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BACKGROUND: Patients undergoing hemodialysis are under considerable physical and mental stress. Few studies indicate an increase of psychiatric morbidity in them. AIM: The aim is to study the prevalence of psychiatric comorbidity in patients undergoing hemodialysis. MATERIALS AND METHODS: A total of 49 consecutive patients of chronic kidney disease undergoing hemodialysis were included in the study with their consent. The Institute Ethics Committee clearance was obtained before the start of the study. The psychiatric interview was conducted only after the dialysis procedure was over. Patients were assessed using the Schedule for Clinical Assessment in Neuropsychiatry and Hamilton rating scale for depression. RESULTS: A total of 49 patients in the age range of 15-64 years were included in the study. Majority of the sample was males (75.5%). Out of the patients enrolled in the study group, 45% had psychiatric comorbidity which included depression (26%), adjustment disorder (12.2%), generalized anxiety disorder (2%), mixed anxiety and depression (2%), and mental and behavioral disorders due to harmful use of alcohol (2%) indicating that patients undergoing hemodialysis is more likely to have mood disorder than other psychiatric disorders. CONCLUSION: Patients with recent-onset dialysis are more prone to psychiatric illnesses as it has a chronic debilitating course with poor outcome leading to major lifestyle changes with occupational disturbance and consequent financial implication.

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Sorghum grain yield can be significantly affected by climatic changes, especially drought and high temperature. The purpose of this study was to evaluate hybrids of grain sorghum grown under normal irrigation conditions or water stress in order to select those likely to be more tolerant of drought. Forty-nine hybrids were grown in a randomized block design experiment, with three replications. The plots consisted of four rows of 5 m length. Grain yield, weight of 1000 grains, harvest index, days to flowering, and plant height were measured. All of these characteristics were affected by water stress; however, grain yield showed the largest relative reduction. Comparison of the various genotypes showed that some hybrids had an acceptable grain yield under water stress, and maintained a high average yield compared to growth without stress. Several hybrids gave better grain yield than commercial check cultivars: 1170090, 1170092, 1170064, 1167026, 1167064, 1170093, 1167008, 1167029, 0009061, 1167092, 1105647, and 1170019 stood out for their acceptable plant height, earliness, and higher productivity.

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BACKGROUND: Increasing population, fast paced industrialization, increased, competitiveness, unanticipated problems in the work place have increased the stress among the females working in health care in recent times. AIM: The aim of the following study is to detect the stress levels among female health care professionals in the age group of 25-35 years and its impact on health. SUBJECTS AND METHODS: A prospective cross-sectional pilot project was conducted in a tertiary care hospital in Eastern part of India, after receiving approval from the Institutional Ethics Committee and informed consent form was taken from the subjects. Stress level in the subjects was assessed according to the presumptive life event stress scale. Females with scores above 200 were selected. For these, initial assessment of anthropometric measurement, electrocardiogram and lipid profile analysis, resting pulse rate, blood pressure, physical fitness index (PFI), breath holding time (BHT), isometric hand grip (IHG) test results were evaluated and recorded. All subjects were given training of progressive muscle relaxation (PMR) for 3 months. After 3 months, the lipid profile and vital parameters, Perceived Stress Scale values were re-evaluated and subjects were asked to repeat the same exercises and data thus recorded were analyzed using Statistical Package for the Social Sciences (SPSS) version 16 (SPSS Inc. Released 2007. SPSS for Windows, Version 16.0. Chicago, SPSS Inc.). RESULTS: Significant decrease in resting heart rate, blood pressure and Perceived Stress Scale levels was seen after PMR training in the subjects. Results of BHT, IHG tests and PFI were significantly increased after PMR training. There was a significant decrease in total cholesterol, triglyceride and low-density lipoprotein cholesterol in subjects after practicing PMR for 3 months. CONCLUSIONS: Increasing stress among female health care professionals is a cause for concern and there is a need to adopt early life-style modification by practicing relaxation exercises to ameliorate stress and to improve not only their quality-of-life in general, but patient care in particular.

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BACKGROUND: There has been an exponential growth in the number of elderly population in India. This study aims to determine the prevalence of dementia in an urban center of Pune and to evaluate the corresponding socio-demographic correlates along with psychiatric morbidity in the study sample. MATERIALS AND METHODS: The study population in Pune and Kirkee cantonments was selected based on 2001 census data. The number of people over 65 years numbered 6721 and 2145 of them were randomly selected for a door-to-door survey. They were initially administered household questionnaire and then subjected to a screening tool. Each participant underwent a brief mental state examination and data was collected on the basis of a structured proforma. Patients underwent a detailed cognitive profile using subtests from CSI-D (community screening instrument - dementia), which included a Consortium to Establish a Registry for Alzheimer's Disease (CERAD) word list, word fluency and delayed recall. Information pertaining to socio-demographic factors in participants and caregivers, caregiver-burden and behavioral and psychological symptoms in participants too were collected from the questionnaire. Radio imaging investigation was also carried out to quantify the deficit. Statistical Package for the Social Sciences (SPSS) software was used to compute the results. RESULTS: Findings revealed that prevalence of dementia in the sample population of elderly aged above 65 years was 4.1%. Socio-demographic factors which conferred a statistically higher risk for dementia were identified to be older age, low socio-economic status, low level of education, presence of family history, whereas, marriage was found to be protective. Burden of care was associated with caring for elderly with dementia with increasing severity of dementia. Patients with dementia performed poorly on cognitive test battery. Social network had a protective effect in respect with severity of dementia. On magnetic resonance imaging (MRI) majority of cases of Alzheimer's Dementia (AD) and Vascular Dementia (VaD) were noted to have both gray and white matter involvement. CONCLUSION: Poor awareness is a key public-health problem. Society plays an important role in the ageing process. The withdrawal of the elderly from the previous societal roles,reduction in all types of interactions i.e. shift of attention from outer world to the inner world, reduction in the power and prestige of the elderly enhance aging process. Aging in Indian culture though a disability is much stressful today in Indian culture as in others.

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BACKGROUND: Amputation of a limb affects almost all aspects of an individual's life. Psychological aspects are important factors for adjustment with the disability. METHODS: The present study was carried out on 50 consecutive male patients admitted to the Artificial Limb Centre. Base line and post therapy psychological assessment was carried out on Hospital Anxiety and Depression Scale (HADS). Trauma Symptom Inventory (TSI) was administered along with Millon Index of personality styles (MIPS). Psychological intervention was given to them on a therapy module proposed by authors. Data was analyzed with the help of SPSS. RESULT: Findings revealed significant differences in scores on HADS, before and after therapy (p<0.05). On Trauma symptom Inventory defensive avoidance and depression were noted to be above cut off level of (>65). Predominant personality styles were self indulgence and internally focused in motivating styles (mean prevalence score <50) and thought guided in thinking styles, dominating and controlling in behaving styles. The analysis of prevalence score of above 50 and less than 50 indicated Confident/Asserting (9B), Submissive / Yielding (11A), having significant change after therapy on score of anxiety (P<0.05). The personality dimension of dutiful and conforming had shown significant influence after therapy (P<0.05) on score of depression. CONCLUSION: The findings indicated psychological assessment and intervention is to be included as a part of the management after amputation.

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BACKGROUND: Serotonin plays an important role in treatment of depression. We evaluated the clinical correlates of plasma serotonin levels in depressed patients before and after treatment. METHODS: Study sample comprised of 40 patients diagnosed on ICD-10 diagnostic criteria, and an equal number of healthy matched controls. Subjects were evaluated on Beck's Depression Inventory (BDI) and Suicide Ideation Scale (SIS), before and after the treatment. Blood samples were collected from all the cases and controls before starting the antidepressant medication with selective serotonin reuptake inhibitors (SSRI's). Serum serotonin levels were measured before and after treatment. RESULT: Significant differences in scores before and after the intervention on BDI, SIS and serotonin levels of cases and controls (p<.000) were noted. Correlation between the serum serotonin levels before and after the treatment, and between the rating scales did not reveal significant association (p > 0.05). Patients with suicidal intentions had lower levels of serotonin. The scores changed after intervention. CONCLUSION: Treatment with SSRI's had shown significant changes in clinical conditions. However these changes did not relate significantly with serum serotonin levels.

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BACKGROUND: Training in medicine is emotionally demanding. Psychological well being of medical students is a matter of concern. There is lack of Indian studies in this area. METHODS: A total of 105 medical student of one batch were assessed utilizing psychophysiological state inventory, Institute for personality and ability testing (IPAT) anxiety and depression scale, achievement motivation scale, scale for locus of control and 16 PF in three phases at one-year intervals. RESULT: Majority of the students had average achievement, motivation and adaptability. Anxiety and depression scores fell within normal limits. In personality profile factor 'B', 'M' and 'Q41' had changed significantly. Achievement motivation showed significant decreases and CSS1 and PO1 scores showed significant increase during the years of medical education. CONCLUSION: The results demonstrate that over satisfaction and relaxed attitude may have poor academic outcome.

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BACKGROUND: The Army Order 3&11/2001 was introduced to curb alcoholism and to weed out habitual alcoholics. Hence a study was carried out in a zonal referral hospital from 01 Jan 2001 to 30 Jun 2003 to assess its effectiveness. METHODS: The subjects consisted of officers, junior commisioned officers and other ranks who satisfied the International Classification of Diseases (ICD) 10 criteria for alcohol dependence. RESULT: Out of 1023 consecutive admissions, alcohol dependent cases numbered 245 (23.95%). They were disposed as under: 57/ 245 (23.6%) in S1 (fit for all duties), 67/245 (27.35%) in S2 (fit for duties with few restrictions), 72/245 (29.39%) in S3 (fit for duties with more restrictions), and 32/245 (13.06%) in S5 (unfit for further service.). CONCLUSION: The data showed that the percentage of cases disposed under fit for all duties had risen four times (23.80 vs 5.86), those invalided out increased by two times (12.70 vs 6.64) and those retained in S2 had reduced (26.46 vs 41.21) after the new policy.

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BACKGROUND: There is a paucity of Indian studies on effectiveness of biofeedback in reducing drug prescription in neurotic and stress related disorders. METHODS: Study sample of generalized anxiety disorders (GAD), mixed anxiety depression, obssessive compulsive disorder (OCD), dissociative disorder and headache were assigned to three groups of 28, 23 and 27 patients respectively. Group 1 were subjected to drug therapy, Group 2 to biofeedback and Group 3 to drugs and biofeedback for 12 weeks. All were followed up at six months and one year. RESULT: At the end of one year, in Group 1, 60.71 % had mild and 17.86 % had moderate anxiety levels, while 21.43% required no further follow up. In Group 2, 39.13 % showed mild and 43.48 % had moderate anxiety levels, while 17.39 % required no follow up. In Group 3, 22.22% had mild and 11.13% had moderate levels of anxiety, while 66.66% required no further treatment. CONCLUSIONS: Biofeedback relaxation with pharmacotherapy is useful in select group of neurotic and psychosomatic cases.

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BACKGROUND: The clinical utility of the Rorschach test in Indians is hampered by the absence of reliable normative data. Method : The Rorschach by Dlopfer's method was administrated to 1256 subjects consisting of 300 normal army personnel, 300 normal civilians, 250 schizophrenics, 300 neurotics and 106 patients with organic disorders. RESULTS: The Rorschach protocols of normal Indian army personnel and normal civilians showed significant differences from one another and also from the western norms. These differences are culturally determined and are not indicative of low intelligence or psychopathology. Patients with schizophrenia, neurosis, head injury and epilepsy show significant differences from the records of normal subjects. The protocols of army schizophrenics show significant deviations from those of normal army personnel and these changes revert to normal with clinical recovery. CONCLUSION: The Rorschach test is not a culture fee test as claimed earlier. In view of the differences from Western norms, Rorschach protocols of Indians should be interpreted using the norms for Indians. In the case of army personnel the norms for army personnel should be used. While the use of the Rorschach to study the personality patterns of normal individuals and as an aid to clinical diagnosis was strongly supported, the findings of the study indicate that the test can also be employed to assess therapeutic response of patients with schizophrenia.

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BACKGROUND: Recent studies have shown a high prevalence of depression and cognitive changes in patients with end-stage renal disease (ERSD) and renal transplant recipients. There are few data available on the cognitive and emotional changes in patients undergoing renal transplantation in India. AIM: To evaluate the changes in cognitive profile and depression in renal transplant recipients. METHODS: Thirty consecutive patients undergoing renal transplantation were evaluated 1 month before and 3 months after successful renal transplant with Beck Depression Inventory (BDI), Weschler Adult Performance Intelligence Scale (WAPIS), Luria Nebraska Neuropsychological battery (LNNB) and Life satisfaction scale. RESULTS: Our study revealed an 86.7% prevalence of depression in ESRD patients as compared to 56.7% in post renal transplant patients. Analysis of neurocognitive functions on LNNB did not reveal any significant impairment. Furthermore, analysis of the Life satisfaction scale revealed most of the patients scored high satisfaction levels despite the stress of their disease. Results on WAPIS brought out significant improvement in intelligence quotient (IQ) after renal transplantation. CONCLUSION: Successful renal transplant is associated with improvement in depression, IQ and life satisfaction.

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1567 clinical samples were obtained for the study; 494 strains of Pseudomonas aeruginosa were isolated (isolation rate of 31.52) and their antibiotic sensitivity patterns tested using Kirby Bauer disk diffusion method. The antibiotic sensitivity testing revealed that Pseudomonas aeruginosa strains were highly resistant to most anti-pseudomonal antibiotics; Amikacin was found to be most suitable for routine use with a sensitivity of 68.01% and the most resistant antibiotic was Netilmicin showing 70.04% resistance. Surprisingly, Gentamycin showed a relatively higher sensitivity of 55.87%. Sensitivity to Imipenem and Meropenem was 100%.

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A questionnaire designed to assess attitudinal profile was mailed to nursing officers in five representative military hospitals. 158 (77.83%) of 203 addressees responded. Cluster analysis indicated higher level of commitment in nursing officers with over 16 years service as compared to those with less than 5 years. Self-image and job-satisfaction, however tended to be eroded with increasing length of service which was also associated with a more authoritarian attitude, relatively less materialistic outlook and (paradoxically) greater negative attitude towards authority figures. Marriage and having children did not influence any parameter. The feeling of sexual harassment increased with seniority in service, as also a perceived erosion in the authority of the principal matron. Relatively junior nursing officers appeared dissatisfied with "too much paper work" and a felt deterioration in working environment as well as the image of Military Nursing Service.

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Six hundred and one patients, who sustained injuries in militant activities, admitted during a 7 month period to a zonal referral hospital were studied. The majority, 54.6% from the Armed Forces and 38.8% from the para-military forces, were in the age group of 22-53 years. There were 40 (6.7%) civilian casualties. These were in the age group of 20-45 years. A large number (75.7%) of the casualties manifested with post-traumatic stress symptoms. 24.3% of them were rated as post-traumatic stress disorder. Six months follow-up revealed persistence of post-traumatic stress disorder in 17.1% of the cases. By one year, 42.1% who responded to the follow-up letters had persistence of post-traumatic stress disorder in 4.95%. Early recognition of this psychic trauma and preventive strategies are discussed.

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Brief hospitalization contributes to quicker and more effective recovery in psychiatric practice. It also leads to a progressive change in the pattern of mental morbidity. Two-year follow-up of patients treated with this technique indicates that recovery is sustained, and relapse/wastage rate is low. There is need for further research in this significant aspect of military medicine.

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Fifty coronary heart disease cases along with an equal number of controls, matched in age and educational levels were studied using Middlesex Hospital Questionnaire, Somatic Inkblot Series I and Command Hospital Questionnaire. They were between 20 and 55 years of age. Obsession and somatic personality traits measured on SIS variables were found to be statistically significant in coronary cases compared to controls. However the subject belief in the philosophy of "Karma" when measured on command hospital questionnaire did not show any difference between the two groups.

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A case of genital self mutilation in schizophrenia is described and its psychopathology discussed.