Mahatma Gandhi Memorial Medical College

About: Mahatma Gandhi Memorial Medical College is a education organization based out in Indore, Madhya Pradesh, India. It is known for research contribution in the topics: Dyslipidemia & Lipid profile. The organization has 210 authors who have published 123 publications receiving 1085 citations. The organization is also known as: MGM Medical College.

Substance Use Disorders (SUD) and Suicidal Behaviors in Adolescents: Insights From Cross-Sectional Inpatient Study

Abstract: Objectives To determine the demographic predictors of suicidal behaviors and measure the association between the spectrum of substance use disorders (SUD) and hospitalization for suicidal behaviors in the adolescent population. Methods We conducted a cross-sectional study using the nationwide inpatient sample and included 466,244 adolescent inpatients with psychiatric illnesses. The study sample was sub-grouped into suicidal (N = 182,454) and non-suicidal (N = 283,790) cohorts. The odds ratio (OR) of association for demographic characteristics and comorbid SUD in the suicidal group was evaluated using a logistic regression model witha P-value < 0.01. Results Our study population included 466,244 adolescent inpatients. Females had higher odds of suicidal behaviors (OR 1.45; 95% CI 1.431-1.470) compared to males. The most prevalent comorbid SUD among suicidal inpatients was cannabis (15.3%) but had a statistically non-significant association with suicidal behaviors (OR 0.98; 95% CI 0.95-0.99). Inpatients with alcohol use disorders had significantly increased odds of association with suicidal behaviors (OR 1.18; CI: 1.142-1.209) compare to other SUD. Among other substances (cannabis and stimulants), there existed a statistically non-significant association with hospitalization for suicidal behaviors. Conclusion Adolescent inpatients with comorbid alcohol use disorders were at 18% higher odds of hospitalization for suicidal behaviors. Our study provides a basis for more research while also suggesting potential avenues for early identification and intervention efforts for comorbid SUD in adolescents requiring psychiatric care to improve their prognosis and quality of life.

Twenty-Four Hour pH Study and Manometry in Gastric Esophageal Substitutes in Children

Abstract: Purpose Studies on the physiology of the transposed stomach as an esophageal substitute in the form of a gastric pull-up or a gastric tube in children are limited. We conducted a study of motility and the pH of gastric esophageal substitutes using manometry and 24-hour pH measurements in 10 such patients. Methods Manometry and 24 hour pH studies were performed on 10 children aged 24 to 55 months who had undergone gastric esophageal replacement. Results Six gastric tubes (4, isoperistaltic; 2, reverse gastric tubes) and 4 gastric pull-ups were studied. Two gastric tubes and 4 gastric pull-ups were transhiatal. Four gastric tubes were retrosternal. The mean of the lowest pH at the midpoint of the substitute was 4.0 (range, 2.8-5.0) and in the stomach remaining below the diaphragm was 3.3 (range, 1.9-4.2). In both types of substitute, the difference between the peak and the nadir pH recorded in the intra-thoracic and the sub-diaphragmatic portion of the stomach was statistically significant (p<0.05), with the pH in the portion below the diaphragm being lower. The lowest pH values in the substitute and in the remnant stomach were noted mainly in the evening hours whereas the highest pH was noted mainly in the morning hours. All the cases showed a simultaneous rise in the intra-cavitatory pressure along the substitute while swallowing. Conclusion The study suggested a normal gastric circadian rhythm in the gastric esophageal substitute. Mass contractions occurred in response to swallowing. The substitute may be able to effectively clear contents.

Acute oedema associated with risperidone use: a report.

Abstract: Risperidone acts by potent serotonergic, dopaminergic and alpha adrenergic receptor antagonism. The most common side effects reported are extrapyramidal symptoms, dizziness, sedation, insomnia, headache, anxiety, nausea, constipation and weight gain. Oedema associated with risperidone use is a rare side effect. Here we present a report on pedal oedema associated with use of oral risperidone 4 mg per day for acute-onset psychotic illness. Through this case report we want to make clinicians aware about this important side effect as it can affect patients' compliance and quality of life.

Pattern, clinical and demographic profile of inpatient psychiatry referrals in a tertiary care teaching hospital: a descriptive study.

Abstract: Background Consultation liaison psychiatry (CLP) as a subspecialty is defined as the area of clinical psychiatry that encompasses clinical understanding, teaching and research activities of psychiatrists and allied health professionals in the non-psychiatric divisions of a general hospital. Psychiatric comorbidity of inpatients in tertiary care hospitals is huge. However, the amount of research in India in the field of consultation liaison is strikingly low. Aim To investigate the sociodemographic profile and psychiatric and physical subtypes of illness in patients admitted in other departments and referred to psychiatry department. Methods The study population comprised all consecutive inpatients referred for psychiatric consultation from other departments of a multispecialty tertiary care teaching hospital over 3 months. In a semistructured proforma, sociodemographic profile, referring departments, reasons for referral, referral rate, psychiatric diagnosis and physical illness diagnosis were recorded and analysed using descriptive statistics. Results 172 patients were included and assessed after referral from various departments, of which 56.4% were male and 43.6% were female. The mean age was about 33.95 years, with majority of the patients in the 21–30 years age group. The referral rate was 1.1%. The maximum referrals were from the medicine department, with abnormal behaviour (26.2%) being the most common reason for referral, followed by alleged suicide attempt or self-harm (24.4%), anxiety (10.5%), substance use (10%) and disorientation (7.6%). The most common psychiatric disorder among patients was depressive disorder (24.4%), followed by substance use disorder (19.7%), schizophrenia and psychotic disorder (9.3%), and stress and trauma-related disorder (8.1%). Conclusion There are very few psychiatry referrals and an alarmingly low referral rate, given the psychiatric morbidities in the medical setting. Psychiatry training should have more weightage across different medical specialties and liaison activities between psychiatry and other disciplines should be augmented, which can lead to a better understanding of psychiatric symptomatology, early symptom recognition, swift referral and ensuring follow-up, which, in turn, would be key to improving CLP services.

Intramedullary Neurocysticercosis Successfully Treated with Medical Therapy

Abstract: To the Editor: Spinal cysticercosis is a rare presentation of neurocysticercosis. Surgical excision of cysticercus followed by cysticidal therapy remains the mainstay of treatment [1]. Authors have reported variable success of treating intramedullary cysticercus with praziquantel or albendazole alone [2–4]. Treatment with cysticidal drug alone in intramedullary lesion remains controversial and paradoxical worsening is feared [5]. We describe an eight-year-old boy with a history of back pain and slowly progressive weakness of both upper limbs and lower limbs for the last 1 mo. Weakness was most prominent in left upper limb with a history of numbness in entire left upper extremity. Examination revealed spinal tenderness along the cervical and thoracic spine. Motor system examination revealed asymmetric spastic quadriparesis (left upper limb predominant) with brisk deep tendon reflexes and extensor plantar response bilaterally. Sensory examination showed decreased response to pain from C6 dermatome to T1 dermatome on left upper limb. Magnetic resonance imaging (MRI) spine revealed intradural intramedullary cysticercosis at C5-C6 level with surrounding cord edema (Fig. 1). MRI brain study was normal. He was started on albendazole therapy (15 mg/kg/d) for 28 d under the cover of oral dexamethasone (0.6 mg/kg/d for 5 d). He had a remarkable improvement in motor weakness and sensory symptoms. In view of clinical improvement with medical treatment, surgically inaccessible intramedullary lesion and fear of post-operative myelotomy related complication, surgical intervention was deferred. At 4 wk follow-up, he had no residual motor weakness and complete resolution of sensory symptoms. There were no adverse effects in terms of the fresh neurological deficit on oral albendazole therapy. The presence of ring enhancing lesion with an eccentric scolex in an endemic area favors neurocysticercosis over other radiological differentials of the intramedullary cystic lesion. The present case describes a child with intramedullary cysticercosis who showed remarkable improvement with albendazole under the cover of steroids with no adverse consequences. The debate of whether steroid worked or albendazole worked in our patient remains unanswered. This report in conjunction with the similar observation by other authors warrants re* Jaya Shankar Kaushik jayashankarkaushik@gmail.com