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   2011| July-December  | Volume 20 | Issue 2  
    Online since October 16, 2012

 
 
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ORIGINAL ARTICLES
Anger attacks in obsessive compulsive disorder
Nitesh Prakash Painuly, Sandeep Grover, Surendra Kumar Mattoo, Nitin Gupta
July-December 2011, 20(2):115-119
DOI:10.4103/0972-6748.102501  PMID:23271866
Background: Research on anger attacks has been mostly limited to depression, and only a few studies have focused on anger attacks in obsessive compulsive disorder. Materials and Methods: In a cross-sectional study all new obsessive compulsive disorder patients aged 20-60 years attending an outpatient clinic were assessed using the anger attack questionnaire, irritability, depression and anxiety scale (for the direction of the aggressive behavior) and quality of life (QOL). Results: The sample consisted of 42 consecutive subjects with obsessive compulsive disorder, out of which 21 (50%) had anger attacks. The obsessive compulsive disorder subjects with and without anger attacks did not show significant differences in terms of sociodemographic variables, duration of illness, treatment, and family history. However, subjects with anger attacks had significantly higher prevalence of panic attacks and comorbid depression. Significantly more subjects with anger attacks exhibited aggressive acts toward spouse, parents, children, and other relatives in the form of yelling and threatening to hurt, trying to hurt, and threatening to leave. However, the two groups did not differ significantly in terms of QOL, except for the psychological domain being worse in the subjects with anger attacks. Conclusion: Anger attacks are present in half of the patients with obsessive compulsive disorder, and they correlate with the presence of comorbid depression.
  4 6,215 71
Six-month trial of Yoga Nidra in menstrual disorder patients: Effects on somatoform symptoms
Khushbu Rani, SC Tiwari, Uma Singh, GG Agrawal, Neena Srivastava
July-December 2011, 20(2):97-102
DOI:10.4103/0972-6748.102489  PMID:23271863
Background: Yoga Nidra is a successful therapy for both recent and long-standing psychological disturbances of all kinds especially depression and high anxiety level and neurotic patterns. Objective: The purpose of the present work, therefore, was to conduct a preliminary randomized study of Yoga Nidra as a treatment in the patients of menstrual disorders with somatoform symptoms. Materials and Methods: Patients were recruited from Department of Obstetrics and Gynecology, CSM Medical University (erstwhile KGMU) Lucknow, Uttar Pradesh, India. One hundred and fifty female patients with menstrual disorders were randomly divided in to two groups 1- Intervention group: 75 subjects (Yoga Nidra intervention and medication) 2- control group: 75 subjects (without Yoga Nidra intervention only medication). Schedule for clinical assessment in neuropsychiatry tool was used. Results: There was significant improvement in pain symptoms (P<0.006), gastrointestinal symptoms (P<0.04), cardiovascular symptoms (P<0.02) and urogenital symptoms (P<0.005) after 6 months of Yoga Nidra therapy in Intervention group in comparison to control group. Conclusion: Yoga Nidra appears to be a promising intervention for psychosomatic problems. It is cost-effective and easy to implement. The results indicate that somatoform symptoms in patients with menstrual disorder can be decreased by learning and applying a program based on Yogic intervention (Yoga Nidra).
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Inhalant abuse: An exploratory study
Rohit Verma, Yatan Pal Singh Balhara, Anju Dhawan
July-December 2011, 20(2):103-106
DOI:10.4103/0972-6748.102493  PMID:23271864
Background: Inhalants are being abused by large numbers of people throughout the world, particularly children and adolescents. It is also an often overlooked form of ubstance abuse in adolescents. Aims: The current study explored the inhalant abuse among adolescents seeking treatment from a tertiary care drug de-addiction clinic. Settings and Design: The study was conducted at a tertiary level multispecialty hospital. Materials and Methods: The current study was a chart review of the cases with inhalant abuse/dependence presenting to the clinic over a 1-year period. All the treatment records of the de-addiction clinic were reviewed, and information was gathered regarding patients with inhalant abuse/dependence. Statistical Analysis: Descriptive statistics with frequency distribution was carried out by using SPSS version 10.0. Results: The mean age of the subjects was 16.24 years (SD±1.9 years; range 12-18 years). Twenty-two percent of the subjects were illiterate. Forty percent of the adolescents had a family history of alcohol use problems and 48% that of tobacco use. The mean age of the initiation of inhalant use was 11.6 years (SD±2.17 years). It varied from 9 to 18 years. Forty percent of the adolescents had made a previous abstinence attempt. Conclusions: The findings provide important information on an underresearched area in psychiatry.
  3 3,779 89
CASE REPORTS
Self-harm by severe glossal injury in schizophrenia
Pookala S Bhat, PK Pardal, M Diwakar
July-December 2011, 20(2):134-135
DOI:10.4103/0972-6748.102524  PMID:23271870
Self-mutilation, the deliberate destruction occurs in a variety of psychiatric disorders.Many methods of self-destructive behavior have been described in literature. Patients of schizophrenia are known to attempt self-harm due to command hallucination, catatonic excitement or because of associated depression, however severe glossal injury by biting has not been reported so far.Authors report case of self-harm of glossal injury by biting in schizophrenia.Treatment and management issues are discussed.
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ORIGINAL ARTICLES
A comparative study of cognitive deficits in patients with delusional disorder and paranoid schizophrenia
Sandeep Grover, Ritu Nehra, Gaurav Bhateja, Parmanand Kulhara, Suresh Kumar
July-December 2011, 20(2):107-114
DOI:10.4103/0972-6748.102499  PMID:23271865
Background: Very few studies have evaluated the neurocognitive functions of patients with persistent delusional disorder. Aim: To study the neurocognitive profile of patients with delusional disorder and compare it with those of patients with paranoid schizophrenia and healthy control subjects. Materials and Methods: Attention concentration, executive functions, memory, and IQ were assessed in 20 patients with delusional disorder and were compared with 20 patients with paranoid schizophrenia and 20 healthy controls. All three groups were matched on age, sex, and level of education. The two patient groups were also matched on duration of illness. Results: In general, patients with delusional disorder performed worst than healthy controls and patients with paranoid schizophrenia performed in between the other two groups. Compared with healthy controls, both patients with delusional disorder and patients with paranoid schizophrenia were significantly impaired on different tests of attention and visual learning and memory. Compared with patients with paranoid schizophrenia, patients with delusional disorder had more impairment different tests of attention, visual learning and memory, verbal working memory, and executive functions. Conclusion: Patients with delusional disorder exhibit cognitive dysfunctions that are very similar to schizophrenia, but are more severe in intensity. The resemblance of cognitive profiles suggests that the two disorders may have similar etiological basis.
  2 3,463 76
CASE REPORTS
Fahr's disease and psychiatric syndromes: A case series
Deepak Ghormode, Uma Maheshwari, Natasha Kate, Sandeep Grover
July-December 2011, 20(2):136-138
DOI:10.4103/0972-6748.102527  PMID:23271871
Fahr's disease is characterized by basal ganglia calcification with clinical manifestations in the form of neuropsychiatric disorders, neurological symptoms, and cognitive symptoms. In this case series, we describe two cases of basal ganglia calcification, one of whom presented with psychotic symptoms and the other with mood symptoms, and discuss the literature with regard to psychiatric manifestations of basal ganglia calcification.
  1 3,126 60
Multiple-etiology delirium and catatonia in an alcoholic with tubercular meningoencephalitis
Suneet Kumar Upadhyaya, Monika Pathania, Archana Sharma
July-December 2011, 20(2):139-141
DOI:10.4103/0972-6748.102528  PMID:23271872
Delirium is a clinical entity with a variety of possible etiological conditions. Clinicians must be vigilant for the possibility of additional etiological factors. Secondly, catatonic patients should be carefully looked for general medical conditions. This case report depicts a chronic alcoholic who presented with withdrawal delirium, later on developed catatonia and then was diagnosed to have tubercular meningoencephalitis, a rare clinical sequence.
  1 2,155 29
Stevens-Johnson syndrome progressing to toxic epidermal necrolysis with haloperidol and carbamazepine combination
Ajay Kumar, Sukanto Sarkar, Samir Kumar Praharaj, Sayeed Akhtar, M Diwakar
July-December 2011, 20(2):131-133
DOI:10.4103/0972-6748.102517  PMID:23271869
Carbamazepine and other anticonvulsants are commoner cause of severe adverse cutaneous drug reactions such as erythema multiforme, toxic epidermal necrolysis (TEN), and Stevens-Johnson syndrome (SJS). We report a case of SJS rapidly progressing to TEN with a combination of haloperidol and carbamazepine in a patient with bipolar affective disorder. The pathophysiological mechanism underlying this reaction is discussed.
  1 2,990 55
EDITORIAL
Positive mental health and its relationship with resilience
Kalpana Srivastava
July-December 2011, 20(2):75-76
DOI:10.4103/0972-6748.102469  PMID:23271858
  1 3,078 111
CASE REPORTS
Aripiprazole for acute mania in an elderly person
Balaji Bharadwaj, Shivanand Kattimani, Anuriddha Mukherjee
July-December 2011, 20(2):142-144
DOI:10.4103/0972-6748.102532  PMID:23271873
New-onset bipolar disorder is rare in the elderly. Symptom profile is similar to that in young adults but the elderly are more likely to have neurological co-morbidities. There are no case reports of elderly mania being treated with aripiprazole, an atypical antipsychotic. A 78-year-old gentleman presented to us with symptoms suggestive of mania of 1 month's duration. He had similar history 3 years ago and a family history of postpartum psychosis in his mother. There were no neurological signs on examination and work-up for an organic etiology was negative except for age-related cerebral atrophy. He improved with aripiprazole and tolerated the medications well. The use of psychotropic medications in the elderly is associated with side-effects of sedation, increased cardiovascular risk, and greater risk of extra-pyramidal side-effects. The use of partial dopaminergic antagonists like aripiprazole may be useful in the balancing of effects and side-effects.
  - 4,128 33
INVITED EDITORIAL
Use and abuse of specific learning disability certificates
Manju Mehta
July-December 2011, 20(2):77-78
DOI:10.4103/0972-6748.102471  PMID:23271859
  - 2,459 98
LETTERS TO EDITOR
Waking up to modafinil in shift work sleep disorder
Dilip Gude
July-December 2011, 20(2):145-145
DOI:10.4103/0972-6748.102533  PMID:23271874
  - 2,136 27
High density lipoprotein: State marker for dependence status of Mahua
Lokesh Kumar Singh, Samir K Praharaj
July-December 2011, 20(2):146-146
DOI:10.4103/0972-6748.102535  PMID:23271875
  - 1,683 20
Leave pooling-the latest trend: Implications
Suneet Kumar Upadhyaya, Archana Sharma, Abhinav Joshi
July-December 2011, 20(2):146-147
DOI:10.4103/0972-6748.102536  PMID:23271876
  - 1,724 19
ORIGINAL ARTICLES
HIV-associated dementia: A diagnostic dilemma
Daniel Saldanha, Sumit Beniwal, Labanya Bhattacharya, Kalpana Srivastava
July-December 2011, 20(2):120-123
DOI:10.4103/0972-6748.102505  PMID:23271867
Background: Considerable clinical research has been conducted to increase our knowledge in understanding the underlying neuropathological significance of HIV viral infection. Aim: To find the incidence of HIV Associated Dementia in a suburban part of India. Materials and Methods: 6135 prospective cases from January 2008 to August 2010 were subjected to pretest counseling. Those willing were tested for HIV status using western blot test. Results: 5688 (92.71%) underwent for detection of HIV.273 (4.8%) were tested positive. 246 out of these (90.10%) were put on ART. 1 (0.37%) was detected to have HAD stage II.38 cases (18.92%) had varied psychiatric symptoms. Conclusion: HAART has considerably reduced morbidity in HIV infection.
  - 2,515 43
A study on factors of dissatisfaction and stress of the blacksmiths resulting from the organizational culture in the surgical instrument industry of India
Tirthankar Ghosh, Banibrata Das, Somnath Gangopadhyay
July-December 2011, 20(2):124-130
DOI:10.4103/0972-6748.102513  PMID:23271868
Background: It is important to understand what motivates workers and the extent to which the organization and other contextual variables satisfy them. The aim of the study was to determine factors of dissatisfaction resulting from the organizational culture among the blacksmiths involved in the surgical instrument industry. Materials and Methods: Fifty male surgical blacksmiths each of the skilled and unskilled groups of the forging section were selected. Organizational Role Stress Scale was used to measure the individuals' role stress and several forms of conflict within an organization. Also, the organizational culture and personal involvement in an organization was measured among the surgical blacksmiths. Results: The mean score for total role stress for Skilled was 71.7 and for unskilled was 77.2. The most frequent type of organizational culture was reported to be hierarchy, both by skilled and unskilled surgical blacksmiths, followed by market and clan culture. Conclusion: This study shows that the skilled surgical blacksmiths have lower level of stress and conflicts in comparison with unskilled surgical blacksmiths. Both skilled and unskilled surgical blacksmiths estimated their level of personal involvement as low and indicated insufficient involvement in work teams. The satisfaction of the employees with their status and role in the organizational culture was also poor for both skilled and unskilled surgical blacksmiths.
  - 3,254 34
A preliminary study to measure and develop job satisfaction scale for medical teachers
Kavita Bhatnagar, Kalpana Srivastava, Amarjit Singh, SL Jadav
July-December 2011, 20(2):91-96
DOI:10.4103/0972-6748.102484  PMID:23271862
Background: Job satisfaction of medical teachers has an impact on quality of medical education and patient care. In this background, the study was planned to develop scale and measure job satisfaction status of medical teachers. Materials and Methods: To generate items pertaining to the scale of job satisfaction, closed-ended and open-ended questionnaires were administered to medical professionals. The job satisfaction questionnaire was developed and rated on Likert type of rating scale. Both quantitative and qualitative methods were used to ascertain job satisfaction among 245 health science faculty of an autonomous educational institution. Factor loading was calculated and final items with strong factor loading were selected. Data were statistically evaluated. Results: Average job satisfaction score was 53.97 on a scale of 1-100. The Cronbach's alpha reliability coefficient was 0.918 for entire set of items. There was statistically significant difference in job satisfaction level across different age groups (P 0.0358) showing a U-shaped pattern and fresh entrants versus reemployed faculty (P 0.0188), former showing lower satisfaction. Opportunity for self-development was biggest satisfier, followed by work, opportunity for promotion, and job security. Factors contributing toward job dissatisfaction were poor utilization of skills, poor promotional prospects, inadequate pay and allowances, work conditions, and work atmosphere. Conclusion: Tertiary care teaching hospitals in autonomous educational institutions need to build infrastructure and create opportunities for their medical professional. Job satisfaction of young entrants needs to be raised further by improving their work environment. This will pave the way for effective delivery of health care.
  - 4,551 138
REVIEW ARTICLES
Cognitive reserve: The warehouse within
Jyoti Prakash, VSSR Ryali, Kalpana Srivastava, PS Bhat, R Shashikumar
July-December 2011, 20(2):79-82
DOI:10.4103/0972-6748.102475  PMID:23271860
Dementia is characterized by progressive and mostly irreversible memory loss. Other neuropsychiatric disorders affect cognition in varying manner. Are all people affected with such disorders manifest clinically in similar manner or does our brain have some reserve to tolerate insults? Relevant researches over the last two decades were scrutinized to understand brain reserve, appreciate the conceptual change in the same over years, and how the same can be improved for better cognition and memory over the year. Literature evidence suggests that the cognitive reserve (CR) is a dynamic and functional concept. There is adequate evidence to suggest that enriched environment and various other measures are likely to improve CR across all age. Improving CR may delay or reverse the effects of aging or brain pathology.
  - 3,102 63
The neuropsychiatric aspects of influenza/swine flu: A selective review
Narayana Manjunatha, Suresh Bada Math, Girish Baburao Kulkarni, Santosh Kumar Chaturvedi
July-December 2011, 20(2):83-90
DOI:10.4103/0972-6748.102479  PMID:23271861
The world witnessed the influenza virus during the seasonal epidemics and pandemics. The current strain of H1N1 (swine flu) pandemic is believed to be the legacy of the influenza pandemic (1918-19). The influenza virus has been implicated in many neuropsychiatric disorders. In view of the recent pandemic, it would be interesting to review the neuropsychiatric aspects of influenza, specifically swine flu. Author used popular search engine 'PUBMED' to search for published articles with different MeSH terms using Boolean operator (AND). Among these, a selective review of the published literature was done. Acute manifestations of swine flu varied from behavioral changes, fear of misdiagnosis during outbreak, neurological features like seizures, encephalopathy, encephalitis, transverse myelitis, aseptic meningitis, multiple sclerosis, and Guillian-Barre Syndrome. Among the chronic manifestations, schizophrenia, Parkinson's disease, mood disorder, dementia, and mental retardation have been hypothesized. Further research is required to understand the etiological hypothesis of the chronic manifestations of influenza. The author urges neuroscientists around the world to make use of the current swine flu pandemic as an opportunity for further research.
  - 4,960 66
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