Study of clinical profile of patients of bipolar mood disorder with and without substance abuse and clinical course variables in the substance abusing bipolar group in one of the tertiary care centre of North India

Background: Bipolar disorder is the sixth leading cause of disability worldwide and has a lifetime prevalence of about 3% in general population. In patients with bipolar disorder there was 58 % lifetime prevalence of co-occurring alcohol abuse and a 38 % lifetime prevalence of co-occurring other substance abuse. Substance abuse interferes with treatment and management approaches of the bipolar disorder.Methods: A cross sectional observational study of 120 male patients divided in substance abusing (60) and non-substance abusing groups (60) with bipolar disorder according to DSM-V, who met the Inclusion criteria . A written informed consent was obtained from the patients and/ or their family members. Patient’s information was recorded on the socio-demographic and clinical profile sheet .Thereafter, YMRS or HAM-D scales were applied as per the phase of the illness.Results: Most of the patients were between 15-25 years in SAB group and 35-50 years in NSAB group, educated, semiskilled and married. Tobacco abuse was the commonest followed by cannabis and alcohol abuse. The mean duration of hospital stay in SAB group was 41.40 days and in NSAB group was 43.20 days. Dysphoric mania, aggressive behavior and suicidal attempts were more in SAB group. Mean total YMRS score of SAB group was greater than NSAB group.Conclusions: Maximum patients had onset of substance abuse before the onset of affective symptoms. Manic symptomatology was more severe in substance abusing group

A study of psychiatric co-morbidity among alcohol dependents

Background: The alcohol use disorders are frequently associated with other co-morbid psychiatric disorders. The aim of this study was to describe the demographic variables, drinking history and psychiatric co-morbidity in alcohol dependent subjects.Methods: In this study, 40 consecutive patients were enrolled. After a minimum 1 month of sobriety, patients who fulfilled ICD-10 criteria of alcohol dependence were interviewed for data collection using Alcohol Use Disorders Identification Test (AUDIT), MINI-International Neuropsychiatric Interview (MINI) (Version-6.0) and a specially designed sociodemographic and clinical interview proforma. Subjects with substance use except tobacco were excluded from study. Main group comparison used chi-square test for categorical variables and the t-test for continuous variables.Results: Most of the patients studied were >40 years of age. Majority were employed (92%), lived in nuclear families (78%) and came from rural background (77.5%). Forty five percent of the patients initiated alcohol drinking between 16-25 years and reported peer pressure (50%) as most significant factor responsible for initiation of drinking alcohol. Mean age of developing alcohol dependence was 25.12 years (SD=4.28). Mean AUDIT score for subjects was 27.7 (SD=4.73). Lifetime psychiatric co-morbid disorders were detected in 45%. Psychiatric disorders most frequently associated with alcohol dependence were major depressive disorder (10%), bipolar affective disorder (7.5%), dysthymia (5%), anxiety disorders (7.5%) and antisocial personality disorder (5%).Conclusion: The study indicates that psychiatric disorders are prevalent in alcohol dependents and mood disorders are the most prevalent ones. It was also observed that co-morbid psychiatric disorders are associated with more severe alcohol problems

Undergraduate nursing students’ attitude towards mental illness: a cross sectional study

Background: People suffering from mental illness commonly face stigma, bias, and discrimination by general public. Health care professionals are not immune to social biases and share the public's attitude meted out to people with mental illness. Nursing students are future health manpower. There are only few studies conducted on medical students’ attitude towards people with mental illnesses in India. We have planned this study to examine the undergraduate nursing students’ attitude towards people suffering from mental illnesses.Methods: It was a cross-sectional study. A total of 220 undergraduate nursing students were selected randomly with their consent to complete the Attitude Scale for Mental Illness (ASMI).Results: The nursing students were found to have a significant positive attitude towards mental illness in five of the six attitudes factors: Restrictiveness (8.42), benevolence (28.6) and stigmatization (7.3), separatism (15.6) and stereotype (9.4) However, these students had negative attitude in pessimistic predictions (12.5) domain as they rated this domain slightly on the higher side.Conclusions: Academic education in this field must be conceptualized and planned in order to favor the change of the attitudes that includes greater utilization of those teaching strategies that challenge beliefs and assumptions and promote a commitment to provide holistic care to people with mental illness

Description of clinical factors for suicide attempts in a tertiary care hospital of northern part of India

Background: Suicide is the result of an act deliberately initiated and performed by a person in the full knowledge or expectation of its fatal outcome. Suicide attempts are a significant public health problem. The present study aimed to explore the variousclinical characteristics of suicideattempters in a tertiary care hospital of Shimla, Himachal Pradesh, a northern state of India.Methods: We conducted a descriptive study among patients with attempted suicide to the department of Psychiatry, Indira Gandhi Medical College (IGMC) Shimla. A structured, self-designed interview schedule and short-form revised Eyseneck personality questionnaire-Hindi (EPQRS-H) was used for data collection. Data was analyzed using Epi info software v 7.2.0.Results: There were total 77 participants in the study out of which 44 (57.1%) were females. Mean age (Standard deviation) of participants was 30.8 years (9.9 years). Relationship problems were the most common (48.1%) recent life event followed by health events (28.6%). Depression was found to be the most common diagnosis (62.3%). Pesticide consumption was the method of attempting suicide in 72.7% of females compared to 66.7% of males.Conclusions: Recent major life events especially relationship problems may lead to majority of suicide attempts. There is urgent need to focus on patients suffering from depression by health personnel as well as family members. The sale of the pesticides should be regulated to keep in check the misuse of the same

Hemicrania continua-like headache associated with carotid dissection may respond to indomethacin

Hemicrania continua (HC) is an idiopathic, chronic disorder characterized by a continuous, strictly unilateral headache associated with ipsilateral cranial autonomic symptoms. The symptoms of HC typically respond dramatically to indomethacin therapy. We describe a patient with traumatic internal carotid artery (ICA) dissection, who presented with a clinical picture mimicking HC that initially responded to indomethacin. Patients with a clinical picture similar to HC should be managed with a high index of suspicion for a possible cervical arterial dissection

Effect of Barrages and Anthropogenic Activities on Ecological Integrity of the Ganga River: A Review on Current Issues and Restoration Efforts

The Ganga River, a lifeline for millions of people in the Indian subcontinent, is facing significant environmental challenges due to the construction of barrages and various anthropogenic activities along its course. This review paper examines the effects of barrages and human interventions on the ecological integrity of the Ganga and explores current issues surrounding its deteriorating ecosystem. Furthermore, it discusses the restoration efforts undertaken to mitigate the ecological impacts and restore the river\u27s health. The construction of dams and barrages can aggravate the situation in the context of the Ganga, which is already suffering from the discharge of industrial and agricultural wastes. The construction of various dams, barrages, and hydroelectric projects is affecting the water flow of the Ganga.  These affect the water flow, resulting in the accumulation of solid waste on the river bed.  Barrages not only affect the water flow but also restrict the migration of aquatic fauna. This affects the hydrological balance of the Ganga as well as the survival and existence of several fish species. This review provides a comprehensive analysis of the effects of barrages and anthropogenic activities on Ganga\u27s ecological integrity, sheds light on the current issues plaguing the river, and highlights the ongoing restoration efforts. By understanding the complex interplay between human activities and ecosystem dynamics, stakeholders can work towards safeguarding Ganga\u27s ecological health and ensuring its sustainable future

Procjena in vitro protoskolicidne učinkovitosti metanolnih biljnih ekstrakata na hidatidne ciste

The present study aimed at an evaluation of the protoscolicidal potential of methanolic extracts of three herbs; Ferula asafoetida (dried latex), Trachyspermum ammi (fruits) and Hippophae salicifolia (leaves) at three different concentrations (10, 20 and 30 mg/mL) for 20, 40 and 60 minute treatment intervals, with respect to standard allopathic drug albendazole. The in-vitro viability of the protoscolices was assessed by the Eosin exclusion method. The slope of mortality and lethal concentration for 50% (LC50) was determined from the regression graphs of the probit mortality of protoscolices plotted against log values of increasing concentrations of herbal extracts for 60 minute treatment intervals. The percentage of mortality caused by various extracts at concentrations ranging from 10-30 mg/mL varied from 29.54-97.76% with maximum mortality of 97.76, 97.30 and 81.91% recorded with methanolic extracts of F. asafoetida, T. ammi and H. salicifolia, respectively. Among all the extracts, the highest protoscolicidal activity was exhibited by F. asafoetida at 20 and 30 mg/mL concentrations in the 60 (97.16%) and 40/60 minutes (97.20% and 97.76%) treatments, respectively, and it showed a minimum LC50 value of 0.204, followed by T. ammi at 0.933. As compared to the standard allopathic drug, albendazole, the methanolic extracts of F. asafoetida and T. ammi exhibited better or comparable protoscolicidal activities.Cilj je istraživanja bila procjena protoskolicidnog potencijala metanolnih ekstrakata triju biljaka: Ferula asafoetida (sušena smola), Trachyspermum ammi (voće) i Hippophae salicifolia (lišće) u trima različitim koncentracijama (10, 20 i 30 mg/mL) u 20, 40 i 60-minutnim pokusnim intervalima u odnosu na standardni alopatski lijek albendazol. In vitro vitalnost protoskoleksa procijenjena je metodom isključivanja eozina. Krivulja pomora i smrtonosne koncentracije za 50 % (LC50) određena je iz regresijskih grafikona mortaliteta protoskoleksa u odnosu na log vrijednosti rastućih koncentracija biljnih ekstrakata tijekom 60-minutnog intervala. Pomor uzrokovan različitim ekstraktima u koncentracijama od 10 do 30 mg/mL varirao je od 29,54 do 97,76 % s najvišim postotkom od 97,76, 97,30 i 81,91 % u slučaju metanolnih ekstrakata F. asafoetida, T. ammi i H. salicifolia. Od svih primijenjenih ekstrakata najvišu protoskolicidnu aktivnost imala je F. asafoetida u koncentracijama od 20 i 30 mg/mL tijekom tretmana od 60 (97,16 %) i 40/60 minuta (97,20 i 97,76%), te je pokazala minimalnu vrijednost LC50 od 0,204, praćenu s T. ammi od 0,933. Usporedbom sa standardnim antiparazitikom albendazolom, metanolni ekstrakti biljaka F. asafoetida i T. ammi ostvarili su bolji ili slični protoskolicidni učinak

Duplication cyst of pyloroduodenal canal: a rare cause of neonatal gastric outlet obstruction: a case report

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