Subdural Hematoma: An Adverse Event of Electroconvulsive Therapy—Case Report and Literature Review

Electroconvulsive therapy (ECT) is commonly used in the management of medication nonresponsive depressive disorder, with proven efficacy in psychiatric practice since many decades. A rare complication of intracranial bleed following this therapeutic procedure has been reported in sporadic case reports in the English literature. We report a case of such a complication in a 42-year-old male, a known case of nonorganic medication nonresponsive depressive disorder for the last two years who required ECT application. Presenting symptoms included altered mental state, urinary incontinence, and repeated episodes of vomiting; following ECT procedure with magnetic resonance imaging (MRI) of the brain suggestive of bilateral acute subdural hematoma. Despite the view that it may be used in neurological conditions without raised intracranial tension, it will be worthwhile to be vigilant during post-ECT recovery for any emergent complications

Psychological autopsy and necropsy of an unusual case of suicide by intravenous toluene

Toluene (methylbenzene; volatile hydrocarbon) is an industrial solvent that causes major injury to the lungs; the organ being the first capillary bed encountered. We report an unusual case of suicide by a 24-year-old male, paramedical professional, with fatal outcome within 16 h of intentional, intravenous self-administration of toluene, with clinical presentation of acute respiratory distress syndrome. Psychological autopsy revealed severe depressive disorder and solvent (inhalant) abuse, with marital disharmony as the precipitating stressor for suicide. Necropsy revealed diffuse congestion of internal organs like lungs and liver, epicardial petechial hemorrhages, and gastric hemorrhages. Treatment of toluene poisoning includes supportive care as no specific antidote is available. Early and aggressive management may be conducive to a favorable outcome with minimal residual pulmonary sequelae. Relevant literature of toluene poisoning was identified via PubMed, PubChem, ToxNet, Hazardous Substances Data Bank (HSDB), Embase, and PsycINFO. To our knowledge, this is the first case of suicide by intravenous administration of toluene in the literature

Intensity and density of stressful life events in first suicide attempters with psychiatric morbidity and comorbidity: A case–control study

Background: Stressful life events (LEs) have been pivotal to suicidal behavior in vulnerable individuals, although its quantum and clustering have remained unclear. This study aimed to estimate and compare the quantum and clustering of LEs across three time periods, three suicide intentionality–lethality categories, and three diagnostic groups in survivors of first suicide attempt (SoFSA). Materials and Methods: One hundred SoFSA were compared to 100 age- and sex-matched controls for LEs across psychiatric and/or personality comorbidity. Presumptive Stressful LE Scale, Risk-Rescue Rating Scale, Hamilton Depression- and Anxiety-Rating Scales, and structured and semi-structured clinical interviews were administered for comprehensive mental health evaluation. Results: SoFSA with age ≥30 years, male gender, schooling 3 within 1 year or >10 lifetimes) and ambiguous LE (≥1 within 1 year or > 3 lifetimes) posing risk for psychiatric morbidity and medically serious suicidal behavior (especially, if lifetime total LE > 10). SoFSA with comorbid psychiatric and personality disorders experience higher intensity and density of LEs than either disorder alone, across all time periods

Qualitative Dermatoglyphics In Idiopathic Epilepsy

Genetic aetiology has been proposed for both idiopathic epilepsy and dermatoglyphics. Hence, the present study has been undertaken to find out the existence of any correlation between dermatoglyphics and idiopathic epilepsy. Material consisted of 100 patients (58 males and 42 females) and 100 controls (52 males and 48 females). Patient′s age ranged from 5 to 40 years and controls were between 18 and 25 years. Dermatoglyphics were obtained by painting method. Qualitative parameters observed were percentage frequency of fingerprint patterns (loops, whorls and arches,), patterns in hypothenar area/ interdigital are and flexion creases (Simian crease, sydney line). On comparison with controls, in males, with hands combined, loops (52.24%) and arches (7.93%) were increased and whorls (39.83%) were decreased (p<0.05). In females, with hands combined, arches (13.1%) and whorls (36.43%) were increased and loops (50.48%) were decreased (p< 0.03). Significant differences have not been observed for the patterns in hypothenar area /interdigital area and flexion creases. These dermatoglyphics features could be used as additional markers to evaluate patients of epilepsy

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Not AvailableNot AvailableVietnam Academy of Agricultural Sciences (VAAS), Vietnam and conducted at ICAR-Indian Institute of Rice Research, Hyderabad, Indi