Calcification of basal ganglia or Fahr's syndrome is a rare disease characterized by bilateral and symmetrical intracranial deposition of calcium mainly in cerebral basal ganglia. Motor and neuropsychiatric symptoms are prominent features. We report a case presented with a few motor symptoms, features of delirium and prominent psychiatric symptoms (disorganized behavior) predominantly evident after the improvement in delirium. Radiological findings were suggestive of bilateral basal ganglia calcification. Parathyroid hormone levels were low with no significant findings in other investigations and negative family history. Patient showed significant improvement in behavioral disturbances with risperidone, low dose of lorazepam, oxcarbazepine, and memantine.
Selective serotonin reuptake inhibitors (SSRIs) can cause the syndrome of inappropriate antidiuretic hormone secretion (SIADH). SIADH is associated with hyponatraemia without oedema. We report the case of a patient who developed acute-onset hyponatraemia that progressed rapidly to serious neurological dysfunction shortly after the introduction of citalopram. All SSRIs including citalopram should be used with care in the elderly. The water and electrolyte balance should be monitored carefully during SSRI therapy.
Background: In developing world, the number of women undergoing miscarriage has increased. Women facing miscarriage are susceptible to develop depression and the risk is more if the perceived social support is low or not adequate. This study was conducted to assess the presence of depressive features and perceived social support and to correlate between the two entities in patients with miscarriage. Methods: This was a cross-sectional, single interview study conducted in 100 consecutive patients with miscarriage in current pregnancy admitted in obstetrics and gynecology ward of a tertiary care center. After ethics committee approval and written informed consent, each patient was individually interviewed using a semi structured proforma. To assess depressive features, Patient Health Questionnaire-9 (PHQ-9) and to evaluate perceived social support-Multidimensional Scale for Perceived Social Support (MSPSS) were administered. Data was analyzed statistically. Results: The mean age of the participant was 28.5 years (3.9), all of them were married, majority of them being housewives, with primary/secondary level of education and from rural area. On assessment with PHQ9, the prevalence of depression was 32%. Among them 17 % had mild depression, 12% had moderate depression, and 3% had severe depression. Women with advancing age, lower education level, unemployment, previous miscarriage, miscarriage following treatment for infertility had significant depression. The perceived social support in the form of family and friends was significantly less in depressed patients. Conclusion: Miscarriage is a significant stressful event in a women's life. These women should be evaluated for depressive symptoms and carers should be psycho-educated regarding need of social support following miscarriage. Early diagnosis and management of depression will help in reducing further morbidity and will improve the quality of life of these patients.
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