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   Table of Contents - Current issue
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January-June 2018
Volume 19 | Issue 1
Page Nos. 1-49

Online since Tuesday, June 26, 2018

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EDITORIAL  

Meditation – The next step in evolution p. 1
Vijayalakshmi Pernenkil
DOI:10.4103/AMH.AMH_20_18  
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REVIEW ARTICLES Top

Stem cell therapy role in neurodegenerative disorders p. 3
Pasam Ravisankar, Koppineedi Dhanavardhan, Kompella Prathyusha, Kattula Rao Vinay Rajan
DOI:10.4103/AMH.AMH_10_18  
Cellular therapies represent a new frontier in the therapy of neurological diseases. Earlier, regeneration of neurons has been admitted as an impossible event. Thus, neurodegenerative disorders (e.g., Alzheimer's disease, Parkinson's disease, and multiple sclerosis), vascular events (e.g., stroke), and traumatic diseases (e.g., spinal cord injury) have been identified as incurable diseases. Later on, tissue reparative and regenerative potential of stem cell researches for these disorders drew attention of scientists to replacement therapy. Now, there are hundreds of current clinical and experimental regenerative treatment studies. One of the most popular therapies is cell transplantation. Transplanted neural stem/precursor cells protect the injured central nervous system using a variety of articulated mechanisms, a mode of action named ''therapeutic plasticity,” encompassing both bystander effects (immunomodulation and enhancement of endogenous repair mechanisms) and cell replacement. An extensive search was made using PubMed, Scopus, and Google Scholar using the following search terms: stem cells, neurodegenerative disorders, Alzheimer's disease, and stem cell therapy. In this review, we presented the possible benefits of stem cell therapy in neurodegenerative disorders.
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Mental health care act 2017: Review and upcoming issues Highly accessed article p. 9
Prasanna Kumar Neredumilli, V Padma, S Radharani
DOI:10.4103/AMH.AMH_8_18  
Mental Health Care (MHC) Act 2017 is published in the Gazette by Government of India. It is aimed at strengthening human rights of persons with mental illness. Changes such as advance directive and nominated representative are new, and review boards and responsibilities of government are clearly emphasized. The objective of this article is to give an overview of MHC act 2017 and its upcoming issues while implementing it.
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ORIGINAL ARTICLES Top

Clinical profile and changes in values of mean platelet volume among panic disorder patients p. 15
Sanjay Yalamanchili, Sai Kiran Pasupula, Raviteja Chilukuri
DOI:10.4103/AMH.AMH_4_18  
Context: The serotonin system is involved in the pathophysiology of anxiety disorders, but it is not practical to measure the serotonin levels inside the brain. Peripheral serotonin activity may reflect the central serotonergic function. An affordable and easy measure of peripheral serotonergic function is the mean platelet volume (MPV). Hence, MPV could possibly be used as a measure of central serotonergic function and hence could be a predictor of treatment outcome and response in panic disorder. Aims: This study aims to study the changes in MPV in patients with panic disorder with or without agoraphobia compared to healthy controls, thereby elucidating the relationship between panic disorder and MPV. Subjects and Methods: Patients (n = 65) who fulfilled the selection criteria and healthy controls (n = 65) were taken up for the study. Sociodemographic details and clinical variables were recorded in a special pro forma prepared for the study. Mini International Neuropsychiatry Interview-Plus was used for screening psychiatric morbidity. The diagnosis of panic disorder was made using the International Classification of Diseases-10 diagnostic criteria. Panic disorder severity scale and panic and agoraphobia scale were administered to all patients. MPV was assessed, and variations in MPV were studied between the groups. Statistical Analysis Used: Two-tailed independent sample t-test was used to compare the cases and controls. Results: It was observed that MPV values were higher for patients with panic disorder than healthy controls. Conclusion: MPV values were higher in panic disorder patients when compared to the healthy controls, so they could serve as predictors/indicators of treatment outcome and response in panic disorder.
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Caregiver burden in alcohol dependence syndrome in relation to the severity of dependence p. 19
RS Swaroopachary, Lokesh Kumar Kalasapati, Sarath Chandra Ivaturi, C M. Pavan Kumar Reddy
DOI:10.4103/AMH.AMH_6_18  
Background: Alcohol dependence is a maladaptive pattern of substance use for a period of 12 months, which is characterized by tolerance, withdrawal symptoms, loss of control, and craving. Burden is defined as the presence of problems, difficulties, or adverse events which affect the life (lives) of the psychiatric patient's significant others. Objective burden is used to identify anything that occurs as a disrupting factor in family life owing to the patient's illness while subjective burden refers to the feeling that a burden is being carried in a subjective sense. Aims: To compare the amount of burden among the caregivers with the severity of alcohol dependence in patients. Methodology: Severity of Alcohol Dependence Questionnaire is used to determine the severity of their condition in alcohol-dependent patients. Caregivers were administered Family Burden Interview Schedule to assess the burden experienced by them. The diagnosis of alcohol dependence syndrome is made in accordance to the ICD-10 criteria. Results: Severe burden is more seen in females, unemployed, in families where domestic violence is present. Conclusions: More severe is the dependence, more is the amount of burden experienced by the caregivers.
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Internet addictive behaviors and subjective well-being among 1st-year medical students p. 24
Vedalaveni Chowdappa Suresh, Wilma Delphine Silvia, Haradanahalli Giriprakash Kshamaa, Swarna Buddha Nayak
DOI:10.4103/AMH.AMH_3_18  
Context: Exponential rise in internet usage over the past two decades has fostered internet addictive behaviors, especially in young adults. In India, medical students undergo tremendous stressful situations and are a vulnerable group for such addictive behaviors. Aims: The aim of the study was to assess subjective happiness of 1st-year medical students and their internet addiction levels Settings and Design: A cross-sectional study done in a medical college in Bangalore, Karnataka, India. Materials and Methods: Sample consisted of 150 1st-year medical students, who self-reported about their internet addictive pattern and subjective well-being on Internet Addiction Test and Subjective Happiness Scale, respectively. Statistical Analysis: Descriptive and inferential statistical analyses were carried out. Significance is assessed at 5% level of significance. Analysis of variance, Student's t-test, and Chi-square/Fisher's Exact test have been used. Results: Of the total sample, 42.7% of students reported of experiencing subjective happiness below the average, 41.3% had average happiness levels, and only 16% had scores above the average. Out of the students, 42.1% who had no internet addiction, 36.4% who had mild levels, and 54.8% who had moderate levels of internet addiction fell below the average happiness level. Conclusions: Those who had higher levels of internet addiction showed reduced subjective happiness. Thus, those who experience decreased subjective happiness without overt psychological disturbances are still prone to have addictive patterns. This should be considered during screening for addictive behaviors.
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Reasons for pursuing psychiatry as a career: A qualitative study of future psychiatrists from India p. 30
Priya Sreedaran, Divya Hegde
DOI:10.4103/AMH.AMH_2_18  
Context: Despite extensive research on the attitudes of medical students toward psychiatry in India as well as worldwide, the actual reasons due to which medical graduates finally select psychiatry for their future careers is still unclear. Aims: To explore the lived experiences of postgraduate psychiatry students pertaining to their reasons for choosing psychiatry for future specialization. Settings: In an Indian medical college general hospital psychiatry setting. Methods and Materials: A qualitative study using focus group discussions and in-depth interviews with postgraduate psychiatry students. Statistical Analysis: Content analysis was used to identify direct and latent themes and develop a model. Results: Major themes underlying the reasons for choosing psychiatry are categorised into candidate related factors, medical college related factors, those related to process of Indian postgraduate medical selection, factors relating to psychiatry as a subject and social factors. Conclusion: The interaction between potentially interested medical under-graduates, their experiences of psychiatry during medical college along with the current system of postgraduate medical selection plays a major role in medical graduates pursuing psychiatry. Key Message: In order to improve future psychiatry recruitment rates in India, the quality of undergraduate psychiatry teaching should be improved. Professional psychiatry organizations should systematically engage with interested medical under-graduates and try to participate in the postgraduate selection process.
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Disability in bipolar affective disorder patients in relation to the duration of illness and current affective state p. 37
RS Swaroopachary, Lokesh Kumar Kalasapati, Sarath Chandra Ivaturi, C M. Pavan Kumar Reddy
DOI:10.4103/AMH.AMH_5_18  
Background: Bipolar affective disorder (BPAD) is an episodic illness in which episodes of depression/Mania/Mixed/Hypomania occur. BPAD has been found to be associated with the following types of disability: increased suicidal behavior, higher unemployment, higher dependence on public assistance, lower annual income, and increased work absenteeism owing to illness, decreased work productivity, poorer overall functioning, lower quality of life, and decreased lifespan. The two affective disorders, major depressive disorder, and bipolar disorders were associated with the large decrements in functioning. Bipolar disorder was particularly strongly associated with having missed time at work. Depressive disorders have been associated with a larger number of disability days and poorer role functioning than several common general medical diseases – arthritis, hypertension, and diabetes. Aims: This study aims to study the disability in bipolar patients in relation to the duration of their illness and current effective state. Methodology: Clinical and sociodemographic details of patients and caregivers were collected using a semi-structured pro forma. Indian Disability Evaluation and Assessment Scale is used to assess patients' disability. The diagnosis of BPAD is made in accordance with the International Classification of Disease-10 criteria. Results: Severe disability is seen where the duration of illness is <10 years. Among depressive patients, the disability is found to of moderate level whereas patients who have a current manic episode experienced severe disability. Conclusions: Severe disability is seen where the duration of illness is <10 years.
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Chronic pain and psychological distress among adults in Udupi p. 42
Paramjot Panda, Suchismita Panda
DOI:10.4103/AMH.AMH_11_18  
Background: Depression is an important public health problem and one of the leading causes of disease burden worldwide. Depression is often comorbid with other chronic diseases and can worsen their associated health outcomes. Few studies have explored the effect of depression alone or as comorbidity, with chronic pain. Objective: The objective of this study was to study the prevalence and pattern of sociodemographic characteristics of persons with depression and chronic pain residing in the Udupi taluk, Karnataka, India. Methodology: This cross-sectional study included 360 participants of above 18 years of age. The participants were recruited using simple random sampling technique from January 2017 to June 2017. Descriptive and analytical methods were used to estimate the prevalence and to identify the associated disorders. Results: It was observed during the study that prevalence of psychological distress (PD) was (58.88%). Majority of the females had moderate-to-severe PD (55.66%). The age group of 35–50 years (36.97%) had moderate-to-severe PD. The other psychiatric disorder associated with chronic pain was somatic dysfunction (27.8%), anxiety (26.9%), social dysfunction (33.8%), and depression in (11.5%). Conclusion: Depression produces the greatest decrement in health compared to the chronic physical disease. These results indicate the urgency of addressing depression as a public health priority to reduce disease burden and disability and to improve the overall health of populations.
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CASE REPORT Top

Anorexia nervosa in rural South India p. 47
Keya Das, KS Ashok
DOI:10.4103/AMH.AMH_17_18  
Anorexia Nervosa, an eating disorder having first been identified in the 17th Century Europe has been considered a western syndrome with emphasis on slimness as a measure of feminine beauty. Global development and rapid changes in South-East Asian countries in economy, mindsets, and Adoption of Western attitude has occurred there have been sporadic reports of Anorexia Nervosa in the past few years in India mostly in cities. Our case report digresses from the familiar theory of Anorexia Nervosa being a westernized concept in presenting a case from Rural South India. We report of a 12-year-old girl child from rural district, South India, belonging to a traditional South Indian family of middle class status, presented with somatic complaints of pain abdomen and vomiting with background of progressive weight loss over 3 months with amenorrhea of 3 months, precipitating factor of comments from relatives about weight gain and menarche. Diagnosis of Anorexia Nervosa was made, with Body Mass Index 14.9. A multidisciplinary approach to treatment was commenced. Authors aim to point out the need to screen for eating disorders irrespective of patients' geographic or cultural affiliations to ensure prompt intervention.
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