Aim This prospective study aimed to clinically correlate the various ocular findings with the neurological status in cases of closed head injury. Methods A total of 200 consecutive cases of closed head injury admitted to a major teaching hospital underwent a thorough ophthalmic assessment. The Glasgow coma scale (GCS) and the Revised trauma score (RTS) were applied to grade the severity of injury and assess the prognosis. Kendall's tau-b and Fisher's exact test were used in the analysis. Results The main causes of head injury were road traffic accidents 52.5% followed by assaults in 34%. Ocular involvement was found in 167(83.5%) cases. These included corneal and scleral tears in 2%, subconjunctival haemorrhage or ecchymosis in 46%, orbital fractures 12%, pupillary involvement 6.5%, papilloedema 5.5%, intraocular trauma 5.5%, proptosis 3%, lateral rectus palsy 2%, lacrimal gland prolapse 1%, and optic nerve trauma 0.5%. All 21 patients (10.5%) who died had eye involvement. In all, 150 cases (75%) with a RTS of 12 had a good prognosis. Of these 124 (82.6%) had ocular involvement of no neurological significance. Conclusions Although sophisticated imaging techniques are available to localize lesions, early ophthalmic assessment in correlation with the GCS aids in prognosticating outcomes. Pupillary involvement, papilloedema, and ocular motor paresis pointed to a more severe head injury. To our knowledge, this is the only prospective study recording ocular findings in the first few hours and attempting a correlation with the final outcome.

Background:Attempted suicide is a common clinical problem in a general hospital setting. It has a serious clinical and socio-economical impact too.Aims:To study the psychosocial, psychiatric, and personality profile of the first suicide attempters in a general hospital.Settings and Design:Cross-sectional, hospital-based, descriptive study.Materials and Methods:All the consecutive cases of first suicide attempt (n=100) treated in a general hospital were studied to know the clinical profile. Variables related to socio-demographic characteristics, family background, suicide characteristics, psychiatric morbidity, and comorbidity were analyzed. Risk-Rescue rating was applied to know the medical seriousness of the suicide attempt. Presumptive stressful life event scale was utilized to calculate life events score. Structured clinical interview (MINI Plus) and semi-structured clinical interview (IPDE) were used for axis-I and axis-II (personality) diagnoses. The results were analyzed using appropriate statistical measures.Results:Family history of psychiatric illnesses (31%) and suicide (11%) were noted. Insecticides and pesticides were the most common agents (71%) employed to attempt suicide. Interpersonal difficulties (46%) were the most frequent stressor. Overall medical seriousness of the suicide attempt was of moderate lethality. 93% of the suicide attempters had at least one axis-I and/or axis-II psychiatric disorder. Most common diagnostic categories were mood disorders, adjustment disorders, and substance-related disorders, with axis-I disorders (89%), personality disorders (52%), and comorbidity of psychiatric disorders (51.6%).Conclusion:Individuals who made first suicide attempt were young adults, had lower educational achievement; overall seriousness of the suicide attempt was of moderate lethality, high prevalence of psychiatric morbidity, personality disorders, and comorbidity, and had sought medical help from general practitioners.

Elevated lipid level is supposed to be one of the main risk factors of atherosclerosis and related cardiovascular diseases and stroke (and is connected to mortality and morbidity). Therefore, lipid lowering is one of the major approaches in prevention of coronary heart diseases and stroke. Though drugs of various categories acting through different mechanisms are available in the antihyperlipidemic therapy, there are still a few problems associated with the currently available lipid lowering drugs. Therefore, medicinal chemists worldwide are designing, synthesizing and evaluating a variety of new molecules for antihyperlipidemic activity to address these problems. One of the important approaches to this is identifying new drug targets for antihyperlipidemic activity. This review summarizes nineteen recently identified and currently being exploited targets for the ongoing research by researchers world over to discover novel leads as potential drugs for antihyperlipidemic therapy.

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