One-pot synthesis of g-C3N4/N-doped CeO2 nanocomposites and their potential visible light-driven photocatalytic degradation of methylene blue dye.

In the pursuit of efficient photocatalytic materials for environmental applications, a new series of g-C3N4/N-doped CeO2 nanocomposites (g-C3N4/N-CeO2 NCs) was synthesized using a straightforward dispersion method. These nanocomposites were systematically characterized to understand their structural, optical, and chemical properties. The photocatalytic performance of g-C3N4/N-CeO2 NCs was evaluated by investigating their ability to degrade methylene blue (MB) dye, a model organic pollutant. The results demonstrate that the integration of g-C3N4 with N-doped CeO2 NCs reduces the optical energy gap compared to pristine N-doped CeO2, leading to enhanced photocatalytic efficiency. It is benefited from the existence of g-C3N4/N-CeO2 NCs not only in promoting the charge separation and inhibits the fast charge recombination but also in improving photocatalytic oxidation performance. Hence, this study highlights the potential of g-C3N4/N-CeO2 NCs as promising candidates for various photocatalytic applications, contributing to the advancement of sustainable environmental remediation technologies.

Silver-decorated SrTiO3 nanoparticles for high-performance supercapacitors and effective remediation of hazardous pollutants.

SrTiO3/Ag nanocomposites were synthesized using a facile wet impregnation method, employing rigorous experimental techniques for comprehensive characterization. XRD, FTIR, UV, PL, FESEM, and HRTEM were meticulously utilized to elucidate their structural, functional, morphological, and optical properties. The electrochemical performance of the SrTiO3/Ag nanocomposite was rigorously assessed, revealing an impressive specific capacitance of 850 F/g at a current density of 1 A. Furthermore, the photocatalytic activity of the SrTiO3/Ag nanocomposite was rigorously examined using methylene blue (MB) dye, and the results were outstanding. After 120 min of UV irradiation, the nanocomposite exhibited an exceptional MB dye degradation efficiency exceeding 88%. The SrTiO3/Ag nanocomposite represents an exemplary catalyst in terms of efficiency, cost-effectiveness, environmental compatibility, and reusability. The electron and superoxide radicals play a chief role in the MB dye degradation process. The inclusion of Ag within the SrTiO3 matrix facilitated the formation of a conductive nano-network, ultimately resulting in superior capacitive and photocatalytic performance.

Construction of novel g-C3N4 coupled efficient Bi2O3 nanoparticles for improved Z-scheme photocatalytic removal of environmental wastewater contaminant: Insight mechanism.

Recently, the major environmental pollution produced by the release of wastewater in liquid type is one of the most extensive forms of foremost pollution in water ecosystems. In this article, the Bi2O3/g-C3N4 nanocomposite with a direct Z-scheme was effectively obtained by a facile hydrothermal system. The crystal structures, surface morphology, chemical composition, and the optical belongings of the as-obtained composite catalysts were examined by Power XRD, FT-IR spectra, High-resolution XPS spectra, FE-SEM images with EDX spectra, High-resolution TEM images, UV-Vis DRS, and PL spectra respectively. Furthermore, the photocatalytic performance was assessed by the degradation of aqueous Rhodamine B (Rh B) dye under visible-light exposure. The Bi2O3/g-C3N4 composite photocatalysts (PCs) showed the maximum photo-degradation efficiency through a rate constant value of 0.0149 min-1, which is 4.9 and 5.3 folds superior to Bi2O3, and GCN, respectively. The better GBO2 nanocomposite PCs showed a superior photocatalytic degradation performance (>82%) of aqueous Rh B dye after five successive recycles. Moreover, based on these outcomes of the radical scavenging test, a direct and effective Z-scheme photocatalytic charger transfer mechanism was also projected. Finally, the reusability of the as-obtained Bi2O3/g-C3N4 nanocomposite has better stability and reusability, which was a favourable applicant for wastewater handling.

Development of Improved Software Intelligent System for Audiological Solutions.

Of late, there has been an increase in hearing impairment cases and to provide the most advantageous solutions to them is an uphill task for audiologists. Significant difficulty faced by the audiologists is in effective programming of hearing aids to provide enhanced satisfaction to the users. The main aim of our study was to develop a software intelligent system (SIS): (i) to perform the required audiological investigations for finding the degree and type of hearing loss, and (ii) to suggest appropriate values of hearing aid parameters for enhancing the speech intelligibility and the satisfaction level among the hearing aid users. In this paper, we present a Neuro-Fuzzy based SIS to automatically predict and suggest the hearing-aid parameters such as gain values, compression ratio and threshold knee point, which are needed to be fixed for different octave frequencies of sound inputs during the hearing-aid trial. The test signals for audiological investigations are generated through the standard hardware present in a personal computer system and with the aid of a software algorithm. The proposed system was validated with 243 subjects' data collected at the Government General Hospital, Chennai, India. The calculated sensitivity, specificity and accuracy of the proposed audiometer incorporated in the SIS were 98.6%, 96.4 and 98.2%, respectively, by comparing its interpretations with those of the 'gold standard' audiometers. Furthermore, 91% (221 of 243) of the hearing impaired subjects attained satisfaction in the first hearing aid trials itself with the gain values as recommended by the improved SIS. The proposed system reduced around 75% of the 'trial and error' time spent by audiologists for enhancing satisfactory usage of the hearing aid. Hence, the proposed SIS could be used to find the degree and type of hearing loss and to recommend hearing aid parameters to provide optimal solutions to the hearing aid users.

Surface shear viscosity as a macroscopic probe of amyloid fibril formation at a fluid interface.

Amyloidogenesis of proteins is of wide interest because amyloid structures are associated with many diseases, including Alzheimer's and type II diabetes. Dozens of different proteins of various sizes are known to form amyloid fibrils. While there are numerous studies on the fibrillization of insulin induced by various perturbations, shearing at fluid interfaces has not received as much attention. Here, we present a study of human insulin fibrillization at room temperature using a deep-channel surface viscometer. The hydrodynamics of the bulk flow equilibrates in just over a minute, but the proteins at the air-water interface exhibit a very slow development during which the surface (excess) shear viscosity deduced from a Newtonian surface model increases slightly over a period of a day and a half. Then, there is a very rapid increase in the surface shear viscosity to effectively unbounded levels as the interface becomes immobilized. Atomic force microscopy shows that fibrils appear at the interface after it becomes immobilized. Fibrillization in the bulk does not occur until much later. This has been verified by concurrent atomic force microscopy and circular dichroism spectroscopy of samples from the bulk. The immobilized interface has zero in-plane shear rate, however due to the bulk flow, there is an increase in the strength of the normal component of the shear rate at the interface, implicating this component of shear in the fibrillization process ultimately resulting in a thick weave of fibrils on the interface. Real-time detection of fibrillization via interfacial rheology may find utility in other studies of proteins at sheared interfaces.

Interference with daily activities and major adverse events during esophageal pH monitoring with bravo wireless capsule versus conventional intranasal catheter: a systematic review of randomized controlled trials.

For three decades, ambulatory 24-hour intranasal pH monitoring has been the established gold standard for detecting acid reflux in patients with refractory gastroesophageal reflux disease. However, device-associated adverse events and unpleasant experiences, reported by patients during pH monitoring have led to the invention of more convenient pH monitors such as Bravo wireless capsule. To compare the interference with daily activities and major adverse events during pH monitoring with Bravo wireless capsule (Bravo) versus conventional intranasal catheter (catheter), PubMed, Cochrane Library, Clinical Trials.gov, and Google Scholar were searched up to March 20, 2015. Only randomized controlled trials in adult patients that compared the interference with routine daily activities and adverse events between Bravo and catheter pH monitors were included. After screening 574 articles, three unique studies with 167 patients met our inclusion criteria. The average age of patients enrolled in these studies was 51 years. Interference with normal daily activities was more in the catheter than Bravo group: 75 ± 5 versus 92 ± 2, P < 0.001 (Andrews et al, findings were reported as100 mm, mean visual analogue scale (VAS) ± standard error of the mean, 100 = completely normal); Wong et al. (mean ± standard error of the mean): 1.3 ± 0.2 versus 0.32 ± 0.1, P = 0.001 and Wenner et al. using 10 cm median VAS (Interquartile range),10 been the worst is 5.7 (2.3-8.0) compared to 0.7 (0.2-3.4), P < 0.0001, respectively. Overall adverse events were more in the catheter group than Bravo (39 ± 4 vs. 26 ± 4, P = 0.012 for Andrews et al. (100 been the worst) and 5.1 (2.0-6.6) vs. 2.1 (0.5-4.6), P < 0.001 for Wenner et al.). No overall adverse events recorded for Wong et al. Most patients in catheter group complained of nasal and throat symptoms. Significantly, runny nose in 24 out of 25 patients (96%) catheter versus 13 out of 25 (52%) Bravo, P = 0.001 and nose pain 15 out 25 (60%) versus 8 out of 25 patients (32%), P = 0.047, respectively for Wong et al. Andrews and Wenner et al also showed profound nasal discomforts in catheter group compared to Bravo (39 ± 3 vs. 10 ± 3, P < 0.001 and 6.5 (1.5-8.0) versus 0.2 (0.0-1.9), P < 0.0001, respectively. Throat symptoms reported in Wong et al. were mainly throat discomfort in catheter group 23 out of 25 patients (92%) versus Bravo 12 out of 25 (48%), P = 0.001 and throat pain catheter (12 out of 25 patients (48%) vs. Bravo 4 out of 25 (16%)), P = 0.032. This trend was also observed in Andrews et al. with profound throat discomfort in the catheter group 43 ± 4 compared to Bravo 19 ± 4, P < 0.001. Majority of the patients randomized to Bravo group reportedly perceived chest pain higher than those in catheter group; 9 out of 25 patients (36%) versus 2 out of 25 (8%), P = 0.037 in Wong et al. 29 ± 4 versus 14 ± 3, P = 0.001 for Andrews et al., 2.4 (0.3-5.9) versus 1.1 (0.3-2.9), P = 0.084 in Wenner et al. respectively (though not statistically significant). Bravo wireless capsule pH monitor interfered less with daily activities and adverse events were minimal compared to conventional intranasal catheter.

Biological and protein-binding studies of newly synthesized polymer-cobalt(III) complexes.

The polymer-cobalt(III) complexes, [Co(bpy)(dien)BPEI]Cl3 · 4H2O (bpy = 2,2'-bipyridine, dien = diethylentriamine, BPEI = branched polyethyleneimine) were synthesized and characterized. The interaction of these complexes with human serum albumin (HSA) and bovine serum albumin (BSA) was investigated under physiological conditions using various physico-chemical techniques. The results reveal that the fluorescence quenching of serum albumins by polymer-cobalt(III) complexes took place through static quenching. The binding of these complexes changed the molecular conformation of the protein considerably. The polymer-cobalt(III) complex with x = 0.365 shows antimicrobial activity against several human pathogens. This complex also induces cytotoxicity against MCF-7 through apoptotic induction. However, further studies are needed to decipher the molecular mode of action of polymer-cobalt(III) complex and for its possible utilization in anticancer therapy.

Studies on the synthesis, characterization, human serum albumin binding and biological activity of single chain surfactant-cobalt(III) complexes.

The interaction of surfactant-cobalt(III) complexes [Co(bpy)(dien)TA](ClO4)3 · 3H2O (1) and [Co(dien)(phen)TA](ClO4)3 · 4H2O (2), where bpy = 2,2'-bipyridine, dien = diethylenetriamine, phen = 1,10-phenanthroline and TA = tetradecylamine with human serum albumin (HSA) under physiological conditions was analyzed using steady state, synchronous, 3D fluorescence, UV/visabsorption and circular dichroism spectroscopic techniques. The results show that these complexes cause the fluorescence quenching of HSA through a static mechanism. The binding constant (Kb ) and number of binding-sites (n) were obtained at different temperatures. The corresponding thermodynamic parameters (∆G°, ∆H° and ∆S°) and Ea were also obtained. According to Förster's non-radiation energy transfer theory, the binding distance (r) between the complexes and HSA were calculated. The results of synchronous and 3D fluorescence spectroscopy indicate that the binding process has changed considerably the polarity around the fluorophores, along with changes in the conformation of the protein. The antimicrobial and anticancer activities of the complexes were tested and the results show that the complexes have good activities against pathogenic microorganisms and cancer cells.

Isolated Myocysticercosis.

Cysticercosis, a parasitic disease caused by larval form of Taenia solium, is a major health concern in the developing world. The encysted larval stage can affect any part of the body, but are most frequently detected in brain, eye, skeletal muscle and subcutaneous tissue. Most muscular cysticercosis are almost always associated with central nervous system involvement or with multiple intramuscular cysts or both. Here we report an unusual case of cysticercosis in right rectus muscle which was an isolated muscle involvement without any other systemic manifestation.

Development of protease resistant and non-cytotoxic Jelleine analogs with enhanced broad spectrum antimicrobial efficacy.

Short systemic half- life of Antimicrobial Peptides (AMP) is one of the major bottlenecks that limits their successful commercialization as therapeutics. In this work, we have designed analogs of the natural AMP Jelleine, obtained from royal jelly of apis mellifera. Among the designed peptides, J3 and J4 were the most potent with broad spectrum activities against a varied class of ESKAPE pathogens and fungus C. albicans. All the developed peptides were more effective against Gram-negative bacteria in comparison to the Gram-positive pathogens, and were especially effective against P. aeruginosa and C. albicans.J3 and J4 were completely trypsin resistant and serum stable, while retaining the non-cytotoxicity of the parent Jelleine, Jc. The designed peptides were membranolytic in their mode of action. CD and MD simulations in the presence of bilayers, established that J3 and J4 were non-structured even upon membrane binding and suggested that biological properties of the AMPs were innocent of any specific secondary structural requirements. Enhancement of charge to increase the antimicrobial potency, controlling the hydrophobic-hydrophilic balance to maintain non-cytotoxicity and induction of unnatural amino acid residues to impart protease resistance, remains some of the fundamental principles in the design of more effective antimicrobial therapeutics of the future, which may help combat the quickly rising menace of antimicrobial resistance in the microbes.

Characterization, mechanical properties, and wear behavior of functionally graded aluminum hybrid composite.

The present work demonstrates the development of SiC/TiS2/AlSi12Cu hybrid functionally graded composite using centrifugal casting and examines its microstructural, mechanical, and tribological properties. A gradient distribution of reinforcement particles was observed with the outer region being particle-rich. EBSD analysis confirms microstructural refinement owing to titanium's grain refining properties and the formation of θ-Al2Cu intermetallic phase. The outer layer of the composite attained a maximum hardness and tensile strength of 93 HB and 202 MPa respectively, which was increased by 7.5% and 8.2%, 20.4% and 13.8%, 22.5% and 44.5% in middle, inner, and as-received alloy respectively. Tribological properties were assessed via dry sliding pin-on-disk tribometer with various process parameters such as load (10-40 N), velocity (1-4 m/s) and distance (500-2000 m), optimized using response surface methodology. The higher wear resistance was attained by the optimized process parameters of 16 N load, 1.6 m/s velocity, and 804 m distance. Results indicated increased material loss with higher load, sliding distance, and velocity, but with enhanced wear resistance in the outer zone. Worn surface analysis revealed deeper grooves, delamination, particle pull-out, and wear tracks under severe conditions. The study emphasizes the composite's potential for high wear applications, linking its microstructural features to its superior wear behavior.

Prevalence and Auditory Characteristics of Auditory Neuropathy Spectrum Disorder in Adult Population with Sensory Neural Hearing Loss: A Hospital Based Study in South India.

Auditory neuropathy spectrum disorder (ANSD) is a heterogenous group of disorder characterized by abnormalities in auditory brainstem responses (ABR) with preserved otoacoustic emissions and/or cochlear microphonics. The aim of the study is to estimate the prevalence and evaluate the audiological characteristics of ANSD in adult population with sensory neural hearing loss. A prospective study was conducted on the adult population (≥ 18 years) attending ENT outpatients clinic at Rajiv Gandhi Government General Hospital, Chennai. All patients reported to the department with auditory and vestibular symptoms underwent case history, otoscopic examination, and routine audiological evaluation (pure tone audiometry, speech audiometry and immittance audiometry). Patients with indications of ANSD in case history and routine audiological evaluation were further evaluated using distortion product otoacoustic emissions and ABR. A total of 8682 adult population was evaluated during the period of 2017 to 2018. Out of 8682 patients, 1343 (15.46%) of them had sensory neural hearing loss of varying degrees. Out of 1343 adults with sensory neural hearing loss, 24 (1.78%) adults were diagnosed as ANSD. The prevalence of ANSD in adult population with sensory neural hearing loss in our study is 1.32% per 1000 adults. The clinical characteristics of ANSD shows impairment in speech perception irrespective of degree of hearing loss, preserved cochlear functions and abnormal ABR. Hence ANSD is not a rare clinical finding in adults with sensory neural hearing loss, but its prevalence was estimated to be lower in Indian population. Often young females are affected causing significant impairment in speech perception and disability.

Post-Traumatic High-Flow Priapism: Accessory Pudendal Origin of Cavernosal Artery From External Iliac Artery - A Case Report.

High-flow priapism is an uncommon condition typically resulting from penile or perineal trauma, due to laceration of cavernosal artery. We present a case of 24-year-old male who presented with post-traumatic painless priapism. Ultrasound showed hematoma with arterio-cavernosal fistula. On CT Angiogram, the cavernosal artery was seen arising from accessory pudendal artery, which arose from inferior epigastric artery (IEA), branch of external iliac artery (EIA). Catheter angiogram of EIA showed fistulous communication at the base of the penis from a branch of IEA. Selective embolisation of the artery was done using 33% glue (n-butyl cyanoacrylate). Post embolisation, no residual filling of the fistula and partial detumescence of penis was noted. Transarterial embolisation is usually preferred as first line of management in high-flow fistulous priapisms.

Emergence of yellowing disease in cucurbitaceous vegetables caused by Crinivirus and Polerovirus in India.

Totally 102 symptomatic samples of cucurbitaceous vegetables showing yellowing were collected from fields of Uttar Pradesh and screened by RT-PCR assay for the presence of Crinivirus and Polerovirus. Among them, Crinivirus (16%) and Polerovirus (23%) were tested positive with the universal primer pairs. Based on the sequence analysis of amplified product, two Crinivirus (Cucurbit chlorotic yellows virus - CCYV and Cucurbit yellow stunting disorder virus - CYSDV) and two Polerovirus (Cucurbit aphid-borne yellows virus - CABYV and Luffa aphid-borne yellows virus - LABYV) species were characterized. Phylogenetic analysis revealed less genetic distance among the Indian isolates of CCYV, CYSDV and LABYV whereas CABYV closely related to Chinese isolates. To the best of our knowledge, this study documents infection of CCYV on cucumber, round melon and muskmelon; CYSDV on satputia and sponge gourd; CABYV on ivy gourd; and LABYV on ridge gourd, satputia and muskmelon for the first time in India.

A distinct strain of tomato leaf curl New Delhi virus that causes mosaic disease in ash gourd and other cucurbitaceous crops.

Ash gourd (Benincasa hispida) is a cucurbitaceous crop cultivated as an edible vegetable rich in vitamins, minerals, dietary fibers and antioxidants. In a field survey conducted in the Udumalpet region of Tamil Nadu during 2019, the incidence of mosaic disease on ash gourd crop was observed to be 75%. The DNA-A and DNA-B components of begomovirus genome have been identified as associated with this disease. Both the cloned DNA-A and DNA-B genomic components shared highest pairwise sequence identities with the isolates of tomato leaf curl New Delhi virus (ToLCNDV), a bipartite begomovirus. Recombinant analysis showed that both the components are possibly evolved through intra-species recombination between ToLCNDV isolates. Tomato leaf curl Bangladesh betasatellite (ToLCBB) is not naturally associated with this sample. The results of infectivity studies on ash gourd and other cucurbitaceous crops demonstrates the Koch's postulates, when co-inoculation of DNA-A and DNA-B of ToLCNDV was undertaken. However, the inoculation of non-cognate ToLCBB along with DNA-A and DNA-B enhances the symptom expression and reduces the time taken for symptom development. Thus, Koch's postulates were proved for these virus complexes on cucurbitaceous crops. Furthermore, an enhanced accumulation of DNA-A component was detected in the cucurbits co-inoculated with ToLCNDV and ToLCBB. This report highlights the importance of investigating the spread of these disease complexes with other cucurbitaceous crops in India.

Facile construction of cost-effective zinc-aluminium polymeric framework for efficient removal of selective both drug and dye from an aqueous medium.

A novel aluminium (Al) and its active alloys are extensively been used in nearly all areas owing to their cost-effectiveness. But when it is subjected to an aqueous medium, gets corroded through a chemical response. In this paper, a novel framework was fabricated by copolymer coating over on Al and loaded with zinc via electro polymerization and electrodeposition method ([EDA- OPDA]Al@Zn). The as-fabricated composite has emerged for the sorption of Methylene Blue (MB) aqueous dye and Paracetomal drug (PAR). The as-fabricated composite framework has been categorized via IR spectra, FE-SEM images, and EDX spectra. The sorption progression was optimized for numerous prompting features like pH, contact time and impact of dosage. Based on kinetics data, the growth in QE value by an enhancement in temperature for adsorption and the higher r values shows the adsorption progression is a pseudo-second-order model. The thermodynamic constraints specify that the field of adsorbate is impulsive and typical endothermic process. Instead, the corrosion resistance of a composite in the 3.5% of NaCl. Solution was explored via EIS spectra and potentio-dynamic polarization. Depending on the observed features, it indicates that the [EDA-OPDA]Al@Zn framework provided fantastic corrosion resistance. So it is obvious that the as-synthesized framework is of multitasking, that it could be successfully performed for the exclusion of MB aqueous dye and PAR drug from the aqueous medium and it also withstands effectively in this corrosive medium.

Anthropogenic nexus on organochlorine pesticide pollution: a case study with Tamiraparani river basin, South India.

The levels of 17 organochlorine pesticides residues (OCPs) in surface water and sediments from Tamiraparani river basin, South India were investigated to evaluate their potential pollution and risk impacts. A total of 96 surface water and sediment samples at 12 sampling stations were collected along the river in four seasons during 2008-2009. The ΣOCP concentrations in surface water and sediments were in the range of 0.1 to 79.9 ng l(-1) and 0.12 to 3,938.7 ng g(-1) dry weight (dw), respectively. Among the OCPs, the levels of dichlorodiphenyltrichloroethanes (DDTs), aldrin, dieldrin, cis-chlordane, trans-chlordane, and mirex were dominant in the sediments. The dominant OCPs in water samples are heptachlor, o,p'-DDE, dieldrin, o,p'-DDD, and mirex, which show different source of contamination pattern among sampling seasons. The distribution pattern of DDTs, hexachlorocyclohexane, and other OCPs in the present study shows heterogenic nature of nonpoint source of pollution. Notable contamination of water and sediment sample that was observed in upstream (S2) 58 ng l(-1) and downstream (S11) 1,693 ng g(-1) dw explains agricultural and municipal outfalls, whereas frequent damming effect reduces the concentration level in the midstream. The overall spatial-temporal distribution pattern of ΣOCP residues are illustrated by GIS package.

Balloon-Assisted Coiling of Intracranial Aneurysms: Technical Details and Evaluation of Local Complications.

Background: Wide-neck intracranial aneurysms need additional devices like balloons or stent for management. Balloon-assisted coiling has evolved both with interventionalist experience and device modifications. Objective: We discussed our experience, evolution, and complications with this novel technique. Materials and Methods: Data of 2014-2019 was retrospectively reviewed for type of balloon used along with complications in intracranial aneurysm coiling. Two hundred five aneurysms were detected in 188 patients, of which balloon-assisted coiling was planned for 198 aneurysms. Both single and double-lumen balloons were used. Aneurysms were divided into bifurcation and sidewall aneurysms. The complications were compared between bifurcation and sidewall aneurysms, and between single and double lumen balloons. Results: Balloon-assisted coiling was planned for 198 aneurysms but successfully done for 195 (98.5%) cases. Single-lumen balloons were used in 56 aneurysms (28.3%), and double-lumen balloons were used in 142 cases (71.7%). Procedural thromboembolism within parent vessel was seen in 28 cases (14.1%); however symptomatic were encountered in 5 cases (2.5%). Intraprocedural rupture of the aneurysmal sac was seen in 9 cases (4.5%). The procedure-related mortality in our series was 1.6% (3/188 patients), and morbidity was 4.3% (8/188 patients). The complications among bifurcation and sidewall aneurysms compared between single- and double-lumen balloons showed a greater number of symptomatic thromboembolic complications in sidewall aneurysms with the use of single lumen balloons. Conclusions: There are significant symptomatic thromboembolic complications in sidewall aneurysms with the use of single-lumen balloons which decreased as interventionalist experience evolved and better hardware developed.

Involvement of Incomplete Hippocampal Inversion in Intractable Epilepsy: Evidence from Neuropsychological Studies.

BACKGROUND: The age of onset of seizure, seizure types, frequency of seizure, structural abnormalities in the brain, and antiepileptic medication (polytherapy) causes increased incidence of anxiety and depression in intractable epilepsy patients. AIM: To compare the anxiety and depression levels in intractable epileptic patients with structural abnormalities [malformations of cortical development (MCD) and incomplete hippocampal inversion (IHI)] and without structural abnormalities. MATERIALS AND METHODS: Participants were selected from (239 males and 171 females) intractable epilepsy patients. They were grouped into four groups; Group 1: 51 nonepileptic age-matched controls, Group 2: 41 intractable epilepsy patients without any brain abnormality, Group 3: 17 intractable epilepsy patients with MCD, and Group 4: 30 intractable epilepsy patients with isolated IHI. Neuropsychiatric tools used were Multiphasic Personality Questionnaire and Weschlers Adult Intelligence Scale to assess anxiety, depression, and intelligence. Groups were classified using 1.5T conventional magnetic resonance imaging and hippocampal volumetric studies. Group comparison design was used. RESULTS: Demographic variables of intractable epilepsy, including seizure types, the frequency of seizure, the age of seizure onset, and antiepileptic drug therapies, did not show significant association between the groups using Chi-square P value. Analysis of variance showed significant anxiety and depression in epileptic patients than the control group (P < 0.01). Post hoc analysis using Tukey's B test showed significant difference in anxiety and depression scores between group value. In group 3 and 4, anxiety scores were significantly different but not depression scores. CONCLUSION: The present study concludes high prevalence of anxiety and depression in intractable seizure. Anxiety is observed predominantly when there is IHI along with depression. We emphasize the need to identify IHI in intractable epilepsy and assess anxiety and depression to treat them effectively.