A study of psychiatrically normal children in a hospital based child guidance clinic

A total of 1330 children who attended a hospital-based child guidance clinic in last three years were studied retrospectively. 7.37% of these were found to have no psychiatric disorder. Epilepsy and scholastic backwardness without any psychiatric disorder, together constituted 70.41% of this group. Children referred to a child guidance clinic require proper assessment to detect psychiatrically normal children who would otherwise receive unnecessary label of psychiatric disorder and treatment.

A clinical analysis of hysteria and psychalgia

A retrospective study of children presenting with pain to the Child Guidance Clinic, during 1984-85 revealed 101 cases of hysteria and 22 of psychalgia. Children in these two groups did not differ significantly with respect to sex, age, education or occupation of parent. Children with psychalgia presented significantly later, and more frequently complained of headaches and abdominal pain. Children with hysteria presented with seizures, abdominal pain and anxiety symptoms. Pain can be of psychological origin also. Early diagnosis is essential to avoid unnecessary investigations and reinforcement of the "sick role".

Bilateral spontaneous temporomandibular joint herniation into the external auditory canal

The clinical and radiological findings in the first case in the literature of spontaneous, bilateral and asymptomatic herniation of soft tissue from the temporomandibular joint into the anterior wall of the external canal are presented. With the patient's mouth closed, the herniations appeared as a dome-shaped swelling located on the anterior wall of each bony external auditory canal. With the patient's mouth opened, the dome-shaped swellings were retracted anteriorly, producing an invagination of the skin of the external canal at the site of the previous herniation. A high resolution CT scan of the temporal bones revealed that the soft tissue of both temporomandibular joints was protruding through a congenital dehiscence in the anterior wall of the tympanic bones.

Tornwaldt's cyst: clinical and radiological aspects

Tornwaldt's bursae or nasopharyngeal bursae originate at the interface between the embryonic tissue from which the vertebrae develop (the notochord), and the developing foregut. If the opening through which the bursa drains into the nasopharynx becomes obstructed, a Tornwaldt's cyst will develop. The history, clinical and radiological findings and the operative management of a patient with an infected Tornwaldt's cyst are presented.

Effect of lithium ingestion on digestive and absorptive function of rat intestine

The long-term effect of lithium treatment on the digestive and absorptive function has been investigated in male albino rats. The uptake of D-glucose, amino acids and activities of cellular and brush border enzymes were evaluated after every 3 months. Significantly increased uptake was observed in 6-month lithium-treated rats. The absorptive capacity (Vmax) for D-glucose increased significantly without alteration in the Michaelis constant. Activities of cellular, brush border membrane disaccharidase, leucine aminopeptidase and Na+,K+-ATPase enzymes were significantly augmented in 6-month lithium-treated animals. The elevation in sucrase activity may be due to induction of enzyme since only Vmax was increased in lithium-treated animals. The present biochemical alterations suggest that long-term lithium ingestion stimulates the small bowel digestive and absorptive functions.

Effect of dietary cadmium intake on serum thyroxine and triiodothyronine concentrations in rhesus monkeys

Circulating thyroxine (T4) and triiodothyronine (T3) concentrations in rhesus monkeys were determined after various periods of cadmium administration in diet. No significant change in serum T4 and T3 levels was observed after 2 months of cadmium treatment. However, cadmium treatment for 4 months and 6 months showed a significant decrease in serum T4 and T3 levels indicating the adverse effect of long-term cadmium intake which increased gradually with duration of treatment.

Portal venous tumor casts causing defect on hepatic imaging

A dilated portal vein has been reported as a cause of a portal defect on liver scan. This report describes a similar defect caused by tumor thrombus casts invading the portal vein and its main branches.

Iodine deficiency and neonatal hypothyroidism

The incidence of neonatal hypothyroidism, as reflected in cord-blood thyroxine and thyrotropin levels, varied from 0.6% to 13.3% in iodine-deficient and normal regions of India (selected districts of Uttar Pradesh and Kerala and the city of Delhi), depending on the degree of environmental iodine deficiency. In populations with a high incidence of neonatal hypothyroidism, an increased prevalence of nerve deafness and a shift to the left in the distribution of IQ scores (towards lower scores) have been demonstrated. These indications of mild brain damage suggest that nutritional iodine deficiency can present in other ways than goitre or cretinism. Determination of the incidence of neonatal hypothyroidism using dried cord-blood spot screening appears to be the most useful and reliable method to assess the risk of brain damage in iodine-deficient areas.

Extradural block. Confirmation of the injection site by X-ray monitoring

X-ray monitoring was used to confirm the accuracy of extradural block in 100 patients who attended the Pain Relief Clinic for treatment of a variety of different conditions. A Tuohy needle was introduced by the central or paramedian approach and conventional physical signs, notably loss of resistance, used to identify entry into the extradural space. A radio-opaque dye was introduced prior to the analgesic solution, to display the injection site. X-ray screening confirmed the accuracy of the block in 83 patients, but unexpectedly in 17 the point of the needle was either just outside the spinal canal or only partly in the extradural space. There was no difficulty in correcting the needle position with the X-ray facilities available. Imprecise needle siting is only partially explained by technical problems. Imprecise siting of the needle may be responsible for at least some cases of inadequate analgesia or unexpected complications. In our view X-ray confirmation of site is essential for difficult extradural blocks, or when neurolytic solutions are introduced into the spinal canal. It may also be useful in teaching and research.

Effects of venous air embolism on the cardiovascular system and acid base balance in the presence and absence of nitrous oxide

Cardiovascular responses and acid-base changes with graded volumes of intravenously injected air were measured in dogs anesthesized with pentobarbital and either 100% oxygen or 50% oxygen and nitrous oxide. Mean arterial blood pressure decreased significantly with 2.5 ml of air/kg in the oxygen group and at all volumes in the nitrous oxide group. The volume of air embolus appeared to increase more than twice in the presence of 50% nitrous oxide. Pulmonary artery wedge pressure increased significantly in both groups, while end-tidal carbon dioxide decreased significantly in both groups. The changes in pulmonary artery wedge pressure and end-tidal carbon dioxide were simultaneous, suggesting that the less invasive monitoring technique may be utilized in diagnosing significant air embolism. Right atrial pressure increased while left atrial pressure decreased significantly in both groups. With injected volumes of 2.0 and 2.5 ml or air/kg, right atrial pressure exceeded left atrial pressure creating the potential of paradoxical air embolism. The pH and PaO2 decreased while PaCO2 increased significantly during air embolization.

A behavioural approach to the treatment of writer's cramp

In (perhaps) one of the largest series, treatment of 30 cases of writer's cramp by behaviour therapy alone, has been studied over a period of 5 years. The therapy techniques used were (i) relaxation therapy and retraining (ii) relaxation therapy, retraining and systematic desenetization. The outcome of both the techniques are very encouraging and show definite improvement in all cases. Various factors responsible for degree of improvement and the duration of treatment are discussed.

Homesexuality - a study of treatment and outcome

In the present study six homosexuals (5 males and 1 female) between 19 to 30 years, were treated by double differential conditioning. Four of them achieved a sexual reorientation. However their attitudes, psychological sophistication, variables affecting the outcome and the problems experienced during therapy are discussed.

Safety and efficacy of atracurium (BW33A) in surgical patients receiving balanced or isoflurane anesthesia

Atracurium was administered in a dose range of 0.027-0.4 mg/kg and dose-response curves were established for both balanced and isoflurane anesthetic techniques. With balanced anesthesia, ED50 and ED95 were 0.12 and 0.27 mg/kg, respectively, while with isoflurane they were 0.07 and 0.13 mg/kg and the least-squares regression line R2 values were 0.71 and 0.64, respectively. With balanced anesthesia there was a significant increase in systolic blood pressure at the 0.04 mg/kg dose (P = 0.02), while with isoflurane the systolic and diastolic blood pressures decreased at the 0.3 mg/kg dose (P less than 0.03). These changes were clinically insignificant. Atracurium is a potent nondepolarizing muscle relaxant which is potentiated by isoflurane. Its cardiovascular effects appear clinically nonsignificant. There is no evidence of histamine release.

Effects of relaxation therapy in management of muscular contraction headache in executives

Five executives suffering from muscular contractions (tension) headache were treated by deep muscular relaxation therapy. Individual sessions were supplemented by practice of relaxation at home, brief relaxation, and cue relaxation during office hours.The effect of therapy, was assessed, by comparing the baseline, pretreatment individual assessment of their behavioral state and self report, with the similar assessment done during and after the successful completion of therapy. The advantages of such an individual assessment & self report in the management of muscular contraction headache are discussed.

A repertory grid comparison of endogenous and neurotic depressions

The Repertory Grid Technique was used to study the construct systems of patients diagnosed as Endogenous and Neurotic Depressions. Twenty-five patients of each category were administered a Rank Order Repertory Grid comprising ten elements and fifteen constructs. The completed matrices were subjected to principal component analysis. Inter-element distance was used as the psychological measure to compare the two groups on characteristics like sell-ideal congruence, self-esteem, self-criticalness, degree of identification with parents, and the degree of temperamental and/or personality differences between parents as perceived by them. No significant differences between the two categories emerged on any of the dimensions referred to above. One striking observation in many grids was a tendency to isolate the element 'self'. Another observation was the difficulties some subjects had with a few elements and constructs probably due to cultural factors.