Seasonality and affective disorders: a report from North India

Case records of the patients with major affective disorders (ICD-10 criteria), seen over a 5 year period in a busy clinic in North India were examined for Seasonal Affective Disorder (SAD) as per DSM-III-R criteria. In addition, seasonality of episodes of all affective disorders was also studied. Around 5.67% of the cases (n=44) retrospectively met the DSM-III-R criteria of SAD and predominant pattern was that of summer depression (n=18). There was also a consistent pattern of seasonal mania either in conjunction with seasonal depression (n=18) or in form of seasonal recurrent mania (n=11). None of the cases of depression showed any atypical vegetative features. In cases not meeting criteria for SAD (n=731), there was a trend for peaks for depressive episodes in winter followed by a smaller peak in summer months while manic episodes had peaks towards rainy and winter months. As compared to seasonal patterns of affective disorders in temperate zones, there was a general trend for opposite patterns of seasonality in SAD as well as in non-SAD. The findings are discussed in context of the climatic conditions of North India.     

Contractile behavior of rat myocardium after reversal of hypertensive hypertrophy

The effects of renovascular hypertension and its reversal on the contractile performance of papillary muscles from rats has been examined. Hypertension of 10 wk duration caused a 48% increase in heart weight and significant prolongations of isometric time to peak tension (TPT), time to half relaxation, and time to peak shortening (TPS). A significant depression in the velocity of shortening was observed in the 10-wk group. However, muscles from hypertensive rats were still able to maintain normal levels of peak isometric developed tension and peak shortening; this may be due to the observed prolongation of TPT and TPS, respectively. In addition, calcium-activated actomyosin ATPase activity was depressed in hearts of hypertensive animals. Reversal of hypertension was studied at 20 wk after the onset of hypertension (10 wk of hypertension followed by 10 wk of normotension). Contractile and biochemical alterations observed in hypertensive animals were reversed in rats undergoing this regime. Thus reversal of a gradually applied pressure overload resulted in the regression of mechanical and biochemical abnormalities associated with the pressure overload myocardial hypertrophy.     

Effect of Preoperative Modifiable Psychological and Behavioural Factors on Early Outcome Following Total Knee Arthroplasty in an Indian Population

BackgroundNon-surgical factors have been found to have significant impact on outcome following Total Knee Arthroplasty (TKA). The study was conducted to know the independent effect of each of the four interacting psychological factors: anxiety, depression, pain catastrophizing and kinesiophobia on early outcome following TKA in an Indian population.Materials and Methods104 consecutive patients undergoing TKA were included in the study and followed up at 6 weeks, 6 months and one year. Preoperatively, Hospital Anxiety and Depression Scale was used to diagnose and quantify anxiety and depression, pain catastrophizing and kinesiophobia were assessed using Pain Catastrophizing Scale and Tampa Scale for Kinesiophobia, respectively. Outcome was assessed on the basis of Knee Society Score and Knee Injury and Osteoarthritis Outcome Score. Regression analysis was done to know independent effect of each factor on outcome scores.ResultsNine (8.7%) patients were found to have undiagnosed psychopathology. The patients with psychopathologies were found to have significantly worse knee outcome scores on follow-up, although the rate of improvement in knee symptoms and function was not significantly different from those without psychopathology. The degree of Anxiety correlated with worse knee pain and stiffness up to 6 months while it correlated with poor knee function for a longer duration. The degree of depression and pain catastrophizing correlated with worse knee pain, stiffness and function at all visits while kinesiophobia didn’t show correlation independent other factors.ConclusionPsychopathology was found to be associated poor knee outcome scores with degree of preoperative depression and pain catastrophizing as significant independent predictors as poor outcome, whereas the effect of degree of anxiety on knee pain and stiffness was found to wane over time. Kinesiophobia didn’t show any independent correlation.Supplementary InformationThe online version of this article (10.1007/s43465-020-00325-x) contains supplementary material, which is available to authorized users.     

Pseudoaneurysm of the superficial femoral artery following accidental trauma: result of treatment by percutaneous stent-graft placement

Accidental trauma frequently involves the extremities, and can extend to involve their blood supply, causing exsanguinating hemorrhage and pseudoaneurysm in the involved blood vessel. This is traditionally managed by surgical repair. We report a case in which control of life-threatening hemorrhage and exclusion of a large, post-traumatic pseudoaneurysm in the superficial femoral artery was performed by a commercially available stent-graft, without complication. This treatment method may be a safe and effective alternative to surgery in selected patients. Received: 10 February 1998; Revision received: 31 March 1998; Accepted: 20 April 1998     

Neuromuscular transmission failure due to common krait (Bungarus caeruleus) envenomation

Neurophysiological studies were performed in 12 patients with neuromuscular paralysis due to envenomation by the common krait (Bungarus caeruleus). All patients presented with an acute, reversible, oculofaciobulbar paresis. In addition, 7 patients had weakness of the limb muscles and 4 required assisted mechanical ventilation. Neurophysiological abnormalities included: (1) a reduction in the amplitude of the median-elicited compound muscle action potential (CMAP) in 4 patients; and (2) a decremental response (>10%) to 3-Hz repetitive nerve stimulation (RNS) in 4 patients. With 1 exception, these abnormalities were noted only in clinically weak muscles. The administration of edrophonium to 6 patients produced an insignificant increase in CMAP amplitudes as well as partial (not significant) improvement in the decremental response to 3-Hz RNS. Neurophysiological studies were performed in 2 patients before and after the administration of 20 mL of polyvalent antivenom. A decrease in amplitude of the median-elicited CMAP amplitude occurred after the administration of antivenom. In 1 patient, administered 100 mL of antivenom, the median-elicited CMAP amplitude increased and the decrement to 3-Hz RNS decreased. Neurophysiological studies can provide useful information regarding the nature, severity, and therapy of the neuroparalytic syndrome of krait envenomation.     

Stochastic modeling of consumer preferences for health care institutions

This paper proposes a stochastic procedure for modeling consumer preferences via LOGIT analysis. First, a simple, non-technical exposition of the use of a stochastic approach in health care marketing is presented. Second, a study illustrating the application of the LOGIT model in assessing consumer preferences for hospitals is given. The paper concludes with several implications of the proposed approach.     

Microbial flora of women with chronic cervicitis

The present study comprised 50 patients of chronic cervicitis attending gynaecological clinic of Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh. The aim of the study was to isolate some of the common sexually transmitted disease (STD) pathogens in chronic cervicitis. Cervical swabs were taken from the patients. The swabs were analysed by various microbiological techniques. Most (78%) of the patients harboured infection, no growth of any organism was found in 22% cases. Ureaplasma urealyticum was the predominant organism isolated in 56% of cases. It was isolated singly in 38% of cases. Various other organisms isolated singly were Chlamydia trachomatis in 2% of cases, candida species in 2% of cases, Staphylococcus epidemidis in 4% of cases, lactobacillus in 4% of cases, and Staphylococcus aureus in 2% of cases. Multiple organisms were isolated in 26% of cases.