Ethical dilemmas encountered in suicide research and management: Experiences of young mental health professionals.

This study aimed to explore ethical dilemmas and challenges faced by young mental healthcare researchers and professionals working with survivors of suicide (hereinafter suicide survivors). Two focus group discussions (FGDs) Researcher FGD (with those engaged in suicide research) and Clinician FGD (with those providing treatment to suicide survivors) - consisting of open-ended questions and lasting for 70-90 minutes were conducted and analysed using Thematic Analysis. Five themes were identified: i) struggling with the incongruity of harm within benefit, ii) difficulty in delineating boundaries, iii) self-doubt in one's professional competence, iv) nature of suicide straining the limits of confidentiality, and v) working with structural limitations. The study helps to understand the obstacles and dilemmas encountered in adhering to ethical principles while working with vulnerable individuals.

A Pilot Study of Correlation between Intelligence Quotient, Social Quotient, and Ayurveda Parameters in Children.

BACKGROUND: Intelligence quotient (IQ) and social quotient (SQ) are comparable in predicting intelligence status. The latter is assessed whenever IQ testing is not possible. According to Ayurveda, Buddhi (intelligence) is affected by Prakriti (body constitution) which depends on the predominance of Tridosha and Triguna. There is a paucity of studies to examine their association. The study was designed to examine correlation among IQ, SQ, performance quotient (PQ) and maladaptive behaviour; and to find out their relationship with primary (Anubandhya) and secondary (Anubandha) doshas with intelligence in children with mild to moderate intellectual disability. METHODOLOGY: Children (n = 120) were recruited from outpatient department of a tertiary care hospital as part of a clinical trial of a novel Ayurveda formulation. Stanford Binet Scale, Vineland Social Maturity Scale, Seguin Form Board Test, and Maladaptive Behavior Schedule-II were administered. Ayurvedic parameters were assessed clinically by Ayurveda practitioner. Separate regression analyses were carried out to look for associations. RESULTS: IQ and SQ were positively correlated (P = 0.01). Maladaptive behavior and SQ were negatively correlated (0.05). SQ was associated with secondary dosha (P = 0.002) and stage of disease (Roga Kriyakala) (P = 0.015). IQ was also associated with secondary dosha (P = 0.008). CONCLUSION: SQ and IQ are positively correlated. The correlation of Anubandha (secondary) dosha was high on IQ and SQ.

Altered resting state functional connectivity in early course schizophrenia.

Impaired connectivity is proposed to underlie pathophysiology of schizophrenia. Existing studies on functional connectivity show inconsistent results. We examined functional connectivity in a clinically homogenous sample of 34 early course schizophrenia patients compared with/to 19 healthy controls using resting state functional magnetic resonance imaging (rsfMRI). Mean duration of illness for schizophrenia patients was 4 ± 1.78 years. Following a comprehensive clinical assessment, rsfMRI data were acquired using a 3.0 T magnetic resonance imaging scanner, and analyzed using FSL version 5.01 software (FMRIB's Software Library, www.fmrib.ox.ac.uk/fsl). Compared to healthy controls, schizophrenia patients had significantly decreased functional connectivity in the left fronto-parietal network, lateral and medial visual network, motor network, default mode network and auditory network. Our data suggests significant functional hypoconnectivity in selected brain networks in early schizophrenia patients compared to controls. It is likely that the observed functional hypoconnectivity may be associated with features of schizophrenia other than those examined in this study. It is possible that hypoconnectivity is necessary but not sufficient to the clinical manifestation of schizophrenia. The examination of functional connectivity as a biomarker should be extended to a wider array of disease phenotypes to better understand its significance.

Case report of comorbid schizophrenia and obsessive compulsive disorder in a patient who was tube-fed for four years by family members because of his refusal to eat.

Refusal to eat is a common presentation in many psychiatric disorders including obsessive compulsive disorder and schizophrenia. In the acute situation it may be a medical emergency; when it becomes chronic it can become an ingrained behavior that is difficult to change. The diagnosis of individuals who refuse to eat may be difficult, particularly in persons with comorbid medical problems, impaired intelligence, or lack of insight into their condition. Tube-feeding is an effective short-term intervention that can be discontinued when the patient re-starts oral intake. However, in some situations patients may become dependent on the use of tube-feeding. We present a case report of a patient with schizophrenia, obsessive compulsive disorder, borderline intelligence, and seizure disorder who was tube-fed by his family members for more than three years because he refused to eat orally.

Dothiepin-induced transient hypomania and extrapyramidal syndrome.

A case has been reported here, who developed transient hypomanic symptoms as well as extrapyramidal symptoms after being switched from sertraline to dothiepin therapy. The possible mechanisms and clinical implications of the same are discussed.

An immunisation trial with in vitro produced Babesia bigemina exoantigens.

Bovine babesiosis, caused by Babesia bigemina, is an important tick-transmitted haemoprotozoan disease in the tropics. This study evaluated the immunoprotective efficacy of in vitro produced B. bigemina exoantigens in bovine calves. The calves inoculated with B. bigemina exoantigens did not show any clinical, parasitological or hypersensitivity reactions after inoculation. They withstood challenge without showing any clinical symptoms except a transient thermal reaction. In contrast, two out of four control calves exhibited clinical symptoms of babesiosis and one died. On challenge, there was a significant reduction in the haematological values of both groups. However, this was more pronounced in the control animals. Challenge resulted into a normocytic hypochromic anaemia. The vaccinated animals revealed a significant rise in antibody titres after vaccination as well as after challenge as detected by a single dilution ELISA. The rise in antibody titres of control animals was only moderate. Inoculation of B. bigemina exoantigens induced a protective immune response in the vaccinated animals which could protect them from infected blood challenge.