sciences & Guru Tegh Bahadur Hospital, Delhi. Materials and Methods: This study was carried in the psychiatry outpatient’s department of University College of Medical Sciences and Guru Tegh Bahadur Hospital, Delhi. Between all possible consecutive cases referred from different out patient and inpatient departments February 2010 to 2011 were included in the study. The subjects were assessed during a semistructured proforma and try severe established in ICD-10. Results: Total number of 484 of patients was referred medicine department sent the maximum number of consultations, followed by surgery, Eye/ENT, orthopaedics. The most prevalent ICD-10 diagnosis was depressive disorder .Psychiatric consultation was sought for various reasons including expert opinion, abnormal behavior, irrelevant talk and other reasons. Conclusion: Consultation Psychiatry through the referral system is only a tip of the iceberg of the actual potential of psychiatric involvement in general hospital practice. There is need for research in this field to explore ways. Further research to warranted to find ways to realise the actual potential of consultation-liaison Psychiatry in a tertiary hospital setup.