Stress Among Health Care Professionals - The Need for Resiliency

Healthcare professionals are subjected to considerable levels of stress such as work overload, excessive working hours, sleep deprivation, repeated exposure to emotionally charged situations, dealing with difficult patients and conflicts with other staffs. Management of such stress should be given due importance, right from the days of training in medical sciences

‘Gas Syndrome’ - A Culture Bound Syndrome

Culture refers to the shared patterns of feelings, beliefs and behaviour that reflect in the way of living in a society. Culture uniquely influence the role functioning or psychosoical wellbeing of people living in a given society by exerting influence on their mind by their traditional health beliefs. Cultural factors influence understanding, presentation, diagnosis, management, course and outcome of many diseases, especially psychiatric disorders. Culture-bound syndromes seem to be episodic, dramatic and discrete patterns of behavioral reactions specific to a particular community that articulate both personal predicament and public concerns. Every culture provides explanations and causal attributions for somatic symptoms. One of the common complaints of persons coming to medical attention is ‘Gas’ or similar terminologies like ‘vayu’ etc. People attribute varied symptoms from abdominal discomfort, chest pain, headache, joint pains, back pain, somatic complaints to ‘Gas’. ‘Gas’ is reported to be the cause for the distress and the primary duty of the treating clinician is to relieve them of the gas. The problem of troubling Gas or vayu has been influencing Indian culture/tradition since ancient days. We do see a significant proportion of patients visiting varied specialists attributing all their problems to Gas. 'Gas Syndrome’ is proposed as a culture bound syndrome

Study of prenatal, natal, and neonatal risk factors associated with autism

Introduction: Autism spectrum disorder is one of the common developmental disabilities. Underlying autism etiology is most likely polygenic but environmental factors may also contribute. Obstetrical and neonatal risk factors have been considered for the development of autism. Objectives: The objectives of the study were to know the presence of antenatal, perinatal and neonatal complications in autistic children. Materials and Methods: Children who were diagnosed with autism were included in the study. Visits were made to the special school for the collection of data with prior consent, and birth details were collected from the parents. Results: A total of 54 children were included in the study. Age of the children ranged from 3 years to 17 years with the mean age of 10.93 years. 39 (72.2%) were boys and 15 (27.8 %) were girls. Advanced maternal age at delivery was noted in 24% of the cases. Antenatal risk factors were seen in 24% of cases and natal risk factors in 20% of the cases. 17% had birth asphyxia. Neonatal intensive care unit admission was noted in 20% of cases, neonatal seizures in 5.6%, respiratory distress in 9.3%, and low birth weight in 17% of cases. 60% of them were first born. Overall, the presence of antenatal, natal, and postnatal risk factors were noted in 57% autism cases. Conclusion: In children with autism, there is increased prevalence of obstetric and neonatal risk factors. These variables should be examined in future for precise assessments of exposures

Stevens-Johnson Syndrome while on lamotrigine and NSAID:A case report

Stevens-Johnson syndrome is a severe immune-mediated cutaneous reaction occurring due to exposure to certain drugs. Lamotrigine is an FDA approved drug used in the treatment of bipolar depression. When it is given concomitantly with sodium valproate, the risk of developing Stevens-Johnson syndrome increases. Here we present the report of a patient with bipolar depression who developed serious skin rashes while on lamotrigine and NSAID prescribed by a local doctor, who recovered after timely management. This case highlights the importance of following proper dosing, drug escalation regimen and managing drug interactions during lamotrigine therapy

Gastric headache: Historical concept still widely prevalent

Ethno-medicine refers to the study of traditional medical practice which is concerned with the cultural interpretation of health, diseases and illness and also addresses the healthcare-seeking process and healing practices. Headache is one of the common symptom for consultation with a doctor. Several patients visiting doctors and specialists with the complaint of headache, attribute the cause to gastritis, gas or to any similar terminology in their local language. Since, the cause connects between head and stomach the condition is known as "gastric headache". The knowledge of gastric headache and its description details were greatly contributed by the medical traditions of ancient Greece, Persia Egypt, India, and China. The possible causality of the gastrointestinal diseases in inducing headaches has been little investigated. We do see a significant proportion of patients visiting varied specialists attributing headache to gas/gastritis. We believe that attribution patterns, explanatory models and research is needed to study gastritis/gas as a cause for headache in different cultures. The difference in the understanding and beliefs of the illness between the clinician and patient can result in inappropriate assessment or dis-satisfaction

‘Gas Syndrome’ - A Culture Bound Syndrome

Culture refers to the shared patterns of feelings, beliefs and behaviour that reflect in the way of living in a society. Culture uniquely influence the role functioning or psychosoical wellbeing of people living in a given society by exerting influence on their mind by their traditional health beliefs. Cultural factors influence understanding, presentation, diagnosis, management, course and outcome of many diseases, especially psychiatric disorders. Culture-bound syndromes seem to be episodic, dramatic and discrete patterns of behavioral reactions specific to a particular community that articulate both personal predicament and public concerns. Every culture provides explanations and causal attributions for somatic symptoms. One of the common complaints of persons coming to medical attention is ‘Gas’ or similar terminologies like ‘vayu’ etc. People attribute varied symptoms from abdominal discomfort, chest pain, headache, joint pains, back pain, somatic complaints to ‘Gas’. ‘Gas’ is reported to be the cause for the distress and the primary duty of the treating clinician is to relieve them of the gas. The problem of troubling Gas or vayu has been influencing Indian culture/tradition since ancient days. We do see a significant proportion of patients visiting varied specialists attributing all their problems to Gas. 'Gas Syndrome’ is proposed as a culture bound syndrome

Suicidality in somatization and undifferentiated somatoform disorders: A hospital-based study

Aim: The aim of this study is to examine suicidality in patients with somatization and undifferentiated somatoform disorders. Materials and Methods: Suicidality was assessed among 105 consecutive patients diagnosed with somatization disorder or undifferentiated somatoform disorder according to the ICD-10 criteria. The Mini-International Neuropsychiatric Interview-Plus and the Columbia-Suicide Severity Rating Scale were used in the study. Results: In the study sample, 68.6% reported wish to be dead, 37.1% reported of nonspecific active suicidal thoughts, and 1.9% reported active suicidal ideation with specific plan and intent. The most frequent reason for suicidal ideation was to end or stop the pain. Conclusion: This study had revealed that somatization and undifferentiated somatoform disorders have a high risk of self-harm

Topical Valproate Solution for Hair Growth

Valproate is used regularly in the treatment of various seizure disorders, bipolar disorder, migraine prophylaxis and off label in many other conditions. Alopecia or hair loss is cosmetic side effect of oral valproate administration. Hair loss with valproate is diffused, non-scarring and dose related. A large number of drugs may interfere with the hair cycle and produce hair loss. We have only a few drugs like Minoxidil, Finasteride used for hair regeneration and both have its own side effects and limitations. In contrast to oral ingestions of valproate causing hair loss, early experiments with topical Valproic acid cream showed hair regeneration. Valproic acid cream is currently unavailable in the market, alternatively, we do have valproate and divalproex solutions available in various strengths which have a potential to be used topically for hair regeneration. The side effects and cost of topical valproate solution could be much less than the available options in the market. Valproate solution topically has the potential to be used for hair growth