Clinical profile of child and adolescent patients attending a mental hospital OPD

Background: Psychiatric morbidity profile of children and adolescents is very different from that of adults. These problems are rising but largely remain unreported. Very few studies have been carried out in this specialty of psychiatry.Methods: In this retrospective file review study, all child and adolescent patients attending the general psychiatry out-patient between January-August 2014 in a city of central India. Semi-structured socio-demographic and clinical profile collection performa and international classification of diseases-10 (ICD-10) were used as tool and statistical analysis was done by using SPSS 16.Results: The results showed that among total 2544 children presented during study period, 175 children (6.8%) had psychiatric morbidity. Most of them were in the age group of 11-16 years, from middle income group, illiterate, Hindu by religion and residing in urban locality. No significant sexual preference was found regarding distribution of the disorders. Mental retardation was commonest (n=112; 64%), without (n=42; 24%) and with co-morbidities (epilepsy n=42; 24%, behavioural disturbance n= 28; 16%) found to be the most prevalent disorder followed by epilepsy (7%), ADHD (5.7%), schizophrenia and other psychosis (5.7%), depression (4%) and autism 1.1% and then others.Conclusions: Mental and psychiatric services for children lag behind those for adults in developing countries. Also, a community based study can be a better study design in future

Ephedrine: direct, indirect or mixed acting sympathomimetic?

Ephedrine is the principal alkaloid that is responsible for the physiological effects of herb ephedra. This herb is found in literature of India and China since ancient times because of its effectiveness as an anti-asthmatic. Ephedrine is classified as sympathomimetic drug. Despite extensive work in this field, the mechanism of action of ephedrine remains controversial. Initial studies classified ephedrine as indirectly acting sympathomimetic, subsequent studies showed ephedrine acts by mixed action by releasing noradrenaline and by acting directly on receptors. However, few recent studies on rat have shown predominant direct action on adrenergic receptors. Hence, there is marked controversy existing whether ephedrine is directly, indirectly or mixed acting drug

Determinants of nutritional outcome among beneficiaries of Nutrition Rehabilitation Centre

Background: Under Mission Balam Sukham, children of 6 months to 5 years having severe acute malnutrition (SAM) along with complications are managed at Nutrition Rehabilitation Centre (NRC). They are admitted for 14 days with the provision of a nutritional diet and medicines. Objectives: To explore determinants of nutritional outcome of SAM children admitted at NRC Methods: A prospective cohort study was conducted comprising 63 children aged 6 months to 5 years having SAM along with complications admitted at NRC of New Civil Hospital, Surat (NCHS) for 10 months. Results: The majority of participants were boys (54%), 12-23 months of age (50.8%), and Grade III socioeconomic class (39.6%). The duration of stay ranged from 2-36 days. The average duration of stay was 12.78 + 6.49 days; 14.26 ± 5.99 days for boys and 11.10 + 6.73 for girls. 18.8% stayed at NRC for 14 days. The average weight gain was 5.46 g/kg/day. A significant improvement in weight was seen in boys (t=2.20, p<0.05), working mothers (t=2.44, p<0.01), exclusively breastfed children (t=3.62, p<0.01) of 6-11 months, full-term children of 12-23 months (t=4.0, p<0.05). The children of 12-23 months (t=2.90, p<0.01) and boys (t=2.15, p<0.05) showed significant improvement in underweight (WAZ). Wasting improved significantly in age below 36 months (p<0.05). 20.6% could achieve the target weight. Conclusion: NRC is an effective life-saving modality for malnutrition but its outcome is associated with factors like boys, exclusive breastfeeding, and full-term

RESEARCH AND REVIEWS: JOURNAL OF PHARMACOLOGY AND TOXICOLOGICAL STUDIES Exploration of Mechanism of Action of Ephedrine on Rat Blood Pressure

ABSTRACT The aim of the study is to study mechanism of action (direct, indirect or mixed) of ephedrine on rat blood pressure by using agents affecting synthesis, storage and release of noradrenaline. 30 male Wistar albino rats divided into 6 groups (n=5). A: ephedrine control, B: tyramine control, C: reserpine + metyrosine + ephedrine, D: reserpine + metyrosine + tyramine, E: desipramine + ephedrine, F: desipramine + tyramine. In A and B: blood pressure responses of ephedrine and tyramine were taken for control, C and D: reserpine was injected 18 hrs. before and metyrosine was injected 2 hrs before taking responses of ephedrine or tyramine respectively. For E and F: desipramine w a s given 10 min. before taking response of ephedrine or tyramine respectively. Rat mean blood pressure was measured by using student's physiograph. Reserpine and metyrosine, inhibits the vesicular uptake and synthesis of noradrenaline respectively decrease the pressor responses of tyramine significantly (p=0.000) but not of ephedrine (p=0.893).Prior administration of desipramine which inhibits axonal uptake of noradrenaline also significantly decreases the effect of tyramine (p=0.000) but do not affect the effect of ephedrine significantly (p=0.893).Study concludes the pressor effect of ephedrine is not mediated by release of noradrenaline from neurons, indicating that ephedrine act directly on adrenergic receptors

Assessment of ophthalmic morbidities in school children (6-14 years) in rural community

Background: School children are affected by various eye disorders like refractive errors, squint, Vitamin A deficiency and eye infections. Most of the ophthalmic morbidities originate in childhood and if they are not diagnosed early they may result in severe disabilities and affects children’s performance in the school. Objectives: To find out prevalence of various ophthalmic morbidities in the school children (6 – 14 years) and to study the socio demographic profile of school children (6 – 14 years) related to ophthalmic morbidities. Materials and Methods: A cross-sectional study was carried out on 500 school children in schools of Aliabada village, Jamnagar district. A Pretested semi-structured proforma was used to collect the information related to study and students were screened for eye disorders by visual acuity testing using snellen’s chart and colour blindness was checked by using Ishihara’s chart and torch light examination. Visual acuity was assessed. Data entry and analysis was done using Microsoft excel 2007 and Epi info. Results: The prevalence of ophthalmic morbidity was found to be 33%. Among the various ophthalmic morbidities, major were refractive errors i.e. 25.6% followed by Vit A deficiency in 8.6% cases and followed by squint 2.4% and various others. The study also found that social class and age were associated with ophthalmic morbidity. It is found statistically significant. Conclusions: Refractive error was the most common ophthalmic morbidity in the school children followed by Vit A deficiency, squint and various others. In the study we found that social class and age were significantly associated with ophthalmic morbidity

The prevalence of psychiatric illness among cannabis users

This study was conducted in a tertiary hospital's psychiatry unit. Legal edible cannabis (bhang) users for more than a year who attended the OPD and IPD during the study period and met the inclusion criteria (age 18 to 60, no history of physical or psychiatric illness) were included in the investigation with their informed consent. 171 patients were recruited after being assured of the study's confidentiality. Special tests evaluated cannabis dependence and psychiatric conditions. (1) CUDIT-R and (2) DSM-5 updated psychiatric morbidity criteria. Population demographics. Patients with CUDs ranged in age from 18 to 60. The majority were age 21 to 30 (49.7%), followed by 31 to 40 (29.8%), 41 to 50 (12.9%), 20 (5.8%), and 51 to 60. (1.8 percent). Male (93.1%) and female patients were roughly evenly split (7.0 percent). 103 of 171 study patients were married (60.2%), compared to 66 unmarried patients (38.6%) who used bhang more often. 1,2% were divorced. The study considered patients' education levels. Middle schoolers had the highest percentage (22.2%), followed by illiterates and graduates (17.5%), high school (12.9%), and postgraduates (0.6 percent). Lower middle class (40.9%) had the most participants, and upper class had the fewest (2.3 percent)

Impact of Front Line Demonstration on Yield and Economics of Hybrid Rice Varieties (JRH-5 and JRH-19)

The objective of the present investigation was to assess the performance of two hybrid rice varieties namely, JRH-5 and JRH-19 under irrigated ecosystem by conducting Frontline demonstrations (FLDs) in three consecutive kharif seasons of the year 2016, 2017, and 2018, in the farmer's fields located in the agro climatic zone of the Chhattisgarh plains. The FLDs were carried out using scientific package and practices of rice. The yield and economic data of the plots compared with the existing farmer practices and variety-MTU-1010 revealed that the FLDs with hybrid rice varieties JRH-19 and JRH-5 performed better. With the enhanced production technologies in FLDs with JRH-5 and JRH-19 and with only an additional input cost of Rs. 2742/ha, the mean grain yield increased by 28.21% over current farmer practices. The average extension gap (12.27 q/ha) and average IBCR (6.14) were high enough to encourage farmers to use the introduced rice production technology with the hybrids JRH-5 and JRH-19

Development, validation and application of single molecule molecular inversion probe based novel integrated genetic screening method for 29 common lysosomal storage disorders in India

Abstract Background Current clinical diagnosis pathway for lysosomal storage disorders (LSDs) involves sequential biochemical enzymatic tests followed by DNA sequencing, which is iterative, has low diagnostic yield and is costly due to overlapping clinical presentations. Here, we describe a novel low-cost and high-throughput sequencing assay using single-molecule molecular inversion probes (smMIPs) to screen for causative single nucleotide variants (SNVs) and copy number variants (CNVs) in genes associated with 29 common LSDs in India. Results 903 smMIPs were designed to target exon and exon–intron boundaries of targeted genes (n = 23; 53.7 kb of the human genome) and were equimolarly pooled to create a sequencing library. After extensive validation in a cohort of 50 patients, we screened 300 patients with either biochemical diagnosis (n = 187) or clinical suspicion (n = 113) of LSDs. A diagnostic yield of 83.4% was observed in patients with prior biochemical diagnosis of LSD. Furthermore, diagnostic yield of 73.9% (n = 54/73) was observed in patients with high clinical suspicion of LSD in contrast with 2.4% (n = 1/40) in patients with low clinical suspicion of LSD. In addition to detecting SNVs, the assay could detect single and multi-exon copy number variants with high confidence. Critically, Niemann-Pick disease type C and neuronal ceroid lipofuscinosis-6 diseases for which biochemical testing is unavailable, could be diagnosed using our assay. Lastly, we observed a non-inferior performance of the assay in DNA extracted from dried blood spots in comparison with whole blood. Conclusion We developed a flexible and scalable assay to reliably detect genetic causes of 29 common LSDs in India. The assay consolidates the detection of multiple variant types in multiple sample types while having improved diagnostic yield at same or lower cost compared to current clinical paradigm