Psychiatric advance statements: an Indian experience.

BACKGROUND: The psychiatric advance statement (PAS) is a document that outlines the preferences of patients in their future treatment. Formulating and writing a PAS has not been studied in low- and middle-income (LAMI) countries. AIM: To study the feasibility of writing a PAS in an Indian population. METHODS: Patients' diagnosed with schizophrenia or schizoaffective psychosis attending the outpatient clinic at the Schizophrenia Research Foundation (SCARF) or its community centres in 2011 were screened using the study criteria. After obtaining informed consent, stratified sampling was used to derive the final sample. RESULTS: Most patients consented to participate in the study (122/123 patients). Following interviews with research assistants, 93 patients were assessed to have the capacity to write a PAS and 92 completed one. The patients were mostly able to complete the PAS on their own. Major themes included choice of treatment facility, type of treatment and nomination of others to take decisions on their behalf. A third of the sample were either from rural areas or not exclusively urban. At the time of the study, about 45% of the sample was rated as being symptomatic. CONCLUSION: Psychotic patients with a long-term illness, a third of them from non-urban areas, were able to write a valid PAS.

High incidence of oligozoospermia and teratozoospermia in human semen infected with the aerobic bacterium Streptococcus faecalis.

Bacterial culture of semen samples from 100 male partners in infertile couples revealed the presence of aerobic bacteria in 49 cases. Streptococcus faecalis (Enterococcus) was isolated from 53%, micrococci species from 20% and alpha-haemolytic streptococci from 16% of the infected samples. The incidence of oligozoospermia and teratozoospermia was significantly (P < 0.05) higher in men whose semen samples contained S. faecalis than those whose semen samples contained micrococci or alpha-haemolytic streptococci or those that did not contain bacteria. The mean sperm concentration, as well as the mean percentage of morphologically normal spermatozoa, was significantly (P < 0.03) lower in semen infected with S. faecalis compared with that containing micrococci or alpha-haemolytic streptococci and the uninfected samples. There is a high incidence of semen infection with S. faecalis, and it is associated with compromised semen quality in terms of sperm concentration and morphology. The presence of micrococci or alpha-haemolytic streptococci does not appear to have any detrimental effect on sperm quality.

Obsessive--compulsive disorder and psychosis.

OBJECTIVE: To study the phenomenology, treatment, course, and outcome of patients with comorbid obsessive-compulsive disorder (OCD) and psychotic features. METHOD: A retrospective chart analysis was conducted on 15 patients with OCD with psychotic features. Data were collected regarding patient demographics, psychiatric diagnosis, duration of illness, treatment details, and clinically determined outcome over time. RESULTS: Obsessive doubts, washing, and checking compulsions were the most commonly seen obsessive-compulsive (OC) symptoms. Of the patients, 53% had first-rank symptoms, and 77% showed significant improvement on treatment with a combination of antipsychotic and antiobsessional drugs. CONCLUSIONS: The observed improvement on treatment with a combination of antiobsessional and antipsychotic drugs supports the use of combination treatment in patients who have both OC and psychotic symptoms.

Differential formation of octadecadienoic acid and octadecatrienoic acid products in control and injured/infected potato tubers.

Lipoxygenases in plants have been implicated in the activation of defense responses against injury/infection. Pathogen-derived polyunsaturated fatty acids, such as arachidonic acid, eicosapentaenoic acid and their metabolites have been shown to elicit defense responses against pathogen infection in plants. However, not much is known about the role of host-derived fatty acids and their metabolites in plant defense responses. In this study, isolation and characterisation of endogenous lipoxygenase metabolites formed in potato tubers in response to injury/infection was undertaken. While 9-hydroperoxyoctadecadienoic acid (9-HPODE), derived from octadecdienoic acid (linoleic acid) is the major lipoxygenase product formed in control potato tubers, 9-hydroperoxyoctadecatrienoic acid (9-HPOTrE), derived from octadecatrienoic acid (alpha-linolenic acid) is the major lipoxygenase product formed in potato tubers in response to injury or infection with Rhizoctonia bataticola. As a result, the relative ratio of 9-HPODE to 9-HPOTrE showed a shift from 4:1 in control to 1:2 and 1:4.5 in injured and infected potato tubers respectively. From this study, it is proposed that lipoxygenase metabolites of octadecadienoic acid may be involved in physiological responses under control conditions, while octadecatrienoic acid metabolites are mediating the defense responses. This forms the first report on the differential formation of endogenous lipoxygenase products in potato tubers under control and stress conditions.

Purification and characterization of rat testicular glutathione S-transferases: role in the synthesis of eicosanoids.

AIM: Purification of glutathione S-transferases (GSTs) from rat testis; separation and identification of various subunits and their role in eicosanoid biosynthesis. METHODS: Purification of rat testicular GSTs by affinity chromatography, employing S-hexylglutathione-linked epoxy-activated Sepharose 6B column and separation of individual subunits by reverse phase-high pressure liquid chromatography (RP-HPLC). Characterization of affinity purified GSTs by Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot analysis. The role of testicular GSTs in eicosanoid biosynthesis was determine by incubating GSTs with 5, 6-Leukotriene A4Me (LTA4Me) and prostaglandin H2(PGH2) and analyzing the products formed on HPLC/TLC. RESULTS: The present study reveals that majority of rat testicular GSTs are of Yb size (60%) with molecular weight of 27 kDa. The most predominant subunits, however, are GST Yn2(27%), followed by GST Yc(24%) and GST Yn1(20%). These testicular GSTs showed very high Leukotriene C4 (LTC4) synthase activity with 5, 6-Leukotriene A4Me (LTA4Me) as the substrate and prostaglandin D (PGD) synthase activity with prostaglandin H2(PGH2) as the substrate. CONCLUSION: Majority of rat testicular GSTs are Yb sized and are involved in the synthesis of eicosanoids like LTC4 and PGD2.

Pulmonary lipid peroxidation and antioxidant defenses during exhaustive physical exercise: the role of vitamin E and selenium.

Physical exercise is known to induce oxidative stress leading to the generation of free radicals. This increased generation of free radicals might lead to lipid peroxidation and tissue damage, more so under deficient/impaired antioxidant states. In the present study, we report the role of vitamin E and selenium (Se) during exercise-induced oxidative stress in the pulmonary tissue. Vitamin E and/or Se deficiency in female albino rats resulted in generation of free radicals as revealed by electron spin resonance (ESR) spectra in the lung tissue, indicating the onset of oxidative stress. When these animals were subjected to a single bout of exhaustive exercise, there was an additional increase in the generation of oxy-free radicals, which might lead to tissue damage. However, no such signals were recorded in the lung tissue of vitamin E- and Se-supplemented animals, when subjected to a similar exercise program, suggesting that protection is offered by vitamin E and Se in combating oxidative stress.

Reproductive exocrine and endocrine profiles and their seasonality in male langur monkeys (Presbytis entellus entellus).

The reproductive exocrine and endocrine profiles in male langurs are reported with an emphasis on seasonality. The animals showed positive response to electroejaculation throughout the year. The sperm concentration varied between 10-383 x 10(6)/ejaculation with wide fluctuations all through the year. No appreciable changes in the motility and percent live sperm were observed throughout the year. The levels of seminal fructose and magnesium remained unchanged throughout the year, while acid phosphatase showed wide fluctuations. Citric acid showed elevation during February and March and LDH showed elevated levels during April and May. The annual range of serum testosterone was 6-34 nMol/l with a peak during July. Cortisol ranged between 575-1587 nMol/l and prolactin ranged between 107-900 mU/l. Wide fluctuations were observed in hormonal levels. No seasonality was exhibited in the seminiferous tubule diameter, nuclear diameter of Sertoli cells and Leydig cells, and the cholesterol, glycogen, and sialic acid contents of testis. None of the parameters studied have shown any correlation with season. The results suggest that the male langurs lack seasonality in their reproductive exocrine and endocrine profiles and thus could be used as model for research in human reproduction.