Anorexia nervosa: An Indian perspective.

Anorexia nervosa is a condition thought to be associated with the western culture. However, the recent publication of a case series from Asia suggests that it is a syndrome related to a changing culture. We present a detailed clinical form of this syndrome based on descriptive analysis of 2 cases of anorexia nervosa. Both these patients were adolescent, school-going girls from middle socioeconomic class of urban background. They were pre-morbidly non-obese and did not have any pressures to pursue slimness for beauty. However, there was an identifiable psychosocial stressor as a precipitant in both of them. Both the patients had symptoms of refusal to eat followed by weight loss. We could not identify any risk factor in our patients for anorexia nervosa. Our report illustrates the differences in developmental and psychodynamic issues related to the development of anorexia nervosa, though the clinical symptoms may be similar.

Assessment of Quality of Life among HIV Positive People Attending Tertiary Hospital of Delhi, India.

As per global HIV/AIDS estimates, a total of 33 million [30.3 – 36.1 million] People were living with HIV in 2007. The world's second-most populous country, India, is experiencing a highly varied HIV epidemic, which appears to be stable or diminishing in some parts while growing at a modest rate in others. Quality of life (QOL) of HIV/AIDS patients is becoming an important component of overall assessment of health care and management in health care settings. It is one of the indicators effectiveness of management of PLHAS . The objective of this study was to determine the QOL of patients with HIV/AIDS in New Delhi. Purposive sampling was used to identify subjects from the antiretroviral therapy clinic (ART) in Lok Nayak hospital. 180 patients were interviewed with the WHOQOL-HIV instrument. This questionnaire included demographic data, multi-item scales and six domains namely physical, psychological, level of independence, social relationships, environment and spirituality religion. Study subjects were aged between 20-56 years. Mean age of all study subjects was 33.85±7.01 years, comprising of 34.4 females. More than 50% of the total subjects had received less than secondary school education. All domains have higher scores for women than men except the psychological domain. Correlation of scores of six domains with overall QOL score and among individual domains was statistically significant. Younger people showed poorer QOL and level of education correlated positively with all domains of QOL. Overall results indicate that quality of life of AIDS attending Lok Nayak hospital is satisfactory.

Gender Differences in Phenomenology of Patients with Obsessive Compulsive Disorder.

Previous studies have shown differences in clinical features of obsessive-compulsive disorder (OCD) between men and women, including mean age at onset of obsessive-compulsive symptoms (OCS), types of OCS, comorbid disorders, course, and prognosis. The aim of this study was to compare male and female patients with OCD on several demographic and clinical characteristics. All new patients with OCD (ICD 10, criteria) who sought treatment at the OCD clinic were evaluated. The assessment instruments used were the semi structured pro forma especially designed for the study, Yale-Brown Obsessive-Compulsive Scale and check list to evaluate OCD severity and symptoms, and a semi structured interview along with standard mental-state examination. Forty seven percent of the patients (n = 31) were males. They had significantly earlier age at onset of OCD and were less likely to be married. They presented significantly more sexual obsessions and females with significantly more contamination obsessions and cleaning and checking compulsions. With regards to comorbidity, we did not find any differences in the frequency of co morbid psychiatric disorders between male and female patients with OCD. No significant differences were observed between sexes concerning family history of OCS or OCD, and global symptoms severity, either in obsession or compulsive subscale or insight point. The present study confirms the presence of sex-related differences described in other countries and cultures. The fact that the OCS starts earlier and probably have a worse impact in men can eventually lead to more specific and efficacious treatment approaches for these patients.

Dissociative Disorder in Rheumatoid Arthritis –A Case Report.

A rare association of dissociative disorder with rheumatoid arthritis is described.

Sexual abuse of street children brought to an observation home.

This study was conducted to assess the magnitude and pattern of sexual abuse among male inmates of an observation home in Delhi. A total of 189 boys aged 6 to 18 years were assessed for sexual abuse using Finkelhors scale and Child Maltreatment History Self-Report followed by clinical examination using American Medical Associations guidelines. Majority of boys were runaways and 38.1 percent had suffered sexual abuse. On clinical examination, 61.1 percent showed physical signs and 40.2 percent showed behavioral signs of sexual abuse. Forcible sex was reported by 44.4 percent of victims and 25 percent had signs suggestive of sexually transmitted diseases. Strangers were the most common perpetrators of sexual abuse.