Aim and Objectives: Although inclusive education of children with intellectual disability is currently an accepted practice, it is often challenged by negative attitude of schoolteachers. We undertook two surveillance studies aimed atStudy A - identifying knowledge and teachers’ attitudes towards children with intellectual disability and practices of inclusive education in a semi-urban school of South India.Study B -Determining the effect of educational intervention towards attitudes on inclusive education.Method: Knowledge, Attitude and Practice surveillance questionnaires (KAP and ATPD) were given to ninety-six consenting schoolteachers in Study A and twenty schoolteachers in Study B and analyzed.Results: In Study A, the overall attitude mean indicated a favorable attitude towards the children with intellectual disability. The mean overall attitude score was 77.1 (SD: 9.58), with a normal distribution. Forty to fifty percent were aware of intellectual disability and attributed them to biological causes. Ninety-two percent agreed on the need for education and stepwise training for a child with an intellectual disability. In real-life practice, results of classroom management were inaccurate. In Study B, knowledge, attitudes and practices towards inclusive education improved with educational intervention with a positive change of 7.19% on the ATDP scale.Conclusion: These findings suggest a generally positive attitude towards intellectual disability and inclusive education. Comprehensive training programs improve knowledge and attitudes towards inclusive education.
Letters to the Editor to underlie a possible coexistence of both primary and secondary (organic) forms of delusional parasitosis. 14 Therefore, a proper detailed neurological and psychological workup is necessary in all such cases.
Declaration of patient consentThe authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Background: Clozapine has well-documented inter-ethnic variations in pharmacokinetics. There is a paucity of data about clozapine use and associated adverse events such as seizures, obsessive compulsive symptoms, neutropenia, and agranulocytosis, from India. Methods: This retrospective cohort study followed up 228 patients initiated on clozapine in a tertiary care referral center in India for an average of 10 years. We calculated incidence rates of new-onset seizures, new-onset obsessive compulsive symptoms, agranulocytosis, and neutropenia. We collected data on doses of clozapine used and serum assays and calculated concentration-to-dose (C/D) ratios. We also collected relevant clinical details about clozapine-induced seizures. Results: In the sample, 16.8% had new-onset seizures, 12.3% had new-onset OC symptoms, 2.7% had neutropenia, and 0.9% had agranulocytosis. The mean C/D ratio was 2.09 (SD = 1.8). Almost half (46.3%) of available serum assays were in the supra-therapeutic range. Seizures were associated with a higher clozapine dose at one year (OR = 1.003; 95%CI = 1.000–1.006; P value = 0.045) and the presence of positive psychotic symptoms at one year (OR = 4.214; 95%CI = 1.894–9.373; P < 0.001). Conclusion: Compared to existing literature, Indians have a higher rate of clozapine- related seizures and need lower doses to reach therapeutic serum levels.
Dhat syndrome is a common semen-loss related physical and psychological distress usually reported by young males. The treatment mainly centres around nonpharmacological strategies such as psychoeducation. Most of the patients present as outpatients to alternative medicine or nonpsychiatry branches and treatment is usually not delivered. Some of the reasons may include perceived need for longer duration of sessions with the patient, available literature with complex psychiatric jargon and barriers to treatment due to stigma attached to psychiatry. This article presents a two session therapy proposal for Dhat syndrome that could be useful as a brief intervention over tele-consultations, and in consultation liaison clinics by nonpsychiatrists as well.
A 48-year-old man who is a known case of bipolar disorder was maintaining well on a combination of carbamazepine and quetiapine for 3 years until he developed fever, severe leucopenia and lymphadenopathy, along with significant loss of weight and appetite. A thorough investigation revealed Kikuchi’s disease as a likely histological diagnosis. Carbamazepine was discontinued and quetiapine was titrated for the management of psychiatric symptoms. The patient gradually made good recovery following discontinuation of carbamazepine and the diagnosis of drug-induced myelosuppression was retained. Clinicians need to be aware of the adverse effects of medications being used for long-term prophylaxis and other possible conditions that may change the course of drug effects.
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