Vssr Ryali

Cognitive and emotional effects of renal transplantation

Background: Recent studies have shown a high prevalence of depression and cognitive changes in patients with end-stage renal disease (ERSD) and renal transplant recipients. There are few data available on the cognitive and emotional changes in patients undergoing renal transplantation in India. Aim: To evaluate the changes in cognitive profile and depression in renal transplant recipients. Methods: Thirty consecutive patients undergoing renal transplantation were evaluated 1 month before and 3 months after successful renal transplant with Beck Depression Inventory (BDI), Weschler Adult Performance Intelligence Scale (WAPIS), Luria Nebraska Neuropsychological battery (LNNB) and Life satisfaction scale. Results: Our study revealed an 86.7% prevalence of depression in ESRD patients as compared to 56.7% in post renal transplant patients. Analysis of neurocognitive functions on LNNB did not reveal any significant impairment. Furthermore, analysis of the Life satisfaction scale revealed most of the patients scored high satisfaction levels despite the stress of their disease. Results on WAPIS brought out significant improvement in intelligence quotient (IQ) after renal transplantation. Conclusion: Successful renal transplant is associated with improvement in depression, IQ and life satisfaction.

Does androgyny have psychoprotective attributes? A cross-sectional community-based study.

Background: In our society, adherence to feminine traits by the female gender had been culturally promoted and socially desired. A few studies, however, entertained the possibility that healthy men and women have some common attributes in their gender orientation. Androgyny and masculinity were found related to positive mental health. Materials and Methods: A cross-sectional study was conducted to assess the level of masculinity and femininity and its relationship with the perception of stress and various psychopathology including anxiety and depression. Results: Masculinity scores of the participants negatively correlated while femininity scores positively correlated with the scores on General Health Questionnaire, Becks Depressive Inventory, Becks Anxiety Inventory, and Perceived Stress Scale. Conclusion: Androgyny is psychoprotective. Empowerment-oriented psychological approaches aimed to encourage psychological androgyny, and masculinity might be therapeutic.

Serum Serotonin Abnormality in Depression.

BACKGROUND Serotonin plays an important role in treatment of depression. We evaluated the clinical correlates of plasma serotonin levels in depressed patients before and after treatment. METHODS Study sample comprised of 40 patients diagnosed on ICD-10 diagnostic criteria, and an equal number of healthy matched controls. Subjects were evaluated on Becks Depression Inventory (BDI) and Suicide Ideation Scale (SIS), before and after the treatment. Blood samples were collected from all the cases and controls before starting the antidepressant medication with selective serotonin reuptake inhibitors (SSRIs). Serum serotonin levels were measured before and after treatment. RESULT Significant differences in scores before and after the intervention on BDI, SIS and serotonin levels of cases and controls (p<.000) were noted. Correlation between the serum serotonin levels before and after the treatment, and between the rating scales did not reveal significant association (p > 0.05). Patients with suicidal intentions had lower levels of serotonin. The scores changed after intervention. CONCLUSION Treatment with SSRIs had shown significant changes in clinical conditions. However these changes did not relate significantly with serum serotonin levels.

Understanding sexuality among Indian urban school adolescents

Context: Adolescence is a very exciting phase of life fraught with many challenges like sexuality. Understanding them is important in helping the adolescents grow up healthily. Aims: To ascertain the attitudes and knowledge about sexuality among school-going adolescents. Settings and Design: Students in two urban schools of an Indian city from class IX to XII were administered a self-reporting questionnaire on matters related to sexuality. Materials and Methods: Requisite ethical clearances were taken as also the consent of the parents and students before administration of the questionnaire. The authors clarified doubts to adolescents. Statistical analysis: Statistical package for social sciences. Results: The incidence of having sexual contact was 30.08% for boys and 17.18% for girls. 6.31% boys and 1.31% girls reported having had experienced sexual intercourse. Friends constituted the main sexual partners for both boys and girls. Sexual abuse had been reported by both girls and boys. These and other findings are discussed in the article. Conclusions: Adolescent school students are involved in sexual activity, but lack adequate knowledge in this regard. Students, teachers, and parents need to understand various aspects of sexuality to be able to help adolescents’ healthy sexual development.

The hippocampus and executive functions in depression.

Background: The relationship between depression, hippocampus (HC), and executive dysfunctions seems complex and has been the focus of research. Recent evidence indicates a possible role of HC in executive dysfunction seen in depression. No such studies on Indian population have been done. Aim: To look for changes in HC and executive functions in depression. Settings and Design: A cross-sectional analytical controlled study. Sample size 50 (controls 50). Materials and Methods: Hippocampal volume and executive dysfunction was measured using structural magnetic resonance imaging (MRI) and Wisconsin Card Sorting Test (WCST), respectively. Findings on these two parameters were compared between depressives and healthy matched controls as well as between first episode (FE) and recurrent depressives and across the severity of depression (mild, moderate, and severe). Statistical Analysis: Statistical Package for Social Sciences (SPSS) version 17 was used for analysis. Normally distributed continuous variables were analyzed with independent t-tests. Analysis of variance (ANOVA) was used for multiple comparisons. Categorical data were compared with χ2 or Fisher′s exact test. Clinical correlations were conducted using Pearson correlations. Result: Depressed patients had a smaller left (Lt) hippocampal volume as well as poor performance on several measures of executive functions. Smaller hippocampal volume was found even in FE. Those who had a past burden of depressive illness had an even smaller hippocampal volume. No direct correlation was found between the HC volume and cognitive dysfunction. Conclusion: Depressive illness appears to be toxic to the HC. The relationship between HC and executive dysfunction in depression may be indirect through its functional connections.

Stress in the Indian Armed Forces: how true and what to do?

Stress among the Indian Armed Forces has been a topic of discussion in the lay press, among civil society, and the political classes over the last decade, often leading to considerable concern for the military leadership. Alleged increases in the rates of suicide, fratricide, stress related physical disorders, psychiatric illnesses, and substance use have been quoted in the lay press and these figures were viewed with concern by the law makers. Military responses that some of these figures could be exaggerated or misrepresented were viewed with scepticism by the general public. Does the available epidemiological data support the contention of a stress epidemic in the Armed Forces? Various social measures to deal with stress of soldiering have been implemented and efforts to improve the psychological health of troops have been undertaken in recent times. How effective have these measures been? In this background it is proposed to review the available literature on the current concepts of stress, evaluation methodologies, epidemiological trends of stress related disorders among soldiers, stress manifestations and the availed coping strategies.

Tobacco-alcohol amblyopia: A rare complication of prolonged alcohol abuse

Tobacco-alcohol amblyopia is rare, however, extremely disabling complication seen in patient with alcohol dependence syndrome, which if not addressed properly and at the right time may lead to persisting deficits. We here report a patient of alcohol-dependence syndrome who presented with significant diminution of vision bilaterally in the background of excess alcohol consumption.

Emotional intelligence scale for medical students

Background: Emotional Intelligence has been associated with positive outcome process in varied professions. There is paucity of Indian literature on the subject; especially involving medical undergraduates; and presently there is no scale available to measure the same in the Indian scenario. Objective: To develop a scale to measure Emotional Intelligence among medical undergraduates. Materials and Methods: Four domains of Emotional intelligence were selected, viz. Self-Awareness, Self-Management, Social-Awareness & Social-Skills and these were included for the purpose of domains of the scale. On the basis of focused group discussions and in-depth deliberations with experts, undergraduate and postgraduate medical students a pool of 50 items was generated. The items were reduced to 27 based on expert consensus and on the basis of frequency of endorsement by expert reviews. It was followed by a pilot study of 50 undergraduates. This completed the preparation of the preliminary draft based on content analysis. The questionnaire was then administered in 480 students and the data was analyzed by appropriate statistical methods. For the purpose of concurrent validity, emotional intelligence scale developed by Dr. Ekta was used. Results: The Cronbachs Alpha for Internal Consistency Reliability was 0.68. The EIS had a significant correlation with social awareness domain of Emotional Intelligence Test (EIT) establishing Concurrent Validity. Conclusion: Emotional Intelligence Scale for medical undergraduates was constructed. Reliability and concurrent validity were also established for the same.

Cognitive reserve: The warehouse within.

Dementia is characterized by progressive and mostly irreversible memory loss. Other neuropsychiatric disorders affect cognition in varying manner. Are all people affected with such disorders manifest clinically in similar manner or does our brain have some reserve to tolerate insults? Relevant researches over the last two decades were scrutinized to understand brain reserve, appreciate the conceptual change in the same over years, and how the same can be improved for better cognition and memory over the year. Literature evidence suggests that the cognitive reserve (CR) is a dynamic and functional concept. There is adequate evidence to suggest that enriched environment and various other measures are likely to improve CR across all age. Improving CR may delay or reverse the effects of aging or brain pathology.

Reduction in Drug Prescription using Biofeedback Relaxation in Neurotic and Psychosomatic Disorders

BACKGROUND There is a paucity of Indian studies on effectiveness of biofeedback in reducing drug prescription in neurotic and stress related disorders. METHODS Study sample of generalized anxiety disorders (GAD), mixed anxiety depression, obssessive compulsive disorder (OCD), dissociative disorder and headache were assigned to three groups of 28, 23 and 27 patients respectively. Group 1 were subjected to drug therapy, Group 2 to biofeedback and Group 3 to drugs and biofeedback for 12 weeks. All were followed up at six months and one year. RESULT At the end of one year, in Group 1, 60.71 % had mild and 17.86 % had moderate anxiety levels, while 21.43% required no further follow up. In Group 2, 39.13 % showed mild and 43.48 % had moderate anxiety levels, while 17.39 % required no follow up. In Group 3, 22.22% had mild and 11.13% had moderate levels of anxiety, while 66.66% required no further treatment. CONCLUSIONS Biofeedback relaxation with pharmacotherapy is useful in select group of neurotic and psychosomatic cases.