A high total plasma homocysteine concentration is an independent risk factor for atherosclerotic complications of end-stage renal disease. Such patients may benefit from higher doses of B vitamins than those currently recommended.

The present study supports set-shifting and inhibitory control and proposes visuoconstructive abilities and delayed verbal recall as potential endophenotypes for OCD.

Background:A fixed-drug eruption (FDE) is a unique cutaneous adverse drug effect in the form of recurrent lesions at the same site after re-exposure to the offending agent.Aim:The aim of the study was to identify changes in trends in fixed drug eruptions with regard to causative drug or patient risk factors.Methods:Cases of FDEs encountered between March 2014 to May 2017 during routine pharmacovigilance activities were analyzed.Results:FDEs made up 8.4% of total adverse drug reactions and 11.1% of cutaneous reactions. Majority of the patients were adults between 18 and 45 years old. The average lag period between drug intake and appearance of FDE was 2.04 days. Commonly affected sites were extremities, lips, head and neck, and genitalia. Number of FDE lesions varied from 1 to > 6, with nearly half the patients (46%) presenting with a single lesion. Antimicrobials (80.6%) and nonsteroidal anti-inflammatory drugs (20.8%) were most frequent drugs implicated. Route of administration was oral for all causative drugs. History of an FDE was positive in 26 (50.2%) of the cases. Majority of the patients (21 out of 25 or 84%) whose lesions appeared within minutes to hours of suspected drug intake had a history of FDE. Furthermore, 66.7% of patients with multiple lesions had a history of FDE while only 34.8% of patients with a single lesion had such a history.Conclusion:FDEs are common cutaneous reactions with antimicrobials and anti-inflammatory agents, with increased likelihood of extensive and multiple lesions in patients with a history of FDE.

Background: The Pharmacovigilance Program of India recommends the use of the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) scale, while many clinicians prefer the Naranjo algorithm for its simplicity. In the present study, we assessed agreement between the two widely used causality assessment scales, that is, the WHO-UMC criteria and the Naranjo algorithm. Materials and Methods: In this study, 842 individual case safety reports were randomly selected from 1000 spontaneously reported forms submitted to the ADR Monitoring Center at a tertiary healthcare Institute in Central India between 2016 and 2018. Two well-trained independent groups performed the causality assessment. One group performed a causality assessment of the 842 ADRs using the WHO-UMC criteria and the other group performed the same using the Naranjo algorithm. The agreement between two ADR causality scales was assessed using the weighted kappa (κ) test. Results: Cohen's kappa coefficient (κ) statistical test was applied between the two scales (WHO-UMC scale and Naranjo algorithm) to find out the agreement between these two scales. “No” agreement was found between the two scales {Kappa statistic with 95% confidence interval = 0.048 ( P < 0.001)}. Conclusion: There was no agreement found between the WHO-UMC criteria and the Naranjo algorithm in our study.

Intrapulmonary aberrant needles are rare in clinical practice. Most common cause till date is the intra-thoracic migration of pins and wires commonly used in treatment of fractures and dislocations of upper extremity. Some cases of traumatic intra-thoracic insertion of needles have also been reported. We report a patient of empyema thoracis due to unusual habit of self-insertion of needles in his body because of some myth. The patient was successfully managed by video-assisted thoracoscopic surgery.

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Background:Abnormal body sensations are reported frequently by schizophrenic patients. Cenesthesias are infrequently recognized and diagnosis of cenesthopathic schizophrenia is rarely made. There are very few studies regarding the same.Aims and Objectives:To assess cenesthesias and different aspects of body image aberration and their relationship with psychopathology in patients with paranoid schizophrenia.Materials and Methods:Seventy patients of paranoid schizophrenia meeting the inclusion and exclusion criteria were assessed with Positive and Negative Symptom Scale(PANSS) for psychopathology, Bonn Scale for Assessment of Basic Symptoms/Category D ‘Cenesthesias’ (BSABS), Image-Marking Procedure(IMP), alteration of body size and body cathexis. Assessments were made at baseline and after two weeks and assessed with SPSS 12.0.Results:The most commonly endorsed items on BSABS were depersonalization, motor weakness, abnormal pain, numbness and stiffness. Patients underestimated lower extremities and feelings of body size change which was positively correlated with PANSS-scores and improved on reassessment. Cenesthesias were positively correlated with disturbances of body concept and were present at onset in 40% and change form in 75.7%.Conclusions:Cenesthesias and body image aberrations are common in paranoid schizophrenia. They are present from onset in few, change form and improve on treatment. Cenesthesias and disturbances of body concept are correlated and body size is associated with other psychopathology.

In low and middle-income countries, access to cancer diagnosis and treatment is suboptimal. Further, compliance to cancer treatment is a major issue due to various reasons including financial barriers, lack of family support and fear of treatment. This article discusses the determinants of treatment completion in cancer patients of a government-run hospital, in a rural part of Punjab in India. The Sangrur hospital-based cancer registry data for the year 2018 have been used. We have registered 2,969 cancer cases, out of which 2,528 (85%) cases were eligible for the analysis. Of the total 2,528 cases, 1,362 (54%) cases completed the cancer directed treatment and 1,166 (46%) did not. The data have been collected from the electronic medical record (EMR) department and entered into CanReg5 software. The bivariate and multivariate binary logistic regression analysis was performed to see the effect of variables on the treatment completion. The results indicate that the elderly age group (>60 years) (odds ratio (OR): 0.52, (95% confidence interval (CI): 0.31–0.86)), distance from hospital (OR: 0.67, (95% CI: 0.50–0.89)) and access to government health schemes (OR: 0.13, (95% CI: 0.10–0.19)] have direct correlation with the treatment completion. The educated patients (OR: 1.49, (95% CI: 1.13–1.96)) and patients who received curative treatment (OR: 2.7, (95% CI: 1.88–3.88)) have shown 58% and 84% compliance to treatment completion, respectively. The other variables like the clinical extent of disease, religion, gender and income do not have any significant effect on the treatment completion. Determinants like age (young), education, distance from the hospital, curative treatment and availability of government health schemes for financial support have shown positive effects on treatment completion. These factors have to be considered by the cancer hospitals, health departments and policymakers while planning for cancer care or control in India.