Detection of Japanese Encephalitis Virus in Vector Mosquitoes in a Non-endemic Area, India

Japanese Encephalitis (JE) is a serious growing public health problem in India, gradually engulfing new areas. In north India, eastern districts of Uttar Pradesh had been highly endemic for JE since 1978. JE outbreak was reported to have jumped over 800 km distance from its earlier most endemic area (eastern parts of north India) to a location (Karnal) in the Haryana state of western parts of north India, during the year 1990, which never reported JE earlier.1 Later, the disease gradually spread to its adjoining districts in the state. First time, from western Uttar Pradesh, 7 cases and 4 deaths due to suspected JE were reported in 2003 from Saharanpur district. In the subsequent year, 13 deaths due to suspected viral encephalitis were reported from 26th September to 23rd October, 2004 from one village namely Khekra, from Baghpat district of Uttar Pradesh which is about 128 km west of Saharanpur. A serosurvey carried out on 24th and 25th October, 2004 among the family members of dead persons revealed hemagglutination inhibition (HI) antibodies against JE and West Nile (WN) virus. Further, an outbreak of suspected JE was reported from Saharanpur district in 2005, with 212 cases and 157 deaths. This caused matter of great concern to extend further studies in Baghpat where prevalence of flavivirus infection was already recorded in the locality. For monitoring of arbovirus activities in an area, detection of virus in human sera is cumbersome, difficult and also not desirable. Therefore, as an alternative approach, detection of virus antigen in mosquitoes by antigen capture enzyme linked immunosorbent assay (ELISA) has provided a reliable tool to comprehend the types of virus circulating in nature.2 Detecting arbovirus in mosquitos forms an important part of vector surveillance and may at times also serve as an early warning signal for outbreaks, if however linked with phonological and epidemiological studies. Vector infection and abundance were found to be good indicators of JE occurrence in surveillance studies conducted in South India.3 An attempt was thus made to detect the presence of JE virus (JEV) antigen in vector mosquitoes by ELISA method from the encephalitis-affected area of Baghpat district and to provide evidence of circulating of Japanese Encephalitis virus (JEV) in natural animal-mosquito cycle

Drug-induced cutaneous adverse drug reactions in dermatology in Dr. B.R. Ambedkar Medical College

Background: Cutaneous adverse drug reactions (ADRs) affect 2-3% of hospitalized patients. The severity varies from mild itching to life-threatening Stevens-Johnson syndrome (SJS). Hence, this study was undertaken to emphasize the need to report ADRs.Methods: The study was carried out in the Department of Dermatology in Dr. B.R Ambedkar Medical College Hospital from June to December 2012. Naranjo’s algorithm was used to determine the causality of an ADR. Informed consent was obtained from each patient, and thorough clinical examination was conducted. All the information was carefully recorded in a pre-designed proforma. To establish the etiologic agent for a particular type of reaction, attention was paid to the drug history, temporal correlation with the drug, duration of the reaction, morphology of the reaction, associated mucosal or systemic involvement, improvement of lesions on withdrawal of the drug.Results: In the present study, all the age groups were affected with cutaneous ADRs, with a higher incidence in age group between 31 and 40 years, non-steroidal anti-inflammatory drugs (NSAIDs) (41.66%) were most commonly observed drug, followed by anti-microbials (25%) and anti-convulsants (21.66%). Fixed drug eruptions (FDE) (46.66%) most commonly observed cutaneous reaction, followed by SJS (16.66%), erythema multiformae (16.66%) most commonly observed ADRs.Conclusions: ADRs are potentially avoidable causes for seeking medical care. FDE was most common ADR and NSAIDs were most common causative agents in our study. ADRs can be prevented by avoiding polypharmacy, obtaining history of any previous skin reaction and the causative agent

Neural changes following cognitive behaviour therapy for psychosis: a longitudinal study

A growing body of evidence demonstrates that persistent positive symptoms, particularly delusions, can be improved by cognitive behaviour therapy for psychosis. Heightened perception and processing of threat are believed to constitute the genesis of delusions. The present study aimed to examine functional brain changes following cognitive behaviour therapy for psychosis. The study involved 56 outpatients with one or more persistent positive distressing symptoms of schizophrenia. Twenty-eight patients receiving cognitive behaviour therapy for psychosis for 6–8 months in addition to their usual treatment were matched with 28 patients receiving treatment as usual. Patients’ symptoms were assessed by a rater blind to treatment group, and they underwent functional magnetic resonance imaging during an affect processing task at baseline and end of treatment follow-up. The two groups were comparable at baseline in terms of clinical and demographic parameters and neural and behavioural responses to facial and control stimuli. The cognitive behaviour therapy for psychosis with treatment-as-usual group (22 subjects) showed significant clinical improvement compared with the treatment-as-usual group (16 subjects), which showed no change at follow-up. The cognitive behaviour therapy for psychosis with treatment-as-usual group, but not the treatment-as-usual group, showed decreased activation of the inferior frontal, insula, thalamus, putamen and occipital areas to fearful and angry expressions at treatment follow-up compared with baseline. Reduction of functional magnetic resonance imaging response during angry expressions correlated directly with symptom improvement. This study provides the first evidence that cognitive behaviour therapy for psychosis attenuates brain responses to threatening stimuli and suggests that cognitive behaviour therapy for psychosis may mediate symptom reduction by promoting processing of threats in a less distressing way

Neural processing of criticism and positive comments from relatives in individuals with schizotypal personality traits

Objectives. High negative expressed emotion by family members towards schizophrenia patients increases the risk of subsequent relapse. The study aimed to determine whether individuals with high schizotypy (HS) and low schizotypy (LS) would differ in activation of brain areas involved in cognitive control when listening to relative criticism

Common and distinct neural effects of risperidone and olanzapine during procedural learning in schizophrenia: A randomised longitudinal fMRI study

© 2015 The Author(s). Rationale: Most cognitive domains show only minimal improvement following typical or atypical antipsychotic treatments in schizophrenia, and some may even worsen. One domain that may worsen is procedural learning, an implicit memory function relying mainly on the integrity of the fronto-striatal system. Objectives: We investigated whether switching to atypical antipsychotics would improve procedural learning and task-related neural activation in patients on typical antipsychotics. Furthermore, we explored the differential effects of the atypical antipsychotics risperidone and olanzapine. Methods: Thirty schizophrenia patients underwent functional magnetic resonance imaging during a 5-min procedural (sequence) learning task on two occasions: at baseline and 7-8 weeks later. Of 30 patients, 10 remained on typical antipsychotics, and 20 were switched randomly in equal numbers to receive either olanzapine (10-20 mg) or risperidone (4-8 mg) for 7-8 weeks. Results: At baseline, patients (all on typical antipsychotics) showed no procedural learning. At follow-up, patients who remained on typical antipsychotics continued to show a lack of procedural learning, whereas those switched to atypical antipsychotics displayed significant procedural learning (p = 0.001) and increased activation in the superior-middle frontal gyrus, anterior cingulate and striatum (cluster-corrected p < 0.05). These neural effects were present as a linear increase over five successive 30-s blocks of sequenced trials. A switch to either risperidone or olanzapine resulted in comparable performance but with both overlapping and distinct task-related activations. Conclusions: Atypical antipsychotics restore procedural learning deficits and associated neural activity in schizophrenia. Furthermore, different atypical antipsychotics produce idiosyncratic task-related neural activations, and this specificity may contribute to their differential long-term clinical profiles.Alexander von Humboldt Foundation; Biomedical Research Centre for Mental Health at the Institute of Psychiatry, King’s College London; South London and Maudsley NHS Foundation Trus

Incidence Of Different Lesions In Brain – 2 Years Study In A Teaching Hospital In Telangana, India

Introduction: The anatomic location of lesion in the brain influences the prognosis and treatment options. There is an increase in the incidence of primary lesions in brain in recent decades. The increasing incidence may be due to improved diagnostic methods such as modern radiologic imaging & better access to neurosurgical services. Objectives: The aim of this article is to study the incidence of brain tumors in two consecutive years. Methods: A total of 139 biopsies from brain and central nervous system were studied in patients attending NH Mallareddy Hospital, Suraram, Qutbullapur, Hyderabad, Telangana, India. The incidence of various lesions were studied lesion wise, location wise , age wise and sex wise. Results: In our study the most common lesion was glioma, commonly seen in third and fourth decades and the common location being frontal lobe. Glioblastoma multiforme and other anaplastic variants were seen after 40 years and pilocytic astrocytoma was noted in children and young adults. Conclusion: The incidence of different gliomas were analyzed on the basis of anatomical location and its histological type. The area with densest occurrence was the anterior subcortical region in the frontal lobe. The most frequent subtypes were glioblastoma multiforme (31.8%), astrocytomas grade I , II and III (30.3%) and oligodendroglioma (13.6%). Our results demonstrate considerable heterogeneity in the anatomic distribution of gliomas in the brain

Colloid cyst in third ventricle - a rare case

Colloid cysts are relatively rare intracranial lesions located in the rostral aspect of the third ventricle usually near the choroid plexus and foramen of Monro. They may produce acute hydrocephalus, brain herniation, and may lead to sudden death. We present the radiologic and pathologic correlation of a colloid cyst of third ventricle in a 49 year old male presenting with severe headache. Magnetic resonance imaging (MRI) and Computed tomography (CT) of brain were suggestive of colloid cyst. Endoscopic excision of cyst was done and the diagnosis was confirmed by histopathological examination. Post operatively the patient was neurologically intact and was discharged a week later. We report the case because of its rarity

Cytological diagnosis of ductal papilloma with apocrine hyperplasia of breast

Intraductal papillomas of the breast are relatively rare benign lesions with an incidence of approximately 2-3% commonly seen in 20 - 40 years aged women and are rare after 50 years of age. We here in report a case of intraductal papilloma of breast in a 66 year old female with significant family history of breast carcinoma which is a rare presentation. She presented with bloody nipple discharge from right breast since one month. On examination, right nipple is enlarged up to 0.8cm in diameter. Mammogram showed no abnormality. Fine needle aspiration cytology (FNAC) of the enlarged nipple was done and a diagnosis of duct papilloma with apocrine hyperplasia was made. This case report emphasizes the role of FNAC in diagnosing this lesion and relieving the patient from physical and mental trauma at an early stag

Prevalence of psychological stress in allergic rhinitis patients attending a tertiary care hospital - A cross sectional study

Background: Allergic Rhinitis (AR) is a common disorder in patients attending Otorhinolaryngology (ENT) department. It has considerable impact on the life of affected individual. Many studies have linked certain psychological disorders to AR. Objective: To estimate the prevalence of psychological stress in AR patients and assess its relation to duration and severity of the disease. Methods: This is a cross-sectional study of AR patients attending ENT OPD during 6 months period. AR patients were diagnosed and classified as per ARIA guidelines. Then they were subjected to standard psychiatric interview and their psychological stress was measured using Perceived Stress Scale (PSS). Results: Of 1804 new patients attending ENT OPD, 58 were diagnosed as suffering from AR. Among them, 29 (50%) were found to have significant stress; 12(20.69%) have Anxiety Disorder and 3(5.17%) were found to have Depressive Disorder. Among AR patients, those with persistent moderate-severe type were found to have high prevalence rate which is statistically significant. There is no relation between intensity of symptoms and duration of illness to significant psychological stress in AR patients. Conclusion: Patients with AR have significant psychological stress which should not be overlooked during treatment. It may be related to inherent pathological factors like IgE level, psychological and social factors rather than intensity and duration of illness