Sanjiba Dutta

Role of oxidative stress in ethanol induced germ cell apoptosis — An experimental study in rats

The study was undertaken to evaluate the possible involvement of oxidative stress in the pathogenesis of ethanol induced testicular atrophy in rats. Adult male rats were orally administered ethanol at a dose of 1.6 g/kg body weight/day for four weeks. Twenty-four hours after the last treatment the rats were sacrificed using anesthetic ether. Testes were removed and weighed. Apoptosis was studied by using the Feulgen reaction on 5 μ thin paraffin sections of testis. Testicular homogenate was prepared and centrifuged. The supernatant was used for the estimation of extent of lipid peroxidation and antioxidant defense status. There was significant reduction in body weight: and in testicular weight and diameter in ethanol treated rats. Extent of germ cell apoptosis was significantly high in ethanol treated rats. Ethanol treated rats showed significantly high tissue TBARS level and glutathione S-transferase activity; and low tissue ascorbic acid, reduced glutathione, superoxide dismutase, catalase, glutathione peroxidase and glutathione reductase activities. Chronic ethanol administration resulted in high oxidative stress in the testes either due to increased extent of lipid peroxidation or due to decreased antioxidant defenses, and thereby induces germ cell apoptosis leading to testicular atrophy.

A profile of substance abusers using the emergency services in a tertiary care hospital in Sikkim.

Background: Sikkim, a state in Northeast India with a population of more than 500,000 and inhabited by indigenous population of Lepchas, Bhutias and Nepalis, lies in the foothills of the Himalayas sharing borders with Tibet, Nepal and Bhutan. Northeast India is a major source of injection drug users (IDUs) and associated HIV/AIDS. Alcohol use is traditionally prevalent in Sikkim and recently, IDU behaviour has also been reported, although systematic information on epidemiology and treatment availability of substance abuse in Sikkim is not available. Aim: To study the sociodemographic and drug use profile of substance abusers using the emergency services in a tertiary care hospital. Methods: A retrospective chart review was used. Patients with history of current drug use seeking emergency services for any medical or surgical consequence incident to substance abuse from July 2000 to June 2005 (60 months) were included in the study. Data were generated from emergency case register, hospital records and case sheets. SPSS 10.0 was used for data analysis. Results: Out of 54 patients seeking emergency services with substance abuse (1.16% of all psychiatric consultations), alcohol abusers were 77.8% and other opioid abusers 14.8%. Prevalence of IDU was 16.66%. Common opioids abused were dextrpropoxyphene and pentazocine, both analgesics. A significant number of patients (46.3%) had a history of >20 days/month frequency of abuse. Median of duration of abuse with all drugs was 12 years, while that with IDU population was 3 years. Alcohol withdrawal was the commonest cause (57.4%) of reporting to the emergency. Psychiatric comorbidity was found among 7.4%. Commonest medications used were chlordiazepoxide and clonidine, for withdrawal and naltrexone, for substitution. No standardized treatment protocol for substitution treatment was available. Conclusions: This is an initial attempt to study the sociodemographic and drug use profile of substance abusers in Sikkim. Demographic and socioeconomic characteristics of substance abusers seeking emergency services are not significantly different from treatment-seeking substance abusers in other parts of India. IDU behaviour has been detected and low median duration of use suggests an emerging problem and need for urgent harm reduction. Alcohol withdrawal was the commonest cause of seeking emergency services, which is related to high prevalence of alcohol abuse in Sikkim. No standardized substitution treatment is available for substance abusers, which may lead to higher rates of relapse.

Experimental therapeutic intervention with alpha tocopherol in ethanol induced testicular injuries in rats.

Infertility is well-established harmful effect in chronic alcoholism and so far, there is no effective treatment for this condition. The study was conducted to determine the effects of alpha tocopherol on ethanol induced testicular injuries in male albino rats of Wistar strain. Five groups (n=6) of animals were used. Group I served as control. Group II received daily 1.6g ethanol/kg body weight/day for 4 weeks orally. Group III received 1.6g ethanol+80mg alpha tocopherol/kg body weight/day for four weeks orally. Group IV received 1.6g ethanol/kg body weight for/day 4 weeks and followed by 80mg alpha tocopherol/kg body weight/day for four weeks orally. Group V received 1.6g ethanol/kg body weight/day orally for 4 weeks, followed by 4 weeks abstinence. Twently-four hours after the last treatment the rats were sacrificed using anesthetic ether. Testes were removed and used for the estimation of extent of lipid peroxidation and tissue levels of antioxidants and steroidogenic enzymes. Alpha tocopherol treatment increased the activities of testicularΔ5, 3β-HSD. Moreover, the treatment was also associated with significant decrease in testicular oxidative stress. Ethanol-induced oxidative stress and decreased steroidogenesis can be reversed by treatment with alpha tocopherol.

Treatment of suicidal depression with ketamine in rapid cycling bipolar disorder

Despite rapid advances in understanding the neurobiology of bipolar disorders, rapid cycling states continue to be the Achilles heel for psychiatrists. This is due to their elusive presentation, poor treatment response, frequent recurrences, high suicidality and overall poor prognosis (Wu and Dunner, 1993; Coryell et al., 2003; Nierenberg et al., 2010). The management of rapid cyclers, especially in the acute depressive phase with antidepressants remains a challenge, due to antidepressant induced mood switches (hypomanic, manic and mixed) and fear of worsening the overall course of illness (Ghaemi et al., 2003). The scenario becomes more complicated in the setting of severe depression with suicidality, where electroconvulsive therapy is the only recommended treatment (Srisurapanont et al., 1995). However, nonavailability, prohibitive costs, negative public perceptions and stigma limit the utility of electroconvulsive therapy (ECT) in clinical settings (Rose et al., 2003). Ketamine, a widely used anaesthetic agent and N-methyl-D-aspartate receptor (NMDA) antagonist offers a way out of this conundrum with its rapid antidepressant and antisuicidal effects with better efficacy and tolerability. We present a case of a 19-yearold female with rapid cycling bipolar depression admitted after a suicide attempt, successfully treated with ketamine when she failed to improve with standard treatment.

Media exposure to earthquake-related content in its aftermath as a risk factor for acute stress disorder

Background: Introduced in DSM-IV, acute stress disorder (ASD) is a psychiatric diagnosis characterised by severe anxiety, dissociation, intrusive thoughts, and other symptoms occurring within one month of experiencing a traumatic event. Research indicates that ASD may place individuals at increased risk of developing chronic posttraumatic stress disorder (PTSD). There is growing evidence that increased media exposure to traumatic events is a risk factor for the development of posttraumatic symptomatology. Aims: We hypothesised that in the aftermath of a natural disaster, excessive exposure to television and Internet coverage might be a risk factor for ASD. Methods: Using a cross-sectional study design in a sample of 300 medical and nursing college students exposed to an earthquake, ASD was assessed with the Stanford Acute Stress Disorder Questionnaire (SARSQ) and media exposure by an interview to capture exposure to earthquake-related news via television and Internet. Results: Thirty six students developed ASD (12%). The odds of greater exposure to earthquake-related content via television was 1.93 times more (95% CI 1.02-3.66, p-value=0.042) and Internet 2.28 times more (95% CI 1.18-4.41, p-value=0.015) in students who developed ASD than those who did not. Conclusions related media content via television and Internet in its aftermath is associated with a

Socioeconomic characteristics of alcohol and other substance users, seeking treatment in Sikkim, North East India

Objectives: The present study was conducted to generate information for better understanding of socioeconomic and CAGE characteristics of alcohol and other substance users who were undergoing treatment in Sikkim. Subjects and Methods: Socioeconomic and CAGE questionnaire was administered to alcohol and other substance abusers of Sikkim (n = 241) who were undergoing treatment in different treatment centers of Sikkim. Information was collected on printed instrument after taking participants consent and data was statistically analyzed. Results: Male participants (93.8%) outnumbered female (6.2%). Majority of the sample were either in the school dropout group or school completed (36.1%) group. Most of the samples were occupationally unemployed, urban residents, Nepali by ethnicity, single, and Hindu (48.5%) by religion. Minimum age for starting of alcohol and drug was 5 years and 7 years respectively. Knowledge about AIDS and its transmission was satisfactory. All the four CAGE characteristics were present in majority of samples. Conclusions: Climate, geographical location, wide and easy availability of alcohol in Sikkim make this state vulnerable for alcohol abuse. Alcohol drinking among parents, sibling and friends found to be important risk factor. Outreach to the community for better acceptability of treatment is an important area to fill the gap of treatment demand and treatment supply.

Descriptive epidemiology and high risk behavior of male prescription opioid abusers: Cross-sectional study from Sikkim, North East India

Background: Sikkim is emerging as an important area for prescription opioid abuse with frequent news of seizures and arrests due to possession of prescription opioids. However, till date there is a little information on descriptive epidemiology and high risk behavior of prescription opioid abusers from Sikkim. Aims: The aim was to describe demographic (age, sex, religion, marital status, community, occupation, etc.); socioeconomic (income, education, family information etc.); and high risk behavior (e.g., injection sharing, visit to commercial sex workers [CSWs], homosexuality etc.) among treatment-seeking prescription opioid abusers in Sikkim. Materials and Methods: Epidemiological data were collected by administering predevised questionnaires from n = 223 prescription opioid abusers (main problem prescription opioids) reporting for treatment at five different drug abuse treatment centers across Sikkim. Results: The mean age of prescription opioid abusers in Sikkim was 27 years; all were male, of Nepalese ethnicity and single/never married, school dropout and/or illiterate, earning < Rs. 10,000/month with most spending almost Rs. 5000 a month on prescription opioids. Most (57.4%) prescription opioid abusers belonged to the urban community. Commonly abused prescription opioids were dextropropoxyphene and codeine. Injection sharing was more in urban areas whereas syringe exchange was observed equally among rural and urban prescription opioid abusers. Among urban injectors visits to CSWs, and multiple sex partners were also common in spite of knowledge about AIDS. Limited condom use was observed among rural respondents. Incidences of arrests, public intoxication, and violence under the influence of prescription opioids were also reported. Conclusion: Both the rural and urban areas of Sikkim show increasing rates of prescription opioid abuse among males. It is more prevalent among school dropouts and unemployed youth. Trends of injection drug use, unsafe injection, high risk behavior have also been observed.