ABSTRACT
The main objective of presenting the case series is that despite dramatic symptomatic response by intra venous lorazepam or electro convulsive therapy irrespective of primary diagnosis in catatonia cases some cases remain difficult to treat by conventional treatment. Here, we present five catatonia cases who did not respond to conventional treatment even when treated for primary psychiatric diagnosis along with treatment for catatonia. They ultimately responded partially or completely to clozapine only, which explains the multi-factorial causation of catatonia syndrome as postulated by different scientific research.
ABSTRACT
OBJECTIVE: This study was conducted to determine the changes in the insular cortex in alcohol dependent subjects, and to compare the same with controls, the associated clinical findings. METHODS: The study group consisted of 30 subjects with alcohol dependence syndrome (ADS) selected randomly from the out patient services of the department of psychiatry of a tertiary care hospital. The control group consisted of 30 matched subjects selected randomly from the out patient department and from patients screened for uncomplicated headache. Both groups were examined by a computerized scan (CT), and Mini Mental Status Examination (MMSE). RESULTS: Chi square, and 't' test were done after calculating the Evan's ratio. The two groups were compared to assess the cortical atrophy and ventricular enlargement. Cognitive functions were tested by MMSE, and the scores were compared. Atrophy was significantly higher in the experimental group; however, it was not significant. Cognitive functioning was found to be significantly impaired in the experimental group. DISCUSSION: The study showed that alcohol dependence leads to cortical atrophy which is age independent. The statistically significant disturbance in the MMSE scores along with the frontal and parietal cortical atrophy is also indicative of the insular cortex involvement in the experimental group. CONCLUSION: Alcohol dependence leads to cerebral atrophy along with the involvement of the insular cortex.
ABSTRACT
OBJECTIVE: Some persons attempt suicide with a strong intention to die and some are not. Presently, no distinctive grouping has been done on the basis of the suicidal intention, though there is a significant variation in the psycho-socio-demographic profile, suicidal ideation, and intent within the persons making suicidal attempt. The aim of our study was to find the psycho-socio-demographic profile, suicide intent in survivors of suicide attempt, categorizing them by suicide intent, and finally to define the deliberate self-harm (DSH) group. MATERIALS AND METHODS: It was a cross-sectional study. Two hundred patients who survived suicide attempt were evaluated by a psychiatrist. The data were recorded for sociodemographic variables, psychiatric disorder, suicide intent, and lethality of suicide attempt. Grouping was done by using suicide intent as the determining dimension. The DSH group was defined by psycho-socio-demographic characteristics of the patient. RESULTS: The mean age of the DSH group was 26.72 years, mostly females (50.5%), semiskilled workers (43.43%) and housewives (32.32%), from nuclear family (60.6%) with no psychiatric disorder (35.35%). Most of them attempted a nonlethal suicide attempt (87.87%) by organophosphorus poisoning (87.87%). CONCLUSIONS: The DSH group is a distinct group among suicide attempters, having different psycho-socio-demographic characteristics.
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UNLABELLED: Opiod dependence is one of the leading psychiatric morbidities in India. The deaddiction centres are meager in number; stigma attached to admission in deaddiction centre is high and most addicts want outpatient treatment so that they do not miss daily wages. Several recent reports stated effectiveness of tramadol in treating opioid withdrawal. This study attempts to compare effectiveness of tramadol with clonidine in opioid withdrawal. METHODOLOGY: A total of 60 patients having heroin dependence were selected and out of them 30 got clonidine treatment and the other 30 got tramadol treatment. The clinical opioid withdrawal scale was used. STATISTICAL ANALYSIS: "t"-Test was used using SPSS (version-16) for comparison. RESULT: Tramadol was more effective in preventing sweating, restlessness, aches, runny nose, GI upset, yawning, anxiety and goose skin. i.e., Tramadol can be used effectively in opioid withdrawal in outpatient based treatment programme.
ABSTRACT
Objective: This case reports highlight atypical presentation of pediatric bipolar mood disorder. Pediatric bipolar disorder is said to be a rare condition with some distinct differences from adult bipolar disorder. Despite the ongoing controversy regarding its exact typology, pediatric bipolar mood disorder is being reported in the form of case reports and in systematic research. Pediatric bipolar disorder is difficult to diagnose because its presentation of symptoms overlaps considerably with conduct problems, and ADHD (attention deficit hyperkinetic disorder). Methods: We report two cases which met a diagnosis of pediatric mood disorder where the presentation of symptoms was unique and atypical. Results: The cases are presented so that they help to raise pertinent questions regarding phenomenology, duration, episodic nature of the illness and management of this important group of disorders. Conclusion: Pediatric bipolar disorder should be viewed with seriousness and pediatric mania should be given importance in the assessment of the typology, prognosis and management of this important group of childhood disorder.
