Sexual dysfunction in men with alcohol dependence.

Background: Prolonged and excessive use of alcohol can affect the sexual function. The occurrence of sexual dysfunction has adverse psychological and interpersonal consequences. Aim: To assess the occurrence and correlates of sexual dysfunction in individuals suffering from alcohol dependence. Materials and Methods: Seventy male subjects hospitalized in a tertiary care hospital for treatment of alcohol dependence syndrome with simple withdrawal symptoms were included in the study with their informed consent. Their sexual function was evaluated utilizing a 14-item changes in sexual functioning questionnaire. Results: According to the findings of the current study, sexual dysfunction is quite prevalent in alcohol-dependent people (75.7%). Erectile dysfunction was the most common disorder, followed by diminished sexual desire and early ejaculation. Conclusion: Alcohol-dependence patients have a high prevalence of sexual dysfunctions. In routine clinical practice, this may be overlooked. Clinicians must be made aware of the frequent occurrence of sexual disorders in alcohol dependence patients.

Pattern of burden on the family of patients with schizophrenia and bipolar disorder: A comparative study.

BACKGROUND: The concept of burden of care came from the realm of behavioral sciences primarily in the context of looking after a psychiatrically ill person. Caregivers of schizophrenia and bipolar affective disorder (BPAD) have to take over the totality of patient care since most of these patients are treated at home. As a result of this, they are exposed to negative consequences of caregiving. AIM: This study aims to assess and compare the pattern of burden among the families having patients with schizophrenia and bipolar disorder. MATERIALS AND METHODS: This cross-sectional, observational study was conducted on the outpatient department level at Ranchi Institute of Neuropsychiatry and Allied Science. This study included 30 patients with schizophrenia and equal number of age- and sex-matched patients with bipolar disorder. The diagnosis was made as per criteria of International Classification of Diseases 10 diagnostic criteria for research. Their caregivers who gave consent for their participation in the study and satisfy the inclusion and exclusion criteria were included in the study by purposive sampling. Tools administered were socio-demographic datasheet and family burden inventory schedule. STATISTICAL ANALYSIS USED: Chi-square test, Fisher's exact test, and Mann-Whitney U test. RESULTS: Total caregiver burden, financial burden, disruption of routine family activities, family leisure, family interaction, and subjective burden felt by caregiver were significantly more in caregivers of schizophrenia patients compared to caregivers of BPAD. There was no significant difference in the two areas of burden, i.e., effect on physical health of the caregivers and effect on mental health of caregivers. CONCLUSION: Caregivers of schizophrenia patients have significantly higher family burden as compared to caregivers of subjects with BPAD.

Prevalence of smartphone addiction and its relation with sleep disturbance and low self- esteem among medical college students.

BACKGROUND: Use of smartphone is on the increase worldwide. They have revolutionized our lives to an extent that was unimaginable before the pandemic. Excessive use of smartphones reaching the levels of potential addiction among medical students and its relation to individual's sleep quality and self-esteem led us to study this prevalence. AIM: This stuay aimed to study the prevalence of smartphone addiction and its relation with self-esteem and sleep disturbance in medical college students. MATERIALS AND METHODS: A cross sectional analytical study was carried out and the prevalence of smartphone addiction, self- esteem, and sleep disturbance was measured using standardized questionnaires smartphone addiction scale short form, Rosenberg self esteem scale, Pittsburgh sleep quality index assessment respectively. RESULTS: Prevalence of smartphone addiction among medical college students was 52%. Smartphone addiction was seen more in boys than girls. There was a significant association between the smartphone addiction and sleep disturbance. However, there was no significant association between smartphone addiction and low self-esteem. CONCLUSION: The prevalence of smartphone addiction among medical students is found to be high and is associated with poor sleep.

Behavioral presentations of focal onset seizures: A case series.

Seizures can have varied presentations and may have different etiological factors. A multidisciplinary approach should be used to treat them. It becomes difficult to diagnose seizures if they have an atypical presentation, particularly so when they manifest as behavioral disturbances. This case series demonstrates four cases with different psychiatric and behavioral manifestations of seizures where the diagnosis had to be done in a multi-disciplinary approach. Two of the cases highlight the fact that in the light of normal investigations, paying attention to detailed history is of prime importance.

Psychogenic nonepileptic seizures: A case series.

Manifestation of abnormal excessive synchronous cortical activity, which is what defines epileptic seizures, is typically absent in seizures with psychological etiology, a heterogeneous set of factors that have been identified. Distinguishing psychogenic nonepileptic seizures (PNES) from epileptic seizures may be difficult at the bedside. We report a case series of PNES which presented with diagnostic dilemma. Diagnostic delay of years with PNES is common. The exact choice of treatment is often difficult and should be based on individual differences in the underlying factors. Outcome can be measured in terms of seizure occurrence (frequency, severity), but other measures might be of greater importance for the patient. Prognosis is varied but studies consistently report that 1/3rd to 1/4th of these cases become chronic.

Differentiation of hepatic encephalopathy from delirium tremens: A case series and review.

Hepatic encephalopathy (HE) is an important and potentially life threatening complication in alcoholic patients with decompensated liver function that develop even as they continue drinking. Delirium tremens, on the other hand, is an acute condition resulting from alcohol abstinence in a person dependent on alcohol, making it a life threatening diagnosis that requires intensive care and successful management of the withdrawal. Often in medical wards, these two conditions are mistaken and so is the management plan confused with each other. Making the right diagnosis early on during the hospital course is extremely important in these critical conditions so as to make an appropriate schedule for treatment and a better outcome for the same. A case series of patients who presented with a diagnostic dilemma is reported. Clinical examinations, diagnostic tools to measure the levels of ammonia and liver function tests and hemogram, West Haven criteria and Child-Pugh grading, and clinical scales of these patients are reported. Increased levels of ammonia were present in all the cases. The subtle similarities in the presentation of the two conditions often make it confusing for the clinician to distinguish between them. Using a simple test of measuring ammonia levels in the blood helps in such situations. The detection of raised levels of ammonia in cases of chronic liver disease helps in not just the diagnosis but also is an important prognostic indicator for development of HE.

Erotomania: A case series.

Erotomania is an unusual psychotic disorder exemplified by an individual's delusions of another person being infatuated with them. The condition is usually, but not exclusively, observed in females who are shy, dependent, and sexually inexperienced. The object of the delusion is usually beyond reach, being of much higher social or financial status, already married or disinterested. We present a case series of three patients suffering from this uncommon disorder.

Induced delusional disorder: A case series.

Phenomenon of induced delusional disorder has a relatively long, controversial history of conceptualization. It is a rare entity and goes undiagnosed mostly as only the primary partner is brought to clinical attention. We present a case series of induced delusional disorder with different presentations. For effective management, understanding the dynamics of relationship shared by the partners and addressing the biopsychosocial factors are crucial. Failure to adhere to treatment poses additional challenge in these cases.

Stigma associated with COVID-19.

A number of incurable, deadly, and disfiguring diseases are associated with stigma which worsens the quality of life of the sufferer. Unfortunately, at the beginning of the COVID-19 pandemic, the disease was associated with severe stigma and extreme prejudice. Stigma of COVID-19 and its adverse effects are briefly discussed and solutions suggested.

Quarantine: Psychological aspects.

Quarantine is an age old methods of preventing the spread of infection by restricting the movement of persons or goods. It has again come to global attention due to its widespread implementation during the COVID-19 pandemic. While the public health utility of quarantine is well established, it is associated with few psychological effects which are neither well known nor recognized. In this communication, the psychological side-effects of quarantine and their prevention are briefly discussed.

Impact of COVID-19 pandemic on healthcare workers.

The COVID-19 pandemic is a healthcare crisis that has led to unprecedented impact on healthcare services. At the heart of the unparalleled crisis, doctors face several challenges in treating patients with COVID-19. The psychological burden and overall wellness of healthcare workers (HCWs) have received heightened awareness, with research continuing to show high rates of burnout, psychological stress, and suicide. Detrimental effects include high rates of infection and death, excessive financial hardships, stress related to known and particularly unknown information, and fear of uncertainty regarding continued impact. Some researchers focused specifically on COVID-19's impact on HCW sleep. Anxiety and stress were significantly increased, leading to negative impacts on both self-efficacy and sleep. Stress is an important factor in drug use. Efforts should be made to explore the factors that are associated with psychological distress, which may lead to symptoms of anxiety, depression, or provoke suicidal ideation, and efforts should be made to control the factors that are modifiable. There needs to be more awareness among doctors and further long-term studies focusing on their mental health as adverse mental health conditions will further affect them as the disease advances.

COVID-19 lockdown - Blessing or disaster?

Despite the dubious results of the nationwide lockdown in India state after state continue to clamp lockdowns indiscriminately and claim that it is a panacea for all their ills. Unverified claims abound and myths are perpetuated without any basis. It is time to take a close look at the hard data and come to logical conclusions regarding the utility of prolonged open-ended lockdowns. Unfortunately, the evidence does not support the use of prolonged lockdowns as a useful strategy to combat the COVID-19 pandemic.