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Objective: To assess and compare the quality of life and disability in patients with schizophrenia and obsessive compulsive disorder. Methods: A cross-sectional study was carried out in the outpatient psychiatry clinics at Jaipur of India. Fifty patients with obsessive compulsive disorder and 47 with schizophrenia (diagnosed as per criteria of the 10th revision of the International Classification of Diseases), and with a minimum duration of 2 years on maintenance treatments, were evaluated. Evaluation was based on the World Health Organization Quality of Life Instrument, the Global Assessment of Functioning scale, and the Indian Disability Evaluation Assessment Scale. The collected data were analysed using descriptive and inferential statistics. Results: Regarding quality of life domains, there was no statistically significant difference between the 2 groups. Obsessive compulsive disorder patients had lower scores on all domains of disability, all such differences being statistically significant. Conclusions: The deleterious effect of illness on quality of life and functioning occur not only in schizophrenic but also in obsessive compulsive disorder patients. Thus management should be planned with this consideration to yield better outcomes in both conditions. [ABSTRACT FROM AUTHOR]

Background: Fenugreek (Trigonella foenum-graecum L.) is an annual medicinal and spice crop belonging to the family Fabaceae. The occurrence of a yellow vein disease was recorded in fenugreek in Jodhpur (India) in 2022. The infection of begomoviruses in legume crops results in significant yield loss and major economic loss. The current study reports an association of a novel begomovirus species associated with yellow vein disease in Fenugreek., Methods and Results: In symptomatic fenugreek plants, geminivirus-like particles were visible under a transmission electron microscope. Further, nucleotide sequence analysis of the rolling circle amplified product revealed 2743 nucleotide DNA-A genome with close relatedness to French bean leaf curl virus (88.21%) and Senna leaf curl virus (87.63%). It was proposed as a new begomovirus species, Fenugreek yellow vein Rajasthan virus. The genome organization suggested the presence of a typical nonanucleotide sequence along with 7 ORFs in DNA-A. A possible recombination event took place in the coat protein (V1) region with Pedilanthus leaf curl virus and Chilli leaf curl virus as major and minor parents. The recombinant virus poses possible threats to several other legume crops. To the best of our knowledge, this is the first report of the association of FeYVRaV with fenugreek yellow vein disease from northwestern India., Conclusions: In conclusion, the presence of a novel begomovirus species associated with yellow vein disease in fenugreek is alarming and needs further studies on its infectivity to prevent its spread to legume crops., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: There are various factors including inflammation that have been studied in bipolar disorder. NLR (Neutrophil to lymphocyte ratio) and PLR (platelet to lymphocyte ratio) are one of them. Various psychotropic drugs can affect the inflammatory state., Aim: This study was planned to find NLR and PLR in bipolar disorder (mania) and psychotropic drug naïve 1 st episode mania., Materials and Methods: Total of 120 subjects were chosen including, 40 bipolar mania, 40 drugs naïve 1 st episode mania, and 40 healthy controls. The severity of mania was assessed by the Young Mania Rating Scale. Blood samples were collected in the morning hours in order to get blood counts., Results: A significantly higher values of neutrophil counts and NLR, while the significant lower values of lymphocyte counts in both 1 st episode and bipolar mania compared to healthy control were observed. The first episode mania group had significantly higher neutrophil counts and NLR in comparison to bipolar mania., Conclusion: Results suggest a possible inflammatory pathophysiology of mania. Psychotropic medicines may have an anti-inflammatory effect, signified by the fact that 1 st episode mania group has a greater level of inflammation in comparison to bipolar mania., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Journal of Psychiatry.)

Background  Brain tumors may be associated with high morbidity, and psychiatric symptoms may be an early manifestation. It is important to address mental symptoms as early as possible because they are prone to develop psychiatric comorbidities in future. If untreated, these situations may worsen and lead to burden upon caregivers. Methods  A total of 176 brain tumor patients between January 2021 and January 2022 constituted the sample size. All recently diagnosed cases of brain tumor with age equal to or more than 18 years who can comprehend and answer questionnaires were included. Patients with a long history of brain tumor or who had a history of a psychiatric illness other than presenting symptoms or any other serious medical illness were excluded. Results  Twenty-seven percent of brain tumor patients had psychiatric symptoms. Depressive symptoms were the most common, associated with 24% of patients, followed by anxiety disorders. Psychiatric disorders were more common in supratentorial compared to infratentorial tumors. Psychiatric symptoms seem to be associated more commonly with malignant tumors and peritumoral edema. Among malignant tumors, depressive symptoms tend to be related with high-grade glioma, and among benign tumors, they were more common in meningioma. No predilection to laterality and anatomical lobe involvement is reported. Conclusion  Screening of psychiatric disorders should be a routine in brain tumor patients. An integrated approach is required to treat brain tumor patients. Healthcare professionals should be more vigilant about the onset of psychiatric symptoms and the need of palliative care to improve the quality of life., Competing Interests: Conflicts of Interest None declared., (Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Introduction: Adjuvating of the epidural block with local anaesthetics during lower limb surgeries improves Intraoperative as well as postoperative analgesia. A comparison of epidural ropivacaine plus dexmedetomidine (RD) versus ropivacaine plus ketamine (RK) was done in terms of quality of the motor and sensory blockade, changes in hemodynamic parameters, and efficacy of analgesia., Methods:  A prospective randomized parallel double-blind study was conducted on 68 patients of the American Society of Anaesthesiologists (ASA) grade 1 and 2, ages 18 to 75 years, which were divided into two groups (RD and RK; 34 patients in each group). After receiving a loading dose through an epidural catheter consisting of 20ml of 0.5% ropivacaine, the epidural infusion was started after an hour of surgery at 5ml/hrs of 0.2% ropivacaine with 1µg/ml dexmedetomidine in Group RD and at 5ml/hrs of 0.2% ropivacaine with 0.5mg/ml ketamine in Group RK for 48 hours. Both groups were compared regarding the onset of sensory and motor block, resolution of sensory and motor block, hemodynamic parameters, analgesic efficacy, and total rescue analgesic requirement in 48 hours., Results: A significant difference was observed in the time of resolution of sensory blockade which was 9.77±2.38 hrs in the RD group as compared to 7.79±1.82 hrs in the RK group (p-value 0.0003) and the time of resolution of motor block was 6.53±2.44 hrs in the RD group compared to 4.58±0.83 hrs in the RK group (p-value 0.001)., Conclusions: Epidural dexmedetomidine significantly increases the duration of analgesia and duration of the motor blockade in comparison to ketamine., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Gujral et al.)

Background: The prevalence of mental health problems and substance abuse in the migrant population is higher than the general population., Aims and Objectives: To assess the prevalence and pattern of mental health issues and substance use in the migrant population and highlight the association with the reverse migration of migrant workers., Methodology: The field staff visited the shelter homes for migrant population in four cities of Northern India (Chandigarh (UT), Bhatinda (Punjab), Panchkula (Haryana) and Jaipur (Rajasthan). After maintaining the social distance and wearing masks by the staff and migrants, written informed consent was taken for participation in the study. The socio-demographic details of reverse migrants were noted down and Hindi version of Patient Health Questionnaire (PHQ-9) for mental health problems and screening tool for pattern of substance abuse was administered. Geographically matched undisplaced were also administered these tools., Results: A total of 275 reverse migrants and 276 undisplaced were included in the study. The prevalence of ever use for all the substances among reverse migrants was 44.4% (122/275) and among undisplaced, it was 45.3%. The prevalence of alcohol, tobacco and cannabis was higher than the general population. The prevalence of at least one diagnosis on PHQ-9 is 13.45% (reverse migrants 19.3% and undisplaced 7.6) and the prevalence of other depressive disorder is significantly higher in reverse migrants (17.1%) than undisplaced (4.0%)., Conclusion: The study concludes that prevalence of mental health issues and substance abuse in migrant population is significantly higher than the general population and the prevalence of at least one diagnosis and other depressive disorder is significantly higher in reverse migrants than undisplaced.

Background: Thyroid function is commonly considered in the assessment of mood disorders. Reports of thyroid dysregulation in patients with mania are associated with several confounding factors. To eliminate confounding factors, studies of first-episode mania are desirable. This study tried to find out any relationship between thyroid disorders and mania., Aim: The aim of this study is to assess and compare the thyroid profile between first-episode mania and healthy controls and to ascertain the correlation between severity and duration of the manic episode with FT3, FT4, and thyroid-stimulating hormone (TSH) levels., Materials and Methods: This was a cross-sectional study conducted in the psychiatry department of a tertiary care hospital. Forty consecutive drug-naïve patients with first-episode mania, diagnosed according to the International Classification of Disease-10 (study group), were matched with 40 healthy controls (control group). Both the groups were compared on the basis of thyroid profile and thyroid levels were correlated with duration and severity of illness in the study group., Results: Nearly 7.5% of cases in the study group had hyperthyroidism, whereas 5% had subclinical hyperthyroidism. In contrast, normal controls showed 5% and 10% prevalence of hypothyroidism and subclinical hypothyroidism, respectively. A statistically significant lower level of TSH was observed in the study group ( P < 0.001), whereas the mean serum levels of FT3 and FT4 were higher in the study group, but the difference was statistically nonsignificant. No significant correlation of thyroid hormones level with duration and severity of illness was noted., Conclusion: Our findings highlight a higher prevalence of hyperthyroidism in patients with mania and suggest the role of thyroid hormones in mania., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Indian Journal of Psychiatry.)

Competing Interests: There are no conflicts of interest.

Objective: To examine the various psychosocial factors associated with reverse migration among migrant workers during the coronavirus disease 2019 (COVID-19) lockdown in India., Methods: A cross-sectional multicenter study was conducted at 4 sites in Northwest India. The migrant workers were recruited from various shelter homes, and information was gathered from reverse migrant workers and controls using various tools including a sociodemographic profile; knowledge, attitudes, and practices questionnaire; and reasons for migration and reverse migration questionnaires. A total of 275 reverse migrant workers and 276 controls participated in the study., Results: There was a considerable difference between reverse migrant workers and controls regarding the question of whether it was safe to travel during lockdown (76.0% vs 26.4%, respectively). The most common route of spread of COVID-19 infection was through touching and sneezing, and symptoms were fever, dry cough, and sore throat in both groups. Reverse migrant workers had low self-esteem and were reluctant to participate in customs of their migration city. A large number of reverse migrant workers reported that they had no money to survive, worried about family back home at their village, felt pressured by family members to come back to the village, and had been terminated from their job., Conclusions: Reverse migrant workers had the attitude that it was safe to travel during the lockdown. About one-fifth of the reverse migrant workers reported no place to live and fear of getting an infection. The reverse migrant workers also reported feeling low and gloomy, restless, and uncertain about the future and fear of death. Lack of jobs was a major factor driving migrant workers from their native homes., (© Copyright 2021 Physicians Postgraduate Press, Inc.)

Competing Interests: There are no conflicts of interest.

Segawa's syndrome, dopamine-responsive dystonia, is a rare genetic disorder that typically begins in childhood by around 4-6 years of age. It is characterized by abnormal gait and dystonia. A 33-year-old man presented for autologous skin grafting of a nonhealing wound under general anesthesia. Successful anesthetic management of patients with this rare disease, though analogous in many ways to that of patients with Parkinson's disease, still pose significant challenges. We present anesthetic nuances to be considered in the management of a patient with Segawa's disease along with a pertinent review of the literature., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Saudi Journal of Anesthesia.)

Background and Aim: The anaesthesiologists are at the highest risk of contracting infection of coronavirus disease 2019 (COVID-19) in emergency room, operation theatres and intensive care units. This overwhelming situation can make them prone for psychological stress leading to anxiety and insomnia., Materials and Methods: We did an online self-administered questionnaire-based observational cross-sectional study amongst anaesthesiologists across India. The objectives were to find out the main causes for anxiety and insomnia in COVID-19 pandemic. Generalised Anxiety Disorder-7 (GAD-7) scale and Insomnia Severity Index (ISI) were used for assessing anxiety and insomnia., Results: Of 512 participants, 74.2% suffered from anxiety and 60.5% suffered from insomnia. The age <35 years, female sex, being married, resident doctors, fear of infection to self or family, fear of salary deductions, increase in working hours, loneliness due to isolation, food and accommodation issues and posting in COVID-19 duty were risk factors for anxiety. ISI scores ≥8 was observed in <35 years, unmarried, those with stress because of COVID-19, fear of loneliness, issues of food and accommodation, increased working hours and with GAD-7 score ≥5. Adjusted odd's ratio of insomnia in participants having GAD-7 score ≥5 was 10.499 (95% confidence interval 6.097-18.080; P < 0.001)., Conclusion: The majority of anaesthesiologists on COVID-19 duty suffer from anxiety and insomnia. Addressing risk factors identified during this study with targeted interventions and psychosocial support will help them to cope better with the stress., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Indian Journal of Anaesthesia.)

Obsessive-compulsive disorder (OCD) is phenotypically heterogeneous. Gender is an important factor mediating this heterogeneity. We examined gender differences in a large sample (n = 945) of OCD patients under a multi-centric study in India. Cross-sectional assessments were done on consecutive adult (>18 years) treatment-seeking patients with a DSM-5 diagnosis of OCD. Subjects were assessed on Structured Clinical Interview for DSM-5-Research Version for comorbid psychiatric illnesses, Yale Brown Obsessive Compulsive Scale for OCD phenomenology and symptom severity, Brown Assessment of Beliefs Scale for insight, Beck's Depression Inventory for severity of depressive symptoms, and the Obsessive Beliefs Questionnaire. On multivariate backward Wald logistic regression analysis, males (59.7%) had more years of education, had a higher rate of checking compulsions and comorbid substance use disorders. Women were more likely to be married, more commonly reported precipitating factors, had a higher rate of hoarding compulsions and comorbid agoraphobia. Findings from this large study validate gender as an important mediator of phenotypic heterogeneity in OCD. The mechanistic basis for these differences might involve complex interactions between biological, cultural and environmental factors., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: The evidence of hypothalamic-pituitary-adrenal axis dysfunction in schizophrenia has been reviewed in the context of the stress-diathesis model. Overactivation of this axis leads to altered blood levels of cortisol and dehydroepiandrosterone sulfate (DHEA-S). These neurosteroids in turn act on the hippocampus and interact with gamma-aminobutyric acid and N-methyl-D-aspartate receptors leading to neurotoxicity and may be involved in the neurobiology of aggression. This study aimed to explore the blood level of these neurosteroids and ascertain its correlation with state aggression and psychopathology in first-episode antipsychotic-naïve schizophrenic patients., Methods: A total of 30 patients with first-episode schizophrenia along with 20 age- and gender-matched healthy controls participated in the study. Both groups were subjected to serum cortisol and DHEA-S measurement after assessment of psychopathology and aggression on a standardised psychometric scale., Results: Serum DHEA-S level was significantly higher in the patient group (p = 0.001). No difference was noted between males and females in the patient group (p = 0.93) but female controls had a significantly lower serum DHEA-S level than male controls (p < 0.01). Serum DHEA-S inversely correlated with scores on Modified Overt Aggression Scale (p = 0.01) but not with Positive and Negative Syndrome Scale (p = 0.39) or Clinical Global Impression Scale (p = 0.28)., Conclusion: The first-episode antipsychotic-naïve schizophrenic patients showed a significantly higher blood level of DHEA-S compared with healthy controls. Serum DHEA-S level has an inverse relationship with aggression and may serve as a biological adaptive mechanism to antagonise the neuronal damage caused by cortisol.

Competing Interests: There are no conflicts of interest.

Context: Multiple vulnerability genes interact with environmental factors to develop a range of phenotypes in the schizophrenia spectrum. Endophenotypes can help characterize the impact of risk genes by providing genetically relevant traits that are more complaisant than the behavioral symptoms that classify mental illness., Aims: We aimed to investigate the neurocognitive endophenotypic markers for schizophrenia in Indian population., Settings and Design: In a cross-sectional study, we assessed neurocognitive functioning in 40 unaffected first-degree relatives (FDR) of schizophrenia patients with an equal number of healthy controls., Materials and Methods: FDR schizophrenia group was compared with the control group on measures of short-term memory, verbal working memory, auditory verbal memory on indices of immediate recall and recognition, visuospatial working memory, visual attention, and executive functions., Results: The study found that FDR schizophrenia scored poorly on all tested measures of neurocognition except visual attention. On calculating composite score, we found that composite neurocognitive score better discriminated the FDR schizophrenia from the control group., Conclusions: Neurocognitive measures of short-term memory, verbal working memory, auditory verbal memory, visuospatial working memory, and executive functions significantly differentiate FDR of patients with schizophrenia from controls and can be considered as endophenotypic markers of schizophrenia in non-Caucasian population. The exactitude of this approach can be increased by calculating a composite neurocognitive score which combines various neurocognitive measures.

Objectives: To evaluate the status of schizotypy, neurological soft signs, and cognitive functions as vulnerability markers for schizophrenia and to investigate the potential value of their combination for early identification of people at high risk for schizophrenia., Methods: A cross-sectional study was conducted. Subjects were drawn from first-degree relatives of inpatients and outpatients with schizophrenia (n = 50). Controls (n = 30) were recruited by word-of-mouth from hospital staff and attendants of hospitalised patients. Subjects who met inclusion criteria on screening were subjected to selected measures for assessment, including Schizotypal Personality Questionnaire-Brief Version, the Cambridge Neurological Inventory, digit span test, paired associate learning test, and visuospatial working memory matrix. Statistical analysis was completed using the independent t test and significance (p value), as well as calculation of effect size (Cohen's d). Discriminant function analysis was used to determine the effect of combining assessment measures., Results: First-degree relatives showed higher schizotypy scores (Cohen's d = 0.88) and neurological soft signs (Cohen's d = 1.55). They scored significantly worse on all neurocognitive measures (Cohen's d = -1.27). Discriminant function analysis showed that Schizotypal Personality Questionnaire-Brief Version, neurological soft signs, and total cognitive index (the sum of weighted scores on individual cognitive scales) in combination better discriminated between the first-degree relative and control groups (Wilks' λ = 0.54)., Conclusion: Use of multiple vulnerability markers could enhance the specificity of measures used to determine risk for schizophrenia.

Background: Social networking sites like Facebook, Orkut and Twitter are virtual communities where users can create individual public profiles, interact with real-life friends and meet other people based on shared interests. An exponential rise in usage of Social Networking Sites have been seen within the last few years. Their ease of use and immediate gratification effect on users has changed the way people in general and students in particular spend their time. Young adults, particularly teenagers tended to be unaware of just how much time they really spent on social networking sites. Negative correlates of Social Networking Sites usage include the decrease in real life social community participation and academic achievement, as well as relationship problems, each of which may be indicative of potential addiction., Aims: the aim of the study was to find out whether teenagers, specially those living in cities spend too much time on social networking websites., Materials and Methods: 200 subjects, both boys and girls were included in the cross sectional study who were given a 20 item Young's internet addiction test modified for social networking sites. The responses were analyzed using chi square test and Fisher's exact test., Results: 24.74% of the students were having occasional or 'frequency' problems while 2.02% of them were experiencing severe problems due to excessive time spent using social networking sites., Conclusion: With the ever increasing popularity of social media, teenagers are devoting significant time to social networking on websites and are prone to get 'addicted' to such form of online social interaction.

Objective: Neurological soft signs (NSS) and cognitive function had been examined in schizophrenia, but their relationship has remained elusive for several years. We examined the relationship between NSS and cognitive functions in the present study., Method: A cross sectional study was carried out. Subjects were drawn from first degree relatives of schizophrenia patients, admitted as inpatient or attending as an outpatient. Controls were recruited by word of mouth from hospital staff and visitors of hospitalized patients. Those subjects who satisfied the screening process were subjected to Cambridge Neurological Inventory for soft sign assessment and digit span test, paired associate learning test (PALT) and visuo-spatial working memory matrix (VSWMM) for cognitive function assessment. Correlation analysis and structural equation modeling (SEM) was used for analysis., Result: Significant negative correlation of primitive reflexes with PALT; of motor coordination with VSWMM, working memory (WM) and cognitive index; of total NSS with WM and cognitive index among first degree relatives. SEM showed that motor soft signs have important negative influence over WM., Conclusion: The current findings indicate that NSS have significant negative effect on cognitive functioning., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Aims: The present study was conducted to assess the effects of duration of hypertension, systolic hypertension, diastolic hypertension, drug compliance and class-of-drug on cognitive functions., Methods and Results: A cohort of young hypertensive subjects was recruited after obtaining informed consent. Subjects with confounding factors, e.g., substance use, neurological disorders, endocrinopathies, inflammatory conditions, psychiatric illnesses, etc., were excluded. Their average systolic and diastolic blood pressure since onset of illness and prescribed drugs were noted from the records. Compliance was assessed with the help of information from subjects as well as the close relatives. MMSE and a battery of neuropsychological tests (Digit Span Test, Trail Making Test Form B, Stroop Test, Visuospatial Working Memory Matrix and Word Fluency Test) was applied to all the participants. Multivariate regression analysis was used for the assessment of associations and one-way ANOVA was performed to assess differences in the mean. Analysis showed that mean age of study subject was 52 years and average duration of hypertension was 9 years. Fourteen percent subjects had obvious cognitive impairment as suggested by MMSE score less than 23. However, when cut-off score was lowered to 20, only 6% subjects fell into this category. Diastolic blood pressure had significant negative association with all of the cognitive measures except Trail Making Test, which was, on the contrary, significantly and negatively associated with systolic blood pressure. Duration of hypertension did not influence cognitive performance in this study. Effect of drug compliance was somewhat variable, but in general good compliance was associated with better cognitive performance. Beta-Blocker therapy hampered cognitive performance, whereas the best performance, especially on tests of semantic memory and pre-frontal functions was seen in subjects taking calcium channel blockers., Conclusions: Diastolic hypertension was associated with significant impairment of cognitive functions in younger subjects. On the other hand good compliance and calcium channel blockers had protective effect on hypertension induced cognitive impairment, especially on the prefrontal functions.

The author conducted a review of studies that compared the efficacy, tolerability and indication for the use of clozapine in current perspectives for the treatment of resistant schizophrenia/ partial responders.

Aim: Hypertension is known to induce many pathological changes in the body, including cardiac hypertrophy, atherosclerosis, micro-aneurisms and stroke. Besides these conspicuous pathologies, it also has subtle effects on the functioning of the brain. These cognitive changes have received little attention despite the fact that they make a large impact on the daily functioning of affected persons. The present study was conducted to assess the effect of hypertension and related factors on cognitive functions in an Indian population., Methods and Results: A cohort of young hypertensive subjects was recruited after obtaining informed consent. Subjects with confounding factors, such as substance use, neurological disorders, endocrinopathies, inflammatory conditions and psychiatric illnesses, were excluded. The average systolic and diastolic blood pressure of the subjects since the onset of illness and prescription of drugs were noted from the records. Compliance was assessed with the help of information given by the subjects and their close relatives. The mini-mental state examination and a battery of neuropsychological tests (digit span test, trail making test, Stroop test, visuospatial working memory matrix and word fluency test) were applied to all participants. Univariate regression analysis was used for the assessment of association and a one-way analysis of variance was performed on categorical variables. The mean age of the subjects was 52 years, and the average duration of hypertension 9 years. Twelve subjects had dementia which could be attributed to the subtle effects of hypertension only. Blood pressure (both systolic and diastolic) had a significant negative association with the cognitive tests. Cognitive impairment was also seen in subjects who reported poor drug compliance and those using beta blockers, while calcium channel blockers played a protective role., Conclusions: Hypertension was associated with a significant decline in cognitive functioning in younger subjects. Good compliance with drugs and the use of calcium channel blockers had a protective effect on hypertension-induced cognitive decline.

A retrospective study was conducted in a psychiatric setup of S.P. Medical College, Bikaner (Raj.) to assess the social demographic and clinical characteristics of hysterical patients. The illness was more common in female patients. Most of the patients were young, married and illiterate. Nearly half of them had faced some stress prior to onset of their illness. Fits of unconsciousness and aphonia were the commonest presentation in female and male patients respectively. Duration of stay was 2-3 days and most of the patient responded well to different treatment modalities.

The present study of fifty patients was aimed at determining the prevalence and nature of recent life events and their role in the precipitation of mania. The role of other factors like family history of psychiatric illness and personality temperament were also taken into account. The study showed that 54% of patients with manic episodes had life events in the preceding one month. The commonest type of life event perceived was a financial problem, large loan, marital and family conflicts and damage to property or crops. Perception of life events had a statistically significant relationship with family history of mental illness and educational status.