A Comparative Analysis of Psychiatric Profile, Depression and Body Dysmorphic Disorder in patients with Amputation and Post Stroke.

INTRODUCTION: Amputation is defined as the removal of extremities of body part by trauma or by Surgical procedure. Amputees may feel empty, and mutilated. Amputation due to Trauma is a catastrophic injury and causes major disability in most of the cases (Wald 2004)1. Loss of limb is associated with low self-esteem, body image Disturbance, social isolation and also a sense of stigmatization (William et al. 2004). In many conditions amputation is unavoidable. Irrespective of the aetiology, Amputation is considered as a mutilating surgery and it definitely affects the lives Of the patients (De Godoy et al. 2002). Limb amputation is a more commonly Occurring event in the present society. The loss of a limb distorts the individual’s body image leading to the thought of Not being a complete human being. The loss of the functions performed with that Limb renders him helpless for sometime. The amputee not only loses physical Functioning, he also loses hope and future aspirations, his plans and ambitions get Shattered. Thus, he loses not only a limb but also a part of his world and future. Most of them remain anxious and worried about their interpersonal relationship in The social, vocational, familial and marital milieu. Individuals having an overt Mental breakdown will need active psychiatric intervention whereas careful Psychiatric interview is necessary for the ones whose mental symptoms are not so Obvious. Limb loss is a major event that can severely impact the psychological health of the Individual concerned. Studies show that 20-60% of the amputees attending follow Up clinics are assessed to be clinically depressed. Individuals with traumatic Amputation irrespective of the age are likely to suffer from body image problems, But these findings are more common in younger individuals. The psychological Reactions to amputation are clearly diverse ranging from severe disability at one Extreme; and a determination to effectively resume a full and active life at other End. In adults the age at which an individual receives the amputation is an Important factor. Studies by Bradway JK et al (1984)2, Kohl SJ Et al (1984)3, Livneh H (1999)4, on the psycho-social adaptation to amputation has led to a Plethora of clinical and empirical findings. Kingdon D et al 1982 equated Amputation with loss of one’s perception of wholeness, while (Parkes CM 1976)5 With loss of spouse and (Block WE et al (1963)6 with symbolic castration & even Death. The individual’s response to a traumatic event is influenced by personality Traits, pre-morbid psychological state, gender, peri-traumatic dissociation, Prolonged disability of traumatic events, lack of social support and inadequate Coping strategies. Previous studies on amputation mainly focused on demographic Profile, coping skills and outcome; with there being a scarcity of literature on Prevalence of various specific psychiatric disorders in the post-amputation period. Most patients with a limb loss irrespective of whether due to traumatic injury or Surgical procedures go through a series of complex psychological reactions Reported by Cansever et al (2003)8. Most people try to cope with it, those who Don’t succeed develop psychiatric symptoms Frank et al (1984)7. Shukla et Al9 noted that psychological intervention in some form is needed in about 50% of All amputees, and Shukla et al9 reported depression to be the most common Psychological reaction following amputation. The three major problems faced by many amputees are anxiety, depression and Physical disability (Green 2007) Horgan & maclachlan (2004)10 found that anxiety is associated with depression, Low self esteem, poorer quality of life and higher level of general anxiety. Both Anxiety and depression are associated with higher disability as age increases. Body image is the combination of psychosocial adjustment and attitude of the Individual that are related to the function and appearance of one’s own body which Can be influenced by the individual and his environmental factors (Horgan & Maclachlan 2004)10. Each person has an idealized body image, which he uses for Measuring perceptions and concepts of his or her own body (Fishman, 1959)11. From another perspective, Flannery & Faria (1999) body image is viewed as a Dynamic, changing phenomenon occurring in a person and it is formed by the Constantly changing perceptions about his body. According to Newell (1991)13, Attractive people after amputation will receive less reinforcement from others Leading to low self-esteem and reduced positive self-image. Jacobsen et al (1997) Supports this stating i.e. Amputation leads to disfigurement which in turn leads to a Negative body image and greater loss of social acceptance. The relationship Between disability experience and stigma are interwoven and inter-dependent. The Reason for the amputee’s subjective perception of being unfit for the society Probably is that body image provides a sense of ‘’self’ ’and also affects the Persons thinking (Wald 2004)1. According to Kolb (1975)14, changes in body Image may cause series of psychological reactions. The psychiatric aspect of amputation has received scant interest in our country, in Spite of accidental injuries being common (Shukla et al., 1982)9. The commonest Psychiatric disorder seen in amputees is major depression. Randall et al. (1945)15 Have reported an incidence of 61 % in non-battle casualties, while Shukla et al. (1982)9 found depressive neurosis (40%) and psychiatric depression (22%) to be The leading psychiatric disorders in amputees; only 35% of the total sample in the Later study had nil psychiatric disorders. The paucity of literature in this field has Prompted us to study about amputation and its co morbid psychiatric conditions so That proper care & management for the patients can be planned. The present study Was undertaken with the aim of studying the psychiatric problems especially Anxiety, depression and Body Dysmorphic Disorder which may be associated with Disability or changed life circumstances in the immediate post-amputation period. A comparison was made with Stroke patients, as these patients often experience Physical and social handicaps similar to amputees. Depression is the most common mood disorder to follow stroke (Starkstein & Robinson, 1989), with major depression affecting around one quarter to one third Of patients (Hackett16).. Depression hampers functional recovery in a post stroke individual. In Diagnostic And statistical manual (DSM) IV Post Stroke Depression classified under “mood Disorder due to general medical condition (i.e. Stroke)” with the specific depressive Features, major depressive-like episodes, manic features or mixed features. Studies Describe that cerebral ischemia is associated with two types of depressive disorder. Incidence of major and minor depression is 25% and 30% respectively. Prevalence May vary over time with an apparent peak 3months after the stroke and Subsequently decline in prevalence at 1 year. Robinson and colleagues studies Showed a spontaneous remission in the natural course of major depression Occurring post stroke in the first to second year following stroke. However in few Cases depression may become chronic and persist for a longer period. While some propose that post stroke depression is due to stroke affecting the Neural circuits concerned with mood regulation (thereby supporting a primary Biological mechanism), others in the scientific community claim it to be due to the Ensuing psycho-social stressors occurring as a result of stroke. Though an Integrated bio- psycho- social model is warranted, most studies clearly suggest Biological mechanism to have an upper hand in the later post stroke period than in The immediate phase. In the same way Anxiety is also common in post stroke individuals with the Incidence rate being 20%, and it is most common in first three to four months after The stroke. Studies and literatures on post stroke anxiety are very few still remain in its Infancy. Studies have concentrated on socio-demographic variables, cognitive Functions and laterality as examined for post stroke depression. Many studies show That there is correlation between anxiety and right hemisphere lesions and also that Co-morbid post stroke anxiety and depression are associated with left hemisphere Lesions [Astrom, (1996)17]. Many studies have shown the relationship between post Stroke anxiety, age and gender. Women and younger individuals are more Vulnerable to develop post stroke anxiety (Morrison, walter et al 200069), while Another study reports no such relationship (Schultz et al).1

Discovery of unusual pulsations in the cool, evolved Am stars HD 98851 and HD 102480

The chemically peculiar (CP) stars HD 98851 and HD 102480 have been discovered to be unusual pulsators during the ``Naini Tal Cape Survey'' programme to search for pulsational variability in CP stars. Time series photometric and spectroscopic observations of these newly discovered stars are reported here. Fourier analyses of the time series photometry reveal that HD 98851 is pulsating mainly with frequencies 0.208 mHz and 0.103 mHz, and HD 102480 is pulsating with frequencies 0.107 mHz, 0.156 mHz and 0.198 mHz. The frequency identifications are all subject to 1 d$^{-1}$ cycle count ambiguities. We have matched the observed low resolution spectra of HD 98851 and HD 102480 in the range 3500-7400 \AA with theoretical synthetic spectra using Kurucz models with solar metallicity and a micro-turbulent velocity 2 km s$^{-1}$. These yield $T_{eff}=7000\pm250$ K, log $g=3.5 \pm 0.5$ for HD 98851 and $T_{eff} = 6750 \pm 250$ K, log $g = 3.0 \pm 0.5$ for HD 102480. We determined the equivalent H-line spectral class of these stars to be F1 IV and F3 III/IV, respectively. A comparison of the location of HD 98851 and HD 102480 in the HR diagram with theoretical stellar evolutionary tracks indicates that both stars are about 1-Gyr-old, 2-$M_{\odot}$ stars that lie towards the red edge of the $\delta$ Sct instability strip. We conclude that HD 98851 and HD 102480 are cool, evolved Am pulsators. The light curves of these pulsating stars have alternating high and low amplitudes, nearly harmonic (or sub-harmonic) period ratios, high pulsational overtones and Am spectral types. This is unusual for both Am and $\delta$ Sct pulsators, making these stars interesting objects.Comment: 9 pages, 6 Figures, Accepted for publication in MNRA

Dissociative attachment of electrons to vibronically excited SO<SUB>2</SUB>

Dissociative electron attachment (DEA) to vibronically excited SO2 in the Clements' band in the 288 to 298 nm region has been studied. The O&#8722; ion yield, to a first approximation, follows the photo absorption spectrum in this range indicating the DEA process to be independent of the vibrational levels in this band. This is in contrast to what is generally observed for vibrational level dependence from the electronic ground state. The current measurements also do not show any qualitative change in the dissociative attachment process due to change of symmetry as one moves from the peaks to the valleys of the Clements band

Multiparameter segmented scan multichannel scaling system

A PC based data acquisition cum control system has been developed using a general purpose interface bus (GPIB/IEEE-488/IEC-625) plug in card and GPIB interfaceable NIM electronics for use in experiments on absorption spectroscopy studies of molecules using laser-induced fluorescence (LIF), resonance multiphoton ionization (REMPI), electron impact ionization and dissociative attachment from the ground state as well as from excited states, to name a few examples. Unlike commercially available multichannel scalers, this system can handle several parameters as the acquisition parameter (e.g., dye laser) is scanned over the desired wavelength in preselected segments saving precious data acquisition time. This system has been tested on laser excited dissociative electron attachment experiments

Insights from Ethylene Glycol Oxidation toward Reduction in the Overpotential Using Sonochemically Derived Orthorhombic CoV₂O₆·2H₂O Sheetlike Structures

The use of sustainable and green hydrogen fuel has received significant attention in recent years, and their production via water splitting technology is sternly hindered by the thermodynamically unfavorable anodic reaction. Herein, orthorhombic CoV2O6·2H2O nanosheets (NSs) were obtained by a facile sonochemical method (328 K, 1 h), and their performance toward the oxygen evolution reaction (OER) is reported for the first time. The hierarchical sheetlike structures render the significant electrochemical active surface area and lowest charge transfer resistance in the alkaline medium (KOH) constituting ethylene glycol (EG). The CoV2O6·2H2O NSs modified nickel foam (CoV2O6·2H2O NSs/NF) unveils an overpotential of 340, 360, and 400 mV at the high current densities of 100, 200, and 500 mA cm–2, respectively, at the optimized content of EG (∼10 mmol). The electrolyzer functioning with CoV2O6·2H2O NSs/NF and KOH solution of EG can reduce electrical energy consumption by ∼11.5% and thereby suppress the hydrogen production cost accompanied by the generation of value-added products. The present investigation spotlights the combined effects of low-temperature synthesis, hierarchical structures, and presence of EG to promote the OER kinetics