Depression is common in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Patients with depression have an earlier onset and rapid progression of cognitive decline. Medial ...temporal lobe atrophy (MTA) is common in AD and MCI, and some degree of atrophy is found in almost all patients. In the present study, an attempt was made to know if MTA is more common in patients with AD/MCI with depression than those without it.
Patients reporting to the outpatient department of a neurology centre of a tertiary care hospital were recruited for the present study. After initial general physical and neurological examination, they were evaluated using National Institute of Neurological and Communicative Disorders and Stroke and Related Disorders Association criteria for diagnosis of AD. Clinical Dementia rating scale was used for the diagnosis of MCI. Cornell scale for depression in dementia (CSDD) was used.
We found 20 cases with depression as per CSDD out of a sample of 37 patients (male:female = 30:7). There were 26 patients with AD and 11 with MCI. The mean age of all patients was 72.33 ± 6.45 years. The mean mini mental status examination score was 19.00 ± 6.73. The mean time since diagnosis was 4.19 ± 3.26 years. The mean Scheltens visual rating scale score for right MTA was 2.08 ± 0.95 and was 2.05 ± 0.94 for the left. Both scores did not differ statistically when analyzed using paired t-test (p > 0.05). However, difference in those with depression (2.36 ± 0.95) from those without depression (1.60 ± 0.74) was significant (p < 0.05).
MTA scores were higher in those with AD/MCI with depression than those without it.
A rare case of primary headache associated with sexual activity in a 40-year-old married Indian man who had coital and postcoital headaches responsive to indomethacin is reported.
Trigeminal neuralgia (TN) is the most common type of neuralgia affecting facial region and is considered to be one of the most painful conditions. Treatment is often unsatisfactory. Newer treatment ...modalities are therefore being tried. Duloxetine is FDA approved drug for painful diabetic neuropathy and has been used in painful symptoms of depression as well. Safety and efficacy of duloxetine was evaluated in patients with trigeminal neuralgia; another chronically painful condition, in an open label manner. A total of 15 patients who fulfilled the diagnostic criteria of International Headache Society for Trigeminal Neuralgia were administered duloxetine 40 mg daily. The efficacy of the drug was evaluated by face scale and Likert's numerical scale. Statistically significant pain relief was reported in 9 out of 15 patients of trigeminal neuralgia. The pain relief was reported as early as in one week and was maintained for 16 weeks. The drug was well tolerated and side-effects reported were mild and reversible. No adverse drug reaction requiring hospitalisation or drug discontinuation was reported in the present study. Duloxetine showed statistically significant pain relief in trigeminal neuralgia. Double-blind, placebo-controlled studies are needed to confirm findings at a large scale.
Snakebite envenomation is a neglected tropical disease and India accounts for maximum mortalities related to snakebites. This could be due to typical health seeking behaviour, inadequately trained ...manpower at the primary care centres or misbeliefs in community that hinder timely treatments of snakebites. The current study reports a total of 76 bites (M:F=40:36) from rural Rajasthan in Western India (Mean age= 29±17 years). The majority of victims went to health care centres e.g., primary care centres (n=44/76=57.8%), including 14 victims who reported to community health centres (18.4%). Although the majority visited health care centres (76.2%) but a total of 23/44 victims (52%) approached faith healers before going to health facilities. A sizable number took consultations from place of worship as per their faith (n=15) and snake charmers (called as bhopa in local language; n=8). Snake charmers performed the dangerous act of sucking the blood from the victim's wound (n=5).
There is a wide range of effective interventions for the prevention of diabetes, but few of these approaches have been extensively utilized in real-world settings. The objective of this systematic ...review was to assess and collate existing evidence in implementation research (IR) on prevention, control and treatment of Diabetes Mellitus (DM) in India.
The Preferred Reporting Items for Systematic Reviews and Meta-analyses - Protocol (PRISMA-P) guidelines were used to create the protocol for the systematic review. Articles published in the previous 20 years (2001–2020) and published in English language were included in the study. Electronic databases such as MEDLINE (through PubMed gateway), EMBASE, and Science Direct; search engines like Google scholar and ProQuest were systematically searched using separate search protocols for each database. Retrieved articles were screened for titles and abstracts and assessed by two independent reviewers. Using standard checklists, the articles also underwent a risk of bias assessment, and a narrative summary was written using SWiM guidelines.
Sixteen studies were included in the review, which included three implementation studies related to screening of diabetes, three studies on the management of diabetes, three studies related to lifestyle interventions, one on behavioral intervention, two on electronic support system-based interventions, and the remaining four studies explored IR in other areas of diabetes. The key attributes of implementation research such as acceptability, feasibility, adoption, economic evaluation measures like cost-effectiveness, operational issues like barriers, and facilitating factors were addressed by most of the studies, in varying extents.
Implementation research on diabetes mellitus in India is very limited which underscores the importance of creating awareness about the need of IR and building capacity and skills for conducting IR among various stakeholders.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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