First Reported Case of Lorazepam-Assisted Interview in a Young Indian Female Presenting with Dissociative Identity Disorder and Improvement in Symptoms after the Interview

Dissociative identity disorder (DID) is one of the most fascinating disorders in psychiatry. The arduous search to reveal the obscurity of this disorder has led to colossal research in this area over the years. Although drug-assisted interviews are not widely used, they may be beneficial for some patients that do not respond to conventional treatments such as supportive psychotherapy or psychopharmacotherapy. Drug-assisted interviews facilitate recall of memories in promoting integration of dissociative information. We report a case of a 16-year-old female with dissociative identity disorder (DID) that was treated with lorazepam-assisted interview and there was rapid improvement in symptoms after the interview

Quality of life and wellbeing in patients receiving electroconvulsive therapy: a study from Kashmir

Background: Electroconvulsive therapy (ECT) is an effective neurostimulative treatment in psychiatric disorders and is widely used throughout the world except few countries. Studies regarding quality of life and well-being in patients receiving electroconvulsive therapy have not been undertaken in our country. Objective of current study was to study the quality of life and well-being in patients receiving Electroconvulsive therapy. Methods: 50 patients who have been prescribed pharmacological drugs form the control group and 50 patients already on psychotropic medication who were prescribed electroconvulsive therapy form the case group were taken up for study. Detailed evaluations were carried out clinically and by measurement of Well-being index. Pre-treatment evaluation was carried out one day before Electroconvulsive therapy, and post treatment was carried out at 3 and 7 week. Data were evaluated by means of chi square and Repeat ANOVA, Post hoc Bonferroni correction for within group comparisons applicable. Results: Mean wellbeing index for study group is 14 which is slightly higher than control (11) (p>0.001.) Well-being index of study group is much higher than that of control group at 3 and 7 week post treatment (p>0.001). Conclusions: Sustained effect on quality of life remains in depression up to 7 weeks and in mania it responds rapidly wanes off within 7 weeks. Electroconvulsive therapy improves the quality of life in psychiatric patients.

Unusual foreign body insertion in rectum and vagina in schizophrenic patient

Insertion of foreign body in to the body is rare in medical literature. Here we report a case of 21 year old female who presented to emergency with acute abdomen and on detailed evaluation turned out to be schizophrenia. Our patient had history of insertion of ball pen in rectum following command hallucination. The foreign body was later removed through laparotomy. The cause of insertion of foreign body are multiple from command hallucination, suicidal attempt, erotism to somatic delusions. Thus the clinician should always be vigilant while dealing with psychiatric patients as sometimes impacted foreign body can present as acute emergency

Psychosocial and medical factors affecting treatment compliance in patients attending psychiatric hospital: a study from Kashmir

Background: Compliance with medication is decisive for treatment of the psychiatric disorders and is necessary for determining the outcome and prognoses of psychiatric patients. While the causes of poor compliance are multifactorial, the psychiatrist should be aware of such factors and may be able to implement interventions to address those factors. The objective of study was to find out the various medical and social reasons affecting treatment Compliance among patients suffering from psychiatric disorders.Methods: A Cross-Sectional study from 2011 to 2012 was conducted in IMHANS (Institute of Mental Health and Neurosciences) Srinagar (J&K), a questionnaire was designed, and the questionnaire included questions on socio-demographic variables, psychiatric illnesses, and Medical and psycho-social affecting treatment compliance. A systematic selection method for choosing the respondents was opted, questionnaire was administered on 200 (n=200) patients who attended the Outpatient department during the period. Simple random sampling method was applied for selection of respondents, the first time visitors to OPD were exclude along with repetition of respondents.Results: Out of 200 respondents studied in the study 41.5 % were males and 58.5% were females. Maximum number of patients (31.5%) studied were in the age group below the 30 years. 3.5% of respondents were in the age group above 70 years. Out of total 200 respondents in the study 74 % of the respondents are in compliance with recommended medicine whereas non-compliance was found in the 26% of studied population. Complications (13.46%) ascending out by usage of psychiatric medicine can be attributed as one of the major case of treatment non-compliance in psychiatric patients, among the psychiatric patients. Accessibility of psychiatric medicine and Financial constrain was also one of the reasons behind the medicine non-compliance (7.69%). Patients with no insight to psychiatric disease also include a good percentage of (5.76 %) of medicine non- compliance.  Conclusions: Non-compliance is a dominant factor which causes possibly causes readmission in psychiatric wards. Compliance in psychiatric patients in general could be enhanced and improved by adequate intervention via patient counselling and patient medicinal care and education

Development and Testing of A Wearable Vibrotactile Haptic Feedback System For Proprioceptive Rehabilitation

The human sense of touch is an integral part of daily life. For tasks involving grasping and manipulation of objects, force feedback is a key requirement. Most of the systems give contact point or complete grasping force feedback; for precision grasping and other physical interactions, finger awareness and force feedback from independent fingers is essential. In this study a novel, wearable proprioceptive rehabilitation system is designed which restores the ability of identifying and distinguishing between individual fingers of a prosthetic hand or an exoskeleton in a non-invasive manner. Moreover, it provides different levels of force feedback from every finger as well, which enables the user to distinguish and control force in precision grasping activities. For testing the system accuracy, classical psychophysical methods were used on a group of 14 voluntary disabled subjects. The tests were conducted in both, ideal and real-world conditions i.e. without and with distractions and accuracies were calculated accordingly. A p-test was also conducted to observe significance between the samples of with and without distraction datasets. The system performed with an overall accuracy of 82.04% which was well above the min. performance measure of 60%. Vi-HaB is standalone system and can be mounted on any upper limb rehabilitation (prosthesis, exoskeleton) system for finger awareness and force feedback

Biallelic variants in CHST3 cause Spondyloepiphyseal dysplasia with joint dislocations in three Pakistani kindreds

Background Skeletal dysplasia is a heterogeneous group of disorders. Spondyloepiphyseal dysplasias comprise one subgroup. Deficiency of carbohydrate sulfotransferase 3 has been reported in a small number of patients with recessively inherited spondyloepiphyseal dysplasia with joint dislocation, short stature and scoliosis. We report here molecular and clinical findings of affected individuals in three consanguineous Pakistani families. Affected individuals in all three families had a uniform phenotype including severe short stature, multiple dislocated joints, progressive scoliosis and facial dysmorphism. Methods Clinical evaluation was done for three unrelated families. Radiological survey of bones was completed for patients from two of the families. Whole exome sequencing index patients from each family was performed followed by Sanger sequencing for validation of segregation of identified variants in respective families. In-silico analysis for determining pathogenicity of identified variants and conservation was done. Results Whole-exome sequencing revealed biallelic variants c.590 T > C;p.(Leu197Pro), c.603C > A;p.(Tyr201Ter) and c.661C > T;p.(Arg221Cys) in CHST3 (NM_004273.5) in the three families with eight, five and two affected individuals, respectively. Contrary to previous reports, affected individuals in none of the families exhibited a hearing loss. Conclusion We describe genotypic and phenotypic findings of three unrelated families with spondyloepiphyseal dysplasia. Our study confirms phenotypic variability and adds to the genotypic spectrum of spondyloepiphyseal dysplasia.Peer reviewe

Performance Optimization Approach of Polymer Modified Asphalt Mixtures with PET and PE Wastes: A Safety Study for Utilizing Eco-Friendly Circular Economy-Based SDGs Concepts

Eco-friendly waste utilization helps in the development of sustainable infrastructures. Recently, researchers have focused on the production of road infrastructures using the circular economy concept of human safety. The objective of this study is to investigate and explore the utilization of optimum polymer waste content for the development of polymer-modified asphalt mixtures using response surface methodology (RSM). RSM based on Box–Behnken design (BBD) was employed to optimize experimental design and included three factors: X1, polymer type; X2, polymer contents; and X3, testing day. The optimized responses determined by the RSM were as follows: MS of 42.98 kN, MF of 5.08 mm, and MQ of 8.66 kN/mm, indicating a favorable and consistent precision in comparison with experimental values. Moreover, the Marshall characteristics of samples prepared with PE were quite improved compared to PET. In conclusion, the incorporation of such polymer wastes in road construction is a sustainable and cost-effective way of improving their engineering properties. This study will help in the development of sustainable road infrastructures supporting human safety and environmentally friendly practices