Open Access Case Report

A Case of Polydipsia in a Psychiatric Patient

Christopher Izehinosen Okpataku

International Neuropsychiatric Disease Journal, Page 1-4
DOI: 10.9734/INDJ/2017/32113

A 28 year old male student, with a long standing history of psychotic disorder, presented with excessive water intake and symptom exacerbation with associated confusion, vomiting and irrational talk, that has started a week before. He drank about 20 L of water daily and had dyselectrolytaemia. He was admitted and managed as a case of Diabetes Insipidus with no improvement until after an inadvertent psychiatric evaluation and management when the correct diagnosis was made. This case is the first to be reported in this country and a learning point for psychogenic polydipsia.

Open Access Short Research Article

Detrimental Effects of Epilepsy and Anti-Epileptic Drugs on Sexual Function and Potency of Epileptic Male Patients

Osama Abdel Salam, Ayman Abd El-Naby, Wael Gbr, Adel Matar, Waleed El-Eraki El-Azab

International Neuropsychiatric Disease Journal, Page 1-9
DOI: 10.9734/INDJ/2017/29392

Objectives: To assess effect of epilepsy and anti-epileptic drug (AED) therapy on sexual function and potency of the epileptic male patients.

Patients and Methods: This is a cross-sectional study incorporated 40 epileptic male patients with mean age of 26.8±2.9 years and 15 control men. All men underwent thorough history taking including age, duration of disease and AED therapy. All selected patients are matched in age, average Body Mass Index (BMI) 20-30. Obese patients, patients with mood disturbance or history of other medical or urological disorders that might affect sexual function were excluded from the study. Potency and erectile dysfunction was assessed by using the Arizona Sexual Experience Scale (ASEX) questionnaire. Fasting morning blood samples were obtained to measure serum level of total testosterone, estradiol and sex hormone-binding globulin (SHBG).

Results: All patients were average body weight. Mean duration of disease was 7.6±2.9 years and mean number of seizure per month was 5.1±2.6 fit/month. Twenty-three of them had left, while 17 men had right temporal lobe epilepsy (TLE) and 29 patients were maintained on AED therapy. Patients had significantly higher ASEX score compared to control men and 20 patients had sexual dysfunction with score value ≥18. patients had right TLE had significantly higher ASEX score compared to both controls and to women had left TLE and 12 patients with right TLE had sexual dysfunction. Patients continue on anti-epileptic medication showed higher ASEX score with statistically significance in comparison to both controlled group and those who were not on treatment and 17 patients had sexual dysfunction were maintained on AED. Serum levels of estradiol were significantly lower, while serum levels of SHBG were significantly higher in epileptic patients compared to controls. There was a positive significant correlation between high ASEX scores identifying sexual dysfunction and high number of seizures/month, right-sided epileptic focus and maintenance on AED.

Conclusion: Epilepsy has a detrimental effect on sexual functions in men and that impact might have been magnified with anti-epileptic drugs, especially for patients with right temporal lobe epilepsy.

Open Access Original Research Article

A Case-control Study to Identify the Risk Factors of Dementia among Clinically Diagnosed Patients in Kerala

Malini Bhattathiry

International Neuropsychiatric Disease Journal, Page 1-8
DOI: 10.9734/INDJ/2017/31691

Context: Dementia is one of the most significant challenges of the 21st century because of its health, social and economic impact. In India over 4.1 million people are affected. Dementia still remains a largely hidden problem in India. There is gross ignorance, neglect and scarce services for people with dementia and their families, especially in the disadvantaged parts of India.

Objective: To identify the risk factors of dementia among the residents of ARDSI (Alzheimer’s and related Disorders Society of India) Centers in Kerala.

Materials and Methods: A case control study involving 51 clinically diagnosed dementia patients from four ARDSI Centers in Kerala were considered as cases and 102 age and gender matched controls were selected from neighborhood.

Using a pretested structured interview schedule the risk factors of dementia were identified.

Results: 51 cases and 102 controls participated in this study. The dementia patients who were in the 70–79 age group constituted 43%.Among the women with dementia 18% were widows. Multiple logistic regression analysis showed that important determinants of dementia were increasing age, married status, family history of dementia and hypertension.

Conclusion: The public awareness about dementia in India is low. A better understanding & identification of the risk factors of dementia which would protect/reduce the risk of dementia is essential for controlling this silent epidemic.

Open Access Original Research Article

Therapeutic Serum Concentration Measurement of Oxcarbazepine in Epilepsy Patient

Rakshya Koirala, Ramesh Khadka, Wang Juli, Wangmengmeng .

International Neuropsychiatric Disease Journal, Page 1-10
DOI: 10.9734/INDJ/2017/32181

Aim: To study measurement of the therapeutic serum concentration of Oxcarbazepine (OXC) in children diagnosed with epilepsy and to analyze the relationship among the serum drug concentration of OXC based on drug dose/weight. To observe therapeutic range of OXC to provide them a reference basis for the effective treatment plan (dose of drug, effectiveness of ongoing drug, adverse reactions). This will help us to make an early decision on the plan of treatment and management to ensure the quality rehabilitation and good prognosis.

Place and Duration of Study: The study was performed in Jiamusi Central hospital, China from Jan. 2016 to May. 2016. 

Objective: To measure the therapeutic serum concentration of Oxcarbazepine (OXC) in 33 Chinese children diagnosed with epilepsy. To investigate and study the association of serum drug concentration of OXC based on drug dose/weight and clinical effects. The aim of our research is to understand the basis of therapeutic range of OXC and possibility of their practical significance as a reference basis for effective treatment plan, thus, helping us to make an effective decision on the plan of treatment and management to ensure quality rehabilitation and good prognosis. Methodology: Thirty-three cases (18 girls,15 boys: age range 3-12 years) were considered based on strict eligibility criteria for Epilepsy along with clinical examination and EEG. From all patients, 100 μl venous blood sample was drawn and sent for API 3200 SERIES HPLC (High performance liquid chromatography): MHD standard for further analysis. Data analysis was performed from obtained measured serum OXC valued using SPSS20.0 Statistical software.

Results: From blood samples of thirty-three epileptic patients, our result showed the mean plasma level of MHD was 11.9 mg/l (mean range 3.44 mg/l to 17.045 mg/l), with mean OXC dose 20.32 mg/kg/day (mean range 5.5 mg/kg/day to 32.14 mg/kg/day) prescribed for 3 weeks to 6 months. Even at lowest serum OXC concentration 3.44 mg/l, seizure was well controlled with no adverse toxicity. Complete seizure control attained among eleven patients. OXC exhibits a linear relationship between drug dose/weight and serum OXC concentration (r=0.0728, p< 0.01); independent to sex and age. 2 cases out of 33 was found to be drug resistant epilepsy.

Conclusion: Our study provided us a time window determination for the effective treatment choice, complete control of epileptic seizures drug resistant epilepsy and no serious side effects were documented. Based on our findings, routine practice of measuring OXC concentration in epilepsy can be a clinical significance. However, further research is required to validate our hypothesis.

Open Access Original Research Article

Intellectual Activity in Patients with Semantic and Motor Afferent Aphasia

Yulia Solovieva, Luis Quintanar

International Neuropsychiatric Disease Journal, Page 1-11
DOI: 10.9734/INDJ/2017/32280

The goal of the study is to analyse the defects of intellectual activity in patients with aphasia. The Scheme for evaluation of Intellectual Activity was applied to four Spanish speaking patients with vascular accidents: two patients with semantic and two with motor afferent aphasia. The Scheme includes items of work with texts and pictures. The analyses showed the defects of the operation of synthesis in motor afferent aphasia and of planning and organising activity in semantic aphasia. All patients required of the external orientation base of action. The results are discussed in terms of the neuropsychological mechanisms of factor of each form of aphasia and of the structure of activity. The authors conclude that external helping is useful as the method of rehabilitation in these types of aphasia.