Usman Hameed

Disruptive mood dysregulation disorder: current insights

Disruptive mood dysregulation disorder (DMDD) was introduced as a new diagnostic entity under the category of depressive disorders in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). It was included in DSM-5 primarily to address concerns about the misdiagnosis and consequent overtreatment of bipolar disorder in children and adolescents. DMDD does provide a home for a large percentage of referred children with severe persistent irritability that did not fit well into any DSM, Fourth Edition (DSM-IV) diagnostic category. However, it has been a controversial addition to the DSM-5 due to lack of published validity studies, leading to questions about its validity as a distinct disorder. In this article, the authors discuss the diagnostic criteria, assessment, epidemiology, criticism of the diagnosis, and pathophysiology, as well as treatment and future directions for DMDD. They also review the literature on severe mood dysregulation, as described by the National Institute of Mental Health, as the scientific support for DMDD is based primarily on studies of severe mood dysregulation.

Mother, Father, and Teacher Agreement on Disruptive Mood Dysregulation Disorder Symptoms in Children with Psychiatric Disorders

Objective: Disruptive Mood Dysregulation Disorder (DMDD) was established as a new DSM-5 disorder despite little published research, and there are no studies investigating agreement between informants on the presence of DMDD symptoms. Methods: Mothers, fathers, and teachers rated DMDD symptoms (irritable-angry mood and temper outbursts) in 768 children with psychiatric disorders ages 6-16. Results: Mother and father ratings were similar, but parent-teacher agreement was poor. Mothers and fathers identified a substantially higher percentage of children with DMDD symptoms (30% and 25%) than did teachers (12%). Conclusion: Our findings are consistent with previous studies demonstrating that parents perceive more externalizing and internalizing symptoms in their children than do teachers. This has implications for interpreting mother, father, and teacher report, which is particularly important for disorders like DMDD that have DSM-5 cross-setting diagnostic requirements. Given our findings, it seems prudent to obtain ratings from both parents and teachers and recognize that parents are likely to report greater DMDD symptoms than teachers.

Invasion of previously unreported dicot plant hosts by chickpea chlorotic dwarf virus in Pakistan

Members of the genus, Mastrevirus (family, Gemniviridae) transmitted by leafhopper vectors infect monocotyledonous or dicotyledonous plants, and infection of agricultural crops results in reduced yield and quality. During 2012, a study was undertaken in the Punjab and Sindh Provinces in Pakistan to determine the identity of suspect geminiviruses associated with symptomatic cotton and vegetable plants exhibiting foliar enations, leaf curling, mosaic, and stunting reminiscent of geminivirus infection. To determine suspect geminiviral identity, fifteen apparently full-length mastrevirus genome (~ 2600 base pairs) were amplified by rolling-circle amplification, digested, cloned into the plasmid vector, pGEM-3Zf+, and sequenced from cucumber, Gossypium arboreum L., Gossypium hirsutum L., okra and tomato. The mastrevirus full-length genome sequences obtained shared their highest pairwise nucleotide sequence identity, at 97.3–98.6%, with previously reported C and L strains of Chickpea chlorotic dwarf virus (CpCDV) from chickpea and cotton in Pakistan, respectively. However, CpCDV has not been previously identified from cucumber, G. arboreum, okra, or tomato. The association of CpCDV with four previously unreported plant hosts suggests that CpCDV strains C and strain L have a broader than expected host range, and therefore may be found to negatively affect vegetable crops, particularly, when grown in proximity to cotton.

Irritability in Pediatric Patients: Normal or Not?

The goal of this article is to describe the concept of irritability in children and youth, which has been revisited in the DSM-5. Traditionally, this behavior has been more commonly associated with mood disorders, which may account for the rising incidence of bipolar disorder diagnosis and overuse of mood-stabilizing medications in pediatric patients. While not predictive of mania, persistent nonepisodic irritability, if undetected, may escalate to violent behavior with potentially serious outcomes. It is therefore important to educate clinicians about how to accurately assess irritability in pediatric patients.

Infectivity of okra enation leaf curl virus and the role of its V2 protein in pathogenicity

Cotton crop has been severely affected by multiple begomoviruses in Pakistan and India. In our previous study, we found okra enation leaf curl virus (OELCuV), cotton leaf curl Multan betasatellite (CLCuMuB) and cotton leaf curl Multan alphasatellite (CLCuMuA) infecting cotton in Pakistan. The current study was designed to investigate the infectivity of OELCuV and its ability to trans-replicate non-cognate CLCuMuB. Agro-infectious clones containing the partial tandem repeats of OELCuV and CLCuMuB were constructed and the infectivity assays were carried out through Agrobacterium mediated transformation in the model host species Nicotiana benthamiana under controlled conditions. The results showed that in the inoculated plants OELCuV alone can cause downward curling and yellowing of leaves with thickened veins. However, when co-inoculated with the non-cognate CLCuMuB it could functionally trans-replicate CLCuMuB resulting in a more severe phenotype. The expression of Pre-coat/V2 protein in the N. benthamiana plants through the potato virus X (PVX) system caused localized cell death after severe leaf curling in the infiltrated leaves. The tissue tropism of the virus was associated with the systemic development of a hypersensitive response (HR), which ultimately lead to the plant death. The results indicated the involvement of V2 protein in the pathogenicity of OELCuV and its ability to trigger the host defense machinery. This study also demonstrated the ability of OELCuV to trans-replicate CLCuMuB resulting in typical leaf curl disease symptoms in N. benthamiana.

A Qualitative Study to Assess How Primary Care Versus Psychiatric Providers Evaluate and Treat Pediatric Patients With Irritability

Objective To determine how primary care versus specialist practitioners assess and treat school-aged children with irritability. Methods Seventeen providers from family medicine, pediatrics, and psychiatry participated in in-depth interviews from June to August 2016 about the process they use to evaluate irritability. Data on demographic traits and measures of confidence were also collected. Results Primary care (family medicine and pediatrics) participants expressed frustration over the lack of time and specialized knowledge they had to accurately assess children with irritability, even though they were often the first clinician consulted when problems arose. There were clear and sometimes contradictory differences between how practitioners with a general versus specialized practice assessed mental health status in the clinic setting. Input on treatment approaches revealed that medication prescription was more common by primary care participants, and therapy was preferred by the psychiatry participants. Conclusions Overall, family medicine and pediatric practitioners were significantly less confident in their ability to evaluate mental health status, while child and adolescent psychiatry participants were supportive of having more initial triage and possible treatment occur at the primary care level, suggesting a need for more training about childhood irritability in the primary care setting.

First Detection of Hollyhock leaf curl virus in Malvastrum coromandelianum in Pakistan

Weeds act as reservoirs of begomoviruses, leading to emergence of novel viruses by recombination that may hamper crop production (Mubin et al. 2010). Due to the importance of weed hosts in the epidemiology and evolution of begomoviruses, we evaluated, a wide spread weed, Malvastrum coromandelianum exhibiting leaf curl symptoms, reminiscent of those caused by begomoviruses (Geminiviridae) in Lahore, Pakistan, during 2012. Three symptomatic leaf samples were collected from different fields infested with the whitefly Bemisia tabaci (Genn.). Total DNA was extracted from each sample using a CTAB method (Doyle 1991). DNA extracts were used as template for polymerase chain reaction (PCR) and rolling circle amplification (RCA) using the TempliPhi TM DNA Amplification Kit (GE Healthcare, USA). Amplified RCA products were digested, with EcoRI, producing a ~ 2.8 kb fragment from each sample. All three fragments were separately cloned into the respective restriction site of pGEM®-3Zf+ (Promega, Madison, WI). Associat...

Construction of an Infectious Chimeric Geminivirus by Molecular Cloning Based on Coinfection and Recombination

In the evolution of geminiviruses, genetic recombination plays a key role in ecological, biochemical and evolutionary processes. They evolve as results of prehistoric inter-genus recombination whereas intra-genus recombination of geminiviruses leads to the emergence of agriculturally important plant pathogens. Geminiviruses are transmitted by leafhoppers, treehoppers and whiteflies. An isolate of Chickpea chlorotic dwarf virus (CpCDV), a monopartite dicot infecting mastrevirus is transmitted by leafhopper. In contrast, Cotton leaf curl burewala virus (CLCuBuV), a monopartite begomovirus, was acquired and transmissible by whitefly to various host plants. In this study, we remove the coat protein (CP) gene of CpCDV by PCR and replaced with that of PCR amplified CLCuBuV-CP. The resultant infectious clone of chimeric CpCDV is produced later named mastrebegomo chimera (pGII0000MBC). By using Agroinfiltration technique (Agrobacterium-mediated inoculation) the chimeric clone along with wild type Clone CpCDV and CLCuBuV are injected on tomato (Lycopersicon esculentum Mill.) and tobacco (Nicotiana benthamiana Domin.) seedlings and get symptoms after 21dpi (days post inoculation). Later, the symptoms appeared on plants were compared with healthy plants. This study elaborates our awareness about the genetic recombination and coexistence of mastreviruses with begomovirus globally including Pakistan and will provide the basic information regarding their management.

Transmission Specificity and Coinfection of Mastrevirus with Begomovirus

Coat protein (CP) of geminivirus is not requisite for replication of viral DNA yet it is multifunctional and have crucial role in virus transmission by insect vector, systemic infection and virion development. Although in geminivirus, systemic infection rely both on function of CP and specific host-geminivirus-vector interaction but in bipartite begomoviruses CP is dispensable for systemic infection and progression of symptoms. Nevertheless its role in spreading systemic infection cannot be neglected in monopartite viruses’ viz. mastrevirus, begomoviruses and curtoviruses, therefore any alteration in CP gene upshot in a new epidemiological adaptation hence worth to study. So the study was designed to present a better picture to view regarding coinfection within different Geminiviruses belonging to mastrevirus and begomovirus particularly due to vector inspecificity consequently resulted in revolutionary recombination events, which ultimately yield new viruses, have more drastic affects on crops. Moreover, co-evolution of both genera may open new horizons in understanding the complexity of cotton leaf curl disease and then to chalk out strategies to counter this emerging threat in Pakistan.