Cognitive behaviour therapy for white coat hypertension-causing latrophobia in adults: randomized controlled trial.

OBJECTIVE: To see whether cognitive behaviour therapy improves blood pressure-oriented latrophobia in adults to manage white coat hypertension. METHODS: Present study was conducted at the Kidney Centre, Sialkot, Pakistan from December 2017 to November 2018, and comprised latrophobic attendees of kidney patients without initially exploring the reason of phobia. Either of the intervention or control group was allotted, randomly. The intervention group underwent 20 weekly sessions of the therapy. Pre- and posttherapy systolic blood pressure (at home and medical clinic) of both the groups was recorded alongside self-perceived level of phobia in subjects of only treatment group. RESULTS: Of 30 subjects of intervention group, 22 (73.3%) completed the therapy. However, control (N = 30) stayed intact. Age statistics were, as: M = 38.2, SD = 11.8, range 20-56 years with male predominance. Moreover, 12 (54.4%) or 20 (90.9%) of them reported severe latrophobia or onset of phobia after childhood, respectively. After therapy, 17 (77.3%) subjects communicated improvement in fear. A significant decline in mean systolic blood pressure was noted in pre- to posttherapy record (149 vs.142 mm of Hg, respectively; t(21)= 8.829, p = 0.0001). CONCLUSION: Generally, cognitive behaviour therapy improves blood pressure-oriented latrophobia in adults.

Endoplasmic Reticulum Stress: Implications for Neuropsychiatric Disorders.

The Endoplasmic reticulum (ER), an indispensable sub-cellular component of the eukaryotic cell carries out essential functions, is critical to the survival of the organism. The chaperone proteins and the folding enzymes which are multi-domain ER effectors carry out 3-dimensional conformation of nascent polypeptides and check misfolded protein aggregation, easing the exit of functional proteins from the ER. Diverse conditions, for instance redox imbalance, alterations in ionic calcium levels, and inflammatory signaling can perturb the functioning of the ER, leading to a build-up of unfolded or misfolded proteins in the lumen. This results in ER stress, and aiming to reinstate protein homeostasis, a well conserved reaction called the unfolded protein response (UPR) is elicited. Equally, in protracted cellular stress or inadequate compensatory reaction, UPR pathway leads to cell loss. Dysfunctional ER mechanisms are responsible for neuronal degeneration in numerous human diseases, for instance Alzheimer's, Parkinson's and Huntington's diseases. In addition, mounting proof indicates that ER stress is incriminated in psychiatric diseases like major depressive disorder, bipolar disorder, and schizophrenia. Accumulating evidence suggests that pharmacological agents regulating the working of ER may have a role in diminishing advancing neuronal dysfunction in neuropsychiatric disorders. Here, new findings are examined which link the foremost mechanisms connecting ER stress and cell homeostasis. Furthermore, a supposed new pathogenic model of major neuropsychiatry disorders is provided, with ER stress proposed as the pivotal step in disease development.

Frequency of obsessive compulsive symptoms in depression: A hospital-based cross-sectional study.

OBJECTIVE: To determine the frequency of obsessive compulsive symptoms in patients suffering from depression. METHODS: This cross-sectional study was conducted at the Allama Iqbal Memorial Teaching, Sialkot, Pakistan, from February 2014 to March 2017, and comprised patients suffering from depression. Every patient was examined by a consultant psychiatrist or a senior medical officer in psychiatry, and a psychologist to establish clinical diagnosis of depression according to the tenth revision of the International Statistical Classification of Diseases and Related Health Problems. Adult patients suffering from depression were included. Patients with severe physical illnesses, other psychiatric illnesses, current, past or family history of obsessive compulsive disorder and drug abuse were excluded. Beck Depression Inventory and Yale Brown Obsessive Compulsive Scale were also administered. Data was analysed using SPSS 21. RESULTS: Of the 5,127 patients, 2,318(45.21%) were males and 2,809(54.79%) females. The mean age of the male and female patients was 35.17±12.39 years (range: 18-73 years) and 33.67±13.27 years (range: 18-70 years), respectively. Besides, 1,991(38.83%) patients had moderate depression, 1,647(32.13%) had mild depression and 1,489(29.04%) had severe depression. Moreover, 1,673(32.63%) patients had obsessive compulsive symptoms, including 497(29.70%) patients with mild depression, 599(35.80%) with moderate depression and 577(34.49%) with severe depression. CONCLUSIONS: Around one-third participants had obsessive compulsive symptoms.

Depression and anxiety in patients undergoing elective and emergency surgery: Cross-sectional study from Allama Iqbal Memorial Teaching Hospital, Sialkot.

OBJECTIVE: To determine the frequency of depression and anxiety in post-operative patients undergoing elective and emergency surgery. METHODS: The cross-sectional analytical study was conducted at the Department of Surgery and Department of Psychiatry of the Allama Iqbal Memorial Teaching Hospital, Sialkot, Pakistan, from September 2013 to April 2016, and comprised patients due for elective or emergency surgery. Patients admitted to the surgical wards, including general surgical, neurosurgical, urological and orthopaedic wards, undergoing major surgical procedures were enrolled. The patients were divided into elective surgery group 1 and emergency surgery group 2. The hospital anxiety and depression scale was used to screen for symptoms of anxiety and depression. SPSS 22 was used for data analysis. RESULTS: Of the 6,624 patients, 4,635(69.97%) were in group 1 and 1,989(30.03%) in group 2.The mean age of patients was 36.75±10.3years in group 1 and 39.11±11.4 years in group 2. There were 1,715(37%) males and 2,920(63%) females in group 1, while 518(26%) males and 1,471(74%) females were in group 2. Anxiety was present in 914(45.95%) and 656(32%) patients at 0 and 3 weeks in patients undergoing emergency surgery, while in elective surgery patients it was noted in 509(10.93%) and 1,390(29.87%) subjects, respectively. Depression was present in 218(10.96%) and 616(30.97%) patients at 0 and 3 weeks in patients undergoing emergency surgery, while in elective surgery it was noted in 463(9.98%) and 1,488(32.1%) respectively. CONCLUSIONS: Depression and anxiety were quite frequent in patients undergoing major surgeries. Anxiety was more common in patients who underwent emergency surgeries.