Suicide risk among psychiatric in-patients in north-central Nigeria

Background: Over the last 45 years, mortality due to suicide has increased in some developed and developing countries among both adults and young people. Suicide has also been reported to be high for individuals with substance abuse, mood and personality disorders, and relatively low rates were reported for patients with anxiety disorders. This study was therefore to determine the socio-demographic and clinical factors associated with the risk of suicide among psychiatric in-patients in North-Central Nigeria.Objective: The aim of this study is to look at the socio-demographic and clinical correlates of having suicide risk among psychiatric in-patients.Method: This is a cross-sectional descriptive study conducted on 112 in-patients admitted in the psychiatric wards of BSUTH Makurdi, FMC Makurdi and JUTH Jos during the study period of July to September, 2017. Every consecutive in-patient who consented for the study was assessed with a proforma carefully designed bythe authors to measure socio-demographic and clinical attributes. Suicide risk was determined using the 'Suicidality Module' of Mini International Neuropsychiatric Interview (M.I.N.I.).Results: Forty-five (40.2%) were males while 67(59.8%) were females. The mean age was 36.98 ±11.09 years, fifty- four (48.2%) subjects were still married at the time of the study. Eighty subjects representing 71.4% of the respondents reported having low (46), moderate (16) or high (18) suicide risk. Having a risk of suicide was significantly associated with the history of default (p=0.001), previous episodes of illness (p=0.005), co-morbid diagnosis (p=0.001), long duration of illness (p=0.001), and not having a good relationship with sexual partner (p=0.002).Conclusion: The study justifies the need for the assessment of suicide risk among in-patients with high degree of suspicion.Keywords: Suicide risk, in-patient, correlate

Port-access coronary artery bypass grafting: A proposed surgical method

AbstractMinimally invasive surgical methods have been developed to provide patients the benefits of open operations with decreased pain and suffering. We have developed a system that allows the performance of cardiopulmonary bypass and myocardial protection with cardioplegic arrest without sternotomy or thoracotomy. In a canine model, we successfully used this system to anastomose the internal thoracic artery to the left anterior descending coronary artery in nine of 10 animals. The left internal thoracic artery was dissected from the chest wall, and the pericardium was opened with the use of thoracoscopic techniques and single lung ventilation. The heart was arrested with a cold blood cardioplegic solution delivered through the central lumen of a balloon occlusion catheter (Endoaortic Clamp; Heartport, Inc., Redwood City, Calif.) in the ascending aorta, and cardiopulmonary bypass was maintained with femorofemoral bypass. An operating microscope modified to allow introduction of the 3.5× magnification objective into the chest was positioned through a 10 mm port over the site of the anastomosis. The anastomosis was performed with modified surgical instruments introduced through additional 5 mm ports. In the cadaver model (n = 7) the internal thoracic artery was harvested and the pericardium opened by means of similar techniques. A precise arteriotomy was made with microvascular thoracoscopic instruments under the modified microscope on four cadavers. In three other cadavers we assessed the exposure provided by a small anterior incision (4 to 6 cm) over the fourth intercostal space. This anterior port can assist in dissection of the distal internal thoracic artery and provides direct access to the left anterior descending, circumflex, and posterior descending arteries. We have demonstrated the potential feasibility of grafting the internal thoracic artery to coronary arteries with the heart arrested and protected, without a major thoracotomy or sternotomy. (J THORAC CARDIOVASC SURG 1996;111:567-73

Framing access to medicines in developing countries: an analysis of media coverage of Canada's Access to Medicines Regime

<p>Abstract</p> <p>Background</p> <p>In September 2003, the Canadian government committed to developing legislation that would facilitate greater access to affordable medicines for developing countries. Over the course of eight months, the legislation, now known as Canada's Access to Medicines Regime (CAMR), went through a controversial policy development process and the newspaper media was one of the major venues in which the policy debates took place. The purpose of this study was to examine how the media framed CAMR to determine how policy goals were conceptualized, which stakeholder interests controlled the public debate and how these variables related to the public policy process.</p> <p>Methods</p> <p>We conducted a qualitative content analysis of newspaper coverage of the CAMR policy and implementation process from 2003-2008. The primary theoretical framework for this study was framing theory. A total of 90 articles from 11 Canadian newspapers were selected for inclusion in our analysis. A team of four researchers coded the articles for themes relating to access to medicines and which stakeholders' voice figured more prominently on each issue. Stakeholders examined included: the research-based industry, the generic industry, civil society, the Canadian government, and developing country representatives.</p> <p>Results</p> <p>The most frequently mentioned themes across all documents were the issues of drug affordability, intellectual property, trade agreements and obligations, and development. Issues such as human rights, pharmaceutical innovation, and economic competitiveness got little media representation. Civil society dominated the media contents, followed far behind by the Canadian government, the research-based and generic pharmaceutical industries. Developing country representatives were hardly represented in the media.</p> <p>Conclusions</p> <p>Media framing obscured the discussion of some of the underlying policy goals in this case and failed to highlight issues which are now significant barriers to the use of the legislation. Using the media to engage the public in more in-depth exploration of the policy issues at stake may contribute to a more informed policy development process. The media can be an effective channel for those stakeholders with a weaker voice in policy deliberations to raise public attention to particular issues; however, the political and institutional context must be taken into account as it may outweigh media framing effects.</p

Toxic effects of phenothiazines on the eye

Publications about the retinotoxic action of phenothiazine derivatives led the author to undertake an ophthalmological investigation in two psychiatric hospitals in The Netherlands. The pharmacological actions of phenothiazine preparations are listed and a survey of the phenothiazine derivatives which are at present in use is given. Some retinotoxic substances are discussed and a survey is given of the literature on the ocular complications of phenothiazine therapy. The eyes of 561 patients were examined. of whom 541 are included in this study. 343 of these patients(63.4 %) were found to have retinopathy. The correlation between the retinopathy and the total dose of phenothiazine preparations taken. and between the retinopathy and the duration of treatment. was highly significant. The correlation between the retinopathy and the average daily dose taken was significant. The retinopathy was associated with a reduced standing potential of the eye. as determined by electro-oculography. It was possibly responsible for diminished visual acuity in some cases, and for an abnormally large proportion of protans in the group of patients with colour defects. It was not possible to ascribe a more severe retinotoxic action to one or more specific phenothiazine derivatives than to others. In the author's opinion regular examination of the eyes of patients who are being treated with phenothiazine preparations in high dosage and for for a long period of time is indicated

Genetic Differences in the Immediate Transcriptome Response to Stress Predict Risk-Related Brain Function and Psychiatric Disorders

Depression risk is exacerbated by genetic factors and stress exposure; however, the biological mechanisms through which these factors interact to confer depression risk are poorly understood. One putative biological mechanism implicates variability in the ability of cortisol, released in response to stress, to trigger a cascade of adaptive genomic and non-genomic processes through glucocorticoid receptor (GR) activation. Here, we demonstrate that common genetic variants in long-range enhancer elements modulate the immediate transcriptional response to GR activation in human blood cells. These functional genetic variants increase risk for depression and co-heritable psychiatric disorders. Moreover, these risk variants are associated with inappropriate amygdala reactivity, a transdiagnostic psychiatric endophenotype and an important stress hormone response trigger. Network modeling and animal experiments suggest that these genetic differences in GR-induced transcriptional activation may mediate the risk for depression and other psychiatric disorders by altering a network of functionally related stress-sensitive genes in blood and brain

Weak interactions between hypohalous acids and dimethylchalcogens

The complexes formed between dimethylchalcogens X(CH 3) 2 (X = S, Se, and Te) and hypohalous acids YOH (Y = F, Cl, Br, and I) have been studied at the MP2/aug'-cc-pVTZ computational level, five minima structures being located. Two of them correspond to hydrogen bonds (HB), another two to halogen bonds (XB) with the chalcogen acting as an electron donor, the last one showing a C-H⋯O contact. The most stable complexes of IOH and BrOH acids present halogen⋯chalcogen interactions with interaction energies, E i, up to -49 kJ mol -1. In the case of the ClOH and FOH molecules, the hydrogen bonded complexes are more stable with interaction energies between -27 and -34 kJ mol -1. Linear correlations between the molecular electrostatic potential (MEP) stationary points at the van der Waals surface and the interaction energy have been found. The contribution of the different energy terms to the total interaction energy was analyzed by means of the DFT-SAPT theory finding that the electrostatic attractive term is dominant in the complexes with HB and XB, excepting a few cases in which the dispersion and induction terms become more important than the electrostatic one. © the Owner Societies 2012.Peer Reviewe

Influence of fluoro and cyano substituents in the aromatic and antiaromatic characteristics of cyclooctatetraene

An exhaustive and systematic study of the structural and electronic properties of cyclooctatetraene (COT) upon substitution of hydrogen atoms by fluoro and cyano groups has been carried out in order to analyse the influence of both substituents on the aromaticity. We found that C-C distances decrease with fluoro substitution while in cyano derivatives the opposite happens. All the compounds retain their original structural type, with the exception of the cyano derivatives; thus, compounds 25CN6T, 27CN6T and 30CN8T show boat-like structure, whereas compounds 20CN5T, 26CN6T, and 29CN7T present twisted structures. Regarding the relative energies of those compounds with the same number of substitutions, it was found that compounds where the X groups were more separated among them were the most stable ones. Inversion barriers (ΔETS) were found to increase with the number of substitutions; in the case of fluoro derivatives these barriers have a two-fold, increase compared to the parent compound while in the cyano ones a three-fold increase was observed. The aromatic character based on the NICS values, was found to increase in the ground singlet states and in the transition states of both fluoro and cyano derivatives. For triplet states, a decrease of the aromatic behaviour was found upon substitution. NICS profiles and 3D NICS isosurfaces confirm such findings. Finally, HOMA indexes corroborate the aromatic changes described by the NICS values, although, no good correlations between both quantities were found.Peer Reviewe

Intramolecular pnicogen interactions in PHF-(CH2) n-PHF (n=2-6) systems

A computational study of the intramolecular pnicogen bond in PHF-(CH 2)n-PHF (n=2-6) systems was carried out. For each compound, two different conformations, (R,R) and (R,S), were considered on the basis of the chirality of the phosphine groups. The characteristics of the closed conformers, in which the pnicogen interaction occurs, were compared with those of the extended conformer. In several cases, the closed conformations are more stable than the extended conformations. The calculated interaction energies of the pnicogen contact, by means of isodesmic reactions, provide values between -3.4 and -26.0 kJ mol-1. Atoms in molecules and electron localization function analysis of the electron density showed that the systems in the closed conformations with short P⋯P distances have a partial covalent character in this interaction. The calculated absolute chemical shieldings of the P atoms showed an exponential relationship with the P⋯P distance. In addition, a search in the Cambridge crystallographic database was carried out to detect those compounds with a potential intramolecular pnicogen bond in the solid phase. The way to interact: A computational study of the intramolecular pnicogen bond in PHF-(CH2)n-PHF (n=2-6) systems is carried out. For each compound, two different conformations, (R,R) and (R,S), are considered on the basis of the chirality of the phosphine groups. The characteristics of the closed conformers, in which the pnicogen interaction occurs, are compared with those of the extended conformer. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.Peer Reviewe