Background: Depression is most common psychiatric disorder in patients with epilepsy and it is the significant cause of morbidity. 1 Upto 50-60 percent of patients with epilepsy may develop psychiatric complications, particularly depression, anxiety, and psychotic disorders. 2 There is growing evidence of biological link between depression and epilepsy, and significant factors involved are the biological amines and gamma amino butyric acid (GABA) 3 along with other neurobiological and psychosocial factors. This study assess the symptoms and severity of psychiatric comorbidities in patients diagnosed with epilepsy. Methods and Findings: This study was conducted on patients attending psychiatric outpatient epilepsy clinic in psychiatry department, government medical college, Amritsar. A total of 40 patients were studied to find out the prevalence and severity of depression by using self applicable questionnaire, Beck depression inventory (BDI), 4 and MINI, in patients who are diagnosed with epilepsy by clinical interview and examination by senior psychiatrist consultant. In the results of our study 50% patients had psychiatric co-morbidities.40% had depressive disorder. Depression is found to be more among females in our study. 22.5 % were females and 17.5% were males. Among depressed patients, 22.5% had severe depression. Prevalence of moderate depression was 15% , and 2.5 % had borderline clinical depression, 5% had psychosis, and 5% had substance dependence. Conclusion: Diagnosing psychiatric co-morbidities can be difficult in patients with epilepsy. The treatment of both epilepsy and depression need for close collaboration. Patient taking antiepileptic medication may have symptoms of depression as a result of their treatment. Sadly, data from drug trials are often helpful. The antiepileptic medications most closely associated with acute depression on initiation of treatment are vigabatrin, phenobarbitone, and topiramate. Depression with topiramate may be due to abrupt cessation of seizures or drug toxicity. Patients starting tiagabine may develop symptoms of agitation, withdrawal, and mood disturbance suggestive of depression;. Thus good awareness and recognition of psychiatric conditions can help a long way in improving the quality of care of patients with epilepsy.
Physical fitness declines during medical residency training. This effect is most notable in residents with higher levels of fitness at the start of medical education. Further studies are necessary to evaluate for a similar decline among civilian residents.
BACKGROUNDCaregivers of patients suffering from mental illness report burden in different areas including effects on family functioning, psychological problems, financial problems and health.The aim of the study is to determine the sociodemographic profile and caregiver burden among caregivers of persons with schizophrenia and to study the effect of patients' psychopathology on caregiver burden scale. MATERIALS AND METHODSThe present study was conducted in the Psychiatry Department, Government Medical College, Amritsar. A sample size of 34 was taken who were primary caregivers (preferably parents or spouse) of schizophrenia patients diagnosed using ICD10. Measures included caregiver's demographic variables and caregiver's burden using the Zarit burden interview and PANSS scale in patients. Statistical Analysis-Data was analysed using SPSS software version 21. RESULTSThe mean age of the caregiver was 42 SD (12.16) years. The majority of the caregivers were parents, married and employed. The mean average score of the responses to Zarit burden interview was (SD=59.52 ± 20.92). Majority of the caregivers experienced severe burden (52.9%), 9 (26.4%) caregivers had reported moderate burden and 6 (17.6%) had reported mild burden. The mean duration of illness was 6.89 (SD=5.03) years. The level of burden experienced was significantly associated with total PANSS score, negative symptoms, positive symptoms, general psychopathology score and duration of schizophrenia illness (p=0.00). CONCLUSIONThere is need for psychological assistance and social support for the vulnerable caregivers to help them reduce the burden levels and employ positive coping strategies.
Background:The epidemic of substance abuse in the present generation has assumed alarming dimensions in the state of Punjab. The success story of Punjab's economy has seemingly come to an end. District Amritsar being close to border is deeply influenced. Maximum cases were registered under the NDPS Act in the year 2012 in Punjab, with the nationally highest drug-related crime rate of 51.6%, against the national average of 2.8% . The present study aims to identify the emerging trends and prevalence of drug abuse among the patients enrolling at Swami Vivekananda drug de-addiction and treatment centre, Amritsar.Methods and findings: In the year 2014 and 2015, consecutive patients on outpatient basis from the month of January 2014 till august 2015 were enrolled. Urine toxicology was done for the drugs abused with rapid immune-chromatographic assay kits available in the centre. A total of 10,568 patients were screened for urine toxicology. Out of 10,568 enrolled patients 9815 patients were found positive for morphine and out of 9815 patients addicted to morphine 5785(54.74%) of patients were abusing heroin in one or other form, which was concluded from the personal interview and general physical examination for scar marks of injectable drug users of heroin. Rest of the substances abused includes other opioids, alcohol, sedatives, cannabis, cocaine, amphetamines and tobacco. The dose of heroin used by the patients varied from person to person but on average most of patients abuse heroin from 500mg up to 2grams on daily basis either in the form of snorting, sniffing or as injectable. Conclusion:High numbers of heroin abusers indicate its high addiction potential. Due to its high cost majority of addicts are not able to procure it and get involved in illegal activities. This publication helps to provide the figure of current alarming rise of heroin abuse among the study population. Immediate steps like demand reduction via proper education of youth and proper treatment of addicts with individual or group counselling are required curtailing the current drug menace in Punjab. Increasing trends of heroin abuse among population is shattering the youth of Punjab. Such a drastic deviation towards heroin abuse can be attributed to its high addiction potential, easy availability, unemployment and socio-occupational pressure faced by youth of Punjab. Awareness regarding the side effects of drugs and their addictive potential should be focused and campaigns in the rural population regarding the preventive measures and treatment options available for addiction should be encouraged.
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