Psychosurgery in Indian Scenario: Time to Think with Phronesis.

With advances in technology, neurosurgical procedures are being examined for potential use in psychiatric conditions. However, the use of neurosurgical procedures in psychiatry carries the baggage of memories of psychosurgery. Different neurosurgical techniques carry their characteristic safety, efficacy, and complication profile. The introduction of deep brain stimulation has generated a new interest in surgical treatment with a distinct advantage over lesioning procedures used in the past. In such a scenario, it is essential that an informed discussion takes place regarding the use of these neurosurgical procedures in psychiatric disorders such that patient safety, informed consent, regulatory requirements, and research are taken care of.

The Experience and Reactions towards Stage 1 COVID-19 among Junior Doctors in India.

BACKGROUND: COVID-19 pandemic is the first modern pandemic and has occurred in an era of social media ubiquity. Despite being in stage 1 of the pandemic, and low numbers of patients, various emotional and behavioral changes were observed in junior doctors. This study was designed to assess the experience and reactions of junior doctors in a tertiary teaching hospital in North India and Tamil Nadu in the immediate aftermath of the nation-wide lockdown. SUBJECTS AND METHODS: This was an observational cross- sectional study of junior doctors working in tertiary care hospitals in Chandigarh and Tamil Nadu. It was conducted from 28th March to 5th April 2020. Ethical clearance obtained and anonymity was maintained. We used a 17-item self-designed questionnaire circulated online. RESULTS: Mean age was 28.64 years (n=362). Though mostly well informed, only 8% restricted themselves to obtaining information from a single source. Around 46% were feeling anxious and many more (73.20%) perceived the same emotion in their peers and even more of them (85.10%) in their family members. Most of them (90.1%) endorsed more than change in behavior, mainly to avoid potential risk (52%) and females tend to self-quarantine themselves more than males. CONCLUSIONS: Knowledge does not play as important a role in the way people behave in an outbreak. Many other covert factors may possible be involved. Strategies leading to reduction in uncertainty, interventions for reassurance in the workplace and better role models would be of help in this outbreak.

Parkinsonism-hyperpyrexia syndrome: A case report and review of literature.

Parkinsonism-hyperpyrexia syndrome (PHS) is a rare but potentially life-threatening complication of the management of Parkinson's disease (PD). Central hypodopaminergic state which results due to abrupt withdrawal of dopaminergic medications in patients with PD is the postulated cause. Clinical manifestations of PHS are very akin to neuroleptic malignant syndrome (NMS). Here, we report a case of a 60-year-old male with 13-year history of PD, who was on Levodopa (300 mg) + Carbidopa (75 mg). On abrupt stoppage of Levodopa (300 mg) + Carbidopa (75 mg), he presented with symptoms akin to NMS, with raised creatine kinase. As soon as the antiparkinsonian medications are reinstituted, the patient recovered completely. Literature in this area is limited to few case reports only. Existing literature recommends prompt reinstitution of antiparkinsonian medications as the mainstay of therapy for patients presenting with PHS.