A series of four clinical cases suggests that catatonic disorder due to a chronic neurologic condition does not respond as reliably to electroconvulsive therapy (ECT) as functional catatonia does. Cases reported in the medical literature show a similar pattern. Presumably this form of catatonia is intrinsically less responsive to ECT, although the possibility remains that a more intense quality of treatment and prophylaxis is needed. Conversely, catatonia resistant to ECT suggests an underlying medical condition.
PURPOSE:To evaluate the visual outcome after laser photocoagulation in diabetic retinopathy. METHODS: One eye each of 100 patients were enrolled in our prospective, randomized, clinical trial study with proliferative diabetic retinopathy/ maculopathy were assessed for visual outcome after treating them with laser photocoagulation. RESULTS: We observed that 62 (62%) patients showed improvement by 1 or more lines on Snell's chart, 26 (26%) deteriorated from baseline visual acuity. The overall mean improved was 0.56 lines on Snell's chart that is clinically significant. CONCLUSION: The results of present collection of hundred patients show a favourable influence of photocoagulation on the improvement and preservation of baseline visual acuity. Timely focal and grid laser photocoagulation helps in improving and stabilizing the visual acuity in patients with diabetic macular edema.
revision of psychiatric classification in general. The book comprises 26 chapters by mostly American contributors and is divided into three parts. The first focuses on gender and examines differences in susceptibility, phenomenology, prognosis and the effects of both biological and sociocultural variables on the presentation of psychiatric disorders in women and men. Arguments for and against the inclusion of separate diagnostic categories for illnesses presenting in women and men are considered. The second section, on early childhood, presents a compelling case for an extensive overhaul of the way psychiatric illnesses in children are currently defined and diagnosed. It recommends a far greater emphasis on developmental considerations, using disorders of mood, anxiety, attachment, feeding and post-traumatic stress disorder as examples. The final section on older people highlights the importance of organic brain pathology in the genesis of a variety of psychiatric conditions, most notably depression, and exposes the inadequacies of current diagnostic systems' abilities to accommodate the impact of physical illness on psychopathology in this population. Throughout the book the various authors lay emphasis on the changing nature of psychiatric classification and its tendency to become more aetiopathologically, rather than descriptively, based, though there is a pragmatic acceptance that given the imminence of DSM-V's publication it will still be largely categorical in nature, like its predecessors. This is not to say that descriptive psychopathology has had its day. Far from it. For, as one author points out, the precise elucidation of phenotype becomes even more important as the ability to determine aetiology becomes more accurate. This book will be of value both to specialists in the fields of women's mental health, child psychiatry and old age psychiatry, for whom it provides a useful summary of current research, and to non-specialists who are interested in psychiatric classification and the direction in which it is heading. On the evidence of this book, this direction seems to be an encouraging one.
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