Open Access Original Research Article

Do Psychiatry and Family Medicine Residents Differ with Regard to Attitudes towards Treating Substance Use Patients

Krishnendu Ghosh, Greg Haggerty, Pratibha Agarwal, Reynaldo Budnah, Jacob Sperber

International Neuropsychiatric Disease Journal, Page 1-6
DOI: 10.9734/INDJ/2016/24195

Background and Objective: Substance use disorders are a major health issue affecting many who present for treatment for psychiatric and medical problems. Substance use is associated with employment problems, relational difficulties, child abuse, stress and percentages of untimely deaths. Training and exposure has been shown to lessen negative stigmatizing attitudes towards the treatment of people suffering from substance abuse problems. In the current study, we investigated whether psychiatry and family medicine residents would have different attitudes towards these patients.

Methods: 23 psychiatry residents and 19 family medicine residents consented were asked write about the last substance abuse patient they treated to prime their memory and then complete a self-report that measures clinicians feelings about their patients.

Results: We found no statistical difference between the family medicine and psychiatry residents with regard to their attitudes and feelings toward SUDs patients they treat. Our results also showed that experience or year of training in the residency program was not linked with any significant different in scores on the CTQ scales.

Conclusion: This result is interesting given that psychiatry residents often have much more training and exposure to this population than their peers in this family medicine residency. But less family medicine departmental hostility towards substance abuse patient as a whole, extra training in the field of addiction for the substance abuse treatment could be possible for this result.

Open Access Original Research Article

Can Sonography Replace Electromyography and Nerve Conduction Velocity in Carpal Tunnel Syndrome?

Ashraf El Badry, Mohammed El Sherif, Toshiki Yoshimine

International Neuropsychiatric Disease Journal, Page 1-10
DOI: 10.9734/INDJ/2016/24211

Purpose of the Study: To justify the efficacy of the ultrasonography (US) in the diagnosis of carpal tunnel syndrome (CTS) in the postoperative follow-up in comparison to electrodiagnostic tests [electromyography (EMG) and nerve conduction velocity (NCV)].

Patients and Methods: One hundred CTS patients were documented through clinically, electrophysiologically, and intraoperatively grading by using the Tuncali grading system (TGS), in Mansoura University Hospital, Insurance Hospital, and EL Ahrar, during the period of April 2014 till March 2015. All patients were evaluated pre and postoperatively by both the gold standard invasive electrodiagnostic (EMG, NCV) and the new noninvasive US tests.

Results: All of the 100 CTS cases (24 men, 76 women) showed improvement in pain after releasing incisions (TGS grades 2 and 3). The CTS diagnosis by electrodiagnostic (EMG and NCV) were 90 positive and 10 negative. However, by the US were 86 positive and 14 negative. Six months after surgery, electrodiagnostic tests (EMG and NCV) had improved in 74% of cases, but with US, it showed improvement in the cross-sectional area (CSA) swelling of median nerve after three weeks in 64 CTS cases (64%). The sensitivity and the specificities were 90% and 79.2% for NCV respectively while for the US were 86% and 77.4% respectively.

Conclusion: US showed improvement of morphological criteria (within 3 weeks) than the betterment of the function by electrodiagnostic (after 6 months) in the postoperative follow-up of CTS cases. Therefore, US examination for CTS can possibly be done without the need for other invasive investigations.

Open Access Original Research Article

Bromocriptine Mesylate Protects against Status Epilepticus and Temporal Lobe Epilepsy: Neurobehavioral, Histopathological and Neurochemical Evidences

Faheem Hyder Pottoo, Nahida Tabassum, Mohammad Maqbool Darziv

International Neuropsychiatric Disease Journal, Page 1-13
DOI: 10.9734/INDJ/2016/24401

Background: Dopamine (DA) plays a major role in the control of epileptic seizures arising in the limbic system, through D1/D2 receptor-mediated signaling.

Objective: The study was intended to investigate whether bromocriptine mesylate (BRC), a dopamine (D2) receptor agonist, has an anti-seizure property, attenuates oxidative stress and neuronal morphological alterations against pilocarpine induced status epilepticus (SE) in mice, using sodium valproate  (SVP) as comparator AED.

Materials and Methods: SVP (300 mg/kg) and BRC (6 &10 mg/kg) were administered orally once daily for a period of 4 weeks followed by pilocarpine (300 mg/kg, i.p) to induce SE. The convulsions were monitored for 2 hrs post pilocarpine injection. At 2 hrs post pilocarpine injection hippocampal malondialdehyde, glutathione reduced, glutathione peroxidase, glutathione reductase and catalase activities were measured. While hippocampal histopathological assessment of neuronal injury was performed 24 hrs post pilocarpine injection.

Results: We report that SVP (300 mg/kg) and BRC (6 &10 mg/kg) were able to reduce seizure severity score (P<0.001, P<0.01, P<0.05), attenuate oxidative damage in lipids and proteins, restore depletion in hippocampal glutathione reduced, glutathione peroxidase and glutathione reductase activities compared to toxic/pilocarpine control. Contrary catalase levels were strengthened as like pilocarpine control. In addition SVP (300 mg/kg) and BRC (6 & 10 mg/kg) protected against degeneration in hippocampal CA1, CA2, CA3 & DG regions (P<0.001, P<0.01, P<0.05) compared to pilocarpine control.

Conclusions: The present study highlights the prominent dysregulation of dopaminergic system in seizures and perspectives for the development of novel therapeutic approaches acompassing dopaminergic drugs in amelioration of epileptic seizures especially status-epilepticus and temporal lobe epilepsy.

Open Access Original Research Article

Black Holes in Brain- Is There Any Relationship between Carotid Artery Plaque Type and Cerebral Micro Bleed? - Cohort from Pakistan

Fatima Mubarak, Shayan Sirat Maheen Anwar, Kainat Baig

International Neuropsychiatric Disease Journal, Page 1-9
DOI: 10.9734/INDJ/2016/22819

Purpose of Study: The purpose of this study is to correlate the presence of chronic micro bleed, patient symptoms, number of chronic micro bleeds and carotid plaque characteristics.

Materials and Methods: Seventy consecutive patients (50 men, 20 women; mean age 64.5; range 45-82 years) were selected for the study. We took every patient’s ipsilateral internal carotid artery and cerebral hemisphere individually. Each patient underwent MRI brain with stroke protocol and ultrasound carotid Doppler for suspected carotid pathology. Chronic micro bleeds were classified by an ordinal scale and carotid plaques were characterized based on their composition, that is, fatty, mixed, or calcified. Patients were classified as symptomatic and asymptomatic. Receiver operating characteristic (ROC) curve were created. Correlation was done to see association between the number of chronic micro bleeds, their symptoms and relationship of plaque type with chronic micro bleeds.

Results: The prevalence of chronic micro bleed was 42.8% (60/140) over all, with prevalence of 61.53% in symptomatic sides. A statistically significant difference between chronic micro bleeds presence was observed, with a P value of <0.0001 and an Odds ratio of 4.4 with 95% confidence interval of range 2.15 to 8.99.

Statistically significant direct correlation with the fatty / soft plaques (correlation coefficient = 0.177; P value = 0.018). No statistically significant association was detected between CMBs and mixed plaque type (correlation coefficient 0.090; P value .145). We also performed the ROC curve analysis for symptomatic (stroke and TIA) and asymptomatic sides and the results were: 0.7849 and 0.6181 respectively, confirming that there is an association between CMBs and symptomatic (stroke/TIA) patients, but no association between CMBs and asymptomatic patients.

Conclusion: This study shows there is increasing trend of chronic micro bleeds with fatty plaques. Moreover, chronic micro bleeds are prevalent in patients who have stroke or transient ischemic attacks.

Open Access Original Research Article

Quality of Life of Subjects with Leprosy and Albinism

Chukwuma M. Attama, Monday N. Igwe, Nichodemus O. Obayi, Emmanuel O. Olose

International Neuropsychiatric Disease Journal, Page 1-6
DOI: 10.9734/INDJ/2016/22931

Background: Disfiguring skin disorders like leprosy and albinism may negatively distort a patient’s body image with resultant impairment in quality of life.

Objective: This study determined and compared the quality of life (QoL) of subjects with leprosy and those with albinism.

Methods: Two hundred subjects were recruited from a Leprosarium and The Albino Foundation in South East Nigeria. The participants were interviewed with Socio-demographic Interview Schedule and WHOQoL-Bref.

Results: Subjects with leprosy had lower QoL scores compared with subjects who have albinism in all domains. Male and female subjects with leprosy scored lower in all domains than male (p = 0.02) and female (p = 0.04) subjects with albinism. Married subjects with leprosy scored lower than married subjects with albinism in environment domain only (p= 0.04). Unmarried subjects with leprosy had lower QoL scores in the social relationship and environment domains (p = 0.01).  Employed and unemployed subjects with leprosy scored lower than employed (p = 0.01) and unemployed (p = 0.03) subjects with albinism in all domains. Educated and uneducated subjects with leprosy scored lower than educated (p = 0.02) and uneducated (p = 0.03) subjects with albinism in all domains.

Conclusion: Impairment in QoL was greater in subjects with leprosy compared to those with albinism.