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Introduction: The study was conducted to evaluate IOP management by surgical modalities such as combined trabeculectomy and phacoemulsification and phacoemulsification surgery alone.Vision impairment is a major public health problem and the burden is increasing with increase in aged population. Aims And Objectives: This study was undertaken for study the IOP management by surgical modalities such as combined trabeculectomy and phacoemulsification and phacoemulsification surgery alone. A pre-designed prospective study was conducted at the OPD of upgraded Department of Ophthalmology at LLRM Medical College,Meerut.A total of 60 patients were divided in to two equal groups randomly and studied.Observation And Result: Majority of the patients in both the groups were aged between 61 – 70 years.Females outnumbered males in this study which was statistically significant between the two groups.The mean pre- operative intra ocular pressure was 23.3 mm Hg in combined surgery group and 23.9 mm Hg in cataract surgery alone group.Mean Intra ocular pressure decreased regularly in each follow up more in combined group than the cataract surgery alone group.The mean intra ocular pressure after 1 years follow up in combined surgery group was 10.8 mm Hg and 13.4 mm Hg in the cataract surgery alone groups which was statistically significant. Mean BCVA before the operation was 3.2 in combined surgery group and 3.8 in cataract surgery before surgery. Mean BCVA declined after 1 year of follow up in combined surgery group was 1.9 and 2.7 in cataract surgery alone group which was statistically significant. The surgery success was complete in 80.0% of the combined surgery group and 60% of the cataract alone group. Criteria For Failure Of Surgeries Ÿ The IOP >23 MMHG at the end of 1 year or Ÿ The IOP not reduced by 20 % from base line at the end of 1 year Conclusion: This study was mainly undertaken to study the efficacy of combined trabeculectomy with cataract extraction and cataract only on primary angle closure glaucoma.This study had found that,the reduction of intra ocular pressure in both the groups but more prominent in combined surgery group than cataract alone surgery group.

BACKGROUND We wanted to compare lensectomy with anterior vitrectomy and conventional methods in the surgical management of congenital cataract. METHODS The present study is an interventional analytical study that entailed 30 patients (33 eyes) of bilateral or unilateral congenital cataract who attended the Ophthalmology outpatient department of LLRM Medical College, Meerut, during the period extending from March 2018 to March 2019. 19 of these patients (63.3 %) were males while 11 (36.7 %) were females. Age of the patients varied from 2 years to 12 years, with a mean age of 5 years 7 months. The maximum number of patients was in the age group of 4 - 8 years in either sex. RESULTS Being a comparative analysis, this study had 39.3 % cases treated by conventional methods and 60.7 % cases managed by lensectomy and anterior vitrectomy. The visual acuity was compared in the conventionally treated patients and lensectomy and anterior vitrectomy treated patients. Amongst the patients managed by conventional methods, 37.5 % had good vision, 12.5 % had fair vision and 50.0 % poor vision. In the lensectomy and anterior vitrectomy treated group, 61.1 % cases had good vision, 22.2 % had fair vision and only 16.7 % had poor vision. Comparing the occurrence of complications in both groups, the conventionally treated group showed an incidence of 32.4 % as compared to 4.4 % in lensectomy and anterior vitrectomy treated group. CONCLUSIONS The lensectomy and anterior vitrectomy treated groups had good vision and fewer complications as compared to the conventional methods. KEY WORDS Cataract, Visual Acuity, Lensectomy, Vitrectomy

BACKGROUNDThere is growing evidence that tDCS in the Dorsolateral Prefrontal Cortex (DLPFC) technique is effective in controlling craving and relapse in ADS patients. Till now the results are inconclusive. Interestingly, the cerebellum is related to impulsive and compulsive behavior which is supported by both structural and functional neuroimaging findings. There are few clinical trials regarding the effect of cerebellar tDCS in ADS.OBJECTIVETo assess the effect of Prefronto-cerebellar tDCS in reducing craving and relapses in ADS patients.METHODSThe study population will be randomly assigned to either of two groups i.e. Active and Sham tDCS group. The active group will receive 10 sessions over 5 days; 2mA current for 15 minutes. The site of anodal stimulation is 2cm below the Iz (inion) and cathodal stimulation at F3 (left prefrontal) and in the sham group will receive the same except that intensity of the current is 0.2mA. Patients will be assessed for craving at 3-time points.CONCLUSIONIt will be helpful in analyzing the effect of stimulating DLPFC as well as the cerebellum which is a potential novel site in reducing craving and relapse in ADS.HIGHLIGHTStDCS in ADS is being tried for the last decade mainly focusing on the frontal area. With the current understanding of the role of the cerebellum in regulating impulsive and compulsive behavior, we intend to add the cerebellum as a potential site for neuromodulation in reducing craving and relapse in ADS patients.

Pediatric cancer treatment includes several chemotherapeutic drugs in combination with adequate supportive management. Symptom distress among pediatric cancer patients on chemotherapy interferes with treatment compliance. Poorly managed distress leads to the decline of the child’s ability physically and mentally and deteriorates the quality of life. This paper shows the effect of chemotherapeutic drugs induced symptom distress, and the effect of early diagnosis in the management and improvement in the quality of life of pediatric cancer patients. For this study60, pediatric cancer patients aged between 10 to 18 years including both the gender were chosen using purposive sampling. Using the M.D. Anderson symptom inventory the symptom distress experienced by the pediatric cancer patients was assessed. The present quantitative cross-sectional study was conducted at the AIIMS, Raipur. The data were analyzed using the descriptive Statistical Package for Social Science Version 16 (SPSS 16). The categorical data was analyzed using chi –square test and the cut off p-value at ≤0.05. Among, the pediatric cancer patients 77.65% (SD 18.85) were experiencing severe symptom distress when on chemotherapy. Whereas 53.65 %( SD 9.63). of them experiencing the symptoms those disturb their activities of daily living in the last twenty four hours at p-value of ≤0.05. There is a need for an adequate support system from the school, social relationship, siblings, and health care team for improving the quality of life of pediatric cancer patients. Animal facilitated therapy, artistics expressions, medical play, procedural education, well organized home bound or school programs help the pediatric cancer patients to manage the symptom distress, thereby improving the treatment outcome. The specific supportive chemotherapeutic management is essential for the pediatric cancer patient’s treatment compliance and prognosis. The health care team, especially nurses play a vital role in early detection of chemotherapeutic agents induced symptom distress and its management.

The study was conducted to evaluate the clinical outcomes of various glaucoma surgeries (trabeculectomy, trabeculectomy with mitomycin-C and glaucoma valve implantation) in cases of refractory glaucoma. When it becomes obvious that medication will not help then alternatives should be tried.These alternatives can be in form of :- Filtration Surgery Termed as trabeculectomy allows drainage of aqueous humor from within the eye to underneath the conjunctiva where it is absorbed. Trabeculectomy with mitomycin C-The use of antifibrotic agents such as mitomycin-C and 5-fluorouracil, along with releasable sutures or laser suture lysis, enhances the longevity of guarded procedures, Drainage Implants Glaucoma drainage devices are designed to divert aqueous humor from the anterior chamber to an external reservoir, where a fibrous capsule forms about 4-6 weeks after surgery and regulates flow. Aims of Study 1. Study the clinical outcomes of trabeculectomy,trabeculetomy with mitomycin-C and glaucoma valve implantation in management of refractory glaucoma patients. 2.Evaluate the complications of glaucoma valve surgery. 3.Study the complications of trabeculectomy,trabeculectomy with mitomycin-C. The proposed study was conducted in upgraded department of ophthalmology,LLRM Medical College,Meerut. Population characteristics were number of eyes treated,diagnosed and follow up.The study was a prospective study with random selection of patients done from the OPD.The randomly selected patients were then divided into three groups, one group was subjected to trabeculectomy, second with trabeculectomy with mitomycin-C and the other group was subjected to glaucoma valve implantation. CRITERIA FOR FAILURE OF SURGERY: Ÿ IOP > 21 mm hg at end of 1 year or Ÿ IOP not reduced by 20% from baseline at end of 1 year or Ÿ IOP

The present study was undertaken to determine the effectiveness of virtual reality therapy on anxiety and symptom distress with chemotherapy among children with cancer. The present study was quasi experimental design with one group pretest and posttest design. A total of 12 participants were recruited in the study following the inclusion and exclusion criteria. After recruiting the participants, they were assigned to experimental and control groups with six participants in each group. The participant was exposed to virtual reality therapy for at least 30 minutes during the chemotherapy administration. The control group was given the wait list measures at the end of the post test. The presents study results support virtual reality therapy as an effective tool in anxiety and symptom distress with chemotherapy among children with cancer. Further, detailed studies are recommended with higher sample size and multi centers to support the implementation of virtual reality therapy as a therapeutic tool in the management of mental health disorders.

India accounts for 18% of the global population and 26·6% of global suicide deaths. However, robust population-based, nationally representative data on suicidality are not readily available to plan and implement suicide prevention programmes in India. We aimed to investigate the prevalence and sociodemographic differentials of suicidality using data from the National Mental Health Survey (NMHS) of India, 2015-16.Trained field data collectors from the NMHS obtained information on suicidality (during the past month) from a community sample of adults aged 18 years and older using the suicidality module of the Mini-International Neuropsychiatric Interview (version 6.0). Suicidality was categorised as low, moderate, high, and overall (representing any suicidality), and examined for sociodemographic differentials using normalised sampling weights. For each of the 12 surveyed states, we calculated the age-standardised suicidality prevalence for men and women, men-to-women ratio of weighted suicidality prevalence, ratio of suicidality to suicide deaths, and ratio of suicide attempts to suicide deaths. We used logistic regression analysis to examine the association between sociodemographic factors and overall suicidality and severity.Among 34 748 participants with complete interviews, 5·1% (95% CI 4·7-5·6) had some level of suicidality, and 0·3% (0·2-0·4) had at least one suicide attempt in the past month. The prevalence of overall suicidality was higher in women (6·0% [5·4-6·6]) than in men (4·1% [3·7-4·6]). The prevalence of overall suicidality was highest in those aged 40-49 years among women and in those aged 60 years or older among men. Compared with their counterparts, individuals with lower educational attainment, individuals residing in urban metropolitan cities, individuals who were widowed, separated, or divorced, and unemployed individuals had a higher prevalence of overall suicidality. The men-to-women ratio of overall suicidality prevalence for India was 0·68 (range 0·55-0·85). For every death by suicide in India, there were more than 200 people with suicidality and more than 15 suicide attempts. We found variations for various severities of suicidality. We found an increased risk for overall suicidality in women versus men (odds ratio [OR] 1·54 [95% CI 1·31-1·81]; p0·0001) and in individuals residing in urban metropolitan cities versus those residing in rural areas (1·75 [1·30-2·35]; p=0·0002). Individuals belonging to the lowest income quintile (reference group with OR1·00 and p0·05 for other income quintiles), those with depressive disorders (28·78 [20·04-41·33]; p0.0001) and those with alcohol use disorders (6·52 [3·83-11·10]; p0.0001) had an increased risk for high suicidality, compared with their corresponding counterparts.A national suicide prevention strategy that is comprehensive, using multisectoral approaches, is required to address the prevailing sociodemographic and other risk factors for reducing suicidality and suicide deaths in India. This study also has implications for other low-income and middle-income countries in south Asia, where sociodemographic factors play a crucial role for suicide prevention.Ministry of Health and Family Welfare, Government of India.

Analyzing the human brain and detection of brain disorders using Electroencephalography (EEG) have gained impetus over past few years. Schizophrenia is a mental disorder which affects the functioning of brain. In this paper, we aim to determine quantitative significant EEG features which can be used to differentiate person having schizophrenia disorder and the healthy ones. Variational mode decomposition method (VMD) is used for feature extraction followed by statistical significance analysis of the extracted values. VMD is a popular decomposition method due to its adaptive nature. In this study, we also aim to examine the efficacy of the method in EEG signal analysis. Six different features were calculated and analyzed over the decomposed EEG signal. Analysis is done by performing statistical significance test on SPSS version 23 and by observing the p-values and error bar graphs. Results indicate that five out of six features turned out to be a very good indicator/markers. Hence, this method could be further extended by applying machine learning approach for the classification based on obtained feature set.

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 (χ2 = 27.67; P < 0.001), sitting and reading (χ2 = 13.6; P = 0.004), traveling in a car (χ2 = 15.09; P = 0.002), afternoon rest time (χ2 = 15.75; P = 0.001), and postlunch quiet time (χ2 = 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.

Aim:-The aim of this study is to analyse the factors causing recurrence of infection in the corneal graft after therapeutic penetrating keratoplasty.Material and Methods:- This study was conducted at Upgraded Department of Ophthalmology, SVBPH,Meerut. This institution performs 120 keratoplasty procedures per year on an average. The study was conducted for a period of one year & 25 patients had reinfection and those who presented with reinfection constituted the sample size complete enumeration.The data thus obtained was compiled and analysed using Statistical Package for Social services (SPSS vs 20). The qualitative variables were analyzed by using frequencies and The qualitative variables were analyzed by using frequencies & percentages & chi square test was used as test of significance.The quantitative variables were presented as measures of central tendency and dispersion. A p value of less than 0.05 was considered as statistically significant Results Initial fungal etiology was the main risk factor for the recurrence of microbial keratitis after TPK in (24%) of the cases followed by persistent epithelial defects (16%),Initial bacterial etiology (12%), Lid abnormalities (8%) ,contact lens use (8%), Secondary ocular hypertension (8%), prior rejection episodes(8%), initial viral etiology (4%) ,peripheral ulcerative keratitis (8%) & suture related problems(4%). Conclusion:- .This study has shown that Fungal keratitis was the main reason for the initial TPK & initial Fungal aetiology was the main risk factor for the reinfection after TPK

Background: Recognizing the need for good quality, scientific and reliable information for strengthening mental health policies and programmes, the National Mental Health Survey (NMHS) of India was implemented by National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, in the year 2015–2016. Aim: To estimate the prevalence, socio-demographic correlates and treatment gap of mental morbidity in a representative population of India. Methods: NMHS was conducted across 12 Indian states where trained field investigators completed 34,802 interviews using tablet-assisted personal interviews. Eligible study subjects (18+ years) in households were selected by a multi-stage, stratified, random cluster sampling technique. Mental morbidity was assessed using MINI 6. Three-tier data monitoring system was adopted for quality assurance. Weighted and specific prevalence estimates were derived (current and lifetime) for different mental disorders. Mental morbidity was defined as those disorders as per the International Statistical Classification of Diseases, Tenth Revision Diagnostic Criteria for Research (ICD-10 DCR). Multivariate logistic regression was conducted to examine risk for mental morbidity by different socio-demographic factors. Survey was approved by central and state-level institutional ethical committees. Results: The weighted lifetime prevalence of ‘any mental morbidity’ was estimated at 13.67% (95% confidence interval (CI) = 13.61, 13.73) and current prevalence was 10.56% (95% CI = 10.51, 10.61). Mental and behavioural problems due to psychoactive substance use (F10–F19; 22.44%), mood disorders (F30–F39; 5.61%) and neurotic and stress-related disorders (F40–F48; 3.70%) were the most commonly prevalent mental morbidity in India. The overall prevalence was estimated to be higher among males, middle-aged individuals, in urban-metros, among less educated and in households with lower income. Treatment gap for overall mental morbidity was 84.5%. Conclusion: NMHS is the largest reported survey of mental morbidity in India. Survey estimated that nearly 150 million individuals suffer from one or the other mental morbidity in India. This information is to be used for planning, delivery and evaluating mental health programming in the country.

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.

Introduction Tobacco use is a major causative factor for cancer. Cessation programs along with diagnosis of cancer as a motivating factor may improve quitting rates in patients. This is a protocol of a study that aims to assess the efficacy of brief tobacco cessation intervention (compared to treatment as usual, TAU) on pattern and attitudes towards tobacco chewing in newly diagnosed head and neck cancer patients and their relatives. Methods The proposed study will be conducted in two phases. Phase 1 will include 105 dyads of patients and relatives and shall assess patterns (amount, frequency, duration of use and dependence etc.) and knowledge and attitudes (quitting, continued use, health-behavioural modifications, long-term effects on treatment etc.) towards tobacco chewing in newly diagnosed head and neck cancer patients using smokeless tobacco and their relatives. Sample will be recruited from outpatients attending the ear, nose, throat and head and neck surgery department of a tertiary health care institute. Phase 2 will be a randomized trial that will compare the efficacy of the 'Brief Intervention for Tobacco when Diagnosed with Oral Cancer' (BITDOC) and TAU, and will include 27 dyads in each of the two groups. Intervention will be delivered in three sessions, based on the principles of motivational interviewing and the 3As model. Conclusions This study will help in the evaluation of the attitude towards smokeless tobacco (SLT) in a population that has faced the adverse consequences from its use and changes brought by a diagnosis of HNC. It will also help in developing a cost-effective model for promotion of smoking cessation.

Additional file 1: Table S1. Domains and components of each domain under NMHS-MHSA. Table S2. Mental Health Systems Assessment Indicators.

Background: Internet use has spread across the world due to easy accessibility and affordability. However, it has been creating many problems at several levels. So, there is a need to identify the suitability of psychometric properties and the factor structure of the widely used Internet Addiction Test (IAT) in the Indian settings. Our objective was to perform an exploratory factor analysis on the IAT and to test the reliability of the scale. Methods: It was a cross-sectional study that included various professional groups. We used an online questionnaire that included sociodemographic details and Young’s IAT. Exploratory factor analysis was used to identify the factor structure of Young’s IAT in the Indian setup. Results: The mean age of the sample (N = 1,782) was 27.7 years (SD = 8.74) with a predominantly male population 1040 (58.4%). In total, 1.0% (17) of the sample had significant problems with internet usage, whereas 13% (232) were in the range of frequent/occasional problems, and the mean score on IAT was 32 (SD = 16.42). Exploratory factor analysis revealed two factors that explained 49% of the variance (Kaiser–Meyer–Olkin measure of sampling adequacy: 0.95, Bartlett’s test of sphericity: P = 0.000). They were “mood and relationship issues” and “duration and productivity.” Cronbach’s α was 0.92, which indicates a high level of internal consistency. Conclusion: In Indian settings, IAT can be understood based on the two-factor structure. The scale has excellent reliability. Further studies are needed to replicate these results, by using confirmatory factor analysis and validity testing.

INTRODUCTION Despite a significant number of patients dependent on "poppy husk" in India, they are poorly characterized. Moreover, scarce data is available with respect to their treatment. METHODS A cohort of 148 patients with "poppy husk" dependence receiving substitution treatment with buprenorphine/naloxone were followed up for 4 years, using a retrospective chart-based assessment. Baseline demographic and substance-related characteristics were described. Retention rates (operationally redefined as "6 months of uninterrupted contact anytime during their visits") over the next 4 years and their predictors were assessed. RESULTS Mean age of onset of "poppy husk" use was found to be 27.51 years, and mean duration of dependence was 18.25 years. Mean amount of poppy husk consumed per month was 3.7 kg. Commonest reasons for initiating and quitting its use were enhancing work efficiency and lack of availability, respectively. Retention rates were 25%. Significant predictors of retention were age more than 40 years (OR = 2.295; 95%CI = 1.015-5.19) and uninterrupted treatment duration for at least 1 month from first contact (for 1 month (OR = 5.625; 95%CI = 2.28-13.89), for 3 months (OR = 10.96; 95%CI = 4.65-25.85), and for 6 months (OR = 52.8; 95%CI:14.08-197.98). DISCUSSION Factors associated with occupation such as enhancing work efficiency and overcoming fatigue are related to use of "poppy husk." While the amount of intake is considerably large among treatment seekers who are dependent on it, their dependence duration is longer and retention rates lower than those reported for patients with prescription and injectable opioid dependence. Specific strategies to tap patients less than 40 years and to target uninterrupted contact in initial phases of maintenance should be developed.

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).

Relation of behavioral and psychological symptoms with dementia has several implications. They predict treatment and prognosis in patients. Anxiety and its association as a psychological symptom despite being well known is not addressed properly in clinical settings. Although generalized anxiety disorder is most commonly seen in patients with dementia, some of them might also present with late-onset separation anxiety. Presentation of separation anxiety in the index patient signifies the fact that atypical age of onset, acuteness of presentation points toward an underlying organic etiology. Patients with such clinical features should be thoroughly assessed for dementia. Clinicians should be aware of the association between separation anxiety and organic deficits.

Distribution of comorbidities in patients with mental retardation or intellectual disabilities (MR/ID) across various age groups is not recognized adequately. Data from 426 patients diagnosed with MR/ID was collected out of 546 samples referred for intelligence assessment. 42.3% had psychiatric comorbidities. The prevalence ratio of psychiatric comorbidity associated with MR/ID was 2.11. Frequency of comorbidities in the order of occurrence was “behavioral impairment > Epilepsy > autism/ADHD” for age-groups 10years and below, and “behavioral impairment > Epilepsy > depression/anxiety” for age-groups 11years and above. We conclude that irrespective of age distribution, behavioral impairment followed by epilepsy are found to be the most common comorbidities.

Understanding the burden and pattern of mental disorders as well as mapping the existing resources for delivery of mental health services in India, has been a felt need over decades. Recognizing this necessity, the Ministry of Health and Family Welfare, Government of India, commissioned the National Mental Health Survey (NMHS) in the year 2014-15. The NMHS aimed to estimate the prevalence and burden of mental health disorders in India and identify current treatment gaps, existing patterns of health-care seeking, service utilization patterns, along with an understanding of the impact and disability due to these disorders. This paper describes the design, steps and the methodology adopted for phase 1 of the NMHS conducted in India. The NMHS phase 1 covered a representative population of 39,532 from 12 states across 6 regions of India, namely, the states of Punjab and Uttar Pradesh (North); Tamil Nadu and Kerala (South); Jharkhand and West Bengal (East); Rajasthan and Gujarat (West); Madhya Pradesh and Chhattisgarh (Central) and Assam and Manipur (North East). The NMHS of India (2015-16) is a unique representative survey which adopted a uniform and standardized methodology which sought to overcome limitations of previous surveys. It employed a multi-stage, stratified, random cluster sampling technique, with random selection of clusters based on Probability Proportionate to Size. It was expected that the findings from the NMHS 2015-16 would reveal the burden of mental disorders, the magnitude of the treatment gap, existing challenges and prevailing barriers in the mental-health delivery systems in the country at a single point in time. It is hoped that the results of NMHS will provide the evidence to strengthen and implement mental health policies and programs in the near future and provide the rationale to enhance investment in mental health care in India. It is also hoped that the NMHS will provide a framework for conducting similar population based surveys on mental health and other public health problems in low and middle-income countries.

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

This study was carried out to investigate the biomedicinal efficacy of a bioactive marker component, butyryl alkannin isolated from n-hexane root extract of Arnebia euchroma against vancomycin-intermediate Staphylococcus aureus (VISA) and methicillin-resistant S. aureus (MRSA) pathogens. As a result, butyryl alkannin showed significant antibacterial activity against multidrug-resistant pathogens of VISA and MRSA as minimum inhibitory concentration values which were found to be 1.56 and 1.56 μg/ml, respectively. These findings justify the biomedicinal efficacy of butyryl alkannin compound.

Langerhans cell histiocytosis (LCH) commonly occurs in children. It mimics infection and many benign and malignant tumours. This disease mainly involves the spine, skull and long bones, and its incidence is sporadic in the small bones of the foot and hand. We could not find any case reports with the involvement of a metatarsal bone, and hence, awareness about its possibility is essential to suspect it as a differential diagnosis of lytic lesions in the foot bones and therefore treat it judiciously. We have reported a case of a 35-year-old woman with spontaneous onset of pain over her right foot for the last year. An extensive curettage was performed, where the histology confirmed the features of LCH. Awareness about this entity and its differential diagnosis may help to clinch and early diagnosis and to treat effectively.

Adverse cutaneous reactions are frequently reported to occur with the use of psychotropic medications, which may lead to poor drug compliance. As compared to other groups of psychotropic medication, antipsychotics, both typical and atypical, are less likely to cause adverse cutaneous reactions. The most frequent cutaneous adverse reactions associated with antipsychotics include fixed drug eruptions, exanthematous eruptions, photosensitivity reactions and altered skin pigmentation. Most of these commonly seen cutaneous adverse reactions are benign and easily treatable. Rarely, severe cutaneous adverse reactions such as erythema multiforme, Steven-Johnson syndrome are toxic epidermal necrolysis and have also been associated with antipsychotics. Olanzapine is one of the most commonly prescribed atypical antipsychotic with metabolic complications as most common adverse effects. Dermatological reactions are rarely observed with olanzapine. We report occurrence of pellagroid skin lesions over exposed areas of upper limbs with olanzapine that resolved completely after its discontinuation.

Objectives Persistent sleep abnormalities during abstinence are a harbinger for relapse in patients with chronic alcohol dependence. The present study aimed to compare polysomnography (PSG) data between ‘recently detoxified’ patients with chronic alcohol dependence and healthy controls. Methods Both conventional sleep architectural and power spectral analyses were conducted. Twenty subjects in each of the groups were enrolled. A 2 nights’ sleep (first-habituation and second-experimental) PSG data was collected. Computer assisted scoring supplemented by manual method using the Rechtschaffen and Kales criteria were used for sleep staging. Twenty eight channels were used for the EEG recording. Spectral power across early NREM (Non-rapid-eye-movement), Slow Wave Sleep and REM was computed using the Welch's averaged periodogram method. Results Results on conventional sleep staging showed that patients had significantly lesser total sleep time, sleep efficiency and stage shifts and longer sleep onset latency; while duration of each NREM stages were significantly lower, and latency of stage 2 NREM was significantly longer in patients. After controlling for multiple comparisons, spectral power analysis revealed significant differences only during REM sleep and specifically in high frequency (beta and gamma) bands. Conclusions Stating the mutually complementary role of conventional and spectral analyses of polysomnography EEG data, we conclude that sleep abnormalities are fairly evident in recently detoxified alcohol dependent patients.