Disposition kinetics and urinary excretion of sulphadimidine in normal and alloxan diabetic dogs

Disposition kinetics and urinary excretion of sulphadimidine were investigated in 16 dogs following a single intravenous injection (100 mg/kg body weight). Biochemical parameters including blood pH, blood glucose, plasma triglycerides and total plasma proteins of these animals were determined. The animals were injected alloxan (125 mg/kg) intravenously and when blood glucose level exceeded 300 mg%, the biochemical parameters, disposition kinetics and urinary excretion of sulphadimidine were determined again. After alloxan treatment of the dogs, there was a highly significant (P less than 0.01) decrease in blood pH, increase in blood glucose and plasma triglycerides levels when compared with the pretreatment values. The alloxan diabetic dogs showed a highly significant (P less than 0.01) reduction in elimination half-life (t1/2 beta) and apparent volume of distribution (Vd(area)) and increase in overall elimination rate constant (kel), total body clearance (ClB) and percentage of sulphadimidine dose excreted in urine. In normal dogs, one-half of the intravenous dose and after alloxan treatment two-third of the dose was eliminated through urinary excretion during 48 hours after injection. This study shows that the metabolic alterations of alloxan induced diabetes in dogs, influence the drug disposition and urinary excretion which indicate the need for the adjustment of dosage regimen in such metabolic disorders.

Overview: narcissistic personality disorder

The authors trace the evolution of narcissistic personality disorder as a nosological entity in a critical survey of the literature, considering and comparing differing theoretical viewpoints regarding the genesis of this disorder. They review its various descriptions, including the one in DSM-III, and develop a composite picture of the syndrome. The disorder consists of characteristic deficits in six broad areas of functioning: 1) self-concept, 2) interpersonal relationships, 3) social adaptation, 4) ethics, standards, and ideals, 5) love and sexuality, and 6) cognitive style. The authors identify guidelines for distinguishing the narcissistic personality from other personality disorders as well as areas needing continued research.

AMA discharge from a psychiatric inpatient unit

This study examines AMA discharges from a psychiatric inpatient unit. Such discharges are found to occur with greater frequency (p .005) among individuals with alcoholism and character disorders. The AMA patients do not, however, seem to form a homogeneous group in themselves. This study identifies two subgroups of AMA patients: the "early" AMA and the "late" AMA, depending upon their length of stay in the hospital prior to AMA discharge. The demographic, clinical and psychodynamic differences between the two sub-groups are discussed. Some practical recommendations are made in regard to the prevention and management of AMA discharge requests.

Schizophrenia and sexuality: a review and a report of twelve unusual cases--part I

This review brings together the considerable, scattered literature on the sexuality of the schizophrenic. It encompasses the reports pertaining not only to the overt sexual behavior of schizophrenics but also their subjective experience including various delusions and hallucinations related to sexuality. Also reviewed are the sexual side effects of antipsychotic medication and sexual crimes and perversions occurring among individuals suffering from schizophrenia. The effectiveness of various treatment modalitites, including sex therapy, in controlling the bizarre sexual behavior that often accompanies schizophrenia, is also considered. Twelve unusual cases are also briefly reported. A greater awareness of these "sexual" symptoms of schizophrenia may be utilized to sharpen diagnostic sensitivity to the incipient forms of the disorder, to estimate prognosis in a given case, and to better understand some sexual crimes. In certain cases, such knowledge may alter the choice of antipsychotic medication.

Coccinia indica in the treatment of patients with diabetes mellitus

Coccinia indica is a creeper which grows wildly in Bangladesh and in many parts of the Indian sub-continent. The plant has been used since ancient times as an antidiabetic drug by physicians who practice the Indian system of medicine known as Ayurvedha. We have conducted a double blind control trial with preparation from the leaves of the plant on uncontrolled, maturity onset diabetics. The trial lasted for six weeks for an individual patient. Out of the 16 patients who received the experimental preparations 10 showed marked improvement in their glucose tolerance while none out of the 16 patients in the dummy group showed such a marked improvement. This difference is highly significant (kappa 2 with Yates' correction = 11.7, P < 0.001).

Differential diagnosis of fugue-like states

Fugue-like states, though usually considered hysterical or epileptic in origin, can occur with many other psychiatric and neurologic conditions. The survey of literature should help the clinician with differential diagnosis. Nine illustrative cases are described and guidelines for investigating a case of fugue are outlined.

The long-distance psychiatric patient in the emergency room. Insights regarding travel and mental illness

This paper deals with the motivational, demographic and clinical characteristics of individuals who seek psychiatric help at facilities located a great distance from their places of residence. The study identifies two subgroups within this category. The first (Intentional or Type A) group is constituted by persons who, owing to their concerns with the social stigma of mental illness, or driven by the desire for a magical solution to their problems, purposely undertake the journey to a distantly located psychiatric center. The second (Incidental or Type B) group consists of vacationers, hitch-hikers and skid-row individuals. While these "long distance patients" (LDP) did not show any differences when compared with the remainder of clinic attendance on demographic variables, distinct clinical features differentiated the two populations. Most significantly the LDP had a higher incidence of schizophrenia and alcohol related problems. The difference was entirely accounted for by the Type B subgroup ((LDP less than 0.01; Type A, NS; Type B less than 0.001). Implications of this finding have been discussed in view of the suggested relationships between travel and mental illness. Administrative problems of the LDP have been briefly commented upon.

Life threatening self-mutilation of the nose

Potentially life threatening self-mutilation of the nose in a patient with a severe passive aggressive character disorder is described. The phenomenological and psychodynamic features of this case are contrasted with those of schizophrenia and factitious dermatoses with similar excoriations.

Obsessional neurosis, marriage, sex and fertility: some transcultural comparisons

In a study of 82 obsessional neurotics, it was found that Indian obsessives, unlike their counterparts in other countries, do not display a higher than expected rate of celibacy, bachelorhood, and low fertility. Some socio-cultural explanations have been offered for these findings.

Socio-cultural and clinical determinants of symptomatology in obsessional neurosis

Eighty-two obsessional neurotics were studied from a phenomenological viewpoint in order to unmask the clinical and socio-cultural determinants of symptom-choice in this disorder. The form of obsessions and compulsions seemed to be affected primarily by intrinsic factors (age, sex, I.Q.) while their content was affected equally, if not more, by extrinsic factors (religion, locality, social class). Patient's age at the onset of illness seemed to be an extremely relevant factor insofar as it affected both the form and the content of symptoms. Some socio-cultural explanations have been offered these findings. The data is important insofar as it provides a baseline for cross-cultural studies of the phenomenology of obsessional illness.

Patients with acute poisoning seen in the department of intensive care-Jinnah Postgraduate Medical Centre, Karachi

A review of 157 cases of acute poisoning admitted to the intensive care unit shows that poisoning was responsible for 40 15% of the cases treated at this unit between 15th January to 31st December, 1976. Inspite of limited facilities the over all mortality from acute poisoning was 9.5% while that due to organo-phosphorus insecticides alone was 7%. A considerable infrequency of organophosphorus insecticides poisoning was observed in developed countries when their data was compared with the present series.

Organo-phosphorus insecticide poisoning-review of 53 cases

A review of 53 cases of organo-phosphorus insecticide poisoning admitted to the department of intensive care at the Jinnah Postgraduate Medical Centre between 15th January to 31st December, 1976 has shown that these insecticides form a majority of the causes of acute poisoning and are associated with a comparatively high mortality rate. Out of a total of 157 cases of acute poisoning admitted to the department, 34% were cases of organo-phosphorus insecticide poisoning forming 13 5% of the total admissions. These insecticides being easily accessible, are frequently used as suicidal agents specially by uneducated housewives. They are highly toxic and their management is very complicated. Of a total of 15 deaths from poisoning, 11 (73%) were due to this cause. This being such a common mode of poisoning in our country, we have presented here our experience of the clinical features and management of these cases.

A phenomenological analysis of symptoms in obsessive-compulsive neurosis

Eighty-two obsessional neurotics were studied from a phenomenological point of view in order to delineate the various forms and contents of obsessions and compulsions. An attempt was made to ascertain the frequency with which the different forms and content occur and their effect on the final outcome of the disorder. Five types of obsessions were identified: doubts, obsessive thinking, fears, impulses, and images, in order of frequency of their occurrence. Compulsive acts could be classified in two types, depending on whether they yielded to or diverted the underlying obsession. One-fourth of the patients displayed no compulsions. The content of obsession could be classified in five broad categories as relating to: dirt and contamination, aggression, inanimate-impersonal themes, religion, and sexual matters, in order of the frequency of their occurrence. The paper, while offering an interpretation of these findings, emphasizes the part played by socio-cultural factors in the character of an obsession's thought content. The absence of compulsions was found to be associated with good prognosis. A downward gradient was noted in the final outcome of patients without compulsions, those with controlling compulsions alone, those with both varieties of compulsions, and those displaying yielding compulsions alone, in that order. Based on this observation the paper suggests a prognosis-related hierarchical continuum of the severity of obsessional disorder.

Adolescent Pregnancy Complication and Wastage in Bangladesh

Introduction: Pregnancy among adolescents is a health risk for the individual as well as the fetus. The main aim of this study is to examine the pregnancy complications and its outcome among adolescent women in Northern region (Rajshahi) of Bangladesh. Methods: The analysis is based on a part of faculty research; University of Rajshahi funded study on adolescent motherhood and pregnancy complications in the region, which involved a micro level survey of 400 adolescent conception aged 10-19 and in-depth interviews with 37 adolescents who had experienced pregnancy wastage. The indicator of poor pregnancy outcomes analysed includes pregnancy or delivery complications and pregnancy wastage. Results: A striking finding is the higher proportions suffer pregnancy problems, especially in cases of early conception. In particular, younger adolescent aged under 20 years has been observed to have the highest proportions of delivery complications and pregnancy wastage due to insufficient intake foods and possible biological immaturity. Conclusion: Early teenage pregnancy and its effects pose very severe different pregnancy and delivery complications consequently wastage. Key words: Adolescent; Pregnancy; Wastage; Odds ratio DOI: 10.3126/jnps.v30i3.3917J Nep Paedtr Soc 2010;30(3):147-153