Search

Nondisrupted, safety ensured, opioid substitution clinic in a COVID-19 designated hospital of a resource-limited state in India Following a break (of one clinic) in regular services of our OS clinic due to the institutional policy, a lot of dissatisfaction was registered by our patients in our teleconsultation platform. For about 3 months since the pandemic broke-out, the All India Institute of Medical Sciences (AIIMS), Raipur, India was the only COVID-19 designated hospital in the entire state of Chhattisgarh. [Extracted from the article]

A letter to the editor is presented regarding High Density Lipoprotein concentration during dependence states of alcoholism.

Background and Aim: Pandemic and consequent lockdowns are likely to affect the drug market by the sudden disruption of the supply chain. We explored the change in the availability, access, purity, and pricing during lockdown from respondents seeking treatment for drugs, alcohol, and tobacco dependence., Materials and Methods: A cross-sectional survey was conducted among 404 respondents from seven treatment centers across India. A structured questionnaire assessed the change in availability, access, quality, and price of substances used during the first phase (March 24-April 14) and the second phase (April 15-May 3) of lockdown., Results: A majority of the respondents in treatment used tobacco (63%) and alcohol (52%). Relatively few respondents used opioids (45%) or cannabis (5%). Heroin (44%) was the most common opioid the respondents were treated for. Seventy-five percent, 65%, and 60% of respondents treated for alcohol, tobacco, and opioid problems, respectively, reported a reduction in the availability and access during the first phase of the lockdown. In the second phase, respondents with alcohol and tobacco dependence reported greater availability than those with opioid and cannabis dependence. The reported price of all substances increased more than 50% during the first phase of lockdown and remained higher throughout the second phase. Deterioration in purity was reported by more than half of the people who used opioid., Conclusion: Lockdown could have affected both licit and illicit drug markets, albeit to a varying degree. The observed changes seemed short-lasting, as suggested by the recovering trends during the second phase of lockdown., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Indian Journal of Psychiatry.)

Background: The unprecedented first wave of the COVID-19 pandemic severely impacted mental health services globally. However, the negative impact of such disruptions on people with substance use disorders (SUD) seeking treatment remains unclear. We aim to explore the behaviors adopted by these individuals to overcome the service disruptions., Materials and Methods: We explored the changes related to substance use behavior (quit attempts, withdrawal experienced, treatment-seeking, and risky behaviors), and behavioral changes in response to COVID-19 lockdown. A cross-sectional survey was conducted among 404 people with SUD seeking treatment from seven centers across India. They were assessed by a specially designed structured questionnaire during the first wave (June-September) of the pandemic., Results: An overwhelming majority experienced withdrawal symptoms, with close to half making quit attempts and seeking treatment during the lockdown. Three-fourth of the sample reported difficulty in accessing treatment services and medications. Patients with opioid use were significantly more likely to think about quitting (χ 2 = 20.408, P = 0.000), make attempts (χ 2 = 12.436, P = 0.000), seek treatment ( χ 2 = 7.536, P = 0.006), and self-medicate for withdrawal symptoms (χ 2 = 5.885, P = 0.015). In turn, those with alcohol use were more likely to use telepsychiatry services (χ 2 = 35.143, P = 0.000) and experience stigma by family members (χ 2 = 29.951, P = 0.000) and neighbors (χ 2 = 17.725, P = 0.000). Among COVID-19 safety precautions, majority practised wearing masks and social distancing but not others., Conclusion: COVID-19 lockdown led a significant proportion of substance users, especially opioid users, to make quit attempts and seek help. However, these could not be sustained due to difficulty in accessing treatment services. Further, significant proportion failed to adhere to COVID-19 safety precautions., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Indian Journal of Psychiatry.)

Competing Interests: There are no conflicts of interest.

Coronary artery bypass graft (CABG) and percutaneous transluminal coronary angioplasty (PTCA) are treatments of choice for coronary artery disease. Quality of life (QoL) is an important factor in determining optimum treatment. This study was aimed to compare changes in QoL, six months post procedure, between CABG and PTCA, and to understand the confounding effect of various contributing factors. Thirty stable angina patients each in CABG and PTCA groups, were followed up for six months. QoL was assessed with WHO-QoL-BREF. Depression was rated on the Hamilton Depression Rating Scale. Changes in QoL and depression within and between CABG and PTCA groups were compared. Multinomial logistic regression was used to measure the predictive strength of treatment type (CABG and PTCA) on QoL, controlling for significant confounders. Although scores of QoL and depression significantly changed over time in both the groups, time×group interaction did not reach to a significance. Significant confounding effects of diabetes (P<0.01), hypertension (P<0.05) and diet restriction (P<0.05) were found. Controlling for confounding effects of these factors, group distribution to PTCA, compared to CABG, significantly predicted greater improvements in QoL (P<0.01)., Competing Interests: None

Background: Interview-based schizophrenia (SCZ) diagnostic methods are not completely valid. Moreover, SCZ-the disease entity is very heterogeneous. Supervised-Machine-Learning (sML) application of Artificial-Intelligence holds a tremendous promise in solving these issues., Aims: To sML-based discriminating validity of resting-state electroencephalographic (EEG) quantitative features in classifying SCZ from healthy and, positive (PS) and negative symptom (NS) subgroups, using a high-density recording., Settings and Design: Data collected at a tertiary care mental-health institute using a cross-sectional study design and analyzed at a premier Engineering Institute., Materials and Methods: Data of 38-SCZ patients and 20-healthy controls were retrieved. The positive-negative subgroup classification was done using Positive and Negative Syndrome Scale operational-criteria. EEG was recorded using 256-channel high-density equipment. Eight priori regions-of-interest were selected. Six-level wavelet decomposition and Kernel-Support Vector Machine (SVM) method were used for feature extraction and data classification., Statistical Analysis: Mann-Whitney test was used for comparison of machine learning-features. Accuracy, sensitivity, specificity, and area under receiver operating characteristics-curve were measured as discriminatory indices of classifications., Results: Accuracy of classifying SCZ from healthy and PS from NS SCZ, were 78.95% and 89.29%, respectively. While beta and gamma frequency related features most accurately classified SCZ from healthy controls, delta and theta frequency related features most accurately classified positive from negative SCZ. Inferior frontal gyrus features most accurately contributed to both the classificatory instances., Conclusions: SVM-based classification and sub-classification of SCZ using EEG data is optimal and might help in improving the "validity" and reducing the "heterogeneity" in the diagnosis of SCZ. These results might only be generalized to acute and moderately ill male SCZ patients., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Indian Journal of Psychiatry.)

Gorham-Stout disease (GSD) is a rare bone disease of unknown etiology, characterized by spontaneous and progressive resorption of bones. This disease occurs most commonly in males of the age group of fewer than 40 years and has no genetic predisposition. It most commonly affects the skull, spine, pelvis and shoulder girdle. The diagnosis of GSD is established based on the combination of clinical, radiologic, and histological features, after excluding other diseases. There is no standard treatment for it so far, and the therapy depends on patient's clinical condition and may include surgery, radiotherapy, and drugs, with varying degrees of success. To the best of our knowledge such involvement of hip and its treatment by a megaprosthesis, in an elderly lady by GSD has not been reported. This case report describes an unusual presentation of the disease of the hip in an elderly female successfully treated with replacement of the deficient proximal femur by using a bipolar hip mega prosthesis of the hip (XLO, India)., (© 2019 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.)

Background: The likelihood of the relation between Internet overuse and comorbid psychiatric conditions is on the rise. However, sleep disturbances are common psychiatric symptoms associated with internet overuse. Our objective was to examine the association of Internet overuse with excessive daytime sleepiness, sleep problems in professionals from India., Materials and Methods: This was a web-based cross-sectional study through a predesigned questionnaire which included various professional groups. The information included in the questionnaire was sociodemographic details, Young's internet addiction test (IAT) and Epworth sleepiness scale (ESS)., Results: About 1.0% of total sample population had severe internet addiction whereas 13% were in the range of moderate internet addiction and the mean score on IAT was found to be 32 (standard deviation [SD] = 16.42). The mean duration of total night time sleep (5.61 ± 1.17) is significantly lower in participants with moderate and severe internet addiction (6.98 ± 1.12) compared to those with no and mild internet addiction. The mean scores of ESS were significantly higher in individuals with moderate and severe addiction (M = 10.64, SD = 4.79). We found that sleepiness while in 5 of the situations such as driving a car (χ 2 = 27.67; P < 0.001), sitting and reading (χ 2 = 13.6; P = 0.004), traveling in a car (χ 2 = 15.09; P = 0.002), afternoon rest time (χ 2 = 15.75; P = 0.001), and postlunch quiet time (χ 2 = 24.09; P < 0.001), predicted membership to moderate-to-severe internet addiction, even after controlling for the confounding effects of age and gender., Conclusions: This study shows an association between Internet overuse, excessive daytime sleepiness, and other sleep problems. Clinicians should be proactive and conscious in scrutinizing the patients for internet addiction and its consequences., Competing Interests: There are no conflicts of interest.

The atypical antipsychotic olanzapine is increasingly being used for various psychiatric conditions. There are few reports of olanzapine overdose in adolescent population. We report a case of 16-year-old adolescent who ingested 750 mg olanzapine, the highest reported nonlethal dose of olanzapine in adolescents. He presented with tachycardia, hypotension, generalized myoclonus, hyperpyrexia, muscular rigidity, leukocytosis and elevated creatine phosphokinase (CPK) levels. He recovered from the toxicity with minimal intervention.