No abstract

Self-injurious behavior (SIB) or self-mutilating behavior (SMB) is rare but can occur in temporal lobe epilepsy. Such a behavior during seizures is not usually recalled by patient. Here is a case with self mutilating behavior in left temporal lobe epilepsy, presented because of its rare manifestation and diagnostic dilemma. A 19 year old unmarried Muslim student presented to emergency with SMB, guilty rumination and a persecutory delusion. The patient was intermittently confused about place and time. In subsequent assessments, he was found harboring death wishes and suicidal ideation. He transiently had auditory hallucination and thought broadcasting. He episodically tried to harm himself by severely biting only his left ring finger. It was difficult to influence him during such episodes. EEG revealed left temporal lobe seizure. Diagnosis of 'Epilepsy and Organic Psychosis' was made. The patient responded well to Antiepileptic and Antipsychotic medications. Keywords: seizure, self injurious behavior, suicide, temporal epilepsy.

No abstract

IntroductionThe distribution pattern and knowledge structure of psychiatric genomics were surveyed based on literature dealing with both psychiatry and genomics/ genetics. Coword analysis and bibliographic coupling of the records retrieved from Scopus and PubMed for 2016-2020 revealed the subsurface research aspects. MethodThe data were analyzed using coword analysis and clustering methods using Sci2 and VOSviewer.Result Analysis of ~3800 records showed that psychiatric genomics is, as expectedly, covered largely under biomedical subjects with a visible interest in other disciplines such as humanities and ethics. A coword analysis was done for all the years, followed by a year-wise analysis based on the keywords, and then a bibliographic coupling based on the cited references. This led to the generation of different clusters of prevalent research areas. The centrality values described the position of each component. Discussion 'Schizophrenia', 'depression', 'pharmacogenomics', and 'immunopathogenesis' were the research topics of overarching interest. 'Gut-brain axis' and 'gene-environment interaction' were the emerging topics, whereas certain topics such as 'child and adolescent psychiatry' remained priorities when compared to earlier studies. The keywords and research focus were diverse. They ranged from genetics to transcriptomics and epigenetics to proteomics of psychiatric disorders. We found a stagnation of science communication in the field with only 0.2% of the articles from the entire corpus relevant to it. The research categories identified in this study reflect the current publication and research trends in psychiatric genomics.

into clinical trials, and the development of targeted treatments was reported by the majority of participants. Challenges associated with genomic testing included difficulty comprehending genomic information during consultations, trouble explaining diagnosis to friends and family and dissatisfaction with length of time taken to receive test results. The need for genomic information to be simplified, specific and understandable was emphasised across all interviews. Families also expressed a desire for the provision of supplementary written and visual information and support resources to complement the information received during consultations. Participants identified the importance of developing rapport with healthcare providers, having a support network when undergoing testing and the need to provide assistance to navigate the health system. Conclusions: The study is ongoing but preliminary findings indicate that parents and families are likely to benefit from condition specific information resources and genetic counselling services beyond the renal clinic in order to optimise psycho-social adjustment during and after receiving genomic testing for kidney disease. 1. Vivante A, Hildebrandt F. Exploring the genetic basis of earlyonset chronic kidney disease.

Introduction: Post Streptococcal Glomerulonephritis (PSGN) generally presents as a constellation of findings usually 2 to 3 weeks post pharyngitis or pyoderma, that includes hematuria, edema and often hypertension. This study aimed to determine the complications, clinicobiochemical profile and outcome of PSGN. Methods: A cross sectional, observational study was done from Jan 2017 over a period of one year. Children presenting to the paediatrics department of B.P. Koirala Institute of Health Sciences with a diagnosis of PSGN were looked for complications. Their clinical and laboratory profile and outcome were also evaluated. Results: A total of 74 cases with PSGN were admitted. The male: female ratio was 2.2:1. The mean age at presentation was 8.9 yrs. AE 3.06 SD. Preceding throat infection was present in 32.4% and preceding skin infection was present in 18.9%. Common clinical characteristics at presentation were cola coloured urine 94.6%, edema 59.5%, reduced urine output 14.9%., headache and vomiting 13.5%, palpitation and dyspnoea in 12.2%, seizure in 6.8%. All were hypertensive with stage II hypertension in 89.2%. Acute Left ventricular failure was seen in 12.2%, Congestive cardiac failure in 8.1%, hypertensive encephalopathy in 6.8%, dyselectrolytemia in 19% and AKI was seen in 4.1%. Elevated Urea and creatinine were present in 8.1% and 4.1% respectively. Other lab parameters were leukocytouria 16%, sub-nephrotic albuminuria 52%, low c3 100%. The mean (SD) of Haemoglobin, Urea, Creatinine, Sodium, Potassium, ASO titre were 10.7gm/dl (1), 27.4mg/dl (13.2), 0.6mg/dl (0.4), 137meq/l (4), 4.0meq/l (0.4), 395units (175), respectively. The association of complication among gender or age group was not significant. None of the cases required ICU admission, the mean duration of hospital stay was 3.38days AE 0.753 SD and all patients had a favourable outcome. Conclusions: PSGN is a significant renal problem in children with significant proportion having life threatening complications at the presentation. Early identification, comprehensive monitoring and management usually results in complete recovery.

Background: Under 5yrs mortality rates among male child is 30 and among female is 26 and overall infant mortality rate 24 per thousand respectively; these are the most vulnerable groups to different morbidity and mortality, and they ought to be fully dependent on parental knowledge and awareness to meet their health needs. Health seeking behavior (HSB) has become a tool for understanding the approach of people towards the health care systems in their respective socio-economic, cultural and demographic circumstances. Methods: A Community based descriptive study among “Tharu” ethnic women with children less than ve years of age in Triyuga Municipality, Nepal. Semistructured questionnaire was used to collect socio-demographic information,, knowledge and current practice regarding health seeking behavior, including awareness and accessibility of health services. Results: Among 406 respondents, 388 of their children were reported ill within last 1 year, with fever accounting for 70%, followed by ARI (65%), diarrhea (6%) and others. Where 52.8% of respondents had appropriate HSB, taking their ill children to hospitals. More than 52% of respondents had hospitals as the rst preference for treatment for every morbidity. Except for access to health care facility, there was no signicant association of HSB was seen with parent's literacy,income, gender preference. Conclusion: With satisfactory awareness, literacy, and accessibility of health care centers, the HSB among tharu women, for the children morbidity seemed to be satisfactory in comparison to national scenario and other marginalized groups

No abstract