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Females with opioid use disorder (OUD) rarely seek help for addiction. We present a series of seven females with OUD attending a tertiary care addiction treatment setting in Assam between December 2022 to August 2023. Most of the patients were primary-educated, young adults, housewives, from lower to middle socioeconomic strata, and were residents of rural or semi-urban areas. All were married, and around half of them were separated. All the patients were dependent on heroin and tobacco. Five of them initiated heroin use while modeling their spouse. Three patients were injecting heroin, and one was seropositive with both HCV and HIV. Five patients received sublingual buprenorphine-naloxone, and three of them followed up subsequently. Financial difficulty, poor family support, and intimate partner violence were major challenges for treatment-seeking and regular follow-up. This case series highlights the need for systematic study and gender-responsive care of females with OUD in Assam.

Background: Major depressive disorder is widely prevalent in post myocardial infarction (MI) period. Various studies have reported a significant relationship between these two major disease states. Aim: To examine depression after MI and its socio-demographic variation. Methods: The study was a follow up study on patients of acute MI (n=50) attending cardiology outpatient department of the Assam Medical College Hospital in four to six weeks after the index event. Screening was done by the Primary Care Evaluation of Mental Disorders and diagnoses of major depressive disorder were established according to the text revision of the fourth edition of the Diagnostic and Statistical Manual for Mental Disorders criteria. Severity of the depression was assessed by the Beck Depression Inventory. Study populations were again reassessed after eight weeks from the index event. Statistical software packages like SPSS-20, XLSTAT, and Microsoft Office Access were used for analysis. Results: Twenty eight and 32% of the study subjects were depressed on their first and second visit respectively. Conclusion: Similar pattern of post MI depression is found in our state likewise in correlation to western and Indian studies which were conducted in different states. So we recommend vigilance from the clinician’s side while handling cases of MI.

Background: Depressive symptoms are very usual in patients experiencing a history of myocardial infarction (MI). An individual who has developed depression after an episode of MI becomes non compliant with the treatment of cardiology. Aim: To test the impact of post MI depression on drug adherence of cardiological medicines. Settings and design: The study was conducted on patients of acute MI (n=50) attending cardiology outpatient department (OPD) of Assam Medical College and Hospital, Dibrugarh at eight weeks after the index event. Methods: Screening was performed by the Primary Care Evaluation of Mental Disorders (PRIME-MD) and diagnoses of major depressive disorder were established according to the text revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria. The eight-item Morisky Medication Adherence Questionnaire was applied to the patients to assess drug adherence after eight weeks from the MI episode. Results: Statistically significant strong association and correlation were found between post MI depression and drug adherence of cardiological medicines (Wald 9.84, Odd’s ratio 2.054, p=0.002, rho=0.714). Conclusion: The result of analysis has revealed that post MI depression has an unfavourable impact on drug adherence, ultimately contributing to increased risk of cardiological morbidity and death rate. Therefore, routine screening of depressive symptoms should be mandatory in cardiology.

Background: Major depressive disorder is very common in patients having history of myocardial infarction (MI). Quality of life (QOL) is seen to be poorer in persons having post MI depression than who are non depressed. Aims: To compare QOL between depressed and non depressed patients with history of recent MI. Settings and design: The study was conducted on patients of acute MI (n=50) attending cardiology outpatient department of Assam Medical College Hospital, Dibrugarh, Assam, India at four to six weeks after the index event. Methods: Screening and diagnosis of depression were done by Primary Care Evaluation of Mental Disorder (PRIME-MD) and the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), respectively. Severity of depression was assessed by Beck Depression Inventory (BDI). QOL was assessed twice, four to six and six to eight weeks after the index event by the World Health Organization QOL (WHOQOL) scale. Comparisons of QOL between depressed and non depressed patients were done by standard statistical procedures. Results: The results showed that there was significant variation in QOL (p

Background: Major depressive disorder is very usual in patients experiencing a history of myocardial infarction (MI). Raising level of Troponin I could be a tool to predict the severity of post myocardial infarction depressive disorder. Aims: The purpose of this work was to test the relationships between levels of Troponin I and severity of post MI depression. Methods: The study was conducted on patients of acute MI (n=100) attending cardiology OPD of Assam Medical College and Hospital, Dibrugarh, Assam in 6- 8 weeks after the index event. Screening was done by The Primary Care Evaluation of Mental Disorders and diagnoses of Major Depressive Disorder were established according to the Diagnostic and Statistical Manual for Mental Disorders fourth edition Test Revision criteria. Severity of the depression was assessed by Beck Depression Inventory. Laboratory reports of serum levels of Troponin I were noted from the medical records of the patients. Statistical tests like the student to test and Pearson correlation were used for analysis. Results: Severity indicators of MI like raising Troponin I has significant association (t test = 3.66, p = 0.0006) and positive correlation (r = 0.797, p= 0.003) with severity of post MI depression. Conclusion: Rising Troponin I levels are associated with increased risk of depression following the myocardial infarction. So it can be utilized to foresee future chances of depression after an attack of myocardial infarction.

Background: Fahr's syndrome (or Fahr's disease) is a rare idiopathic degenerative disorder, characterized by bilateral symmetrical intracranial calcification and manifested as movement disorders, dementia and other behavioural disturbances. Case description: A 50-year-old male with long standing seizure disorder with intact motor and cognitive function presented with behavioural disturbances. Brain CT showed symmetrical calcification in cerebral hemispheres involving caudate nucleus, internal capsule, adjoining area and cerebellum. The history, clinical and radiological features and exclusion of other possibilities in our case point towards this uncommon disorder. Discussion: A substantial number of patients with Fahr's disease present with behavioural disturbances. Usually late onset Fahr's disease with behavioural disturbances is accompanied by cognitive and motor abnormalities. However, in our case no such neurocognitive abnormalities were found along with the behavioural disturbances in the form of psychosis inspite of widespread intracranial calcification. Conclusion: Psychosis may be the sole presentation in a case of late onset Fahr's disease.