Actigraphy in post traumatic stress disorder.

UNLABELLED: Patients with posttraumatic stress disorder (PTSD) frequently complain of sleep disturbances such as insomnia and nightmares. Evaluation of sleep disturbances is often difficult due to the subjective nature of the complaints. Polysomnography (PSG) and other sleep studies are generally not indicated in the evaluation of insomnia or nightmares associated with PTSD. Actigraphy, (electronic activity monitoring) has been used in research to evaluate sleep disturbances in patients with PTSD. We reviewed the literature on the use of actigraphy in evaluation of sleep problems in patients with PTSD. METHODS: A literature search for articles on the topic was conducted on PubMed using the search algorithm (actigraphy[Title/Abstract] OR actigraphic[Title/Abstract]) AND PTSD[Title/Abstract]. Out of 11 search results, 9 studies in which application of actigraphy had relevance to the primary objective and outcome in PTSD patients with sleep problems were selected for review. We also handpicked one additional article from personal communication with our colleagues who have done some of these studies. CONCLUSION: Actigraphy has been used to evaluate circadian rhythm sleep disorders. Use of actigraphy in psychiatry clinics is uncommon. There is no data to support that there are specific actigraphic sleep related findings in PTSD patients. However, it can be a useful tool to complement the use of sleep diaries when assessing sleep and wake patterns in patients with PTSD.

The touch of madness:manto as a psychiatric case study.

UNLABELLED: Saadat Hasan 'Manto' is widely acknowledged as one of the greatest short story writers in the world. He died at the age of forty three from complications of alcoholism. All of his life, he suffered from symptoms of anxiety and depression and his alcohol abuse was intimately linked both to his mental distress as well as his creative genius. This paper examines the life of Manto from a psychiatric perspective and the link between creativity and mental illness. We show how Manto's particular family circumstances led to the development of restlessness and later anxiety in his life; how his substance abuse, especially alcohol abuse exacerbated this mental distress and how it eventually led to his death and how all of these factors were intimately linked to his creative genius and were the source of so many of his literary masterpieces. METHODS: We reviewed seventy five short stories considered to be his best. Writings about Manto's life including his own were reviewed to construct a picture of his life as well as find clues to his mental distress and alcohol abuse. A literature search for articles related to creativity and mental illness was conducted using Google Scholar containing the search terms 'creativity and madness' and 'creativity and mental illness' in the titles of the articles. References most relevant to our case study were identified. CONCLUSION: Manto suffered from symptoms of anxiety and depression which today would meet the diagnostic criteria for Alcohol Dependence and, in later life, Alcohol-induced Psychosis. Appropriate treatment may have prolonged his life although that may have come at the expense of his creativity.

Educating tomorrow's doctors: A cross sectional survey of emotional intelligence and empathy in medical students of Lahore.

OBJECTIVE: Medical education in Pakistan traditionally emphasizes physician's biomedical knowledge with less emphasis on interpersonal skills and ability to relate to the patients. This study explored the emotional intelligence & empathy of undergraduate medical students and investigated its relationship with various factors to act as baseline for future work in this area. METHODOLOGY: The Schutte Emotional Intelligence scale and Davis' Interpersonal Reactivity Index in addition to socio demographic questionnaire were administered to first year and final year medical undergraduates of two medical Institutions in Lahore, Pakistan. Data was analyzed by using SPSS 17 version. RESULTS: The overall mean scores for medical students both on emotional intelligence and empathy is significantly lower than that found in previous literature, highlighting that medical students do not appear to fare better than average people in EQ. Women showed statistically significant higher scores on Appraisal of emotions , Regulation of emotions, Empathic concern Scale & Personal distress scale. Comparison of EI & IRI of students according to medical college year did not show any statistical significance. CONCLUSION: Current medical curriculum and training in Pakistan does not appear to increase EI abilities which are building blocks that may allow students and residents to develop competence. Medical educators in Pakistan should look for ways to incorporate emotional intelligence in medical curriculum which will ultimately contribute towards patient centered practice, patient satisfaction as well as effective communication skills.

Gender Discrimination among Medical Students in Pakistan: A Cross Sectional Survey.

OBJECTIVE: To examine the prevalence and magnitude of gender discrimination experienced by undergraduate medical students, and its repercussions on their academic performance and emotional health. METHODOLOGY: A cross sectional study of 500 medical and dental students studying at a private medical college in Lahore, Pakistan. RESULTS: Majority (78%) of students reported being victims of gender discrimination. Females were the main perpetrators (70.8%).Most common forms were denied opportunities (63%), followed by neglecting students' needs (44.3%), and unethical talk (43.6%). Most common places of gender discrimination were teachers' offices (43.7%) and lecture halls (37.2%). Most of the perpetrators were clerical staff (48%) and professors (43%).Gender discrimination did not affect the academic performance of most victims (62.6%). The most common emotional responses were anger (57.6%), frustration (46.7%) and helplessness (40.3%). 52.4% of students said that gender discrimination still continues and the majority (83.3%) did not report the problem to college authorities. CONCLUSIONS: RESULTS demonstrate that gender discrimination is widely prevalent in undergraduate medical education. Females are both the main victims as well as the main perpetrators. In most cases gender discrimination does not affect academic performance but does cause emotional distress.